[The simultaneous sanative treatment of foci of odontogenic and cardiogenic infections during the surgical treatment of septic endocarditis].
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Biomedical subjects
Publications and source records attributed to V P Zhuravlev.
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The paper analyzes the experience in treating 75 patients with cardiac abscesses of various sites. Abscesses complicated the natural history of infectious endocarditis in all patients. The clinical features of cardiac abscesses are shown to be related to the stage of the destructive process. Echocardiography, follow-up analysis of ECH, PhCG and overall clinical data are demonstrated to play a role in their diagnosis. The paper discusses the specific features of surgical intervention into the heart if abscesses are present. Out of 75 patients who have been operated on for abscessing infectious endocarditis, 53 have had an operation and survived.
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An analysis of the experience with surgical treatment of more than 320 patients with infectious endocarditis has shown the necessity to isolate pyo-septic cardiosurgery into an independent line. The arguments are: the specificity of the contingent of patients, special features of diagnosing, operative technique and period of rehabilitation, sanitizing regimen of the artificial blood circulation and others. The organizational aspect includes the necessity of active surgical tactics in treatment of pyo-surgical foci of cardiac localization. Successful treatment of this category of patients can be performed due to the availability of special antiseptic centers which must closely cooperate with cardiosurgical departments functioning in the regimen of emergency diagnostics and cardiac surgery.
The clinical picture of endocarditis in addicts is characterized by mainly right-sided localization of the process in the heart, poor auscultatory picture of the heart, pleuro-pulmonary manifestations against the background of a feverish course of the disease. The leading role in diagnosis of infectious endocarditis in addicts should be given to echocardiography. A description of three cases of surgical treatment of infectious endocarditis in addicts is presented.
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Forty male patients with coronary heart disease and essential hypertension, as well as 10 normal subjects, were examined, using a psychoemotional test with simultaneous monitoring of arterial blood pressure (BP), heart rate and ECG patterns. The test revealed disorders of cardiac rhythm in 28.6% of coronary patients and induced signs of myocardial ischemia and an anginal attack in 2. Signs of myocardial ischemia were more often provoked in coronary patients by physical stress tests as compared to those involving psychoemotional stress. In hypertensive patients, psychoemotional stress was associated with a more pronounced arterial BP rise, as compared to the results in normotensive individuals (normal subjects and coronary patients). Psychoemotional stress tests can be used alongside other kinds of tests in patients with coronary disease, essential hypertension and cardiac rhythm disorders.
An analysis of changes of indices of integral rheography and blood composition in 34 patients before and after exfusion of 450-600 ml of blood has shown the safety of preparing such doses of autoblood for the substitution of blood loss 4-5 days before cardiosurgical operations.
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