[Homeostasis changes during rehabilitation period after acute chemical poisoning].

The article deals with review of 78 patients of rehabilitation toxicological unit. The patients received resuscitation and detoxification. All patients were divided into three groups; 1st group--patients after poisoning with psychopharmaceuticals, 2nd group--patients after poisoning with cauterizing liquids and 3rd group--patients with encephalopathy after poisoning with neurotoxin (psychopharmaceuticals, narcotics and ethanol). Disorders of rheology, haemostasis and endotoxicosis accrued in all groups. These disorders were a signs of the erythrocytes and platelets aggregation developing and viscoelasticity disorder. Homeostasis changes during rehabilitation period need an accurate diagnostics for purposeful treatment of the defined disorders.

[Problem in the rehabilitation of patients with acute chemical poisonings in the toxicological hospital].

Follow-ups of 693 patients treated at the rehabilitation toxicological department for poisonings with psychopharmacological agents (n=549), cauterants (n=72), and opium narcotics (n=72) were summarized. Moreover, factors, such as the development of complications and the prehospitalization psychosomatic status of patients, influenced the length stay in a unit. Treatment of such patients should be aimed at eliminating at once a few causes that negatively affect the course of recovery for which it is expedient to use the methods of physicochemical hemotherapy, mesodiencephalic modulation, intestinal lavage, and hyperbaric oxygenation.

[Prevention of hyperhydration complications of intestinal lavage in acute poisonings by psychopharmacological agents].

Examination of 45 patients with acute oral poisonings by psychopharmacological agents who underwent for the body's detoxjication intestinal lavage using salt enteral solution that was isoionic to chymus and isoosotic to plasma has revealed its preventive action on the development of tissue hyperhydration and its corrective effect of plasma ionic composition. It has been ascertained that after intestinal lavage, there are significant increases in partial arterial blood oxygen pressure by 80% and in arteriovenous oxygen difference by 90%.

[The first experience in using the polysegmental bioimpedance analysis to determine the bodily fluid sectors in patients with acute exotoxicoses].

The paper gives the results of studying the body's water sectors by the polysegmental bioimpedance assay in 53 patients with acute poisoning of varying severity by psychotropic agents. It shows it expedient to use this assay to identify early water imbalance and to evaluate the efficiency of therapeutic measures. A primary reaction to acute chemical injury has been ascertained to be characterized by a predominant accumulation of cellular fluid. Progressing extracellular hyperhydration accompanied by increased cellular fluid volumes within the first 3 days after the time of intoxication should be considered to be a poor sign in critically ill patients.

[Pathogenetic implication of some laboratory parameters in the development of toxicohypoxic encephalopathy in acute poisoning by psychopharmacological agents].

In 62 patients with acute poisoning, blood gases, immunograms, hemorheology, oxidative stress, and the blood levels of biogenic amines were studied at the toxicogenic and somatogenic stages of poisoning. It was found that the development of toxicohypoxic encephalopathy was affected by the magnitude of changes in laboratory homeostatic parameters among which hemorheological and immunological were prominent.

[Use of sodium hypochlorite in therapy for acute intoxications with methemoglobin formers].

The study of these intoxications has demonstrated that the blood level of methemoglobin (MH) is in conformity with the severity of intoxication. The pathospecific therapeutic effect of sodium hypochlorite (SHC) in acute intoxications of varying severity has been found to appear as a significant intensification of demethemoglobinization and as a three-fold reduction in the half-life of MH. The nonspecific effect of SHC manifests itself in correcting metabolic acidosis and in improving blood oxygenation. The use of SHC accelerates the regression of clinical manifestations of disease and reduces the length of inpatient treatment.

[Effect of sodium hypochlorite on the biotransformation of toxicants in acute poisoning by psychotropic agents].

In acute poisoning by amitriptyline, carbazepine, barbiturates, and ethanol, the effect of sodium hypochlorite on the metabolism of toxicants is manifested as a considerable reduction in their high blood concentrations through oxidative transformation to inactive water-soluble derivatives and as the enhanced urinary elimination of the latter. The rate of the above process depends on the used dose of sodium hypochlorite.

[Predicting the duration of functioning of iliac artery prostheses]. / Prognozirovanie dlitel'nosti funktsionirovaniia sosudistykh protezov pri protezirovanii podvzdoshnykh arterii.

A formula has been computer-derived to predict the duration of the operation of lavsan vascular prostheses, implanted in the iliac artery. The relative mean-square prognostic error is 2.8%. The formula outlines more specific indications for the implantation of iliac arterial prostheses.

[Changes in the ratio of formed elements of the blood in acute exogenous poisoning in children]. / Izmenenie sootnosheniia formennykh élementov krovi pri ostrykh ékzogenykh otravleniiakh u detei.

In order to estimate the informative value of the leukocytic index of intoxication and the neutrophil to lymphocyte ratio in the assessment of the status of children with acute poisonings, the authors analyzed 223 hemograms of 189 children aged 1 to 15 with different types of acute poisonings. The results indicate that these parameters are nonspecific, their values depend on the severity of the patient's status and are unrelated to sex, age, and type of poisoning; a correlation between the concentration of the toxic agent in the blood and hemogram parameters has been confirmed.

[Effect of sodium hypochlorite on neuroregulatory systems in acute psychotropic drug poisoning]. / Vliianie gipokhlorita natriia na sostoianie neiroreguliatornykh sistem organizma pri ostrykh otravleniiakh psikhotropnymi preparatami.

The effect of sodium hypochlorite (SHC) on neuroregulatory systems was studied in patients with acute poisoning with psychotropic drugs infused intravenously as components of infusion therapy. Infusion therapy alone or in complex with SHC does not affect the cholinergic system of the organism. The corrective effect of SHC on the sympathetic, serotonin- and histaminergic systems was more pronounced in comparison with infusion therapy and was the most expressed on day 2 after the treatment.

[Predicting early postoperative thrombosis of vascular prostheses in aorto-femoral position]. / Prognozirovanie rannikh posleoperatsionnykh trombozov sosudistykh protezov v aortobedrennoi pozitsii.

Twenty nine factors influencing the function of vascular prostheses were studied in 100 patients. Five parameters were found by computation allowing the formula for prognosis of early thrombotic complications to be built in patients after reconstructive operations of aorto-femoral prostheses. These parameters are: resistance of the distal vascular bed to blood flow, length and diameter of the profound femoral artery, length and diameter of the vascular prosthesis. The accuracy of prognosis was 92%.

[Expert criteria of the degree of severity of the chemical trauma in acute poisonings by organophosphate insecticides]. / Ekspertnye kriterii stepeni tiazhesti khimicheskoi travmy pri ostrykh otravleniiakh fosfororganicheskimi insektitsidami.

The article deals with quantitative assessment of severity of chemical trauma (according to life-threatening characteristics) in case of acute peroral poisoning with OPI (carbophos and chlorophos). Standard diagrams were plotted which help to assess the life threatening values of the given compounds depending on the initial blood poison level or recorded decrease in enzyme cholinesterase activity. Basic opportunity to assess severity of body lesions in case of poisoning with OPI according to character of specific clinical signs was evidenced.

[Detoxicating effects of physico-chemical hemotherapy in acute exogenous poisoning]. / Detoksikatsionnye éfffekty fiziko-khimicheskoi gemoterapii pri ostrykh ékzogennykh otravleniiakh.

Physical factors (magnetic fields and UV and laser exposure) improve the blood status and sodium hypochlorite therapy accelerates removal of exo- and endogenic toxic substances from the organism, as was demonstrated in more than 1200 patients with various intoxications. These effects are due to activation of the detoxication systems of the organism and more rapid removal of some toxic agents from the blood during hemoperfusion. Adequate dosing of these exposures by means of clinical dosimetry will improve the efficacy and safety of detoxication.

[The dynamics of blood serum middle-molecule peptides in the prognosis of the course of acute pancreatitis]. / Dinamika srednemolekuliarnykh peptidov syvorotki krovi v prognozirovanii techeniia ostrogo pankreatita.

The work is devoted to studying the dynamics of endogenous toxemia by the level of middle mass peptides of blood serum in patients with acute pancreatitis. The level of middle mass peptides was investigated in 116 patients spectrophotometrically after Gabriélian with the wave length 254 nm (1st fraction, MMP-1) and with the wave length 282 nm (2nd fraction, MMP-2). It was found that the ratio of these fractions could be used as a prognostic index of the complicated course of acute pancreatitis. When the initial ration MMp-2/MMP-1 is less that 1 the risk of the development of complications of the second phase of acute pancreatitis is real. The decrease of the level of MMP-1 and MMP-2 during treatment by the 3rd-4th days is considered to be an indicator of the favorable outcome of the disease. The elevation of the level of MMP-1 and MMP-2 by the 3rd-4th days despite the treatment predicts an unfavorable outcome of the disease.

[Disorders of lipid peroxidation processes and blood antioxidant system in acute poisoning with psychotropic drugs]. / Narusheniia protsessov perekisnogo okisleniia lipidov i antioksidantnoi sistemy krovi pri ostrykh otravleniiakh psikhotropnymi preparatami.

Study of lipid peroxidation (LPO) processes and antioxidant defense (AOD) system of the blood in 96 patients with psychotropic drug poisoning of different severity showed disorders in the LPO/AOD system irrespective of the initial level of chemical injury. These disorders are characterized by imbalance in the ratio of LPO and AOD components. The severity and direction of these disorders depend on the severity of intoxication and poison exposure in the body before treatment measures, which dictates correction of these disorders with consideration for individual LPO and AOD parameters.

[Predicting the probable passage of common bile duct calculi in patients with mechanical jaundice]. / Opredelenie veroiatnosti otkhozhdeniia kamnei kholedokha u bol'nykh mekhanicheskoi zheltukhoi.

The authors propose a mathematical method of predictingthe passage of common bile duct calculi. An original mathematical formula derived by a computer allows a 98% accuracy of the prognosis. The estimations were based on the principal parameters influencingthe choledochal calculi movement defined with the help of the regression analysis. Such prediction simplifies the choice of therapeutic policy in mechanical jaundice due to choledocholithiasis.