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Hepatorenal syndrome is a severe complication of liver cirrhosis which is difficult to treat because of a very fast course and lack of adequate dosing recommendations due to the stage of the disease. In this study we aimed to refine the treatment of hepatorenal syndrome type I by modifying the dose of terlipressin, depending on the stage of acute kidney injury (AKI). Objective - to improve the treatment method of hepatorenal syndrome type I in patients with alcoholic liver cirrhosis by selecting the dose of terlipressin depending on the stage of acute kidney injury. For this study were enrolled 161 patients with diagnosis alcoholic liver cirrhosis, complicated with the hepatorenal syndrome. All patients were were randomly divided into control (group 1) (n=79) and study (group 2) (n=82) groups depending on the treatment received (terlipressin in the standard dosage or modified by the response-guided titration method). If the serum creatinine level decreased less than 25% from the baseline, the dose of terlipressin was gradually increased but did not accede 12 mg/24 hours. The stage of AKI was diagnosed using the criteria of Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury, 2012. The risk of short term mortality (within the first 29 days) was prognosed by Model for End-Stage Liver Disease (MELD) score. The kidney function improved better in persons with a modified dose of terlipressin: the complete response rate in them was 81.7%. The response rate in those who received the standard treatment, was 66.7% only (p˂0.05). It was found that the effective dosage of terlipressin is 3 mg/24 for AKI stage I; 6 mg/24 - for AKI stage II; 12 mg/24 - for AKI stage III. The relapse of the disease occurred only in 23.2% patients with modified treatment against 40.1% in the control group (p˂0.05). Short term survival was also significantly higher in the study group - 54.9%, while in the control group it was 37% only (p˂0.05). Thus, correction of terlipressin dosage could improve the results of the treatment and reduce mortality in patients with hepatorenal syndrome type I.

The aim of the study is to identify topical issues of the regulatory framework and the application of legal provisions related to acquisition (collection) of samples for examination in criminal proceedings. To achieve this objective, as well as justify the results, a set of general scientific and special methods is used. The comparative legal method enables to analyze the criminal procedure legislation of Ukraine and other countries, as well as the practice of the European Court of Human Rights. The system-structural method enables to reveal the procedure for sample acquisition for examination. The technical-logical method is the basis for forming the conceptual apparatus in the framework of the subject under study. The statistical method is used in the course of summarizing and processing of the data of investigative and judicial practice. The analysis of the procedure for acquisition (collection) of samples for examination in criminal proceedings is carried out in accordance with the Criminal Procedure Code of Ukraine and international acts. The study states that the CPC of Ukraine, first, does not reveal the concept of "samples for examination," "biological samples"; second, does not fix the list of sample objects that can be obtained for comparative examination; third, does not provide the list of persons authorized to conduct this procedural action and persons, from whom they can be collected. Taking into account the study conducted, the author suggests how to improve the procedure and organization of sample acquisition for examination, as well as recommends how to resolve problematic issues arising during their collection.