Проблема надлежащего исполнения обязанностей, обеспечивающих состязательность уголовного судопроизводства в России

The subject of the research is the mechanism for the execution of criminal procedural duties that ensure the implementation of adversarial in Russian criminal proceedings.The subject of the research is the mechanism for the execution of criminal procedural duties that ensure the implementation of adversarial in Russian criminal proceedings. The purpose of the research is to justify the existence of the problem of organizational-legal support for the proper fulfillment of the duties assigned to participants in the criminal process and to determine the main ways of solving. The hypothesis of the research is the thesis that the combination of legal, organizational, and other means existing in criminal procedure legislation does not guarantee the proper fulfillment of the duties imposed by the legislator on the participants in adversarial criminal proceedings.of the research is to justify the existence of the problem of organizational-legal support for the proper fulfillment of the duties assigned to participants in the criminal process and to determine the main ways of solving. The hypothesis of the research is the thesis that the combination of legal, organizational, and other means existing in criminal procedure legislation does not guarantee the proper fulfillment of the duties imposed by the legislator on the participants in adversarial criminal proceedings.The methodology. General scientific dialectical methods made it possible to study the conditions and the process of evolution of legal duties, to reveal their essence in the field of criminal proceedings. The system-structural method and the situational modeling method were used when studying the intra-system relationships of elements of the mechanism for the execution of criminal procedural duties and the system of means that ensure its implementation. The study of regulatory legal requirements was carried out using the formal legal method.The main results, scope of application. The article examines the problem of organizationallegal support for the proper performance of the duties assigned to participants in the criminal process, guaranteeing the proper implementation of adversarial in criminal proceedings. The general concept of duty is given, and the definition of criminal procedure is formulated. The nature of the duties is revealed and their classification is proposed. The fundamental legal significance of the category "Adversarial" as a principle of criminal procedure is identified and the significance of criminal procedural duties as the main security means of the specified procedural category is justified. The provisions of the current criminal procedure legislation in Russia are critically analyzed from the point of view of the presence or absence of legal and organizational means in them that ensure the creation of the conditions necessary for the emergence of a real possibility of proper performance of duties by participants in the criminal process. It is established that the organizational and legal resources required to effectively ensure the proper performance of criminal procedural duties are insufficient. A problematic situation in criminal proceedings is revealed in the form of imperfection of the means intended to achieve his appointment in the context of the implementation of the adversarial legal regime. The views of scientists on the issues studied in the article are studied, analyzed and evaluated.Conclusions. The essence of the scientific problem of research is formulated and proposals are put forward aimed at improving the criminal procedure regulation of the proper behavior of legally liable participants in the criminal process in order to increase the effectiveness of ensuring the implementation of adversarial in criminal proceedings in Russia.Исследуется механизм исполнения уголовно-процессуальных обязанностей. Обозначается основополагающее значение состязательности в уголовном процессе и обосновывается значимость уголовно-процессуальных обязанностей как обеспечительных средств ее реализации. Критически анализируются положения Уголовно-процессуального кодекса РФ с позиции наличия-отсутствия в них правовых и организационных средств, обеспечивающих создание условий надлежащего исполнения обязанностей. Выявляется проблемная ситуация о недостаточности средств, необходимых для достижения назначения уголовного судопроизводства. Формулируется научная проблема исследования о несовершенстве средств обеспечения, и выдвигаются предложения по совершенствованию уголовно-процессуального регулирования должного поведения участников состязательного российского уголовного процесса

Morphological Deformities in Anuran Amphibians from the Khoper River Valley in the “Privolzhskaya Lesostep’” Nature Reserve and Adjacent Territories

In summer 2016, we investigated Ostrovtsovskaya Lesostep’ (Penza region, Russia) and caught more than 130 specimens belonging to 4 species of anuran amphibians. We found a symmetric case of “hyperxanthism” of the eyes (a new type of anomaly among amphibians) in one Rana arvalis specimen, one asymmetric amely in Bombina bombina, and 21 specimens of Pelophylax ridibundus (19% of total sample) with deformed fore and hind limbs. We define some anomalies as “Rostand’s anomaly P” (in its extreme manifestations). The potential reasons of the morphological anomalies were discussed

U-Pb Ages of Secondary Silica at Yucca Mountain, Nevada: Implications for the Paleohydrology of the Unsaturated Zone

U, Th, and Pb isotopes were analyzed in layers of opal and chalcedony from individual millimeter- to centimeter-thick calcite and silica coatings at Yucca Mountain, Nevada, USA, a site that is being evaluated for a potential high-level nuclear waste repository. These calcite and silica coatings on fractures and in lithophysal cavities in Miocene-age tuffs in the unsaturated zone (UZ) precipitated from descending water and record a long history of percolation through the UZ. Opal and chalcedony have high concentrations of U (10 to 780 ppm) and low concentrations of common Pb as indicated by large values of {sup 206}Pb/{sup 204}Pb (up to 53,806), thus making them suitable for U-Pb age determinations. Interpretations of U-Pb isotopes in opal samples at Yucca Mountain are complicated by the incorporation of excess {sup 234}U at the time of mineral formation, resulting in reverse discordance of U-Pb ages. However, the {sup 207}Pb/{sup 235}U ages are much less affected by deviation from initial secular equilibrium and provide reliable ages of most silica deposits between 0.6 and 9.8 Ma. For chalcedony subsamples showing normal age discordance, these ages may represent minimum times of deposition. Typically, {sup 207}Pb/{sup 235}U ages are consistent with the microstratigraphy in the mineral coating samples, such that the youngest ages are for subsamples from outer layers, intermediate ages are from inner layers, and oldest ages are from innermost layers. {sup 234}U and {sup 230}Th in most silica layers deeper in the coatings are in secular equilibrium with {sup 238}U, which is consistent with their old age and closed system behavior during the past 0.5 m.y. U-Pb ages for subsamples of silica layers from different microstratigraphic positions in individual calcite and silica coating samples collected from lithophysal cavities in the welded part of the Topopah Spring Tuff yield slow long-term average depositional rates of 1 to 5 mm/m.y. These data imply that the deeper parts of the UZ at Yucca Mountain maintained long-term hydrologic stability over the past 10 m.y. despite significant climate variations. U-Pb ages for subsamples of silica layers from different microstratigraphic positions in individual calcite and silica coating samples collected from fractures in the welded part of the overlying Tiva Canyon Tuff indicate larger long-term average depositional rates up to 23 mm/m.y. and an absence of recently deposited materials (ages of outermost layers are 3-5 Ma). These differences between the characteristics of the coatings for samples from the shallower and deeper parts of the UZ may indicate that the nonwelded tuffs (PTn), located between the welded parts of the Tiva Canyon and Topopah Spring Tuffs, play an important role in moderating UZ flow

Morphological Deformities in Anuran Amphibians from the Khoper River Valley in the “Privolzhskaya Lesostep’” Nature Reserve and Adjacent Territories

In summer 2016, we investigated Ostrovtsovskaya Lesostep’ (Penza region, Russia) and caught more than 130 specimens belonging to 4 species of anuran amphibians. We found a symmetric case of “hyperxanthism” of the eyes (a new type of anomaly among amphibians) in one Rana arvalis specimen, one asymmetric amely in Bombina bombina, and 21 specimens of Pelophylax ridibundus (19% of total sample) with deformed fore and hind limbs. We define some anomalies as “Rostand’s anomaly P” (in its extreme manifestations). The potential reasons of the morphological anomalies were discussed.We would like to replace old acknowledgements with: “Authors are grateful to A. Dubois, S.N. Litvinchuk and V.L. Vershinin for valuable advices about classification of anomalies. We are thankful to A.N. Dobrolyubov for opportunity to work on the territory of nature reserve «Privolzhskaya Lesostep’».The work was supported by the RFBR (№ 18-04-00640 А, №16-34-00119 and № 15-29-02550) and by the grant of Mari State University (№ 2017-06b from 11.01.2017).

The place of retroperitoneoscopic method in the treatment of acute obstructive calculous pyelonephritis

In the comparative analysis of the methods of patients treatment with acute obstructive calculous pyelonephritis without preliminary drain of renal cavity system (retroperitoneoscopic approach) was submitted the article, transurethral lithotripsy was performed after preliminary drain of renal cavity system by stent (comparative group 1), and percutaneous nephrolithotripsy, performed after nephrostomy (comparative group 2). Retroperitoneoscopic lithotomy was performed on the first day apply in the hospital. Lithotripsy were performed after treatment the attack of acute pyelonephrit. All patients of 3 groups were with hyperthermia, pain, inflammatory symptoms in analysis of urine, blood. By bacteriologica investigation of urine Escherichia coli, Enterococcus faecalis, Klebsiella were determined in all groups. All stones were R-positive. Retroperitoneoscopic method is more effective and safety in the treatment of patients with acute obstructive calculous pyelonephrit. The stone is removed completely, there are not residual fragments and risk of development bacteriotoxic shock, medical load and time of working disability are less than in comparative groups.В статье представлен сравнительный анализ методов лечения пациентов с острым обструктивным калькулезным пиелонефритом без предварительного дренирования полостной системы (ретроперитонеоскопический доступ), трансуретральной литотрипсии, проводимой после предварительного дренирования полостной системы почки стентом (группа сравнения №1) и перкутанной нефролитотрипсии, выполняемой после нефростомии (группа сравнения №2). ретроперитонеоскопическая литотомия выполнялась в первые сутки обращения в стационар. Литотрипсии проводились после купирования атаки острого пиелонефрита. Все пациенты в трех группах поступали с гипертермией, болевым симптомом, воспалительными изменениями в общих анализах крови и мочи. При бактериологическом исследовании мочи во всех группах высеяны Escherichia coli, Enterococcus faecalis, Klebsiella. Все конкременты были р-контрастными. ретроперитонеоскопический метод в лечении пациентов с острым обструктивным калькулезным пиелонефритом является более эффективным и безопасным. Конкремент удаляется целиком, не остаются резидуальные фрагменты, отсутствие риска развития бактериотоксического шока, медикаментозная нагрузка и периода нетрудоспособности значительно меньше, чем в группах сравнения

A case report of surgical treatment of amiodarone-induced thyrotoxicosis in a patient with multiple organ failure

Amiodarone is a drug used in the treatment of life-threatening arrhythmias, which can lead to the development of amiodarone-induced thyrotoxicosis. In most cases this pathology can be treated by conservative methods; surgical treatment is resorted to in cases of thyrotoxicosis refractory to medical treatment. This case report describes surgical treatment of a patient with amiodarone-induced thyrotoxicosis, progressive heart failure, neurological pathology, bilateral pneumonia, functioning tracheostomy, systemic infectious process, multiple organ dysfunction syndrome, who was treated in the intensive care unit. Due to the lack of response to therapy with antithyroid drugs (thiamazole, lithium preparations and pulse therapy with prednisolone) and a progressive deterioration of the condition in a short period of time, according to vital indicators, the patient underwent thyroidectomy. In the postoperative period, there was a decrease in the occurrence of chronic heart failure symptoms. Medical control of cardiac arrhythmias was achieved. Surgical stage proceeded without complications in the period of 30-days. The patient was discharged for outpatient rehabilitation treatment

Медикаментозная терапия когнитивной дисфункции в малоинвазивной хирургии при анестезии севофлураном

The objective: To conduct a comparative assessment of efficacy of Cytoflavin and Cellex for management of cognitive disorders after videolaparoscopic cholecystectomy performed under general inhalation anesthesia with sevoflurane.Results. In three representative groups (n = 30) of patients, markers of inflammation (CRP and IL-6), levels of brain-specific proteins (S-100 and NSE) were studied. Neuropsychological testing were performed by using the MoCA test, frontal dysfunction test battery (FAB) by two stages (stage I ‒ on the eve of the operation, stage II ‒ on the 7th day of the postoperative period). In patients of Group I (n = 30), disorders of higher mental functions of the early postoperative period persisted, which served as the basis for finding ways to eliminate and manage the identified disorders. For this purpose, Cytoflavin was used in Group II (n = 30), and Cellex was used in Group III (n = 30).Comparative characteristics of the level of brain-specific proteins revealed a statistically significant decrease at stage I in Groups II and III versus Group I. The lowest level of both NSE (by 1.45 μg/l, p = 0.041) and S-100 (by 10.1 ng/l, p = 0.044) was observed in Group III versus Group II. In addition, at the second stage of the study, the greatest severity of the inflammatory response was noted in Groups II and III of patients compared to Group I and this degree of severity could be potentiated by the ongoing drug therapy. If in Group I, disorders of higher mental functions persisted on the 7th day of the postoperative period, then as a result of the ongoing drug therapy in Groups II and III, it was possible to achieve significantly better results of neuropsychological testing.Conclusion. Administration of drug therapy contributed to the improvement of higher mental function eliminating cognitive deficit in the early postoperative period.Цель: провести сравнительную оценку эффективности применения цитофлавина и целлекса для коррекции когнитивных расстройств после видеолапароскопической холецистэктомии, выполненной в условиях общей ингаляционной анестезии севофлураном.Результаты. В трех репрезентативных группах по 30 пациентов исследовали маркеры воспаления (С-реактивный белок и IL-6), уровень мозгоспецифических белков (S-100 и NSE), проводили нейропсихологическое тестирование с помощью МоСА-теста, батареи тестов лобной дисфункции (FAB) на двух этапах (I этап – накануне операции, II этап – на 7-е сут послеоперационного периода). У пациентов 1-й группы (n = 30) сохранялись расстройства высших психических функций (ВПФ) раннего послеоперационного периода, что послужило основанием для поиска путей устранения и коррекции выявленных нарушений. С этой целью во 2-й группе (n = 30) применяли цитофлавин, а в 3-й (n = 30) – целлекс.Сравнительная характеристика уровня мозгоспецифических белков выявила статистически значимое их снижение на II этапе во 2-й и 3-й группах пациентов по сравнению с 1-й группой. Наименьший уровень как NSE (на 1,45 мкг/л, p = 0,041), так и S-100 (на 10,1 нг/л, p = 0,044) отмечался в 3-й группе пациентов по сравнению со 2-й группой. Также на II этапе исследования наибольшая выраженность воспалительного ответа отмечалась во 2-й и 3-й группах больных по сравнению с 1-й и могла быть потенцирована проводимой медикаментозной терапией. Если в 1-й группе больных сохранялись расстройства ВПФ на 7-е сут послеоперационного периода, то в результате проводимой медикаментозной терапии во 2-й и 3-й группах удалось достичь статистически значимо лучших результатов нейропсихологического тестирования.Заключение. Проведение медикаментозной терапии способствовало улучшению состояния ВПФ, устраняя когнитивный дефицит в раннем послеоперационном периоде

Опыт использования системы вакуумной терапии ран при лечении высокого наружного тонкокишечного свища

The article presents the experience of successful patient treatment with a high external small bowel fistula using a combined approach: surgery and vacuum therapy.В статье приведен опыт успешного лечения пациента с высоким наружным тонкокишечным свищом с помощью комбинированного подхода, сочетающего хирургическое вмешательство и вакуумную терапию

Effectiveness of preoperative staging in rectal cancer: digital rectal examination, endoluminal ultrasound or magnetic resonance imaging?

In rectal cancer, preoperative staging should identify early tumours suitable for treatment by surgery alone and locally advanced tumours that require therapy to induce tumour regression from the potential resection margin. Currently, local staging can be performed by digital rectal examination (DRE), endoluminal ultrasound (EUS) or magnetic resonance imaging (MRI). Each staging method was compared for clinical benefit and cost-effectiveness. The accuracy of high-resolution MRI, DRE and EUS in identifying favourable, unfavourable and locally advanced rectal carcinomas in 98 patients undergoing total mesorectal excision was compared prospectively against the resection specimen pathological as the gold standard. Agreement between each staging modality with pathology assessment of tumour favourability was calculated with the chance-corrected agreement given as the kappa statistic, based on marginal homogenised data. Differences in effectiveness of the staging modalities were compared with differences in costs of the staging modalities to generate cost effectiveness ratios. Agreement between staging and histologic assessment of tumour favourability was 94% for MRI (kappa=0.81, s.e.=0.05; kappa(W)=0.83), compared with very poor agreements of 65% for DRE (kappa=0.08, s.e.=0.068, kappa(W)=0.16) and 69% for EUS (kappa=0.17, s.e.=0.065, kappa(W)=0.17). The resource benefits resulting from the use of MRI rather than DRE was 67164 UK pounds and 92244 UK pounds when MRI was used rather than EUS. Magnetic resonance imaging dominated both DRE and EUS on cost and clinical effectiveness by selecting appropriate patients for neoadjuvant therapy and justifies its use for local staging of rectal cancer patients