Place of somatostatin in the treatment of AS is determined by its main pharmacodynamic properties, which include:
1. suppression of secretion of acid and pepsin in the stomach (prevention of stress ulcers);
2. suppression of secretion of pancreatic function (prevention of pancreatic necrosis);
3. suppression of release of gastrointestinal hormones tissue;
4. reduction of pressure in the portal venous system;
5. tsitokinogeneza blockade.
Not being able to dwell in detail on other aspects of treatment of intestinal insufficiency syndrome, we stress that its success is impossible without adequate metabolic support and optimal oxygen transport - as an integral and splanhnicheskogo.
3. Antibacterial Therapy
Antibacterial therapy for the AU in its essence plays the same role as the cessation of bleeding in hemorrhagic shock. Of course, the antimicrobial agents do not affect the running mechanism of the systemic inflammatory response and explosive mediatoza. The problem of antibiotic therapy - etiotropic direction, blocking the systemic inflammatory cascade at the level of its exogenous microbial mediators. It is therefore ineffective antibiotic therapy 2 times increased mortality in the AU [7.16].
As shown by studies conducted in our clinic, inadequate antimicrobial therapy has a large pharmaco-economic value - increasing the cost of drug treatment by 89% and the total cost of hospital treatment increased by more than 30%.
Antibiotic therapy may be ineffective due to various circumstances.
After analyzing the reasons for failure of antibacterial therapy, we rubrifitsirovali them as follows:
1. Antibiotics have no effect on pathogens.
II. Lack of bioavailability of drugs at the source of infection and local dissemination of microorganisms.
III. Development side and toxic effects with antimicrobial agents.
In group 1 the causes of failures of particular importance is the fact that antibiotics are often prescribed without mandatory polymicrobial etiology of AS involving aerobes and anaerobes, focusing on incorrect data bacteriological studies, including those associated with the phenomenon of cultural resistance. Plays an important role and change of priority agents in the treatment of the AU and the development of antibiotic resistance during treatment. Appropriate to emphasize the clinical significance of enterococcal superinfection on the background of the original effective therapy AU aminoglycosides, cephalosporins, fluoroquinolones.
With regard to the development of resistance, our studies have shown different frequency of this phenomenon during treatment with penicillins, cephalosporins, imipinema, fluoroquinolones brand viagra and aminoglycosides: for semisynthetic penicillins, it is 9,2%; cephalosporins II-III generation - 8,6%; imipinema - 4 , 7%, ciprofloxacin - 11.8%; aminoglycosides generation III - 13,4%.
Failure of therapy may be related to the inclusion of an endogenous mechanism of translocation of bacteria and development of alternative foci of infection such as nosocomial pneumonia in patients with peritonitis. This circumstance, first, expanding and changing range of priority pathogens of sepsis, and secondly, the impact on the delivery of antibiotics in the foci of infection. Established that the fractional penetration of antibacterial drugs in different anatomical areas is significantly different, and this leads to a significant reduction in the effective bactericidal concentration at the source of infection [17].
Group II causes of failures due to lack of bioavailability of drugs at the source of infection. This may be due to:
1) the wrong mode of introducing drugs without regard to their kinetic properties;
2) changes in pharmacokinetics under the influence of fluid therapy, forced diuresis and syndrome of capillary leak, the use of extracorporeal detoxification;
3) lack of transport proteins (albumin);
4) violation of the systemic and regional blood flow, especially in the foci of infection;
5) formation of a protective "traps" for microbes (units, microthrombi, protein deposits).
The latter circumstance has played a leading role in the emergence against the background of the AU angiogenic foci of infection that is resistant to the ongoing antibiotic therapy.
Finally, III group of failures related to the toxic effects of antibiotics, exacerbating multiple organ failure characteristic of the AU. Unfortunately, antibiotics have a greater or lesser degree of side effects and organotoksichnostyu. Neither a clinical situation does not create more problems when choosing the most effective and most toxic antibiotic therapy than is the case in the surgical, in particular, abdominal sepsis.
baroreflex activity
careful monitoring
opposite effect
metabolism
tactics
2011年1月26日 星期三
2011年1月20日 星期四
Cleansing of necrosis
Treatment of pressure sores enzymes - effective wound coverings Multiferm
Wound coverings Multferm manufactured using technology that speeds up the healing process difficult and long-term healing of wounds in the 2-3 - Technology enzyme immobilization on support materials.
Proteolytic enzymes known as one of the most effective means for treating necrotic wounds, which include bedsores.
Nevertheless, the widest selection, ointments and powders, which recommend the specialists do not always yield the desired effect. The presence of enzymes in the composition of ointments and ointment dressings for treatment of bedsores in itself does not guarantee the outcome, because the action of such funds is often short and insufficient to achieve the effect.
To understand what means will bring the greatest effect, it is necessary to understand the essence of the concept of "pressure sore".
Decubitus - a zone of necrosis
Sores often occur in bedridden patients with impaired innervation after stroke and spinal injuries. Bedsore - is not just a wound. Bedsores are formed in places of excessive pressure, resulting in disrupted tissue nutrition, and their gradual extinction. Therefore, the pressure sore is a superficial or deep zone of necrosis.
Necrotic tissue serves as an excellent brand viagra online breeding ground for bacteria and pathogens, so the pressure sore quickly progresses: increasing the depth and size of wounds suffered not only the skin, and muscles, often there is inflammation and suppuration.
Without which the treatment of pressure ulcers will be ineffective
Given the causes and nature of the wound healing process in the treatment of pressure sores should follow two basic principles:
1. Completely unload the damaged area by means of special handling tools, such as antiacarian circle, for example, to turn the patient, if possible, on the side, etc. Please note that antiacarian mattresses are more in prevention, not treatment.
2. Ensure effective wound cleansing of necrosis, which is a breeding ground for the development of pathogenic organisms.
Convenient and effective for the treatment of bedsores - wound coverings Multiferm
Most often, experts recommend cleaning the wound surgically, but it brings suffering to the patient and often inconvenient for those who care for it.
An alternative and accessible to all non-surgical method of wound cleansing in home conditions - use of effective means on the basis of proteolytic enzymes.
Proteolytic enzymes are often referred to as "biological scalpel" because they very effectively destroy necrotic tissue, and thus quickly and safely clean the wound.
The use of proteolytic enzymes in purulent surgery itself is not open, so brand name levitra many years there are a variety of means on the basis of enzymes to treat ulcers and bedsores. In this case, crucial technology of production, which would ensure long-term effect of enzymes. That is the secret of the effectiveness of Multiferm.
The composition of therapeutic coating layer includes a multicomponent complex Multiferm enzymes with proteolytic activity, as well as chitosan, which has a powerful regenerative effect and stimulates the formation of new granulation.
Armband Multiferm and manufactured using a patented molecular modeling, which involves adherence to the level of the molecule drug ingredients to the carrier material.
With this technology wound coverings retain 100 percent therapeutic activity throughout the time spent on the wound - up to 48 hours, while ointments, gels and powders "washed out" from the wound for 2-3 hours. Ligation is recommended to do at first once a day, at least achievement of a positive effect, you can move to change dressings once in two days.
If pressure sores are very much get wet for the start of treatment recommended for wound coverings PAM-T, containing a special drainage layer. In addition to the proteolytic action of covering the PAM-T have the ability to absorb a large amount of wound discharge, thereby not only effectively cleaning the wound, and quickly removing it from the wound exudate. Once the wound was no longer get wet, you can proceed to the application of wound coverings Multiferm.
Wound coverings Multiferm and PAM-T has several advantages over traditional methods, which are issued in the form of gels, ointments, powders and solutions for healing.
Wound coverings Multiferm and PAM-T reduces the treatment of wounds in a few times and have a cialis without prescription number of marked advantages:
* Very quickly cleaned the wound of necrotic masses and detritus, "working" on a "biological scalpel"
* Stimulates the formation of granulation tissue and epithelialization top edge. Effect is noticeable from the first days of application.
* Minimize the load on the drug the patient by using micro-doses of drugs to minimize the possibility of side effects, allergies, irritation and pain.
* Cropped inflammation, have mestnoanesteziruyuschee effect.
* Fully atraumatic insertion - do not cause pain during dressing changes, as it does not stick to the damaged surface (if used properly - patch to moisturize).
body weight
daily diet
a peck of salt
pathogenetic mechanisms
Wound coverings Multferm manufactured using technology that speeds up the healing process difficult and long-term healing of wounds in the 2-3 - Technology enzyme immobilization on support materials.
Proteolytic enzymes known as one of the most effective means for treating necrotic wounds, which include bedsores.
Nevertheless, the widest selection, ointments and powders, which recommend the specialists do not always yield the desired effect. The presence of enzymes in the composition of ointments and ointment dressings for treatment of bedsores in itself does not guarantee the outcome, because the action of such funds is often short and insufficient to achieve the effect.
To understand what means will bring the greatest effect, it is necessary to understand the essence of the concept of "pressure sore".
Decubitus - a zone of necrosis
Sores often occur in bedridden patients with impaired innervation after stroke and spinal injuries. Bedsore - is not just a wound. Bedsores are formed in places of excessive pressure, resulting in disrupted tissue nutrition, and their gradual extinction. Therefore, the pressure sore is a superficial or deep zone of necrosis.
Necrotic tissue serves as an excellent brand viagra online breeding ground for bacteria and pathogens, so the pressure sore quickly progresses: increasing the depth and size of wounds suffered not only the skin, and muscles, often there is inflammation and suppuration.
Without which the treatment of pressure ulcers will be ineffective
Given the causes and nature of the wound healing process in the treatment of pressure sores should follow two basic principles:
1. Completely unload the damaged area by means of special handling tools, such as antiacarian circle, for example, to turn the patient, if possible, on the side, etc. Please note that antiacarian mattresses are more in prevention, not treatment.
2. Ensure effective wound cleansing of necrosis, which is a breeding ground for the development of pathogenic organisms.
Convenient and effective for the treatment of bedsores - wound coverings Multiferm
Most often, experts recommend cleaning the wound surgically, but it brings suffering to the patient and often inconvenient for those who care for it.
An alternative and accessible to all non-surgical method of wound cleansing in home conditions - use of effective means on the basis of proteolytic enzymes.
Proteolytic enzymes are often referred to as "biological scalpel" because they very effectively destroy necrotic tissue, and thus quickly and safely clean the wound.
The use of proteolytic enzymes in purulent surgery itself is not open, so brand name levitra many years there are a variety of means on the basis of enzymes to treat ulcers and bedsores. In this case, crucial technology of production, which would ensure long-term effect of enzymes. That is the secret of the effectiveness of Multiferm.
The composition of therapeutic coating layer includes a multicomponent complex Multiferm enzymes with proteolytic activity, as well as chitosan, which has a powerful regenerative effect and stimulates the formation of new granulation.
Armband Multiferm and manufactured using a patented molecular modeling, which involves adherence to the level of the molecule drug ingredients to the carrier material.
With this technology wound coverings retain 100 percent therapeutic activity throughout the time spent on the wound - up to 48 hours, while ointments, gels and powders "washed out" from the wound for 2-3 hours. Ligation is recommended to do at first once a day, at least achievement of a positive effect, you can move to change dressings once in two days.
If pressure sores are very much get wet for the start of treatment recommended for wound coverings PAM-T, containing a special drainage layer. In addition to the proteolytic action of covering the PAM-T have the ability to absorb a large amount of wound discharge, thereby not only effectively cleaning the wound, and quickly removing it from the wound exudate. Once the wound was no longer get wet, you can proceed to the application of wound coverings Multiferm.
Wound coverings Multiferm and PAM-T has several advantages over traditional methods, which are issued in the form of gels, ointments, powders and solutions for healing.
Wound coverings Multiferm and PAM-T reduces the treatment of wounds in a few times and have a cialis without prescription number of marked advantages:
* Very quickly cleaned the wound of necrotic masses and detritus, "working" on a "biological scalpel"
* Stimulates the formation of granulation tissue and epithelialization top edge. Effect is noticeable from the first days of application.
* Minimize the load on the drug the patient by using micro-doses of drugs to minimize the possibility of side effects, allergies, irritation and pain.
* Cropped inflammation, have mestnoanesteziruyuschee effect.
* Fully atraumatic insertion - do not cause pain during dressing changes, as it does not stick to the damaged surface (if used properly - patch to moisturize).
body weight
daily diet
a peck of salt
pathogenetic mechanisms
2011年1月9日 星期日
Osteopathy
Today it is almost impossible to find someone who could be called absolutely healthy. Any disease is present in every one of us. Moreover, these diseases are not always acquired, as very often people are born with various disabilities in the body. Deviations can be as minor as well as significant enough.
As evidenced by recent data, to date, more than 80 percent of infants already have a variety of spinal injuries and skull. And it is important that the negative consequences of these injuries can manifest themselves immediately, but after a while, a certain number of years. Often spinal injury in the newborn baby emerge from the fact that the mother was not yet ready for pregnancy.
Also during the life of the generic spinal cord injuries are added and other acquired injuries. For example, the spine can injure as a result of sports or small drops. Also, large loads, which are one of the causes of spinal injuries, lie in wait for the child in school.
In this case, it is very important to settle brand viagra on time degree-borne loads. Do not forget that it is the spine has a huge impact on the whole tragedy, it depends on him overall health.
In addition to these causes of spinal injuries, there are other fairly common causes. One of such reasons should be called dangerous sports activities, falls from great heights. And also very common disorders of the spine occur as a result of getting into car accidents.
Injuries so called "whiplash." And the basic spinal injury occurs when you brake the car at very high speeds (by the way, do not forget to insure the car or you might lose not only the health but the money).
In this case, at first you do not notice any pain, it seems that anything is wrong with you did not happen, but after a while you pay attention to what you have always wanted to sleep, and that I was one of the consequences of the accident occurred.
Drowsiness is the fact that the body a huge amount of their energy is spent on finding a balance that was lost during injury. And even if after a while the signs of injury will disappear, the injury factor will still remain and will cause neurological problems and pathological character.
In addition to whiplash, an injury can be classified on these: compression of the spinal cord (or the same roots of the brain), hematoma, bones or ligaments, bruising, shaking, stretching, occurs when the bending and lead to the appearance of discontinuities in intervertebral discs. The result was nausheniya circulation headaches, vegetative dystonia, problems in the internal organs, sleep disturbance.
We now turn to the main issue, namely the question of what kind of methods exist for the treatment of various spinal injuries. We can say that today one of the treatments are similar traumas, giving maximum positive results, is osteopathy.
Osteopathy - a type of traditional viagra interactions medicine, which today is recognized by many countries as a very effective method for treating internal diseases, nervous system, musculoskeletal system. In the treatment of this method is carried out effect on the body by hand. Osteopath hands rids the body of the patient from the functional units.
You can also say that osteopathy - a kind of manual therapy. But in contrast to manual therapy, all impact on the patient's body is soft and gentle, then there is no pain. It should also mention one important feature of osteopathy. It lies in the fact visual disturbances that treatment can provide an impetus to ensure that the internal organs began to heal themselves.
But although osteopathy and helps get rid of many different spinal injuries, one should not neglect ordinary care to protect your body from injury. Must start from the very young age. Already in childhood is necessary to ensure that the posture was correct and that the spine does not have to carry too heavy loads.
Necessarily need to be engaged in fitness: in the morning to pay at least 15 minutes of gymnastics. It is advisable to go to the gym, swimming and jogging. In addition, you should not lose sight of the food, which should be correct, include all the necessary vitamins and minerals.
And if the car can take out insurance against theft, the best insurance for the body of the appearance of different injuries are promptly taken measures to prevent them.
Interesting way
function of insulin
Multi-center
As evidenced by recent data, to date, more than 80 percent of infants already have a variety of spinal injuries and skull. And it is important that the negative consequences of these injuries can manifest themselves immediately, but after a while, a certain number of years. Often spinal injury in the newborn baby emerge from the fact that the mother was not yet ready for pregnancy.
Also during the life of the generic spinal cord injuries are added and other acquired injuries. For example, the spine can injure as a result of sports or small drops. Also, large loads, which are one of the causes of spinal injuries, lie in wait for the child in school.
In this case, it is very important to settle brand viagra on time degree-borne loads. Do not forget that it is the spine has a huge impact on the whole tragedy, it depends on him overall health.
In addition to these causes of spinal injuries, there are other fairly common causes. One of such reasons should be called dangerous sports activities, falls from great heights. And also very common disorders of the spine occur as a result of getting into car accidents.
Injuries so called "whiplash." And the basic spinal injury occurs when you brake the car at very high speeds (by the way, do not forget to insure the car or you might lose not only the health but the money).
In this case, at first you do not notice any pain, it seems that anything is wrong with you did not happen, but after a while you pay attention to what you have always wanted to sleep, and that I was one of the consequences of the accident occurred.
Drowsiness is the fact that the body a huge amount of their energy is spent on finding a balance that was lost during injury. And even if after a while the signs of injury will disappear, the injury factor will still remain and will cause neurological problems and pathological character.
In addition to whiplash, an injury can be classified on these: compression of the spinal cord (or the same roots of the brain), hematoma, bones or ligaments, bruising, shaking, stretching, occurs when the bending and lead to the appearance of discontinuities in intervertebral discs. The result was nausheniya circulation headaches, vegetative dystonia, problems in the internal organs, sleep disturbance.
We now turn to the main issue, namely the question of what kind of methods exist for the treatment of various spinal injuries. We can say that today one of the treatments are similar traumas, giving maximum positive results, is osteopathy.
Osteopathy - a type of traditional viagra interactions medicine, which today is recognized by many countries as a very effective method for treating internal diseases, nervous system, musculoskeletal system. In the treatment of this method is carried out effect on the body by hand. Osteopath hands rids the body of the patient from the functional units.
You can also say that osteopathy - a kind of manual therapy. But in contrast to manual therapy, all impact on the patient's body is soft and gentle, then there is no pain. It should also mention one important feature of osteopathy. It lies in the fact visual disturbances that treatment can provide an impetus to ensure that the internal organs began to heal themselves.
But although osteopathy and helps get rid of many different spinal injuries, one should not neglect ordinary care to protect your body from injury. Must start from the very young age. Already in childhood is necessary to ensure that the posture was correct and that the spine does not have to carry too heavy loads.
Necessarily need to be engaged in fitness: in the morning to pay at least 15 minutes of gymnastics. It is advisable to go to the gym, swimming and jogging. In addition, you should not lose sight of the food, which should be correct, include all the necessary vitamins and minerals.
And if the car can take out insurance against theft, the best insurance for the body of the appearance of different injuries are promptly taken measures to prevent them.
Interesting way
function of insulin
Multi-center
2011年1月2日 星期日
Alveolus
Alveolus (from Lat. Alveolus - the cell cavity, a bubble) - puzyrkovidnoe formation in the lung, braided network of capillaries.
The walls of the alveoli are very thin: they consist of only one brand name viagra cell layer. Capillary walls also consist of a single layer of cells. Consequently, being in the alveoli and the air flowing through the blood capillaries are separated by only two layers of cells. Here through the thin wall and gas exchange occurs. The nature of the gas exchange that occurs in the lungs, can be judged by comparing the composition of inhaled and exhaled air.
We breathe the air. It contains 20.94% oxygen, 79.03% azotairaznyh inert gases (argon, neon, helium, etc.) and 0,03% carbon dioxide. The composition of the exhaled air is different: the oxygen in it 16,3%, 4% carbon dioxide, nitrogen and other inert gases, 79.7%.
Contrast these figures. You can see that the amount of oxygen in the lungs decreases, and carbon dioxide - is increasing. Oxygen from the air in the alveoli, goes to the blood and carbon dioxide leaves the blood and passes into the alveolar vozduh.Krov, entering through the pulmonary artery to the lungs, spreads in the capillaries of the huge area of a thin layer of alveoli. It also contributes to gas exchange.
Oxygen, passing from alveolar air into the blood, enters into a chemical bond with hemoglobin.
Oxygenated blood is carried throughout the body and in capillaries of tissues giving oxygen. Here in the blood to carbon dioxide. Oxygen, which gives the blood to tissues is the cell and enters into the chemical processes of metabolism.
In a chemical bond with the hemoglobin is not only oxygen but also other gases. Chemical bonding of hemoglobin with oxygen is very unstable. It is easily formed and easily broken. Exceptionally strong association of hemoglobin with carbon monoxide - carbon monoxide. This strength and Caution against nitrates due to toxic effects of carbon monoxide. Carbon monoxide is so firmly connected with hemoglobin, the oxygen can not enter into relationship with him and did not come to the cells and tissues - a person die from suffocation if you do not make the victim to fresh air.
Heart rate
Megacity
The walls of the alveoli are very thin: they consist of only one brand name viagra cell layer. Capillary walls also consist of a single layer of cells. Consequently, being in the alveoli and the air flowing through the blood capillaries are separated by only two layers of cells. Here through the thin wall and gas exchange occurs. The nature of the gas exchange that occurs in the lungs, can be judged by comparing the composition of inhaled and exhaled air.
We breathe the air. It contains 20.94% oxygen, 79.03% azotairaznyh inert gases (argon, neon, helium, etc.) and 0,03% carbon dioxide. The composition of the exhaled air is different: the oxygen in it 16,3%, 4% carbon dioxide, nitrogen and other inert gases, 79.7%.
Contrast these figures. You can see that the amount of oxygen in the lungs decreases, and carbon dioxide - is increasing. Oxygen from the air in the alveoli, goes to the blood and carbon dioxide leaves the blood and passes into the alveolar vozduh.Krov, entering through the pulmonary artery to the lungs, spreads in the capillaries of the huge area of a thin layer of alveoli. It also contributes to gas exchange.
Oxygen, passing from alveolar air into the blood, enters into a chemical bond with hemoglobin.
Oxygenated blood is carried throughout the body and in capillaries of tissues giving oxygen. Here in the blood to carbon dioxide. Oxygen, which gives the blood to tissues is the cell and enters into the chemical processes of metabolism.
In a chemical bond with the hemoglobin is not only oxygen but also other gases. Chemical bonding of hemoglobin with oxygen is very unstable. It is easily formed and easily broken. Exceptionally strong association of hemoglobin with carbon monoxide - carbon monoxide. This strength and Caution against nitrates due to toxic effects of carbon monoxide. Carbon monoxide is so firmly connected with hemoglobin, the oxygen can not enter into relationship with him and did not come to the cells and tissues - a person die from suffocation if you do not make the victim to fresh air.
Heart rate
Megacity
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