Annotations Pilotovich V.S., Kalachik O.V. Analysis of Renal Rreplacement Therapy in Nephrological Patients in the Republic of Belarus This article analyses the state of renal replacement therapy by methods of intermittent hemodialysis, peritoneal dialysis and kidney transplantation in Belarus in 2010. The data shows a slowdown of increase of the total new patients on hemodialysis up to 2,5% in 2010 (2009 – 8,6%) and patients on peritoneal dialysis (2010 - 4,4%, 2009 – 21,5%). On the other hand kidney transplant activity has risen by 15% and on the whole the coverage with renal replacement therapy in 2010 reached 306,5 patients per one million population. But nephrology care in Belarus has a lot of problems that need to be solved in the next years. There is a lack of qualified nephrologists, some territories do not provide enough dialysis places, the level of peritoneal dialysis is rather low, no possibility for hemodiafiltration and specific drugs supply. Amelchenya O.A. Diagnosis and Treatment of Acute Appendicitis during Pregnancy Acute appendicitis is the most common nonobstetric emergency requiring surgery during pregnancy. The particular dangers of appendicitis in pregnancy lie in the varied presentation of the signs and symptoms, depending on the trimester in which the patient is at the moment and as a result higher chance of delayed diagnosis, increased risk of morbidity for mother and fetus, and fetal loss. Also laparoscopic surgery in pregnancy remains debated, especially in cases of suspected appendicitis. The aim of this study was a literature review of an acute appendicitis in pregnancy. Key words: diagnosis, treatment, appendicitis, pregnancy. Metelskaya M.A., Rogov Y.I. Methodological Classificatory Approaches to the Diagnostics of an Endometrium Hyperplasia (the historical retrospective review and personal observations) Belarusian Medical Academy of Post-graduate Education. The problem of diagnostics of an endometrium hyperplasia is very actual at the present time. The hyperplasia of endometrium has different range of development, sometimes it can take the nature of the precancerous lesion. In this article the morphological classification of the endometrium hyperplasia is represented in the historical retrospective. The principal criteria were determined for the histological diagnosis of endometrium hyperplasia. The authors analyze the basic methodical foundation which pathologists use in the diagnostics of endometrium hyperplasia. The authors describe the morphological criteria of the diagnosis. In this article the histological parameters of WHO classification (last revision) and others are given. The authors conducted the analysis of diagnoses which the morphologist uses in practical work. Key words: morphological classification of endometrial hyperplasia, histologic diagnosis, WHO classification, endometrial intraepithelial neoplasia. Ilukevich G.V., Smirnov V.M., Sаmоluk B.B. Genuine products and generic: trends in conflict Belarusian Medical Academy of Postgraduate Education Clinical Medical Center of the Office of the President of the Republic of Belarus Scientific review is devoted to the analysis of modern pharmaceutical market and share of generic drugs in it. The analysis of the causes and conditions for the appearance of generics that are very different from the branded drugs. In connection with the appearance on the Belarusian market of a new inhalation anesthetic sevoflurane, analysis of available literature on the therapeutic equivalence of the original drug and its generics has been performed. The ways of protecting the market from generic substandard medicines has been identified. Key words: generics and original drugs, bioequivalence, sevoflurane. Valasheniuk A.N., Filinau S.V. Nature of Combined Injuries in Traffic Accidents The article considers in detail the character of associated injuries arising in various participants of traffic accidents. The mechanism of injury for different types of automobile injuries is analyzed in details. The article will be useful for surgery, traumatology, emergency department physicians. Key words: concomitant injury, polytrauma, the nature of associated injuries, mechanism of injury, automobile trauma, road traffic accidents. Rashchynski S.M.1,2, Tretyak S.I.1, Rashchynskay N.T.2, Sologub M.A.2, Sologub I.M.2, Komarovskaya O.O.2 Principles of the Diagnostics and Surgical Treatment of Wirsungorrhagii Department of Surgery #2 of Belarusian State Medical University, Minsk, Belarus 1 2 Department of Hepatobilliary Surgery in Clinic Emergency Medical Care, Minsk, Belarus Purpose. The aim of this study was to analyze the diagnostic and surgical features of wirsungorrhagii (WR) in patients with chronic pancreatitis (CP). Material/Methods. We reviewed our experience with the management of 11 patients admitted to the department of hepatobilliary surgery in Clinic Emergency Medical Care (Minsk) for WR between January 2007 and July 2010. Results. Frequency of WR against CP has made 0,64 %. Eight men and three women with a mean age of Ме [25–75%] = 37 [30,5–41] years presented WR. We studied symptoms of digestive bleeding, contribution of established morphological examinations (upper digestive endoscopy, abdominal ultrasound, computed tomography). All patients have been operated. There were no deaths and no recurrent bleeding. Conclusion. On the basis of the received results and the analysis of literature data, WR demands complex examination and active surgical treatment, which variants depend on the localization of a source of a bleeding in the tissue of pancreas, changed against the CP. Key words: chronic pancreatitis, pancreatic pseudocyst, wirsungorrhagia, management and surgical treatment. Mikhailov A. N., Rimashevsky V. B. The Role of X-ray Examination in the Diagnostics of Gastroesophageal Reflux Disease and its Complications Department of radiodiagnostics Belorussian Medical Academy of Postgraduate Education This article highlights major questions about X-ray imaging of Gastroesophageal Reflux Disease and its complications. It also describes the use of X-ray imaging diagnostics depending on the level of Gastroesophageal Reflux in presence of hernia in esophageal diaphragm apertures, Mallory-Weiss Syndrome and esophagitis symptoms. The article draws attention of medical care providers to importance of using X-ray imaging for differential diagnosis of gastro-intestinal and other diseases. Key words: gastroesophageal reflux disease, gastroesophageal reflux, reflux-esophagitis, Mallory-Weiss Syndrome, ruptures of esophageal mucosa, X-ray examination. Zavada N.V., Chasnoits A.Ch. Ultrasonic dissection and coagulation of tissue during laparoscopic cholecystectomy Belarusian Medical Academy of Post-Graduate Education, Minsk, Belarus This article describes the positive experience of using ultrasonic technique that allowed us to use it successfully during performing laparoscopic cholecystectomy in 36 patients with acute cholecystitis. It was proved that the usage of ultrasonic generator facilitates and enhances performance of the operation and postoperative course, and techniques improved by the authors allow to minimize the negative aspects of ultrasonic dissection and coagulation of tissue when performing endovideolaparoscopic interventions. Key words: acute cholecystitis, laparoscopic cholecystectomy, ultrasonic dissector, monopolar coagulation. Khvorostukhina N.F., Rogozhina I. E., Stolyarova U.V. Prolactin and Steroid Hormones in the Pathogenesis of Miscarriage Department of Obstetrics and Gynecology Medical University, Saratov, Russia The pathogenetic importance of prolactin (PR) and steroid hormones were studied in different versions of miscarriages. Low decrease of PR’s serum concentration (74,288,34 ng/ml; Pk> 0,05) was established in missed abortion cases (1st primary group, n= 63). It is associated with the miometral refractory’s formation in first 3 weeks after fetus death. The drastic decrease of hormone’s level was marked in case of spontaneous abortion (comparison group, n = 43) (Pk<0,05) and long delay of a deceased fetus in an uterus (2nd primary group, n = 41) (Pk<0,01). The positive connection of PR and progesterone was revealed using a correlation analysis method in case of physiology pregnancy and antenatal fetus death. The negative correlations between PR’s serum concentration and cortisol (r = - 0,469, P<0,01), between PR and estradiol (r =-0,495, P<0,01), between PR and dehydroepiandrosterone sulfate (r = -0,671, P<0,01) were revealed in case of spontaneous activation of labour activity. The steroidogenesis activation with fetoplacentus complex was shown in case of spontaneous abortion. Key words: pregnancy, miscarriage, prolactin, steroid hormones. Baghdasaryan N.G. Evaluation of Liver Functional Reserves and Methods of Prediction of Liver Failure in Children The article presents the results of complex clinical and laboratory examination of liver in 171 patients aged 3 months to 16 years with various diseases. There are evaluated and developed clinical diagnostic criteria of liver dysfunction with various diseases in children. The data obtained can be used to quantify the functional reserves of liver with the help of non morphological diagnostic methods. Key words: organ-specific liver enzymes, functional reserve of liver in children, degrees of liver dysfunction. Losev A.V., Petrova L.G., Rjabceva S.N. Clinical and Pathomorphological Results of the Use of Topical Nasal Steroids with Chronic Adenoiditis in Children Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus We studied the clinical efficacy of topical nasal steroid mometasone furoate drug with chronic inflammation of the adenoids in children. The treatment results of 180 children with adenoidal hypertrophy in the background of chronic adenoiditis were presented. These results showed a high efficacy of topical nasal steroid therapy for relief of the main clinical symptoms of adenoiditis, restoration of nasal breathing, reduction of the size of adenoids. During morphologic study of adenoids the data was obtained confirming the presence of chronic inflammatory processes with activation of T-and B-bands in a pharyngeal tonsil, what allows us to consider adenoids as actively functioning organ of immunity. This requires the most gentle attitude toward adenoids in children. Key words: mometasone furoate, immune response, chronic adenoiditis, topical nasal steroids. Solomonova G.A., Zavada N.V. Substantiation Report of the Surgical Treatment Method for Duodenal Ulcer Complicated with Bleeding The results of treatment of 57 patients with chronic duodenal ulcer, complicated with bleeding are analyzed in the article. All the patients have undergone duodenal resection, exteriorizing of the ulcer base from duodenal lumen, diametrical duodenoplasty according to the method offered by the authors. Additionally 31 patients (54,4%) have undergone highly selective proximal vagotomy. Patients were operated with relation to: bleeding recurrence - 22 patients (38,6%), high risk of bleeding recurrence - 9 patients (15,8%), perforation - 19 patients (33,3%), inefficiency of conservative therapy - 7 patients (12,3%). Postoperative period passed without peculiarities for 55 patients (96,4%), 1 patient (1,75%) was diagnosed a dextral lower-lobar nidal pneumonia, 1 patient (1,75%) was diagnosed an anastomositis. No lethal outcomes occurred. The suggested method of surgical treatment for duodenal ulcer complicated with bleeding has shown good near-term results and can be recommended for wide practical application. Key words: duodenal ulcer, bleeding, penetration, stenosis, duodenal resection, exteriorizing of the ulcer base from duodenal lumen, diametrical duodenoplasty. Huminski A.M., Demidchik Y.E., Kushnerov A.I., Fridman M.V. Ultrasound Diagnostics by Method of Complex Assessment of Performances of Ultrasonic Indications of Tumours and Tumor-like Diseases of a Thyroid Gland Minsk City Clinical Oncological Clinic, Belarusian Medical Academy of Post-Graduate Education. Minsk, Belarus The article is devoted to modern problems of differential ultrasonic diagnostics of tumours of a thyroid gland. Reliability of difference of most often met ultrasonic indications of benign and malignant nodal processes of a thyroid gland is surveyed. Quotients of a malignancy of each ultrasonic indication are calculated. The sum of these quotients allows to differentiate with the big degree of probability focal formations of a thyroid gland among themselves. Two methods are offered for definition of probability of presence of malignant tumoral process at ultrasonic diagnostics of focal formations of a thyroid gland. Key words: a thyroid gland, tumours, ultrasonic diagnostics. Barinov A.N. Modern methods of treatment of back pain The article is aimed at updating the existing evidence about the pharmacological and minimally invasive surgical treatment of acute and chronic back pain as well as the cognitive-behaviorial therapy of chronic pain conditions in elderly patients. Osipova L.S., Kuznetsova L.V. Modern approaches to treatment of chronic nonspecific respiratory tract diseases Kukushkin M.L. Combined Therapy of Nonspecific Low Back Pain Institute of General Pathology and Pathophysiology of RAMS, Moscow The article presents data reflecting the causes of low back pain; the principles of diagnosis and clinical features of pain are examined. Additionally, the results of randomized controlled trials on the effectiveness of treatment for patients with nonspecific low back pain are given; according to this data of this trial the use of nonsteroid anti- inflammatory drugs and muscle relaxants is justified and has good level of evidence. Particular attention is given to studies that demonstrate the high efficacy and safety of aceclofenac in patients with low back pain. Key word: low back pain, nonsteroidal anti-inflammatory drugs, aceclofenac.
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