№1, 2019, volume 15

Objective: to identify the features of morphometric parameters of cerebral arteries in adults aged 55-74 years. Material and Methods. As a material of the study we used samples of anterior (АСА), middle (MCA), posterior cerebral (PCA), posterior connective (PCoA), basilar arteries (BA) and vertebral arteries (VA), seized at autopsy 21 corpses of adults who died in old age. External diameter, wall thickness and length of arteries were studied by morphometry. The lumen diameter was calculated as the difference between the outer diameter and the doubled wall thickness. The material was processed by variational-statistical method. Results. The article presents the average values and parameters of variability of the main morphometric parameters of arteries supplying the brain. The results of the comparative analysis with the average values typical for adults aged 21-90 years are presented. Conclusion. The length, wall thickness, outer diameter and lumen diameter of the cerebral arteries in adults 55-74 years are characterized by significant variability. In the studied age range, АСА and PCA are characterized by the same wall thickness; MCA and VAare the same wall thickness, outer diameter and lumen diameter. The wall thickness of BA and VA in the elderly is 28.1 and 17.9% higher than the average value typical for people 21-90 years.

Objective was to study the characteristics of the indicators of the width of the dental arches of the lower jaw at the dolichomorphic form of the skull. Material and Methods. The morphometric parameters of the width of dental arches of the lower jaw have been studied. The work was performed on 28 preparations of skulls of people of both sexes of mature age with physiological occlusion of teeth and dolichomorphic form of the skull. The width of the dental arch was measured between canines, premolars and molars. Results. The maximum value of the width of the dental arch in both men and women was observed in the region of the second molars from the vestibular side. The minimum value of the investigated parameter was revealed in the region of canines on the palatal side. The indicator of the width of both the vestibular and lingual dental arches increased from the level of the canines to the molar level. Conclusion. A significant increase in the parameters of the width of the vestibular dental arch of the lower jaw in men over similar indicators in women was revealed only at the level of canines and first molars, and the parameters of the lingual dental arch only at the level of the second premolars.

Aim: to study key trends in the health status and number of people of military age. Material and Methods. The research materials were official open statistical data and analytical materials of the public health authorities of the Moscow Region, Primorsky Krai and the Russian Federation, statistical data from the Rosstat (www.gks.ru), EIISS (https://fedstat.ru). To solve the tasks in the study, a statistical analysis of the level, dynamics and structure of primary and general morbidity of young men of military age (15—17 years old), as well as dynamic characteristics of the number of people of military age (18- 26 years old) was carried out. Results. The study revealed a negative trend in the number of people of military age (-1,723 thousand people, or-18.5% from 1995 to 2017). The reduction in the number of troops by 2028 will be -43.5% compared with 2010 The overall morbidity among young people aged 15- 17 years from 2006 to 2015 in the Russian Federation increased by 15.2% and amounted to 2247.2. In the structure of general morbidity among young people aged 15-17 years, respiratory diseases dominate in the Russian Federation 33.3%, in the second rank eye disease and accessory apparatus 9.3%, in the third digestive organs (8.8%), on the fourth and fifth musculoskeletal system and connective tissue (7.9%) and injuries, poisoning and other consequences of external factors (7.7%). In the structure of the primary incidence of this category of young people, as in the case of general morbidity, respiratory diseases dominate 47.8%, injuries, poisoning and other consequences of external causes (12.4%) prevail in the second ranking place; on the third diseases of the digestive system (5.7%); in the fourth, diseases of the urogenital system (4.6%); on the fourth and fifth, there are diseases of the eye and its adnexa (4.6%) and diseases of the musculoskeletal system and connective tissue (4.3%), respectively. The incidence of citizens of military age has pronounced regional features. An analysis of the overall incidence in these regions shows that there is a heterogeneous picture in different regions. Thus, the average level of general morbidity in Primorsky Krai among citizens ofmilitary age in 2006-2015 with certain infectious and parasitic diseases exceeds this indicator in the Moscow Region by 49.7%, and in the Russian Federation by 18.1%; neoplasms by 37.8 and 12.9%, respectively, mental disorders and behavioral disorders by 19.1 and 8.6%; diseases of the genitourinary system by 54.7 and 14.5%; other diseases 5.9 and 5.2%. Conclusions. Negative tendencies of primary (+16.0%) and general morbidity (+15.2%) were detected for almost all classes of diseases, significant regional features of the status of recruits, a negative trend in the number of men of military age (by 2028 the decline will be -43.5% compared with 2010). The level of primary incidence of this contingent is currently 1373.8%o and the growth of this indicator over 10 years was 16.0%. When analyzing the incidence of the studied contingent, classes of diseases require the most attention: eye and its adnexa diseases, respiratory diseases, digestive diseases, diseases of ear and mastoid process and nervous system, as well as the genitourinary system diseases.

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.