Relevance. Kidney transplantation is one of the most effective and advanced treatments for end-stage kidney disease. Despite the tremendous experience in transplantation, improvement and optimization of postoperative management and immunosuppression protocols, ultimately all this led to an increase the number of people who is in need of a kidney donor and also led to grow the “Waiting list”. Only in February 2021, in the Republic of Kazakhstan, kidney transplantation was necessary for 3114 people, of which 3017 were adults and 97 children [2]. Based on this data, it is already possible to determine the high need for kidney transplantation. The lack of cadaveric organs has over time led to more frequent use of organs from living donors. The aim of this study is to determine the survival of a kidney transplant in recipients from cadaveric and living kidney donors. Based on statistics for 2018, more than 140 thousand kidney transplant operations were performed worldwide, including 95 479 kidney transplants: of which 34 549 (36%) patients were from living donors and 60 718 (64%) patients from cadaveric donor. Kidney transplantation is by far the most common operation in transplantology [3]. The demand for kidney transplantation is increasing by about 2.5-3% every year, and this growth is typical for the whole world.
Keywords
kidney transplantation, graft dysfunction, related donor, kidney cadaver
Today hand surgery is of more concern to many surgeons, due to in everyday practice, issues related to upper limb injuries and their consequences require solving practical problems, a professional approach, microsurgical skills. The aim of this work is to analyze the literature data on hand injuries consequences and hand tissue defects..
Material and methods. We conducted a systematic search of literature data and selected sources from the data-bases of Cochrane, Google Scholar, PubMed, Elibrary, as well as research papers and educational online publications in English, Russian and Kazakh. Forty papers were included that met the inclusion criteria..
Results. The review article describes the causes of hand injuries consequences, as well as the treatment of this pathological condition. Conclusions. Thus, today there is a tendency towards an increase in the consequences of upperlimbs tendons in-juries, there are a number of reasons contributing to this: the territorial peculiarity of our Republic, low awareness about the existence of hand surgery among the population. After analyzing of reviewed information, we came to the Conclusion that even at the initial visit, patients with hand tendon injuries should receive specialized care.
Keywords
hand surgery, trauma conse-quences, hand tissue defects
The article describes a clinical case of a breakthrough of an echinococcal mediastinal cyst in the thorac-ic aorta and an embolism of the femoral artery. The issues of differential diagnosis and therapeutic tactics are considered. The effectiveness of the use of minimally invasive endovascular methods is highlighted. The need for a multidisciplinary approach and subsequent anthelmintic therapy is shown.
Purpose of the study: to model the operative risk in patients with congenital heart defects, acquired valvular heart disease and ischemic heart disease using the stratification scales EuroSCORE and Aristotle Basic Complexity score. Ma-terials and methods. 559 patients, who were in inpatient treatment in the period from 2011 to 2019 were examined and underwent surgical correction before the surgery. Among them, 327 (58,5%) patients with various forms of congenital heart defects (CHD), 120 (21,5%) patients with isolated and combined acquired valvular heart disease (VHD) and 112 (20,0%) - with chronic forms of ischemic heart disease (IHD)..
Results. According to the Aristotle Basic Complexity score, the operative risk in patients with CHD averaged 6.6±3.8 points, which corresponded to the 2nd level of complexity. The operative risk according to the Aristotle Basic Complexity score in patients with CHD and complicated postoperative course was 8,35±4,1 points (3,0-17,5), and in patients with a smooth course of the postoperative period – 6,34±3,5 points (3,0-2,5) with statistically significant (p=0,002). EuroSCORE scale logistic parameters’s statistical analysis showed that in patients with acquired VHD and a smooth postoperative course, were significantly lower (approximately 3 times) and with a significant difference compared to patients with complicated course: 4,1±3,6% versus 12,9±14,0% (p=0,008). A similar state was observed while analyzing the logistic parameters of the EuroSCORE scale in patients with chronic forms of IHD: 3,6±3,4% and 8,8±10,2%, respectively (p=0,003).
Conclusion: The operative risk according to the Aristotle Basic Com-plexity Score in patients with different types of CHD is statistically significantly different in patients with a complicated and smooth postoperative course (p=0,002). The EuroSCORE stratification risk assessment scale presents certain possibilities for predicting the complicated course of the early postoperative period in patients with acquired VHD (p=0,008).
Prevention and treatment of acute disorders of cerebral circulation is the most important medical and social problem, is of great socio-economic importance. For the prevention of ischemic stroke, carotid endarterectomy has been used since 1954 (Eastcott H. H., 1954; DeBakey M. E., 1975), and carotid angioplasty and stenting since the mid-80s. (Kerber R., 1980). Despite a significant number of randomized multicenter comparative studies of the results of carotid endarterectomy and carotid stenting SAPPHIRE, CREST, CARESS, EVA-3S, SPACE, the issue of choosing the optimal method of surgical treatment of patients with carotid artery stenosis is currently not completely resolved. The work is based on the analysis of the results of surgical treatment of 113 patients with stenosis of the carotid arteries who were treated at the A. N. Syzganov from 2015 to June 2020. The patients were divided into two main groups according to the method of treatment. In the group of carotid endarterectomy, operations were performed in 58 patients, in the group of carotid stenting - 55 operations of stenting of the internal carotid artery with cerebral protection in patients. Thus, the statistical analysis included the results of 113 cases of primary surgery. In the Conclusion of the work carried out, recommendations were developed for the intro-duction and selection of tactics for the introduction of patients with cerebrovascular atherosclerosis.
A carotid body tumor (CBT), also commonly known as nonchromaffin paragangliomas and chemodectomas, is a slowly growing neoplasm originating from carotid body chemoreceptors. Objectives: To present the possible predic-tors of adverse events in the treatment of carotid body tumors..
Materials and methods. The study was performed on basis of Scientific Central Surgery named after A. N. Syzganov. Only 8 patients with 8 tumors who underwent open surgical treatment of CBT over the past 10 years (from 2009 to 2019)..
Results. 6 (75%) patients had a painless mass in the neck, and 2 (25%) painful. According to the results of CTA and arteriography, the patients were classified according to the Shamblin classification (Figure 1), of which 1 patient had the I type of tumor (12.5%), type II in three (37.5%) and type III (50%) 4 patients, one (12%) of which revealed hemodynamically significant stenosis of bifurcation of the com-mon carotid artery (CCA). The average number of days a patient was in the hospital stay increased direct proportional difference and the type of tumor. The time and approach of the operation, intraoperative blood loss, the volume of blood transfusion increased in the same way as the size of the tumor increased, involvement of the carotid artery and malignancy of the tumors. One patient had a cranial nerve injury (temporal), which resolved after additional treatment. Pathology results showed that two patients (25%) had malignant cells in the tumor and one of them located in the lymph nodes..
Conclusion. A rare occurrence, slow growth, asymptomatic course and a limited amount of information on the detection and management of the disease lead to an underestimation of the condition. In addition, the large size of the tumor, the involvement of the carotid arteries and cranial nerves in the process directly affect the surgical approach and increase the risk of complications.
Keywords
carotid body tumor, chemo-dectoma, neck paraganglioma, vascular formation, surgical treatment
Purpose: The aim of this work is to study antibiotic resistance in children before and after surgery. Antibiotic resistance is a topic of concern to all mankind today. These days, the “craze” for antibiotics has become like an epidemic and today, antibiotic resistance is a global problem. This article examines the causes of antibiotic re-sistance, discusses in detail the necessary measures, provides data from the world literature on the importance of this problem in the health sector, the existing mechanisms of the emergence of resistance of pathogenic microorganisms to antibacterial drugs and forms of acquired resistance.
CMV infection is one of the most common infectious complications of viral etiology among both adult patients and children after liver transplantation. Our experience shows that the appointment of preventive therapy led to a decrease in the frequency of indirect effects of CMVI, and also improved the survival rates of patients after transplantation. This article describes in detail the immunological changes in the background of CMV infection and immunosuppression.
Breast cancer (BC) is the most common cancer in the world and the most common malignancy in women. There is growing evidence that lifestyle factors, including diet, body weight, and physical activity, may be associated with a higher risk of breast cancer. Patients with breast cancer undergoing chemotherapy and / or radiotherapy experience various symptoms that impair the patient’s quality of life. Research on dietary interventions during the treatment of breast cancer has shown that certain diets and the addition of certain nutritional components can be useful for reducing side effects caused by medication, increasing therapeutic effectiveness, and preventing the development of primary tumors. Thus, nutritional intervention in patients with breast cancer can be considered an integral part of a multi-modal therapeutic approach. However, further research using dietary interventions in large clinical trials is needed to defini-tively establish effective interventions in these patients, improve long-term survival and quality of life. The article purpose is to generalize the role of dietary natural products and their biologically active compounds in the prevention and treatment of breast cancer, the clinical study of synthetic and natural anti-carcinogenic substances, the selection of effective and safe food products, as well as the choice of diet and lifestyle, as it is determined as a priority in breast cancer research.
Keywords
breast cancer, diet, food, nutrients, prevention, anti-carcinogens
