Experience of using hemosorption in clinical practice

1980 ◽  
Vol 61 (5) ◽  
pp. 9-10
Author(s):  
V. F. Bogoyavlenskiy ◽  
V. S. Girfanov ◽  
I. G. Salihov ◽  
E. S. Margolin ◽  
Sh. A. Muhametzyanov ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Toxic Substances ◽  
Endogenous Intoxication

The results of the treatment of patients with exogenous and endogenous intoxication by the hemosorption method are presented. The effectiveness and safety of this method of purifying the blood from toxic substances make it possible to expand the indications for its use.

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

The role of hepatic lipid modifications in the pathogenesis of surgical endogenous intoxication

2019 ◽  
pp. 65-71
Author(s):  
Г.В. Порядин ◽  
А.П. Власов ◽  
Т.И. Власова ◽  
В.А. Болотских ◽  
Н.А. Мышкина ◽  
...  
Keyword(s):  
Membrane Lipids ◽  
Pathological Process ◽  
Quantitative Composition ◽  
Toxic Substances ◽  
Hepatic Lipid ◽  
Acute Peritonitis ◽  
Endogenous Intoxication ◽  
Tissue Lipids ◽  
Triggering Mechanisms

Цель. Оценка роли модификаций липидов тканей печени в ее детоксикационной способности при остром перитоните. Методика. В эксперименте у собак моделировали острый перитонит различной степени тяжести. Степень эндогенной интоксикации оценивали по уровню токсических продуктов гидрофильной и гидрофобной природы. Представлен новый способ оценки детоксикационной функции печени на основе определения уровня токсических продуктов в крови, притекающей к органу и оттекающей от него. Для характеристики качественного и количественного состава липидов из биопсийного материала печени выделяли липиды, осуществляли их фракционирование и денситометрию. Оценивали интенсивность перекисного окисления липидов, активность фосфолипазы А2 и супероксиддисмутазы. Результаты. Показано, что функциональное состояние печени при хирургическом эндотоксикозе коррелирует с модификацией липидов ее тканевых структур, проявлением чего были существенные изменения состава основных липидов и резкое увеличение хаотропных фракций. Установлена сопряженность изменений состава липидов тканей печени со степенью тяжести патологического процесса. Одними из значимых триггерных механизмов липиддестабилизирующих явлений в тканевых структурах печени являются оксидативный стресс и высокая фосфолипазная активность. При тяжелом течении острого перитонита высока вероятность такого нарушения функционально-метаболического состояния печени, при котором она приобретает самостоятельное патогенетическое значение в продукции токсических субстанций. Заключение. В патогенезе синдрома эндогенной интоксикации при остром перитоните важную патофизиологическую значимость имеет модификация липидов тканей печени, которая является основой острой печеночной недостаточности и формирования нового состояния органа - источника токсинов. Полученные данные определяют векторы патогенетической терапии по предупреждению необратимых повреждений печени с высоким риском неблагоприятного исхода. Background. Despite the interest to the issue of surgical endogenous intoxication, mechanisms of impaired hepatic detoxification function in endogenous intoxication induced by acute peritonitis are studied insufficiently. Aim. To elucidate the role of modifications in membrane lipids of liver cells in imparing its detoxification ability in acute peritonitis. Methods. Acute peritonitis of different severity was modeled in dogs. The authors presented a new method for evaluating the liver detoxification function based on measuring concentrations of toxic products in the blood inflowing to and outflowing from the liver. Hepatic lipids were separated, fractionated and studied by densitometry. The qualitative and quantitative composition of liver lipids, intensity of lipid peroxidation, and activities of phospholipase A2 and superoxide dismutase were measured in liver tissue in the dynamics of experimental peritonitis. Results. In surgical endogenous intoxication, the liver function correlated with the modifications of tissue lipids evident as considerable changes in the composition of major membrane-forming lipids and an increase in chaotropic fractions (fatty acids, lysophospholipids). Changes in the tissue lipid composition correlated with severity of the pathological process. Significant triggering mechanisms for the hepatic lipid modification were oxidative stress and a high phospholipase activity. Conclusion. In severe acute peritonitis, there is a high probability of profound functional and metabolic disorders in the liver so that it acquires an independent pathogenetic significance as a producent of toxic substances.

scholarly journals OPTIMIZATION OF KIDNEYS’ DETOXICATION FUNCTION OF SEPTIC PATIENTS IN THE PERIOD OF STABILIZATION OF TOXIC AUTOAGRESION

2018 ◽  
Vol 6 ◽  
pp. 934-937
Author(s):  
Natalia Maksymchuk ◽  
Victor Konovchuk
Keyword(s):  
Standard Therapy ◽  
Group Iv ◽  
Toxic Substances ◽  
Total Blood ◽  
System A ◽  
Endogenous Intoxication ◽  
Combined Use ◽  
Effector System ◽  
Icd 10 ◽  
Weight Protein

INTRODUCTION: Kidney injuries in the endogenous intoxication syndrome of septic genesis necessitates nephroprotective therapy.OBJECTIVES: The purpose of the work was to determine the effect of the combined use of sorbilact and L-arginine on the detoxification function of kidneys and the levels of separate indicators of endogenous intoxication syndrome.METHODS: Detoxication function of kidneys have been studied in patients of the following groups.The first group (І, control) consisted of 31 patients with systemic inflammatory response syndrome (SIRS, ICD-10: R-65.2).The second group (ІІ) consisted of 22 patients with endogenous intoxication syndrome who were treated according to Surviving Sepsis Campaign 2016 (standard therapy) [9].The third group (IІІ) consisted of 24 patients with endogenous intoxication syndrome, who received sorbilact in addition to standard therapy.The fourth group (IV) consisted of 21 patients with endogenous intoxication syndrome who received sorbilact and L-arginine in addition to standard therapy.Sorbilact infusion to patients of the III and IV groups was performed at a rate of 6-7 ml/kg body weight, intravenously dripping at a rate of 7-8 ml/min. After the end of the infusion of sorbilact, patients of the IV group were infused with 4.2% solution of L-arginine (“Tivortin” intravenous drip according to the instructions). Data was obtained and results gathered on the application of drugs in the period of stabilization (according to the state of regulation of water and ion balance by kidneys) of endogenous intoxication syndrome (fourth day of drugs’ application).As a single-celled receptor-effector system, a Paramecium caudatum culture was used. Low Molecular Weight Protein (LMWP) concentrations in blood and urine were determined using a modified method.RESULTS: Endogenous intoxication syndrome in patients of II-IV groups was characterized by the following indicators: total blood plasma toxicity (Pt) in the II group was 151 ± 6.4 toxicity units / ml, in group ІІ -147 ± 6.2 toxicity units / ml and 130 ± 6.6 toxicity units / ml in group IV. LMWP concentration in group ІІ was 0.61 ± 0.03 conditional units / ml, in ІІІ group - 0.52 ± 0.029 conditional units / ml and 0.43 ± 0.037 conditional units / ml in group IV.The following clearance detoxification function characteristics are established, which are integral indicators of its kidneys performance. Clearance of toxic substances (Ct) in the I group was 2.7 ± 0.06 ml / min, in the II group 2.1 ± 0.09 ml / min, in the III group - 2.9 ± 0.07 ml / min and 3.8 ± 0.08 ml / min in the IV group. Clearness of LMWP (C LMWP) in the 1st group was 15.91 ± 0.69, ml / min, in the II group 14.65 ± 0.79 ml / min, in group ІІІ - 25.61 ± 0.71 ml / min and 37.31 ± 0.7 ml / min in group IV.CONCLUSION: Under conditions of septic endotoxemia in the period of stabilization of endogenous intoxication syndrome optimization of standard therapy with the use of sorbilact and L-arginine is accompanied by the activation of the kidneys’detoxication function according to their clearance characteristics.

scholarly journals Effects of flavonol quercetin on syndrome of endogenous intoxication in experimental periodontitis

Pharmacia ◽  
2021 ◽  
Vol 68 (3) ◽  
pp. 627-632
Author(s):  
Andrii Demkovych ◽  
Vitaliy Shcherba ◽  
Olha Yaremchuk ◽  
Halyna Stoikevych ◽  
Volodymyr Machogan ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Molecular Weight ◽  
Inflammatory Disease ◽  
Water Soluble ◽  
Toxic Substances ◽  
Pathophysiological Mechanism ◽  
Reliable Criterion ◽  
Experimental Animals ◽  
Endogenous Intoxication ◽  
Experimental Periodontitis

The article presents the results of study effect of quercetin on the indicators of endogenous intoxication syndrome under conditions of experimental periodontitis. One of the key links in the pathogenesis of any inflammatory disease, including maxillofacial area, is endogenous intoxication, an important pathophysiological mechanism of which is the activation of lipid peroxidation. The experimental animals were treated by intramuscular injections with water-soluble quercetin for 7 days. For further research the blood serum was selected in which was determined the content of middle molecular weight molecules and erythrocyte intoxication index. Excessive lipoperoxidation was accompanied by accumulation of peroxidation products and depletion of antioxidant reserves, which led to accumulation of toxic substances. That is why the study of the level of middle molecular weight molecules and erythrocyte intoxication index in simulated bacterial-immune periodontitis is a reliable criterion. Quercetin was able to reduce the expression of endogenous intoxication syndrome in experimental bacterial-immune periodontitis.

The miR-21 potential of serving as a biomarker for liver diseases in clinical practice

2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Liver Diseases ◽  
Hepatic Disease ◽  
Noninvasive Detection ◽  
Diagnosis And Prognosis ◽  
Expected Performance ◽  
Potential Biomarker ◽  
Disease Condition ◽  
Complex Regulatory Network

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

Hybrid Telecoaching for Corporate Speech Training and Potential Applications to Clinical Practice

2019 ◽  
Vol 4 (2) ◽  
pp. 322-324
Author(s):  
Thomas F. Burke
Keyword(s):  
Clinical Practice ◽  
Engineering Teams ◽  
Corporate Strategies ◽  
Corporate Speech ◽  
Phone Calls ◽  
Future Clinical Practice ◽  
Fortune 100 ◽  
Potential Applications ◽  
Language Pathology ◽  
Development Engineering

Purpose The purpose of this article was to describe a model for “hybrid speech telecoaching” developed for a Fortune 100 organization and offer a “thought starter” on how clinicians might think of applying these corporate strategies within future clinical practice. Conclusion The author contends in this article that corporate telecommunications and best practices gleaned from software development engineering teams can lend credibility to e-mail, messaging apps, phone calls, or other emerging technology as viable means of hybrid telepractice delivery models and offer ideas about the future of more scalable speech-language pathology services.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham
Keyword(s):  
Clinical Practice ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Speech Language Pathologists ◽  
School Based ◽  
Research Findings ◽  
Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

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