2014, volume 10

Research objective: to carry out differential diagnostics of various nosological forms of a temporal and temporomandibular joint pain dysfunction syndrome. Material and methods. On clinical base of orthopedic odontology chair of SamSMU inspection of 244 patients with temporomandibular joint pain dysfunction syndrome was performed. Diagnostics was carried out according to the special card of inspection which was developed on orthopedic odontology chair of SamSMU and included subjective, objective and special methods of research. As a result of research it is taped: 71 — an occlusal-articulation dysfunctional syndrome, 44 — a neuromuscular dysfunctional syndrome, 76 patients have a hardly set dislocation of intra joint disk and 53 — a habitual dislocation and a subluxation of a temporomandibular joint. We used Yu.A. Petrosov's classification as it displays most precisely the processes happening at pathology of the intra joint relations. Conclusion: On the basis of the obtained data the table of differential diagnostics of various nosological forms of temporomandibular joint pain dysfunction syndrome has been made.

Objective: to reveal and estimate dependence between a long waterless interval, infectious process at mother and pathology of newborn children. Material and Methods: Supervision and research have been carried out in Perinatal Center of Saratov region for the last 2 years. 167 women and 173 newborns were included in the research. The big group was composed by prematurely born children. Women were divided into 2 groups depending on infectious process of patrimonial ways and on duration of a waterless interval. Children were divided on gestation term. Results: fetoplacental insufficiency and threatened miscarriage are the main factors of extremely immature children birth. Under these conditions, prolongation of pregnancy and preparing a fetus to labor act are important factors for improving the adaptive capacity of a premature baby. One of the important factors of insolvency is membranes infection. It is a distinct disease or a result of complications of pregnancy prolongation in women with PROM, is a precursor of systemic inflammatory response and in the majority of newborns was realized in infectious process. Conclusion. Women with infectious pathology of birth canal should be thoroughly sanitized, preventive treatment should be carried out, it would prevent the implementation of fetus infection, reduce posthypoxic disorders and incidence of preterm birth and IUGR. Long PSU without infectious support contributes to a lesser extent implementation of infection in fetus and less effect on a child's neurological status.

Objective: to reveal and estimate dependence between a long waterless interval, infectious process at mother and pathology of newborn children. Material and Methods: Supervision and research have been carried out in Perinatal Center of Saratov region for the last 2 years. 167 women and 173 newborns were included in the research. The big group was composed by prematurely born children. Women were divided into 2 groups depending on infectious process of patrimonial ways and on duration of a waterless interval. Children were divided on gestation term. Results: fetoplacental insufficiency and threatened miscarriage are the main factors of extremely immature children birth. Under these conditions, prolongation of pregnancy and preparing a fetus to labor act are important factors for improving the adaptive capacity of a premature baby. One of the important factors of insolvency is membranes infection. It is a distinct disease or a result of complications of pregnancy prolongation in women with PROM, is a precursor of systemic inflammatory response and in the majority of newborns was realized in infectious process. Conclusion. Women with infectious pathology of birth canal should be thoroughly sanitized, preventive treatment should be carried out, it would prevent the implementation of fetus infection, reduce posthypoxic disorders and incidence of preterm birth and IUGR. Long PSU without infectious support contributes to a lesser extent implementation of infection in fetus and less effect on a child's neurological status.

The review deals with the diagnosis of changes in bone metabolism in children with juvenile idiopathic arthritis (JIA) in terms of disclosure of the pathogenetic mechanisms of immunopathological disorders in the body. It is shown that timely and adequate characterization of the state of mineralization of bone tissue in patients with JIA — as an indicator of systemic catabolic process, remains an ongoing problem, entailing the need for large-scale introduction of new diagnostic techniques. Through the presentation of the traditional methods of diagnosis of bone metabolism, their capabilities, strengths and weaknesses, analyze the advantages of assessing the level of bone formation, taking into account a variety of biochemical markers. The data on the development of modern diagnostic approaches to the assessment of osteopenia complications in children with JIA, based on the characterization of molecular-genetic targets of the process of osteogenesis. Conclusion: for the adequate therapy and its timely correction in children with JIA in the early stages of the disease it is necessary to carry out a comprehensive study on the identification of metabolic disorders of bone, holding it in the dynamics, and actively introducing the practice of modern and affordable methods of diagnosis of osteopenic disorders.

Objective: Specification of indications for surgical treatment of Chiari malformations Type I (CMI) in combination with scoliosis without syringomyelia. Material et Methods: The article describes the results of treatment of children with Chiari malformations Type I (CMI) in combination with scoliosis without syringomyelia. The decompression surgery of the posterior fossa was made in 30 patients with CM I. All patients varied in the degrees of scoliosis. Results were evaluated including clinical and radiological survey, data of computer angiography and ultrasonic diagnostics of head and neck vessels in the preoperative and postoperative periods. The behavior of the angle of the spinal deformity in patients after decompression surgery of the posterior fossa was evaluated. Results: It has been found out that scoliosis convincingly regresses after this operation, if the angle of curvature of less than 30 degrees. Conclusion: The presence of vascular pathology at the level of the cranio-vertebral joints should be taken into account in the determination of indications for surgical treatment of patients with CMI in combination with scoliosis.

Atresia of the aortic arch is a rare congenital disease, often accompanied by congenital heart defects. Isolated atresia of the aorta is rare and usually has a complex deformation with multiple aneurysms, bending of the aorta and its branches. This anatomy complicates the exposure and makes surgery technically complicated with conventional approaches. The aim of the work is the presentation of a case of successful prosthetics of aortic arch and a 5-year observation of a patient with congenital deformation of the aortic arch in severe hypothermia and circulatory arrest. The article presents the variant of surgical tactics in treatment of patients with this form of atresia of aortic arch.

The purpose was to implement system analysis of clinical cases for development of healthcare quality indicators for STe-ACS patients, aimed at achievement of clinical result — decrease of in-hospital mortality. Mathehal and Methods. National recommendations on diagnostic and treatment of patients with myocardial infarction with ST-segment elevation on ECG (2007) were used to determine clinical result of treatment and key measures of medical care. To reveal major causes of clinical result non-achievement fishbone diagram was used. Results. Early reperfusion and optimal medical therapy were determined as the key measures of medical care delivered to patients with STe-ACS. The following indicators were developed to control these measures: «Primary reperfusion», «Thrombolysis in 30 minutes», «Primary percutaneous coronary intervention in 90 minutes», «Dual antiplatelet therapy in hospital», «Beta-blockers administration», «ACE-is/ARBs administration». The major causes of in-hospital mortality were separated. Indicators for assessment the major causes of clinical result non-achievement were proposed. Principal stages of performance measures creation were posed. Conclusion. Recommendation-based and clear definition of clinical result of treatment and key measures of the result achievement combined with methods of systems analysis allows development of evidence-based measures for assessment the quality of care delivered to patients with STe-ACS.

Objective: research is devoted to the development of criteria and methods for prognosis of the next recurrence of exacerbation of ulcerative colitis (UC) after the patient discharged from hospital. Material and Methods: During a period of a year 38 patients with UC were supervised. The criteria used in the prognosis of recurrence included results of the evaluation of quality of life (SF-36 questionnaire), the analysis of the autonomic nervous system (coefficient Hildebrant and Kerdo index) and the level of stressful load procedure Holmes-Rage. Results. It has been established that the risk factors for recurrence include low quality of life on the scale of RP, SF and MH SF-36, the coefficient Hildebrant >5.6 units, Kerdo index 314 points. Conclusion: The obtained data have been processed by multivariate mathematical statistics and the obtained analytical expression allows to prognose the time of recurrence of ulcerative colitis.

Functional systemic approach to the resuscitation and intensive care may be considered as a direct correlation between analysis and synthesis, induction and deduction, and, in general, between the formal and dialectical categories. The realization of this system should be started with the interaction and formation of the final beneficial result. Therefore the experience assessment on the basis of functional systematic approach will enable us to formulate more precisely the subject and methods of resuscitation from the philosophical point of view taking into consideration the interaction of the human life integrity with death phenomenon as fixed in ontogenesis and will allow to methodically justify the distinguishing of functional systems and standard processes both in sanogenesis and thanatogenesis.

The aim of the study is to evaluate influence of estrogen deficiency on lipid profile in women of different age. Material and Methods. 189 women with normal body weight: 44 women with premature menopause (aged <40 years), 69 women with early menopause (aged 40-45 years), and 76 women with natural menopause (aged 46-55 years) have been studied. In all women identification of clinical status has been performed during clinical examination. Results. It is shown that increasing age associated with increasing total cholesterol, triglycerides, low-density lipoprotein (LDL), very low density lipoproteins (VLDL) (p<0.05). We have not observed a significant association between age and level of high-density lipoprotein (HDL) (p=0.117). According with increased age, atherogenic index of plasma (AIP) increases from initial -0.17±0.09 (M±o) to 0.09±0.47 (p<0.05) in women with premature menopause, and to 0.14±0.21 (p<0.05) in other women. Final level of AIP was similar between women aged 40-45 years and women aged 46-55 years (p=0.084). Conclusion. Lipid metabolism disorders were assessed in 73.5% of women with estrogen deficiency. According to the age factor the rate of women with normal lipid metabolism decreases (x2=10,165, p=0.026).