2021 Issue №3

The article analyses the results of the examination and treatment of 18 patients with acute biliary pancreatitis (ABP). They underwent endoscopic retrograde endobiliary interventions (EREBV), which were performed in the X-ray surgery under endotracheal anesthesia using X-ray vision and included the following: endoscopic retrograde cholangiopancreaticography (ERCP), en­doscopic papillosphincterotomy (EPST), lithotripsy, lithoextraction, duct stenting. The following types of EPST, subtotal, limited, papillotomy, were performed.

After performing a papillotomy, 1 (5.6 %) a bleeding was stopped by con­servative measures. The fatal outcome was accounted for 1 (5.6 %). The pa­tient was admitted with symptoms of severe intoxication, pancreatogenic shock, and was diagnosed with total pancreatic necrosis. Despite the intensive therapy, there was a progression of the disease, an increase in multiple organ failure. In the remaining cases, the treatment was successful.

In the nearest period, 16 patients underwent laparoscopic cholecystecto­my within 1 to 6 months. In the long-term period, at the terms of 13 and 18 months, 2 patients had a recurrence of pancreatitis. They were cured by a course of conservative therapy. At the initial admission, these patients were diagnosed with severe pancreatitis and a long history.

Frequency and variability of heart rate served as instruments to assess the stress resistance of two groups of students with different average academic performance in different periods of the educational process: at the beginning and at the end of the autumn semester. Mental stress always statistically sig­nificantly increased the heart rate in both groups of students, but significantly decreased heart rate variability only in the group of students with better aca­demic performance at the end of the academic semester.

The variety of options for the course of gouty arthritis necessitates the search for informative and accessible methods for diagnosing this disease. The detection of the sodium monourate crystals deposits in synovial fluid is asso­ciated with certain technical difficulties. In this regard, ultrasound diagnos­tics of gout is of particular value. The article raises questions of the im­portance of ultrasound assessment of joints in the diagnosis of gouty arthritis. Especially interesting is the possibility of evaluating the first metatarsoph­alangeal joints as a screening area for research. In our work, we found a high frequency of detection of echographic signs of gout in this area, even in the ab­sence of clinical manifestations. The use of ultrasound examination of the first metatarsophalangeal joints can be recommended at the stage of differential di­agnosis of gouty arthritis in clinical practice of primary specialized care.

Catatonia is an important syndrome found in both psychiatry and gen­eral medicine. However, identification and treatment of this phenomenon is difficult without modern diagnostic scales for catatonia.

Purpose — to describe the cases of inhibited and excitable catatonia in adolescents with affective disorders.

Methods — clinical observation in accordance with the ICD-10 diagnos­tic criteria for affective disorders in depression and mania, the use of Beck de­pression scale, Beck anxiety scale, Young scale of mania, Bush-Francis catato­nia rating scale. Differential diagnosis with the participation of a team of spe­cialists: neurologist, psychiatrist, clinical psychologist, cardiologist, infectious disease specialist, pediatrician.

Results and discussion. Catatonia in children occurs in various condi­tions that are not always associated with schizophrenia: with general deve­lopmental disorders, epilepsy, affective disorders, sports injuries of the cervical spine. Difficulties in recognizing and appropriately treating catatonia can lead to poor patient outcomes due to inappropriate treatment that aggravates the course of catatonia. The most effective treatment for catatonia is benzodi­azepine tranquilizers and / or electroconvulsive therapy; the latter is the method of last choice if the early administration of benzodiazepine derivatives has been missed, or they are ineffective even at high doses. The use of a stand­ardized, highly valid Bush-Francis catatonia rating scale will facilitate the di­agnosis of this disorder and taking a fast decision-making.