[Development of purulent-destructive forms of acute pyelonephritis in patients with a history of new coronavirus infection Covid-19].

INTRODUCTION: Since 2019, more than 600 million cases of the new coronavirus infection Covid-19 have been reported worldwide. According to various studies, the development of a systemic inflammatory response and "cytokine storm" play an important role in the pathogenesis of kidney damage, which leads to impaired microcirculation, increased thrombus formation and the development of ischemic areas in the parenchyma. AIM: To study the frequency and possible causes of purulent forms of pyelonephritis in patients who have had a new coronavirus infection Covid-19. MATERIALS AND METHODS: The prospective and retrospective study included the results of 403 patients with acute non-obstructive pyelonephritis in the pre-Covid period and those with a history of a new coronavirus infection. RESULTS: In patients with acute non-obstructive pyelonephritis without past urological history who had a new coronavirus infection, an increase in purulent-destructive forms from 5.0 to 17.0% was noted. One of the reasons is increased antibiotic resistance and the emergence of pan-resistant uropathogens due to irrational use of antibacterial drugs. CONCLUSION: The use of reserve antibacterial drugs in patients with acute pyelonephritis as empirical therapy and anticoagulants in order to improve microcirculation and prevent thrombosis is pathogenetically justified.

[Comprehensive treatment of indolent trophic ulcers of venous aetiology]. / Kompleksnoe lechenie dlitel'no nezazhivaiushchikh troficheskikh iazv venoznoi étiologii.

AIM: The study was undertaken to evaluate efficacy of comprehensive treatment with the use of erbium laser radiation in patients suffering from venous trophic ulcers of lower limbs. PATIENTS AND METHODS: The study included a total of seventy-six 45-to-80-year-old patients. Of these, there were 43 (56.6%) women and 33 (43.4%) men. The duration of the disease averagely amounted to 10.8±4.8 years. In 38 patients, the bottom of the ulcerative defect was with pronounced periulcerative inflammation and various degree of purulent discharge. All patients were admitted to the surgical department and underwent meticulous examination. Erbium laser irradiation was carried out with consideration for the ulcer size. Laser irradiation was performed at a wavelength of 2940 nm, pulse duration - 0.3 ms, laser beam diameter - 7 mm with radiation power of 2.19 J/cm2. RESULTS: Efficacy of treatment was assessed in dynamics by the degree of pain syndrome, ulcer size upon completion of treatment, as well as the rate of trophic ulcer epithelialisation. In 15 (19.7%) patients with varicose disease the vertical and horizontal reflux was eliminated with performing phlebectomy and echosclerotherapy. The obtained findings demonstrated that 42 (91.3%) patients of the study group had decreased terms of the beginning of purification of the fundus of the ulcer. After 6 months of rehabilitation and follow up, complete ulcer healing was achieved in 18 (64.3%) patients of the control group and in 39 (86.7%) patients of the study group. CONCLUSION: The obtained findings showed that laser radiation proved to be an effective method of treatment in patients presenting with indolent trophic ulcers. Comprehensive treatment made it possible to effectively influence the microflora and the state of regional lymph drainage, to stimulate the processes of reparative regeneration.

[The epidemiological risk factors related to labor migration].

The prevention of diseases among migrants becomes a serious problem of public health of subjects of the Russian Federation. The system of public sanitary epidemiological inspection in the field of biological security of the Russian Federation demands a permanent enhancement.

[Informative value of radiodiagnosis methods of pyelo-ureteral strictures in kidney anomaly].

A total of 98 patients aged 18-67 years (mean age 42.5 +/- 10.3 years) suspected to have a pelviureteral stricture (PUS) were examined using ultrasound investigation in B-mode (BUI), excretory urography (EU), angiography, slice and multislice computed tomography (SCT, MSCT). This combined examination allowed to make diagnosis of hydronephrosis in 83 (84.7%) patients including PUS diagnosis in 48 (57.8%) patients. Basing on CT findings PUS was operated in 41 (85.4%) patients. Sensitivity, specificity and accuracy of BUI in detection of the level of the upper urinary tract obstruction was 92.8, 75.0, 89.3%, EU--94.5, 77.8, 92.2, SCT--100, 97, 98.1%, respectively. MSCT detected the level of the obstruction in all the cases. PUS was identified by BUI in 26.5, 89.3, 65.6, EU--in 81.3, 73.7, 79.1, by SCT in 90.5, 96.8, 94.2, MSCT--96.3, 100, 97.8% cases. Thus, MSCT is most effective in radiodiagnosis of PUS and can be recommended as a method of choice in PUS.

[Atopic dermatitis in teenagers as medical and social problem for the Armed Forces].

The analyze of data of official statistics of Department of Health and Social Development speaks for veridical differences in prevalency and morbidity of atopic dermatitis by teen-agers in comparison with children (younger then 14 years old). These indexes are higher in 2-3 times, then these indexes among children. For the first time was effectuated the analyze of health survey. It has been found that in structure of dermatological pathology in general 5/6-3/4 is the group with patients with new-onset diagnosis, and only 1/5-1/4 - is a dispensary group. For children, persons older then 18 and population in general the index of health survey is practically identic and is equal to 0.5. For teen-agers this index is higher - 0.6 and more. The highest abundance and morbidity is: among constituents of the Russian Federation - Privolzhsky Federal district, among it's regions - Ul'yanovsk region.

[Local cellular regulation in formation of postoperative commissures in peritonitis]. / Mestnaia kletochnaia reguliatsiia v obrazovanii posleoperatsionnykh spaek pri peritonite.

Influence of Perphtoran on cells of peritoneal fluid and intestinal serosa was studied experimentally in Wistar rats on the model of peritonitis and mechanic injury of the intestine. Stimulation of macrophage activity and proliferative activity of intestinal mesothelium was seen, number of adhesive surfaces was by half less than in the control group. Treatment of abdominal cavity with Perphtoran in patients led to fast recovery of intestinal peristalsis, more favorable course of postoperative period and better long-term results.

[Antioxidant therapy in combined treatment of postoperative intestinal paresis]. / Antioksidantnaia terapiia v lechenii posleoperatsionnogo pareza kishechnika.

Method of treatment of postoperative intestinal paresis with antioxidant emoxipin in experiment demonstrated that stabilization of redox processes and antioxidant systems in intestinal tissues leads to compensation of energy deficiency and recovery of intestinal peristalsis. Clinical use of this method in combined treatment of patients with postoperative intestinal paresis in acute generalized peritonitis reduces time of postoperative intestinal paresis and intoxication, lethality reduced 1,7-fold.

Experimental study of the use of Perftoran for preventing the formation of postoperative adhesions in peritonitis.

The effect of Perftoran (perfluorocarbon compound) on cells of the peritoneal exudate and small intestinal serosa was studied in Wistar rats with experimental peritonitis and mechanical injury. The peritoneal cavity was treated with Perftoran for preventing postoperative adhesions and the mechanisms of reparative regeneration of the mesothelium after this treatment were studied by immunohistochemical methods and scanning electron microscopy. The increase in macrophage population during the early postoperative period and its decrease at later terms prevented fibroblast activation and promoted epithelialization as early as by day 5.

[The biomicroscopic evaluation of the blood microcirculatory bed in the mesentery of the small intestine during experimental perftoran infusion under normovolemia]. / Biomikroskopicheskaia otsenka gemomikrotsirkuliatornogo rusla bryzheiki tonkoi kishki pri éksperimental'noi infuzii perftorana v usloviiakh normovolemii.

Dynamics of biomicroscopic state of hemomicrocirculatory bed (HMCB) of small intestinal mesentery was studied in go both sexes albino outbred rats in conditions of intravenous administration of 1.0 ml perfuoram (PF) with simultaneous control of the experiment by intravenous isotonic solution administration. Biomicroscopy was performed 30 minutes, 3, 6 and 24 hours later. 30 minutes after the PF administration bloodflow reduction in afferent vessels, elongation of construction period of resistant vessels and 18% decrease of vessels were demonstrated. Precapillary diameter decreased on 23% with respect to control with isotonic solution. Tortuosity of precapillaries and decrease of functioning capillaries number. 3 hours after the PF infusion blood flow turned more slow, signs of adhesion between leukocytes and postcapillary venules lumenal surface appeared and perivascular infiltrate had formed. Diameter of alducent vessels reduced in comparison with control and went lugher against the 30-minutes research stage. On the whole bloodflow in resistant vessels turns homogeneous. 6 hours after PF infusion homogeneous bloodflow could be seen. Number of arteriolar vasomotions grew up to control and made 14 in a minute. Venular diameter was close to control. Biomicroscopy of HMCB 24 hours after infusion did not reveal essential differences compared to with isotonic solution administered.

[The reaction of somatic lymph nodes to experimental exposure to sulfide baths]. / Reaktsiia somaticheskikh limfaticheskikh uzlov na vozdeistvie sul'fidnykh vann v éksperimente.

Influence of strong sulfide baths of the sanatorium "Talgi" to the popliteal and superficial inguinal lymph nodes (LN) has been studied in 35 rats (140-150 g of body mass) and 15 animals have been used as the control. The slices are stained with hematoxyli-eosin, after van Gieson, Romanovsky-Giemsa, Kurnik and silver nitrate impregnation after Foot. The section area of the LN decreases, but amount of lymphoid nodules increases (especially in deep layers of the cortex). In the germinative centers amount of middle lymphocytes and mitoses becomes larger. In the internodular zones of the popliteal nodes amount of macrophages and eosinophiles enlarges significantly, and in the inguinal-amount of mast cells and eosinophiles. In the medullary sinuses amount of macrophages declines. In the medullary cords amount of immature plasma cells and blasts increases, while amount of mature cells decreases.

[State of the microcirculatory bed of the mesentery in experimental dehydration]. / Sostoianie mikrotsirkuliatornogo rusla bryzheiki pri éksperimental'nom degidratsii.

The results of a complex functional-morphological analysis on the state of the mesentric microcirculatory bed have demonstrated a peculiar dynamics in increasing changes of its blood and lymphatic segments. Their degree depends on the stage of dehydration. On the 3d day, the changes revealed are not great and are of redistributive character. On the 6th day dehydration aquires the maximal intensity of changes in vessels and hemodynamics. By the 10th day, maximal level of vascular, intravascular and hemodynamic disorders is evident. Comparing these data and the results of investigations on intracellular and extracellular ion contents, it is possible to suggest a definite staged water elimination from the main depots of the organism. The reserves of extracellular water section are the first to be mobilized at the expense of its interstitial and transcellular links. On the 6th day of the experiment maximal intensity of blood and lymphatic dehydration is noted. Final stages of dehydration are characterized by a pronounced cellular dehydration.

[Morphofunctional analysis of the microcirculatory bed following sublethal dehydration of rats]. / Morfofunktsional'nyi analiz mikrotsirkuliatornogo rusla pri subletal'noi degidratsii u krys.

Sublethal dehydration is followed by a considerable weight loss, drop in rectal temperature, decreasing respiratory rate, increasing tachycardia and hematocrit. Sublethal stages of dehydration result in uniform changes in the dura mater, parietal peritoneum, small intestine mesentery, muscular part of the diaphragm, the renal capsule deformation, discomplexation of microvessel networks and structural changes of microvessel walls. Microvessel morphometry has demonstrated a certain decrease in diameters of all the parts in the objects studied. Maximal decrease of the diameter has been noted in capillary and postcapillary venular parts. The greatest changes in microvessel structure has been noted in the dura mater and in the serous sheets.

[Lability of the temperature analyzer in neurologic clinical practice]. / Issledovaniia labil'nosti temperaturnogo analizatora v nevrologicheskoi klinike

With the aid of thermopulsation the authors determined the maximal frequencies of separately percepted thermal stimula in the different areas of the skin surface (lability of the thermal analyzer). Such studies were performed in normals and in patients with organic brain and spinal lesions. It was established that in pathological conditions changes of lability go far beyond the limits of corresponding morphological changes and demonstrate distributed neurodynamical shifts. These data are considered from the standpoint of extralemniscal disorders of general sensitivity.