Clinical acceptability study of micronized purified flavonoid fraction 1000 mg tablets versus 500 mg tablets in patients suffering acute hemorrhoidal disease.

OBJECTIVE: To compare the clinical acceptability of micronized purified flavonoid fraction (MPFF) 1000 mg with MPFF 500 mg tablets, administered at the same daily dose in patients suffering non-complicated acute hemorrhoids. BACKGROUND: MPFF is an established treatment for hemorrhoidal disease. METHODS: This was a double-blind, multi-center, randomized study. Patients took either MPFF 1000 mg or 500 mg tablets for 7 days (daily dose; 3 g over 4 days followed by 2 g over 3 days). Adverse events were recorded in a patient diary. On day 7, anal pain and bleeding were assessed (visual analog scale [VAS] and Dimitroulopoulos scale, respectively). RESULTS: Patients (162) were randomized to MPFF 1000 mg (79) and MPFF 500 mg (83). No serious adverse events (AEs) occurred; 10 emergent AEs were considered treatment-related (6 for MPFF 1000 mg and 4 for 500 mg). Both regimens were associated with significant reduction in anal pain (VAS); -2.37 cm MPFF 1000 mg (P < 0.001) and -2.17 cm 500 mg (P < 0.001), with a slight trend in favor of MPFF 1000 mg (mean global reduction -2.27 cm, P < 0.001). Bleeding improved significantly in both groups of patients, 56% of patients on MPFF 1000 mg versus 61% on MPFF 500 mg. Bleeding ceased after treatment in 47% patients on MPFF 1000 mg versus 54% on 500 mg. CONCLUSION: After 7 days of treatment with MPFF at the same daily dose, both regimens reduced anal pain and bleeding. MPFF 1000 mg had a comparable safety profile to MPFF 500 mg, with the advantage of fewer tablets. Key limitations: Safety study.

[About the treatment of battlefield injuries of the musculoskeletal system with the help of new "Rod field package"].

Injuries of the musculoskeletal system are at 60% of all battlefield injures and take first place in modern military conflicts. The main antishock measures are: pain management, emergency bleeding control, bone fragment positioning and fracture fixation. Specialist of the centre of traumatology and orthopaedics of the Burdenko General Military Clinical Hospital in cooperation with specialists of department of battlefield surgery of Mandryka Clinical Research and Training Medical Centre analysed the most effective domestic and foreign external fixators and developed Rod field package (RFP). The above mentioned researched had two stages. On the first (analytical) stage specialists formulated requirements for idea rod field external fixator. On the second (experimental) stage tests with the help of plastic models of long bones were carried out. The performed analysis showed, that installation of the external fixator is easy and fast, the external fixator is light and has capabilities for 3D bone fragment positioning and fracture fixation, the external fixator is radiotransparent. Implementation of this package into the clinical practice of delivery of battlefield emergency surgical care may improve results of treatment.

[Application of high technology in liver surgery].

The PlasmaJet, a modem device that provides a high energy flow of ionized gas which seals small blood and lymph vessels has been recently introduced into clinical practice. A comparative retrospective analysis of results of 59 liver surgery with the help of new surgical technologies and standard surgical technique was performed. Liver resection with the use of high technology was accompanied by significantly less intraoperative blood loss, as well as a significant decrease of postoperative complications.

[Variants of retroperitoneal vascular structure in patients with early-stage cervical cancer who underwent systematic paraaortic and pelvic lymphadenectomy].

The aim of this study was to identify variants of retroperitoneal vascular structure during systematic paraaortic lymphadenectomy in patients with early-stage cervical cancer and to investigate the effects of these anomalies in surgical procedures. 79 patients who had undergone systematic paraaortic and bilateral pelvic lymph node dissection between 2006 and 2013 were included. Normal architecture and structural anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were studied. Variants of major retroperitoneal vascular structure were present in 10 patients (12.7%). Variants of renal vessels were identified in 8 patients (10.1%): supernumerary renal arteries and veins observed in 5 patients (6.3%); retroaortic left renal vein type I and II - in 3 patients (3.8%). A rare variant as double vena cava inferior was detected in 1 patient (1.3%). Vessel injury was present no one case in patients with variants of vascular structures and in 1 of 69 (1.4%) patients without variants of retroperitoneal vascular structure. There was no difference in intraoperative hemorrhage, transfusion red blood cell and rate of intraoperative hemoglobin between the groups. Thus the acquisition of knowledge and visualization of vascular variations decrease complications during systematic paraaortic and bilateral pelvic lymphadenectomy.

[The treatment of ulcerative gastrointestinal hemorrhages in the middle-aged and elderly]. / Lechenie iazvennykh zheludochno-kishechnykh krovotechenii v pozhilom i starcheskom vozraste.

Under analysis were results of treatment of 123 patients, 60 years of age and older who had ulcerous gastro-intestinal bleedings. Emergency operations were performed on 46 patients, postponed operations on 30 patients and there were 47 planned operations. Out of 38 patients operated upon for resection of the stomach 5 patients had incompetent sutures of the stomach and duodenum, 4 patients had purulent complications, 9 patients died. Out of 11 patients subjected to simple suturing of the bleeding ulcer only one endured the operation, 10 patients died at the early postoperative period, 3 of them of recurrent bleedings. Vagotomy was made in 65 patients, 6 of them died. The amount of complications was minimum. Long-term results were followed up in all the alive patients at the period from 1 to 5 years. After suturing and dissection of the bleeding ulcer in none of 4 patients were observed good and satisfactory results. After resection of the stomach good results were obtained in 8 of 29 patients, satisfactory in 7 and unsatisfactory in 14 patients. Good long-term results were noted in all 59 patients after vagotomy.