scholarly journals The main clinical symptoms in patients with posterior vaginal wall prolapse and modern non-drug technologies for its relief

Author(s):  
Vitaly A. Epifanov ◽  
Valery Y. Illarionov ◽  
Ekaterina N. Zhumanova

Background. Rectocele is one of the leading causes of abnormal position and dysfunction of the pelvic floor and rectum. Objective: to develop and scientifically substantiate the use of a rehabilitation complex, including general magnetotherapy, electromyostimulation with biofeedback in combination with fractional microablative CO2 laser therapy in patients of different age groups with rectocele after surgery. Methods. The article presents the results of treatment of 100 women with rectocele, who were divided into main and control groups, within each group, depending on their age, they were divided into 2 subgroups: women of childbearing age were included in subgroup A, and women of peri- and menopausal age were included in subgroup B. Patients of the main group in the early postoperative period after plastic surgery for rectocele (from 1 day) were given a course of General magnetotherapy and in the late postoperative period (one month after the operation) a set of measures was performed, consisting of a course of electromyostimulation with biological connection of the pelvic floor muscles 2 intravaginal procedures of fractional microablative CO2 laser therapy at intervals of 45 weeks. Patients of the control group after surgical treatment of rectocele in the late postoperative period received symptomatic therapy, including painkillers and spasmolytics and a set of Kegel exercises. Results. Significant improvements in postoperative treatment were observed in patients of the main group: pelvic pain and periodic pain in the lower abdomen and lower back disappeared in 100% of cases; the main complaints related to violation of rectal emptying and urination were preserved in no more than 57% of cases, sexual complaints in 5%; in 95% of cases, general, vegetative and pre-climacteric complaints disappeared. Conclusion. As a result of the conducted research, it is shown that under the influence of the developed rehabilitation complex, regardless of age, there was a highly reliable dynamics of all complaints due to the influence of physical factors included in it on various pathogenetic links in the development of the disease.

Author(s):  
K. V. Lyadov ◽  
K. V. Kotenko ◽  
E. N. Zhumanova

Background. The high recurrence rate after surgical treatment of pelvic organ prolapse makes it necessary to improve therapeutic methods. Objective: to develop and scientifically substantiate the use of a rehabilitation complex, including general magnetotherapy, electromyostimulation with biofeedback in combination with fractional microablative therapy with a CO2 laser, in patients of different age groups with rectocele after surgery. Methods. The article presents the treatment data for 100 women of childbearing, peri- and menopausal age with rectocele IIIII degree, which were divided into 2 groups comparable in terms of clinical and functional characteristics (main and control), within each group they were divided by 2 subgroups: subgroup A included women of childbearing age, subgroup B included women of peri- and menopausal age. The patients of the main group in the early postoperative period after plastic surgery for rectocella (from 1 day) underwent a course of general magnetotherapy and in the late postoperative period (one month after the operation) they performed a set of measures consisting of a course of electromyostimulation with biological connection of the pelvic floor muscles and a special complex physiotherapy exercises and 2 intravaginal procedures of fractional microablative CO2 laser therapy with an interval of 45 weeks. Patients in the control group after surgical treatment of rectocele in the late postoperative period received symptomatic therapy, including painkillers and antispasmodics, which served as a backdrop for patients of the main group. Results. As a result of the studies, it was found that regardless of the age and severity of uterine blood flow disorders in the uterine arteries in patients with rectocele, the most pronounced dynamics was observed in patients of the main group, which, in our opinion, is associated primarily with the vasoactive effects of general magnetotherapy, manifested in the removal of spasm from arteries and arterioles, improving the contractility of the veins and increasing venous outflow, which in combination with electrical stimulation, exercises to strengthen the muscles of the pelvis bottom and fractional microablative therapy allowed to obtain such a pronounced vasocorrigating effect. Conclusions. Due to the pathogenetic effect of the developed complex (electrical stimulation, exercises to strengthen the pelvic floor muscles and fractional microablative therapy) on one of the main mechanisms of the development of the disease, a pronounced vasocorrecting effect was obtained.


2017 ◽  
Vol 4 (2) ◽  
pp. 8-12
Author(s):  
R. M. Solh ◽  
M. I. Andrukhin ◽  
O. V. Makarov ◽  
V. V. Fedchenkov

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.


Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.


2020 ◽  
Vol 92 (3) ◽  
pp. 50-55
Author(s):  
D. A. Lioznov ◽  
E. J. Karnaukhova ◽  
T. G. Zubkova ◽  
E. V. Shakhlanskaya

Aim. To assess the effectiveness of the use of the antiviral drug enisamium iodide in the complex treatment of acute respiratory viral infections (ARVI) caused by various pathogens in routine clinical practice. Materials and methods. А prospective randomized study included 134 patients who were treated in the epidemic season of influenza and ARVI in 20182019. All patients were examined for the presence of influenza A and B viruses, respiratory syncytial virus, human metapneumovirus, parainfluenza virus, coronaviruses, rhinoviruses, adenoviruses in nasopharyngeal swabs by PCR. Patients of the main group received enisamium iodide along with symptomatic therapy, the control group received only symptomatic therapy. The primary parameter of the effectiveness of therapy was evaluated on the scale of the general severity of the manifestations of ARVI (Total Symptom Score TSS) from the 2nd to the 4th day and by the secondary criteria of effectiveness: assessment of the duration of ARVI, the severity of fever, the proportion of patients with normal body temperature, the duration of the main clinical symptoms of acute respiratory viral infections, the proportion of patients in whom complications requiring antibiotics were noted, the dynamics of interferon status on the 6th day. To conduct a statistical analysis, depending on the efficiency parameter, the ANCOVA method with a fixed group factor and an initial score on the TSS severity scale was used as covariates, a criterion for comparing quantitative indicators in two independent groups. Results. According to the results of the analysis of the primary efficacy parameter, the median (interquartile range) of the average score on the scale of the general severity of ARVI manifestations in the main group was 4.33 (3.675.83), in the comparison group 6.00 (4.677.25; p0.001). The duration of systemic and local manifestations of acute respiratory viral infections was statistically significantly less in the main group (p=0.002 and p=0.019, respectively). Prescription of additional therapy was required in 2 (2.9%) patients of the main group (patients taking enisamium iodide), compared with 8 (11.9%) patients in the control group. Serum levels of interferon  and interferon  on the last day of treatment were statistically significantly higher in patients of the main group compared with the control group (p0.001). Treatment (excellent) was evaluated by 42 (62.7%) patients, while in the control group only 17 (25.8%) patients gave similar ratings. Both patients (p0.001) and doctors (p0.002) rated therapy tolerance better in the study group. Conclusion. The results confirmed the safety and effectiveness of enisamium iodide as a treatment for ARVI and influenza. The antiviral, interferonogenic and anti-inflammatory properties of the drug are involved in the formation of an antiviral response and reduce the risk of complications, which makes it possible to reduce the number of symptomatic agents used.


2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.


2021 ◽  
Vol 8 (1) ◽  
pp. 38-50
Author(s):  
A. E. Bautin ◽  
V. D. Selemir ◽  
A. I. Shafikova ◽  
K. Yu. Afanasyeva ◽  
E. S. Kurskova ◽  
...  

Background. Inhaled nitric oxide is a highly selective pulmonary vasodilator, the potential benefits of which include reduced resistance and pressure in the pulmonary artery without systemic arterial hypotension, vasodilation in well-ventilated areas of the lungs, rapid onset of action, and a fairly low incidence of side effects in the therapeutic dose range. Objective. Тс estimate the clinical efficacy and safety of the method for synthesizing nitric oxide from room air in the postoperative period of cardiac surgery. Design and methods. A total of 110 patients were enrolled in the study: 55 patients were included in the main group (nitric oxide was synthesized from room air by AIT-NO-01 device), 55 patients were enrolled in the retrospective control group (nitric oxide was inhaled from the balloon). Inclusion criteria were: undergone heart surgery, mean pulmonary artery pressure (PAPm) ≥ 25 mm Hg., pulmonary artery wedge pressure (PAWP) ≤ 15 mm Hg. Results. After one hour of nitric oxide inhalation in the main group, there were a 35 % decrease in PVR and a 16 % decrease in PAPm. In the control group, there were a decrease in PVR by 40 % and decrease in PAPm by 19 %. Inhalation of nitric oxide did not affect the systemic circulation hemodynamics both in the main and in the control groups. The median duration of the mechanical ventilation (MV) was 7.3 (4.5; 13.8) h and the median length of stay (LOS) in the ICU was 23.2 (21.3; 46) h in the main group. In the retrospective control group, the median duration of MV was 8.2 (5; 14.1) h, and the length of ICU stay was 24 (22; 45.3) h; found no differences between the groups. Conclusion. Nitric oxide synthesized from room air significantly reduces PVR and PAPm in patients with precapillary pulmonary hypertension after cardiac surgery. There were no significant differences in the effect on a pulmonary circulation, clinical data and side effects between the methods of synthesis of nitric oxide from room air and dosing from balloons.


2009 ◽  
Vol 16 (3) ◽  
pp. 36-44
Author(s):  
Svetlana Semenovna Rodionova ◽  
T N Turgumbaev ◽  
S S Rodionova ◽  
T N Turgumbaev

Assessment of the alendronate influence upon the course of adaptive remodeling of bone tissue adjacent to the implant was performed. Dynamics of mineral bone density (BMD) changes in Gruen zones was compared for 2 groups of female patients. The groups were similar by age, nosology. All operations were performed by the same surgical team with application of one type of implant (Zweymuller). During the first post-operative year patients from the study group (n=38) were taken alendronate (Fosamax-70) once a week and at least 1200 mg of calcium carbonate daily (either as calcium containing food products or calcium carbonate preparations). Patients from control group (n=94) were taken only calcium carbonate by the same scheme within the first postoperative year. It was detected that although by 6th postoperative month alendronate did not decraese BMD loss as compared to controls, within the interval of 6-15 months it significantly increased bone tissue mass accretion. In group of alendronate patients monthly accretion of bone tissue in some Gruen zones (except for R4) was twice and more higher than in control group. Fifteen months later patients from the main group showed BMD deficit only in R4 zone. In the rest of zones bone tissue mass exceeded the basic values and in the majority of zones that increase was trustworthy. In control group BMD deficit was preserved in two proximal zones (R6 and R7) and in zone R6 it even increased as compared to the results of the previous study (12 months after operation).


2014 ◽  
Vol 7 (2) ◽  
pp. 23-29
Author(s):  
Z Zh Al-Rashid ◽  
Aleksey Vladislavovich Malyshev ◽  
Ol’ga Igorevna Lysenko

Purpose. To study the effect of vitrectomy in retinal detachment (RD) treatment on the quality of life (QOL) of patients. Methods. We examined 67 patients who underwent surgical treatment of RD. QOL was assessed by VFQ-25 questionnaire before surgery and after 1 week and 6 months of it. Results. When assessing QOL before surgery, there was a significant reduction of the total QOL index by an average of 35% in comparison to the control group (p < 0.001). In the late postoperative period, a progressive increase of the total QOL index and visual function was recorded. Conclusion. Vitrectomy for the treatment of retinal detachment improves patients’ visual function and quality of life.


2016 ◽  
Vol 15 (2) ◽  
pp. 66-75
Author(s):  
A. E. Shulzhenko ◽  
I. N. Zuikova ◽  
A. V. Karaulov ◽  
R. V. Shchubelko

Introduction. In the formation of recurrent and/or prolonged chronic inflammatory diseases of the upper respiratory tract in addition to the known, previously studied, factors that play an important role in the violation of the human immune system at the level of local (mucosal) and systemic immunity and activation of herpes virus group (Epstein Virus Barr virus, cytomegalovirus, herpes simplex virus type 6). In the treatment of herpesvirus infections, activation of antiviral immunity in domestic medicine used drugs interferon inducer. Objective. To evaluate the efficacy of interferon inductor Amiksin® in patients with chronic recurrent inflammatory diseases of the upper respiratory tract. Materials and methods. Based on separation of “Allergy and Immunotherapy” SSC “Institute of Immunology” FMBA studied low-molecular interferon inductor Amixin® (JSC “Pharmstandard-Tomskhimpharm”, Russia) in the treatment of chronic recurrent inflammatory diseases of the upper respiratory tract. The study included 40 patients between men and women, aged 18 to 65years old with a history of recurrent chronic inflammatory diseases of the upper respiratory tract. Clinical research methods included a medical history, previous efficiency of the treatment, the presence of comorbidities. Laboratory methods include bacteriological crop on flora in the material from the oropharynx and the detection of DNA viruses of herpes group in saliva. Patients of the main group, after clinical and laboratory examination, prescribed therapy with Amixin®. Patients in both groups received symptomatic therapy. The total duration of observation of each patient was 3 months. Results. Amiksin® receiving the drug in patients with acute exacerbation of chronic recurrent upper respiratory tract inflammatory diseases contributed to a more rapid relief of general and local symptoms. Also it found that reduces performance Amiksin® average viral load against Epstein-Barr virus. Over the next 3 months follow-up, 25 % of patients the main group marked exacerbation study pathology of the upper respiratory tract, in the control group of patients with recurrent exacerbations were more - 60 %, indicating that preventive action Amiksin® therapy. Conclusions: The use of low-molecular interferon inductor Amiksin®(JSC “Pharmstandard-Tomskhimpharm”, Russia) in the combined therapy showed good efficacy in reducing the concentration of chronic viral infections in the oropharynx and prevention of chronic relapsing inflammatory diseases of the upper respiratory tract.


2016 ◽  
Vol 22 (2) ◽  
pp. 201621
Author(s):  
Ivanna Koshel

Surgical interventions in the nasal cavity are accompanied by reactive phenomena in the postoperative period. On their background the process of physiological regeneration is disorganized resulting in impaired physiological functions of the nasal cavity.The objective of the research was to study the recovery process of the main physiological functions of the nasal cavity in patients with aspirin-intolerant polypous rhinosinusitis in the postoperative period.Materials and methods. 80 patients with aspirin-intolerant polypous rhinosinusitis at the age of 24-57 years were operated on.All the patients were divided into 2 groups: the control group included 30 patients; the main group comprised 50 patients.Patients of the control group received nasal cavity cleaning, nasal mucosa anemisation, irrigation therapy since the first day of the postoperative period.Patients of the main group received an herbal drug BNO-101 additionally. The effectiveness was assessed on the 3rd, 7th and 10th days of treatment.Results. The postoperative rehabilitation with the inclusion of botanical preparation BNO-101 provided a significant improvement of nasal breathing, mucociliary transport rate and indicators of nasal peak flowmetry compared to the control group. Despite subjective improvement of nasal breathing the indicators of the peak expiratory flow rate in the main group were 34.2% lower than the norm while in the control group they were 54.7% lower than normal ones thereby justifying further treatment.Conclusions. The postoperative rehabilitation of patients with aspirin-intolerant polypous rhinosinusitis provided more rapid improvement of the main functions of the nasal cavity compared to the control group.


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