[The analysis of human resources of medical workers by profile "Stomatology" providing out-patient medical care to population of megalopolis within the framework of mandatory medical insurance].

The statistical report for 2017-2020 demonstrated that in outpatient conditions of multidisciplinary dental clinic providing services under compulsory medical insurance of population of megalopolis, there is increase in the number of physicians of the analyzed profile up to 304.5% and paramedical personnel up to 256.3% at the expense of young personnel. The direct relationship between increasing of the number of top- and middle-level dentists and quality of medical care provided within the framework of compulsory medical insurance was established.

[Leukocyte and thrombocyte glycosaminoglycans in hemophilia A and von Willebrand's disease]. / Glikozaminoglikany leikotsitov i trombotsitov pri gemofilii A i bolezni Villebranda.

AIM: The study of glycosaminoglycanes (GAG) in leukocytes and platelets of patients with hereditary coagulopathy. MATERIALS AND METHODS: GAG concentration, composition and fraction identification were made in 25 patients with hemophilia A and 10 patients with Willebrand disease. RESULTS: In hemophiliacs, leukocytes contained low concentrations of GAG. In those with bleeding and synovitis GAG levels were lower than the average, in those with extensive hematomas in the absence of locomotor disorders the above levels were close to normal. Chondroitinsulphate dominated in GAG composition though it was less polydisperse. Heparin sulphate levels were elevated. Platelet GAG characteristics were close to normal. In Willebrand disease leukocyte GAG content and composition was similar to those in hemophilia A except some differences in electrophoretic properties of small GAG components. CONCLUSION: Metabolism and/or release of GAG from blood cells may be involved in pathogenesis of hemophilia A and Willebrand disease.

[The sonographic characteristics of hemophilic arthropathies]. / Sonograficheskaia kharakteristika gemofilicheskikh atropatii.

The work presents findings of an ultrasonic examination of joints in 30 patients with hemophilia and in 15 healthy persons. Of 30 hemophilic patients 15 had hemarthroses and 15 had chronic hemorrhagic-destructive arthropathies. On the basis of the examinations carried out a conclusion was made about high informative value of sonography as a non-invasive diagnostic method and as estimation of the efficiency of treatment of hemophilic arthropathies.

[The clinico-instrumental characteristics of the kidneys in hemophilia patients]. / Kliniko-instrumental'naia kharakteristika pochek u bol'nykh gemofiliei.

Urinary system was examined in 35 hemophiliacs. 25 of them had in the past 2 to 6 episodes of hematuria. The examinees had also depressed cellular immunity. Their humoral immunity, on the contrary, was activated. In the absence of clinical and x-ray evidence of urinary abnormalities, renal affections were registered in 88.6% of the examinees. According to the data obtained all hemophiliacs suffer from unbalance of cellular and humoral immunity, abnormal clearance of immune complexes, probable renal damage. Therefore, it is desirable to make ultrasonic investigation of the kidneys in all hemophiliacs to check latent renal affection and take therapeutic measures.

[Ultrasonic study of the urinary system in hemophiliacs]. / Ul'trazvukovoe issledovanie mochevydelitel'noi sistemy u bol'nykh gemofiliei.

Ultrasonic investigation of the urinary system and the kidneys has been performed in 40 hemophilia A patients. The size of the kidneys was reduced in the majority of patients, the area of the calices in relation to relevant parenchyma was relatively enlarged. Parenchyma to caliceal-pelvic system ratio made up 1.5:1. The caliculi and pelves were dilated. The resultant ultrasonic picture was characteristic of chronic pyelonephritis. Concrements of the right and left kidney were detected in 45% and 62.5% of the patients, respectively. The bladder looked asymmetric with thick walls and echogenic particles in the cavity. Control laboratory findings failed to reveal any renal pathology. It is clear that diagnostic ultrasound is important in hemophiliacs who may develop latent renal disorders. The risks of replacement therapy with blood preparations and sequela of renal hemorrhages are considered.

[Pathogenesis and therapy of joint inflammation in patients with hemophilia]. / Osobennosti patogeneza i terapii porazhenii sustavov u bol'nykh gemofiliei.

This study was aimed at investigation of immune status in patients with hemophilic arthropathies and design of optimal therapeutic programs for them. 103 hemophiliacs were examined. Of them 56 patients had chronic productive synovitis and 47 osteoarthrosis. All the patients displayed higher levels of CIC and immunoglobulins than normal subjects, the highest values being registered in synovitis. Synovial fluid in them contained CIC and IgG, IgA, IgM. The findings suggest that immune disorders are actively involved in pathogenesis of hemophilic arthropathies. Programs of immunocorrecting therapy of synovitides and osteoarthroses including plasmapheresis and intraarticular administration of hormonal and cytostatic drugs produced a clinical response in 80% of the cases. The remission lasted up to 1 year.

[Caudal epidural anesthesia during interventions on the lower extremities in patients with hemophilia]. / Kaudalnaia épiduralnaia anesteziia pri vmeshchatelstvakh na nizhnikh konechostiakh u bolnykh gemofiliei.

Anesthesia techniques during surgery on the lower extremities have been compared in 57 patients with hemophilia. It has been shown that caudal epidural anesthesia according to an elaborated technique could be a method of choice.

[Results of therapeutic use of plasma- and erythrocytapheresis in patients with arterial thromboobliterating diseases of the extremities]. / Nekotorye itogi primeneniia lechebnogo plazma- i éritrotsita- fereza u bo'lnykh s tromboobliteriruiushchimi zabolevaniiami arterii konechnostei.

The article analyzes results of using methods of plasma- and plasmoerythrocytapheresis in 120 patients with occlusive injuries of main arteries of extremities. The efficiency of the methods used both as isolated ones and in combination with surgical procedures in patients with obliterating atherosclerosis, thromboangiitis, and aorto-arteritis of the extremity vessels and the Raynaud disease is estimated.

[A method of correction of hemorheological disorders in patients with thrombobliterating diseases of the peripheral arteries of the limbs]. / Metody korrektsii gemoreologicheskikh narushenii u bol'nykh s tromboobliteriruiushchimi zabolevaniiami perifericheskikh arterii konechnostei.

Methods of plasm- and plasmoerythrocytapheresis in combination with hemodilution were used in 28 patients with thrombobliterating diseases of the extremity arteries. A conclusion is made of the necessary detection of hemorheological disturbances in this group of patients. The methods used were shown to be promising. The correlation was established between changes of the rheological properties of blood and clinical course of the disease.