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Biomedical subjects

R Z Losev

Publications and source records attributed to R Z Losev.

At least 19 recordsLinked to original sources
PubMed2005

Evaluation of microcirculation in elderly patients with venous trophic ulcers.

Altogether 112 patients over 50 years of age suffering from varicosity and chronic trophic ulcers of the distal limb segments were examined. The work was based on an analysis of the microcirculatory flow in lower limb tissues (laser Doppler flowmetry, BLF 21 system, Transonic Systems Inc., USA) and on the evaluation of tissue metabolism by measuring partial oxygen and carbon dioxide tension (percutaneous polarography; TCM-3 system, Radiometry Company, Denmark). The postischemic and orthostatic tests were used to assess the functional microcirculatory reserve. The data obtained indicate local tissue hypoxia in elderly patients with venous trophic ulcers associated with an increase of the basal flow only in the lower third of the leg. Venous trophic ulcers are marked by a significant reduction of partial oxygen tension in the tissues adjacent to the area of trophic ulcers to 4.3+/-0.5 mm Hg on the average in the presence of the low functional microcirculatory reserve. Local tissue hypoxia in the area of trophic ulcers, which develops despite an increase of blood inflow to the microcirculatory bed evidences inhibition of tissue flow and activation of the arterio-venular bypasses. The results obtained in the course of the study allow to optimize the treatment policy in elderly patients suffering from venous trophic ulcers. In addition to the measures lowering venous hypertension, the treatment should include correction of microcirculatory disorders, which is to be carried out in the pre- and postoperative periods.

Aged↗
PubMed2005

[Modern views of diabetic angiopathy of the lower limbs (epidemiology, risk factor, etiopathogenesis, atherosclerosis of diabetes mellitus). Part I].

Today diabetes mellitus is one of the most important problems of modern medicine. This review provides an analysis of the reported data on the problem of vascular lesion in patients with diabetes mellitus. The authors consider the problems of diabetes mellitus epidemiology and the incidence of vascular pathology in patients with disorders of carbohydrate metabolism. Introduced the characteristics of the main etiopathogenetic aspects of the origination of diabetic angiopathies with regard to the latest studies into the given subject matter. Special attention is focused on the development of atherosclerotic lesion of lower limb arteries in the presence of diabetes mellitus. The authors review the most important causes of initiation and activation of the process of vessel wall lesion and formation of atherosclerotic plaques in diabetic patients. The study of risk factors of vascular pathology with delineation of the most substantial ones is of paramount importance for both prevention and sound pathogenetic treatment of the given pathology as well as for refinement of the results of surgical treatment of atherosclerotic occlusions associated with diabetes mellitus.

Atherosclerosis↗
PubMed2004

[The significance of urgent laparoscopy and mathematical prognosis in diagnosis of patients with combined trauma (preliminary communication) ].

Results of 376 laparoscopies for combined traumas performed during 3 years were analyzed. Characterization of the contingent of the patients and mechanisms of the traumas is given. The diagnosis was correct and exact in 100%, in 78.2% of the patients it was possible to find out the injured organ. The expedience to expand the indications to laparoscopy for combined traumas and to fulfill the operations in the shortest time after admission was stressed. A mathematical evaluation of the strategy of doctor's behavior was made for objectivization of the psychological solution of the doctor concerning the methods of treatment of patients with a combined trauma.

Abdominal Injuries↗
PubMed2001

[Hemorheological disorders in patients with critical ischemia of the lower limbs of atherosclerotic genesis].

A comparative analysis of hemorheological indices was carried out in 105 patients with different variants of the course of critical ischemia of extremities and in 35 patients with intermittent claudication (as a reference group). Disturbances of the rheological properties of blood were revealed in the extremity muscles and in 62.4-68.8% of patients with a low functional reserve of the extremity muscles. All the examined patients had a low level of total cholesterol against the background of dyslipoproteinemia characterized by a decreased level of cholesterol of high density lipoprotein with a mild elevation of the concentration of cholesterol of low and very low density lipoproteins.

Aged↗
PubMed1996

[The current problems of the surgical procedure in acute hemorrhages from gastroduodenal ulcers].

The article presents results of treatment of bleeding gastroduodenal ulcers in 1010 patients for 23 years. The active temporizing policy during the first 8 years resulted in 8.1% lethality while the active methods gave 8.24% lethality in six times greater number of patients. In the active policy urgent and emergency operations were performed on 43.6% of the patients with postoperative lethality 12.9%. Lethality among non-operated patients was 4.6%. Using the active surgical methods allowed lethality to be substantially decreased in the group of non-operated patients. The postoperative lethality was stabilized due to a less amount of recurrent bleedings and of "operations of despair". Recommendations are given to restrict the indications for Billroth-2 gastric resections because of a great risk of incompetent stump of the duodenum. Wider using the organ-saving operations is recommended, especially in elderly patients and against the background of haemorrhagic shock. The growing amount of patients with ulcerous gastroduodenal bleedings (which has become 2.4 times greater for the recent 15 years) makes further investigations in this direction very actual.

Acute Disease↗
PubMed1992

[Intravascular laser irradiation of blood in multimodal treatment of patients with obliterating diseases of the lower limb vessels].

The work analyses the results of the multimodality treatment of 80 patients among whom 20 suffered from endarteritis obliterans and 60 from atherosclerosis obliterans of the lower limb vessels. In the process of complex treatment intravascular laser irradiation of blood (ILIB) was carried out by introducing the light guide into a peripheral vein. In 31 (73.8%) patients with decompensated circulatory disorders in the limbs, a course of ILIB produced a good clinical effect. A positive effect was encountered in 35 (92.1%) of patients with subcompensated circulatory disorders in the lower limbs. The clinical efficacy of ILIB is due to normalization of blood coagulative properties, increase of the fibrinolytic potential, improvement of hemorheology, and normalization of the lipoprotein ratio.

Adult↗
PubMed1991

[Extra-peritoneal operations in arteriosclerotic lesions of the abdominal aorta and its branches].

The study is based on the analysis of the results of examination and operative treatment of 692 patients with atherosclerotic lesions of the aorta, its branches, and the limb arteries. The advantages of the extraperitoneal approach to the aorta over the transperitoneal approach in aorto-femoral reconstructions is proved. Stable postoperative intestinal paresis, peritonitis, intraabdominal bleeding, eventration, and adhesive disease do not occur with this approach. Such operations are not attended by a high incidence of coronary and cerebral vascular complications during and after the operation. The work gives the first appraisal of the results of postoperative plasmapheresis (21 patients) applied for normalization of hemorheological and lipoprotein disorders in different periods after the operation. The suggested complex approach to the treatment of atherosclerosis obliterans facilitates improvement of the immediate and late-term results of reconstructive operations on the vessels.

Adult↗
PubMed1990

[Vein grafts in situ in surgery of atherosclerotic lesions of the arteries of the lower limbs].

Reconstructive operations with the use of autologous veins were carried out on 154 patients with occlusive lesions in the femoropopliteal and femorotibial segments. Reversed autologous vein was used to form a shunt in 109 patients and autologous vein in situ in 45 patients. Patency of the shunts, both in the immediate and late-term periods, was higher in the in situ techniques than in the group with a reversed vein (93.3 and 88.8%; 78.9 and 72.4%, respectively). With the use of micro-surgical techniques the number of good results increased by 20.4%. In successful reconstructions in both groups the malleolobrachial index increased from 0.27 +/- 0.02 to 1.03 +/- 0.15. There were no statistically significant differences in the values of the malleolobrachial index in patients of both groups with functioning shunts in the late-term period (of up to 2 years).

Arteriosclerosis↗
PubMed1989

[Reconstructive surgery in isolated and concurrent atherosclerotic occlusive lesions of the main blood vessels].

The article discusses the choice of operative methods and the stages in the treatment of patients with atherosclerosis of the abdominal aorta and lower limb arteries with consideration for the involvement of the coronary and cerebral arteries in the process. A total of 749 reconstructive operations were conducted on the abdominal aorta, its unpaired branches, arteries of the lower limbs, and coronary and extracranial arteries in 676 patients. The principle of extraperitoneal operations on the abdominal aorta was regarded as the basis in improving the results of treatment of patients with concurrent lesions. The authors substantiate the choice of a one-stage or many-stage type of operations on the vessels of different regions with due account for the localization of the affection, the degree of vascular insufficiency in each channel, and the life prognosis.

Aorta, Abdominal↗
PubMed1982

[Surgical treatment of aneurysm of the abdominal aorta].

Specific features of the course of the process, diagnosis and treatment of 40 patients with aneurysm of the abdominal part of the aorta were studied. Surgical methods used in different groups of the patients were substantiated with special reference to the character of the pathological process. The operation technique permitting to shorten the time of ischemia of tissues of the pelvic organs and extremities is described.

Adolescent↗
PubMed1977

[Unsolved problems of acute injury of major blood vessels of the extremities].

The experience with the treatment of 312 acute blood vessels trauma consecutive cases is generalized in this article. The problems dealing with differential estimation of reconstructive surgery, indications for reconstructive operations on patients with traumatic shock, blood loss and severe ischemia of the injured extremity are considered. Experimental studies on 35 dogs and clinical observations over 95 (30.4%) cases of traumatic shock and blood vessels injury permitted to reveal some peculiarities of homeostasis alterations when the ischemized extremity gets involved into the blood flow, and to show the grounds for using the differential tactics under such conditions.

Acute Disease↗