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Aim. To study the species composition and abundance of anthophilic Hymenopteran insects in the sunflower agrocenosis and the role of its flowers in maintaining biodiversity in the agrocenoses of the Krasnodar Territory. Material and Methods. The studies were conducted during the sunflower growing season in the Krasnodar Territory from 2017 to 2022 in the Kanevsky, Krasnoarmeysky, Krylovsky, Labinsky, Ust‐Labinsky, Tbilisi and Temryuk districts.Results. In sunflower agrocenoses, 53 species of stinging hymenopteran insects from 10 families are found. For each research area, there is an individual insect fauna, which is characteristic of the agrocenosis and actively visits sunflower flowers. The fauna of each district includes mass species, common and rare, most of which are not interested in sunflower flowers, using other resources. The main visitors of sunflower inflorescences are bumblebees, which in a range of circumstances may visit flowers. Most wasp species are casual visitors to sunflower flowers.Conclusion. Most widely represented in the sunflower agrocenosis are insects of the families Halictidae, Andrenidae, Megachilidae, Apidae. In each research area, there are individual situations when common insect species either visit sunflower flowers or completely ignore them. Combining information on all areas, we observe that in the case of certain local conditions, almost all representatives of the fauna can feed on sunflowers, but it is not the principal resources, only complementing the wild flora.

The OBJECTIVE of the study was to identify factors independently influencing intolerance to early enteral feeding via a nasogastric and nasojejunal tube in patients during the early phase of severe acute pancreatitis.METHODS AND MATERIALS. An open, randomized, controlled, cohort study was carried out. Out of 64 patients with predictors of severe acute pancreatitis, a cohort with severe form was isolated, in which 16 patients received nasogastric and 15 patients – nasojejunal feeding. The enteral feeding intolerance criteria were: discharge via the nasogastric tube >500ml at a time or >500ml/day compared to total enteral feeding administered during 24 hours, intensified pain syndrome, abdominal distension, diarrhea, nausea and vomiting. Indicators featuring prognostic significance were identified using the logistic regression technique. The null hypothesis was rejected at p

RELEVANCE Early enteral nutrition is an essential element of intensive care for acute pancreatitis. Its intolerance is manifested by high gastric residual volumes, pain syndrome, bloating, diarrhea, nausea and vomiting. The relevance of our study is determined by the lack of information on how the routes of nutrient delivery affect its tolerability considering the gradual «as­per­protocol» increase in nutrition volumes for patients with moderately severe acute pancreatitis.THE AIM OF THE STUDY Was to identify the key factors that determine intolerance to early nasogastric and nasojejunal enteral feeding in ICU patients with the early phase of moderately severe acute pancreatitis.MATERIAL AND METHODS We conducted an open randomized controlled trial. Out of 64 patients with predicted severe course of acute pancreatitis, we identified a cohort with moderately severe acute pancreatitis, in which 17 (51.5%) patients received early enteral nutrition through a nasogastric tube, and 16 (48.5%) via an endoscopically placed nasojejunal tube. The criteria for nutrition intolerance were as follows: nasogastric tube discharge of more than 500±100 ml at a time or more than 500 ml/day in comparison with the enterally administered during this period, increased pain, bloating, diarrhea, nausea and vomiting. Using the method of logistic regression, indicators with prognostic significance were determined. The null hypothesis was rejected at p

Enteral nutrition in the early phase of predicted severe acute pancreatitis can be administered via a nasogastric or nasojejunal tube. Finding the most effective method in terms of daily balance, the volume of feeding and residual gastric volume in the early period of moderate and severe acute pancreatitis is a current challenge.The aim of the study was to estimate the efficacy of nasogastric and nasojejunal early enteral feeding duringthe early phase of predicted severe acute pancreatitis.Material and methods. The study was prospective, single-center, and randomized. The data were collected from November 2012 to October 2018. The study included 64 ICU patients in the early period of acute pancreatitis exhibiting predictors of severity. During randomization, the patients were assigned to either nasogastric (group 1) or nasojejunal (group 2) feeding for the next four days. The volume of enteral feeding on Day 1 was 250 ml/day, and on each successive day it was increased by 250 ml/day. During group allocation, the disease severity and the way of nutrient administration were taken into account. Daily balance was calculated using the difference between enterally administered and residual gastric volume. Statistical analysis was performed using SPSS v.23 software package. The null hypothesis was rejected at P0.05.Results. The volume of enteral nutrition administered over 4 days did not differ between the study groups. Patients with severe acute pancreatitis had significantly better nutrient absorption over 4 days when the postpyloric route was used (1.63±0.98 l/d) vs the nasogastric one (0.55±0.29 l/d) (P=0.001). In moderate pancreatitis, the enteral nutrition absorption over 4 days did not differ (P=0.107) between the groups with nasogastric (2.06±0.87 l/day) and nasojejunal (2.6±0.45 l/day) feeding.Conclusion. Nasojejunal route is the preferred way to start enteral feeding in patients with severe acute pancreatitis. In moderate acute pancreatitis, feeding can be initiated via the gastric route and only in case of intolerance it should be switched to the nasojejunal one.

Background. Bladder cancer is one of the most common cancers. Non-muscle-invasive bladder cancer is characterized by the high frequency of recurrence after radical treatment (up to 50–60 %), and muscle-invasive bladder cancer has a lower recurrence rate (30 %). Primary metastatic bladder cancer (Bc) is detected in 10–15 % of cases. transurethral resection of the bladder is the main treatment modality for non-muscleinvasive Bc. For muscle-invasive Bc, radical cystectomy is the curative treatment of choice. chemotherapy is used for the treatment of metastatic Bc. the role of surgery for metastatic Bc has not yet been determined. there are only a few reports regarding multimodality treatment including metastasectomy for metastatic Bc. Case description. We present a clinical case of successful treatment of metastatic Bc, we used surgery, radiotherapy, chemotherapy and x-ray endovascular technologies. the patient is alive with no evidence of disease. Conclusion. Our findings are consistent with other reports which indicate that the removal of metastases in patients with advanced urothelial carcinoma is technically feasible and can be safely performed. Metastasectomy can have a positive effect on survival. However, metastasectomy remains the subject of clinical studies, and should be recommended only for patients a good response to systemic therapy.

The treatment of cicatrical stenosis of the trachea was performed in 193 patients at the age 8–65 years (132 of men and 61 women). The length of cicatrical stenosis shaped mainly by growth of granulation tissue and its different combinations consisted of 0,5 to 2,5 cm, getting 3,0 cm and more in 74 cases. The peculiar features of such cicatrical changes were characterized differently depending on its dominating localization on the length of the trachea — in the area of the neck or in the range of the mediastinum. Respiratory distresses, which were the main clinical manifestation of the disease, depended on the degree of stenisis of the trachea opening with the cicatrical process in each case. The decrease of size of the trachea opening with respect to natural size on1/3 was considered as the first degree of stenosis, on2/3 — II degree, more than on2/3 — III degree. The efficiency of endoscopic methods of treatment was the most significant in cicatrical stenosis of trachea with the length not more than 0,5–1,5 сm and dramatically decreased with the increase of length. The cicatrical stenosis of trachea with the length more than 3,5–3,0 сm should be considered as the indication for radical surgical intervention such as resection and plasty of trachea with forming of intertracheal or laryngotracheal anastomosis.