Aim – to evaluate the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) procedure in patients with primary open-angle glaucoma (POAG).
 Material and methods. The study was conducted in 21 patients with POAG and uncompensated intraocular pressure (IOP) using pharmacotherapy. All patients underwent MP-TSCPC procedure with IRIDEX Cyclo G6 device. The follow-up period lasted for 1 month. During this time, the visual acuity, IOP dynamics, complications, as well as the number of hypotensive drugs used were evaluated. Statistical analysis was performed using STATISTICA 12.0 software.
 Results. Among patients with moderate and advanced glaucoma, the IOP reduced by 46.7 (3.3; 64.3) % from baseline values by the end of the follow-up period. The target IOP was achieved in 30.7% of patients. In 75% of patients who achieved target IOP, the number of hypotensive drops used was reduced by 1 component. In all patients with terminal stage glaucoma, pain was relieved, and IOP was reduced by 35.5 (8.4; 41.1) %. No intra- or postoperative complications were reported in any case.
 Conclusion. MP-TSCPC can be considered as a relatively safe adjunctive method to achieve target IOP in addition to medical treatment in patients with moderate and advanced glaucoma, as well as appropriate method to control pain in patients with the terminal stage of the disease.

Aim – to study the results of computer accomodography in children with myopia optical correction in order to assess the optical correction tolerability during visual work at close distance.
 Material and methods. The study of myopia optical correction tolerance in near work included 45 children of school age. Subjective and objective research methods were used: a relative accommodation reserve study and computer accomodography.
 Results. The computer accomodography performed with glasses allowed to determine the nature of the ciliary muscle work in near vision. Computer accomodography data correlated with the value of relative accommodation reserve.
 Conclusion. We recommend to study the relative accommodation reserve and to use computer accomodography when choosing the optical correction for myopic children.

Aim – to substantiate low-traumatic sutureless surgery for piggyback intraocular lens (IOL) reposition as a method of choice in a patient after previous keratorefractive surgery and cataract phacoemulsification.
 The article provides the examination and surgical treatment data of one patient with piggyback intraocular lens dislocation after previous radial keratotomy and keratectasia.
 The presented clinical case shows that proper consideration of eye anatomical features allows for effective low-traumatic sutureless piggyback IOL reposition in patients who have previously undergone radial keratotomy, and may lead to sustainable high visual and functional results.

Excessive scarring in the area of hypotensive glaucoma surgery is still a challenge in ophthalmology as it is the main cause of postoperative IOP elevation. The antiproliferative pharmacologic agents currently used for wound healing modulation are either not effective enough or have poor safety profile.
 The review provides a brief description of wound healing physiology including cytokines involved in it. It also represents the mechanisms of action and effects of drugs that influence wound healing and are used as antiproliferative agents for prevention of excessive scarring in glaucoma surgery.

There is a growing attention to the lens surgery in complicated cases that require to obtain a good functional result and to minimize the surgical volume. The intraocular lens fixation remains a major problem in complicated cases in lens surgery due to the inadequate capsular support. It is essential to achieve the refractive goal and correct positioning of the intraocular lens both immediately after operation and in the long-term period.
 The article reviews current available scientific literature of domestic and international authors devoted to the problem of intraocular lens fixation in complicated cases of lens surgery.

Aim to retrospectively evaluate the treatment results in children with diaphyseal forearm fractures operated on using intramedullary metal osteosynthesis with titanium elastic rods according to the Elastic Stable Intramedullary Nailing (ESIN) method.
 Material and methods. The treatment results of 79 children were included in the retrospective analysis. The patients' mean age was 11.8 years (from 6 to16 years).
 Results. The results of treatment were evaluated using the classification of Anderson et al. [20] in the early postoperative period, at 2, 4 and 6 months after surgery.
 Conclusion. The ESIN osteosynthesis for diaphyseal fractures of the forearm bones in children allows for achieving excellent treatment results and early limb functionality in the absolute majority of cases.

Aim to study the integral scale for assessing enteral insufficiency in patients with acute pancreatitis during the phases of enzyme toxemia and purulent-destructive complications; to develop a strategy for choosing a method for enteral insufficiency correction.
 Material and methods. We have analyzed the treatment outcomes in 232 patients with acute pancreatitis admitted to the surgical department of the Samara Regional Clinical Hospital n. a. V.D. Seredavin for the period from 2013 to 2019. Two study groups were formed: retrospective and prospective. The retrospective (control) group included 175 patients whose treatment outcomes were assessed retrospectively for the parameters of the enteral insufficiency syndrome and measures were suggested for its differentiated correction. The prospective (intervention) group included 57 patients who were treated using the developed principles of enteral insufficiency correction.
 Results. The occurrence of I and II degrees of enteral insufficiency differed significantly depending on the phase of acute pancreatitis. When using complex correction of enteral insufficiency according to the proposed scheme, in patients in the phase of enzyme toxemia the I degree enteral insufficiency was prevalent, the patients in the purulent-destructive phase were more likely to have II degree enteral insufficiency.
 Conclusion. The timely inclusion of enteral insufficiency correction into the complex of therapeutic measures for pancreatitis may improve the treatment outcome in patients with moderate and severe phases of acute pancreatitis.

Aim to create a model for predicting outcomes of resection with colostomy in patients with acute obturation colon obstruction caused by tumor.
 Material and methods.The study design was a retrospective multicenter analysis for the period from 2013 to 2020. At the first stage, we analyzed 3854 medical records of patients who were subject to emergent surgery in the surgical departments of the Samara region for acute colonic cancer obstruction, with tumor localized in the colon. We compared the outcomes of colon primary resection for tumor removal followed by colostomy and surgical treatment with colostomy without resection. At the second stage, we analyzed the complications risk factors in patients with colon primary resection for tumor removal followed by a single-barrel colostomy, n = 1936.
 Results.According to the study, the active surgical intervention had no statistically significant correlation to the increase in number of adverse outcomes. We identified the statistically significant risk factors for an unfavorable outcome after primary intestinal resection. These data allowed us to create and register a soft-ware "Automated system for determining the risk of primary intestinal resection in case of colonic cancer obstruction". The next stage of the study was planned for validation of the developed risk-predicting model, in patients being consistently admitted to on-duty surgical departments.
 Conclusion.The choice of the method of surgery for tumor colonic obstruction is preconditioned by the basic requirement the resolution of intestinal obstruction. In a number of cases, the primary resection of the intestine with a tumor and with the single-barrel colostomy can be performed. If it is possible to perform primary intestinal resection on the basis of traditional principles, the risk of its implementation should be assessed for postoperative complications using a standard method. At present, the standard method does not exist in clinical recommendations and requires development and implementation.

Introduction. Holding mass sports events of international level imposes a special responsibility on the medical services of the host city. The issues of organizing medical support for competitions are one of the foundations for the safety of all participants. By identifying different client groups, the organizers provide optimal conditions for each of them, this also applies to medical support.Aim. To describe the features of medical support in a life-threatening condition to a representative of one of the client groups of the 2018 FIFA World Cup in Samara.Material and methods. A clinical case of stroke that occurred during the 2018 FIFA World Cup in Samara is presented. The stages and timing of the provision of assistance, the interaction between the links of the medical service, the coordination of medical support are described, and the other factors that played a role in the outcome of the patient's disease are also reflected.Results. The fastest possible diagnosis and medical support at the prehospital stage led to the delivery of the patient to an authorized hospital and access to specialized medical care within the time frame envisaged by clinical protocols and recommendations. The inpatient stage of treatment with the use of high-tech methods of surgery and intensive care ended in a complete recovery of the patient. Conclusion. The described clinical case illustrates the expediency of the special requirements put forward to the medical support of major sports competitions. Competent operational planning, training of medical staff and their equipment, built inter- and intradepartmental interactions ensure the availability and quality of medical care, including in life-threatening conditions.

Abstract Purpose To evaluate the clinical outcomes, toxicity and prognostic factors conditioning survival of reirradiation with Proton therapy for recurrent meningiomas. Methods Recurrent meningioma who failed after radiotherapy were re-irradiated with active scanning proton therapy with a median dose of 54 GyRBE (range 50.4-60 GyRBE). Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. The log rank test was performed to compare the entire survival experience between groups (significant p-value ≤ 0.05). Associations between qualitative variables were analyzed with the Fisher exact test (significant p-value ≤ 0.05). Results Thirty-two patients were re-irradiated with Proton therapy (10 grade I, 22 grade II-III). Median tumor volume at the time of re-irradiation was 43 cc (range 1.2-225.5) and median time from prior RT to reirradiation was 66 months (range 4-288). At a median follow-up of 27 months, 1-yr and 2-yr PFS were 89.4% and 74.5% (1-yr and 2-yr PFS were 100% for grade I, 100% and 76% for grade II, 66% and 50% for grade III). 1-yr and 2-yr OS were 86.6% and 83.0% (2-yr OS were 87% for grade I, 86% for grade II, 66% for grade III). Local recurrence rate was 34% with a median time of recurrence of 13.4 months. Five patients (14%) developed radionecrosis with a median time of 3.4 months from the end of PT (range 3-8.8). Conclusions Re-irradiation with proton therapy seems to be a safe and effective treatment in patients with recurrent meningioma, also for large volume and aggressive lesions (grade II-III).