The aim of the study was to assess efficacy and safety of intermittent pneumatic compression (IPC) in addition to the standard prevention of postoperative venous thromboembolism (VTE) in patients with colorectal cancer who are at extremely high risk for VTE. Methods. The authors randomly divided patients, who underwent major surgery for colorectal cancer and had a Caprini score of 11 or more, into two groups — the main (n = 103) and control (n = 97). Standard prevention of venous thromboembolism included compression stockings and low-molecular-weight heparin injections in both groups. Intermittent pneumatic compression was additionally used in the main group. IPC was applied within 12 hours after surgery round-the-clock in the intensive care unit and after patient transfer to the surgical department only during the patient’s stay in bed, with the exception of the 6-hour nightly interval, which ensured compliance at the level of 91 %. The primary outcome was an asymptomatic venous thrombosis of the lower limbs detected by duplex ultrasound scan, which was performed before inclusion and every 3–5 days after surgery during inpatient treatment. Results. The primary outcome occurred in one (1.0 %) patient in the IPC group and 23 (23.7 %) patients in the control group (relative risk 0.04, 95 % confidence interval [CI] 0.01–0.30, p<0.001). Pulmonary embolism occurred in none of the 103 patients in the IPC group and in four (4.1 %) patients in the control group (relative risk 0.10; 95 % CI 0.01–1.92), and postoperative death occurred in none patients in the IPC group and in three (3.1 %) in the control group (relative risk 0.14; 95 % CI 0.01–2.57). Lethal outcomes for other reasons were not observed. Conclusion. Results of adjunctive intermittent pneumatic compression in patients with colorectal cancer and extremely high risk for VTE, who took standard prevention measures, led to a significantly lower incidence of asymptomatic venous thrombosis of the lower limbs than standard thromboprophylaxis alone.

The article presents a clinical case of the treatment of severe radiation proctitis using argon plasma coagulation.

The aim of the study was to determine the effectiveness and safety of the new-generation local hemostatic agents in the prevention and arrest of colonic bleeding during interventional endoscopic procedures. Patients and methods. The study included 72 patients, in the treatment of which the application method of hemostasis was applied: irrigation of 10–30 ml of a 1 % solution of an incomplete silver salt of polyacrylic acid with integrated silver nanoparticles (group 1) and the application or injection method (2.5–5 ml) for the prevention of bleeding (group 2). 94 cases of drug application were registered. Patients were monitored for 14 days after the intervention. Results. The effectiveness of hemostasis during biopsy was 100 %. Additional hemostasis methods were significantly more frequently used (F = 0.00001, p <0.05) in case of polypectomy. The overall effectiveness of preventive measures was 77.08 %. The process of forming a polymethacrylate film did not interfere with the visualization of the bleeding zone and allowed the effective use of additional hemostasis methods. Side effects and complications associated with the use of a hemostatic agent were not observed during the procedures. Recurrent bleeding was not registered. Conclusion. The introduction of new methods of prevention and arrest (hemostasis) of the colonic bleeding and introduction of the new local hemostatic agents is necessary in everyday practice related to the interventional endoscopic procedures. Further research on clarifying the capabilities of the new generation of local hemostatic agent has to be continued.

Tuberculosis of endocrine glands is a rather rare and poorly studied pathology. The level of endocrine lesions in tuberculosis remained quite high before the use of complex chemotherapy, but frequency of tuberculosis of endocrine glands has decreased significantly over the past 50 years and now very few cases are found mainly in countries endemic for tuberculosis. Doctors of different specialties rarely suggest tuberculous etiology as the cause of endocrine dysfunction. Brief information on the localization of endocrine tuberculosis, methods of its radiological and surgical diagnosis are presented in the proposed review.

The aim of the study was to improve the surgical treatment of extended strictures and obliterations of the upper third of the ureter in patients with tuberculosis of the urinary system, post-tuberculosis lesions of the upper urinary tract, recurrent strictures (obliteration) after previously unsuccessful reconstruction of the ureter. Seven patients with this disease underwent reconstruction of the upper third of the ureter and the ureteropelvic segment with removal of the affected part and replacement with a tubularized buccal and lingual flap with fixation to the lumbar muscle. The length of the resected section of the ureter with the ureteropelvic segment zone was from 5 to 9 cm (an average of 7.0 + 1.4 cm). There were no serious complications of 3–4 grade according to the Clavien-Dindo classification, as well as fatal outcomes. No relapses were detected with follow-up periods of up to 32 months. It is concluded that this method can serve as an alternative technique when it is impossible to restore the upper urinary tract using its own ureteral or intestinal tissues.

The main objective of this study was to analyze the adverse drug reactions (ADRs) in elderly patients. We analyzed ADR reports submitted to the Russian Spontaneous Report Database from January to June 2018. ADR cases with the use of antithrombotic drugs, antimicrobials, and drugs that affect the cardiovascular system prevailed. The most frequently reported reactions were general disorders and administration site conditions, cardiovascular disorders, respiratory system disorders, skin disorders, gastrointestinal disorders.