[The risk factors of development of behavior disorders in children of early age fostered in surrogate families].

The study established biological and social psychological risk factors of development of emotional and behavioral disorders, usually onsetting in childhood and adolescence (F90-98) in children of early age in a year of fostering in substitute families. The psychological examination of adoptive mothers was carried out using such methods as MINI-SMIL test, parent attitude to child test (A. Ya. Varga, V. V. Stolin), "Family Relationship Analysis" questionnaire, motivation of adopting child choice test. The statistical processing of research data was carried out using MS Excel XP and Statistica 6.0. The relative risk of various factors was rated using software OpenEpi with 95% confidence interval. The Wald's technique of sequential mathematical analysis was used to identify risk factors and to compile predictive tables. It is established that the most important value in formation of this group of disorders is attributed to health of child while transferring to substitute family, motives of adopting child, personal characteristics of substitute mothers and characteristics of child fostering. The algorithm of predicting health disorders in children of early age fostering in substitute families is developed. The identification of children at risk of developing this pathology permits to apply multi-modal approach to successful prevention and habilitation of children at risk, including medical psychological support, considering physical and mental health of child, psychological characteristics of substitute mothers and abnormalities in mother-child system.

[Endoscopic treatment of esophageal anastomotic leakage using vacuum-assisted closure system]. / Éndoskopicheskoe lechenie nesostoiatel'nosti pishchevodnykh anastomozov s ispol'zovaniem vakuumno-aspiratsionnoi sistemy.

OBJECTIVE: To analyze the effectiveness of vacuum-assisted closure system for esophageal anastomotic leakage. MATERIAL AND METHODS: There were 10 patients with upper gastrointestinal anastomotic leakage who were treated at our institution in 2015-2018. Vacuum aspiration system was applied in all cases. RESULTS: Esophageal wall defect was successfully closed in 9 out of 10 patients after 2-4 courses and the system was eliminated in 11 days on the average. Localized cavity with granulation tissue developed in 1 patient after 5 courses and the system was also eliminated. CONCLUSION: Endoscopic vacuum-assisted therapy is an innovative, minimally invasive, economically profitable and successful method for anastomotic leakage. This procedure should be taken into consideration and widely used in multi-field hospitals.

[PLGA mesh-collagen hybrid scaffold and tissue-engineered product in substitution urethroplasty: experimental validation].

Urethral strictures are a pressing issue in modern medicine. Substitution urethroplasty is considered one of the most effective treatment methods. However, despite the surgery showing good results, many problems remain unresolved, one being substitute material deficiency in extensive or recurrent strictures, as well as in cases requiring multistage surgeries, including those used to treat hypospadias. Graft removal also leaves the donor area prone to diseases and increases the length of surgery leading to a higher risk of intra- and postoperative complications. Tissue engineering (namely tissue-engineered products comprised of scaffolds and cells) may be a useful tool in dealing with these issues. The authors assessed the characteristics of a novel hybrid scaffold created from "reconstructed" collagen and a poly(lactic-co-glycolic acid) mesh. The resulting composite product showed good mechanical properties and functional performance. The hybrid scaffold was non-cytotoxic and provided an adequate base for cell adhesion and proliferation. Biodegradation resulted in the scaffold being replaced by urothelium and urethral mucosa. The newly formed tissues possessed adequate structural and functional properties. Only one rabbit out of 12 developed urethral stricture at the site of scaffold implantation. The above-mentioned facts suggest that the novel hybrid scaffold is a promising tissue-engineered product with potential implication in substitution urethroplasty.