Observations of 153 patients admitted to the rehabilitation toxicological department of the Sklifosovsky Research Institute for Emergency Medicine after severe poisoning with psychopharmacological agents (36), cauterizing fluids (67) and neurotoxicants (drugs of the opium group, ethanol and psychopharmacological agents) (50) were summarized. To assess the systemic response of the body to a chemical injury of varying severity and the treatment used, the factor analysis method was used. For all of the estimated pathological conditions, high hemorrheological abnormalities are of high informational importance, especially during poisoning with psychopharmacological agents. The factor of endotoxicosis also has a noticeable effect, to the greatest extent during poisoning with psychopharmacological agents and cauterizing fluids. During the development of encephalopathy, the importance of blood viscosity, apoptosis and immune status is of informative significance. Factor analysis makes it possible to obtain new information on the pathogenesis of the studied poisonings. The data on the information value of the indicators used, obtained by the factor analysis, is in accordance with positive clinical results (shortening the hospitalization of patients), and therefore are recommended for practical use.
The use of mexidol, MDM and HBO in the treatment of patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation improved the indicators of functional brain activity and cognitive functions.
The aim of the study. Obtaining new data on the pathogenesis of endotoxicosis (ET) in the rehabilitation period of acute poisoning by assessing the conjugacy of hemorheology (HR) disorders with the development of ET. Material and methods. To obtain new information about the pathogenesis of acute poisoning in the rehabilitation period in 145 patients with severe acute poisoning with psychopharmacological agents (PFAp) due to the addition of pneumonia, neurotoxicants (NTp) with the development of toxic hypoxic encephalopathy and corrosive substances (CSp) with deep and widespread burns of the mucous membranes of the gastrointestinal tract, a pair correlation analysis of the block structure of the obtained correlation matrix was undertaken, establishing the relationship between the two indicators, as well as a canonical correlation analysis revealing the nature of the statistical relationship between groups of indicators, with the calculation of the canonical correlation coefficient. Results. As a result, statistically significant correlations were established between the indicators HR (viscometric, aggregation and indicators hemostasis) and ET (total and effective albumin concentration, the level of medium molecular weight peptides, the content of leukocytes, lymphocytes, neutrophils and circulating immune complexes detected in the blood, and his integral indicators) (-0.32-0.48 for PFAp, 0.29-0.35 for NTp and 0.28-(-0.51) for CSp), as well as statistically significant values canonical correlation coefficients, which indicated the development of ET due to disorders of HR. Limitations. The study was performed on laboratory data obtained during the examination of patients with acute poisoning, and therefore has no restrictions for the further use of this methodological approach in clinical trials. Conclusion. The obtained data can serve to optimize the treatment of ET in this pathology by targeted therapeutic effects on parameters of HR (on viscosity and hemostasis in PFAp and NTp, and in CSp, in addition, on aggregation).
The article describes a specialized software application developed by the authors that summarizes the long-term experience of analyzing clinical and laboratory data in clinical toxicology using Microsoft’s Visual Basic for Applications object-oriented programming tools in Excel. The main purpose of the application is a significant (5-10 times) acceleration of the implementation of the complex of the most commonly used statistical algorithms. The application calculates descriptive sample characteristics, identifies deviations of sample distributions from the normal law by several generally accepted criteria, performs statistical comparison of data matrices by several criteria, and automatically generates a number of tables ready for placement in scientific texts for various purposes in Microsoft Word format. The presentation of the output data makes it easy to verify the results of calculations by comparing them with the output forms of the Statistica application software package. The acceleration of obtaining the final result is achieved: 1 – due to the absence of the need to move data from Excel to the package of applied statistical programs; 2 – as a result of automating the determination of task parameters by means of special color markup; 3 – by combining a limited number of the most commonly used statistical methods into one immutable complex; 4 – as a result of the software implementation of statistical comparison of all possible combinations of data matrices involved in the study for a set of indicators as a single operation that does not require user intervention; 5 – due to the application’s use of syntactic transformations of output data and automatic table formation by filling in ready-made templates with calculation results.
BACKGROUND: Diagnostics and treatment of acute poisoning, as well as the rehabilitation measures carried out in relation to them, including the stationary stage, are aimed at the most complete restoration of the lost capabilities of the body. AIMS: Increasing the efficiency of medical rehabilitation of acute poisoning (AP) in a toxicological hospital through a combination of drug therapy and non-drug treatment with preformed physical factors. MATERIAL AND METHODS: Of 1,207 patients with AP psychopharmacological agents (pPFA), neurotoxicants (pNT), cauterizing agents (pCA) and snake bites (SB), who were in the toxicology department of the N.V. Sklifosovsky, 421 patients with an unfavorable course of AP were subjected to an in-depth examination. Intravenous laser hemotherapy (LGT), hyperbaric oxygenation (HBO), mesodiencephalic modulation (MDM), wave biomechanotherapy (WBMT) and ethylmethylhydroxypyridine succinate (EP) were used in cases of 291 patients of the main groups. RESULTS: The unfavorable course of AP was accompanied by an increase in the duration of treatment by 2.26.8 times due to the addition of pneumonia (pPFA), toxicohypoxic encephalopathy (pNT), severe burns of the gastrointestinal tract (pCA) and local edematous-inflammatory changes (SB). There was a syndrome of high blood viscosity and moderate endotoxicosis. The best clinical and laboratory results were obtained with a combination of LHT (90 minutes) with EP (pPFA), HBO and EP (pCA), HBO, MDM, EP (heavy pNT), HBO, EP (moderate pNT) and WBMT (SB). The adaptive capabilities of the organism, the state of the autonomic nervous system (pNT), neuropsychological indicators and electrical activity of the brain (pNT) improved. CONCLUSION: Programmed rehabilitation made it possible to achieve a noticeable reduction in the incidence of symptoms of the studied poisoning (by 54.693.4%), the time to resolve their manifestations (by 9.175%), as well as inpatient treatment (by 16.159.3%), improving functional performance.
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