2023, volume 19

Abstract. Objective: To identify the sociodemographic characteristics, pain level, quality of life, functional state, mobility, and depression level in adults with cerebral palsy (CP). Material and methods. Our study included 78 adults with CP (mean age 24.75±7.66 years, 40.5% males) and 79 control subjects (mean age 26.74±6.72 years, 38.5% males). The quality of life, depression, and mobility of all participants were evaluated. In addition, functional status, functional independence and activity level were evaluated in the adult CP group. The depression level was determined by the Beck Depression Inventory (BDI), the mobility level was identified via Rivermead Mobility Index (RMI), and the quality of life was evaluated by the Short Form-36 (SF-36). The functional level of adults with CP was assessed with Gross Motor Function Classification System. Functional independence and activity level were evaluated using the Functional Independence Measure scale (FIM). Pain level was assessed with Visual Analogue Scale (VAS). Results. The patient and control groups were statistically different in terms of their educational status, marital status, duration of marriage, employment status, and monthly income (p<0.05). SF-36 summary scale scores and subgroup scores, as well as RMI and FIM scores of CP patients, were lower than in the control group. In addition, we revealed a statistically significant positive correlation of FIM scores with SF-36 physical and mental components, along with a statistically significant negative correlation of VAS with FIM, and of FIM with GMFCS: p<0.001, r= 0.450; p=0.013, ^0.279; p=0.022, r= -0.257; p<0.001, r= -0.741, respectively. Conclusion. We established that the quality of life, along with the mobility and functional levels, were lower in young adults with CP than in the control group, while the depression and pain levels were higher vs. control group. Hence, pain, depression, mobility, functional level, and quality of life should be assessed during the follow-up of adult patients with CP

Abstract. Objective: to identify the features of post-vaccination immunity to whooping cough, the state of immuno-logical reactivity in children of the Stavropol Territory. Material and methods. A comprehensive clinical and laboratory examination of 242 children aged 1 to 17 years was carried out. Serological examination of children was carried out at different times after revaccination, as well as an analysis of the parameters of the immune system in children of this age group. Results. A study of the level of immunity tension in children of early and school age showed that a low level of anti-pertussis antibodies was detected in 55% of children already 2-3 years after immunization, meaning that these children were at risk of pertussis, while protective titers of anti-pertussis antibodies were detected only in 34%, and high titers 11% of children. Conclusion. Children vaccinated in anamnesis in Stavropol Territory lose specific antibodies 3 years after the initial vaccination complex.

Abstract. Objective: to clarify the clinical and diagnostic features of arterial hypertension in patients with mild and moderate forms of COVID-19, taking into account the elapsed time. Material and methods. We examined 116 patients aged 44-60 years who were admitted to the hospital with uncontrolled stage 2 arterial hypertension, 96 of them had mild and moderate COVID-19. The patients were divided into two groups: the first group up to 12 weeks after suffering COVID-19 and the second group after 12 weeks. The examination included echocardiography and ambulatory blood pressure (BP) monitoring. Results. In post-COVID-19 patients, the ratio of daytime to nighttime systolic BP was statistically significantly lower than in disease-free patients (p <0,001, p1 =0,015). There was a decrease in the daily BP index in the group 1 and group 2 (11.6±0.8% and 12.2±1.2%, respectively, p=0,001). Among patients after COVID-19, non-dippers were detected, more often in group 1 (9 people (17.6%) versus 2 people (4.4%) (x2=4.18, p=0.042). Conclusion. Arterial hypertension in patients who underwent mild and moderate COVID-19 was characterized by an insufficient decrease in systolic blood pressure at night, the presence of non-dippers with positive dynamics after 12 weeks from the onset of the infectious process.

Abstract. Objective: to evaluate the results of managing patients with subarachnoid hemorrhage in the Krasnoyarsk Region using the Regional Stroke Monitoring (RSM) module for the period 2014-2020. Material and methods. We analyzed 836 electronic applications from regional hospitals of the region in the RSM module for patients with subarachnoid hemorrhage for the period 2014-2020. Results. Over the seven-year period of work in the RSM module (2014-2020) it was possible to increase the number of patients with ruptured cerebral aneurysms transferred from the regions for surgery by 52.2% (from 88 patients in 2014 to 134 in 2020) and reduce the time from the admission of patients with subarachnoid hemorrhage to the regional medical institutions to their transfer to the regional vascular center for 1 day (from 1,5±0,6 days in 2014 to 0,6±0,5 days in 2020). Conclusion. In the geographically long Krasnoyarsk Region, where it is impossible to perform neurosurgical operations in most district hospitals, RSM module helps to track patients with aneurysm ruptures in real time and transfer them to the regional vascular center for surgical treatment in a timely manner, before the re-rupture or development of angiospasm.

Abstract. Objective: to evaluate the sensitivity, specificity and accuracy of a digital algorithm based on convo-lutional neural networks to restore of bones of cranium defects. Material and methods. Neural network training was carried out as a result of 6,000 epochs on 78,000 variants of skull models with artificially generated skull injuries. The evaluation was performed on 222 DICOM series of patients computerized tomography with bones of cranium defects. Results. The indicators of sensitivity, specificity and accuracy were 95.3%, 85.5% and 79.4% respectively. A number of experiments were carried out with step-by-step sorting of three-dimensional models in order to find the reasons for the unsatisfactory skull reconstructing results. Incorrect detection of the skull defect most often occurred in the area of the facial skeleton. After excluding the series with artifacts, the average increase in metrics was 2.6%. Conclusion. Correct determination of the bone defect at the scull model (specificity) by the algorithm had the greatest impact on the surface accuracy. The maximum accuracy of the algorithm, which allows using the obtained surfaces without additional processing in a three-dimensional modeling environment, was achieved on series without the presence of artifacts during computed tomography (83.5%), as well as with defects that do not extend to the skull base (79.5%).

Abstract. This clinical case demonstrates a rare phenomenon in neurosurgical practice — a combination of multiple cerebral aneurysms in the acute period of subarachnoid hemorrhage with craniopharyngioma. A clinical case of an aneurysm of the anterior communicating artery (АСА), intact aneurysms of both middle cerebral arteries (MCA) and craniopharyngioma of cell localization in a 52-year-old patient is presented. A decision was made on one-stage surgical treatment — clipping of a ruptured АСА aneurysm, an intact aneurysm of the right MCA (aneurysm of the left MCA did not require surgical treatment due to its small size) and removal of a craniopharyngioma of cell localization. The postoperative course is smooth, there is no increase in neurological symptoms and the appearance of endocrine disorders, the patient was discharged under the supervision of a neurologist at the place of residence.

Abstract. Objective: to demonstrate the diagnostic features and successful outcome of the combined treatment of a temporoparietal abscess in the left cerebral hemisphere after a patient underwent COVID-19. The choice of a technique for surgical treatment of a brain abscess formed after COVID-19 is very difficult in view of the possible development of secondary hemorrhagic and infectious complications in such patients in the postoperative period. In the presented clinical case, the surgical manual was chosen in the volume of closed external drainage of the abscess cavity using a surgical navigation station and sowing on microflora. In combination with well-chosen antibacterial therapy, this made it possible to reduce the risk of complications, achieve early activation of the patient, and reduce the time of medical and social rehabilitation.

Abstract. Objective: to evaluate the immediate and long-term outcomes of revision knee replacement using porous metaphysical sleeves and cones. Material and methods. The research involved 134 patients who underwent revision arthroplasty of their knee joints. The patients were divided into two groups according to the type of metaphyseal fixator: sleeves (Group 1) — 97 patients, and cones (Group 2) — 37 patients. The evaluation of the surgical outcomes was carried out at discharge from the hospital (in 7-12 days) as well as 6, 12, and 24 months after their surgeries. The survival rate of the implants was analyzed by the Kaplan — Meyer method. A revision with total replacement of the implant or its components was considered to be a critical event. Results. The analysis of the survival rate of the implants using various metaphysical fixators showed that the groups with metaphyseal sleeves and cones do not differ statistically (Log Rank criterion (Mantel — Cox) p=0.108). Conclusion. The medium term follow-up revealed no difference in clinical, functional or radiological outcomes of revision knee arthroplasty using porous cones or metaphyseal sleeves in 2A, 2B, and 3 (by Anderson Orthopaedic Research Institute classification) bone loss replacements.

Abstract. Objective: to evaluate the effect of smoking electronic (SE) cigarettes and tobacco heating systems (THS) on the characteristics of changes in the characteristics of the oral fluid. Material and methods. The results of analysis of oral fluid samples of 150 persons were studied: smoking ES/THS — 50 people each in the group; control group — 50 clinically healthy non-users of ES/THS. Results. Patients in the THS group have a lower salivary secretion rate, a higher oral fluid viscosity at a more neutral salivary pH than control group (p=0.002); whereas patients of the ES group in comparison with the THS group are characterized by a higher saliva secretion rate, a lower viscosity index of the oral fluid at a neutral saliva pH level (p>0.05). Differences were observed in biochemical parameters of total protein concentration (p=0.001), oral fluid calcium concentration (p=0.005), malonic dialdehyde (p=0.007), alkaline phosphatase, and salivary catalase concentration (p=0.004 and p=0.006, respectively) between THS smokers and control group. Conclusion. Smoking THS to a greater extent in comparison with ES and especially with control group reduces the rate of salivation, increases the viscosity of the oral fluid; in this group of smokers, in comparison with ES smokers, a more neutral value of oral fluid acidity was revealed, the concentration of total protein, malonic dialdehyde, phosphates and calcium in saliva was increased with a decrease in alkaline phosphatase and catalase concentrations.

Abstract. The ophthalmic community does not have specific data on the epidemiology of secondary glaucoma against the background of idiopathic expansion of the episcleral veins, risk factors for the development of this disease. There are no generally accepted guidelines for the management and treatment of such patients. Based on our own observation, this paper presents data on the diagnostic tactics and tactics of treating a patient with secondary glaucoma against the background of idiopathic expansion of the episcleral veins.