RESUMO
The results of dynamic microbiological investigation, conducted in 37 patients, suffering diabetic foot syndrome (DFS) during 2008-2009 yrs period, were presented. There were 103 investigations made and 169 species of microorganisms revealed. The microflora structure of surgical infection in patients with DFS was presented by S. aureus (42.85%), P. aeruginosa (32.09%), E. coli (7.66%), S. pyogenes (7.16%), Enterobacteriaceae aerogenes (6.3%), E fecales (1.97%), E. cloacae (1.97%). S. aureus have shown resistance towards ceftriaxone (66.7%), lincomycine (75%), cyprofloxacine (58.3%); P. aeruginosa--towards cephoperazone (100%), amicacine (66.6%), vancomycine (89.9%), cyprofloxacine (87.8%), imipenem (87.8%). Enterobacteriaceae are resistant towards cefuroxym (60%) and amicacine (80%).
Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/microbiologia , Pé Diabético/patologia , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Idoso , Antibacterianos/farmacologia , Diabetes Mellitus Tipo 1/microbiologia , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/microbiologia , Diabetes Mellitus Tipo 2/patologia , Farmacorresistência Bacteriana Múltipla , Feminino , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Humanos , Masculino , Testes de Sensibilidade MicrobianaAssuntos
Aneurisma/cirurgia , Artéria Esplênica/cirurgia , Aneurisma/diagnóstico por imagem , Aneurisma/patologia , Cistos/diagnóstico por imagem , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Artéria Esplênica/diagnóstico por imagem , Artéria Esplênica/patologia , Esplenopatias/diagnóstico por imagem , Esplenopatias/cirurgia , Resultado do Tratamento , UltrassonografiaRESUMO
The simulation model of an acute pancreatitis (AP), using translocation of microorganisms from intestine to ductal system and pancreatic tissue, was created in experiment on dogs. Interrelationships between pancreatic tissue and anaerobic microorganism in an AP were studied, using electron microscopy. Possibility of the microorganisms migration to pancreas from ductal system in early stage of AP due to enhanced reproduction of anaerobic microorganisms in duodenum was established. It is impossible to exclude the possibility of their invasion via the lymph and the blood flow into destructively changed pancreatic tissue in late terms of the disease.
Assuntos
Bactérias Anaeróbias/patogenicidade , Pancreatite Necrosante Aguda/microbiologia , Animais , Bactérias Anaeróbias/fisiologia , Bactérias Anaeróbias/ultraestrutura , Translocação Bacteriana/fisiologia , Modelos Animais de Doenças , Cães , Microscopia Eletrônica , Pancreatite Necrosante Aguda/patologia , Esporos Bacterianos/fisiologia , Esporos Bacterianos/ultraestruturaRESUMO
The results of treatment of 295 patients with complicated chronic pancreatitis (CP) for period from 1996 to 2000 yr were presented. CP without the ducts dilatation was revealed in 37 patients, ductal hypertension--in 19, calcinose fibrous-degenerative CP--in 73, cystic form of CP--in 142, CP in combination with external pancreatic fistula--in 24. Frequency of the complications occurrence in various forms of CP--the obstructive jaundice and cholangitis--was analyzed. Complex approach to the choice of tactic of the operation performance was proposed, application of additional methods of sorptional and immune therapy, depending on the CP form, complicated by the obstructive jaundice and cholangitis, was substantiated.
Assuntos
Colangite/etiologia , Colestase/etiologia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Pancreatite/complicações , Pancreatite/cirurgia , Adulto , Doença Crônica , Feminino , Humanos , MasculinoRESUMO
Estimation of possibilities of dynamic ultrasonic investigation and transcutaneous echocontrolled interventions in diagnosis of various forms of an acute pancreatitis and its complications while examination of 283 patients was conducted. High efficacy of echography and of transcutaneous interventions in early diagnosis of the disease was proved.
Assuntos
Cisto Pancreático/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Doença Aguda , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cisto Pancreático/complicações , Pancreatite/complicações , UltrassonografiaAssuntos
Citocinas/fisiologia , Pancreatite/imunologia , Doença Aguda , Progressão da Doença , HumanosRESUMO
In 46 patients with an destructive acute pancreatitis (AP) the invasive intervention under control of ultrasonography, in 38 of them--in stage of purulent complications, was performed. It had promoted stabilization of state in 39 (89.8%) patients, normalization of clinic--laboratory indexes, that had permitted to realize radical operative intervention with minimum risk in perspective. Invasive intervention under control of ultrasonography--highly effective primary surgical manipulation in complex of treatment of the destructive AP severe forms.
Assuntos
Pancreatite Necrosante Aguda/diagnóstico por imagem , Pancreatite Necrosante Aguda/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite Necrosante Aguda/diagnóstico , Índice de Gravidade de Doença , Pele , Sucção/métodos , UltrassonografiaRESUMO
The electron-microscopical investigation of the pancreatic gland necrosis region had permitted to determine the organ inflammation character.
Assuntos
Pâncreas/ultraestrutura , Pancreatite Necrosante Aguda/patologia , Humanos , Microscopia Eletrônica/métodosRESUMO
The paper analyzes experience gained with the use of Sandostatin in patients with a surgical operation-induced pathology of pancreas. Sandostatin is known to be capable of suppressing the exocrine activity of pancreas, which fact made for decline in the recordable postoperative complications and improvement of results of surgical treatment. The maiden experience gained with its use showed high efficacy of Sandostatin in a multimodality treatment of patients presenting with surgical pathology of pancreas.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Insulinoma/tratamento farmacológico , Octreotida/uso terapêutico , Neoplasias Pancreáticas/tratamento farmacológico , Terapia Combinada , Avaliação de Medicamentos , Humanos , Insulinoma/cirurgia , Pâncreas/efeitos dos fármacos , Pâncreas/metabolismo , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias/prevenção & controleRESUMO
New principle of choice of the surgical treatment method in patients with necrotic pancreatitis was proposed: different operative procedures don't compete one another but are applied in accordance with the disease stage in dynamics. Such tactics permits to choose an optimal surgical approach in every phase of pathologic process course. From 1989 till 1992 the surgical treatment for necrotic pancreatitis was conducted to 54 patients. Pancreatic resection was done to 14 (25.9%) of patients, 4 of whom died. In necrotic focus delimitation or pancreatic tissue sequestration, observed in terms of more than 2 weeks since the disease beginning, necrectomy was conducted in 40 (74.1%) of patients, 4 of whom died.
Assuntos
Pancreatite/cirurgia , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Necrose , Pâncreas/patologia , Pâncreas/cirurgia , Pancreatectomia , Pancreatite/patologia , Fatores de TempoRESUMO
Results of dynamic investigation of beta-endorphins and hormonal state were analysed in 34 patients with pancreonecrosis aged from 23 to 54 years. The dependency of this indexes on the severity of clinical course and presence of complications was determined. The correction ways of injurious action of stress-reaction in pancreonecrosis were proposed.
Assuntos
Endorfinas/sangue , Hormônios/sangue , Pancreatite/fisiopatologia , Estresse Fisiológico/fisiopatologia , Corticosteroides/sangue , Adulto , Peptídeo C/sangue , Feminino , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Necrose , Pancreatite/sangue , Hormônios Hipofisários/sangue , Radioimunoensaio , Hormônios Tireóideos/sangueRESUMO
The reversibility of the changes in the common bile duct after elimination of mechanical obstruction and its adequate drainage in patients with choledocholithiasis was studied. A programmed system of prognostication permitting to choose the optimal type of operative intervention with regard for the sizes of the common bile duct after correction has been developed.
Assuntos
Cálculos Biliares/cirurgia , Colestase/cirurgia , Ducto Colédoco/cirurgia , Drenagem , Duodeno/cirurgia , Cálculos Biliares/diagnóstico , Humanos , Prognóstico , Esfíncter da Ampola Hepatopancreática/cirurgiaRESUMO
Data of performing partial resections of head of the pancreas in 29 patients are described. Depending on the state of the pancreas it is possible to perform external drainage of the major pancreatic duct of the distal stump followed by its delayed occlusion, to form pancreatoenteroanastomosis or recanalization of the duct using a small intestine segment. The partial resections are less traumatic operations and give less amount of postoperative complications.