The Possibilities of Multislice computed Tomography in nasal Anthropometry

Background. Nasal anthropometry is an important aspect of maxillofacial and plastic surgery especially in the preoperative stage of rhinoplasty. Multislice computed tomography (MSCT) permits to assess quantitative the variant nasal anatomy using measuring.Aims: to determine the possibilities of MSCT-anthropometry in nasal configuration grade.Materials and methods. We performed a proand retrospective analysis of MSCT data of maxillofacial region of 50 patients (aged 35 ± 10.7 years old) with changes of nasal height and width and 35 women (32.9 ± 8.4 years old) with normal nasal configuration. The variant anatomy consists in long nose (n = 16), short nose (n = 17), wide nose (n = 17). The nasal height was measured from the nasal root (nasion) to the nasal base (subnasion), the nasal width is the distance between the most lateral aspects of the alae nasi. Besides, the nasal index was calculated. The descriptive statistics of obtained data were presented by mean and standard deviation (SD), also the multiple regression analysis was used. Values of p = 0.005 were considered statistically significant.Results. The results showed that the average nasal height in patients with normal configuration is 51.9 ± 2.63 mm, with short nose – 45.2 ± 1.36 mm, with long nose – 60.3 ± 1.28 mm. The mean nasal widths are 34.9 ± 1.88 mm in normal configuration, 38.8±3.57 in wide nose. The nasal indexes were calculated, their features were detected. These obtained results correlate with anthropometric data of different studies.Conclusions. MSCT-anthropometry is an objective imaging method of variant nasal anatomy that could provide improving quality of diagnostics of patients seeking rhinoplasty and choose a surgical approach

Features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency

Aim. To study the features of clinical manifestations and diagnosis of comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients with late stages of HIV infection with immunodeficiency. Materials and methods. The prospective study included 120 newly identified patients with disseminated pulmonary tuberculosis with Mycobacterium tuberculosis, stage IVB of HIV infection, in the phase of progression and in the absence of antiretroviral therapy, aged 2953 years, who were randomized into 1A and 2A main groups and 1B and 2B comparison groups. Group 1A included 29 patients with comorbidity and pneumocystis pneumonia and group 2A 31 patients with comorbidity of disseminated pulmonary tuberculosis, coronovirus pneumococcal pneumonia, and group 1B and 2B comprised 29 and 31 similar patients, but without coronovirus pneumonia. To diagnose coronavirus pneumonia, PCR of SARS-CoV-2 RNA was used in smears from the nasopharynx and oropharynx, in sputum or in endotracheal aspirate. To detect Pneumocystis jirovecii, the causative agent of pneumocystis pneumonia, a microscopic examination of diagnostic material from the respiratory tract with RomanovskyGiemse and GrokottGmri coloration was carried out, and to detect Streptococcus pneumoniae, the causative agent of pneumococcal pneumonia, the diagnostic material was seeded on special nutrient media with determination of the drug resistance of the resulting culture to broad-spectrum antibiotics. Statistical data processing was carried out using the Microsoft Office Excel 2019 program with the calculation of the average in the group and the standard error of the average, confidence interval. Results. The comorbidity of disseminated pulmonary tuberculosis, coronavirus, pneumocystis and pneumococcal pneumonia in patients in the late stages of HIV infection, in the phase of progression and in the absence of antiretroviral therapy was characterized by severe immunodeficiency, generalization of tuberculosis with multiple extrapulmonary lesions and severe pneumonia. This determines the similarity of clinical manifestations and respiratory symptoms, and also makes it difficult to visualize computed tomographic changes consisting of a complex simultaneous combination of four pathological syndromes: dissemination, pleural pathology, increased pulmonary pattern and adenopathy. Simultaneous layering of several pathologies with the same type of clinical manifestations and computed tomographic changes requires a comprehensive etiological diagnosis of specific diseases to prescribe timely comprehensive treatment and reduce the lethality of this heavy contingent of patients. Conclusion. Patients with disseminated pulmonary tuberculosis and HIV infection who are registered in the office of tuberculosis care for HIV-infected in the tuberculosis dispensary represent a high risk group of COVID-19 infection and the development of coronavirus pneumonia, and with severe immunodeficiency, pneumocystis and pneumococcal pneumonia, should be regularly subjected to preventive studies for timely detection of COVID-19, coronavirus, pneumocystis and pneumococcal pneumonia for the purpose of their emergency isolation and timely treatment

SHORT- AND MIDDLE-TERM RESULTS OF KNEE JOINT REPLACEMENT WITH ZIMMER NexGen CR AND LPS IMPLANTS

The article presents the experience gained by orthopedic unit of Saratov Regional Clinical Hospital at knee joint replacement with modern implants. We analyzed use of Zimmer NexGen CR and LPC implants for initial total knee joint replacement in 285 patients. The monitoring continued for 5 years. Good and excellent results were observed in 92% of cases. Pyogenic complications were observed in 2.3% of cases. The article describes the methods of surgical intervention and post-surgical rehabilitation. We consider our experience with Zimmer NexGen LPS and CR knee-joint implants as positive and prospective for further use

Primary endo-prothesis of shoulder joint at heavy traumatic damages of proximal segment of a shoulder bone and their consequences

Under our supervision there were 123 patients with terms of supervision till 7 years, with fractures,fracture-dislocations of an area of a shoulder joint and chronic damages of this area. There were 57 men and 66 women. All the patients were from 38 to 83 years old, the average age was 55,8 years. 44 patients had various kinds of an osteosynthesis and 79 - endoprosthesis of a shoulder joint. It was proved, that in patients of the senior age group, the expressed bony rarefication, a heavy accompanying pathology of a shoulderjoint (arthrosis of 2-3 grades, defeat of a joint at a number system diseases, etc.) and also at the treatment of consequences of traumas are unconditional, the preference should be given to endoprosthesis of a humeral joint, as to more effective method of treatment

The current state of the issue of using cone beam computed tomography in the diagnosis of musculoskeletal diseases

The high incidence rate and wide range of musculoskeletal pathologies determine the improvement of the diagnostic process. Late diagnosis leads to complications, which in turn increase the percentage of disability. Therefore, the search for the most informative method with the least radiation load on the patient remains an urgent problem for radiologists. Cone beam computed tomography (CBCT) is a modern and  promising technique that has already found wide application in dentistry and otorhinolaryngology. Among the advantages of CBCT are: three-dimensional image; high spatial resolution; low radiation dose. Thanks to technical improvements in equipment and the introduction of new image processing protocols, it has become possible to expand the indications for conducting the researches, including the researches based on imaging of the upper and lower extremities. Based on the results of a CBCT study, we can evaluate: the shape and contour of the bone; solution of continuity of the bone and malposition of bone fragments; the structure of bone tissue and  the  pathological processes occurring in it (destruction, osteoporosis, osteosclerosis); joint congruence and changes in  articular surfaces surrounding soft tissues. Therefore, CBCT can be introduced into the diagnostic process of bones and joints diseases. The use of this technique will find wide application in traumatology and orthopedics (fractures, dislocations, post-traumatic deformities, aseptic necrosis, osteoarthritis), rheumatology (rheumatoid arthritis, polyarthropathy, juvenile arthritis, gout), surgery (osteomyelitis), oncology (benign and malignant bone tumors) both in the adult population and in pediatric practice. This paper presents a review of the literature, which examines the degree of development of the issue of using CBCT and describes study protocols and protocols for processing the obtained images in the diagnosis of musculoskeletal diseases

Using biomass-based fuels including pyrolysis liquids for power and CHP production

The use of biomass-derived liquids (in short: bioliquids) instead of solid biomass can help overcome some of the barriers hindering a wider use of biomass in smaller-scale CHP systems. Relevant bioliquids included biodiesel, vegetable oils as well straight and upgraded pyrolysis oil. In this joint EU-Russian research project Bioliquids-CHP prime movers (engines and turbines) will be developed and modified so that these can run efficiently on bioliquids. At the same time, bioliquids will be upgraded and blended in order to facilitate their use in prime movers. Preliminary results with regard to bioliquid selection, production, and characterisation; the selection and modification of a micro gas turbine; and the development of engines and components are discussed. The research also covers NOx emission reduction and control and an assessment of the benefits and economics of bioliquids-based CHP systems in EU and Russian markets

Ultrasound of Acute Appendicitis in the Admission Room of a Multidisciplinary Surgical Hospital

Ultrasound (US) for diagnosing acute appendicitis (AA) and its complications in the admission room may be used as a primary diagnostic method in urgent patients. A total of 180 adult patients underwent US for suspected appendicitis; these results showed high possibilities in pathology screening and differential diagnosis from similar clinical diseases. The accuracy of US in detecting AA with obvious clinical findings and typical position is 100%, but in retrocecal and retroperitoneal forms, it decreases to 84%. With our algorithm of the right iliac and localized pain regions, US scanning optimizes the screening of patients with suspected AA presented in the admission room

The Imaging of Legg-Calve-Perthes Disease

Diagnosis of hip joint pathology remains a serious problem in childhood and adolescence. A wide range of pathologies—including dysplastic, dystrophic, inflammatory, oncological and post-traumatic diseases of the musculoskeletal system—leads to the advancement of imaging methods and techniques. Legg-Calve-Perthes disease (LCPD) is a common cause of hip pain in children that may be initially clinically and radiographically difficult to diagnose Radiography of the pelvis in two views (anteroposterior and Lauenstein) is the main method of diagnosing aseptic necrosis. Destructive changes of the femoral head and neck of the femur are clearly determined. However, the presence of X-ray negative patterns at the first stage of the disease and the impossibility of visualizing all the anatomical structures induce us to improve the diagnostic algorithm of this difficult pathological process