Autonomic dysreflexia (AD) is a potentially life-threatening condition that develops in patients with spinal cord injury (SCI) at or above the T6 segment. First of all this condition is characterized by uncontrolled arterial hypertension, which can lead to catastrophic complications and even death. The trigger for the development of AD is often urological complications, as well as diagnostic and therapeutic manipulations on the lower urinary tract. It is important for urologists to be aware of the AD syndrome, clinical features of AD, acute and chronic management, as well as prevention episodes of AD in patients with neurogenic lower urinary dysfunction. AD is defined as an increase of systolic blood pressure of 20 mmHg from baseline in response to various afferent stimuli originating below the level of spinal cord injury. AD is based on exaltation of spinal reflex activity with irradiation of impulses in the spinal cord under conditions of dennervation preganglionic sympathetic neurons located above the T6 segment and hyperactivity of peripheral -adrenergic receptors. The main pathophysiological mechanism of AD is hypernoradrenalinemia, leading to vasoconstriction the vessels of the skin, abdominal cavity, muscles below the level of neurological injury.

Introduction. Autonomic dysreflexia (AD) is a life-threatening dangerous condition in patients with spinal cord injury (SCI) above the T6 segment level. It is characterized by a sudden rise in systolic blood pressure more than 20 mmHg, and unpredictable reactions from the autonomic nervous system. An episode of autonomic dysreflexia can lead to several cardiovascular catastrophes – heart attack and/or acute cerebrovascular accident up to a lethal outcome. Currently, there is no diagnostic algorithm and no way to determine risk factors for the occurrence of autonomic dysreflexia.Objective. To search for the most informative diagnostic criteria for autonomic dysreflexia in patients with spinal cord injury.Materials and methods. The study included 40 patients with SCI above the T6 segment. Depending on the SCI degree, two groups were distinguished. Group 1 (n = 14) included patients with complete spinal cord injury, advising category A on the ASIA scale. Group 2 (n = 26) included patients with incomplete spinal cord injury, classified as ASIA-B, C, D. For a preliminary assessment of the risk factors for the development of AD, an ADFSCI questionnaire was used, then a urodynamic study was conducted with simultaneous registration of systolic / diastolic blood pressure (SBP / DBP), and heart rate, which confirmed or denied the presence of AD in patients.Results. According to the ADFSCI questionnaire, most patients showed a high degree of severity of autonomic disorders, suggesting the presence of AD. Subsequently, this assumption was confirmed by the results of a urodynamic testing with simultaneous monitoring of SBP / DBP and heart rate. When comparing the groups, statistically significant differences were found in the parameters of the ADFSCI questionnaire, as well as in the indicators of SBP / DBP (at the points of maximum detrusor pressure and when the cystometric capacity is reached).Conclusion. The obtained results allow us to draw conclusions about the high incidence of AD in patients with SCI above the T6 segment and the need for a preliminary assessment of the risks of developing this condition based on the ADFSCI questionnaire before conducting a urodynamic study. Considering the possible complications of AD, the urodynamic testing should be accompanied by continuous monitoring of the indicators of the cardiovascular system.

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The article presents the results of studies on the effect of fodder meal from flax seeds with the addition of dry tomato and grape pomace, separately and in combination, on the intensity of egg laying, the quality of food eggs and the activity of enzymes of the antioxidant status of laying hens of the second phase of productivity.