[Modern concept of pain syndrome and dental anxiety pathophysiology and prevention]. / Sovremennaia kontseptsiia patofiziologicheskikh mekhanizmov bolevogo sindroma i psikhoémotsional'nogo napriazheniia i ikh profilaktika na stomatologicheskom prieme.

The work presents a wide range of etiological factors and pathogenesis of formation and development of the pain symptom. The conceptual model of pain which consists of the uniform process including four main complementary levels is presented: nociception, algesis, suffering and painful behavior.

IMMUNOMODULATION AND TREATMENT OF ACUTE DESTRUCTIVE PANCREATITIS IN A MULTIDISCIPLINARY SURGICAL HOSPITAL.

This work is based on the analysis of complex treatment of 497 patients with pancreatic necrosis treated at the surgical department of the Republican Hospital No2-Center for Emergency the Republic of Sakha (Yakutia) in the period from 2010 to 2015. The study was able to adapt and improve the two-tier immunocorretion in pancreatic necrosis in a multidisciplinary surgical hospital that along with the other constituents of intensive therapy has allowed a whole to reduce the amount of intra-abdominal and extraabdominal complications--sterile pancreatic necrosis phase--from 23.6% to 14.6 and 31 6% to 15.0% respectively, total lethality--from 17.6% to 7.2% lethality in patients with non-operated group--from 15.6% to 2.2% lethality in the group of patients operated--18.4% to 10.9%. In the phase of infectious complications of pancreatic necrosis lethality rate decreased from 45.8% to 37.7%.

[Structure and dynamics of congenital maxillofacial malformation in Yakutiya region].

The aim of the study was to assess structure and dynamics of congenital facial clefts prevalence in Republic Sokha (Yakutiya) in the last 13 years. Both retrospective and prospective study included 423 children with congenital facial malformations. Dynamic analysis showed cyclical changes in the incidence of cleft lip and palate (CLP) and relatively high regional prevalence of CLIP with tendency to increase. The age of parents of children with congenital facial malformations tend to decrease with time. The received epidemiological data prove the need to improve treatment and rehabilitation protocols for CLP patients in Republic Sokha (Yakutiya).

[Antibiotic prophylaxis and therapy of pancreatonecrosis in multifield surgical hospital].

The article is based on an analysis of results of complex treatment of 497 patients with pancreatonecrosis at the period from 2010 to 2014. All patients were admitted to the surgical departments of Republican hospital No 2 and Centre of Emergency Medicine of Republic of Sakha (Yakutia). The investigation allowed adaptation and development of antibiotic prophylaxis and therapy management in pancreatonecrosis in multifield surgical hospital. More than 80% of patients avoided a contamination of necrotic destruction zones. The level of lethality was reduced in group of patients with infectious complications of pancreatonecrosis from 45.8% to 37.7%.

[The evaluation of the endogenous intoxication level in the sterile phase of pancreonecrosis].

The study is based on the analysis of the conservative and surgical treatment of 123 patients with the "sterile phase" of pancreonecrosis, completed by the evaluation of biochemical indexes of the endogenous intoxication. The achieved results specify the important role of the independent inflammation predictors in a complex estimation of the severity prognosis and the complication possibility after the operative treatment of the acute destructive pancreatitis.

[An analysis of effectiveness of application of various methods of artificial detoxication in patients with sterile phase of pancreatic necroses].

The presented work is based on an analysis of results of conservative and surgical treatment of 65 patients in sterile phase of pancreatic necrosis with the application of various methods of artificial detoxication. Increased efficiency of extracorporal detoxication methods is achieved by an individual selection of the detoxication method depending on the basic clinico-laboratory indicators of toxemia, phases of endogenic intoxication and accounting the mechanism of action of the methods. In the favorable course of the disease against the background of complex treatment using artificial detoxication methods decreased the basic clinico-laboratory indicators used for monitoring the level of endotoxemia and incompetence of the detoxicated bodies and systems as well as of severity of the general condition of the patients. Results of the research performed point to the greater role of using the extracomporal detoxication methods in complex treatment of acute destructive pancreatitis.

[Prognostic value of peroxidase and antioxidant systems in patients with sterile pancreonecrosis].

The submitted survey is based on the analysis of results of conservative and surgical treatment of 123 patients with sterile pancreonecrosis in the view of a complex estimation of intensity of infringement of peroxidation and antioxidation. The research specifies the role of independent predictors of inflammation in a complex estimation of the disease severity and complications possibility after surgery.

[Advantages and disadvantages of various surgical tactics in treatment of infected pancreonecrosis].

Comparative evaluation of various surgical tactics was carried out in 76 patients with infected pancreonecrosis treated during 2000-2007 years. It is estimated that application of staged necrosequestrectomies including programmed schedule of stage revisions and abdominal cavity and retroperitoneal sanations combined with open drainage allows decreasing lethality in patients with pancreatic infections compared to alternative surgical techniques.

[Method of treatment of patients with calculous cholecystitis complicated with mechanical jaundice]. / Taktika lecheniia bolnykh kalkuleznym kholetsistitom, oslozhnennym mekhanicheskoi zheltukhoi.

Data on the treatment of 228 patients with calculous cholecystitis complicated by obstructive jaundice are reported. Two-stage treatment was applied. In the first stage endoscopic and roentgenoendobiliary therapeutic interventions were undertaken to relieve jaundice and remove its causes. In the second stage a planned surgical operation was conducted after elimination of biliary hypertension, which consisted in cholecystectomy in the majority of patients. Such therapeutic tactics reduced mortality by half.

[Optimization of strategy of surgical treatment for acute destructive pancreatitis]. / Optimizatsiia khirurgicheskoi lechebnoi taktiki pri ostrom destruktivnom pankreatite.

Results of surgical treatment of 142 patients with acute destructive pancreatitis were analyzed. The treatment of patients was divided into two periods. The first period included 59 (41.5%) patients when active surgical strategy was used. The second period of observations included 83 (53.5%) patients with the optimized strategy of treatment based on intensive therapy, prognosis of the course of the disease, new antibacterial medicines and new technologies of operative treatment. A comparison of the results of treatment has revealed the advantages of using the optimized strategy and allowed the postoperative lethality to be reduced from 59.3 to 32.5%.

[Gastroduodenal ulcer hemorrhage under conditions of Extreme North (Yakut)]. / Iazvennye gastroduodenal'nye krovotecheniia v usloviiakh Krainego Severa (Iakutii).

Under analysis there were results of treatment of 431 patients with duodenal ulcer bleedings. The authors note that the duodenal ulcer bleedings under conditions of Extreme North (Yakutia) are observed more often in those who come (not in residents). Among specific features of the clinical course of the ulcer disease the authors note a short case history, continuous and severe exacerbation, short remission, frequent development of complications. The authors use in their work active individualized surgical methods and make organ-saving operations aimed at saving the patient's life.