Peculiarities of the formation of polyorganic dysfunction syndrome in experimental abdominal sepsis: kidney dysfunction

Introduction: A steady increase in the incidence of the abdominal sepsis puts it into the top priority in terms of both medical and socio-economic significance. Multiple organ failure/dysfunction syndrome is one of the most important components of the pathogenesis of abdominal sepsis, determining the severity of the course, features of the clinical picture, mortality and outcome. The aim of the study is to determine the dynamics of changes in the functional state of the excretory system under the conditions of modeling of the AS in the acute experiment. Material and methods: The study included acute experiment on 38 white rats with abdominal sepsis modeled by intraabdominal injection of a patented mixture of both aerobic and anaerobic conditionally pathogenic microorganisms' suspension and adjuvant substances influencing local host resistance. This study conforms to international and national standards of bioethics. Kidneys' functional state was evaluated by determining a set of 46 functional markers. Results: All renal function parameters were significantly influenced by abdominal sepsis formation. At the beginning of the formation of the abdominal sepsis, the disruption of the transport of sodium ions is concentrated mainly in the area of the distal tubules. Subsequently, the zone of functional disorders also covers the proximal nephron. Conclusions: Formation of abdominal sepsis is characterized by a complex of physiological changes in the functional state of the kidneys, both adaptive- compensatory and pathological. Renal function undergoes phase changes under abdominal sepsis with predominantly adaptive and compensatory mechanisms dominating at the beginning with further involvement of kidneys' components and formation of renal dysfunction

MORPHOLOGICAL CHANGES IN PURULENT-NECROTIC PROCESSES OF SOFT TISSUES IN PATIENTS IN LOCAL APPLICATION OF SORBENT-ANTIBIOTIC COMPOSITION

Local use of sorbent-antibiotic composition reduce the duration of exudation phase and actively reduce wound surface and formation of new granulation tissue, destruction and lysis of newly formed epithelium is absent

PECULIARITIES OF THE CROSS-CULTURAL COMMUNICATION IN MEDICAL STUDETS

The problem of acquiring the ability to cross-cultural communication is urgent to address the contemporary development stage of a globalized society, since communication is an integral part of the individual living in society. Especially important is the formation of cross-cultural communicative competence of future health professionals. Integration into the global cultural, educational, and economic environment requires high-quality training, including healthcare industry experts capable of successful professional activities within the international community

ABDOMINAL SEPSIS AND ACUTE RESPIRATORY DYSFUNCTION

The aim of the study is to find changes of the functional state of the respiratory system in abdominal sepsis (AS) patients. Seven patients with AS and 9 control group patients after planned surgery have been compared. рО2/рСО2 after ventilation test and 5 min respiration with 100% O2 are most indicative. The conclusion is drawn concerning the necessity to correct treatment tactics of such patients including oxygen enriched therapy into the protocol of treatment

AN EXPERIMENTAL STUDY FOR CALCULATING PATIENTS SEVERITY STATUS IN EMERGENCY SURGERY

Prognostic evaluation of the effectiveness of scoring pathologic conditions was studied by simulating abdominal sepsis in experiment. The application of scoring systems with a prognostic purpose is advisable for using under clinical conditions. It is expedient to combine different evaluation systems with the aim of enhancing prognos¬tic reliability and optimizing the treatment tactics

Pediatric trauma and emergency surgery: an international cross-sectional survey among WSES members

Background: In contrast to adults, the situation for pediatric trauma care from an international point of view and the global management of severely injured children remain rather unclear. The current study investigates structural management of pediatric trauma in centers of different trauma levels as well as experiences with pediatric trauma management around the world. Methods: A web-survey had been distributed to the global mailing list of the World Society of Emergency Surgery from 10/2021-03/2022, investigating characteristics of respondents and affiliated hospitals, case-load of pediatric trauma patients, capacities and infrastructure for critical care in children, trauma team composition, clinical work-up and individual experiences with pediatric trauma management in response to patients´ age. The collaboration group was subdivided regarding sizes of affiliated hospitals to allow comparisons concerning hospital volumes. Comparable results were conducted to statistical analysis. Results: A total of 133 participants from 34 countries, i.e. 5 continents responded to the survey. They were most commonly affiliated with larger hospitals (> 500 beds in 72.9%) and with level I or II trauma centers (82.0%), respectively. 74.4% of hospitals offer unrestricted pediatric medical care, but only 63.2% and 42.9% of the participants had sufficient experiences with trauma care in children ≤ 10 and ≤ 5 years of age (p = 0.0014). This situation is aggravated in participants from smaller hospitals (p < 0.01). With regard to hospital size (≤ 500 versus > 500 in-hospital beds), larger hospitals were more likely affiliated with advanced trauma centers, more elaborated pediatric intensive care infrastructure (p < 0.0001), treated children at all ages more frequently (p = 0.0938) and have higher case-loads of severely injured children < 12 years of age (p = 0.0009). Therefore, the majority of larger hospitals reserve either pediatric surgery departments or board-certified pediatric surgeons (p < 0.0001) and in-hospital trauma management is conducted more multi-disciplinarily. However, the majority of respondents does not feel prepared for treatment of severe pediatric trauma and call for special educational and practical training courses (overall: 80.2% and 64.3%, respectively). Conclusions: Multi-professional management of pediatric trauma and individual experiences with severely injured children depend on volumes, level of trauma centers and infrastructure of the hospital. However, respondents from hospitals at all levels of trauma care complain about an alarming lack of knowledge on pediatric trauma management

Diversity and ethics in trauma and acute care surgery teams: results from an international survey

Background Investigating the context of trauma and acute care surgery, the article aims at understanding the factors that can enhance some ethical aspects, namely the importance of patient consent, the perceptiveness of the ethical role of the trauma leader, and the perceived importance of ethics as an educational subject. Methods The article employs an international questionnaire promoted by the World Society of Emergency Surgery. Results Through the analysis of 402 fully filled questionnaires by surgeons from 72 different countries, the three main ethical topics are investigated through the lens of gender, membership of an academic or non-academic institution, an official trauma team, and a diverse group. In general terms, results highlight greater attention paid by surgeons belonging to academic institutions, official trauma teams, and diverse groups. Conclusions Our results underline that some organizational factors (e.g., the fact that the team belongs to a university context or is more diverse) might lead to the development of a higher sensibility on ethical matters. Embracing cultural diversity forces trauma teams to deal with different mindsets. Organizations should, therefore, consider those elements in defining their organizational procedures. Level of evidence Trauma and acute care teams work under tremendous pressure and complex circumstances, with their members needing to make ethical decisions quickly. The international survey allowed to shed light on how team assembly decisions might represent an opportunity to coordinate team member actions and increase performance