Expert systems as the instrument for postop diseases

There was proposed an expert system for conduction of differential diagnosis of surgical diseases, stimulating the mathematic models creation, the filling up of tables of the features values of all diagnostic hypothesis possible with subsequent staged exception of the least adequate of them. The expert diagnostic system proposed may be applied in clinical practice and pedagogic process while teaching of students.     

Surgical treatment of chronic pancreatitis with ductal hypertension complicated by posterior pancreatic pseudocyst

The experience was summarized concerning the treatment of 5 patients with chronic pancreatitis and ductal hypertension, complicated by retropancreatic pseudocyst. One-stage internal draining of pseudocyst and the pancreatic duct, using the method elaborated in the clinic, was performed. There were no postoperative complications. Late follow-up result is good.     

An acute necrotic pancreatitis as a complication of cystic pancreatic tumor

The peculiarities of the cystic pancreatic tumor morphogenesis were studied up. Possibility and probability of the anastomosis existence between mucinous cystic tumor and pancreatic duct with its secondary mucinous dilatation were confirmed, causing the complications occurrence, an acute pancreatitis in particular. Selecting the surgical tactic in mucinous cystic tumor it is necessary to take into account the probability of the intraductal malignization foci formation, what precludes application of extended pancreatic resection using adjuvant chemotherapy and the postoperative serological control conduction.     

Morphological characteristics of cystic pancreatic tumors

The results of 86 clinical observations of cystic pancreatic tumor are adduced. The expediency of the postoperative pathomorphological investigation conduction was substantiated because of high degree of the cystic pancreatic tumors polymorphism presence and low informativity of preoperative and intraoperative investigations.     

Level of cancer pain knowledge among baccalaureate student nurses

Inadequate nursing education is a major impediment to effective pain relief for cancer patients throughout the world. This study was conducted to identify the level of cancer pain knowledge among baccalaureate student nurses and to determine whether specific activities affect this level of knowledge. Two questionnaires were administered to 82 baccalaureate student nurses in the final course of their program. Although the students displayed a realistic perspective about the severity and prevalence of cancer pain and psychological dependence, specific knowledge deficits and negative attitudes suggest the possibility of inadequate pain management. Specifically, the students believed that (a) maximal analgesic therapy should be delayed until the patient's prognosis was less than 12 months; (b) the proportion of patients whose pain can be controlled by appropriate therapy is less than is possible; (c) increasing pain is related to tolerance rather than to progression of the disease; (d) the preferred route of administration is intravenous rather than oral; and (e) the degree of respiratory depression, rather than constipation, does not decrease with repeated administration. Significant positive correlations (P ≤ 0.05) were found between age and cancer pain knowledge and between attendance at seminars/ workshops and time spent reading professional journal articles. Of the 30% of the participants who perceived a particular person to be a source for obtaining information about cancer pain management, 52% specified a practicing registered nurse. Seminars and workshops were chosen by 59% of the students as the most effective way for nurses to increase their knowledge. This study suggests a need for basic cancer pain management education at the undergraduate level as well as continuing education through seminars and workshops.     

Peculiarities of diagnosis and surgical tactics in cystic pancreatic tumours

Results of selective analysis of examination and operative treatment data in patients with clinical diagnosis of cystic pancreatic tumour for ten-year period were presented. The causes of diagnostic and tactic mistakes were analyzed. The volume of necessary methods of instrumental and laboratory diagnosis, indications for operative treatment, volume of which depends on the tumour morphological characteristic, were determined. In serous cystadenoma the tumour excision or economic pancreatic resection is indicated; in mucinous tumour the extended pancreatic resection is indicated.     

Application of preparations--analogues of somatostatin in surgical pancreatology

The experience of application of shortly acting and durably acting preparations--analogues of somatostatin in complex therapy of various pancreatic diseases was summarized. There was established similar efficacy of the preparations in blockade of the pancreatic external secretion and the various duration of their inhibiting influence on the blood flow. The trustworthy differences in the complications frequency and lethality while application of various preparations--analogues of somatostatin were not revealed.