Опыт лечения пациента с гангреной Фурнье, осложненной тяжелым сепсисом и септическим шоком

The article presents the experience of successful complex surgical treatment of a patient who suffered Fournier's gangrene, complicated by the development of severe sepsis and septic shock.В статье приведен опыт успешного комплексного хирургического лечения пациента, перенесшего гангрену Фурнье (ГФ), осложнившуюся развитием тяжелого сепсиса и септического шока

Применение принципов damage control и использование системы локального отрицательного давления для профилактики инфекционных осложнений у пациента с травматическим отрывом верхней конечности и массивным повреждением мягких тканей

The article presents a clinical case of the successful treatment of a patient with traumatic separation of the upper limb and massive damage to the soft tissues of the upper shoulder and chest. The effectiveness of applying the damage control principles and the method of local negative pressure for the prevention of local and systemic infectious complications is emphasized.В статье приведено клиническое наблюдение успешного лечения пациента с травматическим отрывом верхней конечности и массивным повреждением мягких тканей верхнего плечевого пояса и грудной клетки. Подчеркнута эффективность применения принципов damage control и метода локального отрицательного давления для профилактики местных и системных инфекционных осложнений

Case report of successful treatment of patient with high gastrointestinal fistulas with tertiary peritonitis and severe abdominal sepsis

This article is about the successful treatment of the patient with such heavy complications of a perforative duodenal ulcer as heavy abdominal sepsis, with the subsequent formation of fistulas of gastrointestinal tract. Application of the technique of «open abdomen» using vacuum assisted closure, allowed in this case to realize the principle of «sourcecontrol» and to achieve stabilization of the condition in multiple organ failure and septic shock. It is worth noting the advantage of stage reconstructive surgical interventions to this category of patients that allows to gradually improve quality of life of the patient without high operational risks of big simultaneous reconstructive operations

Interaction of relativistically intense laser pulses with long-scale near critical plasmas for optimization of laser based sources of MeV electrons and gamma-rays

Experiments were performed to study electron acceleration by intense sub-picosecond laser pulses propagating in sub-mm long plasmas of near critical electron density (NCD). Low density foam layers of 300-500 mu m thickness were used as targets. In foams, the NCD-plasma was produced by a mechanism of super-sonic ionization when a well-defined separate ns-pulse was sent onto the foam-target forerunning the relativistic main pulse. The application of sub-mm thick low density foam layers provided a substantial increase of the electron acceleration path in a NCD-plasma compared to the case of freely expanding plasmas created in the interaction of the ns-laser pulse with solid foils. The performed experiments on the electron heating by a 100 J, 750 fs short laser pulse of 2-5 x 10(19) W cm(-2) intensity demonstrated that the effective temperature of supra-thermal electrons increased from 1.5-2 MeV in the case of the relativistic laser interaction with a metallic foil at high laser contrast up to 13 MeV for the laser shots onto the pre-ionized foam. The observed tendency towards a strong increase of the mean electron energy and the number of ultra-relativistic laser-accelerated electrons is reinforced by the results of gamma-yield measurements that showed a 1000-fold increase of the measured doses. The experiment was supported by 3D-PIC and FLUKA simulations, which considered the laser parameters and the geometry of the experimental set-up. Both, measurements and simulations showed a high directionality of the acceleration process, since the strongest increase in the electron energy, charge and corresponding gamma-yield was observed close to the direction of the laser pulse propagation. The charge of super-ponderomotive electrons with energy above 30 MeV reached a very high value of 78 nC