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Biomedical subjects

A F Darenkov

Publications and source records attributed to A F Darenkov.

At least 37 records · Page 2Linked to original sources

[The role of the phenomenon of the redistribution of aminoglycosides in their monitoring and dosage calculation in patients in the terminal stage of kidney failure undergoing systematic hemodialysis treatment].

The kinetics of aminoglycosides (amikacin, netilmycin, gentamicin, tobramycin) were investigated in patients with end-stage renal disease who were on systemic hemodialysis. Their decrease in the blood revealed in pre-dialysis and dialysis periods was exponential. After dialysis termination there was a gradual aminoglycoside increase as compared to the end-dialysis period, which was of linear character and depended on the degree of these agents' dialysis clearance. The cause of the phenomenon is likely to be higher aminoglycoside blood elimination rate than their entering the blood from tissues. A method is proposed to calculate an additional dose of aminoglycosides, taking into account their higher concentrations in the postdialysis period, under permanent monitoring of their blood levels.

Aminoglycosides↗

[The radionuclide assessment of the central hemodynamic indices in patients with urolithiasis, arterial hypertension and varicocele].

Basic parameters of central and intracardiac hemodynamics were studied in 49 urological patients 24 of which with urolithiasis entered group I, 13 with hypertension-group II and 12 with varicocele-group III. The patients' age averaged 46.4, 41.6 and 28.6 years, respectively. The data were provided by routine clinical and laboratory examinations, ECG, one-passage radionuclide cardiography with 132I-albumin using a radiocirculographer of Hungarian manufacture and radiocardioanalyzer RKAZ-01 made in this country. Neither marked ischemic disturbances of the myocardium nor valvular defects were revealed. Ambiguous group-specific shifts presented in central and intracardiac hemodynamics. Total peripheral vascular resistance exhibited a moderate increase while left ventricular circulation time grew 1.5-2-fold. The greater resistance can be attributed to activation of renin-angiotensin system in prolonged ischemia of renal parenchyma due to nephrolithiasis. Group II patients demonstrated parallel elevation of arterial pressure, peripheral resistance, left ventricular performance and output suggesting myocardial functional stress. In group III there was a rise in blood volume, left ventricular performance and output, cardiac index, stroke volume. This myocardial overloading may result from changes in intravascular volumetric relations characteristic of hypervolemia. These hemodynamic changes reflect adaptation in urological patients and should be accounted for in treatment and operative interventions.

Adult↗

[Ultrasonic examination in the diagnosis of closed trauma to the kidney].

Ultrasonic investigations (USI) were used in the diagnosis of closed renal injuries in 59 patients (51 males and 8 females) aged from 17 to 65 years. The lesion of the right kidney was diagnosed in 35 (59.3 per cent) patients, the left kidney was affected in 24 (40.7 per cent) of examinees. In 2 persons the injury of the kidney was combined with the lesion of the urinary bladder. According to USI results, the patients with suspected closed trauma were enrolled in 4 groups: persons with an intact renal parenchyma, fibrous capsula and pelvicaliceal renal system (the contusion of the kidney); persons with normal ultrasonic picture of the kidney and the presence of intermuscular hematoma; those with subcapsular hepatoma; and those with pararenal hematoma. USI technique turned to be high-informative in the diagnosis of the occult renal injuries and permitted evaluating the structure of the kidney, the character and degree of the lesion and following up the status of the compromised organ during the conservative treatment.

Adolescent↗

[A comparative evaluation of the central hemodynamic indices in patients with the terminal stage of kidney failure during dialysis therapy and allografting].

Changes of the functional indices of central and intracardiac hemodynamics during treatment with hemodialysis or peritoneal dialysis, as well as after cadaver kidney transplantation, were studied in 44 patients with the terminal stage of chronic renal failure by means of radiocardiography with 131I-albumin. The signs of cardiac insufficiency were evaluated according to the classes of the cardiologists' New York classification accepted in 1964. Four groups of patients were distinguished during the analysis: group 1-10 patients given intravenous detoxification therapy; group 2-19 patients treated by chronic programmed hemodialysis; group 3-4 patients kept on peritoneal dialysis; group 4-11 patients after allotransplantation of cadaver kidney. It was found that in group 1 patients the indices of central (mean arterial pressure, cardiac and stroke indices, total peripheral vascular resistance, work of the left ventricle) and intracardiac (time of circulation of blood in the heart cavities and lungs) hemodynamics were on the upper normal values and in occasional cases exceeded it. In patients of group 2 the indices of intracardiac hemodynamics grew worse and required an individual approach to the hemodialysis regimens with due account for the volemic disorders. In group 3 some indices of central and intracardiac hemodynamics corresponded to those in group 2, but the circulation volume, and mean arterial pressure were normal, which was reflected by better subjective tolerance to peritoneal dialysis. Analysis of indices in group 4 patients showed improvement of normalization of most parameters of central and intracardiac hemodynamics with gradual increase of diuresis, and abatement of the clinical signs of cardiac insufficiency after successful transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined Modality Therapy↗

[Transurethral electroresection in chronic prostatitis and its complications].

A discussion on possible application of endoscopic surgery for the treatment of chronic prostatitis and its complications is presented. Surgical treatment was performed in 102 patients with chronic prostatitis and isolated or combined prostatic lesions. Most patients were aged 40 to 69 years. Conservative treatment had been ineffective for an average of 5 years. All patients were divided into 6 clinical groups. The most numerous one included patients with chronic prostatitis, complicated by sclerosis of the vesical cervix. Careful patient selection was based on the use of all available up-to-date diagnostic procedures. Principal indications for transurethral electroresection were infravesical obstruction, complicating the underlying disease; persistent pain and dysuria, uncontrollable by conservative means and exhausting the patient, as a result of prostatic retention or calculous or sclerotic complications. Two principal surgical methods were transurethral and subtotal prostatic resection. Possibilities of ultrasonic scanning in the diagnosis of prostatic retention are pointed out. Complication rates and types and surgical results are reported. The results were good in 55%, satisfactory in 36% and poor in 9%. The effect of surgery on sexual capacity is described.

Adult↗

[The role of a sanatorium-health resort factor in the complex treatment of patients with chronic prostatitis].

The results of two-step treatment of 62 patients with chronic prostatitis are presented. The first-step treatment was given at the clinic of the Urologic Research Institute of the RSFSR Ministry of Health, and the second step was completed at the Zheleznovodsk Urologic Clinic of the Pyatigorsk Research Institute of Health Resort Treatment and Physiotherapy. In addition to its medical aspect, treatment for chronic prostatitis has significant social implications, as chronic prostatitis mostly affects males of young or middle age, with the inflammation persisting for long periods of time and leading to sexual and reproductive disorders as well as psychoneuroses. Since chronic prostatitis is regarded as an inflammatory disease of infectious-immunologic etiology, with both parenchymal and interstitial tissues of the prostatic gland affected, the patients underwent antibacterial treatment, adjusted to the causative agent's sensitivity to antibacterial drugs, and the availability of physiotherapeutic procedures in hospital as the first stage of treatment. Those to whom further rehabilitation was indicated were referred to the Zheleznovodsc Urologic Clinic where they were given a treatment course making use of the natural factors: oral and external administration of mineral waters of the Smirnovsky and Slavyanovsky springs, mud treatments and physiotherapy where indicated. Treatment was designed to improve microcirculation in prostatic tissues, and used natural factors, capable of normalizing and activating systemic protective potentials. There were good results (considerably improved general condition, both subjectively felt and objectively documented) in 78%.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗

[Effect of intensive physical loads on renal function].

The purpose of the study was to evaluate the extent of renal functional disorders, developing in response to muscular exercise of varying intensity and duration in 64 professional athletes, aged 17 to 26 years. Comparative characteristics of 131I-hippuran kinetics through the urinary tract both at rest and after "acute" (single) and chronic (many years') physical exercise are obtained. There was a direct relationship between effective renal blood flow and the magnitude of muscular exercise. It is demonstrated that post-exercise renal changes disappear without trace, while individuals, exposed to extreme muscular stress for long periods of time, i.e. the professional athletes, may develop irreversible functional changes. Impaired renal function can hardly be attributed to the emergence of yet another compensatory mechanism, for such notions as 'compensation' and "persistent impairement of functional potentials of an organ" are mutually exclusive.

Adolescent↗