BACKGROUND: Perioperative myocardial injury (MI) and MI after noncardiac surgery (MINS) makes a significant contribution to the structure of complications and mortality in non-cardiac surgery, including those in traumatology. Spinal anesthesia (SA) is usually used for hip surgery. It may be accompanied by arterial hypotension, which, under certain conditions, becomes a leading factor in MI development. Features of both hypotension and MI in patients with concomitant cardiovascular pathology operated on for hip injury remain insufficiently studied. AIM: To determine the frequency of intraoperative arterial hypotension and MI after intraosseous osteosynthesis of the hip under spinal anesthesia in patients with concomitant cardiovascular pathology. MATERIAL AND METHODS: In 275 patients with concomitant cardiovascular pathology, intraosseous synthesis of the hip was performed with SA. The functional class of the patients was assessed according to the American Society of Anesthesiologists scale and the risk of cardiac complications according to the Revised Cardiac Risk Index scale. Blood pressure, heart rate, electrocardiogram, and ST segment were monitored. Before surgery and 13 days thereafter, the troponin T level was measured. The frequency of MI and surgical outcomes were assessed. RESULTS: In the studied sample of patients with hypertonic disease, arterial hypotension associated with SA was observed in 34.2% of cases. Its frequency increased from 15.7% in patients without other comorbidities to 42.9% in patients with a combination of hypertonic disease, CAD, and CHF. A significant relationship was noted between arterial hypotension and MI. A highly sensitive troponin test revealed a significant incidence of myocardial damage (18.2%), and the associated 3-day mortality was 4%. CONCLUSION: SA-induced arterial hypotension is associated with MI risk and appears to be the most dangerous in patients with a combination of hypertonic disease, CAD, and CHF. Monitoring of troponin T levels in patients with risk factors of MI is one of the ways to reduce postoperative mortality and improve surgery outcomes.

Artificial electric lighting in buildings is an important element of any electrical system. The ample use of artificial electric lighting in modern society is indisputable. Apart from its main purpose, if legally designed and installed, electrical lighting promotes the stable work and development of a country’s power engineering. Effective use of energy resources and the capacities of power engineering are keys for the sustainability of economic growth. An increased demand in energy resources has provoked uncontrolled energy consumption and violations in fuel extraction as well as in fuel or electricity use. In the article, the authors try to give an analysis of such violations, which in its turn allows disclosing a few legal loopholes in this economic sector. The owner of energy resources suffers great damages from unauthorized connections to electrical and gas networks. Perpetrators of electrical and thermal energy consumption regulations are subject to civil, criminal, and administrative law. Nevertheless, the authors’ analysis of cases in the courts shows that a great number of them are seldom inquired into, and most perpetrators are very rarely held liable. The aim of the article is to analyze the national legislation to withstand the illegitimate energy resources consumption, to bring to light the issues in this economic sector and to suggest some ways of their solution.

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