Objective. To present a unique clinical case of metastatic lesions of the perirenal space, ureter and bladder in Merkel's carcinoma with the development of transverse myelitis against the background of immuno-oncological therapy.Matherial and methods. The modern states of issue in diagnose and treatment of metastatic Merkel's carcinoma within multidisciplinary approach based on the medical documentation and radiological examinations (CT, MRI) was analysed in this article.Results. The unique clinical case of metastatic Merkel's carcinoma complicated by transverse myelitis during immuno-oncological therapy according to MSCT and MRI examinations report was demonstrated.Conclusion. Radiological examinations such as MSCT, MRI, ultrasound and PET/CT needed for detection, assess the incidence of tumor (metastasis and staging) and treatment efficiency control because of the rare occurrence and insufficient knowledge of Merkel's carcinoma.

Objective: to assess the percentage of mesh “titanium silk” implant shrinkage after inguinal hernia repair surgery in the late postoperative period using multi-slice computed tomography (MSCT). Material and methods. The comparative assessment of the long-term results of treatment in 90 patients with inguinal hernias was performed using MSCT. In 36 (40%) patients of Group 1 the titanium implant was used in Lichtenstein hernia repair surgery. In Group 2, 54 (60%) patients were operated by laparoscopic hernia repair surgery. On day 3 and 3 months after surgery every patient underwent MSCT with subsequent determination of the implant square. Results. The percent of mesh “titanium silk” implant shrinkage 3 months after surgery according to MSCT was 4.4% in Lichtenstein hernia repair group, and 8.3% in laparoscopic hernia repair group. According to Kruskal-Wallis test, there were no statistic differences of this indicator between two groups (p = 0,185). Conclusion. The analysis of long-term results of inguinal hernia repair surgery with titanium mesh implants using MSCT showed that implant square significantly decreases 3 months after surgery. There were no significant differences in implants shrinkage regarding the type of surgery. MSCT is an effective method for evaluating the size of mesh titanium implants after hernia repair surgery.

This study provides a retrospective analysis of work to ensure high quality of medical care in an unfavorable epidemic situation. The consequence of COVID-19 was the implementation of a program to prevent the spread of infection, the re-profiling of medical institu-tions, and the introduction of restrictive and anti-epidemic measures. The experience of our work has shown the effectiveness of changing the order of med-ical care, the organization of the functioning of de-partments and patient routing. The study reflects the measures implemented in the hospital departments, the Department of clinical and laboratory diagnostics, radiation diagnostics and pathology Department. To ensure the safety of patients, it was decided to place patients on a single bed according to the type of infec-tious boxes. The safety of employees was ensured by the use of personal protective equipment, minimiza-tion of contact time with patients, and preventive weekly examination of staff for SARS-CoV-2 infection. The organized and well-coordinated work of the en-tire staff of the institution made it possible to prevent the spread of COVID-19 among employees, to detect cases of infection in a timely manner, and to carry out appropriate isolation and monitoring measures. At the time of completion of infectious diseases departments, the mortality rate among patients was less than 9%. Our experience in reorganizing a multi-specialty facil-ity can be used in the future when working with pa-tients who have undergone COVID-19, as well as in the context of a worsening epidemic situation.