scholarly journals Efficiency of wound dressing made of powder cotton cellulose

2021 ◽  
Vol 102 (1) ◽  
pp. 12-18
Author(s):  
S S Ksembaev ◽  
O V Nesterov ◽  
L N Khafizova
Keyword(s):  
Postoperative Period ◽  
Wound Dressing ◽  
Comparison Group ◽  
Clinical Signs ◽  
Healing Time ◽  
Main Group ◽  
Cotton Cellulose ◽  
Surgical Wound ◽  
Clinical Indicators ◽  
Inflammatory Edema

Aim. To study the effectiveness of a wound dressing made of powdered cotton cellulose for open surgical wounds in the oral cavity. Methods. The effectiveness of a wound dressing made of powdered cotton cellulose during vestibuloplasty was assessed based on clinical indicators. The study included 197 children aged 812 years (boys 91, girls 106), divided into 2 groups the main group (100 children treated with powdered cotton cellulose wound dressing) and the comparison group (97 children, treated with a surgical gauze dressing). The number of children in clinical groups was determined by the copy-pair method. The dynamics of the postoperative period was assessed according to traditional clinical indicators (the presence of pain, inflammatory edema, hematomas, healing time, etc.). The severity of general and local clinical signs was determined by using the system of its assessment in points developed by us. Differences were considered significant at p 0.05. Results. In the postoperative period, the patients of the main group had no complications in contrast to the patients of the comparison group, who had pronounced edema and hematomas of the soft tissues of the chin, edema and hyperemia of the displaced flap. Changes in clinical signs severity in points also prevailed in the comparison group (p 0.001). The surgical wound showed complete epithelialization after 11.40.7 days in the main group and after 13.50.9 days in the comparison group. The reduction in the duration of treatment was 2.10.8 days. Conclusion. When using a wound dressing made of powdered cotton cellulose, the wound is protected from the aggressive environment of the mouth, including microflora, food debris, etc., which excludes the possibility of its secondary infection; there is no pain, postoperative inflammatory edema and hematomas; the surgical wound healing time is reduced; there are no contraindications, no side and allergic reactions.

scholarly journals MODERN METHODS OF PREVENTION AND TREATMENT OF COMPLICATIONS OF CERVICAL ESOPHAGO-ORGAN ANASTOMOSIS AT ESOPHAGOPLASTY

2020 ◽  
Vol 73 (8) ◽  
pp. 1696-1699
Author(s):  
Volodymyr O. Shaprynskyi ◽  
Yevhen V. Shaprynskyi ◽  
Mustafa Bassam Hussein ◽  
Oleg O. Vorovskyi ◽  
Yaroslav V. Karyi ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Postoperative Period ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Diagnostic Algorithm ◽  
Main Group ◽  
Instrumental Method ◽  
Complication Risk ◽  
Esophageal Strictures ◽  
Bed Days

The aim: To improve the results of operative treatment of esophageal strictures by decreasing the rate of failure and stricture of cervical esophago-organ anastomoses. Materials and methods: There were 45 patients with post-burn corrosive gullet strictures, 17 patients with postoperative corrosive strictures, 10 patients with peptic strictures secondary to reflux-esophagitis, 42 patients with esophageal cancer strictures. The patients were divided into two groups: the comparison group – 55 persons and the main group – 59 persons. Patients of comparison group underwent surgical treatment of esophageal strictures according to classic protocols and standards. In the main group of patients we applied proposed diagnostic algorithm with prediction of complication risk and the designed method of esophago-organ anastomosis formation. Results: The results of operative treatment in patients with esophageal strictures showed the development of early postoperative complications in 59 individuals (51.75 %). In the postoperative period six patients died: four – in the comparison group and two – in the main group. Failure of cervical esophago-organ anastomosis and esophageal strictures occurred in 7 patients (11.86 %) of main group and 20 patients (36.36 %) of the comparison group (p<0.05). Conclusions: Application of method predicting the risk of complications of cervical anastomosis, treatment program and instrumental method of formation anastomosis resulted in reduced incidence of failure and strictures of esophago-organ anastomosis from 36.36 % to 11.86 % (p<0.05); decreased time of hospitalization - from 28.2 ± 1.1 to 21.5 ± 0.5 bed-days (p<0.001), postoperative period - from 20.5 ± 1.1 to 16.1 ± 0.7 bed-days (p<0.01); decreased postoperative mortality - from 7.27 % to 3.39 %.

scholarly journals COMPREHENSIVE PREOPERATIVE APPROACH AND ENDOVENOUS ELECTRIC WELDING IN THE TREATMENT OF CHRONIC VENOUS INSUFFICIENCY C6 CLINICAL CLASS

2021 ◽  
pp. 76-81
Author(s):  
S. I. Savolyuk ◽  
A. R. Dembitsky
Keyword(s):  
Negative Pressure ◽  
Comparison Group ◽  
Platelet Rich Plasma ◽  
Healing Time ◽  
Main Group ◽  
Preoperative Preparation ◽  
Plasma Therapy ◽  
Moisture Balance ◽  
Lateral Posterior ◽  
And Control

The evaluation was done in the sphere of preoperative preparation trophic ulcer in patients with CVI using the proposed tactics of mechanochemical debridement and elimination of vertical venous reflux EVEZ method, in comparison with standard preoperative management tactics and EVLT of saphenous veins. It is established that the proposed tactics of preoperative preparation are more effective than classical approaches. Purpose. The use of the EVEZ method in combination with the proposed preoperative preparation of trophic ulcers in the treatment of CVI was determined to be effective. Materials and methods. An analysis of the treatment of 68 patients with CVI C6 clinical class was performed. The patient of the main group received the EVEZ treatment tributaries and perforating veins with preoperative trophic preparation ulcers, which includes: active mechanochemical debridement and control moisture balance in the wound, installation of negative pressure wound therapy system, platelet rich plasma therapy, application drugs based on diosmin and hesperidin. The proposed scheme of preoperative preparation has the following algorithm: Taking a smear from the sore to determine the bacterial spectrum and subsequent rational antibacterial therapy following the results of the antibioticogram; Active mechanochemical debridement with solutions of 0.1% polyaminopropyl biguanide + 0.1% surfactant, povidone-iodine + ethanol + glycerin + laureate 9 and control of moisture balance in the wound with modern hydrogel sore dressings; Installation of VAC system with a constant negative pressure of 120 mm Hg for 3 days for the first 3 performances of the system. Subsequently, VAC therapy was performed in a constant mode with a pressure of 80-120 mm Hg. in patients with insufficient wound cleanliness; After active cleaning, PRP therapy was performed, which involves the introduction of platelet-enriched plasma along the edge of the wound to a depth of 3 to 5 mm. The amount of PRP used depended on the size of the defect and ranged from 1 to 2 ml. All patients of the main group underwent correction of concomitant pathology with systemic use of capillary stabilizing drugs based on diosmin / hesperidin. Patients in the comparison group received standard preoperative preparation and EVLT. Patients of both groups were outpatient for 6 months. 39 of them (57.35%) were women and 29 (42.65%) were men aged 36 to 78 years. The duration of ulcers ranged from 3 months to 7 years. The following localization of venous trophic ulcers was observed: in the area of the medial bone - in 49 (72%) patients, 10 (14.7%) - on the anterior surface, 9 (13.3%) - on the lateral, posterior, anterior medial or anterolateral surface of the tibia. Results. Tactics of preoperative preparation that is offered allowed to achieve: reduction of redness and swelling in the main group on 7.3 ± 0.8 days (comparison group 10.2 ± 0.7 days); complete cleaning of the wound from fibrin and necrotic tissues at 9.1 ± 0.5 days (15.0 ± 1.1); the appearance of granulation tissues at day 12.6 ± 0.9 (18 ± 0.7); the appearance of marginal epithelialization at 15.3 ±0.7 days (20 ± 1.1). Conclusions. The proposed tactics can reduce the term by 1.7 times the preparation of the ulcer for surgery and 1.6 times the healing time of ulcers. The EVEZ method allows performing ablation efficiently and safely trunk great saphenous vein. The use of phlebotonic drugs, which is called Normoven, allows you to accelerate the healing of ulcers and prevent their recurrence.

Experience of the usage of nabumetone in oncogynecologic patients

2017 ◽  
pp. 118-122
Author(s):  
S.M. Kartashov ◽  
◽  
E.M. Oleshko ◽  
Keyword(s):  
Antioxidant Activity ◽  
Postoperative Period ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Malonic Dialdehyde ◽  
Pain Syndrome ◽  
Main Group ◽  
Narcotic Analgesics ◽  
Diene Conjugates ◽  
Results Of Treatment

Objective: to study the effect of nabumetone in oncogynecologic patients in the postoperative period. Materials and methods. There were examined 98 patients of 40-78 years old, who were divided into two groups: the main group - 58 patients, of which 37 - patients with endometrial cancer I-III and 21 - with ovarian cancer of II-IV stage (FIGO); The comparison group included 40 patients (17 and 23 patients respectively). All patients underwent surgical treatment. In the postoperative period, were used NSAIDs - nabumeton. Before the operation and on the 10th day of the postoperative period, the following parameters were studied: a clinical blood test, TNF-a, ceruloplasmin, diene conjugates (DC), malonic dialdehyde (MDA), antioxidant activity (AOA). The content of TNF-a, in the blood serum was determined by radioimmunological, and DC, MDA, AOA by biochemical method. Results. Established: the content of the leukocyte formula before the start of treatment in the compared groups did not reveal any significant differences. After surgical intervention, both groups showed an increase in the absolute values of all leukocyte fractions. The level of ceruloplasmin in the patients of the comparison group increased significantly in the postoperative period, and in the main group the parameters of ceruloplasmin did not differ significantly. The level of TNF-a in the pre- and postoperative period in the compared groups did not differ. On the 10th day of the postoperative period, it significantly increased in the comparison group, and when nabumetone was used during the postoperative period, the level of TNF-a did not increase. The initial indicators characterizing the processes of LPO and AOA in both groups did not differ significantly. Assessing the dynamics of indicators before and after the operation, it was noted that in patients in the blood, the level of DC in both the baseline and in the comparison group increased. The use of nabumethon led to a slight increase in DC. The maintenance MDA in the postoperative period has increased in both groups, however it is unreliable in comparison with parameters before surgical intervention. In the comparison group, after the treatment, the antioxidant defense was reliably reduced. In the main group, the use of nabumetone contributed to a smaller decrease in AOA. The use of nabumeton allowed abandoning of narcotic analgesics in earlier periods of the postoperative period. Conclusion. Use of nabumeton in the postoperative period allows to reduce the pain syndrome, the number of inflammatory complications; contributes to the normalization of LPO processes, inhibits the inhibition of the antioxidant system, which contributes to the reduction of endogenous intoxication and improves the results of treatment of oncogynecologic patients. Key words: nabumeton, oncogynecologic patients, anti-inflammatory action, tumor necrosis factor, ceruloplasmin, diene conjugates, malanialdehyde, antioxidant activity.

scholarly journals Фітопрепарат «Ресверазин» у комплексному лікуванні генералізованого пародонтиту

2018 ◽  
Author(s):  
N. O. Hevkaliuk
Keyword(s):  
Oral Cavity ◽  
Comparison Group ◽  
Clinical Signs ◽  
Main Group ◽  
Complex Treatment ◽  
Average Value ◽  
Periodontal Condition ◽  
Periodontal Infection ◽  
Periodontal Index ◽  
High Prevalence

Summary. High prevalence, unfavorable effects of periodontal infection centers on the oral cavity condition determine the relevance of the problem of the use of phytopreparations in the treatment of generalized periodontitis.The aim of the study – to evaluate the clinical efficacy of the drug Resverazin in the complex treatment of generalized periodontitis.Materials and Methods. The study was attended by 43 patients, patients with chronic generalized periodontitis of primary and stage I. The main group was 25 people, the comparison group was 18. To assess the hygienic state of the cavity, the indices Green-Wermillion, ONI-S, Silness-Loe, Stallard were used. The assessment of the periodontal condition was conducted according to clinical signs; the severity of gingivitis was determined by the PMA index, the state is clear – according to the index of bleeding Muhlleman, the stages of destructive changes in the periodontium – according to the periodontal index (PI). For the treatment of periodontitis in both groups, traditional therapy was used. The patients in the main group were prescribed Resverazin for 1 capsule 2 times a day after eating. The course of treatment was 2 months.Results and Discussion. In an objective survey conducted before treatment, the average value of the index of hygiene in the main group was (1.64±0.31), in the comparison group – (1.59±0.23) points. The PMA index in the main group was (63.12±1.17), in the comparison group – (62.39±1.13) points. The ONI-S, Silness-Loe and Stallard indexes in the patients in the main group were (2.36±0.13), (1.54±0.08), (1.200±0.062) points, in the comparison group – (2.30±0.12), (1.51±0.06) and (0.890±0.032) points, respectively. The values of PI and the Muhlleman index in the groups were (1.22±0.09) and (2.21±0.13) and (1.24±0.13) and (2.18±0.11) points, respectively. During the treatment, a positive dynamics of the studied parameters was observed. The values of the PMA index (%) and PI were (10.23±1.11) and (0.63±0.11) in the main group and (11.22±1.19) and (0.84±0.12) in the comparison group.Conclusions. The obtained results confirm the high clinical efficiency of the natural complex Resverazin, the inclusion of which in the scheme of basic therapy of generalized periodontitis contributes to positive dynamics and stable changes in the tissues of periodontal disease.

scholarly journals THE POSSIBILITIES OF APPLICATION OF DECIMETER-WAVE THERAPY IN DESTRUCTIVE APPENDICITIS CHILDREN

2019 ◽  
Vol 23 (1) ◽  
pp. 4-8
Author(s):  
Ekaterina R. Soloveva ◽  
O. V. Karaseva ◽  
M. F. Vasileva ◽  
S. V. Petrichuk
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Comparison Group ◽  
Abdominal Ultrasound ◽  
Main Group ◽  
Inpatient Stay ◽  
Decimetric Wave ◽  
Insufficiency Syndrome ◽  
Common Laboratory ◽  
Inflammatory Effect

Introduction. The article presents a comparative study of the postoperative period after laparoscopic appendectomy for destructive appendicitis in children with and without application of decimetric-wave therapy (DMWT). Material and methods. The study included 299 children aged from 3 to 17 years, the average age of children accounted for 10.7 ± 3.3 years. Patients were operated on for various forms of destructive appendicitis. The patients observed included 201 boys (67.3%) and 98 girls (32.7%), Destructive appendicitis (DA) was diagnosed in 129 (43.1%) children, appendicular peritonitis (AP) - in (56.9%). Patients of the main group received DMWT, starting from the 1st day after surgery. Patients in the comparison group did not receive physiotherapy. To assess the effectiveness of the use of UHF-therapy in the postoperative period, the following groups were taken into account: 1) intestinal insufficiency syndrome (ISS) and systemic inflammatory response syndrome (SSRS); 2) postoperative complications; 3) abdominal ultrasound data; 4) the dynamics of common laboratory indices 4) the duration of the inpatient stay. Results. In DA cases without peritonitis, ISS and SSRS in the main group were observed by 15.7 and 12.8 times less than in the comparison group, with the duration of ISS decreased by 2.13 times, SSRS by 3.3 times. In AP patients the frequency of ISS decreased by 1.68 times, SSRS - by 1.97 times. By the 5th day of the postoperative period in the main group, both in DA and AP cases, there was a significant increase in the incidence of patients with both leukocytes and lymphocytes count normal for the age, LII, CRP. The inpatient stay in the main group decreased by 1.0±0.7 days in DA patients, in AP cases - by 3.3±0.7 days. Conclusion. Evaluation of the postoperative period, as well as traditional laboratory indices, confirm the effectiveness of DMWTin the postoperative period in DA cases YES, in that the local and systemic anti-inflammatory effect is more pronounced in with AP patients.

scholarly journals Dysplasia of the connective tissue is a factor, aggravating menstrual pain syndrome in adolescent girls

2018 ◽  
Vol 67 (1) ◽  
pp. 38-46
Author(s):  
Valentina S. Orlova ◽  
Oksana V. Trushina ◽  
Irina V. Kalashnikova
Keyword(s):  
Connective Tissue ◽  
Emotional Disorders ◽  
Adolescent Girls ◽  
Comparison Group ◽  
Clinical Signs ◽  
Pain Syndrome ◽  
Main Group ◽  
Mcgill Pain Questionnaire ◽  
Primary Dysmenorrhea ◽  
Menstrual Pain

Background. Menstrual pain syndrome is accompanied by a complex of neurovegetative, metabolic-endocrine and psycho-emotional disorders. Dysplasia of connective tissue is characterized by a high level of functional disorders of the central and autonomic nervous system and emotional disorders. Aim. Detection of features of a clinical current of primary dysmenorrhea in adolescent girls with signs an undifferentiated dysplasia of connecting tissue (UDCT). Materials  and methods. 210 adolescent girls at the age of 11–17 full years suffering primary dysmenorrhea were examined. Depending on the presence or absence of clinical signs of undifferentiated connective tissue, two groups were identified. The main group consisted of 120 patients, the comparison group comprised 90 patients. The severity of the menstrual pain syndrome was assessed using the three scales of the McGill Pain Questionnaire. For psychological testing was used a scale of self-assessment of anxiety of Ch.D. Spielberger – Yu.L. Khanina. Results. In 90.9 ± 2.6% of patients of the main group the debut of a dysmenorrhea has taken place in the period of formation of menstrual function — within the first 2 years after menarche. The average value of the rank index of pain in the main group was higher than in the comparison group (3.5 ± 0.1 and 2.8 ± 0.1, p < 0.001). In an internal picture of perception of pain at patients of the main group the emotional component prevailed. Their psychoemotional status was distinguished by a higher level of the average score of reactive (45.3 ± 0.9 and 36.3 ± 1.4; p < 0.001) and personal (49.9 ± 0.6 and 41.4 ± 1.0; p < 0.001) of anxiety. Conclusions. The obtained results give the grounds to consider the presence of clinical manifestations of an undifferentiated dysplasia of a connecting tissue in adolescent girls as a predictor, which is making heavier a clinical current of a menstrual pain syndrome.

scholarly journals "FAST-TRACK" IN SIMULTANEOUS OPERATIONS AGAINST THE BACKGROUND OF WIDESPREAD PERITONITIS

2018 ◽  
Vol 25 (5) ◽  
pp. 141-146
Author(s):  
V. Yu. Mykhaylichenko ◽  
O. Yu. Gerbali ◽  
U. I. Basnaev ◽  
N. E. Karakursakov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Fast Track ◽  
Comparison Group ◽  
Clinical Laboratory ◽  
Average Duration ◽  
Main Group ◽  
Simultaneous Operations ◽  
Duration Of Hospitalization ◽  
Recovery Program

Aim. This research was conducted to study the possibility and effectiveness of the "Fast-track" fast recovery program application when performing simultaneous operations against the background of widespread peritonitis.Materials and methods. In the course of the study were examined 66 patients, the ratio of woman/man was 45:21. The main group – 32 (48,5%) patients with the major disease of constricted postoperative hernia complicated by the widespread peritonitis and chronic calculous cholecystitis (a prospective analysis of surgical treatment). The comparison group – 34 (51,5%) patients with the identical pathology – the retrospective analysis of surgical treatment. The treatment of patients of the main group was supplemented with the application of the elements of the «Fast-track» program. Whereas, the treatment of patients of the comparison group was performed exclusively according to the standard scheme of the patient management with widespread peritonitis.Results. Clinical, laboratory and instrumental data indicate the positive effect of the "Fast-track" program on the process of rehabilitation of patients in the postoperative period. There was a significant acceleration in the recovery of motorevacuation function of the intestine in patients of the main group in relation to the comparison group and a smaller number of complications in the main group in relation to the comparison group against the background of the application of this technique. As a result, the average duration of hospitalization of patients from the comparison group was 10- 5 days (average 12±2,4 days). While the average duration of hospitalization of patients from the comparison group was 17-20 days (on average 18±1,2 days).Conclusion. The use of the "Fast-track" program in simultaneous operations does not increase the effectiveness of surgical treatment, thereby accelerating the process of rehabilitation of patients in the postoperative period. 

scholarly journals JUSTIFICATION OF THE EFFECTIVENESS OF THE USE OF DALMAXIN RECTAL SUPPOSITORIES (THIOTRIAZOLIN) IN THE COMPLEX TREATMENT OF ACUTE PARAPROCTITIS

2020 ◽  
pp. 54-62
Author(s):  
O. A. Viltsaniuk ◽  
M. V. Mazur
Keyword(s):  
Postoperative Period ◽  
Microbial Contamination ◽  
Comparison Group ◽  
Main Group ◽  
Symptomatic Therapy ◽  
Complex Treatment ◽  
Study Objective ◽  
Endogenous Intoxication ◽  
Hospitalization Period ◽  
Rectal Suppositories

Summary. The problem of treatment of acute purulent paraproctitis is one of the most urgent problems of modern coloproctology. Study objective. To evaluate the effectiveness of the use of Dalmaxin rectal suppositories in the complex treatment of acute paraproctitis. Materials and methods. The effectiveness of use of Dalmaxin rectal suppositories was conducted in 62 patients with acute subcutaneous paraproctitis, assigned to two groups, a main group of 30 patients and a comparison group of 32 patients. All patients underwent radical surgery. Antimicrobial, detoxification and symptomatic therapy was prescribed postoperatively. Local treatment of purulent wounds was carried out using hydrophilic ointments depending on the phase of the wound process; the patients of the main group were additionally administered Dalmaxin rectal suppositories twice a day. The effectiveness of the treatment was evaluated by the severity of the swelling, the nature of the discharge from the wound, the level of microbial contamination, the wound cleansing period, the appearance of granulation tissue and epithelialization, and by cytological examination. Furthermore, general laboratory and biochemical studies were performed. Endogenous intoxication (EI) and its changes in the course of treatment were evaluated by the level of average-mass molecules, leukocyte intoxication index and hematological intoxication index. Statistical processing and comparison of the obtained data was performed using the STATISTICA® 5.5 integrated system (STATSOFT® Inc., USA), license A XX 910A374605FA. Results. The study showed that in patients with acute paraproctitis, the severity of the postoperative period is due to the severe intoxication and the development of a systemic inflammatory response syndrome that were observed in patients at the time of hospitalization. After surgical intervention, clinical and laboratory parameters did not normalize in the first five days of the postoperative period, and only starting from the fifth day, there was a gradual decrease in the level of EI and laboratory indicators, reaching the normal ones only at the time of discharge from the hospital. EI complicates the course of the postoperative period, primarily by weakening the level of humoral immunity and inhibiting the processes of reparative regeneration. When comparing the results of treatment of acute paraproctitis in patients using Dalmaxin rectal suppositories with traditional methods. The hospitalization period of the patients of the main group was also shorter than in the comparison group, and was (9.2 ± 0.5) and (11.9 ± 0.9) bed days, respectively. Conclusions. A comparative evaluation of the use of Dalmaxin in the complex treatment of acute purulent paraproctitis showed that the drug, due to its properties, significantly improves the course of the postoperative period, as evidenced by faster reduction of endogenous intoxication, reduction of microbial contamination and wound cleansing from necrotic tissues, faster granulation and epithelialization, as well as wound healing, thus helping to reduce the time of hospitalization.

scholarly journals EVALUTION OF MAMMARY GLAND PROSTHESIS ROTATION PROPHILAXIS EFFECIENCY IN A THREE YEARS POSTOPERATIVE PERIOD

2019 ◽  
Vol 18 (4) ◽  
pp. 29-36
Author(s):  
O. I. Zakhartseva ◽  
Ya. M. Susak ◽  
L. Yu. Markulan
Keyword(s):  
Mammary Gland ◽  
Postoperative Period ◽  
Comparison Group ◽  
Main Group ◽  
Augmentation Mammoplasty ◽  
Lactation Period ◽  
Significant Difference ◽  
Group A ◽  
Clinically Significant ◽  
One Year

Mammary gland prosthesis rotation (MGPR) after augmentation mammoplasty is a poorly studied complication of plastic surgery. The frequency of MGPR is not well known. There are indications that MGPR of 90○ , which is considered clinically significant, ranges from 0.9 % to 14 %. Preventing methods of MGPR are not developed enough. Aim: determination of the effectiveness of the upper pole reinforcement of «neo pocket» with prolen thread for the prevention of MGPR after primary augmentative mammoplasty (PAMP) in three years of postoperative period. Material and methods. The invectigation is performed on the basis of the Surgery Department No. 4 of Bogomolets NMU in the period from 2013 to 2018. A prospective, independent comparison of the primary augmentative mammaplasty results between three independent groups of patients was performed: two groups of comparison and one main groups. The first group of comparison (Group P1) included 94 patients who evaluated the results of augmentative mammaplasty one year after the operation, the second comparison group (Group P3) – 63 patients three years after this operation. The main group (group O) included 76 patients who had a prospective study after one (group O1) and then three years later (group O3) – 62 patients. In the comparison groups, the standard MGPR was performed, in the main group – according to the developed method. The patients did not differ statistically by age, body mass index (BMI), weight of prostheses, percentage of pregnant women and patients with lactation period. In all the cases, textured prostheses with high and medium profile were implanted. The majority of patients were operated with prostheses from 325-335 ml and 375 ml. The MGPR evaluation was carried out in accordance with the developed method using the ultrasound of the ESAOTE firmware model Technos Partner with a linear sensor with frequency of 12.5 MHz. Data analysis was performed using the IBM SPSS Statistics 22 statistical analysis packets. Results. One year after the operation in the P1 group, a slightly lower, but not reliable percentage of prosthesis rotation – 143 (76.1 %) against 103 (81.7 %) in the group P3, p=0.231, was diagnosed. At the same time, in the P1 group only 4 (4.3 %) women did not have the rotation of the prosthetics of both mammary gland (MG) and in the P3 group 2 women (3.2 %), p=0.001. Significant difference of the frequency of patients with clinically significant MGPR: 11 (11.7 %) patients in the P1 group versus 12 (19.0 %) in the P3 group (p = 0.202) and 13 (6.9 %) in the P1 group against 13 (10.3 %) of the prostheses in the group P3 (p=0.284). In patients in the main group, a small (30.9%) frequency of clinically insignificant MGPR was noticed after PAMP and it did not increase after the three years period (32.1%). In the P1 group, 143 (76.1 %) prostheses were diagnosed with rotation, in the group O1 – 46 (30.3 %), p = 0.001. At the same time, in the P1 group, only 4 (1.6 %) women didn`t have the rotation of the of both MG prostheses and in the group – 39 (51.3 %), p = 0.001, which indicates the effectiveness of the developed methodology. A similar trend was observed in the case of comparison of the three years results between the group P3 and the group O3. The absence of rotation of prostheses was diagnosed in 83 (66.9 %) O3 group and 26 (20.6 %) in the P group, and there was no clinically significant rotation of O3 patients versus group P where these patients were observed: 12 (19.0% ), p=0.001. Conclusion: the method of fixation of the submuscular «neo pocket» upper pole with prolen thread, provides stable protective effect of MGPR and gives a possibility to avoid a clinically significant rotation(more than 900) throughout three years after augmentative mammoplasty comparing with a traditional method – 11.7 %, patients in a year – 19 %, in three years after PAMP, р<0,01.

scholarly journals OF PHOTOPHERESIS IN KIDNEY TRANSPLANTATION

2018 ◽  
Vol 20 (1) ◽  
pp. 55-65 ◽  
Author(s):  
A. P. Faenko ◽  
A. B. Zulkarnayev ◽  
Ju. Ju. Chuksina ◽  
V. A. Fedulkina ◽  
R. O. Kantaria ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Immunosuppressive Therapy ◽  
Postoperative Period ◽  
T Regulatory Cells ◽  
Comparison Group ◽  
Graft Loss ◽  
Infectious Complications ◽  
Main Group ◽  
Late Postoperative Period

Aim– to perform a comparative study of the long-term results of the combined use of extracorporeal photochemotherapy (photopheresis) and drug immunosuppression and standard immunosuppressive therapy in patients after kidney transplantation.Materials and methods. An open cohort randomized study was conducted, including 60 patients with chronic kidney disease stage 5D. All patients underwent single-group cadaveric kidney transplantation. Patients were randomly divided into two groups. All transplants were paired, the fi rst kidney transplant was received by the patient of the main group, the second – by comparison group. 30 patients of the main group received standard protocol of immunosuppression and 10–15 sessions of photopheresis during the fi rst six months after transplantation. All patients of the comparison group received standard immunosuppressive therapy only. End points: primary – graft loss, surrogate – the number of acute rejection episodes and infectious complications, the dynamics of creatinine blood concentration, the glomerular fi ltration rate and daily proteinuria, the dynamics of tacrolimus C0 blood concentration. To study the mechanism of photopheresis action in the late postoperative period, we evaluated the immunological parameters: subpopulation of naive T-cells (CD3+CD4+CD45RO–CD28+), the level of CD28 molecule expression (MFI) on these cells and also – subpopulation of T-regulatory cells (CD3+CD4+CD25 (Hi)CD127–).Results.The use of photopheresis leads to the graft function improvement in the late postoperative period: the creatinine concentration (p = 0.017) in the blood and daily proteinuria (p = 0.011) were lower in patients of the main group, the glomerular fi ltration rate was higher (p = 0.027). The incidence rate ratio (IRR) of rejection in the main group was signifi cantly lower than in the comparison group: 0.2509 (95% CI 0.05386, 0.9167), p = 0.0358. The risk of graft loss was also lower in the main group: IRR 0.2782 (95% CI 0.07562, 0.8657), p = 0.026, as well as the risk of infectious complications: IRR 0.3888 (95% CI 0.2754; 0, 5445), p < 0.0001. Survival rate of transplants was higher in the main group (Log Rank p = 0.009; Breslow p = 0.005). The use of photopheresis made it possible to reduce the concentration of tacrolimus in the late postoperative period (p = 0.0017) without increasing the risk of graft rejection. The photopheresis tolerogenic effect in the late postoperative period may be due to an increase in the population of T-regulatory cells with the CD3+CD4+CD25(Hi)+CD127– phenotype compared to the patients which received only standard immunosuppressive therapy (p = 0.024).Conclusion.The preventive use of photopheresis contributes to improvement of the kidney transplantation long-term outcomes. Further studies are needed to study the mechanisms of photopheresis action and markers of partial immunological tolerance to the allograft.

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