[Pancreatic cancer and diabetes mellitus].
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Biomedical subjects
Publications and source records attributed to T B Duboshina.
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Examined were 27 patients with pancreatic cancer and concomitant diabetes mellitus. It was established that in women, the likelihood of pancreatic cancer development increases with the age. Obesity and cholelithiasis are also the risk factors for development of cancer of the given location. In pancreatic cancer and diabetes mellitus lasting more than 2 years which is an independent disease with a tumor developed against its background, the mutual aggravation syndrome occurs: a severe course of diabetes and increased growth of a neoplasm.
Of the 256 patients with diabetes mellitus and purulent surgical infection, in 20.7%, the complications were revealed: those caused by the course of diabetes mellitus, systemic, caused by progressing of the purulent infection and sepsis. The factors of risk of the development of these complications are considered, the characteristics of immune and hormonal status of the patients is given. The measures directed at prevention and treatment of complications are suggested.
The work deals with the features of the course of gastric and duodenal ulcers in diabetes mellitus and the frequency and pattern of the complications. The authors recommend criteria for preparation for surgical treatment, methods for compensation of the disturbances of carbohydrate metabolism, and the methods of postoperative management of such patients. The late-term results and analysis of treatment are discussed briefly. The coexistence of peptic ulcer and diabetes mellitus is a rare occurrence. During a 20-year period 31 patients were treated at the clinic, 21 of them underwent operation, in 5 patients an operation was considered inexpedient, another 5 patients refused to be operated on. The postoperative period was free of complications in 19 patients, there were no fatal outcomes.
The authors examined 56 patients with various forms of purulent surgical infection. The number of T- and B-lymphocytes and the level of immunoglobulins, complement, and immune complexes was determined. It was established that the level of circulating immune complexes reflects the clinical situation most authentically. Five- or six-fold increase in immune complexes is a constant sign of a persisting and severe inflammatory process marked by the predominance of destructive changes and tendency to generalization.
The article presents data on epidemiology of AIDS and on the significance of this infection in surgical practice.
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Operations were performed in 1020 patients with acute cholecystitis, 530 of them were older than 60. The total postoperative lethality was 2,6% of cases, that in elderly and senile patients was 4,15% of cases. Among 530 patients older than 60, 275 patients (52%) were found to have coronary atherosclerosis and ischemic heart disease. Under consideration were particular contraindications from the cardio-vascular system against operations in the interval. The method described gives the opportunity to fulfil operations in 50% more cases among patients older than 60 having acute cholecystitis.
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A total of 955 surgical patients with concomitant diabetes mellitus were treated at the Stomatological Medical Institute Surgery Faculty Hospital. Therapeutic experience made physicians arrive at a conclusion on the necessity of active detection of carbohydrate metabolic derangements in high risk patients, as well as reasons for the decompensation of diabetes mellitus in surgical patients. Decompensation was caused by the activation of the hypothalamohypophyseal-adrenal system in stress and a considerable increase in contrainsular factors in the blood with a decrease in adaptive function of the pancreas. A high proteolytic activity of the blood in decompensated diabetes mellitus resulted in insulin inactivation. Means for the correction of the above disorders were proposed.
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