Vol 21, No 3 (2015)

During 2007-2012, the analysis was implemented concerning activities of ophthalmologists in the Russian Federation from the point of view of the Federal okrugs and 17 pilot subjects concerning implementation of timekeeping studies in 2013-2014. The factual function of physician position and coefficients of its deviation from average Russian national and okrug data were analyzed. The significant territorial dissonance in mentioned indicators was established that is directly related to age structure of attached contingent. Under increasing of number of persons of elderly age, that is especially specific for the Central Federal Okrug, the inner indicators of factual function of physician position in the subjects are increasing exceeding Russian national data and indicators of okrug in 83.3% of subjects. The emerged situation requires development of organizational measures targeted to resolve manpower problems in the ambulatory polyclinic section of health care.

The technique of combined implantation of electrodes at the same time instant with osteosynthesis by Ilizarov device is applied in The G.A. Ilizarov Russian research center “The restoring traumatology and orthopedics”. In 2001-2013, the neurosurgery department treated 330 patients with traumatic injuries of peripheral nerves who underwent puncture direct electrostimulation (group of patients I). The results were analyzed concerning operative treatment of 80 patients with combine injury of nerve stem and tubular bone (group of patients II). The courses of electrostimulation by low intensive alternating current through implanted electrodes and cutaneous leads. The good results of treatment were obtained in 76.96% of cases in patients from group I. During the first year after treatment the amplitude of M-responses (A=MR) characterized by expressed positive dynamics i.e. up to fourfold increasing of indicator (p<0.01). The values of average amplitude of total electromyogram increased relatively to previous date of examinations up to 180.1% (p<0.001). In the group II, good results of treatment were obtained in 67.5% of patients. During one year after termination of course of electrostimulation the further increasing of values A=MR was noted related to previous date of examinations up to 52.1%. According criterion of average amplitude of total electromyogram the increase consisted 87%. The results permit made a conclusion that direct electrostimulation of nerve stems by alternating current under combined impact on injured structures is an effective one.

The application of technique of injection augmentation of epidermal tissues using polyacrylamide gel, wide-spread in the 1990s, resulted in increasing of rate of recurring hospitalizations. The cause of this occurrence are late specific pyoinflammatory complications conditioned by negative effect of the given substance on human body tissues and requiring optimization of treatment technologies. The article analyzes the results of complex treatment of 20 women with gel phlegmon during 2004-2013. The age of patients was 44-60 years. The depth of purulo-necrotic damage corresponded to level II-III according classification of D. Ahrenholz (1991) and extent - from 67 to 220 cm 2 . The zone of contour plastic of mammary glands was the most frequent localization of damage (17 patients or 85%). The program of complex treatment of all patients alongside with antibacterial therapy and surgical preparation included impact on suppurative focus with air-plasma flow in modes of dissection and NO-therapy. The application of the given technique permitted to reduce volume of intra-operational blood loss (up to 30-35%) and average number of stage necrotomy and significantly accelerate regeneration processes in suppurative focus (up to 1.3-1.5 times) as compared with control group of patients with "commonplace" phlegmon of thigh treated according standard technique.

The first stage of study included determination of risk factors of postnatal pyo-septic complications and development of scale of evaluation of degree of infection risk. The second stage of study included implementation of cohort, prospective, randomized research. The sampling included 176 puerperae with infection risk. The observed women were separated on groups depending on degree of infection risk according the developed scale. The puerperae of comparison group received common antibacterial prevention by cephalosporin of third generation. The puerperae of main group during postnatal period besides prevention with antibiotics, were additionally injected into uterine cavity a contact-type form of sorbent VNIITU-1. The effectiveness of prevention was evaluated by determination of the level of proinflammatory and anti-inflammatory cytokines in aspirate from uterine cavity at first and third day and occurrence of growth of pathogenic flora. In puerperae of comparison group after common antibiotic prevention, growth of pathogenic flora in uterine cavity persisted. This process contributed into increasing of activity of local proinflammatory cytokines (IL-1β), acute-phase protein lactoferrin against the background of decreasing of activity of anti-inflammatory cytokines (IL-10, IL-RAIL). It also testified high activity of local macrophages and absence of tendency of suppression of inflammatory cascade. The proposed mode of prevention of postnatal endometriosis in puerperae with infection risk by intrauterine injection of porous carbonic applicator VNIITU-1 is more effective due to stimulation of full value elimination of agents and their excreted toxins from uterine cavity. Additionally, blocking of local proinflammatory cascade and intensification of involutorial processes of myometrium against the background of restoration of hemodynamics occurs.

About 4-12% of pregnant women suffer from bronchial asthma. The poor control of disease during pregnancy is fraught with development of serious complications both on mother and fetus part. The review presents actual recommendations concerning diagnostic and treatment of bronchial asthma in pregnant and nursing women.

The acute interstitial pneumonia is a disease of group of idiopathic interstitial pneumonias. This illness quite often results in development of respiratory distress syndrome and is characterized by resistance to therapy with systemic glucocorticosteroids. The article presents a case of clinical observation of female patient with acute interstitial pneumonia. The treatment applied included combination of therapy with average high doses of systemic glucocorticosteroids using protective modes of noninvasive ventilation of lungs that resulted in expressed positive effect during short period and permitted to avoid worser scenario of development of disease.