№1, 2020, volume 16

Aim is to analyze the dimensional characteristics of the width of the periodontal fissure in the teeth of the upper and lower jaws with increased tooth abrasion in adults. Material and Methods. 204 people of both sexes aged 22 to 60 years were served as the object of the study. Using cone beam computed tomography, the width of the periodontal fissure was studied at the level of transition of the upper third to the middle third of the root, at the level of transition of the middle third of the root to the lower third, and at the level of the apex of the tooth root. In the upper molars, the measurements were performed at the palatine root, in the molars of the lower jaw — at the distal root. Results. The dimensional characteristics of the width of the periodontal fissure on both jaws statistically significantly increase from the first period of adulthood to the second in persons of both sexes: in men at the level of the upper third of the root by 12.5-96.3%, the middle third —11.8-78.6%, tops of the tooth root —22.2-106.7; in women —by 2.4-65.8, 3.0-22.0and 19.1-93.6%, respectively. Conclusion. The results of the study indicate that the width of the periodontal fissure is not the same in different parts of the root, varies depending on the functional load and does not depend on the group affiliation of the tooth. The width of the periodontal fissure at the level of transition of the upper third of the root to the middle third, the middle third of the root to the lower third and in the region of the apex of the root in the teeth on the lower and upper jaw, statistically significantly increases from the first period of adulthood to the second in both men and women.

Purpose of this research was to identify features of somatometric, index and bioimpedance indicators in the assessment of the physical status of patients with gastric cancer in the Krasnoyarsk region. Material and Methods. In this report constitutes the results of the exploration of 200 patients diagnosed with stomach cancer, 108 women and 92 men. The average age is 61.6 ± 10.9 years. Patients with an established diagnosis of gastric cancer, were examined by anthropometric and bioimpedance methods of research. During the research of the physical status of patients with gastric cancer of different age groups at of both sexes was carried out, the index of body weight (IBW) or J. M. Tanner index (1951). By this index is calculated type of gender dimorphism. Results. Features of the physical development of patients with gastric cancer are received. There are the increased body weight and obesity, gynecomorphic type of men, women have a mesomorfic and gynecomorfic types of a constitution. According to the results of bioimpedance analysis the indexes of component composition of the body, decreased in men and women representatives gynecomorfic body type. Conclusion. The features of somatometric, index and bioimpedance indicators characterizing of the physical development of patients with gastric cancer were revealed.

The aim of the study is to assess the degree of adherence of patients with rheumatic diseases to the treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Material and Methods. 196 patients were surveyed using a specially designed questionnaire, which included Morisky — Green test. Statistical data processing was carried out by methods nonparametric statistics (criterion x2)- Results. Patients took NSAIDs in rheumatoid arthritis (50.0%), ankylosing spon-dylitis (37.8%), vertebrogenic dorsalgia (20.4%). 49.0% of patients took NSAIDs constantly, 39.3% — during courses of treatment, 11.7% — on demand (in pain). 81.1 % of patients were engaged in self-treatment of NSAIDs. 20 patients (10.2%) were adherent to the treatment of NSAIDs, 29 patients (14.8%) were insufficiently adherent (patients were united in one group), 147 patients (75.0%) were not adherent to the treatment. Non-adherent patients mostly violated the regimen of treatment if they felt well (85.7%). For adherent patients the most significant motive was deterioration after taking NSAID (20.4%). Adherent patients mostly had higher education in relation to non-adherent (71.4 and 53.7% respectively) (x2=6.647; p<0.05). Side effects of NSAIDs were absent in 73.5% of adherent patients and in 32,0% of non-adherent (x2=24.795; p<0.01). Conclusion. The level of education, the frequency of side effects and subjective assessment of the patient's state of health affect the degree of adherence of patients with rheumatic diseases to the treatment of NSAIDs.

Aim: to analyze the trust risks structure in medicine and healthcare and to study of the possibilities of online communication in healthcare for managing these risks. Material and Methods. The methodological basis of risk analysis of trust in the institute of medicine was the theory of social trust (Luhmann N., 1988). The study used methods of a systematic approach, structural and functional analysis and typologization. An empirical analysis of the problem of trust in the dyad «patient-medical specialist» carried out in 2018-2019 at the Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n. a. V. I. Razumovsky using the developed and introduced into practice System of interactive monitoring and feedback (SIMF), which allows to improve the quality of management of patient' preparation for the upcoming high-tech operation and the subsequent process of medical rehabilitation of patients (N=381). Result. It has been developed a theoretic model for the treatment of trust risks in healthcare in relation to medical rehabilitation, which is the basis for development practical tools for the prevention of medical, social and socio-psychological risks based on SIMR Conclusion. The use of online communication services increases the effectiveness of medical and rehabilitation measures based on a personalized approach; expands the ability to manage the interaction of patients and medical professionals through the prevention of trust risks in the institute of medicine.

Aim: assessment of level and structure of incidence of female infertility in the territorial subject of the Russian Federation. Material and Methods. The study of the level and structure of incidence of infertility according to negotiability to the period from 2008 to 2017 among women of fertile age (15-44 years) of the Tambov region was carried out. The study of age of women and duration of infertility was carried out to the moment of the request for medical care for 2017 (n=812). Results. For the research period (2008-2017) there is a growth of incidence of female infertility six times to an indicator 3.5 cases on 1000 women of fertile age. Infertility of secondary genesis prevails over primary (53.1 and 46.9% respectively). In 2008, infertility of the endocrine genesis occupied the 3rd rank in the structure of causes (19.5%), in the second place — absolute tube infertility (31.1%), in the first place — infertility due to endometriosis, uterine fibroids, inflammatory processes (49.4%). In 2017, infertility of the endocrine genesis moved to the 1st place with an indicator of 43.3%, infertility of the absolute tube genesis remained in the 2nd place, but the indicator increased to 40.4%. Infertility due to endometriosis, uterine fibroids, inflammatory processes from the 1st rank place moved to 3rd with an indicator of 16.1%. Average age of the women who addressed in 2017 was 29.9±0.17 years. The average duration of infertility was 5.2±0.1 years. Conclusion. Results of the research demonstrate annual increase in number of women with infertility that shows the necessity of improvement of the organization of delivery of health care of this category of persons.

The substantiation of the need to improve the legal model of ensuring the safety of interaction between the patient and medical personnel in the provision of medical services is given. The study conducted a comparative legal analysis of the sources of legal regulation of individual components of the quality of medical services. The material for the assessment were articles of the Federal law "On the basis of health protection of citizens in the Russian Federation", as well as orders approved by the Ministry of Health of the Russian Federation. Proposals have been developed to improve the current legislation aimed at ensuring legal protection of medical personnel. On the basis of the conducted research it is established that there is no legal definition of quality of medical services. Existing laws protect the rights of patients, but the professional activities of medical personnel do not have a system of insurance of risks that create increased danger in the provision of medical care to the population.

The aim is to determine the possibility of organizing monitoring of the air basin according to interregional comparative assessment of the nature of the incidence of environmentally related pathologies. Material and Methods. A comparative analysis of the incidence in the Volga regions by pathologies, the occurrence and development of which correlates with indicators of air pollution. An assessment of the results of socio-hygienic monitoring of the quality of the air basin. Results. Differences in the intensity and nature of dynamic changes in the incidence of environmentally caused pathologies in the regions and their inconsistency with the air quality parameters defined in the framework of socio-hygienic monitoring are established. In the Volgograd region, there is a pronounced tendency to reduce the incidence of children with allergic rhinitis (r=-0.78; R2=61.6%), congenital anomalies (malformations) (r=-0.84; R2=71.3%) and dynamics stabilized incidence of pathologies of the endocrine system, in the Saratov region, the indicators of all these pathologies are stable in dynamics, and in the Astrakhan region their marked, significant growth is noted (allergic rhinitis r=+0.77; R2=58.7%, congenital anomalies r=+0.9; R2=81.8%, endocrine system diseases r=+0.93; R2=86.6%). Differences in the organization of air quality monitoring were revealed. In 2018, the concentration of 25 pollutants was monitored in the Volgograd Region (18,290 studies were conducted), in the Saratov Region — 20 pollutants (4,512 studies), in the Astrakhan Region —11 chemical compounds (1,704 studies). Conclusion. An interregional comparative assessment of the nature of the incidence of environmentally caused pathologies can be used to determine the potential air pollution by the corresponding chemical compounds and can serve as a basis for establishing priority pollutants to be controlled in a particular region.

The aim: to assess the effectiveness of the installation of a suburethral loop with fixation in the obturator membrane in various ways in case of stress urinary incontinence in women. Material and Methods. 191 women aged from 35 to 65 years old were selected with stress urinary incontinence, which were installed with a suburethral loop with fixation in the obturator membrane in various ways: using an in-out trocar method (group A, n=65); trocar out-in method (group B, n=67); without trocar method in-out (group C, n=59). Randomization of patients into groups was carried out by random numbers. As the primary outcome of the installation of a suburethral loop with fixation in the obturator membrane, the frequency and severity of stress urinary incontinence recurrence was studied using a cough test and a Valsalva test after 12, 36 and 60 months. The timing of surgery, the structure and frequency of the immediate postoperative complications were evaluated as secondary outcomes. Results. The time of the operation in group Awas 31 (30; 33) minutes, in group В 53 (52; 54) minutes, in group С 29 (28; 30) minutes, respectively, F12=1908; p=0,001. Stress incontinence recurrence within 12 months after surgery developed in 3.1 % in group A, 0% in group В and 5.1 % in group С (p =0,14; pAC=0,57; p =0,061); within 36 months after surgery in 7.6; 0; 10.1%, respectively (p =0,02; pAC=0,628; pBC=0,007); for 60 months after the operation in 24.6; 11.9; 28.8%, respectively (pAB=0,017; p =0,421; pBC=0,018). Conclusion. Despite the longer time to perform surgery and greater technical complexity, the installation of a suburethral loop with fixation in the obturator membrane by the out-in trocar method is accompanied by a lower incidence of early postoperative complications and recurrence of the disease.

Objective: to study the terms and clinical features of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) development using UPOINT classification in men from 32 to 60 age depending on body weight. Material and Methods. A total of 121 men with CP/CPPS with various body weight aged by 32-60 years were observed. Body Mass Index (BMI) was used to prove absence or presence of overweight and obesity. The diagnosis of CP/CPPS in patients was based on the information of anamnesis, analysis of health cards and case histories. Differential diagnosis of CP/CPPS forms was organized by the cytological and bacteriological studies of prostatic secretion. Results. Only 26.4% of patients with CP/CPPS showed normal body weight. It was observed that in men with excess body weight and obesity the CP/CPPS developed at more earlier periods of their life. The differences of phenotype and clinical manifestations in patients with obesity and normal body index were determined according to the UPOINT classification. Conclusion. The risk of chronic pelvic pain syndrome development in men with obesity (BMI>30) under the 45 years increases in 2.3 times compared to men with normal body weight. The results of men phenotyping with chronic pelvic pain syndrome and obesity snowed the prevalence for P, О and N domains from UPOINT classification thus represent the predominance of disuric symptoms with expressed psychogenic features on the background of pain feelings outside the pelvis.

The review of the literature data on the peculiarities of the pathogenesis of radicular and myelopathic syndromes of cervical osteochondrosis is presented. The issues of differentiated diagnosis of radiculopathic and myelopathic syndromes are considered. The characteristic of various methods of treatment is given. The efficiency and possibility of using electrostimulation of the spinal cord for the treatment of radicular and myelopathic syndromes of cervical osteochondrosis have been studied.