The article represents the performance evaluation of intensive therapy of postoperative intestinal insufficiency in case of generalized peritonitis. 81 patients with postoperative intestinal insufficiency were examined. Constant infusion of 0,5% solution of ropivakain was taken in peridural space (6-10 ml/h). Application of proposed treatment regimen of intestinal insufficiency leads to faster reliable regress of dynamic intestinal insufficiency ultrasound signs, what may cause the beginning of early enteral feeding (from 3-rd day of postoperative stage).

OBJECTIVES: The prophylaxis of infection in hysterectomy is necessary because it decreases the amount of postoperative complications. It has been shown that cefuroxime is an effective antibiotic for prevention of infectious complications after abdominal hysterectomy. It has a bactericidal activity against most pathogens which can lead to wound failure and prolonged the duration of hospitalization. But pharmacoeconomic evaluation is not performed in the numerous investigations. METHODS: 40 women were randomized in equal groups to receive cefuroxime 1,5 g i.v. before start of hysterectomy (group I) and combination of ampicillin 4,0 g/day i.m. and gentamycin 5 mg/kg/day i.m. during 5 days after hysterectomy (group II). The last method is commonly used in city gynecological departments. General condition, temperature, pulse, condition of postoperative wounds, vaginal discharges were evaluated every day by means of a score scale. The sum of scores was performed as total clinical score (TCS). Cost‐minimization analysis was performed for evaluation of economic outcomes of the treatment. RESULTS: Clinical efficacy of the studied regimens was equal because the dynamic of TCS coincided in both groups (100% and 95% accordingly). Condition of wounds was excellent and pathogenic microorganisms were not performed. But in group II were detected skin rash (3 cases) and infectious infiltrate in the place of injection (1 case). Duration of hospitalization was similar in both groups. But total cost in group I was less by 17.7% than in group II (p < 0.05) because acquisition cost was more in group II. CONCLUSIONS: Prophylaxis of infectious complications in hysterectomy by cefuroxime is as effective as combination postoperative treatment with ampicillin plus gentamycin. Cefuroxime has an economic advantage and less danger for patients. This simple method of prophylaxis indicates more compliance and less cost and may be recommended for most cases of hysterectomy.

The article presents a clinical case of severe bilateral pseudomonas sclerokeratitis in a patient with occlusion hydrocephalus and intracranial hypertension, who was in a coma and on a ventilator for 20 days. At first examination (7 days after the onset of purulent keratitis, during which the process had been rapidly progressing), the clinical picture included lagophthalmos, severe purulent corneal ulcer, bilateral purulent scleromalacia, perforated cornea in the left eye. On the same day, in order to maintain eye integrity, urgent reconstructive penetrating sclerokeratoplasty with subsequent sclerocorneal coating was performed in both eyes right in the intensive care unit. Parts of the melted iris and ciliary body pars plana that were left in place were abundantly washed with BSS and moxifloxacin solutions - 150 µg/ml. Postoperative care included forced instillations of antibiotics and antiseptics. Two years after the first surgery, 2 more full-thickness corneal transplantations were performed in the patient's right eye aiming at restoration of its optical system. Thus, immediate sclerokeratoplasty with anterior segment irrigation and intraocular administration of highly diluted antibiotics appeared to be the only chance to save the vision in one eye. The fellow eye, where perforation occurred as a result of severe purulent sclerokeratitis and purulent iridocyclitis, despite all measures taken, lost its sight. After three surgeries (penetrating sclerokeratoplasty and two re-PK), visual acuity in the only seeing (right) eye was 0.1, which can be considered a satisfactory result.

The aim of this article is to provide the detailed study of the changes in the lactobacilli indices of the oral biotope in health and in caries progression in individuals. Materials and methods: Materials included on reports and data of research projects conducted at the Department of Therapeutic Dentistry and Department of Microbiology, Virology and Immunology, Ukrainian Medical Stomatological Academy (Poltava), at the Department of Microbiology of Danylo Halytsky National Medical University (Lviv), completed in 2013;research data documented by the Department of Microbiology, Medical Stomatological Institute (now Ukrainian Medical Stomatological Academy, Poltava) in 1978; literature related to the subject matter. Methodology: the standard methods of dental examination recommended by WHO; methods of system analysis and system approach, bibliosemantic analysis . Results: The presented results indicate that the number of representatives of different types of oral microflora in the oral microbiocenosis is different at different stages of human life. The content of Lactobacilli in children decreases following the rise even under increased dmft indices. Conclusions: The data observed are of great clinical interest when considering the role of Lactobacilli in the protection of the host organism and the initiation of the carious process.

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