№3, 2015, volume 11

Prostate cancer is one of the most urgent problems of modern oncology. The article provides an overview of the methods of treatment of locally advanced prostate cancer, comparative characteristics, the advantages of both independent and combined methods. The results of multicenter studies have been stated.

The article deals with the problem of development and the modern state of biomechanics as a scientific and practical direction in medicine under the context of technological advance herein a specific attention is paid to the achievements of the Russian schools. It is shown a necessity of wide usage of instrumental biomechanical diagnostics of locomotive disorders for intrinsic substantiation of rehabilitation treatment tactics and monitoring of its medical efficiency particularly for persons with remote effects of surgical interventions such as osteosynthesis, spondylosynthesis, total joint replacements. Non-invasive technique, possibility of its multiple application and rather low cost make actual using of locomotion clinical analysis techniques for rehabilitation treatment of concerned patients of different age groups.

Objective: to define the risk factors adversely influencing prenatal development at premature birth at use of methods of assisted reproductive technology (ART); to estimate premature' infants health from multiple induced pregnancy according to Perinatal Center of Saratov for last 3 years. Material and Methods. Under supervision there were 139 pregnant women with application ART. 202 children (51 twins were born and 5 triplet babies), from them 83 premature infants born from multiple induced pregnancy have been analyzed. Results. The newborns examined by method ART, were distributed as follows: 22-28 weeks — 19 children; 29-32 weeks — 23; 33-36 weeks — 41. Asphyxia at birth was marked at all premature infants. Respiratory insufficiency at birth is revealed in 87,3% of cases. The most frequent pathologies in premature infants are revealed: neurologic infringements and bronchopulmonary pathology occured at all children, developmental anomaly — 33, 8%, retinopathies in premature infants — 26,5%. The mortality causes include: extreme immaturity, cerebral leukomalacia, IVN 3 degrees. Conclusion. The risk factors, premature birth at application of methods ART are revealed: aged primiparas, pharmacological influence, absence of physiological conditions of prenatal development; multifetation. The high percent of birth of children with ELBW and ULBW is revealed. RDCN with further BPD development, retinopathies in premature infants and CNS defeat is more often occured.

The aim of the article is to present clinical experience of conducting the patient with a genetic syndrome of Langer — Saldino in branch of resuscitation and intensive therapy of newborns of Perinatal Center of Saratov. It is necessary to notice that the described pathology is a rare autosomal dominant disease shown by plural developmental anomalies and determines great attention from the practical point of view. The given syndrome concerns mortality diseases leading to lethal outcomes on early terms of prenatal development, or in the nearest neonatal period from respiratory insufficiency.

Objective: to develop an algorithm for surgical treatment of pain and spasticity in patients with consequences of spinal cord injury. Materials and Methods. The basis of the algorithm initiated a retrospective study of results of surgical treatment of 273 patients with pain and spastic syndromes after spinal cord injury, which consistently met neuromodula-tion techniques and destructive surgery. Results. The developed algorithm tested in 166 patients with pain and spastic syndromes provided positive results in 88.6% of cases with spastic and in 80.4% of observations for pain and spastic-pain syndromes. Conclusion. The proposed algorithm allows systematizing neuromodulation methods and so-called «radical» destructive operations in the treatment of pain and spasticity, and thereby improving the results of rehabilitation of patients with consequences of spinal cord injury.

The goal is to study the cerebral blood flow and psychometric characteristics in veterans of Afghanistan with early forms of chronic brain ischemia. Material and Methods. The study included 74 veterans of the Afghan war aged from 45 to 55 years: group 1, 28 people with NPNKM; Group 2-28 patients with circulatory encephalopathy stage 1; group 3-18 healthy persons. Doppler examination of cerebral vessels was carried out on the unit «Smart-lite». Reactive and personal anxiety of patients was assessed using the scale of Spielberger, evaluation of the quality of life through the test SAN. Determining the level of neuroticism and psychoticism was conducted by the scale of neuroticism and psy-choticism. Results: The study of cerebral blood flow in the Afghan war veterans showed signs of insolvency of carotid and carotid-basilar anastomoses, hypoperfusion phenomenon with the depletion of autoregulation, violation of the outflow of venous blood at the level of the microvasculature, accompanied by cerebral arteries spasm. More than 40% of patients with early forms of chronic brain ischemia had high personal anxiety, low levels of well-being and activity, with maximum expression of dyscirculatory hypoxia. Conclusion. Readaptation of veterans of Afghanistan is accompanied by the changes in psychometric performance and the formation of the earliest forms of brain chronic ischemia associated with inadequate hemodynamics providing increased functional activity of the brain and the inefficiency of compensatory-adaptive reactions.

Purpose: to assess reproducibility of measurement of the width of lateral ventricles of the fetal brain by ultrasound investigation in the second trimester of pregnancy. Material and Methods. The volume of the 34 normal fetal brains at 18-21 weeks of gestation was retrospectively evaluated. Two experienced specialists measured the width of lateral ventricles from each fetus twice. Results. Intra-operator differences of the first specialist constituted 0,136±0,065mm, of the second specialist — 0,156±0,066mm. Inter — operator differences counted 0,191±0,062mm. Conclusion. Measurement of the width of lateral ventricles is highly reproducible, it should be performed by ultrasound investigation in the second trimester of pregnancy.

The aim of the study was to provide the data on the course of myocardial infarction (Ml) associated with diabetes mellitus (DM) in hospital. Material and methods. 102 patients with Ml were included in two cohorts, first with DM, second — without DM. Groups were compatible by gender, age and standard therapy. Results. Angiocoronarography data have revealed that patients of group 1 were characterized by multiple vessels lesion due to "rescue" angioplasty with stenting performed 5 times. Patients with DM demonstrated in-hospital higher rate of both acute (by Killip) and chronic (by NYHA) heart failure of advanced degrees as well as recurrent Ml, early postinfarction angina pectoris, heart rhythm disorders and hematomas due to injections. Conclusion. The previously mentioned results lead to higher mortality in this group. Significant elevation of CRP, interleukin-6 and epidermal growth factor levels proved more activated systemic inflammatory response in patients with Ml and DM playing key role in pathogenesis of complications of the disease.

The aim of the study is to describe the development of the algorithm for the data analysis of Russian coronary artery disease (CAD) Registry. The algorithm allows determining the need in percutaneous coronary intervention (PCI) and evaluation the validity of PCI in patients with stable CAD on the basis of appropriate use criteria for coronary revascularization by the American College of Cardiology. Two measures propose for clinical decision support and automated assessment of PCI appropriateness «The need in PCI in patients with stable CAD» and «PCI validity in patients with stable CAD».

The aim of the study is to assess the quality of health care among penitentiary employees with hypertension in the Saratov region from 2003 to 2013. Material and Methods. The data from 62 employees with hypertension (43 men and 19 women) who followed up in the dispensary of Branch of Center of Medical and Social Rehabilitation of Medical Unit no.64 of Russian Federal Penitentiary Service in 2013 were evaluated. We analyzed retrospectively the quality of health care in every calendar year from 2003 to 2013 according to the following categories: control of blood pressure (BP), control of physical activity, control of smoking, control of weight, control of diet, control of cholesterol. To assess the quality of care we used clinical indicators implemented in the Federal Hypertension Register. Results. During the overall period (2003-2013) counseling on physical activity, smoking, weight and eating was optimal. However, only physical activity was controlled effectively in patients. The measures on control of BP and cholesterol needed improvement. Conclusion. Despite relatively good quality of the majority of health care measures among hypertensive patients in the Center of Medical and Social Rehabilitation, the effectiveness of these measures has been found out to be insufficient. It may be due to poor patients' adherence to recommendations.