[A case of granulomatous tubulointerstitial nephritis in a patient with pulmonary sarcoidosis].

A clinical observation is presented of a patient with pulmonary sarcoidosis, who was diagnosed with kidney damage after three years with the development of chronic renal failure and the need for replacement therapy. A histological examination of the renal biopsy revealed a granulomatous process in the interstitial tissue, which was regarded as an extrapulmonary manifestation of sarcoidosis. Pulse therapy with glucocorticoids was prescribed and an attempt was made to reduce hemodialysis sessions.

[Comparison of the pattern injuries of the shoulder joint after dislocation in patients different age groups.]

The aim of the study is to compare the frequency of the rotator cuff tears in patients younger and older than 60 years during shoulder dislocation. The study included the results of observation of 101 patients after shoulder dislocation without signs of damage of the rotator cuff before the trauma. All the patients were divided into 2 groups: older and younger than 60. All the patients after the injury underwent radiography and MRI. Pattern of injury of the shoulder joint was assessed via MRI. In patients younger than 60 years, the risk of a fracture of anterior margin of glenoid during the acute shoulder dislocation is higher by 5,18 times (95% CI 1,4-12,7) than in patients older than 60 years, due to direct mechanism and high-energy trauma in patients younger than 60 years. The risk of a fracture of the head of the humerus in the group of patients older than 60 years is 27,75 times higher (95% CI 3,57-215,135) than in the group of patients younger than 60, which is associated with age-related osteoporosis in the proximal humerus in patients of the older age group. In patients older than 60 years during the dislocation of the shoulder, the rotator cuff of the shoulder is damaged in 78,6% of cases, whereas in young patients it is 32,9%. The risk of rotator cuff damage in the older age group is 11,15 times (95% CI 4,047-30,734) higher than in young patients. Thus, all patients, especially those older than 60, should be undergo MRI to increase the accuracy of diagnosing of soft tissue injuries, which affects the choice of techniques and method of treatment.