DETERMINATION OF THERAPEUTIC AND DIAGNOSTIC TACTICS IN PENETRATING SHOOTING AND PUNCH-CUTTING INJURIES OF THE CHEST USING SPIRAL COMPUTER TOMOGRAPHY

Summary. The aim of the study was to improve the quality of diagnosis of chest injuries and to optimize surgical tactics through the use of spiral computed tomography. Material and research methods. The work is based on prospective analysis of the results of spiral computed tomography of patients with chest injuries for the period from 2014 to 2020. Results and its discussion. The results of SCT make it possible to objectify the choice of surgical tactics and the most rational type of access. The use of SCT has become expedient for chest injuries both before surgery in patients with stable hemodynamics and in the postoperative period to identify early complications. Conclusions. Based on the study, it was concluded that the use of SCT in patients with chest wounds makes it possible to choose rational treatment tactics, optimal access for surgery and drainage area, as well as apply minimally invasive treatment methods. Conducting CT studies in dynamics allows us to assess the effectiveness of conservative and surgical treatment and promptly make adjustments to the treatment.

Experience of surgical treatment of vertebral artery injuries

The aim of the study was to analyze the results of spinal artery damage treatment of the injured. Materials and methods. An 2-year analysis of treating 7 patients with vertebral artery injuries admitted to the City Hospital (GB) No. 26 of St. Petersburg was carried out. The problems of diagnosing and treating these injuries have been identified. The solutions to these problems have been suggested. Two clinical cases of successful treatment of injured patients with spinal artery damage have been presented. Results. Theres a possibility of damaging vertebral arteries in neck injuries thus defining the need for introducing high-informative methods of inspection (a spiral computer tomography contrast angiography, a Magnetic Resonance Imaging) and low-invasive (X-ray endovascular) interventions in urgent surgery. The implementation of complex instrumental examinations, their nature, the number of them and urgency should be determined by a surgeon individually considering the recommendations of related specialists. Conclusions. Regardless of the wound size and the patients condition, examination and treatment of patients with neck injuries should be carried out in large hospitals with angiosurgeon and other narrow specialists in the panel of doctors with the 24-hour surveillance, as well as access to full examination and high-tech urgent operational interventions.

INCIDENTAL FINDINGS OF PARANASAL SINUSES IDENTIFIED ON COMPUTER TOMOGRAPHY SCANS

The research work has been dedicated for computer tomography and devoted to the analysis of computer tomography scans. Visual diagnostic methods are widely applied in medicine. Therefore incidental findings are more often. An incidental finding is any abnormality not related to the illness or causes that prompted the diagnostic imaging test. Abnormalities of the paranasal sinuses are frequently encountered as incidental findings during spiral computer tomography evaluation of head and cone beam computer tomography for dental purposes. The growing number of imaging techniques performed per patient causes an increase in the number of incidental findings. How these findings should be managed is far from settled.The aim of this study was to retrospectively analyze the occurrence and type of incidental abnormalities of paranasal sinuses detected by radiographic examinations in the Latvian population of adults.The research work includes retrospective data of three hundred patients. They underwent spiral computer tomography scan of the head referred for non-sinus pathologies in Pauls Stradins Clinical University Hospital in Latvia between February 2015 and October 2015.This is the first report describing incidental findings of paranasal sinuses, the types, the most frequently affected sinuses in Latvian population of adults and also associations between incidental findings and such factors as age, gender, season, septal deviation and enlarged inferior nasal turbinates.

Розбіжності комп’ютерно-томографічних параметрів верхньощелепних пазух між здоровими і хворими на гнійний гайморит юнаками або чоловіками Поділля

РОЗБІЖНОСТІ КОМП’ЮТЕРНО-ТОМОГРАФІЧНИХ ПАРАМЕТРІВ ВЕРХНЬОЩЕЛЕПНИХ ПАЗУХ МІЖ ЗДОРОВИМИ І ХВОРИМИ НА ГНІЙНИЙ ГАЙМОРИТ ЮНАКАМИ АБО ЧОЛОВІКАМИ ПОДІЛЛЯ - Метою дослідження було встановити відмінності комп’ютерно-томографічних параметрів верхньощелепних пазух (ВЩП) між здоровими і хворими на гострий гнійний гайморит (ГГГ) юнаками або чоловіками Поділля з урахуванням і без урахування краніотипу. На базі НДЦВНМУ імені М. І. Пирогова було проведено антропологічне обстеження 45 юнаків віком від 18 до 21 року, хворих на ГГГ, та 55 чоловіків віком від 22 до 25 років, хворих на ГГГ у третьому поколінні мешканців Подільського регіону України. З бази даних НДЦ ВНМУ імені М. І. Пирогова взято первинні антропометричні показники 136 практично здорових юнаків і 72 чоловіків аналогічного хворим юнакам і чоловікам віку, також у третьому поколінні мешканців Поділля. Комп’ютерно-томографічне дослідження ВЩП виконувалося на спіральному рентгенівському комп’ютерному томографі “ELscint Select SP”. Статистичну обробку морфометричних показників ВЩП проведено в ліцензійному статистичному пакеті “STATISTICA 6.1” з використанням непараметричних методів оцінки отриманих результатів. Доведено, що найбільш виражені розбіжності досліджуваних розмірів встановлені між відповідними групами здорових і хворих на ГГГ юнаків без урахування краніотипу та між відповідними групами здорових і хворих на ГГГ чоловіка- ми-брахіцефалами.<br />РАЗЛИЧИЯ КОМПЬЮТЕРНО-ТОМОГРАФИЧЕСКИХ ПАРАМЕТРОВ ВЕРХНЕЧЕЛЮСТНЫХ ПАЗУХ МЕЖДУ ЗДОРОВЫМИ И БОЛЬНЫМИ ГНОЙНЫМ ГАЙМОРИТОМ ЮНОШАМИ ИЛИ МУЖЧИНАМИ ПОДОЛЬЯ - Цель исследования - установить отличия компьютерно-томографических параметров верхнечелюстных пазух (ВЧП) между здоровыми и больными острым гнойным гайморитом (ОГГ) юношами или мужчинами Подолья с учетом и без учета краниотипа. На базе НИЦ ВНМУ имени Н. И. Пирогова было проведено антропологическое обследование 45 юношей в возрасте от 18 до 21 года, больных ОГГ, и 55 мужчин в возрасте от 22 до 25 лет, больных ОГГ, в третьем поколении жителей Подольского региона Украины. С базы данных НИЦ ВНМУ имени Н. И. Пирогова взяты первичные антропометрические показатели 136 практически здоровых юношей и 72 мужчин аналогичного больным юношам и мужчинам возраста, также в третьем поколении жителей Подолья. Компьютерно-томографическое исследование ВЧП проводили на спиральном рентгеновском компьютерном томографе “ELscint Select SP”. Статистическая обработка морфометрических показателей ВЧП проведена в лицензионном статистическом пакете “STATISTICA 6.1” с использованием непараметрических методов оценки полученных результатов. Доказано, что наиболее выраженные различия исследуемых размеров установлены между соответствующими группами здоровых и больных ОГГ юношей без учета краниотипа и между соответствующими группами здоровых и больных ОГГ мужчинами-брахицефалами.<br />DIFFERENCES OF COMPUTED TOMOGRAPHY PARAMETERS OF MAXILLARY SINUS BETWEEN HEALTHY AND PATIENTS WITH PURULENT SINUSITIS YOUTHS OR MEN OF PODILLYA - Aim of our work - set computer-tomographic differences parameters of maxillary sinuses (MS) between healthy and sick with acute purulent sinusitis (APS) boys or men of Podillya with and without craniotypes. Based on SRC VNMU by Pyrohov was conducted anthropological<br />examination of 45 patients with APS boys aged from 18 to 21 years, and 55 patients with APS men aged from 22 to 25 years, in the third generation residents of Podillya region of Ukraine. From the data base of the SRC VNMU by Pyrohov were taken initial anthropometric indexes of 136 practically healthy boys and 72 male patients of similar age boys and men, and in the third generation residents of Podillya. Computer-tomographic study of MS was carried out on spiral computer tomography X-ray “ELscint Select SP”. Statistical analysis of morphometric parameters of MS held in licensed statistical package “STATISTICA 6.1” using nonparametric methods for assessing the results. It is proved that the most pronounced differences of the studied sizes are set between the relevant groups of healthy and sick boys with APS excluding craniotypes and between the respective groups of healthy and sick men with APS brachycephal.<br />Ключові слова: морфометрія, краніотип, здорові юнаки та чоловіки, хворі на гострий гнійний гайморит, комп'ютерна томографія, верхньощелепна пазуха.<br />Ключевые слова: морфометрия, краниотип, здоровые юноши и мужчины, больные острым гнойным гайморитом, компьютерная томография, верхнечелюстная пазуха.<br />Key words: morphometry, craniotype, healthy boys and men, patients with acute purulent sinusitis, computed tomography, maxillary sinus.

ТHE DIAGNOSIS OF ARTICULATE SURFACE CHANGES OF COXOFEMORAL JOINT IN COXARTHROSIS PATIENTS BY SPIRAL COMPUTER TOMOGRAPHY

The objective was to study changes of an articulate surface (AS) of coxofemoral joints (CFJ) at patients with osteoarthrosis (OА), using СТ Methods. The group of patients (92 joints), suffering bilateral OА 2nd and 3rd radiological stage was tested by СТ. The width of AS in front, anteromedial, posterolateral, back sides was measured; thus joints of all patients have been preliminary divided in two groups: group (A) with uniform narrowing of an articulate surface and group (B) with nonuniform narrowing AS. Comparison of sizes and areas of joint space in different parts was performed.