Laparoscopic Roux-en-Y reconstruction in a patient with afferent loop syndrome and peptic ulcers of gastroenteroanastomosis - A first experience

This paper is devoted to the description of a currently rare clinical observation of the surgical treatment of a patient with postgastroresection syndrome (afferent loop syndrome and peptic ulcers of gastroenteroanastomosis) - resection of the stomach stump with laparoscopic Roux-en-Y reconstructio

Возможности ультразвукового исследования в выявлении дивертикулита в условиях стационарного отделения скорой помощи

The aim of this prospective study was to evaluate ultrasound capabilities in differential diagnosis of intestinal diverticular disease, diverticulitis and other acute abdomen pathology.Material and methods. The study included 29 patients at the age of 48-95 years, which were admitted to emergency department with clinical symptoms of acute abdomen pain. All patients underwent complex clinical examination, comprising laboratory and instrumental diagnostic methods. Ultrasound of intestines was performed according to a specially developed step-by-step algorithm.Results. Sensitivity of the method was 68%, specificity 80%, accuracy 72.0%, PPT 86.0%, NPT 57.0%.Conclusion. Rather high diagnostic informative value and non-invasiveness of intestine's ultrasound allow to reconsider the sequence of instrumental methods of diagnosis for patients with suspicion on acute diverticulitis, and to consider ultrasound as a first line method of diagnosis.Цель исследования: оценка возможностей ультразвукового исследования в дифференциальной диагностике дивертикулярной болезни кишечника, диверти-кулитов и другой острой абдоминальной патологии.Материал и методы. В исследование включено 29 пациентов в возрасте от 48 до 95 лет, экстренно поступивших в стационар с клинической симптоматикой острого живота. Всем обследованным пациентам было выполнено комплексное клиническое исследование, включавшее в себя лабораторно-инструментальные методы исследования. Ультразвуковое исследование кишечника выполнялось по специально разработанному поэтапному алгоритму.Результаты. Чувствительность метода составила 68%, специфичность - 80,0%, точность - 72,0%, прогностическая ценность положительного результата -86,0%, прогностическая ценность отрицательного результата - 57,0%.Заключение. Достаточно высокая диагностическая информативность и неинвазивность ультразвукового исследования кишечника позволяют пересмотреть последовательность выполнения инструментальных методов обследования у пациентов с подозрением на острые дивертикулиты и рассматривать ультразвуковое исследование в качестве метода первой линии диагностики

DIAGNOSTIC PROBLEMS OF MUCOVISCIDOSIS AND WAYS OF SOLUTION IN RUSSIA

Mucoviscidosis is a monogenic autosomal recessive caused by the CFTR gene mutations and characterized by pronounced genetic heterogeneity and clinical polymorphism, which emphasizes the need in comprehensive diagnosis and molecular-genetic verification of the final diagnosis. Quality and duration of a mucoviscidosis patient depend on early diagnosis and timely adequate therapy. The article presents mucoviscidosis diagnostic methods and protocols and capabilities of the modern molecular-genetic pathological diagnosis; a review of DNA diagnostic sets has been performed. As sets of some of the genes typical to the Russian population have not been registered in the Russian Federation, mutations in 20% of the patients cannot be specified. In order to solve this problem it is necessary to develop DNA diagnostic sets specific for the Russian Federation, ensure genetic diagnosis of the disease, including sequencing methods at the expense of the federal budget, increase the amount of information and improve quality of teaching this discipline to  students of medial universities and at postgraduate courses for appropriate specialists