Presents an analysis of outpatient and inpatient medical records of patients delivered in infectious hospital № 4 of Ufa with suspected acute intestinal infection and transferred after clinical laboratory examination or from admissions for emergency indications, either from the intestinal-diagnostic unit after the establishment of the non-core nature of the disease in other hospitals. The most informative clinical symptoms and of anamnestic data in the differential diagnosis of acute intestinal infections, acute surgical diseases of abdominal organs (acute appendicitis, intestinal obstruction, cholecystitis and cholelithiasis, incarcerated hernia, diverticular disease, peritonitis, pancreatic necrosis), tumors of the intestine and thrombosis of the mesenteric vessels. In the differential diagnosis of a large circle of non-core diseases were used the results of additional research: the General analysis of blood and urine, capriform, bacteriological and enzyme immunoassay of faeces and vomit on pathogenic and conditionally pathogenic enterobacteria, rotaviruses, as well as the ultrasound and radiography of the abdomen, sigmoidoscopy. 

In clause results endovascular methods of treatment of 70 patients with tumoral defeats of a liver of men 47 (67,1 %), women 23 (32,9 %), from them are presented: a primary cancer of a liver 42 (60 %) cases, metastatic defeats of a liver 28 (40 %). Chemo-infusions a hepatic artery it is executed at 50 patients, from them at a primary cancer of a liver at 32 (45,7 %) by patients, at metastatic defeats of a liver at 18 (25,7 %) patients. At 20 patients it is lead chemo-embolisations a hepatic artery, from them at a primary cancer of a liver 10 (17,1 %) by patients, at metastatic defeats of a liver 8 (11,4 %) patients. Data obtained by us have shown efficiency chemo-infusions a hepatic artery at a primary cancer of a liver at 19 (45,2 %) to patients with high quality of a life that enables wider application of a technique for rendering special treatment of this complex category of patients. Results chemo-embolisations a hepatic artery at a primary cancer of a liver also encourage, as after 1 procedure gives stabilization of process and improves quality of a life of patients. 

Computed tomography (CT) is the main tool in the radiation diagnosis of organs, systems and their diseases, which allows obtaining the most accurate representation of the anatomical and functional state of the kidney. Also CT scans have been used in the diagnosis of transplanted kidneys, especially in cases where it is necessary to have accurate information about the viability of the transplanted organ. The article presents visualizing abilities of computed tomography, own experience of its application in patients after kidney transplantation, including in patients receiving renal replacement therapy. The research was carried out taking into account «clinical recommendations for the prevention, diagnosis and treatment of contrast-induced nephropathy» of the Scientific Society of Nephrologists of Russia and the Association of Nephrologists of Russia, and recommendations KDIGO (Kidney Disease Improving Global Outcomes an initiative to improve global outcomes of kidney disease) This article considers the relevance of the use of CT in the clinical practice of examining patients after kidney transplantation. 

Elective or emergence surgery often is closely connected with development of hypercatabolism-hypermetabolism syndrome. Non-effective and late nutritional support in surgical critically ill patients lead to several consequences and complications such as: wound and nosocomial infectons, gastric stress ulcers, pressure ulcers, prolonged artificial lung ventilation, increased length of stay in ICU and hospital. Energy deficit is one of the important components of critical illness and it corresponds with multiple organ dysfunction progression. Prospective study was provided in 18 beds surgical intensive care unit (SICU). 106 patient medical cards were divided into 4 groupstwo control and two basic with espiratory support (subgroup with artificial lung ventilation and subgroup without artificial lung ventilation). We compared the effectiviness of two methods for the estimation of patients energy needsspecial equations and indirect calorimetry. As a result we found out that main markers of energy and protein metabolism and nutritive status were significantly higher in indirect calorimetry groupswith and without artificial lung ventilation. Conclusion: Indirect calorimetry method usage for the estimation of energy needs in surgical ICU patients is more effective than special equations method during first 7 days of critical illness and may be recommended for clinical practice implication. 

Prostate cancer prevalence is in fourth place in the overall structure of tumors and in second place among malignant diseases in older men. The cancer detection rate of preventive inspections using traditional research methods remains very low, and the timeliness of early diagnosis of tumors of the prostate gland determine the modern methods of X-ray imaging. The aim of this study was to estimate the role of computed tomography as a method of Xray imaging, in identifying the various prostate neoplasia with specification of semiotics, diagnostic criteria of various tumors. Research conducted at multispiral 128-slice CT scanner OPTIMA 660 produced by General Electric (United States). The study involved 66 patients aged 38-79 years with various diseases of the prostate. The fact of referral to the computed tomography was preceded by a primary appointment at urology specialist followed by rectal finger study positive or dubious reaction to prostate specific antigen, by transrectal ultrasound. The study showed that CT is not a universal method of diagnosis, excluding other imaging techniques, especially multiparametric magnetic resonance imaging. But that method has a number of incontestable advantages that allow to remain indispensable in the algorithm integrated diagnostic approach. First of all, it is an extensive long area of scanning combined with small thickness of the layer to be allocated. And, in the case of some phase strengthening of the gland tissues the technique, in some cases, allows to trace a malignant neoplastic process. But in general, its differential diagnosis with benign regeneration nodes in the gland tissue is usually difficult and requires further modification. 

The most effective method of early diagnosis of tumors of mammary glands is selfcontrol. To develop practical recommendations for self-monitoring of the breast in everyday life the study included the analysis of scientific and patent literature, original technical solutions, with an assessment of their strengths and weaknesses. It is shown that for selfcontrol of the breast in everyday life the most suitable way is to monitor the color range of the infrared image of the breast using a thermal imager during and after air blowing air with a hair dryer in a room temperature. Principle of the method is based on the fact that tumors violate uniformity of structure of tissues, their thermal conductivity and/or heat. For examples the study reviewed clinical cases of self-control of the mammary glands in patients with breast tumor and without cancer. Identified steadiness of change in local temperature and color images of breast tissue allows to confirm the absence of lesions and the presence of a zone of unevenness and asymmetry of the local temperature and color images to diagnose a modified thermal conductivity or heat tissue glands and assume the presence of neoplasm in its projection. Thus, for domestic self-control of mammary glands it is advised to monitor the colour range of infrared thermal images on the screen during and after air blowing. When it is assumed that monocolor gland is indicative of the homogeneity of its structure, and multi-colored image of the gland suggests the presence of tumors. 

The emergence of neuronavigational systems, ultrasonic modules resulted in a new neurosurgery type i.e. cranial image guided surgery, which involves precise verification of borders of the pathological formation, size, regional swelling degree of vascularization of neoplasms and differentiation of feeding arteries and draining veins. The main purpose of this work is to comparatively characterize intraoperative ultrasonography machines capacity of the previous generation B-k medical Falcon 2101 EXL (2003) and Bk medical (2017) 5000 (Denmark) in surgery of brain tumors. The study was conducted on 22 patients with intracranial neoplasms, operated on the basis of the neurosurgical Department of the Republican Clinical Hospital named after G.G. Kuvatov (city of Ufa) The study found that the use of ultrasonic scanner Bk medical 5000 allowed to more accurately visualize the tumor location, which greatly facilitated the task of the surgeon in choosing optimal access to the neoplasm, especially when using convex mini sensor through the trephine opening. Highly detailed normal brain tissue, blood vessels, tumors and zone of regional edema helped determine the optimal operational size, which has reduced the time of surgical manipulation. Using ULTRASONIC module Bk medical5000 inthe mode of intraoperative sonography enables to assess the degree of invasion of the tumor into the lumen of the venous sinus and the nature of collateral blood flow that will determine the level of safe resection of sinus. Using intraoperative ultrasonography after visual removal of diffusely growing tumors there was a good vizualization of residual tumor tissue, which later was removed under ULTRASOUND control Bk medical 5000. Elastography mode in malignant brain tumors enabled to intraoperatively assess the degree of malignancy as well as determine the radicalness of its removal. Implementing into practice the mobile ULTRASOUND module Bk medical 5000 will significantly improve the quality of specialized high-tech patient care in all areas of urgent and selective neurosurgery, reducing the risk of post-operative complications, thereby reducing time limits for patients to stay in hospital. 

To study the dependence of the wound infection rate after cesarean section and the level of postoperative intra-abdominal pressure (IAP) in obese patients. A study was conducted, involving 313 patients delivered by cesarean section. All patients were divided into 4 groups: control group 90, with degree I obesity 137, with II 49 and III 37 patients. The frequency of development of wound postoperative complications was determined, bacteriological studies of amniotic fluid, placenta, lousy and discharge wound of the anterior abdominal wall were carried out. Postoperative dynamics of IAP was investigated. IAP research was carried out using vesical indirect method. Wound postoperative complications were diagnosed in 17,9% of the puerperas, 8,6% of them had a discrepancy and suppuration of the sutures in the anterior abdominal wall. The incidence of wound complications increased with increasing severity of obesity. In patients with severe obesity, in the sowing of septic purulent wounds, microorganisms of the genus Escherichia coli, Enterococcus spp. prevailed. Analysis of postoperative dynamics of IAP showed that in obese patients its values exceeded those in the control group at all stages of the study. The correlation analysis showed the presence of a positive average force of communication between the postoperative intestinal paresis and the development of wound infection, r = 0,500 (p < 0,01). The relationship between wound infection and postoperative dynamics of IAP was approaching a strong-r ratio of 0,654 (p<0,001). Representatives of the intestinal microbioma are leading in patients with obesity in infection of the postoperative wound. In the contamination of the intestinal microflora, intra-abdominal hypertension (IAH) is one of the main triggers. Long-term persistent IAH in the postoperative period is a significant risk factor for the development of postoperative infectious complications.

Peritoneal commissures is the phenomenon of adhesions formation with apparent symptom group of violations in functioning of the gastrointestinal tract and small pelvis. Unlike other postoperative complications adhesive disease is characterized by high risk for life manifestations in the form of intestinal obstruction, infertility and chronic pain. It is known that in the process of restoring the integrity of the peritoneum the decisive role is given to makrophages, peritoneal immune system, processes of angiogenesis, increasing fibroblasts and collagen production. However, the biochemical processes taking place in the intercellular matrix of connective tissue, particularly, the exchange of glycosaminoglycans in the formation of peritoneal adhesions have not been studied. In this context, the main objective of this work was to study levels of glycosaminoglycans of the blood in the development of adhesive disease and justification of the use of indicators to exchange connective tissue as additional prognostic criteria for the development of postoperative adhesions. An open prospective randomized trial analyzed the data of 67 patients that were admitted for the planned reconstructive surgery on the anterior abdominal wall to eliminate postoperative ventral hernia, at the surgery department of State Clinical Hospital No. 8, city ofUFAduring the period of 2005-2008. The severity of adhesions was assessed and contrasted to the results of determination of glycosaminoglycans in blood serum. The total content of glycosaminoglycans, hyaluronic acid, chondroitin sulfates and heparan sulfates was determined. Postoperative monitoring stages of the studied indicators -3, 5 and 7 day after herniotomy. The group of patients with adhesive peritoneum desease showed total content of glycosaminoglycans by 19.2% (p < 0.0001) higher than reference values. It should be noted that there was continuous growth of all factions of glycosaminoglycans during all seven days of the postoperative monitoring. The growth of the overall content of the glycosaminoglycans made 261% (p < 0.0001) compared with the control group. Method of ROC-analysis established that the area under the ROC curve is a common glycosaminoglycans is equal 0.824 ± 0.055, 95% confidence interval-0.906 0.711. Sensitivity-70.4% (54.8 -86.0), specificity is 97.5% (82.4 -98.6). The optimum point for the division amounted to 30 μmol/l. Positive predicting level amounted to 96.8%, negative 75.1%. Thus, the assessment of the level of glycosaminoglycans can serve as an additional prognostic test to diagnose disturbance in intercellular matrix that can be used in the diagnosis of commissural process and in monitoring the effectiveness of preventive measures. 

Free radicals have taken a firm place among the explanatory principles of the onset and development of tumors. Unambiguous ideas about the role of these highly active agents in carcinogenesis have not yet been obtained. The experimental results are contradictory, often the opposite. The field of study of the value of the activity of antioxidant systems based on the results obtained is no less controversial. In this regard, the urgent problem is the need to prescribe antioxidants in oncology. Antitumor effects of antioxidants are being questioned in many works, which brings to the forefront the appropriateness and adequacy of their appointment. The ambiguous role of free radicals in carcinogenesis determines the development of therapeutic strategies based on the precise modulation of oxidative processes.

Artery aneurysms of pool celiac trunk and superior mesenteric artery are not often in clinical practice. Often, the first clinical manifestation of the aneurysm is a hemorrhagic shock which proceed from its rupture. The risk of aneurysm rupture doesn’t depend on their size, ranging from 3% to 10%. But the mortality from aneurysm rupture can be reaches 36%. As we know well that the aneurysm ruptures has a high rate of mortality, treatment as symptomatic as asymptomatic aneurysms are essential. The authors of the article represent the demonstration of successful endovascular treatment of aneurysms splenic artery and posttraumatic aneurysm of common hepatic artery using modern embolization materials. In the first case performed embolization of lumen aneurysm by embolization coil with next installation in the lumen of the artery stent graft, in the second case – the feeding artery was embolized by microemboles. Nowadays, the medical instruments for X – ray surgical interventions allow you to perform a complete embolization of pathological structures such as aneurysms of the main arteries of the celiac trunk. Thanks to low level of interventions endovascular therapies can be related to the method of choice in the treatment of many surgical diseases in compulsory with the open methods of operation.

Iatrogenic dissection of the coronary arteries is a rare, but life-threatening complication of Interventional surgery. There are almost complete descriptions of the main causes of risk groups, clinical and angiographic characteristics of coronary arteries dissections. However, the available literature does not have significant studies clearly regulating further tactics to resolve this condition. Traditionally, the selection methods are: coronary artery bypass surgery, endovascular stenting of dissection defect of arteries and, in rare cases, conservative treatment. In this paper we present a clinical case of iatrogenic non occlusal dissection of coronary artery during planned selective coronary angiography, which developed acute occlusion of the mouth of the anterior descending artery. Stent thrombosis was diagnosed 30 minutes after balloon angioplasty with stenting front descending artery. It was followed by balloon angioplasty of the stented segment and stenting of the proximal segment of the anterior descending artery. The control selective coronary angiography diagnosed dissection of the anterior descending artery, implantation of coronary graph-stent was performed. There is a retrospective analysis of complications received and a review of the literature on this topic. The findings show that under conditions of iatrogenic dissection of coronary artery the immediate stenting seems a reasonable and feasible treatment option with acceptable delayed results. But, of course, first one should pay attention to the technical aspects and materiel of the coronary interventions that will reduce the risks of any diagnostic or interventional procedure.