lang.ru. Ovsyankina ES, Dobkin VG, Firsov VA et al. Lazeroterapija 8. v kompleksnom lechenii tuberkuljoza ljogkih u podrostkov: Posobie dlja vrachej [Laser therapy in the complex treatment of pulmonary tuberculosis in adolescents: A Manual for Physicians]. Problemy tuberkuljoza i boleznej ljogkih [Problems of tuberculosis and lung diseases]. 2005; 1: 56-61. Parmon EM, Barshcheuski VS, Kamyshnikov VS. 9. Kombinirovannoe nizkointensivnoe lazernoe izluchenie pri tuberkuljoze pochek [Combined low-intensity laser radiation when renal tuberculosis]. Problemy tuberkuljoza i boleznej ljogkih [Problems of tuberculosis and lung diseases]. 2003; 6: 28-33. Pilnik GV, Khanin АL, Nicotina GL. Jeffektivnost' 10. kompleksnoj terapii bol'nyh tuberkulezom legkih s primeneniem sovremennyh fizioterapevticheskih metodov [Efficiency of complex therapy of patients with a pulmonary TB with use of modern physiotherapeutic methods]. Cb. materialov nauchno-prakticheskoj konferencii. «Medicina 21 veka» [Coll. of materials of scientific and practical conference «Medicine of 21 centuries»]. Novokuznetsk, 2015: 102-103. Fizioterapija: nacional'noe rukovodstvo [Physiotherapy: 11. national leadership]. ed GN Ponomarenko. M: GEOTAR Media, 2009. 864 p. Khanin AL, Long SA. Vlijanie mediko-social'nyh faktorov 12. riska na jeffektivnost' lechenija vpervye vyjavlennyh bol'nyh tuberkulezom [Effect of medical and social risk factors on the effectiveness of the treatment of newly diagnosed TB patients]/ Sb. materialov mezhdunarodnoj nauchnoprakticheskoj konferencii «Social'no-znachimye bolezni». [Proc. International scientific-practical conference «Socio-significant diseases»]. Kemerovo, 2004: 55-57. Hudzik LB, Morozova ТI. Proteolitichekie sistemy krovi u 13. bol'nyh tuberkuljozom ljogkih [Proteolytic system of blood at Patient with pulmonary TB]. Problemy tuberkuljoza [Problems of tuberculosis]. 1994; 5: 56-58. Chastnaja fizioterapija / uchebnoe posobie [Private 14. physiotherapy / textbook]. ed GN Ponomarenko. M:

reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. carbon dioxide 30 [27][28][29][30][31][32][33][34][35] mmHg and median temperature 37.1 [36.8-37.3]°C. After removal of artefacts, the mean monitoring time was 22 h08 (8 h54). All patients had impaired cerebral autoregulation during their monitoring time. The mean IAR index was 17 (9.5) %. During H 0 H 6 and H 18 H 24 , the majority of our patients; respectively 53 and 71 % had an IAR index > 10 %. Conclusion According to our data, patients with septic shock had impaired cerebral autoregulation within the first 24 hours of their admission in the ICU. In our patients, we described a variability of distribution of impaired autoregulation according to time. ReferencesSchramm P, Klein KU, Falkenberg L, et al. Impaired cerebrovascular autoregulation in patients with severe sepsis and sepsis-associated delirium. Crit Care 2012; 16: R181. Aries MJH, Czosnyka M, Budohoski KP, et al. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury. Crit. Care Med. 2012.

No abstract

The objective of the study: to study certain parameters of the autonomic nervous system (ANS) and cognitive functions in patients with acute alcohol intoxication of different severity degrees. Subjects and methods. 312 patients with acute alcohol intoxication and chronic alcohol abuse were enrolled in the study. Manifestations, medical history, the duration of drinking bout, ethanol blood level were assessed. Blood panel included ALT, AST, LDH, and blood levels of free ammonia, lactate, and medium molecules. The subjects were divided into three groups: Group I - 78 patients with severe alcohol intoxication, Group II – 166 patients with moderate alcohol intoxication, and Group III – 68 patients with mild alcohol intoxication. The state of ANS was assessed according to the following indicators: heart rate, systolic and diastolic blood pressure, Kerdo vegetative index, and results of cardiointervalography by R.M. Baevsky (1986). The severity of intellectual impairment was assessed using the ММSE scale for 10 positions, the FAB scale for 6 positions, as well as the Reitan test in seconds on the 1st day. Results. In patients of Group I, the alcohol level was 1.5 and 1.35 times lower versus patients in Groups II and III. All patients with severe intoxication had symptoms of toxic hepatitis, which was manifested by a significant increase in ALT, AST, LDH and bilirubin, exceeding the normal limits by 5.4, 5.4, 1.8, and 1.7 times, respectively. Ammonia blood levels in patients with severe intoxication exceeded the norm by 5.6 times, in patients with moderate severity of intoxication – by 3 times, and even in patients with a mild degree – by 1.5 times. The lactic acid level in patients of Group I was 3.2 times above the norm, in patients of Groups II and III – 2.0 and 1.4 times, respectively. In patients with severe intoxication, there was an increase in blood levels of medium molecules over 0.6 units of optical density which reflected severe endogenous intoxication. Assessment of ANS parameters in patients of three groups revealed development of hypersympathicotonia due to the increased tone of the sympathetic department of ANS in proportion to intoxication severity. Cognitive functions at admission were inhibited in proportion to the severity of the patient's condition. Intelligence level as per MMSE scale: at admission, patients of Groups III and II demonstrated mild and moderate cognitive impairment (25.8 ± 2.1 and 23.31 ± 1.80 points); in Group I, indicators for all items were 1.5 times lower versus Groups II and III. Intelligence as per the FAB scale: in patients with severe intoxication, deviations in conceptualization and dynamic praxis were noted. The Reitan test results were best in patients from Group III. Subsequently, 63 (80.7%) patients with severe alcohol intoxication developed alcoholic delirium. Conclusion. Patients with alcohol intoxication demonstrated a decrease in cognitive functions and impaired intelligence proportional to the severity of intoxication and levels of lactate and free ammonia. Increased tone of the sympathetic division of the ANS is typical of acute alcohol intoxication during drinking bout. Cardiointervalography parameters can be used to assess the severity of alcohol intoxication.

Background. The one-year renal graft survival rates have grown to 93.4% for transplantation from cadaveric and 97.2% from living donors. Early detection and elimination of complications after kidney transplantation improve these figures.The study purpose was to develop an algorithm for the diagnosis and treatment tactics of postoperative complications after kidney transplantation by reviewing literature data and analyzing the results of our own experience.Material and methods. The study included 75 patients who underwent kidney transplantation from a living donor at the Republican Research Centre of Emergency Medicine from March 2018 to December 2019.Results. The original authors' algorithm developed for the diagnosis and treatment of complications after kidney transplantation covers all postoperative complications that lead to renal transplant dysfunction. It is based on assessing the symptoms that typically occur in a specific complication. The main instrumental methods in the diagnosis of postoperative complications are ultrasound and radiological investigational techniques. The biopsy has the main role in diagnosing a graft rejection. Among 75 patients after kidney transplantation, 23 (30.6%) developed various early postoperative complications, including both surgical and immunological ones. Renal graft dysfunction was eliminated in 17 (73.9%) of 23 patients. The loss of a transplanted kidney was associated with the death of 7 recipients (9.3%). The causes of death were pulmonary embolism in 2 (2.7%) cases, infection and sepsis as a result of immunosuppression in 2 (2.7%) cases, hypovolemic shock in 2 (2.7%) cases, and acute ischemic stroke in 1 (1.3%) case. Two recipients underwent renal transplant nephrectomy. The cause of nephrectomy was graft rejection and bleeding from the renal artery. A oneyear survival rate was 90.7%. The proposed treatment and diagnostic algorithm showed a 95.7% diagnostic value in identifying the complications, and 91.3% of the therapeutic effect in coping with a renal transplant dysfunction.Conclusions. Early treatment of revealed complications allows saving the transplanted kidney function. Step-bystep differential diagnosis of complications after kidney transplantation, according to the proposed algorithm, allows choosing the treatment tactics based on complication pathogenesis.