[Modern view of people falling syndrome elderly and senial age (literature review).]

The review article analyzes scientific publications devoted to the actual problem of modern society - the syndrome of falls in elderly and senile people. The multifactorial nature of falls is demonstrated, which must be taken into account when carrying out diagnostic and therapeutic measures. The information obtained made it possible to identify the most significant conditions and diseases leading to an increase in the frequency of falls. The paper systematizes information about the causes of falls and the prevention of falls, diagnosis and complex treatment of elderly and senile patients. Attention is drawn to the victims of elderly and senile age with traumatic injuries.

[Improvement of the early diagnostic system and complex treatment elderly aged victims with severe traumatic brain injury of postoperative infectious - inflammatory complications.]

Improve the system of early diagnostic and complex treatment of postoperative infectious - inflammatory complications in victims of elderly ages with severe cranial injury. Medical institutions of Saint-Petersburg provided examination and treatment to 94 victims of elderly ages who were operated due to severe cranial injury. Examinations to identify inflammatory complications were provided from the body temperature rising and included laboratory tests, ultrasonography, X-Rays, Computer Tomography. The complex measures taken allowed to reduce severity and duration of postoperative inflammatory complications, cut the average bed-day hospital treatment from 42±6 days to 33±5 days in victims located in the neurosurgery department. Probability of infectious - inflammatory pulmonary complications development increases regardless of age. At the same time inflammatory urine tract complications most often occur among elderly age men who suffer from prostate hyperplasia and malfunction of the urination process after a long time of using intraurethral catheters. Early complex diagnostic examination allows the timely diagnosis of postoperative complications, and to begin the adequate treatment of victims.

[Megapolis medical rehabilitation system of elderly patients with severe cranio-cerebral injury.]

The capacities of systemic standard graded medical rehabilitation were assessed in 469 patients carried out surgical intervention for severe craniocerebral injury at Saint-Petersburg hospitals in 2010-2017. As a result of neurorehabilitation system introduction rates of infectious-inflammatory complications associated with physical inactivity were significantly decreased. An average length of stay at hospital was decreased from 34±5 to 23±4 days. At discharge from neurosurgical hospital the Barthel index of activities of daily living was 42±8 points. After inpatient rehabilitation course an average Barthel index was increased to 70±6 points. And after outpatient rehabilitation course an average Barthel index had reached 70±6 points.

[Experience with surgical necrectomy for deep frostbitis using physical means to influence the tissue]

The efficiency of the methods of necrectomy for deep frostbite was analyzed according to the data of outcomes of surgical treatment of 272 patients with cold injury. It was shown that dissection of necrotic tissue in deep frostbite using modern physical techniques (electrosurgical, radiosurgical and argon-plasma dissector) improved immediate results of surgical treatment (due to decreased intraoperative blood loss, frequency of suppuration, cases of amputation, time of hospitalization) and optimized the wound process (by reducing the microbial contamination of the wounds) and accelerated the proliferative phase of regeneration.

[Pathogenesis and treatment of patients after polytrauma]

Urinary tract infectious-inflammatory complications frequently occur after polytrauma. Among many causes of such complications is low resistance to infection. Addition of the immunomodulator cycloferon to combined treatment of polytrauma improves prophylaxis and treatment of acute pyelonephritis in patients with combined trauma.

[Rational approach to treatment of patients with polytrauma complicated by urinary tract infection]

Development of secondary immune dysbalance in patients with polytrauma complicated by urinary tract infection (acute pyelonephritis) was observed. In such cases bacterial complications were highly possible, that required the use of immunotropic drugs (cycloferon) increasing the host nonspecific resistance, responsible for Th1 immune response. The cycloferon therapy of the patients with chronic pyelonephritis normalized the lymphocyte electrophoretic mobility promoting efficient recovery of the immune homeostasis. Cycloferon was shown to be effective in the prophylaxis and therapy of infective inflammation in the patients with polytrauma, that was evident of the antibacterial therapy efficacy increasing and more rapid healing of the infective inflammation.

[Characteristics of the diagnosis of purulent pyelonephritis]

Results of diagnosing pyelonephritis in 106 patients using ultrasonography, CT and thermovision were analyzed. Purulent pyelonephritis (PP) was diagnosed in 57 patients, serous pyelonephritis--in 49 patients. The sensitivity of ultrasonography in the diagnosing of PP was more than 80%, that of CT--90%. The methods used allowed the 100% improvement of the differential diagnosis of renal abscess, apostematous nephritis and pyonephrosis. The greatest problems were met in the diagnosis of renal carbuncle which was detected in 50% of cases by ultrasonography and in 54% of patients by CT. The minimum sizes of the destruction focus when the diagnosis could be reliable were 2 cm for ultrasonography and 1.5 cm for CT. Only using the findings of CT could diagnose emphysematous pyelonephritis. Thermovision could not find any definite criteria of PP. The timely diagnosis of PP allowed the organ-saving operations to be fulfilled in the overwhelming amount of the patients. Positive results of the treatment using the above mentioned diagnostic methods were obtained in 98.8% of the patients.