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Biomedical subjects

A V Vatazin

Publications and source records attributed to A V Vatazin.

At least 19 recordsLinked to original sources
PubMed2005

[Infectious complications in using mofetil micofenolate in patients with renal allotransplant].

AIM: To study infectious complications in renal transplant recipients receiving mycophenolate mofetil (MMF) for prevention of acute transplant rejection or treatment of chronic allograft nephropathy (CAN). MATERIAL AND METHODS: A group of renal transplant recipients (n=47) receiving 1.0-2.0 g/day MMF with cyclosporine A (CsA) and steroids as maintaining immunosuppression was compared to a group (n=47) taking triple immunosuppressive therapy which included azathioprine (Aza). Separate group of patients (n=9) received MMF for treatment of CAN. In all groups etiology and incidence of infections were evaluated. RESULTS: During 2 years various posttransplant infections developed in 72.3% patients on MMF and 93.6% on Aza. The incidence of viral infections was 53.2% in MMF and 59.6% in Aza group, the incidence of bacterial infection--55.3 and 70.2%, respectively. Among 9 recipients with CAN the infections occurred in five. There were two cases of active tuberculosis in Aza group, one--in MMF group and one in patients with CAN. CONCLUSION: We suggest that MMF in the dose 1-2 g/day does not increase infection rates in renal transplant recipients comparing Aza.

Acute Disease↗
PubMed2005

[Effectiveness of hemofiltration in patients with peritonitis and acute respiratory distress syndrome].

The subjects of the study were 149 patients with severe pyo-septic complications of abdominal diseases, resulting in multiple organ failure syndrome (MOFS) with clinical and laboratory manifestations. Acute respiratory distress syndrome (ARDS) as a component of MOFS was diagnosed in 39 (26.2%) patients. The complex treatment included hemofiltration in a volume of at least 25 liters. The study shows that hemofiltration is an effective and pathogenetic method of complex treatment of MOFS, which has a positive effect on the main pathogenetic mechanisms in ARDS, thus allowing improvement of oxygen transport in blood. Hemofiltration improves central hemodynamics as well as blood circulation in the lungs and peripheral tissues in patients with MOFS and ARDS; it allows correction of volemic and metabolic disorders, and endogenous intoxication reduction. The use of hemofiltration in ARDS led to a 2-fold lethality reduction.

Adult↗
PubMed1998

[Weak-flow membrane blood oxygenation in treatment of patients with peritonitis].

The application of the level of molecules with medium molecular mass (MM) and wave length E254 and 280 nm was tried in 30 patients, operated on for various diseases of the organs of abdominal cavity and their purulent complications. Besides routine treatment weak flow membrane blood oxygenation was carried out. As a result of the study it was established that the level of medium molecular peptides appears to be a criteria of effectiveness of the weak-flow membrane blood oxygenation and determines duration of the procedure. The initial concentration of MM from 1,0 relative units and more duration of the blood oxygenation period should be limited by 2 hours. This method can be regarded, as independent mode od detoxication.

Adult↗
PubMed1994

[Extracorporeal detoxication in the treatment of peritonitis complicated with multiple organ insufficiency].

The article deals with experience in the use of filtration and combined methods of extracorporeal detoxification in 201 patients with peritonitis in the phase of polyorganic insufficiency. The methods were developed in the department of abdominal surgery of the Moscow Regional Scientific Research Clinical Institute. The authors show the indications for and the advantages, the mechanisms of the effect, and the results of bifiltration cascade exchange plasmapheresis, improved hemofiltration method, and selective detoxification of portal blood, and the combination of these methods with continuous membrane blood oxygenation. The mortality reduced from 46.6% in the control group to 26.5% in the main group.

Adult↗
PubMed1991

[The hemodynamic criteria of the efficacy of cascade filtration exchange plasmapheresis in diffuse suppurative peritonitis].

The influence of the cascade filtration exchange plasmapheresis on the central and organ haemodynamics was studied in 15 patients in the terminal phase of diffuse purulent peritonitis. The procedure was found to be followed by the activation of the cardio-vascular system function if it was initially depressed and by its weakening in cases of excessive strain. The worse functional state of haemodynamics 1 day after plasmapheresis is the earliest symptom of progressing endotoxemia and is though to be an indication for redetoxication.

Adolescent↗
PubMed1991

[Myocardial reserve during filtration detoxification in patients with suppurative peritonitis].

Feasibility of measuring functional reserve of the myocardium under functional loads simulated by extracorporeal circulation was tried in 36 patients with diffuse purulent peritonitis on filtration detoxication. Altogether 49 sessions of hemofiltration and filtration exchange plasmapheresis were performed controlled by tetrapolar rheography. It is demonstrated that persistent decline of systolic and cardiac output, an increase of central blood volume and occurrence of a pathological impedance wave in response to pre- and postload on the myocardium during extracorporeal detoxication may serve an indication of a subclinical myocardial failure. Detection of a reduced myocardial reserve suggests restriction of hemodilution in plasmapheresis and infusion therapy or lasix administration in postfiltration period.

Cardiography, Impedance↗
PubMed1990

[Hemofiltration in the terminal phase of diffuse suppurative peritonitis].

Hemofiltration was for the first time used in multiple-modality treatment of 26 patients with peritonitis in the terminal phase with symptoms of organic and multi-organ insufficiency. Indications to and contraindications against this treatment modality were developed, as was the optimal scheme of hemofiltration in peritonitis patients. This method was found the most effective in patients with symptoms of multi-organ insufficiency (respiratory distress syndrome, nephropathy, hypodynamic syndrome, toxic and hypotoxic edema of the brain). Inclusion of this method into the complex of therapeutic measures has helped prolong the intensive care of peritonitis patients in the terminal phase in the majority of cases. Fourteen patients died, the death rate has made up 53.8 percent.

Adolescent↗
PubMedDate not supplied

[Malignant tumors in patients with kidney transplants ].

In this retrospective study we evaluated incidence of malignancies observed among 718 renal transplant recipients with at least 6 months of follow-up. A total of 461 men and 257 women (mean age at transplantation 36.3 +/- 8.3 years) were included. Thirty three out of 718 recipients (4.6%) developed malignant neoplasia: 45.4% of these were Kaposi's sarcomas, 12.1%--cancers of the uterine cervix, 12.1% cancers of the stomach, 12.1%--basal cell carcinomas, 6.06%--posttransplant lymphoproliferative disorder. There was no significant effect of either cyclosporin A doses or OKT3/ATG on the incidence of the tumors. Mean age of transplant recipients with malignancies was statistically higher as compared to those without malignancies (45.5 +/- 8.2 years versus 36.1 +/- 8.4 years, p < 0.00001). The median time from onset of end-stage renal failure (dialysis start) and from the transplantation to the diagnosis of the tumor make up 32 (16-161) and 23 (5-158) months, respectively. One renal transplant patient suffered from multiple myeloma with aggressive course.

Adult↗
PubMedDate not supplied

[Integrated hemodynamic response to hemofiltration and peritoneal dialysis in patients with acute renal failure].

Central hemodynamics was studied by integral polyrheography in 24 patients with acute renal failure (ARF) during hemofiltration (HF) and in 18 patients with ARF during peritoneal dialysis. All central hemodynamic parameters improved by the end of HF. However stroke volume decreased by 26.6%, stroke index by 24.4%, minute volume by 25.7%, and cardiac index by 24.8% as early as at the moment of extracorporeal contour filling. This was paralleled by an increase of total peripheral vascular resistance from 1321 +/- 124 to 1586 +/- 106 din/(cm*c-5) (by 16.7%). Hence, clear-cut signs of centralization of circulation were seen during the initial period of HF in patients with ARF. Peritoneal dialysis did not lead to centralization of circulation in patients with ARF; moreover, minute heart volume increased by 9% during some stages of the procedure, stroke volume increased significantly (p < 0.05), other parameters increased, but total peripheral vascular resistance was virtually unchanged. After removal of dialysis solution from the abdominal cavity all hemodynamic parameters returned to the initial values. Hence, both hemofiltration and peritoneal dialysis ameliorate the central hemodynamics. However peritoneal dialysis does not involve even temporary centralization of circulation, which has a positive impact on the course of acute tubular necrosis.

Acute Kidney Injury↗
PubMedDate not supplied

[Selective detoxication of the portal vein blood in toxic hepatopathy in patients with peritonitis].

Selective detoxication of the blood from the portal vein was carried out in 31 patients with peritonitis complicated by multiple organ dysfunction including toxic hepatopathy. Selective extracorporeal detoxication of the blood from the portal vein possesses notable regional hemodynamic advantages in comparison with other variants of vascular approaches and essentially improves the transhepatic bloodflow. The authors emphasize that bifiltration cascade exchange portoplasmapheresis is a method of choice in severe toxic hepatopathy in patients with peritonitis. They recommend alternating bifiltration cascade exchange portoplasmapheresis with portohemofiltration in patients with toxic hepatonephropathy.

Adolescent↗
PubMedDate not supplied

[Continuous low-flow vein-vein hemofiltration in peritonitis: changes in the severity of endotoxicosis as a criterion for the efficiency of the technique].

The efficiency of intermittent and continuous hemofiltration was comparatively evaluated in the complex treatment of 27 patients having multiple organ dysfunction along with pyoseptic complications of abdominal diseases. Based on the study of a broad spectrum of markers of toxicosis and the severity of organ dysfunction, it was concluded that the efficiency of the procedure should be objectively evaluated to optimize the time of its performance.

Female↗