EPIdemiology of Surgery-Associated Acute Kidney Injury (EPIS-AKI) : Study protocol for a multicentre, observational trial

More than 300 million surgical procedures are performed each year. Acute kidney injury (AKI) is a common complication after major surgery and is associated with adverse short-term and long-term outcomes. However, there is a large variation in the incidence of reported AKI rates. The establishment of an accurate epidemiology of surgery-associated AKI is important for healthcare policy, quality initiatives, clinical trials, as well as for improving guidelines. The objective of the Epidemiology of Surgery-associated Acute Kidney Injury (EPIS-AKI) trial is to prospectively evaluate the epidemiology of AKI after major surgery using the latest Kidney Disease: Improving Global Outcomes (KDIGO) consensus definition of AKI. EPIS-AKI is an international prospective, observational, multicentre cohort study including 10 000 patients undergoing major surgery who are subsequently admitted to the ICU or a similar high dependency unit. The primary endpoint is the incidence of AKI within 72 hours after surgery according to the KDIGO criteria. Secondary endpoints include use of renal replacement therapy (RRT), mortality during ICU and hospital stay, length of ICU and hospital stay and major adverse kidney events (combined endpoint consisting of persistent renal dysfunction, RRT and mortality) at day 90. Further, we will evaluate preoperative and intraoperative risk factors affecting the incidence of postoperative AKI. In an add-on analysis, we will assess urinary biomarkers for early detection of AKI. EPIS-AKI has been approved by the leading Ethics Committee of the Medical Council North Rhine-Westphalia, of the Westphalian Wilhelms-University Münster and the corresponding Ethics Committee at each participating site. Results will be disseminated widely and published in peer-reviewed journals, presented at conferences and used to design further AKI-related trials. Trial registration number NCT04165369

Fundamentals of legal regulation of administrative and judicial procedures related to compulsory medical intervention: The experience of foreign countries

The paper analyzes the legal regulation of administrative and judicial procedures related to compulsory medical intervention. Relying on foreign experience in this field, the authors compare the legal guidelines of countries in this area, focusing on different legal practices in this area. Since compulsory medical intervention is associated with the restriction of human rights, the article draws attention to international legal standards in the studied direction. © 2019, Media Sphera Publishing Group. All rights reserved

The current state of telemedicine development in Russia: Legal and legislative regulation

The paper considers the current state, development and introduction of telemedicine in the Russian Federation in accordance with the current national/federal regulatory and legal acts and scientific publications. It also presents the actual problems of obtaining and providing medical services through telemedicine technologies. Main emphasis is laid on the legal status of a healthcare worker in providing medical care through telemedicine technologies; possible problems that a doctor or another healthcare worker associated with telemedicine may face are identified. © 2019, Media Sphera Publishing Group. All rights reserved