RESUMO
Blakemore probe-obturator was previously preferable for primary hemostasis in patients with bleeding from esophageal varices. Currently, Danis self-expanding nitinol stent became an effective alternative. According to some manufacturers, Danis stent has some advantages over balloon tamponade. We report implantation of nitinol stent for hemostasis in a patient with multiple recurrent bleeding and ineffective endoscopic manipulations. A method of stent fixation for prevention of distal migration as the most common complication is described.
Assuntos
Varizes Esofágicas e Gástricas , Hemorragia Gastrointestinal , Hipertensão Portal , Ligas , Materiais Biocompatíveis , Varizes Esofágicas e Gástricas/diagnóstico , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/cirurgia , Esofagoscopia , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Hemostasia Cirúrgica/instrumentação , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/diagnóstico , Falha de Prótese , Implantação de Prótese/métodos , StentsRESUMO
Actual consumption of toxic elements in the body of an adult human in the Republic of Tatarstan (during the period of the study of the production in 2008-2012) amounts for lead: 0.68 mg/week for cadmium: 0.18 mg/day, arsenic: 0.68 mg/day, mercury: 0.21 mg/week (per 1 kg body weight) or respectively: 22.81%, 18.0%, 13.69%, 4.27% of the allowable levels of the chemical load. We have performed calculations with account of the balance of food resources per capita per year in the Republic of Tatarstan. This analysis showed that the main dietary sources of income for cadmium there are milk and dairy products (48.32%), bakery products (16.07%), meat and meat products (13.22%); for lead there are bakely products (26.85%), potatoes (24.36%), milk and dairy products (23.94%), meat and meat products (7.55%); for mercury there are milk and dairy products (53.72%), meat and meat products (16.82%), potatoes (10.92%); fish and fish products (4.74%); for arsenic there are milk and dairy products (72.51%), meat and meat products (12.8%), bakery products (3.05% ,); fish and fish products (2.23%). It is important to know not only what products are the most contaminated, but what place in the structure of the nutrition they take.
Assuntos
Laticínios/análise , Monitoramento Ambiental/métodos , Produtos Pesqueiros/análise , Contaminação de Alimentos/estatística & dados numéricos , Doenças Transmitidas por Alimentos/epidemiologia , Produtos da Carne/análise , Medição de Risco/métodos , Adulto , Contaminação de Alimentos/análise , Doenças Transmitidas por Alimentos/diagnóstico , Doenças Transmitidas por Alimentos/prevenção & controle , Humanos , Estudos Retrospectivos , Tartaristão/epidemiologiaRESUMO
Surgical methods of treatment of diureticoresistant ascites in 198 patients with portal hypertension are analyzed: portocaval bypass (n = 16), lymphovenous anastomosis (n = 64), ductolysis (n = 24), and peritoneovenous bypass (n = 94). The most stable positive results was achieved after portocaval bypass, but it can be performed only in a small part of patients. Peritoneovenous bypass and lymphovenous anastomosis demonstrated shorter effect but they had less risk and were better tolerated than portocaval bypass. Efficacy of these surgeries depends not only on accurate indications and contraindications but also on functional resource of the liver and organism's reserves. Following these conditions and individual approach to choice of surgical methods of resistant ascites' treatment may improve quality of life and lifespan of patients with portal hypertension.
Assuntos
Ascite/etiologia , Ascite/cirurgia , Hipertensão Portal/complicações , Sistema Linfático/cirurgia , Anastomose Cirúrgica/métodos , Humanos , Derivação Peritoneovenosa , Derivação Portocava Cirúrgica , Resultado do TratamentoRESUMO
Native "Vitaflon" vascular graft made of spongeous polytetrafluoroethylene for portocaval shunt was evaluated in patients with portal hypertension. Experimental series in grey rabbits proved high biological inertness of the graft. It was used for portocaval shunt in 13 patients. The follow-up from 1 to 32 months demonstrated successful results in 12 cases.
Assuntos
Materiais Biocompatíveis , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Politetrafluoretileno , Derivação Portossistêmica Cirúrgica , Animais , Estudos de Avaliação como Assunto , Feminino , Humanos , Hipertensão Portal/cirurgia , Desenho de Prótese , Coelhos , Resultado do TratamentoAssuntos
Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Hipertensão Portal/terapia , Doença Aguda , Adolescente , Adulto , Idoso , Terapia Combinada , Quimioterapia Combinada , Endoscopia do Sistema Digestório , Varizes Esofágicas e Gástricas/diagnóstico , Varizes Esofágicas e Gástricas/etiologia , Feminino , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemostase Endoscópica/instrumentação , Hemostase Endoscópica/métodos , Hemostáticos/administração & dosagem , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/diagnóstico , Masculino , Pessoa de Meia-Idade , Nitroglicerina/administração & dosagem , Plasma , RecidivaRESUMO
Effects of albumin on N-demethylation reactions of substrates in rat liver microsomes were studied in vitro. Albumin was found both to accelerate and to inhibit the reaction of demethylation. The interaction between ligand and albumin appears to be responsible for these effects. The role of the effect in the metabolism of either xenobiotics or endogenous substances is discussed.
Assuntos
Albuminas/metabolismo , Formaldeído/metabolismo , Animais , Cinética , Ligantes , Metilação , Microssomos Hepáticos/metabolismo , Ratos , Ratos WistarRESUMO
The rat experiments studied the impact of inductors and inhibitors of enzymatic activity of xenobiotic metabolism on the pharmacological activity of sodium thiopental and ketamine and on the pharmacokinetics of sodium thiopental. Cocarboxylase, cobalt chloride and cimetidine enhanced the pharmacological action of sodium thiopental, but failed to exert any action on the effect of ketamine. The preparations of vitamin K, particularly vikasol and menadione sodium bisulfite, and phenobarbital attenuated the effects of these anesthetics, but tocopherol unchanged it. Phenobarbital and vikasol accelerated blood elimination of sodium thiopental, whereas cimetidine and cocarboxylase slowed down this process.