scholarly journals Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients

2018 ◽  
Vol 10 (2) ◽  
pp. 79-86
Author(s):  
N I Glushkov ◽  
T L Gorshenin ◽  
S K Dulaeva
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Traditional Methods ◽  
Western State ◽  
Surgical Tactics ◽  
Medical University ◽  
Ray Methods ◽  
North Western

The results of diagnostics and surgical treatment of the combined complications of colon cancer in elderly and senile patients are presented. It is established that modern ray methods of research, along with traditional methods, allow to improve the quality of diagnostics of combined complications. The introduction of endovideosurgical technologies helps to reduce the number of postoperative complications and lethality. (For citation: Glushkov NI, Gorshenin TL, Dulaeva SK. Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):79-86. doi: 10.17816/mechnikov201810279-86).

Improving the efficiency of the postoperative period in the surgical treatment cancer patients with metastatic bone fractures upper and lower extremities using elixir altai ("vitavis") in combination with ion-activated water resources

10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Bone Fractures ◽  
Infectious Complications ◽  
Lower Limbs ◽  
Oncologic Patients

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.

scholarly journals МОЖЛИВОСТІ ВИКОРИСТАННЯ ПЕРИКАРДІОСКОПІЇ

World Science ◽  
2019 ◽  
Vol 2 (2(42)) ◽  
pp. 19-21
Author(s):  
Комарчук В. В. ◽  
Урсол Г. М. ◽  
Комарчук Є. В.
Keyword(s):  
Surgical Treatment ◽  
Pericardial Effusion ◽  
Minimally Invasive ◽  
Diagnosis And Treatment ◽  
Traditional Methods

Pericardial effusion is the most common pericardial pathology. This disease has been described even during the days of Hippocrates. The first method of drainage of pericardium was described by Larrey in 1810. Since then, the number of interventions in the pericardium has increased significantly and diversified. Novadays minimally invasive interventions have become increasingly important.The aim of our study. To estimate the application results of pericardioscopy during the diagnosis and treatment of pericardial deseases. Materials and methods. The application results of pericardioscopy during surgical treatment of 1958 patients with various diseases were analyzed and estimated.Results. In contradistinction to traditional methods, the pericardioscopy helps to reduce operational trauma, the risk of complications and relapses without reducing the quality of treatment.Conclusions. Using pericardioscopy can significantly reduce the time of diagnostic, treatment and rehabilitation, as well as increase their effectiveness.

Microparticles of blood cells in patients with COVID-19 as a marker of hemostasis activation

2020 ◽  
Author(s):  
О.В. Сироткина ◽  
А.И. Ермаков ◽  
Л.Б. Гайковая ◽  
Д.А. Кудлай ◽  
Т.В. Вавилова
Keyword(s):  
Blood Cells ◽  
Severe Infection ◽  
Control Group ◽  
Clotting System ◽  
Relative Level ◽  
Western State ◽  
Reference Limit ◽  
Increased Risk ◽  
Medical University ◽  
North Western

Введение. Наблюдения за больными COVID-19 показали развитие коагулопатии на фоне тяжелой инфекции, вызванной SARC–CoV-2. Патогенетические механизмы влияния SARC–CoV-2 на систему гемостаза в настоящее время активно исследуются, однако для практического здравоохранения крайне актуальным является поиск маркеров активации системы свертывания крови с целью ранней профилактики тромбоэмболических осложнений у пациентов с COVID-19. Цель исследования: определить количество микрочастиц, отделяющихся от клеток крови, у больных COVID-19 и здоровых индивидуумов и проанализировать корреляцию числа микрочастиц с лабораторными и клиническими характеристиками пациентов. Материалы и методы. Обследованы 10 пациентов с COVID-19, госпитализированных в ФГБОУ ВО СЗГМУ им. И. И. Мечникова Минздрава России в период июнь-июль 2020 г., контрольную группу составили 12 сотрудников ФГБОУ ВО СЗГМУ им. И.И. Мечникова Минздрава России без признаков острого респираторного заболевания, без сердечно-сосудистых и тромбоэмболических эпизодов в анамнезе. У всех обследованных выполнен клинический анализ крови, исследованы маркеры активации и воспаления, а также измерено количество внеклеточных микровезикул — экзосом на проточном цитометре. Результаты. У пациентов с COVID-19 по сравнению с контрольной группой наблюдалось увеличение относительного количества нейтрофилов и снижение тромбоцитов. Такие маркеры как фибриноген, С-реактивный белок, ферритин, интерлейкин-6 и лактатдегидрогеназа значительно превышали верхнюю границу референтных значений. При этом количество экзосом оказалось значимо выше у пациентов с COVID-19 по сравнению со здоровыми лицами (% позитивных событий) — 93,2 [88,7–96,5] против 56,2 [50,5–73,5] соответственно (p = 0,00001) и коррелировало с относительным уровнем нейтрофилов. Среди проанализированных экзосом преобладали микрочастицы тромбоцитарного и лейкоцитарного происхождения. Заключение. Увеличение количества внеклеточных микрочастиц у больных COVID-19 может быть использовано как маркер активации гемостаза и повышенного риска тромботических осложнений на фоне инфекционного заболевания. Background. The monitoring of COVID-19 patients showed the development of coagulopathy in the context of severe infection caused by SARC–CoV-2. The pathogenetic mechanisms of SARC–CoV-2 influence on hemostasis are currently being actively examined, but the search for markers of the blood-clotting system activation for early prevention of thromboembolic complications in patients with COVID-19 is highly relevant for the practical health care. Objectives: to analyze the number of microparticles that separate from blood cells due to the hemostasis activation in COVID-19 patients and in healthy donors and to analyze the correlation between microparticles number and laboratory and clinical characteristics of patients. Patients /Methods. The study included 10 patients with COVID-19 who were hospitalized in Mechnikov North- Western State Medical University in June- July 2020; the control group consisted of 12 employees of Mechnikov North- Western State Medical University without signs of acute respiratory disease, without cardiovascular and thromboembolic episodes in the history. All patients and individuals in the control group had their blood clinically tested on a 5-Diff hematological analyzer, markers for activation and inflammation were examined, and the number of extracellular microvesicles (exosomes) was measured on the flow cytometer. Results. Patients with COVID-19 had an increase in the relative amount of neutrophiles and a decrease in platelets compared to controls. Markers such as fibrinogen, C-reactive protein, ferritin, interleukine-6 and lactate dehydrogenase significantly exceeded the upper reference limit. The number of exosomes was significantly higher in patients with COVID-19 compared to healthy controls (% of positive events) — 93.2 [88.7–96.5] vs. 56.2 [50.5–73.5] respectively (p = 0.00001), and correlated with the relative level of neutrophiles. Among the exosomes analyzed, platelet and leukocyte microparticles prevailed. Conclusions. The increase of extracellular microparticles in COVID-19 patients can be used as a marker of hemostasis activation and increased risk of thrombotic complications in the context of severe infectious disease.

scholarly journals APPENDICULAR PERITONITIS IN CHILDREN: AN EFFICIENT SURGICAL APPROACH AND INTENSIVE CARE

2020 ◽  
Vol 24 (2) ◽  
pp. 62-70
Author(s):  
O. V. Karaseva ◽  
Kseniia E. Utkina ◽  
A. L. Gorelik ◽  
A. V. Timofeeva ◽  
D. E. Golikov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Intestinal Obstruction ◽  
Postoperative Period ◽  
Diffuse Peritonitis ◽  
Surgical Tactics ◽  
Adhesive Intestinal Obstruction ◽  
Local Protocol

Introduction. Currently, there is no any unified approach to the treatment of complicated forms of acute appendicitis in children. The purpose of our study is to evaluate the effectiveness of the local Protocol for diagnostics and treatment of appendicular peritonitis (AP) in children. Material and methods. 149 children with AP, aged 2 - 17 (11 ± 3.5 ), were included into the study. All of them were treated at the Clinical and Research Institute Emergency Pediatric Surgery and Trauma (CRIEPST) in 2015-2018. In the gender structure, boys (104; 69.8%) prevailed over girls (45; 30.2%). The following parameters were evaluated: AP structure, surgical tactics, postoperative course (incidence of postoperative intestinal failure syndrome (IFS), postoperative complications, length of hospital stay). A tactics for surgical treatment and volume of intensive care in the postoperative period were defined depending on AP severity and according to the local Protocol. Laparoscopic appendectomy was performed in 145 (97.3%) patients. There were no intraoperative complications and conversions in the studied group. In case of periappendiular abscess (PA) 3 (2.7%), patients had puncture and abscess drainage under ultrasound control. Results. While analyzing the AP structure by forms , the following picture was shown: free and abscessed forms were approximately equal - 72 (48.3%) and 77 (51.7%), respectively (p > 0.05). Diffuse peritonitis - 31.5%; generalized - 16.8%; combined - 17.4%; periappendicular abscess (PA) stage 1-14.8%; PA 2-16.8%; PA 3-2.7%. Postoperative complications - 4 (2.7%): postoperative abdominal abscesses - 3 (2.0%); early adhesive intestinal obstruction - 1 (0.7%). In postoperative abscesses, puncture and drainage were performed under ultrasound control; in early adhesive intestinal obstruction - laparoscopic adhesiolysis. All the children recovered. Length of intensive care was 2.9 ± 1.8 days; hospitalization - 12.0 ± 5.2 days. Conclusion. The local Protocol developed by the researchers helps to define a surgical tactics and volume of intensive care in the postoperative period. Laparoscopic surgery, in the vast majority of cases, is an optimal and effective technique for AP surgical treatment in children. Contraindications to laparoscopic surgery are PA 3 and total abscessing peritonitis.

scholarly journals Hemophagocytic syndrome and ankylosing spondylitis

2018 ◽  
Vol 10 (2) ◽  
pp. 113-120
Author(s):  
A R Belogurov ◽  
V I Mazurov ◽  
E N Tcigan ◽  
V V Tyrenko ◽  
M M Toporkov ◽  
...  
Keyword(s):  
Immune System ◽  
Ankylosing Spondylitis ◽  
Autoimmune Disease ◽  
Clinical Case ◽  
Hemophagocytic Syndrome ◽  
Western State ◽  
Long Time ◽  
Medical University ◽  
North Western ◽  
Excessive Activation

Hemophagocytic syndrome is a consequence of excessive activation of the immune system that develops as a rule in response to infection, neoplasm or as a result of an autoimmune disease leading to uncontrolled hyperinflammatory syndrome, internal injuries, cytopenia and death. The diagnosis of the syndrome is complex and is based on the criteria accepted by the society for the study of hemophagocytosis syndrome in 2004. Therapy involves the use of a combination of cytostatics and glucocorticoids and is carried out for a long time. The article describes the clinical case of hemophagocytic syndrome in a patient with ankylosing spondylitis. (For citation: Belogurov AR, Mazurov VI, Tcigan EN, et al. Hemophagocytic syndrome and ankylosing spondylitis. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):113-120. doi: 10.17816/mechnikov2018102113-120).

scholarly journals Differentiated treatment tactics in surgery of liver echinococcosis

2020 ◽  
Vol 174 (5) ◽  
pp. 72-77
Author(s):  
A. M. Shamsiev ◽  
J. A. Shamsiev ◽  
K. E. Rakhmanov ◽  
S. S. Davlatov
Keyword(s):  
Postoperative Complications ◽  
Integrated Approach ◽  
Disease Recurrence ◽  
Medical Institute ◽  
Preventive Chemotherapy ◽  
Residual Cavity ◽  
Laparotomy Wound ◽  
Surgical Tactics ◽  
Surgery Department

Purpose of the study. Improving the quality of treatment for liver echinococcosis by improving surgical tactics and developing eff ective methods to reduce disease recurrence. Materials and methods: 371 patients with echinococcosis of the liver, who were admitted to the surgery department of the 2nd clinic of Samarkand State Medical Institute, were examined. Of the 371 patients in 311 (83.8%) patients, the disease was detected for the fi rst time and in 60 (16.2%) patients, echinococcosis was recurrent. The results of the study: compared with 2005–2008. the incidence of postoperative complications decreased from 13.1 to 4.3%. Complications such as suppuration of the residual cavity (6 times), suppuration of the laparotomy wound (2 times), the formation of bile fi stulas (3 times), and no subphrenic abscesses began to occur much less frequently. The duration of inpatient treatment after surgery decreased by 2 times compared with the control — from 21.2 ± 1.2 to 10.9 ± 0.3 days. Conclusions: the developed algorithm for choosing the tactics of surgical treatment of liver echinococcosis, taking into account the integrated approach to choosing access, the method of treatment and elimination of the residual cavity, as well as preventive chemotherapy, has improved the quality of care by reducing the frequency of immediate postoperative complications from 12.5% to 4, 3% (p = 0.027 according to the χ2 criterion) and relapse of the disease from 11.9% to 2.6% (p = 0.031 according to the χ2 criterion).

scholarly journals Results of surgical treatment of patients of elderly and senile age with complicated forms of locally advanced colon cancer

2019 ◽  
Vol 11 (2) ◽  
pp. 35-42
Author(s):  
N. I. Glushkov ◽  
T. L. Gorshenin ◽  
M. Ya. Belikova ◽  
S. K. Dulaeva ◽  
I. K. Borovik
Keyword(s):  
Colon Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Locally Advanced ◽  
Results Of Treatment ◽  
Advanced Colon Cancer

The paper analyzes the results of treatment of 74 elderly and senile patients with complicated forms of locally advanced colon cancer. The article demonstrates the prevalence of symptomatic operations due to the severity of the condition advanced oncological process. The use of endovideosurgical technologies in treating patients with complications of locally advanced colon cancer reduces the number of postoperative complications.

scholarly journals Improvement of surgical tactics in acute destructive cholecystitis

2021 ◽  
pp. 17-22
Author(s):  
Z. Y. Saydullaev ◽  
S. S. Davlatov ◽  
K. E. Rakhmanov
Keyword(s):  
Surgical Treatment ◽  
Integrated Approach ◽  
World Health ◽  
Medical Institute ◽  
State Medical Institute ◽  
Number Of Patients ◽  
The World ◽  
Surgical Tactics ◽  
Health Organization

Abstract. Relevance. According to the World Health Organization, in the world due to the increase in the incidence of cholelithiasis, there is an increase in the number of patients with destructive forms of this pathology. The aim of the study is to improve the quality of treatment of patients with acute destructive cholecystitis by improving surgical tactics. Materials and research methods. The work is based on the assessment of the results of surgical treatment of patients with acute destructive cholecystitis who were treated in the surgical departments of the 1st clinic of the Samarkand State Medical Institute (clinical base of the departments of surgical diseases No. 1 and general surgery of the Samarkand State Medical Institute) for the period from 2016 to 2020. Conclusions. The tactics of surgical treatment of patients with destructive cholecystitis, taking into account an integrated approach to the choice of access, made it possible to improve the quality of care by reducing the frequency of immediate postoperative complications from 13.4% (11 patients in the comparison group) to 1.7% (2 patients in the main group).

scholarly journals Ways to improve the immediate results of treating complicated colon cancer in elderly and senile patients

2019 ◽  
Vol 11 (1) ◽  
pp. 21-26
Author(s):  
Nikolay I. Glushkov ◽  
Konstantin V. Pavelets ◽  
Timofey L. Gorshenin ◽  
Mikhail Y. Lobanov ◽  
Yuliya S. Shishlikova
Keyword(s):  
Colon Cancer ◽  
Cardiovascular Risk ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Perioperative Period ◽  
Cardiac Complications ◽  
Control Group ◽  
Tei Index ◽  
Minimally Invasive Methods

The article analyzes the results of treating 545 elderly and senile patients with complicated forms of colon cancer and severe concomitant pathology. Depending on the method of surgical treatment, the patients were divided into two groups. The control group consisted of 408 patients, who were performed traditional surgery without investigating the Tei index. The patients of the main group were operated using endovideosurgical technologies. In addition, the calculation of systolic-diastolic ratio by means of Doppler echocardiography was carried out. Measuring the Tei index allowed correcting cardiovascular risk in the perioperative period, thereby increasing operability and reducing the number of postoperative cardiac complications. The use of minimally invasive methods of surgical treatment for colon cancer contributed to a decrease in the frequency of postoperative complications. Thus, it contributed to reducing hospital mortality from 29.9% to 2.2%.

scholarly journals SURGICAL TREATMENT OF A CHILD WITH DEEP BURN OF THE FACE

2018 ◽  
Vol 8 (3) ◽  
pp. 81-87
Author(s):  
V. V. Rybchenok ◽  
O. I. Starostin ◽  
A. V. Trusov ◽  
M. A. Shcherbakova ◽  
V. V. Stepanovich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Body Surface ◽  
Subsequent Treatment ◽  
Full Thickness ◽  
Severe Condition ◽  
Facial Burns ◽  
The Face ◽  
Surgical Tactics

Total deep facial burns represent one of the most complex clinical tasks for a surgeon. A child’s quality of life and complexity of subsequent treatment stages depends on effective surgical tactics used during the acute period of a burn trauma. The article describes the use of full-thickness graft preliminarily stretched with an endoexpander when treating deep facial burns in a child with the total burns involving 60% of body surface and thermoinhalation lesion. The surgery was done on the 36th day of staying at the hospital in spite of the patient’s severe condition. 

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