Urolithiasis is an urgent problem of surgical urology, about 200 thousand operations are performed annually in the Russian Federation. The complicated course of the postoperative period is accompanied by changes in homeostasis associated with immune activation and dysregulation of the endothelial system. The study evaluated the parameters of lymphocyte plasma membrane blebbing in patients with complicated and uncomplicated postoperative urolithiasis. 240 patients suffering from urolithiasis took part, who underwent surgical treatment. Patients were divided into two clinical groups: I clinical group (n = 130) – patients with a favorable course of the postoperative period of urolithiasis, II clinical group (n = 110) – patients with a complicated course of the postoperative period of urolithiasis. The control group was – 25 practically healthy persons. Lymphocyte membrane status was assessed by phase contrast microscopy. The maximum frequency of plasma membrane changes was recorded in patients with postoperative complications and amounted to 15.92 [13.20; 17.01] when evaluating initial blebbing and 21.93 [17.67; 30.45] for terminal blebbing. With a favorable course of postoperative period, patients with urolithiasis did not have statistically significant changes in the parameters of blebbing of the plasma membrane of lymphocytes.
The work is based on a retrospective analysis of literature data covering tactical approaches, indications and contraindications, treatment results in patients with HIV infection who underwent organ transplantation. The analysis of the most up-to-date publications on organ transplantation in HIV-infected patients in the Russian Federation and abroad has been carried out. The criteria under which the transplantation of an HIV-infected patient is most favorable are noted. Cases of transplantation with subsequent results are described: donor (HIV-) – recipient (HIV+), donor (HIV+) – RECIPIENT (HIV+) and donor (HIV+) – RECIPIENT (HIV-). The main purpose of the review is to analyze modern foreign and domestic literature on the issue of tactical approaches to organ transplantation in HIV-infected patients. It has been established that different countries have different approaches to organ transplantation in HIV-infected patients.
Aim. To assess the surgical risk in HIV-infected patients who received the surgical treatment within the penitentiary system of Kemerovo Region.Materials and Methods. We retrospectively analysed the physical status and the extent of surgical risk in 296 HIV-infected patients who underwent elective (n = 201) or emergency (n = 95) surgery in Hospital №1 (Kemerovo) from 2015 to 2018. Physical status was assessed according to American Society of Anesthesiologists (ASA) Physical Status Classification System. Surgical risk was scored according to Moscow Scientific Society of Anesthesiologists and Critical Care.Results. The majority of patients had 3 (48.4 and 36.3% in emergency and elective patients, respectively) or 4a (30.5 and 45.8% in emergency and elective patients, respectively) stages of HIV infection. Opportunistic infections were diagnosed in 49.3% of patients and were always accompanied by superficial mycoses. Physical status of most patients (47.4% and 63.7% in emergency and elective patients, respectively) corresponded to ASA physical status class 3. Emergency patients mainly had surgical risk class 3 (n = 50, 52.6%) while elective patients often had surgical risk class 2 (n = 106, 52.7%). The prevalence of postoperative complications, most often impaired wound healing, was 9.8%.Conclusion. More than 80% of HIV-infected patients who underwent surgical interventions within the penitentiary system of Kuzbass were at III or IV stages of HIV infection, entailing a high frequency of opportunistic diseases such as superficial mycoses and dictating the need to include antifungal treatment into the surgical treatment. Impaired wound healing was the most frequent postoperative complication.
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