2015, volume 11

Conventional and innovative pedagogical technologies are two intercommunicative aspects of the common specialists' professional educational process and specific stages to highly professional skills. The role of pedagogues has been determined to be very significant as they should distinctly define each pedagogical technologies proportion ratio to promote stable work of graduates from higher medical educational institutions.

Objective: the probable determination of severe sepsis in patients of elderly and senile age with necrotic erysipelas based on a comprehensive assessment (clinical examination using systems — scales and determination of the level markers of SIRS). Material and methods. The analysis of peculiarities of necrotic erysipelas clinical course in 59 patients. The first group consisted of 17 patients with severe sepsis, the second — 18 patients with sepsis without multiple organ failure, in the comparison group —22 patients with local infection. We determined albumin, urea, creatinine, pro-calcitonin of plasma. The scale SAPS III was used to quantify SIRS, scale SOFA —to determine the extent of damage to organs and systems. Results. The most sensitive marker of developing sepsis in patients with necrotic erysipelas was procalcitonin. The second important indicator of SIRS severity in patients with necrotic erysipelas was the blood albumin. Scale SAPS III also allows to select a group of patients with high risk of developing severe sepsis. Use of the SOFA to predict the scale has been found out to be less important. Conclusion. A comprehensive assessment of the severity of the condition by scale SAPS III in combination with determining the levels of procalcitonin and plasma albumin is advisable to apply for prediction the probability of developing severe sepsis in patients of elderly and senile age with necrotic erysipelas. For the last indicator it is important to assess of absolute values and the decrease of its concentration.

В обзоре литературы представлены сведения об отдаленных осложнениях уретеросигмостомии Mainz pouch II, таких, как пиелонефрит и метаболические нарушения. Анализируются механизмы их развития, обсуждаются перспективы прогноза, ранней диагностики и способов борьбы с ними.

Objective: to study pathophysiological mechanisms of local (pulmonary) inflammatory reaction in the sharp and early periods of a traumatic disease of a spinal cord on the basis of an assessment of dynamic changes of cellular structure of a bronchial secret, an alveolar epithelium and a microbic landscape of a tracheobronchial tree at patients with the complicated damages of cervical department of a backbone. Materials and methods. Methods of cytologic, immunofermental and bacteriological researches at 40 patients with the complicated damages of cervical department of a backbone to dynamics studied the contents the neutrofil of leukocytes and alveolar macrophages in a bronchial secret, a mutsin antigene 3GE5 and surfaktant protein D in serum of blood, character of microbic flora of a tracheobronchial tree and its some biological properties. Results. Activation of local (pulmonary) inflammatory reaction in the sharp and early periods of a traumatic disease of a spinal cord is characterized by increase of the contents the neutrofil of leukocytes in a bronchial secret for the 7-14th days, lymphocyts — for the 1-14th days increase in the maintenance of a mutsin antigene 3GE5 for the 14th days and SP-D —for the 1-14th days, allocation from respiratory substrata of opportunistic microorganisms in clinically significant concentration; knocking over — increase of quantity of alveolar macrophages, decrease in the maintenance of a mutsin antigene 3GE5 and SP-D for the 21-30th days and sanitation of a locus of an infection in a tracheobronchial tree. Conclusion. The pathophysiological mechanisms defining changes of cellular structure of a bronchial secret, an alveolar epithelium and a microbic landscape of a tracheobronchial tree in the sharp and early periods of a traumatic disease of a spinal cord play an important role in development of organ (pulmonary) inflammatory reaction.

Purpose: to define regularities of variability of bone structures of a hip joint depending on type of dysplastic coxarthrosis and to develop tactics of total endoprosthesis replacement. Objects of research. 106 patients with dysplastic coxarthrosis of varying severity, passing treatment on the basis of Federal State Budget Institution of Saratov Scientific Research Institute of Traumatology and Orthopedics from 2005 to 2014 applying methods X, KT-, MRT-metry variation and statistical methods. Results: According to anatomic features of a hip joint at dysplastic coxarthrosis of various types algorithms of choice of acetabularand femoral components of endoprosthesis, and also tactics of total endoprosthesis replacement in groups of research are developed. Conclusion. The choice of a standard size of an endoprosthesis of a hip joint needs to be carried out taking into account X-ray anatomic features of a hip joint and degree of expressiveness of the dysplastic changes. At dysplastic coxarthrosis of the l-ll types it is necessary to carry out standard total endoprosthesis replacement; at coxarthrosis of the III type —total endoprosthesis replacement in combination with plasticity of a roof of acetabular hollow; at coxarthrosis of the IV type — total endoprosthesis replacement in a combination from the shortening femur osteotomy.

Objective. The present study examines the value of intraoperative neurovisualization as an imaging tool for decision making in the management of traumatic nerve injuries. Materials and methods. 43 patients with traumatic nerve lesions were examined by electrodiagnostic study, ultrasonography and contrast neurography. Results. A complex intraoperative examination have been used to guide surgical decision making in patients with peripheral nerve injuries of limbs. Conclusion. The results of complex intraoperative examination became the basis of diagnosis and treatment algorithm for surgical treatment of peripheral nerves injuries.

Purpose: to establish the diagnostic value of the immune cells composition and cytokine activity of the cells in wound discharge from patients with acute odontogenic inflammatory diseases of maxillofacial region. Materials and methods. A total of 31 patients with acute odontogenic inflammatory diseases of maxillofacial region were examined. The number of immune cells and pro-inflammatory cytokines content (IL1(3, MCP1, IL6, IL8, TNFa) in the wound discharge were determined. Results. It has been established that depending on the severity of the inflammatory process in maxillofacial region the immune cells composition and levels of pro-inflammatory cytokines are changing. Conclusion. Determination of the immune cells composition and level of cytokines in the wound discharge can be used for estimation of the character and severity of acute odontogenic inflammatory processes in the maxillofacial region.

The aim: to prove the necessity of professional oral hygiene before the fixation of permanent orthodontic equipment in individuals with dental and facial anomalies based on the study of biomarkers of gingival fluid. Materials and Methods: Clinical, cytological examination and gingival fluid test on cytokine levels in 80 patients. Results: In patients with dentofacial anomalies observed decline in hygiene index, and increase the content of gingival fluid neutrophils and degenerative epithelial cells. It is accompanied by an increase in the concentration of the main group of pro-inflammatory and osteogenic cytokines, growth factors. Conclusion: Preliminary conducting professional oral hygiene to orthodontic treatment in patients with dentofacial anomalies leads to the conservation values of satisfactory hygienic indices of the mouth. In this case, the increase in the content of gingival fluid neutrophils and degenerative epithelial cells, with increased concentrations of the main group of pro-inflammatory and osteogenic cytokines has been defined insignificant.

Congenital malformation is one of the most common causes of infant mortality. The Russian Healthcare Ministry has approved a wide range of measures to decrease the number of babies born with malformations. Due to the measures taken, prenatal diagnostics of such malformations as cardiac malformation, nervous system malformation, various space occupying lesions has become more effective. However, there is a number of malformations hardly detected until the birth. This problem also concerns some abnormalities of the gastrointestinal tract. One of such malformations "silent" during prenatal diagnostics is, particularly, focal aplasia of the stomach muscular layer. This work deals with the case of such malformation observed in a newborn baby.

The aim is to study the characteristics of clinical and laboratory picture of neonatal diabetes mellitus in a premature baby; to analyze the course of the disease for 18 months, to determine the mechanisms of development of neonatal diabetes mellitus, to develop a differentiated approach in the treatment of neonatal diabetes mellitus.