Article describes current features of early breast cancer diagnosis in older women. Authors put their attention on main problems and controversies of breast cancer (BC) mammographic screening in older women. Aim was to define relationship between BC incidence in different age groups. Material and methods. Authors analyzed data from Moscow Cancer Registry in 2013-2015. BC incidence in patients 40-74 old and older than 75 years was compared. We used Mann-Whitney U-test for estimation of differences between these groups. Results. BC incidence in women 75 years old or older was in 1.65 times higher than in women 40-74 years old. U-test analysis revealed that there were no differences in amount of firstly diagnosed BC between age groups 40-74 old and older than 75 years (p > 0,05). Also amounts of new BC cases in different age groups were no significant differences (p > 0,05). Age of BC diagnosis dependence on patient age was weaker in patients with late stages of BC. Conclusion. BC mammographic screening should be performed in women 75 years or older. In the absence of sufficient evidences of effectiveness of breast cancer mammographic screening final decision needs to accept individually.

CT-scanning with contrast enhancement under outpatient treatment provided patients with a number of benefits. In practice, however, doctors in municipal clinics faced a number of challenges, including the possibility of adverse reactions to the injection of contrast agents in the absence of clinics intensive care services. Study objective. To evaluate possibilities and analyze problems of CT with contrast enhancement for outpatient treatment. To assess the experience of clinical usage of contrast medium lohexol for CT with intravenous bolus enhancement in relation to diagnostic efficiency and safety among 392 clinic ’s patients in the radiology laboratory. Materials and methods. CT-scanning was performed on a Toshiba Aquilion 64 machine. The patients were administered 80-100 ml of lohexol (Unihexol) intravenously (in the cubital vein) at a speed of 3-5 ml/s according to standard methods of bolus contrast enhancement. The group of 392 paints had various pathologies. In these patients the regions studied were brain, organs of neck, chest, abdomen and lower pelvis, lower limb. Results. Contrast enhancement of all received images in 392 studies was high. Iohexol showed good tolerability, acute and late adverse reactions when using the medium have not registered in any case. The study describes the results of the investigations, which are new for outpatient institutions: angiography and coronaiy angiography with three-dimensional reconstruction of blood vessels. Conclusions. It can be concluded from the results that the use of intravenous contrast media in CT is possible and necessary in the departments of radiology of the clinics for the right sample group of patients sent for testing. Iohexol can be recommended for wide use in the diagnosis of radiology outpatient services.

The article dealt with the causes of the state of imaginary well-being in epilepsy. A clinical case, which showed that patients with juvenile myoclonic epilepsy, myoclonic seizures, which are obligate for this form have been identified for the first time in the course of video EEG-monitoring is only 2.5 years after the debut of epilepsy. This was misdiagnosed another form of epilepsy, and as a result, assigned to the wrong antiepileptic therapy, which in turn has led to a deterioration.

Pilot results of new quantifying ultrasound methodic of liver steatosis evaluation in dB/cm are presented in this article. Main stages of the methodic standardization are tested in control group of patients (n = 90). Liver biopsy (n = 40) and dual-energy X-ray absorbtiometry in “Whole Body” regime (n = 148) were reference methods in clinical group of patients (n = 148) with overweight and non-alcoholic fatty liver disease. The correlation of ultrasound liver steatosis diagnostics and liver biopsy was r = 0.86 at S0 and r = 0.84 at S₃.

Technological progress and significant modernization of minimally invasive methods of treatment led to the fact that robotic technologies occupy leading positions in medicine. The wide application of robotic surgical systems is due not only to high technological efficiency, but also to the tendency to transition to organ-preserving operations. Robotic technologies have all the advantages of minimally invasive techniques (such as the degree of hemorrhage, the frequency of blood transfusion, the length of hospital stay, etc.) and significantly exceed the used laparoscopic techniques, and the results of surgical interventions differ for the better from those in open operations. Thousands of successful robotic operations conducted around the world testify to the widespread introduction of robotic technologies in virtually all branches of medicine. This article describes the most current robotic technologies used in modern urological practice using robotic surgical systems.

375 athletes and ballet dancers with lumbar and sacral MFPS with piezoelectric shock wave using Piezoson 100+ and Piezowave units (Richard Wolf, Germany) is presented. Authors developed a technique and necessary parameters of shock wave influence depending on pathogenesis of MFPS, pathology of the spine and the combination of the affected muscles.

Rosacea is a chronic skin disease with the polyethological nature, which is found everywhere - the prevalence of this dermatosis in European countries reaches 22 %. The social significance of the disease is due to its progression, a tendency to relapse, and a decrease in the patients quality of life in the absence of supportive corrective therapy. One of the leading roles in the pathogenesis of this disease belongs to vascular pathology, in this regard, local therapy with a neodymium laser with a wavelength of 1064 nm is one of the most optimal methods in terms of efficacy and tolerability, the absence of systemic side effects and having no limitations on the patient s skin type. Materials and methods. Ten patients with confirmed erythematoma-telangiectatic subtype of rosacea participated in the study, of whom 100 % were women. The median age was 55.4 ± 4.3 years. Patients were assigned local monotherapy with a Nd: YAG-laser (1064 nm). To assess the effectiveness, we used the data of the average erythema of the skin of both cheeks using the Multi Skin Test Center MC 750; as well as photo measurement of the vascular component of the facial skin with the help of Reveal Imager (Canfield) system before and 1 week after the completion of the course of therapy; in addition, the results were evaluated according to the IGA dermatological status index (from 0 to 5 points) and the patient s quality of life index (DIQL) as well before and 1 week after the completion of the course of therapy. A total of 3 to 4 sessions of therapy were performed depending on the achievement of the clinical effect. Results. Monotherapy with neodymium laser (1064 nm) has a pronounced therapeutic effect in the treatment of patients with erythematous-telangiectatic rosacea subtype. After the therapy, clinical remission was found in 7 out of 10 patients, in 3 patients out of 10, a significant improvement was achieved, which was confirmed by the positive dynamics of the dermatological status index (IGA), DIQL as well as the data of hardware and photo-measurements. During the treatment no clinically significant side effects were found.

During the study of patients with sarcoidosis we ve identified two types of plasmatic lipoidosis: dyslipoproteinemia HA (marked hyper-beta-lipoproteidemia with mild hypertriglyceridemia) and dyslipoproteinemia IIB (both marked hyper-beta-lipoproteidemia and hypertriglyceridemia). Type IIB was identified in 70 % cases (in 14 of 20 patients), and type II A in 6 patients. Deviation of lipoidosis activity index (LAI) either above or below reference values indicates the presence of dyslipidemia and also reflects the inflammation activity and insufficient antioxidant capacity. Obviously, the index can be considered as a predictor of high cardiovascular risk. Hypertriglyceridemia is major cardiovascular risk factor which was undeservedly forgotten. Epidemiological data demonstrate significant increase of overall long-term mortality and cardiovascular risk in patients with moderate and severe hypertriglyceridemia. Genetic studies also cogently confirm the causal role of hypertriglyceridemia in atherogenesis, elevation of cardiovascular risk and mortality. High level of serum triglycerides leads to intracardial deposition of triglycerides and their metabolites. If causes so called cardiac lipotoxicity promoting myocardial hypertrophy and fibrosis, degenerative changes. So hypertriglyceridemia is realized by the pathologic triad: unstable plaque, trombophilia and heart remodeling. That requires correction of hypertriglyceridemia as a multifaceted pathological factor.

The clinical analysis of urine provides the doctor with a large amount of diagnostic information both for the diagnosis stage and for monitoring the course of the widest range of diseases. The article discusses the clinical diagnostic significance of the main indicators of urinalysis, the specific methods of their determination, which can affect the results of the analysis, the necessary conditions for ensuring a high quality of the urinalysis in the health facility, and also focuses on the aspects that the clinician should take into account when interpreting the results analysis.

Acute respiratory viral infections are the most common illness in childhood. One of the most important factors that contribute to development of acute respiratory infections are immature immune system, stress, excessive physical activity and mental stress, unbalanced nutrition. High temperature, using a lot of drugs and disease itself contribute to gastrointestinal disorders, weight loss, weakening of a child and decreased immunity. The question is how to restore a child’s health after disease and prevent development of a new one. Foremost it is necessary to provide a child with complete and balanced nutrition. The best choice is Clinutren junior - therapeutic and preventive nutrition for the children from one to ten years old.