Background. Surgical correction and stabilization of post-traumatic spine deformations is connected with a neurologic complication development risk. However, at the moment there are no predictive scores for risk assessment of surgical neurologic complications in this category of patients.

Aim. We offer an express system to estimate risk of neurologic complications after surgery in patients with posttraumatic thoracic and lumbar spine deformations.

Material and methods. The analysis of treatment results of 124 patients with post-traumatic deformations of thoracic and lumbar spine during 2003–2017 was carried out. Among those there were 70 males and 54 females aged from 18 up to 54 years. Operations are executed in terms from 6 months up to 14 years from the moment of a trauma. In 61 cases deformation development was a result of diagnostic mistakes and/or not effective conservative treatment. Failed surgery was observed in 63 cases.

Results. The analysis of clinical material has allowed to allocate 3 factors predetermining possibility of neurologic complications after surgical treatment. They are as follows: a functional condition of a spinal cord and roots in the late post-traumatic period, the spondylosis characteristics of the post-traumatic stenosis of the vertebral channel and localization of the spinal column deformation. For each of these factors there are several gradations according to their symptom intensity. All possible combinations of various gradation of above mentioned three specified factors sum up 46 estimated options for the risk of neurologic complication development following surgery for posttraumatic lumbar and thoracic spine deformations.

Conclusion. This suggested score could be a basis for express estimation of the risk for post-surgical neurologic complications development.

Background. Estimation of safety and efficiency of platelet-rich plasma in complex treatment in patients with persistent large ulcers.

Material and methods. Two clinical cases of patients with long persistent ulcers of the lower extremities that were administered local injections of the autologic platelet-rich plasma in the wound area in combination with or without autodermoplasty.

Results. In the first case the patient had a trophic ulcer after erysipelatous inflammation without dynamics to healing in the setting of the carried treatment. Surgery was contraindicated due to severe accompanying pathology. This patient had 6 PRP courses (once a week). The regional epithelialization appeared on the 2nd week. After 6 injections full wound healing was noted. In the second case the patient had a long persistent post-traumatic ulcer with 2% square. The autodermoplasty with local introduction of PRP was performed. We observed a full graft acceptance on the 6th day.

Conclusion. PRP use will allow to improve outcomes of treatment persistent ulcers of the lower extremities. It represents extremely important to continue work on PRP application due to an absence of complications and obvious contraindications in this method for carrying out comprehensive analysis.

The rupture of the pulmonary artery during balloon valvular dilatation is rare and the severest complication. In this clinical case we described the rupture of the pulmonary artery in a 10-month-old baby with cardiac tamponada and an extreme hemodilution due to blood loss. CPR has been using for 40 minutes but being ineffective. For 3 days we have been applying ECMO. This patient was discharged without any neurological disorders.

Correction of the patent ductus arteriosus (PDA) takes an important place in management of congenital heart defects (CHD). Untreated PDA can lead to heart failure due to left ventricular myocardial hypertrophy (LVH), pulmonary hypertension, bacterial endocarditis, pulmonary infection, and rarely the development of ductal wall aneurysm, its calcification and further rupture.

It is believed that the closure of PDA is indicated in any child or adult who develops pathognomonic symptoms: expansion of the left heart; the presence of signs of pulmonary hypertension with left-right blood discharge; prior endocarditis. In asymptomatic patients with PDA accompanied by left ventricular hypertrophy closure of the duct is indicated to reduce the risk of further complications.

There were various surgical methods of PDA treatment discovered in the period of the development of medical industry. Previously the most common intervention was ligation of the duct, accompanied by thoracotomy. However, in the present days the ligation of PDA is extremely rare. Endovascular occlusion has taken the lead in the modern practice. Its purpose is to close the duct with intravascular access with help of specialised tools.

In this article we present a case of PDA management in a patient with clinical manifestation of PDA at the age of 35 years.

We presented a clinical case of a patient treated for facial burns. We performed full thickness skin grafting taken from the abdominal surface. For treatment of abdominal wound we used dermal autologous fibroblasts, performed free skin grafting with split-skin grafts, and then placed a vacuum closure. A sufficient result was achieved.

We present a clinical case of an ischemic stroke in a young man, 37 years in the setting of severe cardiac pathology (coronary heart disease, repeated myocardial infarctions with a cardiomyopathy and progressing chronic heart failure). This patient had an orthotopic heart transplantation. In a month we observed an intense violation of cerebral blood circulation, the diagnosis was established: an ischemic stroke in the right carotid pool with formation of the advanced area of ischemia in the right frontotemporal and subcortical area. Total condition was complicated with cerebral edema and dislocation syndrome.

In the course of diagnostic search this patient demonstrated genetically caused thrombophilic predisposition in the form of gene-mutation of the blood coagulating factor – plasminogen activator inhibitor (PAI - heterozygote), a glycoprotein Ia (ITAG 2 heterozygote), F7 heterozygote; the genetic polymorphism associated with violation of a folate cycle - MTHFR 1298 heterozygote, MTR heterozygote. The revealed mutations in heterozygous state genes with predisposition to thrombophilic complications can serve as a background for disorders in anti-coagulation and coagulation system which can appear at identification the factors starting the mechanism of its development. In a case with this patient, we speak about a secondary thrombophilia as a reason of an ischemic stroke in the setting of cardiac pathology, repeated myocardial infarctions, orthotopic heart transplantation, obesity. All above-mentioned factors allowed to administer reasonable pathogenetically justified antiagregant and anticoagulant therapy, folic acid drugs, group B vitamins for a purpose of secondary prevention of thrombotic complications.

We observed issues of etiology and pathogenesis, differentiatied diagnosis of entotic sound which is one of the frequent otoneurological complaints. Classification of this symptom is described.

Orthostatic hypotension (OH) is an excessive decrease of arterial blood pressure when one takes a vertical position. It represents violation of arterial blood pressure circulation at various states and is not an independent disease. OH is associated with an increased risk of the general mortality, incidence of myocardial infarction and cerebral stroke, falling and syncope. We describe definition, classification, prevalence and natural history of OH in this article.