The objective: to analyze literature and to compile the most accurate and complete view of lactic acidosis and specific parameters of its treatment in anesthesiology and resuscitation practice. Result. Lactate levels are commonly evaluated in critically ill patients. Hyperlactatemia is defined as a lactate level >2 mmol/L and it is common in the critical care setting. Hyperlactatemia and lactic acidosis may develop due to increase in lactate production, a decrease in lactate clearance, or a combination of both. The current review provides an overview of pathophysiology of lactate elevation followed by analysis of different etiologies of hyperlactatemia in critically ill patients.Additionally, approach to differential diagnosis and treatment of elevated lactate levels in this category of patients is discussed.

Constipation (constipation, obstipation) is a symptom in which the frequency of the act of defecation is less than 3 times a week and is accompanied by the release of solid, scanty feces with a feeling of incomplete emptying of the rectum and often requiring additional effort. World health organization in the « International statistical classification of diseases and health-related problems. ICD-10 « refers to constipation diseases (code K59. 0). At the same time, gastroenterological organizations such as the world organization of gastroenterologists and the American gastroenterological Association take a different position, emphasizing that constipation is not a disease, but a symptom. Most often constipation affects young children and the elderly (over 60 years). The feeling of difficulty in emptying the bowel, the impossibility of relief, despite persistent straining, the need to apply additional, stimulating the release of the rectum from the feces, actions (pressure on the perineum, the side walls of the anus, the vagina). The constant state of insufficient emptying of the rectal ampoule often leads to the development of perineal prolapse syndrome. Chronic constipation is diagnosed in cases where the frequency of stool becomes less than 3 times a week, defecation is significantly difficult and requires pronounced efforts, the consistency of the stool is dense, tubercular, there is a feeling of incomplete liberation of the rectum from feces. Constipation is a very common digestive disorder among the population, the tendency to constipation can lead to the development of serious proctological diseases, so this problem has a high degree of social significance. Due to its prevalence and pronounced deterioration in the quality of life of patients, chronic constipation is isolated in an independent syndrome, and currently the problem of constipation is actively studied by proctologists, gastroenterologists and other specialists. This article is devoted to the main issues of modern therapy of constipation.

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Defence cooperation between Poland and the United States significantly affects the security agenda of Russia, the Baltic region, and Europe as a whole. On the one hand, Poland intends to become a key partner of the US in ensuring European security. On the other hand, it has ambitions to take the leading position in the security area among the Baltic States. The Polish leadership sees an additional advantage in expanding military cooperation with the United States, regarding it as a jumping board to accelerating its economic and technological development. This article examines a mechanism underlying defence cooperation between the US and Poland, i.e. lobbying Poland’s interests in another state. This allows Warsaw to actively promote its interests in the US. The research methodology employed includes the periodisation of Polish lobbying activities in the US and an empirical study of lobbying based on analysis of original documents, many of which have been analysed for the first time. It is shown that, under the existing party system, Poland will not abandon strategic partnership with the United States, primarily in security and defence. Over the study period, Poland quickly gained experience in promoting its interests in the US through direct lobbying, showing flexibility in negotiations, relying on the two-party support in the US Congress, successfully coordinating the activities of its governing bodies and various corporations which are submitted to tight state control.

The duodenum ulcer disease (DUD) has high specific weight among digestive tract pathologies, influencing working capacity and quality of life of patients. Now the tendency of increase in mortality and complications of DUD against the background of decrease in incidence is characteristic of Russia.For the purpose of identification of the patients infected with H. pylori and also purposes of the most effective H. pylori therapy by him are accepted the recommendations developed by the V Maastricht consensus (Management of Helicobacter pylori infection – the Maastricht V/Florence Consensuns report).Besides H. pylori therapy to patients the medicines promoting maintenance intragastric рН > 3 not less than 18–20 hours a day are also appointed. Such effect PPI, antacids and H2-receptor antagonists have. PPI are characterized by more expressed antisecretory action and do not cause a tachyphylaxis, than favourably differ from histamine H2-receptor antagonists.Lancid (lansoprazole) – medicine from the PPI group. It is shown to application for treatment of DUD and for an eradication of H. pylori at the infected patients with erosive and ulcer damages of a stomach and duodenum (as a part of complex therapy). Lansoprazole as a part of Lancid promotes faster healing of ulcer defects and decrease in clinically expressed symptomatology in comparison with omeprazole and pantoprazole.

The article is devoted to modern issues of etiology, in particular, the theory of biofilms as the most promising direction of research. Biofilms are most often represented by the association of microorganisms in which they, through coexistence in close contacts, acquire new properties, expressed in an atypical clinical picture. This determines problems of rapid diagnosis and pathogenesis, in which both the local and systemic secondary immunodeficiency state is put in the forefront, autoimmune inflammation and reactions of free radical oxidation. The most typical symptoms and signs of inflammatory diseases of the pelvic organs include, in particular, chronic salpingo-oophoritis - a common nosological item from this group, which has important social and demographic significance, since the most affected group, according to statistics, are women of reproductive age. The emphasis was placed on approaches to diagnosis using not only data from the collected history and physical examination but also methods based on modern instrumental and minimally invasive methods. Special attention was paid to measures aimed at correcting risk factors and preventing this disease, etiotropic therapy with the presentation of a specific scheme of the most rational antibiotic therapy, pathogenetic and symptomatic treatment to alleviate the condition before the eradication of the pathogenic microorganism or their association in the composition of biofilms and cure patients, and correction such unpleasant complications as vaginal dysbiosis, which can develop against a background of powerful antibiotic therapy and is not a measure of inadequate treatment and change of the selected regimen.

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