Obstetric-gynecologic tactics in treatment of the puerperant woman with severe obstetrical pathobiology which complicate by evolution multiorgan failure

The aim of the present study: to analyse the results of treatment and outcomes of the obstetrical patient at puerperal period with multiorgan failure which due by gestosis, obstetrical haemorrhage, obstetrical sepsis. Was analysed 157 cases from 2000-2007 year. Of the 115 treatment patients (73,2%) was with kept uterus, 42 females (26,6%) was put to hysterectomy surgery at the place of delivery. Methods of the diagnostic and treatment: 15% of cases — laparoscopy, in 20% hysteroscopy with vacuum-aspiration or instrumental curettage. In 71,3% cases reproductive function of patients were saved by the adequate intensive care and well-timed use of the endoscopic method. At 88% of the puerperants was favorable outcomes. CONCLUSION: well-timed surgical sanitation of the infection focus with use as minimally invasive methods, in such a way radical surgical intervention, appear one of condition successful treatment of multiorgan failure, reduce quantity severe suppurative complications and enlarge chances of the patients for favorable outcome.Цель исследования: оценить результаты лечения и исходы у акушерских больных в послеродовом периоде с полиорганной недостаточностью (ПОН), развившейся в результате гестоза, акушерских кровотечений, акушерского сепсиса. Проведен анализ 157 случаев за 2000-2007 гг. Из них 115 пациенток (73,2%) поступили с сохраненной маткой, у 42 (26,6%) — произведена гистерэктомия по месту родов. Методы диагностики и лечения: в 15% случаев — лапароскопии, в 20% — гистероскопии с вакуум-аспирацией или инструментальным кюретажем. В 71,3% случаев за счет адекватной интенсивной терапии и своевременного применения эндоскопических методик пациенткам была сохранена репродуктивная функция. У 88% родильниц — исход благоприятный. Таким образом, своевременная хирургическая санация очага инфекции с использованием как малоинвазивных методик, так и радикального хирургического вмешательства, является одним из условий успешного проведения лечения ПОН, снижает количество тяжелых гнойно-септических осложнений и увеличивает шансы больных на благоприятный исход

Prognosis treatment exodus parturients with multiple organ failure

Objective: То study the dynamics on the basis of the basic parameters of homeostasis in patients with multiple organ failure after complicated delivery to identify the most informative clinical and laboratory parameters that predict treatment outcome. Material and Methods: a retrospective cohort study that included 173 women with multiple organ failure after complicated delivery. Divided into 3 groups: group 1 (n = 86) - the surviving patients with intact uterus, group 2 (n = 67) - the surviving patients who had undergone hysterectomy; third group (n = 20) - the dead woman in childbirth. Assessment of patients was carried out on set of clinical and laboratory signs, according to standard research in resuscitation and intensive care admission (2-3 days after birth) on the 5th day after birth and on the 10th day. Results and discussion. Noteworthy significantly shorter period of delivery patients, who subsequently managed to maintain reproductive function (33,86 + 0,56 weeks.). Women with a favorable outcome later, less time spent in hospitals 1 and 2 levels (2,88 + 0,37). Patients of group 1 had a lesion on the average of 2 systems, two groups of woman in childbirth - 3 systems, and subsequently died (group 3) – 4 systems. In the study of the basic parameters of homeostasis in parturients dynamics have been identified and formulated criteria for informative decision rule forecast preservation of reproductive function, which can guide the work of practitioners.Цель работы: на основании изучения динамики основных параметров гомеостаза у пациенток с полиорганной недостаточностью после осложненных родов выявить наиболее информативные клинико-лабораторные показатели, позволяющие прогнозировать исход лечения. Материал и методы: проведено ретроспективное когортное исследование, в которое были включены 173 женщины с полиорганной недостаточностью после осложненных родов. Выделены 3 группы: 1-я группа (п=86)- выжившие пациентки с сохраненной маткой: 2-я группа (п=67)- выжившие пациентки, перенесшие гистерэктомию; 3-я группа (п=20)- умершие родильницы. Оценка состояния пациенток проводилась по совокупности клиниколабораторных признаков, согласно стандарту исследования в отделениях реанимации и интенсивной терапии при поступлении (2-3 сутки после родов), на 5-е сутки после родов и на 10-е сутки. Результаты и обсуждение. Обращает на себя внимание достоверно меньший срок родоразрешения пациенток, у которых в дальнейшем удалось сохранить репродуктивную функцию (33,86+0,56 нед.). Женщины, с благоприятным исходом впоследствии, меньшее время пробыли в ЛПУ 1 и 2 уровня (2,88+0,37). Пациентки 1 группы имели поражение в среднем 2-х систем, родильницы 2 группы - 3-х систем, а умершие впоследствии (3 группа) - 4-х систем. При исследовании основных параметров гомеостаза родильниц в динамике были выявлены информативные критерии и сформулировано решающее правило прогноза сохранения репродуктивной функции, которым могут руководствоваться в своей работе практические врачи

Basic Criteria for Terminology Selection in Compiling Lexicographic Model of Sociological Terminology in English

The article describes the process of terminology selection for sociological terminology dictionary and attempts to justify the selection criteria on the basis of fundamental terminology characteristics and requirements. The terms were selected from sociologic dictionaries, encyclopedias, monographs, scientific articles. The selection revealed particular signs of uncertainty within English sociological terminology such as cases of synonymy and polysemy, variability of spelling as well as the lack of common vision among the specialists. All these can be seen as tokens of immature terminology. At the same time, there are also traits inherent to older terminologies such as the existence of the so-called terminological core, consisting mostly of single-word and two-word terms

Conceptual Metaphor in Sociological Terminology

The article deals with a metaphoric perspective in the study of sociological terminology. Metaphor has long been widely used in reasoning and writing within humanitarian discourse. When Sociology was singled out as a separate discipline, it inherited metaphor as a tool of scientific analysis, which made it an invaluable source of sociological terminology. The article reveals that source domains for metaphors in Sociology are found in anthropocentricity of cognition, activity-based and cultural concepts

Respiratory mycoplasmosis in pediatrician's practice

Respiratory mycoplasmosis is a group of infectious and inflammatory diseases of the respiratory system caused by pathogenic microorganisms - Mycoplasma species. It was found that the major causative agent is Mycoplasma pneumoniae (M. pneumoniae). The role of other mycoplasma pathogens in the development of respiratory infections still remains a subject of debate. Hence, the term "respiratory mycoplasmosis" is generally associated with M-pneumoniae infection [5, 7, 15, 22]

NEW APPROACHES TO MANAGING COUGH IN ACUTE RESPIRATORY INFECTIONS IN CHILDREN

Rational therapy is one of the basic conditions for an effective and safe treatment. Polypharmacy is a frequent mistake of rational therapy which is particularly relevant in pediatric practice. Given that polypharmacy is especially common in the treatment of children with acute respiratory infections (ARI), we consider it appropriate to focus on the challenges of rational therapy of ARI symptoms, one of which is cough. [1

The Lysozyme Activity in Liver and сOlon Dysbiozis After Experimental Antibiotic Therapy

As far as antibiotics cause dysbiotic and hepatotoxic side effects, there appeared the interest to the experimental study of the influence of antibiotics on the antimicrobial function of the liver and colon microbiota, especially lysozyme activity in tissues of rats.Aim –is to study the influence of several antibiotics on lysozyme activity in the liver, blood serum and colon.Methods. The studies were realized on rats of Wistar line, that were administered with soluble forms of antibiotics with drinking water: cefixime (20 mg/kg), or sumamed (25 mg/kg), or amoxiclav (40 mg/kg), or lincomycin (60 mg/kg) during 5 days, or antihelicobacter complex (omeprasole 1,33 mg/kg, amoxil-К 50 mg/kg and clarithromycin 7,5 mg/kg) for 8 days. Doses corresponded to developers' recommendations. Euthanasia of animals was realized under thiopental anesthesia (40 mg/kg) in 5 days after the last intake of antibiotics. Lysozyme and urease activity was determined the blood serum, homogenates of the liver and colon mucosa, and the dysbiosis degree was calculated by their level according to Levitsky by the enzymatic method. The results were processed using Student t-criterion.Results. Antibiotics cause the decrease of lysozyme activity in the colon mucosa, blood serum and liver of rats. This factor decreases most after using lincomycin and antihelicobacter complex, insignificantly – after amoxiclav. Synchronously, urease activity in the colon mucosa, blood serum and liver and also the dysbiosis degree in the colon increase. Lincomycin and antihelicobacter complex essentially raised these indices. The course of amoxiclav, in opposite, caused the minimal effect on urease activity and dysbiosis degree. The obtained results allow to presuppose that reproduction of pathogenic and conventionally pathogenic microflora in the mucosa of the large intestine, established by the increase of urease activity, may be a result of weakening of activity of the antimicrobial factor of lysozyme of the liver and colon after the realized antibiotic therapy. It must be taken into account at elaborating the prophylaxis of side effects of antibiotic

Treatment of acute respiratory viral infections and influenza in children: the minimal sufficiency principle

Acute respiratory viral infections (ARVI) occupy a special place in pediatric practice. This is due to several factors including high incidence, increased morbidity, frequently severe course and risk of complications especially in children with premorbidities, as well as a significant economic and social burden [1]. It should be specifically noted that ARVI in children is the main reason for seeking medical care on an outpatient basis, accounting for more than 90% of all doctor visits during the epidemic outbreak of the disease [2]

Frequently ill children: has everything been resolved?

The article presents an analysis of causes of recurrent respiratory infections in children. The special attention is drawn to the need for improvement of the epidemiological, anamnestic, social and other data to clarify the causes and provoking factors for increased respiratory morbidity. It has been shown that allergic diseases, immunodeficiency states, persistent herpetic infections, functional gastrointestinal disorders, etc. are often hidden.under the mask of “frequently ill children”. This determines the importance of a detailed assessment of clinical manifestations of each episode of the disease and the correct interpretation of examination results for the timely diagnosis specification. It was proposed to move from targeting the “frequently ill children” group to nosological verification, which have a high level of respiratory morbidity. It has been proved that early arriving at a diagnosis makes it possible to timely prescribe etiopathogenetic therapy, which significantly increases the effectiveness of treatment. The article presents an analysis of clinical studies of the effectiveness and safety of OM-85 immunomodulator of bacterial origin in children with recurrent respiratory diseases