Therapeutic thoracic duct drainage: A systematic review of the Eastern European experience and future potential.

Thoracic duct drainage (TDD) is gaining renewed interest, largely due to accumulation of evidence supporting the gut-lymph model, where toxic mesenteric lymph from the intestine contributes to development of multi-organ failure in acute and critical illness (ACI). Advances in minimally invasive TDD have added to this growing interest. The English TDD literature has been previously reviewed, but the more extensive Eastern European literature has not been available to English readers. Therefore, we undertook a systematic search of Eastern European human TDD studies using Scopus and PubMed databases and Russian language websites. Indications for TDD, clinical outcomes, and complications were reviewed. 113 studies, published between 1965 and 2015, were reviewed. The most common indications for TDD were hepatic failure, acute pancreatitis, and peritonitis. It was often used late and when other treatment options had been exhausted. Human TDD appeared safe and probably effective, especially when combined with lymphosorption. The benefit appeared to correlate with the volume of lymph drained. A randomized controlled trial (and some case-control studies) showed reduced mortality in patients with ACI with TDD. Other benefits included rapid normalization of blood parameters and decreased organ edema. This review provides further support for the gut-lymph model and justification for high quality randomized controlled trials of TDD in ACI. It also highlights other potential indications for TDD, such as bridging patients with liver failure to surgery or transplant.

[Pathogenesis and treatment of hemocoagulation disorders in an acute necrotic pancreatitis].

Results of investigation of content of activated protein C, Intercellular Adhesion Molecule -1 (ICAM-1) and interleukin (IL)--18 in the patients with an acute pancreatitis were presented. At the hospital attendance the concentration of IL-18, ICAM-1 increase and the activated protein C level lowering were noted. The strict immediate correlation connection between serum blood level of IL-18, ICAM-1 and hematocrit and the reverse one--between these mediators concentration and the activated protein C content--were noted during all period of observation.

[The use of anti-cytokines in the treatment of acute pancreatitis]. / Zastosuvannia antytsytokiniv u likuvanni hostroho pankreatytu.

The pentoxifylline application in complex therapy of an acute pancreatitis had promoted the reduction of the antiinflammatory cytokines contents in the blood serum and the disease course relief.

[The classification of cystic lesions of the pancreas]. / Do pytannia klasyfikatsiï kistoznykh urazhen' pidshlunkovoï zalozy.

The paper focuses on different classifications of cystic affections of the pancreas. The most simplified classification is proposed to be used in routine practice, which facilitates clinical recognition and permits the selection of optimum, in the first place, surgical, tactics.

[The prostaglandin I2 and thromboxane A2 content of the blood of dogs in the dynamic development of hemorrhagic shock]. / Soderzhanie prostaglandina I2 i tromboksana A2 v krovi sobak v dinamike razvitiia gemorragicheskogo shoka.

The content of prostaglandin I2 (PGI2) and thromboxane (Tx) A2 in the venous blood was studied in 5 dogs in the time course of hemorrhagic shock simulated by a single jet blood-letting from the femoral artery. PGI2 and TxA2 concentrations were estimated by the levels of their stable metabolites in RIA. It was found that acute hemorrhage stimulated the synthesis of prostanoids studied up to the animals' death. However, with the shock progressing, a shift took place in the ratio PGI2/TxA2 from 1:3.8 to 1:5.2, due to a higher rise of TxA2. Possible causes of PGI2 synthesis decrease and TxA2 production increase in hemorrhagic shock were considered. Basing on the data obtained a conclusion has been made on the necessity of exogenous PGI2 (prostacyclin) inclusion into the combined therapy of hemorrhagic shock.

[Contents of prostaglandins F2alpha, I2 (prostacyclin) and thromboxane A2 in the dog liver during development of hemorrhagic shock]. / Soderzhanie prostaglandinov F2alfa, I2 (prostatsiklina) i tromboksana A2 v pecheni sobak v dinamike razvitiia gemorragicheskogo shoka.

Contents of prostaglandins (PGs) F2 alpha, I2 and thromboxane (TH) A2 in the liver of 6 dogs has been studied in dynamics of hemorrhagic shock development. The results show that acute haemorrhage (31.9 +/- 1.6 ml/kg) stimulates the synthesis and release of all the eicosanoids studied. Nevertheless, in the progression of shock a significant difference was noticed between the high TXA2 and PGF2 alpha rates and comparatively lower rise of PGI2 production. The late stage of shock (201 +/- 44 minutes after haemorrhage) was characterized by a further rise in TXA2 and PGF2 alpha rates with simultaneous lowering of PGI2 as a result of vascular endothelium affection which is the main source for prostacyclin synthesis. In view of the antagonism of PGI2 to TXA2 and PGF2 alpha and its cytoprotective effects, the results of present investigation give the experimental background for using prostacyclin or its synthetic analogues in a complex therapy of acute liver failure in clinic.

[The efficacy of foridon in treating stenocardia patients]. / Efektyvnist' forydonu pry likuvanni khvorykh na stenokardiiu.

A study is presented of the effect of a new native calcium antagonist foridon on the course of the disease central and peripheral hemodynamics, fatty metabolism, lipid peroxidation intensity, activity of ceruloplasmin and catalase, iron and chromium saturation of transferrin, content of cyclic nucleotides in thrombocytes, the state of cellular immunity and the number of circulating immune complex in 30 patients with advancing and stable exertion stenocardia (control--30 analogous patients treated by phynoptin and corinfar). It was established that foridon produced a positive effect on the intensity of the pain syndrome, hemodynamics, degree of lipid peroxidation, content of cyclic nucleotides and immune status of stenocardia patients.

[The content of prostaglandins A and E in the blood and renal tissues in the early phase of experimental acute renal failure caused by the crush syndrome]. / Soderzhanie prostaglandinov grupp A i E v krovi i tkaniakh pochek v rannei faze éksperimental'noi ostroi pochechnoi nedostatochnosti, vyzvannoi krash-sindromom.

Prostaglandin (PG) A and E content in the blood and renal tissues (cortex and medulla) has been studied in 25 dogs in the early phase of acute renal failure (ARF). It has been found that by the 4th hour of compression PG content increases drastically in the blood and renal cortex and decreases in the renal medulla. Compression relief and ARF progress were accompanied by a drop in PG concentration both in the blood and the renal cortex and medulla. It is concluded that enhanced PGE2 synthesis is a protective reaction preventing the damage of the renal structure and function. The following decrease in PGE2 level is mediated by progressing effect of aggressive factors on the interstitial cells of the renal medulla and the endothelial cells of the cortex vessels--as a basic source of endogenous PG synthesis. The results obtained are experimental proof of PGE2 use in the complex therapy of ARF.