[The social hygienic aspects of reproductive behavior of women aged 40-45 years].

In the context of forecasted decreasing of natality, actuality of studying its causes for organizational decision-making increases. The purpose of the study was to determine factors affecting reproductive behavior of women aged 40-45 years residing in areas with different natality levels in 2020-2021. The cohort, analytical, sociological methods were applied. The results of study demonstrated that in areas with high natality level most of urban women with higher education and high income resides in conditions of dormitory or mortgage flat and working in profile of their specialty. They are characterized by belated marriage that results in postponed child-bearing. The areas with low natality are characterized by dwelling of rural women with secondary or secondary specialized education. They reside in their own homes and work in other occupations than their specialty. The analysis of social status of women of different age groups will permit more selective approach in developing measures of increasing natality in modern conditions.

Risk Factors and Methods for Predicting Ovarian Hyperstimulation Syndrome (OHSS) in the in vitro Fertilization.

Ovarian hyperstimulation syndrome (OHSS) is the most severe and life-threatening complication of assisted reproductive technologies (ART). OHSS is based on an excessive ovarian response to ovarian stimulation; however, the pathogenesis has not been fully understood yet. The most serious complications of OHSS are thromboembolic complications and ovarian torsion. The current study describes the risk factors for the development of ovarian hyperstimulation syndrome and proposes a method for specific prediction of this syndrome. This study was designed to investigate 671 therapeutic cycles in the IVF program during 2009-2018. All patients were divided into two groups. Group one (n=56) included women who developed OHSS during the IVF procedure. Group two (n=615) consisted of women who did not have this complication during the IVF procedure. All the observation and examination outcomes were entered into a specially developed questionnaire, and then into a Microsoft Excel spreadsheet. The data were processed by variable statistics using Statistica 10.0. Analyzing of the recorded data revealed that the rate of OHSS was higher in the group of younger women, aged 30.76±3.67 years, in comparison with those aged 32.78±4.40 years in the group of patients without OHSS (p<0.05). The analysis of the initial phase of the reproductive system has confirmed that the group of patients with OHSS had a higher level of prolactin, 462.84±191.56 mIU/L in comparison with 363.43±187.84 mIU/L, which corresponded to the group of women without OHSS (p<0.05). In our results, 7.15±1.04% of cases with OHSS had obesity, while of the patients from the group without OHSS suffered from it (p<0.05). OHSS is the most severe iatrogenic complication of ART, therefore it is extremely important to consider its risk factors and take timely preventive measures. This study has established a high relationship between the studied risk factors and ovarian hyperstimulation syndrome and proposed a model for predicting this syndrome.

Surgical treatment of post-traumatic defects of the soft tissues of the head with necrosis of the calvarial bones.

Experience with the treatment of patients with defects of the soft tissues of the head and necrosis of the calvarial bones has been generalized. Results of treatment using multiple craniotomy, osteonecrectomy and various methods of dermatoplasty aiming at restoration of the skin cover are discussed. The methods of treatment focused on the preservation of osteonecrotic parts and thus the hard integument of the calvaria ensuring prevention of intracranial suppurative complications, creation of a full-value skin cover, a more favourable outcome of injury and work ability of the patients are discussed and recommended.

[Means of filling in extensive defects with cutaneous-subcutaneous-fascial flaps on a Filatov pedicle]. / Sposoby zameshcheniia obshirnykh defektov kozhno-podkozhno-fastsial'nymi loskutami na filatovskom steble.

The authors propose methods for closing vast defects by cutaneous-fascial grafts transferred on the Filatov's pedicle through the upper extremity. These whole thickness grafts must be previously subjected to surgical training which eliminates risk of ischemia. The tubular feeding pedicle is convenient for care and prevents infections in the postoperative period. The first method consists in the forming of the Filatov's pedicle (as the first step) which is then transferred onto the hand (the second step). In the first method both steps are supposed to be fulfilled simultaneously in order to shorten time of treatment. The methods described were used for closing great wounds on the head and lower extremities in 8 patients.

[Use of thyroidin for stimulating oxidative processes in the tissues of burn patients]. / Primenenie tireoidina dlia stimuliatsii okislitel'nykh protsessov v tkaniakh u obozhzhennykh.

Thyroidin was used in 30 patients with the burned disease at the stage of septicotoxemia with the burn exhaustion of the I--II degree and the square surface of granulated wounds not more than 20% of the body surface. Small doses of thyroidin used according to the proposed scheme in combination with the intensive oxygen therapy gave an obviously positive curative effect. Normal utilization of oxygen by tissues and the improved capillary blood flow were finally observed. These measures caused reviving of regenerative processes and normalization of protein metabolism.

[Treatment of donor wounds after cutting of full-thickness skin transplants with a dermatome]. / Lechenie donorskikh ran posle srezaniia dermatomom polnosloinykh kozhnykh transplantatov.

An analysis of the results of the treatment of 180 donor wounds following cutting off thick or full-thickness grafts by means of a dermatome in 123 patients with post-burn deformities and contractures is presented. The healing period variants, depending on the thickness of the grafts and on the treatment method, have been found. The authors recommend to cover the donor wounds with thin grafts or with sieve grafts.

[Prevention and treatment of postburn deformations of the breasts]. / Profilaktika i lechenie posleozhogovykh deformatsii molochnykh zhelez

Twenty six girls with deep burns of the anterior and lateral surface of the chest were treated in Gorky Research Institute of Traumatology and Orthopedy. The obserrvations indicated that an early closure of burn wounds in this region with adequate skin grafts could prevent gross deformity of mammary glands. Moreover, 70 females with deformation of mammary glands were under observations. In 16 of them operative procedures were undertaken for isolated lesions of 22 mammary glands. Various methods of skin plasty were employed: local, free, combined. Good and satisfactory results were gained. In 54 female patients deformities in the region of 68 mammary glands were eliminated simultaneously during surgical procedures for cicatricial contractures of the brachial joint, coxa and neck. The results obtained are described.