bluuebunny/crossref_metadata_2025 huggingface dataset:
COMPLEX PHYSIOTHERAPY IN CHILDREN WITH ACUTE BACTERIAL NECROTIZING PNEUMONIA
Authors: Eredjibokova M. Yu , Shadrina Elina Mikhailovna , Barova N. K , Vasilieva S. R , Radchenko N. A
Published: September 2020

Acute bacterial-destructive pneumonia is one of the most severe chronic inflammatory diseases of childhood, occurs in 10-15% of pneumonia in children. The effectiveness of physiotherapeutic procedures (ultrahigh frequency electric field on the inflammatory focus, magnetotherapy, electrophoresis with polymineral napkins based on natural iodide-bromine water) was evaluated in the framework of the complex treatment of pneumonia in children, which included the use of conservative and surgical methods. The early appointment of complex physiotherapy treatment improved the patients’ condition on the 3rd-4th day, thanks to the mobilization of energy resources of biological tissues, the activation of metabolic processes and the immune system of the body. The combined application of physical (permanent galvanic current) and chemical factors had an anti-inflammatory, absorbable effect, prevented the development of pleural adhesions.
REHABILITATION MEASURES OF DENTAL DIRECTION IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS IN SANATORIUM-RESORT CONDITIONS
Authors: Kaladze N. N , Galkina Olga Petrovna , Bezrukov S. G
Published: September 2020

Physiotherapeutic procedures normalize physicochemical processes at the cellular and molecular levels. The complex application of natural factors for reducing the interference of the leading pathological focus and deviations of other localization, including the maxillofacial region is actual. The purpose of the study is the development of a therapeutic and prophylactic dental complex for patients with juvenile rheumatoid arthritis (JRA) staying in sanatorium. Material and methods. 30 patients with JRA in the Evpatoriya were examined. Patients of the comparison group receved standart therapy. Patients of the main group additionally received bioresonance stimulation (BRS) of the collar zone and projection of large salivary glands; the oral cavity was rinsed with a solution of the brine from Saky’s Lake. Dental indices, rate of salivation, saliva viscosity, cortisol and ACTH in oral fluid and blood were determined. Results. The effectiveness of dental care in resort conditions was noted in both groups, but the reduction of rate of salivation and viscosity of oral fluid was more dynamic (on 31,58% and 15,6%), reflecting the ability of the BRS to regulate functional activity salivary glands. Cortisol in the OF decreased, which indirectly indicated the physiological activity of the excretory apparatus of the salivary glands at the level of transport molecular metabolism. Conclusions. Staying patients with JRA in the sanatorium-resort conditions in Evpatoriya has a general health effect. “Small” balneotherapy of the brine from Saky’s Lake improves oral hygiene. BRS-therapy restores the functional activity of salivary glands, promotes regulation of cortisol and ACTH levels. Providing rehabilitation dental care for patients with JRA, in the conditions of the resort is justified.
Primary open angle glaucoma: scientometric analysis of evidence research
Authors: Borzunov Oleg Igorevich , Ponomarenko G. N.
Published: September 2020

The article presents modern data of scientometric analysis and scientific substantiation of the introduction of the evidentiary approach to the development of the strategy of physical therapy of primary open-angle glaucoma (POAG).

Aim is to conduct a scientometric analysis of evidence-based studies on the use of therapeutic physical factors in the therapy of primary open-angle glaucoma.

Results. The paper considers the proposed mechanisms of action and the clinical effects of proven therapeutic physical factors in the therapy of POAG. Particular attention is paid to evidence-based studies on the use of magnetotherapy, electrical stimulation, laser stimulation. In the course of the comprehensive analysis, recommendations on the use of therapeutic physical factors in the treatment of patients with POAG based on evidence were suggested.

Сonclusion. An obligatory link in the therapy of patients with POAG is the analysis of existing evidence-based studies and the implementation of new quality randomized controlled clinical trials to study the effect of therapeutic physical factors on the course of POAG treatment.
Assessment of effectiveness of sanatorium medical rehabilitation of patients with bronchial asthma by international classification of functioning, disability and health
Authors: Dudchenko Leyla Shamilevna , Mizin V. I. , Belyaeva S. N. , Maslikova G. G. , Kozhemyachenko E. N. , Kolesnik D. S. , Dmitrievskiy A. A.
Published: September 2020

The purpose of study was to elaborate methodology of assessment of effectiveness of a medical rehabilitation in patients with the bronchial asthma with use of the International Classification of Functioning, Disability and Health (ICF). Under observation there were 420 patients with bronchial asthma who received sanatorium treatment on the Southern coast of the Crimea. All patients received the clinical, laboratory and functional trial. For assessment of a condition of patients according to provisions of ICF, a set of domains was developed for patients with bronchial asthma. The health resort medical rehabilitation in the climatic resort leads to reliable increase of asthma control. Changes of continuants of the offered domains before carrying out sanatorium medical rehabilitation had reliable positive dynamics. A proposed methodology can be used for assessment of functional condition of patients with bronchial asthma under health resort medical rehabilitation.
Efficiency of application of natural and preformed physical factors at the resort in patients with postolocystectomic syndrome
Authors: Merkulova G. A. , Kaysinova Agnessa Sardoevna , Kudryavtsev A. A. , Fedorova T. E. , Tekeeva F. I. , Ahkubekova N. K.
Published: September 2020

The objective: to study the effectiveness of natural and preformed physical factors in correcting functional state of liver in patients with postcholecystectomy syndrome.

Material and methods. We examined 80 patients after cholecystectomy at the age of 45.410.2 years. Patients received spa therapy with the use of drinking mineral water Essentuki-Novaya and foam licorice baths (comparison group; n=40) and additionally magnetotherapy on the upper half of the body (main group; n=40).

Results. After the treatment, patients showed a positive dynamics of clinical symptoms of the disease, functional liver tests, lipid metabolism, normalization of lipid peroxidation.

Conclusion. The complex application of natural healing factors and magnetotherapy to patients after cholecystectomy leads to a significant improvement in the basic functions of the hepatobiliary system, normalizes peroxide homeostasis, stabilizes lipid metabolism, prevents the development of inflammatory-degenerative and stagnant phenomena in the biliary system, which prevents the progression of the pathological process.
Effect of noninvasive neuromodulation in the menopusal period in women
Authors: Voropaev Aleksey Alekseevich , Gaidarova A. Kh. , Kotenko N. V. , Rachin A. P. , Badalov N. G.
Published: September 2020

In women with extragenital pathology in the menopausal period, the use of noninvasive neuromodulation for the treatment of psychovegetative disorders has been proposed. The method allows to reduce the severity of menopausal and psychosomatic (depression, anxiety) disorders and the level of their mutual influence.
Immediate and long-term results of physiotherapeutic treatment of patients with chronic constipation in abnormal development of the colon
Authors: Litvinova Olga N.
Published: September 2020

Background. Currently, the issue of effective conservative treatment of constipation in cases of colon developmental abnormalities remains open.

Aim: to study the immediate and long-term results of the treatment of chronic constipation in case of colon development abnormalities, through individualization of the physiotherapeutic methods used, depending on the type of pathology.

Methods. The article presents the experience of treatment in the Department of Internal Medicine of the Lugansk Republican Clinical Hospital, from 2013 to the present, of 389 patients with chronic constipation in colon developmental abnormalities. We used types of electrical stimulation, different in the method of applying electrodes and the stimulating current parameters. In the work, we used the serial apparatus Endoton 01-B. We evaluated the immediate and long-term results of treatment in the period from 6 months to 3 years.

Results. After 34 courses of rectal electrostimulation of patients with compensated and subcompensated forms of the disease, for 67 months, 346 (88.95%) patients had regular independent defecation with an interval of 2436 hours. The remaining 43 (11.05%) patients with subcompensated and decompensated forms of the disease received 56 courses of rectal electrical stimulation during the year. A persistent positive effect was obtained, namely independent defecation with an interval of 3648 hours.

Conclusion. Rectal electrical stimulation for this pathology is considered the method of choice. The functional immediate and long-term results of rehabilitation of patients confirmed the correctness of the approach chosen.
Pharmacopuncture in common pathological conditions*
Authors: Agasarov L. G. , Gerasimenko M. Yu. , Konchugova T. V. , Maryanovsky A. A. , Drobyshev V. A. , Vasilyeva E. S. , Safiullina G. I. , Tardov M. V. , Tyan V. N. , Boldin A. V. , Bokova I. A. , Dashina T. A. , Chigarev A. A.
Published: September 2020

Clinical recommendations have been developed based on the analysis of Russian and international experience in the use of pharmacopuncture which is a contemporary medical technology combining the therapeutic possibilities of reflex therapy and clinical pharmacology. The first part of the recommendations sets out general provisions on the document structure and content that meet the requirements of GOST R 56034-2014 Clinical recommendations (treatment protocols).

* Pharmacopuncture in common pathological conditions: clinical recommendations. M., 2017 p. 39. Available at: https://docplayer.ru/53018894-Klinicheskie-rekomendacii-farmakopunktura-pri-rasprostranennyh-patologicheskih-sostoyaniyah.html. Link active on 06/15/2018.
THE PERCEPTION OF VALUE OF HEALTH AND HEALTHY LIFE-STYLE BY THE FACULTY OF MEDICAL UNIVERSITIES
Authors: Reshetnikov A. V , Prisiajnaia N. V , Reshetnikov V. A , Litvinova T. M
Published: September 2020

The article presents the results of medical sociological survey with purpose to study concepts and motivation attitudes of the faculty of medical universities in relation to healthy life-style and its components. The survey results demonstrated that in spite of rather wide-spread aspiration for preservation of one's own health (refusal of harmful habits, regular dispensarization, involvement into sport activities) a significant percentage of the faculty of medical university suffers from inadequate level of commitment to principles of healthy life-style. It is noted that implementation of healthy life-style is prevented besides working load and time deficiency, by number of such «anti-motives» as inner unreadiness and lower level of motivation to healthy life-style.
THE SOCIAL PORTRAIT OF PATIENT OF MUNICIPAL POLYCLINIC
Authors: Reshetnikov A. V , Ellanskiy Yu. G , Aivazyan Sh. G
Published: September 2020

The article presents results of medical and sociological study carried out with purpose of exploring social characteristics of patients of municipal polyclinics in Rostov-on-Don. The derived results were compared with opinions of patients about their own health status, as well as with their perception of dispensarization. The results of the study demonstrated that mostly the patient of municipal polyclinic is characterized as woman (68.2%), aged 65 years and older (22.4%) or 18-25 years (19.1%), with higher education (51.1%) and married (55.9%). The social status of typical female patient of municipal polyclinic is worker (41.6%) or retired person (30.9%), considering her health condition to be rather poor than good (74.5%). The average rate of annual appealability to municipal polyclinic is 3.9 ± 0.3 times per year. At that, high level of patient compliance (78.6% and inadequate awareness of possibilities of dispensarization, including its purpose and tasks (only 24.7% passed dispensarization in 2018-2019) is established. The level of awareness of dispensarization program is related to age of patient (65 years and older), rate of visits to medical organization (municipal polyclinic), awareness of health maintenance and promotion.
THE SOCIAL RESPONSIVENESS OF HEALTH CARE SYSTEM: THE REGIONAL ASPECTS
Authors: Shigaev N. N , Krom I. L , Erugina M. V , Eremina M. G , Skorobogatova L. G
Published: September 2020

According to the WHO, social responsiveness is associated with non-medical indices of health care system functioning. The integral index of responsiveness of health care system at providing specialized medical care to children in rural areas of the region was applied for assessing the degree of concordance of regional health care system to expectations of population. The most positive appraisals of respondents were given to indices of social responsiveness determined by professionalism of the medical personnel of the Oblast children hospital. The survey results demonstrated that main problem of respondents is transport accessibility of specialized medical care for children in rural areas of the region.
THE SOCIAL PERSPECTIVES OF DIGITIZATION OF HEALTH CARE: THE MEDICAL SOCIOLOGICAL ASPECT
Authors: Shamshurina N. G
Published: September 2020

In the Russian Federation, the technology platform «Medicine of the future» is specifically identified in the sector of digital economics. In the «Medicine and health care» sector, diagnostic systems based on molecular and cellular targets, genomic, post-genomic and cellular technologies are singled out. In the «Pharmaceutical industry" sector, the breakthrough areas include such innovative pharmaceuticals as vaccines (DNA vaccines), hormonal agents, coagulation factors, drugs based on cytokines, monoclonal antibodies, drugs for demographically significant diseases, antiseptics. In the sector of «Production of new materials» the priority targets is development of nano-technology and nano-materials and technologies of elaboration of bio-compatible materials. The main target is training and retraining of personnel in digital medicine skills, organization of national technological platforms for on-line education, on-line medicine and adjustment of existing and development of new educational programs. The social alterations resulting due to health care digitalization are associated with transformation of the structure of labor market of medical personnel, giving rise to emergence of new medical professions at the scientific research junction. The social perspectives of health care digitalization reflect formation of «knowledge society», development of information society and digital economics as a whole, development of competitive technologies and services in medicine. The world expert community, implementing sociological and socio-economic research, confirms that digitalization of medicine and economics gave rise to the ideology of «Social Investment» («Impact Investing», or, otherwise, «investment in social effect»). The digitalization of health care and economics has led to the need of developing new civilizational paradigm, to the necessity of human dimension of technological and economic processes. The positive social changes caused by development of digital medicine, do not exclude the emergence of social risks, manifested in possible violation of privacy, patients' rights, reducing level of security and dangerous dehumanization of society, reducing the value of patient as individual in conditions of development of biomedicine and genetic engineering as areas of digital medicine.
THE CONSTRUCTIBLE IMAGE OF ORPHAN CHILD IN IDEAS OF MOSCOVITES
Authors: Prisyazhnaya N. V
Published: September 2020

The article considers the ideas of Muscovites concerning issues of social orphanhood, th condition in which child is left without any actual parental care. According to the results of sociological survey the obvious family problems are mostly associated with parents' dependence on psychoactive substances, while condition of "hidden" social orphanhood is developed as a result of high employment or parents' centering on their own interests. At the same time, the ideas expressed by respondents concerning image of socially orphan child had negative connotation that is reflected in the constructible image of orphan child of any gender aged from 7 to 10 years, unkempt and lagging in physical development, demonstrating range of negative emotions (sadness, anger, fear, guilt) and maladaptive behavior but not having any characteristics (disorders) of health.
The surgical treatment of primary congenital (infantile) glaucoma
Authors: Khamroeva Yulduz Abdurasdhidovna
Published: September 2020

Aim. The objective of the present study was to evaluate the effectiveness of the surgical intervention for the treatment of the children at the age from 3 to 10 years suffering from primary congenital (infantile) glaucoma depending on the severity of the morphometric changes. Materials and methods. A total of 16 patients (30 eyes) were available for the examination. Three patient (6 eyes) presented with mild glaucoma, 8 ones (15 eyes) with advanced glaucoma, and 5 (10 eyes) with end-stage glaucoma. All the patients underwent the surgical treatment supplemented by a course of neuroprotective therapy during the postoperative period (6 months after surgery). Results. Based on the results of the preoperative examination, the children with mild glaucoma underwent the surgical intervention on 5 eyes with the use of non-penetrating deep sclerotomy. The patients with advanced glaucoma and the children with terminal glaucoma were operated on 15 and 8 eyes respectively by means of “ab externo” sinusotrabeculotomy. The filtering operation was performed on two eyes of the children with terminal glaucoma with the use of our original method. Conclusion. The above surgical technologies allowed to decrease the frequency of intra- and postoperative complications by 15%, avoid secondary interventions, decrease intraocular pressure in 12.3% of the patients, and improve visual acuity by 0.15 in comparison with its initial value.
Binocular diplopia: the diagnostics and treatment
Authors: Aklaeva Nailya Anvarovna
Published: September 2020

Binocular diplopia is a complex form of oculomotor pathology. The present article describes the modern approaches to the diagnostics of this condition and its combined treatment including both functional and surgical methods as well as prismatic correction. The proposed scheme for the management of binocular diplopia makes it possible to achieve the significant improvement of the major functional characteristics and to markedly enhance the quality of life of the patients with this pathology.
THE EVALUATION OF THE TYPES OF FIXATION OF INTRAOCULAR LENSES DURING LENSECTOMY IN THE CHILDREN PRESENTING WITH MARFAN’S SYNDROME
Authors: Pershin K. B , Pashinova N. F , Cherkashina A. V , Tsygankov A. Yu
Published: September 2020

Aim. The objective of the present study was to evaluate the results of lensectomy in the combination with intraocular lens implantation including various types of their fixation in the children presenting with Marfan’s syndrome. Materials and methods. The study included 16 children presenting with Marfan’s syndrome and congenital cataract (31 eyes) at the age from 3 to 16 (mean 9.8+-4.1) years treated in the Excimer Eye Centre during a period from 2003 to 2015. The best corrected visual acuity (BCVA) prior to the surgical treatment was estimated at 0.1-0.4 (0.32+-0.16). All the patients underwent early phacoemulsification of the cataract in the combination with the intraocular lens implantation after the standard ophthalmological examination. Various types of intraocular lens implants were applied, namely AcrySof SN 60AT (n=2), SN60WF (n=3), MA60AC (n=19), MA60BM (n=2), and toric SN60T5 (n=3). The choice of the method for the intraocular Implant fixation depended on the degree of lens ectopia, the capsule characteristics, and the age of the patient. Results. Three main types of lens fixation were identified, viz. the mixed type (n-5), intracapsular (n-15) and intrascleral (n= 11) types. The BCVA measured within 12-36 months after the surgical intervention: was 0.4-1.0 (0.78+-0.26). The dislocation of the implanted intraocular lens was documented in 10 children, including all the three cases in the group with the mixed type of fixation without suturing and two cases of membranous cataract. Lens dislocation developed in 6 eyes of the patients with the Intracapsular localization of the intraocular lens and in 7 other eyes of the children comprising this group. Secondary lens reposition was required in a single patient who had undergone intrascleral lens fixation. No cases of uveitis, retinal detachment, macular oedema, and other complications were documented. Conclusion. In all the cases of lensectomy in the combination with the intraocular lens implantation in the children presenting with Marfan’s syndrome, the well apparent improvement of the visual functions and reduction of the severity of ambliopathy have been achieved. The lowest frequency of postoperative complications and the best functional outcome of the surgical treatment were documented in the group of the children with the intrascleral fixation of the intraocular lens implants. However, further studies involving a large sample of the patients are needed to obtain the statistically significant data for the evaluation of the long-term outcomes of the surgical treatment of the children presenting with Marfan’s syndrome and the choice of the optimal method for the fixation of the intraocular lens implants.
THE SPECIFIC FEATURES OF FLUORESCEIN ANGIOGRAPHY OF THE RETINA IN THE CHILDREN OF DIFFERENT AGE AND THE POSSIBLE COMPLICATIONS OF ITS APPLICATION
Authors: Zaitcev Nikolai Anatol’evich
Published: September 2020

Purpose. The objective of the present study was the further adaptation of the fluorescence angiography technique for the examination of the children of different ages and the evaluation of the nature, severity, and frequency of complications likely to develop in the course of such examination as a result of intravenous administration of sodium fluorescein and its intake. Material and methods. A total of 957 children at the age varying between 1.5 months and 16 years were divided into two age groups. The first group consisted of 204 (21.3%) children under the age of 1.5 months and up to 5 years including premature babies in whom fluorescence retinal angiography was performed under general anesthesia with the use of the specially developed and improved methodology. The second group was comprised of 753 (78.7%) children at the age between 6 and 16 years. To 649 of these children (86.2%), the dye was injected intravenously whereas to 104 (13.8%) of them sodium fluorescein was given per os. Results. We have developed and further improved the method for fluorescence angiography in the children of various ages including premature infants. The fluorescence angiography of the fundus of the eye in the children at the age from 1.5 months and up to 16 years resulted in the complications of varying severity in 5.2% of the patients. Mild complications in the form of nausea or vomiting accounted for 3.8% of their total number. The moderately severe complications (1.0%) manifested themselves as the development of the collaptoid state or urticaria. The severe complications (0.2%) were apparent as bronchospasm and laryngospasm. No complications whatever were documented in the children after the oral intake of a 10% sodium fluorescein solution. Conclusion. The intravenous fluorescence angiography is a fairly safe method for the examination of the fundus of the eye in the children, however it can be accompanied in rare cases (3.8%) by the complications the majority of which (75%) are mild disorders. Both intravenous administration of sodium fluorescein under general anesthesia and its oral intake can be regarded as safe interventions.
GLAUCOMA IN THE CHILDREN PRESENTING WITH STAGES IV AND V OF RETINOPATHY OF PREMATURITY: THE PECULIAR FEATURES OF THE TREATMENT AND OUTCOMES
Authors: Konikova Ol’ga Aleksandrovna , Diskalenko O. V , Gaydar M. V , Brzheskiy V. V
Published: September 2020

Purpose. The objective of the present work was to study the specific features and the effectiveness of the management of glaucoma in the children presenting with stages IV and V of retinopathy of prematurity after vitreoretinal surgical treatment of retinal detachment. Material and Methods. A total of 172 patients (299 eyes) with stages IVa, IVb, and V of retinopathy of prematurity were involved in the prospective cohort study after they had undergone the vitreoretinal surgical intervention for the treatment of retinal detachment. The duration of the follow-up period was 5 years. The treatment of glaucoma included cyclophotocoagulation and the implantation of the Ahmed glaucoma valve drainage. Results. In the early postoperative period, the anatomical success of the surgical treatment of retinal detachment at stages IVa and IVb of the retinopathy of prematurity was estimated at 95,3% and 97,1% respectively; the frequency of smoothing out of the retina associated with the formation of the retinal reattachment zones at stage V of the disease amounted to 63.6%. The frequency of the development of glaucoma was estimated to be 24,0% at stage IVa, 18,3% at stage IVb, and 9,2% at stage V. The clinical manifestations of glaucoma developing at stage IVa retinopathy of prematurity were especially well apparent in the patients with the congenital disease. The secondary neovascular glaucoma without buphthalmos was usually associated with stages IVb and V of retinopathy of prematurity. The effectiveness of cyclophotocoagulation efficacy was estimated to be 36,4% at stage IVa compared with 50,0% and 57,3% at stages IVb and V respectively. The implantation of the Ahmed glaucoma valve drainage proved efficient in 9 out of the 10 cases; still 77.8% of the patients needed a repeated revision for the evaluation of the state of the Ahmed valve drainage. The study has demonstrated that the overall success of the glaucoma treatment in the children presenting with stages IVa retinopathy of prematurity was 100% compared with 3.5% and 33.3% in those with stages IVb and V of the disease respectively. Conclusion. The glaucoma developing in the children with stages IV and V of retinopathy of prematurity is a refractory neovascular condition especially if it is associated with stages IVb and V of the primary disease.
THE APPLICATION OF TYPE A BOTULINUM TOXIN FOR THE TREATMENT OF PATIENTS PRESENTING WITH VARIOUS FORMS OF STRABISMUS
Authors: Efimova E. L
Published: September 2020

The use of type A botulinum toxin (BTX-A) for the treatment of strabismus was for the first time proposed in the early 1980s by the American ophthalmologist Alan Scott. The earliest applications of the botulinum toxin in the clinical practice included the treatment of strabismus and blepharospasm. The use of this agent can be particularly useful in the situations where the surgical treatment of strabismus is either undesirable or impracticable for one or another reasons; moreover, injections of BTX-A were successfully used to treat the patients presenting with severe diplopia. The results of the application of the botulinum toxin reported by different authors vary considerably which dictates the necessity of a deeper insight into the mechanisms underlying its action and their further investigation. The commonest complications of therapy with this medication are a temporary ptosis and vertical deviation. The systemic complications of BTX-A application have never been documented; its repeated injections are believed to be safe for the patients.
THE SURGICAL CORRECTION OF THE ANOMALIES OF THE POSTERIOR CAPSULE OF THE LENS
Authors: Babadzhanova Lola Dzhananovna , Turakulova D. M , Kariev A. V , Berdaliev A. F
Published: September 2020

Aim. The objective of the present work was to describe the surgical strategy used for the correction of congenital cataract in the children presenting with the anomalies in the posterior capsule of the lens making possible intracapsular implantation of the IOL. Material and methods. The analysis of the surgical strategy for the removal of congenital cataract in the children presenting with the anomalies in the posterior capsule of the lens was performed based on the results of objective examination of its clinical and anatomical features in 40 patients (71 eyes) with the use of biomicroscopy, ophthalmoscopy, and ultrasound study. Results. The intact transparent posterior capsule of the lens was found in 28% of the examined children while 72% of them exhibited changes in the capsule in the form of thinning (33%), lenticone (25%), fibrous degeneration with the presence of calcificates (14%). The choice of the differential surgical treatment of the above anomalies was made on an individual basis. Implantation into the capsular bag proved successful in 81% of all the cases and into the ciliary furrow in 15%. Implantation of IOL was found impossible in $% of the patients. Due to a major defect of the capsular bag. Conclusion. The surgical treatment of congenital cataract with concomitant changes in the shape and transparency of the posterior capsule of the lens requires a differential approach in order to carry out intracapsular implantation of IOL even in the case of manifest posterior lenticone and avoid the development of intra- and postoperative complications.
THE ROLE OF NEURORETINOPROTECTION IN THE PEDIATRIC OPHTHALMOLOGICAL PRACTICE
Authors: Saidasheva Elvira I.
Published: September 2020

This article presents the author’s many year experience with the use of domestic medications of peptide structure for the combined treatment of various diseases of the optic nerve and the retina in the children. In addition it summarizes the results of the relevant investigations. The clinical effectiveness of retinalamin used as a neuroprotector for the treatment of the disabling conditions, such as atrophy of the optic nerve, retinopathy of prematurity, and degenerative myopia and post-therapy rehabilitation, is demonstrated.
CONSEQUENCES OF BURN INJURY OF ADNEXA IN CHILDREN. THE EFFECTIVENESS OF SURGICAL TREATMENT
Authors: Filatova I. A
Published: September 2020

Аim. Тo assess the effectiveness of surgical treatment of consequences of burn injury of adnexa in children. Material and methods. The analysis of clinical material over the past 10 years. The clinical group consisted of 59 patients (44 - male, 15 - female) with the consequences of burn injury of adnexa in age from 2 months to 18 years (m = 9.17 ±3.23 years). The burn trauma were the following: thermal (flame, hot objects, gas explosion) - 43, chemical (acid, alkali) - 11, combined (melted lead/glass) - 5. The time that has passed after the burn until the first stage of surgical treatment ranged from 1 month to 2 years (m= 9.7 ± 5.1 months). The author describes in detail the clinical picture, noting that significant lagophthalmos is dominated by the consequences of thermal burns, the consequences of chemical burns occurred entropion, symblepharon, leucoma. 11 patients had anophthalmos. In all, 121 operations were performed in 59 patients (1 to 4 stages, m = 2,1±1,1) with an interval from 3 to 12 months (m=8.3 months): removal of lagophthalmos with method of local plastics or free skin grafting; elimination of symblepharon or reconstruction of the conjunctival cavity with lips/cheeks’ mucous grafting; the strengthening of the eyelids’ edges, eyelashes plastic. The technics of the operation is described. Follow up period for patients from 6 months to 13 years (m=6,7±2,1). Results. Wound healing in all cases took place in the usual time. Skin sutures were removed after 7-9 days, traction sutures in 3 weeks, blepharorophy in 1-6 months. Engraftment of the transplanted free skin and mucous’ grafts was without a significant reduction. Visual function were preserved and improved in all the cases (44 patients). Cosmetic contact lenses were chosen in 4 patients with Vis = 0. A stable position of the prosthesis achieved in patients with anophthalmos. Conclusion. Consequences of burn injury of adnexa in children are diverse and require a differentiated approach to the choice of timing, priority, and methods of surgical treatment. Eyelid plasty is advisable to perform in the “cold” period after the completion of processes of scar tissue formation in the absence of threats to the condition of the eye.. Reconstruction should be performed at any time to prevent the development of ulcers or perforation of the cornea in the presence of the inversion of eyelids, symblepharon, significant lagophthalmos causing suffering of cornea.
ACHIEVEMENTS OF PEDIATRIC OPHTHALMOLOGY IN THE RUSSIAN FEDERATION FOR 10 YEARS
Authors: Katargina L. A , Arestova N. N , Michaylova L. A
Published: September 2020

In recent years, there have been significant positive changes in the organization of ophthalmological care for children, formed the legal basis for the provision of medical care to children with ophthalmopathology, increased the availability and quality of medical care, detectability of ophthalmopathology (6%), increased the results of treatment, which reduced the level of primary disability per 10 thousand of the child population in the Russian Federation has declined from 1.4 in 2004. to 0.9 in 2016. Early treatment has helped reduce blindness and low vision in 2.6 times (from 58.4 in 2009 up to 22.7 in 2016). The rapid development of pediatric ophthalmology is due to the introduction of new highly informative objective methods of research, high-tech surgical and laser treatment in the leading ophthalmic centers of Russia: Federal clinical recommendations on diagnosis, monitoring and treatment of children with retinopathy of prematurity (active phase), myopia, congenital cataracts, retinoblastoma, concomitant strabismus, congenital glaucoma, uveitis associated with juvenile idiopathic arthritis, congenital pathology of lacrimal pathways in newborns and children of the first year of life have been developed and put into practice.
Regional anesthesia in spine and spinal cord surgery
Authors: Ezhevskaya Anna A.
Published: September 2020

The review is concerned with the summarizing, systematization and analysis of the results of current clinical studies of the use of regional techniques of anesthesia during the spine surgery and spinal cord surgery on the intraoperative stage, as well as regional techniques of postoperative pain management. The current review represents new data concerning description of various regional techniques of anesthesia, the different choice of anesthesia and analgesia, depending on the type of surgery and used drugs. The present overview will focus on possibilities of the use of regional anesthesia at various stages of surgery, including prolonged analgesia in the postoperative period and options combinations of drugs and techniques themselves. We have suggested that there are new opportunities to improve the safety of anesthesia, reduce the number of side effects, as well as finding new solutions for collaborative use of regional anesthesia and neurophysiological monitoring, development of optimal schemes of anesthesia, which should contribute to a better understanding of the issue and expand the possibilities of using the achievements of anesthesiology in medical practice. Although regional techniques are increasingly demonstrating its advantages over general anesthesia, including spine surgery, further research is mandatory in this field of medicine to determine their influence on the surgery outcome of the treatment and the patient's recovery as a whole.
Pain as a symptom of tuberculosis spondylitis (complex analysis on the mono-central cohort study)
Authors: Pulkina Olga N. , Mushkin A. U , Ulrikh G. E , Kuklin D. V , Kalinin U. V
Published: September 2020

Goal of the research: to evaluate intensity and pain components in patients with tuberculous spondylitis addmited to the hospital for planned surgical treatment. Patients (n=115) with tuberculous spondylitis, addmited to the planned radical reconstructive surgery. Before surgery pain intensity in patients was evaluated according to VAS, as well as senso-discriminative, affective and cognitive components of pain, the presence of neuropathic component, the level of anxiety and depression being also evaluated. Patients addmited to the planned surgical treatment have multiple comorbidities, chronic pain of average intensity, in which there is a 48% neuropathic component, more than 60% of patients have an affective component and there are also numerous predictors of formation of high-pain intensity in the postoperative period. The assessment of pain in patients with tuberculous spondylitis should be carried out using both a visual analogue scale and complex questionnaires to identify the nature and components of pain, the presence of neuropathic and affective component with a view of corresponding correction of the treatment.
ANAESTHESIA FOR HIP FRACTURE SURGERY IN GERIATRIC PATIENTS (CLINICAL GUIDELINES)
Authors: Koriachkin Victor A. , Zabolotski D. V , Kuzmin V. V , Anisimov O. G , Ezhevsky A. A , Zagrekov V. I
Published: September 2020

Clinical guideline contained a summary on the management of hip fractures in the elderly. Presents the key positions, the implementation of which is required in the perioperative period. Special attention is given pain relief, prevention of delirium and management of patients in the postoperative period.
CENTRAL ACTIVITY ANALGETIC NEFOPAM AS A COMPONENT OF ANALGOSEDATION IN OPHTHALMOSURGERY
Authors: Myasnikova Victoria V. , Bityukov U. V , Dereza S. V , Kuznetcov I. V , Poryadina O. V , Fedorenko S. S , Cherkasova I. V , Chuprin S. V
Published: September 2020

Prospective research was made to evaluate the efficiency of nefopam in anasthesiology manual- analgosedation with preserved consciousness- during anticataractal and antiglaucoma operations. The research involved 2 groups of patients: with nefopam analgesia and tramadol analgesia. Data of research includes evaluation of the dynamics of hemodynamic information and oxygenation, rate of intraoperation critical incidents (oculocardiac syndrome, other arrhythmias, hypertension and hypotension). By verbal pain assessment scale we have compared the level of intraoperation analgesia. We get the following results: combination of nefopam and droperidol provides analgosedation which is more hemodynamic stable and has significantly lower intraoperation critical incidents then analgosedation of tramadol. Nefopam has undesirable side effects like temperate increase in heart rate and pain during injection along the vein in combination with ketorolac. Sufficient dose for analgesia at old-aged patients in ophthalmosurgical practice is 10 mg of nefopam.
DOES ANEMIA AFFECT PERIOPERATIVE PAIN INTENSITY IN AGED PATIENTS WITH DIABETIC FOOT SYNDROME?
Authors: Sheina Mariy A. , Sokologorskiy S. V , Zvyagin A. A , Orudzheva S. A
Published: September 2020

Background: As diabetes takes on pandemic proportions more than 500000 aged (over 50 years) patients undergo pedis amputation yearly. Anemia is very often accompanied diabetes mostly in aged patients. Anemia may influence somehow the pain severity in postoperative period. Objective: To investigate the possible anemia influence on severity of post surgery pain in aged diabetes patients with anemia. Design: A retrospective medical documentation analysis. Setting: Federal scientific centre. Patients: 58 diabetes patients aged from 50 to 75 with and without anemia after elective pedis surgery. Intervention. Patients were allocated to one of four groups: - 16 patients with anemia who received naropin combined with lidocaine for peripheral nerve blockades (I group), 14 patients with anemia who received only naropin (II group), 11 patients without anemia who received naropin combined with lidocaine (III group) and 17 11 patients without anemia who received only naropin. Main outcome measures: Levels of mean arterial pressure, oxygen delivery index, glycaemia and VAS scores were evaluated on four time points: 24 hours before surgery, in operating room, 12 and 24 hours after surgery respectively. Results. VAS scores and levels of mean pressure was higher in anemia groups postoperativly - 3,3±1,50 vs 0,6±0,82 and 101,7±7,81 mm Hg vs 87,9±12,08 mm Hg respectively. Glycaemia levels had no statistically significant differences neither in time points nor in groups. Oxygen delivery index levels also had no differences in time points but levels were significantly different between groups. Conclusion: Taking in account the results of the analysis it is obvious that anemia contributes to the severity of pain in postoperative period in aged diabetes patients somehow. More clinical investigations must be done to evaluate exact portion of anemia contribution.
INTRAOPERATIVE NAUSEA AND VOMITING DURING CESAREAN SECTION UNDER SPINAL ANESTHESIA
Authors: Pogodin A. M , Shifman E. M
Published: September 2020

The review covers the main causes and risk factors for intraoperative nausea and vomiting during cesarean section under spinal anesthesia. The analysis of existing drugs for the prevention of this complication. Special attention is paid to the prevention of intraoperative nausea and vomiting in obstetric patients’ profile.
CAUDAL ANESTHESIA DURING BRACHYTHERAPY FOR PROSTATE CANCER (CASE REPORT)
Authors: Potapov Aleksandr L. , Derbugov V. N , Obuhov A. A , Parshin V. S , Berezovskaya T. P , Smolkin A. L
Published: September 2020

The case report of anesthesia during brachytherapy for prostate cancer in patient with spinal comorbidity and neurological deficits has been presented. It has been shown that caudal anesthesia with MR-scanning, palpation of anatomical landmarks and ultrasonography navigation might be a method of choice in this patients.
FEATURES OF REGIONAL ANESTHESIA AND POSSIBLE COMPLICATIONS IN OPHTHALMIC SURGERY
Authors: Myasnikova Victoria V. , Sahnov S. N , Martsinkevich A. O , Golovataya M. V
Published: September 2020

In ophthalmic surgery, the choice of the method of anesthesia presents certain difficulties for both the anesthesiologist and the ophthalmologist. According to world statistics, the most frequently performed ophthalmic operations are performed in patients of the older age group who have concomitant chronic somatic diseases (diabetes mellitus, hypertension, atherosclerosis, etc.). It is advisable to use local anesthesia in the elderly, as well as in patients with severe co-morbidities or contraindications to general anesthesia. The review presents the characteristics of local anesthetics and the types of local anesthesia used in ophthalmic surgery (vesicular blockade, facial nerve blockade, retrobulbar anesthesia, peribulbar anesthesia, instillation or topical anesthesia). Also in the article, possible complications of these methods of regional anesthesia, their prevention and the principles of emergency care in case of their occurrence are described. Particular attention in the review is given to the toxicity of local anesthetics.
PROLONGED EPIDURAL ANALGESIA AFTER COLORECTAL SURGERY IN ELDERLY PATIENTS
Authors: Savushkin Alexander V. , Khachaturova E. A , Balykova E. V
Published: September 2020

Objective: to compare the effectiveness of prolonged epidural analgesia by continuous infusion or bolus administration on demand, as well as the timing and volume of early mobilization with two methods of postoperative analgesia. Material and methods: prospective randomized study enrolled 161 patients with colorectal cancer aged from 60 to 89 years, operated by means of laparotomy and laparoscopy. In the main group (n=80), postoperative prolonged epidural analgesia was carried out using individual pumps with an initial rate of 0.2% ropivacaine solution of 4-6 ml/h. In the comparison group, epidural analgesia was provided by bolus administration of 4-6 ml of 0.2% ropivacaine solution on demand. Results: In the main group with open surgical interventions, in contrast to the comparison group, prolonged epidural analgesia provided a decrease in the intensity of pain on the second (2.7 ± 1.8 and 4.1 ± 1.4 score, p < 0.001), third (2.6 ± 1.6 and 3.9 ± 1.1 score, p < 0.001), fourth day (2.3 ± 1.7 and 3.5 ± 1.2 score, p < 0.001). Prolonged epidural analgesia in the main group allowed more patients to be activated on the second (64.2% (52 of 81), p < 0.001), third (97.5% (79 of 81), p < 0.001) and fourth (100%, p < 0.002) days. The average time of activity in the main group was three times higher on the third day and twice - on the fourth day (p < 0.001). Conclusion: Postoperative prolonged epidural analgesia is highly effective in elderly patients during their treatment with enhanced recovery methods.
PAIN SYNDROMES DEVELOPING IN PATIENTS DURING LONG-TERM HEMODIALYSIS
Authors: Spasova Arina P. , Barysheva O. Yu , Tikhova G. P
Published: September 2020

Objective. To assess the frequency and intensity of painful muscle spasms (cramps) in patients with end-stage CKD during hemodialysis; to determine the impact of potentially modifiable risk factors on their development. Materials and Methods. The study involved 111 male and female patients receiving treatment on hemodialysis program. Crumps intensity was assessed using a brief pain questionnaire two hours after hemodialysis initiation, during three consecutive procedures. The HADS questionnaire was used to detect anxiety and depression. Blood pressure, interdialysis weight gain were evaluated during three consecutive dialysis procedures. Phosphate binders were taken into account for all patients in the sample. Serum concentrations of phosphorus (P), total calcium (Ca) and parathyroid hormone (iPTG) were determined in all patients. Results. The mean age of patients was 51.8 ± 2.3 years, the mean duration of hemodialysis treatment was 7.7 ± 0.9 years, the mean procedure duration was 12 ± 0.24 hours per week, the mean level of KT/V was 1.4 ± 0.03. The frequency of crumps was 55%, the mean intensity was 5.2±1.8 points by the numerical rating scale (NRS). Compared with the group of patients without crumps, the risk of pain muscle spasms increased with increasing age of patients, hemodialysis experience, interdialysis weight gain. An important modifiable risk factor was intradialysis hypotension (or 10.9 (95%CI 3,0; 38.9) p = 0.0002). Statistically significant differences between the groups with or without cramps not obtained on any of the three indicators of mineral metabolism (PTH (p = 0,87); P (p = 0,25); overall Ca (p = 0,70)). Conclusion. Painful muscle spasms (cramps) occur in every second patient on hemodialysis program. The impact on potentially modifiable risk factors for muscle spasms, such as interdialysis weight gain, hypotension during hemodialysis, and phosphorus level correction, can reduce the frequency and intensity of this type of pain syndrome.
Postoperative analgesia in plastic surgery
Authors: Ovechkin Alexei M. , Zvizhuleva A. A
Published: September 2020

The review is devoted to the questions of prophylaxis and treatment of postoperative pain in plastic surgery. The pain in plastic surgery remains a serious problem in particular after major reconstructive-reparative operations. It impedes patient timely discharge from hospital in same-day surgery. Postoperative pain in plastic surgery may become chronic in 10-40% cases especially after operations on mammary glands. The basis of postoperative analgesia in plastic surgery is combined using of nonopioid analgesics (NSAIDs, paracetamol, gabapentin) and different variants of regional analgesia. Opioid analgesics are considered as reserve drugs for cases when nonopioid analgesia isn't effective.