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Biomedical subjects

V S Savel'ev

Publications and source records attributed to V S Savel'ev.

At least 19 recordsLinked to original sources
PubMed2006

[Risk factors of chronic venous insufficiency of the lower extremities and possibilities of its medication in therapeutic practice].

AIM: To verify incidence of risk factors of chronic venous insufficiency (CVI) of the lower limbs and efficacy of outpatient treatment. MATERIALS AND METHODS: A total of 4388 patients were examined by questioning and examination of the lower limbs. 1209 patients with CVI stages C1, C2 and C3 were included in the study. They received recommendations to use elastic compression, topic modalities, physiotherapy. Patients of the study group were given, in addition, detralex for 8 weeks. RESULTS: Characteristic symptoms of CVI were seen in 68% males and 84% females but only 17.5 and 20%, respectively, had complaints. The risk was highest in history of CVI in the patient's mother, sitting or standing job, hard physical labour, obesity and constipation, two or more labours in women. The effect was achieved in the detralex group. CONCLUSION: Many outpatients had symptoms of chronic venous insufficiency but had no complaints. Detralex therapy proved highly effective in outpatient practice.

Adolescent↗
PubMed2006

[C677T mutation in methylentetrahydrofolatereductase gene in patients with venous thromboses from the central region of Russia correlates with a high risk of pulmonary artery thromboembolism].

AIM: To investigate genetic factors of risk (RF) to develop venous thrombosis and pulmonary artery thromboembolism (PATE) in population of central Russia. MATERIAL AND METHODS: We studied polymorphism of the genes of coagulation factor II (G20210A), factor V (G1691A) and methylentetrahydrofolatereductase (MTHFR) with polymerase chain reaction and restriction analysis of DNA amplified sites. We estimated prevalence of the mutations in healthy population and in patients with flebothrombosis as well as effects of the mutations on a PATE rate in patients with thrombosis. We examined 97 patients with documented flebothrombosis. PATE was detected in 54 of them. The control group consisted of 56 healthy volunteers matched by age and gender. RESULTS: G1691A mutation in the gene of coagulation factor V (Leiden mutation of factor V--LMFV) in healthy population occurred in 3.6%, in patients with flebothromboses--in 19.6% (OR = 6.58; 95% CI from 1.47 to 29.42; p = 0.006). Heterozygous mutation G20210A in prothrombine gene was detected in 8 (8.2%) patients (p = 0.027), while this mutation was registered in none controls. Polymorphism of MTHFR gene (C677T) was seen both in the control and patients (60.7 and 52.6%, respectively). LMFV occurrence in patients with flebothrombosis and PATE is less than in patients with flebothrombosis without TEPA (16.7 and 23%, respectively). The PATE risk is significantly higher in carriers of mutant allele 677CT and 677TT of MTHFR compared to patients free of this mutation (OR = 3.11; CI 95% from 1.35 to 7.15; p = 0.006). Homozygous inheritance of this mutation in males combined with PATE in 100% cases. Of 8 carriers of heterozygous mutation G20210A in prothrombin gene PATE was detected in 5 carriers. CONCLUSION: LMFV and mutation G20210A in prothrombin gene are genetic risk factors of venous thrombosis. LMFV is not a PATE risk factor. Mutation C677T in MTHFR gene has no influence on the risk of venous thromboses but makes PATE much more probable. This suggests that it may be a genetic risk factor of PATE in this disease.

Adolescent↗
PubMed2004

[Critical ischemia resulted from inadequate outpatient management of lower limb chronic arterial obliterations].

Management of critical and subcritical lower limb ischemia poses a challenge due to poor effectiveness and high costs of therapy. Problem solving supposes not only the development of effective surgical and medical management of severe arterial insufficiency, but also preventive efforts on early outpatient stage. The paper reviews 611 patients with lower limb arterial obliterative lesions and correlates age, sex, concomitant diseases, stage of arterial insufficiency and risk factors. Consideration of these parameters can be useful in choosing the most effective management strategy. Authors mention that in community outpatient facilities treatment effectiveness of chronic lower limb arterial obliterative lesions does not exceed 40%, white the success of conservative treatment according to the protocol developed in their clinics reaches 90%. It means that there is a real perspective of lowering the incidence of severe lower limb arterial insufficiency managed in hospital environment by improving preventive and therapeutic strategies at outpatient care level.

Adult↗
PubMed2003

[Endovascular surgery in prophylaxis of pulmonary thromboembolism and treatment of acute venous thrombosis].

From 1995 to 2001 1089 patients underwent 1141 endovascular procedures for treatment of acute thrombosis of vena cava inferior (VCI) system and prophylaxis of pulmonary thromboembolism (PT) including 61 catheter thrombectomies from VCI and common iliac veins, 35 regional thrombolyses, 880 implantations of permanent cava-filter "hourglass" and it modifications, 159 implantations of temporary cava-filter "umbrella", 3 implantations of filter-stent, 3 thrombectomies of a giant mobile thrombus with Dotter basket with subsequent cava-filter implantation. Efficacy of PT prophylaxis after these procedures was 97.9%. Catheter thrombectomy and regional thrombolysis permitted to repair passage through deep veins in 69.8% patients. Temporary cava-filter after treatment was removed in 49.1% patients. After implantations of permanent cava-filters early and late complications were seen in 8.9% cases.

Acute Disease↗
PubMed2003

Peripheral macrohemodynamics in patients with lower limb arteriosclerosis obliterans and type II diabetes mellitus.

The paper presents characteristic features of lower limb atherosclerotic lesions in patients with diabetes mellitus: more prominent calcification of vascular wall (involving media), frequent involvement of distal vascular segments and a symmetry of lesions. Typical variants are shown in images obtained with duplex angioscanning. The authors conclude that there are no principal differences in the course of lower limb arteriosclerosis obliterans between diabetics and non-diabetics. Nevertheless some special features were mentioned, particularly in clinical manifestation of intermittent claudication that can be attributed to concurrent diabetic neuropathy. Difficulties in clinical interpretation of lower limb arterial insufficiency for patients with diabetes mellitus determine the necessity of obligatory examination of peripheral vasculature. The authors advocate the discrete subclinical stage of the disease with increased rate of vascular accidents. The data may be interesting for angiologists, vascular surgeons, endocrine legists and other medical professions.

Aged↗
PubMed2003

[Gastrointestinal hemorrhages as complications of gastropathies associated with intake of nonsteroidal anti-inflammatory drugs].

AIM: To examine gastroduodenal mucosa in patients treated with nonsteroidal anti-inflammatory drugs (NSAID), to evaluate the rate and severity of gastrointestinal hemorrhage (GIH) as NSAID-gastropathy manifestation by the results of clinical and device tests. MATERIAL AND METHODS: A retrospective analysis of 2042 case histories of patients admitted to the surgical department of the Moscow city hospital N 1 in 1997-2001 with diagnosis GIH confirmed at esophagogastroduodenoscopy (EGDS). 989 patients (566 males and 423 females) had acute GIH from the upper gastrointestinal tract. RESULTS: Relationship between intake of NSAID and GIH was documented in 342 patients (16.7% of overall number of the examinees and 34.6% of patients with acute GIH). According to EGDS, GIH was provoked by gastric lesions (68%), duodenal lesions (20%), gastroduodenal lesions (9%), esophageal erosions (3%). GIH was caused primarily by low-dose aspirin, indometacin, diclofenak and ibuprofen. Severe GIH occurred in 28.9% cases, moderate and mild ones in 20.8 and 50.3%, respectively. CONCLUSION: To reduce the incidence of GIH, it is necessary to take preventive measures against NSAId-gastropathies.

Acute Disease↗
PubMed2003

[Clinical and instrumental characteristics of gastrointestinal bleeding caused by non-steroidal anti-inflammatory drugs].

UNLABELLED: There was a study of the condition of mucous membranes of upper parts of the gastrointestinal tract in patients with gastrointestinal bleedings (GIB), who were taking non-steroidal anti-inflammatory drugs (NSAID); the blood loss severity was assessed. 2,042 health records of patients, who came to surgical departments with the gastrointestinal bleeding diagnosis, were studied pro- and retrospectively. A group of 342 patients with GIB induced by NSAID was selected. The age of the group of patients under examination was from 17 to 86. RESULTS: Chronological relation between the application of NSAID and GIB was discovered in 16.7% of all cases. When assessing the bleeding source area, stomach affections were discovered in 68% of cases; duodenal affections were discovered in 20% of cases; associated stomach and duodenal affections were recorded in 9% of cases; esophagus erosion was found in 3% of cases. Bleedings were most often induced by the application of Aspirin, Indometacin, Diclofenac and Ibuprofen. Severe bleedings were revealed in 28.9% of cases, medium bleedings were recorded in 20.8% of cases, and 50.3% of cases were attributed to light bleedings.

Adolescent↗
PubMed2001

Heart rhythm disturbances during the acute period of massive pulmonary embolism.

We studied the type, incidence, and dynamics of arrhythmia during the acute phase of massive pulmonary embolism complicated or uncomplicated by cardiac insufficiency. Complicated and uncomplicated massive pulmonary embolisms were accompanied by the appearance of individual and allorhythmic ventricular extrasystoles, respectively. The rise of right ventricular pressure to 70 mm Hg was critical for the development of allorhythmia. Allorhythmia started 3-268 sec after attaining critical ventricular pressure. Heart rhythm spontaneously recovered in 100 and 78% animals with uncomplicated and complicated massive pulmonary embolism, respectively. The duration of paroxysmal allorhythmia varied from 15 sec to 15 min. Electrophysiological processes in the myocardium were normalized with progression of uncomplicated massive pulmonary embolism: the incidence of single and, in particular, allorhythmic extrasystoles decreased, and electrocardiographic parameters returned to normal.

Acute Disease↗
PubMed2000

[The role of antibacterial prophylaxis and therapy in pancreonecrosis].

The research of efficiency of different antibacterial prophylactic and therapy procedures among 89 patients suffering destructive pancreatitis is presented in the article. Determined that optimized tactics of antibacterial prophylactic and therapy with using of such medicines like carbapenems have the important value in cardinal improvement of the results of multi-stage surgical and intensive treatment of the patients suffering pancreonecrosis.

Adult↗
PubMed1995

[Dyslipoproteinemia in pancreonecrosis: cause-effect interrelationships].

The work analyzes the results of study of lipid metabolism in 53 patients who underwent operation for pancreatogenic peritonitis. The blood for the test was collected from the portal vein, the hepatic vein, and the aorta which made it possible to appraise metabolism in the liver according to the "entry-exit" blood flow system. It is shown that due to pancreatogenic toxemia, toxemic hepatocytic dyslipoproteinemia develops in patients with pancreonecrosis and persists in the late period. As a consequence of such a condition of lipid metabolism, early atherosclerotic damages to the arteries of the heart and brain and the peripheral arteries occur in patients after pancreonecrosis. The fate of patients was studied 8-10 years after the operation. The nature of atherosclerotic manifestations of toxemic hepatocytic dyslipoproteinemia in the late period after recovery from destructive pancreatitis was determined on the basis of study of central and peripheral hemodynamics.

Arteriosclerosis↗
PubMed1994

[Potential uses of plasma scalpel in liver and gallbladder surgery].

The article deals with the results of experimental studies and clinical experience in the use of the plasma scalpel in 25 unbred dogs and 192 patients with diseases of the liver and gallbladder. Histological studies of the hepatic tissue after treatment with the laser scalpel allowed the conclusion that such manipulations are safe. The advantages of using the device for arresting bleeding and the flow of bile from the resected hepatic areas were revealed. The accumulated experience in operations on the liver and gallbladder with a plasma scalpel made it possible to develop optimal approaches to the use of the plasma flow in resections of the liver and to suggest three methods for removal of the gallbladder. Their introduction into practice improved the intraoperative possibilities of treatment of the gallbladder bed.

Acute Disease↗