The First Republican Clinical Hospital of the Ministry of Health of the Udmurt Republic

Objective: to identify the species composition of pathogens causing acute odontogenic inflammatory process in the children’s jaws; to examine the sensitivity and resistance of the isolated microflora to antibiotics of various groups; and to determine the dependence of the disease clinical course on the type of dominant pathogen. Materials and Methods.The results of a microbiological study of exudate from purulent odontogenic foci of 900 children regarding periostitis and osteomyelitis of the jaws were analyzed. Results. In 65.6% of cases, the causative agent was Streptococcus pyogenes known as group A beta-hemolytic streptococcus (GABHS) possessing a high sensitivity to vancomycin (99%), fluoroquinolones (98%), beta-lactam antibiotics (91%), and the highest resistance to macrolides (41%). We have also isolated Streptococcus viridans (6.1%), Streptococcus pneumoniae (4.3%) andmixed microflora (14.3%). The syndrome of endogenous intoxication of the body was manifested by high fever in 56% of cases, by leukocytosis in 38% of patents, and by acceleration of the erythrocyte sedimentation rate in 57.4% of study subjects. There was no statistically significant difference in the degree of endogenous intoxication between groups with different types of streptococci. Conclusion. The cause of the inflammatory process in the jaws was GABHS (65.6% of cases) with a high sensitivity to vancomycin (99%), fluoroquinolones (98%), and beta-lactam antibiotics (91%).

Currently, there is an increase in the number of patients with nodular formations of the thyroid gland (TG), which requires preoperative diagnostics, which allows to detect in a timely manner follicular neoplasia and highly differentiated forms of cancer, colloid goiter with compression of the neck organs, nodular and diffuse toxic goiter (DUS) [5]. Most often, the nodes are located in the thyroid gland, but there are cases with atypical localization. Ectopia of the thyroid gland, or thyroid ectopia (from the Greek “ektopos”, i.e. “displaced”) is the presence of its atypical tissue in a place that is not characteristic of normal localization. This pathology develops due to a violation of the migration of progenitor cells of the thyroid gland during its embryonic development. The prevalence of thyroid ectopia is 1 per 100,000–300,000 people, 1 case per 4–8 thousand patients with thyroid pathology. Among the sick in 65–80 % of cases are women. According to the studied literature, thyroid ectopia can become a source of malignancy, so timely diagnosis and surgical treatment is necessary to prevent the development of life-threatening conditions. An analysis of a clinical case of atypical location of a thyroid nodule with a suspected oncological neoplasm in case of recurrence after hemithyroidectomy was carried out.

An example of the use of 3D-modeling of 3D-printing in the diagnosis and choice of a surgical approach for the treatment of hepaticocholedochal stricture is given. The inclusion of meglumine sodium succinate (intravenous drip, once a day, 500 ml, course of 10 days) into the therapy regimen was substantiated, which contributed to the reduction of intoxication syndrome due to its antihypoxic mechanism of action and, as a result, to a reduction in the duration of hospitalization and an increase in the quality of life of the patient.

INTRODUCTION: Medical staff limits often the presence of parents in ICU with their children, citing the fact that parents can bring serious difficulties to the work of the department. OBJECTIVE: To evaluate social and psycho-emotional aspects of joint stay of a family member (parents) with a patient (child) in ICU from the viewpoint of the medical stuff. MATERIALS AND METHODS: The study included hospitals, which followed the principles of a family centered care (FCC) approach in the treatment of patients (median and quartiles years — 4.00 (2.00; 10.00)). The 417 questionnaires were analyzed. The data were subjected to descriptive analysis. RESULTS: Respondents assessed the working conditions and the level of their wages not higher than satisfactory in more than 30 % of the answers. In the spectrum of assistance provided by family members to a patient in the ICU, the medical staff indicated 89 % and 91.5 % respectively sanitary and hygienic care, 82 % and 81.9 % — feeding him, 32 % and 47.1 % — assistance in transportation patient. The first level of preparation of parents for caring for a patient in the ICU was 3 (2; 3) — doctors and 3 (2; 3) — nurses, and when the patient was transferred from the ICU — 4 (3; 4) and 3 (3; 4) respectively. Claims in the opinion of the medical staff from patients and parents were due to their underestimation of the complexity of the situation with the patient (58 % and 48.6 %), the characteristics of patients (33 % and 36.3 %) and their parents (48 % and 39.8 %), insufficient awareness of the patientʼs health status (nurses — 23.2 %). CONCLUSIONS: The FCC in the ICU does not introduce significant psycho-emotional and labor loads in the professional activities of medical staff and creates positive conditions for increasing the level of knowledge and skills of parents in caring for their children.

The purpose of the work is to establish the degree of influence of various modifiers on the course of chronic generalized periodontitis. We examined 83 periodontal patients. During the examination, in addition to the obligatory volume, data on somatic burden and dependence on smoking were included with the determination of the number of cigarettes smoked per day. Bleeding of the gums was determined in the area of all teeth. To determine the rate of progression of periodontitis on the basis of orthopantomogram data, an indirect indicator was calculated — the decrease in the alveolar bone in relation to the patient's age. It was established by the research that the modeling of periodontitis, with an identical hygienic state of the oral cavity of patients, is affected by concomitant somatic pathology, especially diabetes mellitus, making the course of periodontitis worse; and also a bad habit — smoking, which contributes to more pronounced vascular changes in the periodontium in patients with clinical manifestations of periodontitis. Recommendations are given to take into account the concomitant pathology of internal organs and the degree of dependence of patients on tobacco smoking when planning periodontal treatment, in order to correct these risk factors and motivate the patient to cooperate with a doctor.

The oil industry is a leader in the negative impact on all areas of the natural environment. Polluting the atmospheric air, soil, surface and underground waters, oil production processes expose the population living in the adjacent territory to the dangerous effects of xenobiotics. The reproductive system is the most sensitive to environmental problems.The aim of the studywas to identify the features of the intrauterine development of fetuses of women living in the territory of oil technogenesis in comparison with the fetuses of women living in a territory without it. A comparative assessment of the frequency of blastogenesis defects in the studied groups was carried out as a result of the analysis of embryological protocols of women who received infertility treatment using methods of assisted reproductive technologies. In order to assess the frequency and structure of defects in embryogenesis and fetogenesis, an analysis of cases of congenital malformations was carried out according to the data of the primary medical documentation of the Medical Genetic Consultation.The identification of differences in the development of embryos was determined by the Pearson agreement criterion. Assessment of statistically significant differences in indicators in the study of the frequency and structure of congenital anomalies in fetuses identified by ultrasound and in newborns, the structure of factors that influenced the mother during pregnancy, which could lead to the development of congenital anomalies and complications of the course of pregnancy, was carried out using t-Student's criterion. Defects of cleavage and blastulation of embryos of women in the observation group were revealed. It was found that the frequency of birth of children with congenital anomalies in the territories of oil technogenesis is statistically significantly higher than in the territories without it. In the observation group, congenital anomalies of the respiratory system detected by ultrasound examination of the fetus, congenital anomalies of the genitals, urinary organs, musculoskeletal systems, multiple malformations revealed antenatally are statistically significantly more common.

With growing experience in the HoLEP, it can replace TURP as the "gold standard" for the surgical management of BPH, and therefore this technique is the most studied surgical modality. Despite the proven effectiveness of HoLEP in the treatment of patients with BPH, its widespread use has been associated with both intra- and postoperative complications. To improve the results of surgical management of patients with BPH. The study comprised 310 patients who underwent HoLEP for BPH. HoLEP was performed using the Gillings technique. presence of LUTS (Qmax<15 ml/s, Qav<10 ml/s, presence of residual urine, I-PSS score> 5, QoL score> 2), absence of an active inflammatory process of the urogenital organs. Intraoperative complications included severe hemorrhage in 16 (5.2%), the bladder wall injury in 17 (5.5%) and the ureteral orifice injury in 2 (0.6%) patients. 275 (88.7%) had no intraoperative complications. Early postoperative complications included fever in 4 (1.3%), the bladder tamponade that required cystoscopy and evacuation of blood clots in 7 (2.3%) and acute urinary retention in 36 (11.8%) patients. 263 (84.6%) patients had no postoperative complications. Long-term postoperative complications comprised urinary incontinence in 39 (12.6%) patients and urethral strictures requiring surgical treatment in 9 (2.9%) patients. There were no long-term complications in 262 (84.5%) patients. HoLEP is an effective and safe surgical modality for treating patients with BPH with minimal complications, suitable for any size of the prostate.