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1.
Diabetes Metab Syndr ; 12(2): 189-194, 2018.
Article in English | MEDLINE | ID: mdl-29050916

ABSTRACT

Current advances in diabetic foot ulcers (DFU) treatment are discussed. Normal and pathological wound healing process are observed and the role of growth factors (GFs) is elucidated. Current techniques involving GFs and platelet rich plasma (PRP) are compared. Up-to-date research suggests that treatment with single growth factor (GF) could be insufficient and not encompassing all pathological changes in DFU bed. Efficiency of PRP is rather controversial and lacks evidence. Thus the use of cocktail of particular GFs is suggested. Pro et contra of each approach are discussed.


Subject(s)
Diabetic Foot/diagnosis , Diabetic Foot/therapy , Intercellular Signaling Peptides and Proteins/administration & dosage , Platelet-Rich Plasma , Diabetic Foot/blood , Drug Combinations , Forecasting , Humans , Treatment Outcome , Wound Healing/drug effects , Wound Healing/physiology
2.
Ter Arkh ; 89(11): 69-78, 2017.
Article in Russian | MEDLINE | ID: mdl-29260749

ABSTRACT

Hemolytic uremic syndrome (HUS) is a rare, but menacing condition registered mainly in children. The paper gives a detailed description and analysis of a clinical case of HUS with a favorable outcome in an adult woman who developed the syndrome in the presence of bloody diarrhea. It considers an update on the etiology, pathogenesis, and clinical features of HUS associated with diarrheal syndrome and discusses differential diagnostic features, diagnostic problems, and characteristics of management tactics for patients.


Subject(s)
Diarrhea/diagnosis , Hemolytic-Uremic Syndrome/diagnosis , Adult , Diagnosis, Differential , Diarrhea/complications , Female , Hemolytic-Uremic Syndrome/etiology , Humans , Syndrome
3.
Vestn Ross Akad Med Nauk ; (1): 8-12, 2010.
Article in Russian | MEDLINE | ID: mdl-20408432

ABSTRACT

Early diagnosis of post-operative infectious complications was established based on semiotic evaluation, SAPS-based analysis of severity of the disease, and results of ultrasound studies. SAPS analysis of functional disorders proved a reliable tool for diagnosis of peritonitis but less accurate for diagnosis of intra-abdominal abscess. Ultrasound revealed meaningful symptoms of infectious complications, such as the presence of free and confined fluids in the abdominal cavity, increased small intestine diameter, disturbed peristalsis. High diagnostic efficiency of laparoscopy permits it to be used to verify or turn down complication and thereby avoid repeated surgical intervention. The proposed approach made it possible to significantly accelerate diagnosis.


Subject(s)
Abdominal Abscess/diagnosis , Abdominal Abscess/therapy , Peritonitis/diagnosis , Peritonitis/therapy , Postoperative Complications/diagnosis , Postoperative Complications/therapy , Abdominal Abscess/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Laparoscopy , Male , Middle Aged , Peritonitis/diagnostic imaging , Postoperative Complications/diagnostic imaging , Ultrasonography , Young Adult
4.
Vestn Khir Im I I Grek ; 167(4): 81-4, 2008.
Article in Russian | MEDLINE | ID: mdl-18942444

ABSTRACT

The authors made an analysis of postoperative hernias in 32 patients. General and local causes are considered. The proposed technical methods used for exclusion of local causes allowed the frequency of postoperative hernias to be reduced from 1.9% to 0.5%.


Subject(s)
Cholecystectomy, Laparoscopic/adverse effects , Hernia, Ventral/etiology , Plastic Surgery Procedures/methods , Adult , Aged , Female , Follow-Up Studies , Gallbladder Diseases/surgery , Hernia, Ventral/surgery , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Suture Techniques , Treatment Outcome
5.
Khirurgiia (Mosk) ; (2): 24-8, 2007.
Article in Russian | MEDLINE | ID: mdl-17495827

ABSTRACT

Advantages and disadvantages of different methods of surgery termination at generalized peritonitis are discussed. Drainage of abdominal cavity can not guarantee adequate sanation. Disadvantages of peritoneal lavage exceed the clinical value of this method. Active influence on infectious process during postoperative period can be realized with laparostomy, programmed revisions and sanations of abdominal cavity. These methods lead to recovery of more 80% patients with generalized peritonitis. Laparoscopic sanation is effective when bacterial contamination of peritoneal exudation doesn't exceed 10(5) mb/g.


Subject(s)
Laparoscopy/methods , Peritonitis/surgery , Humans
8.
Khirurgiia (Mosk) ; (4): 32-5, 2003.
Article in Russian | MEDLINE | ID: mdl-12744133

ABSTRACT

One thousand three hundred and ten patients with peritonitis have undergone surgery: local limited peritonitis was in 230 patients, local unlimited--in 342, general--in 738 patients. After surgery suppuration of the wound was seen in 92 (7.1%) patients, phlegmons of the abdominal wall--in 16 (1.3%), progressive peritonitis--in 40 (3.1%), abscesses of abdominal cavity--in 13 (1.0%), eventration--in 19 (1.5%), adhesive intestinal obstruction--in 17 (1.3%). Laparoscopy was used for diagnosis of intraabdominal complications in 47 patients. This allowed to avoid unjustified laparotomies in 20 patients. Application of laparoscopy is limited by degree of bacterial contamination of peritoneal exudates. Early adhesive intestinal obstruction in 7 patients was treated with endoscopic procedure. Sonography is effective in diagnosis of intraabdominal complications, detection of site of safe puncture before postoperative laparoscopy and drainage of abscesses.


Subject(s)
Peritonitis/surgery , Postoperative Complications , Abdominal Abscess/etiology , Diaphragmatic Eventration/etiology , Humans , Intestinal Obstruction/etiology , Postoperative Complications/diagnostic imaging , Postoperative Complications/mortality , Postoperative Complications/surgery , Surgical Wound Infection/etiology , Ultrasonography
9.
Khirurgiia (Mosk) ; (8): 8-12, 2001.
Article in Russian | MEDLINE | ID: mdl-11552540

ABSTRACT

956 patients with general peritonitis were operated: 596 patients--for diffuse peritonitis, 360--for general peritonitis. The causes of peritonitis were: perforating gastroduodenal ulcers (454), acute destructive appendicitis (190), acute destructive cholecystitis (82), perforation of small intestine and colon (96), postoperative peritonitis (80), other diseases (54). In low degree of bacterial contamination of abdominal cavity (not more Ig 5 CFU/g) operations were completed without abdominal drainage, laparoscopic variant of the operation being optimal. In postoperative period, out of 691 patients with low degree of bacterial contamination wound infection was in 7.9%, intraabdominal infection--in 2.5%, polyorganic insufficiency--in 1.0%; lethality was 5.9%. In high degree of bacterial contamination (more Ig 5 CFU/g) and massive unremovable fibrinous patch on the peritoneum the programmed revisions and sanations of abdominal cavity were performed, sometimes--control laparoscopic revisions. In postoperative period of 256 patients with high degree of bacterial contamination wound infection arose in 6.0%, intraabdominal infection--in 4.2%, polyorganic insufficiency [symbol: see text] in 42.6%; lethality was 18.1%.


Subject(s)
Peritonitis/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Laparoscopy , Male , Middle Aged , Peritonitis/classification , Peritonitis/etiology , Reoperation , Time Factors
11.
Khirurgiia (Mosk) ; (6): 43-6, 1999.
Article in Russian | MEDLINE | ID: mdl-10410517

ABSTRACT

582 laparoscopic operations for various urgent diseases of the organs of abdominal cavity were made. 190 of them were performed for acute appendicitis, 266--for acute cholecystitis and its complications, 33--for pancreonecrosis, 39--for perforated gastro-duodenal ulcers, 32--for acute bowel obstruction and 22--for other pathological conditions. The necessity of conversion to conventional open surgery has arose in 41 (7.0%) patients. Intraoperative complications were detected in 7 (1.3%) patients. Postoperative complications developed in 18 (3.3%) patients. 2 patients (0.4%) died. The obtained results of treatment made it possible to recommend laparoscopic operations in acute abdominal diseases.


Subject(s)
Laparoscopy , Abdomen/surgery , Abdomen, Acute/complications , Abdomen, Acute/surgery , Acute Disease , Appendicitis/complications , Appendicitis/surgery , Cholecystitis/surgery , Duodenal Ulcer/complications , Duodenal Ulcer/surgery , Emergencies , Female , Humans , Middle Aged , Peptic Ulcer Perforation/surgery , Peritonitis/surgery
12.
Khirurgiia (Mosk) ; (1): 50-2, 1999.
Article in Russian | MEDLINE | ID: mdl-10050515

ABSTRACT

According to the authors' opinion nasointestinal intubation have some advantages over "open" methods of decompression of the small bowel in paralytic intestinal obstruction resulted from peritonitis and mechanical obstruction of the small bowel. The authors' experience with more than 500 their own cases indicates, that application of nasointestinal intubation is not only necessary, but safe as well if keeping strictly to the established technique. Technical aspects of the method, possible errors which could occur during the performance of nasointestinal intubation and introduction of the probe are described. Complications which made up 2.6% are analysed.


Subject(s)
Gastrointestinal Diseases/therapy , Intestine, Small , Intubation, Gastrointestinal/methods , Nose , Humans , Intubation
13.
Vestn Khir Im I I Grek ; 157(3): 69-72, 1998.
Article in Russian | MEDLINE | ID: mdl-9751978

ABSTRACT

The authors have performed operations on 32 patients with perforated ulcers of the duodenum and 7 patients with perforated ulcers of the stomach. The diameter of the perforations was 2-8 mm. In 10 of the 39 patients the perforation defects could not be sutured by the laparoscopic method. The authors consider that of great significance for the decision to make laparoscopic operations was the diagnosis of peritonitis, size and localization of the perforation, the surgeon's experience with endoscopic operating. The technique of laparoscopic suturing the perforations is described. Special attention is paid to the special disposition of the surgeon and his assistant at the operating table.


Subject(s)
Duodenal Ulcer/complications , Duodenal Ulcer/surgery , Laparoscopy/methods , Peptic Ulcer Perforation/surgery , Stomach Ulcer/complications , Stomach Ulcer/surgery , Female , Humans , Male , Middle Aged , Needles , Suction , Suture Techniques/instrumentation , Sutures , Treatment Outcome
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