scholarly journals Experience in treating patients with diabetes and anastomotic false aneurysm after reconstructive interventions in the aortic-femoral segment

2021 ◽  
pp. 37-42
Author(s):  
P. I. Nikulnikov ◽  
O. V. Liksunov ◽  
A. V. Ratushniuk ◽  
V. L. Severyn ◽  
A. G. Bicher ◽  
...  
Keyword(s):  
False Aneurysm ◽  
Clinical Symptoms ◽  
Wound Complication ◽  
Pharmacological Agents ◽  
Ultrasound Monitoring ◽  
Results Of Treatment ◽  
Abdominal Aortic ◽  
Patients With Diabetes ◽  
Dynamic Ultrasound ◽  
Surgical Tactics

The purpose of the work isto analyze and improve the results of treatment of patients with diabetes and anastomotic false aneurysm (FA) after reconstructive interventions. Materials and methods. The results of diagnostic examinations in 79 patients with 93 false anastomotic aneurysms were analyzed, the criteria of wound complication (hematoma, infiltrate), patency of shunts, bleeding, heart attack, stroke were evaluated. Among the patients there were 75 (94.9 %) men and 4 (5.1 %) women aged 40—75 years (mean age — (58.4 ± 2.9) years). 69 (87.3 %) patients underwent surgery for atherosclerotic lesions of the pelvic vessels and lower extremities, including 43 (54.4 %) patients with diabetes, 3 (3.8 %) — for abdominal aortic aneurysm, 4 (5.1 %) — after vascular injury, 3 (3.8%) — due to nonspecific aortic arteritis. A total of 79 patients underwent 93 reconstructive interventions. Results and discussion. The time of onset of clinical symptoms (pain, pulsation), which give reason to suspect the occurrence of FA, ranged from 8 days to 19 years: in 15 patients — less than 1 year, in 59 — up to 10 years, in 5 — up to 20 years. The average duration of FA formation after surgery is 62.5 months. The absence of pathological changes in the area of the proximal anastomosis and the presence of adequate outflow pathways in most cases allow us to limit the reconstruction of the distal anastomosis. Conclusions. Early diagnosis and surgical tactics for false anastomotic aneurysms in patients with diabetes can prevent complications and improve the results of surgical treatment. The optimal type of surgery for false aneurysms is their removal with re-prosthesis of the affected segment, which allows to save the limb and the patient's life. The use of modern pharmacological agents allows to reduce the progression of atherosclerosis, which is the main cause of false aneurysms. Dynamic ultrasound monitoring is required for patients who have undergone reconstructive vascular surgery.

scholarly journals Diagnostics and surgical tactics in the injury of the heart

2019 ◽  
Vol 178 (2) ◽  
pp. 15-21
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
N. Yu. Rucheykin ◽  
M. E. Tseimakh ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Cardiac Injury ◽  
Diagnostic Error ◽  
Long Term Results ◽  
Satisfactory Condition ◽  
Results Of Treatment ◽  
Clinical Observations ◽  
Cardiology Department ◽  
Surgical Tactics

The objective is to analyze own clinical observations with the purpose of optimization of diagnostics and application of the adequate medical grant to patients with wounds of heart.Material and methods. The results of treatment of 268 patients with heart wounds operated in the clinic for the last 27 years were analyzed. The majority of patients 202 (75.4 %) had penetrating and through wounds to the heart, 66 (24.6 %) had non-penetrating injuries. The diagnosis was based on clinical symptoms, the results of electrocardiographic, echocardiographic and x-ray studies. The clinical picture depended on the nature of the wound – penetrating or non-penetrating. Videothoracoscopy helped to clarify the nature of the damage of the heart in vague diagnostic cases. In most patients, heart damage was recognized in a timely manner, a diagnostic error was committed in 18 (6.7 %) patients. In 59 (22.0 %) cases, myocardial wounds were stitched with P-shaped sutures, and in 209 (78.0 %) – with nodular sutures.Results. 240 (89.6 %) patients were discharged in satisfactory condition, 11 (4.1%) patients were transferred to the cardiology department for the follow-up treatment, 17 patients died with penetrating or through cardiac injury. The mortality rate was 6.4 %.Conclusion. Emergency surgery is the only effective method of treating heart injury. Long-term results of treatment were traced in 38 patients in terms of 1 year to 10 years. All patients had a clinical recovery.

scholarly journals FEATURES OF THE DYNAMICS OF THE II DEGREE OF SEVERETY BACTERIAL KERATITES IN DIABETIC PATIENTS AT DIFFERENT STAGES OF DIABETIC POLYNEYROPATHY

2021 ◽  
pp. 5-10
Author(s):  
O. V. Zavoloka
Keyword(s):  
Clinical Symptoms ◽  
Healing Process ◽  
Anterior Segment ◽  
Diabetic Polyneuropathy ◽  
Diabetic Patients ◽  
Bacterial Keratitis ◽  
Results Of Treatment ◽  
Patients With Diabetes ◽  
Type 1 Dm ◽  
Degree Of Severity

Summary. The neuro-trophic condition of the cornea affects the healing process of corneal defects in patients with keratitis, causing the severity, duration and consequences of the disease. The aim was to identify the features of the dynamics of the II degree of severity bacterial keratitis in patients with diabetes mellitus (DM) at different stages of the severity of diabetic polyneuropathy (DPN). Materials and methods. The results of treatment of 19 patients with bacterial keratitis of the II degree of severity and type 1 DM were analyzed. II degree of severity of bacterial keratitis was determined according to our proposed scheme at a sum of points 15-21. All patients were treated with instillations of the antibiotic ofloxacin, antiseptics, antioxidants, reparants, artificial tears, mydriatics, systemic anti-inflammatory therapy. Patients were divided into two groups according to the severity of DPN: with symptomatic (first group) and stage with impaired DPN (second group). In addition to standard, ophthalmic examination methods included bacteriological examination, fluorescein test, OCT of the anterior segment of the eye, non-contact corneal esthesiometry. Results and discussion. In most patients of the second group, corneal sensitivity and depth of edema of the corneal tissues surrounding the ulcer, the size of the ulcer defect and the depth of corneal infiltration, the degree of pericorneal injection, the depth of the corneal ulcer defect from the 1st, 7th, 10th and 14th days of observation, respectively, were higher than in patients of the first group (p<0,05). The consequence of the disease in patients of the second group was more severe than in patients of the first group. Conclusions. In patients with the stage of impaired DPN, bacterial keratitis is characterized by a longer duration and severity of clinical symptoms, as well as worse consequences of the disease than in patients with symptomatic DPN.

scholarly journals A 60-year-old woman with asymptomatic total thoracic–abdominal aortic aneurysm

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianying Deng ◽  
Wei Liu
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Effective Treatment ◽  
Clinical Symptoms ◽  
Aortic Aneurysms ◽  
Case Presentation ◽  
Second Stage ◽  
Aortic Replacement ◽  
Abdominal Aortic ◽  
Thoracoabdominal Aortic Replacement

Abstract Introduction Total thoracic–abdominal aortic aneurysm is a rare disease in cardiovascular surgery, with high surgical risk and high mortality. Surgery is considered the most effective treatment for total aortic aneurysms. Case presentation Our group admitted a 60-year-old female patients with asymptomatic complex total thoracic–abdominal aortic aneurysm, and successfully performed two-staged surgery, namely Bentall + Sun’s operation in the first-stage and thoracoabdominal aortic replacement in the second-stage. The results of the surgery were satisfactory. Conclusions Patients with total thoracic–abdominal aortic aneurysm may not have typical clinical symptoms and require a careful and comprehensive physical examination and related auxiliary examinations by clinicians. Staged repair of total thoracic–abdominal aortic aneurysms is still a safe and effective treatment.

Differential diagnosis of chiasmal-cellular cyst

2020 ◽  
pp. 47-59
Author(s):  
Nikita Sergeevich Puzakov ◽  
Vladislav Yurievich Cherebillo ◽  
Ilya Aleksandrovich Tregubenko ◽  
Evgeniy Igorevich Kozak ◽  
Yuliya Igorevna Ryumina
Keyword(s):  
Surgical Treatment ◽  
Pituitary Adenomas ◽  
Comparison Group ◽  
Clinical Symptoms ◽  
Differential Diagnostics ◽  
Diagnostic Features ◽  
Accurate Preoperative Diagnosis ◽  
Colloid Cysts ◽  
Surgical Tactics ◽  
Cellular Area

The clinical symptoms of chiasmal-cellular formations are similar, which significantly complicates its differential diagnostics. The differential diagnostics of chiasmal-cellular cysts, which include colloid cysts, arachnoid cysts, Rathke’s pouch cysts, epidermoid and dermoid cysts, is especially difficult. Nevertheless, an accurate preoperative differential diagnostics of chiasmal-cellular cysts is an important stage of preparation for surgical treatment, which allows determining the surgical tactics in advance, because each group of chiasmal-cellular cysts has its own features of surgical treatment, which significantly reduce the number of complications and minimize the number of recurrences. This study intended to improve the efficiency of diagnostics of the chiasmal-cellular cysts by determining the criteria for its differential diagnostics. 94 patients with chiasmal-cellular cysts and pituitary adenomas were examined and treated in the period of 2009 and 2018 for this purpose. As the most frequent pathology of the chiasmal-cellular area, pituitary adenomas were selected as a comparison group due to the fact that it is often necessary to differentiate chiasmal-cellular cysts with this pathology. Patients were divided into 5 groups according to the nosology of the disease. Clinical picture, laboratory analysis and MRI data were studied in each group. Statistical analysis and comparison of the data obtained among all groups were performed, and it allowed to determine the distinctive diagnostic features incidental to each group. It is possible to make an accurate preoperative diagnosis based on the specific features of differential diagnostics.

scholarly journals EFFICACY AND SAFETY OF NASAL SPRAY PREVALIN IN THE TREATMENT OF ALLERGIC RHINITIS PATIENTS

2012 ◽  
Vol 9 (5) ◽  
pp. 55-59
Author(s):  
A A Tsyvkina ◽  
L V Luss ◽  
S V Tsarev ◽  
N V Shartanova
Keyword(s):  
Allergic Rhinitis ◽  
Nasal Cavity ◽  
Nasal Spray ◽  
Clinical Effect ◽  
Clinical Symptoms ◽  
Efficacy And Safety ◽  
Nasal Breathing ◽  
Results Of Treatment ◽  
Functional Methods ◽  
Positive Clinical Effect

Background. To study of efficacy, tolerability and safety of nasal spray Prevalin in the treatment of allergic rhinitis patients. Methods. 30 patients with allergic rhinitis in the age of18 till 45 years were observed. Prevalin was given as one insufflation into each nasal cavity 3 times a day for 21 days. Results of treatment were assessed by the dynamics of clinical symptoms and the results of functional methods . Results. The positive clinical effect was observed in 22 patients (73,3%), using Prevalin. Clinical effect was characterized by the restoration of nasal breathing, reduce swelling of the nasal mucosa. We did not establish a good result of treatment in 8 patients. Conclusion. The study demonstrated clinical efficacy and safety of spray Prevalin.

scholarly journals Septic complications in patients with neck wounds

2020 ◽  
Vol 84 (3) ◽  
pp. 64-66
Author(s):  
M.Yu. Sizyi
Keyword(s):  
Head And Neck ◽  
Social Conditions ◽  
Steady Increase ◽  
Neck Trauma ◽  
Septic Complications ◽  
Traumatic Injuries ◽  
Results Of Treatment ◽  
Car Accidents ◽  
The Social ◽  
Surgical Tactics

Nowadays, we have been a steady increase in injuries as the social conditions of life and have changed. Statistically found that 54.0 % of people of car accidents have injuries to the head and neck. According to the literature, mortality in patients with neck injury which is complicating by pyoinflammatory persists up to 30.0-76.0 %. The management of neck trauma can be challenging and sometimes overwhelming, as this anatomical region contains many vital structures. These structures may pose a diagnostic and therapeutic dilemma. Our research based on the results of diagnosis and treatment of 124 patients with a purulent mediastinitis, complicating traumatic injuries of the neck organs. Among these men – 92 (74.2 %), women – 32 (25.8 %). The results of treatment depend on timely diagnosis, hospitalization in a specialized compartment and conducting active surgical tactics

scholarly journals Questions of complex treatment of extensive small pelvis phlegmons in patients with diabetes mellitus

2019 ◽  
Vol 41 part 3 (2) ◽  
pp. 21-24
Author(s):  
N. N. Veligotskiy ◽  
A. S. Trushin ◽  
A. I. Seroshtanov ◽  
A. A. Sheptukha ◽  
I. Ye. Bugakov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Multiple Organ ◽  
Complex Treatment ◽  
Ozone Therapy ◽  
Treatment Results ◽  
Results Of Treatment ◽  
Patients With Diabetes

The complex treatment results of 127 patients with extensive purulent processes in diabetes mellitus that were treated in our clinic with ozone therapy and ultrasonic cavitations at 2001–2018 are presents. The problems of the course of the disease and the aggravating influence of the accompanying pathology on it are noted. The options improving the results of treatment considered.Keywords: phlegmon, small pelvis, diabetes mellitus, multiple organ failure, ozone therapy, cavitations.

scholarly journals SURGICAL TREATMENT OF ANOMALIES OF FIXATION OF THE COLON IN CHILDREN

2020 ◽  
Vol 19 (4) ◽  
pp. 32-36
Author(s):  
O. Bodnar
Keyword(s):  
Congenital Anomaly ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Results Of Treatment ◽  
Left Diaphragm ◽  
Comparative Group ◽  
The Right ◽  
Paroxysmal Pain ◽  
Over Time

Pyrrhic disease is a congenital anomaly that occurs during embryogenesis due to the fixation of the splenic angle of the colon by a short and highly located left transverse-diaphragmatic ligament, creating a sharp bend and forming a "wellbore". In this case the passage of feces on a cross colon becomes difficult, there is also its sagging to a small pelvis. This pathology is characterized by paroxysmal pain (aggravated by exercise and after eating) and prolonged constipation, which progresses over time. Hilaiditis syndrome is a rather rare pathology in which there is an interposition of the hepatic angle of the colon between the liver and the diaphragm. There are permanent and intermittent localizations. The work generalizes the experience of evaluation of clinical manifestations and remote results of treatment of children with chronic colostasis caused by fixation abnormalities of the colon. 58 children were detected to have Payre’s disease, with Cyilaiditi’s syndrome – 3 children. 24 patients with Payre’s disease and 2 Cyilaiditi’s syndrome were operated on. To assess the effectiveness of surgery, children were divided into two groups: I group – comparative and II group - experienced. In I group (n=12 children) – the analysis of surgical treatment was performed traditionally. In II group (n=14 children) – the analysis of surgical treatment was conducted by means of the methods proposed. Traditional surgical treatment of Payre’s disease in children was followed by relapse of chronic constipation in 45,45%, pain in 50%, flatulence in 33,33% and failure of the ileocoecal closing apparatus in 100% of children. Unsatisfactory outcomes of surgical treatment of Cyilaiditi’s syndrome was observed in a child from the comparative group. Relapse of clinical symptoms to a lesser degree than before the surgery was found in 1 child from the experienced group. To treat Payre’s disease the following operation is proposed: intersection of the left diaphragm-colon ligament, resection of transverse colon and colofixation of the left bending of the colon. To treat Cyilaiditi’s syndrome (in case of dolichoascendocolon) the following operation is suggested: hepatopexy, resection of the right bending of the colon with ascending transversal anastomosis “end to end”, fixing of right bending of the colon. Their reasonability is being proved.

scholarly journals SURGICAL TREATMENT OF CHRONIC VENOUS DEFICIENCY OF LOWER EXTREMITIES

2020 ◽  
pp. 68-73
Author(s):  
I. B. Babynkina ◽  
A. A. Novikova ◽  
G. P. Babynkina
Keyword(s):  
Surgical Treatment ◽  
Lower Extremities ◽  
Outpatient Basis ◽  
Perforating Veins ◽  
Results Of Treatment ◽  
Cosmetic Effect ◽  
Modern Economic ◽  
Surgical Tactics ◽  
Tissue Trauma ◽  
Standard Operations

Summary. The aim. Improving the results of treatment of patients with decompensated forms of chronic venous insufficiency in post-thrombophlebitic and varicose diseases based on the use of differentiated pathogenetically substantiated surgical tactics. Materials and methods. The basis of the work is the study of the results of surgical treatment of 102 patients not previously operated on with postthrombophlebitic disease of the lower extremities in the decompensated stage of CVI. All patients underwent combined surgical treatment, including the elimination of perforating insufficiency and various modifications of the operation on the superficial veins to eliminate vertical reflux. Results and discussion. The combined operation for clipping perforating veins allows the operation to interrupt blood circulation through insolvent perforating veins, including on an outpatient basis, minimizing tissue trauma during puncture rather than sectional access to a vein. The cosmetic effect of the operation is significantly increased, which is especially important in the treatment of women. Since the operation can be performed on an outpatient basis, the number of days of incapacity for work is significantly reduced compared to standard operations on perforating veins, which is a particularly important circumstance in modern economic conditions. Conclusion. Using the proposed method allows to achieve optimal conditions for the restoration of trophism of affected tissues, leading to a decrease in the number of complications and a reduction in hospitalization.

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