Features of diagnosis and treatment of spleen abscesses.

The purpose of the study is to clarify the causes, features of clinical manifestations, to evaluate the results of diagnosis and surgical treatment of patients with sepleen abscesses. The article presents data on the results of diagnosis and treatment of 19 patients with spleen abscesses who were treated at the Surgery Department of the Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov, from 2006 to 2018. A comparative analysis of the etiological factors of spleen abscesses among a selected group of patients was carried out. It was established that among the causes of spleen abscesses according to our data were: bacterial endocarditis, purulent diseases of the pancreas, trauma, simple cysts, portal vein thrombosis. When analyzing the results of inoculation of the contents of abscesses, it was determined that E.Coli (26.3%), St. Epidermalis (21.1%), Ac.Baumani (10.5%) and P. Aeruginosa 21.1%) occur the most often. For the diagnosis of spleen abscesses, general clinical, biochemical, and hardware methods of investigation (computed tomography, ultrasound examination of the abdominal organs) were used. The treatment of spleen abscesses was complex and included conservative therapy and surgical methods. As a surgical treatment minimally invasive, laparoscopic, as well as open techniques were used. The main surgical method was percutaneous drainage with ultrasound monitoring (42.1%). Relapse of abscess with this treatment option in the remote period was detected in 1 (5.6%) patient. In 5 (26.3%) cases patients with spleen abscesses underwent laparotomy and splenectomy. Laparoscopy was performed in 2 (10.5%) patients with spleen abscesses, operations were completed by opening, debridement and drainage of the abscess cavity and abdominal cavity. Fatal cases were not observed in the treatment of spleen abscesses. The combination of conservative therapy (using etiotropic antibacterial therapy) and surgical treatment (a combination of minimally invasive and laparoscopic techniques) allowed to achieve good treatment results. The number of complications was 15.8%

EAS array of the NEVOD Experimental Complex

A new setup for registration of the electromagnetic component of the EAS at the “knee” region of the energy spectrum of primary cosmic rays (PCR) is now under construction on the basis of the experimental complex NEVOD-DECOR (Moscow, Russia). The EAS array detecting system has a cluster organization. Clusters are located in the MEPhI campus. The specific features of the array registering system that provides particle detection, data acquisition, cluster synchronization and events selection are discussed. The results of counter characteristics study are also presented

Diagnosis of adrenal glands incidentaloma.

In this study the results of examination and treatment of 91 patients with adrenal glands incidentaloma were analyzed. According to the results of the morphological study, adenomas were the most common (n=60). Among malignant tumors, ACC was detected in 7 patients, low and undifferentiated cancer – in 3 patients, sarcoma – in 2 patients and metastasis of cancer – in 4 patients. To assess the nature of the tumor, the following criteria were used: size and density according to CT. In 43 patients with neoplasms less than4 cmin 9,3% of cases malignant adrenalomas occurred, at 4-6 cm(n=29) - in 17,2% of cases, more than6 cm(n=19) - in 31,6%. In patients with ACC, 71,4% of tumors exceeded6 cm, 28,5% - were within 4-6 cm, 14,1% - less than4 cm. The frequency of detection of malignant incidentalomas increases in proportion to the growth of tumor size, and with a diameter of more than4 cmit was 27,1%. Adrenal adenomas in 31.6% of cases were from 4 to6 cm, and in 10% - more than6 cm. Thus, the orientation only on the size of tumors did not provide enough convincing grounds for determining its malignant potential. High native density was noted in ACC (33.4±2.8 HU), ganglioneuroma (36.6 НU) and metastases of cancer (43.6±9.0 HU). Low density was found in adenomas (0.4±10.7 HU) and adrenal cysts (6.0±8.2 HU), p<0.05. The most informative method of investigation in adrenal incidentalomas was CT, with sensitivity in adenomas and cancers – 98,3% and 94,4% respectively, specificity – 82,4% and 84,6%