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Biomedical subjects

A N Shcherbiuk

Publications and source records attributed to A N Shcherbiuk.

At least 19 recordsLinked to original sources
PubMed1999

[Diet regimes in acute pancreatitis].

A method of determination of the duration of curative fasting in acute pancreatitis, depending on the degree of severity of patients' condition is described. The dependence between the probability of exacerbation of the process after resumption of feeding, the degree of severity of the condition at admittance, the duration of the fast vs degree of the severity of the condition in which the feeding was resumed was studied, for this purpose the method for calculation of so called coefficient of the degree of severity of acute pancreatitis was developed. 130 patients with acute pancreatitis underwent the treatment according to this method.

Acute Disease↗
PubMed1999

[The dynamics of blood serum middle-molecule peptides in the prognosis of the course of acute pancreatitis].

The work is devoted to studying the dynamics of endogenous toxemia by the level of middle mass peptides of blood serum in patients with acute pancreatitis. The level of middle mass peptides was investigated in 116 patients spectrophotometrically after Gabriélian with the wave length 254 nm (1st fraction, MMP-1) and with the wave length 282 nm (2nd fraction, MMP-2). It was found that the ratio of these fractions could be used as a prognostic index of the complicated course of acute pancreatitis. When the initial ration MMp-2/MMP-1 is less that 1 the risk of the development of complications of the second phase of acute pancreatitis is real. The decrease of the level of MMP-1 and MMP-2 during treatment by the 3rd-4th days is considered to be an indicator of the favorable outcome of the disease. The elevation of the level of MMP-1 and MMP-2 by the 3rd-4th days despite the treatment predicts an unfavorable outcome of the disease.

Acute Disease↗
PubMed1998

[Choice of optimal policy for treatment of acute pancreatitis].

662 case records of patients with acute pancreatitis are analysed and principles for the choice of optimal treatment of patients with acute pancreatitis (AP) are established. The most justified policy in treatment of AD patients seems to be conservative-expectant. The treatment should satisfy the phases of the course of acute pancreatitis and severity of the disease. At the first stage of the disease the treatment should be aimed at correction of pancreatic toxemia and prophylaxis of pyogenic complications. Surgical interventions at this phase are risky and hardly justified. If there are indications for drainage, laparoscopy and small invasive interventions under US control are preferable. At the second stage conservative-expectant policy should be also used as a method of choice, and treatment should be aimed at prophylaxis of purulent complications. The presence of aseptic necroses are not an absolute indication for surgery if there are no clear signs of suppuration. The presence of purulent complications is an indication for surgical treatment; extraperitoneal approaches to pyogenous areas and their drainage by wide two-lumen tubes for the following use of aspiration--lavage treatment are more preferable.

Adult↗
PubMed1998

[Reconstructive surgery in injuries of major arteries and veins].

Retrospective analysis of surgical treatment for injuries of 408 major arteries and veins in 352 patients in the department of vascular surgery of N.V. Sklifossovsky Research Institute of Emergency Care from 1989 to 1996 is presented. Of 126 cases of prosthetic reconstructions in 72.2% autoveins were used, in 18.3%--synthetic prosthesis, and in 9.5% homologous arterial biologic prosthesis. Good results were obtained in 13.1% of patients, amputations were made in 4.8%. Lethality was 4.0%. Principles of treatment of combined injuries, prophylaxis of syndrome of inclusion and other complications are autlined.

Arteries↗
PubMed1992

[Endoscopic pharmacologic denervation of the stomach in the treatment of acute pancreatitis].

The article discusses the results of medicamentous denervation of the stomach performed in 69 patients with various forms of pancreatitis 1-4 days after the onset of the disease. The efficacy of treatment was significantly higher statistically in the group of patients who were subjected to endoscopic medicamentous denervation of the stomach practically in all degrees of severity. By reducing the effect of the vagus nerve on the pathological process, this method makes it possible to improve considerably the results of treatment of patients with acute pancreatitis and shorten the terms of therapeutic fasting and in--patient treatment. Endoscopic medicamentous denervation of the stomach is indicated for all patients with acute pancreatitis in the immediate period after the onset of the disease, and the results are best when it is undertaken before destructive processes develop in the pancreas.

Acute Disease↗
PubMed1991

[Individual choice of ribonuclease and fluorofur doses in the treatment of patients with acute pancreatitis].

A method is suggested for individual calculation of optimal doses of ribonuclease and fluorofur on the basis of a standardized index--the degree of severity. A CM 1404 computer was used in solving the problem. From analysis of 500 case records by means of programs of discriminant and multidimensional linear regressive analysis a mathematical dependence was found between some parameters indirectly reflecting the severity of the patient's condition, the ribonuclease dose, and the efficacy of the treatment. A similar dependence for fluorofur was also studied. The discovered statistical regularity was realized as a nomogram for calculating the degree of severity and individual optimal doses of ribonuclease and fluorofur. The method was used in 114 patients. All the compared indices were found to be better than those in the group of patients for whom the dose of the agents (ribonuclease) was calculated on the basis of a constant dose per kg weight.

Acute Disease↗
PubMed1991

[Predicting the probable passage of common bile duct calculi in patients with mechanical jaundice].

The authors propose a mathematical method of predictingthe passage of common bile duct calculi. An original mathematical formula derived by a computer allows a 98% accuracy of the prognosis. The estimations were based on the principal parameters influencingthe choledochal calculi movement defined with the help of the regression analysis. Such prediction simplifies the choice of therapeutic policy in mechanical jaundice due to choledocholithiasis.

Aged↗
PubMed1990

[Prognostication of severity of the course in acute pancreatitis].

The authors picked out 200 case records of the patients with acute pancreatitis using a method of random sample. By means of the method of step-by-step discriminant analysis, the severity of the course of the disease was prognosticated. The age of a patient, duration of the disease, body temperature, leukocytic count and glucose level in the blood, amylase activity in the urine, presence of another pathology were analysed. The solving rule permitting to prognosticate an outcome of the disease with a high degree of probability was obtained. A variable directly dependent on the severity of a course of the disease--"degree of the severity of acute pancreatitis" was established.

Acute Disease↗