[Selection of the method of sanitization of the abdominal cavity in diffuse suppurative peritonitis in obstetrics and gynecology].
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Biomedical subjects
Publications and source records attributed to M I Kuzin.
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The authors analyse the first experience in the use of magnetic resonance tomography (MP-tomography) in the diagnosis of some surgical diseases. MR-tomography of the mammary gland (257 patients), thymus (55 patients), adrenals (41 patients), and hypophysis (18 patients) was conducted. The results of the examination were compared with the findings of other diagnostic methods and verified intraoperatively and histologically. The authors claim that the high informativeness of MR-tomography, its noninvasiveness, the absence of a radiation load, and the possibility of repeating the examination many times in three mutually-perpendicular planes distinguish the method favorably and dictate the necessity of its further study in clinical medicine.
AIDS incidence is sharply growing in all countries. Doctors specialists in all fields of medicine may come in contact in the process of treatment with HIV carriers or patients suffering from AIDS, when the clinical picture is vividly manifested. The most frequently encountered HIV-dependent complex of symptoms includes persisting fever, lymphadenopathy, weight loss, diarrhoea. Blood test for HIV antibodies confirms the diagnosis. Treatment of surgical diseases in HIV-infected patients is justified in the latent period of the syndrome. In a marked clinical picture of AIDS and the presence of an opportunistic infection the patient survives no longer than 18 months. It is advisable in such cases, in the interest of the patient and the surgeon, to refrain from undertaking a planned operation because its mortality is very high. Only emergency interventions are indicated. During contact with a HIV-infected patient the medical staff must follow strictly the rules of hospital hygiene and antisepsis . The work must be carried out in gloves, protective glasses, and masks, and injure of the hands with sharp instruments must be avoided. The personnel must be trained and educated in working with HIV-infected patients.
The work evaluates the results of treatment of duodenal ulcer in 152 young patients. The state's financial losses connected with their treatment by various methods are counted up. Prolonged nonoperative treatment was applied in 52 patients (group I), organ-preserving operations were carried out in 100 patients (group II). Group I patients felt much worse, most of them suffered from annual recurrences of the disease, 21% underwent various operative interventions later due to the development of complications. Good and excellent results were recorded in 86% of group II patients. It was established that not only are the clinical results better in group II patients, but the economical losses in timely performance of organ-preserving operations are half those in prolonged nonoperative therapy.
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The authors describe the results of clinical and electromyography examinations of 20 patients with grave generalized myasthenia, carried out within the short-term (up to 2 weeks) and long-term period (up to 1 year) after splenectomy. In these patients, the preceding therapy (thymectomy, gamma-therapy of the thymic area, the treatment with prednisolone, azathioprine, plasmapheresis, etc) had not produced any beneficial effect. The efficacy of splenectomy was assessed according to the Keens classification (A-E). In the short-term period after splenectomy the C effect was recorded in 13 out of the 20 patients. Out of 9 patients examined in the long-term period, the B effect was revealed in 3 patients, the C effect persisted in 3 patients, and 3 patients manifested the return to the initial status, namely to the E effect. Therefore in the group of patients with grave generalized myasthenia, the efficacy of splenectomy amounted to 65%. In view of this fact the inclusion of the given treatment method into the multimodality treatment of myasthenic patients is regarded advisable.
A total of 230 patients with myasthenia, polymositis, disseminated sclerosis and myeloradiculopolyneuronitis were administered high doses of prednisolone (up to 100 mg) every other day. The treatment efficacy and low incidence of side effects and complications are emphasized. High doses of prednisolone given every other day do not inhibit secretions of endogenic ACTH and cortisol. The immunodepressant effect of the drug remains unchanged.
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