Сравнительная оценка влияния опиоидной и эпидуральной аналгезии на систему гемостаза женщин во время родов

The Purpose of the study investigation — a study of the influence opioid and epidural analgezium on hemostasis beside women’s in perinatal period, as well as determination of the possibility of the preventive maintenance hemostatic complications by way to optimization intranatalis anesthetizations. 90 pregnant were examined, women in childbirth and woman recently confineds by means of new instrumental method -— hemocoagulography. It is revealled that only epidural analgezium statistical realistically influences on functional condition of the system hemostasis.Цель исследования - изучение влияния опиоидной и эпидуральной аналгезии на гемостаз у женщин в перинатальном периоде, а также определение возможности профилактики гемостазиологических осложнений путем оптимизации интранатального обезболивания. Было обследовано 90 беременных, рожениц и родильниц с помощью нового инструментального метода - гемокоагулографии. Выявлено, что только эпидуральная аналгезия статистически достоверно оказывает влияние на функциональное состояние системы гемостаза

Магнитно-резонансная диагностика жидкостных скоплений при остром интерстициальном панкреатите

The article analyses MR examinations of 160 patients with interstitial acute pancreatitis, in absence of MR signs of necrosis of pancreatic parenchyma; the incidence of fluid collections and their outcomes are estimated. Small single fluid collections in the first day after an attack of acute pancreatitis were revealed in 27.5% of cases, multiple and large fluid collections without signs of parenchymal necrosis were revealed in 15.6%. Follow-up MR examinations showed full resolution of peripancreatic fluid collections in 78.7% of cases. Resistant unencapsulated and partially encapsulated collections were found in 7 of 47 patients (14.9%). Local complications requiring surgical intervention developed exclusively in patients with fluid collections and amounted to 1.9% of the whole group of 160 patients, and 6.4% of patients with acute pancreatitis without signs of necrosis of pancreas and peripancreatic fat, but with fluid collections.The authors came to the conclusion that routine MR examinations of patients with interstitial acute pancreatitis were indicated for patients with fluid collections to estimate the dynamics of changes (resolution of collections or development of complications).В статье проанализированы магнитно-резонансные (МР) исследования 160 пациентов с легкой формой острого панкреатита при отсутствии МР-признаков некроза паренхимы поджелудочной железы, оценена частота жидкостных скоплений и их исходы. Одиночные, небольших размеров жидкостные скопления в первые сутки после атаки острого панкреатита выявлены в 27,5% случаев, множественные и большие скопления жидкости выявлены в 15,6%. Контрольные МР-исследования показали полное рассасывание ретроперитонеальных скоплений жидкости в 78,7% случаев. Стойкие неинкапсулированные и частично инкапсулированные скопления определены у 7 (14,9%) пациентов из 47. Локальные осложнения, потребовавшие хирургического вмешательства, развились исключительно у пациентов с жидкостными скоплениями, и составили 1,9% на всю группу, а у больных с жидкостными скоплениями — 6,4%.Авторы исследования пришли к выводу, что стандартные МР-исследования у пациентов с легкими интерстициальными формами острого панкреатита показаны больным со скоплениями жидкости для определения динамики развития изменений (рассасывание или развитие осложнений)

The comparative estimation of the influence opioid and epidural analgezium to women’s system gemostasis in perinatal period

The Purpose of the study investigation — a study of the influence opioid and epidural analgezium on hemostasis beside women’s in perinatal period, as well as determination of the possibility of the preventive maintenance hemostatic complications by way to optimization intranatalis anesthetizations. 90 pregnant were examined, women in childbirth and woman recently confineds by means of new instrumental method -— hemocoagulography. It is revealled that only epidural analgezium statistical realistically influences on functional condition of the system hemostasis

MR diagnosis of fluid collections in acute interstitial pancreatitis

The article analyses MR examinations of 160 patients with interstitial acute pancreatitis, in absence of MR signs of necrosis of pancreatic parenchyma; the incidence of fluid collections and their outcomes are estimated. Small single fluid collections in the first day after an attack of acute pancreatitis were revealed in 27.5% of cases, multiple and large fluid collections without signs of parenchymal necrosis were revealed in 15.6%. Follow-up MR examinations showed full resolution of peripancreatic fluid collections in 78.7% of cases. Resistant unencapsulated and partially encapsulated collections were found in 7 of 47 patients (14.9%). Local complications requiring surgical intervention developed exclusively in patients with fluid collections and amounted to 1.9% of the whole group of 160 patients, and 6.4% of patients with acute pancreatitis without signs of necrosis of pancreas and peripancreatic fat, but with fluid collections.The authors came to the conclusion that routine MR examinations of patients with interstitial acute pancreatitis were indicated for patients with fluid collections to estimate the dynamics of changes (resolution of collections or development of complications)

ANTI-B-CELL THERAPY AT IMMUNE INFLAMMATORY RHEUMATIC DISEASES: EFFICACY AND TOLERABILITY IN 229 PATIENTS

Objective: to assess the efficacy and tolerability of Rituximab treatment in patients with serious immune inflammatory rheumatic diseases (IRD) like systemic lupus erythematosus (SLE), systemic sclerosis (SS), systemic vasculitis (SV), Sjogren syndrome (SjS), dermatomyositis/polymyositis (DM/PM).Subjects and methods. The clinical efficacy has been analyzed in 229 patients with IRD: SLE (n=97), SV (n=50), SS (n=40), SjS (n=23) and DM/PM (n=19). Rituximab treatment was accompanied by administration of glucocorticoids and/or immunosuppressive drugs. Most patients demonstrated resistance to or low tolerability of standard therapy. Efficacy of treatment was analyzed in each group with the criteria relevant for each disease. To compare clinical response to the treatment between the groups we used gradations accepted by international registries: complete (good) response, partial response, no response. Average duration of monitoring comprised 72 (1–288) weeks after the first introduction of Rituximab. Average Rituximab dose administered to patients over the period of monitoring was low and varied from 1.6±0.84 in DM/PM to 3.1±1.75 in SV. About 80% of patients received one or two courses of Rituximab except for patients with SS (half of them received three and more courses).Results. «Complete response» was observed in 50.6%, «partial response» – in 35% of patients. Rituximab courses provided positive dynamics in clinical scores and allowed to reduce supportive dose of glucocorticoids and to lower the dose or withdraw of immune-stimulating drugs. Multiple Rituximab courses provided stable and longlasting effect. Recurrences were observed less frequently, whereas efficacy of the therapy increased during a year and longer. Occurrence of adverse events and mortality rate were comparable to data of other national Rituximab registries.Conclusion. The results of the study may prove administration of Rituximab in patients with resistance to standard therap