ABSTRACT
The clinical examples of the use of modern endoscopic minimally invasive technologies in patients with urinary tract anomalies and in complex clinical cases are presented in the article. The techniques and features of percutaneous nephrolithotomy, retrograde intrarenal surgery (RIRS), antegrade ureteroscopy using f lexible scope in this category of patients are discussed. The paper confirms the efficiency and necessity of further development of endourological methods for the treatment of urolithiasis.
Subject(s)
Kidney Calculi , Lithotripsy , Nephrolithotomy, Percutaneous , Nephrostomy, Percutaneous , Urinary Tract , Urolithiasis , Humans , Urolithiasis/surgery , Ureteroscopy/methods , Nephrolithotomy, Percutaneous/methods , Lithotripsy/methods , Kidney Calculi/surgery , Treatment OutcomeABSTRACT
INTRODUCTION: Damage to the organs of the urinary system (UMS) in road trauma (DT) is 4%, of which multiple and combined - over 70%. The aim of the study is to determine the main organizational and clinical directions for improving the EMC in case of trauma OMS in a trauma center of the 1st level. MATERIAL AND METHODS: For the period from 2017 to 2020. 508 injured with road polytrauma were admitted to the hospital. Of these, trauma and secondary injuries were diagnosed in 108 people (21.3%), which were divided into three groups: the first - 73 (67.6%) victims with the injury of the OMVS, the second - 25 (23.1%) with secondary damage kidney, the third - 10 (9.3%) patients with "neurogenic bladder" with spinal trauma. The assessment of the severity of damage was carried out using the ISS scales and tables of the IH P and IH C. RESULTS: It has been shown that the introduction of an interdisciplinary approach to the organization of in-hospital routing and differentiated algorithms of medical and diagnostic tactics based on the concept of traumatic disease, led to the establishment of a final diagnosis in every third victim in the early stages, as well as to a decrease in the overall mortality rate by 3.7%, the overall mortality rate was 12,2%. The key directions for improving the efficiency and quality of care in case of dominant and concomitant trauma of the urinary system have been identified, based on the tactics of programmed multistage surgical treatment (Damage Control Urological). CONCLUSION: In the FSBI "3CVKG A.A. Vishnevsky "developed, organized and implemented a system and algorithm for the provision of specialized medical care for trauma to the Ministry of Railways, including high-tech assistance to victims of road accidents, associated with the regional and federal services of disaster medicine.
Subject(s)
Multiple Trauma , Wounds and Injuries , Accidents, Traffic , Hospitals , Humans , Multiple Trauma/diagnosis , Multiple Trauma/therapyABSTRACT
The article presents a review of acute surgical pathology and the frequency of its occurrence, complicating alcohol poisoning, cauterizing liquids, narcotic and psychotropic drugs and acute emerging metabolic (protein-energy). The development of surgical complications in poisoning was observed in patients in severe and very severe condition and is accompanied by a sharp increase in mortality (75%) and severe energy dysfunction. The most diverse and difficult flowing surgical complications were encountered in alcohol poisoning and cauterizing liquids.
Subject(s)
Poisoning , Postoperative Complications , Protein Deficiency , Acute Disease , Humans , Poisoning/metabolism , Poisoning/mortality , Poisoning/surgery , Postoperative Complications/metabolism , Postoperative Complications/mortality , Postoperative Complications/therapy , Protein Deficiency/etiology , Protein Deficiency/metabolism , Protein Deficiency/therapyABSTRACT
The authors propose a mathematical model of the influence of the environment on the aging of living systems. This model is based on the concept of continuous adaptation to the environment of biosystems from the moment of its birth. Adaptation rate as rate of risk of destructions accumulation in BS is studied as competition between two simultaneous processes: BS destruction and recombination of damages defined by kinetics of autocatalytic chemical reactions. The influence of the environment is taken into account by the parameters of the model, in the general case, depending on the time. The model reflects the provisions of thermodynamics, gerontology and typical results observed in medical experiments.
Subject(s)
Adaptation, Physiological/physiology , Aging/physiology , Models, Biological , Models, Theoretical , Geriatrics/methods , HumansABSTRACT
Nonspecific resistance was studied in patients in acute psychotic poisoning complicated with varying pneumonias. The indices obtained during long (120-min) blood incubation with an object of phagocytosis, namely phagocytic index, phagocytic number, bactericidity index, HCT test, and cytochemical activity index were shown to be of the highest informative value that characterizes the state of nonspecific mechanisms of immune protection. The diminished microphagocytic functional activity along with the severity of pneumonia was ascertained to result in the development of an inflammatory process.
