Rpose of the study. To study the relationship between fatal cardiovascular events and non-alcoholic fatty liver disease (NAFLD) among the population of the Irkutsk region. Materials and methods. The study was conducted on the basis of the Irkutsk Regional Bureau of Forensic Medicine. The object of the study was the medical documentation - “The autopsy report”. Results. To study the possible relationship, a retrospective analysis of the results of 2220 autopsies performed over 3 years was carried out: 2010-2012. in the pathological department. Signs of non-alcoholic fatty liver disease according to morphological studies were identified in 271 cases. Conclusions. 1.In patients with NAFLD, body weight can be equally normal and increased. Among patients with increased body weight, women predominate. 2. In men, there is a moderate positive correlation between the thickness of the subcutaneous fat and the mass of the liver; in women, this connection was not found. 3. Morphologically, coarse fatty degeneration of the liver is more common. 4. Every second patient with NAFLD (49%) died of CVD. Among the dead, men reliably predominate. The dominant cause of death is cardiovascular disease (AMI), followed by impaired cerebral circulation. Mortality peaks in middle and old age. 5. The total mortality from CVD for 3 years according to the pathology department of the Irkutsk Regional Clinical Hospital was 423 cases (19%) (n = 2220). Among all deaths from CVD, one in three (133 cases (31.4%)) had fatty changes in the liver. Conclusion: the results obtained confirm the hypothesis of the existence of a relationship between NAFLD and CVD, which is based on disorders of fat metabolism that develop as a result of impaired normal function of hepatocytes against the background of their fatty lesions. In accordance with this statement, it is necessary to think about considering NAFLD as a component of metabolic syndrome.
Background: The research aims to improve the surgical treatment results of incisional ventral hernia by applying a case-specific approach and a new method of anterior abdominal wall surgery. Materials and Methods: The paper reports the results of the prospective dynamic cohort study on 219 patients under 60 years of age, with small and medium hernias and up to 10 cm defects in the anterior abdominal wall (W1–W2), who underwent incisional ventral hernia treatment with mesh endoprostheses. Results: The paper offers a selection algorithm for anterior abdominal wall repair surgery and an original proprietary technique. We have developed and described in detail a new ‘extra-sublay’ technique of surgical intervention. The paper displays the frequency and pattern of complications, as well as the quality of life of patients after different prosthetic surgeries. In the main group, 65.0% of patients showed improvement, 88.4% showed long-term surgical success, 13.6% faced complications, and 4.5% experienced recurrence. Conclusion: After receiving the “on lay” treatment, 59.4% of patients showed positive results, 74.7% showed long-term surgical success, 40% had complications, and 3.1% experienced recurrence. After the “sub lay” intervention, 40.0% of patients demonstrated excellent results, 81.9% reached long-term success, 12% had complications, and 1.4% encountered recurrence. Highlights: The article shows a selection algorithm for anterior abdominal wall plastic repair method. One of the factors that cause relapses and ventral hernias themselves is obesity. The authors’ method of the VH surgical treatment has shown good results. Excellent indicators showed 65.0% of patients of the main group.
BACKGROUND: One of the most serious diseases among all emergency abdominal pathology is an acute violation of the mesenteric blood circulation. The rapid development of intestinal ischemia results in its infarction and necrosis. AIM: The study aims to assess the survival rate of patients with mesenteric vascular thrombosis, taking into account, the predictor characteristics influence of disease development factors. METHODS: The study presents a retrospective analysis of mesenteric vascular thrombosis clinical cases for 2016–2019. During this period, there were 147 patients with an established diagnosis at the Irkutsk Clinical Hospital No. 1, 21 of them met the study criteria. RESULTS: According to the type of thrombosis, there were two groups – occlusive (Group I, n = 11) and non occlusive (Group II, n = 10). Four patients (36.3%) of Group I and 7 patients (70%) of Group II (p = 0.388) recovered from the disease. Three patients (27.2%) of Group I and 4 patients (40%) of Group II (p = 0.662) received conservative therapy, 2 of them (66.6%) in Group I and 4 (100%) in Group II (p = 0.724) recovered from the disease. In addition, the authors performed a mortality assessment, according to the timing of the visit to a medical institution. Four (50%) out of eight patients who applied in the first 12 h, 2 (66%) out of three – in the first 12–24 h, and 5 (50%) out of 10 for more than 24 h of illness had a positive treatment result in the combined group. CONCLUSION: The patients over 70 years old with peritoneal symptoms and established intestinal necrosis have an extremely unfavorable prognosis. The primary mesenteric vessel thrombosis with additional contrast angiography still gives a moderate treatment prognosis.
The Aim of research is to improve the results of surgical treatment of incisional ventral hernia by applying a case-specific approach and a new method of plastic repair of anterior abdominal wall. The prospective controlled dynamic study is based on incisional ventral hernia treatment results with the use of meshed endoprostheses among 219 patients. On-lay alloplasty was used in patients younger than 60 years of age, without severe concomitant pathology, with small and medium hernias and anterior abdominal wall defect of up to 10 cm (W1 - W2). The article shows a selection algorithm for anterior abdominal wall plastic repair method. It goes through advantages of the author’s proprietary technique. The article displays frequency and patterns of complications, life quality of the patients after various prosthetic plastic repairs. In the main group, positive treatment results were observed in 65.0%, long-term results of the operation were observed in 88.4%, complications occurred in 13.6%, relapse in 4.5%. «On lay» treatment tactics showed positive results in 59.4%, long-term results of the operation were observed in 74.7%, complications occurred in 40%, relapse in 3.1%. After «sub lay» intervention, excellent results were observed in 40.0% of patients, long-term results of the operation were observed in 81.9%, complications occurred in 12%, and relapse in 1.4%.
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