Prerenal kidney damage in patients with local cold injury

Introduction. Important links in the pathogenesis of cold alterations are vascular damage and powerful systemic alterations. The presence of premorbid pathology and the duration of the wound process negatively affects to the function of most organs and systems, including the kidneys. Renal insufficiency in patients with frostbite develops in the acute period of cold damage. This is indicated by a decrease in the amount of urine and an increase in creatinine levels in victims with frostbite. In this regard, the identification and analysis of the dynamics of new markers of renal dysfunction in patients with frostbite is promising both from a scientific and practical point of view.The aim. To investigate the dynamics of changes in serum creatinine, NGAL and cystatin C levels in patients with local cold trauma.Materials and methods. The study included 60 patients with frostbite of the III–IV degree of distal limb segments. The study was carried out depending on the volume of the lesion and the timing from the moment of cryoalteration.The results of the study. In patients with grade III–IV frostbite, an increase in the level of lipocalin and serum creatinine was detected in the blood. The concentration of lipocalin and serum creatinine is directly proportional to the volume of cold-affected tissues. Indicators of lipocalin and serum creatinine decrease in the late stages of cryopreservation. The level of cystatin C significantly decreases during all periods of frostbite; the concentration of the latter does not depend on the severity of cryopreservation

ANIMAL WELFARE: EUROPEAN STANDARDS AS A BASIS FOR REFORMING NATIONAL LEGISLATION IN UKRAINE

ABSTRACT: Nowadays, Ukraine faces numerous challenges in animal welfare, including ensuring animal welfare, keeping and veterinary care for stray animals, protecting them from cruelty, and preserving endangered species. These areas are important and create the need to improve national legislation and its application. The problem is also becoming more urgent within the framework of Ukraine’s European integration vector, accompanied by the harmonization of national legislation with EU law and the ratification and implementation of European standards in the relevant area. The subject matter of the study necessitated the use of dialectical, systemic, structural-functional and informational approaches. The article aims to study the legal regulation of animal rights protection in Ukraine and analyze the animal treatment standards in foreign countries and international organizations. Keywords: animals; animal protection; international standards; animal cruelty; animal rights.   Bem-estar animal: Padrões europeus como base para reformar a legislação nacional na Ucrânia   RESUMO: Atualmente, a Ucrânia enfrenta inúmeros desafios na área de bem-estar animal, incluindo as garantias e manutenção dos cuidados veterinários de animais perdidos, a proteção da crueldade e preservação de espécies ameaçadas de extinção. Estas áreas são importantes e criam a necessidade de melhorar a legislação nacional e a sua aplicação. O problema também se torna mais urgente no quadro do vetor de integração europeia da Ucrânia, acompanhado pela harmonização da legislação nacional com a legislação da União Européia (EU), e consequentemente, pela ratificação e implementação das normas europeias dessa área relevante, no território nacional. O objeto do estudo exigiu o uso de abordagens dialéticas, sistêmicas, estrutural-funcionais e informacionais. O artigo visa estudar a regulamentação legal da proteção dos direitos dos animais na Ucrânia e analisar os padrões de tratamento animal em países estrangeiros e organizações internacionais da UE. Palavras-chave: animais; proteção animal; padrões internacionais; crueldade animal; direito dos animais.ABSTRACT: Nowadays, Ukraine faces numerous challenges in animal welfare, including ensuring animal welfare, keeping and veterinary care for stray animals, protecting them from cruelty, and preserving endangered species. These areas are important and create the need to improve national legislation and its application. The problem is also becoming more urgent within the framework of Ukraine’s European integration vector, accompanied by the harmonization of national legislation with EU law and the ratification and implementation of European standards in the relevant area. The subject matter of the study necessitated the use of dialectical, systemic, structural-functional and informational approaches. The article aims to study the legal regulation of animal rights protection in Ukraine and analyze the animal treatment standards in foreign countries and international organizations. Keywords: animals; animal protection; international standards; animal cruelty; animal rights.   Bem-estar animal: Padrões europeus como base para reformar a legislação nacional na Ucrânia   RESUMO: Atualmente, a Ucrânia enfrenta inúmeros desafios na área de bem-estar animal, incluindo as garantias e manutenção dos cuidados veterinários de animais perdidos, a proteção da crueldade e preservação de espécies ameaçadas de extinção. Estas áreas são importantes e criam a necessidade de melhorar a legislação nacional e a sua aplicação. O problema também se torna mais urgente no quadro do vetor de integração europeia da Ucrânia, acompanhado pela harmonização da legislação nacional com a legislação da União Européia (EU), e consequentemente, pela ratificação e implementação das normas europeias dessa área relevante, no território nacional. O objeto do estudo exigiu o uso de abordagens dialéticas, sistêmicas, estrutural-funcionais e informacionais. O artigo visa estudar a regulamentação legal da proteção dos direitos dos animais na Ucrânia e analisar os padrões de tratamento animal em países estrangeiros e organizações internacionais da UE. Palavras-chave: animais; proteção animal; padrões internacionais; crueldade animal; direito dos animais

Laparoscopic radical prostatectomy with sparing of the proximal prostatic urethra

Introduction. The most common treatment option for prostate cancer is radical prostatectomy, which involves the removal of the prostate itself and the prostatic urethra in a single block, followed by the formation of a vesicourethral anastomosis. This approach is fraught with postoperative complications, such as urinary incontinence and strictures of anastomosis. In this sense, the clinic's staff faced the question of the possibility of a urethral-sparing variant of operative benefit for a certain category of patients.Objective. To assess the possibility of performing radical prostatectomy with sparing of the proximal prostatic urethra in the laparoscopic version, its advantages, and disadvantages.Materials & methods. From 2021 to 2022, 18 successful laparoscopic operations were performed using this technique at the St. Luke Clinical Multidisciplinary Medical Centre. Patients were selected according to the above criteria. In the preoperative period, patients underwent a standard examination in accordance with guidelines, including a blood test for prostate-specific antigen (PSA), ultrasound, magnetic resonance imaging (MRI) with 3D-modelling, data from a multifocal prostate biopsy, the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF), the Quality of Life (QoL) index due to urinary disorders, assessment by the Partin’s nomogram. Intraoperative ratios, early and late postoperative complications, length of hospital stay, day of catheter removal, and time to complete urethral recovery were evaluated to study the effectiveness of this surgery type. PSA testing, uroflowmetry with post-void residual urine measurement and IPSS questionnaire were carried out one month after surgery.Results. There was an improvement in all measurements one month after surgery: median values of the mean urine flow rate increased by 1.7 ml/s, median values of the max urine flow rate increased by 3.7 ml/s, the IPSS decreased by 12 points.Conclusion. Based on the results of the study, clinical observations, and statistical analysis of the data obtained, it can be concluded that laparoscopic radical prostatectomy with sparing of the proximal prostatic urethra is the preferred surgical option for this pathology, due to its organ-preserving nature

Особенности патологической анатомии легких при COVID-19

The research aim is to study the morphological features of COVID-19 in the lungs of patients who died in Moscow from March 20 to June 6, 2020. Methods. Autopsy material of the lungs from 123 deceased (54 women, 69 men) with COVID-19 coronavirus infection (confirmed by PCR) was analyzed, the median age was 71 (30 – 94) years, and the duration of the disease was 14 (3 – 65) days. In all cases, the patient’s medical records and autopsy reports were analyzed. Macro- and microscopic changes in the lungs were evaluated in all the observations. Results. The pathology of the lungs in COVID-19 corresponds to various phases of diffuse alveolar damage (DAD). The exudative phase of DAD was detected in 54 (43.9%), the proliferative phase – in 21 (14.63%), and their combination – in 51 (41.46%) of the deceased. Histological features of different phases of DAD are described. Conclusion. An analysis of autopsy material revealed a mismatch between the duration of the course of the disease and the phase of diffuse alveolar damage. A significant portion of the dead found a combination of exudative and proliferative phases of the disease. Histological signs that indirectly indicate a violation of the coagulation system during COVID-19 are described.Целью статьи явилось изучение особенностей морфологических изменений в легких у умерших от COVID-19 в Москве за период 20.03.20–06.06.20. Материалы и методы. Проанализирован аутопсийный материал легких умерших от коронавирусной инфекции COVID-19 больных (n = 123: 54 женщины, 69 мужчин; средний возраст – 71 (30–94) год; продолжительность заболевания – 14 (3–65) суток), подтвержденной методом полимеразной цепной реакции. Проанализированы медицинские карты всех стационарных больных и все протоколы вскрытий. По данным всех наблюдений оценены макро- и микроскопические изменения в легких. Результаты. Патоморфологические изменения в легких соответствовали различным фазам диффузного альвеолярного повреждения (ДАП). Экссудативная фаза ДАП выявлена у 54 (43,9 %), пролиферативная – у 21 (14,63 %), их сочетание – у 51 (41,46 %) умершего. Описаны патогистологические особенности изменений в разные фазы заболевания. Заключение. При анализе аутопсийного материала установлено несоответствие между продолжительностью течения заболевания и фазой ДАП. У значительной части умерших обнаружено сочетание экссудативной и пролиферативной фазы заболевания. Описаны гистологические признаки, косвенно указывающие на нарушение системы коагуляции в течении COVID-19

Klitoroplastika in congenital adrenal hyperplasia

Given observation successful klitoroplastika by the original method in a patient with congenital adrenal hyperplasia and klitoromegalia.</em

Parameters of the school environment as a factor that affects the health of pupils

The article studies the influence of environmental factors on the children′s organism of whose health is an indicator of the ecological situation. School buildings and facilities in many respects do not meet the standards imposed on such institutions. In this research, measurements were made of physical factors of the school environment, assess the health status of students