ABSTRACT
According to the World Health Organization, it is recorded steady growth of the number of chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD), in recent years. As an independent nosological entity, NAFLD is one of the risk factors for cardiovascular diseases, associated with abdominal-visceral obesity, peripheral insulin resistance (IR), and is regarded as the hepatic component of Metabolic syndrome (MS). Nowadays there are no generally accepted national standards for diagnosis and treatment of NAFLD for physicians, gen- eral practitioners, gastroenterologists in Russia. This was the essential reason in their development. The main reason of The guidelines development is the absence of generally accepted national standards for diagnosis and treatment of NAFLD for physicians, general practitioners, gastroenterologists in Russia. These guidelines are based on the global and local data of treatment experience of NAFLD, recently published in reviews, analytical studies in the literature. Guidelines are intended for physicians, general practitioners, gastroenterologists and contain the description of the preferred approaches to the provision of diagnostic, curative and preventive care of patients NAFLD. The quality of recommendations was grading according to the GRADE approach.
Subject(s)
Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/pathology , Non-alcoholic Fatty Liver Disease/therapy , Humans , Practice Guidelines as TopicABSTRACT
Data of 14 patients with chronic cystic pancreatitis, complicated by intracystic bleeding, were analyzed. Early diagnosis of a bleeding episode provides an in-time diagnostic and treatment procedures. Angiographic bleeding vessel occlusion is considered to be a method of choice. When the latter is impossible, a method of temporary intraoperative hemostasis is suggested, which decreases blood loss and permits an adequate surgical aid.
Subject(s)
Hemostasis, Surgical/methods , Pancreatic Cyst/surgery , Pancreatitis, Chronic/surgery , Postoperative Hemorrhage/prevention & control , Adult , Female , Humans , Male , Middle Aged , Pancreatic Cyst/etiology , Pancreatitis, Chronic/complications , Postoperative Hemorrhage/diagnostic imaging , Radiography , UltrasonographySubject(s)
Muscle, Skeletal/pathology , Myxoma/pathology , Pelvic Neoplasms/pathology , Adult , Female , Humans , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/surgery , Myxoma/diagnostic imaging , Myxoma/surgery , Pelvic Neoplasms/diagnostic imaging , Pelvic Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
78 patients aged from 14 to 73 years (57 men, 21 women) with complications after trauma of the liver were studied. Minimally invasive operations (puncture, drainage, puncture + drainage) were performed in 62 (79%) patients. 8 patients with small bilema received conservative treatment under visual follow-up. 8 patients with middle and big posttraumatic lesions not treated with minimally invasive surgery entered control group. Intracavitary prolonged proteolysis with immobilized proteinases (imosimase Literum, Novosibirsk) was used. Imosimase injection led to lysis of thick inflammation products, intensified sanation of focus. There were neither complications nor lethal outcomes. 2 (2.6%) patients were operated. Tissue sequestrum and bleeding were indications for surgery. Efficacy of minimally invasive treatment of posttraumatic lesion of the iver was 96%.
Subject(s)
Abdominal Injuries/complications , Liver/injuries , Liver/surgery , Minimally Invasive Surgical Procedures , Abdominal Injuries/microbiology , Abdominal Injuries/surgery , Adolescent , Adult , Aged , Endopeptidases/therapeutic use , Female , Humans , Liver/microbiology , Male , Middle Aged , Treatment OutcomeABSTRACT
Some anatomical grounds of postoperative extravisceral abscess formation, methods and results of their treatment, therapeutic policy in abscesses of parenchymatous organs are presented. 681 patients with abdominal abscess of various location were examined. Detailed analysis of ultrasonic and computed tomographic semiotics of postoperative extravisceral suppurative focus was carried out in 164 patients. The risk zones of extravisceral abscess formation in the conditions of changed visceral syntopy and destroyed ligamentic structures were determined. The efficiency of puncture-drainage treatment in different variants of subdiaphragmatic abscess was 89.4%, in abscess of omental bursa--83.3%. Intracavital prolonged proteolysis by immobilized proteinases (imosimase) was applied. The injection of imosimase in abscess cavity led to its content lysis, including the thick products of inflammation, improving their secretion through the drainage. In the majority of the patients, the puncture-drainage treatment of abscesses of various etiology and pathogenesis is an adequate method of sanation.
