HYPERACTIVE BLADDER SYNDROME SECONDARY TO BAROTRAUMA AND CHRONIC STRESS.

OBJECTIVE: The aim: To improve the results of treatment of hyperactive bladder syndrome in men of working age on the background of barotrauma and stress, as a consequence of combat trauma. PATIENTS AND METHODS: Materials and methods: An analysis of the questionnaire and the results of the clinical examination of 32 patients, injured servicemen and people who were injured in combat zones was carried out. The drug solifenacin succinate was used in the treatment complex, which is a specific antagonist of M3 subtype cholinergic receptors. Its influence allows you to achieve relaxation of the bladder detrusor and reduce the contractility of hyperactive bladder. RESULTS: Results: The main criterion for the effectiveness of the treatment was a decrease in the number of urgent cases, the frequency of urination and manifestations of nocturia by 50% or more, which was considered a positive effect. At the same time, the positive effect was differentiated as follows : an improvement of these parameters by 75% or more from the initial value which is a good result; reduction of symptoms in the range of 50-75% is satisfactory; less than 50% is an unsatisfactory result. A positive effect from the treatment after 8 weeks was observed in 88% of patients, of which 52% had a good result and 36% had a satisfactory result. CONCLUSION: Conclusions: The proposed complex of treatment of hyperactive bladder syndrome as a result of combat trauma against the background of barotrauma with neurological consequences and chronic stress allows to achieve a pronounced clinical effect in the vast majority of male patients of working age. And the diagnostic complex allows you to emphasize aspects of clinical vigilance, both for doctors of a specialized branch and of doctors of a general direction.

Barotrauma after liquid nitrogen ingestion: a case report and literature review.

A 25-year-old man developed a gastric perforation after ingesting a homemade drink containing liquid nitrogen. Surgical repair had to be postponed to seek consultations with experts because the available practitioners in this case, including emergency physicians, surgeons, and anesthesiologists, had little experience and knowledge about the source of the patient's pneumothorax and subcutaneous emphysema. The patient ultimately underwent exploratory laparotomy with general anesthesia, considering that delaying the operation would lead to a longer duration of bacterial peritonitis and delay the standard treatment of postoperative systemic infectious complications. Our literature review revealed that barotrauma is the unique injury mechanism underlying liquid nitrogen ingestion. Injuries to the airway and esophagus are rare.

Deviceless low-pressure operation; a cost-effective way to reduce CO2-induced barotrauma during hand-assisted laparoscopic donor nephrectomy.

Between March 2008 and March 2011, hand-assisted laparoscopic donor nephrectomles were performed on 70 patients. Following the first 26 cases undertaken based on guidelines in the literature, we modified the procedure to avoid barotrauma to the kidney caused by the usual 12-13 mm Hg CO(2) pneumoperitoneum or pneumoretroperitoneum. The perirenal CO(2) pressure, therefore, was decreased to 8 mm Hg from the beginning of the surgery; the operation was performed without using a handport. Our early experience with the modified technique suggested that the safety and duration of the procedure were not affected but the incidence of delayed graft function due to barotrauma was decreased, a cost-effective improvement.

Efeito do óxido nítrico sobre a lesão pulmonar induzida por barotrauma em ratos / Effect of nitric acid under pulmonare lesion induzida by barotrauma in rats

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A review of the respiratory effects of smoking cocaine.

A variety of pulmonary complications related to the use of freebase cocaine have been reported in the medical literature. Pulmonary barotrauma, hypersensitivity pneumonitis, pulmonary hemorrhage, obliterative bronchiolitis, asthma, and pulmonary edema have all recently been described. The number of reports are few, reflecting either the low incidence of these complications or the lack of recognition of these phenomena as cocaine-related illnesses. The mechanism by which freebase cocaine can injure the lung is not well defined. Whether an abnormal immunologic response to cocaine freebase can result in hemorrhage, pneumonitis, bronchiolitis, or asthma remains speculative. Whether cardiogenic or non-cardiogenic factors play a role in the development of pulmonary edema in freebase smokers has not yet been determined. Likewise, the roles of either cocaine, tobacco, or adulterants in producing the observed abnormalities of lung function remain controversial. Further reporting of freebase-related pulmonary complications, as well as the development of appropriate animal models, is needed.

Negative pressure in the middle ear in children after nitrous oxide anaesthesia.

A study was conducted to measure the pressure in the middle ear in healthy children, following nitrous oxide anaesthesia. Premedication with chloral hydrate and scopolamine orally was similar in all patients and awake patients received thiopentone 4-5 mg X kg-1 for induction of anaesthesia. All received nitrous oxide (66 per cent) in oxygen and halothane or isoflurane as required. Exposure to nitrous oxide varied from 17-100 minutes, mean 47 minutes. All patients developed negative pressure in one or both ears in the first day following anaesthesia. This is a higher incidence than previously reported and may be explained by the inability of children to equilibrate negative middle ear pressure via the eustachian tube.

Nitrous oxide and the middle ear.

A case of hearing deficit following nitrous oxide anaesthesia is reported. The mechanism and time course of nitrous oxide-induced intratympanic pressure changes are described and contrasted with the effects of non-nitrous oxide anaesthesia. The rate of increase is about 10 mm H20/min. The possibility that nitrous oxide may cause displacement of tympanic membrane grafts both outwards and inwards, or disrupt the reconstructed middle ear conducting mechanism, is raised again.