[Modern problems of modelling and treatment of soft tissues abscesses]. / Sovremennye problemy modelirovaniya i lecheniya abstsessov myagkikh tkanei.

Increase of the frequency of soft tissues pyoinflammatory diseases and purulent-septic complications against the background the antibiotic-resistance of organism dictates the necessity of search of rational new surgical technologies and preparations with the intense bactericidal effect. Period of the connective tissue (cicatrix) formation on a place of wound defect of the operated purulent abscess of soft tissue (PAST) is defined by the speed of the granulations and epithelial tissue formation. Therefore, one of the task of experimental surgery is search of new methods of the effective postoperative influence on terms of the regeneration and complete obliteration of the PAST cavity. The perspective direction in treatment of surgical infection is application of metals nanoparticles. In treatment of pyoinflammatory processes it is applied the preparation Eplan and also zinc oxide nanoparticles which have bactericidal, antiinflammatory and regenerative effects. However, till now it was not carried out experimental works on modelling and surgical treatment of PAST with local application of the laser technologies in combinations with Eplan and metals nanoparticles.

[CERVICAL CANCER REHABILITATION: A PROSPECTIVE STUDY].

Aim - to evaluate the rehabilitation program impact on the quality of life of оncogynecological patients and to introduce this approach in clinical practice. The study included93 reproductive-aged women, who underwent the cervical cancer treatment. Patients were divided into two groups: the experimental group, which received rehabilitation, and the control group. The thrombotic complications risk, lymphatic system condition, cognitive functions and anxiety level were assessed in all patients using special questionnaires, physical examination, and laboratory assessment. The lower limbs lymphedema was observed in 19.1% of cases in the control group and in 2.1% in the experimental group (p <0.05). According to the Moka test data, cognitive impairment level at the end of the study was 24.02 (17-30, CI: = 22.5-25.54) in the control group and 26.85 (19-30, CI: = 26.0 - 27.64) in the experimental group (p <0.05). The cognitive impairment subjective signs were significantly higher in the control group (p <0.05) as well. The anxiety level at the end of the study was 7.022 (1-19, CI: = 5.91-8.13) in the experimental group and 11.02 (4-22, CI: = 9.83-12.22) in the control group (p <0.05). At the end of the study, the following depression levels were obtained: 12.43 (5 - 21; CI: = 11.23 - 13.64) and 7.69 (1 -14; CI: = 6.77 - 8.62) in the control and the experimental group respectively (p <0.05). At the end of the study, deep vein thrombosis was observed in 21 patients in the control group (44.7%) and 7 patients in the experimental group (15.22%) (p <0.05). One patient from the control group had PATE. According to EORTC QLQ-C30, the quality of life and socialization level was significantly higher in the experimental group, while fatigue level was lower. At the end of the study, 36.2% and 76.0% of patients in the control and the experimental group respectively were employed. The rehabilitation program improves the emotional and cognitive functioning, induced menopause associated somatic disorders, quality of life, and work capacity.

[A variant of functionally active esophagogastric anastomosis in the surgery of stenosing lesions of the esophagus]. / Variant funktsional'no aktivnogo sheinogo ézofagogastroanastomoza v khirurgii stenoziruiushchikh porazhenii pishchevoda.

A method of forming a cervical are flux esophgeal-gastric anastomosis has been developed allowing to exclude or considerably decrease the effect of esophago-gastro-pharingeal reflux on the esophageal stump mucosa after subtotal resection of the esophagus and performing one-moment esophagogastroplasty. A muscular constrictor and a circular invagination valve formed in the area of the esophagogastroanastomosis represent a single mechanism having the functional properties approximating the natural esophagocardial passage which prevents the reflux of the stomach contents into the esophagus stump and is a guarantee of prophylactics of reflux-esophagitis and stenosis of the created anastomosis.

[The correction of the disseminated intravascular coagulation syndrome in the emergency surgery of gastrointestinal tract cancer]. / Korrektsiia sindroma disseminirovannogo vnutrisosudistogo svertyvaniia krovi v neotlozhnoi khirurgii raka zheludochno-kishechnogo trakta.

The authors estimate results of correction of the hemostasis system in surgical treatment of 63 patients with complicated carcinoma of the gastro-intestinal tract. It was found that purulent peritonitis, profuse hemorrhage and obturative obstruction facilitated the development of local and generalized DIC syndrome. Methods of correction of the hemostasis system, endogenous intoxication during preoperative preparing are described. Expedience of radical operations is stressed. Complex postoperative detoxication is recommended as well as measures for the restoration of activity of the vascular-thrombocytic hemostasis and prevention of thrombus formation.

[The diagnosis and clinical assessment of the disseminated intravascular coagulation syndrome in complicated cancer of the gastrointestinal tract]. / Diagnostika i klinicheskaia otsenka sindroma disseminirovannogo vnutrisosudistogo svertyvaniia krovi pri oslozhnennom rake zheludochno-kishechnogo trakta.

Under study were the state of the hemostasis system, the level of endogenous intoxication and anti-infectional defense in 63 patients with complicated carcinoma of the gastro-intestinal tract (GIT). It was established that the patients had the syndrome of disseminated intravascular coagulation (DIC) of blood which at first was of local character. Acute complications of carcinoma of GIT, first of all purulent peritonitis and profuse gastro-intestinal bleedings, aggravate endotoxicosis and facilitate the development of the acute DIC syndrome. A conception of the development of the intoxicative DIC syndrome is presented and proposed are informative methods of the assessment of hemostasis in emergency surgery of carcinoma of the GIT.

[Correction of endogenous poisoning in patients with peritonitis in gastric and intestinal tumors]. / Korrektsiia éndogennoi intoksikatsii pri peritonite u bol'nykh s opukholiami zheludka i kishechnika.

Peculiarities of endogenous intoxication in peritonitis in 63 patients with cancer of the stomach and intestine were studied. Three degrees of the intoxication syndrome severity were distinguished: the mild, moderate and severe ones. It is shown that the severity degree of intoxication depends on a phase of peritonitis, stage of tumorous process and state of anti-infective protection of an organism. The steps for surgical detoxication of an organism, depending on severity degree of endogenous intoxication, were defined. Use of a complex of treatment permitted to reduce postoperative lethality of the patients to 33%.

[Prevention of hypotonic hemorrhage in the placental and early puerperal period with prostenone]. / Profilaktika gipotonicheskikh krovotechenii v poslerodovom i rannem poslerodovom periodakh prostenonom.

To prevent afterbirth and early postpartum hemorrhages the authors used prostenone in 46 (the main group) and oxytocin in 20 females (control group). Intraplacental blood pressure and coagulation parameters were studied. With prostenone, the mean amount of the blood loss turned to be significantly lower (137 +/- 13 ml) than with oxytocin (208 +/- 17 ml). Administration of prostenone led to a significant elevation of prothrombin index alone and tolerance to heparine. As there was an insignificant difference between the parameters in the main and control groups, the mechanism of prostenone's effect on the myometrium required further studies.

[Pregnancy and diabetes mellitus]. / Beremennost' i sakharnyi diabet.

The dynamics of the placental lactogenic hormone level, insulin requirements, and glycaemia during pregnancy was studied in diabetes I and II patients and diabetic pregnancies. Fructose amine and C-peptide levels in maternal and neonatal blood were measured in different diabetes types. The risk of diabetes I development in relation to the incidence of the HLA-system antigens was assessed. The need for a functional insulin therapy prior to and during pregnancy was substantiated.

[Characteristics of peritonitis in cancer of the gastrointestinal tract]. / Osobennosti peritonita pri rake zheludochno-kishechnogo trakta.

Under analysis was material of treatment of 63 patients with gastric and colonic cancer complicated by acute peritonitis. An atypical asymptomatic course of the subreactive and a reactive forms of peritonitis is associated with pronounced inhibition of factors of antiinfection defense in elderly patients with the III-IV degrees of cancer. Complex stimulating therapy is indicated in the postoperative period because of immunodepression taking place after urgent operative interventions.

[Prolonged-action contraceptives]. / Kontratsevtivy prolongirovannogo deistviia.

PIP: Various aspects of injectable prolonged-action steroid contraceptives are reviewed with special emphasis on the effectiveness of depo- medroxyprogesterone (depo-provera) and norethisterone enanthate (NE). Both preparations have progestogen activity. Depo-provera was 1st used for the treatment of endometriosis and threatened abortion. As a contraceptive, 150 mg depo-provera is given every 90 days (once every 3 months). NE is also given 200 mg during the 1st 5 days of a cycle; injections are repeated 2 months later and then every 3 months. The incidence of pregnancy following depo-provera use did not exceed 1/100 women-years. Clinical trials of NE indicated the incidence of pregnancy ranging from 1-3.6/100 women-years (depending upon drug administration schedule). The contraceptive effect of both depo-provera and NE was shown to be associated with inhibition of ovulation. The majority of women treated with depo-provera or NE developed various disorders of the menstrual cycle. Amenorrhea development was found to depend upon duration of administration, and was more frequent after depo-provera than after NE. Metabolic effects of depo-provera and NE included decrease in the blood level of cholesterol in high-density lipoproteins, and an increase in the fasting levels of glucose and insulin. Depo- provera did not affect liver function. Epidemiological studies did not show an increase in cancer incidence following the use of depo-provera. Restoration of fertility occurred about 5.5 months after termination of depo-provera administration. Injectable contraception recommended primarily in young women who want to increase the intervals between childbirths. Women older than 40 years should use other methods of contraception.^ieng