Purpose. The research goal comprises primary analysis of CT examinations results and their interpretation by comparing with the data already available in the literature.Material and methods. During the period from April 17, 2020 to May 18, 2020, 830 chest CT scans were performed and results of 123 CDs with CT scans made by other institutions were interpreted. Follow-up examinations were carried out every 3–4 days or when clinical presentation changed. At the primary stage, we have analysed in a more detail way a group of 69 patients, who were diagnosed with CT-3 or CT-4 volume of lung damage at least once during hospitalization. The patients underwent PCR analysis three times during hospitalization. Among 69 patients, 34 patients had a positive PCR test at least once, the remaining 35 patients had a clinic, corresponding with this disease.Results. At the initial examination, ground-glass opacity prevailed, as it was observed in 44 cases (64%), and lung tissue consolidation was observed in 25 cases (36%) in a group of 69 patients. When comparing the two groups, the average age of the patients with consolidation changes was statistically significantly lower than one of the group where ground-glass opacity prevailed – 51.7 and 59.4 years, respectively (p = 0.01) In the group of patients with pulmonary tissue consolidation, there were fewer concomitant diseases, fatal outcomes, positive PCR test results, a shorter hospitalization period, and fewer cases of tocilizumab administration were noted. At the initial examination the average percentage of pulmonary parenchyma involvement in the group of patients with lung tissue consolidation was higher (63.3%; p = 0.04), follow-up examinations showed c statistically significantly lower average values of the increase in the percentage of involvement of the parenchyma, which acquired negative values after the third CT scan (8.3 after the 2nd CT and −5.2 after the 3rd CT versus 18.5 and 3 in the GGO glass group; p = 0.02 and 0.03, respectively). No visible differences in CT between the period from the onset of the disease and the predominant symptom in CT were revealed. Meanwhile, on the 5th day (the day of the check-up CT examination) the largest number of patients was determined in both groups.Conclusion. An analysis of our experience during the first month of operation of Covid-19 Hospital is presented. According to our data, the appearance of consolidation at the initial CT examination is probably not related to the period, when the disease has been in progress, and may be associated with a more favorable course of the process.
ÔÃÁÓ Ôåäåðàëüíûé íàó÷íî-êëèíè÷åñêèé öåíòð ñïåöèàëèçèðîâàííûõ âèäîâ ìåäèöèíñêîé ïîìîùè è ìåäèöèíñêèõ òåõíîëîãèé Ôåäåðàëüíîãî ìåäèêî-áèîëîãè÷åñêîãî àãåíòñòâà Ðîññèè, ÌîñêâàОдной из возможных причин стойкого болевого абдоминального синдрома является хроническая ишемия кишечника, обусловленная той или иной степенью окклюзии мезентериальных сосудов. В связи с многообразием клинических проявлений, маловыраженной их специфичностью и недостаточной осведомленностью врачей общего профиля своевременная диагностика синдрома хронической абдоминальной ишемии (СХАИ) затруднена. Основными методами диагностики на современном этапе являются: ультразвуковое дуплексное сканирование, спиральная компьютерная томография, магниторезонансная томография в режиме непрямой ангиографии и прямая ангиография. Методом выбора хирургического лечения остается чрескожная транслюминальная ангиопластика и стентирование артерий.Ключевые слова: болевой синдром, окклюзия артерий, ангиография. SYNDROME OF CHRONIC ABDOMINAL ISCHEMIA IN THE PRACTICE OF GENERAL SURGEONSYu.V. Ivanov, A.V. Chupin, D.V. Sazonov, D.P. LebedevOne possible cause of resistant abdominal pain syndrome is a chronic intestinal ischemia caused by varying degrees of occlusion of the mesenteric vessels. Due to the variety of clinical manifesta tions, just noticeable their specificity and lack of awareness of general practitioners timely diagno sis of the syndrome of chronic abdominal ischemia is difficult. The main methods of diagnosis at this stage are: ultrasound duplex scanning, spiral computed tomography, magnetic resonance computed tomography angiography in the mode of indirect and direct angiography. The method of choice of surgical treatment is percutaneous transluminal angioplasty and stenting of the arteries.
Aim. This study aimed to investigate potential use of radiofrequency obliteration (RFO) of angiomatous tissues in patients with venous malformations. Materials and Methods. A single-center study retrospectively involved 42 clinical cases [57.1% of men (n=24), aged 18-44 years; 42.8% of women (n=18) aged 18-56 years] of venous angiodysplasia, with a total of 46 interventions using RFO. Clinical manifestations of the disease were primarily characterized by pain syndrome (71.4%), cosmetic defect (100%), and edema syndrome (95.2%). Results. Clinical improvement was possibly achieved with the reduction of the intensity of manifestations of angiomatous processes in 37 patients (88.1%). Stable and partial obliterations of caverns in the zone of exposure to radiofrequency were recorded in 37 (88.0%) and 5 (12.0%) patients, respectively. In caverns with small diameter, obliteration was achieved in 100% of the cases. Postoperative complications included bleeding (2.4%), burns in the zone of electrode introduction (2.4%), lymphorrhea (2.4%), and hypesthesia (2.4%). With this, according to the results of duplex scanning performed on control visits, no significant disease progression was observed. In the same patient, several complications could occur. All complications regressed within a month and required no treatment in hospital conditions. Conclusion. RFO showed advantage as a minimally invasive treatment method of venous angiodysplasias. Results suggest that RFO can be recommended for use in patients with 1 cm depth of lesion with caverns of medium and large diameter as an independent treatment method and in combination with standard resection methods.
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