Coronavirus infection and systemic inflammatory reaction syndrome.

OBJECTIVE: Aim: The purpose of this study was a clinical approbation of the Kometad drug (international non-proprietary name sodium colistimethate), an antibiotic from the polymyxin group in patients with severe course of confirmed сoronavirus infection in the intensive care unit of the Branch of the I. Zhekenova Municipal Clinical Infectious Diseases Hospital.. PATIENTS AND METHODS: Materials and Methods: The methodology is based on both theoretical and empirical methods of scientific cognition. During the study, the features of the Coronavirus infection and the inflammatory reaction syndrome were considered, which became quite a big problem during the pandemic. RESULTS: Results: The main indications for the tested drug and the consequences of its use for one age group were also determined. CONCLUSION: Conclusions: The conclusion was made about the positive dynamics of the patients' health status, and recommendations were given for further research in this area. The practical significance of this study lies in the first clinical approbation of the Kometad drug, which can be used in medicine to reduce the severity of the systemic inflammatory reaction syndrome and improve the patient's health as a result of the disease of Coronavirus infection, after further clinical trials of the drug with different age groups of patients.

Causes of adverse outcomes in acute intestinal obstruction.

OBJECTIVES: The purpose of this study is to analyse the effectiveness of methods of diagnosis and treatment of patients with acute intestinal obstruction. METHODS: A total of 123 patients were examined, who were diagnosed based on history, an overview X-ray of the abdominal cavity, a contrast examination of the intestine, and contrast marks according to Yu. L. Shalkov and irrigoscopy. 57.4 % of patients had all typical aspects of the disease, 17.7 % - indolent aspects, and 4.8 % - atypical. In the case of colonic obstruction, the method of irrigoscopy is informative. To restore intestinal function, patients with acute intestinal obstruction of the small intestine are indicated with a Yu. L. Shalkov nasogastroenteral tube or a double-drainage nasointestinal tube. And with the colonic form of the disease, it is necessary to perform a Hartmann-type operation and establish a Maidl-type anastomosis. RESULTS: It was noted that with indolent or atypical aspects of the disease, patients received medical care late. It is shown that in the case of resection of necrotic areas of the intestine, it is informative to determine the resection boundary using the vasoscopy method using a 1 % aqueous solution of methylene blue. It was found that the optimal distance from the edge of the resection is 3 cm. CONCLUSIONS: The results of this study are of interest to clinicians who are engaged in the diagnosis and treatment of patients with acute intestinal obstruction.

A forecasting method of postoperative intestinal paralysis and its timely resolution.

Introduction: The development of intestinal paresis after surgery in patients with acute surgical conditions complicated by peritonitis is an urgent problem of abdominal surgery. Aim: To study the effectiveness of the developed methods, as well as to predict the risk of intestinal paresis, and establish the possibilities of correcting this condition in patients with acute surgical pathology complicated by peritonitis. Material and methods: Twenty patients were examined, in whom the temperature parameters of the mucous membrane and skin of the cheek were measured, based on which the probability of developing paresis was predicted. Results: The proposed method of thermometry of the mucous membrane and cheek skin made it possible to predict a high risk of intestinal paresis in 75% of patients and low risk in 25% of patients. It was shown that 80% of patients had a complete restoration of intestinal motility on the first day after the start of treatment. In 20% of cases, a partial improvement in the motor evacuation function of the intestine was observed on the first day, and full recovery was noted on the second day after the start of therapy. Conclusions: The developed methods are highly effective and suitable for predicting and correcting intestinal paresis in patients with acute surgical conditions in the postoperative period.

Pathogenetic justification of digestive tract dysfunction correction to reduce the risk of ventricular extrasystoles after coronary bypass grafting.

Introduction: In heart pathology, abdominal pathology is often detected, but due attention has not been paid to this issue, and algorithms for predicting, preventing, and correcting the coefficient of endothelial dysfunction (CED) after coronary artery bypass grafting (CABG) with the use of artificial circulation (AC) have not been developed. Aim: To substantiate the pathogenetic expediency of correction of postoperative intestinal paresis after coronary artery bypass grafting for the prevention of functional cardiac complications. Material and methods: 147 men were divided into 2 groups. Statistical processing of the obtained data was performed using Windows Microsoft Excel software and parametric methods of variational statistics, and the reliability of differences was determined using Student's formula and table. Results: It was found that in group II, after coronary artery bypass grafting, the clinical symptoms of intestinal dysfunction were significantly less (p = 0.019), and the recovery of defecation was significantly faster (p = 0.033) than in group I. After coronary artery bypass grafting, the frequency of high-grade extrasystoles in group II was significantly lower than in group I (p = 0.033). Conclusions: The application of the digestive tract dysfunction correction program is pathogenetically justified because it provides a reduction in the frequency of intestinal paresis and hence a reduction in the frequency of development of ventricular extrasystoles of high gradations after coronary artery bypass grafting.