ABSTRACT
Ten (1.8%) out of 558 patients with end-stage chronic renal failure on program hemodialysis developed infective endocarditis (IE). The average length of hemodialysis before IE was 17.0 +/- 14.5 months. The main cause of IE was infection of the site of vascular approaches. The diagnosis was difficult; Duke criteria modified by J. Li et al. (2000) allowed evidenced diagnosis of IE only in 30% of cases, while modified criteria offered by the authors did it in 50% of cases. The article discusses rational antibacterial therapy. Hospital lethality in IE is as high as 50%.
Subject(s)
Endocarditis, Bacterial/microbiology , Renal Dialysis , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Diabetic Neuropathies/epidemiology , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/epidemiology , Female , Glomerulonephritis/epidemiology , Glomerulonephritis/therapy , Humans , Male , Middle Aged , Renal Dialysis/methodsABSTRACT
Addition of splenocytokine therapy to combined therapy of peptic ulcer accelerated healing and prolonged remission.
Subject(s)
Cytokines/therapeutic use , Immunity, Cellular/immunology , Immunotherapy/methods , Peptic Ulcer/drug therapy , Peptic Ulcer/surgery , Spleen/chemistry , Adult , Aged , Animals , Antimicrobial Cationic Peptides/metabolism , Blood Proteins/metabolism , Complement System Proteins/metabolism , Endoscopy, Gastrointestinal , Female , Hemofiltration/methods , Humans , Lymphocytes/immunology , Male , Middle Aged , Muramidase/metabolism , Peptic Ulcer/immunology , Spleen/immunology , Sus scrofa , Tissue Extracts/therapeutic useABSTRACT
The paper analyzes some experience in treating 203 victims with crush syndrome (CS). The victims' status is determined by the force and time of compression, the degree and magnitude of destructive muscular changes, accompanying by lesions and occurring complications. Varying renal dysfunction was revealed in 97 (47.8%) patients, 55 (27%) patients developed mild and severe acute renal failure (ARF) and 38 (18.7%) patients had mild AFR. Renal dysfunction was not detected in 106 (52.2%) patients. The development of severe AFR in CS is a marker of the severity of injury, the body's response to injury and shock; it dictates the tactics of intensive therapy using extracorporeal techniques of detoxification and active or delayed surgical removal of necrotic muscles, which permits prevention of prolonged severe endotoxication and pyoseptic and vital complications. Two-three-week persistent unremoved foci of muscle necrosis and endotoxicosis exhaust the body's adaptive mechanisms, cause severe dysfunction of other organs and systems, promote delayed renal function recovery and ARF resolution.
Subject(s)
Acute Kidney Injury/therapy , Crush Syndrome/complications , Disasters , Acute Kidney Injury/etiology , Adolescent , Adult , Aged , Armenia , Child , Critical Care , Crush Syndrome/diagnosis , Female , Health Status Indicators , Humans , Male , Middle Aged , Prognosis , Treatment Outcome , USSRABSTRACT
The clinical efficiency, safety and accessibility of a lot of artificial blood clearance procedures are provided by the versatility of equipment operational capacities, computerization, automatization, expendable blood-conducting elements, higher independence through the electrochemical regeneration of a dialyzing solution, a reduced range of the hardwares used and their simplified designing implementation. A clearance technique-invariant pattern of polyblock of technical equipment with a universal perfusion unit wherein perfusion is accompanied by centralized equipment control has been proposed and introduced into practice.
Subject(s)
Dialysis Solutions , Extracorporeal Circulation/instrumentation , Kidneys, Artificial , Renal Dialysis/instrumentation , Therapy, Computer-Assisted/instrumentation , Equipment Design , Extracorporeal Circulation/methods , Humans , Renal Dialysis/methods , Therapy, Computer-Assisted/methodsABSTRACT
Two groups of patients with terminal chronic renal failure (TCRF) treated from 1970 to 1979 (group 1) and in 1980-1989 (group 2) have been compared in respect to treatment results. All the patients underwent programmed hemodialysis performed on different equipment and according to different regimens. The results of group 2 appeared better: the lethality decreased by 18%, mean survival from 6 months to 4.5 years, up to half of the patients were able to receive hemodialysis procedures outpatiently, 30% of the patients were prepared to receive a renal transplant. The above positive shifts were achieved due to utilization of updated equipment, improved water purification, 3-stage technique of hemodialysis, antianemic drug eprex and vanalpha against osteodystrophy.
Subject(s)
Erythropoietin/therapeutic use , Kidney Failure, Chronic/therapy , Kidney Transplantation , Recombinant Proteins/therapeutic use , Renal Dialysis , Adolescent , Adult , Aged , Combined Modality Therapy , Critical Illness , Female , Humans , Kidney Failure, Chronic/mortality , Male , Middle Aged , Survival RateSubject(s)
Critical Care/organization & administration , Crush Syndrome/therapy , Disasters , Emergency Medical Services/organization & administration , Multiple Trauma/complications , Shock, Traumatic/therapy , Adolescent , Adult , Aged , Armenia , Child , Crush Syndrome/etiology , Female , Humans , Male , Middle Aged , Multiple Trauma/therapy , Time FactorsABSTRACT
Based on the study of the echocardiography data in 44 patients with chronic renal failure it has been shown that the incidence and the degree of left ventricle hypertrophy is related to the duration of arterial hypertension, increased cardiac output, and metabolic abnormalities. Echocardiographic studies made over time revealed a progressive deterioration of myocardial contractility. Pericarditis that ensues promotes the deterioration of left ventricle contractility and aggravates heart insufficiency. The diastolic murmur of aortal regurgitation should be differentiated as pertaining to infectious endocarditis or to relative insufficiency of the aortal valve. Two-dimensional echocardiography favours differentiation of left ventricle myocardial hypertrophy, makes it possible to locate the fluid in the pericardium more accurately, and to evaluate the treatment efficacy for pericarditis.
