[Intensification of the organism detoxification ability under surgical endogenous intoxication]. / Povyshenie detoksikatsionnoi sposobnosti organizma pri khirurgicheskom éndotoksikoze.

The purpose of the study is to establish the effectiveness of remaxol in the correction of endogenous intoxication in patients with acute peritonitis. MATERIAL AND METHODS: The work is based on the results of clinical and laboratory studies. The clinic examined 55 patients with acute moderate peritonitis as complication of various diseases (acute appendicitis, perforated gastric or duodenal ulcer, acute intestinal obstruction, acute destructive cholecystitis). Before surgical operation and in the early postoperative period we evaluated the severity of endogenous intoxication by the level of hydrophilic and hydrophobic toxic products. The content of molecular products of lipids peroxidation - oxidative stress, phospholipase activity were determined in the blood plasma. In the study group (n = 28) in the postoperative therapy additionally included remaxol (400 ml intravenous fluids). RESULTS: Research established that the occurrence of endogenous intoxication syndrome in patients with acute peritonitis associated with the activation of oxidative stress and phospholipases, high intensity of which is maintained even after elimination of the source of peritonitis with manifestation on the 1st day after surgery. Remaxol include leads to a significant reduction in the severity of intoxication syndrome in patients with acute peritonitis. Positive effect of the drug on the correction of endogenous intoxication is largely determined by its ability to significantly reduce oxidative stress and the activity of phospholipases, as the most important membrane destabilizing agents. The greatest detoxication effect of the drug is recorded when it is applied already at the preoperative stage of patients when its ability to reduce the activity of trigger agents of catabolic processes implemented to the greatest extent. CONCLUSION: In acute moderate peritonitis, remaxol use before surgery or in the early postoperative period in complex therapy leads to a significant correction of factors contributing to the development and preservation of the intensification of catabolic processes - one of the sources of endogenous intoxication.

[Restoration of tissue reparative ability during acute pancreatitis (in Russian only)]. / Vosstanovlenie reparativnoi sposobnosti tkanei pri ostrom pankreatite.

AIM: The purpose of the study was to establish the effectiveness of Remaxol in restoring tissue reparative ability of laparotomy wound in acute severe pancreatitis. MATERIAL AND METHODS: The work is based on the results of experimental and clinical studies. Experiments were carried out using acute total pancreatic necrosis model under anesthesia on 30 dogs. Furthermore, 28 patients with acute severe pancreatitis were examined and underwent surgery on various purulent-necrotic complications. In the postoperative period, healing and metabolic processes were evaluated in the tissues along the sutures line of the laparotomy wound. Also, such parameters as endogenous intoxication, oxidative stress, and phospholipase activity were evaluated at the organism level. In the studied groups, Remaxol is included in the postoperative therapy. RESULTS: It has been established that during acute severe pancreatitis reparative potential of tissues is significantly reduced, which is caused by a significant disruption of trophism, activation of phospholipases and peroxidation of membrane lipids. Disorders of homeokinesis at the organism level play a negative role in tissue reparative potential reduction. Inclusion of Remaxol in the complex therapy of acute pancreatitis leads to a decrease in duration of wound healing by reduction in the phase of inflammation. Optimization of the healing process occurs due to complex effect of the drug at organ and body level, which results in improvement of the trophism and, what's more, stabilizes membranes of regenerating cells. CONCLUSION: In case of acute severe pancreatitis, the use of Remaxol in early postoperative period in the complex therapy leads to a significant correction of factors that adversely affect regeneration and contributes to the restoration of tissue reparative potential.

[Possibilities of tissue repair induction during mechanical jaundice of non-tumor genesis]. / Vozmozhnosti indutsirovaniia reparatsii tkanei pri mekhanicheskoi zheltukhe neopukholevogo proiskhozhdeniia.

AIM: The aim of this research was to study the effects of complex therapy with Remaxol inclusion on laparotomy wound tissue reparative process in patients with obstructive jaundice in early postoperative period. MATERIAL AND METHODS: Clinical and laboratory studies were carried out in 55 patients undergoing surgery of the biliary tract, including 35 patients with mechanical jaundice of non-tumor origin and 17 of them received Remaxol (for 5 days daily intravenous infusions of 400 ml each) in the early postoperative period. RESULTS: It has been proved that mechanical jaundice is a significant complication in the reparative process of laparotomy wound tissue structures. A significant decrease in the reparative potential of tissues can occur due to a local deterioration of the tissue metabolism of regenerating structures, and on the organism level - endogenous intoxication syndrome, hypoxia, oxidative stress, hypoalbuminemia. CONCLUSION: Remaxol is a drug with hepatoprotective, antioxidant and antihypoxant effects and its use in patients with obstructive jaundice makes it possible to correct disease pathogenetic impact on organic and organism level, which leads to optimization of reparative regeneration. A noticeable decrease in the early postoperative period of wound complications has been established as well as a significant reduction in days patients spent in the hospital.

[Increase of reparative potential of fabrics in sugar diabetes]. / Povyshenie reparativnogo potentsiala tkanei pri sakharnom diabete.

AIM: The purpose of the study was to study the effectiveness of the domestic drug Remaxol in reparative processes of laparotomic wound tissues in acute surgical abdominal pathology in patients with diabetes mellitus. MATERIAL AND METHODS: Clinical and laboratory studies were performed in 86 patients with acute surgical pathology of the abdominal cavity, 56 patients with type 1 diabetes mellitus, including 26 patients who received Remaxol in the early postoperative period (daily intravenous infusions of 400.0 ml for 5 days). RESULTS: It was established that diabetes mellitus is an important aggravating factor in the reparative process of tissue structures of a laparotomic wound. Undoubtedly, a significant factor in reducing the reparative potential of tissues is a significant activation of factors leading to membrane-destabilizing phenomena - oxidative stress, activation of phospholipases, hypoxia. The inclusion of Remaxol, which has antioxidant and antihypoxic effects, allows to significantly correct these pathogenetic components, which is the basis for optimization of the reparative process against the background of diabetes mellitus. There was a significant decrease in wound complications in the early postoperative period, a significant reduction in the stay of patients in the hospital.

Metabolic Restructuring in the Liver under Conditions of Endogenous Intoxication.

Significant metabolic alterations in the liver were observed in dogs with modeled acute peritonitis. These changes significantly impaired detoxification function of the liver, which was seen from the increase in the titer of toxic products in the early post-surgery period not only in the lymph, but also in the blood plasma. The key pathogenic mechanism leading to acute liver failure is destabilization of cell membrane resulting from LPO, phospholipase activity, and tissue hypoxia. Activation of LPO and increase in phospholipase activity in the liver tissues were observed within 12 h after peritonitis modeling.

[Violations of oxygen transport function of hemoglobin in surgical endointoxication and their correction using remaxol].

AIM: To study the effectiveness of remaxol in erythrocytes oxygen transport function correction in patients with surgical endotoxicosis. MATERIAL AND METHODS: Two groups of patients (main (n = 25) and comparison (n = 27) groups) with acute appendicitis complicated by peritonitis were compared. All patients underwent standard postoperative treatment including infusion therapy 1600--2000 ml/day, antibiotics as combination of semi-synthetic penicillins and aminoglycosides, anesthetic and desensitizing therapy. In the main group daily intravenous infusion of remaxol 400 ml for 5 days was used. The first dose was administered intraoperatively or immediately after surgery. Patients underwent emergency surgery and destructive forms of acute appendicitis accompanied by diffuse purulent or purulent-fibrinous peritonitis were diagnosed. Removal of appendix, debridement and drainage of the abdominal cavity were performed. Observation of clinical and laboratory tests were carried out at admission and in 1, 3, 5 days after surgery. CONCLUSION: Acute peritonitis leads to changes of hemoglobin conformation and its oxygen-binding capacity according to spectroscopy that is an important factor in the development of general hypoxia. The greatest changes in the hemoglobin molecule were found in the 1st day after surgery as a result of surgical aggression. It is proved that modified conformational state of hemoglobin is associated with processes of lipid peroxidation and endogenous intoxication. Combined therapy with remaxol is effective to correct oxygen transport function of hemoglobin in acute peritonitis. Pronounced positive effect of the drug weakening manifestations of surgical aggression is noted after the first administration. Therapeutic efficacy of the drug is explained by its ability to reduce lipid peroxidation. Rapid recovery of homeostasis including decrease of general hypoxia using remaxol resulted in a clinical benefit.