The long-term monitoring of the state of the freshwater ecosystem of the River Yenisei revealed the statistically reliable content of heavy metals (Fe, Zn, Cd, Cu, U, etc.) in the water, bottom sediments, phyto- and zoo-plankton, and muscle mass of commercial fish (benthos eaters, predators and herbivorous fish) consuming different types of food. The values of the indices of the ecological state of the Yenisei River were estimated to vary from 2.38 to 2.85. The total index of risk for the water, considering the reference doses, amounts to 0.16 for the water, and to 0.47 for the flesh of commercial fish. The total index of risk for the population consuming freshwater and fish from the Yenisei River amounts to IR=0.63. The obtained value of the index is, in general, of no danger for the population health. Though the carcinogenic substances were not accurately revealed, non-carcinogenic substances were estimated to the level of non-threshold risks. The non-threshold risks of non-carcinogenic substances was found 0.017, far lower than permissible limit 0.050. The ratio of reflectory-olfactory effects and total non-carcinogenic risk was found, respectively, 0.01 and 0.34. The integrated indictor was 0.35, which did not exceed the regulatory level (II≤1). Conclusively, the risks associated to various analyzed indicators did not exceed the permissible levels and did not require additional measures of monitoring the water quality.

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Results: Serum OPG concentrations increased throughout the study period (p = 7.26x10 -5 ) while RANKL concentrations did not change (p = 0.19). The OPG:RANKL ratio exhibited a 6.2-fold increase between Days 1 and 5. CTX-1 concentrations were lower (p = 0.006) 30 minutes after the 50 U/kg FVIII infusion. CTX-1 response for each participant was assessed using linear regression throughout the time course. Spine L1-L4 Z-score (SZ) and Hip Total Z-score (HTZ) correlate with CTX-1 response (p = 3.4x10 -4 and 0.014, respectively). The mean age of participants was 25.2 ± 2.1 at time of first study visit. Participants had a mean SZ of −0.74 ± 0.34, HTZ of −0.17 ± 0.32, Hip Neck Z-score (HNZ) of −0.16 ± 0.35, and HJHS of 20 ± 5. HTZ and HNZ decreased significantly with patient age (p = 0.027 and 0.032) while SZ and HJHS did not (p = 0.18 and 0.16). Consequently, age correction was applied to BMD comparisons. Statistical comparisons between HAL, EQ-5D-3L, and BHQ answers, BMD data, and HJHS are shown in Table 1. Summary/Conclusion: This prospective study demonstrates a relationship between FVIII deficiency and bone disease in PwH. OPG acts as a decoy ligand to RANKL, inhibiting osteoclastic bone resorption. The observed increase in OPG:RANKL ratio suggests FVIII has a direct impact on this pathway. Decreased CTX-1 concentrations following factor infusion and correlations between CTX-1 response and BMD further suggests that FVIII plays a role in moderating bone remodeling. Hemophilia-associated bone and joint pathology is associated with decreased quality of life. Correlations between BMD and questionnaire responses demonstrate that poor bone and joint health is physically limiting, causes discomfort, and negatively impacts perceptions of personal well-being. Furthermore, correlations between BMD and HJHS and ISTH-BAT responses (Table 1) illustrate a relationship between bleeding management and skeletal health. PwH with lower BMD report more nose and gum bleeds, suggesting a link between FVIII replacement and skeletal health. Bleeds in the extremities were not correlated with decreased BMD or increased HJHS, but abdominal (stomach, iliopsoas) and other bleeds were. Analysis of these data is ongoing.

Разработка способа адаптации размеров лапаротомии к топографо-анатомическим параметрам живота больных тонкокишечной непроходимостьюАктуальность. Оптимизация размеров опе-ративного доступа положительно влияет на динамику выздоровления. Размер срединной лапаротомии при операциях по поводу тонкоки-шечной непроходимости определяется обычно без учета особенностей анатомического строе-ния брюшной полости больного.Цель -улучшить результаты лечения больных острой тонкокишечной непроходимостью путем адаптации параметров срединной лапаротомии к конституциональным особенностям пациента. Материал и методы.Проанализированы ре-зультаты лечения 101 больного острой тон-кокишечной непроходимостью. Пациентам 1-й группы (n = 49) лапаротомию выполняли, руководствуясь вновь разработанным спо-собом определения размеров лапаротомии. Больные из 2-й группы (n = 52) проходили лече-ние в период, когда способ находился на стадии разработки. С целью выявления оптимальных параметров лапаротомии проведен анатомиче-ский эксперимент на 90 трупах долихо-, мезо-и брахиморфного типов телосложения.