Objective. The aim of the study is to analyze the design features of orthopedic appliances used to preserve or restore the transverse arch of the foot and determine the most promising product. Materials and methods. Orthopedic products that were used to correct forefoot flattening in 350 patients aged 1782 years were analyzed. Of the total number of patients, 321 were women, and only 29 were men; 252 people were diagnosed with transverse flatfoot of stages 12, while maintaining high elasticity of the arches, and in 34 cases, there was a pronounced rigidity. Flatness was combined with valgus deformity of one finger in the range of 20300 in 218 patients. The pathological process reached stages 34, and the degree of elasticity of the arches was low in 98 patients. The products were used after various operations in 86 patients, while they were used as a conservative correction in the rest. Results. All orthopedic appliances were divided into groups according to several criteria (design features and functional perspectives). An analysis of the strengths and weaknesses of the first three allowed us to identify the fourth group, which included products that provided the ability to adjust the size of the forefoot and at the same time restored the transverse arch. They were successfully used both in the rehabilitation period, after various reconstructive operations, and with conservative treatment. Conclusion. One of the main goals in the treatment of this category of patients is restoration of the transverse arch of the foot during flattening (surgically, conservatively, or in combination), should be used according to indications and, if necessary, be combined with other corrective elements. All this will allow to achieve both therapeutic and cosmetic results and ultimately improve their quality of life.
Aim of the study. An actual problem of the modern approach to the management of patients in the post-traumatic period with the aim of predicting, preventing and treating complications of post-traumatic pneumonia is the assessment of the dynamics of the cytokine profile in this period.Material and methods. Investigations were carried out at the time of hospitalization prior medical interventions. During the research the following methods were used: clinical, physical, instrumental, follow-up, radiation (MRI, CT, X-Ray), endoscopic, laboratory. Blood was taken from the peripheral vein on the first, third, fifth, seventh and ninth day of hospitalization to determine the interlikin profile. The definition of Proinflammatory cytokines: IL-1, IL-6 and IL-10 in the blood serum performed by ELISA on the immunofermental analyzer Abbott AXSYM using standard kits ProCon (“Protein contour”, St. Petersburg, Russia). Data were processed statistically using Student’s t-test.Results. Analysis of the results of determination of IL-1 in the serum of patients DK showed that in all stages of the disease, in addition to IV, the contents of this cytokine exceeded the control values in varying degrees of severity. While the levels of IL-1 in the serum of patients with the 1ststage of the disease was 4.0 times; stage 2–3.4 times; the third stage is 1.5 times higher than normal. And only in patients with very severe stage of pneumonia contents IL-1 did not differ from the norm. A similar picture was observed when determining the serum content of patients with a very severe stage of pneumonia, and only in contrast to the level of IL-1 in patients with a very severe stage of pneumonia, the IL-6 content remained significantly higher than normal. So, the content of IL-10 in patients with a very severe stage of pneumonia of stage I, II, III and IV of the disease averaged 330.7±24.5, respectively; 210.5±17.3; 123.4±15.3 and 98.5±12.7 pg/ml (in all cases p<0.05). CONCLUSION The results obtained in a comparative study of contents of proinflammatory cytokines (IL-1, IL-6 and TNF-a) in the blood serum showed that the determination of the spectrum of cytokines in peripheral blood, in our opinion, is the most perspective and can be a key marker for early detection of inflammation. Key words: post-traumatic pneumonii, interlikin profile, peripheral blood serum>˂0.05).Conclusion. The results obtained in a comparative study of contents of proinflammatory cytokines (IL-1, IL-6 and TNF-a) in the blood serum showed that the determination of the spectrum of cytokines in peripheral blood, in our opinion, is the most perspective and can be a key marker for early detection of inflammation.
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