Efficiency Evaluation of the Peridural Analgesia Methods After Hemorrhoidectomy

This article presents the results of a comparative assessment of the effectiveness of epidural anesthesia with a combination of local anesthetic and morphine with an automatic syringe, the technique of epidural analgesia in the bolus mode at specified time intervals and at the patient's request, and analgesia in the form of a continuous epidural infusion of 0.5% bipuvicaine solution in combination with a narcotic drug in patients after hemorrhoidectomy. Based on the results of the analysis, it can be concluded that the method of prolonged epidural analgesia in the postoperative period allows achieving good results with the least complications.

The use of transdermal therapeutic systems for chemical pleurodesis in a patient with prolonged air leakage after lung resection for cancer

This clinical observation demonstrates a method of a motivated use of a transdermal therapeutic system (TTS) based on fentanyl for chemical pleurodesis in a patient with prolonged air leakage after lung resection for cancer. The most common complication after elective lung resections is an alveolar-pleural fistula or prolonged air leakage. This clinical phenomenon occurs as a result of communication between the alveoli of the lung parenchyma distal to the segmental bronchus and the pleural cavity. In most cases, air leakage through the drains is eliminated spontaneously, but the frequency of prolonged pneumostasis absence in the postoperative period can reach 25 %, which has a negative effect on the outcomes of surgical interventions due to the development of pneumonia and empyema. Long-term drainage of the pleural cavity does not always end with aerostasis and requires repeated invasive interventions. One of the ways to achieve the tightness of the lung tissue involves various methods of chemical pleurodesis, which is a surgical manipulation – the introduction of a sclerosing chemical substance into the pleural cavity by spraying medical talc through a trocar or a injecting tetracycline solution into the pleural drains. The chemical causes aseptic inflammation and adhesions between the visceral and parietal pleura, followed by obliteration of the pleural cavity. The sclerosant introduction is accompanied by severe pain that can provoke respiratory and/or hemodynamic deficits, up to apnea and life-threatening heart rhythm disturbances. Pain relief during chemical pleurodesis is obviously an important factor in the prevention of a number of complications in patients undergoing surgery for lung cancer. Bolus intravenous injections of narcotic analgesics lead to an analgesic effect, but a short-term one due to the absence of a depot in the body and a sharp drop in the drug concentration in the blood serum. Unfortunately, this method of introducing narcotic drugs can cause various complications in weakened and elderly cancer patients, such as respiratory depression and cardiac arrest. The TTS action is characterized with continuous dosing and the creation of a constant concentration of the narcotic drug over a certain period of time. This method provides a multilevel and systematic approach to pain relief, reduces toxicity and minimizes the inhibition of the central mechanisms of external respiration regulation without causing respiratory and cardiac disorders in patients who underwent lung resection.

External study possibilities of a dead body solution about the death occurrence from psychotropic and narcotic drug poisoning

Background: Poisoning with psychotropic and narcotic substances is still leads to the general structure of fatal intoxications. A decreased traditional psychotropic and narcotic drug fatal poisoning and an increased new synthetic psychoactive substances and combined consumption are recorded in the country. Aims: This study aimed to study the dynamics of drug poisoning incidence according to the annual report data in 20172020 in the Krasnodar territory and establish their predominant etiology. Analyze the medical literature and identify the data mostly described during the external examination that suggests narcotic drug exposure possibility of the body. Comparison of the literature and external examination results of the corpse from the Expert Conclusions (Acts of forensic medical research) to further use the signs to create a profile of the suspected poisoned corpse with narcotic substances. Material and methods: The study material includes the annual reports of the State Budgetary Healthcare Institution Bureau SME of the Ministry of Health of the Krasnodar Territory in 20172020, archival medical documentation autopsy reports in cases of death from narcotic substances; domestic and foreign literary sources. Results: In the Krasnodar Territory, opiates account for a large proportion of drug deaths. Psychotropic and narcotic drug intake is often (up to 30%) combined with alcohol consumption. The study showed that forensic pathology rarely uses external signs that make up the profile of a corpse suspected of drug poisoning at the initial stage. The most common signs (in 50% of cases) were: injection traces, cyanotic and flushed face, conjunctival hemorrhages, and whitish-pink foam in the nose or mouth openings. Others were not given due attention. Conclusion: The research topic dictates the need for further study and problem development, accumulation, and systematization of the obtained material for subsequent use.

On the Issue of Simulation Training in the Cycle of Additional Professional Education "Turnover of Narcotic and Psychotropic Drugs"

Simulation training is an interactive type of educational activity realized through immersion in the environment, by recreating a real clinical situation. At the same time, it is not possible to observe the maximum immersion in reality when training on the circulation of narcotic drug and psychotropic substance due to strict control measures on the part of the supervisory authorities in terms of the circulation of narcotic drugs and psychotropic substances. The article discusses options for resolving the issue of organizing simulation training on the circulation of narcotic and psychotropic substances for nurses.

Clinical and forensic aspect’s of the cocaine body packer in senegal

This study aims to describe the clinical and forensic features of the cocaine body packer in Senegal.This research work is a retrospective and descriptive study. It was conducted based on 19 suspect cases attended for medical care at the Hospital of tambacounda. Suspects were exclusively male subjects, aged 24 to 33 years and Nigerian citizens. All of them were asymptomatic. Pelvic touch was positive in 42.1% of cases. Abdominal radiography pointed out that all the suspects presented with damage (100%). The average number of drug pellets carried per person was 43+/- 20 units. Body drug packing is a reality in Senegal. Narcotic drug policies should invest in capacity building by financing effective diagnostic tools.

Epidemiology of amyloidosis (prevalence of etiological thinking)

Амилоидоз - патологический процесс, вызванный различными средовыми и наследственными этиологическими факторами, развивающийся по собственным законам вне зависимости от первичных причин, его вызвавших. По этой причине систематизация сведений об эпидемиологии амилоидной болезни является трудной задачей по причине различий используемых методик статистического анализа, отсутствия единой, принятой во всем мире классификации этой патологии, различий учета этой патологии клиницистами и патологоанатомической службой. Неcмотря на наличие классификации амилоидозов ВОЗ, основанной на патогенетическом принципе, статистический учет случаев амилоидоза проводится по отдельным нозологическим формам. Поэтому часть случаев амилоидоза проходит мимо статистического учета. В целом это создает неправильное впечатление, что амилоидоз встречается значительно реже, чем это есть на самом деле. Цель исследования - анализ доступных данных литературы по эпидемиологии амилоидоза для приблизительной оценки реальной картины распространенности этого вида патологии. Результаты. Проведен анализ данных литературы по эпидемиологии амилоидоза, болезни Альцгеймера, АL- и AA-амилоидозов, LECT2 амилоидоза, наследственных амилоидозов, фармакологического амилоидоза и амилоидоза, вызванного приемом наркотических средств. Проанализированы связи распространённости амилоидоза с возрастом и полом. Выявлены различия методов исследования эпидемиологии амилоидоза, приводящие к получению несопоставимых данных. Поскольку разные авторы не использовали единые методики оценки эпидемиологии амилоидоза, данные, полученные в одном и том же географическом районе, различаются иногда на порядок. Предложена к обсуждению собственная классификация амилоида по происхождению. Поскольку амилоидоз является не диагнозом, а патологическим процессом, предлагается отказаться от нозологического принципа статистического учета случаев амилоидоза в пользу патогенетической классификации ВОЗ. Заключение. Единых сопоставимых сведений о распространенности и заболеваемости амилоидозом нет, по этой причине необходимо введение обязательного исследования материала биопсий и аутопсий на наличие амилоида с помощью окрашивания конго красным. Также необходимо создание цифрового национального реестра больных амилоидозом и разработка методов ранней прижизненной диагностики амилоидоза, возможно, на основе протеомного анализа плазмы крови. Amyloidosis is a pathological process caused by various environmental and hereditary etiological factors. It develops according to its own rules, regardless of the primary events that caused it. Systematization of information about amyloid disease epidemiology is a challenging task due to differences in the methods used for statistical analysis, the lack of a unified worldwide classification of this pathology, and differences in the description of this pathology by clinicians and pathologists. Despite a WHO classification of amyloidosis based on a pathogenetic principle, statistics on some amyloidosis cases are performed by individual nosological forms. Therefore, some amyloidosis cases are not included in statistical analyses. In general, this creates an incorrect impression that amyloidosis is much less common than it actually is. The aim of this study is to analyze the available literature data on the epidemiology of amyloidosis in order to approximate the correct prevalence of this pathology. Results. The published data on the epidemiology of amyloidosis, Alzheimer’s disease, AL- and AA-amyloidoses, LECT2 amyloidosis, hereditary amyloidoses, pharmacological amyloidosis, and narcotic drug induced amyloidosis were analyzed. Also the relationship of amyloidosis with age and sex was taken into account. Differences were identified in research methods for the epidemiology of amyloidosis that led to incompatible data. Since different authors use different methods for assessing the epidemiology of amyloidosis, data obtained in the same geographical area sometimes differed by an order of magnitude. Own classification of amyloidosis by origin is proposed for discussion. Since amyloidosis is not a diagnosis, but a pathological process, it is proposed to abandon the nosological principle of statistical accounting of amyloidosis cases in favor of the WHO pathogenetic classification. Conclusion. There are no uniformly comparable data on the prevalence and incidence of amyloidosis. For this reason, mandatory staining with Congo red of biopsy and autopsy material for the presence of amyloid is required. It is also necessary to create a digital national registry of patients with amyloidosis and to develop methods for early lifetime diagnosis of amyloidosis, possibly based on proteomic analysis of blood plasma.

The European Arrest Warrant in Designer Drugs Cases. With or Without Verification of Double Criminality?

The cross-border character of the designer drugs crimes forced the UE countries to cooperate in criminal prosecution. At first sight, in European Union law, there are proper instruments to enforce such cooperation. The Framework Decision on the European Arrest Warrant introduces the model of cross-border prosecution and abandons the requirement of double criminality in case of the group of the 32 crimes, listed in the Article 2 (2) of the FD EAW. The question is whether such a simple variant of EAW (without checking double criminality) may be enforced in designer drug cases. The work presents an argumentation that the normative meaning of Article 2 (2) of the FD EAW has to be established under European and international law. As long as a particular new drug is not internationally recognized as ‘psychotropic substance’ or ‘narcotic drug’, its trafficking cannot be treated as one of the 32 crimes, mentioned above.

Corporate governance and organized crimes: Comparative analytical study of the legislative role

This research aims to study the organized crime, its characteristics, and the legislative role in combating it. Due to its reception of many refugees from Syria, Iraq, Yemen, and Libya, the United Arab Emirates (UAE) and Jordan witnessed a widespread of numerous forms of organized crimes such as drug crimes, money laundering, and human trafficking. The authors seek to clarify how Emirati and Jordanian lawmakers dealt with such crime, and whether their legal texts were sufficient and consistent with international conventions. An analytical and comparative approach was the methodology utilized to conduct the study. The authors tackled this research through, the demonstration of the concept of organized crime in the international conventions and national legislation and the viewpoints of Jurisprudence in this regard. Organized crime is described as a threat to national security and as a crime that has dire political implications at the national and international levels (Campbell, 2014). The research has focused on the laws concerning common organized crimes such as narcotic drug trafficking, human trafficking, and money laundering. This research highlighted the efforts exerted by legislators in both countries to combat organized crimes. The findings indicate that both countries enforced specific laws and regulations to stop such crimes

METHODS OF SEPARATION AT THE PREPARATORY STAGE OF CRIMINAL EXAMINATION OF MATERIAL EVIDENCE

In expert practice, questions often arise related to the separation of research objects from a mixture of dissimilar particles of solid materials, liquids of different densities, emulsions, and two-phase media. During the study, physical and chemical separation methods are used. The choice of the separation method depends on the percentage composition and properties of the mixture and its constituent components. Expert research is carried out using various separation methods: by mass (inertial), by size, electrical, magnetic, radiometric, photometric, etc. Chemical separation is its separate type. The analysis of expert practice indicates that separation is mainly applied during the forensic investigation of metals and alloys (solids), drugs (solids, liquid substances) and petroleum products (liquid substances). The article analyzes the methods of separation at the preparatory stage of the expert study of micro-particles of precious metals and handicraft drugs. Forensic investigation of products made of metals and alloys is one of the most difficult, since the detection and separation of micro-particles of the metal under study from other metal particles and their subsequent identification require the use of both chemical and instrumental research methods. The separation of the metal under study from the mixture of other metal particles was carried out by the method of mechanical and magnetic separation and chemical (selective dissolution) separation. In the course of the expert study opium acetylated using chromatographic methods difficulties often arise associated with separation of components due to the presence of large amounts of acetylated opium extractable from poppy straw ballast substances (in particular chlorophyll). The use of an inertial separation method makes it possible to speed up the separation of an aqueous solution of a narcotic drug emulsion and an extracting organic solvent.