Vol 34, No 1 (2023)

Breast reconstruction using autologous flaps is the gold standard in breast reconstruction plastic surgery. The use of anterior abdominal wall flaps in reconstruction surgery makes it possible to achieve the most natural aesthetic result, since tissue consistency in the anterior abdominal wall is similar to that in the breast. When choosing a reconstruction technique, account is taken of a number of factors, such as age, body mass index, concomitant diseases, the anatomical features of blood supply to the donor and recipient regions, a history of abdominal surgery, and cicatricial deformity of the anterior abdominal wall.

Particular emphasis is placed on the impact of postoperative radiotherapy (RT) on autologous breast reconstruction. Studies are currently made to reduce the incidence of complications during autologous breast reconstruction, to shorten the rehabilitation period, and to establish the most optimal timing of autologous reconstruction in patients with breast cancer during complex/combination treatment. A literary analysis has shown the comparable rates of complications and reoperations in the groups of patients with and without postoperative RT.

The qualitative or semi-quantitative assessment of amniotic fluid volume (AFV) is a standard component of every ultrasound in the second and third trimesters of pregnancy. AFV abnormalities are associated with various pregnancy complications. In clinical practice, ultrasound (US) assessment of AFV is used in conjunction with other clinical and sonographic parameters (biophysical profile, non-stress test, estimated fetal weight on ultrasound, clinical examination) to make effective medical decisions to maintain fetal well-being in the management of pregnancies with obstetric complications. US is the most common AFV assessment technique, in which AFV is determined on a basis of the opinion of a physician (qualitatively) or on a basis of the value of the maximum vertical pocket (MVP) and amniotic fluid index. These techniques are well suited for detecting fetuses with normal AFV; however, they have insufficient accuracy for diagnosing oligohydramnios and polyhydramnios. Furthermore, ultrasound AFV assessment in twins poorly corresponds with the reference values for oligohydramnios and polyhydramnios. Despite this, it is advisable to use qualitative and semi-quantitative (MVP) methods for AFV assessment. Results for each twin are interpreted using the same MVP criteria as those for single fetuses.

Objective. To analyze the literature data reflecting the medical and social significance of osteoporosis (OP), the prevention of osteoporotic fractures (OPFs), including that with Osteomed, Osteomed Forte, and Osteo-Vit D₃ (Parafarm, Russia).

Material and methods. The authors analyzed research articles reflecting the medical and social significance of OP, the prevention of OPFs, including that using Osteomed, Osteomed Forte, and Osteo-Vit D₃ (Parafarm, Russia),

Results. The paper presents the results of studying the effect of the new Russian drug Osteomed Forte on the hormonal status of women during the combination treatment of postmenopausal OP. The patients who took Osteomed Forte were observed to have an increase in bone mineral density and a decrease in the sizes of bone cavities, as well as their closure. Osteo-Vit D₃ was a highly effective drug in preventing and treating recurrent bone fractures, including in children with OP. The efficacy of Osteo-Vit D₃ in preventing recurrent fractures was noted to be highly competitive with that of calcium preparations made in foreign countries.

Conclusion. Thus, Osteomed, Osteomed Forte, and Osteo-Vit D₃ (Parafarm, Russia) can be recommended for the prevention of OPFs in patients with OP, by taking into account their age, gender, comorbidity, and a personalized approach when selecting a management strategy for a particular patient.

Due to systemic allergic inflammation, intestinal changes, and malnutrition, atopic diseases can be complicated by iron deficiency conditions.

Objective. To determine the values of hemoglobin (Hb) and the frequency of anemia in children and adolescents with atopic dermatitis (AD) and asthma and to present the possible causes of the disorders.

Results. In 2001, a total of 180 children (mean age 4 years) with AD were examined; their Hb concentration was 109.3±9.8 g/l; of them 77 (43%) children had <110 g/L. In the control group of 210 healthy children (mean age 4 years), their Hb level was 122.4±10.1 g/L (р<0.01). In 2019, a total of 130 children (mean age 4 years) with AD were examined; their Hb concentration was 112.0±9.7 g/L, while 9 (6.9%) children had <110 g/L. In the control group of 129 patients (mean age 4 years), their Hb concentration ran to 123.0±9.5 g/L (p = 0.05). Also in 2019, a total of 110 children (mean age 12 years) with asthma were examined; their Hb concentration was 118.0±5.5 g/L, of them 5 (4.5%) children (including 3 adolescent girls) had a Hb concentration of <110 g/L. In the control group of 98 patients, their Hb concentration was 127.0±4.2 g/L (p = 0.05). In all groups of children with atopic diseases, anemia was associated with iron deficiency.

Conclusion. The frequency of anemia among the examined children with atopy was higher than that in the general population. According to the results of the authors’ own and independent studies, iron deficiency states can result from systemic allergic inflammation with intestinal involvement, metabolic disorders, and nutritional deficiencies. Iron deficiency conditions can contribute to the development of allergy and deteriorate its course.

The paper presents modern ideas about the clinical and diagnostic features of lung dysplasia in preterm babies in the early neonatal period. Lung dysplasia is shown to be a common and antenatally diagnosed congenital malformation of the respiratory system. The semiotics of lung dysplasia and respiratory distress syndrome in the newborn is compared. The authors consider the characteristics of the main respiratory patterns of traditional and high-frequency oscillatory ventilation, which are often used for respiratory support for premature babies in the neonatal intensive care unit. They discuss the pathogenetic role of hemodynamically significant patent ductus arteriosus in premature babies with respiratory failure. It is emphasized that for the timely detection of chromosomal abnormalities and congenital malformations in a fetus, it is necessary for pregnant and parturient women to regularly attend antenatal care clinics and to undergo prenatal screening. The paper describes a clinical case that considers the capabilities of diagnostic search and the parameters of monitoring the vital functions of a premature baby in the early neonatal period during intensive care in the neonatal intensive care unit.

The paper presents the results of studying the level of school anxiety among primary school juniorpupils (n=70), by using the data of a parent survey. The study showed that 71.4% of the children displayed personality traits that could identify 5 entities of behavioral disorders. It is noteworthy that the predominant types of behavior were irritability (44.5%), maladaptive responses (42.8%), and increased excitability (20.4%).

The parent questionnaire survey could identify a group of children with increased anxiety that had not been previously established and needs to have a closer look due to the high risk of an anxious and neurotic trait type and to the negative impact on the intellectual development of a child and somatic well-being.

Cancer patients often face serious anatomical, functional, immunological, metabolic, and mental disorders and reduced work and social opportunities resulting from the use of multistage, invasive treatment options. The authors have reviewed literature on various methods for rehabilitation of cancer patients, including gynecological ones, after surgery, radiation, and chemotherapy.

In an era of multidrug-resistant bacterial infections that are depleting the use of chemical antibiotics, and highly effective types of antibiotics are being developed less and less, modern medicine must look for new therapeutic methods to treat infectious diseases. Potential antibacterial solutions include bacteriophage-based therapeutics, which have very different properties from the broad-spectrum antibiotics that are currently the standard of care and can be used in combination with them, often in synergy. This review traces the evolution of the development of approaches to bacteriophage therapy and outlines ways to introduce phage therapy into the practice of modern medicine.

The article is devoted to the actual problem of modern medicine - the analysis of the association of functional somatic disorders (FSD) in adolescents with the presence and level of stress. A review of data on the prevalence, etiology and clinical manifestations of the main types of FSD (recurrent headaches and abdominal pain, dorsalgia, asthenic syndrome, syncope and panic attacks) in children and adolescents was carried out. The results of our own study are included, which showed that a high level of stress was associated with the presence of asthenic syndrome (AS), chronic tension headache (TH), and frequent abdominal pain. Moderately and significantly increased levels of stress were associated with the presence of arterial hypertension (AH), AS, frequent abdominal pain, frequent pain in the cervical spine (CS), and panic disorders in children. Approaches to the correction of the level of stress tension and the prevention of its negative impact on the development of FSD are highlighted. The need for further scientific research in this direction is emphasized.