Analysis of national and foreign trials investigating accumulation of experience in innovative technologies using the learning curves.

Earching for Russian-language manuscripts was carried out within the references of the articles and in the ELIBRARY database. Selleck Sodium L-lactate Foreign trials were selected from the PubMed database according to the keywords «learning curves in surgical practice». The discovered publications were studied for accordance with the objectives of this study.

Accumulation of experience in new technologies by using of learning curves is valuable to improve the training, determine duration of development of new technology and the factors affecting its characteristics.

The method is high-quality for comprehensive analysis of experience accumulation in new surgical technologies.

The method is high-quality for comprehensive analysis of experience accumulation in new surgical technologies.Mine-explosive trauma is one of the most serious types of combat lesion and injuries in peacetime. We report a patient with mine-explosive trauma of the lower limbs followed by injury of the vascular bundle. Well-coordinated work of a multidisciplinary team of specialists at all stages of treatment is presented. The management was effective to save patient’s life, avoid amputation and restore lower limb function.We report 3 patients with coronary artery disease and kidney cancer followed by thrombosis of inferior vena cava and right cardiac chambers undergoing simultaneous surgery.Two patients with severe liver trauma undergoing staged surgical treatment are reported in the article.Treatment of solitary cholangiogenic liver abscesses is considered in the article. Successful treatment of cholangiogenic liver abscess with hybrid technologies is reported. The authors conclude that restoration of bile outflow is essential for fast elimination of the abscess.Available data indicate a worse prognosis in cancer patients with COVID-19. Surgical treatment of lung cancer in the conditions of the COVID-19 pandemic poses new challenges to ensure the perioperative safety of patients.

To prevent infection of patients in the perioperative period and, in case of infection, to prevent the severe course of COVID-19.

In the conditions of the COVID-19 pandemic within two months (March-April 2020) 138 patients underwent surgical treatment for malignant tumors, including 22 videothoracoscopic operations 3 (13.6%) segmentectomies, 16 (72.7%) lobectomies, and 5 (22.7%) bilobectomies for non-small cell lung cancer.

Following the principles that ensure the prevention of infection and the prevention of severe COVID-19, we managed to avoid the first stage of the pandemic (March-April 2020) cases of infection with a new coronavirus infection in patients who underwent surgical treatment for lung cancer.

Following the principles that ensure the prevention of infection and the prevention of severe COVID-19, we managed to avoid the first stage of the pandemic (March-April 2020) cases of infection with a new coronavirus infection in patients who underwent surgical treatment for lung cancer.

To evaluate symptom-modifying effects of a two-month parenteral therapy with chondroitin sulfate («Mucosat») in patients with knee and/or hip osteoarthritis (OA) in various combinations of adjuvant therapy.

There were 70 patients with primary and/or post-traumatic unilateral/bilateral knee and/or hip osteoarthritis (Kellgren-Lawrence grade I-II). Pain syndrome severity was assessed as ≥ 50 mm (100-mm VAS), total Leken’s index – ≥ 5 points. The main group comprised 40 patients who received Mucosat for 60 days. NSAIDs were additionally prescribed in 9 (22.5%) of these patients. The control group included 30 patients with intra-articular injection of hyaluronic acid. All patients underwent clinical and functional examination (rating scales VAS, Leken’s total index, WOMAC index, EQ-5D health questionnaire), laboratory diagnosis (IL-1, IL-6, TNF-α), X-ray examination, assessment of adverse events at 5 visits.

Administration of chondroitin sulfate is associated with reduced local pain syndrome and functional normalization of musculoskeletal system. Prolonged pain-free period with high safety profile due to reduced need for NSAIDs is an advantage of Mucosat therapy. Thus, this drug may be recommended for initial therapy. A combination of chondroitin sulfate with intra-articular injection of hyaluronic acid may be perspective for optimization of therapy and secondary prevention of exacerbations of OA. Further research is required.

Administration of chondroitin sulfate is associated with reduced local pain syndrome and functional normalization of musculoskeletal system. Prolonged pain-free period with high safety profile due to reduced need for NSAIDs is an advantage of Mucosat therapy. Thus, this drug may be recommended for initial therapy. A combination of chondroitin sulfate with intra-articular injection of hyaluronic acid may be perspective for optimization of therapy and secondary prevention of exacerbations of OA. Further research is required.The paper is a narrative review of the literature on the use of direct oral anticoagulants (DOACs) for the VTE treatment in challenging patients senile age (≥75 years), impaired renal function (estimated glomerular filtration rate ≤50 ml/min), fragility (one of the previous characteristics and/or bodyweight ≤50 kg). The paper discusses the studies of EINSTEIN DVT and PE (rivaroxaban), AMPLIFY (apixaban), HOKUSAI-VTE (edoxaban), RE-COVER I and II (dabigatran) in the focus of the secondary analysis in the pre-specified patient’s subgroups, as well as their pooled analyzes and meta-analyzes. Based on the results of this review, it was concluded that in a subgroup of senile age patients, dabigatran increases the risk of major bleeding by 4.8 times and has no advantages over vitamin K antagonists (VKA); rivaroxaban and apixaban retain superiority over VKA on the safety outcomes and reduce the risk of major bleeding by 73% and 77%. In the subgroup of patients with impaired renal function, the use of apixaban and dabigatran is associated with an increase in the risk of major bleeding by 6.5 and 7.3 times, and these DOACs do not have advantages over VKA; rivaroxaban retains its superiority over VKA and reduces the risk of major bleeding by 78%. For fragile patients, a secondary analysis is available only for rivaroxaban, which remains superior to VKA on safety endpoints and reduces the risk of major bleeding by 73%. In the absence of direct comparisons between the available DOACs, the presented data can be used as a rational approach for the choice of appropriate treatment for VTE in challenging patients.