State Severity Assessment in Patients with Obstructive Jaundice using PMGMU2018h Scale Adapted to the Russian Medical and Economic Standards.

The aim of the study was to assess the effectivity of PMGMU2018h scale for evaluation of the state severity degree of patients suffering from obstructive jaundice relative to other common assessment scales. MATERIALS AND METHODS: Thirty physical parameters have been studied and compared according to different assessment scales in each of 258 patients with obstructive jaundice treated in three medical settings. RESULTS: The main drawback of the examined scales is the necessity to use the parameters for calculations not included in the medical and economic standards of the Russian Federation. This feature makes these scales unsuitable for making decisions on the tactics of managing a concrete patient in the hospitals of the Russian Federation. The scale developed by us for the assessment of the state severity of patients suffering from obstructive jaundice is completely devoid of subjectivism, does not depend on a surgeon's qualifications, and possesses high specificity to the given disease.

[Zinc status improving as a pathogenetically grounded platform for maintaining immunity during SARS-CoV-2 pandemic].

The problem of increasing immunity has become especially relevant in the conditions of the rapid spread of the new coronavirus infection SARS-CoV-2. Nowadays it has been proven that a deficiency of certain micronutrients in the diet can disrupt chemical, structural and regulatory processes in the organism, which negatively affects, first of all, the state of immune system. Zinc is one of the most significant essential trace elements affecting immunological resistance. The aim of the study was to substantiate the need of including zinc-containing products and diet supplements in the diet of the population during the SARS-CoV-2 pandemic on the basis of the study of pathogenetic mechanisms of various disorders of the immunological status under zinc deficit. Material and methods. This review analyzes the data from scientific electronic libraries CyberLeninka, eLIBRARY.RU, the Google Scholar databases and bibliographic medical databases MEDLINE and PubMed-NCBI. Results and discussion. During the SARS-CoV-2 pandemic, adequate zinc supply is especially important, due to its antiviral, immunomodulatory and antiapoptotic effects. This element also regulates the severity of the cytokine response, exhibits antibacterial properties and helps to compensate for chronic comorbid diseases, which plays a particularly significant role in preventing severe SARS-CoV-2 and recurrent respiratory diseases. Prevention and correction of zinc deficiency is considered as one of the important measures during the SARS-CoV-2 pandemic, aimed at increasing antiviral and general immunity, reducing the systemic inflammatory response and correcting hormonal and metabolic status. Conclusion. The pathogenetically substantiated inclusion of zinc-containing foods and supplements in the diet will enhance the immunity of the population during the SARSCoV- 2 pandemic.

[Posterior thoracotomy in ventral decubitus].

The rigidity of the chest wall, thank to its bone framework, determines the variety of operative access in thoracic surgery, both thoracoscopic and open. The posterior thoracotomy on the bed of the resected rib in ventral decubitus is traditionally but gratuitously rarely used access. The method permits comfortable access to trachea, bifurcation, main bronchi and thoracic esophagus. It can also be used in cases of foregoing thoracothomy. Authors own the experience of 111 cases with the use of posterior thoracotomy in ventral decubitus. The access proved to be preferable for the operations on the membranous part of the trachea and main bronchi, some localizations of thoracic tracheoesophageal fistula. The access suggests fast mobilization of the root of the lung without foregoing pneumolisis, which is important in cases of pleural cavity obliteration after tuberculosis or pleural empyem.