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Biomedical subjects

K M Grinev

Publications and source records attributed to K M Grinev.

9 recordsLinked to original sources
PubMed2006

[Necrotizing fasciitis: pathophysiological and clinical aspects of the problem].

The data of literature and results of treatment of 17 patients with necrotizing fasciitis are analyzed. Original conception of pathogenesis based on thrombosis of microcirculatory vessels of superficial fascia is described. Endotoxemia manifested with clinical picture of sepsis and septic shock. Successful treatment is possible in cases of early diagnosis, urgent surgical treatment and intensive antibiotic therapy. Urgent cryobiopsy of tissues is an important diagnostic point. Lethality was 50% (it reaches 75% according to the literature data), this can be explained by late hospitalization and delayed operation.

Adult↗
PubMed2006

[Syndrome of infectious-toxic shock in the structure of patients with necrotizing fasciitis].

Among 28 patients with necrotizing fasciitis 18 patients had the syndrome of infectious-toxic shock with clinically severe manifestations. Nine of them had the disease with most serious (lightening-like) clinical forms of severe sepsis that led to lethal outcomes within 1-3 days. This form is referred to as an irreversible septic shock and genetically is due to two factors: 1. Type of the pathogen (Streptococcus pyogenes) whose toxin is responsible for the septic shock syndrome. 2. Spacious zone of the superficial fascia necrosis, a massive source of endotoxemia resulting from generalized thrombosis of the microcirculation bed of the fascial structures. There is no alternative to the method of treatment of patients with necrotizing fasciitis but urgent (immediately after the diagnosis) and aggressive in volume and character operation as well as an adequate resuscitation management and antibiotic therapy.

Aged↗
PubMed2005

[Necrotizing fasciitis].

An experience with treatment of four patients with necrotizing fasciitis (NF) and a review of literature were used to characterize this rare but dangerous for life disease, The pathogen of NF is a hemolytic group A streptococcus and anaerobes. The mechanism of the development of fasciitis is based on impairments in the microcirculatory bed due to the action on the cytokine endothelium. Rapidly progressing necrosis of fasciae results in a number of complications. The treatment consists of the early and aggressive necrectomy and intensive antibiotic therapy in combination with immunomodulation.

Adult↗
PubMed2005

[Aneurysms of the pancreaticoduodenal artery in association with stenosis or occlusion of the celiac trunk].

On the basis of an analysis of 69 patients including 2 personal observations the authors discuss the questions of pathogenesis, clinical picture, diagnosis and treatment of aneurysms of the pancreaticoduodenal artery in association with stenosis or occlusion of the celiac trunk (CT). A description of 2 cases with a true not broken aneurysms of the inferior pancreaticoduodenal artery and subocclusion of the celiac trunk is given which was caused by compression of the latter by the median arcuate ligament of the diaphragm and neurofibrous tissue of the celiac plexus. These patients were detected as a result of examinations and operative treatment of 556 patients with compressive stenosis of the celiac trunk for the period from 1982 through 2002. In one case a transcatheter embolization of the aneurysm was fulfilled followed in 3 months by a compression of the celiac trunk, in the other case a compression of the celiac trunk was made first and then in 5 months it was followed by resection of the aneurysm with a favorable outcome.

Adult↗
PubMed2002

[Some aspects of treatment of dissecting aneurysm of the aorta].

The problem of dissecting aneurysms of the aorta (DAA) is discussed on the basis of an analysis of treatment of 63 patients, a comparison of 19 clinico-morphological findings included. It was found that in elderly and senile patients DAA often developed in its abdominal portion against the background of atheromatous-ulcerous lesions responsible for the "scrappy" dissection and formation of "pockets" in the aorta wall. The formation of distal fenestration with a "double-barrel" was observed much more rarely. For the early diagnosis of the aorta aneurysm dopplerography of the abdominal part of the aorta is recommended in elderly and senile patients with arterial hypertension and symptoms of occlusion in the aorta-femoral segment. The operative treatment of DAA and its long-term results are analyzed. A case of clinical management of dissecting aneurysm of the ascending portion of the aorta developed against the background of congenitial dysplasia of the connective tissue successfully operated in a woman with rheumatism is described.

Adult↗
PubMed2001

[Course of heart failure in patients with terminal chronic kidney failure on chronic hemodialysis].

AIM: To evaluate peculiarities of the course of cardiac failure (CF) in initiation of hemodialysis therapy (HT) in patients with terminal chronic renal failure (CRF) and 24 months after HT; to elucidate CF causes late in HT. MATERIAL AND METHODS: Cardiohemodynamics was studied in 152 patients with terminal CRF during 2 years of HT. RESULTS: At initiation of HT, cardiohemodynamics was characterized by hyperkinetic syndrome, high total peripheral resistance, weak left ventricular systolic function, diastolic dysfunction. Chronic HT for 2 years led to attenuation of hyperkinetic syndrome, improvement of left ventricular systolic function, highly increased bypass blood flow along the arteriovenous fistula. The correction of the blood flow along the arteriovenous fistula arrested manifestations of CF in all the patients. CONCLUSION: Drugs with positive inotropic action are contraindicated in patients with terminal CRF on chronic hemodialysis having CF. Regular measurements of blood flow along the arteriovenous fistula are recommended for early detection and correction of increased bypass blood flow.

Adolescent↗
PubMed1997

[The large-pore stent in the treatment of abdominal aortic aneurysms].

The authors have performed 8 endoprostheses for aneurysms of the abdominal segment of the abdominal aorta. The open cellular stent of nitinol was implanted with diameter 32 mm, bringing system 9.0 F. The implantation was carried out without problems in 7 patients, in one patient there was dislocation of the distal fragment of the endoprosthesis which required surgical intervention. The average time of operations was (7.6 +/- 4.5) min. The open stent allowed the invasiveness of operation, its technical complexity and duration to be reduced.

Aged↗
PubMedDate not supplied

[The regulation of bone marrow hematopoiesis in splenectomy and splenic autotransplantation in mice].

The method of heterotopic transplantation of the bone marrow was used to study the influence of splenectomy and autotransplantation of the spleen onto the hemopoietic and osteogenic tissues of the bone marrow in mice. After splenectomy at early stages of the formation of the heterotopic hemopoiesis focus the amount of myelokaryocytes increased while in the stationary bone marrow population (the femur bone) their amount dropped by the same time. Autotransplantation of the spleen made the amount of myelokaryocytes equal to the level of control, but did not eliminate the effect of decrease of the mass of osteogenic tissue in the heterotopic hemopoiesis focus arising after splenectomy, which might be related with the influence of splenectomy on the stem osteogenic cells-precursors of the bone marrow.

Animals↗