RESUMEN
OBJECTIVE: To evaluate the effectiveness of minimally invasive technologies of lithotripsy and hydraulic antegrade lithoextraction in complex treatment of choledocholithiasis. MATERIAL AND METHODS: In the main group, 74 patients with choledocholithiasis underwent complex treatment with minimally invasive lithotripsy and hydraulic antegrade lithoextraction. In the control group, 177 patients with choledocholithiasis complicated by obstructive jaundice underwent complex treatment without minimally invasive lithotripsy and hydraulic antegrade lithoextraction. RESULTS: Both groups were characterized by significant decrease of serum bilirubin, markers of cytolysis and cholestasis with regression of clinical manifestations of obstructive jaundice. At the same time, early and delayed postoperative complications were significantly more common in the control group. Most of these complications accounted for interventions through laparotomy such as external drainage of the common bile duct and hepaticojejunostomy. There were no similar procedures in the main group due to the use of minimally invasive technologies of lithotripsy and antegrade hydraulic lithoextraction. CONCLUSION: Minimally invasive lithotripsy and antegrade hydraulic lithoextraction are safe alternatives to traditional methods of lithoextraction and can be recommended in case of ineffective laparoscopic and retrograde endoscopic lithoextraction.
Asunto(s)
Coledocolitiasis , Ictericia Obstructiva , Laparoscopía , Litotricia , Humanos , Coledocolitiasis/diagnóstico , Coledocolitiasis/cirugía , Esfinterotomía Endoscópica/métodos , Ictericia Obstructiva/cirugía , Litotricia/efectos adversos , Litotricia/métodos , Laparoscopía/efectos adversos , Laparoscopía/métodos , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Colangiopancreatografia Retrógrada Endoscópica/métodos , Resultado del TratamientoRESUMEN
Digital videotape recording was done in 81 patients with pulmonary tuberculosis involving the upper lobe of one of the lungs during bronchoscopy. Video filming was used to measure the cross-section area of the ostia of all segmental bronchi of the intact and affected lung. The findings suggest that there is some increase in the mean values of the cross-section area of the ostia of the bronchi draining the affected lobe as compared with the similar parameters in patients in whom this lung is intact. The endoscopic signs of diffuse atrophic endobronchitis are also more significantly frequently detected on the ipsilateral side of the involvement.
Asunto(s)
Bronquios/patología , Bronquitis/patología , Broncoscopía/métodos , Tuberculosis Pulmonar/patología , Adolescente , Adulto , Bronquitis/etiología , Diagnóstico Diferencial , Humanos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Tuberculosis Pulmonar/complicaciones , Grabación en Video , Adulto JovenRESUMEN
This paper reviews the methodological and technical possibilities of the application of modern imaging methods (ultrasonography, computer tomography and its variety spiral computer tomography, magnetic resonance tomography, endoscopic investigation) for the study of intravital anatomy of body regions, inner organs, their structures and cavities. It is shown that these methods provide the objective information on the position, dimensions, and structure of the objects under study Using the morphometric methods with further variation-statistical analysis gives the objective quantitative characteristics, allows to distinguish marginal and most common variants of form and dimensions of anatomical structures.
Asunto(s)
Anatomía/métodos , Broncoscopía , Endoscopía del Sistema Digestivo , Tomografía Computarizada por Rayos X , Ultrasonografía , Humanos , Procesamiento de Imagen Asistido por ComputadorRESUMEN
In connection with the introduction of new economic mechanisms in public health a necessity has arisen for thorough and comprehensive evaluation of final results of the performance of curative and preventive institutions and some of their units, which are the positive changes in the population health. A great number of indicators reflecting some aspects of population health demand the search of integral evaluation methods. The indicator of mean life expectancy and its modifications is one of such integral indicators. Mean life expectancy indicators of patients with certain nosology and deficiency of mean life expectancy from some diseases in dynamics permit one to evaluate the measures taken to control these or those diseases and their cost-effectiveness which is of importance in evaluating the contribution of labour of medical personnel to the reduction of mortality from specific diseases. The paper provides simplified methods for calculating the above-mentioned indicators which in contrast to classical methods do not require complex mathematical calculations and therefore are intelligible for public health bodies and institutions of any level.
Asunto(s)
Enfermedades Cardiovasculares/mortalidad , Esperanza de Vida , Neoplasias/mortalidad , Enfermedades Respiratorias/mortalidad , Adulto , Enfermedades Cardiovasculares/diagnóstico , Niño , Humanos , Matemática , Neoplasias/diagnóstico , Pronóstico , Enfermedades Respiratorias/diagnóstico , Índice de Severidad de la Enfermedad , UcraniaRESUMEN
The ways of developing the mortality rate from respiratory and cardiovascular diseases have been studied in the Ukrainian SSR according to the data of the Bureau (Centre) of Health Statistics, Ministry of Health of the Ukrainian SSR, analysis of 18 thousand of death certificates in a number of regions of the Republic, analysis of materials of 545 autopsies in persons aged 75 and over. As a result of the studies conducted it was found that the mortality rate from respiratory diseases did not reflect the real mortality. The main inaccuracies in defining respiratory diseases as a cause of death were found in the age group of 60 and over and especially in the group of 75 years and over as the diagnoses in this age group were practically not verified.