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Biomedical subjects

M M Abakumov

Publications and source records attributed to M M Abakumov.

At least 19 recordsLinked to original sources
PubMed2006

[Video-thoracoscopy in the treatment of patients with penetrating wound of the thorax].

Thoracoscopic surgical procedures were used in the treatment of 79 patients with penetrating wound of the thorax complicated by hemothorax. Small hemothorax was diagnosed in 72.1% patients; 56.1% had injuries of thoracic organs, 26.3% -- injuries of diaphragm. Thoracoscopic hemostasis and correction of intrathoracic injuries were performed in 84,6% patients. Conversion to video-assisted minimally-invasive thoracotomy (because of injuries of the diaphragm as a rule) occurred in 15,8% patients, conversion to typical thoracotomy -- in 3.5%. In medium hemothorax (16.4% patients) injuries of thoracic organs and anatomic structures were diagnosed in 76.9% cases. Hemostasis and correction of intrathoracic injuries through thoracoscopic approach were performed in 43.8% patients, conversion to typical thoracotomy was necessary in 7% cases. Big hemothorax was diagnosed in 11.4% patients, 55.6% of them had injuries of thoracic organs and anatomic structures. Complete thoracoscopic procedure was performed in 44.4% cases; 33.3 patients required conversion to thoracotomy. Thoracoscopy is an effective method of surgical treatment of thoracic injuries in patients who don't require urgent thoracotomy. This procedure permits repair of intrathoracic injuries in 73.4% cases. Postoperative complications were seen in 15% cases, postoperative lethality was 1.4%.

Adult↗
PubMed2006

[Aerobic metabolism of leucocytes, and acute phase proteins in early post-hemorrhagic period in patients with penetrating thoracal and abdominal wounds].

The subjects of the study were 82 patients with penetrating gunshot (17 cases) and stab-and-cut (65 cases) thoracal and abdominal wounds, complicated by an acute blood loss of 600 to 4500 ml. Aerobic metabolism of neutrophiles was studied using spontaneous and activated HCT test and chemoluminescent analysis; the concentration of acute phase proteins (fibronectin, ceruloplasmin, C-reactive protein, and haptoglobin) during the first two days after surgery was measured. The study revealed that bigger blood loss was associated with more pronounced increase of the number of spontaneously activated neutrophiles with low bactericidal potential, decrease of fibronectin and ceruloplasmin concentrations, and increase of C-reactive protein and haptoglobin concentrations. Retrospective analysis of the treatment results showed that the rate of suppurative complications did not depend on the wound character or blood loss volume, but was higher in patients with prolonged disbalance of acute phase proteins and aerobic metabolism (12.4% vs. 2.6% in patients without such disturbances).

Abdominal Injuries↗
PubMed2006

[Traumatic hemobilia].

Authors describe experience of diagnosis and treatment of hemobilia at 10 of 743 patients with trauma of liver. At 7 patients hemobilia was due to closed trauma, and at 3--due to injuries. For diagnosis of hemobilia the USE, Doppler examination of hepatic vessels, esophagogastroduodenoscopy, selective angiography of liver were used. Selective embolization was effective at 7 of 8 patients. Hemobilia has been cured conservatively at 2 patients. Two patients died. It is concluded that complex examination including dopplerography of hepatic liver, esophagogastroduodenoscopy, selective angiography is necessary for diagnosis of traumatic hemobilia. Traumatic hemobilia must be suspected at patients with symptoms of gastrointestinal bleeding in postoperative (posttraumatic) period, and diagnosis of other sources of bleeding does not exclude hemobilia. Selective angiography and embolization of afferent arterial branch is the most effective and safe method of traumatic hemobilia treatment.

Adolescent↗
PubMed2006

[Structure of hospital lethality in polytrauma and ways to reduce it].

Case histories of 276 patients and autopsy protocols for patients who had died of polytrauma in 2002-2003 were analyzed. It was found that hospital polytrauma lethality is characterized by two peaks: within the first 24 hours after trauma (34.3% of the victims) and on day 4 and later after polytrauma (53.2%). Acute blood loss and shock are the cause of early lethality. In the period from 1 to 3 days after trauma the main causes of death are edema and dislocation of the brain in patients with dominating craniocerebral injury. Late mortality (on day 4 and later) is associated with infectious complications. The overall lethality after polytrauma decreased from 26-30% to 18.5-18.9% for the recent 10 years due to shortening of presurgical period, "cell-saver" use, improvement of anesthetic and intensive care management, mini-invasive osteosynthesis, timely prevention and treatment of brain edema, preventive use of last generation antibiotics and immune correction.

Aged↗
PubMed2005

[Diagnosis and treatment of simultaneous injuries of the thorax and abdomen].

Results of examinations and treatment of 167 patients with simultaneous injuries of the thorax and abdomen are presented. It is demonstrated that x-ray and ultrasonic examinations help make choice on right surgical policy. All the patients were divided into two groups. Study group (137 patients) was treated according to proposed curative algorithm. The rest 30 patients were included into control group. Volume of intra-surgical hemorrhage and time of surgery were greater in the control group compared with the study group. Proposed algorithm permitted to reduce number of postoperative complications from 46.7 to 21.2%, and lethality -- from 13.3 to 4.1%.

Abdomen↗
PubMed2005

[Cytokines in complex treatment of posttraumatic empyema of the pleura].

Results of treatment of 114 patients with posttraumatic empyema of the pleura (EP) after closed injury of the thorax (62), stab-incised (43) and missile (9) wounds are presented. In complex treatment of 25 patients one of cytokines - recombinant interleukin-1v (betaleukin) -- was administered intravenously (10 patients) and intrapleurally (15 patients). Control group consisted of 35 similar patients treated with traditional methods including drainage and sanitation of empyema's cavity with protheolytic enzymes, antibacterial and detoxication therapy. Comparative analysis has demonstrated that patients of the study group showed fast normalization of immunogram's parameters, decrease of duration of purulent process (51+/-4 days, on the average, in the control group and 28+/-3 days in the study group) due to fast obliteration of purulent cavity, and decrease of rate of chronic forms of EP (from 20 to 4%) which required surgical treatment.

Adult↗
PubMed2005

[Nitric oxide and blood coagulation system in clinical practice].

The article presents data concerning the effect of endothelium NO on vascular wall antithrombogenic properties, and the mechanism of NO antithrobogenic activity. The authors summarize the results of their own investigations and literature data on the role of thrombocyte NO in intravascular antithrombogenesis and the regulation of coagulation factors. Thrombocytes produce 16 times more NO then other blood cells do. A correlation between thrombocyte NO and several coagulation factors has been proved; thus complex study of NO effect on internal and external coagulation mechanisms, factors of fibrinolysis and their inhibitors, acute-phase inflammatory proteins, playing an important role in hemostasis, may bring new interesting findings. It is evident, that this knowledge will help to find ways of pathogenetic hemostasis regulation in various extremal conditions.

Blood Coagulation↗
PubMed2004

[Treatment and diagnostic policy in gunshot wounds of the pancreas].

Results of treatment of 71 patients with gun-shot wounds of the pancreas were analyzed. Features and structure of gun-shot abdominal penetrating wounds with injury of the pancreas, potential of up-to-date diagnostic methods were studied. Surgical policy in combined injuries of hollow organs and pancreas was developed. Variants and sequence of surgeries were determined depending on location and types of pancreatic injuries. Proposed treatment and diagnostic policy permitted to reduce rate of purulent and septic complications by 11.1% and lethality by 5.3%.

Abdominal Injuries↗
PubMed2004

[The endoscopic and morphological diagnostics of gastroesophageal reflux].

The experiences with endoscopic examinations of 140 patients with gastroesophageal reflux followed by the development of reflux-esophagitis (RE) of different degree are presented. The authors describe the complicated and uncomplicated forms of RE. The uncomplicated forms include RE with unimpaired integrity of the epithelium, erosive RE, erosive-ulcerous RE. The complicated forms include peptic ulcer of the esophagus, peptic stricture and Barrett esophagus. The degree of RE was found to depend on the character and degree of impairment of the obturating function of the cardia. The morphological examination of the esophagus mucosa was performed in 35 patients. Morphological heterogeneity of the so called "catarrhal RE" was shown that makes the expedience of using this term in clinical practice doubtful. Exact endoscopic and morphological criteria of the differential diagnostics of erosive and erosive-ulcerous RE, erosive-ulcerous RE and peptic ulcer of the esophagus are described.

Acute Disease↗
PubMed2003

[Generation of nitric oxide by peripheral blood leukocytes and platelets in thoracic and abdominal wounds].

Generation of nitric oxide (NO) by human blood leukocytes and platelets was studied in 23 healthy persons and in 22 patients with thoracic and abdominal wounds. The sum of points ranged, in victims, from 12 to 19 according to the APACHE II severity-degree condition. Leukocytes and blood platelets were isolated from blood by differential centrifuging. The leukocyte suspension was diluted by an absolute medium (RPMI 1640, embryonic calf serum, L-glutamine, antibiotics) up to 5 x 10(6) cells in 0.5 ml; while the blood platelet suspension was diluted to 05 x 10(8) in 0.5 ml, and they were cultivated for 15 at 37 degrees C. The concentration of NO nitrite metabolite was determined by Griss reaction. The NO content in leukocyte supernatant of healthy persons amounted to 0.38 +/- 0.03 nmol/0.5 x 10(6) leukocytes; while in patients this figure essentially increased--up to 1.06 +/- 0.08 nmol/5 x 10(6) leukocytes, (p < 0.001). The NO content in blood-platelet supernatant amounted, in the normal condition, to 1.07 +/- 0.07 nmol/0.5 x 10(8) blood platelets; in the victims it was 1.52 +/- 0.11 nmol/L blood platelets, (p < 0.01). The relative production of NO by leukocytes was found to be, in healthy persons, 0.75 +/- 0.06 mumol/L, (p < 0.001), in patients--3.05 +/- 0.22 mumol/L, (p < 0.01). The absolute NO concentration was determined with regard for an actual content of leukocytes and blood platelets in each healthy person and in each patient with thoracic and abdominal wounds. The absolute production of NO by leukocytes was, in healthy persons, 0.47 +/- 0.05 mumol/L, in patients--2.29 +/- 0.23 mumol/L, (p < 0.001). The absolute generation of NO by blood platelets was, in norm, 7.70 +/- 0.55 mumol/L, and in patients--11.45 +/- 0.84 mumol/L, (p < 0.0011). Consequently, the absolute production of NO by blood platelets is by 16 times higher than the absolute production of NO by leukocytes in healthy people. Thus, stress enhances the NO generation by both leukocytes and blood platelets.

APACHE↗
PubMed2003

[Instrumental diagnosis of reflux esophagitis].

One hundred and forty patients with clinical symptoms of gastroesophageal reflux disease were examined. Instrumental examination included esophagogastroduodenoscopy (140 patients) with target biopsy (44 patients), x-ray study of the esophagus and stomach (95), intragastric pH-metry (74), esophagomanometry (67). It is demonstrated that all the patients with clinical picture of gastroesophageal reflux disease suffer from reflux-esophagitis (RE) of various severity. Definite morphological equivalents correspond to each of endoscopic forms of RE. Complex instrumental diagnosis of RE must include intragastric pH-metry and esophagomanometry in line with esophagogastroduodenoscopy and morphological study. It is necessary to perform x-ray study in peptic strictures of the esophagus and in combination of RE with large axial hiatal hernias. Cardial or cardial-fundal hiatal hernia, increase of intragastric pressure and hyperacidity promote development of the most severe (destructive) forms of RE.

Adult↗
PubMed2003

[General issues of medical care in multiple trauma].

Experience in diagnosis and treatment of patients with combined trauma is presented. The clinicoanatomic classification of combined traumas with their division into 7 groups is proposed. The process of medical care is subdivided in 4 stages - prehospital, critical care, specialized clinical and rehabilitation. The number of patients and their qualitative characteristics at each stage are different. The majority of the lethal outcomes occur at prehospital and critical care stages. Improvement of medical care at the prehospital stage may be realized trough creation of diagnostic and treatment algorithms, at critical care stage - by adequate infusion-transfusion therapy and determination of surgical care priority. Prophylaxis and treatment of complications are very important at the second and third stages. At the rehabilitation stage 84,6% patients need treatment of locomotor lesions, 14.5% - damages of the brain, 0.5% - damages of the spinal cord. Traumas of the thorax and the abdomen don't require long rehabilitation.

Abdominal Injuries↗