Vol 19, No 7-2 (2017)

Complicated skin and soft tissue infections (cSSTIs) are the more extreme end of clinical spectrum SSTI’s, encompassing a range of clinical presentations such as deep-seated infection, a requirement for surgical intervention, the presence of systemic signs of sepsis. Staphylococcus aureus is the commonest cause of SSTI across all continents, although its epidemiology in terms of causative strains and antibiotic susceptibility can no longer be predicted with accuracy. The epidemiology of community-acquired and healthcare-acquired strains is constantly shifting and this presents challenges in the choice of empirical antibiotic therapy. Toxin production (Panton-Valentine leucocidin) may complicate the presentation still further. Polymicrobial infection with Gram-positive and Gram-negative organisms and anaerobes may occur in diabetic foot infections and burns. Successful management of cSSTI involves prompt recognition, timely surgical drainage and debridement, intensive care if required and appropriate antibiotic therapy. The mainstays of treatment are the penicillins, cephalosporins, clindamycin, co-trimoxazole and b-lactam/b-lactamase inhibitor combinations are indicated for polymicrobial infection. A range of new agents for the treatment of methicillin-resistant Staphylococcus aureus infections have compared favourably with the glycopeptides and some have distinct pharmacokinetic advantages. These include linezolid, daptomycin, tigecycline, telavancin, ceftaroline and tedizolid.

Progressive development of microorganisms’ resistance to antibiotics limits their widespread systematic application of prophylactic for local skin damage in favor of more severe injuries. Local application of preparations on the basis of a combination of antibiotics and silver has a significant advantage in the prevention of infectious process in the wound area compared with the individual drugs also possess antifungal and antiviral effect. These combinations are mutually potentiate the antimicrobial effect and allow the use of lower doses.

Prescribing of NSAIDs in modern clinical practice is a routine procedure. However, all aspects of NSAIDs safety are often not assessed. The article highlights the main aspects of safe prescription of NSAIDs, which every doctor should be guided in his practice.

Iron deficiency anemia (IDA) is associated with several pathologic conditions of the gastrointestinal tract. In addition to inflammatory bowel disease, IDA is often associated with chronic liver disease. Different factors such as chronic blood loss, malabsorption, inflammation, may contribute to the development of IDA. Although patients with symptoms of anemia often initially turn to gastroenterologists approach to diagnosis and treatment, as well as measures for subsequent monitoring of the patient are not standardized and optimal. Iron deficiency, even without the development of symptoms of anemia, can significantly affect the physical health and cognitive function, reduce quality of life. So important is regular assessment of iron concentration and understanding of the clinical consequences of reducing the concentration of serum iron by specialists of different profile: surgeons, internists, cardiologists. Currently, the range of treatment options awaiting increases due to the introduction into clinical practice of effective and well-tolerated iron preparations for parenteral administration. Available in scientific periodicals there is a lack of systematic reviews for the treatment of IDA and, in particular, its treatment for patients with diseases of the gastrointestinal tract. In the presented review summarizes the current understanding of the period of awaiting for specific gastrointestinal and hepatic disorders and discusses a unified approach to the treatment of anemia and iron deficiency in daily clinical practice.

The designed and introduced into the clinic methods of the intestine seam on different level of the gastrointestinal tract, in base which lies the principles precisional technology, allowing ideal to adapt the layer sutured fabric belly and intestine. The experiments were run for 85 rabbits. It is studied mechanical other-ность precisional sutures when shaping gastrointestinal anastamosis (20 experiences), small intestine anastamosis - (25 experiences) and is made someone large intestine anastamosis (25 experiences). In checking series experience (15 rabbits) small intestine anastamosis were formed sutures Aliberta-SHmidena. The clinical study are organized beside 53 sick with different surgical diseases and high degree to probability of the origin postoperative complications. Designed by us methodses aplying under extraabdominal liquidation of kolostoms (7 sick) and cecostoms (4 sick). Inwardly abdominal operations (the resections of the belly, fine and large intestine, suturing wounds of the belly and small intestine) are made beside 42 sick. In the course of work use morphological, histological, bacteriological and physical methods of the study. The analysis given about mechanical toughness anastamosis has revealled the trace. At imposition gastroentero- and is made someone look large intestine anastamosis, formed precisional sutures during 1 day from begin experiments, mechanical toughness varies between 144±4.1 and 152±4.2 mm Hg. In checking group anastamosis sutures Alibert-Shmidens toughness was 168±4.3 mm Hg. However in all experience toughness anastamosis, regardless of methodses of the intestine seam is saved it is enough high, vastly exceeds the possible pressure in bright spot of the alimentary canal. At microscopically, anastamosis formed precisionally sutures, regardless of that, are assessed they on belly, fine or thick bowels, the general to show good their passability, nearly full absence infiltrates and inflammatory process over anastamosis at early periods after operation. Histologically, inflammatory reaction on suturing material was noted minimum. Threads polypropylene through 1-3 months after operation encircled fine connecting capsule. It is realized that offered methods of the intestine seam allow to obtain optimum healing an anastamosis, providing here with sufficient mechanical toughness and biological hermeticity of anastamosis. Postoperative period beside all sick run smoothly. The lethal upshot is not noted.

Nowadays a practicing coloproctologist is increasingly faced with a very common combination of diseases, such as anal fissures and chronic hemorrhoids. The aim of the study was to evaluate the effectiveness of complex therapy for combined pathology of the anal canal, by using the combination drug “Relief PRO” in the main group of patients. Reducing the intensity of the pain syndrome on day 15 (D15) of the treatment was noted by 33 (89.2%) of the patients in the main group and 26 (78.8%) - in the control group. Analysis of the results showed that after 60 days (D60), the study group showed a significant reducing of the pain syndrome, which does not require further correction. Epithelization was noted in 31 (83.8%) of the patient in the main group, and a persistent decrease of itching and burning sensation was also noted. These results prove the multifactorial therapeutic effect of the drug “Relief PRO”, which is achieved due to the combined composition (including, glucocorticosteroid - fluocortolone and lidocaine).