Hereditary breast and ovarian cancer is one of the most common genetic pathology. Medical and genetic counseling of patients with hereditary breast and ovarian cancer and their families plays the important role in cancer care, as it helps to develop the set of diagnostic, preventive and therapeutic measures aimed at monitoring healthy individuals and to create personalized approaches to the treatment of patients.

Vitamin D takes part into the metabolism of the bone tissue, regulating the processes of mineralization and remodeling. There are a lot of data on uses of using of vitamin D in patients of trauma and orthopedic profile, but opinions about the method of taking, dosage, effectiveness differ greatly and requires more in-depth research.

The objective of this study was to review and analyze of actual clinical and experimental researches related to the influence of metabolites of vitamin D in the endoprosthesis of large joints, among the available sources of medical database of PubMed, Cohraine, e-Library.

The results of most studies of local and systemic use of metabolites of vitamin D led to the conclusion about the beneficial effects of these compounds on bone regeneration in traumatology and orthopedics. However, further researches are required to clearly identify the clinical application of these approaches.

We supposed that the following factors considered for long-term work: assessment of long-term effect and usage of standardized doses, learning new derivatives of vitamin D, synergy in the combinations of vitamin D preparations, pharmacokinetics of vitamin D preparations and polymorphisms of genes associated with vitamin D, genes influencing the life activity of bone and assessment of the effect of concomitant disease, systemic pathological processes on related of vitamin D metabolism, and bone restoration. We are also define the simultaneous corrections of vitamin D levels as an important component of the compensation of bone disorders in trauma and orthopedic patients.

Neuroblastoma is a malignant tumor derived from the neuroblasts of the sympathetic nervous system, which develop in any region of the nervous system. Usually, neuroblastoma is detected in children aged 1–2 years. About 90% of cases are diagnosed before the age of 5 years. The incidence of adult neuroblastoma is only 0.3 cases per million people per year. The clinical course and biological activity of adult neuroblastoma is different than children neuroblastoma. Early diagnosis of this disease in adults is necessary for timely start of treatment and increasing life expectancy. In this clinical observation, we present a detailed description of the course of this rare disease in the 34-year-old male and literature review on adult neuroblastoma.

Introduction. According to WHO data, COPD is the 4th cause of death in the world. The important problems of COPD are frequent exacerbations, comorbid conditions and late diagnosis. One of the most important factors in the formation of COPD is smoking. Recently, special attention is paid to the peculiarities of the course of COPD in women.

The objective of this study was to reveal the peculiarities of smoking status in people of different sexes with different severity of respiratory symptoms in order to further creating the groups of patients on tobacco cessation.

Material and methods. 108 smoking patients aged 20 to 60 years were examined in real outpatient practice. Besides the questionnaire, all examined underwent spirometry and CO determination (ppm) in exhaled air.

Results. Analysis of the results of the study showed that women started smoking later than men. The number of day-today smoked cigarettes, the smoking index, and the degree of nicotine addiction in women were significantly less that was naturally accompanied by a significantly lower content of CO in the exhaled air. Broncho obstructive syndrome was found in 56% of men and 44% of women; the degree of nicotine addiction and respiratory symptoms were interrelated only in women (r=0.50, p<0.01). The period of withdrawal from tobacco smoking was significantly longer in women despite of the almost equal motivation to smoking cessation and the number of attempts of getting rid of tobacco addiction.

Conclusions. Significant gender peculiarities of smoking status the degree of motivation to smoking cessation, their relationship with respiratory symptoms were revealed which requires the introduction of different approaches to the programs of healthy lifestyle in people of different sexes. 

Introduction. Surgically induced astigmatism (SIA) is one of the reasons of the patient’s dissatisfaction with the refractive result after phacoemulsification (PHACO). The degree of SIA depends mainly on the type, length, shape and location of the tunnel, the distance to the optical center of the cornea, as well as the biomechanical properties of the cornea. Pseudoexfoliation syndrome (PEX) is associated with a change of the biomechanical properties of the cornea. The issue of the effect of these changes on the degree of SIA remains unexplored.

The objective is to assess the influence of PEX on the degree of SIA after PHACO.

Material and methods. The study included 42 patients (42 eyes) admitted for surgical treatment of cataracts to the V micro-surgical Department of the HMB № 2. The main group consisted of 20 patients (20 eyes) with PEX, the control group consisted of 22 patients (22 eyes) without PEX.

The groups were of equal sex and age. The main selection criterion for the main group was the detection of pseudoexfoliative material on the anterior lens capsule, along the pupillary edge edge or in the corner of the anterior chamber. The exclusion criteria were the traumatic and uveal cataracts, glaucoma and laser vision correction in the anamnesis. All patients underwent keratotopography (TMS-3, Tomey, Japan) preoperatively and in 4 to 6 weeks after surgery.

Results. There was no significant difference in the degree of SIA (limbal incision, 2.4 mm) among the groups provided the formation of a 2.4 mm limbal tunnel. Moreover, there was no significant difference in the degree of SIA between the nasal and temporal limbal tunnels within the groups. 

Introduction. Nowadays, it is important to study the mechanisms of psychological adaptation in patients with early stage of chronic cerebral ischemia (ES CCI) from the standpoint of biopsychosocial approach.

The objective of the study was to develop the algorithm for identifying psychosocial characteristics of patients with ES CCI and providing them with psychotherapeutic care. Material and methods. 280 patients with ES CCI developed against a background of arterial hypertension and/or cerebral atherosclerosis (middle age 53.9±8.1 years (from 30 to 72 years) gender index 1:1) were selected for the study. The control group included healthy individuals comparable to those in the main group according to gender and age characteristics (n=32, middle age 52.4±6.5 years (31–65 years), gender index 1:1, p>0.05 ). The panel of psychological methods was used to identify the individual psychological and socio-environmental factors in patients with ES CCI.

Results and conclusions. A three-stage algorithm of psychological and psychotherapeutic support of patients with early stage of chronic cerebral ischemia (ES CCI) was developed and tested by the multidisciplinary team of specialists. At the stage of opportunistic screening, the neurologist used express methods for diagnosing cognitive (Mini-test of mental state), emotional (Hospital scale of anxiety and depression), vegetative disorders (the Wayne test) among the studied persons. At the stage of selective screening, the medical psychologist performed systemic psychodiagnostics of the ES CCI. At the stage of treatment, a correction was made: psychovegetative disorders by progressive muscular relaxation; anxiety-depressive manifestations – cognitive re-attribution according to A. Beck; obsessive-phobic disorders – direct motivated suggestion in reality with elements of clarification and persuasion. The indicators of the effectiveness of psychological and psychotherapeutic correction in patients with ES CCI were: positive dynamics of the Scale of quality of life SF-36 and regression of integrative indicators of the Scale of psychopathological manifestations of SCL-90-R – «Index of overall severity of symptoms» and «Total number of affirmative answers». Thus, the algorithm described above is suitable for use in practical healthcare for optimizing individual therapeutic strategies. 

 

Introduction. Nowadays, the prevention of dental diseases is very important in dentistry. The main measure aimed at prevention of dental diseases is an individual oral hygiene. Its effectiveness depends on the quality and regularity, as well as the proper selection of means of individual oral hygiene.

The objective is to study the effectiveness of using the certain toothpastes with different active ingredients.

Material and methods. Toothpastes «А» and «B» were used to study the effectiveness of using the certain toothpastes with different active ingredients. Probantes at the age of 50 to 70 years, with the presence of dental deposits and periodontal disease of moderate and severe degrees of severity took part in the study of the effectiveness of using these toothpastes. They were divided into two groups of 26 people in each group. The study evaluated the following indices: the hygiene index of Green – Vermillion (1964), gingival PMA index (Parma, 1960), the bleeding index of Muhleman and Son (1971). Results. The experiment discovered the decrease of the values of the digital indicators of the hygiene index of Green – Vermillion, gingival PMA index, and the bleeding index of Muhleman and Son in all groups during the whole period. These changes of the values of the indices were accompanied with the simultaneously increase in the values of a cleansing effect, anti-inflammatory and hemostatic efficiency.

Conclusions. Toothpastes «А» and «В» are treatment-and-prophylactic toothpastes, acting effectively on the tissues and organs of the oral cavity with prolonged use. 

This paper presents the experience of practical use of the technology of computer stabilography with biological feedback in rehabilitation of patients suffering from lumbar-sacral dorsopathies and diagnosed large lumbar hernias. The data of high diagnostic and rehabilitation effectiveness of stabilometry systems was obtained during the 14-days observation period of 16 patients with clinical manifestations of L5-S1 radiculopathy and dorsalgia. The method was used in assessment of neurology deficit and secondary myotonic disturbances. The decrease of intensity of pain and recovery of axial balance and coordination were achieved. As a statistically significant improvement of the equilibrium, the Romberg’s coefficient was decreased from 670 to 295% (p<0.05) during the drug therapy and 10 trainings on stabiloplatform. The achieved data show the improvement of segmental motor and sensory functions, decrease of disturbances in statics and dynamics of vertebral column in patients with radicular syndrome and large hernias after the rehabilitation course with the application of the technology of computer stabilometry.

Gastric leak is the most dangerous postoperative complication of laparoscopic sleeve gastrectomy. Traditional surgical treatment options and endoscopic stent placement are not always successful. Negative Pressure Wound Therapy (NPWT) has shown itself like a new successful and feasible treatment option for leaks of different etiology after gastro-esophageal surgery.

The initial body mass index (BMI) of the patient was 46 and co-morbidity was represented: arterial hypertension, type 2 diabetes and dyslipidemia. NPWT was initiated in 14 days after laparoscopic sleeve gastrectomy. The abdominal part of the system were changed 3 times for14 days. The patient was discharged from the hospital in 14 days after the secondary sutures to the wound. No relevant complications related to the procedure were observed during the course of the vacuum therapy. It combines defect closure, effective drainage and allows doing a periodic inspection of the wound cavity. NPWT is a successful, safety and effective treatment option for the leaks after laparoscopic sleeve gastrectomy 

Spinal dural arteriovenous fistula (SDAVF) is a rare disease, however, with nonspecific initial symptoms, like back pain, parestesias, gait imbalance, weakness and numbness in extremities. Para- or tetraparesis, disturbance of deep sensation and pelvic organs functions may develop during the course of disease. There isn’t any specific laboratory tests. So, the diagnostics of dural fistulas is complex. The main screening method is magnetic resonance tomography (MRI), which may suspect or reveal dural fistula. Spinal angiography is a «golden standard» in diagnostics. Options of treatment include microsurgical separation or endovascular embolisation of fistula. The article presents a clinical case of SDAVF in thoracic region of spine. Related to complains, neurological exam and MRI data, the vascular mass was suspected and spinal angiography was per-formed to confirm the presence of SDAVF. After surgical treatment the patient was observed to rehabilitation course, which had improved his status. In sum, appropriate diagnostics, surgical intervention and rehabilitation are the main factors related to successful treatment of patients with SDAVF.