[EXPERIENCE IN ARTHROSCOPIC TREATMENT OF PATIENTS WITH HAGLUND'S DEFORMATION].

This study aimed to evaluate the results of treatment of patients with anterolateral chronic instability after arthroscopic stabilization of the ankle joint using anchor fixators, to determine the risk factors for the recurrence of instability after surgery and methods of their diagnosis. The study involved 28 patients from 2016 to 2020. performed 28 arthroscopic operations for chronic lateral instability. The Arthroscopic Brostrom-Gould operation was performed. 22 patients were women and 6 were men. The average age of the patient was 38.6 years (22-55 years). Ankle arthroscopy was performed using a shaver, an ablator, and an anchor fixator. All the patients were discharged the next day; immobilization of the ankle joint in the orthosis was 6 weeks from the moment of surgery. The scores were assessed by the AOFAS (American Orthopedic Society for Foot and Ankle Surgery) scale and VAS - a visual analog scale designed to measure the intensity of pain, then the patient's condition was assessed. The average follow-up was 58.4 months. The AOFAS scores significantly improved from a postoperative mean of 52.6 to 98.6 at the final grade (p˂0.005). All patients are satisfied with the result of the operation. The scores on the VAS scale were on average 6-8 points. Arthroscopic Brostrom-Gould operation has proven to be a safe and effective surgical method for treating chronic lateral instability of the ankle joint.

[EXPERIENCE IN ARTHROSCOPIC TREATMENT OF PATIENTS WITH HAGLUND'S DEFORMATION].

The goal of this study was to evaluate the results of arthroscopic calcaneoplasty for the treatment of posterior calcaneal bursitis and Haglund's disease. The study involved 28 patients who underwent 30 arthroscopic surgeries for Haglund's disease from 2015 to 2019. Retrocalcanealneoplasty and supracalcaneoplasty were performed using a shaver, an ablator; with the help of a drill, the bone was resected until the contact in the Achilles tendon was eliminated in the position of dorsiflexion of the foot. All patients were discharged the next day and allowed full leg load in the second week after surgery. The AOFAS (American Orthopedic Society for Foot and Ankle Surgery) and VAS scores were calculated, and the patient's condition was estimated. Results: The average follow-up was 58.4 months. The AOFAS scores significantly improved from the average 52.6 to 98.6 at the final estimation (p˂0.005). All patients were satisfied with the result of the surgery. VAS scores were low. Conclusion: Arthroscopic calcaneoplasty has proven to be a safe and effective surgical method for the treatment of posterior calcaneal bursitis and Haglund's disease.

[The laboratory specialist and clinical interpretation of laboratory results].

The requirements of standards concerning content of laboratory consulting services, including and discussion about individual clinical cases. The information about grounds of interpretation of results of laboratory analyses is presented. The methods of comparison with reference intervals values and decision thresholds, evaluation of effects of various types of non-pathogenic variations, including pharmaceuticals took by patient are considered. The unacceptability of conventional evaluation of obtained results and necessity of individual approach in clinical decision making is emphasized. The particular attention is paid to responsibility of laboratory for urgent informing of clinicians about detected critical alterations of laboratory indicators in patients with high risk of unfavorable outcome. The article presents information about literary sources based both on recommendations of laboratory specialists concerning interpretation and application of laboratory tests and on evaluation of significance of laboratory information under various forms of pathology by leading representatives of clinical disciplines.

[The shortcomings of technical regulation in sphere of circulation of medical devices for diagnostic in vitro in the Russian Federation: the state of affairs and proposed solutions].

The article presents analysis of international and national trends in area of development of normative legal documents in sphere of circulation of medical devices for diagnostic in vitro. The comparative analysis was made concerning certain principles of formation of nomenclature of medical devices for diagnostic in vitro in the international practice and in the Russian Federation. The necessity of reformation of national normative legal base in this issue is demonstrated.

[The point-of-care testing and security of patient: advantages and risks].

The point-of-care testing obtains growing prevalence in medical practice due to application of portative analytical devices of advanced technologies. The advantages of these devises are more prompt analysis results and more simple procedure of application disposable for duplication by laymen. However, in practical work, are obvious the shortcomings related to direct and potential risks for patient in case of using unreliable analysis results as a validation of implementation of treatment measures harmful for patient. Under implementation and application of point-of-care testing the ratio advantages/risks is to be carefully assessed.

The risk of photochemical reactions.

In January 1987, an incident occurred at a petrochemical complex in Salavat, Russia. The incident resulted in the poisoning of 17 people by the products of photochemical smog. This paper describes the incident and discusses the possibility of chemical reactions that pose toxic hazardous situations for chemical plant personnel. Pollutants present in the atmosphere as a result of continuous releases can result in the formation of toxic substances and the poisoning of people, even when permissible levels of concentrations are not exceeded for the initial pollutants. In addition, this paper addresses the need to consider the possibility of secondary chemical reactions in the environment while planning chemical plant activity.

[Participation of adrenal hormones in the genesis of arterial hypertension of hypothalamic origin]. / Ob uchastii gormonov nadpochechnikov v geneze arterial'noi gipertenzii gipotalamicheskogo proiskhozhdeniia

Continuous many-hour stimulation of the hypothalamic negative emotiogenic centres (ventromedial nuclei) evoked a stable arterial hypertension with a peculiar phasic dynamics of the adrenal secretory activity in waking immobilized rabbits. Bilateral extirpation of the adrenal glands decreased the initial level of the average arterial pressure, inhibiting development of stable arterial hypertension. Many-hour stimulation of the mentioned structures also produced stable arterial hypertension in adrenalectomized rabbits if preceded by the administration of hydrocortisone together with adrenaline. Against the background of separate administration of hydrocortisone and adrenaline to adrenalectomized rabbits, many-hour stimulation of the ventromedial hypothalamus evoked a short-term rise in the arterial pressure. A conclusion was drawn that activation of hormones of the adrenal cortical and medullary layers played an important part in the formation of stable arterial hypertension in rabbits under continuous many-hour stimulation of the hypothalamic negative emotiogenic centres.

[Change in catecholamine and acetylcholine concentration in myocardial tissue in assisted circulation]. / Izmenenie kontsentratsii katekholaminov i atsetikholina v tkani miokarda pri vspomogatel'nom krovoobrashchenii

The authors stress the importance of reactions associated with the concentration of biologically active substances in the body tissues, in particular their influence on the contractility and escitability of the heart muscle. They cite the results consequent upon a study on the catecholamines and acetylcholine content in the myocardial tissue of the left ventricle and left auricle of the heart before and after institution of an auxilliary circulation effected with the aid of a valveless pump connected to the subclavicular artery in 22 dogs. An analysis of the results demonstrated that by producing counter-pulsation with the pump the concentration of catecholamines and acetylcholine in the tissues of the left head diminishes, but the fall of the catecholamines concentration does not reach the level typical of cardiac insufficiency. The authors believe that investigations of this kind may help elaborate optimal conditions and a permissible duration of the auxilliary circulation.