Selecting variants of drug treatment of non-complicated duodenal ulcer (based on a study of results of Rabeprazole efficiency)]

This article presents considerations currently under discussion about the probability of HP participation in the ulcer causation as well as information about Rabeprazole efficiency for anti-helicobacter therapy of non-complicated duodenal ulcer (as a result of 7-day anti-helicobacter therapy, the healing of duodenal bulbs was recorded in 82.6% of cases; HP eradication was recorded in 86.9% of cases 4 weeks after the termination of the treatment) based on the analysis of scientific literature data and personal experience. Considerations related to the conduction of a possible study in the field of ulcer therapy that is not associated with Helicobacter pylori are presented.     

Causes of mitral valve re-stenosis and the ways of its prevention

The authors evaluated comparatively the results of surgical treatment of mitral stenosis in 203 patients after open mitral commissurotomy (OMC) (their personal experience) and the literature data concerning 168 patients who underwent closed mitral commissurotomy (CMC). The frequency of mitral stenosis recurrences with the use of both methods was determined. OMC was on a par with CMC in safety and exceeded it in efficacy. The frequency of mitral restenosis was considerably lower after OMC than after CMC (p less than 0.05). The authors claim that the main cause of mitral stenosis recurrences is residual stenosis developing in inadequate correction of the anomaly, while the principal preventive measure is OMC which makes it possible to separate the fused commissures completely, remove the subvalvar adhesions, and restore the mobility of the cusps.     

Conduction anesthesia in orthopedic operations in injuries of the extremities

An analysis of results of using conduction anesthesia for various operations on extremities of 274 patients of different age groups has been made. Complete effects were achieved in 91% of the patients, 5% of the patients were potentiated with neuroleptanalgesia drugs because of insufficient anesthesia, in 2% of the patients general anesthesia was used. The method of conduction anesthesia makes it possible to use a conveyer method of bringing patients to the operating room. It is more economical as compared with narcosis, easy in use. It may be recommended for wider use.     

Surgical tactics in bilateral resections of the lungs

The article generalizes experience in 118 bilateral resections of the lungs carried out within 4 years at the Chelyabinsk Regional Antituberculosis Hospital, among which 63% (74) were one-stage bilateral operations. A clinical effect was produced in 97.5% of patients. Postoperative mortality was 1.7%. The authors prefer one-stage bilateral resections and resort to stage-by-stage operations only in cases with severe concomitant diseases, marked respiratory insufficiency, in a large volume of the resection, particularly if it is combined with thoracoplasty. A transsternal approach in one-stage bilateral resections is indicated when the upper parts of the lung must be resected in a large volume, in cases in which difficulties in exposure of the lungs are not expected; one-stage opening of both pleural sacs is recommended in this case for adequate inspection of the lungs before their resection.