Vol 23, No 2 (2019)

Relevance: one of the causes of menstrual disorders are functional disorders associated with a violation of the central regulatory level.The aim: integratively assess the functional state of healthy girls, depending on the phase and duration of the menstrual cycle. Materials and methods: observations were performed on 65 practically healthy girls 18-19 years old with regular menstrual cycles. They conducted questionnaires, gynecological examinations, tests on functional diagnostics tests, ultrasound scanning of pelvic organs. To determine the phases of the menstrual cycle used the method of Ogin-Knaus, the onset of ovulation used a test for luteinizing hormone (strip tests of the brand Eviplan). The concentration in the blood of estradiol and progesterone was selectively determined. All subjects underwent a cardio-respiratory synchronism test. The parameters of the serous-respiratory synchronism determined the index of the regulatory-adaptive status, and according to it the regulatory-adaptive capabilities (functional state) were evaluated. Statistical analysis of the results of the study was carried out using the following programs: «STATISTICA 10» of «Stat Soft, Inc.». After establishing the normal distribution of the variant, significant differences were used in comparing the mean values in paired comparisons, taking the t-test of Student for p < 0.05. Results: in 35 people the duration of the menstrual cycle was 21-27 days. In the follicular phase, the regulatory-adaptive status index was 183.0 ± 0.4, which indicated a high regulatory adaptive capacity. In the luteal phase, respectively, 60.1 ± 0.3, - good regulatory adaptive capacity. In 30 watchers, the cycle was 28 to 32 days. In the follicular phase, the regulatory-adaptive status index was 156.5 ± 0.6. Regulatory adaptive capabilities were good. In the luteal phase, respectively, 52.4 ± 0.5 are good regulatory adaptive capacities. The conclusion: Regulatory adaptive opportunities for female students are greater in the follicular phase of the menstrual cycle than in the luteal cycle. Regulatory adaptive capacity is greater for a cycle of 21 to 27 days than for a cycle of 28 to 32 days.

Acute cholecystitis (AC) is one of the most common surgical diagnoses in emergency setting. Despite its high incidence there remains a range of treatment approaches. There is growing evidence in support of performing early cholecystectomy for acute cholecystitis but the definition of early operation varies from 0 through 10 days from onset or admission. The optimum time to perform cholecystectomy is still controversial. Aim. To determine the best practice for the patients presenting with AC focused on patients characteristics, timing of surgery, disease severity and intra- and postoperative complications. Materials and Methods. A multicentric retrospective study was conducted and included 754 patients operated for acute cholecystitis at 8 hospitals in 4 cities of Russian Federation (Moscow, Yekaterinburg, Volgograd, Kislovodsk) during 1 year period (from Jan 1, 2011 to Dec 31, 2011). Median time from symptoms onset to hospitalization varied from 15 to 72 hours, and median time spent at hospitals before operation was 9-71 hours. Results. We found that optimal time for cholecystectomy is 60 hours from the onset of symptoms in Grade I AC (TG18) and 36 hours for patients with Grade II of the disease. Delay of the operation beyond this time leads to more difficult cholecystectomies and higher complication rates. We compared results of the surgical treatment of AC in 2 groups of patients, operated in median 9 [4; 13] and 50 [29; 88] hours from admission using propensity score matching technique. Rate of Grade I AC in the 1st group was higher (59,8% vs 17,0%, p < 0,001) and incidences of gangrenous cholecystitis (15,3% vs 34,1%, p < 0,001) and difficult cholecystectomies (28,4% vs 41,5%, p=0,003) were lower. The Integral Complications Severity Index (based on Accordion classification and takes into account all intra- and postoperative complications and summarizes their respective severity) was also lower in the 1st group. Conclusions. The optimal time for cholecystectomy for mild (Grade I) acute cholecystitis is 60 hours of presentation of disease and for Grade II - 36 hours from symptoms onset. Cholecystectomy performed after short trial conservative treatment in 6-8 hours from admission yielded the best outcomes.

The article presents a clinical case of a patient who was implanted with a phakic lens 27 years ago. At the moment, the patient was diagnosed with a complicated cataract on the background of hyperphakia. This article describes the effectiveness of the step-by-step operational approach in a patient with hyperphakia, which allowed achieving high visual functions.

In work is described practical approach to the expert system building for the analysis skeleton planar scintigramms. The aim is to analyze the numerical characteristics of bone metastases by scintigraphy. Objective. Progress in the development of bioinformatics and mathematical methods in biomedicine, as well as the development of computer and telecommunications systems and networks determines the look of the present and future of oncology technology and of medicine in general. At last years of one of the directions of high-tech-medicine development is a processing the digital image: improvement of quality of image, recovering image, its recognition of separate elements. Recognition of pathological processes is one of the most important problems of processing the medical image. Methods and results. Method of computer-aided analysis of planar osteostsintigrammy studied the skeleton of patients with breast cancer are in complete remission and in the phase progression of the disease with metastases to the skeleton. As analyzed parameter was used brightness of images. The study of the physiological accumulation of radiopharmaceuticals in patients without metastasis to the skeleton indicates a wide variation in the brightness values of the scintigram in some areas of the skeleton. At the same anatomical areas of the skeleton there are significant differences in the values of the index of average brightness. In almost all areas of the skeleton averages of the brightness lesions hyperfixation RFP for scintigram significantly prevail over those of «physiological» lesions hyperfixation. Thus, there is a direct relationship between the levels of accumulation of the radiopharmaceutical in areas of the skeleton without metastatic lesion and bone metastases occurring in these zones. Consider methodological approaches to studies of quality of qualifier at the expert system building for the analysis skeleton planar scintigramms, as well as results of conducting calculations.

The article contains the results of a survey of 11,850 persons of both sexes in eight Federal Districts of the Russian Federation. The survey was conducted on the following age groups of men and women: 12-17, 18-30, 31-45 and 46-60 years. In each group of subjects, the number of questionnaires was at least 150 persons of each sex. When comparing the consumption of macronutrients in different federal districts, it is established that there are insignificant age and gender differences in the level of their consumption. Studies have shown that the intake of proteins and carbohydrates is within the recommended consumption rates, and the fat component has been increased in the population of all federal districts of Russia.

Every year on the Earth, as a result of road accidents (road traffic accidents), 1.25 million people are die and 50 million are injured of varying degrees of severity, of which more than 30% of the dead are people of working age. This dictates the adoption of decisive measures in the field of prevention and elimination of the consequences of accidents, which requires detailed and reliable statistical data. Aim: to compare statistical data on the dead and injured in road accidents in the Udmurt Republic for 2011-2016. Materials and methods. Statistical data was obtained from the official databases of the Budgetary Healthcare Institution of the Udmurt Republic “Republican Medical Information and Analytical Center of the Ministry of Health of the Udmurt Republic” (“RMIAC of the UR”, MH of the UR) and the official website of Traffic police “Main Traffic Safety Directorate of the Ministry of the Interior of the Russian Federation” (“MTSD of the RF”, TP). The calculation of the indicators was carried out using the calculation of the arithmetic mean of simple, errors of representativeness, the reliability of differences of indicators by the Student’s t -test was determined. Results. It has been established that the data of the “MTSD of the RF” and “RMIAC of the UR” for the dead and injured in road accidents differ significantly. According to TP for 2011-2016 years 1471 people died on the roads of the Udmurt Republic, according to the MH of the UR - 1165 people, which, when converted to 100 thousand people, this figure differs 1.3 times ( p < 0.05). On average, over the five-year period, according to official data of the traffic police, non-fatal injuries of 120.0 ± 22.6 per 100 thousand people annually get on the roads of the Udmurt Republic, according to the Ministry of Health of the Udmurt Republic - 2 times more often ( p < 0.05) (230.4 ± 38,1 per 100 thousand population). Conclusion: A comparative analysis of road traffic injuries “MTSD of the RF” and “RMIAC of the UR” showed a discrepancy in statistical data on the dead and injured, which requires a revision of the system of accounting for accidents and changes in the scheme of information transfer.