scholarly journals Application of early necrectomy of a deep skin burn on rats with acute radiation syndrome of mild severity

2019 ◽  
Vol 21 (2) ◽  
pp. 149-154
Author(s):  
V A Kozyaev ◽  
I V Chmyrev ◽  
A B Seleznev ◽  
V I Legeza ◽  
E V Ivchenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
The Body ◽  
Hot Water ◽  
Acute Radiation ◽  
Skin Burn ◽  
Γ Irradiation ◽  
Operative Trauma ◽  
Acute Radiation Syndrome ◽  
Severity Of Injury

The involvement of countries possessing nuclear weapons in local and regional armed conflicts poses a threat of use of nuclear weapon. In the case of this combined radiation injuries can make up to 70% of sanitary losses. The existing ideas about the methods of surgical treatment of combined radiation-thermal injures are contradictory and do not clearly provide procedure depending on the severity of injury or in non-classical forms of injury. The idea of the study was to estimate the effectiveness of performing an early necrectomy of a burn eschar after a two-factor injury, which includes modeling mild acute radiation syndrome in addition to a thermal burn on rats. A deep skin burn was simulated with hot water over an area of 10% of the body surface after total γ-irradiation at a dose of 3 Gy. Then after 3 h the burn eschar necrectomy was performed. It was established that the chosen method of surgical treatment of a deep burn significantly aggravates the severity of irradiated animals, which is manifested by the death of more than 50% of rats in the first 4 days after necrectomy. The operative trauma became the leading component of the combined injury formed and determined the severity of its course. Thus, the burn eschar necrectomy modifies a light two-factor radiation-thermal injury to a classic combined radiation injury. Despite the severe postoperative period, necrectomy significantly accelerates the healing of burn wounds in irradiated animals. This indicates the promise of finding methods for compensating abnormalities developing in the postoperative period in order to accelerate wound healing before the onset of radiation sickness and prevent infectious complications.

scholarly journals Analysis of risk factors for different types of anesthetic support of newborns and infants with surgical pathology

2020 ◽  
pp. 28-34
Author(s):  
V.I. Snisar ◽  
◽  
O.O. Vlasov ◽  
I.A. Makedonskyy ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Congenital Malformations ◽  
Fatal Case ◽  
The Body ◽  
Surgical Correction ◽  
Simple Logistic

High-quality anesthetic support during surgical correction of congenital malformations of internal organs and the postoperative period in newborns and infants is complicated by concomitant diseases, significantly affects the processes of metabolism, gas exchange, homeostasis, cerebral, peripheral hemodynamics, etc. before, during and after the surgical intervention. Purpose — to identify the leading risk factors associated with death in various types of anesthetic support for newborns and infants during surgical correction of congenital malformations. Materials and methods. The retrospective study included newborns with congenital malformations of the surgical profile, as well as infants who received and continued stepwise surgical treatment for congenital malformations, depending on the chosen combined anesthetic accompaniment (inhalation + regional anesthesia and inhalation + intravenous anesthesia). The study was carried out in the following stages: 1) to conduct surgical treatment and anesthetic support, 2) introduction of the child into anesthesia, 3) the traumatic stage of the operation, 4) within 1 hour after the operation, 5) 24 hours after the operation. Risk factors were determined by simple logistic regression with the calculation of the odds ratio, 95% confidence interval (95% CI). Results. Among the functional indicators of the vital functions of the body of children with congenital disorders before, during, immediately and 24 hours after surgery against the background of combined anesthesia, with a simple logistic regression analysis, the chance of a fatal case increases with deviations from the norm of peripheral saturation — at all stages of surgical support (7.8–15.0 times); cerebral oxygenation of the child — at the moments of induction into anesthesia and in the postoperative period (10.8 at the stage 2, 72.0 times at the stage 4); increased diastolic blood pressure at the stage of induction of the child into anesthesia (1.6 times). Conclusions. To prevent the chances of death under various types of anesthesia for children with congenital malformations during surgical treatment, it is advisable to more closely monitor blood pressure, cerebral, peripheral oximetry and promptly correct the impaired condition of the child. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: newborns, infants, congenital malformations, anesthesia, risk factors.

scholarly journals Pathophysiology and clinical symp toms of acute radiation syndrome

2020 ◽  
Vol 7 (2) ◽  
pp. 127-134
Author(s):  
Wiktoria Kudła ◽  
Arkadiusz Trzos ◽  
Karol Łyziński
Keyword(s):  
Ionizing Radiation ◽  
Clinical Symptoms ◽  
Medical Personnel ◽  
The State ◽  
The Body ◽  
Acute Radiation ◽  
Armed Conflicts ◽  
Acute Radiation Syndrome ◽  
Emergency Medical ◽  
The Impact

Introduction: The use of radiation sources in various areas of life generates the risk of accidents and radiation disasters. The increase in terrorist threats as well as the risk of an outbreak of new armed conflicts carries the risk of using radioactive materials by terrorist groups and the military. Exposure to high doses of radiation and absorbing above-threshold doses by victims may cause acute radiation syndrome (ARS), as well as some distant effects. Personnel of the State Emergency Medical System (EMS) will be the first professional medical team in the process of providing assistance to such victims. The effects of further medical treatment in the hospital will depend on EMS’s first response, radiological triage and initial interventions taken. The aim: To present pathophysiology and clinical symptoms of acute radiation syndrome in the context of the medical practice of the EMS. Material and methods: For the purpose of this publication, an analysis of literature on the subject of the mechanism of ionizing radiation and its effects on the human body was performed. The work is focused on the interpretation of research results and their presentation from the EMS’s perspective. Results: The publication presents the impact of ionizing radiation on the body, the mechanism of damage to cellular structures and its consequences for individual organs and systems. ARS’s clinical (hematopoietic, intestinal, cerebrovascular) syndromes were discussed in detail, paying attention to radiation doses, the sensitivity of individual systems and organs, the dynamics of individual phases, as well as the ability to recognize and assess the severity of their progression by EMS personnel. Conclusions: The knowledge of pathophysiology, and ARS’s symptoms and dynamics is important to respond correctly to radiation incidents. This knowledge allows for efficient organization and emergency management during rescue operations. The increase in the risk of radiation incidents and radiation disasters generates the need for appropriate preparation of emergency rescuers, in particular, of the medical personnel of the State Emergency Medical Services.

scholarly journals Stationary replacement technologies in the surgical treatment of simultaneous pathology in gynecological patients

2018 ◽  
pp. 64-71
Author(s):  
A. N. Shikhmetov ◽  
L. A. Osin ◽  
A. M. Zadikyan ◽  
A. A. Pazichev
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Subsequent Treatment ◽  
The Body ◽  
Operating Table ◽  
Operating Team ◽  
Simultaneous Operations ◽  
Repeated Surgery

The authors analyzed the results of simultaneous operations in 238 patients with regard to the combined surgical and gynecological pathology performed in the hospital-replacing environment of the ВСDС of PAO «Gazprom». Previously, all patients were assigned to the sequence of stages, the location of trocars, taking into account the additional stages of the operation, the position of the monitor, the location of the operating team, the position of the patient on the operating table during each stage. Performing simultaneous laparoscopic operations does not lead to an increase in the number of intra- and postoperative complications in comparison with isolated interventions and is not accompanied by great technical difficulties, but causes a somewhat longer duration (on average, 20.6 ± 1.5 min), which, in our opinion , is not critical for anesthesia. There were no significant differences in the course of the early postoperative period and the intensity of the functional systems of the body. Advantages of simultaneous operations are undeniable: two or three surgical diseases are cured simultaneously, progression or serious complication of the disease is prevented, operative treatment of which would be postponed for a later period, the risk of repeated surgery and anesthesia is eliminated, the time of total stay of the patient in the hospital and subsequent treatment is reduced, economic efficiency of treatment is increased.

Peculiarities of the course of radiation-mechanical injuries during modeling of bone-muscular trauma of the limbs in expirement

2020 ◽  
Vol 22 (4) ◽  
pp. 82-86
Author(s):  
S. I. Slukhay ◽  
K. P. Golovko ◽  
I. S. Drachev ◽  
D. V. Remizov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
Morphological Changes ◽  
Mechanical Damage ◽  
The Body ◽  
Acute Radiation ◽  
Weapons Of Mass Destruction ◽  
Internal Organs ◽  
Septic Complications ◽  
Experimental Animals

Experimental data on the course of the wound process and changes in the internal organs of animals during acute radiation sickness are presented. Morphological changes in the wound and with a fracture of the femur, on the model of combined radiation-mechanical conduction in 30 experimental animals (rats). It was found that wounds after primary surgical treatment often suppurate, and the performed osteosynthesis in fractures of tubular bones turns out to be an untenable delivery of metal structures. An unfavorable course of the wound process is noted in the form of pronounced purulent-necrotic changes in soft tissues, which leads to the appearance of degenerative-dystrophic changes in internal organs in experimental animals. The development of the infectious process in the wound, radiation damage is more severe, while the lethality increases by 2023%. The total area and thickness of the newly formed granulation tissue is 1,52 times less than in non-irradiated animals. As a consequence of the disturbance of reparative processes during the development of the mutual burdening syndrome, the consolidation of the fracture with radiation injury to rats was completed in 28,51,2 days, while in non-irradiated animals it was already by 2023 days. The reason for the death of animals is purulent-septic complications in 21 (73%) irradiated rats. Sepsis due to St. aureus was noted in 14 (66,6%) rats and St. epidermalis in 2 (9,5%) animals. Colibacillary sepsis was recorded in 5 (23,8%) rats. Thus, in the conditions of the use of weapons of mass destruction, radiation-mechanical damage will occupy one of the leading places in the structure of sanitary losses. At the same time, the simultaneous effect of radiation and a mechanical factor on the body forms one of the most dangerous variants of damage, in which a favorable outcome is predicted only in milder forms of acute radiation syndrome and provided that surgical treatment is timely.

scholarly journals PECULIARITIES OF THE REHABILITATION PROGRAM IN ELDERLY PATIENTS IN THE POST-OPERATIVE PERIOD WITH ACUTE CALCULOUS CHOLECYSTITIS

2021 ◽  
pp. 108-113
Author(s):  
I. K. Churpiy ◽  
V. K. Churpiy ◽  
K. L. Churpiy ◽  
N. R. Golod ◽  
L. P. Fedorivska
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Rehabilitation Program ◽  
Early Postoperative Period ◽  
The Body ◽  
Maximum Efficiency ◽  
Surgical Trauma ◽  
Acute Calculous Cholecystitis ◽  
Calculous Cholecystitis

Currently, the elderly and senile account for 10 to 25% of all hospitalized for acute calculous cholecystitis. High operative-anesthetic risk, concomitant diseases and low resistance to surgical trauma are the cause of high frequency of postoperative complications and fatalities in this category of patients. In recent years, a reduction in postoperative mortality in acute cholecystitis, which is currently 0.28-2.9%, with gangrenous cholecystitis, it is higher to 17.8%. The aim of the study is to analyze and develop a rehabilitation program in the postoperative period in elderly and senile patients after surgery with acute calculous cholecystitis. Materials and methods We conducted an analysis of surgical treatment of 53 elderly and senile patients with acute calculous cholecystitis. In all patients, this diagnosis was confirmed intraoperatively and histologically. The age of all patients ranged from 61 to 89 years (mean 72.4 ± 8.7 years). Among the examined sick men there were 12 (22.6%), women - 41 (77.4%). The main criteria for assessing and creating a rehabilitation program in patients after surgery with acute calculous cholecystitis were the following processes: improving the general condition of patients, restoring intestinal motility, restoring or improving all impaired cardiovascular and respiratory functions, prevention of general complications (cardiovascular, respiratory, urinary, digestive and other systems), local (from the wound), normalization of blood parameters, One of the important components of successful surgical treatment of patients in the postoperative period is the timely restoration of respiratory, cardiovascular, digestive system after surgery. a guarantee of prevention of probable postoperative complications which are formed in the first 3-5 days after surgery. Objectives of the rehabilitation program in the early postoperative period in elderly and senile patients with acute calculous cholecystitis: to reduce the impact of drugs and accelerate the excretion of toxic substances from the body; restore adequate respiration and oxygen saturation; improve external respiration function, bronchial patency and bronchial drainage function; stabilize central hemodynamics to reduce peripheral circulatory disorders; prevent complications from the gastrointestinal tract, thromboembolic complications; prevent complications from the postoperative wound. Conclusions: Development of a rehabilitation program is a mandatory component in operated patients. Particular attention is paid to elderly and senile patients, who require a set of rehabilitation measures to be minimal, but sufficient to restore lost or reduced body functions in the early postoperative period, but at the same time, it should not exceed the patient's capabilities and ensure maximum efficiency. restoration. Start a rehabilitation program (breathing exercises, kinesiotherapy, massage, inhalation in combination with physiotherapy procedures) should be 12 - 16 hours after surgery. Prospects for further development Continue to develop a rehabilitation program for elderly and senile patients, taking into account the functional capabilities of the body in the long period of rehabilitation.

scholarly journals Mitigative efficacy of the clinical dosage administration of granulocyte colony-stimulating factor and romiplostim in mice with severe acute radiation syndrome

2020 ◽  
Author(s):  
Masaru Yamaguchi ◽  
Marino Suzuki ◽  
Moeri Funaba ◽  
Akane Chiba ◽  
Ikuo Kashiwakura
Keyword(s):  
Cell Apoptosis ◽  
Cell Senescence ◽  
The Body ◽  
Acute Radiation ◽  
Related Factor ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Acute Radiation Syndrome ◽  
Stimulating Factor ◽  
Dosage Administration

Abstract Background: It has been reported that the high-dosage administration of domestically approved pharmaceutical drugs, especially granulocyte colony-stimulating factor (G-CSF) and romiplostim (RP), is a rapid and appropriate medical treatment for preventing severe acute radiation syndrome (ARS) of victims exposed to lethal total-body irradiation (TBI). However, it remains unclear whether or not the clinical dosage administration of these drugs can ameliorate TBI-induced ARS and related high mortality in order to find various drug treatment options and less toxic optimum protocol depending on the situation surrounding the radiological accidents.Methods: We assessed the clinical dosage administration in combination with G-CSF and RP as intraperitoneal injection in C57BL/6J mice exposed to more than 7-Gy lethal dose of X-ray TBI for the survival study evaluated by the log-rank test. Bone marrow and splenic cells were collected on the 21st day, when 1 week have passed from last administration, to detect the level of cell apoptosis, intracellular reactive oxygen species (ROS), and nuclear factor erythroid 2-related factor 2 (Nrf2)-related anti-oxidative gene expressions, and enzyme-linked immune sorbent assay using sera was performed for cell senescence and inflammation status analyzed with one-way ANOVA and Tukey-Kramer or Bonferroni/Dunn multiple comparison tests.Results: The combined once-daily administration of 10 μg/kg G-CSF for 4 times and 10 μg/kg RP once a week for 3 times improve the 30-day survival rate of lethal TBI mice compared with untreated TBI mice, accompanied by a gradual increase in the body weight and hematopoietic cell numbers. The radio-mitigative effect is probably attributed to the scavenging of ROS and the reduction in cell apoptosis. These changes were associated with the upregulation of Nrf2 and its downstream anti-oxidative targets in TBI mice. Furthermore, this combination modulated TBI-induced cell senescence and inflammation markers. Conclusions: This study suggested that the clinical dosage administration in combination with G-CSF and RP may also have radio-mitigative effects on mice exposed to lethal TBI and may be a potent therapeutic agent for mitigating radiation-induced severe ARS.

scholarly journals Acute Radiation Syndrome and the Microbiome: Impact and Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Brynn A. Hollingsworth ◽  
David R. Cassatt ◽  
Andrea L. DiCarlo ◽  
Carmen I. Rios ◽  
Merriline M. Satyamitra ◽  
...  
Keyword(s):  
Radiation Injury ◽  
Human Microbiome ◽  
Human Microbiome Project ◽  
The Body ◽  
National Institutes Of Health ◽  
Acute Radiation ◽  
Acute Radiation Syndrome ◽  
Public Health Emergencies ◽  
Medical Countermeasures ◽  
Potential Use

Study of the human microbiota has been a centuries-long endeavor, but since the inception of the National Institutes of Health (NIH) Human Microbiome Project in 2007, research has greatly expanded, including the space involving radiation injury. As acute radiation syndrome (ARS) is multisystemic, the microbiome niches across all areas of the body may be affected. This review highlights advances in radiation research examining the effect of irradiation on the microbiome and its potential use as a target for medical countermeasures or biodosimetry approaches, or as a medical countermeasure itself. The authors also address animal model considerations for designing studies, and the potential to use the microbiome as a biomarker to assess radiation exposure and predict outcome. Recent research has shown that the microbiome holds enormous potential for mitigation of radiation injury, in the context of both radiotherapy and radiological/nuclear public health emergencies. Gaps still exist, but the field is moving forward with much promise.

scholarly journals Rehabilitation of women after conservative and surgical treatment

2021 ◽  
Author(s):  
R. S. Moldassarina ◽  
G. K. Manabayeva ◽  
Z. Ye. Akylzhanova ◽  
A. M. Rashidova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Healing Process ◽  
Psychological Trauma ◽  
The Body ◽  
Medical Rehabilitation ◽  
Practical Significance ◽  
Modern World ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

The relevance of the study is due to the increase in the volume of conservative and surgical care for women who need mandatory rehabilitation measures in the postoperative period. Until relatively recently, there were very few rehabilitation facilities in the country where women could recover under the supervision of a nurse. Therefore, rehabilitation could drag on for many months and it was very difficult to fully return to normal life. In the modern world, it has become possible to undergo all the necessary analyzes and conduct treatment using the latest scientific methods on high-precision equipment, and then perform a full course of postoperative regeneration. After all, medical centers have great technological capabilities today and control the healing process as soon as possible. The nature of the measures for the recovery of women depends on the changes in the body, which are due to the individual background at the time of treatment. It is important to understand the dependence of a woman's position at the time of recovery: the duration of taking medications, the presence of psychological trauma, the development of chronic diseases, the frequency of repeated interventions. The aim of the study is a step-by-step volumetric study of the implementation of various measures aimed at the rehabilitation of women after conservative and surgical treatment. Modern approaches require responsibility, high qualifications of medical personnel and the direct participation of the patient himself in this process. Timely start of rehabilitation ensures productive restoration of lost functions. The main principle of success is the use of standardized methods, informing the patient at all stages of treatment, using techniques with minimal consequences and maximum impact, and analyzing the course of the postoperative period. The need for an in-depth study of the features of providing medical care to patients with gynecological diseases, including after surgical interventions, is confirmed. The practical significance of the material lies in the high-quality and effective organization of medical rehabilitation, which is of key importance for the full restoration of the functions of the woman's reproductive system.

scholarly journals Mitigative Efficacy of the Clinical Dosage Administration of Granulocyte Colony-stimulating Factor and Romiplostim in Mice With Severe Acute Radiation Syndrome

2020 ◽  
Author(s):  
Masaru Yamaguchi ◽  
Marino Suzuki ◽  
Moeri Funaba ◽  
Akane Chiba ◽  
Ikuo Kashiwakura
Keyword(s):  
Cell Apoptosis ◽  
Cell Senescence ◽  
The Body ◽  
Acute Radiation ◽  
Related Factor ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Acute Radiation Syndrome ◽  
Stimulating Factor ◽  
Dosage Administration

Abstract Background:It has been reported that the high-dosage administration of domestically approved pharmaceutical drugs, especially granulocyte colony-stimulating factor (G-CSF) and romiplostim (RP), is a rapid and appropriate medical treatment for preventing severe acute radiation syndrome (ARS) of victims exposed to lethal total-body irradiation (TBI). However, it remains unclear whether or not the clinical dosage administration of these drugs can ameliorate TBI-induced ARS and related high mortality in order to find various drug treatment options and less toxic optimum protocol depending on the situation surrounding the radiological accidents.Methods:We assessed the clinical dosageadministration in combination with G-CSF and RP as intraperitoneal injection in C57BL/6J mice exposed to more than 7-Gy lethal dose of X-ray TBI for the survival studyevaluated by the log-rank test. Bone marrow and splenic cellswere collected on the 21st day, when1 week have passed from last administration, to detect the level of cell apoptosis, intracellular reactive oxygen species (ROS), and nuclear factor erythroid 2-related factor 2 (Nrf2)-related anti-oxidative gene expressions, and enzyme-linked immune sorbent assayusing serawas performed for cell senescence and inflammationstatusanalyzed with one-way ANOVA and Tukey-Kramer or Bonferroni/Dunn multiple comparison tests.Results: The combined once-daily administration of 10 μg/kg G-CSF for 4 times and 10 μg/kgRP once a week for 3 times improve the 30-day survival rate of lethal TBI mice compared with untreated TBI mice, accompanied by a gradual increase in the body weight and hematopoietic cell numbers. The radio-mitigative effect is probably attributed to the scavenging of ROS and the reduction in cell apoptosis. These changes were associated with the upregulation of Nrf2 and its downstream anti-oxidative targets in TBI mice. Furthermore, this combination modulated TBI-induced cell senescence and inflammation markers. Conclusions:This study suggested that the clinical dosage administration in combination with G-CSF and RP may also have radio-mitigative effects on mice exposed to lethal TBI and may be a potent therapeutic agent for mitigating radiation-induced severe ARS.

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