Vol 22, No 4 (2016)

The laparoscopic trans-abdominal pre-peritoneal hernioplasty is an effective technique of treatment of uncomplicated hernia. However, application of this technique at complicated forms (inguinal-scrotal, repeatedly relapsing, strangulated hernias) continues to be a point at issue. The treatment of inguinal-scrotal hernia requires from surgeon availability of considerable experience independently of selected technique. The study was carried out to evaluate reliability and effectiveness of application of trans-abdominal pre-peritoneal hernioplasty under inguinal-scrotal hernia. In municipal clinical hospital № 4 8 operations of hernioplasty was implemented using trans-abdominal pre-peritoneal hernioplasty from 2014 to 2015. The technical intra-operational characteristics of techniques were analyzed. The evaluation of intra-operational and post-operational complications in early post-operational period and after 3 and 6 months after operation was implemented. All hernias were primary and onesided ones and were operated by the same surgeon. The average duration of operation made up to 93.5 min. In no cases the conversion was needed. No severe intra-operational complications were detected. In no case chronic pain and relapsing were detected. The total rate of post-operative complications made up to 12.5%. All patients were satisfied with operation in 3 and 6 months after discharge from the hospital. According the results of study, trans-abdominal pre-peritoneal hernioplasty is an effective technique of treatment of inguinal-scrotal hernias comparative with results of treatment of primary uncomplicated hernias.

The study was carried out to investigate clinical and neuro-physiological characteristics of sensomotor disorders in patients at different time periods after hemispheric ischemic stroke. The sampling of 133 patients with ischemic stroke in right hemisphere and left hemisphere were examined in late recovering and residual period (58 and 75 patients accordingly). The trans-cranial magnetic stimulation, abdominal reflexes and sensomotor induced potentials were implemented. It is demonstrated that in patients even in one year after stroke processes of functional rehabilitation of various degree of expression continue to be present. The constancy and degree of manifestation of sensomotor disorders and compensatory possibilities as well are determined by afferent component of post-stroke deficiency that supposes long-term effect for broadening possibilities of neuro-rehabilitation of patients after stroke.

Lately, layer-wise keratoplasty became the first operation of choice in case of pathology of cornea. In view of satisfying results of endothelial surgery similar operations are implemented at earlier stages that increases need in donor tissue. With increasing of life span of population, also increases number of patients in need of transplantation of cornea. The number of intact cadaver cornea decreases because of stable increase of surgical interventions on front segment of eye. The present article presents original ten years experience concerning optimization of application of donor tissue and indicate on possibilities of further increasing of number of applied keratoplasties. From 2009 to 2015 in the Helmholtz Moscow research institute of eyes diseases 652 transplantations of cornea were implemented in various modifications: straight-through keratoplasty, transplantation of Descemet's membrane with endothelium (DMEK), deep front layer-wise keratoplasty, endokeratoplasty (DSEK) with various modes of transplant formation and 23 frontal layer-wise keratoplasties. In transplantation were also used eyes of donors with radial keratotomy, after laser keratomileusis and with artificial intra-ocular lens. To implement 652 operations 528 cadaver eyes with average age 41 ± 32,5 years (varying from 21 to 87 years) were required. The number of transplantations increased approximately on 50% at potential up to 75%. The lamellar surgery permits using corneal donor tissue with altered frontal surface and to increase number of transplantations of cornea. The renunciation of application of corneal donor tissue with altered frontal surface is inexpedient.

The study was carried out to investigate using rabbits in vivo effect of Gliquidone on functional activity of protein-carrier of glycoprotein-P (P-gp, ABCB1-protein). The activity of P-gp was evaluated according pharmacokinetics of its marker substrate - Fexofenadine after single endogastric introduction. The application of Gliquidone in dosage of 10 mg per 1 kg of body mass during 14 days resulted in no alteration of concentration of Fexofenadine, period of its partial ejection, area under pharmacokinetic curve “concentration-time” from zero to last point of blood sampling, area under pharmacokinetic curve “concentration-time” from zero to infinity and also time of holding of marker substrate, total clearance and absorption coefficient. All this testifies absence of effect of Gliquidone on functional activity of protein-carrier at the level of integral organism. No alterations of pharmacokinetic parameters of Fexofenadine at the 5th day of cessation of Gliquidone were observed.

The iron-deficiency conditions continue to be an actual problem all over the world being present in half of population of the terrestrial globe. The development of iron deficiency often depends on gender and age. In females specific role is played by hypermenorrhea and repeated pregnancies (iron deficiency and iron-deficiency anemia are found 6 times more often in females than in males). The anemia of chronic diseases by it prevalence takes second place after iron-deficiency anemia. The prevalence of anemia of chronic diseases in elder and senile age varies within range 2,9-61% in males and 3,3-41% in females. In young and mature age anemia of chronic diseases more often occurs in females. There are anemias when content of iron in organism and its resources are within limits of norm or higher - sideroahrestical anemias. The percentage of them in structure of hypochromic anemias is smallish. The diagnostic and differential diagnostic of anemias related to iron metabolism. The anemias are diverse according to clinical hematological characteristics. At selection of diagnostic schemes, treatment of anemias differs on leading pathogenic mechanism. However, to facilitate diagnostic and differential diagnostic the color indicator and morphological classifications are considered. The differentiated diagnostic of anemias is based on data of clinical, laboratory and instrumental analysis. The blood analysis under anemia is to take into account indices of Hb, size of erythrocytes, their saturation with Hb, average volume of erythrocytes, and average content of hemoglobin in erythrocytes, amount of reticulocytes and other cells permitting judging about character and activity of erythropoiesis. The article presents algorithm of examination of patient under hypochromic and microcytic anemia, diagnostic and differentiated diagnostic of acute post-hemorrhagic anemia, anemia of chronic course, iron-deficiency anemia, anemia of chronic diseases, sideroahrestical anemia, iron-saturated anemia due to leaden intoxication, inherent iron-saturated anemia of pharmaceutical genesis, thyroprival anemia and thalassemia.