CAROTIDSCORE.RU-The first Russian computer program for risk stratification of postoperative complications of carotid endarterectomy.

GOAL: Presentation of the first Russian computer program (www.carotidscore.ru) for risk stratification of postoperative complications of carotid endarterectomy (CEE). MATERIAL AND METHODS: The present study is based on the analysis of a multicenter Russian database that includes 25,812 patients after CEE operated on from 01/01/2010 to 04/01/2022. The following types of CEE were implemented: 6814 classical CEE with plastic reconstruction of the reconstruction zone with a patch; 18,998 eversion CEE. RESULTS: In the hospital postoperative period, 0.18% developed a lethal outcome, 0.14%-myocardial infarction, 0.35%-stroke. The combined endpoint was 0.68%. For each factor present in patients, a predictive coefficient was calculated. The prognostic coefficient was a numerical indicator reflecting the strength of the influence of each factor on the development of postoperative complications. Based on this formula, predictive coefficients were calculated for each factor present in patients in our study. The total contribution of these factors was reflected in "%" and denoted the risk of postoperative complications with a minimum value of 0% and a maximum of 100%. On the basis of the obtained calculations, a computer program CarotidSCORE was created. Its graphical interface is based on the QT framework (https://www.qt.io), which has established itself as one of the best solutions for desktop applications. It is possible not only to calculate the probability of developing a complication, but also to save all data about the patient in JSON format (for the patient's personal card and his anamnesis). The CarotidSCORE program contains 47 patient parameters, including clinical-demographic, anamnestic and angiographic characteristics. It allows you to choose one of the four types of CEE, which will provide an accurate stratification of the risk of complications for each of them in person. CONCLUSION: CarotidSCORE (www.carotidscore.ru) is able to determine the likelihood of postoperative complications in patients undergoing CEE.

[Effect on performance ozonized perftoran cytokine profile in generalized peritonitis].

The article analyzes the results of surgical treatment of 78 patients with generalized peritonitis (GP) between the ages of 18 to 76 years. Severity was assessed by RP Mannheim peritoneal index (MPI). The study was conducted according to a comparative evaluation of the method of treatment in both groups. In the comparison group included 38 patients who received conventional therapy without immune complex. In 40 patients of the study group on the background of complex therapeutic measures in pre- and postoperative additionally used concomitant local and systemic ozone therapy (OT) with ozonatedperftoran (OP). All patients in the dynamics of blood prior to surgery, on the 3rd and 7th day after surgery was determined TNF-α, IL-4 and IL-8 by IFA. In general, patients in both groups at admission were identified imbalance between pro- and anti-inflammatory cytokines. Patients of the main group on the complex background of basic therapy combined local and systemic administration of OP positive effect in terms of acceleration available cytokine imbalance. The complex therapeutic interventions GP application of local and systemic OT with OP accelerates elimination of imbalances in the cytokine profile.

[Impact of a combined application of ozonized perftoran and glutoxim on the immune status of the patients and the cytokines profile in extended peritonitis].

The immune status was studied while surgical treatment of 74 patients, suffering extended peritonitis (EP). In 38 patients (group of comparison) a complex routine therapy was conducted, in 36 (the main group)--along with routine complex measures of treatment a local and systemic ozonotherapy, using ozonized perftoran (OP) and glutoxim (for immunocorrection), were applied. The patients severity state was estimated in accordance to the Mahnheim's peritoneal index. In all the patients while hospitalization there were revealed changes in T--and B--links of immunity, in phagocytosis and the cytokins profile, significant of which have depended upon the EP severity. The combined local and systemic application of OP and glutoxim in complex of conservative treatment is pathogenetically substantiated, it permits more rapidly to eliminate the immunity disorders and the cytokines balance, as well as inflammatory process in abdominal cavity and to improve the results of surgical treatment significantly.

[Application of ozonated perftoran in the treatment of spreaded peritonitis].

Results of surgical treatment of 114 patients, suffering spreaded peritonitis of various etkoogy, were analyzed. To patients of the comparison group basic conservative therapy was conducted. In patients of the main group was applied intravenous infusion of ozonated perftoran (OP) in 1 mg/kg dose, concentration of ozone 5 mg/l, solely or together with metabolic immunomodulator and detoxicator glutoxim. To all the patients the routine clinical investigations were conducted: in the blood erythrocytes there were measured concentration of diane conjugates, of malonic dialdehyde, activity of catalase, content of the middle molecular mass peptides in blood and urine, as well as of rest nitrogen, urea, creatinine, common bilirubin, state of the protein and electrolyte balance. Basing on analysis of results of the conducted investigations there was revealed, that combined, local and systematic, application of OP and glutoxim together with basic therapy in spreaded peritonitis is pathogenetically substantiated.

[Treatment of experimental pancreonecrosis by occlusion of the pancreatic ducts and cryodestruction of necrotic foci]. / Lechenie éksperimenta'lnogo pancreonekroza okkliuziei pankreaticheskikh protokov i kriodestruktsii ochagov nekroza.

Experimental investigations (experiments in 61 dogs) have shown the application of drug occlusion on the gland duct system with cryodestruction of necrosis foci to be a promising method for treatment of pancreonecrosis.