Dental hyperesthesia in Russia is determined in patients in more than 65% percent of cases. In particular, the main age when the transformation of teeth occurs is observed in patients aged 30-59 years.The cause of this phenomenon is usually the gum recession. It is required to clearly understand how surgical justification of treatment is carried out and how the implementation of the proposed technology is possible. In particular, the basis should be a structure that allows you to reduce the loss of the aesthetic part of a smile, compensate for the loss of the functional part of the dental space, as well as determine the possibility of complete restoration of damaged tissues and other forms of disorders in dentistry.The authors proposed the technology of millimeter wave therapy, which had not previously been widely practiced. The paper presents the main techniques and software and hardware development.

Treatment of acute adhesive intestinal obstruction is one of the most difficult issues of surgery. The appearance of minimally invasive techniques, such as laparoscopy, made the operation less traumatic, with the result that patients recover faster after the intervention. However, laparoscopy is associated with a large number of complications, due to the limitations imposed by the technique itself.The aim of our work was to evaluate the effectiveness of treatment of adhesive intestinal obstruction with laparoscopic methods in comparison with laparotomy. The results of treatment of 65 patients undergoing laparoscopy and 50 people who underwent laparotomy were evaluated. As a result, it was noted that during laparoscopy, patient recovery is faster - they have fewer complications, the gastrointestinal function is restored, less endotoxification, less frequent complications and, as a result, hospital stay is shorter. Therefore, laparoscopy may be recommended as an operation of choice in patients with acute adhesive intestinal obstruction.

Spontaneous rupture of esophagus is a rare condition and is associated with a high mortality. The diagnosis and treatment of Boerhaave’s syndrome is a difficult problem and it has no single solution. The english and Russian articles about the problem to create the guideline for diagnosis and treatment of patients with Boerhaave’s syndrome were analyzed. The articles were found in «e-library» and «pubmed» on request «spontaneous rupture of esophagus» and «Boerhaave’s syndrome». Also own experience of treatment in the treatment of two patients was analyzed. Three steps algorithm for the diagnosis include: detection of main symptoms, differential diagnosis and final objective diagnosis of esophagus rupture. The algorithm may be undertaken in different level hospitals. The importance of determining hydropneumothorax on chest x-ray is accented. The guideline considers the ability of the hospital, the condition of the patient, localization and time of esophagus rupture. Advantages and disadvantages of the different treatment approach are also shown. Design of the guideline is presented in schema-view. Step-by-step the following the guideline algorithm allows to establish the diagnosis and to choose the optimal treatment option. The problem requires more extensive coverage in the literature and further study in order to compare the effectiveness of treatment approach and indications for them.

Mammary paget’s disease is a special type of breast cancer, Mammary paget’s disease is a special type of breast cancer, which is rare.The clinical man if estation is the eczematous changes of the nipple and areolar complex, which is also called eczematoid carcinoma. Objective To evaluate surgery treatment of extramammary Paget’ s disease (eMPD) and explore how to reduce its recurrence.

The calves play a significant role in selfesteem in women and are an important part of the body contour. Therefore, the desire to improve the shape of the legs is natural. In the late 90s and early 2000s the use of polyacrylamide gel (PAAG) for contour plastics of soft tissues was popular. Many years after the injection of PAAG, complications such as gel migration, edema, and suppuration develop. The only way to treat these complications is surgery. After the removal of PAAG and necrotic masses, deformations and a shortage of lower leg tissues appear, which cause depression in patients. Replenishing the volume of the calve only by installing a silicone implant is difficult due to a shortage of integumentary tissues, and the use of microsurgical auto flap transplantation is hardly justified.A case of correcting a significant deficit of the calf tissues in a 45-year-old patient after the removal of PAAG is presented. To achieve an optimal contour, the volume is restored by a custom-made silicone implant. The deficit of epithelial tissues is replenished by acellular dermal matrix (ADM). A stable result was obtained.The physical properties of ADM are similar to the crural fascia. Installation of ADM allows to completely isolate the implant from the subdermal space and skin wound. The use of ADM does not require microsurgical techniques, it is simpler and safer than free flaps transplantation.

The article deals with the validity and effectiveness of the use of chondroprotector Alflutop in the treatment of patients with the initial stages of post-traumatic and idiopathic osteoarthritis of the knee joint. The aim of the study was to evaluate the effects of Alflutop (as part of complex therapy) on the functional status of the affected joint at 2 week of follow-up compared with the use of hyaluronic acid preparations. The open study of the combined conservative therapy of two pools of outpatient patients (n=65) with initial stages of gonarthrosis (I-II degree according to the Kellgren-Lawrence classification) for the period from 2017 to 2018 with a subject assessment of the articular component of the treatment was conducted. In the comparison group, the combination of NSAIDs + Central action muscle relaxant + sodium hyaluronate was used, in the main group Alflutop was used. As a result of the study of the clinical efficacy of the proposed therapy regimens in patients with a predominance of the arthritic component of the disease, positive results of drug therapy in both groups of observation were established. By the end of the study, the amplitude of movements and the severity of the pain syndrome showed statistically significant positive changes, and the severity of synovitis and laboratory data were unreliable. Taking into account the best pharmacoeconomical parameters of therapy in the main group, the use of Alflutop as a chondroprotector is more justified. None of the patients was excluded from the study, all patients underwent a course of therapy satisfactorily, no adverse events occurred.

The distribution of working time of a pediatric orthopedist at an outpatient reception without a nurse was studied. The method of direct time observation of medical activity in the form of study of working hours of the head of the traumatological department of the clinic for 1 month was used. 500 patients of both sexes aged from 3 months were investigated, up to 18 years with various orthopedic pathology. The results of the study indicate the irrational use of time for mediocre contact with the patient - the main activity - due to the large volume of work performed with documentation. Pediatric orthopedist at the outpatient clinic without nurses spend 33% of their time on their core business, 57% - on documentation, 8% auxiliary, 1% for service and 1% for the total.

The article presents the main milestones of the life and scientific creativity of the professor. N.M. Volkovich is widely known for studies in abdominal surgery, traumatology, orthopedics, otorhinolaryngology, urology, gynecology and neurosurgery. Little-known facts from his life are established. working in the Aleksandrovskaya hospital, Volkovich gained extensive experience in clinical surgery and traumatology. It was stressed that the most significant contribution was made by N.M. Volkovitch in traumatology. It is noted that he advocated the expediency of early rising of patients, defended the principle of functional treatment of fractures. The work of Nikolai Markianovich on the treatment of fractures is analyzed, literally until the end of his days, having completed numerous works with an extensive monograph “Damage to bones and joints.” Under his leadership, 84 scientific works were published, of which about half in German, amaze with the variety of topics touched. As time has shown, the main theoretical and practical positions and discoveries of the scientist still form the basis of our knowledge in fundamental surgery and traumatology.