Intramedullary osteosynthesis in the treatment of humerus fracture consequences

Aim: retrospective analysis of surgical treatment results of patients with the consequences of humerus fractures by locking intramedullary constructions. Material and Methods. 69 patients with ununited fractures and false joints of humerus diaphysis (39 females, 56.7±11.5 yrs (56.5%) and 30 males, 52.3±9.8 yrs (43.5%)) comprised observation group. In the course of surgical intervention they were treated by locking intramedullary rods to perform fragment anchorage, this including 12 patients (17%) with ununited humerus diaphysis fractures after conservative treatment, and 57 (83%) with false humerus joints. Clinical (limb functional restoration) and X-ray (integrity signs) methods were applied for the diagnostics and control of integrity restoration in bone structures; for the assessment of treatment outcomes we used standardized system of outcomes of locomotor fractures and their consequences (SOI-1). Results. Consolidation of the fracture up to 6 months postoperatively was observed in all patients with ununited humerus fractures, treatment outcomes by SOI were 85-94% of anatomic and physiological norm. The consolidation of humerus bone occurred in 50 patients with false joints with</p

ОПЕРАТИВНОЕ ЛЕЧЕНИЕ ПАРАЛИТИЧЕСКОЙ ЭКВИНУСНОЙ ДЕФОРМАЦИИ СТОПЫ ТЯЖЕЛОЙ СТЕПЕНИ У ВЗРОСЛЫХ(СЛУЧАЙ ИЗ КЛИНИЧЕСКОЙ ПРАКТИКИ)

The short-term result of treatment of the patient with an severe clubfoot who underwent a surgical treatment is represented. Besides the patient suffered from talipes varus and short cavovarus deformity which were eliminated during the surgery. To eliminate a multicomponent talipes a technique of two-stage surgical treatment of the given severe pathology devised in SarNIITO was used. It made it possible to achieve a complete elimination of the talipes, a high-grade restoration of anatomy and functions of the ankle, and in the future it will allow to improve life quality of the particular patient.Представлен ближайший результат лечения больного с тяжёлой степенью эквинусной деформации стопы, которому выполнили оперативное лечение, устраняя при этом имеющиеся варусную и полую деформации. Для этого использовали разработанную в СарНИИТО методику двухэтапного оперативного лечения данной тяжёлой патологии. Это позволило добиться полного устранения деформации стопы, полноценного восстановления анатомичности и функции голеностопного сустава, а в будущем позволит улучшить качество жизни данного пациента

INTERACTION OF SILVER MOLECULAR CLUSTERS, INTRODUCED BY LOW-TEMPERATURE ION EXCHANGE METHOD, WITH NANOPARTICLES OF CdS IN FLUORINE PHOSPHATE GLASSES

Glasses with metallic and semi-conductive nano-particles appear to be perspective non-linear and luminescent materials of photonics. It was shown in theory that composite optical materials containing semi-conductive CdS-core with Ag shell (or vice versa) are optimal for enhancement of non-linear Kerr effect. Interaction of such an ensemble of particles leads to the forming of Ag island structures on the CdS particle, and formation of acanthite Ag2S on the two phases border (CdS-Ag) is minimal. In glasses synthesis of CdS quantum dots occurred due to thermal treatment close to glass transition temperature; introduction of silver was realized by low-temperature ion exchange (LIE). The main object of this work is investigation of Ag+ -LIE effect on the growth of CdS nano-particles. Two glasses were explored in this work: without CdS (glass 1) and with CdS (glass 2), processed by LIE at the temperature of 320°С for 10, 20 and 30 minutes and subsequent heat treatment at temperatures of 410°С and 420°С. In case of glass 1, intensive luminescence appears as a result of LIE, and subsequent heat treatment results in surface resonance at λ=410 nm. In case of glass 2, absorbance spectra change appears that is specific for formation of acanthite and weak luminescence shifting to long-wavelength region (from 550 to 700 nm) as a result of applying LIE and heat treatment. It indicates the growth of CdS quantum dots. Experiment has shown that quantum efficiency increases to 70% for glass 2 containing CdS quantum dots without LIE, while glass that contains silver shows steep decrease of quantum efficiency to 0%. That decrease is caused by formation of acanthite Ag2S on the surface of CdS quantum dot

Comparative analysis of external osteosyn-thesis in the treatment of patients with extraarticular fractures of proximal femur

Aim: to perform comparative analysis of surgical outcomes of patients with extraarticular fractures of proximal femur with the use of various types of external osteosynthesis. Material and Methods. 169 patients with extaarticular fractures of proximal femur who underwent surgical interventions with various kinds of external osteosynthesis were the subject of the study. Results. Extra-cortical osteosynthesis with DHS-construction provided the restoration of anatomic and functional characteristics by 90.3±0.6% of normal values in the short-term and by 95.2±0.4% in the long-term postoperative period. The implantation of intramedullary constructs resulted in high percentage of positive short-term (92.1±0.6%) and long-term (96.7±0.75%) treatment outcomes. Conclusion. The use of intramedullary osteosynthesis</p

Surgical repair of juxta-articular distal femur fractures and posttraumatic conditions

Objective To retrospectively review surgical repair of juxta-articular distal femur fractures and posttraumatic conditions. Material and methods The review included 65 patients with juxta-articular distal femur fractures and posttraumatic conditions repaired with plating (n = 44), intramedullary nailing (n = 16) and transosseous osteosynthesis (n = 5) between 2009 and 2016. The patients were divided into 2 groups depending on time of injury. SOI-1 was used for outcome measure. Results Functional recovery was observed in 71 to 97 % (average, 89.1 ± 0.6 %) of the first group at short-term followup and an average of 94.7 ± 0.45 % of anatomical and function norm at a long term. Short-term anatomical and functional outcomes ranged from 63 to 93 scores in the second group and were an average of 82 ± 0.7 % of the norm. Conclusion Better outcomes were obtained in the first group (an average of 94.7 ± 0.45 % of anatomical and functional norm). Plating with accurate bone reduction and reliable fixation provided throughout consolidation phase showed better outcomes in both groups of patients. Intramedullary nailing was practical for straightforward supracondylar injuries type 33А1. Transosseous osteosynthesis could be advocated for open and gunshot injuries to minimize risk of infection and provide stable bone fixation

Concerning the Allocation of Emerging Natural Foci of the Currently Important Infectious Diseases in the West of Kazakhstan

Within the period of 2000-2011, in the West of Kazakhstan, identified have been five, previously unknown in the territory, natural foci of dangerous infectious diseases such as hemorrhagic fever with renal syndrome, Astrakhan spotty fever, Crimean hemorrhagic fever, West Nile fever, and tick-borne viral encephalitis. The reason is that key ecological factors for the persistence of the infections in the local biocoenoses occurred. It is characteristic that circulation of the agents of new infectious diseases is registered in the territory of the long-established natural plague and tularemia foci. Since 2000 and on, hemorrhagic fever with renal syndrome morbidity is registered in the Western-Kazakhstan Region on a regular basis. There is some evidence to identification of West Nile fever patients in the territory of Russia in 2012, which came from Kazakhstan. Based on the spatial distribution of the natural foci of various infections, Western-Kazakhstan Region has been subdivided into four areas. In order to provide for the effective prophylaxis of emerging diseases, it is essential that healthcare facilities and services dealing with infectious diseases are consolidated and reinforced, and epidemiological surveillance is improved with the current conditions in mind

Dissemination of <i>Yersinia pestis</i> of Medieval Biovar in Northern, North-Western Caspian Sea Region and Fore-Caucasus in the second Half of the Twentieth Century

Objective of the study was to determine the origin of Y. pestis strains that widely disseminated in natural plague foci of Northern, North-Western Caspian Sea region and Fore-Caucasus in the second half of the XX century. Materials and methods. We have carried out the investigation of properties and whole genome sequencing of 22 Y. pestis strains, isolated between 1923 and 2003 in five natural foci of the souslik type, situated in Northern and North-Western Caspian Sea region and Fore-Caucasus. Phylogenetic analysis was conducted using the data of whole genome SNP-typing, based on 1348 identified SNPs. The search of SNPs in the core genome was performed with the help of Wombac 2.0 software. Phylogenetic relations were analyzed using Maximum Likelihood dendrogram, GTR model. Results and discussion. All the studied strains from the foci of Northern, North-Western Caspian Sea region and Fore-Caucasus fall into phylogenetic branch 2. MED1of medieval biovar. On the basis of whole genome SNP-analysis, existence of two groups of closely related strains, comprising the strains dated 1923-1945 and 1962-2003, has been revealed. The predecessors of the 1962-2003 strains from the Northern, North-Western Caspian Sea region and Fore-Caucasus on the phylogenetic tree are the strains from Northern Aral Sea region that go back to 1945. It testifies to the fact that synchronized activation of a group of natural foci in Caspian Sea lowland and Fore-Caucasus in 1975-1979, after prolonged 20-37 year long breaks, could be caused by the dissemination of the strains from the Northern Aral Sea region. The data of epizootic observations indicate that activation of Volga-Ural sandy plague focus in 1960s preceded the start of registration of plague epizooties in the territory of natural foci of souslik type in Northern, North-Western Caspian sea region and Fore-Caucasus

Comparative Analysis of Particularly Dangerous Infections Manifestations in the Territory of the Saratov and West-Kazakhstan Regions with a View to Advanced Epidemiological Risk Assessment

On the model of the Saratov and West-Kazakhstan regions carried out is the analysis of the current epidemiological and epizootiological situations in the cross-border territories of the two states: the Russian Federation and the Republic of Kazakhstan. Depicted is not only the common area of natural-focal territories of old-established infections, such as tularemia, but an intense outspread and formation of natural foci of the emerging infectious diseases too: Crimean hemorrhagic and West Nile fevers. This phenomenon assumes a great deal of importance due to dissemination and circulation of previously unknown to these areas infections concurrently in the two neighboring regions. Specified uniformity of epidemiological public risks in the bordering regions testifies to the need for development and implementation of the integrated system for prevention and response to the emergency situations in the sphere of sanitary-epidemiological welfare of the population in the territory of both of them

Impact of the Present-Day Climate Changes on the Natural Plague Foci Condition, Situated in the Territory of the Russian Federation and Other CIS Countries

Climate changes determine dynamics of epizootic activity of natural plague foci in the XX and XXI centuries. Obvious shift to continentality in the Northern hemisphere can put an end to inter-epizootic period in lowland steppe and semi-desert natural foci of the Pre-Caucasian region, North and North-West Caspian Sea regions. Presently observed conjoined development of inter-epizootic periods in natural plague foci with different biocoenotic structure in the territory of Pre-Caspian Lowland gives the grounds for assuming the presence of a common cause preconditioning parasitic system depression in the region. One of the key elements of this phenomenon is a change of status of little souslik – formerly the main plague carrier in the region. Subsequent to the climate change the key role of plague carrier is more often played by non-hibernating rodent species nowadays. Thus a significant increase in epizootic potential of steppe natural plague foci in the territory of Kazakhstan and Central Asia is prognosticated. With the further temperature fall during wintertime, snow cover height increase and glacial area extension epizootic activity of the mountain and high mountain foci must drop off significantly. Alongside with this updated data on plague agent ecology, predetermining possibility of its existence in the soil biota, confirm the key role of climactic factors in the plague enzootic outbreak

Significance of raise of proinflammatory cytokines level in urine at acute chronic calculous pyelonephritis

Research is conducted in urine of the maintenance proinflammatory цитокинов (IL-1 p, IL-6, IL-8) at 70 patients with staghorn nephrolithiasis, the complicated latent pyelonephritis (25) and with an aggravation of a chronic pyelonephritis (45). In comparison group 15 patients with a cystitis, in control group - 30 practically healthy faces are surveyed. It is established that at patients calculous pyelonephritis and a cystitis in urine considerable lifting of the maintenance proinflammatory cytokines takes place. For laboratory acknowledgement of an aggravation calculous pyelonephritis maintenance research in urine IL-8 has the greatest diagnostic sensitivity and specificity.Проведено исследование в моче содержания провоспалительных цитокинов (ИЛ-1р, ИЛ-6, ИЛ-8) у 70 пациентов с коралловидным нефролитиазом, осложненным латентным пиелонефритом (25) и с обострением хронического пиелонефрита (45). В группе сравнения обследовано 15 пациентов с циститами ,в контрольной группе - 30 практически здоровых лиц. Установлено, что у больных калькулезным пиелонефритом и циститами в моче имеет место значительный подъем содержания провоспалительных цитокинов. Наибольшую диагностическую чувствительность и специфичность для лабораторного подтверждения обострения калькулезного пиелонефрита имеет исследование содержания в моче ИЛ-8