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Лечение в Израиле - главная / Предварительная консультация / Статьи наших врачей / Статьи медицинского директора компании «Медсервис Израиль»

Статьи медицинского директора компании «Медсервис Израиль» Будянского Владимира Михайловича

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Related Articles, Links

[Acute respiratory failure as the 1st symptom of migration of a central venous catheter into the mediastinum]

[Article in Russian]

Budianskiĭ VM, Shulutko EM, Galstian GM.

Reports a case with late development of hydromediastinum and right-side hydrothorax as a result of migration of the central venous catheter into the mediastinum. Acute respiratory insufficiency was the first symptom of this complication.

Publication Types:
  • Case Reports
  • English Abstract

PMID: 8533960 [PubMed - indexed for MEDLINE]

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[The course and prognosis of septic shock in patients with hemoblastoses and aplastic anemia in a state of agranulocytosis]

[Article in Russian]

Galstian GM, Budianskiĭ VM, Gorodetskiĭ VM.

The course and prognosis of septic shock developing during agranulocytosis were retrospectively studied in 59 hematological patients (52 ones with hemoblastosis and 7 with aplastic anemia). Out of 59 patients with septic shock hospitalized at department for anesthesiology and reanimation, in 5 shock was arrested and they were transferred to other departments of the hospital. All patients with failure of more than three organ systems, with SAPS score of 21 at admission, and a history of splenectomy died in the anesthesiology and reanimation department. The diagnosis of the underlying disease, resistance to chemotherapy administered, disease stage, persistent agranulocytosis, and artificial ventilation of the lungs which had to be resorted to did not influence the prognosis of septic shock. Even after effective antishock therapy all patients with aplastic anemia died, as did the patients with resistance to chemotherapy administered for the underlying disease and those without signs of granulocytopoiesis recovery. Hence, the prognosis is unfavorable for patients with septic shock in a state of agranulocytosis, if their SAPS score on admission is higher than 21, if they develop polyorgan failure with involvement of more than three organ systems, have a history of splenectomy, their hemoblastosis is resistant to chemotherapy, and there are no prospects for granulocytopoiesis recovery.

Publication Types:
  • English Abstract

PMID: 8686934 [PubMed - indexed for MEDLINE]

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[Spontaneous gas gangrene in a female patient with aplastic anemia]

[Article in Russian]

Budianskiĭ VM, Gorelov VG, Shulutko EA, Mikhaĭlova EA, Mosolova SV.

Publication Types:
  • Case Reports
  • Review

PMID: 8771667 [PubMed - indexed for MEDLINE]

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[The biological characteristics and treatment of acute promyelocytic leukemia]

[Article in Russian]

Savchenko VG, Parovichnikova EN, Isaev VG, Demidova IA, Kuliev RG, Gribanova EO, Kliasova GA, Kucher RA, Sokolov AN, Momotiuk KS, Ol'shanskaia IuV, Tiurina NG, Tikhonova LIu, Galstian GM, Budianskiĭ VM, Belousov EA, Lapin VA, Voloshin SV, Konstaninova TS, Filatov LB, Porokhina ON, Smirnova EA.

Publication Types:
  • Editorial
  • Review

PMID: 9742627 [PubMed - indexed for MEDLINE]

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[Multiple-organ pathology in septic shock in patients with hemoblastoses]

[Article in Russian]

Galstian GM, Gorodetskiĭ VM, Shulutko EM, Budianskiĭ VM, Bulanov AIu, Dobrodeev AS, Prosolov NV, Vasil'ev SA, Orel EB, Biriukova LS.

A prospective study of 20 patients with hemoblastosis and septic shock (SS) was carried out by invasive monitoring of the central hemodynamics and oxygen transport, evaluation of biochemical and coagulological parameters, and assessment of the severity of clinical condition by the APACHE II and SOFA scores. Septic shock was effectively treated in 12 patients, 5 of them were discharged from the department (group 1) and 7 died in intensive care wards from various complications (group 2). Eight patients died during the first 2 days from SS resistant to therapy (group 3). Group 2 patients were in need of a longer inotropic support than group 1 patients (5.8 +/- 1.6 vs. 2.7 +/- 0.8 days, p < 0.01). The deficit of bases was more expressed in groups 2 and 3 in comparison with group 1 (-11.3 +/- 3 and -2.7 +/- 9.1 mmol/liter vs. 1.4 +/- 4.4 mmol/liter) and left ventricular stroke index (LVSI) and oxygen delivery were lower. LVSI and base deficit were in linear correlation (rho = 0.4, p < 0.05). XIIa-dependent fibrinolysis was suppressed in all patients, which was more pronounced in group 3 in comparison with groups 1 and 2 (135 +/- 47.4 vs. 103 +/- 27 and 88.3 +/- 42.3). According to SOFA score, the severity of cardiovascular disorders during day 1 of SS was the same in all groups, while starting from day 2 it decreased in patients who survived. Acute respiratory failure was lower in group 1 only on day 1 according to SOFA. More pronounced (according to SOFA) hepatorenal failure was observed in group 2 in comparison with other patients. Organ involvement in hemoblastosis was detected at autopsy in 8 out of 13 cases. Hence, the need in prolonged cardiovascular support of SS patients is associated with development of polyorgan involvement. Fibrinolysis suppression is a frequent early manifestation of hemostasis disorders. Specific neoplastic organ involvement was observed in 61.5% patients with hemoblastosis who died from SS and its complications.

Publication Types:
  • Comparative Study
  • English Abstract

PMID: 10833835 [PubMed - indexed for MEDLINE]