2021

POEMS syndrome is a rare multi-system disorder caused by circulating immunoglobulins in the blood due to plasma
cell dyscrasia. POEMS is an acronym that stands for the following symptoms: P –polyneuropathy, O- organomegaly, E
–Endocrinopathy, M- M-protein, S – skin change.
The main clinical feature of this syndrome is a progressive polyneuropathy with predominant motor disturbances. The
disease is potentially fatal, and the quality of the patient's life deteriorates progressive due to neuropathy, massive peripheral
edema, pleural effusion and ascites. Serious complications, such as multiple organ failure, restrictive lung disease
and pulmonary hypertension, lead to an unfavorable prognosis.

Freguency of met of neurogenic acraturesiss is examined in this article, factors resulting in urology complications at a
stroke. The forms of symptoms of lower urinary ways are described. Conservative and operative methods over of
treatment of neurogenic acraturesiss are brought.

The article shows that a significant proportion of neuroendocrine tumors of the pancreas are non-functional, i.e., not secreting
into the blood a variety of gastrointestinal hormones and polypeptides and as a result, not accompanied by typical
clinical manifestations. Unfortunately, often the scan search starts in the detection of distant metastases of neuroendocrine
tumors. Currently, the only radical method of treatment of hormonally functioning tumors of the pancreas is surgical. It
is indicated that symptomatic therapy can be considered as a stage of preoperative preparation of the patient. The article
examines the rational and integrated use of modern Arsenal of surgical and therapeutic methods, which enable significantly
prolong life, improve its quality in patients with metastatic forms of neuroendocrine tumors of the pancreas.

When looked at the latest news for 2021, we can see that tens of millions of people have contracted the coronavirus.
More than a million people have died or are facing long-term health effects from the virus. The review article is devoted to the study of the biochemical specificities of changing the algorithm of hyaluronic acid in the alveoli of the
lungs with Covid-19. An analysis of the literature covering the problem to date is carried out. On computed tomograms, which do each patient with suspected coronavirus, lucent areas are noted - “ground glass” syndrome, that
contain liquid. So, the analysis of the literature showed that the coronavirus damages the membrane (membranes) of
the alveoli, which causes the outpouring of hyaluronic acid from them. A group of scientists assume that hyaluronic
acid is the leading cause of death in severe Covid-19 lung infections. The study showed that COVID-19 demonstrates
a high level of proinflammatory of cytokines in the affected alveoles and in endothelial cells of blood vessels, in addition to increasing neutrophil extracellular traps that activate hemostatic factors. Consequently, thrombosis in the
pulmonary microcirculation leads to an increase in respiratory failure. The article further describes the role of
hyaluronic acid and the concept of “bradykinin storm” in the development of respiratory failure and the therapeutic
effects of COVID-19 heparin. Scientists have found that in addition to the anticoagulant effect, heparin can bind to
the “spike” protein of the SARS-CoV-2 virus and function as a competitive inhibitor for the entry of viruses, thereby
reducing the infectivity of the process [1].

Tte the review article presents data from domestic and foreign literature regarding the problems of performing simultaneous operations in gynecology, assessing trauma and clinical and economic efficiency, an integrated systematic approach to eliminating simultaneous pathologies, the features of performing combined operations in
gynecological diseases and a combination of other surgical pathologies. Performing simultaneous laparoscopic operation does not lead to an increase in the number of intra- and postoperative complications in comparison
with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer
duration , which, in our opinion, is not critical for anesthesia. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the
disease is prevented , operative treatmend of wich would be postponed for a later period , the risk of repeated
surgery and anesthesia is eliminated , the time of total stay of the patiend in the hospital and subsequend treatment is reduced , economic efficiency of treatment is increased.

This review of the literature reflects information about the etiopathogenesis of chronic recurrent herpetic lesions
of the oral mucosa and the parotid region. Methods of diagnosis and treatment of chronic herpetic stomatitis by
various authors are described. Algorithms of local and general drug therapy of patients with this pathology are described.