Aim of the study is to develop the diagnostic checklist based on the incidence and significance analysis of the external features of the dysplasia of the connective tissue (DCT) for its screening and assessment of its prevalence in the adolescents' population. Materials and methods.110 adolescents (aged from 10 to 14 years) were examined, 81 of them had the dysplasia of the connective tissue (the first group). The second group was presented by 29 adolescents without DCT. The presence and degree of manifestation of DCT were established according to the criterions of Kadurina T. I., Gorbunova V.N. (2009), Т. Milkovska-Dimitrova (1987). There were the physical, laboratory and instrumental examination. Statistical processing of the results was carried out using Statistica 6.0 program and IBM SPSS

The study aimed to review the literature on the classical risk factors for knee osteoarthritis and their possible role in the development of this pathology in patients with unilateral transtibial amputation in terms of potential rehabilitation prospects. A search of publications was carried out using PubMed databases of the US National Center for Biotechnology Information and the website of the Elsevier publishing house. Well-established increased risk factors for knee osteoarthritis are old age, female gender, lower limb muscle weakness, low or excessive physical activity, overweight, a history of knee joint injury or surgery, chronic knee pain. These factors are common for disabled persons with unilateral transtibial amputation, which, combined with specific mechanical factors, makes these persons more vulnerable to the development and progression of osteoarthritis. Programs aimed at eliminating modifiable risk factors for the development of knee osteoarthritis can contribute to the preservation of knee joint function in the long term and improve the quality of life of persons with unilateral transtibial amputation. This requires the well-coordinated efforts of a multidisciplinary team, as well as the participation of the disabled persons themselves. Identification and management of the potentially modifiable classical risk factors for the development of knee osteoarthritis are one of the promising pathways of rehabilitation of persons with unilateral transtibial amputation.

Development of the undifferentiated connective tissue dysplasia (UCTD) is influenced by various adverse factors to the fetus during intrauterine growth. There is not a clear linkage to the contribution of the separate factors to the development of the UCTD.Aims of the studyare to determine the risk factors associated with the development of the UCTD of the adolescents and to appreciate the predictive value of the examined factors related to UCTD to form the dispensary groups of the children with UCTD.Materials and methods. During the first stage of the study there was an examination of 110 adolescents at the age of 10–14 years old, the UCTD presence was established according to the scale proposed by T.I. Kadurina and V.N. Gorbunova (2009). During the second stage the data of the prenatal casework and maternity hospital records attached to the out-patient medical records were examined to detect the specialties of the antenatal life course. During the third stage 2 groups were formed: with the presence of UCTD (n = 81) and without UCTD (n = 29). The mother groups were formed accordingly with the adolescents groups.Results. The pregnancy of the mothers of the adolescents with UCTD proceeded against the anemia, threatening miscarriage, chronic fetal hypoxia, chronic fetoplacental insufficiency, toxicosis, gestosis, and concomitant chronic conditions (thyroid, kidneys, digestive apparatus, aspiration pathology) more common than the pregnancy of the mothers of the adolescents without UCTD. The binary logistic regression method allowed the predictors of the UCTD’s formation to be determined, there were: toxicosis during the gestation course (OR = 10.9; CI 95% 2.94–40.49), anemia of pregnancy (OR = 8.6; CI 95%: 2.42–30.81), gestosis (OR = 6.53; CI 95%: 1.27–33.71), chronic fetal hypoxia (OR = 4.4; CI 95%: 1.09–17.83) and pre-existing chronic conditions of the mothers (OR = 3.6; CI 95%: 0.86–15.48). Different factor combination enhances the likelihood of the delivery of a child with UCTD more than 6.5-fold: chronic conditions of the mothers and chronic fetal hypoxia (OR = 6.8; CI 95%: 1.95–48.57); anemia of pregnancy and chronic fetal hypoxia (OR = 7.2; CI 95%: 1.01–50.99), and toxicosis (OR = 10.4; CI 95%: 1.48–72.82).Conclusion. The risk factors associated to the development of UCTD in adolescents are: toxicosis during the gestation course, anemia of pregnancy, gestosis, chronic fetal hypoxia and pre-existing chronic conditions of the mothers. The use of the equation of the binary logistic regression allows the prediction of the possibility of the development of UCTD in adolescents at the level of 80.9% and to form the dispensary groups of children in order to prevent the development of dysplastic-dependent pathology

Early detection of the connective tissue dysplasia (CTD) is hampered as the used diagnostic criteria are complex and subjective. The aim of the study is to examine the incidence and clinical profile of the adolescent CTD by means of the screening checklist. Methods. The study included the pupils at the age of 10-14 years. The questionnaire designed to reveal the 7 CTD's signs (thin skin, skin hyperelasticity, keloid cicatrix, blue sclera, soft auricles, arachnodactylia, joints hypermobility), containing 12 illustrated questions with explanation for the parents, was performed as a screening method. The conditionally healthy group (the absence of CTD) consisted of the adolescents with below 12 points total and CTD group was presented by the adolescents with 13 and more points. The physical development was appreciated according to the centile tables, Quetelet index and Vargui index. The health status analysis was based on the outpatient medical records. Results. 1560 pupils were the participants of the study: 752 boys (48.2%) and 808 girls (51.8%). CTD signs were observed in 965 (61.9%) children. The adolescents with CTD's signs demonstrated the following characters more often than the adolescents without CTD's signs: soft auricles-788 (81.7%) against 277 (46.6%), skin hyperelasticity-685 (71%) against 93 (15.6%), joints hypermobility-665 (68.9%) against 203 (34.1%), blue sclera-665 (68.9%) against 184 (30.9%), arachnodactylia-534 (55.3%) against 57 (9.6%). The disharmonious physical development because of the underweight body took place in 430 (52.3%) adolescents with CTD. Compared to the conditionally healthy group the most of the adolescents with CTD had the pathology of the musculoskeletal system (scoliosis, flatfoot), myopia, vegetative-vascular dystonia, digestive apparatus diseases. The CTD is associated with greater probability of the development of above mentioned pathologies, that can be indicative of the contribution of the anomalies of the connective tissue development into the etiopathogenesis of the these diseases. Conclusion. It is established that there is the high prevalence of the CTD signs among the adolescents (pupils) at the age of 10-14 years.

ВведениеПри осуществлении мер социальной поддержки инвалидов Российская Федерация (РФ) ориентируется на нормы международного права. В 2012 г. Рос сийской Федерацией была ратифицирована Конвенция ООН о правах инвалидов, что предусматривает ответственность за исполнение обозначенных Конвенцией обязательств. Согласно ст. 4 Конвенции, го сударства-участники «обязуются обеспечивать и поощрять полную реализа цию всех прав человека и основных свобод всеми инвалидами без какой бы то ни было дискриминации по признаку инвалидности», в том числе «проводить или поощрять исследовательскую и конструкторскую разработку, а также способствовать наличию и использованию новых технологий, включая информационно-коммуникационные технологии, средств, облегчающих мобильность, устройств и ассистивных технологий, подходящих для инвалидов, с уделением первоочередного внимания недорогим технологиям» [1]. Государства-участники обязуются «принимать эффективные меры для обеспечения индивидуальной мобильности инвалидов с максимально возможной степенью их самостоятельности», в том числе путем:… «облегчения доступа инвалидов к качественным средствам, облегчающим мобильность, устройствам, ассистивным технологиям…».Реализация основных направлений реабилитации инвалидов предусматривает использование ими технических средств реабилита ции (ТСР). К ТСР относятся устройства, которые благодаря специальным свойствам обеспечивают компенсацию или устранение ограничений способностей инвалидов к бытовой, общественной и профессиональной деятельности, вызванных наруше-нием здоровья со стойкими расстройствами функций организма. Они должны обеспечивать по вышение возможностей инвалидов вести самостоятельный образ жизни, сохранять максимально возможный уровень мобильности и доступа к ин формации и образованию [2]. По данным J.F. Borisoff и соавт. (2018), основным препятствием для мобильности и участия инвалидов является недоступная общественная среда [3].Вопрос целесообразного и эффективного назначения ТСР остаётся открытым в реабилитационных практиках во всём мире. Целесообразный подбор ТСР возможен при условии всестороннего подхода, охватывающего не только медицинскую сторону нуждаемости в ТСР, но и социальные факторы, способствующие или препятствующие пользованию ТСР. Напротив, ненадлежащий подход к подбору ТСР приводит к частичному или полному отказу человека от использования назначенного ТСР. Так, по данным западных исследований, показатели пользования ТСР варьируют от 49 % до 95 % [4][5][6]. Таким образом, несмотря на большую экономическую нагрузку на систему социального обеспечения, связанную с обеспечением и обслуживанием ТСР, основная цель предоставления инвалиду ТСР, которая заключается в повышении степени независимости пользователя, остаётся в значительной степени не достигнутой.Во избежание такого нецелесообразного расходования ресурсов, по мнению ряда исследователей, при подборе ТСР необходимо учитывать потенциальное влияние широкого спектра факторов. Одним из ключевых аспектов данного процесса является установление социальных факторов [7, 8, 9, 10]. ...