Laparoscopic Renal Cryoablation

In light of evidence linking radical nephrectomy and consequent suboptimal renal function to adverse cardiovascular events and increased mortality, research into nephron-sparing techniques for renal masses widely expanded in the past two decades. The American Urological Association (AUA) guidelines now explicitly list partial nephrectomy as the standard of care for the management of T1a renal tumors. Because of the increasing utilization of cross-sectional imaging, up to 70% of newly detected renal masses are stage T1a, making them more amenable to minimally invasive nephron-sparing therapies including laparoscopic and robotic partial nephrectomy and ablative therapies. Cryosurgery has emerged as a leading option for renal ablation, and compared with surgical techniques it offers benefits in preserving renal function with fewer complications, shorter hospitalization times, and allows for quicker convalescence. A mature dataset exists at this time, with intermediate and long-term follow-up data available. Cryosurgical recommendations as a first-line therapy are made at this time in limited populations, including elderly patients, patients with multiple comorbidities, and those with a solitary kidney. As more data emerge on oncologic efficacy, and technical experience and the technology continue to improve, the application of this modality will likely be extended in future treatment guidelines

Reasonable standards for smart cities

The paper considers the issues of creating smart cities from the point of view of sustainable development of subjects, the role of the internet of things for a modern understanding of the development of smart communities, when the Internet has become the main means of communication not only for people, but also for subjects. The world experience of creation of normative base by technical Committee ISO/TC268 Sustainable development of communities is analyzed. The role of the internet of things (STK 1/ WG 10) is noted as an important part of the identified problem and for a understanding of the development of smart communities, when the internet has become the main means of communication not only for people but also for subjects. Particular attention is paid to the state of affairs in the standardization of requirements for «subjects of sustainable development» in theRussian Federation. Proposals have been developed for work in the establishment of common rules, regulations for such an urgent and multifunctional object of standardization, as the subject of sustainable development or a smart city.</jats:p