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The report presents modern views on the origin and pathomorphological characteristics of the cholesterol granuloma of the petrous apex of temporal bone, its clinical comparison with congenital cholesteatoma of the same localization. The differential diagnostic features in CT and MRI scans are analyzed in detail, and the principles of surgical treatment, indications and contraindications are discussed. Also the case of atypical course of cholesterol granuloma is presented, which was difficult in the diagnostics but with a successful treatment result.

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BACKGROUND: The objective of the study was to evaluate the cost-utility of bariatric surgery in England. METHODS: A state-transition Markov model was developed to compare the costs and outcomes of two treatment approaches for patients with morbid obesity: bariatric surgery, including gastric bypass, sleeve gastrectomy and adjustable gastric banding; and non-surgical usual care. Parameters of the effectiveness of surgery and complications were informed by data from the UK National Bariatric Surgery Registry, the Scandinavian Obesity Registry and the Swedish Obese Subjects study. Costs and utilities were informed by UK sources. RESULTS: Bariatric surgery was associated with reduced mean costs to the health service by €2742 (£1944), and gain of 0·8 life-years and 4·0 quality-adjusted life-years (QALYs) over a lifetime compared with usual care. Bariatric surgery also had the potential to reduce the lifetime risks of obesity-related cardiovascular diseases and diabetes. Delaying surgery for up to 3 years resulted in a reduction of 0·7 QALYs and a minor decrease of €2058 (£1459) in associated healthcare costs. CONCLUSION: Currently used surgical methods were found to be cost saving over the lifetime of individuals treated in England.

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The purpose of the research was the investigation of the characteristics of insulin resistance, levels of adipokines, myokines and collagen metabolites type I in children in orphanages and social rehabilitation centers (SRC). The study involved 69 children aged 7-12 years. The first group consisted of 20 children from SRC, the second - 16 children living in orphanages, control group included 33 children (1-2 health groups) from wealthy families. The average length of stay of children in SRP was 1.0 (0.5-2.5) month, in orphanages - 38 (22-44) months. The groups were comparable in age and sex. Anthropometric indices were determined, in blood serum glucose concentration was measured by glucose oxidase method, blood serum level of insulin, cortisol, leptin, adiponectin, resistin, apelin, myostatin, collagen metabolites were determined by ELISA. Children from orphanages and SRC had significantly lower anthropometric indices in comparison with the control group. Particularly low parameters were observed in children from SRP, which in growth, body weight, chest circumference and body mass index significantly lagged behind the control group peers. The children from SRP as compared with the control group revealed higher insulin resistance index (3.33±0.49 vs 2.29±0.29, p<0.05) and cortisol level (405.21±38.21 vs 313.08±25.97 nmol/l, p>0.05). There were changes (p<0.05) in blood serum content of adipokines - reduced leptin level (5.35±1.55 vs 14.00±3.10 ng/ml) and increased apelin level (4.07±0.82 vs 2.19±0.41 ng/ml), as well as higher levels (p<0.05) of myostatin (183.95±16.3 vs 116.4±9.4 ng/ml) and C-terminal telopeptide of type I collagen (1.11±0.11 vs 0.72±0.08 ng/ml). The children in orphanages compared with the control group had lower levels of insulin (5.04±0.69 vs 11.3±1.12 µIU/ml), high insulin sensitivity - HOMA-IR was 1.01±0.16. The children in orphanages have even more pronounced reduction in leptin concentration (2.69±0.4 ng/ml), a decrease of resistin (4.99±0.32 vs 7.16±0.70 ng/ml, p<0.05), increased concentration (p<0.05) of apelin (3.53±0.67 ng/ml), myostatin (181.17±10.2 ng/ml) and C-terminal telopeptide of type I collagen (2.70±0.22 ng/ml). Features of hormone and cytokine regulation of metabolism make it particularly urgent to prevent disorders of eating behavior and to promote a healthy lifestyle among children left without parental care.

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BACKGROUND: Diabetes remission is an important outcome after bariatric surgery. The purpose of this study was to identify risk prediction models of diabetes remission after bariatric surgery. METHODS: A systematic literature review was performed in MEDLINE, MEDLINE-In-Process, Embase and the Cochrane Central Register of Controlled Trials databases in April 2015. All English-language full-text published derivation and validation studies for risk prediction models on diabetic outcomes after bariatric surgery were included. Data extraction included population, outcomes, variables, intervention, model discrimination and calibration. RESULTS: Of 2330 studies retrieved, eight met the inclusion criteria. Of these, six presented development of risk prediction models and two reported validation of existing models. All included models were developed to predict diabetes remission. Internal validation using tenfold validation was reported for one model. Two models (ABCD score and DiaRem score) had external validation using independent patient cohorts with diabetes remission assessed at 12 and 14 months respectively. Of the 11 cohorts included in the eight studies, calibration was not reported in any cohort, and discrimination was reported in two. CONCLUSION: A variety of models are available for predicting risk of diabetes following bariatric surgery, but only two have undergone external validation.

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UNLABELLED: Pain is one of the major symptoms of the osteoarthritis (OA). The objective of the study was to evaluate impact of combined therapy with diclofenac, aescin and original glucosamine sulfate on pain severity in patients with OA of different localizations in real life clinical settings in Russia and Ukraine. METHODS: Design--prospective, non-controlled, before and after post-marketing study. Study was performed in 38 cities across Russia and Ukraine in 2012. Registered anti-inflammatory and symptomatic slow acting drugs were used according to the registered indications and dosages. In Russian sites combined therapy A using diclofenac ("Dorosan" formulation, Rottapharm S.p.A., aerosole 1%, 3-4 times/day) for two weeks, original glucosamine sulfate ("Dona" formulation, Rottapharm S.p.A.) intramuscular (ampule 200 mg/ml, 2 ml 3 times/week) for 4 weeks and per os (powder 1500 mg, once/day) for 8 weeks was used. In Ukraine sites (scheme B) diclofenac was substituted with topical aescin ("Reparil-Gel" formulation, Madaus AG, tube 400 mg, 2-3 times/day) anti-inflammatory product. Physicians were free to change therapy and study organizers had no impact on prescribing and management practice. Patients with OA of different localizations were included into the study. Pain severity was assessed using numeric rating scale. Total duration of the study was 8 weeks. Questionnaires were distributed to patients via physician out-patient offices. The only endpoint was the difference in median pain severity at the end of the study compared with the baseline level. RESULTS: In total 4931 patients were included into the study (mean age 57 +/- 12 years, 75% were females). Scheme A was used in 3956 patients and scheme B in 975 patients. The median pain severity decreased from 0.7 at the baseline (interquartile range +/- 0.2) to 0.2 (interquartile range +/- 0.2) after 8 weeks of the study in both treatment regimens (p < 0.001). Limitations of the study include absence of the control group, collection of the questionnaires from physician offices, rather than directly from patients, limited range of clinical data collected and use of single instrument to assess pain severity. CONCLUSIONS: Post-marketing study of combined therapy of OA of different localizations using diclofenac, aescin and original glucosamine sulfate in Russia and Ukraine demonstrated decrease of the pain severity, assessed by numeric rating scale, after 8 weeks of the treatment.

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We perform an analytical and numerical study of the phase transitions in three-dimensional Z(N) lattice gauge theories at finite temperature for N>4, exploiting equivalence of these models with a generalized version of the two-dimensional vector Potts models in the limit of vanishing spatial coupling. In this limit the Polyakov loops play the role of Z(N) spins. The effective couplings of these two-dimensional spin models are calculated explicitly. It is argued that the effective spin models have two phase transitions of BKT type. This is confirmed by large-scale Monte Carlo simulations. Using a cluster algorithm we locate the position of the critical points and study the critical behavior across both phase transitions in details. In particular, we determine various critical indices and compute the helicity modulus, the average action, and the specific heat. A scaling formula for the critical points with N is proposed.

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We investigate both analytically and numerically the renormalization group equations in two-dimensional (2D) Z(N) vector models. The position of the critical points of the two phase transitions for N>4 is established and the critical index ν is computed. For N=7 and 17 the critical points are located by Monte Carlo simulations, and some of the corresponding critical indices are determined. The behavior of the helicity modulus is studied for N=5, 7, and 17. Using these and other available Monte Carlo data we discuss the scaling of the critical points with N and some other open theoretical problems.

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We investigate the critical properties of the two-dimensional Z(5) vector model. For this purpose, we propose a cluster algorithm, valid for Z(N) models with odd values of N. The two-dimensional Z(5) vector model is conjectured to exhibit two phase transitions with a massless intermediate phase. We locate the position of the critical points and study the critical behavior across both phase transitions in details. In particular, we determine various critical indices and compare the results with analytical predictions.

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There no doubts that hypercholesterolemia and elevated concentrations of low density lipoprotein (LDL) cholesterol (Ch) especially is one of main risk factors of premature development of ischemic heart disease (IHD) in middle aged men. Proofs of dependence of development of IHD on Ch and LDL-Ch levels in middle aged women are less convincing. Relationship between IHD risk and levels of total Ch and LDL-Ch weakens with age. For example according to data of Framingham study relationship of IHD total Ch level in men was close only in the age group 35-64 years and questionable in age group 65-94 years. Moreover according to data of epidemiological investigations after 70-80 years relationship between total Ch and IHD death becomes negative both in men and women. In a row of prospective studies it was found that in elderly people reverse relationship exists between total mortality and baseline concentrations of total Ch at the account of higher mortality due to extracardiac diseases in people with hypocholesterolemia.

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Hypocholesterinemic drugs from the statins class are effective means of primary and secondary prevention of ischemic heart disease (IHD) in middle aged men who comprised predominant majority of patients participating in randomized controlled trials (RCT). Proofs of favorable influence of statins on origination and progression of IHD in women and elderly people are less convincing. In majority of RCTs of therapy with statins results of which were analyzed separately for men and women no lowering of rates of coronary events were found among women and people older then 65 - 70 years. Moreover in some trials increases of all cause mortality were observed in statin treated patients at the account of deaths from non-cardiovascular causes (cancer deaths in particular). In the PROSPER trial pravastatin not only turned out useless in men and women aged 70 - 82 years, but significantly increased rate of breast cancer. In ALLHAT-LLT in patients aged 65 years and older and in women pravastatin lowered neither total number of nonfatal myocardial infarctions and IHD deaths, nor total mortality. In SPARCL and TNT in which efficacy and safety of high dose statin (e.g. atorvastatin 80 mg/day) was assessed there occurred augmentation of risk of hemorrhagic stroke and mortality from noncardiovascular causes including cancer and infections. One of meta-analyses of RCTs revealed significant increase in breast cancer risk associated with treatment with statins, in another meta-analysis more close relationship was noted between statins and development of cancer in elderly patients. Thus the problem of efficacy and safety of long-term therapy with statins remains open and requires further investigation.

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Theoretical prerequisites for the development of new methods for treatment of children with cleft palate by physical factor exposure are presented. Morphofunctional characteristics of the central nervous system formation during the prenatal and early postnatal periods are described. A multi-level method of magnetic laser exposure of the cerebrocortical precentral gyrus and electrostimulation by the ciliary reflex system, modifying the central regulation and adaptation mechanisms during the immediate period after uranoplasty, has been developed.

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127 case records were analysed retrospectively. All the patients had otitis media purulenta chronica and had undergone tympanoplasty (a closed variant). Regular revision of the trepanation cavity was performed in patients with cholesteatoma. Residual cholesteatoma was detected in 5 of 76 patients with cholesteatoma before the first operation, recurrent cholesteatoma occurred in 2 patients. Normal position of the neotympanic membrane and recovery of normal anatomy of the external acoustic meatus were achieved in 116 (91.3%) operated patients. Preservation or improvement of hearing were observed in all the patients. Bone-air gap under 30 dB was obtained in 79%. Thus, the proposed variant of closed staged tympanoplasty is effective for sanation of the infection focus with subsequent hearing improvement.

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The paper presents rationale for design of new procedures of physiotherapy in children with expanded palate and upper lip; morphofunctional features of prenatal and early postnatal formation of central nervous system; a multilayer technique of magneto-laser radiation to the projection of the anterior central gyrus and the technique of electrostimulation by the system of the wink reflex which can influence central mechanisms of regulation and adaptation before and early after uranoplasty and cheiloplasty.

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The Kiev Research Institute of Otorhinolaryngology has built an automatic diagnostic system that includes a Raduga thermograph and a CM-1403 computer. The diagnostic algorithms are based on the thermosemiotics of ENT inflammatory diseases developed by the authors. The advantages of the system are: production of a hard copy of thermograms, registration and long storage of information, mathematical treatment of thermal images, data base and rapid search for the thermogram needed, screening diagnosis based on the "healthy-sick" principle.

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Infrared thermography proved useful for the diagnosis and treatment efficacy studies in the mandibular trauma injuries, trigeminal neuralgies, facial and cervical purulent inflammatory diseases. It appeared also effective in detection of dangerous complications: odontogenous mediastinitis and facial veins thrombophlebitis.

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Comparative ontogenetic investigation of cytoarchitectonics of the cerebral neocortex has been performed in Cetacea and Primates using paraffin frontal and sagittal cerebral sections stained after Nissl. Cerebral hemispheres of dolphins, whales, monkeys and human being have been studied at various periods of prenatal development and in mature individuals. The comparison has been made at similar stages of cytoarchitectonical differentiation of the cortical plate. At two first stages of the prenatal ontogenesis (formation of the cortical plate and its differentiation into layers) there is not any principle differences between the Cetacea and Primates. Peculiarities of the cerebral cortical plate differentiation in the Cetacea (absence of the internal granular layer IV) is determined at the stage of stratification. Similar agranular character of the cerebral cortex differentiation is maintained during the whole subsequent ontogenesis in the Cetacea (heterogenetic type of the neocortex after Brodman). Absence of the layer IV in the cerebral neocortex determines some other principles in the spatial organization of the cortical-subcortical and in the intracortical connections in the Cetacea brain. This is confirmed by modern data of morphological and electrophysiological investigations. Perhaps, a comparatively more simple initial architectonics of the Cetacea brain limited the level of their functional possibilities, the latter is comparable only with anthropoid apes.

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The results of a clinico-morphological examination of 4 patients with perinatal encephalopathy and 2 patients with infantile cerebral paralysis who died of intercurrent diseases at the age of 1 to 8 months are presented. It has been established that considerable alterations in the cytoarchitectonics in the cortical portions of the brain correlate with the functional disorders of cortical-subcortical interactions in these patients, particularly in grave course of infantile cerebral paralysis.

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