Article contains epidemiologic and clinical information about 81 case of postinfarction myocardial rupture occurred in Saint-Petersburg Research Institute of Emergency Care n.a. I. I. Dzhanelidze in 2009- 2012. Diagnoses were confirmed in autopsy. Some predictors of the future myocardial rupture were established, as activation of systemic inflammation among them.
The objective: the evaluation of depressive state in men with peptic ulcer of stomach and duodenum, which have sexual disorders. Patients and methods. The study is based on the generalization of the results of complex examination and treatment of 130 patients with peptic ulcer disease duodenal ulcer in remission and gastric ulcer in remission who have sexual disorders; the first were 76 (58.5±4.3%) patients, the second – 54 (41.5±4.3%); p<0.05. They entered the main group. The comparison group consisted of 100 men with peptic ulcer disease duodenal ulcer and gastric ulcer that also in remission who did not complain of sexual disorders; accordingly, they were of 66.0±4.7% and 34.0±3.3%; p<0.05. The creation of this group are motivated by the need to determine the characteristics of changes in the quality of life, psychological status between patients with these somatic diseases, but if not combined with sexual disorders. For this purpose was used the referential group consisted of 20 healthy men, the survey results of which complements the existing normalized values most approximate to this population. All groups were matched for age, and the first two – for the duration of peptic ulcer disease. Results. It is determined that the frequency of manifestations of depression in patients with peptic ulcer disease duodenal ulcer and gastric ulcer with sexual disorders identified parameters, among which stood out significantly mental anxiety (85.4±3.1%), depressive mood (73.1±3.8%), somatic anxiety (66.1±4.3%), reduced efficiency and activity (64.6±4.1 percent). Their combination in various embodiments burdened the situation. Exclusively in patients with peptic ulcer disease were most prevalent somatic anxiety (32.0±4.6%), depressive mood (28,0±4,5%), capacity and activity (24.0±4.2%). It is revealed that most duodenal ulcer and gastric ulcer with sexual disorders (60.8±4.2%) characterized by a high level of personal anxiety and almost equally often low to moderate (19.2±3.4% and 20.0±3.4%, respectively). However, 93.0% of patients only with peptic ulcer were also noted its low level of expression. At the same time, among the first significantly more often observed the average level of situational anxiety (62.3±4.2%), every third – low (28.5±3.9%) and others (10.0 %) – high, whereas among second – frequency dominated low level (63.0±4.9% vs 31.0±4.9% of the average and 6.0±2.3% – high). Conclusion. It was confirmed the hypothesis of dependence between the presence of in patients with peptic ulcer disease various intensities of depression, mental tension, mainly situational anxiety and the development of sexual dysfunctions, as evidenced by the discovery in 14% of cases of erectile dysfunction. It was proven the principle of improving the early identification of sexual disorders in men with chronic somatic diseases, for example peptic ulcer disease, the essence of which – a mandatory inclusion in the medical history, as diagnostic method of two key parameters: the satisfaction of sexual intercourse and satisfaction with sexual life in General. Key words: gastric ulcer and duodenal ulcers, sexual function disorders, psychological disorders, and depression.
ABSTRACT. A 53-year-old male patient had extensive traumatic damage to the right lower limb in a car accident that happened 17 years ago, which subsequently led to a large amputation at the hip level. Later, adduction contracture in the right hip joint with a complex regional pain syndrome developed. Due to the ineffectiveness of various methods of conservative treatment, it was decided to perform right-sided lumbar sympathectomy. Ten days later, the patient was discharged for outpatient treatment. The result of the operation was a complete relief of pain syndrome both in the early postoperative and in the long-term periods of time. Despite the large number of types of conservative therapy in modern clinical practice, none of them is perfect. Doctors decide to operate less often, trying to minimize the intervention. However, therapeutic effects are not always possible as monotherapy, often requiring additional treatments. Due to the wide development and distribution of medical products, doctors often neglect or forget about such a method as lumbar sympathectomy. Therefore, the problem of complex regional pain syndrome remains relevant today.
Цель -выяснить влияние терапии дексаметазоном на показатели иммунной реактивности, интенсивность окислительного стресса и деструкции тканей при острой ишемии нижних конечностей, представляющей угрозу потери конечности
Acute ischemia occurs due to obstruction of blood circulation, causing oxidative stress and tissue destruction. Restoration of blood flow ‒ reperfusion syndrome ‒ tissue antigens rush into the bloodstream, increasing the production of ROS and stimulating inflammation. The purpose of the work is to determine the relationship of oxidative stress, inflammation with the severity and outcome of the disease. 44 patients with acute ischemia of the lower limbs and basic therapy were observed. Studied the change in the process of treating blood oxidative activity by the level of chemiluminescence, total antioxidant activity plasma, C-reactive protein level as a marker of inflammation and creatine kinase, reflecting tissue damage, white blood cell count with leukogram count and neutrophilic lymphocyte ratio. Acute ischemia of the lower limbs is accompanied by destruction of tissues and an increase in ROS production, a decrease in total antioxidant activity, and an increase in systemic inflammation during the reperfusion period. With an increase in the severity of the disease, an increase in oxidative stress is observed, which exacerbates the destruction of tissues and provokes a further increase in the systemic inflammatory response.
