Vol. 5 No. 5-6 (2018): VESTNIK of KSMA

Abstract: The article analyzes the results of implemented measures to optimize the system of infection control in the National hospital at the Ministry of health of the Kyrgyz Republic. Implemented measures to optimize the system of infection control have increased the overall rate of monitoring and evaluation of infectious control in the National hospital by 19.8%, which significantly increases the safety of medical care, both for the patient and for medical personnel. The increase in the cost of optimizing the system of infection control by 15.2% in the National hospital allowed to increase the overall percentage of performance of the IC criteria for the Laundry complex by 50%; operating units by 37.5%, medical waste management by 28.6%; safety of medical procedures by 22.7%; central sterilization department  by 12.5%.

Administrative support and stereotyping of commitment is the main mechanism for improving the effectiveness of the infection control system at the National hospital.

Resume. The article presents the epidemiological situation at the beginning of 2018 year. The number of HIV-infected people is increasing every year. As of 01.01.2018, this number reached 7,948 people; among them 7,532 people are Kyrgyz citizens. A large number of HIV infections occur between the ages of 20 and 50, with a total of 6,774 people, with a peak of 25-49 years (5,556). HIV / AIDS is a medical and social problem, many of which problems remain unresolved. It requires the efforts of both governmental and non-governmental organizations.

The aim of examination: Improvement of the patients with health’s wound surgical treatment results on the basis of central and peripheric hemodynamics.

Methods of examination: general clinical, statistic, special (roentgenological, ultrasonography, thoracopscopy and electrocardiography), indexes of central and peripheric hemodynamics (frequency of heart contractions, striking indexes, heart indexes).

Results and their novelty: It is revealed that different directions of hypo circulatory changes of central and peripheric hemodynamics in the patients begin to from in the first minutes and hours of taking heart trauma. These hypo circulatory changes of central and peripheric hemodynamics are caused by forming of DlC-syndrom, increasing of central venous pressure, increasing of intrapleural pressure, growing of physical viscosity of the whole blood and its components.

The work is scientifically based on the fact, that a surgeon practically no opportunity and time to make necessary collection of instrumental examinations of the patients with pericardial injury and health’s wounds. That’s why in such special situations it is necessary to make the following clinic-prognostic criteria’s of health’s wound: trauma’s circumstances, localization of the primary wound in the “space of Grekov”, pulmonary respiration, hemopneumothorax manifestation, cutaneous integument, blood pressure, pulse pattern, pain, heart tones, dyspnea presence, state of consciousness, papillary reflex and CVP, their manifestation dynamics is determined by the presence or absence of cardiac tamponade.

Recommendations of using: having worked out and studied clinic-prognostic criteria’s (verbality) in health’s wounds are recommended for practical public health and for invasion to emergency surgery.

There are 109 males (85.8%) among examined and 18 females (14.2%) in this study. Age of injured patients ranged from 17 to 82 years. Median age was 42.4±5.6 years. Eight patients out of 127 died after surgery. General mortality was 6.3%.

The analysis of data in 127 patients with severe traumatic brain injury was given. Age of injured patients ranged from 17 to 82 years. There are 109 males (85.8%) among examined and 18 females (14.2%).

The management of complicated colon cancer (locally invasive, obstructed, or perforated cancers) can pose diagnostic and therapeutic challenges to surgical management. Adherence to traditional surgical oncologic principles must often be balanced with the patients' clinical presentation and other parameters. While the goal of an R0 (no residual microscopic disease) resection must always be kept in mind, situations sometimes arise which can make this difficult to achieve. Recognition of complicated disease and availability of varied therapeutic modalities is important to ensure favorable patient outcomes. This review will discuss the surgical management of complicated colon cancer, with special focus on locally advanced disease. The study examines the question of optimizing surgical treatment and additional therapeutic manipulations for complicated colon cancer. The most promising and readily available advance in the management of patients with obstructing colon cancers is the endoluminal colonic stent. Newer stent delivery devices now make selected right colonic lesions accessible to endoluminal stenting, and can be utilized in select cases not suitable for surgical resection. Colonic stents can be used either as primary treatment for patients with obstructing tumors not amenable to resection or as a bridge to surgical resection. For patients who are “bridged” with endoluminal stenting, resection can be considered once the proximal colon has been adequately decompressed and, at surgeon preference, the patient can undergo a mechanical bowel preparation.

Prospective study basing on results of diagnostics and management in 114 patients with brain concussion performed. Patients’ age varied between 18 and 75 years. Male 98 (86.0%), female - 16 (14.0%) were in the series. Mean age was 36years.

In diagnostics of skull brain injury, leading methods of investigation have been computed tomography and electroencephalography. Topographic charting with EEG and CT in different forms of skull brain injury in 96% cases have allowed to diagnosis reliably hindered focal brain injuries due to anatomical areas. Revealed peculiarities of the brain bioelectrical activity and anatomical topographical foci of injury in traumatic disease dynamics allowed adequate evaluation of severity and local injuries, founding of management efficacy and prognosis of skull brain injury outcome.

Research object: The results of investigation and management of 441 patients with combined skull brain and eye injuries presented.

Research methods: Investigation was based on results of clinical study, X-ray, ophthalmoscopy, visual fields and eye fundus examination.

Gained results: new classification of combined skull brain and eye injuries was elaborated; evaluation algorithm for combined skull brain and eye injuries invented;   standard of care volume for combined skull brain and eye injuries worked out.

The authors analyzed the results of complex treatment of 21 patients with polytrauma including 12 (57.2 %) patients with extremity bones injuries, 9 (42.8 %) patients with pelvic bones injuries treated at the traumatological departments  from 2013-2014 years. The developed spare immobilization of lower extremity in patients with polytrauma provides adequate fixation and traction of the lower extremity in reanimation period and in emergency of external osteosynthesis by external fixator of crus or femur bones.

The introduction of surgical management of patients in acute period of polytrauma using invasive technology of fractures fixation allowed to provide early stabilization of patient state, to avoid diagnostic mistakes and to obtain positive results of treatment in 98% cases.

The article is devoted to a review of the literature on the evalution of the severity of injury and the severity of the condition of victims in polytrauma. Modern methods for objectively assessing the severity of damage and predicting the outcome of a traumatic disease are presented. In assessing the severity of damage, both anatomical indicators and physiological parameters that characterize the body's response to severe injury are taken into account. The known objective methods of damage assessment in polytrauma both abroad and in the CIS countries have a number of shortcomings in terms of taking into account all factors affecting the polytrauma forecast. The problem of developing a universal rating scale for polytrauma is associated with a variety of injuries and functional impairments occurring in the victim’s body and understudied of predictors of injury outcome. The authors note the need to further improve ways to assess the severity of the condition of victims with polytrauma. This problem is a promising direction in the development of damage surgery.

Summary: from a study of the history of metabolic syndrome in children the main risk factors are the sickness of parents, especially hypertension, obesity and diabetes mellitus, weight-height rates at birth, as well as past diseases of children. There are more girls with metabolic syndrome for 3.7% than boys and the average age of children was 12.0 ± 0.44.

Resume. The article presents the results of clinical and laboratory examination of young children from large and small families. The peculiarity of the clinical course of CAP in children from large families are: extremely burdened history of the disease, late hospitalization with clinical symptoms, life-threatening.

Abstract: the article describes a rare clinical case of severe chronic granulomatous candidiasis in a child of fifteen years in dynamics, with the onset of the disease in infancy and late diagnosis at 6 years with lesions of the scalp, face, trunk, and brushes that accompanied the accompanying iron deficiency anemia and ascariasis. After 9 years from the moment of the first hospitalization, the patient experienced an aggravation of the process with a widespread lesion of the facial skin, breasts and was represented by plaques with massive crusts and scales on the surface. A good effect was obtained from complex treatment with fluconazole, vitamin preparations and local therapy with an «Eskaderm», 10% sulfur salicylic ointment.

Summary. The article briefly presents the linguistic analysis of medical terminological vocabulary, which functions in scientific and educational medical texts, and also reveals the ways of their semantization. Practical goal of training medical students in the Russian language for mastering professional vocabulary.