[Modern view of people falling syndrome elderly and senial age (literature review).]

The review article analyzes scientific publications devoted to the actual problem of modern society - the syndrome of falls in elderly and senile people. The multifactorial nature of falls is demonstrated, which must be taken into account when carrying out diagnostic and therapeutic measures. The information obtained made it possible to identify the most significant conditions and diseases leading to an increase in the frequency of falls. The paper systematizes information about the causes of falls and the prevention of falls, diagnosis and complex treatment of elderly and senile patients. Attention is drawn to the victims of elderly and senile age with traumatic injuries.

[Fast track recovery protocols for extended pelvic surgery]. / Protokoly uskorennogo vyzdorovleniya pri rasshirenno-kombinirovannykh operatsiyakh na organakh malogo taza.

OBJECTIVE: To compare the immediate results of extended pelvic surgery before and after introduction of standardized fast track surgery (FTS) protocol into routine clinical practice. MATERIAL AND METHODS: The study included 111 patients with pelvic tumors who underwent extended pelvic surgery. The control group included 59 patients whose perioperative management implied traditional approaches (2018-2019), the main group - 52 patients with FTS protocol (2020-2021). Age, BMI and ECOG status were similar. In the main group, females (90.4% vs. 74.6%; p=0.046), patients with recurrent (46.2% vs. 22.0%; p=0.009) and complicated tumors (26.9% vs. 11.9%; p=0.054) prevailed. Obstructive resection without anastomosis was less common in the main group (28.8% vs. 47.5%; p=0.068). RESULTS: Surgery time was higher (319±125 min vs. 236±79 min, p<0.001) in the main group, but blood loss (238±154 ml vs. 282±150 ml, p=0.029) and incidence of blood transfusions (23.1% vs. 42.4%, p=0.043) were lower. Moreover, complications (36.6% vs. 54.3%; p=0.086), mild complications (Clavien-Dindo class I-II) (11.6% vs. 28.8%; p=0.034) and local infectious complications (19.2% vs. 42.4%; p=0.009) were less common in the main group. Two patients died in the control group due to sepsis following colonic anastomosis and bladder suture failure, respectively. Postoperative hospital-stay was similar (14±9.1 days vs. 14.4±9 days; p=0.89). CONCLUSION: FTS protocol is possible and safe in patients with locally advanced and recurrent malignant pelvic tumors. This approach reduces blood loss, the number of blood transfusions and risk of postoperative infections.

[Improvement of the early diagnostic system and complex treatment elderly aged victims with severe traumatic brain injury of postoperative infectious - inflammatory complications.]

Improve the system of early diagnostic and complex treatment of postoperative infectious - inflammatory complications in victims of elderly ages with severe cranial injury. Medical institutions of Saint-Petersburg provided examination and treatment to 94 victims of elderly ages who were operated due to severe cranial injury. Examinations to identify inflammatory complications were provided from the body temperature rising and included laboratory tests, ultrasonography, X-Rays, Computer Tomography. The complex measures taken allowed to reduce severity and duration of postoperative inflammatory complications, cut the average bed-day hospital treatment from 42±6 days to 33±5 days in victims located in the neurosurgery department. Probability of infectious - inflammatory pulmonary complications development increases regardless of age. At the same time inflammatory urine tract complications most often occur among elderly age men who suffer from prostate hyperplasia and malfunction of the urination process after a long time of using intraurethral catheters. Early complex diagnostic examination allows the timely diagnosis of postoperative complications, and to begin the adequate treatment of victims.

[Megapolis medical rehabilitation system of elderly patients with severe cranio-cerebral injury.]

The capacities of systemic standard graded medical rehabilitation were assessed in 469 patients carried out surgical intervention for severe craniocerebral injury at Saint-Petersburg hospitals in 2010-2017. As a result of neurorehabilitation system introduction rates of infectious-inflammatory complications associated with physical inactivity were significantly decreased. An average length of stay at hospital was decreased from 34±5 to 23±4 days. At discharge from neurosurgical hospital the Barthel index of activities of daily living was 42±8 points. After inpatient rehabilitation course an average Barthel index was increased to 70±6 points. And after outpatient rehabilitation course an average Barthel index had reached 70±6 points.

[Craniometric differences between karyotypic races of the common shrew Sorex araneus (Mammalia) as a result of limited hybridization].

The contact points of four karyotypic races (St. Petersburg, Moscow, Seliger and West Dvina) of the common shrew Sorex araneus L. were studied at the Valdai Hills (European Russia) in an area unimpeded by geographic barriers. The populations of the races are separated by narrow hybrid zones that represent the most complex heterozygous hybrid karyotypes. At these points of contact, the morphometric differentiation of karyotype races was examined in 12 cranial measurements in 190 shrews of a known karyotype. A. comparison of the mean values in studied samples of immature shrews revealed statistically significant differences and the correlation of some measurements in order to describe the level of musculus temporalis. It has been proposed that morphometric differences in the karyotypic races were preserved and accumulated because of a 50% reduction of the frequencies of hybrids. The deviation from the Hardy-Weinberg ration in the frequencies of the genotype and haploid sets of chromosomes in the hybrid zones can be attributed to a number of fatalities of hybrid embryos or the nonrandom mating of karyotypic races. The ethological isolation might arise in the evolution of some karyotypic races from the reduced fitness of the hybrids.

[Narrow hybrid zone between Moscow and Western Dvina chromosomal races and specific features of population isolation in common shrew Sorex araneus (mammalia)].

The contact zone between Moscow and Western Dvina chromosomal races of common shrew Sorex araneus L. at the south of the Valdai Hights was traced over a distance of 20 km. Within this, close to parapatric, contact zone of chromosomal races the width of sympatry zone was about 500 m (the narrowest among currently known hybrid zones), and the proportion of hybrids was 24.3%. It was shown that in bimodal hybrid zones between chromosomal races of common shrew the width of sympatry zones varied from 0.5 to 13 km. This width does not correlate with the cytogenetic features of the hybrids, and seems to be determined by competitive relations between the races. The hybrid proportion is determined by the type of hybrid heterozygosity, and decreased in the race sympatry zone from 33-40 to 21.5-25.2%. The decrease of the hybrid proportion can be associated with the abnormal fertility of either the first generation, or the backcross hybrids.

[Meiosis in gray voles of the subgenus microtus (rodentia, arvicolinae) and in their hybrids].

The results of light and electron microscopic (EM) studies of meiosis in Microtus arvalis males of the karyoform "arvalis" (2n = 46, NFa = 80), in hybrids between the chromosomal forms arvalis and obscurus (2n = 46, NFa = 68), in M. rossiaemeridionalis voles (2n = 54, NFa = 54), and in a hybrid between the species M. rossiaemeridionalis and M. kermanensis (2n = 54, NFa = 54) are presented. SC (synaptonemal complex) karyotypes of the parental forms and the hybrids were constructed on the basis of measurements of the length ofautosomal SCs revealed by the EM analysis in spermatocytes at the stage of middle pachytene. The SC karyotypes of M. arvalis and the hybrids female obscurus x male arvalis consist of 22 synaptonemal complexes of autosomal bivalents and the axial elements of the synaptonemal complexes of the sex chromosomes X and Y. The SC karyotypes of M. rossiaemeridionalis and the hybrid M. rossiaemeridionalis x M. kermanensis consist of 26 synaptonemal complexes of autosomal bivalents and a sex bivalent; they differ only in the length of the Y chromosome axis (Y chromosome in the hybrid was inherited from M. kermanensis). Asynaptic configurations of the autosomal SCs were not observed in the hybrids. The SC axial elements of the X and Y chromosomes in the parental forms and in the hybrids were located close to each other throughout pachytene, but they did not form a synaptic region. The normal synapsis in sterile hybrids (M. rossiaemeridionalis x M. kermanensis) and the behavior of the sex chromosomes in meiosis in fertile and sterile hybrids are discussed in the context of specific features of meiosis and reproductive isolation.

[Extracorporeal shockwave lithotripsy in the treatment of urolithiasis in children].

Extracorporeal shock wave lithotripsy (ESWL) was performed in 1451 children with urolithiasis aged from 7 months to 16 years. A total of 2464 sessions were made. Low-energy impulses in ESWL were effective in 98.8% children with concrements up to 2.0 cm in size and in 98.8% of those with stones larger than 2.0 cm. We believe that main factors of high efficiency of ESWL in children are: more friable structure of stones, small depth of stone location, faster evacuation of the stone fragments. ESWL with low energy impulses is highly effective and is not accompanied with traumatic complications. Renal parenchyma is not affected.

[Food additive urisan in combined treatment of urolithiasis].

Thirty three urolithiasis patients (13 males, 18 females aged 29-77 years, 2 children, duration of the disease 1-17 years) received food additive urisan in combined treatment of urolithiasis. Blood and urine biochemistry was studied by 11 parameters to evaluate renal function and lithogenesis before and after intake of urisan. Standard treatment was combined with intake of 2 capsules (1100 mg) of urisan twice a day at meal for 2-3 weeks. The data were processed statistically. It is shown that urisan contributes to intensification of renal filtration function, to reduction of hyperuricemia and urine pH, intensification of uric acid excretion, continuation of inflammation remission, attenuation of proteinurea in urolithiasis patients with exacerbation of chronic pyelonephritis.

[Changes of hemo- and liquor-dynamics during intravascular interventions on venous-arterial malformations of the brain].

Changes in the arterial and venous blood flow and liquor-dynamics during intravascular venous-arterial interventions were studied in 30 patients with venous-arterial malformations of the brain. It was found that against the background of reduced venous-arterial shunting no expected drop of pressure in the jugular veins occured. Data were obtained on possible active autoregulation of pressure by the jugular veins. The investigation of pressure in the sinus system of the brain has shown that it correlates with intracerebral and systemic arterial pressure. The results obtained can be used in vascular neurosurgery, anesthesiology and neurology.

[Sex chromosomes at early meiosis in three wood mice species of the genus Apodemus (Rodentia, Muridae)].

The prophase of the first meiotic division was studied in field mice of the species Apodemus (Sylvaemus) flavicollis, A. (S.) ponticus, and A. (S.) uralensis by light and electron microscopy. The karyotypes of the species were described on the base of electron microscopy of synaptonemal complexes in spermatocytes I. The axial elements of the sex chromosomes at early-middle pachytene can synapse along the major portion of the Y axis; at late pachytene-early diplotene, the synapsis region shrinks; and at diakinesis-metaphase I, X and Y chromosomes associate tail-to-tail in all species studied. The behavior of sex chromosomes in the synapsis in the species studied was quite uniform. The results are discussed in the context of earlier data on the behavior of sex chromosomes in various rodent species in meiosis prophase I and their banding.

[Assessment of metabolic disturbances risk factors in urolithiasis children with questionnaire survey].

Risk factors of metabolic disturbances in children with urolithiasis were studied in 38 children aged 1.7 to 14 years. The information for the disease history was obtained from the parents of the children participating in the study. The parents filled in special questionnaire which has detected that 14.2% of fathers and 72% of mothers had chronic diseases; when pregnant, 81.5% mothers had toxicosis and gestosis, 23% suffered from various viral and bacterial infections treated for a short time with drugs; 63% mothers did not keep diet before pregnancy but pregnancy and lactation made 77% of them pay due attention to their food and diet regime. Breast feeding lasted for the first 2-6 and 1-2 months in 38 and 50% mothers, respectively. Feeding was mixed from birth in 23% babies. Development of metabolic disturbances in children leading to urolithiasis depends on many factors closely linked with environment pollutants, life style of the parents, gynecological health of mothers, intercurrent diseases. Immunogenetic, hereditary mechanisms are involved in triggering urolithiasis in children.

Predator odour and its impact on male fertility and reproduction in Phodopus campbelli hamsters.

This study investigated the influence of cat urine odour in suppressing development and fertility in Campbell's hamster males. Exposure to this odour from postnatal day 11 until day 45 (sexual maturation) resulted in reduced sex organ weights, reduced testosterone levels and in an increase in abnormalities of the synaptonemal complex in both sex chromosomes and autosomes. Subsequent breeding experiments revealed a significant decrease in litter size. All these data indicate a severe effect of predator odour on the breeding success of potential prey species. It is assumed that these effects are caused by the sulphurous compounds in the urine; however, the underlying mechanisms are not yet known.

[Characteristics of the first meiotic division in hamster hybrids obtained by backcrossing Phodopus sungorus and Phodopus campbelli]. / Osobennosti pervogo deleniia meioza u gibridov khomiachkov Phodopus sungorus i Phodopus campbelli ot vozvratnykh skreshchivanii.

Spermatocytes of fertile, subfertile, and sterile hamster hybrids obtained by backcrossing Phodopus sungorus and Ph. campbelli were analyzed under light and electron microscopes. Light microscopy showed that early meiosis was blocked in pachitene in the spermatocytes of sterile hybrids. The X and Y chromosomes were dissociated in metaphase I in several fertile and subfertile animals. Electron microscopic analysis of the synaptonemal complex (SC) revealed a disturbed synapsis of sex chromosomes and autosomes in all hybrids. Dissociation of the sex chromosomes, terminal and interstitial asynapsis, and interlocking of autosomes were observed. Disturbed synapsis in hybrids was assumed to result from the difference between Ph. sungorus and Ph. campbelli in not only their chromosomes, but their genes as well.