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

НЕКОТОРЫЕ ТЕОРЕТИЧЕСКИЕ АСПЕКТЫ КОМПЛЕКСНОГО КЛИНИКО-ПСИХОЛОГИЧЕСКОГО ИССЛЕДОВАНИЯ БОЛЬНЫХ АУТОИММУННЫМИ ЗАБОЛЕВАНИЯМИ ПЕЧЕНИ С ИСХОДОМ В ЦИРРОЗ ПЕРЕД ТРАНСПЛАНТАЦИЕЙ ПЕЧЕНИ

This article presents preliminary results of complex clinical-psychological investigation of patients with autoim- mune liver diseases with cirrhosis waiting for liver transplant. The data discussed defense role of anxiety com- bined with other emotional affective disorders, psychological mechanisms in combination with coping strategies of stress-overcoming behavior in the state of disease and their involvement in formation of the clinical picture of the disease. It considers the need for differential diagnosis of the pathology using modern experimental- psychological methods in connection with further building of psychological aid to patients with autoimmune liver diseases. В статье представлены предварительные результаты комплексного клинико-психологического исследо- вания больных с аутоиммунными заболеваниями печени в состоянии цирроза, ожидающих трансплан- тации печени. В статье приводятся данные о роли тревоги в сочетании с другими эмоционально аф- фективными расстройствами, механизмов психологической защиты в сочетании с копинг-стратегиями стресс-преодолевающего поведения в состоянии болезни и их участие в формировании клинической картины заболевания. Рассматривается необходимость проведения дифференциальной диагностики ука- занной патологии с использованием современных экспериментально-психологических методов в связи с дальнейшим построением психологической помощи больным с аутоиммунными заболеваниями печени.

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

The Future of the Russian-Chinese Role in the Middle East Under the Decline of US Hegemony: “the Arabian Gulf Region is a Model”

Since the second Gulf crisis in 1990, it has been thought that Russia can no longer protect its allies or exert influence on regional issues, and that the United States is the only actor in International and regional affairs. This impression was confirmed by the NATO strikes on Serbia in 1999, the US invasion of Iraq in 2003, and the NATO strikes on Libya in 2011. But the Russian position on the Syrian crisis came counter to expectations and closer to the Soviet positions during the Cold War, when Moscow stood firm in confronting Washington to protect its interests and allies. Syria is an important strategic ally and a foothold for Russia means losing the entire Middle East, which is inconceivable for Moscow. This is demonstrated by the clear diplomatic activity that Russian diplomacy has witnessed in the region since Vladimir Putin took power in Russia in 2000 and the jumps in economic and technical cooperation between Russia and a number of countries in the region

Ecotoxicological hazard assessment of deicing chemicals for higher plants

The article presents data on ecotoxicological hazard assessment of different types of deicing chemicals for higher plants. The assessment was carried out according to a specifically developed rapid test on oats seeds. The phytoeffect was determined by comparing the lengths of the seedling roots placed in a solution of deicing chemicals and was calculated by the effect size of root growth inhibition comparing with proof sample. The safest composition of deicing chemicals was determined

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

COMPARATIVE STUDY OF EMOTIONAL DISORDERS STRUCTURE IN PATIENTS BEFORE AND AFTER ORTHOTOPIC LIVER TRANSPLANTATION

Being based on a private experience, authors considered necessary to study features of emotional disorders that will allow understanding the mechanism of mental adaptation to disease at patients before and after OLT. In comparative research of structure of emotional frustration at the patients making the most numerous groups of patients before transplantation of a liver (viral hepatitis and autoimmune liver diseases), 129 persons, from them 75 before OLT are included at entering into a waiting list and 54 to through 22 ± 9 days after OLT. Distinctions in structure of emotional frustration are revealed: at patients with autoimmune liver diseases be- fore OLT and viral hepatitis after OLT the semiology combined with disturbing-depressive experiences and hypochondriac fixings is brightly expressed neurotic, them distinguishes high level of personal uneasiness. For patients with autoimmune liver diseases after OLT and viral hepatitis before OLT are characteristic moderately expressed neurotic frustration of an asthenia circle and low level of personal and situational anxiety

SOME THEORETICAL ASPECTS OF COMPLEX CLINICAL-PSYCHOLOGICAL INVESTIGATION OF PATIENTS WITH AUTOIMMUNE LIVER DISEASES IN CIRRHOTIC STAGE BEFORE LIVER TRANSPLANTATION

This article presents preliminary results of complex clinical-psychological investigation of patients with autoim- mune liver diseases with cirrhosis waiting for liver transplant. The data discussed defense role of anxiety com- bined with other emotional affective disorders, psychological mechanisms in combination with coping strategies of stress-overcoming behavior in the state of disease and their involvement in formation of the clinical picture of the disease. It considers the need for differential diagnosis of the pathology using modern experimental- psychological methods in connection with further building of psychological aid to patients with autoimmune liver diseases