Background and Objectives: To propose a new classification of diabetic foot syndrome adapted for inclusion in the ICD-10 (the ICD-10 is the 10th revision of the International Statistical Classification of Diseases) and providing more reliable data on the number of clinical cases. Materials and Methods: A randomized controlled trial was performed. A total of 180 patients (36.6%) discharged from the hospital after surgical treatment and 312 patients (63.4%) who applied independently were observed and analysed. All patients had type 2 diabetes and were comparable in gender, age, duration of diabetes, area and nature of the wound defect. Results: We proposed to add the following to the existing ICD-10 and the emerging ICD-11 codes: Edf10.0—insulin-dependent diabetes mellitus with diabetic foot syndrome and Edf11.0—non-insulin-dependent diabetes mellitus with diabetic foot syndrome, where “df” is an acronym for diabetic foot. The new classification designates the seven most frequent areas of the lesion and five degrees of depth of soft tissue lesions. Conclusions: The proposed classification adapted for ICD-10 will enable the standardisation of diagnosis, providing a complete picture of this complication of diabetes mellitus, determining the number of amputations and their validity. Accurate statistics will allow for objective funding and timely preventive measures.
Aim. To improve the results of treatment in patients with thoracoabdominal injuries (TAI) by means of creating the method of determining indications for the use of classical or endoscopic surgeries in respect of this pathology. Materials and methods. Seventy-six sufferers from TAI were divided into 2 groups. Results. The method of successive determination of indications for the use of classical or endoscopic surgeries in patients with TAI was created on the basis of treatment of 41 (53.95 %) patients of group II. This method was used to treat 35 (46.05 %) patients of group I. Conclusions. Rational approach to the choice between the use of advantages of classical and endoscopic surgeries depending on characteristics of clinical situation permitted to elevate the quality of treatment in patients with TAI.
Introduction: Frequency of primary hepatic cancer makes 3-5 persons per 100 000, metastatic cancer is 20-30 times higher. Metastatic lesions of the liver are diagnosed in 20-50% of patients during primary visit to a doctor. Operability of hepatic cancer is not more than 15-20% that dictates usage of radio-frequency ablation (RFA) in combined treatment. Methods: Two hundred thirty five patients with primary and metastatic tumours of the liver were treated from 2012 till 2017. The mean age was 63, 6AE7, 1. Metastases of colorectal cancer were diagnosed in 143 (60,8%) patients, hepatocellular carcinoma-in 30 (12,8%), cancer metastases of the other organs-in 62 (26,4%). Size of liver foci varied from 1,5 to 6 sm. Atypical liver resections were performed to 86 patients, RFA was fulfilled to 149 patients. Size of tumours in RFA was not more than 5 sm. Chemotherapy was applied to all the patients. Results: Postoperative complications after atypical resections of the liver occurred in 5, 81% (n=5) cases: bleeding-in 2 (2, 33%), biloma-in 1 (1, 16%), subdiaphragmatic abscess-in 1 (1, 16%), pleuritis-in 1 (1, 16%) case. After RFA complications were observed in 4 (2, 68%) cases: hematoma, biliary fistula, subdiaphragmatic abscess, reactive pleuritis. Survival rate after atypical liver resections during 3-5 years was 44, 6% and 26, 8% respectively, after RFA-42, 4% and 22, 9%. Conclusion: Usage of atypical resections is rational for small subcapsular located tumours. For intraparenchymatous located tumours RFA is recommended.
Aim: To identify a connection between acute and chronic pancreatitis and primary hyperparathyroidism on the base of clinical cases. To consider the features of the diagnosis and treatment of acute and chronic pancreatitis with primary hyperparathyroidism.Materials and methods: Over the past 10 years, there have been observed 3 cases of pancreatitis with primary hyperparathyroidism. Two patients were diagnosed with chronic pancreatitis, one patient was diagnosed with acute destructive pancreatitis. Patients were undergoing surgery, parathyroidectomy was performed.Results: Primary hyperparathyroidism is rarely associated with the occurrence of acute or chronic pancreatitis, but hypercalcemia plays an important role in the pathogenesis of these diseases. Pancreatitis usually occurs in the late stage of hyperparathyroidism, which explains the low prevalence of this association in developed countries, where primary hyperparathyroidism is diagnosed at an early stage of the disease.Conclusion: These clinical cases of radical surgical treatment of parathyroid adenoma associated with severe concomitant pathology testifies to the effectiveness of the surgical method in some cases. It is necessary to take into account severe concomitant pathology and diagnose and correct it in time.
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