[Endoscopic intragastric injection of botulinum toxin in the treatment of patients with morbid obesity: opportunities and prospects]. / Endoskopicheskaya intragastral'naya in"ektsiya botulinicheskogo toksina v lechenii bol'nykh s morbidnym ozhireniem: vozmozhnosti i perspektivy.

The authors consider modern epidemiological and demographic data on morbid obesity. Literature review is devoted to non-surgical treatment of patients with morbid obesity. The authors analyze the results of experimental and clinical studies on endoscopic intragastric injection of botulinum toxin and bariatric efficacy of this approach. The indications for endoscopic intragastric injection of botulinum toxin and advantages of this technique are clearly formulated. The authors identified the most significant criteria for objective assessment of clinical effectiveness of endoscopic intragastral injection of botulinum toxin, as well as scientific and methodological principles necessary for this technique. Clinical efficacy of intragastric injection of botulinum toxin including overweight loss, anorexigenic and gastroparetic effects indicates inconsistent results and certain unresolved problems. Thus, large-scale multiple-center randomized controlled trials and multivariate analysis are required to determine the role of endoscopic intragastric injection of botulinum toxin in complex treatment of patients with morbid obesity.

[Colorectal cancer liver metastases: current state of the problem, priority treatment approaches]. / Metastazy kolorektal'nogo raka v pechen': sovremennoe sostoyanie problemy, prioritetnye podkhody v lechenii.

The review is devoted to the world trends in epidemiology of colorectal cancer and treatment of colorectal cancer liver metastases. The authors analyze the effectiveness of traditional (resection) and modern minimally invasive methods of local destruction (radiofrequency thermoablation, microwave ablation, cryoablation), stereotactic radiotherapy, radiosurgery, targeted therapy and endovascular techniques (chemoinfusion, chemoembolization, radioembolization). It was emphasized that searching for new chemotherapeutic and targeted drugs is one of the reserve ways to improve treatment outcomes in patients with potentially resectable colorectal cancer liver metastases. The possibilities and prospects of liver transplantation as a priority treatment strategy for patients with unresectable bilobar colorectal cancer liver metastases are highlighted.

[Nasointestinal intubation in surgery of acute intestinal obstruction and peritonitis: past, present and future]. / Nazointestinal'naya intubatsiya v khirurgii ostroi kishechnoi neprokhodimosti i peritonita: proshloe, nastoyashchee i budushchee.

The authors analyze history of development nasointestinal intubation for abdominal decompression in patients acute intestinal obstruction and widespread peritonitis, contribution of Russian and foreign surgical schools to improvement and popularization of this technique. Advisability, clinical efficacy, advantages and disadvantages of this method are stated. The prospects of nasointestinal intubation in the foreseeable future are considered in these patients. Certain technical features of nasointestinal intubation and complications are described. The causes of negative attitude of foreign surgeons to nasointestinal intubation and motivation for refusing of this technique are discussed. Considering the arguments of supporters and opponents, the authors conclude that complete rejection of this technique is premature. A differentiated approach to nasointestinal intubation according to strict indications seems to be more legitimate than categorical rejection.

[Efferent methods and hyperbaric oxygen therapy for great vessels injuries of extremities]. / Rezul'taty primeneniia éfferentnykh metodov i giperbaricheskoi oksigenatsii pri travmakh krupnykh arterii konechnostei.

AIM: To evaluate an efficacy of efferent therapy of great vessels injuries of extremities and acute limb ischemia. MATERIAL AND METHODS: There were 197 patients (main group -107, control group - 90 patients) with great vessels injuries of extremities and acute limb ischemia. The patients of the main group underwent plasmapheresis, ultraviolet irradiation of blood (UVIB) and hyperbaric oxygen (HBO) therapy. Efferent methods were used depending on the severity of acute ischemia, intoxication and infection (intoxication - plasmapheresis, ischemia - plasmapheresis + HBO, infections - UVIB, their combination - plasmapheresis + UVIB + HBO). RESULTS: Limb amputation and necrectomy were required only in 2 (1.96%) and 3 (2.8%) patients of the main group, mortality - 0.94% (n=1). In the control group these values were 16 (17.8%), 10 (11.1%) and 7 (7.8%), respectively. CONCLUSION: Efferent methods are effective in patients with traumatic vascular injuries and acute limb ischemia regarding improvement of clinical outcomes and 2-fold reduction of hospital-stay, less number of amputations and decreased mortality rate.

[APPLICATION OF FISTULA PLUG WITH THE FIBRIN ADHESIVE IN TREATMENT OF RECTAL FISTULAS].

Results of surgical treatment of 21 patients, suffering high transsphincteric and extrasphincteric rectal fistulas, were studied. In patients of Group I the fistula passage was closed, using fistula plug obturator; and in patients of Group II--by the same, but preprocessed by fibrin adhesive. The fistula aperture germeticity, prophylaxis of rude cicatrices development in operative wound zone, promotion of better fixation of bioplastic material were guaranteed, using fistula plug obturator with preprocessing, using fibrin adhesive.

A rare case of urinary schistosomiasis in Turkey.

Schistosomiasis is a chronic, parasitic disease and is endemic in some countries, primarily in Africa, Latin America and Asia. In some regions, Schistosoma haematobium is one of the principal causes of haematuria. In Turkey, due to the increasing amount of travel to and from endemic regions, the number of cases is also rising. We report a case of a 22-year-old Nigerian male who was admitted to our hospital with haematuria. Direct microbiological examination revealed S. haematobium eggs in his urine specimen. Schistosomiasis was diagnosed by pathology testing. Schistosomiasis has not been seen frequently in Turkey, and we therefore discuss the epidemiology, treatment options and clinical importance of S. haematobium.

Fluid dynamics of gingiva and gingival health in children with end stage renal failure.

OBJECTIVES: Impaired homeostasis and fluid balance are important physiopathological alterations in patients with chronic renal failure which may adversely affect the fluid dynamics and health status of tissues and organs. There are insufficient data about this phenomenon in periodontal tissues. The aim of this study was to evaluate the fluid dynamics of gingiva in children with end stage renal failure (ESRF), correlating this entity with gingival health in the same patient group. DESIGN: Fifteen paediatric ESRF patients undergoing peritoneal dialysis (test group) and 15 systemically healthy children (control group) who were without periodontitis participated in the study. Fluid dynamics of gingiva were assessed via the gingival crevicular fluid (GCF) volume and tissue osmotic pressure (GOP) levels in the groups. GCF volume was measured using a Periotron 8000, whereas GOP was measured using a digital osmometer. Silness and Löe Plaque index (PI) and, Löe and Silness gingival index (GI) scores were utilized to determine the gingival health status in the study population. RESULTS: There were increases in the GCF volume and GOP of the test group compared to those of the control group (p<0.01). The PI and GI scores were higher in the test group than in the control group (p<0.01). Strong and positive correlations were found between GI and GCF volume, GI and GOP and, GCF volume and GOP in both groups (p<0.01). CONCLUSIONS: Our findings suggest that the fluid dynamics of gingiva may alter in children with ESRF, and this phenomenon may consequently affect the gingival health of these patients.