scholarly journals PURULENT SEPTIC COMPLICATIONS OF ACUTE PANCREATITIS AND THEIR PATHOGENETIC RELATIONSHIP WITH HELICOBACTER PYLORI

2021 ◽  
Vol 29 (5) ◽  
pp. 542-548
Author(s):  
I.V. Kolosovych ◽  
◽  
I.V. Hanol ◽  
Keyword(s):  
Acute Pancreatitis ◽  
Helicobacter Pylori ◽  
Antibiotic Therapy ◽  
Positive Result ◽  
Comparison Group ◽  
Main Group ◽  
Immunoglobulin M ◽  
Septic Complications ◽  
Bacteriological Study

Objective. To study of the role of Helicobacter pylori as an etiological factor of acute pancreatitis and a marker of the development of its purulent-septic complications. Мethods. The study was conducted in the period of 2015-2020; patients with acute pancreatitis (n=124) were divided into 2 groups: the main group (66 patients with moderate severity and severe course) and the comparison group (58 patients with a mild form). All patients underwent a screening study of Helicobacter pylori in feces and serological blood test to detect antibodies, namely immunoglobulin M to Helicobacter pylori (determination of the phase of the disease - acute or chronic). In 39 (31.5%) patients of the main group, a bacteriological study of biological and biopsyspecimensof antral mucous membrane were taken and examined histologically for organisms. The selection of antibiotics for treatment was carried out taking into account the infection of patients with Helicobacter pylori and was performed using the author’s method, the effectiveness of treatment was controlled microbiologically. Results. The positive result of the express test was in 66 (100%) patients of the main group and in 39 (67.2%) patients in the comparison group. During serological examination, a positive result was obtained: 24 hours after hospitalization - in 8 (13.8%) patients in the comparison group, in 23 (34.8%) patients in the main group; after 7 days - in 9 (15.5%) patients and 42 (63.3%) patients, respectively. Helicobacter pylori is sensitive to the majority of antibiotics used to treat purulent-septic complications of acute pancreatitis; after finishing the course of antibiotic therapy, eradication was achieved in 37 (94.9%) patients of the main group. Conclusion. Positive results of a serological study of Нelicobacter pylori after 7 days from the moment of hospitalization were more common in patients of the main group (63.3%) in relation to the comparison group (15.5%) (χ<sup>2</sup>=28.9, p<0.001), which gives grounds to consider bacteria, as one of the markers of the development of purulent-septic complications of acute pancreatitis. What this paper adds The role of Helicobacter pylori (HP) in the pathogenesis of acute pancreatitis has been studied for the first time and its value as a marker for septic complications development of acute pancreatitis is shown. It allowed optimizing the etiotropic antibiotic therapy for this disease.

scholarly journals Нelicobacter pylori as etiological factor of acute pancreatitis and marker of its purulent-septic complications development

2020 ◽  
Vol 87 (7-8) ◽  
pp. 15-19
Author(s):  
І. V. Коlosovych ◽  
І. V. Hanol ◽  
К. О. Lebedieva
Keyword(s):  
Acute Pancreatitis ◽  
Positive Result ◽  
Biological Material ◽  
Etiological Factor ◽  
Control Group ◽  
Septic Complications ◽  
Group A ◽  
Bacteriological Investigation ◽  
Positive Results

Objective. Studying of role of Нelicobacter pylori as etiological factor of acute pancreatitis and marker of development of its purulent-septic complications. Маterials and methods. Screening investigation was performed in all 124 patients, suffering acute pancreatitis and admitted to hospital; then a screening investigation of Нelicobacter pylori in feces and the blood serological investigation was conducted. In 39 (31.5%) patients bacteriological investigation of biological material for revealing of Нelicobacter pylori was conducted. The patients were distributed into two groups: the main - 66 patients with severe and with a middle severity course of acute pancreatitis and a control one - 58 patients with light course of acute pancreatitis. Results. Positive results of fecal express-test were obtained in 105 (84.7%) patients. In accordance to the blood serological investigations results in 24 h from the admittance to hospital moment in a control group a positive result was obtained in 8 (13.8%) patients, and in the main - in 23 (34.8%); while in 7 days - in 9 (15.5%) and 42 (63.6%) patients, accordingly. Аntibiotics, which are applied for therapy in purulent-septic complications of acute pancreatitis, guarantee the efficacy of eradication of Нelicobacter pylori in 94.9% patients. Conclusion. The enhancement of quantity of the blood positive serological investigations by 28.8% (р < 0.001) in patients of the main group in 7 days from the admittance to the hospital date trusts, that Нelicobacter pylori constitutes not the only one etiological factor in acute pancreatitis, but a possible marker of development of its purulent-septic complications as well.

Optimization of prevention measures of septic complications in women with high infectious risk

2018 ◽  
pp. 108-113
Author(s):  
Yu.R. Feyta ◽  
◽  
V.I. Pyrohova ◽  
Keyword(s):  
High Risk ◽  
Postpartum Period ◽  
Comparison Group ◽  
Infectious Complications ◽  
Main Group ◽  
Septic Complications ◽  
Effective Prevention ◽  
Vaginal Gel ◽  
Infectious Risk ◽  
Treatment Techniques

Despite the introduction of modern diagnostic technologies, prophylaxis and treatment techniques in obstetrical practice, the incidence of postpartum purulent-septic complications (PPSC) remains rather high and is an important medical and social problem, as they take one of the leading places in the structure of maternal morbidity and mortality. The objective: to improve the management of parturient womenwith a perineal birth injury in anamnesis, as part of an effective prevention of purulent-septic complications of puerperium. Materials and methods. The study included 77parturient women. Main and comparative groups were formed by women with a violation of the integrity of the perineum in the previous labor and with a high risk of developing infectious complications in puerperium. Women of the main group (n = 24) during each vaginal examination in labor (and an additional injection in 15-30 minutes after the rupture of the membranes) and twice a dayat a dose of 5 ml for 5 days postpartum, an antiseptic agent in the form of a vaginal gel, which consists of: 0.02% decamethoxin (antiseptic component), 0.5% hyaluronic acid (regenerating component) and lactate buffer (regulatory component). The comparison group included 27 women, without using vaginal gel in laborand using traditional wound treatment techniques in the postpartum period. The control group consisted of 26 women with uncomplicated somatic status, physiological course of pregnancy and labor. The evaluation of the effectiveness of the prescribed treatment was based on subjective symptoms (pain, discomfort, burning in the region of the perineal sutures), clinical data (swelling, hyperemia, nature of suturing healing), generally accepted indicators in dynamics (bacterioscopy of vaginal contents, pH-metry of the vaginal environment). Results. At the background of the use of three-component vaginal gel in the main group, the level of injury of soft tissues of the birth canal in these deliveries was lower by 19.9% than in the comparison group, prevalence of the 1st degreeperineumruptures, decreased the need for repeated episio- and perineotomy, which reduced the duration stay at hospital and improved postpartum rehabilitation in relation to the comparison group. On the third day of puerperium, hyperemia and edema of the wound area in women of the main group were observed almost three times less compared with the comparison group. On the fifth day of the puerperium in the main group the complaints were insignificant and appeared on the average 5 times less often, the healing was by the primary tension without infectious complications. The use of vaginal gel reduced the number of leukocytes in wound secretions by shortening the time of wound epithelization (1.5 times faster than in the parous from the comparison group). On the fifth day of using vaginal gel, 2/3 of the patients observed normalization of the vaginal microflora, the restoration of pH was observed. The results indicate the benefits of early onset of prophylactic measures and high effectiveness of topical antiseptic therapy in women with high infectious risk. Conclusions.In order to prevent antibiotic resistance tactics of prevention of PPSC in the group of high-risk septic complications provides one of the elements of anintegrated approach to use local antiseptics. Inclusion of the latter into a complex of prophylactic and treatment measures in the management of a high-riskwomen in puerperium contributes to the reduction of traumatic and infectious complications and provides more favorable course of labor and the postpartum period. Key words: labor traumatism, postpartum purulent-septic complications, local antiseptic.

scholarly journals CURRENT ASPECTS OF DIAGNOSTICS AND TREATMENT OF ACUTE BILLARIAN PANCREATITIS

2018 ◽  
Vol 14 (3-4) ◽  
pp. 74-79
Author(s):  
I.V. Kolosovych ◽  
B.H. Bezrodnyi ◽  
I.V. Hanol
Keyword(s):  
Acute Pancreatitis ◽  
Length Of Stay ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Main Group ◽  
Duct System ◽  
Results Of Treatment ◽  
Positive Clinical Effect ◽  
Number Of Patients ◽  
Comparative Group

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).

Chronic Pruritus Associated with Helicobacter Pylori

2002 ◽  
Vol 6 (2) ◽  
pp. 103-108
Author(s):  
Roshini Kandyil ◽  
Nadia S. Satya ◽  
Robert A. Swerlick
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Therapy ◽  
Breath Test ◽  
Urea Breath Test ◽  
Complete Relief ◽  
Active Infection ◽  
Temporary Relief ◽  
Chronic Pruritus ◽  
H Pylori

Background: Helicobacter pylori is an established cause of gastritis and has been implicated in extradigestive diseases. Objective: To investigate the role of H. pylori in patients with unexplained refractory pruritus. Methods: Ten patients with severe pruritus unresponsive to conventional therapy were evaluated for active H. pylori infection by H. pylori serology followed by either esophagogastroduodenoscopy (EGD) or urea breath test. Of the 10 patients, 8 were found to have active infection. All 10 received anti- H. pylori antibiotic therapy and were reevaluated for relief of pruritus. Results: Of 8 patients with active H. pylori infection, 87.5% (7/8) had some type of pruritus relief after triple therapy. Of these, 62.5% (5/8) had complete relief and 25% (2/8) had temporary relief of pruritus. The remaining 12.5% (1/8) did not respond. Two control patients without active H. pylori infection had no relief of pruritus with therapy. Conclusions: We have identified a population of patients with refractory pruritus and active H. pylori infection whose pruritus resolved after eradication of H. pylori.

scholarly journals SPEAKING OF PREVENTION OF ACUTE PANCREATITIS AFTER ENDOSCOPIC CHOLANGIOPANCREATO-GRAPHY

2020 ◽  
pp. 45-48
Author(s):  
V. I. Lupaltsov ◽  
N. N. Skalii ◽  
A. I. Yagnyuk ◽  
V. S. Kotovshchіkov
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Pancreatic Necrosis ◽  
Preventive Measures ◽  
Comparison Group ◽  
Main Group ◽  
Pancreatic Ducts ◽  
Terminal Part ◽  
Highly Effective ◽  
The Common

Summary. Purpose. To study the manometric control of pressure in the pancreatic ducts when performing ERCP and to determine its capabilities in the early diagnosis of postmanipulative pancreatitis. Materials and methods. The study was conducted to identify postmanipulative pancreatitis in 122 patients with impaired patency of the terminal part of the common bile duct who underwent ERCP. Patients were divided into two groups: the main – 58 patients and the comparison group – 64 patients. In 58 patients of the main group, the pressure in the pancreatic duct was studied by the device we developed. One makes it possible to register early signs of acute postmanipulative pancreatitis with conducting timely preventive measures for its development. Results. Using the proposed device that records the pressure in the pancreatic ducts, acute postmanipulative pancreatitis was diagnosed in 6.9 % of patients in the main group, while in the comparison group it developed in 21.9 % of cases. Mild forms of APMP in the comparison group were noted in 11 patients and in 4 patients in the main group. Severe APMP caused by focal pancreatic necrosis occurred in three cases of the comparison group. Conclusions. 1. ERCP is a highly effective method for diagnosing diseases of the pancreatobiliary zone, at the same time, sometimes fraught with the danger of developing serious complications, one of which is acute postmanipulative pancreatitis. 2. Monometric control during ERCP is a highly effective method for the diagnosis of early forms of acute postmanipulative pancreatitis, which can be recommended in the clinical practice of endoscopic surgeries.

scholarly journals Peculiarities of early diagnosis and tactics of treatment in an acute pancreatitis in pregnant women

2018 ◽  
Vol 85 (6) ◽  
pp. 13-17
Author(s):  
Ya. P. Feleshtynskyi ◽  
О. V. Golyanovskyi ◽  
Т. P. Pavliv
Keyword(s):  
Acute Pancreatitis ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Comparison Group ◽  
Early Stage ◽  
Treatment Algorithm ◽  
Main Group ◽  
Diagnosis And Treatment ◽  
Treatment Results ◽  
Standard Methods

Objective. Improvement of the treatment results of an acute pancreatitis in pregnant women, using enhanced early diagnosis and tactics of treatment. Маterials and methods. Analysis of the diagnosis and treatment results was conducted in 123 pregnant women, suffering an acute pancreatitis. In the main group (61 pregnant women) the elaborated algorithm of diagnosis and treatment for an acute pancreatitis in the period 2012 - 2018 yrs was applied, while in a comparison group (62 pregnant women) - the standard methods of diagnosis and treatment in an acute pancreatitis for the period of 2006 - 2012 yrs. Results. In the main group in 100% of the patients an acute pancreatitis was revealed on early stage. This have had guaranteed the effect obtaining from the conservative therapy in 27 (44.3%) pregnant women, using miniinvasive surgical interventions - in 31 (50.8%) and to prevent postoperative lethality. In a comparison group in 26 (41.9%) patients an acute pancreatitis diagnosis was established in (8 ± 2.1) days after the disease beginning. In a comparison group the conservative treatment effect was observed in 21 (33.9%) patients only. Two (3.2%) pregnant women died. Conclusion. Application of the diagnostic-treatment algorithm, comparing with standard methods, permits to diagnose an acute pancreatitis in pregnant women on early stage, to reduce the complications and lethality rate.

scholarly journals Fluid resuscitation patients with burn sepsis

2020 ◽  
pp. 42-43
Author(s):  
O.M. Kovalenko ◽  
O.I. Osadcha ◽  
A.A. Kovalenko ◽  
A.S. Grisha ◽  
O.M. Lynnyk ◽  
...  
Keyword(s):  
Comparison Group ◽  
Total Body Surface Area ◽  
Clinical Manifestations ◽  
Main Group ◽  
Oxidation Products ◽  
Control Group ◽  
Carbonyl Groups ◽  
Septic Complications ◽  
Endogenous Intoxication ◽  
Lipid Oxidation Products

Objective. The purpose the of the study is to improve the fluid therapy regimens for burn sepsis patient. Materials and methods. The study is based on the observation 52 patients with burn sepsis aged 23 to 65 years, with a total body surface area more than 35 % at the Kyiv City Clinical Hospital № 2 during 2016-2019. Patients were divided into two groups: the main group – 30 patients were treated with crystalloids, plasma, albumin and Rheosorbilact (RSL); control group – 16 patients received treatment without using of RSL. Clinical and biochemical parameters of endogenous intoxication (tissue destruction products, medium weight molecules (MWM), concentrations of lipid oxidation products (LOP) – by diene conjugate content and oxidatively modified proteins (OMP) – by carbonyl groups) were studied. Results and discussion. Syndrome of endogenous intoxication was an increase in burn sepsis patients, which correlated with an increase in the number of LOP, OMP, MWM, namely an increase in the hydrophobic (most toxic) fraction of MWM, which is 2-3 times higher than in healthy, sick and both groups. MWM and hydrophobic fraction remained high during the observation period in patients of the comparison group. MWM decreased by 1.35 times in patients of the main group relative to the group of crystalloids. The level of carbonyl groups of serum OMP in patients of the comparison group was 50 % higher than in the main group. The indicators of LOP exceeded 1.45 times in the comparison group, which testified to the continuation of oxidative stress and the continuation of systemic inflammation. Acute respiratory distress syndrome (ARDS) was characterized by the appearance of bilateral infiltrates in the lungs, according to radiography. This common organ dysfunction was detected in 75 % of patients in the comparison group and in 63 % of patients in the RSL-group. The duration of mechanical ventilation in the main group decreased by 1,6 days. Conclusions. The use of Rheosorbylact for patients with burn sepsis at a dose of 15 ml/kg has led to a decrease in the manifestations of intoxication syndrome, reduction of MWM, LOP, OMP, clinical manifestations of systemic inflammatory response, septic complications by 1.3 times, septic shock from 16 to 12 %, and the incidence of ARDS from 75 to 63 %.

Clinical value of c-reactive protein level in predicting the development of postpartum endometritis

2020 ◽  
Vol 69 (2) ◽  
pp. 5-14
Author(s):  
Tatyana V. Batrakova ◽  
Irina E. Zazerskaya ◽  
Tatyana V. Vavilova ◽  
Vitaly N. Kustarov
Keyword(s):  
Postpartum Period ◽  
Comparison Group ◽  
Threshold Value ◽  
Main Group ◽  
C Reactive Protein ◽  
Clinical Value ◽  
Septic Complications ◽  
Reactive Protein ◽  
Diagnostic Threshold ◽  
Wide Range

Hypothesis/aims of study. In the Russian Federation, postpartum septic complications are third among the causes of maternal mortality, along with obstetric bleeding and preeclampsia. A wide range of methods for predicting postpartum endometritis has been proposed. However, none of these methods has sufficient clinical efficacy. The lack of information and the lack of clear criteria highlight the difficulties in the early diagnosis and prognosis of postpartum endometritis. The aim of this study was to evaluate the role of C-reactive protein (CRP) in the prediction of postpartum endometritis in puerperas with a high risk of developing septic complications. Study design, materials and methods. The study included 135 puerperas, who were retrospectively divided into two groups. The main group consisted of women with developed postpartum endometritis (n = 72), and the comparison group comprised individuals with physiological course of the postpartum period (n = 63). Serum CRP levels were determined for all puerperas on days 1 and 3 of the postpartum period using the immunoturbodimetric method. Results. On day 1 of the postpartum period, the diagnostic threshold value for CRP levels was 69 mg / ml. The sensitivity and specificity of the method were low: 62% (95% CI 5074) and 65% (95% CI 5176), respectively. The predictability at a CRP level above 69 mg / ml was 67% (95% CI 5477). Thus, in puerperas on day 1 of the postpartum period at a CRP level above 69 mg / ml, the probability of developing postpartum endometritis was 67%, the chances of developing postpartum endometritis being extremely low, increasing by 1.76 times. There were no statistically significant differences when comparing CRP levels in the study groups of puerperas on day 1 of the postpartum period. On day 3 of the postpartum period, CRP level was significantly higher in the main group of puerperas 148 mg / ml (95% CI 126171), and in the comparison group 43 mg / ml (95% CI 3849) (p = 6 1014). On the 3rd day of the postpartum period, the diagnostic threshold value for CRP levels was 60 mg / ml. The sensitivity of the method was moderate 79% (95% CI 6886), the specificity of the method being high 93% (95% CI 8598). The predictability at a CRP level above 60 mg / ml was 93% (95% CI 8496). Thus, in postpartum women on day 3 of the postpartum period at a CRP level above 60 mg / ml, the probability of developing postpartum endometritis was 93%, with the chances of developing postpartum endometritis increased by 10 times (95% CI 530). In addition, determining CRP level on day 3 of the postpartum period is clinically informative, as evidenced by the standardized effect size (SES) equal to 1.4 (p = 6 1014). This is confirmed by the ROC analysis data: the clinical significance value (AUC indicator) was 0.89 (CI 0.810.93), according to which CRP determination is evaluated as a method with high clinical informativity. Conclusion. The determination of CRP on day 3 of the postpartum period is a clinically informative method. An increase in CRP level above 60 mg / ml is a predictor of postpartum endometritis with a sensitivity of 79% and a high probability (93%).

scholarly journals Photodynamic therapy of gunshot wounds soft tissue

2019 ◽  
Keyword(s):  
Photodynamic Therapy ◽  
Antibiotic Therapy ◽  
Soft Tissues ◽  
Comparison Group ◽  
Healing Process ◽  
Gunshot Wounds ◽  
Main Group ◽  
Water Soluble ◽  
Wound Healing Process ◽  
Comparison Groups

Introduction. An important component of the treatment of gunshot wounds is antibiotic therapy. Unfortunately, due to the antibiotic resistance of many strains of microorganisms, there remains a risk of purulent- infectious complications even with prolonged antibiotic therapy. In recent years, methods of physical action, in particular, photodynamic therapy (PDT), have been used to accelerate bacterial decontamination of wounds. Gunshot wounds have their own characteristics that create certain difficulties for the application of the method of photodynamic therapy. Purpose. Аnalyzes the results of the application of the developed PDT method in the complex treatment of gunshot wounds of soft tissues. Materials and methods. A comparison was made of the main indicators of the wound healing process between the wounded of the main group who used PDT (n = 52) and the comparison group (n = 32) who used treatment with complex water-soluble ointments. To increase the effectiveness of the method, the «Photolon» photosensitizer was administered in two ways: by injection infiltration of tissues around the wound and by application directly to the wound surface. The wavelength of laser radiation is 660 nm. The dose of laser energy was 20 J/cm2. Results. The results of the study showed an improvement in the course of the wound process in all respects when using PDT: the period of regression of local edema in the main group on (3.7 ± 0.4) days in the comparison group (6.2 ± 0.5), the period of wound cleansing (4.7 ± 0.6) days (7.3 ± 0.8) days, respectively; the timing of the start of granulation (4.6 ± 0.5) days and (7.8 ± 0.6). At the beginning of treatment, 45 pathogenic strains were isolated in 38 (73.1 %) wounded main groups and 26 strains in 22 (68.7 %) wounded comparison groups. A day after the use of PDT, pathogenic wound microflora was isolated in 5 (9.6 %) wounded main groups — 5 strains and 23 strains in 19 (59.4 %) wounded comparison groups. Conclusions. The effects of PDT were observed: rapid inactivation of pathogenic wound microflora, reduction of edema, pain syndrome and stimulation of granulation growth, which contributes to early closure of wounds.

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