The work presents an analysis of the results of thyroid surgery in 3758 patients. The majority of interventions were performed within 1975-1985 and amounted to 2863 (76.18%) cases, of which 72 (1.92%) were for giant benign neoplasms. Diagnosis verification was carried out in 2613 (69.53%) patients using scintigraphy, and in 1145 (30.47%) - echography. The median age was 52.7±15.8 years. The distribution by sex is 713 (18.97%) male and 3045 (81.03%) female. Most 2572 (68.44%) surgical interventions were performed under local anesthesia. Damage to the return nerve after surgery occurred in 127 (3.38%) patients, and in giant neoplasms in 31. In 18 (0.48%) patients, clinical manifestations of return nerve injury occurred on the opposite side. Positive dynamics from the treatment complex were observed in 113 (88.97%) patients, at the same time, 14 (11.02%) had persistent damage to the return nerve. In the early postoperative period there were phenomena of hypocalcemia during the first day in 384 (10.22%) patients, by the end of the second day - in 292 (7.77%), by the end of the third day - in 12 (0.33%), of which 248 (6.59%) are elderly. 112 (2.98%) cases involved intraoperative bleeding. The source of hemorrhage in 103 (2.74%) cases was neoplasm capsule vessels. It has been established that the mismatch between the size of surgical access and pathological mass (giant thyrotoxic goiter), disruption of the stages of intervention (except early planned cases), intimate fusion with the capsule, its thin wall, disregard of video monitoring data are risk factors for intraoperative complications in benign thyroid diseases. The use of nonstandard techniques («making Novocain cushion,» change of intervention algorithm) allows to visualize clearly nearby anatomical structures, and therefore, in the future - atraumatic operation.

Purpose: to compare the effectiveness of laser therapy and traditional methods for managing diabetic patients with purulent-necrotic lesions in their lower extremities.Material and methods. The article presents a retrospective analysis of outcomes after treatment of 76 patients with diabetes mellitus having purulent-necrotic lesions in their lower extremities. Patients were divided into two groups. The first (main) group consisted of 34 patients in whom traditional treatment was accompanied by intravenous laser blood irradiation and local laser therapy; the second (control) group consisted of 42 patients who received only traditional treatment.Results. Laser therapy contributed to more rapid reduction of wound defect (17.4 %) compared to patients after traditional treatment (11.1 %); it reduced the period of transition to inflammatory-regenerative changes, promoted a smaller number of high amputations of lower limbs from 14 to 6 % as well as shortened the length of hospital stay by 11.2 days.Conclusion. Laser light therapy in patients with diabetic foot accelerates cleansing and reduction of the wound area, allows to reduce or eliminate inflammatory process in shorter time than with traditional treatment.

OBJECTIVE: Evaluate the effect of hyperbaric oxygenation course on indicators of central hemodynamics, heart-rate variability and ability to concentrate and switch attention in soldiers with traumatic brain injury. MATERIALS AND METHODS: The main group contained 50 patients with combat traumatic brain injury, aged 25-45, whose comprehensive treatment course included hyperbaric oxygenation. The control group consisted of 20 patients, treated with medical therapy under the clinical protocol. Hyperbaric oxygenation treatment was carried out in BLKS-303 MK pressure apparatuses in the 0.3–0.7 ati mode with an isopression exposure of 40 min. The course of hyperbaric oxygenation included 10±2 sessions per day. The indicators of heart-rate variability and central hemodynamics were measured. Bourdon proofreading sample was used to assess alertness and ability to switch attention. Statistics. Statistical analysis of data was performed using “Statistica for Windows 6.5” program. Comparisons are shown as median values (Me) and quartile range (LQ÷UQ) (25% and 75% percentile). Criteria of significance was considered p<0,05. the Mann-Whitney test was used to compare quantitative indicators in the main and control groups, the Wilcoxon T test was applied when studying the dynamics of change in indicators in the study groups. RESULTS: Including hyperbaric oxygenation in the complex therapy of patients with combat traumatic brain injury led to significant reduction in indicators of sympathetic activity - mode amplitude - up to 35,7 % (29,5÷48,0), decrease of tension index up to 116,5 %/с2  (99,0÷122,0) and recovery of vegetative equilibrium indicator LF/HF up to 2,8 (2,5÷4,3). Patients with hyperkinetic type of blood circulation in the main group, compared to the control group experienced significant reduction in stroke volume index to 41,8 (40,7÷54,8) ml/m2 cardiac index up to 4,6 (4,4÷5,2) kg*m/min/m2 , decreased energy expenditure for blood moving to 12,3 (12,3÷12,7) Wh/l. improve coordination is observed in 54 % of the main group in comparison with 34 % of the control group, reduced pathological reflexes - in 50 % of the main group, compared to 22 % of the control group, decrease in the severity of deep reflection disorders - in 55 % of the main group versus 28 % of the control group. Conducting Bourdon proofreading sample test after HBO course in the main group, compared to the control group showed significant error reduction from 12,7 (10,2÷14,6) to 4,2 (3,7÷5,2) (р<0,001); reliable error reduction from 11,8 (9,6÷12,8) to 8,4 (6,5÷10,2) (р<0,05) was noted in the control group. DISCUSSION: Early application of hyperbaric oxygenation in the complex therapy of patients with combat traumatic brain injury contributes to rapid normalization of central hemodynamics, decrease in the severity of impact on the sympathetic part of the autonomic nervous system, reduction in the degree of cardiac rhythm management centralization. Reliable regression of focal symptoms in the main group was accompanied by significant improvement in concentration and stability of attention, ability to switch it, compared to the control group. CONCLUTION: Including hyperbaric oxygenation in the complex treatment of traumatic brain injury can significantly increase therapy efficiency, resulting in faster restoration of impaired brain functions, memory and attention activation, normalizing the indicators of heart-rate variability and central hemodynamics, and promotes transition to a more economical operating mode according to the new level of oxygenation.

Retrospective analysis of treatment outcomes of 65 patients with purulent-necrotic forms of diabetic foot: group I (35 patients), who received integrated treatment using laser therapy, group II (30 patients), who received traditional treatment. It was established that the use of laser therapy in these patients compared to traditional therapy allows reducing the duration of the inflammatory reaction in tissues (from 6-8 days to 4-5 days), and subsequently to the appearance of granulations on day 7-8 and marginal epithelization by the end of 10 days, which leads to a reduction in the length of treatment.

The development and implementation of new more effective minimally invasive technologies for the treatment of simple thyroid cysts is current. evaluating the effectiveness of a method of treating simple thyroid cysts involving echo-assisted puncture, evacuation of contents and subsequent introduction of methotrexate into a cavity. The results of examination and treatment of 67 patients suffering from thyroid cysts are presented. Asymptomatic flow was noted in the majority of 61 (91.04%) patients, 4 (4.99%) - noted swallowing, and 2 (2.97%) - difficulty swallowing. For the first time, 42 (55.26%) patients independently identified their education, and 34 (44.74%) during a preventive medical examination. When echo-examined, all patients showed cystic thyroid masses, the average size of which was 20.8±8.3 mm. Outpatient in aseptic conditions under the control of ultrasound, puncture aspiration of the contents was carried out and subsequent intra-cavity administration of methotrexate solution with a cytostatic content of 20 mg to 30 mg. The volume of methotrexate introduced corresponded to the amount of aspirated liquid - 11.9 ± 3.8 ml (range from 2.5 to 16.2 ml). With control sonography, performed a month after the intervention in 51 (76.12%) cases, cystic formation was not visualized, in 5 (7.46%) - the maximum size of the latter did not exceed 9 mm, in 11 (16.42%) cases - the cavity decreased by no more than one third. After 12 months with a control ultrasound, all cystic masses underwent regression: in 61 (91.04%) cases, no masses were echo-visualized, in 3 (4.48%) - the maximum size of the latter did not exceed 9 mm. High efficiency (no formation or reduction of the latter to 9 mm) in 95,52% of cases is echo-proved.