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[Sorption detoxification in the combined therapy of chemical eye burns].

Comparative assessment of results after treatment of 90 patients with chemical burns of moderate and severe degrees was made using a sorption (103 eyes) and traditional (47 eyes) methods of treatment. The sorption method included the usage of ocular medicinal ionometabolic insertions and a 10% medicinal gelatine that are able to eliminate ions from the burning substance and toxic product formed in the eye due to burns. As a result of treatment, the sorption method allowed to obtain higher functional results, to achieve a shorter time for the patient's stay in the hospital, by 11.2 bed-days, on the average. Thanks to the sorption method introduced into the clinical practice the economic effect made up about 50,000 rubles yearly.

Acute Disease

[Effect of sorption detoxification in severe burns on the development of cell-mediated reactions in the vascular and extravascular phases of inflammation].

In combined use of general and local sorption detoxication in 30 patients with severe burns, the pronounced antiinflammatory action is caused by redistribution of neutrophilic granulocytes with different activity of myeloperoxidase systems, decrease in lesion of a vascular wall and development of the perfect cellular reactions into extravascular phase of inflammation. The area of deep burn wounds reduced 2.8-fold when compared with that in patients, in whom no sorption methods were used.

Adolescent

[Adaptation reactions in acute peritonitis and their correction using sorption detoxification].

Examined were 233 patients with acute peritonitis. In patients, who underwent the conventional intensive infusion therapy alone, in complicated course of the postoperative period, within 28 days, the high level of pathologic stress reactions was observed, which correlated with changes in the content of middle molecular mass peptides (MMMP). In uncomplicated course of the postoperative period, the MMMP level and adaptation reactions didn't differ from the control findings. Hemosorption in patients with high toxin level was accompanied by the decline in MMMP concentration below the diagnostic level, restoration of physiologic adaptation reactions.

Acute Disease

[Myoglobinopathy as a cause of acute interstitial nephritis].

The course of the acute renal failure (ARF) was studied in 3 patients with rhabdomyolysis (1 with the position compression syndrome, 1 with march myoglobinuria, and 1 with chronic recurrent rhabdomyolysis). The ARF syndromes were revealed in 2 patients 5-7 days after onset of the disease; in 1 patient (chronic recurrent rhabdomyolysis), ARF recurred. This suggests that the patients developed acute interstitial nephritis (AIN) Prolonged myolytic conditions due to ill-timed initiation of treatment led to the fact that AIN was complicated by ARF in 2 patients, and 1 patient with chronic myopathy had an "immune readiness" for myoglobin to affect the kidneys, which also resulted in ARF. It was stressed that the methods of extracorporeal detoxification (hemodialysis, hemosorption) were highly effective in treating AIN and ARF.

Acute Disease

Detoxification and mineral supplementation as functions of geophagy.

Clays employed historically in the consumption of astringent acorns plus seven edible clays from Africa were examined in relation to the functional significance of human geophagy. On the basis of sorptive maxima for tannic acid ranging from 5.6 to 23.7 mg/g, we conclude that adsorption of tannic acid in traditional acorn preparation methods in California and Sardinia helped make these nuts palatable. Calcium available in solution at pH 2.0 and 0.1 mol NaCl/L was 2.10 and 0.71 mg/g for the Sardinian and Californian clays, respectively. The African clays released calcium, copper, iron, magnesium, manganese, or zinc in amounts of nutritional significance from some clays but not from others. A clay recovered from an archaeological site occupied by Homo erectus and early H. sapiens was indistinguishable mineralogically, in detoxification capacity and in available minerals, from clays used in Africa today. We suggest that the physiological significance of geophagy made it important in the evolution of human dietary behavior.

Cooking

[Substantiation and effectiveness of various methods of detoxification in burns].

On the basis of comparison of the intoxication manifestations at the cellular level, findings of blood toxicometry, and as well study of the factors of antitoxic resistance of an organism in 217 patients who suffered from burns, the indications for performance of basic transfusion therapy, extracorporeal detoxication of the blood, and also postsorptive transfusion therapy have been established.

Blood Transfusion

[The affinity lavage of the abdominal cavity in diffuse peritonitis with liquid sorbents based on cross-linked dextrans].

Experiments were conducted on 35 Wistar rats with generalized purulent peritonitis. Twenty-four hours after infection the authors introduced into the animals' abdominal cavity gels of cross-linked dextrans with immobilized polymixin (50 mg/g dry weight) and terrilithin (100 PE/g dry weight), as well as a combination of these sorbents with 24-hour exposure in a 5 ml volume. The object of the study was the detoxification effect. The authors revealed a phenomenon of agglutination of red cells of an ox or rat sensitized by plasma of sick animals in mixing with sephadex G-200 granules with polymixin W immobilized on them. The agglutination titers determined the activity of the sorbent taking part in lavage of the abdominal cavity. The study showed that cross-linked dextrans with immobilized polymixin B and terrilithin introduced into the abdominal cavity in peritonitis are capable of extracting substrates possessing affinity to them, the polymixin sorbent raises the quality of careful mechanical lavage. Combination of gels based on cross-linked dextrans with enzymatic and affinity functions in relation to toxins leads to detoxification and restoration of the disturbed biochemical values by 87%.

Abdomen

[Modern detoxication methods in surgical patients].

The therapeutic possibilities of peritoneal dialysis, hemodialysis, and hemo- and lymphosorption in the treatment of the intoxication syndrome were studied in 786 patients. The causes of the intoxication syndrome were as follows: postoperative peritonitis (98), acute renal insufficiency of various etiology (493), acute hepatorenal insufficiency with exogenous poisoning (178), diffuse purulent peritonitis (11), pancreatogenic peritonitis (6). Enzymatic lavage and peritoneal dialysis were applied in 98 patients, hemodialysis methods in 493, hemosorption was conducted 360 times in 178 patients and lymphosorption in 17 patients. The efficacy of the modern methods of detoxification of the organism was demonstrated, which was evaluated from the patients' improved general condition, improvement of the values of hemodynamics, concentration of toxic metabolites and middle-mass molecules in the blood, and the results of the paramecium test.

Adolescent

[Efferent detoxification therapy in the complex treatment of diffuse suppurative peritonitis].

Upon the analysis of efferent combined therapy for diffuse purulent peritonitis in 130 patients, it was found that efferent detoxication promotes elimination of intoxication, correction of homeostasis abnormalities, recovery of basic systems of the body, a decrease of postoperative lethality and complications. The choice of the optimal detoxication method should be individual and adjusted for a peritonitis stage and a concrete clinical purpose.

Adult

[Extracorporeal methods for detoxification in the combined treatment of gunshot peritonitis].

On the basis of examination results and treatment of 49 patients with abdominal gunshot injuries the article emphasizes that the clinical picture of gunshot peritonitis develops much faster, and the syndrome of intoxication proceeds far harder, than in cases of peritonitis with another etiology. The authors make a conclusion that an early application of extracorporal methods of detoxication (hemosorption, plasmapheresis, ultraviolet irradiation of autologous blood, xenospleen connection) could minimize the level of intoxication and contribute to the correction of the immune status.

Adolescent