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 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).

scholarly journals Clinical and immunologic assessment of a complex of therapeutic-preventive measures concerning chronic catarrhal gingivitis in children with comorbid diabetes mellitus

2020 ◽  
Vol 73 (2) ◽  
pp. 298-301
Author(s):  
Oksana I. Godovanets ◽  
Аnastasiia V. Kotelban ◽  
Petro V. Moroz ◽  
Oleksandr O. Vitkovskyi ◽  
Tetiana S. Kitsak ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Oral Fluid ◽  
Preventive Measures ◽  
Main Group ◽  
Antiseptic Solution ◽  
Similar Tendency ◽  
Group A ◽  
Comparative Group ◽  
The Common

The aim of our study is to increase the efficacy of treatment of chronic catarrhal gingivitis in children suffering from type 1 diabetes mellitus by means of improvement of the methods of pharmacological correction on the basis of investigation of clinical-immunologic peculiarities of the disease. Materials and methods: 2 groups of the study were formed. Children received basic insulin therapy. The treatment of chronic catarrhal gingivitis in children from the main group were suggested the antiseptic solution “Decasan”; pill of a probiotic action “BioGaia ProDentis” and the immune modulator “Imupret”. Children from the comparative group were treated according to the common scheme. Results: The state of the oral hygiene in all the children after treatment improved considerably. According to PMA index inflammatory process was completely eliminated in children from the main group. A similar tendency was observed concerning sextants with gingival bleeding. In children dental calculus was lacking after treatment. Lysozyme activity in the oral fluid of children after treatment increased approximately 37.50% in the main group, and 16,67 % – in the comparison group. A similar tendency was found concerning sIgА level. Conclusions: Therefore, conducted course of the treatment concerning chronic catarrhal gingivitis promoted considerable improvement of the periodontal tissue in children.

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 Ultrasound-guided drainage of walled-off pancreatic necrosis. Case report.

2015 ◽  
Vol 17 (2) ◽  
pp. 259
Author(s):  
Bogdan Popa ◽  
Madalina Ilie ◽  
Oana Plotogea ◽  
Ionut Olteanu ◽  
Claudiu Turculet ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Percutaneous Drainage ◽  
Pancreatic Necrosis ◽  
Surgical Intervention ◽  
Biliary Duct ◽  
Ultrasound Guided ◽  
Endoscopic Retrograde ◽  
The Common ◽  
The Right ◽  
Walled Off Necrosis

ERCP (endoscopic retrograde cholangiopancreatography) represents a safe endoscopic procedure and serious complica- tions (perforation, haemorrhage, and acute pancreatitis) are usually uncommon. We present the case of a 38-year-old patient with gallstones in the common biliary duct who developed acute pancreatitis after ERCP. One month later a huge fluid col- lection with necrotic tissue in the right paracolic gutter was found, the fluid being drained by percutaneous drainage under ultrasonographic guiding. The particularity of the case is the post-ERCP pancreatitis, complicated with walled-off necrosis, resolved without surgical intervention by using percutaneous drainage.

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.

ANTIMICROBIAL PEPTIDES AND UBIQUITIN PROTEIN LIGASE E3 IN DESTRUCTIVE FORMS OF PANCREATITIS

2020 ◽  
pp. 74-80
Author(s):  
Baichorov E.Kh. ◽  
Baturin V.A. ◽  
Gandzha N.S. ◽  
Salpagarov Sh.R. ◽  
Bairamukov R.R.
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Blood Serum ◽  
Pancreatic Necrosis ◽  
Operative Mortality ◽  
Reliable Determination ◽  
Ubiquitin Protein Ligase ◽  
New Methods ◽  
Instrumental Methods

The development of methods for predicting and pre-venting the development of infectious destructive forms of acute pancreatitis for clinical practice is one of the important problems of pancreatology, the solu-tion of which would reduce post-operative mortality in severe acute pancreatitis, reaching 30-80%. To date, traditional laboratory and instrumental methods of diagnosis do not fully satisfy clinicians, since they do not always allow timely and reliable determination of the probability and time of microbial contamina-tion of pancreatic and parapancreatic tissue in pa-tients with destructive pancreatitis. In this regard, it is of interest to search for new methods for predicting and timely diagnosis of infected forms of pancreatic necrosis, which would significantly improve the re-sults of treatment of severe forms of acute pancreatitis. The use of changes in the dynamics of levels of antimi-crobial peptides - α-defensins and Ubiquitin Protein Ligase E3 in the blood serum of patients for diagnos-tic purposes makes it possible to predict and deter-mine earlier the transformation of sterile pancreone-crosis into infected and can be used as markers of the development of contamination of destructive forms of acute pancreatitis.

scholarly journals Combined prevention of fetal growth restriction based on determination of diagnostic markers

2021 ◽  
pp. 9-15
Author(s):  
Vladimir Golyanovskyi
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Preventive Measures ◽  
Comparison Group ◽  
Fetal Distress ◽  
Main Group ◽  
Growth Restriction ◽  
Control Group ◽  
High Risk Women ◽  
Micro Elements

Due to the morbidity of mothers and newborns caused by fetal growth restriction (FGR) and preeclampsia, preventive measures should be taken, especially in women at high risk of developing these conditions. Many studies have been conducted on the prevention of FGR and preeclampsia in high-risk women, especially anticoagulants, aspirin, paravastatin, nitric oxide, microelements (L-arginine, folic acid, vitamins E and C, phytonutrients, vitamin D) and calcium. The aim is to improve perinatal consequences by preventing FGR in high-risk women. Materials and methods: A prospective study of 137 pregnant women in the period of 110–136 weeks was conducted at the Perinatal Center in Kyiv. Pregnant women were divided into 3 groups. The main group included 47 women at high risk of FGR who received therapy (low doses of aspirin, low molecular weight heparin (LMWH) and vitamin and micro elements drugs). The comparison group included 45 women who had a high risk of FGR but did not receive treatment. The control group consisted of 45 women who were not at risk of FGR. The frequency of FGR and placental dysfunction were analyzed as well as a fetal distress was analyzed ante- and intranatally. Results: Therapy with low doses of aspirin, LMWH and a complex preparation of vitamins and micro elements improves the course of pregnancy and gestational complications. In the main group FGR was detected in 8.5 %, in the comparison group – in 17.8 %, in the control group – 4.4 %. Placental dysfunction was detected in 13.3 % in the control group, and only 6.4 % in the main group that was close to the control group – 2.2 %. Similar tendencies were found for fetal distress ante- and intranatally. Conclusions: The proposed prophylactic measures can improve maternal outcomes by reducing the level of gestational complications in pregnant women with biochemical signs of risk of FGR development. In addition, these preventive measures can reduce the frequency of children births with growth restriction, which significantly reduces early neonatal and perinatal morbidity and mortality.

scholarly journals Changes in the ducts of the pancreas with pancreatic necrosis

2019 ◽  
Vol 23 (3) ◽  
pp. 349-353
Author(s):  
G.Ya. Kostyuk ◽  
O.G. Kostyuk ◽  
M.V. Burkov ◽  
I.A. Golubovsky ◽  
M.P. Bulko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Histological Examination ◽  
Pancreatic Secretion ◽  
Pancreatic Necrosis ◽  
Experimental Studies ◽  
Pancreatic Ducts ◽  
Severe Pancreatitis ◽  
Hematoxylin And Eosin ◽  
Blood Elements

The article presents data on the development in the lumen of the pancreatic duct of condensed protein masses in people who died from the development of severe acute pancreatitis. 10 pancreas (areas of the head, body and tail, ductal system of the pancreas) of people who died of acute pancreatitis were subjected to histological examination. The material was fixed in 10% formalin solution, carried out in alcohols of increasing strength and enclosed in celloidin. The sections were stained with hematoxylin and eosin. A histological examination revealed that the condensed masses were represented by heterogeneous protein formations, cells of desquamated ductal epithelium, blood elements, fibrin threads. They completely filled the lumen of the pancreatic ducts and stopped the movement of pancreatic secretion. The data on the treatment of severe pancreatitis in experimental studies using the method of bougie and washing the pancreatic ducts with a novocaine-contrical mixture are presented. Two methods are proposed for restoring the permeability of the pancreatic duct in pancreatic necrosis in humans. Possible ways of the formation of fistulas and cysts are suggested, as a complication in the severe course of acute pancreatitis.

scholarly journals The Model of Acute Pancreatitis of Different Degree in Experiment

2019 ◽  
Vol 12 (4) ◽  
pp. 240-247
Author(s):  
Petr Mihailovich Nazarenko ◽  
Аlexsandr Ivanovich Konoplya ◽  
Paul Cherepovich Mekailyan ◽  
Alex Leonidovich Loktionov ◽  
Dmitriy Petrovich Nazarenko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Ducts ◽  
Solution Ph ◽  
Experimental Conditions ◽  
Aseptic Inflammation ◽  
Experimental Animals ◽  
Number Of Patients ◽  
The Common

Relevance of the topic. Acute pancreatitis (OP) is originally an aseptic inflammation of the pancreas, with possible damage to the surrounding tissues and individual organs, as well as systems, which is the third most common after acute appendicitis and acute cholecystitis in the number of patients. In this regard, an experimental model is needed to further determine the tactics of management and treatment of patients with acute pancreatitis of varying severity. Objective: to develop a universal model of acute pancreatitis with the ability to control the area of ​​pancreatic necrosis through the use of various overlays (distal or proximal to the confluence of the accessory pancreatic duct into the common bile duct) of the ligature, which will ensure the development of total or subtotal pancreatonecrosis. Materials and methods. Matured white Wistar rats weighing 250-300 g were chosen as objects for the study. The simulation of acute pancreatitis in the experiment was carried out using a 50% bile solution (pH = 6.0) followed by intraductal injection without cannulation of the major duodenal papilla. To control the degree of severity and area of ​​the pancreas lesion, we use the staged overlay of turnstiles at the confluence of the additional pancreatic ducts and the common bile duct, which ensures the development of acute pancreatitis of varying severity. On the 5th day, the rats were removed from the experiment, an autopsy was performed with the removal of pancreatic preparations for further histological examination. The evaluation of the immune and oxidative parameters of the blood of experimental animals. Statistical processing of the obtained results was performed using descriptive and variation statistics techniques. Results. In the course of this work, moderate and severe acute pancreatitis is modeled, which allows us to focus on the course of each subject to variation statistics, determining their reliability, which is an important condition for creating the necessary platform for further study of the management and treatment of this disease. Findings. I use the resulting model, we managed: - to obtain a high reliable result of operations with minimal death of experimental animals, i.e. high repeatability of positive results; - perform an accessible operation with obvious technical simplicity; - see the possibility of a simulated disease for a long time up to 5 or more days, which subsequently allows medical intervention and testing of new dosage forms and drugs for treatment and studying their effects. Thus, it is possible to judge the universality of this model of acute pancreatitis under experimental conditions.

scholarly journals CLINICAL STUDY OF OPTIMIZED APPROACHES TO LOCAL PREVENTION OF DENTAL CARIES IN PATIENTS WITH TYPE 1 DIABETES MELLITUS

2019 ◽  
pp. 10-15
Author(s):  
O.A. Udod ◽  
A.S. Kulish
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Dental Caries ◽  
Type 1 Diabetes Mellitus ◽  
Preventive Measures ◽  
Comparison Group ◽  
Main Group ◽  
The State ◽  
Degree Of Risk

The prevalence of dental caries is high in people with type 1 diabetes mellitus and it is about 81.1-100%, however 57.1% are diagnosed with multiple dental caries. The effectiveness of caries prevention is only 48.3%. In the prevention of dental caries has significant role to exogenous methods of prevention with fluorides, but fluoride compounds adversely affect the condition of patients with diabetes mellitus. It’s advisable to use in patients with caries preventive measures containing nanohydroxyapatite and xylitol. The purpose is to conduct a research of optimized approach to local prevention of dental caries in patients with type 1 diabetes mellitus by the fluoride-free agents, taking into account the degree of risk of dental caries in patients and the state of diabetes compensation. Materials and methods. The review of  95 patients with type 1 diabetes mellitus in the state of compensation, subcompensation and decompensation was from 18 to 35 years and disease duration was from 1 to 24 years. The main group included 50 people, the comparison group was 45 people. The index of caries intensity DMF, structure functional indices of enamel acid resistance (TER) were determined in patients. Also the increase in the intensity of dental caries after 6 and 12 months, reducing the increase in caries after 12 months were defined.The patients of the main group, according to individualized approaches, taking into account the degree of risk of dental caries and the state of compensation of diabetes mellitus were subjected to local caries preventive measures, which included the use of fluoride-free products containing nanohydroxyapatite and xylitol, and means of enzymes lactoperoxidase system, patients of the comparison group - traditional local fluoroprophylaxis. Results and discussion. In patients of the main group after 6 months of caries-preventive measures of structure functional indices of enamel acid resistance was 3.52±0.19 points, 12 months – 3.14±0.16 points, the index improved to 1.7 times (p<0,05), compared to baseline (5.26±0,27 points). In the comparison group of patients, after 6 months, enamel acid resistance was 4.09±0.21 points, after 12 months - 3.86±0.18 points, which is only 1.3 times better (p<0.05) than the baseline index (5.02±0.25 points). Before the start of caries preventive measures, the caries intensity index DMF in patients of the main group was 13.7±0.84, after 6 months it increased to 13.8±0.86, the increase in the intensity of caries was 0.1. In the patients of the comparison group, the corresponding indexes of DMF were 12.3±0.85 and 12.6±0.91, increase the intensity of caries was 0.3 and was higher by 3 times. After 12 months, patients in the main group DMF index slightly increased to 14.0±0.87, increase the intensity of caries was 0.3. In the comparison group DMF index value was 13.1±0.93, increase the intensity was significantly higher (2.7 times) and it was 0.8. Reduction of increase the intensity of dental caries was 62.5%. Conclusion. Topical application in patients with type 1 diabetes mellitus of caries prophylactic agents containing nanohydroxyapatite and xylitol, as well as agents with enzymes of the lactoperoxidase system for 12 months on individualized approaches taking into account the degree of risk of dental caries and the state compensation of diabetes mellitus promoted caries resistance of enamel 1.7 times, reducing the intensity of caries by 2.7 times, allowed to reduction the dental caries growth by 62.5%.

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