RESUMEN
An intratissual electrical stimulation, accompanied by irritation of their central neurons, is used to recover the function of damaged peripheral nerves. Treatment results exceeded those with the use of cutaneous electrical stimulation, which is confirmed by comparative results of trial animal experiments. The time and quality of peripheral nerves' function recovery in comparison of intratissual and cutaneous electrical stimulation methods remain unknown. OBJECTIVE: To evaluate the time and quality of peripheral nerves' functions recovery after their suturing and conducting two different methods of electrical stimulation, namely intratissual and cutaneous, in projection of central neurons of damaged spinal nerves in the postoperative period. MATERIAL AND METHODS: The basic technical parameters of the method of peripheral nerves' functions recovery in the postoperative period were ptacticed. Postoperative rehabilitation treatment was performed in 77 patients with traumatic peripheral nerves' injuries at the level of the forearm: in 42 with intratissual electrical stimulation, in 35 - using cutaneous one with similar characteristics of electrical current and concomitant pharmacological therapy. The follow-up duration was 2 years. RESULTS: A significant (in 4-6 times) reduction in time of treatment and a greater improvement in qualitative indicators when using intratissual electrical stimulation compared to the use of cutaneous stimulation were obtained. The effectiveness of the restorative therapy was dependent on the number of procedures, and a complete recovery of the damaged peripheral nerves' functions was observed after three courses of intratissual electrical stimulation. CONCLUSION: The time and degree of recovery of peripheral nerves' functions depends on the functional activity of their central neurons at the level of the spinal cord. The activation of these neurons by low-frequency electrical current allows to activate their trophic function. Thus, the cutaneous electrical stimulation does not cause the necessary level of irritation of the neurons due to the fact that the skin is a barrier to electrical current, which reduces its impact in 200-500 times. The intratissual electrical stimulation allows to solve the problem by supplying the needle-electrode much closer to the «target¼. The proposed method of intratissual electrical stimulation has shown its advantage over cutaneous electrical stimulation, significantly reducing the duration of the restorative treatment and increasing its qualitative indicators.
Asunto(s)
Nervios Periféricos , Humanos , Masculino , Femenino , Nervios Periféricos/fisiología , Adulto , Traumatismos de los Nervios Periféricos/rehabilitación , Traumatismos de los Nervios Periféricos/terapia , Traumatismos de los Nervios Periféricos/fisiopatología , Terapia por Estimulación Eléctrica/métodos , Recuperación de la Función/fisiología , Persona de Mediana EdadRESUMEN
Gastrointestinal haemorrhage is a common cause of emergency admission of patients to surgical hospitals. Within the structure of nosological entities, not unreasonably referred to the rarest causes of gastrointestinal bleeding is the formation of an aortointestinal fistula whose early diagnosis is of paramount importance. The clinical picture may be different but it is mostly represented by gastrointestinal haemorrhage. The incidence of gastrointestinal fistulas following a surgical intervention ranges from 0.6 to 2.3%. Unless timely diagnosed and with incorrect therapeutic decision-making, the mortality rate amounts to 90%. In this article we present a clinical case report regarding successful treatment of a patient presenting with a secondary aortoduodenal fistula occurring 5 years after previously performed aortofemoral bypass grafting and complicated by relapsing intestinal bleeding and acute ischaemia of the right lower extremity.
Asunto(s)
Enfermedades de la Aorta/diagnóstico , Enfermedades Duodenales/diagnóstico , Enfermedades Duodenales/etiología , Enfermedades Duodenales/cirugía , Fístula Intestinal/diagnóstico , Fístula Intestinal/etiología , Fístula Intestinal/cirugía , Aorta Abdominal , Hemorragia Gastrointestinal/diagnóstico , HumanosRESUMEN
Obliterating diseases of the lower extremity arteries occupy a high proportion in the structure of cardiovascular morbidity in the population among the developed countries. The steadily progressing course of obliterating atherosclerosis leads to the critical lower limb ischemia and causes an unfavorable prognosis for preserving the extremity, as well as the patient's life. Nowadays, there are two ways of surgical management of this pathology: endovascular and open reconstructive interventions. The choice of the method is based on a comprehensive keeping of the patient-specific records, including the anatomical characterization of the arterial bed lesions. In case of extended occlusion of the superficial femoral artery, the open reconstructive surgery using a large saphenous vein as a transplant is recommended. This circumstance is confirmed by the autovein patency in the long term compared with a synthetic prosthesis according to the results of randomized clinical trials. Therefore, with the formation of a distal anastomosis below the gap of the knee joint, the patency of the autovein and synthetic prosthesis after 5 years is 71% and 44% respectively. In this article, we represent a clinical case of successful treatment of a patient with progression of atherosclerotic lesions of the infrainguinal segment arteries. A staged revascularization of the femoral-popliteal segment arteries using technique of a reversed vein on both lower extremities after attempts of the conservative treatment and x-ray endovascular intervention was performed. A feature of this case is the creation of a new bifurcation of the popliteal artery during the formation of a distal anastomosis below the fissure of the knee joint under the contitions of a high discharge of the anterior tibial artery.The given clinical case demonstrates the advantages of invasive surgical tactics with the aim of preserving the limb and improving the patient's quality of life.
Asunto(s)
Aterosclerosis , Extremidad Inferior , Grado de Desobstrucción Vascular , Humanos , Arteria Poplítea , Calidad de Vida , Resultado del TratamientoRESUMEN
BACKGROUND: Interstitial electrostimulation (IES) is used to treat spinal pain syndromes. The phenomena occurring in tissue around the electrode that is connected to a vertebra remain unknown. AIM: To reveal the mechanisms of action of IES on inflammatory and dystrophic phenomena and blood flow in osseous and paravertebral tissues in low back pain syndrome. METHODS: Examinations were made in 64 patients with back pain of vertebral genesis in an exacerbation or incomplete remission with intervertebral disc protrusions. Two homogeneous groups of patients treated with different techniques of electrotherapy were identified. A study group was treated with IES, in which the active electrode as a sterile injection needle was brought into the focus of pathology in contact with the diseased vertebra. A control group received a cutaneous procedure with a 50 Hz current with the same physical parameters. Blood flow in the bone and the adjacent tissues and the intensity of pain syndrome were studied. That in the vertebrae was investigated using needle-rheography and polarography. RESULTS: The intensity of pain depends on circulatory disturbances affecting the vertebral tissues, where a focus of inflammation is formed with signs of free radicals, acidosis, and edema. IES could relieve pain in 90.5% of patients. At the same time, blood circulation in the vertebral tissues considerably improved. Cutaneous electrostimulation was not found to have a substantial effect. The result of the therapeutic effect can be explained by electrochemical phenomena in the plasma from the vessels in the focus of inflammation and by electrophysical processes on the cell membranes of the tissue around its anode introduced. CONCLUSION: IES is a pathogenetic treatment. In this case, the active anode electrode must be inserted into the focus of pathology, resulting in a contact with the diseased vertebra.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Dolor de la Región Lumbar/terapia , Humanos , Columna Vertebral , Resultado del TratamientoRESUMEN
The article deals with the analysis of biochemical and morphological alterations in the functional state of the endothelium of laboratory animals after a reconstructive surgical intervention on the abdominal aorta. These alterations were assessed at various terms following operative treatment in the comparison group and intact control group. The authors carried out of computer-assisted morphometry of the reconstruction zone on histological preparations for correct interpretation of the biochemical alterations and assessment of the correlation between the studied biochemical indices in blood and the arterial wall.
Asunto(s)
Aorta Abdominal/cirugía , Enfermedades de la Aorta/cirugía , Biomarcadores/metabolismo , Endotelio Vascular/patología , Procedimientos de Cirugía Plástica , Animales , Aorta Abdominal/metabolismo , Aorta Abdominal/patología , Enfermedades de la Aorta/metabolismo , Enfermedades de la Aorta/patología , Gatos , Modelos Animales de Enfermedad , Endotelio Vascular/metabolismo , HiperplasiaRESUMEN
Prostate cancer is one of the most common malignancies among males. 125I brachytherapy is a current, effective, comparatively safe, and easy-to-reproduce treatment. The Russian X-ray Radiology Research Center has implanted 125I microsources in patients with localized and locally advanced prostate cancer since 2003; 689 125I implantations were performed in the past year. Tumor-specific survival after brachytherapy did not differ greatly from that following radical prostatectomy. Thus, brachytherapy is a current high-tech treatment for prostate cancer. This therapy shows fewer adverse postradiation effects than radiation teletherapy.
Asunto(s)
Braquiterapia/métodos , Radioisótopos de Yodo/uso terapéutico , Neoplasias de la Próstata/radioterapia , Humanos , Masculino , Resultado del TratamientoRESUMEN
The serum levels of some indices of the LPO antioxidant system (dienic conjugates, antioxidative activity), cytokines (IL-1beta, TNF-alpha, IL-4) and the blood antiprotease system protein alpha2-macroglobulin were studied in 97 patients with closed long bone fractures. Based on the finding, a procedure was devised to evaluate the course of an inflammatory process in the early postoperative period, which predicted the development of pyoinflammatory complications at a stage of preclinical manifestations.
Asunto(s)
Antioxidantes/metabolismo , Citocinas/sangre , Fracturas Óseas/sangre , Inflamación/sangre , Inflamación/diagnóstico , Adulto , Femenino , Fracturas Óseas/complicaciones , Fracturas Óseas/diagnóstico , Fracturas Óseas/cirugía , Humanos , Inflamación/etiología , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/diagnóstico , Periodo PosoperatorioRESUMEN
An investigation of the content of interleukins (IL-1alpha, IL-4) in blood serum, indices of the system of "LP-antioxidants" (DC, AOA) was performed in 92 patients with open fractures of long tubular bones. A method of early diagnosis of purulent complications in the postoperative period was worked out which allows timely necessary correction to be introduced in the plans of treatment.
Asunto(s)
Fijación de Fractura/métodos , Fracturas Óseas/cirugía , Fracturas Abiertas/cirugía , Infección de la Herida Quirúrgica/diagnóstico , Fracturas del Fémur/cirugía , Estudios de Seguimiento , Humanos , Fracturas del Húmero/cirugía , Estrés Oxidativo , Pronóstico , Fracturas del Radio/cirugía , Supuración , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/metabolismo , Fracturas de la Tibia/cirugíaAsunto(s)
Citocinas/sangre , Fracturas Abiertas/diagnóstico , Infección de la Herida Quirúrgica/diagnóstico , Absceso/complicaciones , Absceso/diagnóstico , Absceso/inmunología , Adulto , Algoritmos , Celulitis (Flemón)/complicaciones , Celulitis (Flemón)/diagnóstico , Celulitis (Flemón)/inmunología , Extremidades/lesiones , Femenino , Fracturas Abiertas/complicaciones , Fracturas Abiertas/inmunología , Humanos , Masculino , Persona de Mediana Edad , Osteomielitis/complicaciones , Osteomielitis/diagnóstico , Osteomielitis/inmunología , Periostitis/complicaciones , Periostitis/diagnóstico , Periostitis/inmunología , Valor Predictivo de las Pruebas , Pronóstico , Infección de la Herida Quirúrgica/inmunologíaRESUMEN
Under study was the influence of cytomedins on the system of immunity in patients with developed surgical infection in a traumatology clinic. The investigation of immune reactions under conditions of purulent infection of different etiology has shown the necessity to include the up-to-date and purposeful immunomodulating therapy (cytomedins) in the complex of treatment which allows arrest of the inflammatory process in the wound in earlier terms.
Asunto(s)
Péptidos/inmunología , Péptidos/uso terapéutico , Infección de la Herida Quirúrgica/tratamiento farmacológico , Cicatrización de Heridas/efectos de los fármacos , Adolescente , Adulto , Antiulcerosos/uso terapéutico , Terapia Combinada , Femenino , Humanos , Masculino , Infección de la Herida Quirúrgica/inmunología , Infección de la Herida Quirúrgica/terapia , Factores de Tiempo , Resultado del Tratamiento , Cicatrización de Heridas/inmunologíaRESUMEN
Effect of tissue ischemia on immunity was studied in patients with developing surgical infection after injuries. Tissue hypoxia is one of the factors promoting the formation of immunity failure. Study of the course of immune reactions under conditions of hypoxia in suppurative infection of different etiology opens new diagnostic criteria and demonstrates the necessity of a differentiated approach to immunomodulating therapy of patients with local and total surgical infections of different etiology.
Asunto(s)
Hipoxia/inmunología , Infección de la Herida Quirúrgica/inmunología , Linfocitos B/patología , Femenino , Humanos , Hipoxia/complicaciones , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Recuento de Leucocitos , Masculino , Supuración , Infección de la Herida Quirúrgica/complicaciones , Linfocitos T Colaboradores-Inductores/patología , Linfocitos T Reguladores/patologíaAsunto(s)
Peces/anatomía & histología , Peces/fisiología , Homeostasis/fisiología , Riñón/fisiología , Riñón/ultraestructura , Ósmosis/fisiología , Animales , Calcio/sangre , Calcio/metabolismo , Calcio/orina , Peces/clasificación , Agua Dulce , Branquias/citología , Branquias/fisiología , Mucosa Intestinal/metabolismo , Riñón/citología , Túbulos Renales/fisiología , Túbulos Renales/ultraestructura , Magnesio/sangre , Magnesio/metabolismo , Magnesio/orina , Nefronas/fisiología , Nefronas/ultraestructura , Concentración Osmolar , Presión Osmótica , Potasio/sangre , Potasio/metabolismo , Potasio/orina , Agua de Mar , Sodio/sangre , Sodio/metabolismo , Sodio/orina , Especificidad de la EspecieRESUMEN
The qualitative spectrum of laboratory tests and the share of positive results of the main tests were assessed at laboratories of two large multi-profile treatment-and-prophylaxis hospitals in the city of Chita. Studies of pigment and carbohydrate metabolism predominate (25.2 and 23.1%). Other frequent tests were assessment of blood enzymes (18.4%) and of protein (9.3%) and mineral (6.1%) metabolism. The share of improperly performed tests was 22.8%. The authors propose to improve the quality of laboratory studies by ruling out the "unnecessary" tests.
Asunto(s)
Laboratorios de Hospital/normas , Control de Calidad , SiberiaRESUMEN
The authors propose a new kind of conservative treatment-the intratissue electrostimulation when electric current is brought directly to the pathology focus. An analysis of results of clinical and biomechanical examination of 72 patients of the main and control groups allowed a conclusion to be made concerning high effectiveness of the new kind of therapy which makes the terms of treatment 2 times shorter. Mechanisms of curative effects reestablishing blood circulation and metabolism in the joints are studied.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Osteoartritis/rehabilitación , Adulto , Anciano , Fenómenos Biomecánicos , Terapia Combinada , Terapia por Estimulación Eléctrica/instrumentación , Electrodos , Estudios de Evaluación como Asunto , Humanos , Persona de Mediana Edad , Agujas , Osteoartritis/fisiopatología , Factores de TiempoRESUMEN
Blood plasma protein fractures of the acute phase of inflammation are thought to be a sensitive test for diagnosing the activity of the inflammatory process. Their indicators can be used for control of therapy and in prognosing of the appearance of adhesive disease in the patient after recovery from peritonitis.
Asunto(s)
Peritonitis/complicaciones , Complicaciones Posoperatorias/etiología , Enfermedad Aguda , Adulto , Apendicitis/complicaciones , Apendicitis/cirugía , Biomarcadores/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Peritonitis/etiología , Peritonitis/cirugía , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/diagnóstico , Pronóstico , Adherencias Tisulares/sangre , Adherencias Tisulares/diagnóstico , Adherencias Tisulares/etiologíaRESUMEN
The authors propose the new therapeutical technique of intraosseous electrostimulation for arthrosis deformans. The technique consists in that electric current is applied just to the area of joint lesion. It is highly effective, halves the period of therapy, reduces the frequency of relapses.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Osteoartritis/rehabilitación , Terapia Combinada , Terapia por Estimulación Eléctrica/instrumentación , Estudios de Evaluación como Asunto , Estudios de Seguimiento , Humanos , Articulación de la Rodilla , Agujas , Osteoartritis/epidemiología , Osteoartritis de la Cadera/epidemiología , Osteoartritis de la Cadera/rehabilitación , Recurrencia , Inducción de RemisiónRESUMEN
For the estimation of the intoxication degree an analysis of dynamics of the level of medium-sized molecules (LMM) in blood serum was made in 71 patients with purulent wounds in different courses of the wound process. The results obtained were compared with the parameters of bacteriological and cytological characteristics. It was found that the 1.5 times elevation of LMM with values up to 0.380 units spoke of the compensated degree of intoxication with the following favourable course and disappearance by the 5th day of the postoperative period. While the 2-3 times elevation of LMM parameters--up to 0.710 units lies outside the limits of compensatory potentialities and complex antibacterial therapy normalized them by the 9th day. The comparison of dynamics of the parameters studied shows their clear correlative relationship.
Asunto(s)
Péptidos/sangre , Infección de Heridas/sangre , Absceso/sangre , Absceso/microbiología , Celulitis (Flemón)/sangre , Celulitis (Flemón)/microbiología , Femenino , Humanos , Sustancias Macromoleculares , Mastitis/sangre , Mastitis/microbiología , Peso Molecular , Factores de Tiempo , Infección de Heridas/microbiologíaRESUMEN
Components of the intracellular mediators system: calmodulin in leukocytes, Ca2+ and cyclic nucleotides in leukocytes and blood plasma were studied in children with attack of bronchial asthma and heart failure. Alterations in content of these biologically active substances correlated with clinical manifestations of bronchial asthma: severity of the disease, duration of the attack, contractile activity of myocardium. Calmodulin, Ca2+ and cyclic nucleotides were demonstrated to be involved in development of the asthmatic attack. Alterations in the system calmodulin-Ca2+ were related to adaptation and contributed to realization of regulating effects responsible for a decrease of impairments in tissues.
Asunto(s)
Asma/metabolismo , Cardiopatías/complicaciones , Sistemas de Mensajero Secundario , Adolescente , Asma/complicaciones , Calcio/sangre , Calmodulina/sangre , Cationes Bivalentes , Niño , Preescolar , AMP Cíclico/sangre , GMP Cíclico/sangre , Humanos , Leucocitos/químicaRESUMEN
A new method of regional electrostimulation by means of influencing with low-intensity and frequency rectangular impulse current upon the sympathetic trunk in combination with a purulent wound treatment by the low-frequency ultrasound in the liquid media of tomicide contributes to significant enhancing the effectiveness of treatment of the patients, 2-fold shortening of a hydratation phase duration, rapid stabilization of general state of the patients. No side effects and complications were noted in performance of electrostimulation.
Asunto(s)
Traumatismos del Brazo/complicaciones , Terapia por Estimulación Eléctrica/métodos , Ganglios Simpáticos , Traumatismos de la Pierna/complicaciones , Mastitis/terapia , Terapia por Ultrasonido , Infección de Heridas/terapia , Terapia Combinada , Femenino , Humanos , Cicatrización de Heridas , Infección de Heridas/etiologíaRESUMEN
Overall 995 children with different somatic chronic diseases were examined for viral hepatitis B markers demonstration using up-to-date highly sensitive methods (hemagglutination inhibition test, EIA). In the control group (children with acute intestinal infections), HBV-infection markers were discovered in 4.3%. Children with diabetes mellitus (13.1%), chronic renal diseases (18.9%), pulmonary diseases (32.8%), bronchial asthma (33.3%) and hemophilia (85.2%) are attributed to the group at greater risk for HBV infection. As a rule, the rate of HBV-infection markers demonstration in chronic somatic diseases was higher in considerable duration of the underlying illness. The overwhelming majority of the children examined had suffered subclinical forms of HBV-infection as shown by the disease history, whereupon they manifested antibodies against HBV antigens. HBs-antigenemia, that persisted for a long time (chronic HBV-infection) was demonstrable far less frequently. The authors provide evidence for the necessity of carrying out a broad-scale screening of HBV-infection markers in the indicated risk groups and vaccination against hepatitis B in children without HBsAG and without immunity to viral hepatitis B. The importance of measures aimed at preventing infections transmitted via blood is emphasized.