RESUMO
The article considers issues of necessity of development and implementation of mobile application of patient within the framework of automated system of remote monitoring of human health indicators as a mean of increasing quality of medical care of patients.
Assuntos
Indicadores Básicos de Saúde , Aplicativos Móveis/normas , Monitorização Ambulatorial/normas , Qualidade da Assistência à Saúde/normas , Humanos , Federação RussaRESUMO
RESEARCH OBJECTIVE: Study preoperative and intraoperative risk factors for acute postoperative pancreatitis after surgical treatment of the pancreatic diseases. MATERIAL AND METHODS: Predictive value of the probable preoperative and intraoperative risk factors of the acute postoperative pancreatitis after surgical treatment of the proximal and distal pancreatic cancer were explored and evaluated. Patients were divided at the high risk group and mild risk group using a specially developed formula. RESULTS: Preoperative and intraoperative risk factors of the acute postoperative pancreatitis were detected and had predictive value. Much of the identified preoperative risk factors indirectly or objectively showed morphology and function of the pancreas. The importance at the development of the acute postoperative pancreatitis playing the conditions of sur gical intervention, its volume and features of technology, results of the intraoperative research of the pathological focus and status of the pancreatic tissue. Its risk factors have been ranked to intraoperative risk factors. The Identification of the intraoperative risk factors of the acute postoperative pancreatitis allowed to make correction of the risk of complications determined at the preoperative stage. CONCLUSION: The data on the effect of various technological solutions and surgical tactics to the possibility of the development of the acute postoperative pancreatitis should be considered in predicting the development of complications and in develop the most effective and safe technologies of the surgical treatment of the pancreatic diseases, as well as in optimization of the prevention of the acute postoperative pancreatitis and postoperative complications.
Assuntos
Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/efeitos adversos , Pancreatite/etiologia , Doença Aguda , Amilases/sangue , Colangiopancreatografia Retrógrada Endoscópica , Humanos , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Pancreaticoduodenectomia/métodos , Pancreatite/diagnóstico , Valor Preditivo dos Testes , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , UltrassonografiaRESUMO
In experiments on dogs the exocrine secretion of pancreatic segment graft after its autotransplantation and of pancreatic stamps after proximal resection of the pancreas was investigated. More significant impairment of the exocrine secretion of the pancreas was revealed in animals after pancreatic graft autotransplantation in comparison with animals after the proximal resection of the pancreas. Maintenance of the adaptation of pancreatic exocrine secretion to the nutritional composition of the intestinal contents and "generalized inhibition" of pancreatic exocrine secretion caused by duodenal trypsin infusion was revealed in all groups.
Assuntos
Transplante de Pâncreas/métodos , Pâncreas/metabolismo , Pâncreas/cirurgia , Suco Pancreático/metabolismo , Adaptação Fisiológica/efeitos dos fármacos , Adaptação Fisiológica/fisiologia , Anastomose em-Y de Roux , Animais , Cães , Intestino Delgado/cirurgia , Pâncreas/efeitos dos fármacos , Pâncreas Exócrino/efeitos dos fármacos , Pâncreas Exócrino/metabolismo , Suco Pancreático/química , Suco Pancreático/enzimologia , Transplante Autólogo , Tripsina/farmacologiaRESUMO
Dynamics of cholecystokinin-like, secretin and somatostatin immunoreactivity of blood plasma and extracts of duodenal mucosa, frequency of acute pancreatitis (AP) after the resection of the duodenum was studied on not purebred dogs. Rising of a secretin concentration in blood plasma after the clinoid resection of the duodenum, accompanied by decreasing of its concentration in duodenal mucosa, was revealed. Decreasing of cholecystokinin concentration in a neutral extract was revealed. In 24 hours alter resection of the duodenum AP was observed in 38% of cases, infusion of the lorglumide was reduced the frequency of this complication up to 6.2% (p<0.05).
