2019, volume 15

Aim: to estimate the frequency of rhegmatogenous retinal detachment among the population of the Central Black Earth region. Material and Methods. A retrospective study on the study of patients with myopia, who turned to the rhegmatogenous retinal detachment (RRD) in "S. Fedorov Eye Microsurgery Federal State Institution" in the period from 2006 to 2017 The epidemiological characteristics of patients who have applied to the RRF from five regions of the Central Black Earth Region (Belgorod, Voronezh, Kursk, Lipetsk, Tambov) are presented. Results. There is an annual increase in the number of patients with myopia complicated by RRD. The highest number of cases of myopia complicated by RRD was recorded in the age group of 50-59 years and 60 years and older, the smallest — in the age group 0-19 years. The female population suffers from a myopia complicated by the RRD equally with the male, but in the age groups 20-29 years, 30-39 years, men suffer more often, in the age groups 50-59 years, 60 years and older, women suffer more often. Among the patients from the Voronezh region, the largest number of cases of RRD was registered in the age group of 50-59 years, among patients from Tambov, Lipetsk and Kursk regions — in the age category of 60 years and older, from Belgorod region — in the age category of 30-39 years. The majority is represented by pensioners (60.3%), working people — 20.8%, disabled people — 15.8%, others 3.1%. Conclusion. Among the population of the regions of the Central Black Earth region, there is an annual increase in the number of patients with RRD, while the number of such patients will only increase, which indicates the need to improve the organization of eye care to the public.

Objective: to study the frequency of occurrence of risk factors for cardiovascular disease among the working population of Saratov and to analyze the effectiveness of measures to promote a healthy lifestyle in the district health Center. Material and methods. The study was conducted on the basis of thehealth Center of the Saratov city polyclinic №17. For 2013-2017 surveyed 50301 patient of working age. The plan of the survey included the collection of anamnesis to identify risk factors for cardiovascular disease, physical examination with the implementation of anthropometry (determination of growth, calculation of body mass index), measurement of blood pressure, determination of total cholesterol and glucose in capillary blood. The total risk of fatal cardiovascular complications was assessed on the SCORE scale. Portable peripheral Doppler analyzer Smart Dop 30 EX with automatic measurement of systolic blood pressure and calculation of ankle-brachial index was used for angiological screening. Results: The most common risk factors were poor nutrition and physical activity, hypercholesterolemia, hyperglycemia, overweight and obesity. A decrease in the number of smokers since 2013 by more than 1.5 times: from 12.9 to 7.5%. The incidence of hypertension increased from 29.1 to 41.7%. Conclusion. It was found that more than 70% of patients who applied had risk factors for major chronic noncommunicable diseases. Overweight and obesity, irrational nutrition, low physical activity were detected in more than 50% of cases; hypercholesterolemia was determined in 45% of cases, hyperglycemia in 25%. Over the past 5 years, the incidence of hypertension among patients of working age has increased, primarily due to improved detection. It is important to carry out preventive programs, starting with students and young people, to inform citizens and motivate them to lead a healthy lifestyle.

 . SObjective: analysis of the state of health, medical activity, social and demographic characteristics of women of child-bearing age to develop a set of medical and organizational measures aimed at reducing the loss of maternal and child health, improving the system of maternal and child health. Material and Methods. The following methods were used in the work: bibliographic, analytical, mathematical- statistical, sociological (questioning). The material of the study was 596 questionnaires of a sociological survey of women — patients of the regional perinatal center. Each questionnaire included 48 questions combined into 6 blocks (social, demographic characteristics, state of health, medical activity), which were processed using the statistical program PASW (Predictive Analytics Software) Statistics 22 Results. It was found that the majority of respondents considered themselves to be in the healthy group, every fifth considered that they had chronic diseases and 11.9% felt sick. In the structure of chronic pathology, the largest proportion was accounted for by respiratory diseases, ENT organs, circulatory system diseases, gynecological diseases. Conclusion. On the basis of the obtained data, the directions for improving the system of maternal and child health have been proposed, such as: strengthening preventive activities, improving the quality of clinical examination of the female population; improvement of continuity in the work of institutions of the maternal and child welfare system; introduction of interactive forms of education for pregnant women.

A rare case of cerebral venous circulation disorder in a female patient with peripheral cancer metastasis of the right lung upper lobe to the area of precentral and postcentral gyri of the left cerebrum hemisphere in the immediate post- surgical period is present. It has been shown that the diagnostics of impaired circulation throuth the superficial cerebral veins is rather complicated due to the lack of clinical symptoms specificity and poor sensitivity of neurovisualization methods.

Objective: to identify the variability and contingency of parameters characterizing the structure of the hip joint in children 4-7 years of age, among themselves and with the severity of dysplastic changes in the bone and soft tissue structures of the hip joint. Material and Methods. 132 children aged 4-7 years with dysplasia TBS with different degrees of severity of dysplastic changes (177 joints) were examined. The following characteristics of dysplasia joint were under the study: angular radiological parameters, cartilage defect, electroneuromyographic signs, indicators of the biomechanics of gait. The degree of dysplasia (mild, moderate, severe) was assessed by the method developed by the authors to determine the severity of hip dysplastic changes in points. Results. Light changes in the hip joint were diagnosed in 9 patients aged 4-7 years (15 joints); moderate dysplastic disorders were found in 74 patients (96 joints); pronounced signs of dysplasia were found in 49 patients (66 joints). The coefficient of variation of signs characterizing TDS dysplasia varies from 2.8 to 18.8%. The module of correlation coefficients characterizing the binding force of the studied features is in the range from 0.7 to 0.9. Conclusion. The angular radiological parameters, cartilage defect, electroneuromyographic signs, indicators of the biomechanics of gait characterized by considerable variability and are correlated with strong and close power among themselves and with the degree of dysplastic changes of the bone and soft tissue structures of TBS.

Objective: to assess the accuracy of the femoral neck resection using the developed "Device for positioning tools for the installation of the femoral component of the hip prosthesis". Material and Methods. On the basis of the Department of traumatology and orthopedics of Voronezh state medical University n.a. N.N. Burdenko conducted experimental studies on 40 models of plastic bones. In the comparison group resection was performed using the proposed device, in the control group — using a standard guide. Results. Experimental studies have demonstrated higher accuracy of femoral neck osteotomy in the comparison group. The average value of the neck filing angle in the frontal plane in the comparison group was 3.2° higher than in the control group (p<0.05), and in the sagittal difference was 3.1°. The average distance from the line of the osteotomy to the apex of the greater trochanter in both groups was not significantly different (p=0.62). Conclusion. The use of the developed device allows to perform osteotomy of the femoral neck with high accuracy, as well as to control the position of the leg endoprosthesis, which helps to reduce the number of complications and improve the quality of life of patients.

Objective: to estimate the changes of effective stresses (by Mises) at three types of loads (axial, lateral and twisting) for various types of intramedullary nails synthesizing modeled fractures of A1; A3; B2 types at the level of femur bone middle third. Material and Methods. To solve the preclinical tasks computer simulation of biomechanical systems bone-fixing pin and method of finite elements were employed. Results. The nails developed by SarNIITO excel ChM and Fixion rods in stress-deformed condition, fatigue strength and stability of fixation of the examined types of fractures parameters of 12- 23%. Conclusion. The mechanical characteristics of SarNIITO nails proved to be of clinical use and may be recommended for patients with femur bone diaphysis fractures.

Objective: to evaluate the outcomes of various methods of surgical interventions and functional properties of lower extremities in patients with complicated ankle fractures. Material and Methods. Clinical outcomes of 140 surgically managed patients with unstable bimalleolar and trimalleolar fractures were studied. 80 patients were managed with external fixation devices applied by original method (main group) and 60 patients were managed with submersible structures (comparison group). Results. Compared to submersible structures, the use of transosseous metalosteosynthesis has led to 100% ankle fracture unions. In early postsurgery period the index of average anatomic and functional result reached values of 93.4% corresponding to "good" and 6.6% corresponding to "satisfactory". Conclusion. It has been established with rheovasography data that transosseous osteosynthesis contributed to restoration of blood microcir-culation in the damaged segment of lower extremity in 8 weeks period after surgery and submersible structures in 6 months period.

 Literature review is devoted to the analysis of scientific findings about extraosseous effects of vitamin D on the immune system of the periodontal tissues. It was found that the biological functions of vitamin D (VD) in the body are diverse.Along with the detailed study of the effect on metabolic processes in bone tissue, VD makes a significant contribution to a large number of processes that ensure the activity of the immune system. In addition, VD increases the production of "endogenous antibiotics". This allows us to consider VD as a therapeutic agent that prevents the development of inflammatory and destructive changes in the periodontal tissues in population with simultaneous slowing of bone loss and preservation of bone mass of the dentofacial system. Currently detected hidden hypovitaminosis VD in almost majority of the population is considered a leading factor in the development of periodontal disease and its prevention and treatment is one of the most important tasks of therapeutic dentistry.

Leukemia in children (leukemia) is a systemic hemoblastosis, accompanied by a violation of bone marrow hemato- poiesis and replacement of normal blood cells with immature blast cells of the leukocyte series. Acute megakaryoblastic leukemia-one of the rarest forms of acute leukemia (1-3% of all leukaemias), which is characterized by the presence in the blood and bone marrow, along with undifferentiated blasts also megakaryoblasts, ugly megakaryocytes and platelet clusters. The work presents a clinical case of congenital acute megakaryoblastic leukemia in the child S., combined with the mosaic form of Down syndrome and a congenital heart defect.