Intoxication Syndrome In Patients Research Articles

Immunoreactivity and intoxication syndrome in patients with chronic viral hepatitis c

Method: Etiological, gender, age and laboratory characteristics of chronic viral hepatitis C (СVHC) were studied and analyzed. The distribution of patients depending on the virus genotype, the activity degree and the severity of liver fibrosis were found out. Indices of non-specific reactivity, endogenous intoxication and inflammation in the course of СVHC, their dependence on treatment were studied. Correlations between the values of non-specific reactivity, endogenous intoxication, inflammation and patients’ affiliation to the group of injecting drug users, the APRI score, the stage of liver fibrosis and the virus genotype were estimated. Significant increase in endogenous intoxication (LII, HII, ISS), non-specific immunoreactivity (IR, LMR, Ilymph, IA) and inflammation (ILG) at decrease in some endogenous intoxication indices (ISL, NRR) and inflammation (KI, ILESR) in patients with CHCV compared with healthy persons were established. Result: The decrease in endogenous intoxication indices (LII; HII; ISL; ISS; NRR) were observed during antiviral treatment. Such unambiguous reaction of non-specific immunoreactivity indices and inflammation indices were not observed: some of them increased (Ilymph, IA), some of them decreased (IR, NLR; ELR). KI decreased during the treatment, but ILG increased. Direct correlation between patients’ affiliation to a group of injecting drug patients and the values of HII, NRR (p<0.05), between the APRI score and Ilymph level (p<0.05) was identified. Conclusion: No correlation between the indices values and fibrosis severity (according to METAVIR) and virus genotype was found. Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 508-514

Assessment of endogenous intoxication based on the study of medium and low molecular weight substances in patients with myocardial infarction against a background of chronic obstructive pulmonary disease

Introduction. Frequent comorbidity of chronic obstructive pulmonary disease and myocardial infarction is due to the commonality of a number of etiopathogenetic links and the development of endogenous intoxication syndrome. The convincing markers of endogenous intoxication syndrome are medium and low molecular weight molecules including medium and low molecular weight substances and oligopeptides.Aim. To study the levels of medium and low molecular weight substances in patients with myocardial infarction against the background of chronic obstructive pulmonary disease.Materials and methods. 225 patients with myocardial infarction were examined. In 195 patients the infarction developed against the background of COPD, in 130 patients – without COPD. The comparison group consisted of 110 somatically healthy individuals. Substances of medium and low molecular weight (MLMWS) and oligopeptides (OP) were determined by direct spectrometry (according to M.Y. Malakhova, 1995) in plasma, erythrocytes and urine. Endogenous intoxication indices and intoxication coefficient were calculated on the basis of these indices. Statistical processing of the data was performed using SPSS 26.0 software package.Results. In blood plasma and erythrocytes, the levels of average molecules in both studied groups were statistically significantly higher compared to controls. The highest levels were detected in comorbid patients. In the group of patients with myocardial infarction without chronic obstructive pulmonary disease 60% of the examined patients had phase I endogenous intoxication. Phase III intoxication prevailed among comorbid patients with myocardial infarction against chronic obstructive pulmonary disease – 62,6%.Conclusions. Molecules of average mass have proven to be informative indices of endogenous intoxication syndrome in patients with myocardial infarction accompanied by chronic obstructive pulmonary disease. This opens the prospect of using these indices in the development of assessment scales and the creation of prognostic algorithms in patients with cardiorespiratory comorbidity.

Outpatient diagnosis of endogenous intoxication in surgery

Introduction. In recent years, there has been an increase in the number of patients with purulent surgical diseases with severe endogenous intoxication and renal dysfunction. The problem of early diagnosis of purulent diseases is still not completely solved. The health systems of developed industrial Western countries do not always manage to provide all citizens with adequate high-quality medical care. This is due to the current health crisis. The problems of diagnosis, treatment, prevention and prediction of purulent diseases in surgery can be solved thanks to advanced digital technologies.Aim of the study. To develop a diagnostic method for early detection of endogenous intoxication in outpatient surgery.Materials and methods. We created three groups of observations for the design of a neural network system for the diagnosis of endogenous intoxication syndrome and chronic kidney disease. In the first group, the hematological parameters of 150 healthy people were studied. In the second group, the hematological parameters of 40 patients with chronic kidney disease without chronic kidney failure were studied. The third group included 84 patients with chronic kidney disease and end-stage chronic kidney failure. The following 25 laboratory parameters were studied: hemoglobin, red blood cells, color index, white blood cells, rod-shaped neutrophil white blood cells, segmental neutrophil white blood cells, eosinophils, basophils, lymphocytes, monocytes, ESR, total protein, albumins, urea, creatinine, bilirubin, beta-lipoproteins, cholesterol, glucose, seromucoid, sialic acid, potassium, sodium, chlorine, calcium. Statistical, neural network and algorithms with elements of fuzzy neural networks were used on a sample consisting of hematological parameters of 274 patients with chronic kidney disease and healthy ones based on 25 laboratory parameters. Mathematical modeling was carried out at the Department of “Computer Technologies” of the Penza State University.Results. The effectiveness of neural network diagnostics of endogenous intoxication syndrome in patients with chronic kidney disease without chronic kidney failure reached 88.2%, and in patients with chronic kidney disease and chronic kidney failure – 97.6%.Conclusion. The neural network method of diagnosis can help improve the early diagnosis of endogenous intoxication syndrome in outpatient surgery.

Outpatient diagnosis of endogenous intoxication in surgery

Introduction. In recent years, there has been an increase in the number of patients with purulent surgical diseases with severe endogenous intoxication and renal dysfunction. The problem of early diagnosis of purulent diseases is still not completely solved. The health systems of developed industrial Western countries do not always manage to provide all citizens with adequate high-quality medical care. This is due to the current health crisis. The problems of diagnosis, treatment, prevention and prediction of purulent diseases in surgery can be solved thanks to advanced digital technologies.Aim of the study. To develop a diagnostic method for early detection of endogenous intoxication in outpatient surgery.Materials and methods. We created three groups of observations for the design of a neural network system for the diagnosis of endogenous intoxication syndrome and chronic kidney disease. In the first group, the hematological parameters of 150 healthy people were studied. In the second group, the hematological parameters of 40 patients with chronic kidney disease without chronic kidney failure were studied. The third group included 84 patients with chronic kidney disease and end-stage chronic kidney failure. The following 25 laboratory parameters were studied: hemoglobin, red blood cells, color index, white blood cells, rod-shaped neutrophil white blood cells, segmental neutrophil white blood cells, eosinophils, basophils, lymphocytes, monocytes, ESR, total protein, albumins, urea, creatinine, bilirubin, beta-lipoproteins, cholesterol, glucose, seromucoid, sialic acid, potassium, sodium, chlorine, calcium. Statistical, neural network and algorithms with elements of fuzzy neural networks were used on a sample consisting of hematological parameters of 274 patients with chronic kidney disease and healthy ones based on 25 laboratory parameters. Mathematical modeling was carried out at the Department of “Computer Technologies” of the Penza State University.Results. The effectiveness of neural network diagnostics of endogenous intoxication syndrome in patients with chronic kidney disease without chronic kidney failure reached 88.2%, and in patients with chronic kidney disease and chronic kidney failure – 97.6%.Conclusion. The neural network method of diagnosis can help improve the early diagnosis of endogenous intoxication syndrome in outpatient surgery.

Features of the clinic in patients with non-tumor mechanical jaundice with concomitant pathology

The Objective was to improve the results of diagnostics of the severity of patients with complications of cholelithiasis, occurring in the form of mechanical jaundice, against the background of comorbidity.Methods and Materials. 537 patients admitted in the clinic of hospital surgery of Kabardino-Balkar State University named after H. M. Berbekov in the period from 2010 to 2019 were examined. The terms of admission to the hospital were different. 25 (4.6 %) people were admitted in a short period of time up to 6 hours. A day after the onset of the disease – 82 (15.3 %) people. More than half – 277 (51.6 %) people were hospitalized a week after the onset of the disease. We analyzed the data of comorbidity scales of CIRS, Kaplan–Feinstein and Mary Charlson Index, as well as biochemical criteria reflecting the severity of calculous cholecystitis, jaundice and concomitant diseases.Results. As a result of their analysis and comparison, we found that comorbidity in patients of this kind is the main aggravating factor and worsens the пeneral condition as the stages of jaundice develop.Conclusion. We found out that a common biochemical tests as for characterizing changes of the hepatocyte in nontumor obstructive jaundice, and for evaluating the degree of impact of comorbidity are the content of blood alkaline phosphatase, creatine phosphokinase and transaminases. Intoxication syndrome in patients with cholangitis and comorbidity so negatively affect all organs and systems of the body that it can lead to inoperability.

ОСОБЕННОСТИ ИНТОКСИКАЦИОННОГО СИНДРОМА У ПАЦИЕНТОВ С НЕСПЕЦИФИЧЕСКИМ ОСТЕОМИЕЛИТОМ ПОЗВОНОЧНИКА

Background. Nonspecific spinal osteomyelitis (NSO) is a serious purulent-inflammatory disease, accompanied by high mortality and disability of patients. Aim. To study the characteristics of intoxication syndrome (IS) in patients with NSO and to assess the degree of influence of the activity of the inflammatory process in the bone structures of the spinal column on the degree of intoxication. Material and methods. The neutrophil-lymphocyte ratio, leukocyte and hematological indices of intoxication, nuclear index of the degree of endotoxicosis, immunoreactivity index were studied in 46 patients with NSO. The relationship between the activity of the inflammatory process in the structures of the spinal column and the degree of IS has been studied. Results. The severity of IS in patients with complicated forms of NSO was significantly (p 0,05). A mathematical model was developed (Рχ2 = 0,0003), which makes it possible to suspect purulent complications in a patient with NSO by the severity of IS (sensitivity 65,38%, specificity 80%). Conclusion. The presence of IS makes it possible to suspect purulent complications in patients with NSO, which requires an extended diagnostic preoperative search.

Intensification of the organism detoxification ability under surgical endogenous intoxication

The work is based on the results of clinical and laboratory studies. The clinic examined 55 patients with acute moderate peritonitis as complication of various diseases (acute appendicitis, perforated gastric or duodenal ulcer, acute intestinal obstruction, acute destructive cholecystitis). Before surgical operation and in the early postoperative period we evaluated the severity of endogenous intoxication by the level of hydrophilic and hydrophobic toxic products. The content of molecular products of lipids peroxidation - oxidative stress, phospholipase activity were determined in the blood plasma. In the study group (n = 28) in the postoperative therapy additionally included remaxol (400 ml intravenous fluids). Research established that the occurrence of endogenous intoxication syndrome in patients with acute peritonitis associated with the activation of oxidative stress and phospholipases, high intensity of which is maintained even after elimination of the source of peritonitis with manifestation on the 1st day after surgery. Remaxol include leads to a significant reduction in the severity of intoxication syndrome in patients with acute peritonitis. Positive effect of the drug on the correction of endogenous intoxication is largely determined by its ability to significantly reduce oxidative stress and the activity of phospholipases, as the most important membrane destabilizing agents. The greatest detoxication effect of the drug is recorded when it is applied already at the preoperative stage of patients when its ability to reduce the activity of trigger agents of catabolic processes implemented to the greatest extent. In acute moderate peritonitis, remaxol use before surgery or in the early postoperative period in complex therapy leads to a significant correction of factors contributing to the development and preservation of the intensification of catabolic processes - one of the sources of endogenous intoxication.

OPTIMIZATION OF KIDNEYS’ DETOXICATION FUNCTION OF SEPTIC PATIENTS IN THE PERIOD OF STABILIZATION OF TOXIC AUTOAGRESION

INTRODUCTION: Kidney injuries in the endogenous intoxication syndrome of septic genesis necessitates nephroprotective therapy.OBJECTIVES: The purpose of the work was to determine the effect of the combined use of sorbilact and L-arginine on the detoxification function of kidneys and the levels of separate indicators of endogenous intoxication syndrome.METHODS: Detoxication function of kidneys have been studied in patients of the following groups.The first group (І, control) consisted of 31 patients with systemic inflammatory response syndrome (SIRS, ICD-10: R-65.2).The second group (ІІ) consisted of 22 patients with endogenous intoxication syndrome who were treated according to Surviving Sepsis Campaign 2016 (standard therapy) [9].The third group (IІІ) consisted of 24 patients with endogenous intoxication syndrome, who received sorbilact in addition to standard therapy.The fourth group (IV) consisted of 21 patients with endogenous intoxication syndrome who received sorbilact and L-arginine in addition to standard therapy.Sorbilact infusion to patients of the III and IV groups was performed at a rate of 6-7 ml/kg body weight, intravenously dripping at a rate of 7-8 ml/min. After the end of the infusion of sorbilact, patients of the IV group were infused with 4.2% solution of L-arginine (“Tivortin” intravenous drip according to the instructions). Data was obtained and results gathered on the application of drugs in the period of stabilization (according to the state of regulation of water and ion balance by kidneys) of endogenous intoxication syndrome (fourth day of drugs’ application).As a single-celled receptor-effector system, a Paramecium caudatum culture was used. Low Molecular Weight Protein (LMWP) concentrations in blood and urine were determined using a modified method.RESULTS: Endogenous intoxication syndrome in patients of II-IV groups was characterized by the following indicators: total blood plasma toxicity (Pt) in the II group was 151 ± 6.4 toxicity units / ml, in group ІІ -147 ± 6.2 toxicity units / ml and 130 ± 6.6 toxicity units / ml in group IV. LMWP concentration in group ІІ was 0.61 ± 0.03 conditional units / ml, in ІІІ group - 0.52 ± 0.029 conditional units / ml and 0.43 ± 0.037 conditional units / ml in group IV.The following clearance detoxification function characteristics are established, which are integral indicators of its kidneys performance. Clearance of toxic substances (Ct) in the I group was 2.7 ± 0.06 ml / min, in the II group 2.1 ± 0.09 ml / min, in the III group - 2.9 ± 0.07 ml / min and 3.8 ± 0.08 ml / min in the IV group. Clearness of LMWP (C LMWP) in the 1st group was 15.91 ± 0.69, ml / min, in the II group 14.65 ± 0.79 ml / min, in group ІІІ - 25.61 ± 0.71 ml / min and 37.31 ± 0.7 ml / min in group IV.CONCLUSION: Under conditions of septic endotoxemia in the period of stabilization of endogenous intoxication syndrome optimization of standard therapy with the use of sorbilact and L-arginine is accompanied by the activation of the kidneys’detoxication function according to their clearance characteristics.

Синдром ендогенної інтоксикації у хворих на цукровий діабет в поєднанні з неалкогольною жировою хворобою печінки

Синдром ендогенної інтоксикації у хворих на цукровий діабет в поєднанні з неалкогольною жировою хворобою печінки

Применение нового отечественного противовирусного препарата в этиотропной терапии гриппа

Изучено влияние нового противовирусного препарата триазавирин на клиническое течение гриппа средней степени тяжести у взрослых пациентов. Клиническую эффективность препарата изучали в сопоставлении с таковой для осельтамивира. Были сформированы 2 группы пациентов: группа триазавирина (30 человек) и группа осельтамивира (29 человек). Триазавирин назначали по 1 капсуле (250 мг) 3 раза в сутки, осельтамивир – по 1 капсуле (75 мг) 2 раза в сутки. Оба препарата применялись внутрь в течение 5 сут. Симптоматическая терапия у больных обеих групп была идентична. Получены сопоставимые результаты в проведенном сравнительном изучении клинической эффективности и безопасности противовирусной терапии гриппа триазавирином и осельтамивиром. Показано некоторое преимущество триазавирина в купировании интоксикационного синдрома у больных гриппом.

Intoxication syndrome in patients with pulmonary tuberculosis in relation to the system glutathione transferase gene polymorphism

In 178 patients with different clinical forms of pulmonary tuberculosis carried out pharmacogenetic testing to determine gene polymorphism glutathione S-transferase system (GSTM1, GSTT1). Estimated the severity and duration of clinical manifestations of the syndrome of intoxication, depending on the gene polymorphism of glutathione S-transferase system (GSTM1, GSTT1). It was found that the combination of “zero” to develop genotypes GSTM1 and GSTT1 enzyme is a predictor of the severity and duration of symptoms of intoxication persisting.

Features of course of intoxication syndrome while using glutoxin in patients with first diagnosed pulmonary tuberculosis depending on thyroid homeostasis

The article presents results of the study of features of intoxication syndrome in patients with impaired thyroid homeostasis during a treatment with glutoxim established based on analysis of the examination of 25 patients with newly diagnosed pulmonary tuberculosis with preserved sensitivity to anti-TB drugs. Results of the study showed that in patients with pulmonary tuberculosis when applying glutoxin in the program of pathogenic treatment, disappearance of intoxication syndrome occurs in more people than in patients treated with a standard procedure (p<0.05).

Влияние миниинвазивных колостом на микробную обсемененность брюшной полости и развитие интоксикационного синдрома у больных раком прямой кишки, осложненным острой непроходимостью

The article studies the influence of proximal colostomy formed through minimal access for microbial contamination of the abdominal cavity during the radical phase of treatment and the dynamics of the inflammatory changes and intoxication syndrome in patients with rectal cancer complicated by acute obstruction. The research on microbial contamination of the abdominal cavity was made in 32 patients, including 15 patients in whom obstruction was resolved conservatively and 17 patients in whom was made a proximal colostomy through mini-invasive access to eliminate acute obstruction. In 30 patients were investigated acute phase proteins and determined the level of toxemia available by calculation leukocyte index of intoxication. Blood sampling was carried out in patients with acute intestinal obstruction directly before applying the proximal colostomy, and before the second - a radical step treatment in 7-10 days. Found that the imposition of the proximal colostomy through minimal access does not lead to an increase in microbial contamination of the abdomen; helps reduce the level of acute phase proteins, the level of general toxemia and reduces the risk of postoperative inflammatory complications before performing radical phase of treatment.

Endogenous intoxication syndrome in patients in the late stages of obliterating atherosclerosis of the vessels

Endogenous intoxication syndrome in patients in the late stages of obliterating atherosclerosis of the vessels