We conclude that ESWL with the Siemens Lithostar-plus is the most effective and cost-efficient in morbidly obese patients with pelvic stones sized between 6 and 20 mm. 87% success rate was achieved. The increased distance from the skin surface to the stone in those patients does not decrease the success rate provided the stone is positioned in the focal point or within 3 cm of it on the extended shock pathway. ESWL should not be considered as the first line of treatment in the morbidly obese patients with low caliceal stones where the stone was positioned more than 1 cm from the focal point on the extended shock pathway.

Purpose: Clinical studies produce conflicting results on pain relief for shock wave lithotripsy (SWL). We performed a systematic review and meta-analysis to compare non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in pain relief for SWL powered by an electromagnetic generator. Material and Methods: A search of MEDLINE and EMBASE was performed and all randomized controlled trials comparing NSAIDs and opioids in pain relief for SWL using modern electromagnetic lithotripters were included in the analysis. Data from 3 trials (244 patients) were pooled. The primary outcome measure was adequate analgesia, defined as "if no additional pain relief was used". The difference in the proportion of patients with adequate anesthesia was compared between the NSAIDs and opioids groups as an odds ratio and odds ratio were pooled across the 3 trials with a fixed effects model. Results: There was no statistically significant difference between using NSAIDs and opioids for pain relief during SWL using modern electromagnetic lithotripters (odds ratio 0.886, 95% CI 0.446-1,760, p = 0.730). Conclusions: Our analysis shows that in relieving pain during SWL using modern electromagnetic lithotripters NSAIDs are as effective as opioids.

Interest in the transmutation of long-lived radioactive elements into stable or short-lived elements by means of nuclear reactions has increased sharply in the last few years. Specialists who support the practical application of methods for burning up radionuclides agree that efforts must first be focused on transuranium elements (237Np, 244Cm, 241Am, 241pu) as well as long-lived fission products, such as t29I and 99Tc [l, 2]. Radiation burnup of Np, Am and Cm and fission products with long half-lives is possible only after they are separated from the main mass of the spent fuel, including uranium and plutonium. Besides the main problem of eliminating an ecologically dangerous, long-lived radionuclide, transmutation of technetium will make it possible to obtain more stable ruthenium, which can then be used for industrial purposes.In studying methods for separating technetium from spent nuclear fuel, it becomes obvious that calcium pertechnetate obtained on an industrial scale (only at the Industrial Association NMayak') requires additional purification (even though it is of high radiochemical purity) in order to meet the requirements imposed on transmuted target preparations.According to the technical conditions, the content of radioactive impurities in 99Tc preparations should not exceed 0.024% of its own radioactivity. Radioactive impurities in technetium compounds were monitored on an ionizing-radiation spectrometer. In the course of this work new methods of preparation and analysis of especially pure technetium preparations were developed and tested.Data on the radiocbemical purity of industrial preparations of technetium are given in Table 1. The data were obtained by using methods which were developed for analytical monitoring.One can see from Table 1 that the main impurities in the 99Tc preparations are 98"1"c, l~ 137Cs, 238pu, 241Am, 239pu, 9~ Their content is at the level of 3.10 -4 of the radioactivity of 99Tc (radiochemical purity 99.9997%). Under production conditions, technetium preparations of higher purity cannot be obtained by technological schemes.To increase the radiochemical purity of technetium preparations, the initial potassium pertechnetate must be additionally purified by means of an optimal technological scheme for converting KTcO 4 into NH4TcO 4, which is the most acceptable form of the material for subsequent production of technetitun metal. When ammonium pertechnetate is reduced by hydrogen, only gaseous products and technetium metal are formed: NH4TcO 4 + 2H 2 ---, I/2N 2 + 4H20 + To. The conversion of KTcO 4 into NH4TcO 4 is possible on a KU-2 cation exchanger in an H + form followed by neutralization of the technetium acid by ammonia. Ammonium pertechnetate easily crystallizes from water solutions, which makes it possible to obtain this compound with a high purity.Extraction, ion-exchange, and precipitation methods for concentrating and removing from technetium the accompanying elements are well known and are described in detail in the literature. These methods can also be combined....

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Мета: розробити методику рентгенометричного вимірювання антеторсії ніжки та антеверсії чашки ендопротеза в пацієнтів після ендопротезування кульшового суглоба. Матеріали та методи. Розроблена методика рентгенометричного вимірювання величин антеторсії ніжки та антеверсії чашки після ендопротезування кульшового суглоба. З листопада 2015 по листопад 2016 року ми вимірювали антеверсію чашки й антеторсію ніжки ендопротеза у 23 пацієнтів після ендопротезування кульшового суглоба рентгенометрично за допомогою розробленого нами методу й порівняли отримані показники з даними комп’ютерної томографії. Результати. З’ясовано, що середня величина кута антеторсії ніжки ендопротеза в групі за даними комп’ютерної томографії становила 7,4 ± 1,9°, кута антеверсії — 20,2 ± 6,1°. Аналогічні показники величин кутів антеторсії та антеверсії за даними рентгенометрії, виконаної за розробленою нами методикою, становили 5,2 ± 0,6° та 24,1 ± 6,2° відповідно. Порівняльний аналіз між групами даних комп’ютерної томографії та рентгенометрії не виявив статистично значимих розбіжностей, що підтверджує вірогідність досліджуваного методу (p = 0,346 для величини кута антеторсії ніжки, p = 0,191 для величини кута антеверсії чашки). Ви­сновки. Розроблена нами методика визначення величин кутів антеторсії ніжки та антеверсії чашки ендопротеза за даними рентгенометрії не поступається за точністю аналогічним вимірюванням за допомогою комп’ютерної томографії.