Vol 17, No 1-2 (2017)

In preparation for in vitro fertilization a two-dimensional echography and dopplerography were held for infertile women planning IVF for the first time and having ineffective IVF attempts in medical history. The obtained data were compared with those of fertile patients. It was found that the signs of chronic endometritis are often detected in women with IVF failure in medical history. It points to the leading role of this disease in the pathogenesis of infertility. Based on the studies the criteria of preparedness of the endometrium for implantation during IVF cycle were highlighted.

The article describes the experience of the application of urogynecological pessary for the treatment of genital prolapse in menopause and postmenopause women. The findings of the authors’ investigations of the application of a pessary are represented in the article. The use of urogynecological pessary in prolapse of internal genital organs in elderly women is an effective treatment.

Immunohistochemical studies of the endometrium, ultrasound diagnostics in the pre-gestation period, as well as determination of the content of significant interleukins for implantation were performed in women with habitual pregnancy loss. The influence of hormone therapy in particular 17-β-ethinyl estradiol and progesterone on the endometrium was evaluated. It was found that after the treatment in the stroma and in the glands of women, the number of estrogen receptors increased, and the number of progesterone receptors remained the same. Levels of all interleukins in the uterine cavity aspirations decreased.

The article presents data on monitoring the level of HbF since early gestation. At the end of the first and in the middle of the second trimesters of gestation, a statistically significant increase in the level of fetal hemoglobin was recorded in women whose pregnancy was complicated by placental insufficiency with a disturbed fetal condition (growth retardation and / or chronic fetal hypoxia) by contrast with the control group (error probability was less than 5% ). The data obtained during the study necessitate to consider fetal hemoglobin level in high perinatal risk women as a criterion for predicting the impaired fetal condition associated with placental insufficiency. This investigation should be started in the first trimester of gestation.

Authors evaluate the morphofunctional state of the endometrium in infertile patients planning to have in vitro fertilization for the first time and having an ineffective IVF attempts in medical history, as well as in fertile women. It is shown that the pathology is significantly more often revealed in infertile patients during the morphological study of the endometrium biopsy specimens, and at the same time the chronic endometritis is revealed in 13% of cases greater than by the results of the ultrasound. Morphological criteria of preparedness of the endometrium for implantation were formulated.

The article studies blood pressure changes and biomechanical parameters in the main arteries in case of extrasystolic arrhythmia. In extrasystolic arrhythmia it a special kind of the secondary hemodynamic arterial hypertension, extrasystolic hypertension develops.

Patients with hypertensive disease often have diastolic left ventricular dysfunction which is a predictor of serious cardiovascular complications such as chronic heart failure. The aim of the study was to determine clinical significance of the new echocardiographic parameter namely left ventricular myocardial performance index and compare it with the traditional echocardiographic parameters in patients with essential hypertension. Studies have shown that increase in the index of myocardial performance at rest and reduction of its reserve on physical exertion reflect decrease in the life quality in male patients with hypertensive disease and mild diastolic dysfunction without clinical signs of chronic heart failure.

This review presents the recent data on the diagnosis and management of amiodarone-induced thyrotoxicosis (AIT). Specific amiodarone-induced changes in the thyroid function are described. The correct diagnosis of AIT type is of major importance as it determines the treatment. Our own experience and the analysis of common mistakes in the diagnosis and management of AIT in elderly patients are given.

The article is devoted to the problem of concurrent chronic obstructive pulmonary disease (COPD) and diabetes mellitus type 2 (DM2). The assessment of DM2 influence on the current, clinical, laboratory, instrumental, functional status of patients with COPD, the life quality of patients is carried out.

The purpose of this work is to evaluate the effectiveness of surgical treatment outcome in patients with transverse spread of a foot. The article analyzes the results of surgical interventions in 72 patients with this pathology. Accoording to sex, age and degree of deformation all patients were divided into two clinical groups. The first group included patients who were treated by a known method of eliminating the transverse spreading of the foot and deviation of the big toe outwards. Patients of the second group were treated by a new method of surgical treatment of transverse spreading of the foot. Comparative evaluation of the treatment outcome was carried out with the use of X-ray angulometric functional methods preoperatively and 12 months postoperatively in accordance with the principles of evidence-based medicine. Result was by 2.8 better in the second clinical group, 52.9 % and 18.59 % respectively. This indicates of an improvement in the functional state of the foot and lower extremity of patients who has underwent a new surgical treatment broad forefoot.

The article presents the method of defect repair in umbilical hernias by IPOM techniques, evaluates obtained results. The article also compares this technique and achieved results with the previous ones. The operation without mobilisation and removing of hernia sac by means of special techniques such as desquamation and peritoneodesis allows to make a smaller surgical incision, to decrease the lesion of the tissue, and therefore to reduce the number of postoperative complications.

This paper evaluated the results of diagnostics, treatment modalities and results of surgical treatment of patients with various diseases of the thyroid gland. The patients underwent surgical treatment in the surgical department NGHCI “Railway Clinical Hospital” in Samara for 2013 through 2015. Surgical treatment was personalized and depended upon nosological entity and the scope of lesion. The best options are as follows: thyroidectomy is good for for mixed toxic goiter, hemithyroidectomy is for toxic adenoma, subtotal resection of thyroid gland is for patients with diffuse toxic goiter, thyroidectomy is for multinodular euthyroid goiter, hemithyroidectomy is for nodular goiter.

The article studies technical inaccuracy in endoscopic paplillosphinctrerotomy. They may cause retroduodenal perforation. The article also studies its clinical manifestation, ways of prevention of retroperitoneal flegmon.

After the application treatments on 736 patients with isolated chest trauma complicated by pneumonia and hemothorax, aged from 15 to 92 the analysis has been done. A new method for remediation of the pleural cavity It allows to improve the results of conservative management of patients with stage, avoid complications and vain open and VATS operations. Using tools developed for drainage pleural cavities allows you to type quickly and efficiently pleural cavity drainage, reduce the wound channel and traumatic intervention. It is proved that the participation of the thoracic surgeon and the use of original treatments for which the RF received patents in patients with isolated chest trauma complicated by pneumonia and hemothorax, It allows to achieve adequate sanitation pleural cavity through the puncture needle 81% of victims, through pleural drainage - at 60.14%, while the number of thoracic surgery decreases till 2 13.05%, of which 48.86% - VATS operation involving thoracic surgeon, to avoid deaths, at 45.59% decrease the number of complications - posttraumatic pneumonia, pleurisy, long air vent for drainage, subcutaneous emphysema, festering wounds, acute empyema. Participation thoracic surgeon in the treatment of patients with isolated chest trauma, complicated by pneumonia and hemothorax in the standby surgical hospital city hospital allowed to achieve the following results: increase the relative benefit applied treatments (EPP) to 93.75%; increase the absolute the usefulness of treatments (PAP) to 45%; the number of patients, which needs to be treated to achieve the expected outcome (NNT) It amounted to 2.22; the number of complications in the treatment of victims decreased by 45.59%.

Background. The effectiveness of endoscopic examination can be significantly increased my means of additional diagnostic modalities that employ different endoscopic equipment. Its use implies both treatment of instruments after each use and storage requirements that can ensure sterility of instruments. This requirement creates certain problem in small endoscopic procedure rooms. This study is aimed at optimizing the storage of endoscopic equipment in such a setting. Materials and methods. The authors designed an endoscope storage cabinet and studied its operating potential. Results. The wall-mounted endoscope storage cabinet has the maximally obtainable depth that enables to use the inner workspace most effectively. The cabinet has 10 fixing hooks to hold the endoscopic equipment and a built-in bactericidal lamp to maintain sterility inside the cabinet. A convection cooling mechanism to the lamp is provided. Conclusions. The proposed version of the endoscopic equipment storage cabinet occupies minimal space and fulfills its intended purpose of maintaining a sterile environment.

The vestibular position of maxillary canines occurs in various occlusion abnormalities. This condition is often accompanied by lack of space for them. Maxillary size reduction leads to a lack of space for individual teeth canines in particular. Overdevelopment of the lower jaw and small size of the upper one is one of the causes of mesial occlusion. Twenty-seven patients with mesial occlusion were examined and vestibular position of the canines was revealed. The age of the patients was from 18 to 36 years. 10 male patients and 17 female patients were studied.

The article is devoted to the treatment of patients with periodontal diseases by means of complex remedies containing natural ingredients. The efficiency of complex treatment has been studied. There was positive dynamics. Index of hygiene decreased by 43.0 ± 0.3%, bleeding index reduced by 52.00 ± 0.06% and gingival index decreased by 49.00 ± 0,08%. The effectiveness of treatment was higher in patients who received both conventional treatment and drug complex based on natural ingredients.

The article focuses on treatment of patients with postoperative recurrent cancer and the esophageal-gastric anastomosis. The article also discusses results of combined radiotherapy and chemotherapy.

The article is devoted to the assessment of the effects of harmful environmental factors on the health of the population of a large industrial center. The main pollutants were revealed. Dynamics changes of the pollution level are presented in the article. It was revealed that high anthropogenic burden resulted in a high level of ecologically dependent morbidity in Samara.

The article studies epidemiological features of incidence of respiratory diseases among cadets of Military Medical Academy n.a. S.M. Kirov. The findings are compared with similar incidence of other categories of military personnel. The difference in the conditions of epidemic process development depending on the conditions of official activities is assessed. Components of the organizational and functional form of monitoring of the incidence among the cadets developed by the authors are given.

The article studies the relationship between forming compliance factors (trust to your doctor, subjectively perceived respect from the attending physician, satisfaction with health care delivery) and the parameters of the doctor-patient interaction (accessible explanations during physical examination and performing manipulations, evaluation of communication time between doctor and patient, disclosure of health, disease, and treatment information, clarification of findings and management strategies) in women who are in prison. The highest relationship was between the subjectively perceived respect from the doctor, trust to the doctor and satisfaction with health care delivery and explanation and completeness of health, disease, and treatment information. The findings exclude the effect of potential confounding factors such as education level, age, institutional time.

The article describes the method of determination vegetation phases. Medicinal plants of Polygonum aviculare L., Polygonum hydropiper L., Polygonum persicaria L. are studied by means of polyacrylamide gel electrophoresis on malate dehydrogenase molecular forms.

Bupleurum scorzonerifolium is a promising plant. Its liquid form is used in folk medicine to treat liver, gall bladder, gastrointestinal disorders. The dry extract from this plant has a high concentration of biologically active substances. The optimal conditions of the raw material extraction of are established. The optimal extraction temperature is 60 0С, the number of extraction stages is 3. The phase contact time is as follows: 1st extraction stage 60% ethyl alcohol is within 120 min, 2nd extraction stage 60% ethyl alcohol is within 60 min, 3rd stage of extraction 70% ethyl alcohol is within 30 min. During the extraction mixing of raw materials is performed. Dry extract yield is 22.42%, the quantitative content of the total flavonoids is 19.39%.