The study found that SertaSil reduced the time to reaching a clean wound by 60% compared to Gentaxane and promoted faster wound closure and better recovery. These findings suggest that SertaSil may be valuable for use in the treatment of wounds in patients.
Introduction and purpose. Diabetes is one of the underlying causes of blindness and other long-term negative consequences that significantly affect patients’ quality of life. The study aimed to determine the indicators characterizing the pathogenetic mechanisms of the development of vascular dysfunction, in particular diabetic retinopathy (DR), and the relationship of these changes with nitric oxide. Material and methods. There were 2114 patients with various surgical diseases under observation (including 1073 patients with purulent-septic soft tissue diseases), among them there were 193 patients with type 2 diabetes mellitus (DM) and 134 patients with Wagner stage 2-5 diabetic foot syndrome (DFS) and diabetic retinopathy in the main group (268 eyes). The comparison group included 59 patients (118 eyes) of the corresponding age with DM without DFS and DR. Both groups were the same in age and gender. Results. The level of the end products of nitric oxide metabolism in peripheral blood was found to be 1.78 times (p<0.01) higher compared with patients without DR. A decrease in the activity of superoxide dismutase (SOD) in patients with DR was by 1.56 times (p<0.01) lower relative to the comparison group. The content of thiobarbituric acid (TBA)-active products in the peripheral blood of patients of the main group exceeded by 1.58 times (p <0.01) the reference values of patients without DR. When determining the content of S-nitrosithiols, an increase in these indicators in the main group was found to be 2.38 times (p<0.01). Patients in the main group with DR also showed a 5.13-fold (p<0.001) increase in peripheral blood homocysteine concentration. NO is known to have both positive and harmful effects depending on its concentration. On the one hand, NO causes relaxation of blood vessels by reducing blood pressure, prevents platelet aggregation and adhesion, limits LDL cholesterol oxidation, suppresses smooth muscle cell proliferation, and reduces the expression of proinflammatory genes that are associated with atherogenesis. It is known that NO can have both positive and harmful effects, depending on its concentration. On the one hand, NO causes relaxation of blood vessels, reducing blood pressure, prevents platelet aggregation and adhesion, limits the oxidation of LDL cholesterol, suppresses the proliferation of smooth muscle cells, and reduces the expression of pro-inflammatory genes that are associated with atherogenesis. On the other hand, NO interacts with O2-, leading to the inactivation of NO and the production of peroxynitrite, which post-transcriptionally modifies proteins and negatively affects their function. This can contribute to endothelial dysfunction by stimulating the production of inflammatory mediators and lipid peroxidation and thus increasing cell permeability. Conclusions. The findings show that the patients with diabetes mellitus complicated by retinopathy and DFS had a significant increase in the content of nitric oxide in the peripheral blood, the cause of which is hyperglycemia. The use of an intercellular mediator (nitric oxide), which contributes to the physiological regulation of the hemodynamics of the eye, protects vascular endothelial cells from pathogenic factors of ischemia, will help clinicians choose an effective pharmacological therapy appropriate for a particular patient and a particular eye.
Objective. To study a functional state of cardio-vascular system in patients, suffering peritonitis. Materials and methods. Analysis of dynamics in the electrocardiogram changes in 166 patients, including 84 women and 82 men, was conducted for studying of functional state of cardio-vascular system in extended peritonitis. Results. Changes on electrocardiograms were non monotonous and depended on the peritonitis stage. In 28.3% patients diffuse changes in myocardium were observed, while in 43.9% - moderate. In 42.6% patients the disorders in metabolic processes in myocardium were revealed. Changes in conductivity and excitability were noted merely in half of the patients. Hypoxia was observed in 17.7% patients in reactive stage of peritonitis, in 32.0% - in a toxic, in 75.8% - in terminal. Tachycardia in a reactive stage of peritonitis was noted in 77.4% patients, in toxic one - in 89.3%, and in terminal - in 86.2% patients. In terminal stage of peritonitis in 13.8% patients bradycardia was noted. The blood supply disorders of various compartments of myocardium was revealed in 34.4% patients. Conclusion. Functional changes of cardio-vascular system in patients depends on stage of peritonitis. In all the patients, suffering peritonitis, medicinal correction of the cardio-vascular system work must be conducted, while its intensity depends on stage of peritonitis.
У статті наведено випадок складності діагностики дивертикулу Меккеля, ускладненого некрозом та перфорацією дивертикулу, міжпетельним абсцесом, тонкокишковою декомпенсованою непрохідністю, загальним серозним перитонітом.
Objective. To prove experimentally the effectiveness of a new generation of application sorbent by studying the morphological changes during the wound process. Methods. Depending on the drug used to treat purulent wounds, we divided the animals into three groups. In the main group (group I) the study was performed on 20 rats, they used an application sorbent, which includes aerosil with immobilization on its matrix ornidazole (Patent of Ukraine for utility model № 115228). The comparison group (group II) consisted of 10 rats, which used the known sorbent "Gentaxan", which includes: gentamicin sulfate, L-tryptophan and zinc sulfate. The comparison group (group III) was 10 rats. In this group for the treatment of purulent wounds used 10% sodium chloride solution, followed by a transition to ointment "Levomekol", which includes chloramphenicol and methyluracil. Results. The results of the study show that in the main group already on the seventh day in comparison with the comparison groups was found granulation tissue with a large number of newly formed vessels of the microcirculatory tract and pronounced proliferation of fibroblasts, indicating acceleration of wound healing. In the comparison groups, the regeneration process was slower. Conclusion. Pathomorphological examination revealed that drugs with sorption properties contribute to a faster reduction of edema and inflammation, and treatment with application sorbent used in the main group, significantly accelerates the processes of connective tissue repair and wound epithelization, ie accelerates wound healing processes with comparison groups.
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