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Urolithiasis is a common multifactorial disease characterized by a high recurrence rate. This review is devoted to the urine pH as one of the main factors determining its lithogenic properties. It affects the excretion of lithogenic substances and stone formation inhibitors, the solubility, and the crystallization of substances involved in stone formation. The urine pH significantly affects the solubility of uric acid in urine, which decreases at a pH < 5.5. This explains the high incidence of uric acid concretions in patients with metabolic syndrome. Their insulin resistance leads to a decrease in the excretion of ammonium ions in the proximal tubules, leading to persistent urine acidification. The activity of many transport processes involved in the processing of calcium, citrates and phosphates is sensitive to changes in systemic or local pH. The data on the effect of urine pH on the solubility of calcium oxalate remain contradictory. At the same time, there is no doubt about the determining role of urine pH in the excretion of citrate, the most important stone formation inhibitor. The alkaline urine pH promotes the formation of concretions containing calcium phosphates. In conditions of constantly elevated urine pH in patients with persistent urease-producing urinary tract infection, a rapid growth of "infectious" concretions occurs. The review summarizes information on the causes of the decrease and increase in the urine pH, as well as the possibilities of medicinal and non-medicinal methods of modifying the urine pH during the prevention of stone formation recurrence.

Objective. To study specific features of potassium metabolism and myocardial damage markers in the children with bronchial asthma, depending on the level of BA control. Materials and methods. Comprehensive examination was carried out in 189 children with persistent BA aged 6–17 years: group 1 consisted of 124 with uncontrolled course of the disease, group 2 – 30 patients with partially controlled BA and 35 patients with controlled BA. The comparison group consisted of 30 patients with controlled asthma without changes from the cardiovascular system. The unified flame photometry method with fluid analyzer FFA-1 was used to determine the erythrocyte potassium level. Total creatine phosphokinase level was estimated by UV-test. Creatine phosphokinase-MB level was determined by M-subunit immunoinhibition. Total lactic dehydrogenase-1 level was calculated by modified colorimetric method using an assay kit for colorimetric determination of total LDH. Serum LDH1 level was estimated by UV-method with the kit for determination of isoenzyme LDH1 activity. Results. In the children with UC BA serum K+ and erythrocyte K+ level was significantly lower compared to the children with PC BA, C BA, C BA with no changes in CVS and the control group. Total CPK and CPK-MB isoenzyme level in the children with UC BA, was significantly higher compared to those with PC BA, C BA, C BA without CVS changes and the control group. In the children with PC BA, total serum CPK level was also significantly higher compared to C BA (P = 0.007), C BA without CVS (P = 0.0002) changes and the control group (P = 0.001). Conclusion. Thus, the study demonstrated significant decrease of potassium level in blood serum and erythrocytes, twofold increase of total creatine phosphokinase and lactic dehydrogenase-1 isoenzyme levels, threefold increase in creatine phosphokinase-MB isoenzyme level, and one and a half time increase of total lactic dehydrogenase in the children with uncontrolled course of bronchial asthma.

Objective: to study the indices of general and specific quality of life in schoolchildren, depending on the level of bronchial asthma control. Materials and methods: Quality of life parameters of 189 in-patients with BA, aged 6–17 years and 95 controls were studied. Parallel questioning with subsequent analysis of quality of life indices in 189 parents of BA children and 95 parents of the control group children was performed. General QL was evaluated using РedsQL (Pediatric Quality of Life Inventory 4.0). Specific quality of life was evaluated using specific quality of life questionnaire for the children ill with bronchial asthma – PAQLQ (Pediatric Asthma Quality of Life Questionnaire). Statistical analysis of the data obtained was done by variance statistical methods using the standard program package of multivariate statistical analysis Statistica 6.0 Results. The study found the index of physical functioning to be 43.6 [31.3–62.5] points in the children with UC BA, 53.1 [37.5–68.2] points in those with PC BA, being significantly lower as compared to the control group children – 79.6 [56.0–100.0] points (P < 0.001). Рhysical functioning index in the children with UC BA was 1.7 times lower as compared to those with C BA. Comparison of the indices in those with PC BA – 53,1 [37.5–68.2] points and C BA – 74.1 [50.0–76.0] points, showed that physical activity in the children with PC BA was significantly lower as compared to those with C BA (P < 0.001). The analysis showed no significant difference between the answers of the children with asthma and their parents. No significant difference between the answers of healthy children’s parents and the children themselves was revealed as well (P > 0.05). The cumulative index of QL was dependent on the level of BA control. It was 2.5 [1.4–3.6] points in the children with UC BA, being significantly lower as compared to those with PC BA – 3.9 [2.8–4.9] points, and C BA – 6.2 [5.6–6.8] points (р

Xenon is an inert gas being very close to an ideal anesthetic. Goal of the study: to evaluate changes in gases and acid-base balance of arterial blood during general xenon anesthesia with the closed circuit and to compare it with general anesthesia with sevoflurane. Methods. The article describes a prospective assessment of anesthesia with expanded hemodynamic monitoring in 50 patients undergoing planned surgery. Based on the main inhalation anesthetic (xenon or sevoflurane) patients were divided into two groups. The monitoring included blood gases and O2 delivery; cardiac output was evaluated through analysis of arterial pressure pulse wave after calibration by transpulmonary thermodilution (PiCCO). Results. Xenon anesthesia did not result in serious disorders of acid-base balance and O2 delivery and compared to sevoflurane the metabolic acidosis was less frequent as well as the need to manage it. Changes in the lactate level provided the evidence that both inhalation anesthetics did not result in serious disorders of tissue perfusion and gas exchange.

Goal of the study: to identify the predictors of continuous hospital stay in adult patients with acquired valvular disease, operated with hypothermic and normothermic cardiopulmonary bypass due definitive repair of the disease. Materials and methods: 140 patients who had surgical treatment of acquired valvular disease with the use of cardiopulmonary bypass were randomly divided into two similar groups where hypothermic and normothermic cardiopulmonary bypasses were used. Peri-operative concentration of NT-proBNP, clinical course of the post-operative period, hospital morbidly and mortality were assessed. Results. No confident difference was observed in the changes of NT-proBNP in the groups, what could provide the evidence of the similar effects of both hypothermic and normothermic cardiopulmonary bypasses on integrative functional rates of cardiovascular system. However it was noted that increase of NT-proBNP plasma concentration during first 24 hours after the surgery, as well as age, chronic obstructive pulmonary disease (COPD), maximum degree of chronic cardiac failure (CCF), duration of artificial pulmonary ventilation (APV), episodes of atrial fibrillation (AF) in the post-operative period were the predictors of continuous hospital stay Conclusion. The degree of the increase in post-operative level of NT-proBNP does not depend on the perfusion temperature. NT-proBNP plasma concentration during first 24 hours after the surgery, age, COPD, maximum degree of CCF, duration of APV, episodes of AF in the post-operative period are independent predictors of continuous hospital stay.

The literature review describes the specifics of anesthesia when performing surgeries on the thyroid and parathyroid glands with neuromonitoring of recurrent laryngeal nerves. This technique has been described, the rationale of its use and role of the anesthesiologist in the provision of full functioning of neuromonitoring have been investigated. The article describes the anesthesia techniques (choice of neuromuscular relaxant, hypnotic and analgesic agents), method of endotracheal tube insertion, electrode positioning, causes of potential failures and ways of their management.