Search

Background. Acute pancreatitis is an inflammatory disease of the exocrine part of the pancreas, accompanied by various complications and further development of necrosis of the gland and parapancreatic tissue with possible secondary infection. The study of experimental models shows that the acinar cells surrounding the islets of Langerhans remain relatively intact, indicating that endogenous insulin is a protective factor for the pancreatic parenchyma. The purpose of the study was to determine the dependence of endogenous insulin levels on the extent of pancreatic parenchymal damage. Materials and methods. Prospective analysis of endogenous insulin levels in 51 patients with acute pancreatitis. Results. Comparison of the mean values of endogenous insulin revealed that in patients with necrotizing pancreatitis, the median value was statistically significantly lower than in patients without pancreatic necrosis (p

Abstract There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p

Background. Acute pancreatitis is an aseptic inflammation of the pancreas with diverse complications and further development of necrosis of the gland, parapancreatic tissue and possible addition of secondary infection. A significant number of biochemical markers that can be predictors of pancreatitis complications are still being researched. However, most of them are expensive and their indicators are increased only in the first 24–48 hours after the onset of the disease, so they are not used in daily clinical routine. The purpose of this study is to evaluate the factors that indicate an elevated risk of necrosis in acute severe pancreatitis. Materials and methods. A retrospective analysis of 80 patients with acute pancreatitis was performed via creation of a multivariate logistic regression model. Results. The dependence of the risk of pancreatic necrosis on the following factor signs was found: lipase at the onset of the disease (cut-off value = 599.6 U/l, area under the receiver operating characteristic curve (АUС) = 0.72 (95% confidence interval (СІ) 0.57–0.88)), severity of the disease, fibrinogen on day 3 of the disease (cut-off value = 9.7, АUС = 0.65 (95% СІ 0.48–0.81)), C-reactive protein (cut-off value = 175.7 mg/L, AUC = 0.70 (95% CI 0.54–0.86)), and intra-abdominal mean capillary perfusion pressure on the first day of the disease (cut-off value ≤ 63.3 mm Hg, АUС = 0.88 (95% СІ 0.77–0.99)). The autopsy results revealed the presence of necrosis and microthrombosis of the pancreas. Conclusions. Factors that may indicate an increased risk of pancreatic necrosis were high levels of lipase, fibrinogen on the third day of the disease, C-reactive protein, decreased intra-abdominal mean capillary perfusion pressure, severity of the disease, and the presence of portosplenomesentric thrombosis.

Aim: to present the principles of functioning of the regional registry of inflammatory bowel disease (IBD) patients in Saint Petersburg on the basis of the City Health Information System (Saint Petersburg IBD Registry).Key points. The Saint Petersburg IBD Registry consists of General Statistical Module and Clinical Module. The General Statistical Module is intended to analyze the prevalence of ulcerative colitis and Crohn's disease, the number of patient visits to medical institutions; to assess the burden on the healthcare system, demographic characteristics, routing and mortality for the whole region. The Clinical Module allows to assess the IBD features in prospective observation. The register case report form is integrated into the patient's status in the Medical Information System of the medical institution. Saint Petersburg IBD Registry operates on the basis of the Saint Petersburg Medical Center of Information and Analysis within the framework of the Regional Medical Data Collection System of the Russian state information system “Regional Fragment of the Unified State Information System in the Healthcare Branch”. The accumulation of prospective data in the Clinical Module continues, which in the near future will make it possible to test and configure the automated analytical block of the registry.Conclusion. The functioning of the Saint Petersburg IBD Registry allows to achieve following primary goals within region: assessment of the epidemiological features of IBD in Saint Petersburg; dynamic assessment of the disease features; assessment and planning of health care resources required to provide care to IBD patients; improvement of approaches to the treatment taking into account the specifics of the region; assessment of the effectiveness and tolerability of specific treatment including biologics.

У статті, відповідно до положень Криміналь­ного процесуального кодексу України, розкри­вається зміст належності доказів як чинника, що має обов'язково враховуватися під час оцінки доказів у кримінальному провадженні. Вказано на співвідношення належності доказів із деяки­ми правовими категоріями інституту доказуван­ня. Висунуто пропозиції, які можуть стати в на­годі під час удосконалення понятійного апарату теорії доказів та положень чинного законодав­ства. Актуальність публікації обумовлена потребою удосконалення процесу доказування під час досудового розслідування та судового розгляду, вироблення ефективних механізмів успішного виконання завдань кримінального проваджен­ня, які визначено у ст. 2 КПК України. Метою підготовки статті було розкриття ос­новних питань правової природи належності доказів, відповідно до визначення, наданого у ст. 85 КПК України. Передумовами до форму­вання вказаної мети стали сучасні проблеми, які виникають під час досудового розслідування у кримінальних провадженнях. Під час підготовки публікації використано загальнонаукові та спеціальні методи наукового пізнання. Так із загальнонаукових методів засто­совано, зокрема, системно-структурний метод, метод функціонального аналізу, із спеціальних - формально-юридичний, логіко-процесуальний методи, метод порівняльного правознавства. Проаналізовано основні законодавчі норми, які стосуються тематики публікації. У статті доводиться, що удосконалення по­нятійного апарату, правильне формулюван­ня правових ознак доказів через призму норм міжнародних конвенцій сприятиме доверше­ності процесуального закону та забезпечить уніфікований підхід до належного дотриман­ня прав, свобод і законних інтересів учасників кримінального провадження. При цьому авто­рами враховувалося, що вимоги про належність доказів не набули в законодавстві імперативно­го характеру, а тому вони вирішуються індиві­дуально слідчим, прокурором та судом у кож­ному окремому випадку. Пізнання обставин, які підлягають доказуванню у кримінальному про­вадженні є метою доказування, а належність є ознакою, яка не лише характеризує докази, а й виступає засобом досягнення означеної мети.

Many common illnesses, for reasons that have not been identified, differentially affect men and women. For instance, the autoimmune diseases systemic lupus erythematosus (SLE) and Sjögren's syndrome affect nine times more women than men1, whereas schizophrenia affects men with greater frequency and severity relative to women2. All three illnesses have their strongest common genetic associations in the major histocompatibility complex (MHC) locus, an association that in SLE and Sjögren's syndrome has long been thought to arise from alleles of the human leukocyte antigen (HLA) genes at that locus3-6. Here we show that variation of the complement component 4 (C4) genes C4A and C4B, which are also at the MHC locus and have been linked to increased risk for schizophrenia7, generates 7-fold variation in risk for SLE and 16-fold variation in risk for Sjögren's syndrome among individuals with common C4 genotypes, with C4A protecting more strongly than C4B in both illnesses. The same alleles that increase risk for schizophrenia greatly reduce risk for SLE and Sjögren's syndrome. In all three illnesses, C4 alleles act more strongly in men than in women: common combinations of C4A and C4B generated 14-fold variation in risk for SLE, 31-fold variation in risk for Sjögren's syndrome, and 1.7-fold variation in schizophrenia risk among men (versus 6-fold, 15-fold and 1.26-fold variation in risk among women, respectively). At a protein level, both C4 and its effector C3 were present at higher levels in cerebrospinal fluid and plasma8,9 in men than in women among adults aged between 20 and 50 years, corresponding to the ages of differential disease vulnerability. Sex differences in complement protein levels may help to explain the more potent effects of C4 alleles in men, women's greater risk of SLE and Sjögren's syndrome and men's greater vulnerability to schizophrenia. These results implicate the complement system as a source of sexual dimorphism in vulnerability to diverse illnesses.

PURPOSE. Development of a laboratory unit for a compressed air energy storage and calculation of its operating modes using Aspen HYSYS and ANSYS software packages.METHODS. The authors have developed an experimental unit of a compressed air energy storage and calculation with a capacity of 1 kW. The principle of operation of the unit consists in pumping compressed air into the receiver by a compressor, followed by the release of air from the receiver into the expander of the original design, which generates electrical energy. RESULTS. During the development of the prototype, 4 gears were made of various structural materials: AISI 304 stainless steel, LS59-1 brass and POM-S polyacetal. During assembly, lapping and running-in, it was found experimentally that the optimal solution in terms of antifriction characteristics, strength and longer service life is the use of gears made of polyacetal. To simulate the operating modes of the laboratory stand, a model was compiled in the Aspen HYSYS software package. The need for a dynamic model arose to simulate the process of unloading the receiver. A graph of the change in air flow at the inlet to the expander depending on the position of the control valve is presented.CONCLUSION. The advantages of using CAES as a method of accumulating electrical energy include high maneuverability and operation in wide ranges of temperature and pressure, which makes such power plants cheaper and more durable. The CAES accumulates energy in the form of compressed air, which then goes to generate electricity during peak loads.

Мета - визначити оптимізовану систему передопераційної підготовки пацієнток з артеріальною (АГ) та легеневою гіпертензію (ЛГ). Матеріали та методи. Обстежено 35 пацієнток. Підготовлено до оперативного лікування 25 (71,4%) пацієнток з АГ, із них 19 (54,3%) жінкам проведено планові операції, а 6 (17,1%) - оперативне втручання в ургентному порядку. Також підготовлено до операції 10 (28,6%) пацієнток із ЛГ, оперативне втручання яким виконано в плановому порядку. Пацієнти, яким виконано планові операції, обстежені згідно зі стандартами медичної установи, враховуючи протоколи Європейської асоціації кардіологів (ESC) від 2022 р. Результати. Встановлено, що АГ I стадії діагностовано в 15 (42,9%) пацієнток, а II стадії - у 10 (28,6%) жінок; ЛГ I стадії - у 7 (20%) хворих, а II стадії - у 3 (8,6%) жінок. При підготовці пацієнтів до оперативного втручання ретельно підібрано медикаментозну терапію АГ, яка впливала на різні ланки патогенезу захворювання. У пацієнтів з ЛГ, яким заплановано оперативне лікування, медикаментозну терапію в багатьох випадках чітко регламентовано та призначено відповідно до клінічних проявів захворювання і перебігу периопераційного періоду. У пацієнтів, яких прооперовано в плановому порядку з дотриманням розробленої схеми передопераційної підготовки, не виявлено ускладнень із боку серцевої-судинної системи. Показник артеріального тиску в більшості випадків був у межах вікової норми, відсутні випадки венозної тромбоемболії, а тяжкість серцевої недостатності не посилювалася. Висновки. Рекомендовано чітке дотримання схеми доопераційної підготовки, починаючи з догоспітального етапу обстеження та лікування пацієнтів з АГ та ЛГ. Визначення та дотримання оптимізованої схеми передопераційної підготовки показало свою ефективність, сприяло відсутності ускладнень із боку серцево-судинної системи, стабілізації артеріального тиску в периопераційному періоді, характеризувалося відсутністю випадків венозної тромбоeмболії, а тяжкість серцевої недостатності не посилювалася. Дослідження виконано відповідно до принципів Гельсінської декларації. Протокол дослідження ухвалено Локальним етичним комітетом зазначеної в роботі установи. На проведення досліджень отримано інформовану згоду пацієнток. Автори заявляють про відсутність конфлікту інтересів.

This article discusses methods of diagnosis and treatment of community-acquired pneumonia in children, focuses on the practical issues of etiology and symptoms of the disease.

Genome-wide association studies (GWASs) are highly effective at identifying common risk variants for schizophrenia. Rare risk variants are also important contributors to schizophrenia etiology but, with the exception of large copy number variants, are difficult to detect with GWAS. Exome and genome sequencing, which have accelerated the study of rare variants, are expensive so alternative methods are needed to aid detection of rare variants. Here we re-analyze an Irish schizophrenia GWAS dataset (n = 3,473) by performing identity-by-descent (IBD) mapping followed by exome sequencing of individuals identified as sharing risk haplotypes to search for rare risk variants in coding regions. We identified 45 rare haplotypes (>1 cM) that were significantly more common in cases than controls. By exome sequencing 105 haplotype carriers, we investigated these haplotypes for functional coding variants that could be tested for association in independent GWAS samples. We identified one rare missense variant in PCNT but did not find statistical support for an association with schizophrenia in a replication analysis. However, IBD mapping can prioritize both individual samples and genomic regions for follow-up analysis but genome rather than exome sequencing may be more effective at detecting risk variants on rare haplotypes.

The objective of this review is to optimize the use of antibiotic therapy for COVID-19 based on the published and our own data. The decision to prescribe antibiotic therapy in case of secondary bacterial pneumonia associated with SARS-CoV-2 should be based on a comprehensive assessment of the results of clinical, laboratory and instrumental examination including the elevated level of procalcitonin (more than 0,5 ng/ml).To achieve this objective, 48 publications were analyzed.

The topic of variability is one of the most demanded in the field of phraseology, since the interrelation of variability and stability is the essential characteristic of phraseological expressions as reproducible language expressions. The relevance of the research is the need to study the trends of phraseological changes, including new approaches to systematizing these changes, which requires the development of methods and techniques of analyzing different types of variability. The aim is to analyze the phenomenon of phraseological variation on the material of phraseological units with anthroponyms, identify types of variation of anthroponyms as parts of phraseological units, describe the traditional and occasional nature of changes and determine the boundaries between variations and autonomous units. With the help of analytic-descriptive method, semantic analysis of dictionary definitions, contextual analysis and corpus method, the role of anthroponymic component in the semantics and structure of phraseological units and the significance of this component variation for changing phraseological units and defining them as variants or autonomous units are characterized. The usual and occasional nature of variation is shown. The following types of variation of the component-anthroponym are identified and examined in detail: variation of forms (onym or its forms); lexical variation (onym/onym; onym/appellative; no lexical variation of onym); syntactic variation. The first type is represented by phonetic, word-formation, morphological, structural variation of the units. Lexical variation is manifested, as a rule, in the substitution of assonant names, including names with gender inversion. Syntactic variation associated with quantitative changes in onyms leads to figurative and structural-semantic changes, modification of the unit, its convergence with phraseological schemes. The analysis of the impact of certain changes in the anthroponymic component on the semantic identity of phraseological units allows to determine the status of phraseological units as variants or autonomous units. The study shows that the anthroponym within phraseological units of different types is a representative component in describing the phenomenon of phraseological variation. In the future, the types of variation of the anthroponym identified may classify the types of Russian phraseological units variation, as well as identify the specificity of variation of phraseological units in other languages.

У статті досліджено міжнародні засоби захисту прав і свобод людини та громадянина в Україні. Проаналізований український досвід підтверджує, що ступінь захисту прав і свобод людини в будь-якій державі сьогодні залежить не тільки від рівня й ефективності національної судової системи, а також від інтеграції в міжнародну систему захисту прав і свобод людини та громадянина. Україна бере активну участь у міжнародних відносинах, укладає договори, угоди та надалі ратифікує їх. У кожній державі, особливе місце у правовій системі займають міжнародні нормативні договори. Тому, такий принцип як імплементація в національну правову систему ратифікованих конвенцій та міжнародних договорів є однією із найважливіших засад захисту прав людини. Підкреслено, що проблема захисту прав людини та її основних свобод виходять далеко за межі однієї держави. Саме права людини нині є найпоширенішим чинником взаємодії національних правових систем, оскільки сприяють інтеграції загальносвітового й регіонального правового простору. Зазначено, що відповідно до Конституції України, функція захисту прав і свобод людини покладена на Президента України (як гаранта прав людини), Конституційний Суд України (головний судовий орган захисту прав громадян України) та Уповноваженого Верховної Ради з прав людини в Україні. У ст. 9 Конституції України визнається пріоритет принципів та норм міжнародного права та їх належність до правової системи України, гарантується кожному право на звернення до міжнародних органів захисту прав і свобод, якщо вичерпано всі наявні внутрішньодержавні засоби правового захисту. До механізмів універсального співробітництва та контролю належить насамперед ООН, однією з цілей діяльності якої є міжнародна співпраця задля розв’язання міжнародних проблем економічного, соціального, культурного та гуманітарного характеру, а також заохочення та розвиток поваги до прав людини й основних свобод усіх, незалежно від раси, статі, мови та релігії.

Стаття присвячена раку апендикса. Ця патологія зустрічається вкрай рідко. Частота раку червоподібного відростка становить 0,5% усіх форм раку товстого кишечника. Протягом останнього десятиліття спостерігається тенденція до зростання частоти такої форми раку товстого кишечника. За гістологічною класифікацією виділяють 7 форм зазначеної злоякісної патології: нейроендокринна пухлина, муцинозна цистаденома, муцинозна цистаденокарцинома, аденокарцинома товстої кишки, бокалоклітинний рак, перстнеподібноклітинна аденокарцинома, парагангліома. Мета - з огляду на рідкісність раку апендикулярного відростка навести клінічний випадок його лікування у відділенні оперативної гінекології ДУ «Інститут педіатрії, акушерства і гінекології імені академіка О.М. Лук’янової НАМН України» для формування настороженості лікарів щодо цієї патології. Висвітлено фактори ризику розвитку раку апендикулярного відростка. Детально описано клінічні прояви, діагностичні критерії та лікувальну тактику цього виду новоутворення товстого кишечника. Наведено дані 5-річної виживаності та прогнозу при такому виді онкологічної патології. Окремо детально висвітлено результати власного клінічного спостереження раку червоподібного відростка в пацієнтки. Дослідження виконано відповідно до принципів Гельсінської декларації. На проведення досліджень отримано інформовану згоду пацієнтки. Автори заявляють про відсутність конфлікту інтересів.

extrathyroidal invasion (ETI) of papillary thyroid cancer (PTC) is a risk factor for locoregional metastasis. The clinical significance of minimal ETI depending on the primary tumor size has not been studied thoroughly. The combination of tumor diameter and minimal ETI can be used as a reliable prognostic factor for persistence of the disease. Given that the identification of the minimal ETI is possible only during the final histopathological study, there is a need to assess the existing preoperative clinical predictors that increase the probability of minimal ETI of PTC. The aim of the study is to assess preoperative clinical predictors that increase the probability of minimal extrathyroidal invasion of papillary thyroid cancer. A retro-prospective single-center study of preoperative clinical predictors that increase the probability of extrathyroidal invasion of thyroid cancer was conducted. Data from 514 patients aged 5 to 81 years were processed. Patients underwent surgery for papillary thyroid cancer for the first time. Scope of the operation: extrafascial thyroidectomy. Central neck dissection. Lymphadenectomy. All patients had clinical signs of low risk of recurrence. The mean age of patients was 44.4 ± 14.5 years. There were 91 men (17.7%) and 423 women (82.3%). Patients were divided into two groups: group 1 with 169 patients with minimal extraorganic invasion aged 5 to 71 years, group 2 with 345 patients without invasion aged 10 to 81 years. The following features were taken into account for the analysis: 1) age of patients; 2) their sex; 3) the size of the dominant tumor. The results were statistically processed using a specialized statistical program StatPlus Pro v.7 (AnalystSoft Inc.) and Epitools statistical calculators (Ausvet, https://epitools.ausvet.com.au/). According to the results, both by age (mean age of patients in group 1 - 44.7 ± 14.4 years; mean age of patients in group 2 - 44.3 ± 14.6 years) and by sex (in group 1 – 30 men (17.8%), 139 women (82.2%), in group 2 – 61 men (17.7%), 284 women (82.3%), the groups were almost identical, both groups were significantly (p 10 mm, while in group 2 there were only 42.6% of such patients. Within the size ranges up to 10 mm, the probability of detection of invasion is 14.0% - 21.6%, while within the size ranges over 10 mm, it may be 41.9% - 50.0%. A tumor size of PTC over 10 mm, with a diagnostic strength of 61.9%, increases the risk of minimal extrathyroidal invasion. The average size of the primary tumor in the group of patients with minimal ETI is 15.0 (10.0; 20.0) mm, which is statistically significantly higher (p

Background. Acute pancreatitis is an inflammatory disease of the exocrine part of the pancreas, accompanied by various complications and further development of necrosis of the gland and parapancreatic tissue with possible secondary infection. The study of experimental models shows that the acinar cells surrounding the islets of Langerhans remain relatively intact, indicating that endogenous insulin is a protective factor for the pancreatic parenchyma. The purpose of the study was to determine the dependence of endogenous insulin levels on the extent of pancreatic parenchymal damage. Materials and methods. Prospective analysis of endogenous insulin levels in 51 patients with acute pancreatitis. Results. Comparison of the mean values of endogenous insulin revealed that in patients with necrotizing pancreatitis, the median value was statistically significantly lower than in patients without pancreatic necrosis (p < 0.001). Moreover, in pancreatic necrosis, the determined level of endogenous insulin did not exceed 9 mcIU/ml and in 7 (13.7 %) patients, insulin was below the reference values. ROC analysis showed that low endogenous insulin is a risk factor for pancreatic necrosis. The threshold value of endogenous insulin, at which pancreatic necrosis was most often diagnosed, was determined, cut-off value of 5.3 mcIU/ml, AUC of 0.96 (95% CI 0.92–1.00) (sensitivity 91.89 % (95% CI 78.09–98.3 %), specificity 71.43 % (95% CI 41.9–91.61 %), PPV 89.47 % (95% CI 78.69–95.14 %), NPV 76.92 % (95% CI 51.74–91.2 %)). Conclusions. There was a statistically significant difference between the mean insulin values depending on the volume and location of pancreatic parenchymal damage (p < 0.001). In patients without pancreatic necrosis, endogenous insulin was statistically significantly higher than in those with pancreatic necrosis (p < 0.001). Binomial logistic regression analysis showed that the development of pancreatic necrosis in patients with acute pancreatitis significantly depended on the values of endogenous insulin at hospitalization. The level of endogenous insulin may be an additional indicator of the acute pancreatitis severity and the formation of necrotic changes in the pancreatic tissue, which will allow for correct initiation of treatment. [ABSTRACT FROM AUTHOR]

A promising method of energy storage is the combination of hydrogen and compressed-air energy storage (CAES) systems. CAES systems are divided into diabatic, adiabatic, and isothermal cycles. In the diabatic cycle, thermal energy after air compression is discharged into the environment, and the scheme implies the use of organic fuel. Taking into account the prospects of the decarbonization of the energy industry, it is advisable to replace natural gas in the diabatic CAES scheme with hydrogen obtained by electrolysis using power-to-gas technology. In this article, the SENECA-1A project is considered as a high-power hybrid unit, using hydrogen instead of natural gas. The results show that while keeping the 214 MW turbines powered, the transition to hydrogen reduces carbon dioxide emissions from 8.8 to 0.0 kg/s, while the formation of water vapor will increase from 17.6 to 27.4 kg/s. It is shown that the adiabatic CAES SENECA-1A mode, compared to the diabatic, has 0.0 carbon dioxide and water vapor emission with relatively higher efficiency (71.5 vs. 62.1%). At the same time, the main advantage of the diabatic CAES is the possibility to produce more power in the turbine block (214 vs. 131.6 MW), having fewer capital costs. Thus, choosing the technology is a subject of complex technical, economic, and ecological study.

The problem of timely diagnosis and proper management of patients with cystic fibrosis is crucial not only in our country, but throughout the world. Experts of the Union of Pediatricians of Russia have considered various issues of etiology, pathogenesis, epidemiology, diagnosis, and treatment of this genetic disease in a modern light. Particular attention was paid to screening methods for early diagnosis of cystic fibrosis. The principles of complex therapy were justified, including rational use of antibacterial and mucolytic drugs and enzyme replacement therapy that significantly determine the disease prognosis.

The article deals with the life of the Kalmyks who lived on the territory of the Don Cossacks in the 17th–early 20th centuries. The processes of isolation of the resettled Kalmyks on the Don land, gradual entry into the political and socio-economic space of the Don Cossacks are studied. A significant contribution of the Don Kalmyks to the socioeconomic development of the Cossack region, the protection of the Russian Empire from external encroachments is noted. The subject of the study is the system of measures taken by the leadership of the Don Cossacks in order to transition the Kalmyks from nomadism to settled life. The features of the transition of the Don Kalmyks to sedentary life as a result of the sedentarization policy pursued by the authorities, the main goal of which was to change the economy, life, social structure of the Kalmyk-Cossacks, their full inclusion in the general economic and cultural activities of the region, are traced. Particular attention is paid to the study of changes in the economy, spiritual life, mentality of the Don Kalmyks. The experience of management and cultural and spiritual interaction of the Don Kalmyks with the Cossacks, accumulated by the nomads during their three-century residence on the territory of the Don Cossacks, is considered. It is emphasized that this invaluable experience helped the Don Kalmyks to quickly adapt and painlessly engage in socioeconomic transformations in the Kalmyk Autonomous Region, where they were resettled in the 20s and 30s of the last century by a government decision. The conclusion is made about the positive impact of the Don Kalmyks who have settled down to settled life on the accelerated process of settling in the KAO. The research materials can be useful for students, graduate students, researchers, teachers of schools, educational institutions, all those who are interested in the history of the Don region, the Don Kalmyks.

The review analyzes the monograph by Croatian historian Branko Ostajmer Narodna stranka u Slavoniji i Srijemu 1883.–1903. [The People’s Party in Slavonia and Srem in 1883–1903] and considers the historiography, source base, structure, and content of the book. Not only does the author of the monograph contribute to the development of Croatian historiography, but he also polemicizes with his predecessors and contemporaries. The extant archival sources of the period studied by B. Ostajmer are not plentiful, so the book is largely based on periodicals. A specific feature of his work is the author’s focus on the outstanding personalities of the era associated with the activities of the People’s Party. In addition, it is necessary to highlight the author’s analysis of Slavonism, a concept that is important for understanding the period and the region under study. B. Ostajmer studies the internal organization of the party and its electorate, including the interaction with individual social and ethnic groups, as well as the activities of the party in the context of Croat-Hungarian relations. Much space in the narrative is given to the figure of Croatian Ban K. Khuen-Héderváry, whose reign was taken as the chronological framework of the work. The book can be of interest to historians of parties and social movements of the Modern Era as well as specialists in Croatia, the Balkans, and Central Europe.

preoperative ascending cholangitis is one of the main factors of unsatisfactory treatment outcomes and prognosis in patients with malignant obstructive jaundice. The aim of our study was to evaluate the diagnostic value of CRP /PA coefficient in preoperative ascending cholangitis diagnosis, the effectiveness of preoperative preparation and the possibility of infectious complications, which will improve the treatment quality and prognosis of this cohort of patients. The end points of the study were: to determine the reference rate of the СRP/PA coefficient; to evaluate the coefficient value for cholangitis and its severity at the stages of treatment; assess its importance in detecting postoperative infectious complications. A one-center prospective study of the treatment results of 84 patients who underwent biliary decompression in the preoperative period was conducted. All patients were diagnosed with preoperative ascending cholangitis according to the Tokyo Guidelines, 2018 criteria - I grade - in 48 (57.1%) patients, II grade - in 36 (42.9%) patients. It was determined that the median СRP/PA in healthy patients was 0.01 (0.01-0.02) of the main surgical intervention was significantly higher - 0.21 (0.13-0.45) and 0.02 (0.01-0.03) than in healthy individuals - 0.01 (0.01-0.02) ); p

Testing of prototypes of equipment is the most important stage of their development. The article considers a low-power high-frequency ion engine RD0310 which was manufactured and tested at the production base of the KBHA joint-stock company. The tests were carried out in a vacuum chamber with a volume of 5.66 m3, the vacuum pumping system of which allows for a pressure inside the chamber of no more than 110-5mm Hg. with xenon consumption of up to 0.7 mg/s, which is as close as possible to space conditions. During the tests, the cyclogram of starting and stopping the engine was worked out, and the thrust dependences on the flow rate of the working fluid, the power of the high-frequency generator and the voltage at the emission electrode were obtained. According to the test results, stable engine operation was achieved and the following values were obtained: the thrust of 9.1mN at a specific impulse of 3740 s.

Objective.To estimate the impact of preoperative biliary decompression inpatients, suffering tumorogenic obturation jaundice, complicated by ascending cholangitis, on development of postoperative complications. Materials and methods. The one-centre retrospective investigation of the treatment results was conducted in 136 patients, suffering tumorogenic obturation jaundice. In 84 patients preoperative biliary decompression was done (Group I). In 52 patients preoperative biliary decompression was not performed (Group II).In all the Group I patients an ascending preoperative cholangitis was diagnosed: in 48 (57.1%) -of the I degree severity, in 36 (42.9%) - of the II degree of severity. In 21 (40.4%) patients of Group II preoperative ascending cholangitis I degree of severity was revealed. Results. Performance of preoperative biliary decompression did not worsen postoperative results, taking into account the postoperative complications structure (p=0.07), but influenced the wound infection development (p=0.01). Additional factors were determined: preoperative ascending cholangitis of I degree (p=0.007) and II degree (p=0.001) of severity; hyperbilirubinemia over 250 mcmol/l (p= 0.03); delay in operative treatment more than by 3 weeks after preoperative biliary decompression (р= 0.02); presence of the antibioticoresistant microflora in a time of preoperative biliary decompression (p=0.009) and at the operation time (p=0.002). Conclusion. Performance of preoperative biliary decompression raises the risk for the wound infection development, but is not the cause for postoperative prognosis worsening, taking into account the postoperative complications structure.

This article presents the textbook of the famous Transcarpathian and Slovak Rusinist Valery Padyak Istoriia karpatorusyns′koho natsional′noho teatra y dramaturgiï [History of the Carpatho-Rusyn National theatre and drama]. The Rusyns (more precisely, the Carpatho-Rusyns) are the autochthonous East Slavic population of the Carpathian region: Ukrainian Transcarpathia and the adjacent regions of Poland, Slovakia, Hungary, and Romania. There is also a Rusyn diaspora present in Serbia, Croatia, the USA, Canada, and other states. The number of Rusyns in the world is a controversial issue, one reason for this being their polyvariant identification. At present, a significant proportion of ethnic Rusyns consider themselves representatives of an independent people, who are not Ukrainian or Russian. Padyak, a staunch supporter of the Rusyn ethno-national identity and at the same time a serious academic scientist, made an attempt to trace the development of drama and theatre in the Rusyn environment in parallel with the processes of Rusyn national self-determination. The author traces the evolution of folk theatre performances to the modern Rusyn national theatre, which is actively being developed in different states with Rusyn inhabitants. V. Padyak pays increased attention to theater and drama in the second half of the nineteenth and early twentieth centuries, as well as during the period when Subcarpathian Rus (Transcarpathia) entered the structure of interwar Czechoslovakia and Horthy Hungary. In contrast, the author hardly examines post-war theater life in the Transcarpathian region, believing that its study is more appropriate in the context of Ukrainian, rather than Rusyn, studies. This textbook by V. Padyak, addressed primarily to Rusynist students at the University of Prešov (Slovakia), is of undoubted interest to anyone interested in the history and culture of the Rusyns.

The annual conference Slavic World: Community and Diversity is a good platform for young researchers from different universities and research centers, both domestic and foreign, where they can share their scholarly achievements with colleagues and talk about their own vision of a particular problem related to the study of the diversity of the Slavic world. This year was no exception, and the historical section of the conference was held on 25–26 May in a mixed format: full-time participation and on the ZOOM platform owing to coronavirus restrictions. The speakers at the conference dedicated to the Day of Slavic Writing and Culture again discussed a wide range of issues related to the history of the Slavic peoples from the Middle Ages to the present day in national, regional, and international contexts. Following the conference, a collection of abstracts will be published. Researchers not only showed the results of their research, but also enriched themselves with new knowledge, were given a platform to express their opinions and discuss them with colleagues, and shared their experience. Many speeches aroused lively interest, and sometimes a heated discussion, which indicates the relevance of the topics addressed at the event. Annual participation in the conference contributes to the strengthening of further cooperation between scholars.

Велике значення в розвитку гострої кишкової непрохідності (ГКН) має зміна кінетики кишечника в період вагітності. У вагітних сповільнюється ритмічна функція кишечника внаслідок підвищення порогу збудливості його рецепторів до біологічно активних речовин. Наведено огляд сучасних літературних джерел з проблеми гострої кишкової непрохідності у вагітних. За даними зарубіжних літературних джерел, частота кишкової непрохідності у вагітних становить 1:3600–1:66000, а ускладнення хвороб органів травлення посідають 4$те місце серед причин материнської смертності під час вагітності — 9%. За даними вітчизняних наукових джерел, частота, з якою кишкова непрохідність зустрічається у вагітних, дорівнює 1:40000–1:50000 пологів, летальність досягає 35–50%, мертвонароджуваність — 60–75%. Розвиток захворювання спричиняють фізіологічні зміни в організмі вагітної жінки. Зі збільшенням терміну вагітності відбуваються зміни анатомічних взаєморозташувань органів черевної порожнини. Починаючи з ІІ триместру вагітності, матка виходить за межі малого тазу та поступово займає всю черевну порожнину. Збільшення розміру матки, обумовлене гіпертрофією та гіперплазією м'язових волокон, навколоплодовими водами, ростом плода, призводить до підвищення внутрішньочеревного тиску, зміщення тонкого кишечника та попереково-ободової кишки доверху, тим самим створюючи умови для здавлювання петель кишечника, вузлоутворення, розвитку закрепів. Представлено сучасну класифікацію, клініку, діагностику та методи лікування цієї хірургічної патології. Описано клінічний випадок гострої кишкової непрохідності у 51-річної вагітної з шостою бажаною вагітністю, яка настала в результаті допоміжних репродуктивних технологій та великим інтергенетичним інтервалом. Лікування кишкової непрохідності у вагітних здійснюють і хірург, і акушер–гінеколог. Консервативні лікувальні заходи проводяться одночасно з діагностичними процедурами. Відсутність ефекту від консервативної терапії протягом 2 год є показанням для оперативного втручання. Основна мета хірургічного втручання — усунути причини кишкової непрохідності та відновити функцію кишечника. Обсяг оперативного втручання визначається в кожному конкретному випадку індивідуально та залежить від виду ГКН й давності захворювання. Обрана тактика ведення передопераційного періоду, обсяг виконаного оперативного втручання, анестезіологічне забезпечення та адекватне ведення післяопераційного періоду дають змогу вилікувати гостру хірургічну патологію, зберегти бажану вагітність, уникнути розвитку акушерських і хірургічних гнійно-септичних ускладнень. Дослідження виконано відповідно до принципів Гельсінської декларації. На проведення досліджень отримано інформовану згоду жінки. Автори заявляють про відсутність конфлікту інтересів.

The practice of interviewing government officials was widespread in the parliamentary countries of Western Europe as early as the 19th century. It remained deeply alien to the Russian authoritarian system until the revolution of 1905-1907. The monopoly of political utterance belonged to the monarch; the lower-ranking officials acted only as mute executors of his sacred will. To this power, subjects could make requests and petitions, but not ask questions or demand a report. Only such atypical figures for official Russia as Finance Minister I. A. Vyshnegradsky and then S. Yu. Witte dared to speak to the public with explanations of their policies. The article considers the unpublished interview of Vyshnegradsky given by him to Prince A. V. Meshchersky on June 28, 1889. The topic of the conversation was the most urgent petitions of the Poltava nobility to reduce railway tariffs for the transportation of grain cargo and the need for financial support by the state for the indebted landowner’s estates. Prince Meshchersky acted as a lobbyist for noble interests and intended to encourage Vyshnegradsky to promote their promotion more actively. The course of reviving the economic and political hegemony of the nobility determined government policy in the era of Alexander III, so the Minister of Finance was careful in his statements. Sympathizing with the words of the noble aspirations, he however made it clear to the interlocutor that the demands of the nobility were not fully feasible. Further, Vyshnegradsky detailed his financial program, which gave priority to fighting budget deficits, tightening tax and customs policies, but not wasting public funds to support inefficient landowners. All subsequent economic policies of Vyshnegradsky corresponded to this program. S. Yu. Witte, his successor as Minister of Finance, continued this program, causing growing discontent among the nobility and its patrons in the government

The effect of vacuum annealing (600 °C, 30 min) on the temperature stability against oxidation in air of germanium nanowires obtained by cathodic deposition from aqueous solutions of germanium oxide was studied by the method of photoluminescence in the visible range and Raman scattering. The stability was checked by laser annealing at temperatures above 1000 °C. It was shown that the evolution of photoluminescence and Raman peaks is associated with the formation of germanium oxide or suboxide upon laser annealing. Preliminary vacuum annealing of the sample significantly suppresses this process. The observed effect is associated with the formation of germanium oxide and the influence of indium atoms on this process.

The article presents comprehensive studies of the chemical composition and morphology of nanotubular anodic TiO2 layers at the first stages of the porous structure nucleation, by scanning electron microscopy (SEM), Auger spectroscopy (AES), time-of-flight secondary ion mass spectrometry (TOF.SIMS). Our goal was to show the profile distribution of chemical elements and reaction products at each of the initial stages of the anodic oxide growth in the ethylene glycol-based electrolyte containing fluoride, which will help expand the understanding of pore formation mechanism.

Objective. Determination of impact of combination, consisted of 3% solution of silicon dioxide and antibacterial preparations, on bacterial cultures of S. aureus, P. aeruginosa, E. coli. Materials and methods. Clean cultures of bacteria, kept in Collection of Microorganisms in Department of Microbiology and Immunology of Training–Scientific Centre «Іnstitute of Biology and Medicine» of Taras Shevchenko National University: S. aureus (Rosenbach, 1884), P. aeruginosa (Schröter, 1872; Migula, 1900), E. coli (Migula, 1895; Castellani і Chalmers, 1919) were applied. Action of antibacterial preparations cefoperazon, cefoperazon–sulbactam, ampicillin–sulbactam, amicacin, as well as enterosorbent 3% solution of silicon dioxide, was investigated. In the investigation the impact of antibacterial preparations and silicon dioxide together with antibacterial preparations on test–cultures of bacteria was studied, using broth and agarised medium of Muller–Hinton. Results. The data, obtained in the investigation, trust efficacy of combined application of 3% solution of silicon dioxide, owing sorption capacity, with antibacterial preparations in reduction or elimination of subsequent growth of bacterial test–cultures of S. aureus, P. aeruginosa, E. coli. Combination of 3% solution of silicon dioxide with ampicillin–sulbactam in dilutions 64 and 32 mg/l promotes reduction of the E. coli growth on surface of agarised medium in comparison with the investigation variant without application of 3% solution of silicon dioxide. While polyresistence of P. aeruginosa revealed, 3%solution of silicon dioxide together with cefoperazon–sulbactam in concentrations 8 and 16 mg/l and ceftazidime in concentrations 8, 16, 32, 64 mg/l guarantees bactericidal effect for this microorganism. Growth of P. aeruginosa while application of 3% solution of silicon dioxide in combination with ampicillin–sulbactam in dilutions 8, 16, 32, 64 mg/l was arrested. Application of 3% solution of silicon dioxide in combination with amicacin–sulbactam 16 mg/l inhibits the S. aureus growth, what is observed, when combination of 3% solution of silicon dioxide with amicacin in dilutions 8, 16 mg/l and cefoperazon–sulbactam in dilutions 8, 16 mg/l are exploited. Growth of the microorganism do not evolve in variants of the investigation without 3% solution of silicon dioxide, as well as with him, if amikacin is applied in concentrations 64 and 32 mg/l. Conclusion. The biliary ducts drainage in obturative jaundice of tumoral genesis and subsequent presence of drainage (internal or external) constitute the main risk factors for their colonization by multiresistant microorganisms. At the same time, the biliary ducts drainage in combination with antibioticotherapy is estimated as an urgent method for control of the infection primary focus in an acute cholangitis. Establishing of procedure for application of 3% solution of silicon dioxide in combination with certain groups of antibacterial preparations for microorganisms revealed constitute important measure for bacteriobilia prophylaxis. The further investigations conduction with wider spectrum of antibacterial preparations and 3% solution of silicon dioxide for control of clinically significant species of microorganisms is necessary and perspective.

The review is devoted to the analysis of the effectiveness of the use of bacterial lysate OM-85 in the complex therapy of acute respiratory tract infections (ARTI) in children. We analyzed 10 controlled clinical trials, including 7 randomized ones (of which 2 were double-blind, placebo-controlled), which included a total of about 800 patients under the age of 15 years, as well as one observational study, which included 587 children under 12 years of age. In all studies, it was found that the use of bacterial lysate OM-85 in children with ARTI leads to a significantly faster improvement. Also, in some studies, it was shown that the use of this immunostimulant reduces the need for antibiotic therapy and has a pronounced stimulating effect on the immune response: it increases the level of immunoglobulins and interferons, as well as other components of the anti-infective response. Thus, a review of the available scientific publications shows the high efficiency of bacterial lysate OM-85 in the treatment of respiratory infections in children, which makes it possible to recommend the inclusion of this immunostimulant in the complex therapy of ARTI in pediatric practice. At the same time, further clinical studies and generalization of their results in a systematic manner are needed in order to form final conclusions about the therapeutic efficacy of OM-85 bacterial lysate and recommendations for its use.

Power facilities use large amounts of water to cool steam in the steam turbine condensers, and lubricating oils, gas and air in turbine sets. The key requirement for the quality of cooling water is to ensure normal vacuum in condensers. Cooling water must not form mineral and biological deposits and corrosion products in the system. Deposits of mineral salts in the condenser tube system, as well as in auxiliary cooling systems, lead to deterioration in heat exchange and a major decrease in the cost effectiveness of the power equipment operation, and require the heat-exchange equipment to be periodically cleaned. The source water used for cooling is normally taken from nearby water bodies (large rivers or lakes). Circulating water supply systems are used most commonly: these systems use repeatedly the same water inventory for cooling, and require only small amounts of water added to make up for evaporation losses. Coolers, in this case, are cooling towers, spray pools and evaporation ponds. The water chemistry should ensure the operation of equipment without any damage to its components or the loss of efficiency caused by the corrosion of the internal surfaces as well as without scale and sludge formation. It is exactly when using circulating water supply that a stabilizing treatment program is the most practicable way to ensure a cost-effective and environmentally friendly mode of operation. To inhibit scaling processes on the heat-exchange surfaces of the turbine condenser tubes at the Novovoronezh NPP’s unit 5, the cooling water was treated with the NALCO 1392 inhibitor. The results of the NALCO 1392 inhibitor pilot tests in the circulating water supply system (with a cooling pool) are presented.

Радіаційні технології, засновані на застосуванні потужних пучків електронів та гамма-випромінювання тісно пов'язані з необхідністю дозиметрії цих пучків. Вельми успішною для цих цілей є дозиметрія, заснована на використанні реакції непружного розсіювання гамма-квантів на цілому ряді ядер з утворенням ізомерів з різними періодами напіврозпаду і енергіями квантів випромінювання. Прикладом такого застосування в дозиметрії є реакція 115In (γ,γ')115mIn в результаті якої утворюється ізомер 115mIn, що має гамма-лінію з енергією 336,24 кеВ і період напіврозпаду 4,5 годин. Мало місце успішне застосування цієї методики в дозиметрії при вирішенні певних практичних завдань (опромінювальні комплекси на основі джерел 60Со - кобальтові «гармати»). У даній роботі показано, що використання детекторів з In для дозиметрії гамма-випромінювання з широким енергетичним спектром (гальмівне випромінювання) пов'язане зі значною невизначеністю при вимірюванні еквівалентної дози гамма-спектра з верхньою межею 10 МеВ. Така невизначеність обумовлена відносно високим порогом вищезгаданої реакції -1,08 МеВ. В даній роботі визначено кількісний вклад у повний потік випромінювання ділянки гамма-спектра нижче порогу (γ,γ') реакції на ядрі In та показано, що в залежності від напрямку випромінювання має місце систематична похибка при вимірюванні еквівалентної дози, що досягає 20-60%. Досліджено та запропоновано для використання альтернативні матеріали - детектори, що дозволяють зменшити систематичну похибку при вимірі еквівалентної дози до 2-3%, що є цілком прийнятним для практичного застосування.

The Middle Darriwilian Isotopic Carbon Excursion (MDICE) is a global isotopic event described in sections from different palaeocontinents. Here we present new stable carbon isotopic data from carbonates of ten sections in different parts of the Baltoscandian Palaeobasin (Estonia, Latvia, Lithuania, Sweden, NW Russia). The definition of the MDICE as a chemostratigraphic unit is discussed, as well as the subdivision of its peak into two distinct peaks. The MDICE is one of the longest carbon isotopic events in the Palaeozoic. It was preceded by the L-chondritic cosmic dust flow event, which may have been responsible for cooling through the Darriwilian and the initiation of the Great Ordovician Biodiversification Event. High-resolution chemostratigraphic analyses show that the time interval between these environmental events and the base of the MDICE is up to one million years. Due to the long duration of the MDICE the modelling of this excursion should address more complex scenarios than a simple response of the carbon cycle to rapid climatic perturbations.

Chronic hyperglycemia, insulin resistance, endothelial dysfunction, and disturbance of the integrity of the blood-brain barrier are considered as strategically important links in the development of cognitive deficits in diabetic encephalopathy. Taking this into account, one of the modern trends in the optimization of the treatment of cognitive impairments induced by prolonged hyperglycemia is the co-administration of agents with antihyperglycemic and nootropic activity, in particular, metformin with piracetam. It has been shown that under conditions of experimental alloxan-induced hyperglycemia, piracetam has insufficient nootropic potential for eliminating cognitive deficits. Metformin has a weak nootropic effect in short-term use in low doses, without exhibiting these properties in prolonged administration. When combined with piracetam, metformin potentiates its antiamnesic properties, which helps to restore cognitive functions impaired by hyperglycemia. It is assumed that the mechanisms of such synergism are mediated by a decrease in the content of early and late markers of the destruction of protein molecules, the level of stable nitric oxide metabolites in the cerebral cortex, as well as a significant limitation of the manifestations of ultrastructural destructive changes in hippocampal neurons with a simultaneous improvement in the state of its microvasculature. The obtained results indicate the expediency of the combined use of metformin with nootropic agents for the prevention or treatment of cognitive impairments that occur as a result of diabetes mellitus.

The paper presents a corpus-inspired analysis of lexico-grammatical changes of proverbs in American press and web communication as documented in two synchronous and historical corpora (namely COCA and COHA). Being a case study of two proverbs, Actions speak louder than words and Handsome is as handsome does, it reveals differing types of changes such as variants, derivatives based on modifications (mostly adnominal ones), and derivatives based on syntactic transformations. The tendency is noted for one of the proverbs to turn into a phraseoscheme X is as X does (including but not limited to the “Gumpism” Stupid is as stupid does).

Мета — провести клініко-статистичний аналіз перебігу вагітності та пологів у жінок із лейоміомою матки; визначити особливості соматичного та репродуктивного здоров'я роділь і породіль, ускладнення вагітності, хірургічної допомоги в пологах, стану новонароджених. Матеріали та методи. Проаналізовано історії хвороб 405 вагітних жінок із лейоміомою матки, із них 205 народили, а 200 перебували на стаціонарному лікуванні в період 2009–2018 рр. Результати та висновки. Лейоматозні вузли виявлено під час вагітності у 96 (46,8%) пацієнток, лейоміому матки діагностовано до вагітності у 109 (53,2%) жінок. Фіброматозні вузли тіла матки розташовані субсерозно у 59% вагітних, інтрамурально — у 41%. Підслизових вузлів не виявлено. З популяції пацієнток, які народжували, 79 (38,5%) жінок розроджені шляхом операції кесаревого розтину, 53 (25,8%) жінкам проведено консервативну міомектомію. У 7 випадках під час операції кесаревого розтину виконано неповну гістеректомію без додатків, в 1 випадку — екстирпацію матки з трубами. У популяції вагітних, які перебували на стаціонарному лікуванні, лейоматозні вузли виявлено під час вагітності у 86 (43%) жінок, лейоміому матки діагностовано до вагітності у 114 (57%) жінок. Вузли на матці розташовані субсерозно у 56% вагітних, інтрамурально — у 44%. Субмукозних вузлів не виявлено. Також не відмічено маткових кровотеч у зв'язку з лейоміомою. Оперативні втручання у жінок із приводу видалення лейоматозних вузлів під час вагітності проведено тільки в 3 випадках: у 2 вагітних із гігантською інтрамурально-субсерозною фіброміомою; вузли здавлювали, деформували порожнину матки і здавлювали правий сегмент печінки, у третьому випадку діагностовано некроз вузла, розташований субсерозно. Дослідження виконано відповідно до принципів Гельсінської Декларації. Протокол дослідження ухвалено Локальним етичним комітетом зазначеної в роботі установи. На проведення досліджень отримано інформовану згоду жінок.

Objective. To establish the connection between lipemia and course of an acute pancreatitis. Materials and methods. The investigation design: «case - control». There were incorporated 93 patients, suffering an acute pancreatitis. Group «case» - 11 patients with acute pancreatitis and lipemia, Group «control» - 82 patients with acute pancreatitis without lipemia. Interrelationship was investigated in accordance to the relative risk index between lipemia and the factors signs: the acute pancreatitis severity degree, recurrent course of the disease, presence of diabetes mellitus and alcoholic anamnesis. Results. Comparative analysis of rate for the factors signs revealing have established, that possibility of development of severe acute pancreatitis and possibility of the alcohol-induced acute pancreatitis occurrence in groups of patients did not differ statistically meaningful (p > 0.05). While comparing a rate of the acute pancreatitis recurrence and the diabetes mellitus presence in groups of patients there were differences revealed on the significant level: p=0.02 and p=0.04 accordingly. Lipemia constitutes a risk factor for recurrent course of an acute pancreatitis and diabetes mellitus in patients with an acute pancreatitis: relative risk 7.5 (95% CI 1.8 - 26.6, p=0.02), RR 6.1 (95% CI 1.2 - 28.7, p= 0.02) accordingly. Conclusion. Presence of lipemia did not impact the acute pancreatitis severity (p=0.98). Possibility of the acute pancreatitis recurrence in patients with lipemia in 7 times is higher, than in patients with an acute pancreatitis without lipemia (p=0.02). Possibility of diabetes mellitus presence in patients with an acute pancreatitis and lipemia is in 6 times higher, than in patients wihout lipemia (p= 0.02). Timely diagnosis and correction of a dislipoproteinemia constitutes a prophylactic measure, which is capable to lower the rate of an acute pancreatitis recurrence.

Aim of the study To determine the effect of extrapancreatic infection (EPI) on antibacterial resistance of pancreatic infectious agents in patients with acute infected necrotic pancreatitis Materials and Methods A longitudinal retrospective case-control study was conducted. The Object of the study were the patients with infected acute necrotizing pancreatitis (ANP). The subject of the study was the acquired AMR of pancreatic infection (PI) agents in patients with ANP. The control group included 27 patients who had a positive bacterial culture from sources of PI. 21 patients were included in the risk group, in which the additional source of EPI was recorded. Bacteriological monitoring was conducted in two stages: the primary identification of the agent of PI and the completion of inpatient treatment. Microbiological identification of the pathogen of EPI was performed before the primary determination of the pathogen of PI, and in the interval between stages I and II of the study. According to the results of the resistance profile of PI to AMR, all patients were divided into four clusters: I - patients who identified only antibiotic-sensitive bacterial strains (AMR"-"), II - patients with defined MDR-bacteria (multidrug-resistant), III - patients with XDR-bacteria (extensively drug-resistant), IV - patients with PDR bacteria (pandrug-resistant). Results The presence of EPI in patients with ANP influences the development of AMRs of PI toward increasing XDR and PDR strains (p=0.008 and p=0.04, respectively). In patients with infected ANP with the EPI, the risk of developing XDR infection was 2.4 times higher than the risk of developing this level of AMR in patients with no EPI (RR-2.4 (95% CI-1.16-4.91), p=0.03). EPI increases the risk of PDR PI by 8 times (RR-8.0 (95% CI-1.04-61.5) p=0.04). For each patient with infected ANP with signs of EPI, the risk of developing XDR strains was 36%, and PDR strains - 25%. Conclusions The presence of extrapancreatic sources of infection is a risk factor for development of AMR strains of microorganisms that persist in the sources of pancreatic infection. In this category of patients the risk of identification of extensively resistant strains was increased by 2.4-fold (p=0.03) and PDR strains by 8-fold (p=0.04), compared with patients with infected ANP without EPI.