Current Problems of the Diagnostics and Treatment of Sepsis and Burn Injuries: The Modified Pathogenetic Concept

Background: The deep understanding of pathogenesis is a key moment in the formation of the modern strategy of modern medicine. We conducted the thorough analysis of the microscopic processes occurring in the bodies of patients with purulent-septic complications. The modified pathogenetic concept of the diagnostic and treatment model of diseases with septic complications is presented. The obtained information about the mechanisms of origin and development of these diseases is fundamentally important for finding the modern effective methods of treating patients. The aim of the research is to modify treatment tactics for patients with sepsis and burn injuries based on the modified pathogenetic concept using modern diagnostics, i.e. the method of fluorescence spectroscopy (MFS) and biomarkers. Materials and Methods: The proposed modified pathogenetic concept of the diagnostic and treatment model of diseases with purulent-septic complications along with standard methods was used successfully for effective treatment of 15 patients with sepsis and 25 with burn injuries. Results: 3 main scenarios of behaviour of spectral-fluorescence characteristics of patients with sepsis are illustrated. Spectral-fluorescence markers of sepsis were studied, which are informative 24 to 48 hours before the appearance of obvious clinical and laboratory signs of significant changes in the general somatic status of patients. Conclusions: The proposed diagnostic and therapeutic approach is new and fundamentally important for diagnostics and monitoring of the process of treatment of patients with purulent-septic diseases and burn injuries. An in-depth understanding of the dynamics of septic complications and the corresponding changes of the main markers of these diseases during treatment is especially relevant. The use of infusion therapy with solutions of donor albumin as an effective pathogenetic treatment is scientifically justified.

The Pathogenetic Concept of the Diagnostic-Treatment Approach for Patients with Purulent-Septic Complications

Background: The significant improvement of immediate and long-term functional results of treating patients is the fundamental problem of modern medical science. A deep understanding of the pathogenesis is the key point in creating the management strategy for patients with various diseases. Information about the mechanisms of origin and development of purulent-inflammatory diseases and sepsis is essential for finding effective ways to prevent and treat them. The aim of the research is to use the method of fluorescence spectroscopy in creating the pathogenetic diagnostic and treatment model for the prevention and treatment of purulent-inflammatory diseases and sepsis, modification of treatment tactics, search for new markers of purulent-septic diseases, as well as monitoring of patients during the treatment. Materials and methods: The proposed approach, along with standard diagnostic methods, was used to organize the treatment process of 100 patients with purulent-inflammatory diseases, including 15 patients with sepsis, 35 with acute inflammatory abdominal pathology, 20 patients with burn injury (main group) and 35 patients with burn injury (comparison group). Results: The behavior of spectral-fluorescent characteristics in their dynamics has been studied, and the new markers for assessing patients’ conditions have been proposed. Their effectiveness for the diagnosis of purulent-septic diseases has been proved, which advances the results of standard research methods by 24 - 48 hours. Conclusions: The proposed diagnostic and treatment approach is fundamentally important for diagnosis and monitoring during the treatment of patients with purulent-septic diseases. Particularly relevant is the proposal to modify the treatment process for these patients, associated with the use of infusion of donor albumin solutions.

Development Ideas for the Multidisciplinary Integrative Diagnosis and Treatment System of Pelvic Floor Medicine

With the rapid growth of the aging population,pelvic floor dysfunction(PFD)has become a new type of high‑incidence disorder.This disorder can be caused by injury,functional deterioration,or coordination disorders of pelvic support structures,such as pelvic floor muscles,connective tissues,and pelvic floor muscle fiber.The symptoms can include dyssynergic defecation,fecal incontinence,overactive bladder,urinary incontinence,pelvic organ prolapse,hemorrhoids,sexual dysfunction,chronic urinary retention,and chronic pelvic pain.PFD often presents itself as a combination of symptoms involving urological,gynecological,anorectal,and psychological aspects.Under such circumstances,the development of multidisciplinary integrative diagnosis for PFD has become a trend.