This work aims to evaluate the prognostic value of the demographical and clinical data on long-term outcomes (up to 12 months) in patients with severe acquired brain injury with vegetative state/unresponsive wakefulness syndrome (VS/UWS/UWS) or a minimally conscious state (MCS). Patients (n = 211) with VS/UWS/UWS (n = 123) and MCS (n = 88) were admitted to the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology after anoxic brain injury (n = 53), vascular lesions (n = 59), traumatic brain injury (n = 93), and other causes (n = 6). At the beginning of the 12-month study, younger age and a higher score by the Coma Recovery Scale-Revised (CRS-R) predicted a survival. However, no reliable markers of significant positive dynamics of consciousness were found. Based on the etiology, anoxic brain injury has the most unfavorable prognosis. For patients with vascular lesions, the first three months after injury have the most important prognostic value. No correlations were found between survival, increased consciousness, and gender. The demographic and clinical characteristics of patients with chronic DOC can be used to predict long-term mortality in patients with chronic disorders of consciousness. Further research should be devoted to finding reliable predictors of recovery of consciousness.

Aim. The aim of our work was the development and testing method of hysterectomy, which would greatly facilitate radical hysterectomy in patients who are overweight. Materials and methods. In the main group of supervision were included 76 women who had 0 and stage 1 prolapse by POP-Q classification and were operated under minimally invasive surgery of RPCPCM in the period from 2019 to 2020because of uterine fibroids by the method developed by us.The control group consisted of 50 women whom was performed intrafascial hysterectomy by the method of Oldridge. To study the vaginal profile marked by two indicators: the length of the vagina and the range of displacement of the proximal point of the vagina (apex), which were determined before surgery and 24 months after surgery at intervals of one year. Determining the length of the vagina was performed in the supine position, immediately determine the most proximal point of the vagina. Results and discussion Conclusions. Methods of intrafascial hysterectomy using high-frequency diathermy are effective in preventing prolapse stump and shortening of the vagina. Shortening of the vagina in patients in the control group may have been caused by the degenerative processes due to serious injury of support structures and vessels of proximal vagina with the emergence in this context of inflammatory processes in the stump. Shortening of the vagina in patients operated on the proposed method was observed. Trends shortening of the vagina or prolapse at follow-up were found.

No abstract

Relevance. Until now, there is an ongoing debate about the value of different indicators of blood pressure (BP) − systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse blood pressure (PBP) as predictors of essential hypertension (EH). In this regard the issue of target BP levels in patients of different ages remains studied incompletely.            Objective is to determine peculiarities of 24 hour ambulatory blood pressure monitoring indices in patients with essential hypertension, stage II of different age groups. Materials and methods. ABPM indicators were determined in 130 patients who were divided into 4 groups. 1st group (n=57) – middle-aged hypertensive patients (45-59 years old); 2nd group (n=43) – elderly hypertensive patients (60-74 years old); 3rd group (n=15) – middle-aged patients without EH – control for the 1st group; 4th group (n=15) − elderly patients without EH − control for the 2nd group. Indices of ABPM were determined using a portable recorder ABPM-04 (company "Meditech", Hungary). Measurements of BP were performed every 15 minutes during the day (from 6 to 22 hours) and every 30 minutes at night (from 22 to 6 hours). We determined the following indices: the average daily SBP (mm Hg), the average daly DBP (mm Hg), the average BP (mm Hg); the maximal daily SBP (mm Hg), the maximal daily DBP (mm Hg). The daily index (DI) was also calculated − the percentage of BP decrease at night compared to daytime BP calculated in % DI of SBP, DI of DBP, DI of average BP. Results. In group 1 the average and maximal DBP were lower than in group 2  by 7,4% (p<0,001) and 13,1% (p<0,05), respectively. In group 1, the average daily and maximal SBP decreased by 3,8% and 4,1%, respectively; average heart rate by 3,8%; DI of SBP by 7,8% and DI of average BP by 5,8% but the data were unreliably smaller compared to the data of middle-aged patients. In group 1, the maximal DBP, DI SBP and DBP were not significantly different from the corresponding indicators in the control group. The maximal DBP was higher by 29,3% and amounted to 115,6±21,0 mm Hg and DI SBP and DI DBP are lower by 11,1% and 17,9%, respectively; and were equal to 9,6±7,4 and 13,8±8,1, respectively. In the 2nd group the following parameters decreased unreliably (p>0,05): heart rate by 8,6% and was 63,0±9,1/min., DI SBP by 17,6% and was 8,9±5,5%; DI DBP by 16,1% and was 14,1±7,1%; DI of average BP– by 20,4% and was equal to 11,3±6,1%. Conclusions. It is found that with the age DBP decreases with steadily increased SBP in hypertensive patients. The average daily and the maximal daily DBP are significantly less by 7,4% (p<0,001) and 13,1% (p<0,05) accordingly in elderly patients compared with the middle-aged.

No abstract