scholarly journals Evaluation of effectiveness of thioctic acid use in combined therapy of angiodistonia and polyneuropathy syndrome

2020 ◽  
Vol 37 (4) ◽  
pp. 17-25
Author(s):  
Natal'ja N. Malyutina ◽  
Arina F. Bolotova ◽  
Roman B. Eremeev ◽  
Dmitriy Yu. Sosnin

Objective. The aim of the study was to investigate the effectiveness of the preparation of thioctic acid combined with standard therapy among patients with angiodistonic syndrome and vegetative-sensory polyneuropathy of the extremities due to the influence of general vibration. Materials and methods. A prospective randomized study of two groups of patients with vibration disease was conducted: the main group (n = 30) and the comparison group (n = 30). All patients received standard therapy, while the main group received additional therapy with octolipen (300 mg per os 2 times a day). Results. The results of questionnaires and objective examination of patients did not establish the occurrence of any side effects when including the drug in the therapy. The survey data proved statistically significant differences in the assessment of pain syndrome at rest and in the occurrence of night pains (p = 0.022). At the same time, when assessing the severity of paresthesia, no statistically significant difference was found between the groups (p = 0.5536). The therapy was accompanied by normalization of the antioxidant status (AOS) in both groups: in the main group, the median AOS increased by 1.342 times and in the comparison group by 1.267 times. In the statistical evaluation, the inclusion of thioctic acid in the treatment was accompanied by a statistically significant increase in the AOS not only with the initial data (p 0.00001), but also in comparison with the results of treatment of patients in the comparison group (p = 0.0387). The data from the reovasographic study also showed that the therapy was more effective with additional inclusion of thioctic acid drug to it. Conclusions. Thus, the data obtained justify the feasibility and effectiveness of using thioctic acid preparation in the treatment of angiodistonia and polyneuropathy syndromes.


2017 ◽  
pp. 118-122
Author(s):  
S.M. Kartashov ◽  
◽  
E.M. Oleshko ◽  

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.



2021 ◽  
Vol 37 (6) ◽  
pp. 102-110
Author(s):  
D. S. Zolotukhin ◽  
I. V. Krochek ◽  
S. V. Sergiyko

Objective. To carry out a comparative analysis of the results of epithelial coccygeal course treatment using laser-induced interstitial thermotherapy LIT) under ultrasound control and traditional open excision. The high trauma rate of traditional operations in the epithelial coccygeal course ECC), the duration of hospital stay, pain syndrome force surgeons to search for new technologies in the treatment of this pathology. Materials and methods. A retrospective analysis of the treatment results of 369 patients with ECC who were admitted to the clinic for elective surgery in the period from 2009 to 2019 was carried out. There were 264 men 71.5 %) and 105 women 28.5 %). The mean age was 26.9 7.2 years. The patients were divided into 2 groups: 190 patients of the main group underwent surgery using a fiber-optic laser under ultrasound guidance, 179 patients of the comparison group underwent traditional radical excision of ECC with application of primary sutures or various types of plastic. Results. The severity of pain syndrome after surgery in patients of the main group was 1.7 0.6 points, in the comparison group 3.5 1.3 points by a five-point visual analogue scale VAS) for pain. The duration of inpatient treatment in the main group was 1.8 0.4 days, in the comparison group 11.5 1.7 days. Moreover, in 197 76.1 %) patients of the main group, the operation was performed on an outpatient basis. The restoration of working capacity in the main group occurred after 5.2 1.2 days, and in the comparison group after 17.4 2.8. After traditional operations, the relapse of the disease was noted in 11.7 %, and after laser treatment, slightly more than 12.1 %. Satisfaction with the results of treatment in the main group was noted in 95.1 %, and in the comparison group in 90 % of patients. Conclusions. The obtained results of treatment allow us to recommend the technique of interstitial laser obliteration of the coccygeal cyst under ultrasound navigation developed in the clinic for widespread use in practical work of surgeons.



2018 ◽  
Vol 14 (3-4) ◽  
pp. 74-79
Author(s):  
I.V. Kolosovych ◽  
B.H. Bezrodnyi ◽  
I.V. Hanol

Relevance. The article is devoted to the problem of diagnosis and treatment of acute biliary pancreatitis, which remains one of the most common surgical diseases of the abdominal cavity and accounts for 33.2% of the total number of patients with acute pancreatitis. Objective of the work is to improve the diagnosis and results of surgical treatment of patients with acute pancreatitis of biliary etiology. Materials and methods. The results of treatment of 264 patients with acute pancreatitis of biliary etiology are analyzed. Operative treatment was applied in 92 (34,8 %) patients: endoscopic operations were performed in 44 patients (16,7 %). Thus, in 10 (3,8 %) patients, endoscopic papilloprotectomy was performed with the auditory of the duct system and the extraction of concrements. In other cases, organo-preserving intervention was performed without disturbing the morphofunctional integrity of the sphincter apparatus of the duct system: the cannulation in 6 (2,3%) patients, mechanical (balloon) in 5 (1,9 %) cases, pharmacological (myogenic antispasmodic) dilatation of distal duct and a large duodenal papilla in 11 (4,2 %) patients. In residual choledocholithiasis, a technique of papillotomy under the control of choledochoscopy was proposed – 12 (4,54 %) patients. A comparative analysis of the effectiveness of the treatment of patients who used the "open" (comparative group) and noninvasive endoscopic interventions in the early disease (the main group) was performed. Results. So in the main group the length of stay in the hospital was 12±3,2 days, respectively, in the comparison group – 26±4,3 days. In 42 (95,4 %) patients who had undergone endoscopic surgery, a positive clinical effect, a rapid regress of the symptoms of acute pancreatitis was achieved. In two (4,5 %) patients in the main group, the course was complicated by the development of the abscess of the stuffing box, and puncture under ultrasound control was performed. In patients of the comparison group complications arose in 5 (41,6 %) patients, it is noteworthy that all of them had undergone operative interventions, which were limited only to the rehabilitation and drainage of the abdominal cavity, a stuffing box bag. The mortality rate among unopposed was 1,2 % (2 patients), and among the operated – 11,9 % (11 patients). Among prooperated patients who died, 81,8 % (9 people) were elderly patients. Conclusions. The use of minimally invasive endoscopic interventions in the early phase of the disease reduces the length of stay of patients in the hospital from 26±4,3 days (comparison group) to 12 3,2 days (main group) and the number of complications occurring by 37,1 % (P <0, 05). Application of the proposed method of papillotomy under the control of choledochoscopy makes it possible to reduce the risk of perforation of the wall of the duodenum with the development of peritonitis or retroperitoneal phlegmon by 1,2 % (P <0,05).



2020 ◽  
Vol 10 (2) ◽  
pp. 31-38
Author(s):  
V. N. Blokhina ◽  
M. M. Kopachka ◽  
E. M. Troshina ◽  
D. S. Kanshin ◽  
S. G. Nikolaev

Introduction. Lumbosacral radiculopathy is а leading cause of long-term disability. Taking into a consideration the duration of treatment radiculopathy, the risk of developing adverse reactions when taking analgesics, non-steroidal anti-inflammatory drugs, the physiotherapeutic method — repetitive peripheral magnetic stimulation may become a promising method of therapy.Aim of the study. Assessment of the effectiveness of the complex treatment for patients with lumbosacral radiculopathy using the course of the repetitive peripheral magnetic stimulation.Materials and methods. Forty patients with lumbosacral radiculopathy were enrolled in the open non-randomized study, were divided into 2 parallel groups. The patients of the 1st group received a course of traditional treatment and a course of the repetitive peripheral magnetic stimulation. The patients of the 2nd group were treated with the traditional treatment without the course of the stimulation. A magnetic stimulator MagPro (Magventure, Denmark) was used for repetitive peripheral magnetic stimulation.Results. A significant difference (p <0.001) was registered regarding the reduction of pain syndrome and the improvement of the functional status after treatment in both groups. 14 (70 %) patients of the first group achieved a pain visual analogue scale relief by 50 % after 10 repetitive peripheral magnetic stimulation sessions, while 6 (30 %) patients did this after 15 repetitive peripheral magnetic stimulation sessions. We did not observed a statistically significant differences (p >0.05) in pain syndrome, functional status, anxiety level at the end of follow-up between the groups.Conclusion. We did not receive the benefits of the repetitive peripheral magnetic stimulation course in comparison with a traditional treatment of a lumbosacral radiculopathy. Further placebo-controlled studies to study the effect of repetitive peripheral magnetic stimulation on pain and anxiety in patients with back pain and radiculopathy are required.



2021 ◽  
Vol 23 (3) ◽  
pp. 17-22
Author(s):  
Aleksey A. Sazonov ◽  
Nicolay A. Maistrenko ◽  
Pavel N. Romashchenko ◽  
Ivan A. Makarov

The effectiveness of the original technique of hemorrhoidectomy with lateral ultrasonic dissection in the cutting mode was analyzed from a clinical standpoint and studied according to pathomorphological changes in tissues during its use. A comparative assessment of the immediate results of treatment as well as pathomorphological changes in the tissue of removed hemorrhoids in two groups of patients was performed. The main group included 30 patients in whom the original hemorrhoidectomy technique with lateral ultrasound dissection in the cutting mode was used. The control group consisted of 30 patients who underwent Milligan Morgan hemorrhoidectomy using electrocoagulation. No significant difference was found between these groups in terms of the age and sex structure of patients, as well as the main clinical characteristics of the disease. In a comparative analysis of the immediate treatment results, the intensity of the pain syndrome and the incidence of postoperative complications were lower in the main group than in the control group. In the assessment of pathomorphological changes, the depth of coagulation necrosis and the severity of necrobiotic changes in the underlying layer after hemorrhoidectomy with lateral ultrasonic dissection in the cutting mode were significantly less than those after Milligan Morgan surgery using electrocoagulation. A significant difference was also revealed in the timing of tissue regeneration. The formation of active granulations in the postoperative wound area in the main group was noted on postoperative days 1416, while this process developed no earlier than on postoperative day 20 in the control group. As a result, complete epithelialization of wounds after hemorrhoidectomy with lateral ultrasound dissection in the cutting mode occurred much earlier, i.e., postoperative days 2630. A similar process after the Milligan Morgan hemorrhoidectomy using monopolar coagulation was completed only on postoperative days 3638. Thus, the use of the original technique of lateral ultrasound dissection provides a more sparing effect on tissues, which is the key to a favorable course of the postoperative period and rapid rehabilitation of patients.



2019 ◽  
pp. 156-161
Author(s):  
E. A. Voroshilova

The article presents the results of a comparative randomized study, the purpose of which was to evaluate the effectiveness of the use of aminodihydrophthalasindione sodium (Galavit, LLC SELVIM, Russia) in the treatment of patients undergoing an abortion. Included in the study, 48 women were divided into two groups, 24 patients of the main group in addition to the standard rehabilitation were treated with aminodihydrophthalasindione sodium in the comparison group – 24 patients underwent only standard rehabilitation. In this study, all patients (100%) of the main group who were treated with aminodihydrophthalasindione sodium in addition to the standard therapy marked reduction of the clinical symptoms of the disease and positive dynamics was observed at ultrasound. In the control group, the full clinical effect of treatment was observed only in 10 patients (52.6%). 9 women (47,4%) required repeated therapy. Ultrasound studies in 12 patients (63.2%) showed changes equivalent to endometritis.



2021 ◽  
Vol 5 (6) ◽  
pp. 366-372
Author(s):  
I.V. Matoshina ◽  
◽  
M.A. Livzan ◽  
M.M. Fedorin ◽  
I.V. Lapteva ◽  
...  

Aim: to evaluate the efficacy and safety of combined therapy with a proton pump inhibitor (PPI) and an esophagoprotector to relieve the symptoms of reflux esophagitis, improve the life quality of patients and achieve faster and complete disease remission. Patients and Methods: a randomized study included 60 patients, including 33 men (mean age 40.96±13.44 years) and 27 women (mean age 48.29±12.69 years) with a duration of gastroesophageal reflux disease (GERD) of 21.85±15.48 months and C/D stage of reflux esophagitis. Depending on the prescribed treatment, the patients were divided into 2 groups of 30 subjects. Patients of the main group received complex therapy: PPI pantoprazole 40 mg once per day and esophagoprotector based on hyaluronic acid, chondroitin sulfate and poloxamer 407. In the comparison group, only pantoprazole was prescribed at the same dosage. The duration of the treatment course in both groups was 4 weeks. Before and after treatment, the presence and severity of complaints were assessed on the Likert scale, life quality according to the SF-36 questionnaire and endoscopic examination data. Results: after the end of the therapy course, a statistically significant decrease in the severity of epigastric burning, regurgitation, substernal pain, gaseous eructation, odynophagia and dysphagia was found both in the main group (in all cases p<0.05, Wilcoxon Matched Pairs Test) and the comparison group (in all cases p<0,05, Wilcoxon Matched Pairs Test). The use of combination therapy made it possible to achieve a more significant improvement in the life quality of patients in all indicators versus PPI monotherapy. In addition, 3 (10%) patients of the main group achieved endoscopic remission, while there were no such patients in the comparison group. The use of esophagoprotector in addition to PPI made it possible to reach the primary and secondary endpoints significantly more commonly versus during monotherapy. Conclusion: the obtained data indicate the high efficiency and safety of PPI therapy in combination with esophagoprotector for relieving the disease symptoms and improving the life quality of patients, faster and complete remission of reflux esophagitis by additional restoration of the esophageal mucosa resistance. Esophagoprotector as a component of complex therapy together with PPI allows achieving clinical and endoscopic disease remission in patients with erosive esophagitis in shorter terms. KEYWORDS: gastroesophageal reflux disease, esophageal mucosa resistance, esophagoprotection, proton pump inhibitor, quality of life. FOR CITATION: Matoshina I.V., Livzan M.A., Fedorin M.M., Lapteva I.V. Efficacy of combined therapy in patients with erosive gastroesophageal reflux disease. Russian Medical Inquiry. 2021;5(6):366–372 (in Russ.). DOI: 10.32364/2587-6821-2021-5-6-366-372.



2020 ◽  
pp. 37-38
Author(s):  
M.Ya. Kamilova ◽  
N. Amin-Zade

Objective. To evaluate the effectiveness of a tranexamic acid for the prevention of critical bleeding in women with preeclampsia. Materials and methods. 31 puerperas with postpartum hypotonic bleeding. Inclusion criteria: reproductive age, severe preeclampsia, postpartum hemorrhage, volume of blood loss – 700 ml, voluntary consent to the administration of the tranexamic acid. Exclusion criteria: delivery by the caesarean section. When providing emergency care, along with other standard measures, 14 women (the main group) were injected with the tranexamic acid when blood loss reached 700 ml, 17 women (the comparison group) did not receive the tranexamic acid. Research methods: measurement of the volume of blood loss (by the calculation method and by the method of measuring blood loss), statistical analysis – comparison of populations by qualitative characteristics. Results and discussion. A bleeding with a blood loss of 700-800 ml was registered in 7 women of the main group and in 6 women of the comparison group, with a blood loss of 800-900 ml – in 6 and 4 women, with the blood loss 900-1000 ml – in 1 and 7 women, respectively. There was a significant difference in outcomes (blood loss – 900-1000 ml) depending on the use of the tranexamic acid (Fisher’s exact test – 0.04537; p<0.05). Evaluation of the strength of the relationship between the frequency of aggravation of bleeding and the use of the tranexamic acid for the prevention of massive bleeding established a relationship of average strength (Cramer’s criterion – 0.387). Pregnant women with severe preeclampsia are at risk of the developing obstetric bleeding, which is associated with secondary changes in the hemostatic system in women with preeclampsia. With obstetric bleeding in women with preeclampsia, the balance between the coagulation, anti-coagulation and fibrinolytic systems is disturbed faster. Fibrinolysis is activated faster due to the limitation of thrombus formation due to the breakdown of fibrin in thrombi and the fibrinolytic properties of the fibrin breakdown products themselves. The use of the tranexamic acid in the obstetric bleeding is justified by the antifibrinolysis effect of the drug. Further research on the use of the tranexamic acid for the prevention of massive bleeding, confirmed by laboratory data, is highly relevant. Conclusions. The use of tranexamic acid with the onset of obstetric bleeding in women with risk factors for the secondary thrombocytopathy will prevent the aggravation of coagulopathy and reduce the incidence of massive obstetric bleeding caused by a disseminated intravascular coagulation.



Author(s):  
O. V. Avdeev ◽  
Y. K. Zmarko ◽  
A. B. Boykiv ◽  
R. O. Drevnitska

The high prevalence of inflammatory processes in the periodontitis of children, the ineffective effectiveness of preventive and curative measures can contribute to the development of generalized periodontitis, therefore it remains urgent to develop pathogenetic effects in the treatment of chronic catarrhal gingivitis.The aim of the study – a comparative assessment of the traditional treatment of chronic catarrhal gingivitis in children aged 6–7 years with therapy using an anti-inflammatory gel with neovitin.Materials and Methods. 61 children aged 6–7 years, suffering from chronic catarrhal gingivitis, were taken under clinical supervision and divided into groups: the main (30 children) and the comparative (31 children). All children underwent conventional therapy in accordance with the protocols for the provision of medical care – basic therapy. In the main group, for a month, pathogenetic agents were used: an anti-inflammatory gel with neovitin, hygiene products were recommended. In the comparative group, 3 % hydrogen peroxide solution was used for local therapy, for rinsing of the mouth (during the first week of treatment) – Rotokan, a therapeutic and prophylactic toothpaste.Examination and control examinations were carried out with the hygienic state of the mouth determined by the hygienic index of Yu. A. Fedorov and V. V. Volodkina, prevalence and intensity of the inflammatory process in the gums with the help of the Schiller-Pisarev test and the PMA index, oral fluid index (lysozyme content, formation of oxydradicals, urease activity, degree of dysbiosis, pH and viscosity).Results and Discussion. After the treatment, elimination of gum inflammation in patients of the main group was accompanied by a decrease in the PMA index by 3.8 times; formation of oxyradicals decreased in children of the main group by 6.35 %; in the comparative group – by 6.15 %. Urease activity decreased in children of the main group by 16.37 % (p<0.05), the viscosity of the oral fluid of children decreased in 2.65 times in the main group and in 2.13 times in the comparative group (p<0.05). The lysozyme content increased in children of the main group by 15.61 % (p<0.05) in the comparison group – by 9.63% (p<0.05). The treatment after 0.5 years caused an increase in the lysozyme content in the oral fluid of the children of the main group to the level of the control group. The degree of dysbiosis decreased in the main group, in the comparison group tended to increase.Conclusions. The use of the proposed therapy with gel with neovitin contributed to the best results of treatment: reducing the degree of inflammation of the gums, the number of visits to the doctor, improving the indices of nonspecific protection in the oral fluid of 6-7 years-old children and, to a greater extent, six months after the treatment.



2012 ◽  
Vol 93 (1) ◽  
pp. 38-43
Author(s):  
Yu A Plakseychuk ◽  
R Z Salikhov ◽  
V V Soloviev

Aim. To evaluate the results of treatment using the authors’ proposed method of arthrodesis of the ankle and subtalar joints, based on the combination of bone grafting with compression in the Ilizarov apparatus. Methods. Conducted was a clinical and radiographic evaluation of the results of arthrodesis in the Ilizarov apparatus in 286 patients with osteoarthritis of the ankle and subtalar joints (during the last 15 years). 36 (12.6%) patients (the main group) were operated on using the authors’ proposed technique. Results. Bone adhesion as a result of arthrodesis was achieved in all patients of the main group. Excellent functional results were achieved in 11 out of 36 patients (30.5%), good results - in 22 (61.1%) patients, satisfactory results - in 3 (8.4%) patients. Bone adhesion as a result of arthrodesis in 250 patients of the comparison group was achieved in 243 patients (97.2%). In this group excellent functional results were achieved in 76 out of 250 patients (30.4%), good results - in 145 (58%) patients, satisfactory results - in 21 (8.4%) patients, poor results - in 8 (3.2%) patients. Conclusion. The proposed method of biarticular arthrodesis makes it possible to improve the trophism of the arthrodesis zone, to conduct the correction of posttraumatic deformities in the region of the ankle and subtalar joints, provides a durable and solid bone ankylosis of the ankle and subtalar joints, and makes it possible to achieve adhesion even in severe forms of osteoarthritis of the ankle and subtalar joints.



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