16 research outputs found

    Clinical Recommendations of the Northwest Society for Enteral and Parenteral Nutrition, Interregional Association for Emergency Surgery, Russian Gastroenterological Association, Union of Rehabilitation Therapists of Russia and Russian Transplantation Society on Diagnosis and Treatment of Short Bowel Syndrome-Associated Intestinal Failure in Adults

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    Aim. Current clinical recommendations address the epidemiology, causes, clinical manifestations and pathogenesis of possible immediate and long-term complications, as well as the problematic issues related to treatment and rehabilitation of adult short bowel syndrome patients.Key points. Short bowel syndrome (SBS) is a symptom complex of impaired digestion caused by the reduction of small intestine absorptive surface and manifested by intestinal failure (IF) of various severity (maldigestion and malabsorption) developing into malnutrition and systemic somatogenic disorders. The vital strategic aspects of its treatment are the personalisation of liquid, macro- and micronutrients consumption as well as avoidance of intestinal failure- and parenteral nutrition-associated complications. Various nutritional support regimes and the indications for infusion therapy and maintenance parenteral nutrition are considered in this patient category, also in outpatient settings. To mitigate the dependence on intravenous fluid- and nutrient administration and attain enteral autonomy in SBS-IF patients, the use of recombinant glucagon-like peptide-2 (GLP-2) is justified as exerting a pronounced trophic effect on the epithelial regenerative potential as well as structural and functional adaptation of intestinal mucosa. The SBS-IF patients prescribed with home parenteral nutrition and/or their caregivers should be trained in a special programme that covers the catheter care, preparation of infusion solutions and nutrient mixture container, infusion pump operation as well as the prevention, recognition and management of complications. The main referral indications for small bowel transplantation (SBT) are: fast-progressing cholestatic liver disease-complicated irreversible intestinal failure; thrombosis of two or more central venous conduits used for parenteral nutrition; recurrent catheter-associated bloodstream infection.Conclusion. Current recommendations on diagnosis and treatment as well as the developed criteria of medical aid quality assessment are applicable at different levels of healthcare

    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

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    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

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

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    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

    A rough set-based association rule approach implemented on exploring beverages product spectrum

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    [[abstract]]When items are classified according to whether they have more or less of a characteristic, the scale used is referred to as an ordinal scale. The main characteristic of the ordinal scale is that the categories have a logical or ordered relationship to each other. Thus, the ordinal scale data processing is very common in marketing, satisfaction and attitudinal research. This study proposes a new data mining method, using a rough set-based association rule, to analyze ordinal scale data, which has the ability to handle uncertainty in the data classification/sorting process. The induction of rough-set rules is presented as method of dealing with data uncertainty, while creating predictive if—then rules that generalize data values, for the beverage market in Taiwan. Empirical evaluation reveals that the proposed Rough Set Associational Rule (RSAR), combined with rough set theory, is superior to existing methods of data classification and can more effectively address the problems associated with ordinal scale data, for exploration of a beverage product spectrum.[[notice]]補正完畢[[incitationindex]]SCI[[booktype]]紙本[[booktype]]電子

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

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    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
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