scholarly journals WAYS TO IMPROVE THE RESULTS OF TREATMENT OF PATIENTS WITH CHOLELITHIASIS AND MECHANICAL JAUNDICE.

ASJ. ◽  
2021 ◽  
Vol 1 (56) ◽  
pp. 33-39
Author(s):  
R. Kalibatov ◽  
O. Logvina ◽  
R. Kalmykova
Keyword(s):  
Bile Ducts ◽  
Surgical Intervention ◽  
Pathological Process ◽  
Control Group ◽  
Results Of Treatment ◽  
Different Types ◽  
Complications Of Cholelithiasis ◽  
Personalized Approach ◽  
Complications And Mortality ◽  
Medium Weight

Purpose. To create a personalized tactic of surgical treatment of patients with BSD and MJ considering the stage of the pathological process and thereby improve the results of treatment. Materials and methods. The experience of diagnosis and treatment of 537 patients with complications of cholelithiasis, manifested by mechanical jaundice, was analyzed. The first stage was 537 minimally invasive decompressions of the biliary tract, the second-500 different types of endosurgical interventions. Results. Depending on the tactical principles, all the subjects were divided into two groups. In one (control) group (n = 249), patients were admitted from 2010 to 2014. Their treatment was empirical: decompression of the bile tree was performed at different times, and surgery was performed without taking into account the stages of the pathological process and the severity of the patients. In the other analyzed group (n = 251), patients were admitted to the hospital from 2015 to 2019. Their treatment tactics were personalized: taking into account the stages of mechanical jaundice. individual terms of decompression of the bile ducts and the choice of surgical intervention were determined. When comparing the results obtained, the advantage of the personalized approach was established: a decrease in the percentage of postoperative complications and mortality was revealed. Conclusion. In patients with cholelithiasis and jaundice, the severity of the condition is due to hyperbilirubinemia. Stage 2 of mechanical jaundice-determined by the severity of cytolysis in hepatic insufficiency, manifested by hypertransaminasemia. The severity of cholangitis is determined by purulent-inflammatory, as well as septic signs of the disease, characterized by leukocytosis, circulating immune complexes and medium-weight molecules. In the cholestatic stage of jaundice development, treatment is planned, in the cytolytic stage — urgent, and in cholangitis-emergency. The use of personalized tactics for the treatment of patients with breast cancer has reduced the number of complications and mortality.

scholarly journals Laparoscopic sanitation of the abdominal cavity in complex treatment of patients with generalized peritonitis

2012 ◽  
Vol 93 (2) ◽  
pp. 287-289 ◽  
Author(s):  
I S Malkov ◽  
E K Salakhov
Keyword(s):  
Abdominal Cavity ◽  
Low Frequency ◽  
Pathological Process ◽  
Control Group ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Generalized Peritonitis ◽  
Low Frequency Ultrasound ◽  
Analysis Of Results ◽  
Frequency Ultrasound

Aim. To develop a method of programmed laparoscopic sanitation in patients with generalized forms of peritonitis with the use of low-frequency ultrasound energy. Methods. Conducted was an analysis of results of treatment of 211 patients with generalized peritonitis admitted to the surgical department of the City Clinical Hospital №7 from 2000 to 2010. The main group comprised 37 patients in whom laparoscopic sanitation with the use of low-frequency ultrasound was performed. The control group included 174 patients who underwent conventional relaparotomy due to progression of the pathological process in the abdominal cavity. Results. The proposed method of laparoscopic sanitation helped to reduce mortality by 12%, and the development of postoperative complications by 8% compared with control group in patients of the II stage of severity of peritonitis according to the Mannheim peritoneal index. Conclusion. The developed method of programmed videolaparoscopic sanitations of the abdominal cavity with the use of low-frequency ultrasound in patients with generalized peritonitis has a pronounced bactericidal and bacteriostatic effect.

Epidemiological features of the course of non-tumor mechanical jaundice (comparative clinical and statistical review)

2019 ◽  
pp. 102-109
Author(s):  
M. V. Kukosh ◽  
V. E. Fedorov ◽  
O. A. Logvina
Keyword(s):  
Old Age ◽  
Average Rate ◽  
Pathological Process ◽  
High Tech ◽  
Women Patients ◽  
Extrahepatic Cholestasis ◽  
Epidemiological Features ◽  
Number Of Patients ◽  
Complications Of Cholelithiasis ◽  
Complications And Mortality

The epidemiology of mechanical jaundice (MJ) caused by complications of cholelithiasis has its own specific historical characteristic: the first successes before the period associated with the accumulation of primary material, then – the development of additional methods of diagnosis of cholecystitis and its complications. The modern stage is connected with the introduction and development of high-tech minimally invasive technologies. The average rate of this disease is gradually increasing. This is primarily due to the introduction to the work of the surgeon, ultrasound and endoscopic diagnostics, allowing to separate a mechanical jaundice at the stage of the pathological process: extrahepatic cholestasis, stones in the bile ducts with hepatocytes and purulent cholangitis with septic manifestations. The percentages of frequency of each stage began to differ depending on the sex, age and severity of the syndrome of mutual aggravation of concomitant diseases. Complications in the form of MJ began to occur more often in men, although previously they prevailed in women. Patients with MJ in old age and old age often began to be hospitalized in surgical hospitals for operations. This led to a sharp increase in the number of patients with severe comorbidities or a combination of one or more decompensated diseases. At high figures remain indicators of complications and mortality, which do not tend to decrease.

scholarly journals Association of food patterns with different forms of small intestinal bacterial overgroth syndrome and treatment efficacy

2019 ◽  
Vol 91 (10) ◽  
pp. 82-90
Author(s):  
V I Pilipenko ◽  
V A Isakov ◽  
S V Morozov ◽  
A V Vlasova ◽  
M A Naydenova
Keyword(s):  
Breath Test ◽  
Gas Production ◽  
Poultry Meat ◽  
Control Group ◽  
Results Of Treatment ◽  
Food Patterns ◽  
Source Data ◽  
Different Types ◽  
Small Intestinal ◽  
And Control

Aim. To assess food patterns in patients with different types of SIBO and their impact onto the course and treatment outcomes. Materials and methods. The data of 988 patients who signed informed consent surved as a source data. On the basis of lactulose breath test (LBT; GastroCH4eck, Bedfont, UK), the patients were selected into one of the studied groups: SIBO-H2, SIBO-CH4, SIBO-CH4-H2 and control. Twenty - four hours food recall test was used to analyze nutritional habits. In patients with SIBO-H2, standard treatment with Tilichinol 100 mg/Tilbrochinol 200 mg (Intetrix, Beaufour-Ipsen International, France) 2 caps BID for 10 days) was provided. Efficacy of treatment was assessed on the bass of the result of LBT 2 month after treatment completion. Mann-Whitney T test (Statistica 10, StatSoft, USA) was used to compare nutritional patterns in patients with or without SIBO, in different types of SIBO and in accordance to the results of treatment. Results and discussion. Nine hundred eighty eight patients were enrolled. On the basis of hydrogene breath test they were divided into 4 main groups: SIBO of hydrogen - producing flora (SIBO-H2, n=526), methane - producing flora (SIBO-CH4, n=129), SIBO with hyperproduction of methane and hydrogene (SIBO-CH4-H2, n=225). The control group consisted of 108 patients with no no excessive gas production on LBT. In contrast to controls, nutritional patterns of patients with SIBO were characterized by low dietary fiber and amount of red meat dishes in the rations. Those with SIBO-CH4 consumed more fruits (p=0.03), vegetables (p=0.003), and fish (p=0.026), compared to those with other variants of SIBO and the control group. Nutritional patterns of SIBO-H2 group were characterized by larger amount of poultry meat consumption (p=0.026) compared to other SIBO groups and controls. In SIBO-H2 “cured” group greater amounts of buckwheat (p

METHODS FOR SIMULATION OF ACUTE BRAIN ISCHEMIA: PATHOPHYSIOLOGICAL SUBSTANTIATION OF SELECTION AND IMPORTANCE FOR CLINICAL PRACTICE

2019 ◽  
pp. 142-152
Author(s):  
Б.И. Гельцер ◽  
Э.В. Слабенко ◽  
Ю.В. Заяц ◽  
В.Н. Котельников
Keyword(s):  
Clinical Practice ◽  
Experimental Studies ◽  
Cerebrovascular Diseases ◽  
Experimental Models ◽  
Pathological Process ◽  
Ischemic Brain ◽  
Actual Clinical Practice ◽  
Acute Cerebral Ischemia ◽  
Different Types ◽  
Acute Brain Ischemia

Одним из основных требований к разработке экспериментальных моделей цереброваскулярных заболеваний является их максимальная приближенность к реальной клинической практике. В работе систематизированы данные по основным методам моделирования острой ишемии головного мозга (ОИГМ), представлена их классификация, анализируются данные о преимуществах и недостатках той или иной модели. Обсуждаются результаты экспериментальных исследований по изучению патогенеза ОИГМ с использованием различных моделей (полной и неполной глобальной, локальной и мультифокальной ишемии) и способов их реализации (перевязка артерий, клипирование, коагуляция, эмболизация и др.). Особое внимание уделяется «стабильности» последствий острого нарушения мозгового кровообращения: необратимых ишемических повреждений головного мозга или обратимых с реперфузией заданной продолжительности. Отмечается, что важное значение в этих исследованиях должно принадлежать современным методам прижизненной визуализации очагов острого ишемического повреждения, что позволяет оценивать динамику патологического процесса. Предлагаемый метод отвечает требованиям гуманного обращения с животными. Подчеркивается, что выбор релевантной модели ОИГМ определяется задачами предстоящего исследования и технологическими ресурсами научной лаборатории. Development of experimental models for acute forms of cerebrovascular diseases is essential for implementation of methods for their prevention and treatment. One of the principal requirements to such models is their maximum approximation to actual clinical practice. This review systematized major models of acute cerebral ischemia (ACI), their classification, and presented information about their advantages and shortcomings. Also, the review presented results of experimental studies on pathophysiological mechanisms of different types of modeled ACI (complete and incomplete global, local, and multifocal ischemia) and methods for creating these models (arterial ligation, clipping, coagulation, embolization, etc.). Particular attention was paid to “stability” of the consequences of acutely impaired cerebral circulation - an irreversible ischemic brain injury or a reversible injury with reperfusion of a given duration. The authors emphasized that in such studies, a special significance should be given to intravital imaging of acute ischemic damage foci using modern methods, which allow assessing the dynamics of the pathological process and meet the requirements to humane treatment of animals. The choice of a relevant ACI model is determined by objectives of the planned study and the technological resources available at the research laboratory.

Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

2018 ◽  
pp. 39-42
Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Paranasal Sinuses ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Sodium Hyaluronate ◽  
Main Group ◽  
Control Group ◽  
Nasal Breathing ◽  
Minimal Invasiveness

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.

scholarly journals AB0267 HOW EFFECTIVE IS PAIN MANAGEMENT IN THE PATIENTS’ OPINION? DATA FROM THE COMPAS STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1160.1-1160
Author(s):  
E. Pogozheva ◽  
A. Karateev ◽  
V. Amirdzhanova
Keyword(s):  
Pain Management ◽  
Pain Therapy ◽  
Significant Proportion ◽  
Connective Tissue Diseases ◽  
Underlying Disease ◽  
Additional Treatment ◽  
Results Of Treatment ◽  
Analgesic Therapy ◽  
Folk Remedies ◽  
Personalized Approach

Objectives:to evaluate the effectiveness and satisfaction of pain management in patients with rheumatic diseases (RD) according to a survey in the COMPAS (Quality of Pain Management according to Patients with Arthritis and Back pain) study.Methods:the survey involved 1040 patients with RD (rheumatoid arthritis-40.6%, osteoarthritis -32.1%, spondyloarthritis-10.6%, connective tissue diseases-8.6% of patients). 76.8% were women, the mean age was 55.8±14.0 years. 35.7% of patients continued to work in their specialty, 31.6% had various degrees of disability. The effectiveness of pain therapy was evaluated by the patient in the last month preceding the survey on a 5-point scale, where 1 - no effect and 5-excellent effect. Patients ‘ satisfaction with treatment, possible reasons for the lack of effectiveness of pain therapy and the use of additional treatment tools were also evaluated.Results:as therapy for the underlying disease, 40% of patients received conventional disease modifying antirheumatic drugs, 33.1% - glucocorticoids, 7.2% - biological agents and 15.2% - symptomatic slow-acting drugs in osteoarthritis. At the same time, 68% of patients needed additional analgesic therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Slightly less than half of the surveyed patients (46.9%) noted a moderate effect of analgesic therapy, 22.7% - a low effect and 5% - no effect, 23.7% rated the effectiveness of therapy as good and only 1.7% - as excellent. At the same time, only 15.6% of patients were completely satisfied with the result of NSAIDs, 64% were partially satisfied with the treatment and 20.4% were completely dissatisfied. As the reason of insufficient effectiveness of NSAIDs, most often (34.3%) patients named fear of adverse events associated with taking drugs, 19.4% - weak drugs, 15.3% - insufficient attention of doctors to complaints, 6.6% - poor diagnosis of the causes of pain. Others found it difficult to answer or were completely satisfied with the treatment. 40% of patients used additional methods, most often chiropractic (12.3%), acupuncture (4.8%), physiotherapy (12.7%) and folk remedies (7.4%).Conclusion:A significant proportion of patients with RD don’t have adequate pain control. Only 25.4% of patients rate the result of treatment as good and excellent, and even fewer patients (15.6%) are completely satisfied with the results of therapy. Thus, a personalized approach to analgesic therapy is necessary, taking into account the expectations of patients regarding the results of treatment.Disclosure of Interests:None declared

scholarly journals The Effect of Different Types of Internal Curing Liquid on the Properties of Alkali-Activated Slag (AAS) Mortar

2021 ◽  
Vol 13 (4) ◽  
pp. 2407
Author(s):  
Guang-Zhu Zhang ◽  
Xiao-Yong Wang ◽  
Tae-Wan Kim ◽  
Jong-Yeon Lim ◽  
Yi Han
Keyword(s):  
Mechanical Properties ◽  
Compressive Strength ◽  
Deionized Water ◽  
Internal Curing ◽  
Control Group ◽  
Alkali Activated Slag ◽  
Different Types ◽  
Naoh Solution ◽  
Activated Slag ◽  
Alkali Activated

This study shows the effect of different types of internal curing liquid on the properties of alkali-activated slag (AAS) mortar. NaOH solution and deionized water were used as the liquid internal curing agents and zeolite sand was the internal curing agent that replaced the standard sand at 15% and 30%, respectively. Experiments on the mechanical properties, hydration kinetics, autogenous shrinkage (AS), internal temperature, internal relative humidity, surface electrical resistivity, ultrasonic pulse velocity (UPV), and setting time were performed. The conclusions are as follows: (1) the setting times of AAS mortars with internal curing by water were longer than those of internal curing by NaOH solution. (2) NaOH solution more effectively reduces the AS of AAS mortars than water when used as an internal curing liquid. (3) The cumulative heat of the AAS mortar when using water for internal curing is substantially reduced compared to the control group. (4) For the AAS mortars with NaOH solution as an internal curing liquid, compared with the control specimen, the compressive strength results are increased. However, a decrease in compressive strength values occurs when water is used as an internal curing liquid in the AAS mortar. (5) The UPV decreases as the content of zeolite sand that replaces the standard sand increases. (6) When internal curing is carried out with water as the internal curing liquid, the surface resistivity values of the AAS mortar are higher than when the alkali solution is used as the internal curing liquid. To sum up, both NaOH and deionized water are effective as internal curing liquids, but the NaOH solution shows a better performance in terms of reducing shrinkage and improving mechanical properties than deionized water.

scholarly journals Prediction of renal dysfunction in patients with obstructive icterus

2011 ◽  
Vol 64 (9-10) ◽  
pp. 503-506 ◽  
Author(s):  
Suzana Raicevic-Sibinovic ◽  
Aleksandar Nagorni ◽  
Vesna Brzacki ◽  
Mirjana Radisavljevic
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Concentration Index ◽  
Surgical Intervention ◽  
Urine Osmolality ◽  
Sodium Concentration ◽  
Control Group ◽  
Osmotic Concentration ◽  
Creatinine Concentration ◽  
Urinary Osmolality

Introduction. Renal dysfunction is one of complications in patients with obstructive icterus. It is important to recognize it early and take adequate measure to prevent its occurrence. One third of the patients with obstructive icterus have deterioration of renal function before surgical intervention. The aim of the research was to assess the renal dysfunction markers in patients with obstructive icterus. The following factors were examined: diuresis, urinary sodium concentration, sodium excretory fraction, urine osmolality, osmotic concentration index, creatinine concentration index and renal index of lesion. Material and methods. The study included 85 patients with obstructive icterus (50 patients before surgical intervention and 35 after surgical intervention) and 30 patients without icterus as a control group. The patients with normal renal function before the development of the disease were included. Results. Malignant etiology was present in 39 patients and benign in 46 patients of the examined group. The evaluation parameters of renal function were examined in all of the patients. Creatinine concentration index led to the greatest change in the coefficient value of an internal consistency, showing that it was the best renal function marker in the examined group of patients with icterus. The next one was the urinary osmolality, since its exclusion would lead to a decrease in the value of Cronbach ? coefficient to 0.06. Icterus and surgical intervention show statistically significant effects to change in the value of the markers of laboratory differentiation of renal function, observed as an entire set. Discussion and conclusion. The examination showed that the concentration clearances of creatinine and urine osmolality are the parameters which point to the probability of renal dysfunction occurrence in obstructive icterus.

CONCENTRATIONS DE LA PROGESTERONE, DES OESTROGENES ET DU CORTISOL DANS LE PLASMA DES VACHES AYANT DONNE NAISSANCE A DES JUMEAUX OU AYANT EU DES RETENTIONS PLACENTAIRES

1979 ◽  
Vol 59 (3) ◽  
pp. 481-490 ◽  
Author(s):  
P. MATTON ◽  
V. ADELAKOUN ◽  
J. J. DUFOUR
Keyword(s):  
Plasma Concentration ◽  
Postpartum Period ◽  
Multiple Births ◽  
Control Group ◽  
Plasma Progesterone ◽  
Retained Placenta ◽  
Different Types ◽  
Foetal Membranes ◽  
Plasma Steroids ◽  
Peripartum Period

Plasma steroids (cortisol, progesterone, estrone and estradiol) were studied during the peripartum period in cows with three different types of parturition: unifoetal normal (VUN), unifoetal with retained placenta (VRP), multifoetal with or without retained placenta (VG). In the control group, cortisol rose gradually from 8 ng/ml on day −7 to 11 ng/ml on the day of parturition and thereafter came back to the level of day −7. In the VRP group, cortisol was slightly lower than in the control on day −7 and it did not vary significantly before or after parturition. In the group of cows with multiple births, where retained placenta was encountered in 3/4 cases, cortisol was much higher than in control animals. Plasma progesterone decreased gradually from 5.5 ng/ml to less than 1 ng/ml on the day of parturition in the control group. In the group VRP and VG, it was significantly higher than in the control on the 2 days before and on the day of parturition. The patterns of estrone and estradiol were similar in the groups VUN and VRP until the first day following parturition, but much higher in the cows giving birth to twins. During the postpartum period, the drop in estrogens was much slower in the VRP and VG groups than in the VUN control group. These results suggest that retention of the placenta is not linked with the plasma concentration of cortisol but rather associated with an increased level of progesterone on the day of parturition and that the slower decrease in estrogen levels after parturition would be the result of the persisting attachment of the foetal membranes.

Morbidity of in-hospital purulent-septic infections of adults patients after different types of endovascular cardiosurgical operations

2020 ◽  
pp. 13-19
Author(s):  
Viktor Ivanovich Sergevnin ◽  
Larisa Gennadievna Kudryavtseva ◽  
Anna Igorevna Zolotukhina
Keyword(s):  
Medical Records ◽  
Heart Surgery ◽  
Surgical Intervention ◽  
Heart Rhythm ◽  
Community Acquired Pneumonia ◽  
Short Term ◽  
Intervention Community ◽  
Duration Of Surgery ◽  
Different Types ◽  
Low Incidence

An estimate of the incidence of nosocomial purulent-septic infections (GSI) of adult patients after various types of closed heart surgery according to the results of a study of medical records of 3275 patients is presented. It was established that the incidence rate of typical GSI after endovascular cardiac surgery was 3.1, with prenosological forms — 3.9 per 1000 operations. The main clinical options for postoperative GSI were infections in the field of surgical intervention, community-acquired pneumonia, urinary tract infection and bloodstream infection. There were no statistically significant differences between the incidence of GSI after stenting of the coronary arteries, operations for heart rhythm disturbances, stenosis of the carotid artery and other operations. The low incidence of GSI after closed heart surgery is due to the short duration of surgery, as well as the absence or short-term resuscitation of patients.

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