2020, volume 16

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.

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.