Urinary System Iatrogenic Injuries: Problem Review.

INTRODUCTION: From May to December 2019, a literature review of the urinary system iatrogenic injury problem was performed. The most cited, representative articles in PubMed, Scopus, and WoS databases dedicated to this problem were selected. Urinary system iatrogenic injuries include ureter, bladder, urethra, and kidney traumas. It is widely thought that the main causes of such injuries are urological, obstetric, gynecological, and surgical operations on the retroperitoneal space, pelvis, or perineum. METHODS: The purpose of the study is to describe all aspects of the iatrogenic injure problem, under the established scheme and for each of the most damaged organs: the urethra, bladder, kidney, and ureter. The treatment of confirmed iatrogenic injuries largely depends on the period of its detection. Modern medical procedures provide conservative or minimally invasive treatment. An untimely diagnosis worsens the treatment prognosis. "Overlooked" urinary system trauma is a serious threat to society and a particular patient. Thus, incorrect or traumatic catheterization can lead to infection (RR 95%) and urethral stricture (RR ≥11-36%), and percutaneous puncture nephrostomy can cause the risk of functional renal parenchyma loss (median 5%), urinary congestion (7%), or sepsis (0.6-1.5%). RESULTS: Lost gain, profits, long-term and expensive, possibly multistage treatment, stress and depression, and the risks of suicide put a heavy financial, moral, and ethical burden on a person and society. Also, iatrogenic injury might have legal consequences. DISCUSSION/CONCLUSION: Thus, the significant problem of urinary tract iatrogenic injuries is still difficult to solve. There is a need to implement mandatory examining algorithms for patients at risk, as well as the multidisciplinary principle for all pelvic surgery.

Near-Field Mapping of Optical Fabry-Perot Modes in All-Dielectric Nanoantennas.

Subwavelength optical resonators and scatterers are dramatically expanding the toolset of the optical sciences and photonics engineering. By offering the opportunity to control and shape light waves in nanoscale volumes, recent developments using high-refractive-index dielectric scatterers gave rise to efficient flat-optical components such as lenses, polarizers, phase plates, color routers, and nonlinear elements with a subwavelength thickness. In this work, we take a deeper look into the unique interaction of light with rod-shaped amorphous silicon scatterers by tapping into their resonant modes with a localized subwavelength light source-an aperture scanning near-field probe. Our experimental configuration essentially constitutes a dielectric antenna that is locally driven by the aperture probe. We show how leaky transverse electric and magnetic modes can selectively be excited and form specific near-field distribution depending on wavelength and antenna dimensions. The probe's transmittance is furthermore enhanced upon coupling to the Fabry-Perot cavity modes, revealing all-dielectric nanorods as efficient transmitter antennas for the radiation of subwavelength emitters, in addition to constituting an elementary building block for all-dielectric metasurfaces and flat optics.

A multidisciplinary approach to urinary system iatrogenic injuries.

INTRODUCTION: Urinary system iatrogenic injuries appear because of urological, obstetric-gynecological, and surgical manipulations in the retroperitoneal space, pelvis, or perineum. The purpose of this research was to analyze and obtain knowledge about the issue of iatrogenic injuries, to apply injury prevention algorithms, and to assess multidisciplinary perspectives in modern surgery. MATERIAL AND METHODS: The research was interdisciplinary and consisted of several modules: a prospective, single-centre study of urinary system iatrogenic injuries (476 patients) along with four interregional and international procedural types of research. RESULTS: The analysis results indicate an extremely high significance of urinary system injuries evoking numerous negative consequences that are hard to eliminate. A comparative assessment of interdisciplinary interaction demonstrates the more effective interpretation of examination results, more comprehensive and credible clinical diagnosis, more qualitative evaluation of a patient's condition, more effective choice of initial treatment policy, and more satisfactory treatment in patients' opinion. The research allowed for the identification of a typical procedural mistake in the urethral catheter setting causing a high risk of urethra injuries followed by urethra strictures or consecutive infections of the urinary tract. CONCLUSIONS: More complicated treatment procedures cause a higher probability of urinary system iatrogenic injuries. The absence of unified algorithms and typical procedural mistakes cause such incidents. A partial solution to this issue could be found in a more profound interdisciplinary interaction in all treatment phases as well as in identifying and eliminating procedural mistakes.

Advances in modern osteotomies around the knee : Report on the Association of Sports Traumatology, Arthroscopy, Orthopaedic surgery, Rehabilitation (ASTAOR) Moscow International Osteotomy Congress 2017.

Corrective lower limb osteotomies are innovative and efficient therapeutic procedures for restoring axial alignment and managing unicompartmental knee osteoarthritis. This review presents critical insights into the up-dated clinical knowledge on osteotomies for complex posttraumatic or congenital lower limb deformities with a focus on high tibial osteotomies, including a comprehensive overview of basic principles of osteotomy planning, biomechanical considerations of different implants for osteotomies and insights in specific bone deformity correction techniques. Emphasis is placed on complex cases of lower limb osteotomies associated with ligament and multiaxial instability including pediatric cases, computer-assisted navigation, external fixation for long bone deformity correction and return to sport after such osteotomies. Altogether, these advances in the experimental and clinical knowledge of complex lower limb osteotomies allow generating improved, adapted therapeutic regimens to treat congenital and acquired lower limb deformities.

The impact of fetal load of Hirudo verbana saline extract antigens on morphometrical, hematological and immunological parameters of rats in the early stages of post-embryonic development

The aim of the study was to determine the immunostimulatory effect of antigens from saline extract of the medicinal leech on the morphometric parameters of the body and major immunogenic organs of rats. Wild-type female rats were administered medicinal leech saline extract antigens intraperitoneally two weeks before and two weeks after mating (in total four injections). The offspring were examined, as were the mothers after feeding the offspring, at 1, 15, 30, 60 days after birth. The morphometric parameters of the animals were recorded. The animals were then decapitated under anesthesia and subjected to the following tests: morphometric parameters of immunogenic organs (spleen and thymus), total white blood cell count, red blood cell count, hemoglobin, color index and leukocyte formula. In addition, the absorption activity of neutrophils was examined: phagocyte index, phagocyte number, phagocytic capacity of the blood, the number of active phagocytes. From day 1, the medicinal leech antigens were associated with increased numbers of white blood cells and red blood cells, elevated hemoglobin level, increased absorption activity of neutrophils; however, the colour index remained in the normal range. These changes indicate that the antigens found in the saliva of medicinal leeches have an immune-stimulating influence on leucopoiesis, erythropoiesis and morphogenesis.

Effect of medicinal leeches' antigens on the proliferative response of human blood mononuclear cells and cytokine production in vitro.

UNLABELLED: The purpose of research is to study the influence of plant mitogens and antigens of the water-salt extract from the bodies of Hirudo verbana, H. medicinalis, H. orientalis on the reaction of lymphocyte blast-transformation and the synthesis of pro-inflammatory cytokines (IL-1ß, IL-8, TNF-α) in patients' cell culture supernatants before and after hirudotherapy. RESEARCH METHODS: the reaction of lymphocyte blast-transformation; the determination of proinflammatory cytokines by ELISA. After hirudotherapy increased values of the reaction of lymphocyte blasttransformation have got bigger in all stimulated types of cell culture, but reactivity on medicinal leeches antigens proceeded to unproductive immunogenesis (apoptosis and necrosis). In supernatants of mitogen- and antigen-stimulated lymphocyte cultures induced high levels of pro-inflammatory cytokines after hirudotherapy have decreased adequately to apoptotic induction of lymphocytes by medicinal leeches' antigens.

Basic morphofunctional features of pharmaceutic leech (Hirudo verbana Carena, 1820) tissues in various forms of response after hirudotherapeutic procedures.

It is analyzed morphofunctional features of Hirudo verbana tissues on histological sections in order to determine the possible causes of their partial death after hirudotherapeutic procedure. In the study was taken 4 groups of leeches: hungry (control), healthy well-fed, well-fed that vomited blood and well-fed dead. Morphofunctional changes in midgut of healthy well-fed H. verbana compared to the hungry are the changes of epithelium height through stretching eaten blood. In well-fed that vomited blood and well-fed dead leeches in the intestinal epithelium were observed degenerative processes that are accompanied by a decrease in the height of the epithelium, its partial desquamation. Botryoidal tissue of hungry leeches is in an inactive state, in healthy well-fed ones it responds with an increased physiological vascularization, activation of some botryoidal granulocytes with an increase in their average size, on receipt of the products of digestion. Activation of some botryoidal granulocytes, without a significant increase in their sizes, in well-fed leeches that vomited eaten blood and well-fed dead leeches, with increased infiltration of the adjacent connective tissue lymphocyte- and macrophage-like cells, amebocytes and granulocytes indicates the development of pathological processes, which are resulting in immunological conflict between eaten human blood and leeches' tissue microenvironment.