Saratov JOURNAL of Medical and Scientific Research

South Ural State Medical University

Prognostic significance of delirium in the intensive care period of acute myocardial infarction

Year: 2016, volume 12 Issue: №1 Pages: 36-39
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Yulin A.S., Ermakov M.A., Gavrilova E.S., Astakhov A.A.
Organization: South Ural State Medical University
Summary:

The aim: to identify the frequency and clinical features of delirium in acute myocardial infarction (AMI) in the conditions of the intensive care unit. Material and Methods. The study involved 104 patients (43,3% women and 56,7% men) with AMI during the stay at the intensive care unit. The average age was 68,0 [59,0-76,7] years. Delirium was diagnosed using the criteria questionnaire Moss-ICU. For neurodevelopmental testing we used screening tests and rating scales. Results. The incidence of delirium in patients in this category was 28,8%. Most frequently delirium develops in patients aged 60-89 years: in the age group 60-74 years 25,0%, in the group of 75-89 years 44,7%. Delirium developed in the 1-2 day stay in the intensive care unit and intensive care. The average duration of delirium was 7,7 days. Hypoproductive form of delirium was detected in 64,3% of all cases, hyperproductive form in 21,4% of patients, mixed form in 14,2% of patients. The occurrence of delirium is associated with an increase of the duration of stay at the intensive care unit at 6 times compared with patients without delirium. Conclusion. The presence of delirium greatly increases the probability of death in the reanimation period of acute myocardial infarction. Moss questionnaire and training of doctors to work with rating scales should be accepted in all ICU intensive care units for early diagnosis of delirium and immediate correction of disorders of consciousness in patients in critical condition.

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Clermont operation as a preventive method of post-cholecystectomy complications

Year: 2015, volume 11 Issue: №3 Pages: 341-345
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Studenikin L.V., Bondarevsky I.Ya.
Organization: South Ural State Medical University
Summary:

Objective: to contribute to better surgical intervention outcomes in patients with cholelithiasis. Material and Methods. 41 patients were investigated prior to elective cholecystectomy The group of the study has formed the patients with raised level of the total bile acids and verified X-rays duodenal dyskinesia in subcompensation. These patients underwent laparoscopic cholecystectomy supplemented with mobilization of duodenojejunal junction without dissection of Treitz ligament (Clermont operation). Other patients underwent standard laparoscopic cholecystectomy. Life quality evaluation was performed 30 days after the surgical intervention using the unified GSRS questionnaire followed by statistical treatment. Results. Laparoscopic cholecystectomy performed simultaneously with Clermont procedure is executed in 29,3% cases (12 patients) with duodenal dyskinesia according to the classification of Ya. D. Vitebsky Life quality in group of the study was well above, than in groups of the comparison. The bile acids in group of the study were far less, than in comparison groups. Conclusion. Laparoscopic cholecystectomy performed simultaneously with Clermont operation is considered to be minimally invasive and rather effective in prevention of post-cholecystectomy complications.

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Changes in the lipid composition of blood under the influence of a single submaximal exercise capacity (experimental research).

Year: 2015, volume 11 Issue: №2 Pages: 123-125
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ermolaeva E.N.
Organization: South Ural State Medical University
Summary:

In acute physical exercise, there is a change in oxygen delivery working tissues, blood gas transport function and efficiency of the use of oxygen by cells in the process of metabolism, which is the basis for compensation for physical activities. Lipid metabolism plays an important role in the energy supply of muscle activity. The aim of our research is to study the effect of a single submaximal exercise capacity by changing the lipid profile of peripheral blood. Materials and Methods. The study was performed on 18 white rats. Model of acute exercise: animals swam 4 minutes with a load weighing 20% of body weight. Blood sampling was performed by intracardiac way, right after exercise. The blood lipid profile was determined. Results. In the experiment reported an increase in triglycerides, total cholesterol, very low-density lipoproteins, but the atherogenic ratio is maintained at the control values, due to a significant increase in the level of high-density lipoprotein. Conclusion. Acute submaximal exercise capacity by untrained body has an atherogenic effect. Working muscles during physical activity is a major consumer of free fatty acids, which are the source of atherogenic lipoprotein form of the very low and low density.

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