Data on etiopatogenetichesky aspects of formation are presented in article ekvinus-ache deformations of feet at cerebral palsy and also questions of diagnostics and approaches to treatment of this pathology are considered.

Tis review describes different virus taxa that are more prevalent in some variants of urological pathology. Te search of articles was conducted in the information portals of Te Cochrane Database, MEDLINE / PubMed Database, eLIBRARY, ClinicalKey for the period 2008-2018. As a result, the most current and representative studies, containing an interpretation of the dynamics of opinions indicating the involvement of viruses in various urological diseases were selected. Te bacterial component is the most studied in the etiology and pathogenesis of inflammatory diseases, but the viral component, as a rule, remains outside the scope of routine examination of patients, which stagnates conducting of adequate therapy and prevention of infectious and inflammatory diseases in urology.

Objective: to characterize the efcacy of nelfnavir and lopinavir/ritonavir in the starting regimens of antiretroviral therapy for HIV-infected pediatric patients.

Materials and methods: 50 HIV-infected patients aged 24-36 months were treated with abacavir and lamivudine in combination with nelfnavir (24 children) or lopinavir/ritonavir (26 patients).

Results: Using both antiretroviral therapy schemes leads to suppression of HIV replication, improvement of clinical and immunological parameters. However, the treatment with lopinavir/ritonavir revealed a signifcant positive changes of HIV blood viral load, immune status and clinical picture. With the help of mathematical modeling, the signifcance of lopinavir/ritonavir appointment as an independent predictor of effectiveness prolongation of antiretroviral therapy has been proved. As a side effect of lopinavir/ritonavir developed dyspeptic symptoms.

Conclusion: Te results of the study indicate the high efcacy and safety of lopinavir/ritonavir use compared to nelfnavir in HIV-infected pediatric patients.

Objective: to reveal the morphometric regularities of the depth indices of the dental arches of the upper and lower jaws of the mesocrane skull type.

Material and methods: the morphometric parameters of the depth of the dental arches of the upper and lower jaws were investigated. Te work was performed on 144 preparations of mesocrane skull type of people of both sexes of mature age with physiological occlusion of teeth. Te depth of the dental arch was measured from the point located at the center of the cutting edge of the medial incisor to the point of intersection with the line connecting the distal surfaces of the tooth crowns at the level of the canines, frst premolars, second premolars, frst molars, and second molars.

Results: the range of confdence limits of the depth of the dental arches of the upper jaw in men at the level of canines and premolars surpassed those of women. Te range of confdence limits of the depth of the dental arches of the lower jaw in men and women at all levels of measurement was similar.

Conclusions: the indices of the confdence limits of the depth of the vestibular and palatal dental arches of the upper and lower jaws are revealed. Te new data obtained as a result of the research, supplement and expand the information on the studied parameters, both in theoretical and clinical aspects.

Objective: to evaluate the possibilities of normobaric hypoxic training (NHT) in the human brain protection from the damaging effects of oxygen defciency.

Materials and methods: the study involved 18 men, aged 19-23 years, who underwent NHT: 15 treatments daily 2-hour stay in a hypoxic gas medium (HGM) having an oxygen content 15.0 ± 0.5% (HGM-15). Beforestarting the NHT (I phase), and afer 1-2 days afer its closure (II stage) were carried hypoxic samples (staying in HGM-15) before and during which the subjects were recorded the electroencephalogram (EEG) and mental performance were evaluated (the «Route» test).

Results: when the frst hypoxic test was carried out, the subjects had a decrease in the alpha-rhythm index (on average by 10-15 %, p = 0.013) and its amplitude (by 10-12 %, p = 0.044) compared to the usual environmental conditions. At the same time, the share of low-amplitude slow waves increased (p = 0.019). Te integral indicator of the «Route» test during staying of the subjects in the HGM-15 decreased on average by 18% compared to the usual conditions (p <0.001). Te obtained data testifed about negative influence of staying in HGM -15 on the functioning of the higher parts of the brain. Afer carrying out NHT, all subjects showed a signifcant reduction in the negative reactions of spontaneous EEG to hypoxia: when the sample was repeated, the alpha-rhythm index and its amplitude did not change signifcantly (in comparison with air breathing), signs of excessive slow wave activity were absent. Reduction of the integral indicator of mental performance when staying in HGM-15 amounted to an average of only 6%.

Conclusions: NHT in the developed regime is an effective means of the brain protection from the damaging effect of oxygen defciency and can be used in the system of physiological training of specialists to perform tasks of activity in conditions of reduced partial pressure of oxygen.

Objective: to study the frequency of vena cava inferior (VCI) injuries by the elements of the modern structures vena cava flters (VCF) and the penetration into surrounding organs and tissues, which revealed during the open surgical interventions for different complications due to the presence of a fltering device in the late post-implantation period.

Material and methods: the study had included 31 patient of different age groups, operated for the period from 2008 to 2017 with late complications of implantation of VCF.

Results: penetration of structural elements of VCF beyond the limits of VCI was revealed in 20 patients, and 9 of them — in surrounding organs and main vessels. Te age of this group of patients was from 20 to 58 years. Te length of the fltering device in the VCI was from one month to 18 years (Me - 14.5 months). In 95 % of cases, this was the conical models VCF and their parts penetrated the paracaval space. In 5 patients, the elements of the flter device penetrated into the duodenum, 2 in the gonadal veins, and two observations - into the aortic wall and into the liver tissue.

Conclusions: damage vascular wall of VCI with elements of the VCF and their penetration into the surrounding organs and tissues in the distant post implantation period is a common complication, in the prevailing part of the observations caused by the implantation of the conical structure VCF.

Objective: to determine the effect of the initial comorbid burden in patients with metastatic colorectal cancer (CRC) and resectable liver metastases on the development of postoperative complications, depending on the use of laparoscopic or standard open operations.

Materials and Methods: the study included 311 patients with verifed metastatic CRC T3-4N1-2M1 and resectable metastases in the liver. Depending on the organization of the surgical treatment, the patients were divided into two groups: the main group (n=161) performed laparoscopic surgical interventions and a control group (n=150) of patients with the same pathology who underwent traditional open operations. Te comorbidity was assessed by the Charlins comorbidity index, the risk of cardiovascular complications according to Goldman, the adjusted Lee index. Te effect of comorbidity on postoperative complications was studied by the method of constructing conjugacy tables.

Results: in patients with metastatic RTC in class IV of the risk of cardiovascular complications according to Goldman and high cardiovascular risk in the Lee index, open surgical interventions had an advantage over laparoscopic surgery because of the risk of life-threatening cardiopulmonary pathology. In the I-III class of the risk of cardiovascular complications according to Goldman and low, as well as intermediate cardiovascular risk in Lee, the laparoscopic operations were not accompanied by an increased risk of postoperative cardiovascular complications and were accompanied, in addition to the traditional advantages of minor trauma, by reducing the complications associated with removal oncological drug, as well as infectious wound complications in the place of surgical intervention. Conclusion: when deciding whether to perform laparoscopic interventions in patients with metastatic CRC and resectable metastases in the liver, it is necessary to assess the comorbid load on the Goldman and Lee index before the operation.

Objective: assessment of the effectiveness of the use of Polymuramil in complex with IVG therapy with patients with CVID and ХLA with insufcient replacement therapy.

Materials and methods: there were 10 patients with insufcient effectiveness of IVIG replacement therapy, receiving complex IVIG therapy and immunomodulator Polymuramil at a dose of 200 μg / 0.5 ml No. 5 intramuscularly every other day, under study. Surface and intracellular markers of cells of the congenital and acquired immune response, serum immunoglobulins of class A, M, G - in the radial immunodiffusion in the Mancini gel, the oxygen-dependent metabolic activity of neutrophils in NST-test were assessed with the help of flow cytometry, before and afer 3 months and a comparative analysis of the obtained data was conducted.

Results: analysis of the data revealed a signifcant increase in markers of lymphocyte activation, which indicates the induction properties of the studied immunomodulator by increasing the activation potentials of the cellular link of adaptive immunity in patients with primary immunodefciency.

Summary: in patients with a genetically mediated defect of the humoral immunity against the background of complex therapy with the use of Polymuramil, the activation of congenital and adaptive immunity is registered, which is confrmed, in addition to laboratory indexes, by a decrease in the frequency of exacerbations of chronic inflammatory diseases.

Objective: to improve the results of treatment of patients with acute appendicitis. Te results of surgical treatment of 360 patients with acute appendicitis were presented.

Materials and methods: in predicting of development of intra-abdominal adhesions in patients afer appendectomy and of effectiveness of anti-adhesion therapy in postoperative period was used clinical, laboratorial (phenotype signs of connective tissue dysplasia syndrome, activity of the enzyme N-acetyltransferase, a test system based on sorbents with magnetic properties with immobilized granular antigen from adhesive tissue), instrumental methods of research. Te frst group included 120 (50%) patients who underwent standard appendectomy. In 120 patients with acute appendicitis (the second group) the elements of “Fast-Track” surgery was used in performing classical laparotomy appendectomy. Te third group consisted of 120 patients who underwent laparoscopic appendectomy.

Results: all patients with diagnosed adhesive process in the early stages of its development in postoperative period were provided with anti-adhesion therapy. Te least number of postoperative complications was observed in cases of multimodal approach to treatment of acute appendicitis.

Conclusions: application of “Fast-Track” surgery principles allowed to reduce development of intra-abdominal adhesion afer surgery compared with traditional appendectomy on 6.6 %, and with laparoscopic — on 2.8 %.

Objective: to study the frequency of occurrence of diseases of the cardiovascular system in the course of routine physical examination of the child population, with the purpose of early recognition of various pathological conditions, including structural anomalies of the heart and large vessels.

Material and methods: total examined 260 childrens aged 6 to 14 years, 118 girls (45.3 %) and 142 boys (54.6 %). Screening survey was performed in the parasternal, apical and subcostal positions. Time to research occupied from 7 to 20 minutes.

Results: out of 260 children who passed clinical examination a structural anomalies of the heart was detected in 56 patients (21,5 % of all researches).

Conclusions: the clinical examination of children population has a colossal medical and social important not only in Russia, but all over the world. Echocardiographic screening of children of preschool age is necessary for timely detection of cardiovascular pathology, especially occurring asymptomatically.

Objective: to determine the cut-off of natriuretic peptide for optimization dyagnosis heart failure in comorbid patients with thyrotoxicosis, to assess the dynamics of this indicator during therapy.

Materials and methods: 111 patients (58,3±5,6 years) were divided into 4 groups. Te main group consisted of 25 patients with CHD, CHF II-III FC and thyrotoxicosis; the 1st group of comparison - 30 patients with CHD and CHF II-III FC, without thyrotoxicosis; the 2nd group — 30 patients with thyrotoxicosis without CHD, the 3rd group - 26 patients with thyrotoxicosis and CHD, with no signs of CHF. Te fnding of thyroid gland, the level of NT-proBNP was estimated at baseline and afer 6 months therapy. A new cut-off NT-proBNP for the diagnosis of CHF in comorbid patients was calculated by using ROC analysis.

Results: the high concentration of NT-proBNP was detected in all patients (more then 125 pg/ml), in the 2nd comparison group — 225.5 (180.1, 376.1) pg/ml. Te NT-proBNP values in the patients of the 1st and 3rd comparison groups did not differ signifcantly. Te highest level of NT-proBNP was detected in the main group — 712.1 (434.3, 893.9) pg/ml. A cut-off of this marker for screening CHF in comorbid patients with CHD and thyrotoxicosis was calculated - 556.4 pg/ml (a sensitivity of 72 %, a specifcity of 100 %, an accuracy of 87.2 % (p <0.001)). Afer 6 months therapy in the 2nd comparison group the level of NT-proBNP decreased by 74 % (р<0,0001) and has reached the normal value (64,6 (42,2;76,3)); in the main group the level decreased by 43% and was 406,7 (309,1; 498,6) pg/ml.

Conclusions: the patients of all groups showed an increased concentration of NT-proBNP. Te highest level of NT-proBNP was observed in the group of patients with CHF by CHD and thyrotoxicosis. Te level of NT-proBNP was determined - 556.4 pg/ml, which allows us to diagnose CHF in patients with a combination of CHD and thyrotoxicosis.

Objective: to study the infection of the adult and children’s population of the Rostov and Astrakhan regions by the bacteria Helicobacter pylori, to determine the frequency of H. pylori pathogenicity factors in different age groups of the population.

Materials and methods: 118 adults and 112 children were examined. Te presence of H. pylori DNA and the pathogenicity factors of CagA and VacA in the biopsy material of the mucous membrane of the antrum of the stomach was determined by PCR.

Results: a signifcantly smaller percentage of H. pylori–positive patients is characteristic of the child population. Te prevalent H. pylori genotype in the infant population is the avirulent genotype Vac s2m2 (60%) (χ2: p <0.005). Genotype CagA + VacAs1 VacAm1 is a marker of peptic ulcer for adult population of the Rostov region.

Conclusion: Te conducted studies allowed to establish differences in infection of the population with H. pylori bacteria and the frequency of the distribution of virulent genotypes depending on the region, age and severity of the pathology.

Clinical observation of a patient with a paraneoplastic polyneuropathy, associated with ovarian cancer, is presented. A feature of this case is its relative rarity. Stages of development of neurological disorders in combination with laboratory diagnostics data led to the need for oncological search, which resulted in the detection of ovarian cancer. Te histological diagnosis is confrmed by immunohistochemical method. Malignant tumor was detected one year afer the appearance of the frst signs of sensory polyneuropathy, which confrms the paraneoplastic nature of neurological disorders. A timely treatment for a malignant tumor can lead to the stabilization of neurological symptoms.