ABSTRACT
The article raises a question of the passion by many doctors for treating the patients with a great number of medicines. Recommendations on the medicine-free therapy are given which include giving up harmful habits and on healthy mode of life.
Subject(s)
Clinical Medicine/trends , Complementary Therapies/trends , Clinical Medicine/history , Drug Therapy , Forecasting , History, 20th Century , History, 21st Century , Humans , Life Style , Medicine, TraditionalABSTRACT
Teaching surgery to students of the medical college represents a complex dynamic process based on the achievements and advantages of domestic medical education. The article presents an analysis of historical aspects of teaching surgery formed under the influence of N.I.Pirogov's ideas and shows the necessity of searching for new forms of organization of teaching surgery at the up-to-date stage of reorganization of higher professional school. Special attention is given to a compulsory preservation of traditional principles of the system of teaching surgery verified by almost two centuries of experience of using it.
Subject(s)
Curriculum/standards , Education, Medical, Graduate/organization & administration , General Surgery/education , Academic Medical Centers , Education, Medical, Graduate/standards , Humans , RussiaABSTRACT
The work presents results of comparative investigations of the integral hydrodynamic characteristics of the best for today domestic mechanical heart valve (MHV) Medinzh-2 (MI-2) and the turn-disk domestic MHV--LIKS-2, EMIKS (E) and foreign MHV--Medtronic-Hall, Bjork-Shiley (BS), Sorin (SO) and bicuspid valves--St. Jude Medical (SJ), Carbomedics in the stationary and in the pulsatile flows. It was found that according to the main hydrodynamic characteristics including the outlet flow structure, MHV MI-2 was substantially superior to MHV E, BS and SO, and by certain characteristics it approximated to the best foreign MHV SJ. Like all mechanical heart valves, the valve MI-2 disturbs the uniformity of the inlet flow and forms a complex non-stationary flow with detached zones, areas of great shear stresses, with vortex structures of different types, and hence the task of hydrodynamic optimization of its construction is thought to become actual. The comparison of clinical parameters of work of the valve MI-2 with its hydrodynamic characteristics confirms its high hemodynamic effectiveness and thrombo-resistance in patients at long-term periods of follow-up, taking into account the adequate correction of disbalance of hemostasis.
Subject(s)
Heart Valve Prosthesis , Mitral Valve , Hemorheology , Models, CardiovascularABSTRACT
The authors made an analysis of social-economical conditions limiting the possibilities of rendering cardiosurgical care to children. Possible ways are mapped out allowing to increase the amount of operations on children with congenital heart diseases.
Subject(s)
Heart Defects, Congenital/surgery , Adolescent , Age Factors , Aortic Valve , Child , Child, Preschool , Heart Septal Defects, Atrial/complications , Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Ventricular/complications , Heart Septal Defects, Ventricular/surgery , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation , Humans , Hypertension, Pulmonary/complications , Russia , Socioeconomic FactorsABSTRACT
The tendency for the wide use of the term "obstructive" in chronic nonspecific lung diseases, which has contemplated in the literature on pulmonology and practice, is discussed. In the author's opinion, the term is invalid since it corresponds neither to the pathomorphological nor pathophysiological essence of data on the diseases and entails poor treatment results.
Subject(s)
Lung Diseases, Obstructive/etiology , Lung Diseases, Obstructive/pathology , Pulmonary Medicine , Humans , Lung Diseases, Obstructive/therapy , Pulmonary Medicine/methods , Pulmonary Medicine/trends , Terminology as TopicABSTRACT
The use of an original device developed by the authors which was introduced in the blood flow in experiments in dogs has confirmed the presence of coiled blood flow in different parts of the aorta. The rate, direction and angle of coiling were calculated. The results obtained suggest that the fact of coiling the blood flow should be taken into account when constructing new models of artificial valves of the heart in order to decrease the energy value of the cardiac output, to prevent injury of the formed elements of blood and thrombogenesis.
Subject(s)
Aorta/physiology , Heart Valve Prosthesis , Ventricular Function, Left/physiology , Animals , Blood Flow Velocity , Cardiac Output , Dogs , Heart Valve Prosthesis/adverse effects , Models, Biological , Prosthesis Design , Regional Blood Flow , Thrombosis/prevention & controlABSTRACT
Under analysis are results of treatment of 21 patients. Positive effects were obtained in 19 of them. This effect was noted in 6 patients during 2 years.
Subject(s)
Arteriosclerosis Obliterans/therapy , Leg/blood supply , Pain , Aged , Aged, 80 and over , Arteriosclerosis Obliterans/diagnosis , Evaluation Studies as Topic , Exercise Test/methods , Follow-Up Studies , Humans , Intermittent Claudication/diagnosis , Intermittent Claudication/therapy , Male , Middle Aged , Physical Stimulation/methodsSubject(s)
General Surgery , Physicians/standards , General Surgery/education , Humanism , Humans , Physician-Patient Relations , WorkforceABSTRACT
Complex estimation of the state of the lungs at the postperfusion and early postoperative periods based on roentgenological, clinical data, investigations of the parameters of oxygenation and mechanics of respiration was carried out in 32 children with septal defects of the heart, operated upon under conditions of artificial blood circulation with different kinds of the transfusion maintenance including the apparatus "Cell Saver 5" (CS) for the reinfusion of autoerythrocytes. The dynamics of endotoxicosis, hematological parameters during and after operation and requirements in transfusion media were studied. Differences in these indicators were established between the patients operated upon with the use of donor hemocomponents and those who were operated upon with CS. It allowed a conclusion about the role of the method of intraoperative reinfusion of erythrocytes in substantially less frequency and severity of the postperfusional pulmonary complications in this category of patients.
Subject(s)
Blood Transfusion, Autologous/methods , Cardiac Surgical Procedures , Erythrocyte Transfusion/methods , Intraoperative Care/methods , Postoperative Complications/prevention & control , Respiratory Insufficiency/prevention & control , Blood Transfusion, Autologous/instrumentation , Child , Erythrocyte Transfusion/instrumentation , Extracorporeal Circulation/instrumentation , Extracorporeal Circulation/methods , Female , Heart Septal Defects, Atrial/blood , Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Ventricular/blood , Heart Septal Defects, Ventricular/surgery , Humans , Intraoperative Care/instrumentation , Male , Postoperative Complications/blood , Postoperative Complications/etiology , Respiratory Insufficiency/blood , Respiratory Insufficiency/etiology , Risk FactorsABSTRACT
Some literature data are presented on the problem of cardiac surgery in patients with chronic renal insufficiency under regular hemodialysis and on the specificity of performing operations on such patients under conditions of artificial circulation. The authors describe their first experience of a one-step prosthezing of the aortal valve and plication of the dissecting aneurysm of the ascending part of the aorta in the patient receiving the regular hemodialysis during 5 years as well as the positive results of this original operation in dynamics of the first year of observations.
Subject(s)
Aortic Aneurysm/surgery , Aortic Dissection/surgery , Endocarditis, Bacterial/complications , Heart Valve Prosthesis , Kidney Failure, Chronic/complications , Renal Dialysis , Acute Disease , Adult , Aortic Dissection/diagnosis , Aorta/surgery , Aortic Aneurysm/diagnosis , Aortic Valve , Combined Modality Therapy , Endocarditis, Bacterial/diagnosis , Hepatitis B/complications , Hepatitis B/diagnosis , Hepatitis, Chronic/complications , Hepatitis, Chronic/diagnosis , Humans , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/therapy , MaleABSTRACT
Distinct changes of basic indicators of cellular immunity were diagnosed in 157 patients with rheumatic heart disease which needed surgical correction. A classification of disturbances of cellular immunity is proposed. A definite correlation between the degree of cellular immunity disturbances and basic clinical parameters of the rheumatic heart disease was followed as well as the influence of the immunological changes on the prognosis of operation results and the outcome of the disease.
Subject(s)
Aortic Valve , Mitral Valve , Rheumatic Heart Disease/immunology , Adult , Aortic Valve/surgery , Heart Failure/immunology , Heart Failure/surgery , Heart Valve Diseases/immunology , Heart Valve Diseases/surgery , Humans , Immunity, Cellular , Middle Aged , Mitral Valve/surgery , Postoperative Complications/epidemiology , Prognosis , Rheumatic Heart Disease/surgery , T-Lymphocytes/immunology , Treatment OutcomeABSTRACT
Directed correction of immunity by physiotherapeutic methods was used at the period of preoperative preparing 45 patients who needed the operation for rheumatic valvular disease of the heart. The number of purulent complications during the postoperative period in the group of patients subjected to direct correction of the immune status was found to be less than in the control group.