№1, 2020, volume 16

The presented clinical case demonstrates the advantages of one-stage replacement of the metacarpal defect (in osteoblastoclastoma) with the involvement of the distal articular head with the help of bone-articular avascular auto-transplant of the third metatarsal bone. The use of bone-articular avascular graft of the third metatarsal bone allowed almost perfectly compensate for the defect of the metacarpal bone. Optimal functional and aesthetic results with complete restoration of the lost anatomy were obtained. The duration of the operation was 1 hour 45 minutes. There were no complications in the immediate postoperative period.

Purpose: to evaluate the efficacy and safety of hydroxyapatite coated spokes for osteosynthesis in patients with femoral neck fractures in a multiple trauma. Material and Methods. We studied 26 patients of both sexes with severe injuries (on the ISS scale, the severity of the injury corresponded to 22-27 points). All revealed a fracture of the femoral neck, which was combined: with bruises of the brain (N=6) or kidney (N=12), fractures of the pelvis (N=18), ribs (N=8) or shin bones (N=4), rupture of the lung (N=4). All underwent treatment aimed at stabilizing the function of internal organs and systems, osteosynthesis of the femoral neck with a bundle of spokes with their fixation in the llizarov apparatus. Patients were randomized into 2 groups: main (N=11) — for osteosynthesis spokes with hydroxyapatite coating were used; control (N=15) — spokes without coating were used. To assess the effectiveness and safety of the use of spokes with hydroxyapatite coating, clinical and laboratory methods were used. Results. In the main group, positive results of treatment were observed in 10 patients (90.9%; Cl: 67.9-99.9%), in the control group-11 (73.3%; Cl: 48.9-91.8%). The patients of the main group have an average fracture consolidation time of 1.2 times less. After surgery, the activity of alkaline phosphatase is higher (P=0.04). The frequency of deviation of laboratory blood parameters from the norm in these patients is comparable with the frequency noted in the control group. Conclusion. The use of spokes with hydroxyapatite coating in the treatment of patients with femoral neck fractures in conditions of multiple trauma reduces the duration of fixation of bone fragments and increases the number of positive results of treatment by reducing the number of complications.

The review presents the prospects of deeper research of post-traumatic osteoarthrosis etiology and pathogenesis. The contemporary diagnostic and treatment strategies are analyzed. Web-resources eLibrary and PubMed as well as scientific literature from the library of Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery were used as a source of data.

Aim: to estimate the cardiovascular risk in patients with chronic periodontitis (CP) different severity. Material and Methods. 2400 persons (65.6% male, aged from 40 to 64 years) were examined. Body mass index, lipid spectrum, blood glucose and C-reactive protein levels were determined, and tonometry was performed. The 10-year risk of a cardiovascular event was calculated using SCORE (Systematic Coronary Risk Evaluation) and Reynolds Risk Score. The concentration of interleukin-6 (IL-6) in the oral fluid was studied. Results. Patients with moderate to severe CP are characterized a high incidence of the main cardiovascular risk factors (arterial hypertension, smoking, dyslipidemia, obesity) compared to those with person with intact periodontal tissue and patients with mild CP For patients with CP with a moderate risk of fatal cardiovascular events on the SCORE, it is advisable to calculate the cardiovascular risk on the Reynolds Risk Score too. The oral fluid's level of IL-6 in the patients with CP may be considered as an additional marker of high risk of fatal cardiovascular events. Conclusion. The relation between the results of severe CP as missing teeth, loss of periodontal bone and the risk of fatal cardiovascular events is important for clinical use and may be used as an additional cardiovascular risk marker for patients with chronic periodontitis.

Objective: to determine the features of peri-implant tissues healing in conditions of tobacco intoxication and the possibility of their correction by using electromagnetic terahertz radiation at the frequency (EMR THF) of 129.0 GHz. Material and Methods. 36 rabbits were divided into control group and three experimental ones. In the experimental groups, tobacco intoxication was simulated for 6 weeks, then implantation was performed and tobacco intoxication was maintained until the end of the experiment. In the 1st experimental group, physiotherapy was not performed; in the 2nd and 3rd groups, various schemes of THF therapy were used. The results were evaluated using histological methods. Results. In the control group, the most active regeneration processes were noted. Among the experimental groups, the best indicators were achieved in the groups where THF radiation was used. The thickness of the connective tissue layer after 1 month was significantly lower in the 2nd and 3rd groups, amounting to 48.0±3.9 and 42.7±3.4 urn, respectively, than in the 1st group: 76.4±3.5 urn (p<0.05), this dynamics continued after 3 months. Osteogenesis in the 2nd and 3rd groups took place with less cartilage formation than in the 1st group (p<0.05). Conclusion. Analysis of histomorphom-etry data shows the effectiveness of THF therapy for the correction of the regeneration process violations after dental implantation in conditions of tobacco intoxication.

Purpose: clinical and anamnestic characteristics of rosacea and perioral dermatitis in women of reproductive age. Material and Methods. 81 women (50 with rosacea and 31 with perioral dermatitis) from the age of 18 to 49 were examined. Clinical and anamnestic data were studied. Results. The incidence of rosacea in women increases by the end of the fertile period, while the peak of the incidence of perioral dermatitis is noted at the beginning of the fourth decade of life. Patients with rosacea, more often than with perioral dermatitis, have a family history with a predominance of maternal inheritance (p<0.001). They also have a significantly higher level of the accompanying pathology (p<0.05). In the formation of perioral dermatitis, the use of topical corticosteroids (38.7%) and the abuse of cosmetics (32.3%) play an undoubted role. In women of childbearing age, the prevalence of erythematous-telangiectatic subtype of rosacea (64.0%) is revealed, with a relatively low frequency (2.0%) of eye damage. In patients with perioral dermatitis revealed a more pronounced decrease in quality of life with no dependence on the severity of the skin process (p=0.046). Conclusion. The revealed clinical features of rosacea and perioral dermatitis indicate the nosological independence of these disorders with the dominating role in forming of rosacea — constitutional, and in perioral dermatitis — exogenous factors.

A clinical case of a rare retinocytoma tumor in a patient with swelling cataract and phacomorphic glaucoma is presented. A comprehensive examination of the patient using various diagnostic methods allowed to make the correct diagnosis and conduct timely surgical treatment with predictable results.

Purpose: to assess the psychosomatic status and quality of life (QOL) of patients undergoing treatment and examination in a cardiac surgery hospital. Material and Methods. The study included 425 patients divided into 243 (57%) men and 182 (43%) women; median age was 61 (54; 66) years. In addition to the standard clinical examination, the quality of life and psychological status of patients were assessed. Patients completed standardized questionnaires of QOL: the Short Form Medical Outcomes Study (SF36), the Minnesota Living with Heart Failure Questionnaire (MLHFQ), Hospital Anxiety and Depression Scale (HADS). Results. Indicators of the psychological component of the questionnaire were statistically significantly lower in women compared with male patients: vital activity (VT) 45 (30; 60) vs 50 (35; 65) p<0.001, social functioning (SF) 63 (38; 75) vs 64 (50; 88) p<0.001, and the level of anxiety and depression were significantly higher in women 9 (6; 12) vs 6 (3; 9) and 7 (4; 10) vs 5 (3; 8) (p<0.001).The values of the physical component of health were also lower in women: physical functioning (PF) 45 (25; 65) vs 55 (35; 80) p<0.001; bodily pain (BP) 41 (41; 74) vs 51 (41; 74) p<0.001. Low QOL scores and high levels of anxiety and depression were not due to the severity of the disease, men had more severe nosological status. Conclusion. Most of the patients entering the cardiac surgery hospital have clinically expressed anxiety and depression, which have negatively effect on the quality of their life. This is more typical for female patients.

The review is devoted to the assessment of the effectiveness of measures to improve the outcome of preterm birth. An analysis of randomized multicenter studies from 2014 to 2019 of the database of the National Library of Medicine PubMed was carried out. Information is presented on the effectiveness of the prevention of respiratory distress syndrome, tocolytic therapy, neuroprotection of the fetus, systemic antibacterial therapy.

The aim of the review is to analyze the complications of cesarean section (CS), the associated maternal and perinatal mortality, taking into account the economic development of the country, indications for CS, urgency, methods of surgery and anesthesia, and preventive measures. For a systematic review, a search was conducted on electronic research databases reporting maternal or perinatal morbidity and mortality associated with CS. The analysis included 167 studies, including 5,100,161 operations of CS and 8216 cases of maternal mortality meeting the inclusion criteria. The prevalence of complications associated with CS was calculated, the odds ratio (OR) and the relative risk (RR) with confidence interval (Cl) 95% were calculated. The risk of death for women in low- and middle-income countries who had CS was 7.6 per 1000 [95% Cl: 6.6-8.6]; in highly developed countries 0.6 per 1000 [95% Cl: 0.08-0.9]. In low-income countries, perinatal mortality was 84.7 per 1000 CS [95% Cl: 70.5-100.2]. Perinatal mortality in high-income countries is 12.7 per 1000 cops [95% Cl: 6.85-18.3]. The most common perioperative complications in CS were: bleeding (OR=0.52 [95% Cl: 0.48-0.57]), infection (OR=13.4 [95% Cl: 9.7-22.3]) and venous thromboembolism (OR=1.4 [95% Cl: 1.2-3.5]). Low-income countries have high maternal mortality and require optimized conditions for CS. A significant increase in the incidence of CS in high-income countries did not lead to a corresponding decrease in neonatal morbidity and mortality, but it increased the risk to the health and life of women.