PREVENTION AND TREATMENT OF SYNDROME OF INTESTINAL FAILURE
The syndrome of intestinal insufficiency in the AU is not only an important component, but the main factor of the pathogenesis of MODS. Moreover, the violation of the barrier function of the gastrointestinal tract syndrome of intestinal insufficiency creates conditions for the uncontrolled translocation of conditionally pathogenic microorganisms and their processes and maintain septic process even at a sufficiently effective remediation of other foci of infection. Intestinal failure, in fact, becomes the "motor" tanatogenesis AU, because damage to anatomical and physiological integrity of the gastrointestinal tract is included in a vicious cycle of metabolic distress syndrome and deep depression intestinal mechanisms of anti-infectious protection.
That is why prevention and correction of intestinal insufficiency syndrome is the most important area of therapy AU.
The Clinic of Surgery Medical University developed strategic directions for the treatment of this syndrome (Table 4).
Table 4
Ways of treating intestinal insufficiency syndrome
Maintaining normal microecology tract:
* Selective decontamination of the digestive tract;
* Optimal systemic antibiotic therapy.
Correction of disorders of the gastrointestinal tract:
* Drainage of the gastrointestinal tract;
* Enterosorption;
* Early enteral nutrition (and possibly natural);
* Restoration of intestinal motility;
* Application enteroprotektorov (somatostatin).
Correction of metabolic distress syndrome
Optimization of oxygen transport and microcirculation
Of particular importance is the elimination of increased intraintestinal pressure associated with abnormal sequestration in the lumen of the intestinal tube of the critical volumes of liquids and gases. In this situation, an active drainage GIT aims to actively remove the intestinal contents, thereby ensuring the effect of intestinal decompression [6]. Reducing intraintestinal pressure ensures the recovery process of blood circulation in the intestinal wall and the normalization of its motor, the barrier and metabolic functions [3].
Given the data on the pathogenesis of GI syndrome, functional impairment in AS with the maximum severity of violations in the small intestine, completely shown is the predominant drainage of the entire small intestine or proximal of its divisions.
It should be noted that currently there is no consensus on the selection method of draining the small intestine. Thus, most surgeons prefer a private method, when the probe is conducted into the intestine antegrade. In this case, the shortcomings of the method are: low efficiency of drainage due to the need for continued active aspiration of the probe against the pressure gradient, the development of respiratory disorders, mainly in patients of senile and elderly, the dislocation of the probe with the development of aspiration into the airways [3,6].
Public methods of drainage (via the gastro-, entero-, appendix-, tsekostomy) have not lost their practical value in our days, but have limited brand viagra application due to the large number of complications (detachment of the stoma, the formation of intestinal fistulas with the development of water-electrolyte and metabolic disorders) [6]. Keep in mind that prolonged use of nazointestinalnogo or nasogastric drainage leads to infection in the overlying gastrointestinal and tracheobronchial tree, which, in combination with a long forced horizontal position of the patient and continued mechanical ventilation is the cause of the progressive increase in the number of nosocomial pyo-septic complications in the AU.
Of particular importance in the prevention and treatment of intestinal insufficiency syndrome in the AU is the timely appointment of a synthetic somatostatin (stilamin / Ares-Serono / or sandostatin / Sandoz Pharma /). Studies conducted in various centers, as well as in our clinic (VS Savel'ev et al., 1996) [5], suggest this drug is not only effective in the treatment of pancreatitis, gastrointestinal bleeding, and fistula, and systemic and enteroprotektorom adaptogen digestive system.
sensitivity to sodium
multivitamin
Review CNS
long time
choice for correction
mercredi 26 janvier 2011
jeudi 20 janvier 2011
Own skeleton
Transplant team met staff of the Russian Scientific Center of Surgery named after Petrovsky (RNTSH) under the leadership of Professor Vladimir Parshin.
Operation technique brand viagra online developed by Professor Paolo Macchiarini - head of the regenerative surgery and biotransplantatsii Italian Blades Karredzhi. To prevent rejection, he cleaned the trachea from the cell donor. Thus obtained connective tissue skeleton of the body "inhabited" by cells of the recipient, then a new trachea grown in the bioreactor.
Subsequently, Macchiarini was implanted directly into the frame of the trachea of the brand name levitra recipient's body, where groups were formed body. Since 2007, Western European countries held eight transplantations using the new method.
Employees RNTSH perform the operation 26-year-old student from Kazakhstan. In 2006, she had an accident, after which a period of nine months in a coma and was connected to a ventilator. As a result of long-duration trehostomicheskoy tubes in his body lumen has narrowed, and doctors had to regularly expand the trachea endoscopic method.
Before transplantation of donor trachea frame, brought Macchiarini, was treated mononuclear cells of bone marrow patients who prevent rejection foreign body. In addition, the trachea was placed fragments of mucosa from which formed the new mucosa, as well as absorbable stent to generic viagra maintain the structure of the body during its formation.
Intervention, during which the patient's trachea old was replaced by a new, lasted six hours. After 16 days after surgery resident of Kazakhstan was able to give a short interview. Parshin, in turn, noted that in a few days she will be discharged from hospital.
He added that in 2011 employees RNTSH going to get their own skeleton of the trachea by the method Macchiarini and hold another transplant. According to the surgeon, at the present time, the center is considering four candidates for this operation.
raise blood pressure
autoimune syndrome
no significant effect
human history
Operation technique brand viagra online developed by Professor Paolo Macchiarini - head of the regenerative surgery and biotransplantatsii Italian Blades Karredzhi. To prevent rejection, he cleaned the trachea from the cell donor. Thus obtained connective tissue skeleton of the body "inhabited" by cells of the recipient, then a new trachea grown in the bioreactor.
Subsequently, Macchiarini was implanted directly into the frame of the trachea of the brand name levitra recipient's body, where groups were formed body. Since 2007, Western European countries held eight transplantations using the new method.
Employees RNTSH perform the operation 26-year-old student from Kazakhstan. In 2006, she had an accident, after which a period of nine months in a coma and was connected to a ventilator. As a result of long-duration trehostomicheskoy tubes in his body lumen has narrowed, and doctors had to regularly expand the trachea endoscopic method.
Before transplantation of donor trachea frame, brought Macchiarini, was treated mononuclear cells of bone marrow patients who prevent rejection foreign body. In addition, the trachea was placed fragments of mucosa from which formed the new mucosa, as well as absorbable stent to generic viagra maintain the structure of the body during its formation.
Intervention, during which the patient's trachea old was replaced by a new, lasted six hours. After 16 days after surgery resident of Kazakhstan was able to give a short interview. Parshin, in turn, noted that in a few days she will be discharged from hospital.
He added that in 2011 employees RNTSH going to get their own skeleton of the trachea by the method Macchiarini and hold another transplant. According to the surgeon, at the present time, the center is considering four candidates for this operation.
raise blood pressure
autoimune syndrome
no significant effect
human history
dimanche 9 janvier 2011
Laser treatment
A unique non-surgical treatment of varicose veins, no pain, no scars, no bruises!
"The treatment of varicose veins without surgery, without a scar" - a standard leaflet leading European and American hospitals for the treatment of varicose legs.
Development Endovasal laser coagulation (EVLK) has revolutionized the surgical treatment of varicose veins of the lower extremities.
After 40 minutes of finding the operating ex-patient varicose rises from the operating table to a healthy person!
Endovasal laser coagulation (EVLK) becomes the main type of surgical treatment of varicose disease abroad.
Laser treatment of varicose veins - is an operation without a single incision is made of puncture under ultrasound control using local anesthesia.
The technique is to laser irradiation on the venous wall. Vienna needle puncture in the popliteal region, the thigh is held laser fiber, then, is "burning" veins using laser radiation. In this case, Vienna spazmiruetsya and its lumen closed. After some time the coagulated Vienna grows connective tissue and dissolves.
Local anesthesia - an ideal opportunity for those brand viagrawho are afraid of injections in the back (epidural) or general anesthesia (endotracheal anesthesia).
In operation uses unique technology security controls laser emission.
Large scientific studies suggest that after EVLK has the lowest percentage of complications compared with other surgical methods of treatment of varicose veins legs.
Given the small trauma of the treatment of varicose veins, any rehabilitation after such operations is not required. An hour after the operation, you will be able to leave the clinic, and it is - a normal practice.
Advantages of the method
- Operation without cuts.
- After the operation, minimal discomfort, no pain.
- No bruises, no bruising.
- The ideal operation in cosmetic terms.
- Minimum number of diagnosed postoperative complications.
Disadvantages of the method
- In case of large diameter, the greater saphenous vein surgery without incisions is not possible.
- Operation economically costly for the patient.
What kind of laser coagulation is shown in each case may be determined only after a thorough ultrasound examination of leg veins.
If the veins on ultrasound do not EVLK (largest diameter of the greater saphenous vein), then apply the combined technique of phlebectomy with laser coagulation (operation with a single cut).
Combined phlebectomy with laser coagulation (operation with a single cut)
Once the data is color duplex scanning show inability to perform the puncture technique (the diameter of the veins will be too broad), you will be viagra erection enhances offered an operation with elements of classic phlebectomy.
The operation is performed under epidural anesthesia. Will be made a small incision in the groin (1.5 cm) of which will be bandaged main Vienna, which makes prevention of recurrence in the future.
Through the same incision will be introduced by a laser fiber into the vein and performed laser photocoagulation. If necessary, the tributaries of the great saphenous vein or small saphenous vein will be removed from the micro-puncture technique for miniflebektomii or will be made sclerotherapy, ie the whole operation is limited to a single incision in the groin.
Advantages of the combined method
- A smaller percentage of recurrence in the future
- The operation less traumatic than the classic phlebectomy
- High cosmetic results
Disadvantages of the combined method
- It is necessary to carry out sections
- Requires an epidural
Guaranteed treatment effectiveness is achieved latest equipment, modern techniques and long experience of the doctor-phlebologist higher qualification.
The result - beautiful, healthy feet!
Your hands
american scientists
Clinical situation
"The treatment of varicose veins without surgery, without a scar" - a standard leaflet leading European and American hospitals for the treatment of varicose legs.
Development Endovasal laser coagulation (EVLK) has revolutionized the surgical treatment of varicose veins of the lower extremities.
After 40 minutes of finding the operating ex-patient varicose rises from the operating table to a healthy person!
Endovasal laser coagulation (EVLK) becomes the main type of surgical treatment of varicose disease abroad.
Laser treatment of varicose veins - is an operation without a single incision is made of puncture under ultrasound control using local anesthesia.
The technique is to laser irradiation on the venous wall. Vienna needle puncture in the popliteal region, the thigh is held laser fiber, then, is "burning" veins using laser radiation. In this case, Vienna spazmiruetsya and its lumen closed. After some time the coagulated Vienna grows connective tissue and dissolves.
Local anesthesia - an ideal opportunity for those brand viagrawho are afraid of injections in the back (epidural) or general anesthesia (endotracheal anesthesia).
In operation uses unique technology security controls laser emission.
Large scientific studies suggest that after EVLK has the lowest percentage of complications compared with other surgical methods of treatment of varicose veins legs.
Given the small trauma of the treatment of varicose veins, any rehabilitation after such operations is not required. An hour after the operation, you will be able to leave the clinic, and it is - a normal practice.
Advantages of the method
- Operation without cuts.
- After the operation, minimal discomfort, no pain.
- No bruises, no bruising.
- The ideal operation in cosmetic terms.
- Minimum number of diagnosed postoperative complications.
Disadvantages of the method
- In case of large diameter, the greater saphenous vein surgery without incisions is not possible.
- Operation economically costly for the patient.
What kind of laser coagulation is shown in each case may be determined only after a thorough ultrasound examination of leg veins.
If the veins on ultrasound do not EVLK (largest diameter of the greater saphenous vein), then apply the combined technique of phlebectomy with laser coagulation (operation with a single cut).
Combined phlebectomy with laser coagulation (operation with a single cut)
Once the data is color duplex scanning show inability to perform the puncture technique (the diameter of the veins will be too broad), you will be viagra erection enhances offered an operation with elements of classic phlebectomy.
The operation is performed under epidural anesthesia. Will be made a small incision in the groin (1.5 cm) of which will be bandaged main Vienna, which makes prevention of recurrence in the future.
Through the same incision will be introduced by a laser fiber into the vein and performed laser photocoagulation. If necessary, the tributaries of the great saphenous vein or small saphenous vein will be removed from the micro-puncture technique for miniflebektomii or will be made sclerotherapy, ie the whole operation is limited to a single incision in the groin.
Advantages of the combined method
- A smaller percentage of recurrence in the future
- The operation less traumatic than the classic phlebectomy
- High cosmetic results
Disadvantages of the combined method
- It is necessary to carry out sections
- Requires an epidural
Guaranteed treatment effectiveness is achieved latest equipment, modern techniques and long experience of the doctor-phlebologist higher qualification.
The result - beautiful, healthy feet!
Your hands
american scientists
Clinical situation
dimanche 2 janvier 2011
Safety regulations
How to protect yourself from infection, "ashamed" infections, says doctor dermato Moscow STI clinic № 8 Tatiana Kurbatov.
- Are there any such skin-venereal disease, which can be caught by chance - in transport, on the street? - In transport and on the street - no sex - sexually transmitted diseases are usually not infected. However, apart from the sexual route of transmission there is also a consumer.
Therefore, in beauty salons and medical facilities should brand name viagra ensure that all instruments properly disinfected. You should not use general personal hygiene items, towels or linens. Ideally, of course, would be good to have all of the individual. With regard to skin diseases - they, unfortunately, in fact, you can pick up a vehicle or on the street without even knowing it.
- So, we run the risk and trying on clothes in a shop, and putting a new thing not laundered after shopping in a store? - Yes, sadly. You can get infected with a handshake, over money, clothes or shoes. This should be borne in mind when we try something in a store, even more so - on the market. Shoes can be measured only in his socks.
In transport - look who we sit next to - and think about who sat in front of us. Try to keep your children, if possible, lack of handrails in the transport and do not touch the items, which during the day touched hundreds of people. No matter how banal sound, coming from the street back home - change shoes, wash your hands, take a shower.
- Where can to find out the real cause and not feel uncomfortable? - You should never put itself diagnosis: "These are my allergies - has eaten something" or "it's on my nerves." Always necessary to confirm the diagnosis by laboratory tests. You can contact the district Venereal Diseases Dispensary or clinic in the community. If it turns out that some of our "arsenal", you will be referred again to the clinic. I assure you, "curve" while nobody is looking.
In Moscow, for example, there are also several items of urgent preventive treatment, which if necessary can be accessed around the clock. In extreme cases, should be treated with the genitals of soap foam. - Is there a means of somehow boost immunity, to Viagra can not at all avoid bad disease? - I think that to raise your immunity can and should be. And not just when it comes to "bad" sores. Pick a specific, appropriate immune drug for each patient to help the doctor.
Also - a healthy lifestyle, nutrition, multivitamins, sports, walking outdoors. - Is it true that women with a history of childhood diathesis or suffering from "cold" on the lips are particularly prone to skin-venereal diseases? - Well, it's not quite true. What is popularly called the "cold", this manifestation of herpes virus. Not being a communicable venereal disease, he may nevertheless be transmitted sexually and by household. The herpes virus is of two types.
The virus is the second type "lives" is strictly in the genital area, but the virus is the first type, if earlier arose mainly on the face, it is now not uncommon, and on the genitals. Full recovery from herpes to date, unfortunately, is impossible. But it is actually lengthen periods zatihaniya disease and reduce the frequency of exacerbations. With regard to diathesis - in women undergoing his childhood, the skin is usually more sensitive and vulnerable, and has more than the others, the number of micro traumas.
They are good "gateway" for infection.
Ladies, the diseases associated with irritation of the skin, most likely to be infected pustular infections and sexually transmitted diseases character. This is due to the presence of mikrotreschinok on the skin. Such people must be doubly careful.
German physician
Massage manual
- Are there any such skin-venereal disease, which can be caught by chance - in transport, on the street? - In transport and on the street - no sex - sexually transmitted diseases are usually not infected. However, apart from the sexual route of transmission there is also a consumer.
Therefore, in beauty salons and medical facilities should brand name viagra ensure that all instruments properly disinfected. You should not use general personal hygiene items, towels or linens. Ideally, of course, would be good to have all of the individual. With regard to skin diseases - they, unfortunately, in fact, you can pick up a vehicle or on the street without even knowing it.
- So, we run the risk and trying on clothes in a shop, and putting a new thing not laundered after shopping in a store? - Yes, sadly. You can get infected with a handshake, over money, clothes or shoes. This should be borne in mind when we try something in a store, even more so - on the market. Shoes can be measured only in his socks.
In transport - look who we sit next to - and think about who sat in front of us. Try to keep your children, if possible, lack of handrails in the transport and do not touch the items, which during the day touched hundreds of people. No matter how banal sound, coming from the street back home - change shoes, wash your hands, take a shower.
- Where can to find out the real cause and not feel uncomfortable? - You should never put itself diagnosis: "These are my allergies - has eaten something" or "it's on my nerves." Always necessary to confirm the diagnosis by laboratory tests. You can contact the district Venereal Diseases Dispensary or clinic in the community. If it turns out that some of our "arsenal", you will be referred again to the clinic. I assure you, "curve" while nobody is looking.
In Moscow, for example, there are also several items of urgent preventive treatment, which if necessary can be accessed around the clock. In extreme cases, should be treated with the genitals of soap foam. - Is there a means of somehow boost immunity, to Viagra can not at all avoid bad disease? - I think that to raise your immunity can and should be. And not just when it comes to "bad" sores. Pick a specific, appropriate immune drug for each patient to help the doctor.
Also - a healthy lifestyle, nutrition, multivitamins, sports, walking outdoors. - Is it true that women with a history of childhood diathesis or suffering from "cold" on the lips are particularly prone to skin-venereal diseases? - Well, it's not quite true. What is popularly called the "cold", this manifestation of herpes virus. Not being a communicable venereal disease, he may nevertheless be transmitted sexually and by household. The herpes virus is of two types.
The virus is the second type "lives" is strictly in the genital area, but the virus is the first type, if earlier arose mainly on the face, it is now not uncommon, and on the genitals. Full recovery from herpes to date, unfortunately, is impossible. But it is actually lengthen periods zatihaniya disease and reduce the frequency of exacerbations. With regard to diathesis - in women undergoing his childhood, the skin is usually more sensitive and vulnerable, and has more than the others, the number of micro traumas.
They are good "gateway" for infection.
Ladies, the diseases associated with irritation of the skin, most likely to be infected pustular infections and sexually transmitted diseases character. This is due to the presence of mikrotreschinok on the skin. Such people must be doubly careful.
German physician
Massage manual
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