ABSTRACT
OBJECTIVE: To study the dynamics of population indicators: the total number of deaths from diseases of the circulatory system, coronary heart disease, cerebrovascular diseases and strokes, hospitalization profile for strokes, their structure and mortality in the Tomsk region for several years in comparison with these indicators for the Russian Federation and the Siberian Federal District. MATERIAL AND METHODS: A retrospective study was conducted using acute cerebrovascular accidents monitoring data and data of the Territorial body of state statistics of the Tomsk region in comparison with the literature data. The indicators of all causes of death, from circulatory diseases, coronary heart disease, cerebrovascular diseases and stroke in the territory of the Tomsk region, profile of hospitalization, structure of acute cerebrovascular accidents were analyzed for several years. Particular attention was paid to case fatality rate, one of the key indicators of the effectiveness of the system of care for patients with stroke. RESULTS: Typical for many regions of the Russian Federation predominance of chronic forms in the structure of mortality from circulatory diseases, the absence of significant differences in the structure of strokes, as well as the features of the Tomsk region in the form of high levels of hospitalization profile and hospital case fatality rate, were revealed. The dependence of hospital mortality on logistics is shown, on the basis of which assumptions are made about the possible causes of high fatality rates in the region: excessive centralization of the system of vascular centers and the absence of really working mechanisms for timely reevacuation from them. CONCLUSION: To bring chronic circulatory diseases structure in line with international standards, it is necessary to regulate the rules for formulating and coding diagnoses. In order to reduce hospital fatality rates in the Tomsk region, it is necessary to carry out organizational measures: opening a primary vascular department in the area of responsibility of the regional stroke center, as well as strengthening rehabilitation and palliative services for the timely reevacuation of patients from vascular centers.
Subject(s)
Cardiovascular Diseases , Cardiovascular System , Stroke , Humans , Retrospective Studies , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/therapy , Russia/epidemiology , Stroke/epidemiology , Stroke/therapySubject(s)
Cholecystectomy , Cholecystitis/surgery , Diuretics/administration & dosage , Sorption Detoxification/methods , Toxemia/therapy , Acute Disease , Adult , Aged , Cholecystitis/blood , Cholecystitis/complications , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Preoperative Care , Toxemia/etiologyABSTRACT
A prolonged infusion of noradrenaline (40 mkg) into the mesenterial artery was carried out in the early postoperative period in 30 patients with diffuse purulent peritonitis in order to arrest the inflammatory reaction of the peritoneum. More rapid decrease of intoxication, prevention of plasmatic losses and less lethality were noted as compared with the control group.
Subject(s)
Norepinephrine/administration & dosage , Peritonitis/therapy , Aged , Critical Care/methods , Drainage , Female , Follow-Up Studies , Humans , Infusions, Intra-Arterial , Mesenteric Arteries , Middle Aged , Time FactorsABSTRACT
An analysis of 127 case histories of patients with diffuse peritonitis treated in the clinic during 1979-1982 has been made. But for all the complex intensive treatment, generalization of the inflammatory process in the abdominal cavity has been shown to cause high mortality rate (76%). The patients' age substantially aggravated the prognosis. 79% of the victims were older than 60. In 56,6% of cases the development of peritonitis had different complications, 11% needed relaparotomy to treat the complications. Late diagnosis of the disease was specifically responsible for unsatisfactory results--two thirds of the patients had toxic or terminal stages of the disease.
Subject(s)
Peritonitis/therapy , Adult , Age Factors , Aged , Combined Modality Therapy , Humans , Middle Aged , Outcome and Process Assessment, Health Care , Peritonitis/etiology , Peritonitis/mortality , Postoperative Complications/therapyABSTRACT
On the basis of examination of microcirculation by the method of contact microscopy and evaluation of the survival rate of rats with experimental peritonitis the authors have shown a positive effect (reduced lethality) of the intraperitoneal administration of noradrenaline at the expense of reduced capillary blood flow and reduced intoxication.
