Chronic kidney disease is considered an important medical and social problem of modern society, due to its significant prevalence, high cost of treatment, persistent impairment of basic renal functions, the risk of complications and mortality. The noted rapid growth in the population of the number of patients with reduced renal function. The number of patients constantly receiving renal replacement therapy is growing steadily every year. In 90 % of patients with chronic renal failure who are on renal replacement therapy, including programmed hemodialysis, various pathological changes in the gastrointestinal tract are manifested, which are often diagnosed by instrumental and laboratory studies. The observed widespread prevalence of purulent-septic diseases, among which peritonitis occupies up to 25 % of all surgical patients, including those on programmed hemodialysis, leads to the search for new diagnostic justified criteria for its verification. Lack of reliable laboratory methods for early and timely diagnosis of uremic pseudoperitonitis and peritonitis in patients on renal replacement therapy (programmed hemodialysis), blurred clinical manifestations, possible atypical course of peritonitis, the ambiguity of laboratory parameters of the severity of peritonitis, non-specificity of the clinical manifestations of peritonitis lead to untimely diagnostics and belated surgical interventions, which complicates the choice of medical tactics.

The main tendencies of the development of tactics of surgical treatment of patients with acute obturation colonic obstruction of tumour genesis in conditions of a general surgical hospital are described. Over the past decades, surgical tactics have changed qualitatively in the treatment of obturation intestinal obstruction against the background of a colon tumour. According to numerous statistics, with emergency resection interventions, the results are worse, and the mortality and incidence of complications are higher than with planned ones. In the tumour process in the right sections of the colon, right-handed hemicolectomy surgery and the formation of primary iliac-colon anastomosis remain the generally accepted standard. In the case of treatment of tumour lesions in the left parts of the colon, modern mini-invasive technologies are used, designed for temporary recanalization and decompression of the colon and involving subsequent operations with the application of primary anastomosis. Metal self-expanding colorectal stents and mini-invasive drainage interventions with clear imaging of the probe by X-ray and tomography techniques in the treatment of acute obturation colorectal obstruction of tumour genesis are promising areas for further research not only in coloproctology departments but also in emergency general surgical hospitals.

The article provides an overview of the latest literature data on the problem of allergic rhinitis in children. Modern views on the causes, risk factors of the disease, pathogenetic mechanisms of the development of allergic rhinitis, classification criteria and the nomenclature of this pathology are substantiated. Modern concepts and approaches to the diagnosis and treatment of allergic rhinitis in children are considered.

According to the Guidelines for the treatment of hypertension of the European society of cardiology and the European society of hypertension, one of the main classes of drugs recommended for use in hypertension are angiotensin converting enzyme inhibitors. The results of numerous studies have confirmed that angiotensin converting enzymeinhibitors reduce the risk of General mortality and mortality from cardiovascular diseases, but the use of drugs in this group is associated with the risk of developing adverse reactions, the main of which are dry cough, orthostatic collapse, hyperkalemia, angioedema. This review is devoted to the study of the safety profile of angiotensin converting enzyme inhibitors, the features of adverse reactions development in various categories of patients. The aim of this work is to increase patients ' compliance to antihypertensive pharmacotherapy and reduce the risk of developing complications from the cardiovascular system.

The aim of the research: to study and analyze the level of Klotho protein in patients with chronic obstructive pulmonary disease depending on the tobacco smoking duration. Materials and Methods. Patients with chronic obstructive pulmonary disease (n = 54) with moderate and severe stages of the disease were divided into three subgroups of patients depending of the tobacco smoking duration: the first subgroup - from 10 to 20 years, the second subgroup - from 20 to 30 years, and the third subgroup - from 30 and more years of tobacco smoking duration. Somatically healthy volunteers (n = 30) were examined as a control group. Results. The Klotho protein level in patients with chronic obstructive pulmonary disease was statistically significantly lower (p < 0,001) than in somatically healthy volunteers. The value of the Klotho protein level also had statistically significant differences in the analyzed subgroups of patients with chronic obstructive pulmonary disease (depending on the tobacco smoking duration). According to the results of the correlation analysis, a relationship was revealed between the level of Klotho protein and the smoking index, and also between the level of Klotho protein and the tobacco smoking duration. Conclusions. The lowest level of Klotho protein was in the subgroup of patients with tobacco smoking duration of 30 and more years. At the same time, the Klotho protein level in subgroup of patients with tobacco smoking duration from 30 and more years was statistically significantly lower compared to the subgroups of patients with less tobacco smoking duration (from 20 to 30 years and from 10 to 20 years). A large relationship between the level of Klotho protein and tobacco smoking duration was registered in the subgroup of patients with tobacco smoking duration of 30 and more years.

Uterine fibroids is the most common tumour of the reproductive system. Despite the presence of a large number of ongoing studies, the study of this pathology is still relevant due to many unresolved pathogenesis issues. The presence of genetic predisposition, belonging to the black race, age, especially late reproductive, early menarche, absence of births in the history and, of course, obesity are considered as risk factors for uterine fibroids development. In this regard, the study aimed to study the relationship between fetal macrosomia, obesity and the risk of the formation of hormone-dependent tumours of the genitals. The research methods included the study of apoptosis processes in simple and proliferating uterine fibroids by determining the level of the ligand inducing apoptosis, which made it possible to identify a group of patients with a high proliferative activity of myomatous nodes, and when analyzing the patient histories, the most significant signs and characteristics were identified, in the presence of which significantly increases the likelihood of detecting uterine fibroids. The results of the study presented in this paper allow us to set the necessary accents and form risk groups for uterine fibroids development and, above all, the most mitotically active variant - proliferating uterine fibroids.

This study is devoted to the assessment of the acute toxicity of the pyrimidine compound 3-(2-Benzyloxy-2-oxoethyl)quinazoline-4(3H) - one (VMA-13-03) in order to determine the possibility of further study of its pharmacological activity. The study was conducted on non-linear male rats of 3 months of age. The animals were divided into groups: the control group - animals that received an equiobject of distilled water; the experimental groups-animals that received an intragastric substance in doses of 500; 1000; 2000; 4000 mg/kg. Possible manifestations of acute toxicity were determined within 14 days after administration of the compound, assessing the general condition, body weight, condition of the hair and skin, and mucous membranes, and hematological and biochemical blood tests were performed. The assessment of the acute toxicity of the new pyrimidine derivative showed that this compound can be classified as class 4 toxicity or low toxic substances. However, due to the fact that when this compound was administered at a dose of 4000 mg/kg, changes in biochemical parameters were observed, indicating the possible development of pathological changes in the hepatobiliary system, it is necessary to study the chronic toxicity of the pyrimidine derivative under study.

The combined prospective-retrospective study analyzed the results of the treatment of 157 patients operated on for obstructive intestinal obstruction due to tumours of the right colon. In the control group (81 patients), risk factors for the development of complications and “nonradicality” of surgical interventions, D2 lymphadenectomy, as well as causes that worsen the general prognosis and long-term oncological results were identified. In the main group, 76 patients underwent a developed complex diagnostic and treatment algorithm and a modified technique of laparoscopic mesocolonectomy with D3 lymph node dissection. The average number of affected lymph nodes in patients of the main group with identified metastases was 17,4 ± 4,2 compared to 10,2 ± 4,6 in patients in the control group.In both groups, the greatest number of complications was observed in patients with decompensated intestinal obstruction and multiple organ failure or a clinic of peritonitis. Intraoperative and postoperative complications in patients in the main and control groups were comparable and did not differ statistically (p > 0,05). A smaller number of anastomotic leaks in patients of the main group (n = 3; 3,9 %) compared with patients in the control group (n = 5; 6,2 %) is associated with the use of intraoperative decompression of the colon.The proposed D3 lymph node dissection technique allows increasing the number of removed lymph nodes without impairing the immediate results of patient treatment.

The hydatide form of echinococcosis cystus, despite the endemic nature of the disease, is a fairly common pathology today. The localization of the parasitic cyst in the pancreas belongs to a rare pathology, its occurrence accounts for less than 1 %. Presented is a clinical case of successful treatment of a patient with a rare localization of echinococcal cyst in the pancreas. Surgery was performed in the form of a pericystectomy.