The paper analyzes the results of a comparative study of sepsis markers: presepsin (PSP), procalcitonin (PCT), C-reactive protein (CRP) in sepsis in newborns. The clinical application of these indicators was as-sessed, their diagnostic effectiveness and prognostic significance in the perinatal center of Almaty (Repub-lic of Kazakhstan). We have shown that when monitoring the dynamics of the development of sepsis, pre-sepsin, unlike other markers, reliably reflects the real dynamics of its severity, and quickly and adequately changes depending on the effectiveness of therapy.
Keywords
sepsis, newborns, presepsin, procalcitonin, C-reactive protein
The main methods of laboratory diagnosis of autoimmune diseases (AD) are: the reaction of indirect immu-nofluorescence, enzyme immunodetection and immunoblotting. There are direct and indirect reaction of immu-nofluorescence. The method of direct immunofluorescence is used to detect Ig deposits and complement factors in biopsy samples of skin and kidneys. The reaction of indirect immunofluorescence is used to detect Ab in the blood serum and other biological fluids. It should be noted that this method requires very high qualification of the technician. The disadvantages of this method are the subjective account of the results and the complexity, lack of standardization of substrates, reagents, microscope. Computer-based systems for interpreting cell fluorescence tests contribute to the standardization and improvement of reproducibility of the reaction of indirect immunofluo-rescence in the determination of autoantibodies in patients with rheumatoid diseases. named after A. N. Syzganova medical sciences The blood serum of 17 patients were studied with this method for the presence of the following autoan-tibodies: Antinuclear Antibodies (ANA), Cytoplasmic antineutrophil antibodies (cANCA), Perinuclear Anti-neutrophil Antibodies (pANCA). The studies were conducted on the AKLIDES apparatus made by company “Medipan GmbH”, Germany. Modern methods of serological diagnosis RIF were applied in Kazakhstan for the first time to assess serological activity of SLE. Currently in Kazakhstan there is a need for accurate diag-nostics of autoimmune rheumatic diseases. The correct diagnosis with early stages of this disease will stop the process of disease progression and improve life quality of patients.
We report a case of metastatic cardiac tumor developed from breast cancer. It describes the diagnosis of the disease from the moment of arrival until discharge of the patient, as well as the difficulties caused by patient’s deliberate withholding of information. Conclusions were made about the most and the least infor-mative research methods for this diagnosis, the importance of thorough history recording, and the need to double check and compare the clinical data with the words of the patient.
Relevance. Currently, the main directions of treatment of postoperative disorders after pulmonectomy are infusion-transfusion maintenance of hemodynamics, antibacterial chemoprophylaxis of infectious com-plications and perioperative nutritional support. An analysis of the literature data showed that the severity and originality of the course of the postoperative period is determined by hemodynamic disturbances and the function of vital organs, which determines the relevance of this problem..
Materials and methods. The study was conducted on 12 laboratory animals (rabbits). The state of the pulmonary artery, pulmonary tissue and portal blood flow was studied by radioisotope method from the moment of pulmonary artery ligation up to one month after pulmonectomy. Hemodynamics was evaluated after 1 and 3 hours, 1; 3 and 7 days and a month later..
Results. Removal of one lung significantly disrupts the hemodynamics of the remaining lung, which occurs during ligation of the pulmonary artery. Violation of pulmonary blood flow, in turn, leads to a violation of the portal-venous blood flow that occurs during blinking of the bronchi, and a violation of local blood flow is recorded 3 hours after pulmonectomy.
Materials and methods. The study enrolled107 patients aged 56 ± 7,5 among which 96 men (89,7 %). The entry criteria: I-III degree of ischemic mitral regurgitation on echocardiography, angiography reveling coronary artery disease requiring surgical revascularization, sinus rhythm with the heart rate ranging from 60 to 89 per minute, superior echocardiography visualization of LA endocardium. We hypothesize that atrial changes in deformation and deformation rate can be associated with severity of regurgitation..
Results. Values of left atrium mechanical function decline proportionally to IMR severity. Longitudinal deformation and LA deformation rate reflect link with IMR greater than conventional indices used for estima-tion of LA geometry.
Keywords
Ischemic mitral regurgitation, left atrium, longitudinal deformation
For creation of system of the correct and timely choice of tactics at the combined pathologies of bili-ary system within 5 years researches on 80 patients were carried out. Cholecystectomy was performed in 20 patients on the background of chronic pancreatitis with a concomitant exacerbation of chronic stone cholecystitis,after which the developed pancreatitis in 40% of patients became the cause of death. For a thorough solution of the problem in the combined pathologies of the biliary system, the authors created an algorithm table due to the fact that the results of examinations and anamnestic data exceed the figure 35 and difficulties are created in the differential evaluation of such a number of indicators. The data is processed on the computer according to the created algorithm table. The use of 60 patients divided into 3 groups provides timely thorough diagnosis, adequate preventive measures corresponding to the detected pathological changes both before and during the operation, drainage of the bile ducts along with cholecys-tectomy provides early and persistent treatment of acute pancreatitis. Mortality among these patients is 5%. Also, the diagnosis of the algorithm program allows you to timely recognize the developed pathological and functional changes(in most cases, left aside) not only in the biliary system, but also in other parts of the digestive tract, as well as the implementation of the necessary measures during the operation. This in turn leaves no room for the development of pathological syndromes after surgery. The accuracy of the program in the diagnosis is 92.7%, the prognosis of the disease is 86.2%. The proposed surgical tactics are confi-dently offered to practitioners.
The aim of the study: to develop prognostic criteria for assessing the severity of PH, as well as for conducting stage-by-stage endoscopic prophylaxis of bleeding from esophageal and gastric varices in the long-term treatment.
Materials and methods. This study is based on the research of the results of endoscopic treatment of 157 patients with EGV admitted to the Scientific Center for Surgery named after M. A. Topchibashev for the period from 2009-2019. Among these patients with PH, 111 (70.7%) were male, 46 (29.3%) were female. The age of patients varied from 31 to 83 years (average 46.3 ± 1.7 years). The age of 77.7% (122 patients) of the studied was 31-60 years, which indicates the prevalence of the working age persons among the studied patients..
Conclusion. In the literature there are various mathematical models for predicting the postoperative stage of the disease. It should be noted that today there is no ideal model for predicting the relapse of bleeding. Since a significant part of the models was developed before the widespread use of endoscopic intervention in clinical practice.
Bleeding is complicated by both acute and chronic duodenal ulcers. The most severe bleeding is compli-cated by chronic ulcers, which, as a rule, penetrate deeply into the DNA wall and penetrate into neighboring organs. In these cases, the bleeding can be massive, since the blood vessels, gaping in the ulcer with tight edges and bottom, are poorly thrombosed. Surgical tactics in the treatment of patients with acute bleeding from an ulcer depends largely on the accuracy of the diagnosis, the nature of the ulcer (acute or chronic). The problems of treating patients with penetrating duodenal ulcer persist. Researchers study the pos-sibilities of different surgical methods for treating patients with pronounced morphological changes in the area of duodenal ulcers, developing during its penetration, and determine the optimal type of operation for this duodenal ulcer, the choice of treatment for patients with duodenal ulcer with pronounced morphological changes attracts special attention of researchers. There are various proposals for its surgical treatment. In patients with this category, the question of preference for gastrectomy or vagotomy remains. Moreover, the need for surgery in patients with penetrating ulcers, a number of authors questioned. The solution of the problems posed was the purpose of the present study.
Combined Echinococcosis of the chest and abdomen is one of the causes of morbidity and disability in the Republic of Kazakhstan. The incidence, according to statistics, in 2017 per 100,000 people was 217 cases of Echinococcosis (1). The article reviewed the organization of surgical care in the combined Echinococcosis of the chest and abdominal organs, from these data there are obvious problems in the health care system and the necessity of the optimize the diagnosis and treatment.
A review of the results of aortic valve replacement using autologous pericardium was carried out using the Ozaki technique. The article shows data on 30-day and long-term mortality, the percentage of aortic stenosis or regurgitation due to Ozaki surgery, freedom from reoperation, as well as the mean and peak gradient on the aortic valve according to various authors.
Materials and methods. 53 patients(men - 9, women - 44) with vari¬cose veins of the lower extremities were hospitalized on the basis of Kaspar clinic and private UNI clinic . The duration of varicose disease ranged from 1 to 47 years and averaged 21.2±10.9 years. Clinical examination was carried out according to the generally accepted method for these patients. The study included the results of examination and treatment of 53 patients in the period from 2016- 2019 with varicose veins of the lower extremities. The patients were divided into 2 groups. The main group included 31 patients who underwent endovasal laser ablation of the main saphenous veins. The control group consisted of 22 cases of varicose disease in which traditional phlebectomy was used..
Results. Successful transcutaneous access to the PV and placement of a laser light guide in it was carried out in 30 patients. One patient was recorded extravasation with the formation of hematoma during the puncture, in connection with which there was no repeated puncture of PV in the framework of this procedure. It should be noted that the failure in the implementation of EVLA was on the 3rd patient, which we cause with the initial stage of mastering the EVLA PV technique and the relatively small diameter and length of the PV. The procedure was well tolerated by all patients. The average diameter of the treated PV was 3.7 mm (3 to 4.8 mm), and the length was 3.6 cm (2.4 to 6.8 cm). Qualitative ablation of PV was observed in 41 patients, which was confirmed by duplex sonography. Repeated intervention was required in 1 patient after an unsuccessful attempt to puncture the PV.
The article presents the case of installing the occluder into the atrial septal defect, after which becomes frequent the attacks of ventricular premature beats and paroxysmal tachycardia, which cannot be stopped by drug therapy and radiofrequency ablation. The problem was solved by surgical treatment - removal of the occluder and closure of the atrial septal defect with a patch from the autopericardium. The surgical method for certain locations of the atrial septal defect is fundamental in the treatment of this pathology. This clinical case demonstrates the ability to perform such operations with a good result. surgical treatment
