Mittwoch, 26. Januar 2011

Body section

The problem of prevention of postoperative septic complications in abdominal surgery still remains relevant. This is largely due to the fact that with increasing number of complex operations with the use of modern technology increases the scope and duration of surgical interventions, increase tissue trauma and blood loss, which contribute to the development of postoperative infectious complications in the first place - wound infection. Treatment of wound infection requires additional costs and significantly increases the time of hospital stay.

Despite the increase in techniques of surgical intervention and the introduction of preventive measures, the frequency of postoperative wound infections in operations on the abdominal organs remains high. Thus, the number of postoperative suppurative complications in planned abdominal surgery is 6-8%, while, if the "clean" operations, septic complications developed in 0,8-2%, then the "dirty" or contaminated wounds suppuration number increased to 20% [39].

The frequency of suppuration of postoperative wounds in the abdominal cavity is determined by the nature of the disease, the degree of trauma surgery and the possibility of microbial infection of the wound.

When performing low-impact laparoscopic cholecystectomy incidence of postoperative septic complications is 0,6-6% [7,19,46,47], while laparotomic cholecystectomy increases to 5-26% [4,5].

In the structure of postoperative pyo-inflammatory complications is also a small percentage (1.8%) occupied and operation of selective proximal vagotomy (SPV) [32].

Increase the frequency of wound purulent complications observed after surgery with opening of hollow organs. The frequency of postoperative infectious complications increases significantly with gastric resection and varies from 4 to 26% [11.48].

The frequency of septic complications remain high during operations on the liver - 27-58% [1,6,8,23], the pancreas - 40-70% [17,29,30,54,62].

A large number (68%) of postoperative septic complications observed in surgical interventions on the colon [36]. The most serious complication of abdominal surgery is peritonitis, the incidence of which varies from 3 to 70% and the mortality rate in this case reaches 20% [4,5].

According to the report of the national surveillance system for nosocomial infections (CDC's National Nosocomial Infections Surveillance (NNIS), United States) infection of surgical intervention (SSI) is the third most frequently recorded nosocomial infection, accounting for 14 to 16% of all nosocomial infections among all hospitalized patients [ 64]. From 1986 to 1996, hospitals, conducting epidemiological surveillance of SSI within the NNIS, registered 15,523 SSI following 593,344 operations. Of this total, SSI two-thirds were located in the incision area and one third involved the organs or cavities in the surgical approach [64]. The emergence of SSI prolongs hospital stay of 10 days and increases the cost of hospitalization in 2000 dollars [56.57]. Despite significant progress in the prevention, diagnosis and treatment of surgical infection of its development in the U.S. approximately doubles the cost of hospitalization [72].

If the earlier question about the feasibility of using antibiotics prophylactically in abdominal surgery is widely debated, it is now, most researchers have concluded on the necessity and brand viagra importance of this method [9,13,21,24,27,28,34,37,39 , 42,51,63,68]. Today, antibiotic prophylaxis of postoperative infections - a common part of surgical practice in the pure-contaminated operations, as well as some clean procedures [70].

Under the prophylactic use of antimicrobials in surgery should understand prevent postoperative infectious complications by preoperative (perioperative) prescribing, with broad spectrum antimicrobial action, covering the expected pathogens in an operated organ and the surgical wound (after surgery) and provide for the creation of concentrations in the tissues, sufficient to suppress infecting microflora. Antibiotic prophylaxis reduces the number of postoperative suppuration, mortality, and reduce economic costs associated with the development of infection. At the same time, antibiotic prophylaxis of wound infection in planned abdominal surgery at the present time, many issues have not yet found a definitive answer.

In the literature [20,67,67,73] in recent years, the approaches to the standard definition of SSI, which is possible by comparing the infectious complications in any of the anatomical section of the body that have been opened or are manipulated during the operation (Table 1 and 2) and which may be the criterion for the effectiveness of perioperative prophylactic antimicrobial agents.

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Donnerstag, 20. Januar 2011

Erosive and ulcerative

The first kidney transplant HIV-infected Muller and her colleagues met for about two years ago. Total to date South African Transplant spent nine similar operations.

Fear of doctors who conducted the transplant, is the possibility brand viagra online of a recipient of reinfection (superinfection), as if infected by different strains of immunodeficiency virus may appear resistant to antiretroviral agent.

In this regard, the kidneys were taken from HIV-infected donors who had died not from AIDS but for other reasons, including as a result of an accident. Physicians selected donors who did not receive antiretroviursnye drugs, and do not suffer from typical of AIDS opportunistic infections.

Renal function after transplantation recovered from all recipients. Mueller noted that all transplant patients feel fine. Transplant added that a report on the transactions she was invited to speak at a conference of the National Institutes of Health
One of the most serious complications in victims of severe thermal burns - bleeding from the upper gastrointestinal tract (GIT), occurs with a frequency 0,15-41,5% [5, 6, 14, 15, 23]. If the fatality rate of bleeding from upper GIT in victims of severe injuries ranging from 8 to 30%, then baked, it can reach 80%. The main source of bleeding in these patients are acute erosion and ulcers of the esophagus, stomach and duodenal ulcer (DU) [7, 24, 30, 32, 34, 39].

Acute erosion and ulcers occur in all parts of the intestinal tube [15]. Most often they manifest complications as bleeding or perforation [19, 24, 27, 28]. Patients being treated in intensive care units, the frequency of clinically significant gastrointestinal bleeding (hypotension, transfusion needs in the blood) is 1.5% [43, 46].

In modern classifications among ulcer bleeding on etiologic grounds allocated hemorrhage from acute ulcers on the basis of stress [16, 17]. According to IS Osipov [15], acute gastrointestinal generic viagra ulcers differ from stress the fact that the formation of the first major role played by the weakening of protective factors and trophic disorders in the walls of hollow organs of the digestive tract, the latter developed mainly as a result of the activation factors of aggression. Such a division in the clinic looks rather arbitrary, since tyazheloobozhzhennyh these processes occur together, are closely related to each other, and treatment should be directed to all the possible pathogenesis. In foreign literature, and acute stress ulcers is not clearly separated. The term "stress ulcer" is usually applied to mucosal lesions, diagnosed in patients who are critically ill or exposed to stress of any origin [31, 41, 43, 44]. Severe surface erosion are usually multiple, starting in the fundus of the stomach, and progress towards the antral region and duodenal [23, 28, 29, 36, 44, 46].

It is noted that victims of severe thermal burns frequency and amplitude of erosive and ulcerative lesions of upper gastrointestinal bleeding and are directly proportional to the area and depth of burn and degree of burn shock [7]. Acute erosion and ulcers in the gastrointestinal tract in patients younger than 60 years often develop with burns over 20% of the body, the older - and with minimal burns (10%), and with increasing area of the burn increases the risk of erosive ulcer bleeding at all stages of burn disease. At the risk of bleeding should also include patients with isolated burns of the respiratory tract II-III degree burns or with a combination of airway and limited skin burns [6, 34].

Various theories of the pathogenesis of erosive and ulcerative lesions of upper gastrointestinal mucosa, but none of them can not fully explain the occurrence of acute ulcers. It is recognized that the final link ulcerogenesis is disruption of the normal balance of protective brand name levitra factors and aggression in relation to the mucosa [13, 45].

The factors protect the gastric mucosa and duodenum are: 1) mucous-bicarbonate barrier, 2) a system of endogenous prostaglandins, and 3) mechanisms for active regeneration of epithelium, and 4) an intense circulation in the mucosa, 5) antroduodenalny "acid brake". Aggression factors include: 1) acid-peptic factor, and 2) contamination of the gastric mucosa Helicobacter pylori; 3) gastroduodenal dismotoriku and 4) mucous traumatism, and 5) increased cialis without prescription activity of free radical oxidation of lipids [18, 21, 28, 38].

A large body of evidence suggests that upper gastrointestinal hypoperfusion can lead to ulceration of the mucosa [44, 45]. In tyazheloobozhzhennyh Education acute erosions and ulcers in the esophagus, stomach, duodenum is one component of multiple organ dysfunction syndrome (MODS), often leading to death [6, 27, 37, 49]. This syndrome leads to an increase in the frequency of adverse outcome of disease in surgical clinics and the leading cause of mortality in patients in critical condition [9, 11]. The basis of the formation of OPA is a systemic inflammatory response syndrome - a non-specific response against any deleterious effects [9]. AS Ermolov et al. [7] have revealed at roasted high levels of endogenous intoxication, which is recognized as a major factor of lesions causing erosive ulcer bleeding.

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Sonntag, 9. Januar 2011

Heart surgery

Most non-neoplastic lesions of the pancreas (RV) can be attributed to a form of pancreatitis. The result of the development of all forms of the disease are in various degrees progressive atrophy of glandular tissue, fibrosis and replacement of connective tissue cellular elements of the parenchyma of the pancreas.

Acute and chronic pancreatitis (AP and CP) are often brand viagra treated as two separate diseases. In most cases, however, correct to speak of a single phase of inflammatory-degenerative processes in the pancreas, when exacerbation of the destruction of gland tissue alternate with periods of relative prosperity. Thus, CPs can be considered as a continuation and outcome of the OP, and his sharp attacks - as episodes of chronic pancreatic lesions.

CP without pain attacks, but with a pronounced foreign and endocrine pancreatic insufficiency is based on increasing sclerosis of tissues due to primary metabolic disorders. In a number of diseases and syndromes (viral hepatitis, ulcerative colitis, hemochromatosis, infectious mononucleosis, etc.) may experience changes in sclerotic tissue pancreas without clinical signs of pancreatitis. Thus, recurrent pancreatitis - an important but not the only form of the disease.

Most of the etiological factors of AP and CP are common or similar.

Etiologies of acute pancreatitis are:

• mechanical blockade of the ampoule Father (gallstones papillostenoz, pancreas divisum, duodenal diverticula);

• Toxic and metabolic factors (alcohol, hypertriglyceridemia (endogenous and exogenous), hypercalcemia (hyperparathyroidism on the soil or exogenous), drugs);

• infection (viruses - mumps, adenovirus, Coxsackie, mycoplasmosis, worm infestation (ascariasis);

• ischemia (circulatory shock (for example, heart surgery), vasculitis, embolism, hypoproteinemia, malignant hypertension);

• tumors (primary and metastatic pancreatic cancer);

• pregnancy;

• Other diseases (Crohn's disease with localization in the duodenum (DC), gastric ulcer penetrating, cystic fibrosis of the pancreas, intermittent porphyria, thrombocytopenic purpura).

Etiological factors of chronic pancreatitis: alcohol, giperglitseridemiya, hypercalcemia, congenital pancreatitis, hemochromatosis, annular pancreas, biliary cirrhosis, sclerosing cholangitis.

Hole-and choledocholithiasis approximately half of the patients is the cause of the OP and CP due to reflux of bile into the pancreatic duct obstruction in ampoules Vater.

According to the theory of two-phase "persistent choledocholithiasis [1] in the first phase of the smaller stones cause spasm of Oddi's sphincter and reflux of bile viagra the main causes of impotence ducts in the pancreas, leading to swelling of the latter, the second phase of larger stones block the flow of activated pancreatic secretions, which can cause the development of pancreatic necrosis.

Secondary holangiogenny pancreatitis is recurrent episodes of character with the development of OP, in the chronic stage of gross anatomical changes in the pancreas and its functional disorders occur less frequently.

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Sonntag, 2. Januar 2011

Magic alternative

In no case can not apply the Pasteur effect in oncology, as it is done different categories on this basis and there was a fundamental error in oncology.

Otto Warburg is really wrong when he said that in the cancer cells increased the intensity of fermentation and decrease the intensity of oxidation (respiration). And why was born on such a conclusion? Warburg found that cancer cells consume significantly less oxygen than healthy (this is the greatest service Warburg) - this was the reason for this conclusion. It is generally accepted opinion forced to make a mistake.

- M. Jolondz: "... can not deny the fact that the first time a type of glucose oxidation in the life of each malignant cell is the fermentation (glycolysis)! ... Thus, virtually all tumors develop for a long time out of cells, which in normal conditions doopuholevyh had no contact with the circulatory system .... Germination of the tumor capillary circulatory system returns the tumor cells to breath (anaerobic energy process) .... Growing tumor cells have no contact with the circulatory system and can not, like muscles send lactic acid for conversion into glucose. Growing tumor cells were forced to seek to enhance glycolysis and increase the intensity of the accumulation of lactic acid .... Beginning of the degeneration of healthy cells into a tumor is a change in the genome, genetic apparatus of the cells .... In fact, the second phase of its development the tumor cells do not consume oxygen .... Since the beginning of sprouting capillaries ... tumor cells begin to get oxygen to the blood and return to the aerobic process. "

Can not help noticing serious contradictions. As well as science, M. Jolondz commit the same mistake, referring to the fermentation (anaerobic respiration) and oxidation (aerobic respiration) of living cells, including cancer.

He wrongly supported the conclusion of Pasteur: "fermentation - it's just life in the absence of oxygen." Let the reader is not surprised by the conclusion that living cells do not inherent to life in the absence of oxygen. For in the absence of oxygen live (but not vegetative, ie, animal) cells are always killed, including cancer. Already today we can firmly state that the fermentation process, such as in a living cell is not, and can not be. Today, it is easy to confirm the experiments. All one has already carried out experiments have shown convincingly that a living cell (and cancer) in the absence of oxygen always dies.

And was right Warburg, that cancer cells consume oxygen, but significantly less than healthy. Cancer cells, just like the muscle cell under load, lacks oxygen. As a result, there are such oxidized products such as lactic acid. It also builds and embryonic stem cells.

Today it is necessary to change existing brand name viagra attitudes and beliefs. Cancer cells occurs in healthy tissues where there is sufficient blood system. But as the only healthy cells begin to transform into cancer cells and there is growing tumor, circulatory system simply did not have time to grow into new tissue formed tumors. Therefore, there is a misconception about the origin of cancer cells outside the circulatory system. We must not forget another important detail that so much of the tumor, which had not yet succeeded, due to the rapid development of tumors grow blood system, as oxygen is present. But this oxygen passes through the mechanism of cutaneous respiration, and unfortunately, the researchers about it just forgot. And in this development and breathing cancer cells similar to embryonic.

Nobody has been able to grow in oxygen-free (anaerobic) environment, much less maintain vitality both healthy and abnormal cells, including cancer. All have forgotten that Pasteur conducted experiments with the simultaneous presence of products of plant cells and microorganisms, rather than individually. Living cells is unique to oxidation - aerobic respiration.

Why do cancer cells and forced to consume significantly less oxygen? Strengthening the muscles are simply not enough oxygen supplied by blood. Ie hard work of muscles artificially stimulated leads to hypoxia, in contrast to normal muscle function. When uncontrolled division of cancer cells and rapid growth while their clones (tumors) due to the fact that the circulatory system does not manage to grow, cancer cells are forced to limit at some time in the supply of oxygen. This is the reason that they consume significantly less oxygen. Today, there are enough experiments when an insignificant increase in tumor blood system has time to germinate and cancer cells do not experience oxygen starvation.

Inexcusable mistake of the author that he is sinning on the changes in the genome during cell degeneration. This is plainly wrong. As already noted, the experiments clearly show the complete identity and the absence of any change of the oncogene and the gene of healthy cells. And in a rather developed a strain of the tumor can be found not only the modified genes, but other pathology of other processes other than cancer, as well as direct result of degeneration is not healthy cells, but directly to the cancer. And above it is clear that the author in respect of genes expressed quite contradictory and mutually own conclusions.

- M. Jolondz: "In fact, oxygen starvation retards the transformation into a cancerous tumor on 6-10 and even 20 years .... In fact, malignant tumors within 6-10 years developing in oraganizme generally out of touch with the vessels the circulatory system .... Improved circulation of the cancer, followed by an increase in supply of cancer cells with oxygen, nutrients and plastic materials, is the worst enemy of the organism, a cancer patient .... Cancer cells are extracted before fermentation energy, before it became cancerous, but they were still just malignant cells. Becoming cancerous after germination in the tumor capillaries circulatory system, now these cells extract energy from glucose combustion, ie, 19 times more efficient than fermentation, and glucose obtained from blood as needed, taking it from other organs and tissues.

Unfortunately, the author has not managed to solve the mystery of cancer. Everything is much simpler. Tumor growth rates ahead of sprouting capillaries in her circulatory system. This leads to their starvation. Starvation of cancer cells outside the tissue does not affect the oncologic process as it occurs after the formation of cancer cells. Never before has the oxygen was not an enemy to the living cell, and especially for cancer patients. To understand the mystery of cancer need to understand, but what accelerates the processes in a healthy cell? That sooner or later leads to the transformation of this cell into a cancer. Ie into one in which change the process went beyond homeostasis, and embarked on an irreversible path of development.

But most importantly, that not only must understand that accelerates in a healthy cell. Similarly, it is something also accelerates and formed cancer cells. We need to understand that only the Oncology (cancer) process (this is the secret of cancer) if it arose in the body, then sooner or later may be cited as one of the outcomes of the irreversible transformation of healthy cells into cancer cells. If we manage to understand the mechanism of cancer process, it will be able to understand and secret cancer.

- M. Jolondz: "At the same time we will try to break free from errors and chemotherapy, makes this method in some legendary monster, devouring cancer patients .... Thus, treatment should be the action of only one of the main poisons (hemlock, colchicum or aconite, which must be rotated, but not used simultaneously).

Indeed, correctly says the author of chemotherapy and other methods of traditional medicine. But even before he talked about it more than once. I wonder why M. Jolondz not disclose the cause of devouring cancer patients, of which he speaks? On the negatives of the methods well said, Polling, twice winner of two Nobel Prizes personal. He said that we now treat patients by methods that kill them before the disease itself.

And do not forget that non-traditional methods are also included in the called Polling. M. Jolondz not even noticed that he was talking about it, noting that the treatment should be carried out poisons. Venom as do methods of traditional medicine kills cancer cells. And he also does not spare healthy.

The main reason is that in traditional medicine and alternative devouring cancer patients is the sole reason - just because the methods used are equally indiscriminate and affect both cancer and healthy cells. That damage to healthy cells and lead to a situation in which the patient is not killed by the disease itself, and methods of treatment used.

Nothing essential, methods that offer M. Jolondz not differ from those commonly used. These methods do not exclude damage to healthy cells, although they are more forgiving.

In conclusion, we reiterate that the work of any scientist if he is trying to change something in the problems, even if it does not get the deserved respect and honor. M. Jolondz failed to solve the mystery of cancer, but he managed to do enough to progress towards the mystery of cancer. And this is invaluable and worthy of attention, work. It's time to search is not in the tumor and not in cancer cells, and long before they occur.

And even if not perfect and does not give the expected results of the methods used, both in traditional and in alternative medicine, they somehow improve the situation of the patient at this stage of development of medicine and someone to inspire hope for recovery.

One thing is obvious now Viagra enhancing orgasm that the methods are in fact affect the abnormal cells, and not only in oncology, it is time to depart. For this is the way to relapse. To science arose the need for new approaches for its existing role at this stage of development of science has already played. Real experiment on a new basis and in a different direction will answer many questions.

I sincerely thank M. Jolondz, for his work formed the basis for this discussion, for his work, like many others, gave impetus to the search, for no longer necessary to make the same mistakes. Of course, that his work made it possible to search in a different and perhaps closer closer to disclosing the secrets of cancer.

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