RESUMO
The problem of community narcotization, the increase of number of individuals using drugs and other psychic active substances, the shortening of remittance duration of the narcological patients, the increase of the lethal outcomes numbers in patients with various dependencies because of general somatic complications of main disease, the increase of numbers of women involved into drug dependency problems, call for searching new progressive technologies in narcological care management, including the new approaches in the assessment of the effectiveness of implementing activities. The multifactorial analysis application as a methodological evaluation tool is quite relevant nowadays.
Assuntos
Serviços de Saúde Mental/normas , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Feminino , Humanos , Masculino , Federação RussaRESUMO
The facts that the clinical manifestations of alcohol-associated urgent conditions are polymorphic, and that terms traditionally used by doctors to characterize these conditions are diverse, determine objective difficulties in rendering medical aid in such situations. However, the number of urgent alcohol-associated conditions grows every year. Analysis of diagnostic errors demonstrates that 30% of doctor's errors are subjective. Mistaken diagnosis is followed by casual treatment, independently on its cost and length. Treatment of alcohol-associated pathology is prerogative of general practitioners, which makes knowledge of clinical picture, terminology, legal aspects of rendering medical aid, expertise of the ability to work, and therapeutic tactics in urgent alcohol-associated conditions, important to doctors of all specialties.
Assuntos
Intoxicação Alcoólica/terapia , Algoritmos , Tratamento de Emergência/normas , Guias de Prática Clínica como Assunto , Competência Clínica , Tomada de Decisões , Tratamento de Emergência/métodos , Humanos , Índice de Gravidade de DoençaAssuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Embolização Terapêutica , Infusões Intra-Arteriais , Neuroblastoma/tratamento farmacológico , Neoplasias Peritoneais/tratamento farmacológico , Rabdomiossarcoma/tratamento farmacológico , Tumor de Wilms/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Criança , Pré-Escolar , Humanos , LactenteRESUMO
Experience in roentgenovascular interventions was summed up for 14 patients aged 17 to 38 (11 men and 3 women). Indications for them were closed liver damages (6), life-threatening hemorrhage resulting from repeated operations for liver echinococcosis (1), primary hepatocellular cancer (4), liver hemangioma (2), metastases of melanoma to the liver (1). Hemostatic sponge, Gianturco's spiral, 60% glucose solution in combination with aminocaproic acid were used as embolizing agents. Complications were observed in one case. Gall bladder necrosis developed after distal-proximal embolization with a hemostatic sponge and spirals. Roentgenovascular occlusion of the hepatic artery can be used to stop dangerous hemorrhage, in inoperable liver tumors as one of the palliative methods in order to prolong the patient's life; its combination with other therapeutic methods will make it possible to extend indications for its use.
Assuntos
Embolização Terapêutica , Hepatopatias/terapia , Neoplasias Hepáticas/terapia , Adolescente , Adulto , Feminino , Artéria Hepática , Humanos , Neoplasias Hepáticas/secundário , MasculinoAssuntos
Aminocaproatos/administração & dosagem , Ácido Aminocaproico/administração & dosagem , Embolização Terapêutica/métodos , Hemoperitônio/terapia , Artéria Esplênica , Ruptura Esplênica/complicações , Adulto , Criança , Pré-Escolar , Hemoperitônio/etiologia , Humanos , Infusões Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Pré-MedicaçãoAssuntos
Embolização Terapêutica/métodos , Doenças Urológicas/terapia , Adolescente , Adulto , Idoso , Artérias , Criança , Pré-Escolar , Embolização Terapêutica/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Doenças Urológicas/complicaçõesRESUMO
Under analysis is the authors' experience with roentgen-endovascular occlusions (REO) in 18 patients with closed injuries of the abdomen with massive hemorrhage. The embolization of spleen vessels was made in 8 patients, hepatic vessels--in 5 patients, renal vessels--in 3 patients and iliac artery branches--in 2 patients. In 10 cases REO was used as an independent method for arrest of hemorrhage and in 8 patients--for the preoperative preparation of the patients. The home hemostatic sponge was used in combination with superselective administration of the aminocaproic acid as the embolizing material.
Assuntos
Traumatismos Abdominais/complicações , Embolização Terapêutica , Hemoperitônio/terapia , Adolescente , Adulto , Idoso , Angiografia , Criança , Feminino , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/etiologia , Artéria Hepática/lesões , Humanos , Artéria Ilíaca/lesões , Pessoa de Meia-Idade , Artéria Renal/lesões , Artéria Esplênica/lesõesAssuntos
Angiografia , Radiografia Abdominal , Traumatismos Abdominais/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , MasculinoRESUMO
On the basis of 87 urgent angiographies in 65 patients the diagnosis of injuries of parenchymatous organs is described. The patients are divided into 4 groups: 1-contusion of the organ, 2-subcapsular and central hematomas, 3-transcapsular ruptures and fragmentation of the organ, 4-multiple injuries. Urgent angiography helps to make the exact diagnosis, to establish the character of injuries and to choose the method of treatment of the patients and the operation technique.
