[Comment of the article by Ia. S. Tsimmerman "On Teaching Certain Key Issues in Therapy of Internal Diseases" (Klinicheskaia meditsina, 2001; No. 10)].
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Biomedical subjects
Publications and source records attributed to E S Ryss.
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Clinical and bacteriological examinations performed in 138 patients with chronic renal failure (CRF) have found in the majority of late-stage examinees endogenic chronic colitis (ECC). This should be taken into consideration when prescribing repeat enteroclysis for correction of some uremia symptoms. Etiologically, ECC may be due to intestinal dysbacteriosis.
Enterosorbents were tried clinically in 90 patients with chronic renal failure and in vitro (immersion into gastric juice, enteral and colon content). Advantages of granulated carbone sorbents over polyphepan, lignin derivative, were evident.
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The authors analyze pilot experience with clinical introduction of intestinal dialysis in 7 uremic patients. Repeated sessions of the dialysis relieved some symptoms of uremic intoxication. The method may be of value in contraindications to chronic hemodialysis for chronic renal failure. The technique is easily performed and well tolerated by the patients. The investigations should be continued.
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Two groups of patients with chronic renal failure (CRF) underwent chronic hemodialysis within 1976-1990. Acute ulcerogenic situation in them arose during month 1-3 of the treatment. Formation of ulcers was closely related to the acid-peptic factor. Hemodialysis procedure was found to contribute to ulcerogenesis, chronic hemodialysis being somewhat an iatrogenic risk factor in such patients. Modern policy of managing duodenal ulcers in hemodialysis patients is discussed.
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The therapeutic efficacy of the continuous 6-week application of the enterosorbents CKH-4M and CKT-6A was traced in 64 patients with chronic renal diseases and different stages of chronic renal failure (CRF). The treatment was established to be most effective in the early stages of CRF. The morphologically verified manifest nephrogenic gastropathy was often associated with lack of the therapeutic effect and deterioration of the clinico-laboratory characteristics. Enterosorption brought about a decrease of ammonia concentration in gastric juice coupled with a positive time course of changes in dyspeptic disorders in such patients.
A conception of ++non-ulcerative dyspepsia is suggested. Relevant symptoms and their pathogenetic mechanisms are outlined. Basing on clinical aspects, separate forms of the syndrome, therapeutic and diagnostic approaches to each of the forms with special emphasis on pilot chemotherapy are considered.