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Biomedical subjects

Iu L Shevchenko

Publications and source records attributed to Iu L Shevchenko.

At least 19 recordsLinked to original sources
PubMed2003

[Prognosis of outcome of radical surgery in patients with lung cancer associated with severe complications and concurrent diseases].

From 1981 to 2001 (20 years) 1307 patients with lung cancer underwent surgery. Postoperative lethality was 1.7% (after 635 pneumonectomies it was 2.4%, after 672 lob- and bilobectomies--1.2%). Medical histories of 171 operated patients with severe concomitant diseases was studied to analyze surgical outcomes depending on such important factors as age, concomitant diseases, surgical trauma. It is demonstrated that age of patients is not a factor of postoperative prognosis, but concomitant diseases and surgical trauma (i.e. pneumonectomy) are important factors of it. Results of surgery in the group of patients with four and more concomitant diseases after pneumonectomy were most unfavorable (lethality was 22.9%). In less severe surgical trauma (lobectomy) results of surgery were more favorable. It is concluded that surgery in patients with a lot of concomitant diseases must be less radical to obtain lower lethality. Radicality of treatment in these patients is ensured due to complex chemo- and radiation therapy after surgery.

Adult↗
PubMed2003

[Current aspects of diagnosis and treatment of symptomatic arterial hypertension of adrenal genesis].

AIM: To analyse the experience in diagnosis and treatment of arterial hypertension (AH) of adrenal genesis. MATERIAL AND METHODS: A total of 243 patients with adrenal AH (mean age 46.3 +/- 3.2 years) were examined. 134 of them had endogenic adrenohypercorticism (EAH), 62--primary hyperaldosteronism (PHA), 47--chromaffin tissue tumors (CTT). Diurnal urinary excretion of adrenal hormones (epinephrine, norepinephrine, aldosteron, hydrocortisone) and peripheral blood hormones (aldosteron, renin, hydrocortisone, ACTH) were measured. Topic diagnosis was made with ultrasound, computed tomography, MR-imaging, angiography, adrenal venous sampling and 123I-MIBG scintigraphy. RESULTS: Adrenalectomy was made in 224 patients (predominantly with tumor lesions). 19 patients (idiopathic hyperaldosteronism, advanced adrenocortical carcinoma) were treated conservatively (calcium antagonists, ACE inhibitors, AT1-receptor blockers, spironolacton). Good results of the surgical treatment were achieved in 60% patients with aldosterone-producing adenoma and adrenal Cushing's syndrome as well as in 80.5% patients with pheochromocytoma. Long-term outcomes depend on hypertension duration, histologic type of the tumor, age and family hypertension history (risk of essential hypertension). CONCLUSION: Hypertension of adrenal origin occurs more frequently than it was supposed previously. Its late diagnosis may be due to lack of typical signs and symptoms, insufficient application of novel diagnostic techniques and poor alertness of physicians. It is recommended to include tests for adrenal hormones in urine and blood and ultrasound investigation of the adrenals in a complex of primary examination of patients with severe refractory hypertension.

Adrenal Cortex↗
PubMed2002

[Change in central hemodynamics in lymphoma patients].

AIM: To elucidate features of hemodynamics in patients with lymphoma and hemodynamic effects of polychemotherapy. MATERIAL AND METHODS: Parameters of central hemodynamics were studied echocardiographycally in 42 patients with lymphoma. RESULTS: In a definite rise in the levels of tumor progression markers, changes in the immunity, impaired hemopoiesis there was rearrangement of hemodynamics (development of tachycardia, trend to excentric remodeling of the left ventricle). The above changes in hemodynamics enhanced in conduction of polychemotherapy. CONCLUSION: To avoid cardiotoxicity of polychemotherapy, lymphoma patients should receive cardioprotectors.

Echocardiography↗
PubMed2001

[Altered left ventricular diastolic function in patients with lymphogranulomatosis].

Impaired elastic characteristics of the left heart ventricle and restructuring of its diastolic bloodflow were revealed in 28 patients with Hodgkin's disease by complex Doppler echocardiographic study of intracardiac hemodynamics. The most pronounced disorders of the diastolic function were detected in patients with pericardial involvement. More pronounced tumor intoxication in patients with mixed-cell variant of the tumor resulted in remodeling of the left ventricle, left atrial dysfunction, and restructuring of the diastolic bloodflow, which indicated combined impairment of the left ventricular diastolic relaxation and left atrial contractility. Chemotherapy augmented disorders in diastolic bloodflow, the increase in the number of polychemotherapy courses being associated with a trend to deterioration of left-ventricular relaxation. Hence, tumor intoxication and drug cardiotoxicity determine the formation of central hemodynamic disorders, one of whose principal components is diastolic dysfunction of the left heart ventricle.

Hodgkin Disease↗
PubMed2001

[Adrenergic innervation of the myocardium in patients with cardiac syndrome X].

11 syndrome X patients and 8 healthy controls were investigated by myocardial scintigraphy (SPECT) with 123-I-MIBG. Regional defects in cardiac 123-I-MIBG uptake were found in 90% syndrome X patients. Total cardiac 123-I-MIBG uptake appeared significantly higher in syndrome X patients. Perfusion defects on stress 99m-Tc-MIBI scintigraphy were found in 10 syndrome X patients who had also abnormal 123-I-MIBG scintigrams. It is suggested that impairment of efferent cardiac adrenergic nerve fiber function in syndrome X patients may contribute to pathophysiologic and clinical features of syndrome X.

3-Iodobenzylguanidine↗
PubMed2000

[Electrocardiographic changes during coronarography].

The endocardial manipulations and bolus intracoronary administration of contrast substances, of the first generation in particular, can induce disturbances of the myocardium repolarization and different disturbances of the cardiac rhythm, life-threatening included. The aim of the investigation is to assess transitory electrophysiological alterations in the myocardium during coronarography and during the first day after it. Under examination there were 39 patients with ischemic heart disease and stenocardia of the II-III functional classes in whom the coronarography was performed according to clinical indications. The Holtner dynamic observation of ECG was made in all the patients. All the ECG changes were detected and estimated during coronarography: arrhythmias, disturbances of conduction and transitory ischemic alterations of the myocardium. It gives a possibility to decide between the methods of pharmacological correction of possible disturbances.

Aged↗
PubMed2000

[The ways of improvement of surgeons' training at the Department of Managerial Medical Staff of the Military Medicine Academy].

The urgent need to discuss with military surgeons the problem of improvement of educational process in the faculty of managerial medical staff of the Military-and-Medical Academy under the new social-and-economic conditions against the background of the RF Armed Forces reformation has prompted the authors to write this article. The first report deals with the problems of general organization of educational process taking into account the needs for surgeons with higher military education and creation of certified specialized surgical care in the Troops. The authors suggest that all people with interests at stake should express their opinion concerning this problem.

Curriculum↗
PubMed1999

[Diagnosis and treatment of early bleedings after open-heart surgery].

On the basis of practical experience of the clinic for Cardiovascular Surgery and up-to-date literature data the causes of early bleedings after open-heart surgery are summarized. The main clinical, roentgenological and laboratory features of the bleeding and the methods for the assessment of their origin are demonstrated. The authors consider pathophysiologic causes of hemocoagulation disturbances after surgery with artificial circulation. Characteristics of clinical and laboratory tests for coagulation and hemostasis disturbances and the algorhythms for their interpretation are described. Both nonspecific and pathogenetic methods for management of coagulopathy bleedings in early postoperative period have been described and discussed.

Blood Coagulation Tests↗
PubMed1999

[Role of heat-shock proteins in cardioprotection of patients operated on for ischemic heart disease].

Major stress protein HSP72 is known to participate in protecting cells and organisms against harmful factors including ischemia, trauma etc. Under study was the level of HSP72 in the myocardium of 32 patients with coronary disease operated in Military-medical academy. HSP72 was detected in probes of the right atria before and after pre-cardiopulmonary bypass in all cases induction of HSP72 was observed in 40% of patients, and directly correlated with the time of cardiopulmonary bypass and standing of the disease. The cardioprotective effect of the elevated pre-operational level of HSP72 was shown to be proportionate to the lower activity of cardiospecific enzymes, creatine phosphokinase (CK-MB). It is suggested that HSP72 is involved in the mechanism of cardioprotection during cardiopulmonary bypass.

Adult↗
PubMed1999

[Prevention of prosthetic heart valve infection].

Fourty patients with primary and secondary infective endocarditis of the native heart valves as well as patients with rheumatic heart diseases not complicated by infective endocarditis were operated upon in the clinic from 1996 till 1998. The prosthetic heart valves in which the tissue cuff was sutures by blanket suture along the perimeter with a silver thread were implanted to 25 patients. In the other 15 patients (a control group) prosthetics were made using unchanged construction of the prosthesis (without the silver thread). Patients with valve prostheses sutured with the silver thread had smooth postoperative period. They had no prosthetic endocarditis either at the early or at late postoperative periods. In 3 patients of the control group infective endocarditis of the valve prosthesis developed at different periods after operation. All of them were reoperated. The authors consider that defense of the tissue cuff of the prosthetic valve with the silver thread allows risk of the development of prosthetic endocarditis to be substantially reduced. In the cases described it was completely avoided.

Adolescent↗
PubMed1999

[Continuous inhalation administration of surfactant-BL for control of adult respiratory distress syndrome after reconstruction of the abdominal aorta].

A 62-year-old patient with Leriche's syndrome and critical ischemia of the low extremities has undergone the surgery of aortofemoral grafting. A patient has developed the severe ARDS on the second day of reperfusion (bilateral diffuse infiltrates, PO2/FiO2 < 100, lung injury score was 3). Different ways of administration of bovine surfactant (SURFACTANT BL, Russia) were used during the treatment. Total application time was 84 hours, total dose was 4000 mg (50 mg/kg). Considerable improvement of lung function occurred after start of the continuous inhalation of surfactant with a constant rate of 63 mg/h. Two hours after this step PO2/FiO2 reached 400 mm Hg and remained stable 12 hours more, up to the end of surfactant administration. The patient was soon successfully extubated and discharged on the 25th day after surgery. It is supposed that in spite of a small total dose of bovine surfactant the success was achieved due to an early start of the surfactant replacement, continuous inhalation and its definite rate.

Administration, Inhalation↗