.

Aim. To devise a method of filling subscapular cavity with a biologically active and easily removing material to patients with lung tuberculesis.

Materials and methods. 31 patients with common destructive lung tuberculesis underwent the investigation, they being operated on the basis of the methodics mentioned. We made comparative estimation of their functional changes during postoperative period with cases after standard operations.

Results. The method of temporary filling of subscapular cavity after toracoplasty was devised for additional sqeezing of the lung apex. The mechanism for filling extrapleural cavity with latex was elaborated.

Conclusion. This method of filling stands in the way of premature straightening of the lung apex when applying the toracoplasty. The study of basic clinical - functional data showed, that no deterioration of basic hemodynamic outcomes such as pulse, arterial pressure was noted in the method devised by us.

Aim. To analyse mistakes of medical help based on data of reviewed fatal outcomes and critical incidents in Saint-Petersburg by an independent expert for 2000-2003.

Materials and methods. Formalized cards were used ti investigate mistakes in diagnostics and treatment at stages of out- patientt and in-patient departments.

Results. The analysis of mistakes made at the level of in-patient department has revealed the predominance of its treatment unlike the out-patient one. Moreover, in spite of classification of the mistakes, it should be underlined that in most cases the mistakes are associated with uncomplete examination of patients' state or late diagnostics that caused inadequate and belated medical help.

Conclusion. The analysis of medical help mistakes at all stages would prevent lethality of the patients.

Aim. To analyse medical and social sequences of fractures in femoral proximal section associated with osteoporosis for grounding scientifically the necessity of foundation of the regional Centre of OP prophylaxis and therapy.

Material and methods. Epidemiologic peculiarities of fractures in femoral proximal section on the background of osteoporosis in Yakutsk were studied on the basis of data such as case reports, ambulatory cards, patient's registers from the orthopedic-traumatologic department and traumatologic centre within RH №l - Centre of Urgent Medical Care. Subjects were people aged 50 and older with fractures addressed from January 1997 till December 2001. 356 cases (90,1%) of the all registered 395 fractures in femoral proximal section (S72.0 - S72.1) were described as minimal traumas, i.e. when falling from small height, and spontaneous ones as associated with osteoporosis. Remote outcomes of fractures and therapeutic outcomes in alive patients were subjected to recontrolling in 1 and 2 years and 2 years in the whole. Fatal outcomes were counted in percentage of the whole number of controls.

Results. Detected high lethality exceeding the population's death rate among the same age-group 7,2 times (4,1 in men and 9,5 in women, p>0,001) and sharp deterioration of living quality revealed itself in limiting motor and social activity are conditioned by osteoporosis namely as the basic cause of femoral fractures (90,1%). The results detected testify to the necessity of founding the regional Centre of OP prophylaxis.

Aim. To study efficiency and tolerance of intensive chemotherapy based on WHO standards in treatment of lung tuberculesis at the initial level among elderly and old patients.

Materials and methods. Dynamic observation was conducted to 100 patients aged 60 to 87, who had undergone intensive chemotherapy (simultaneous appointment of isoniasid, riphampisin, pirasinamid, etambutol and/or streptomisin) due to the lung tuberculesis at the initial level.

Results. The intensive chemotherapy was satisfactorily tolerated by most elderly and old patients (78%). Use of WHO standard regimens allows to discontinue bacteria elimination at earlier stages (93,7 vs 71,4%; P<0,05), and more frequent closure of decomposition cavity (47,3% vs 25,0%; P<0,05) compared with individual regimens of chemotherapy.