Vol 24, No 1 (2013)

To treat ulcerative gastroduodenal hemorrhage remains one of the most pressing problems of urgent surgery, the available methods for endoscopic hemostasis do not meet fully the requirements of safety, effectiveness, and validity, thus causing the overall and postoperative mortality rates to remain high in our country as well as worldwide.

According to the data available in the literature, the rate of varicocele in the general population is 10-30%. The prevalence of the disease increases with age and may be as great as 75-77,3%. With the introduction of current studies, almost 80% of cases of varicocele are found to have it bilaterally. Bilateral varicocele leads to hypotrophy of the testes and their considerably reduced volume regardless of the degree of the disease. Varicocele is a cause of primary and secondary male infertility in 40 and 80% of cases, respectively. The bilateral process can cause severe oligoasthenoteratozoospermia, including azoospermia. Sperm DNA fragmentation is more marked in men with varicocele. If untreated, varicocele may give rise to infertility even in those who have normal values of a spermogram. Microsurgical subvaginal varicocelectomy described by Marmara is the gold standard for treating patients with varicocele. Many works have provided support for the positive impact of varicocelectomy on the likelihood of spontaneous conception in the partners of patients, by improving their spermogram, reducing sperm DNA damage, normalizing blood hormone levels, elaborating fewer reactive oxygen species, and recovering Leydig cell function irrespective of patient age.

The paper describes a case of chronic alcoholic pancreatitis with pancreatic cysts, which occurs under the guise of alcoholic liver cirrhosis. The major diagnostic criteria for pancreatogenic ascites are discussed.

Improving endoscopic techniques (gastroscopy, endosonography) has not solved the problem associated with the differential diagnosis of gastric diseases. Special investigations are required to estimate the diagnostic potential of a set of radiodiagnostic methods for ulcers, polyps, organic stenoses and nonepithelial submucosal masses of the stomach wall.

The paper considers different pathogenic variants of diarrhea syndrome associated with the use of antibacterial drugs. It deals with the prevention and treatment of Clostridium difficile-associated colitis in the context of evidence-based medicine. Attention focusses on the rational use of antibiotics.

Agents that selectively affect gastrointestinal tract smooth muscles, such as mebeverine, pinaverium bromide, are preferred to relieve abdominal pain in biliary pathology. The use of mebeverine (Duspataline®) in patients with biliary tract disease promotes a stable reduction in the magnitude of abdominal pain, disappearance of dyspeptic signs, improvement or normalization of an ultrasonographic pattern and laboratory indices.

The key mechanism of the pathogenesis of intestinal inflammatory diseases is the failed immu-nological tolerance to intestinal antigens, above all microbial and food antigens, causing the im-munological control over a progressive intestinal inflammatory process to be lost. In this connec-tion, it is relevant to use combination drugs containing a prebiotic component along with short-chain fatty acids, particularly butyric acid that exerts a cytoprotective effect. Zacofalk®NMX is shown to be effective in using as an adjunct to therapy in children with nonspecific ulcerative colitis.

The rate of production of the amyloid precursor protein - free immunoglobulin light chains (FLC) - is an important factor for estimating disease prognosis and therapeutic effectiveness. A 3-fold FLC reduction as compared to the normal values has increased the chances of a good prognosis by about 6 times.

Comparative assessment of different treatment options for proximal hypospadias showed greater reliability and better cosmetic results in children who had received two-stage Turner-Warwick-Bracka treatment.

The paper presents the results of total endoprosthesic replacement of the hip joint using trabecular tantalum trochanteric components. The study is based on 358 operations performed in 2008-2012. The authors consider indications for surgery; the surgical results are traced over 5 years; there is no case of instability of the cup of a tantalum-coated endoprosthesis.

The differentiated use of pathogenetically sound complexes of physiotherapeutic measures in adolescents with idiopathic scoliosis ensures the reduction in the spinal curvature angle, the formation of a muscular corset, and the prevention of progressive biomechanical and neurodystrophic disorders.