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Biomedical subjects

N A Kuznetsov

Publications and source records attributed to N A Kuznetsov.

At least 19 recordsLinked to original sources
PubMed2005

[Individual prognosis of severity of postoperative period and outcome of general peritonitis].

Evaluation of severity according to SAPS scale and examination of dynamics of middle molecules in blood plasma (MCMn) were carried out in 167 patients with different surgical diseases complicated with general peritonitis. It is demonstrated that level of MCMn compared with SAPS scale data is objective index of endotoxicosis, severity of general peritonitis, and it can be regarded as criterion of prognosis of disease outcome. Dynamic assessment of MCMn level has the most diagnostic importance in groups of patients with 5 - 12 scores according to SAPS scale. Prognostic value of this index is small when infectious-toxic shock occurs.

Adolescent↗
PubMed2005

[Mini-invasive technologies in diagnosis and treatment of major vessels diseases].

Experience with 150 endovascular stents and endoprostheses including ones of vertebral and carotid arteries (first experience in Russia) is analyzed. Mini-invasive surgery is indicated for patients with isolated arterial lesions (segmental stenosis, short occlusions), changed and hard for surgery parts of vascular system (renal, visceral arteries, branches of aortic arch), restenosis after traditional surgeries and also for patients with severe concomitant diseases. Rate of complications of carotid endovascular stenting was 4,3%. The follow-up ranged from 2 months to 5,5 years. There were no restenoses in the stented zone. Complete absence of complains and regress of neurological symptoms were seen in 89% patients.

Blood Vessel Prosthesis↗
PubMed2005

[Results of application of synthetic antioxidants in treatment of patients with destructive pancreatitis].

Results of examination and treatment of 103 patients with pancreonecrosis are presented. Influence of antioxidant mexidol on acute pancreatitis (AP) was studied. It is demonstrated that mexidol in AP permits to slow down destructive processes in the pancreas, promotes localization of inflammation and normalization of clinical and laboratory picture of the disease that permits to decrease significantly number of severe complications of AP and reduce lethality.

Antioxidants↗
PubMed2005

[Surgical technologies in the treatment of varicose veins of the lower extremities complicated with trophic ulcer].

Results of an open randomized study of staged treatment of 94 patients suffering from varicose veins of the lower extremities with open infected trophic ulcers of the shank were analyzed. All the patients were divided into 3 groups depending on the treatment variant. Based on this study, clinical efficacy of early correction of upper vertical venous-venous reflux is substantiated. Efficacy of CO(2) laser application for sanation of trophic venous ulcers and practical importance of their auto-venous plastic reconstruction are demonstrated. Thus, up-to-date technologies provide differential treatment in patients with trophic venous ulcers.

Anti-Infective Agents, Local↗
PubMed2005

[Extracorporeal detoxication in patients with destructive pancreatitis].

Criteria of severity of endogenous intoxication in patients with destructive pancreatitis in enzymatic toxemia are discussed. It is demonstrated that the level of middle mass molecules and integral index of affection of the pancreas, abdominal cavity and retroperitoneal space are objective criteria of endogenous intoxication and can be used for determination of indications for extracorporeal detoxication and for assessment of treatment efficacy. Prescription of extracorporeal detoxication according to these criteria in an early period of the disease before multiple organ failure development promotes faster management of endotoxemia, prophylaxis of septic complications, decreases lethality and period of treatment of patients with destructive pancreatitis.

Adult↗
PubMed2004

[Lesions of retroperitoneal fatty tissue in destructive pancreatitis].

Experience of examination and treatment of 102 patients with lesion of retroperitoneal space undergone surgery for pancreonecrosis is analyzed. Based of data of ultrasonic examination, computed tomography, surgery and autopsy laws of morphologic transformation and ways of spread of pathologic process into retroperitoneal space in pancreonecrosis were revealed. Developed scheme is important for substantiation of surgical policy.

Adipose Tissue↗
PubMed2004

[Correction of enteral insufficiency syndrome in general peritonitis].

Efficacy of enteral ozone lavage in combined treatment of patients with general peritonitis is analyzed. It is demonstrated that intestinal lavage with ozone-enriched physiological salt solution through nasointestinal probe in postoperative period eliminates effectively bacterial contamination of the intestine, decreases toxicity of enteral contents and leads to significant improvement of functional characteristics of the small intestine and results of treatment.

Enterosorption↗
PubMed2004

[Treatment of patients with pancreonecrosis].

Results of treatment of patients with necrotic acute pancreatitis taking into account a risk of an unfavorable course of the disease are analyzed. The risk is determined according to the level of albumin measured with fluorescent test. This approach to choice of policy of treatment which doesn't correspond to clinical picture and treatment may be regarded as preventive permits to improve results of treatment in all variants of the disease. Decreased number of severe complications, lethality and time of hospitalization in necrotic pancreatitis an demonstrated.

Adult↗
PubMed2003

[Prognosis of outcome of radical surgery in patients with lung cancer associated with severe complications and concurrent diseases].

From 1981 to 2001 (20 years) 1307 patients with lung cancer underwent surgery. Postoperative lethality was 1.7% (after 635 pneumonectomies it was 2.4%, after 672 lob- and bilobectomies--1.2%). Medical histories of 171 operated patients with severe concomitant diseases was studied to analyze surgical outcomes depending on such important factors as age, concomitant diseases, surgical trauma. It is demonstrated that age of patients is not a factor of postoperative prognosis, but concomitant diseases and surgical trauma (i.e. pneumonectomy) are important factors of it. Results of surgery in the group of patients with four and more concomitant diseases after pneumonectomy were most unfavorable (lethality was 22.9%). In less severe surgical trauma (lobectomy) results of surgery were more favorable. It is concluded that surgery in patients with a lot of concomitant diseases must be less radical to obtain lower lethality. Radicality of treatment in these patients is ensured due to complex chemo- and radiation therapy after surgery.

Adult↗
PubMed2003

[Choice of the policy, terms, and method of surgery in acute cholecystitis].

Results of treatment of 763 patients with different forms of cholecystitis were analyzed. It was revealed that complex ultrasonic examination with dopplerography identifies the form of acute cholecystitis, allows to, predict technical difficulties in cholecystectomy and define optimum method of surgery. Comparative assessment of time of surgeries, rate of conversion of surgical approach, number of intra- and postoperative complications, lethality demonstrated that early urgent surgeries in acute cholecystitis before formation of inflammatory paravesical infiltrate in patients without high anesthesiological risk were similar to ones in elective surgeries and surpassed results of delayed surgeries. Early urgent surgeries permit to decrease hospital stay of patients with acute cholecystitis and reduce cost of treatment.

Acute Disease↗
PubMed2003

[Prediction of postoperative complications in elective surgery].

Experience in prediction of surgical outcomes is summarized. Preliminary results of elective treatment of various surgical diseases are reviewed. Over the last 14 years some theoretical problems of prediction (surgical risk) were solved by the authors and decision making in critical situations is illustrated. Surgical outcomes in 500 patients operated on from 1972 to 2002 (30 years) were analyzed depending on a number of factors--age, severity of combined diseases and surgery traumaticity. It is noted that qualitative assessment of surgical risk is not enough for decision on the method of surgical treatment. It is necessary to create adequate and simple classification of criteria of postoperative prognosis in elective surgery able to realize quantitative assessment of surgical risk.

Adult↗
PubMed2003

[Early diagnosis of intra-abdominal complications after surgery on the stomach and the duodenum].

Ultrasonic examination early after surgery permits to visualize "zone of surgery", to evaluate stomach, duodenum or their stump, to diagnose motor-evacuatory and purulent-septic complications, to determine policy of their treatment. Dynamic ultrasonic examinations permit to realize daily monitoring of "surgical zone" and timely correction of therapy, to reduce number of x-ray and endoscopic examinations after surgery that leads to improving of treatment results.

Abdomen↗
PubMed2003

[Comparative assessment of the results of open carotid endarterectomy and carotid aftery stenting].

A comparative study of 48 carotid stent grafting and 23 open carotid endarterectomies was carried out. Patients of both groups were comparable by cerebrovascular insufficiency degree and concomitant diseases. General rate of complications after carotid stent grafting (CSG) was 5.1%. There was a small ischemic stroke with right-sided hemiparesis and aphasia in one patient during CSG. Complete regress of the neurological symptoms was seen on the 5th day. In the nearest postoperative period after CSG there was a big ischemic stroke in the territory of MCA in one patient. Rate of complications after open carotid endarterectomy (OCEAE) was 8.7% Transient ischemic attacks were seen in 2 patients in early postoperative period. Paresis of the IX cranial nerves was in one patient. In long-term postoperative period after CSG 2 patients died due to cardiac causes. One patient died 18 months after OCEAE due to ischemic stroke. In long-term period after OCEAE restenosis of the internal carotid artery was seen in 4.5% cases, while there were no restenosis after CSG. It is concluded that CSG is an effective method of treatment of carotid stenosis with lower lethality and postoperative complications rate compared with OCEAE. Indications for CSG are symptomatic stenosis of ICA (>60%), asymptomatic stenosis of ICA(>70%), two-sided lesions of the carotid arteries, carotid stenosis with lesions of other brachiocephalic arteries, insufficiency of Willis circle.

Adult↗
PubMed2002

Phosphate measurements during hypokinesia and phosphate supplements in disclosing phosphate changes in hypokinetic subjects.

BACKGROUND: Hypokinesia (diminished movement) induces significant phosphate (P) change, however, little is known about P retention and P depletion during hypokinesia (HK). Measuring P retention and P balance during HK and P supplementation, the objective of this work was to disclose whether HK could contribute to the decreased P retention and consequently to P depletion in normal subjects. METHODS: Studies were done during 30 days pre-HK period and 364 days HK period. Forty normal male individuals aged, 25.3+/-6.4 years were chosen as subjects. They were divided equally into 4 groups: unsupplemented active control subjects (UACS), unsupplemented hypokinetic subjects (UHKS), supplemented active control subjects (SACS) and supplemented hypokinetic subjects (SHKS). Hypokinetic subjects were limited to an average walking distance of 0.5 km day-l, while active control subjects were kept on an average running distance of 9.6 km day-l. Both, SHKS and SACS received daily 14 mmol dicalcium phosphate per kg body weight. RESULTS: Negative P balance, fecal P, urinary calcium (Ca) and P excretion, serum P and total (Cat) level increased significantly (p<0.05) while P retention, serum intact parathyroid hormone (iPTH), 1,25 dihydroxyvitamin D (1,25 (OH)2 D3) and thyrocalcitonin (TC) decreased significantly (p<0.05) in SHKS and UHKS compared with their pre-HK values and their respective active controls (SACS and UACS). However, negative P balance, P retention incapacity, serum, fecal and urinary P level increased significantly (p<0.05) more in SHKS compared with UHKS. Fecal P loss, urinary P and Ca loss, serum P and Cat level, iPTH, TC and 1,25 (OH)2 D3 level, P retention and P balance change insignificantly (p>0.05) in SACS and UACS compared with their pre-HK level. CONCLUSIONS: It was concluded that a significant P excretion in urine and feces in spite of negative P balance and P supplementation may demonstrate reduced P retention, while a significant increase of negative P balance may demonstrate P depletion. Clearly, P intake, regardless of its low or higher dose, was significantly wasted during HK probably due to the decreased ability of the body to retain P.

Adult↗