Complications of surgical and therapeutic interventions in ICD-10 does not have a single compact section: some of them proposed to encode filed relating to the relevant body systems (eg, Section 1 - Diseases of the circulatory system are subheadings "functional impairment after cardiac surgery," in section
To a point to disruption of the functioning colostomy, "etc.), others proposed to encode a section of T (injured), where the rubric T80-T88 are generally termed" complications of surgical and medical interventions, not elsewhere classified. " In this case, there are four main classes:
To develop standards of diagnosis and treatment of contaminated surgery, this classification is clearly insufficient, but may be accepted as a basis for clarifying the following levels of a hierarchical tree of 3-5 decimal point.
Classification of medical procedures is a fundamental basis for planning health care, compulsory health insurance funds, the calculation of tariffs for medical services, standards of diagnosis and treatment. Currently, there are at least 4 sources containing the classifiers of health services:
International Classification of Procedures in Medicine (WHO, Geneva, 1978). List of surgical procedures (1989 - see above).
The Moscow city register of medical services to children and adult population (the last revision in 1998), used by all medical institutions in Moscow, working in the MLA. Perhaps such lists exist in other regions.
Industrial Classification "Ordinary medical care" developed by the Laboratory of Standardization of MMA. IM Sechenov.
Classifiers medical services provided with respect to the profile of their institutions are also organizations, leading automated information system of accounting of treated patients.
It is expedient to carry out the synthesis of the above classifications of services, based on the principles and column classifications.
With regard to disease stage and outcome (outcomes), it is still, apparently, in most areas of medicine there is no generally accepted international classifications. As an example the situation with the study of outcomes in surgery. Number of studies on the surgical procedures in recent years has grown exponentially. The first question that arises is: what to measure? Most often, this measure of improvement (deterioration), since the surgery aims to reduce violations of the structure or function.
Death - an important indicator, but infrequent, so it is not enough. It is useful to use the fact that the WHO called the "consequences of disease: failure - loss of anatomical or physiological structures and functions, violation of disability - loss of ability to engage in normal activity and disability. In the WHO there are measures violations disability or disability.
Measure of failure, of course, important. However, her one is not enough. Are also needed and patient brand viagra measures such as quality of life.
Our experience in the field of compulsory health insurance, as well as the construction of medical expert systems has shown that "the expert knows more than aware of, but the data contained more than the expert knows." Therefore, to develop standards for diagnosis and treatment must be the accumulation of real data on the incidence of hospitalization and the structure of services in different regions and hospitals of different levels with a subsequent statistical study using the methods of multivariate data analysis.
With this purpose in Surgery Institute. AV Vishnevsky, we developed and implemented since 1995, "Automated registration services, combined with the universal system of data analysis STATISTICA. Accumulated archive of over 15,000 admissions to the institute, including all of the patients treated over the years in the department of wounds and wound infections.
baroreflex activity
choice for correction
complications
inhibitory effects
myocardial infarction
Wednesday, January 26, 2011
Thursday, January 20, 2011
Clinics in Moscow
This was discussed at the 11th Scientific and Practical Conference of operating nurses. Conference on infection control in the surgical hospital, was held 25-26 November 2010 in Moscow at the FGI FNTSTIO them. Acad. VI Shumakova.
Specialists of the company 3M, a global brand viagra online manufacturer of medical products to prevent infections, skin protection and treatment of wounds, attended the conference and presented a proven innovative solutions for preventing hospital-acquired infections.
Transparent film labels for fixation of the central and peripheral catheters 3M ™ Tegaderm ™, a cut of the film antimicrobial 3M ™ Ioban ™, sterilization systems 3M ™ Steri-Vac ™, hypoallergenic surgical plasters and dressings, which create an antimicrobial and antiviral barrier can significantly reduce and minimize risk of infection of patients in surgical hospitals.
For conference participants, experts "3M Russia" held a practical training on correct and effective use of antimicrobial films, 3M ™ Ioban ™, is used for all types of surgery. Cut operating film ZM ™ Ioban ™ 2 provides the highest level to date aseptic surgical field throughout the operation as a result of combining the effects of iodophor and mechanical immobilization of microbes. Application of the film eliminates the contact tools, gloves and liquid with skin bacteria and their penetration into the wound, inhibits a wide range of microbes.
"One of the components that characterize the" health index for the nation, is the incidence of nosocomial infections, which reflects the quality of care provided to the population, and significantly generic viagra increases the level of economic cost. Therefore, the prophylaxis of nosocomial infections today are among the priorities for health development and research. 3M Company has expertise in the prevention of nosocomial infections and provides its products and solutions for hospitals and clinics in Russia ", - noted at the conference.
It was attended by nurses operating the leading clinics in Moscow, St. Petersburg and other Russian regions, as well as colleagues from Estonia, Sweden, Norway and Latvia. The aim of the conference was to share local and international best practices, new technologies in the operating business and to address the most acute problems of surgical care.
Pencils from the network IKEA stores have been used in surgery. Small cheap pencils to go around in the store, turned out to be an excellent tool for labeling on the surface of the bone.
In carrying out complex operations, as described in the Christmas issue of British Medical Journal two surgeons from the UK, doctors have to apply labels on the bones - which show where to make cuts. This seemingly trivial, the procedure is associated with certain difficulties, since the series used for labeling on the skin colors too actively absorbed by bone tissue or, conversely, does not stay on the surface.
Pencils were the best option - the only disadvantage surgeons called cracking after several sterilizations. However, with this "problem" is easy to handle, pencil wound silicone tape (silicone easily withstands boiling and steaming), or simply throwing out and replacing it with new one - a cheap price it is quite allow.
time debut
autoimune syndrome
thrombotic events
diabetic nephropathy
Specialists of the company 3M, a global brand viagra online manufacturer of medical products to prevent infections, skin protection and treatment of wounds, attended the conference and presented a proven innovative solutions for preventing hospital-acquired infections.
Transparent film labels for fixation of the central and peripheral catheters 3M ™ Tegaderm ™, a cut of the film antimicrobial 3M ™ Ioban ™, sterilization systems 3M ™ Steri-Vac ™, hypoallergenic surgical plasters and dressings, which create an antimicrobial and antiviral barrier can significantly reduce and minimize risk of infection of patients in surgical hospitals.
For conference participants, experts "3M Russia" held a practical training on correct and effective use of antimicrobial films, 3M ™ Ioban ™, is used for all types of surgery. Cut operating film ZM ™ Ioban ™ 2 provides the highest level to date aseptic surgical field throughout the operation as a result of combining the effects of iodophor and mechanical immobilization of microbes. Application of the film eliminates the contact tools, gloves and liquid with skin bacteria and their penetration into the wound, inhibits a wide range of microbes.
"One of the components that characterize the" health index for the nation, is the incidence of nosocomial infections, which reflects the quality of care provided to the population, and significantly generic viagra increases the level of economic cost. Therefore, the prophylaxis of nosocomial infections today are among the priorities for health development and research. 3M Company has expertise in the prevention of nosocomial infections and provides its products and solutions for hospitals and clinics in Russia ", - noted at the conference.
It was attended by nurses operating the leading clinics in Moscow, St. Petersburg and other Russian regions, as well as colleagues from Estonia, Sweden, Norway and Latvia. The aim of the conference was to share local and international best practices, new technologies in the operating business and to address the most acute problems of surgical care.
Pencils from the network IKEA stores have been used in surgery. Small cheap pencils to go around in the store, turned out to be an excellent tool for labeling on the surface of the bone.
In carrying out complex operations, as described in the Christmas issue of British Medical Journal two surgeons from the UK, doctors have to apply labels on the bones - which show where to make cuts. This seemingly trivial, the procedure is associated with certain difficulties, since the series used for labeling on the skin colors too actively absorbed by bone tissue or, conversely, does not stay on the surface.
Pencils were the best option - the only disadvantage surgeons called cracking after several sterilizations. However, with this "problem" is easy to handle, pencil wound silicone tape (silicone easily withstands boiling and steaming), or simply throwing out and replacing it with new one - a cheap price it is quite allow.
time debut
autoimune syndrome
thrombotic events
diabetic nephropathy
Sunday, January 9, 2011
Water-soluble polymers
In our imagination polymers are associated with plastic utensils, washable wallpaper and raincoat, that is, we perceive them as a substance very resistant to water. But there are those that dissolve in water! You have long been familiar with them, just not paying attention. Well, well, try to tell something interesting about them.
Of water-soluble polymers is quite possible to produce yarns and fabrics. But, apparently, who need clothes, disappearing brand viagra in the rain, or a disposable swimsuit? Meanwhile, thread, water soluble, are needed. And most of all, perhaps, surgery. For stitching wounds, and ligation of blood vessels they use "thread" of silk, hair, catgut (thin strips of veal or sheep intestines). Silk and hair are not absorbed, so the seams after the healing has to take off. Catgut dissolves itself in the body, but often even before the complete healing of wounds.
Threads made of polymers, such as polyglycolic acid, do not have these drawbacks, they dissolve only after complete cicatrization, and completely eliminated from the body. For such filaments are characteristic clear deadlines for dispersal, the lack of response of body tissues, the strength and number of other positive properties. Therefore, at present about 80% used worldwide suture material - biodegradable polymer threads.
Slowly soluble fabrics and fibers can be used as an effective wound dressing, if chemically combine a polymer such as polyvinyl alcohol, the molecules of microbicides. Clothing doctors, napkins and sheets made from such fabrics, fully decontaminated when wetted with water.
New drugs on the basis of water-soluble polymers are increasingly used in medicine. Their main advantage - the prolonged effect, ie a medicine enters the body immediately, but gradually, over a certain period of time. This allows them to use less, reduce one-time dose. Drugs act longer, and happens to bring them to the damaged organ can only be by water-soluble polymers.
A striking example - eye treatment film. They, unlike the droplets, which rapidly deteriorate and easily washed away with tears, provide long-term effect of drugs on the patient's eyes. The basis of such films - the same water-soluble polymers. Polymer base film dissolves in the tear fluid, gradually releasing the drug, for example, fibrinolysin, and provides a prolonged action of the enzyme, whose concentration viagra two-chamber vessel reaches a maximum at 12 hours and maintained at this level throughout the day.
They often avoid injections. They have to do when the drugs are destroyed in the acidic environment of the stomach. If the patient to give a "polymer" pill, which can not be the action of gastric juice, but readily soluble in alkaline intestine, the medication will be delivered as intended and without injections.
Well, themselves polymer solutions, whether they are fit for something? Sure! For example, blood, and this precious liquid, as it is sometimes not enough! But the blood - is "alive" the variance of blood cells in plasma - an aqueous solution of biopolymers. Is it possible to replace it, at least temporarily, other polymers, capable to perform the same functions? Imagine if you can. As early as 1915, the year in practice used blood substitute based on gelatin. To replace the blood in the apparatus of artificial circulation for a long time used drugs such as zhelatinol. Already from the name shows that it too is prepared from a natural polymer - gelatin. In the forties and still used blood substitutes based on dextran, and many other water-soluble polymers. These drugs are still not quite perfect, but work to create a full-blood substitute continues.
Restore
control of glycemia
Important function
Of water-soluble polymers is quite possible to produce yarns and fabrics. But, apparently, who need clothes, disappearing brand viagra in the rain, or a disposable swimsuit? Meanwhile, thread, water soluble, are needed. And most of all, perhaps, surgery. For stitching wounds, and ligation of blood vessels they use "thread" of silk, hair, catgut (thin strips of veal or sheep intestines). Silk and hair are not absorbed, so the seams after the healing has to take off. Catgut dissolves itself in the body, but often even before the complete healing of wounds.
Threads made of polymers, such as polyglycolic acid, do not have these drawbacks, they dissolve only after complete cicatrization, and completely eliminated from the body. For such filaments are characteristic clear deadlines for dispersal, the lack of response of body tissues, the strength and number of other positive properties. Therefore, at present about 80% used worldwide suture material - biodegradable polymer threads.
Slowly soluble fabrics and fibers can be used as an effective wound dressing, if chemically combine a polymer such as polyvinyl alcohol, the molecules of microbicides. Clothing doctors, napkins and sheets made from such fabrics, fully decontaminated when wetted with water.
New drugs on the basis of water-soluble polymers are increasingly used in medicine. Their main advantage - the prolonged effect, ie a medicine enters the body immediately, but gradually, over a certain period of time. This allows them to use less, reduce one-time dose. Drugs act longer, and happens to bring them to the damaged organ can only be by water-soluble polymers.
A striking example - eye treatment film. They, unlike the droplets, which rapidly deteriorate and easily washed away with tears, provide long-term effect of drugs on the patient's eyes. The basis of such films - the same water-soluble polymers. Polymer base film dissolves in the tear fluid, gradually releasing the drug, for example, fibrinolysin, and provides a prolonged action of the enzyme, whose concentration viagra two-chamber vessel reaches a maximum at 12 hours and maintained at this level throughout the day.
They often avoid injections. They have to do when the drugs are destroyed in the acidic environment of the stomach. If the patient to give a "polymer" pill, which can not be the action of gastric juice, but readily soluble in alkaline intestine, the medication will be delivered as intended and without injections.
Well, themselves polymer solutions, whether they are fit for something? Sure! For example, blood, and this precious liquid, as it is sometimes not enough! But the blood - is "alive" the variance of blood cells in plasma - an aqueous solution of biopolymers. Is it possible to replace it, at least temporarily, other polymers, capable to perform the same functions? Imagine if you can. As early as 1915, the year in practice used blood substitute based on gelatin. To replace the blood in the apparatus of artificial circulation for a long time used drugs such as zhelatinol. Already from the name shows that it too is prepared from a natural polymer - gelatin. In the forties and still used blood substitutes based on dextran, and many other water-soluble polymers. These drugs are still not quite perfect, but work to create a full-blood substitute continues.
Restore
control of glycemia
Important function
Sunday, January 2, 2011
Swimming pool
Most often, women find not just the usual vaginal discharge, begin to worry and react this way: what if it's something bad? However, do not rush and do not panic. Much more frequently than sexually transmitted diseases, is a simple vaginitis, also called colpitis. He declares himself long thick whitish discharge, which may be watery, purulent, and even frothy. While urinating often worried about itching and burning sensation.
In this case, a woman is constantly experiencing discomfort in the vulva, feeling the heat and gravity. Sexual intercourse may become painful. It would seem that all this is far from obvious pathology, but little things sometimes turn into major trouble and spoils the mood. Great harm to the banal vaginitis, despite the discomfort, the body does not cause.
True, at first glance picture of the disease is similar to other, more brand name viagra serious inflammatory diseases: candidiasis, trichomoniasis, gonorrhea, chlamydia. Therefore, in order to make sure that this disease you do not necessarily need to consult a doctor / gynecologist. These diseases can already lead to serious complications - infertility, ectopic pregnancy, ovarian inflammation, and treat them fairly difficult. Therefore, self-vaginitis is better not to do so as not to miss serious disease. An experienced doctor will check the mirrors and microscopy of vaginal smears. And then the correct diagnosis. If you have found a simple vaginitis, it is not dangerous.
After all, illness caused by these microorganisms, which under normal circumstances always live in the vagina, but there are present in small amounts, giving primacy useful lactic acid bacteria. Under certain circumstances, the ecological balance can shift in another direction. Lactic acid bacteria is becoming less and opportunistic begin to proliferate and cause inflammation. These pathogens include staphylococci, streptococci, E. coli and others. Often, their rapid reproduction occurs during pregnancy: changing hormones of the body. It entails a change in the acidity of the vagina.
This creates better conditions for microbes. Therefore, just in case, turn in the analysis of a pregnancy. Violation of the microflora in pregnant women also need to be treated: in addition to discomfort, it creates more and a threat to the child: at birth during passage through the birth canal, he can catch pathogens. It is believed that coleitis also increases the risk of ruptures of the cervix during childbirth. The cause of this disease may be a variety of common diseases. You can get infected and not so benign forms of vaginitis, such as chlamydial. And from the other women suffering from this infection.
This usually happens when you visit a swimming pool, gym, using someone else's toilet. Before the diagnosis will be clarified, extreme caution and try to protect against the risk of infecting their home. And one very important condition: the period of treatment before full recovery Viagra to prevent impotence from sexual activity should be avoided. How can you mend coleitis? First, you need to calm inflammation, reduce the number of pathogens and induce ecological balance back - toward the lactic acid bacteria.
Usually this makes the vaginal douching with potassium permanganate, chamomile, clary sage, yarrow and other herbs, antiseptic solutions. However, this procedure should not be used too often to not interfere with the restoration of normal microflora and acidity of the vagina. Currently, the treatment of vaginitis, there is also a wide range of ready-made candles and vaginal tablets with anti-inflammatory and antiseptic action.
From the use of antibiotics is better to abstain, since bacteria are often insensitive to them, and the normal die. After application of these drugs, when discomfort will disappear, do not rush to interrupt treatment. Recovery should be confirmed by laboratory analysis of indicators of vaginal discharge. But that's not all. After normalization of the assays doctor may prescribe drugs that stimulate the growth of lactobacilli and restoring vaginal microflora. And only posleetogo can forget about vaginitis.
Empty stomach
Hostile
In this case, a woman is constantly experiencing discomfort in the vulva, feeling the heat and gravity. Sexual intercourse may become painful. It would seem that all this is far from obvious pathology, but little things sometimes turn into major trouble and spoils the mood. Great harm to the banal vaginitis, despite the discomfort, the body does not cause.
True, at first glance picture of the disease is similar to other, more brand name viagra serious inflammatory diseases: candidiasis, trichomoniasis, gonorrhea, chlamydia. Therefore, in order to make sure that this disease you do not necessarily need to consult a doctor / gynecologist. These diseases can already lead to serious complications - infertility, ectopic pregnancy, ovarian inflammation, and treat them fairly difficult. Therefore, self-vaginitis is better not to do so as not to miss serious disease. An experienced doctor will check the mirrors and microscopy of vaginal smears. And then the correct diagnosis. If you have found a simple vaginitis, it is not dangerous.
After all, illness caused by these microorganisms, which under normal circumstances always live in the vagina, but there are present in small amounts, giving primacy useful lactic acid bacteria. Under certain circumstances, the ecological balance can shift in another direction. Lactic acid bacteria is becoming less and opportunistic begin to proliferate and cause inflammation. These pathogens include staphylococci, streptococci, E. coli and others. Often, their rapid reproduction occurs during pregnancy: changing hormones of the body. It entails a change in the acidity of the vagina.
This creates better conditions for microbes. Therefore, just in case, turn in the analysis of a pregnancy. Violation of the microflora in pregnant women also need to be treated: in addition to discomfort, it creates more and a threat to the child: at birth during passage through the birth canal, he can catch pathogens. It is believed that coleitis also increases the risk of ruptures of the cervix during childbirth. The cause of this disease may be a variety of common diseases. You can get infected and not so benign forms of vaginitis, such as chlamydial. And from the other women suffering from this infection.
This usually happens when you visit a swimming pool, gym, using someone else's toilet. Before the diagnosis will be clarified, extreme caution and try to protect against the risk of infecting their home. And one very important condition: the period of treatment before full recovery Viagra to prevent impotence from sexual activity should be avoided. How can you mend coleitis? First, you need to calm inflammation, reduce the number of pathogens and induce ecological balance back - toward the lactic acid bacteria.
Usually this makes the vaginal douching with potassium permanganate, chamomile, clary sage, yarrow and other herbs, antiseptic solutions. However, this procedure should not be used too often to not interfere with the restoration of normal microflora and acidity of the vagina. Currently, the treatment of vaginitis, there is also a wide range of ready-made candles and vaginal tablets with anti-inflammatory and antiseptic action.
From the use of antibiotics is better to abstain, since bacteria are often insensitive to them, and the normal die. After application of these drugs, when discomfort will disappear, do not rush to interrupt treatment. Recovery should be confirmed by laboratory analysis of indicators of vaginal discharge. But that's not all. After normalization of the assays doctor may prescribe drugs that stimulate the growth of lactobacilli and restoring vaginal microflora. And only posleetogo can forget about vaginitis.
Empty stomach
Hostile
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