[Free radical processes in the pathogenesis of involutional skin changes].

AIM: To study the role of free radical processes (FRP) in the development of involutional skin changes and their correction. SUBJECTS AND METHODS: One hundred and twenty patients aged 18 to 74 years with various degrees of involutional facial and cervical skin changes were examined. Clinical and laboratory assessments were made over time. The oxygen and lipid peroxidase parameters of FRP were estimated; objective and subjective visualization, Doppler flowmetry of the facial skin, and colorimetric study of the skin color spectrum were done. RESULTS: The imbalance between oxygen and lipid peroxide components of FRP was found to increase with advancing age. These processes correlate with the severity of involutional skin changes and objectify the early use of energy-correcting therapy (ECT). The incorporation of ECT with cytoflavin positively affects FRP values and clinical and instrumental findings of involutional facial and cervical skin changes, by improving microcirculation. The patients with first-second degree involutional skin changes achieved the best results. CONCLUSION: The findings permit cytoflavin to be recommended as one of the components of therapy aimed to stabilize intradermal exchange processes as part cosmetic manipulations in aesthetic medicine.

[Free radical processes in patients with the gastro-intestinal bleedings].

The role of the free radical processes (FRP) is shown and objectified in the development of the ulcer gastro-intestinal bleedings (UGIB). It is revealed on the first day of hospitalization already. The greatest imbalance of the FRP is registered in heavy patients with acute UGIB. It appeared like decrease of the oxygen and activation of the lipid FRP disregulation. Unheavy patients have FRP changes refer to the oxygen part of the oxidation process only. Intensification FRP in process of increase of weight disease consists in decrease activity oxygen and increase a lipid disbalance. FRP disbalance has long time proceeds, last till the patient's discharge. Results of the research prove as much as possible early inclusion in a complex of medical actions antoixidant therapy. The high efficiency of the energetic corrector reamberin in a dose of 400-800 ml was shown in patients with UGIB.

[The new algorithm of diagnostics, prevention and treatment of acute erosive and ulcerative lesions of the gastrointestinal tract].

The work presents an analysis of treatment 745 patients with gastrointestinal bleeding from acute ulcers. Algorithm diagnosis and treatment of acute ulcers by different groups of patients. Treatment depends on the nature of secretory activity stomach bleeding risk of relapse and localization ulcers.

[Objective system of evaluating severity of illness in the choice of therapeutic strategy in aged and elderly patients].

Use of mark systems estimation MODS and APACHE II at patients of elderly and senile age with the complicated forms of a stomach ulcer allows objectively to judge weight of a condition of the patient risk of operative treatment and to estimate the probable forecast of disease and mortality.

[Surgical tactics in gastrointestinal hemorrhages in elderly].

At the present stage the number of operations is reduced at a ulcer gastroenteric bleeding. Occurrence modern antysecretor drags and wide introduction endoscopic and endovascular methods of hemostasis has led to decrease of urgent operative interventions in group of patients with high risk of rebleeding in 4 times. The number of such minimal operations was reduced in 10 times. They do not give expected hemostasis effect and are accompanied high mortality. Change of surgical tactics at elderly patients has led to decrease postoperative mortality from 15.8 up to 5.8% and the general mortality from 15.8 up to 9.6%.

Influence of pharmacological preconditioning on the results of lifting operations efficiency.

The main aim of the study is to determine the effectiveness and safety of lifting operations in women with varying degrees of involuntary changes of facial skin, in particular when applying pharmacological conditioning, with the objectification of the role of the latter. MATERIALS AND METHODS: A research and surgical treatment were conducted to eliminate involutional changes of various degrees in the facial skin of 461 women aged 35-75 years. Surface lifting was performed in 20.2% of patients, SMAS-lifting - 49.0%, SMAS-lifting with a three-level endoscopic assist lift of the lower face zone was performed in 30.8% of women. Before the surgery in 13.2% of cases, I degree of involutional changes in facial skin was registered, 47.9% - grade II, 38.9% - grade III. Patients were divided into two comparable groups. With the standard preparation without additional drug correction, 299 women (64.9%) were operated on in the preoperative period, they made up a comparison group. The main group included 162 (35.1%) women who underwent therapeutic conditioning before the lifting operation (Cytoflavin, n = 86; Actovegin n = 23; Ethylmethylhydroxypyridine succinate, n = 32; Meldonium, n = 21; Pentoxifylline, n = 31; Vinpocetine n = 27). Instrumental evaluation of the skin dermal microcirculation was performed using laser Doppler flowmetry and estimation of transcutaneous oxygen tension. In the blood plasma, the parameters of free radical processes (FRP) were studied. FRP were studied in terms of generation of active oxygen forms by leukocytes - intensity of chemiluminescence basal and intensity of chemiluminescence stimulated, as well as antiperoxide plasma activity and malondialdehyde. Early postoperative complications were analyzed, the number of repeated lifting surgical corrections on the face was studied for 5 years. RESULTS: The role of FRP in the pathogenesis of involuntary changes in the facial skin has been established. The imbalance of FRP was expressed in the intensification of the reactive oxygen species generation and products of lipid peroxidation. This correlated with disorders of cutaneous microcirculation and a decrease in the saturation of the facial tissues with oxygen, manifested by an increasing energy deficit and the severity of involutional skin changes. The obtained data justify the expediency of using pharmacological conditioning with energy correcting antioxidant medicine. Preoperative conditioning allowed to reduce the number of early postlifting complications associated with tissue trophism in a quarter, especially during surface lifting. In addition, in the preconditioning group, the scar was more cosmetic already at the seventh day after the operation. Based on the study of postoperative catamnesis, self-assessment data and laboratory-instrumental methods of skin system examination in people of different ages, it was revealed that while using SMAS-lifting with a three-level endoscopic-assisted lifting of the lower part of the face, the lowest frequency of complications and the best 5-year effectiveness were established.

[Videolaparoscopy in the treatment of peritoneal commissures in the abdominal cavity].

The article describes the results of the examination and treatment of patients with peritoneal commissures in the abdominal cavity. The study was conducted by members of the Hospital Surgery Chair No. 1 of the Russian State Medical University based on the Municipal Clinical Hospital No. 15. The article also describes and analyzes the up-to-date methods of the examination of patients having peritoneal commissures in the abdominal cavity and results of videolaparoscopical adheolysis. The algorithm of the examination of patients with peritoneal commissures was developed; indications for videolaparoscopical adheolysis in the emergency and selective surgery were studied and defined.

[Therapeutic and diagnostic tactics in complication of ulcer disease in elderly and aged]. / Lechebno-diagnosticheskaia taktika pri oslozhneniiakh iazvennoi bolezni v pozhilom i starcheskom vozraste.

In 78% of cases the ulcerative disease in elderly age proceeds with complications and presents a serious surgical problem. The specificity of elderly patients is the combination of several pathologies, on background of which the ulcerative disease proceeds. The level of an expressiveness of accompanying pathology influences on the prognosis of disease course and on the choice of medical tactics. Therefore for objectivization of state heaviness of the patient group mark systems of an estimation MODS and APACHE III are used. The interventions in gastroduodenal bleedings for the patients of elderly age should be differentiated and depended on a risk degree of bleeding relapse and adequate estimation of MODS heaviness. In 55.4% of the elderly patients the ulcerative perforation occur without antecedent history. Therefore indications to sewing of ulcers, including little-invasive interventions, should be extended in this group of the patients. The size of radical surgical interventions in absence of manifestation of the polyorganic insufficiency for the elderly patients should be the same, as for the younger patients.

[Pathophysiological features of duodenal ulcers in elderly and senile patients]. / Patofiziologicheskie osobennosti izvennoi bolezni dvenadtsatiperstnoi kishki u bol'nykh pozhilogo i starcheskogo vozrasta.

The following conclusions can be drawn on the basis of the research results: 1. There is no reliable distinction between central hemodynamics and gastric blood flow indices in patients from different age groups. 2. The blood flow in the stomach wall is in a distinct direct proportion to acid production. 3. The gastric blood flow is doubled in most patients with acid peptic ulcers, as compared with the norm. 4. The role of the ischemic factor in the development of duodenal ulcers is not pronounced in elderly patients.

[Prognosis of the course of complicated ulcer disease and mortality in aged and senile patients]. / Prognoz techeniia oslozhnennoi iazvennoibolezni i letal'nosti u bol'nykh pozhilogo i starcheskogo vozrasta.

The developed system for forecasting the course of the disease in elderly and senile patients made it possible to distinguish two variants of the ulcer course: favorable and unfavorable. Its application confirmed that it is possible to use the forecast evaluation system in studies of remote results. In case of an unfavorable forecast, this provides the ground for urgent recommendations for surgical treatment in this group of patients without waiting for life-threatening complications to develop.