[High tibial osteotomy with computer navigation for medial gonarthritis]. / Sravnitel'nye rezul'taty lecheniya medial'nogo gonartrita metodom vysokoi tibial'noi osteotomii s ispol'zovaniem komp'yuternoi navigatsii.

OBJECTIVE: To study significance of computer navigation for improving clinical and radiological results of medial gonarthritis treatment compared to non-invasive methods of lower limb axis correction control. MATERIAL AND METHODS: The study included 73 patients who were divided into 2 groups. The main group included 40 patients, the control group - 33 patients. In the main group, high tibial osteotomy was performed using computer navigation, in the control group - using non-invasive techniques. Clinical assessment was carried out according to the KSS, KOOS and VAS scales. We assessed the main reference angles of the lower limb considering X-ray data. RESULTS: Both groups were characterized by postoperative improvement of clinical results according to various scales. Computer navigation provided higher accuracy in most cases. We focused on target correction of 3° valgus. CONCLUSION: High tibial osteotomy with computer navigation or non-invasive techniques is an effective treatment method for medial gonarthritis. There are no significant differences in clinical results according to the KSS and KOOS scales, as well as X-ray data after correction. We found significant differences in VAS scores.

[Clinical and functional outcomes of valgus osteotomy in patients with medial gonarthrosis (preliminary results)]. / Rezul'taty val'giziruyushchei osteotomii u patsientov s medial'nym gonartrozom (predvaritel'nye rezul'taty).

OBJECTIVE: To analyze gait biomechanics before and after corrective osteotomies around the knee joint in patients with medial gonarthrosis. MATERIAL AND METHODS: The study recruited 5 patients (6 surgeries) with medial gonartrosis and varus knee deformity. Gait biomechanics was analyzed in preoperative period and 6 months later. The control group consisted of 20 healthy people. RESULTS: Knee joint biomechanics was almost normal in postoperative period. Amplitude of knee joint flexion was increased. Moreover, hip joint flexion-extension amplitude was increased on both sides and often exceeded normal values. Clinical results showed significant increase in IKS (from 55 to 89.6) and VAS score (from 7.7 to 2.3). Postoperative correction angle varied within 1.5-2° of valgus. CONCLUSION: Corrective osteotomy around the knee joint is effective for medial gonarthrosis. We obtained favorable clinical results and limb axis correction after surgery without significant hypercorrection. Gait biomechanics was also improved.

High-pressure injection injuries of the fingers: Long-term follow-up in patients after extensive debridement.

High-pressure injection injuries to the fingers resulting from the introduction of a foreign substance, such as oil or paint, through a minor puncture wound are rare but can have serious clinical consequences. The objective of this article was to examine the long-term outcomes after surgical debridement of these injuries. We present a retrospective case series of 8 adults who had a high-pressure injection injury to their hand and underwent surgical debridement in our facility. Data were extracted from our outpatient registry. Assessment included a full physical examination, grip strength, range of motion, two-point discrimination and Quick Disability of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. We followed 8 male patients for an average of 12.7 years. Their average age was 37 at time of injury and all had injured their right dominant hand. Seventy-five percent of the injuries were to the index finger. Seven out of the 8 patients returned to their pre-injury occupation, 4 out of 8 patients had reduced range of motion of the affected digit. Injury sequelae adversely affected activities of daily living (ADL) with an average QuickDASH score of 26. Grip strength in the injured hand was reduced by an average of 35% in 6 out of 8 patients compared with the uninjured hand. Sensation was also reduced in the affected digit in 7 out of 8 patients. All patients suffered from some level of neuropathic pain and/or cold intolerance. High pressure injection injury to the fingers is a serious event found amongst industrial laborers. In most patients, this injury will lead to long-term disability along with a negative impact on ADL. However, most patients eventually return to their pre-injury occupation. Extensive, single or repeat debridement of high-pressure injection injuries remains a valid treatment option with good long-term results.

[Endosonography in diagnosis of choledocholithiasis].

BACKGROUND AND STUDY AIMS: In 38-80% patients with suspicion to choledocholithiasis were no stones in common bile duct (CBD) after endoscopic retrograde cholangiopancreatography (ERCP). ERCP is not safe procedure and has a risk of complications ranging 4-15%. The aim of our study was to estimate the diagnostic value and safety of endoscopic ultrasound (EUS) in CBD stones diagnosis. PATIENTS AND METHODS: In patients with medium probability of CBD stones (i.e. CBD ≤ 10 mm and/or bilirubin ≤ 2 times upper normal) was performed BUS with Pentax EG-3870UTK and Hitachi EUB-7000HV. From September 2012 till December 2013 it were done 72 investigations in patients with suspicion of CBD stones. RESULTS: After EUS suspicion for CBD stones were in 21 patients. Average size of hyperechoic defects was 5.6 ± 3.3 (2-12) mm. ERCP was performed in 20 of them. Stones were confirmed and removed in 18 patients, in 2 patients without stones it was found a stricture of terminal part of CBD. In 9 patients absence of stones was confirmed during laparoscopic cholecystectomy with IOC. Patients without indications to cholecystectomy were followed for six months and there were no additional investigations. It were no complications after EUS. EUS sensitivity was 100%, specificity--96.2%, PPV--90%, NPV--100%. CONCLUSION: EUS is effective tool for diagnosis of CBD stones in patients with medium probability of choledocholithiasis. It could be recommended as a first diagnostic step in these patients because the risk of complications is negligible.

[Possibilities of sterilization of medical equipment using ultrasonics combined with disinfectants and sterilizing agents]. / Izuchenie vozmozhnosti sterilizatsii nekotorykh izdelii medi- tsinskogo naznacxhenia s pomo'shchiu u'ltrazvuka v kombinatsii s dezinfitsiruiushchimi i sterilizuiushchimi sredstvami.

An ultrasound Y3Y-0.25-0 unit was used to reach the sterilizing effect during the treatment of metal surgical appliances packed in a row by means of ultrasound combined with 6% hydrogen peroxide (40 degrees C) for 60 minutes and with 1% (according to peracetic acid) desoxone-1 (18 degrees C) for 45 minutes. This made it possible to attain a 3-fold reduction of the time required for sterilization during treatment of the appliances by combination of ultrasound and 6% hydrogen peroxide as compared to sterilization with the aid of the solution alone under the same conditions.

[Methods of reducing the amount of pediculocide residues on bed linens to safe levels]. / Metody snizheniia ostatochnykh kolichestv pedikulitsidov na be'le do bezopasnykh urovnei.

The means for reducing the residue of organophosphorous and pyrethrin pediculicides on the fabric to safety levels have been developed due to the use of gas and liquid chromatography. The proposed procedures include linen washing after its pediculicidal treatment. Optimal conditions for the removal of the above substances from the fabric have been set forth. Actual quantity of pediculicides on the fabric after its treatment has been identified.

[Tactics in using aerosols for disinfection of therapeutic and prophylactic institutions]. / Taktika primeneniia aérozolei dlia tselei dezinfektsii pomeshchenii lechebno-profilakticheskikh uchrezhdenii.

Two Soviet sprayers (ABD-2600H and EOC-5) are recommended for the disinfection of the surfaces and indoor air in the curative and prophylactic facilities. A special impetus has been given to the use of chloramine aerosols that ensure higher efficacy of disinfection, reduce the aerosol consumption and the period of the presence of active chlorine in the air of the treated place.