№2, 2014, volume 10

Purpose: identification of the structure providing outflow of liquid from stomodeum in the process of formation. Material and Methods. 150 stomodea have been investigated for the ways of removal of liquid by the following methods: stage-by-stage freezing, contrasting and macerations. Result. One of the ways of removal of liquid from enamel of a being formed tooth is the crypt canal. Conclusion. Function of the channel of a crypt of developing teeth consists of removal of biological specific dental fluid from a surface of enamel of stomodeum in a mouth in the following options: on an oral surface of alveolar processes, near a periodontal fissure, or directly in a periodontium of a milk tooth — predecessor.

Aim: to study the outcomes of labour after the application of «KIWI» vacuum-system. Materials and Methods. Retrospective analysis of labour records with vacuum-extraction of fetus (main group: n=35) and with emergency cesarean section (comparison group: n=18)on indications similar to those in the main group, has been undertaken. Results. High rate of extragenital pathology in groups (70,7% and 72,3%) as well as aggravated obstetric-gynecologic anamnesis (36,9% and 55,6%) has been revealed. Pregnancies of 50,7% women of the main group have been complicated by placentofetal insufficiency and chronic fetal hypoxia; in the comparison group 27,7% threatened miscarriage has been observed accordingly in 20% and 33,3%. Conditions for vacuum extraction have been the following: fetus asphyxia (52,3%), labour pains weakness (47,7%). Having evaluated the state of health of the new-born children of the main groupstraight complications (cephalohematomas, cervical injury, subaponeurotic hemorrhage, Duchen-Erb paresis, intraventricularhemorrage) have been observed in 53,8% of children. In the comparison group direct complications have been marked in 22,3% of cases. Conclusions. Comparatively high rate of labour traumatism in the main group may be explained by violations in conditions and techniques of vacuum-extractions as well as by non-observance of indications and contra-indications for the application of this operational method during the labour of pregnant women of high risk groups.

Objective: to improve surgical intervention outcomes in patients with cholelithiasis. Material and method. Sixty four patients were investigated before the elective cholecystectomy. The level of bile acids in the blood serum was determined before and after laparoscopic cholecystectomy. In case of the elevated level of bile acids gastric and duodenal radiography was performed to determine the degree of duodenal dyskinesia. Dyskinesia assessment was carried out according to the classification of Ya. D. Vitebsky. Dyskinesia was verified by laboratory and X-ray studies in 9 patients who underwent laparoscopic cholecystectomy supplemented with mobilization of duodenojejunal junction without dissection of Treitz ligament (Clermont operation). Life quality evaluation was performed in 30 days after the surgical intervention using the unified GSRS questionnaire followed by statistical treatment. Results. Laparoscopic cholecystectomy performed simultaneously with Clermont procedure improved the life quality of patients with cholelithiasis and duodenal dyskinesia. This method is considered to be minimally invasive and rather effective in prevention of post-cholecystec-tomy complications. Conclusion. The suggested method proved to be effective, but insufficient number of the observed cases and the lack of long-term data demand the continuation of the study.

Purpose: to reveal the structure of the disease between homeless people and leading factors, influencing its formation. Material and Methods. Information on diseases was received from the data of homeless entering the Saratov Clinical hospital №2 and Clinical hospital №6 in 2013. The questionnaire of students ofthe 5th course of Medical University on the subject of problem of medical help rendering to homeless. Results. The majority of hospitalized homeless suffered acute respiratory diseases (17,5%). It has been determined that 53% of students are ready to renderthe medical help to homeless, but 39% of students do not consider rendering medical assistance. Conclusion. The research has showed the health state of homeless is conditioned by the weather and psychological and social status. The problems of medical service for homeless are of great importance for future doctors. But specific medical attitude don't formed enough in young doctors.

The purpose of the study is to develop a comprehensive treatment aimed at improving uveoscleral outflow in the application of dynamic laser magnetic stimulation of the drainage system of the eye and evaluation of its effectiveness in treating patients with primary open-angle glaucoma (POAG). Material. 106 patients diagnosed POAG I, II, III stages were examined. Group 1 consisted of 62 patients treated with medical therapy and dynamic laser magnetic stimulation of the drainage system of the eye using the "AMO-ATOS-ICL", produced by JSC "TRIMA", Saratov. Group 2 consisted of 64 patients who received only medical therapy. Comprehensive survey including standard eye examination, static perimetry, visual evoked potentials study, the study of intraocular blood flow was conducted to all patients. Analysis of the results of the complex therapeutic effects showed that as the result of treatment 73% of patients had a decrease of intraocular pressure and the ease factor outflow increase. 52% of patients had a decrease in the number and area of relative. 63% of patients had activation of intraocular blood flow. These indices remained stable for three months. Conclusion. The treatment with the technique of dynamic laser magnetic stimulation of the drainage system of the eye of patients with primary open-angle glaucoma leads to lower intraocular pressure, and to the improvement of dopple-rographic and perimetric indications.

Hemangiomas are the most common tumors of skin and soft tissues in children. In recent years, the number of patients suffering hemangiomas becomes increasing. Aim: to evaluate the efficacy of non-selective (3-blockers in treatment of hemangiomas in infants with short duration of the disease. Materials and methods. Propranolol, a non-selective (3-blocker, was chosen as a medication. Observed group was composed of 5 infants aged 1 year. Starting dosage of propranolol was 2-4 mg, with hemodynamic parameters being controlled before and after the drug administration. Target dosage was 2.0-2.5 mg/kg. Results. All children had a distinct clinical improvement after 1 week of propranolol treatment. In 4 infants Doppler mode ultrasound scan of hemangiomas demonstrated the hollowing of a feeding vessel. Resistance index was reduced in 4 infants. Shrinking of hemangiomas was stated in 2 infants during ultrasound scanning. All infants continue to be observed by surgeons and pediatricians. The drug is well-tolerated. Adverse effects during the treatment with propranolol have not be noticed, both during the in-patient and out-patient phase. Conclusion. Using propranolol as the first-line drug opens new possibilities in the conservative therapy of hemangiomas when surgical intervention is not possible.

The research goal is to optimize the management of patients with serum PSA level falling in the range of 4-10 ng/ ml by designing and educating of an artificial neural network, which may be used to predict prostate gland morphology basing on clinical, laboratory and imaging data. Material and methods. Data of 254 patients, who were admitted to the oncological Department of S. R. Mirotvortsev Clinical hospital for transrectal prostate biopsy, was collected to construct several artificial neural networks with different architecture. External validation was performed on 27 patients, who had prostate biopsy in January-February 2014. Results. One-layer network, consisting of 11 input, 9 hidden and 3 output neurons, was determined to be the most successful: in 92.6% cases it was correct in predicting prostate cancer or its absence. Input factors were evaluated according to their relative importance, from more important to less important: prostate volume, serum PSA, patient's age, prostate consistency, PSA velocity, prostate symmetry, previous negative biopsy, free serum PSA, intake of 5-alpha-reductase inhibitors. Conclusion. Artificial neural networks may be used to predict morphological findings in prostate biopsy. High PSA density and firm prostate consistency should cause suspicion of prostate cancer.

The aim: to use veloergometry test at patients of high anaeshtesiology-operative risk before traumatic operations for functional operability determination. Material and methods: Randomized prospective research with the double "blind" control has been performed at 95 patients of high risk (ASA>III), undergoing long and traumatic operations on thoracic and abdominal organs. Patients have divided into groups without complications and with complications (51 and 44 patients) which one day prior to operation have spent veloergometry test (VEMT). Average dynamic pressure (ADP), the general peripheral resistance of vessels (GPRV), a core index (Cl); arterio-venous (a-v) difference on oxygen, oxygen delivery to tissues, consumption of oxygen and coefficients extraction oxygen in tissues; energy consumption have been investigated. Statistics has been done by nonparametric methods. Results. In response to veloergometry test in both groups growth of Cl at the expense of a tachycardia and GPRV fall which in complication group remains above norm is noted. In group without complications coefficients extraction oxygen in tissues were normalised, a-v difference on 02 became above norm, in other group — coefficients extraction oxygen in tissues and a-v difference on 02 began to exceed norm, and oxygen consumption has grown almost in 2 times. After VEMT a-v a difference on О and oxygen consumption were essentially above in group with complications. Under the influence of VEMT markecT stabilization of function of vegetative nervous systems (VNS). The number of complications made 39: intraoperation cardiovascular — 23, postoperative respiratory — 16. Clinically important connection (p=0,069) of perioperative complications with growth a-v differences on oxygen and a power interchanging have been received. Conclusion. Thus, the oxygen-energy exchange and the vegetative status can be referred to clinical functional operability determination.

Purpose: to study the use of Internet technologies in the provision of pharmaceutical care to the population and pharmacists' attitude to this problem. Material and Methods. Various interpretations of the term «Internet pharmacy» in the literature and regulations were studied by the method of content analysis, pharmacists' attitude to the online pharmacies was revealed by conducting surveys in Saratov and the Saratov region. Results. Current legislation restricts the remote drug sale, thus functioning of full-scale Internet pharmacies in the Russian Federation is not possible. Most pharmacists are not aware of the legitimacy of online pharmacies, legality of home and work delivery of drugs, purchased in the online pharmacy, and are not familiar with the existing documents regulating the activities of online pharmacies. Conclusion. The current situation with online pharmacies working in the Russian Federation produces difficulties in the control of online pharmacy activity and involves significant risks for consumers.

Aim. The optimization of orthodontic treatment planning of patients through the study of different methods for calculating the teleroentgenogram (TRG). Material and Methods. The analysis was conducted in patients' teleroentgenogram with various dentoalveolar anomalies. Materials were taken from the archives of the clinic of pediatric dentistry and orthodontics. TRG calculation was made by the method of Schwarz, the method of Downes and the method of Tweed. Results. The research identified the types of profiles of patients. Each author had his own idea about «ideal face» and ways to achieve a harmonious profile. It is not enough one method to analyze TWG for planning orthodontic treatment because it does not give a complete clinical picture. Conclusion. It is necessary to find a comprehensive research method TRG which will combine the advantages of the proven methods.