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6. ОСОБЛИВОСТІ ПЕРЕБІГУ ТРАВМИ ЖИВОТА У ПОСТРАЖДАЛИХ У СТАНІ АЛКОГОЛЬНОЇ ІНТОКСИКАЦІЇ

Author

Kulachek, Ya. V., Ifthodiy, A. G., Kozlovska, I. M., Beltsan, O. V., and Kulachek, V. T.

Subjects
абдомінальна травма, алкогольна інтоксикація, посттравматичні ускладнення, abdominal trauma, alcohol intoxication, post-traumatic complications, абдоминальная травма, алкогольная интоксикация, посттравматические осложнения
Abstract

The objective of the work is to improve the quality of diagnosis and treatment of victims with dominant abdominal trauma and alcohol intoxication, to determine prognostic valuable indicators that affect the way of the post-traumatic process, investigate the causes of the complicated postoperative period and find ways to solve this problem. In the period from 2014 to 2019 the study included 58 victims with a dominant abdominal trauma of various etiologies (81 % traffic accidents, 10 % falling from a height, 9 % penetrating stab and gunshot wounds of the abdomen). The state of alcohol intoxication at the time of hospitalization was 65 % among those injured with a dominant abdominal trauma. Among the dead in the post-traumatic period, both in the control and in the main group there was no reliable relationship between the state of alcohol intoxication and without it as the cause of death. A special place for determining and controlling the dynamics of the post-traumatic period and predicting complications was determined by the level of medium-weight molecules, which characterize the level not only of endogenous intoxication and the elements of the immune system. In order to determine the relationship of the influence of alcohol intoxication on the course of the post-traumatic process, we studied non-specific resistance by determining the level of circulating immune complexes and phagocytosis indicators. Indicators of molecules of middle weight differed between groups of patients already at the stages of hospitalization by 25 % from the level of the control group. Abdominal trauma remains an important problem of modern surgery, which has a large number of external factors influencing the course of the post-traumatic period, which must be taken into account for the qualitative diagnosis and treatment of the dominant abdominal injury. Alcohol intoxication against the ground of abdominal trauma has an adverse effect and creates preconditions for a complicated post-traumatic process., Целью работы является улучшение качества диагностики и лечения пострадавших с доминирующей травмой живота и алкогольной интоксикацией. А также определить прогностические значащие показатели, что влияют на протекание посттравматического процесса. Исследовать причины возникновения осложнённого протекания послеоперационного периода и найти пути разрешения данной проблемы. В период с 2014 по 2019 гг. в исследование были включены 58 пострадавших с доминирующей травмой живота разной этиологии (81 % дорожно-транспортные происшествия, 10 % падения с высоты, 9 % проникающие колото-резаные и огнестрельные ранения живота). Состояние алкогольной интоксикации на момент госпитализации составляло 65 % среди травмированных с доминирующей травмой живота. Среди умерших в посттравматическом периоде как в контрольной, так и в основной группе не было достоверной связи между состоянием алкогольной интоксикации и без нее как причина летального исхода. Особенное место для определения и контроля динамики протекания посттравматического периода и прогнозирования осложнения определялся уровень молекул средней массы, которые характеризируют уровень не только эндогенной интоксикации и элементы иммунной системы. С целью определения взаимосвязи влияния алкогольной интоксикации на протекание посттравматического процесса нами была исследована неспецифическая резистентность путем определения уровня циркулирующих иммунных комплексов и показателей фагоцитоза. Показатели молекул средней массы отличались между группами больных уже на этапах госпитализации на 25 % от уровня контрольной группы. Травма живота остается актуальной проблемой современной хирургии, которая имеет большое количество факторов внешнего влияния на протекание посттравматического периода, что необходимо учитывать для качественной диагностики и лечения доминирующего повреждения живота. Ал-когольная интоксикация на фоне травмы живота имеет неблагоприятное влияние и создает предпосылки для осложненного протекания посттравматического процесса., Метою роботи є покращити якість діагностики та лікування постраждалих із домінуючою травмою живота та алкогольною інтоксикацією. Виявити прогностично значущі показники, що впливають на перебіг посттравматичного періоду. Дослідити причини виникнення ускладненого перебігу післяопераційного періоду та знайти шляхи вирішення вказаної проблеми. У період з 2014 по 2019 рр. в дослідження були включені 58 постраждалих із домінуючою травмою живота різної етіології (81 % дорожньо-транспортні пригоди, 10 % падіння з висоти, 9 % проникаючі колото-різані та вогнепальні поранення живота). Стан алкогольної інтоксикації на момент госпіталізації становив 65 % серед травмованих із домінуючою травмою живота. Серед померлих у посттравматичному періоді як в контрольній, так і в основній групі не було достовірного зв’язку між наявною алкогольною інтоксикацією та без неї як причини летального наслідку. Особливе місце для визначення та контролю динаміки перебігу посттравматичного процесу та прогнозування ускладнень визначався рівень молекул середньої маси, що характеризують рівень не тільки ендогенної інтоксикації, але й елементи імунної системи. З метою визначення взаємозв’язку впливу алкогольної інтоксикації на перебіг посттравматичного процесу нами досліджувалась неспецифічна резистентність шляхом визначення рівня циркулюючих імунних комплексів та показниками фагоцитозу. Показники молекули середньої тяжкості відрізнялись між групами хворих уже на етапах госпіталізації на 25% від рівня контрольної групи. Травма живота залишається актуальною проблемою сучасної хірургії, що має велику кількість факторів зовнішнього впливу на перебіг посттравматичного періоду, що необхідно враховувати для якісної діагностики та лікування домінуючого пошкодження живота. Алкогольна інтоксикація на фоні травми живота має несприятливий вплив та створює передумови до ускладненого перебігу посттравматичного процесу.

Published
2019

10. MANAGEMENT OF THE EARLY POSTOPERATIVE PERIOD AFTER SURGICAL TREATMENT OF CHRONIC ANAL FISSURES

Author

Kozlovska, I. M., Ifthodiy, A. G., Kulachek, Ya. V., Hrebenyuk, V. I., Kozlovska, I. M., Ifthodiy, A. G., Kulachek, Ya. V., and Hrebenyuk, V. I.

Abstract

Taking into account a high rate of unsatisfactory results of surgical treatment of chronic anal fissures (CAF), low quality of life and the need for postoperative (p/o) rehabilitation of such patients, the objective of the work was to improve the results of surgical treatment of CAF due to optimization of the early p/o period. We examined 68 patients with the CAF. In the main group during the p/o period since the 2nd day, the intratissue electrophoresis was performed from 3 to 5 times with «Dioxysol®-Darnitsa» solution with a current density of 0.05 mA/cm2, during 60 minutes, in the control group - standard methods of p/o treatment were used. The intensity of pain was significantly reduced from the third day after the operation in patients who had galvanization sessions since the 2nd day, as well as during the entire period of the early period, the pain level was always significantly lower than in the control group. If on the first day after the operation all patients needed anesthesia, and the majority of them received narcotic analgesics, on the third day only 4 (11.43%) of the patients in the main group received anesthesia contrary to all patients (100%) of the control group. On the fourth day, the main group did not require anesthesia, while in the control group 28 patients (84.85%) still had anesthesia. Assessing the p/o period and remote results of treatment, according to all criteria, the effectiveness of treatment tactics in the main group is higher. In particular, the relapse of fissures occurred in 2.32 times more often in the control group. In addition, it became possible to reduce the time of complete wound healing by 2.66 days. The use of intra-tissue electrophoresis in patients at the early p/o period after surgical treatment of CAF increases the effectiveness of treatment by 31%, improves the quality of life of patients by 1,2-1,3 times, promotes rapid recovery after surgery, reduces the frequency of early and late p/o complications.

Published
2019

11. PECULIARITIES OF ABDOMINAL TRAUMA IN VICTIMS WITH ALCOHOL INTOXICATION

Author

Kulachek, Ya. V., Ifthodiy, A. G., Kozlovska, I. M., Beltsan, O. V., Kulachek, V. T., Kulachek, Ya. V., Ifthodiy, A. G., Kozlovska, I. M., Beltsan, O. V., and Kulachek, V. T.

Abstract

The objective of the work is to improve the quality of diagnosis and treatment of victims with dominant abdominal trauma and alcohol intoxication, to determine prognostic valuable indicators that affect the way of the post-traumatic process, investigate the causes of the complicated postoperative period and find ways to solve this problem. In the period from 2014 to 2019 the study included 58 victims with a dominant abdominal trauma of various etiologies (81 % traffic accidents, 10 % falling from a height, 9 % penetrating stab and gunshot wounds of the abdomen). The state of alcohol intoxication at the time of hospitalization was 65 % among those injured with a dominant abdominal trauma. Among the dead in the post-traumatic period, both in the control and in the main group there was no reliable relationship between the state of alcohol intoxication and without it as the cause of death. A special place for determining and controlling the dynamics of the post-traumatic period and predicting complications was determined by the level of medium-weight molecules, which characterize the level not only of endogenous intoxication and the elements of the immune system. In order to determine the relationship of the influence of alcohol intoxication on the course of the post-traumatic process, we studied non-specific resistance by determining the level of circulating immune complexes and phagocytosis indicators. Indicators of molecules of middle weight differed between groups of patients already at the stages of hospitalization by 25 % from the level of the control group. Abdominal trauma remains an important problem of modern surgery, which has a large number of external factors influencing the course of the post-traumatic period, which must be taken into account for the qualitative diagnosis and treatment of the dominant abdominal injury. Alcohol intoxication against the ground of abdominal trauma has an adverse effect and creates preconditions for a complicated post-traumati

Published
2019

15. Strategy for the management of uncomplicated retinal detachments: the European vitreo-retinal society retinal detachment study report 1

Author

BENMERZOUGA N, METTI F, RAZZARI A, MIESBAUER P, SCHÖNHERR U, ZEYNALOVA Z, BASHIR SJ, JACOB J, KOCH P, LADHA R, SMETS E, STALMANS P, DARE A, DEVENYI R, LAM WC, SHAHEEDA M, POTAMITIS T, CHRISTENSEN SR, RAYES E, MORTADA H, SHOUMAN A, HOLM M, ALBINET P, AMAR JP, BECQUET F, BERROD JP, BOULZE M, BOSCHER C, COURJARET JC, DENION E, FOURMAUX, E, GUIGOU S, HAMON F, LAFONTAINE PO, LE ROUIC JF, LEYNAUD JL, NOCHEZ Y, PERONE JM, RYSANEK B, SOYEUR R, BOPP S, BRIX A, HÖHN F, KUSSEROW C, LUCKE K, MOHR A, SCHÜLER A, WEINBERGER A, GOTZARIDIS S, KARATZENIS D, STEFANIOTOU M, K. TSILIMBARIS MK, TSOURIS D, TSANG CW, GABOR R, SZIJARTO Z, BABU N, BANKER AS, BAPAYE M, KELKAR A, ENTEZARI, M, FATEH MOGHADAM HF, RAMEZANI A, SAFARPOUR LIMA B, OMER K, BOSCIA F, CHIARA FRENO M, CIAN R, DONVITO G, FACINO M, LESNONI G, LIUZZI, F, METE M, MININNI F, MOCHI B, PRIMAVERA V, PERTILE G, TURCO I, VASTARELLA P, FONG K, LEE M, VP LOO A, ARAGON HARRISON O, FLORES AGUILAR M, LOPEZ MONTERO LM, LOPEZCARASA HERNANDEZ G, VELASCO I, BOEYDEN V, BOSSCHA M, DE VRIES KNOPPERT W, LINDSTEDT, E. RENARDEL DE LAVALETTE VW, VAN DEN BIESEN PR, ALHASSAN M, BAERLAND TP, BOBER AM, FORSAA V, FOSSEN K, VARHAUG P, ATIENZA J.r. NF, CISIECKI S, FRYCZKOWSKI P, KOWAL LANGE A, MICHALEWSKA Z, MICHALEWSKI J, NAWROCKI J, NOWOSIELSKA A, ODROBINA D, PIETRAS TRZPIEL M, ZAKRZEWSKA A, MEIRELES A, TEIXEIRA S, ELSHAFEI M, DANIELESCU C, TALU S, ALTYNBAEV U, GORIN A, SEREJINE I, EL DEEB M, DAVIDOVIC S, IGNJATOVIC Z, STEFANICKOVA J, VENTER L, CHANG W, JO YL, KIM JY, LEE J, LIM ST, SAGONG M, ASCASO FJ, CASTRO J, CORDOVES L. DESCO ESTEBAN C, MORENO MANRESA J, VILAPLANA D, JANIEC S, TOMIC Z, BEN YAHIA S, ACAR N, GÜNGEL H, KAPRAN Z, OSMANBASOGLU O, OZDEK S, TOPBAS S, TOTAN Y, ÜNVER YB, CHICHUR D, DOBROVOLSKEY O, KOZLOVSKA I, LYTVYNCHUK L, PHYLYPCHUK O, POSTOLOVSKA A, SERGIIENKO A, SHEVCHYK V, WINDER S, CULOTTA J, KIM S, KING J, KURUP SK, LIN SJ, PACURARIU R, ROTH D, SINCLAIR S, WEBER P, DOAN H, TUNG T., ROMANO, MARIO, Benmerzouga, N, Metti, F, Razzari, A, Miesbauer, P, Schönherr, U, Zeynalova, Z, Bashir, Sj, Jacob, J, Koch, P, Ladha, R, Smets, E, Stalmans, P, Dare, A, Devenyi, R, Lam, Wc, Shaheeda, M, Potamitis, T, Christensen, Sr, Rayes, E, Mortada, H, Shouman, A, Holm, M, Albinet, P, Amar, Jp, Becquet, F, Berrod, Jp, Boulze, M, Boscher, C, Courjaret, Jc, Denion, E, Fourmaux, E, Guigou, S, Hamon, F, Lafontaine, Po, LE ROUIC, Jf, Leynaud, Jl, Nochez, Y, Perone, Jm, Rysanek, B, Soyeur, R, Bopp, S, Brix, A, Höhn, F, Kusserow, C, Lucke, K, Mohr, A, Schüler, A, Weinberger, A, Gotzaridis, S, Karatzenis, D, Stefaniotou, M, K., TSILIMBARIS MK, Tsouris, D, Tsang, Cw, Gabor, R, Szijarto, Z, Babu, N, Banker, A, Bapaye, M, Kelkar, A, Entezari, M, FATEH MOGHADAM, Hf, Ramezani, A, SAFARPOUR LIMA, B, Omer, K, Boscia, F, CHIARA FRENO, M, Cian, R, Donvito, G, Facino, M, Lesnoni, G, Liuzzi, F, Mete, M, Mininni, F, Mochi, B, Primavera, V, Romano, Mario, Pertile, G, Turco, I, Vastarella, P, Fong, K, Lee, M, VP LOO, A, ARAGON HARRISON, O, FLORES AGUILAR, M, LOPEZ MONTERO, Lm, LOPEZCARASA HERNANDEZ, G, Velasco, I, Boeyden, V, Bosscha, M, DE VRIES KNOPPERT, W, Lindstedt, E., RENARDEL DE LAVALETTE VW, VAN DEN BIESEN, Pr, Alhassan, M, Baerland, Tp, Bober, Am, Forsaa, V, Fossen, K, Varhaug, P, ATIENZA J. r., Nf, Cisiecki, S, Fryczkowski, P, KOWAL LANGE, A, Michalewska, Z, Michalewski, J, Nawrocki, J, Nowosielska, A, Odrobina, D, PIETRAS TRZPIEL, M, Zakrzewska, A, Meireles, A, Teixeira, S, Elshafei, M, Danielescu, C, Talu, S, Altynbaev, U, Gorin, A, Serejine, I, EL DEEB, M, Davidovic, S, Ignjatovic, Z, Stefanickova, J, Venter, L, Chang, W, Jo, Yl, Kim, Jy, Lee, J, Lim, St, Sagong, M, Ascaso, Fj, Castro, J, CORDOVES L., DESCO ESTEBAN C, MORENO MANRESA, J, Vilaplana, D, Janiec, S, Tomic, Z, BEN YAHIA, S, Acar, N, Güngel, H, Kapran, Z, Osmanbasoglu, O, Ozdek, S, Topbas, S, Totan, Y, Ünver, Yb, Chichur, D, Dobrovolskey, O, Kozlovska, I, Lytvynchuk, L, Phylypchuk, O, Postolovska, A, Sergiienko, A, Shevchyk, V, Winder, S, Culotta, J, Kim, S, King, J, Kurup, Sk, Lin, Sj, Pacurariu, R, Roth, D, Sinclair, S, Weber, P, Doan, H, and Tung, T.

Abstract

OBJECTIVE: To study success and failure in the treatment of uncomplicated rhegmatogenous retinal detachments (RRDs). DESIGN: Nonrandomized, multicenter retrospective study. PARTICIPANTS: One hundred seventy-six surgeons from 48 countries spanning 5 continents provided information on the primary procedures for 7678 cases of RRDs including 4179 patients with uncomplicated RRDs. METHODS: Reported data included specific clinical findings, the method of repair, and the outcome after intervention. MAIN OUTCOME MEASURES: Final failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachment (level 3 failure rate). RESULTS: Four thousand one hundred seventy-nine uncomplicated cases of RRD were included. Combining phakic, pseudophakic, and aphakic groups, those treated with scleral buckle alone (n = 1341) had a significantly lower final failure rate than those treated with vitrectomy, with or without a supplemental buckle (n = 2723; P = 0.04). In phakic patients, final failure rate was lower in the scleral buckle group compared with those who had vitrectomy, with or without a supplemental buckle (P = 0.028). In pseudophakic patients, the failure rate of the initial procedure was lower in the vitrectomy group compared with the scleral buckle group (P = 3×10(-8)). There was no statistically significant difference in failure rate between segmental (n = 721) and encircling (n = 351) buckles (P = 0.5). Those who underwent vitrectomy with a supplemental scleral buckle (n = 488) had an increased failure rate compared with those who underwent vitrectomy alone (n = 2235; P = 0.048). Pneumatic retinopexy was found to be comparable with scleral buckle when a retinal hole was present (P = 0.65), but not in cases with a flap tear (P = 0.034). CONCLUSIONS: In the treatment of uncomplicated phakic retinal detachments, repair using scleral buckle may be a good option. There was no significant difference between segmental versus 360-degree buckle. For pseudophakic uncomplicated retinal detachments, the surgeon should balance the risks and benefits of vitrectomy versus scleral buckle and keep in mind that the single-surgery reattachment rate may be higher with vitrectomy. However, if a vitrectomy is to be performed, these data suggest that a supplemental buckle is not helpful.

Published
2013

16. Strategy for the management of complex retinal detachments: the European vitreo-retinal society retinal detachment study report 2

Author

BENMERZOUGA N, METTI F, RAZZARI A, MIESBAUER P, SCHÖNHERR U, ZEYNALOVA Z, BASHIR SJ, JACOB J, KOCH P, LADHA R, SMETS E, STALMANS P, DARE A, DEVENYI R, LAM WC, SHAHEEDA M, POTAMITIS T, CHRISTENSEN SR, RAYES E, MORTADA H, SHOUMAN A, HOLM M, ALBINET P, AMAR JP, BECQUET F, BERROD JP, BOULZE M, BOSCHER C, COURJARET JC, DENION E, FOURMAUX, E, GUIGOU S, HAMON F, LAFONTAINE PO, LE ROUIC JF, LEYNAUD JL, NOCHEZ Y, PERONE JM, RYSANEK B, SOYEUR R, BOPP S, BRIX A, HÖHN F, KUSSEROW C, LUCKE K, MOHR A, SCHÜLER A, WEINBERGER A, GOTZARIDIS S, KARATZENIS D, STEFANIOTOU M, K. TSILIMBARIS MK, TSOURIS D, TSANG CW, GABOR R, SZIJARTO Z, BABU N, BANKER AS, BAPAYE M, KELKAR A, ENTEZARI, M, FATEH MOGHADAM HF, RAMEZANI A, SAFARPOUR LIMA B, OMER K, BOSCIA F, CHIARA FRENO M, CIAN R, DONVITO G, FACINO M, LESNONI G, LIUZZI, F, METE M, MININNI F, MOCHI B, PRIMAVERA V, PERTILE G, TURCO I, VASTARELLA P, FONG K, LEE M, VP LOO A, ARAGON HARRISON O, FLORES AGUILAR M, LOPEZ MONTERO LM, LOPEZCARASA HERNANDEZ G, VELASCO I, BOEYDEN V, BOSSCHA M, DE VRIES KNOPPERT W, LINDSTEDT, E. RENARDEL DE LAVALETTE VW, VAN DEN BIESEN PR, ALHASSAN M, BAERLAND TP, BOBER AM, FORSAA V, FOSSEN K, VARHAUG P, ATIENZA J.r. NF, CISIECKI S, FRYCZKOWSKI P, KOWAL LANGE A, MICHALEWSKA Z, MICHALEWSKI J, NAWROCKI J, NOWOSIELSKA A, ODROBINA D, PIETRAS TRZPIEL M, ZAKRZEWSKA A, MEIRELES A, TEIXEIRA S, ELSHAFEI M, DANIELESCU C, TALU S, ALTYNBAEV U, GORIN A, SEREJINE I, EL DEEB M, DAVIDOVIC S, IGNJATOVIC Z, STEFANICKOVA J, VENTER L, CHANG W, JO YL, KIM JY, LEE J, LIM ST, SAGONG M, ASCASO FJ, CASTRO J, CORDOVES L. DESCO ESTEBAN C, MORENO MANRESA J, VILAPLANA D, JANIEC S, TOMIC Z, BEN YAHIA S, ACAR N, GÜNGEL H, KAPRAN Z, OSMANBASOGLU O, OZDEK S, TOPBAS S, TOTAN Y, ÜNVER YB, CHICHUR D, DOBROVOLSKEY O, KOZLOVSKA I, LYTVYNCHUK L, PHYLYPCHUK O, POSTOLOVSKA A, SERGIIENKO A, SHEVCHYK V, WINDER S, CULOTTA J, KIM S, KING J, KURUP SK, LIN SJ, PACURARIU R, ROTH D, SINCLAIR S, WEBER P, DOAN H, TUNG T., ROMANO, MARIO, Benmerzouga, N, Metti, F, Razzari, A, Miesbauer, P, Schönherr, U, Zeynalova, Z, Bashir, Sj, Jacob, J, Koch, P, Ladha, R, Smets, E, Stalmans, P, Dare, A, Devenyi, R, Lam, Wc, Shaheeda, M, Potamitis, T, Christensen, Sr, Rayes, E, Mortada, H, Shouman, A, Holm, M, Albinet, P, Amar, Jp, Becquet, F, Berrod, Jp, Boulze, M, Boscher, C, Courjaret, Jc, Denion, E, Fourmaux, E, Guigou, S, Hamon, F, Lafontaine, Po, LE ROUIC, Jf, Leynaud, Jl, Nochez, Y, Perone, Jm, Rysanek, B, Soyeur, R, Bopp, S, Brix, A, Höhn, F, Kusserow, C, Lucke, K, Mohr, A, Schüler, A, Weinberger, A, Gotzaridis, S, Karatzenis, D, Stefaniotou, M, K., TSILIMBARIS MK, Tsouris, D, Tsang, Cw, Gabor, R, Szijarto, Z, Babu, N, Banker, A, Bapaye, M, Kelkar, A, Entezari, M, FATEH MOGHADAM, Hf, Ramezani, A, SAFARPOUR LIMA, B, Omer, K, Boscia, F, CHIARA FRENO, M, Cian, R, Donvito, G, Facino, M, Lesnoni, G, Liuzzi, F, Mete, M, Mininni, F, Mochi, B, Primavera, V, Romano, Mario, Pertile, G, Turco, I, Vastarella, P, Fong, K, Lee, M, VP LOO, A, ARAGON HARRISON, O, FLORES AGUILAR, M, LOPEZ MONTERO, Lm, LOPEZCARASA HERNANDEZ, G, Velasco, I, Boeyden, V, Bosscha, M, DE VRIES KNOPPERT, W, Lindstedt, E., RENARDEL DE LAVALETTE VW, VAN DEN BIESEN, Pr, Alhassan, M, Baerland, Tp, Bober, Am, Forsaa, V, Fossen, K, Varhaug, P, ATIENZA J. r., Nf, Cisiecki, S, Fryczkowski, P, KOWAL LANGE, A, Michalewska, Z, Michalewski, J, Nawrocki, J, Nowosielska, A, Odrobina, D, PIETRAS TRZPIEL, M, Zakrzewska, A, Meireles, A, Teixeira, S, Elshafei, M, Danielescu, C, Talu, S, Altynbaev, U, Gorin, A, Serejine, I, EL DEEB, M, Davidovic, S, Ignjatovic, Z, Stefanickova, J, Venter, L, Chang, W, Jo, Yl, Kim, Jy, Lee, J, Lim, St, Sagong, M, Ascaso, Fj, Castro, J, CORDOVES L., DESCO ESTEBAN C, MORENO MANRESA, J, Vilaplana, D, Janiec, S, Tomic, Z, BEN YAHIA, S, Acar, N, Güngel, H, Kapran, Z, Osmanbasoglu, O, Ozdek, S, Topbas, S, Totan, Y, Ünver, Yb, Chichur, D, Dobrovolskey, O, Kozlovska, I, Lytvynchuk, L, Phylypchuk, O, Postolovska, A, Sergiienko, A, Shevchyk, V, Winder, S, Culotta, J, Kim, S, King, J, Kurup, Sk, Lin, Sj, Pacurariu, R, Roth, D, Sinclair, S, Weber, P, Doan, H, and Tung, T.

Abstract

OBJECTIVE: To study the outcome of the treatment of complex rhegmatogenous retinal detachments (RRDs). DESIGN: Nonrandomized, multicenter, retrospective study. PARTICIPANTS: One hundred seventy-six surgeons from 48 countries spanning 5 continents reported primary procedures for 7678 RRDs. METHODS: Reported data included clinical manifestations, the method of repair, and the outcome. MAIN OUTCOME MEASURES: Failure of retinal detachment repair (level 1 failure rate), remaining silicone oil at the study's conclusion (level 2 failure rate), and need for additional procedures to repair the detachments (level 3 failure rate). RESULTS: The main categories of complex retinal detachments evaluated in this investigation were: (1) grade B proliferative vitreoretinopathy (PVR; n = 917), (2) grade C-1 PVR (n = 637), (3) choroidal detachment or significant hypotony (n = 578), (4) large or giant retinal tears (n = 1167), and (5) macular holes (n = 153). In grade B PVR, the level 1 failure rate was higher when treated with a scleral buckle alone versus vitrectomy (P = 0.0017). In grade C-1 PVR, there was no statistically significant difference in the level 1 failure rate between those treated with vitrectomy, with or without scleral buckle, and those treated with scleral buckle alone (P = 0.7). Vitrectomy with a supplemental buckle had an increased failure rate compared with those who did not receive a buckle (P = 0.007). There was no statistically significant difference in level 1 failure rate between tamponade with gas versus silicone oil in patients with grade B or C-1 PVR. Cases with choroidal detachment or hypotony treated with vitrectomy had a significantly lower failure rate versus treatment with scleral buckle alone (P = 0.0015). Large or giant retinal tears treated with vitrectomy also had a significantly lower failure rate versus treatment with scleral buckle (P = 7×10(-8)). CONCLUSIONS: In patients with retinal detachment, when choroidal detachment, hypotony, a large tear, or a giant tear is present, vitrectomy is the procedure of choice. In retinal detachments with PVR, tamponade with either gas or silicone oil can be considered. If a vitrectomy is to be performed, these data suggest that a supplemental buckle may not be helpful. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Published
2013

17. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Author

Sartelli, M., Labricciosa, F.M., Barbadoro, P., Pagani, L., Ansaloni, L., Brink, A.J., Carlet, J., Khanna, A., Chichom-Mefire, A., Coccolini, F., Saverio, S. Di, May, A.K., Viale, P., Watkins, R.R., Scudeller, L., Abbo, L.M., Abu-Zidan, F.M., Adesunkanmi, A.K., Al-Dahir, S., Al-Hasan, M.N., Alis, H., Alves, C., Araujo da Silva, A.R., Augustin, G., Bala, M., Barie, P.S., Beltran, M.A., Bhangu, A., Bouchra, B., Brecher, S.M., Cainzos, M.A., Camacho-Ortiz, A., Catani, M., Chandy, S.J., Jusoh, A.C., Cherry-Bukowiec, J.R., Chiara, O., Colak, E., Cornely, O.A., Cui, Y., Demetrashvili, Z., Simone, B. De, Waele, J.J. De, Dhingra, S., Marzo, F. Di, Dogjani, A., Dorj, G., Dortet, L., Duane, T.M., Elmangory, M.M., Enani, M.A., Ferrada, P., Esteban Foianini, J., Gachabayov, M., Gandhi, C., Ghnnam, W.M., Giamarellou, H., Gkiokas, G., Gomi, H., Goranovic, T., Griffiths, E.A., Guerra Gronerth, R.I., Haidamus Monteiro, J.C., Hardcastle, T.C., Hecker, A., Hodonou, A.M., Ioannidis, O., Isik, A., Iskandar, K.A., Kafil, H.S., Kanj, S.S., Kaplan, L.J., Kapoor, G., Karamarkovic, A.R., Kenig, J., Kerschaever, I., Khamis, F., Khokha, V., Kiguba, R., Kim, H.B., Ko, W.C., Koike, K., Kozlovska, I., Kumar, A., Lagunes, L., Latifi, R., Lee, J.G., Lee, Y.R., Leppaniemi, A., Li, Y., Liang, S.Y., Lowman, W., Machain, G.M., Maegele, M., Major, P., Malama, S., Manzano-Nunez, R., Marinis, A., Casas, I., Goor, H. van, Zuidema, W.P., Catena, F., Sartelli, M., Labricciosa, F.M., Barbadoro, P., Pagani, L., Ansaloni, L., Brink, A.J., Carlet, J., Khanna, A., Chichom-Mefire, A., Coccolini, F., Saverio, S. Di, May, A.K., Viale, P., Watkins, R.R., Scudeller, L., Abbo, L.M., Abu-Zidan, F.M., Adesunkanmi, A.K., Al-Dahir, S., Al-Hasan, M.N., Alis, H., Alves, C., Araujo da Silva, A.R., Augustin, G., Bala, M., Barie, P.S., Beltran, M.A., Bhangu, A., Bouchra, B., Brecher, S.M., Cainzos, M.A., Camacho-Ortiz, A., Catani, M., Chandy, S.J., Jusoh, A.C., Cherry-Bukowiec, J.R., Chiara, O., Colak, E., Cornely, O.A., Cui, Y., Demetrashvili, Z., Simone, B. De, Waele, J.J. De, Dhingra, S., Marzo, F. Di, Dogjani, A., Dorj, G., Dortet, L., Duane, T.M., Elmangory, M.M., Enani, M.A., Ferrada, P., Esteban Foianini, J., Gachabayov, M., Gandhi, C., Ghnnam, W.M., Giamarellou, H., Gkiokas, G., Gomi, H., Goranovic, T., Griffiths, E.A., Guerra Gronerth, R.I., Haidamus Monteiro, J.C., Hardcastle, T.C., Hecker, A., Hodonou, A.M., Ioannidis, O., Isik, A., Iskandar, K.A., Kafil, H.S., Kanj, S.S., Kaplan, L.J., Kapoor, G., Karamarkovic, A.R., Kenig, J., Kerschaever, I., Khamis, F., Khokha, V., Kiguba, R., Kim, H.B., Ko, W.C., Koike, K., Kozlovska, I., Kumar, A., Lagunes, L., Latifi, R., Lee, J.G., Lee, Y.R., Leppaniemi, A., Li, Y., Liang, S.Y., Lowman, W., Machain, G.M., Maegele, M., Major, P., Malama, S., Manzano-Nunez, R., Marinis, A., Casas, I., Goor, H. van, Zuidema, W.P., and Catena, F.

Abstract

Contains fulltext : 177987.pdf (publisher's version ) (Open Access), BACKGROUND: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. METHODS: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. RESULTS: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). CONCLUSION: T

Published
2017

18. WAY OF PREOPERATIVE PREPARATION FOR PATIENTS WITH CHRONIC ANAL FISSURES

Author

Iftodii, A. H., Kozlovska, I. M., Iftodii, A. H., and Kozlovska, I. M.

Abstract

The use of intratissue electrophoresis with a dioksyzol solution as a preoperative preparation of patients with chronic anal fissures of the void causes reduction of the manifestation of hemodynamic disorder, acute inflammatory responses in tissues anal fissure and encourages the development of young granulation tissue in the area of the wound edges and the edge of the resection, contributes to the reduction of the intensity of the pain syndrome, reduces expression of inflammation, stimulates reparative processes in the area of the crack, accelerates epithelization and the healing of surgical wounds, quickly removes spasm of the sphincter and anal pain, tearing main pathogenetic mechanism of the disease.

Published
2017

19. Влияние микрофлоры кишечника на патогенез течения хронических осложненных анальных трещин

Author

Iftodii, A. H., Kozlovska, I. M., Olenovych, O. A., Bilyk, O. V., and Brodovs’kyi, S. P.

Subjects
intestinal microflora of faeces, мікрофлора кишкових випорожнень, микрофлора анальной трещины, микрофлора кишечных испражнений, хронічні анальні тріщини, мікрофлора анальної тріщини, chronic anal fissures, microflora anal fissure, хронические анальные трещины
Abstract

We study the influence of the stool microflora on the formation of anal fissures microorganisms and the role of the latter in the pathogenesis of chronic disease. Conducted bacteriological studies suggest that the pathogenesis of chronic anal fissure involved opportunistic and pathogenic organisms. General bacterial contamination of fissures was 3,75±0,27 lg CFU/sm3 in discharge, and quantitative content of certain bacterial species varied from 1,95±0,18 to 2,63±0,21 lg CFU in discharge. Therefore, the treatment of this pathology should include the therapy aimed at eradication of microorganisms by various antibacterial agents and methods., Изучено влияние микрофлоры испражнений на формирование микрофлоры анальных трещин и роль последней в патогенезе хронического заболевания. Проведенные бактериологические исследования свидетельствуют, что в патогенезе развития хронических анальных трещин участвует условно-патогенная и патогенная микрофлора. Общая бактериальная контаминация трещин составляла 3,75±0,27 lg КОЕ/см3 в смыве, а количественное содержание отдельных видов бактерий колебался от 1,95±0,18 до 2,63±0,21 lg КОЕ в смыве. Поэтому при лечении данной патологии необходимо применять терапию, направленную на эрадикацию данной микрофлоры различными антибактериальными препаратами и физическими методами., Вивчено вплив мікрофлори випорожнень на формування мікрофлори анальних тріщин та роль останньої у патогенезі хронічного захворювання. Проведені бактеріологічні дослідження свідчать, що в патогенезі розвитку хронічних анальних тріщин бере участь умовно-патогенна та патогенна мікрофлора. Загальна бактеріальна контамінація тріщин становила 3,75±0,27 lg КУО/см3 у змиві, а кількісний вміст окремих видів бактерій коливався від 1,95±0,18 до 2,63±0,21 lg КУО у змиві. Показано, що при лікуванні даної патології необхідно застосовувати терапію, направлену на ерадикацію даної мікрофлори різними антибактеріальними препаратами та фізичними методами.

Published
2014

21. ЕФЕКТИВНІСТЬ ВИКОРИСТАННЯ НИЗЬКОЧАСТОТНОГО УЛЬТРАЗВУКУ В САНАЦІЇ ГНІЙНО-НЕКРОТИЧНИХ РАН

Author

Shkvarkovky, I. V., Antoniuk, T. V., Kozlovska, I. M., and Grodetsky, V. K.

Subjects
гнойно-воспалительные процессы, ультразвуковая кавитация, гнійно-запальні процеси, ультразвукова кавітація, inflammatory processes, ultrasonic cavitation
Abstract

Necrotic processes of soft tissue, according to the literature, indicate the urgency of the problem. Treatment of complicated by chronic process, multidrug-resistant microorgan­isms to antibacterial agents, nonspecific inflammation of the soft tissues of Nonbacterial origin, concomitant diseases (diabetes, obliterating vascular lesions, immunodeficiency). In connection with this the interest increased in methods of active rehabilita­tion purulent processes, which are based on different physical phenomena., Гнойно-некротические процессы мягких тканей, по данным литературы, свидетельствуют об актуальности проблемы. Лечение осложняется хронизацией процесса, по­лирезистентностью микроорганизмов к антибактериальным средствам, неспецифическими воспалительными процессами мягких тканей небактериального происхождения, сопутству­ющей патологией (сахарный диабет, облитерирующие пора­жения сосудов, иммунодефицитные состояния). В связи с этим возрос интерес к методикам активной санации гнойных процессов, основанных на различных физических явлениях., Гнійно-некротичні процеси м’яких тканин, за даними літератури, свідчать про актуальність проблеми. Лікування ускладнюється хронізацією процесу, полірезистентністю мікроорганізмів до антибактеріальних засобів, неспецифічними запальними процесами м’яких тканин небактеріального поход­ження, супутньою патологією (цукровий діабет, облітеруючі ураження судин, імунодефіцитні стани). У зв’язку з цим зросла зацікавленість методиками активної санації гнійних процесів, які базуються на різних фізичних явищах.

Published
2013

22. Effect of intestinal microflora on the pathogenesis of recurrent anal fissure chronic complications

Author

Iftodii, A. H., Kozlovska, I. M., Olenovych, O. A., Bilyk, O. V., Brodovs’kyi, S. P., Iftodii, A. H., Kozlovska, I. M., Olenovych, O. A., Bilyk, O. V., and Brodovs’kyi, S. P.

Abstract

We study the influence of the stool microflora on the formation of anal fissures microorganisms and the role of the latter in the pathogenesis of chronic disease. Conducted bacteriological studies suggest that the pathogenesis of chronic anal fissure involved opportunistic and pathogenic organisms. General bacterial contamination of fissures was 3,75±0,27 lg CFU/sm3 in discharge, and quantitative content of certain bacterial species varied from 1,95±0,18 to 2,63±0,21 lg CFU in discharge. Therefore, the treatment of this pathology should include the therapy aimed at eradication of microorganisms by various antibacterial agents and methods.

Published
2014

23. EFFICIENCY LOW-FREQUENCY ULTRASOUND IN SANATION OF PYO-NECROTIC WOUNDS

Author

Shkvarkovky, I. V., Antoniuk, T. V., Kozlovska, I. M., Grodetsky, V. K., Shkvarkovky, I. V., Antoniuk, T. V., Kozlovska, I. M., and Grodetsky, V. K.

Abstract

Necrotic processes of soft tissue, according to the literature, indicate the urgency of the problem. Treatment of complicated by chronic process, multidrug-resistant microorgan­isms to antibacterial agents, nonspecific inflammation of the soft tissues of Nonbacterial origin, concomitant diseases (diabetes, obliterating vascular lesions, immunodeficiency). In connection with this the interest increased in methods of active rehabilita­tion purulent processes, which are based on different physical phenomena.

Published
2013

24. VACUUM THERAPY IN THE TREATMENT OF PYO-NECROTIC PROCESS

Author

Shkvarkovskyi, I. V., Antoniuk, T. V., Kozlovska, I. M., Rusak, O. B., Shkvarkovskyi, I. V., Antoniuk, T. V., Kozlovska, I. M., and Rusak, O. B.

Abstract

The paper submits an analysis of modern methods of a surgical treatment of pyoseptic processes of the soft tissues and infections postoperative complications. An effective remedial procedure is vacuum the therapy.

Published
2013

29. PREVENTION AND TREATMENT OF PANCREATITIS AFTER ENDOSCOPIC SURGERY ON THE BILE DUCT.

Author

Shkvarkovskyj I, Moskaliuk O, Kozlovska I, Kolotylo O, and Rusak O

Subjects
Humans, Male, Postoperative Complications prevention & control, Postoperative Complications etiology, Female, Middle Aged, Aged, Bile Ducts surgery, Adult, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Jaundice, Obstructive surgery, Jaundice, Obstructive etiology, Risk Factors, Cholangiopancreatography, Endoscopic Retrograde adverse effects, Pancreatitis etiology, Pancreatitis prevention & control
Abstract

Up-to-date endoscopic correction methods for obstructive diseases of the pancreatic-biliary system occupy a leading position among the arsenal of methods to treat mechanical jaundice. The purpose of the paper is to verify the mechanisms and factors promoting pancreatitis development after endoscopic retrograde cholangiopancreatography (ERCP) and to summarize the efforts to prevent and treat this complication. Materials and methods. A detailed analysis of the structure of nosological units resulting in frequent development of mechanical jaundice was made by the results of treatment of 1214 patients. Results and discussion. The role and place of possible factors promoting development of post-ERCP pancreatitis are determined. The causes of development of intra- and post-ERCP complications are studied. Attention is focused on finding ways to prevent the development of post-ERCP pancreatitis. The therapeutic tactics of management of patients with post-ERCP pancreatitis were carried out according to the recommendations of the European Association of Endoscopic Surgeons (EAES). It should be noted that the algorithm of patient management who during surgery presented technical preconditions of development of post-ERCP pancreatitis is not finally formulated. The experience of administration of pharmacological prevention found in literature is indicative of the fact that it does not provide favorable course of the postoperative period in all cases. First of all, it refers to the patients with high risks who develop severe development followed by unfavorable results. Despite a recognized effectiveness of non-steroidal anti-inflammatory drugs, 2% patients develop severe post-ERCP pancreatitis.

Published
2024

30. The Global Alliance for Infections in Surgery: defining a model for antimicrobial stewardship-results from an international cross-sectional survey.

Author

Sartelli M, Labricciosa FM, Barbadoro P, Pagani L, Ansaloni L, Brink AJ, Carlet J, Khanna A, Chichom-Mefire A, Coccolini F, Di Saverio S, May AK, Viale P, Watkins RR, Scudeller L, Abbo LM, Abu-Zidan FM, Adesunkanmi AK, Al-Dahir S, Al-Hasan MN, Alis H, Alves C, Araujo da Silva AR, Augustin G, Bala M, Barie PS, Beltrán MA, Bhangu A, Bouchra B, Brecher SM, Caínzos MA, Camacho-Ortiz A, Catani M, Chandy SJ, Jusoh AC, Cherry-Bukowiec JR, Chiara O, Colak E, Cornely OA, Cui Y, Demetrashvili Z, De Simone B, De Waele JJ, Dhingra S, Di Marzo F, Dogjani A, Dorj G, Dortet L, Duane TM, Elmangory MM, Enani MA, Ferrada P, Esteban Foianini J, Gachabayov M, Gandhi C, Ghnnam WM, Giamarellou H, Gkiokas G, Gomi H, Goranovic T, Griffiths EA, Guerra Gronerth RI, Haidamus Monteiro JC, Hardcastle TC, Hecker A, Hodonou AM, Ioannidis O, Isik A, Iskandar KA, Kafil HS, Kanj SS, Kaplan LJ, Kapoor G, Karamarkovic AR, Kenig J, Kerschaever I, Khamis F, Khokha V, Kiguba R, Kim HB, Ko WC, Koike K, Kozlovska I, Kumar A, Lagunes L, Latifi R, Lee JG, Lee YR, Leppäniemi A, Li Y, Liang SY, Lowman W, Machain GM, Maegele M, Major P, Malama S, Manzano-Nunez R, Marinis A, Martinez Casas I, Marwah S, Maseda E, McFarlane ME, Memish Z, Mertz D, Mesina C, Mishra SK, Moore EE, Munyika A, Mylonakis E, Napolitano L, Negoi I, Nestorovic MD, Nicolau DP, Omari AH, Ordonez CA, Paiva JA, Pant ND, Parreira JG, Pędziwiatr M, Pereira BM, Ponce-de-Leon A, Poulakou G, Preller J, Pulcini C, Pupelis G, Quiodettis M, Rawson TM, Reis T, Rems M, Rizoli S, Roberts J, Pereira NR, Rodríguez-Baño J, Sakakushev B, Sanders J, Santos N, Sato N, Sawyer RG, Scarpelini S, Scoccia L, Shafiq N, Shelat V, Sifri CD, Siribumrungwong B, Søreide K, Soto R, de Souza HP, Talving P, Trung NT, Tessier JM, Tumbarello M, Ulrych J, Uranues S, Van Goor H, Vereczkei A, Wagenlehner F, Xiao Y, Yuan KC, Wechsler-Fördös A, Zahar JR, Zakrison TL, Zuckerbraun B, Zuidema WP, and Catena F

Subjects
Cross-Sectional Studies, Global Health trends, Humans, Surveys and Questionnaires, Anti-Infective Agents therapeutic use, Antimicrobial Stewardship methods, Intraabdominal Infections drug therapy, Postoperative Complications drug therapy
Abstract

Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world., Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery., Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p  < 0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%)., Conclusion: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.

Published
2017
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31. [EXPEDIENCY OF THE INTRATISSUE ELECTROPHORESIS APPLICATION IN PREOPERATIVE PREPARATION OF PATIENTS, SUFFERING CHRONIC ANAL FISSURE].

Author

Iftodiy AG and Kozlovska IM

Subjects
Adult, Aged, Anal Canal drug effects, Anal Canal pathology, Anal Canal surgery, Anesthetics, Local therapeutic use, Anti-Infective Agents therapeutic use, Chronic Disease, Female, Fissure in Ano pathology, Humans, Male, Middle Aged, Pain physiopathology, Pain Measurement, Preoperative Care methods, Re-Epithelialization physiology, Treatment Outcome, Fissure in Ano surgery, Fissure in Ano therapy, Isotachophoresis methods, Lidocaine therapeutic use, Pain prevention & control, Quinoxalines therapeutic use
Abstract

The experience of preoperative application of the intratissue electrophoresis with the dioxysol solution was analyzed for the patients, suffering chronic anal fissure. In the patients, beginning from the first day, there was proved the reduction of the pain syndrome severity, hemodynamic disorders, an acute inflammatory reactions in the anal fissure tissue, the young granulations growth in the edge of the wound and resection. Application of the method proposed have promoted the inflammatory process severity reduction, the reparative processes in anal fissure stimulation, the operation wound epithelization acceleration, the anal sphincter muscle spasmelimination, which constitutes the main pathogenetic mechanism of the disease.

Published
2017

32. [ОPTIMIZATION OF SURGICAL TREATMENT OF HEMORRHOIDAL DISEASE STAGES III-IV].

Author

Brodovskyi SP, Iftodiy AG, and Kozlovska IM

Subjects
Abscess diagnosis, Abscess pathology, Adult, Anal Canal abnormalities, Anal Canal pathology, Electrocoagulation instrumentation, Fecal Incontinence diagnosis, Fecal Incontinence pathology, Female, Hemorrhoidectomy instrumentation, Hemorrhoids pathology, Humans, Intraoperative Complications diagnosis, Intraoperative Complications pathology, Laser Therapy instrumentation, Male, Middle Aged, Muscular Diseases diagnosis, Muscular Diseases pathology, Radiofrequency Therapy, Severity of Illness Index, Treatment Outcome, Electrocoagulation methods, Hemorrhoidectomy methods, Hemorrhoids surgery, Laser Therapy methods, Operative Blood Salvage methods, Recovery of Function
Abstract

The treatment results in patients, suffering chronic hemorrhoidal disease stages III- IV, in accordance to the elaborated method of hemorrhoidectomy, using radio-wave scalpel «Surgitron TM» with further welding of vascular pedicle, applying high-frequency electrocoagulator ЕК-301М1, are presented. In the patients, оperated on in accordance to the method proposed, the intraoperative complications rate and the blood loss severity were essentially lesser than in a comparison group. Owing an adequate level of surgical skills, the operative treatment method elaborated guarantees the reduction of early and late postoperative morbidity, rapid coming back to routine way of living postoperatively.

Published
2017

33. [MORPHOGENESIS OF THE ANODERM STRUCTURAL CHANGES IN PATIENTS WITH CHRONIC ANAL FISSURES].

Author

Iftodiy A, Kozlovska I, Davydenko I, Tiuleneva E, and Besedinska E

Subjects
Chronic Disease, Edema physiopathology, Female, Fissure in Ano physiopathology, Humans, Male, Parakeratosis physiopathology, Wound Healing, Anal Canal pathology, Epithelium pathology, Fissure in Ano pathology, Morphogenesis
Abstract

The objective of the study is to find peculiarities of the anoderm structural changes of morphogenesis in patients with chronic anal fissures (CAF) for further substantiation of therapeutic methods. The material of the study was the tissues of dissected anal complex (bottom and margins of ulcer, hypertrophic anal papilla, sentinel pile) from 33 patients. Histological examination found the defect of the stratified squamous epithelium. The epidermis of the marginal area of the wound, hypertrophic with signs of parakeratosis and acanthosis, hanged over the bottom. The surface of the bottom and margins of the wound in 31 cases (94%) was with thickening of rough fibrous masses. The bottom of ulcer in 29 (88%) cases is presented by sclerosed connective tissue. An increased amount of collagen fibers was found forming fuchsinophil is bundles. In 24 (73%) cases the scar on the fuchsine bottom of fissure was 3,4 mm (0,3±0,02) in deep. There are separate complexes of newly formed blood vessels with prevailing localization in the lateral walls of the wound. The blood vessels were with main by fibrosis in deep areas of the wound. Moderate interstitial edema and focal interstitial inflammatory infiltration mostly of lymphocytes and fibroblasts were detected; the amount of macrophages was not substantial. Considering cicatrical rebuilding of the anoderm of ulcer bottom caused, first of all, by hypoxia leading to activation of collagen-producing function of fibroblastes and absence of the signs of epithelization, patients with CAF should be treated surgically dissecting the bottom and margins of fissure in the complex with hypertrophic anal papilla and sentinel pile.

Published
2015

34. Impact of gadolinium-157 containing nanoscale magnetosensitive composites on morfofunctional properties of cells in vitro.

Author

Lavrenchuk HY, Shevchenko YB, Petranovska AL, Asmolkova VS, Oksamytnyi VM, Kozlovska IV, and Yavorska OH

Abstract

Objective - to investigate the morphofunctional cells properties under the action of magneticallybased nanocomposites containing gadolinium-157. Materials and methods. Experimental studies are performed in cell culture line L929 Nanocomposites based on magnetite modified by functional amino groups chemically fixed by diethylenetriaminepentaacetic acid (DTPA) and gadolinium - (Fe3O4/γ-APS/DTPA-Gd) were studied (1), also by meso-2,3-dimercaptosuccinic acid (DMSA) - (Fe3O4/DMSA-Gd), which binds to the hydroxyl group of magnetite surface (2); gadolinium was adsorbed from a solution of gadolinium sulfate. Reagent 3 - magnetic substance Fe3O4 with sodium oleate. Morphofunctional characteristics of cell culture were evaluated in various terms by standard indicators of sustainability: proliferative and mitotic activity and the number of giant multinuclear cells, apoptosis. Results and conclusions. We established that magnetdriven nanocomposites with gadolinium modified by DTPA and DMSA, were more biocompatibile to cells: incubation of cells with neutron capture agents (NCA) in the studied range of concentrations showed no toxicity, except maximum concentration, while decreasing cells adhesive properties. For all nanocomposites we observed decrease in mitotic activity in the background of the control cell population density, which may indicate synchronization of cell division. We found that the stabilized by sodium oleate ferrite caused destructive changes in cell culture only at concentrations of 500 μg / ml, but reduced mitotic activity in cell culture in 3-5 times in the whole range of concentrations. It is shown that magnetdriven nanocomposites induce different levels of apoptosis in cultured cells depending on the concentration of the reactants., (H. Y. Lavrenchuk, Y. B. Shevchenko, A. L. Petranovska, V. S. Asmolkova, V. M. Oksamytnyi, I. V. Kozlovska, O. H. Yavorska.)

Published
2014

35. Interleukin 28B Gene Polymorphism and Association with Chronic Hepatitis C Therapy Results in Latvia.

Author

Tolmane I, Rozentale B, Keiss J, Ivancenko L, Subnikova N, Reinholde Z, Kozlovska I, Sumlaninova N, Laivacuma S, and Simanis R

Abstract

Introduction. With the standard treatment of chronic hepatitis C, sustained virological response (SVR) can be achieved only in half of all patients. Interleukin-28B appears to be involved in the control of HCV infection, and the genetic polymorphism of the encoding IL-28B gene may determine the efficacy of clearance of HCV. The aim of this paper was to detect IL-28B gene polymorphism in Latvia and to analyze therapy results. This is the first study on IL-28B gene polymorphism in Latvia. Material and Methods. There were 159 chronic viral hepatitis C patients included in the study. In order to detect IL-28B gene polymorphism, we used molecular biology techniques and methods: classical DNA separation, amplification by PCR, and standard sequencing. Genotype was defined as CC, CT, TC, or TT type. 142 patients were treated with the standard of care treatment. Results were analyzed according to IL-28B polymorphism. Results. There were 53 patients (33%) with CC genotype, 84 patients (53%) with CT/TC genotype, and 22 patients (14%) with TT genotype. 34 patients (74%) in CC genotype subgroup achieved SVR versus 50 patients (52%) in non-CC subgroups. In patients with genotype 1, SVR was achieved in 16 patients (84%) in CC subgroup versus 30 patients (47.6%) in non-CC subgroups, P = 0.007. Conclusions. The most common genotype of IL28B in Latvia is CT/TC, with an incidence of 53%. Patients with CC genotype achieved SVR more often than CT or TT subgroups. IL28B gene polymorphism therefore is a strong predictor of treatment result.

Published
2012
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