Objective Transbronchial endosonography (EBUS) is a relatively new method for diagnosing of the pathological condition of the thoracic organs. Analysis of 10 years of our experience in the use of transbronchial endosonography in a specialized center.

Material and Methods During the period from April 2010 to April 2020, 756 transbronchial endosonographies were conducted on 756 patients. The studies were carried out for various indications: 1) Group 1 (483) – transbronchial puncture of the lymph nodes in order to obtain morphological confirmation of the etiology; 2) Group 2 (260) – staging of suspected or verified lung cancer to determine the descriptor N; 3) Group 3 (13) – a study that ended only with obtaining an endosonographic image. All patients underwent transbronchial endosonography using the special ultrasound bronchoscope EB-1970UK (Pentax Corp.) and the ultrasound scanner EUB 5000 Plus G OB/GYN – Vascular Ultrasound (HITACHI Corp.).

Results General information content was 78%; verification of mediastinal lymphadenopathy was 72% (57, 79, 58% for smears, cytoblocks and smears + cytoblocks, cytoblocks vs smears + cytoblocks, p < 0.05). Verification of local changes in the mediastinum – 66%; verification of peribronchial tumor – 87%. Lung cancer staging – 87% (82, 88, 86% for smears, cytoblocks vs smears + cytoblocks, respectively, р > 0.05)

Conclusion Тhe diagnostic utility of EBUS for the verification of mediastinal lymphadenopathy can range from 37,5 to 83% and rise with increasing experience for all persons involved. The use of cytoblocks showed the best results. The diagnostic utility of staging varies from 60 to 100% and does not depend on the method of processing the aspiration material.

Objective The goal is to optimize the diagnosis of complications after thread implantation using high-resolution ultrasound (US).

Material and Methods The study design included the formation of twelve sample comparison groups. Inclusion criteria for the group: women without evident somatic pathology after cosmetic implantation in various periods after the procedure. The difference between the groups was in the chemical composition of the material (L-lactic acid, polydiaxanone, copolymer of L-actide with ԑ-caprolactone, polypropylene, polyester fiber in a silicone sheath, metal), complaints (the presence of amyctic, the presence of overcorrection, the absence of complaints), the period of time after implantation (up to 6 months, from 6 to 12 months, more than a year). Then ultrasound was performed, 33 qualitative and 7 quantitative indicators were analyzed. The study involved 93 women aged 29 to 65 years after the thread implantation. The circulation period varied from 3 days to 20 years.

Results An analysis of the relationship between quantitative and qualitative features revealed statistically significant connections between the presence of an acoustic shadow and threads of polylactic acid and polypropylene, the presence of reverberation, and the metal – gold (p < 0.0001). Relationships were established between polyester fibers in a silicone sheath with complaints of inflammation, the presence of edema during examination, perifocal edema around the thread during ultrasound (p < 0.0001). The difference was also found between the diameter of the thread in the group of patients examined up to 6 months and the group in the period 6–12 months after implantation (p < 0.0001), as well as the group up to 6 months and more than a year (p = 0.0033).

Conclusion The presence of an acoustic shadow, a thread diameter of more than 1 mm are ultrasound signs of fibrotic changes around the thread. The characteristic echographic signs of inflammation around the thread will be a zone of reduced echoicity, corresponding to perifocal edema. Hypercorrection is a consequence of fibrotic changes development around the thread.

Objective To compare the rotational stability of fusion constructs using bisegmental fixation of Th12-L2 vertebrae with anterior stabilization or pedicle screw fixation.

Material and Methods The strength, rigidity and limit of elasticity in the “injured vertebral motion segments (VMS) – bisegmental anterior stabilization” system under dislocating rotational loads were estimated. The data obtained were compared with the similar characteristics of the “injured VMS – bisegmental 4-screw transpedicular metal construction” system and intact spine segments.

Results Under rotational loads the limits of elasticity of injured spine segments of Th12-L2 with anterior stabilization and transpedicular screw fixation (TSF) is 45.5 and 41.7%, respectively, and the general strength is 66.4% and 80%, respectively, as compared with those intact VMS. Rigidity parameters of anterior-stabilized and pedicle screw fixated VMS with unstable damage of L1 are 60.2 and 93.9%, accordingly, in comparison with those intact VMS.

Conclusion No significant differences were observed between bisegmental anterior stabilization and bisegmental pedicle screw fixation of thoracolumbar junction in terms of the key mechanical properties. When treating patients with unstable thoracolumbar spine injuries using bisegmental anterior stabilization or transpedicular fixation with 4-screw spinal system possible rotation motion amplitude of operated segments must not exceed 50% of maximum physiological limits.

Objective Development of an ultrasound diagnostic matrix for predicting the severity of proliferative changes in the ovarian focal lesion.

Material and Methods The research was conducted on the basis of the Clinical Oncology Center, Regional Clinical Hospital no. 2. Echography (B-mode), color Doppler mapping, energy Doppler mapping (pulsation index, resistance index) on GE Voluson E8 and Aloka SSD 3500 devices were used as research methods. Retrospectively, 81 patients of reproductive age from 18 to 45 years were examined. Depending on the histological structure of ovarian lesion, the results of surgical treatment, dynamic observation and the outcome of the disease, were divided into 4 clinical groups: I (n = 12; 14,8%) – controls with no changes in the structure of the ovaries; II (n = 20; 24,7%) – patients with retention ovarian lesions; III (n = 20; 24,7%) – with benign tumors; IV (n = 29; 35,8%) – with malignant tumors.

Results A large number of diagnostic parameters does not always allow to formulate an instrumental diagnosis correctly because they have different diagnostic significance. That is why we made an attempt to create a diagnostic matrix. For each of the 18 parameters, three answers were offered. When analyzing the results of the study, there was an increase in the number of pathological parameters from II to IV clinical groups. Thus, in group III, the combination of 2 pathological signs was found in 65% of cases, and 3 signs – in 25% of the examined women. In group IV, the combination of 2 signs was determined in 82% of the subjects, and 3 signs in 65%.

Conclusion Thus, we found out that in-depth ultrasound examination (color Doppler imaging, pulsed Doppler) allowed to identify the severity of the proliferative changes and to give the prognosis of the disease.

Background One of the relevant tasks of modern urology is the correct understanding of symptoms of the lower urinary tract (LUTS). The social aspect of overactive bladder syndrome (OAB) and the lack of objective ways for non-invasive diagnostics make it necessary to search for new study methods. There is increasing evidence that urination diary can be a clinically powerful tool for assessing bladder sensation, especially in cases of obtaining information not only about the volume of micturition, but also about the degree of urgency with each individual urination. To date, several tools have been developed to assess the severity of OAB, including the international scale of Overactive Bladder Symptom Score (OABSS), proposed by Y. Homma and J. G. Blaivas in 2006–2007.

Objective Тo identify the most significant signs of urgency in men with benign prostatic hyperplasia and overactive bladder with and without detrusor hyperactivity (DH).

Material and Methods To assess the OAB, patients completed the OABSS, visual analogue scale (VAS), and also kept urination diaries. After the results were obtained, the severity of symptoms was evaluated, considering the data of the urination diary. All patients underwent a complex urodynamic study (CUDI), the results of which were compared with subjective criteria for the severity of urgency and the most significant clinical signs of detrusor hyperactivity.

Results Against the background of the analysis of the data obtained, it was possible to classify nocturia by type in 93 patients. One patient (1.07%) had diurnal polyuria. Nocturnal polyuria was in 39 (41.9%) people. Decreased bladder capacity was found in 43 (46.2%) men. Ten (10.7%) patients had various sleep disorders. The IPSS was 24 ± 0.91, the mean score was 14 ± 0.7 points for irritative symptoms according to IPSS (questions 2, 4 and 7) and 13 ± 0.8 points for obstructive symptoms. From the data reported by CUDI, spontaneous detrusor activity was detected in 49 (43.7%) patients, in 63 (56.2%) it was not registered. When analyzing the VAS, it was found that the urgency in patients with BPH and DH, reflecting the initiation of the urge to urinate, is 31 ± 0.6 mm (p < 0.05). On average the indices of the difficulty of holding the urge are higher by 2.9 ± 0.2 points (p < 0.05) in those patients who have DH. When answering the question "How often cannot you retain urine with a strong sudden urge?", the indicators were recorded higher by 3.1 ± 0.3 points (p < 0.05), in patients with detrusor hyperactivity.

Conclusions In patients with BPH and the presence of urgency, the frequency of the urge to urinate is 32% higher, and the difficulty of maintaining the urge is 46% more pronounced, compared with the examined men who do not have detrusive hyperactivity.

Introduction Coronavirus disease (COVID-19) caused by SARS-CoV-2 virus identified in 2019, forces cardiology departments to quickly adapt existing clinical guidelines to the new reality, and this is particularly relevant for scheduling patients with acute coronary syndrome (ACS). The article demonstrates how COVID-19 has affected emergency cardiac surgery care.

Objective To analyze the features of completed cases of emergency coronary artery bypass grafting (ECABG) and COVID-19 diagnosed during the postoperative period at the Research Institute – Ochapovsky Regional Hospital no. 1 for the period from May 1, 2020 to February 1, 2021. Material and Methods Completed cases of ECABG have been retrospectively studied. EACS was performed in 145 patients: in 79 people with unstable angina pectoris (NS), in 40 with Q-negative myocardial infarction (MI), in 14 cases with primary Q-positive MI, in 12 patients with recurrent MI. The condition for ECABG was a negative SARS-Cov-2 PCR result and the absence of viral pneumonia by CT. The patients were divided into 2 subgroups. The first one included people with ECABG that were not diagnosed with COVID-19 during postoperative follow-up in the hospital. Subgroup II had patients with ECABG and COVID-19 diagnosed during the hospitalization.

Results Contingency tables showed a statistically significant interaction between group membership and mortality, 2.3% (n = 3) in subgroup 1 and 20% (n = 3) in subgroup 2, Pearson’s test χ2 = 10.6, p < 0.05. When analyzing survival rate in the EACS + COVID-19 subgroup, it is worth paying attention to the cumulative proportion of survivors, considering the severity of the course of viral pneumonia. The proportion of such patients with CT-4 by the 32nd day of hospital stay was 0.3.

Conclusions Mortality rate in the postoperative course after ECABG with COVID-19 is significantly higher. In patients who underwent ECABG and died in the early and late postoperative period from COVID-19, a new coronavirus infection was diagnosed at a later date. In these cases, a considerably longer duration of CPB and a higher level of ferritin were revealed at the time of transference to the observation department. Survival rate in ECABG patients due to primary Q-negative MI is significantly lower in comparison with patients hospitalized for unstable angina.

Extracorporeal membrane oxygenation (ECMO) has been used for more than 20 years in the treatment of severe respiratory distress syndrome. However, ECMO in some categories of patients is not sufficiently covered in the literature, due to a small number of registered cases. This group includes pregnant women and women in labor. During the intensive care of such patients, the entire available range of therapeutic manipulations and measures that can favorably affect the outcome of the disease should be used. We have describe a clinical case of successful ECMO in a patient with novel coronavirus disease (COVID-19) and obstetric sepsis developed in the early postpartum period.

Background Chronic neuropathic pain is a common occurrence, its prevalence ranges from 7 to 10% of the total population. Currently, the only official document that includes neuropathic pain is the International Classification of Headaches Disorders (ICHD-3), in which this type of pain is associated with traumatic brain injury and neuralgia. Until now, there has been no generally accepted terminology and classification of chronic neuropathic pain.

Objective To provide the current terminology, classification and additional characteristics of neuropathic chronic pain.

Results The review of modern terminology and classification of neuropathic chronic pain describes the terms included in the concept of chronic peripheral and central neuropathic pain, identifies pain subtypes, as well as its additional characteristics such as the intensity of neuropathic pain, the severity of suffering and disability.

Conclusions Thus, the presented recent classification of chronic neuropathic pain is an exhaustive list of the most common neuropathic pain syndromes. The inclusion of classification into clinical practice will help to draw attention to the problem of treatment of chronic neuropathic pain by WHO members, carrying out epidemiological studies and making a correct diagnosis, and therefore the appointment of adequate treatment methods.

Increasing life expectancy is the goal of social programs in the Russian Federation as a reflection of the success of public health. Globally, there is a trend for aging of the population, contributing to an increased risk for lung cancer developing which is primarily a disease of the elderly. Chronologic age or performance scores alone are not accurate predictors of patients’ capacity for tolerating aggressive cancer therapies. Use of a comprehensive geriatric assessment to determine treatment strategy is able to reduce toxicities and treatment failures. Safe elderly patients are often able to tolerate surgical resection, radiation, and/or chemotherapy appropriate for their tumor stage, with outcomes similar to those of younger patients, albeit with higher rates of treatment-related toxicity.

The article describes the life path of a famous Kuban surgeon Vkadimir K. Krasovitov. The historical aspects of the creation of full-layer skin plasty technique according to Krasovitov are presented, the relevance of its use in our days is analyzed, and the development of new types of skin autoplastics is presented. In addition, the author describes the history of candidate dissertation of V.K. Krasovitov's, as well as the monograph ‘Primary plastic surgery with rejected skin flaps’.