[Analysis of dental care provided to the adult population with infectious diseases in in-patient departments]. / Analiz vidov i ob"emov stomatologicheskoi pomoshchi, okazyvaemoi vzroslomu naseleniyu s infektsionnymi boleznyami v usloviyakh statsionara.

The purpose of the study was to analyze the types and volumes of treatment and prophylactic services provided to the adult population with infectious diseases in the dental office of a multidisciplinary hospital. MATERIALS AND METHODS: The types and volumes of dental care provided to the adult population with infectious diseases in a multidisciplinary hospital have been analyzed. RESULTS: The study showed that dentists use 49 types of services when treating adults with infectious diseases, which corresponds to 29.88% of the compulsory medical insurance classifier in Moscow. Provided services can be conditionally divided into 4 groups: consultation, diagnostic, preventive and medicinal manipulations. The share of consulting services corresponds to 18.16±0.41% of the total volume of services provided; on average patients made 320.8 visits to the dentist's doctors per year, which corresponds to 2.38 visits for each patient. The proportion of medicinal manipulations, diagnostic and preventive services corresponds to 68.64±0.49%, 7.02±0.27% and 6.17±0.26%, respectively. Services related to the diagnosis and treatment of diseases of the oral mucosa and salivary glands dominate with 69.3%, on average 5.51 services are provided per visit. CONCLUSION: The compulsory medical insurance program for the city of Moscow should provide services for the diagnosis, treatment and prevention of dental diseases, provided by doctors specializing in «dentistry¼, for patients with infectious diseases who are undergoing treatment in inpatient conditions.

[THE OPINION OF POPULATION CONCERNING ISSUE OF DRUG USE AS A SOCIAL HYGIENIC FACTOR].

The article indicates that in modern society the trends of reevaluation and redefinition of moral and social limits, regulating legitimate and non-legitimate pleasure. The popularity of programs of decreasing of narcotization harm is increasing to the prejudice of comprehensive conception of necessity of social prevention of drug abuse as a system of influence of public authorities and institutions of civil society with purpose to minimize drug effect. The modeling of such exposition pressure directing individual to "drug-independent" behavior by all totality of mechanisms society dispose is one of major tasks of drug abuse control. The article is targeted to reveal qualitative quantitative characteristics of public opinion in Russia and parameters of monitoring of public opinion on the basis of content analysis of secondary sources and qualitative analysis of sociological surveys. It is concluded that efforts information of public opinion are to be related to targets and tasks available in sphere of drug control and belonging to the structure of targets and tasks of public health and social hygiene. The core content of public opinion should not have a character of exclusively suggestion of drugs but is to reflect behavioral readiness of citizen to implement social control of narcotism.

[Succession caused by beaver (Castor fiber L.) life activity: II. A refined Markov model].

The refined Markov model of cyclic zoogenic successions caused by beaver (Castor fiber L.) life activity represents a discrete chain of the following six states: flooded forest, swamped forest, pond, grassy swamp, shrubby swamp, and wet forest, which correspond to certain stages of succession. Those stages are defined, and a conceptual scheme of probable transitions between them for one time step is constructed from the knowledge of beaver behaviour in small river floodplains of "Bryanskii Les" Reserve. We calibrated the corresponding matrix of transition probabilities according to the optimization principle: minimizing differences between the model outcome and reality; the model generates a distribution of relative areas corresponding to the stages of succession, that has to be compared to those gained from case studies in the Reserve during 2002-2006. The time step is chosen to equal 2 years, and the first-step data in the sum of differences are given various weights, w (between 0 and 1). The value of w = 0.2 is selected due to its optimality and for some additional reasons. By the formulae of finite homogeneous Markov chain theory, we obtained the main results of the calibrated model, namely, a steady-state distribution of stage areas, indexes of cyclicity, and the mean durations (M(j)) of succession stages. The results of calibration give an objective quantitative nature to the expert knowledge of the course of succession and get a proper interpretation. The 2010 data, which are not involved in the calibration procedure, enabled assessing the quality of prediction by the homogeneous model in short-term (from the 2006 situation): the error of model area distribution relative to the distribution observed in 2010 falls into the range of 9-17%, the best prognosis being given by the least optimal matrices (rejected values of w). This indicates a formally heterogeneous nature of succession processes in time. Thus, the refined version of the homogeneous Markov chain has not eliminated all the contradictions between the model results and expert knowledge, which suggests a further model development towards a "logically inhomogeneous" version or/and refusal to postulate the Markov property in the conceptual scheme of succession.

[Succession caused by beaver (Castor fiber L.) life activity: I. What is learnt from the calibration of a simple Markov model].

A homogeneous Markov chain of three aggregated states "pond--swamp--wood" is proposed as a model of cyclic zoogenic successions caused by beaver (Castor fiber L.) life activity in a forest biogeocoenosis. To calibrate the chain transition matrix, the data have appeared sufficient that were gained from field studies undertaken in "Bryanskii Les" Reserve in the years of 2002-2008. Major outcomes of the calibrated model ensue from the formulae of finite homogeneous Markov chain theory: the stationary probability distribution of states, thematrix (T) of mean first passage times, and the mean durations (M(j)) of succession stages. The former illustrates the distribution of relative areas under succession stages if the current trends and transition rates of succession are conserved in the long-term--it has appeared close to the observed distribution. Matrix T provides for quantitative characteristics of the cyclic process, specifying the ranges the experts proposed for the duration of stages in the conceptual scheme of succession. The calculated values of M(j) detect potential discrepancies between empirical data, the expert knowledge that summarizes the data, and the postulates accepted in the mathematical model. The calculated M2 value falls outside the expert range, which gives a reason to doubt the validity of expert estimation proposed, the aggregation mode chosen for chain states, or/and the accuracy-of data available, i.e., to draw certain "lessons" from partially successful calibration. Refusal to postulate the time homogeneity or the Markov property of the chain is also discussed among possible ways to improve the model.

[Specific features with of intramedullary osteosynthesis with blocking in fractures of the shin bones at different levels].

The results of closed intramedullary osteosynthesis with blocking were analyzed in 180 patients with open (in 22) and closed (in 158 patients) fractures of shin bones fulfilled within the period from 3 days to 3.5 months after trauma. In 16 patients the intramedullary canal was drilled out. The exact reposition of the shin-bone in closed intramedullary osteosynthesis was obtained in 142 patients: the terms of consolidation in this case were (6.4+/-1.3) months. The examination of all the patients in the period from 6 months to 2 years after operation has shown consolidation of the shin-bone fracture in 176 (97.7%) of them.

On monitoring anthropogenic airborne uranium concentrations and (235)U/(238)U isotopic ratio by Lichen - bio-indicator technique.

Lichens are widely used to assess the atmospheric pollution by heavy metals and radionuclides. However, few studies are available in publications on using lichens to qualitatively assess the atmospheric pollution levels. The paper presents research results applying epiphytic lichens as bio-monitors of quantitative atmospheric contamination with uranium. The observations were conducted during 2.5 years in the natural environment. Two experimental sites were used: one in the vicinity of a uranium contamination source, the other one - at a sufficient distance away to represent the background conditions. Air and lichens were sampled at both sites monthly. Epiphytic lichens Hypogimnia physodes were used as bio-indicators. Lichen samples were taken from various trees at about 1.5m from the ground. Air was sampled with filters at sampling stations. The uranium content in lichen and air samples as well as isotopic mass ratios (235)U/(238)U were measured by mass-spectrometer technique after uranium pre-extraction. Measured content of uranium were 1.45 mgkg(-1) in lichen at 2.09 E-04 microgm(-3) in air and 0.106 mgkg(-1) in lichen at 1.13 E-05 microgm(-3) in air. The relationship of the uranium content in atmosphere and that in lichens was determined, C(AIR)=exp(1.1 x C(LICHEN)-12). The possibility of separate identification of natural and man-made uranium in lichens was demonstrated in principle.

[Results of the treatment of pseudarthrosis of the tibia by subsurface and extrafocal osteosynthesis]. / Rezul'taty lecheniia psevdoartrozov bol'shebertsovoi kosti pri pogruzhnom i vneochagovom osteosinteze.

The results of treatment of 417 patients with pseudoarthroses of the tibia (aged from 17 to 71 years) with the use of various methods: by internal fixation with auto- and allografts, metal plates as well as in the use of extranidal (extralocal) osteosynthesis were analysed. The number of consolidation failures was minimal after autoplasty by Khakhutov and bone autoplasty. The rate of healing after osteosynthesis was substantially lower in internal fixation, than in extranidal (extralocal) osteosynthesis. Inflammatory complications occur less frequently when osteoplasty by Khakhutov was used. The highest rate of complications was observed in tibialization and in bilocal osteosynthesis.

[The causes for the worsening of treatment results in patients with infected pseudarthroses of the tibia in recent years]. / Prichiny ukhudsheniia rezul'tatov lecheniia bol'nykh s infitsirovannymi psevdoartrozami bol'shebertsovoi kosti v poslednie gody.

Under analysis were results of treatment of 141 patients with infected pseudoarthroses of the tibia. Among them there were 10 women and 131 men aged from 18 to 62 years. The long-term results were followed-up during the period from 2 to 20 years. The analysis allowed a supposition that a combination of tibia segment resection and plasty with local tissues completed by suturing the wound, drainage and external fixation with the Ilizarov device leads to deterioration of the outcomes. A careful approach to treatment of such patients including the division of treatment into the stages of debridement and reconstruction seems to be more productive.

Topical steroid therapy in oral lichen planus: review of a novel delivery method in 24 patients.

Lichen planus is a chronic mucocutaneous disorder of unknown etiology. The natural progression of oral lichen planus (OLP) is long and can extend over a number of years. Although many patients with OLP remain asymptomatic, some experience periods of marked inflammation with breakdown of the lesions, and require treatment. Corticosteroids are the mainstay of treatment for oral lesions, but delivery to affected mucosal sites can be problematic. The purpose of this study was to retrospectively review the results of topical steroid therapy in a group of patients with OLP, using a novel delivery method. The records of 33 patients with biopsy-proven OLP were reviewed and the relevant clinical features were noted at minimum review intervals of one, six and 12 months. Of this group, 24 patients had been treated using a standardized treatment protocol consisting of a corticosteroid ointment applied topically to mucosal lesions using cloth strips. Gingival lesions were treated using a steroid preparation in an adhesive paste. Nine patients remained asymptomatic and were not treated. In the treated group, 14/24 (58 per cent) of patients showed an improvement in symptoms by one month. The remainder showed no change or a worsening of their symptoms. Repetition of the treatment protocol resulted in improvement in all the non-responders, and by one year 23 of 24 (96 per cent) of the patients had experienced improvement or control of their symptoms. Long-term failure to control the symptoms in the single non-responding case was related to poor patient compliance. Results from this study show that a novel delivery method and treatment protocol for the application of topical steroids onto lesional mucosa is useful for the symptomatic control of oral lichen planus.

Tactics and general principles in the treatment of polytraumatized disaster victims.

The authors reviewed their experiences of treating masses of victims after disasters in Arzamas, Armenia, and Ethiopia. To handle these vast numbers of victims, local hospitals were reorganized into specialized clinics with appropriate equipment and medical personnel. Some of the patients were evacuated to multispecialized clinics or rear hospitals. A complex of diagnostic and treatment modalities were used on these patients, including intrabone injections, immunoprophylaxis for purulent complications, skin and bone grafting and external fixation systems designed in Russia. The overwhelming majority of the patients was discharged with good results. To prevent common tactical, treatment, and surgical mistakes, it is necessary to improve medical education to train multispecialized teams in disaster medicine prepared to work under extreme conditions.

[Means of positioning fragments by smoothly controlled stresses]. / Sposob repozitsii otlomkov plavno upravliaemymi nagruzkami

In fractures or luxations muscles being in the state of retraction or contracture and with lost capacity to spontaneous relaxation and lengthening may relaxe and lengthen as a result of application of relatively small smoothly controlled stresses incessantly lessening along with muscle lengthening. The long-term experience with the use of the elaborated method in the clinic of general surgery and hospitals of the Gorky City proved convincingly great opportunities of nonoperative treatment of fractures and reduction of dislocations.