Patients with diseases of the paranasal sinuses make up, according to various sources, from 15% to 62% of the total number of those who applied to ENT hospitals, ENT offices of polyclinic medical institutions. .Approximately 30% of women experience rhinitis symptoms during pregnancy.
В настоящее время во всем мире интенсивно развивается новая медицинская технология — фотодинамическая терапия (ФДТ0. В последние годы появились научные публикации, посвященные применению ФДТ для лечения гнойных ран, в которых отмечены преимущества ФДТ по сравнению с традиционной терапией, в частности выраженный антибактериальный и противовоспалительный эффект. Эффективность ФДТ не зависит от спектра чувствительности патогенных микроорганизмов к антибиотикам.
Проблемы интенсивной терапии у детей включают в себя различные аспекты, такие как повышенный риск развития инфекций, нарушения гемодинамики, острые состояния органов, токсикозы и многие другие. В связи с этим возникает необходимость постоянного совершенствования методов интенсивной терапии и оптимизации лечения у детей.
BACKGROUND: Sepsis is one of the leading causes of hospital mortality in children. a decisive role in improving the results of treatment of this group of patients belongs to early diagnosis and pathogenetic therapy. AIM: this study optimizes the diagnosis and intensive care of surgical sepsis in children based on clinical and laboratory criteria and bacteriological monitoring.
MATERIALS AND METHODS: the study period is 2018–2020. the study subjects were children (n = 73) with surgical pathology (diffuse purulent peritonitis, bacterial destruction of the lungs, post-traumatic brain hematomas, injuries of the abdominal organs, and others). clinical and laboratory parameters were analyzed, and microbiological monitoring was performed to determine antibiotic sensitivity.
RESULTS: Patients who developed sepsis had a pronounced hypermetabolic syndrome, which was manifested by tachycardia and tachypnea, hyperthermia, low levels of albumin, and total protein in the blood. Protein catabolism in patients was accompanied by a decrease in globulins (IgG) synthesis and the development of a secondary immunodeficiency state. Both gram-positive and gram-negative microorganisms were involved in developing surgical sepsis in children, increasing the proportion of the latter. Given the high proportion of multi-resistant flora, empirical combined de-escalation antibiotic therapy (aBt) with broad-spectrum antibiotics was prescribed. this was followed by its revision based on microbiological monitoring and clinical and laboratory data of the patient with sepsis. Studies have shown the effectiveness of complex intensive care in 86.3% of cases. Mortality occurred in 13.7% of cases. Patients with severe surgical pathology died: fecal, generalized peritonitis, severe traumatic brain injury + coma with irreversible neurological disorders, and urosepsis against the background of chronic renal failure after repeated surgical interventions.
CONCLUSIONS: early diagnosis of sepsis, rational aBt under the control of microbiological monitoring, non-aggressive infusion therapy, and active sanitation of the surgical infection focus contributed to a decrease in mortality in this category of patients.
Abstract. In ischemic heart disease (CHD), progressive disorders of the hemostasis system are corrected with shorter and longer antiplatelet therapy. However, recent studies have consistently demonstrated the development of up to 25% of all possible side effects and complications of anticoagulant and antiplatelet therapy.
Purpose of the study: to study the effect and complication of anticoagulant therapy on the state of the gastroduodenal zone in patients with ischemic heart disease.
Material and methods: 146 patients with ischemic heart disease (CHD), were examined, among them there were 12 (8.22%) patients with acute myocardial infarction (MI), 68 (46.57%) with progressive intense angina pectoris (PNS), intense angina pectoris (NS , functional class III-IV) - 66 (45.20%) people. The average age of the patients was 56.3 ± 2.4 years.
Results and its discussion: in the present study, the “ulcerative” history was assessed and whether there was a complication (bleeding, penetration or perforation). Detailing the data of the anamnesis made it possible to establish that the "ulcerative" anamnesis was detected only in 22.60% of cases. In other cases, as the duration of the course of the disease increases and, accordingly, the duration of the use of antiplatelet agents and anticoagulants, there is a directly proportional relationship to the increase in the frequency of gastropathy.
The author shows the clinical and statistical study of the impact of various risk factors (age, sex, bad habits, dietary treatment, occupational hazard) for the development of pathology gepatopankreatoduodenalnoy system, the gravity of the current.
This article discusses the issues of rational safe pharmacotherapy in clinical practice, the need to take into account the age characteristics of the body when choosing medicines, accurate prediction of the effect of a particular drug on the developing and elderly body, the features of the use of medicines in young children, the use of "unlicensed" drugs and prescribing them not in accordance with theinstructions for their use, the proper use of medicines in accordance with clinical necessity., criteria for evaluating the rational use of medicines. When conducting drug therapy, the doctor should adhere to the principles of general patterns of prescribing drugs, and it is also necessary to apply an individual approach to each patient, taking into account age, gender, anamnesis, concomitant diseases, features of metabolism and hemodynamics
Purpose of reseach: to optimize outcomes of therapy of the patients SD, purulent - septic complicated of lower extremities (PSCLE), by monitoring, duly revealing of character disturbans of function of the liver and purposeful correction them in complex therapy of the specified pathological condition.
Methods of research: clinical-biochemical researches, ECG, ultrasonic research of the liver, ultrasonic dopplerography, percutaneus definition a pressure (voltage) of oxygen, angiography, radionuclide researches, psichometric tests.
The results achieved and their novelty: the carried researches have shown, that the liver is not one of the basic organs - targets at SD (at the expense of features it blood circulation), at decompenciation SD, complicated PSCLE, there is an essential infringement liver blood circulation in system lever artery, to the subsequent disturbance of its numerous functions. The inclusion in complex therapy hepatoprotectory, antioxygents and preparations blocking ALT activity is pathogenic proved and promotes optimization of outcomes such of complication SD, as PSCLE.
Practical significance: the elaborated and offered complex therapy of the patients provides of optimization of outcomes, is an effective method of treatment and preventive maintenance of complications.
Degree of introduction and economic efficiency: the results of research have been introduced into practice of branches intensive therapy and reanimation 2-clinic TMA and Republican Centre of Purulent Surgery and Surgical Complication of Sugar Diabetes
Area of application: reanimation and intensive therapy, surgery.
Malignant tumors firmly occupy a leading place in the structure of morbidity and mortality in many leading countries of the world. As the authors of literary sources note, research in the field of certain areas of combined therapy of malignant neoplasms is currently being intensively developed. The development of drugs to combat neoplasms is developing especially intensively, since drug therapy is the leading component of the combined method of treating malignant tumors.
Subject of the inquiry: 97 patients with ankylosing spondylitis, 20 healthy volunteers.
Aim of the inquiry: to assess metabolic activity of erythrocytes and peculiarities of fcrrokinctics in using Fhlogcnzymc in the complex therapy of patients with AS. Methods of research: functional-metabolic process erythrocytes and ferrokinctics (scrum iron, ferritin, saturation of transferrin with iron) lipid peroxidation and antioxidant system.
The results achieved and their novelty: For the first time purposeful complex study was conducted of metabolic process parameters in erythrocytes and fcrrokinctics, lipid peroxidation and antioxidant system processes, Willebrand factor, atherogenicity in relation to the clinical course of the disease. Functional-metabolic disorders in erythrocytes in fcrrokinctics determined systemic changes in blood, with their extent associating with severity of the clinical course of AS. For the first time it was found that the use of Fhlogcnzymc in the complex treatment improved clinical course of the disease. The shortening of clinical recovery period was associated with normalization of parameters characterizing functional metabolic activity in crythrocytea and ferrokinctics. Systemic enzyme therapy was proved to increase the effect of conventional therapy by a directed improvement of functional metabolic processes in erythrocytes, energetic activity and ferrokinctics which allowed inclusion of systemic enzyme therapy preparations for hemic hypoxia in patients with AS.
Practical value: Use of Fhlogcnzymc in the complex treatment of AS increased the efficacy of therapy, decreased the rate of drug side-effects, allowed us to decrease the doses of basic preparations and non-stcroid anti-inflammatory. Changes of laboratory parameters in Fhlogcnzymc using included more significant decrease of acute phase indices, increase of hemoglobin and erythrocyte concentration in the peripheral blood.
Degree of inculcate and economic efficiency: conclusions and practical recommendations were introduced into the practice of departments of rheumatology, nephrology of the third clinic of the Tashkent Medical Academy and into teaching process of departments of faculty and hospital therapy, folk medicine, internal diseases of the stomatological faculty and clinical pharmacology of the Tashkent Medical Academy.
Sphere of usage: rheumatology, therapy.