2017, volume 13

Objective: to determine the ratio of obstetricians and gynecologists roles during childbirth. Material and Methods. The questioning of obstetricians and gynecologists in the Volgograd and Rostov region has been conducted. The population was 1181. Sample random N=300. Results. Respondents acknowledge their own responsibility in 98%. Midwives agree that a woman is the main actor in the process of childbirth, but just 52,7% consider that it is necessary to inform a woman of principle for her birthing situations and do not trust its ability to make adequate decisions (52%). Conclusion. Obstetricians and gynecologists consider themselves the main actors of the process of childbirth, although not rule out the usefulness of the participation of other health professionals, respected the autonomy of women in decision-making, but prefer a higher level of confidence on the doctor. The application of advances personalized medicine is considered necessary for 69.7% of respondents, while recognizing their lack of awareness on this issue.

Objective: to study exotoxin A Pseudomonas aeruginosa influence on physical and mental efficiency of white rats. Material and Methods. The experiments were carried out on white rats following intraperitoneal injections of exotoxin A Pseudomonas of different doses (0.1,0.5 and 1.0 LD50). Physical and mental efficiency of white rats was determined by the scheme of "Machfs camera". Results. Introducing exotoxin A Pseudomonas of 1 LD50 there was conditioned response damage in 20% of animals. The amount of cases of physical incapacity introducing highly effective doses of exotoxin A Pseudomonas overcomes the amount of cases of reaction destruction (44%). Conclusion. Exotoxin A Pseudomonas aeruginosa does not reveal a selective effect on the central nervous system and significant influence on physical efficiency of white rats.

Aim: to investigate the influence of red laser irradiation on the processes of self-assembly of core histones H2A and H2B. Material and Methods. Solutions of human histone proteins were used in the work. Self-assembly was studied by the method of wedge dehydration. Image facies analysis consisted in their qualitative characterization and calculation of quantitative indicators with subsequent statistical processing. Results. It was established that linearly polarized laser light of the red region of the spectrum (A=660 nm, 1 J/cm2) significantly modifies the process of self-assembly of core histone H2B, while the structure of the facies of H2A histone changing to a lesser extent. Conclusion. Red laser radiation influences on the on the processes of self-assembly of core histones H2A and H2B. There is a differential sensitivity of different classes of histones to laser action. Histone proteins used in the experiments are present in the form of aqueous salt solutions. Red light realizes the effect seems to be due to the formation of singlet oxygen by direct laser excitation of molecular oxygen.

Objective: to define the regional structure of comorbid conditions of early rheumatoid arthritis (RA) and the cost of treatment. Material and Methods. Medical records of 100 patients with RA hospitalized in Velikiy Novgorod in 2010 and 2014 were analyzed. Range of drugs, used by doctors in the early stage of RA were considered, and and drugs were systematized. Pharmaceutical and economic analysis of medical records was conducted. Statistical data processing was executed using MS Excel. Results. A wide distribution of comorbid conditions in patients with early state of rheumatoid arthritis was established, the structure of concomitant pathology was determined. All the prescribed drugs and preparations with a frequency of more than 3% are allocated. The average cost for each drug use has been calculated, an ABC-analysis has been performed. Conclusion. Comparison of medical appointments and regulatory lists revealed that the standard is not fully observed. At an early stage of RA a high percentage of patients with comorbid conditions was noted (85.7-93.3%), predominantly cardiovascular, gastrointestinal, thyroid diseases. Cost of treatment of RA at an early stage and the most frequent comorbid status in 2014 has increased in comparison with 2010, the range of drugs in 2014 has decreased by 32%. The results of ABC-analysis of medicinal appointments revealed qualitative and quantitative changes in the major positions of the drugs.

The purpose of this experimental study is to study the patterns of morphological response of the abdominal wall tissues to the implantation of a combined (xenopericardial plate and polyester mesh) hernia prosthesis. Material and Methods. The experiment was carried out on fifteen rabbits of the breed Chinchilla weighing up to 3.5kg. The combined prosthesis was implanted intra — abdominally. The animals were withdrawn from the experiment after 2 weeks, 1 month and 2 months. After the beginning of the study morphological and morphometric assessment of the tissue state in the implantation zone of the prosthesis was carried out. Results. The combined hernia prosthesis when implanted into the anterial abdominal wall causes a rather pronounced inflammatory reaction, progressing within a month after the operation. By the second month of the experiment, signs of inflammation decrease. In this case, active growth of the young connective tissue in the implant from the side of the polyester mesh occurs. Xenopericardial plate, facing the abdominal cavity with a smooth side does not cause the formation of connective tissue, which protects the abdominal cavity from the occurrence of adhesions in the postoperative period. Conclusion. The use of combined hernia prosthesis for implantation into the abdominal wall allows avoiding a number of complications which often occur when using prostheses of other types.

The aim of the article: to study the medical and social aspects of diabetes mellitus and diabetic retinopathy at the regional level. Material and Methods. The prevalence, structure and dynamics of diabetes and diabetic retinopathy (DR) were analyzed among the population of the Tambov region for a seven-year period from 2010 to 2016 based on statistical compendiums on the main indicators of health facilities and the health of the population of the Tambov region (2010-2016) Russian statistical yearbooks (2010-2016), data from the regional State register of patients with diabetes. Results. In 2016 in the Tambov region, the prevalence of DR in type 1 diabetes is 53.2%, with type 2 diabetes 31.2%, significantly higher than all-Russian indicators, which were registered at 27.2% in patients with type 1 diabetes and 13.0% of patients with type 2 diabetes. Conclusion. The results of the comparative analysis of the level and structure of diabetes and DR indicate a negative trend among the population of the Tambov region, which dictates the need to develop effective and inexpensive methods for preventing the development and progression of DRs and making management decisions based on them.

The purpose of the study is to assess possibilities of applying the method of transmission polarization mapping for characterization of sclera structure. Material and methods. In the work, samples of rat, rabbit, porcine, and human sclera were examined. Samples of the human sclera were taken (enucleation of the eyeball) from patients with diagnoses: terminal painful glaucoma, subatrophy of the eyeball. From the enucleated eyes, sclera samples were taken from the posterior pole of the eye and from the equator. The sample transparency required for carrying out transmission polarization mapping in thick samples was achieved using immersion optical clearing, 85% and 50% aqueous glycerol solutions and 40% aqueous glucose solution being used as immersion agents. The polarization mapping system used in this work was assembled on the basis of a polarization microscope equipped with a measuring video camera. Re-sults. It is shown that the method of transmission polarization mapping can be used to measure the parameters of the orientational order of scleral collagen fibers, mapping of human sclera samples requiring conduction of the polarization measurements under optical clearing conditions. Since the disorganization of collagen structures of eye connective tissue can be considered as the initial stage of glaucoma process, the technique of transmission polarization mapping can be used as a basis for in vitro studies of the pathogenesis of primary open-angle glaucoma. Conclusion. The potential and limitations of polarization mapping in studying sclera structure in vitro have been established.

Aim: analysis of clinical and functional results, histomorphological changes of corneas in the application of the method of corneal collagen crosslinking with the formation of a femtosecond intrastromal pocket. Material and Methods. We studied 20 patients (20 eyes) that were operated for progressive keratoconus (1-2 stage) with a peripheral zone of maximum ectasia arrangement via corneal collagen cross-linking with femtosecond formation of intrastromal pocket for introduction of a photosensitizerand local ultraviolet radiation. Results. The result was a decrease of surgery duration and reduction of the severity of pain in the early postoperative period. Conclusion. This method allows to increase the safety of the treatment of keratoconus, reducing the risk of postoperative complications.

Objective: to reveal glaucomatous changes and to analyze the intraocular and blood pressure dynamics of a spiritual orchestra musicians during playing their instruments. Material and Methods. Under supervision were 80 musicians aged from 20 to 76 years, with a professional experience from 5 to 50 years. The following examinations were carried out: visometry, kinetic perimetry, ophthalmoscopy of the fundus, Maklakov tonometry, blood pressure measurement (BP) and non-contact transpalpebral tonometry (Po). The dynamics of pressure was evaluated while playing the wind instruments. Results. In the examined group of cases, glaucoma was not identified. During the first minute of playing the IOP (Po) of all musicians was observed to rise to an average of 29.25±0.53 mm Hg with a gradual decrease in five minutes to 24.12±0.51 and full normalization to 15.57±0.53mm Hg after 15 minutes. Arterial BP rose slightly and came back to normal 5 minutes after the end of playing. Conclusion. During the first minutes of playing the wind instruments, the musicians have an increase of BP and IOP due to the activation of the sympathoadrenal system, which leads to the launch of a cascade of adaptive changes, and as a result to full normalization. Such systematic occupational loads may be a contributing factor in the development of glaucoma, which necessitates regular preventive examinations by an ophthalmologist.

Objective: clinical studies of inhalation anesthesia with sevoflurane as the main anesthetic for various diseases in children with vitreoretinal operations. Material and Methods. There was considered the age groups of children from 3 to 16 years old. Among 76 children: 18 with non-prosperrous psycho-emotional statuses, 2 with ICP, 2 with bronchial asthma, 3 with atopic dermatitis, 5 with small anomalies of heart development, 46 were somatically healthy. All of children had different ophthalmosuregery pathology. Results. The performing of general anesthesia by sevoflurane at vitreoretinal surgeries of children with the different diseases and ophthalmological pathologies displayed appropriateness and safety during the surgeries. Conclusion. The appliance of sevoflurane is the reasonable and optimal scheme in modern ophtalmosurgery and anesthesiology.