Репозиторий Университета

Background: Although the relationship between acute alcohol consumption and injuries is well recognized, studies exploring how the time of day the drinking commences affects alcohol-related injuries have been scarce. This contribution examines the associations between the time at which the drinking began and the duration of the drinking, the volume of alcohol consumed, the injury type, and the blood alcohol concentration (BAC) level. Method: This study employed a cross-sectional survey, which was conducted in two hospital emergency departments (ED) in Chiangmai Province, Thailand. The sample was composed of 519 injured patients aged 18 years and older. Outcome measures included the BAC and type of injury. Exposures included the quantity of alcohol consumed, the time the drinking commenced, and the pattern of drinking involved. Results: The injured patients who drank alcohol within six hours prior to sustaining their injury were more likely to get injured and present themselves at the ED at night (20:00–04:00) compared to those who sustained an injury but did not drink in the hours prior. However, this relationship was only true for unintentional injuries, not intentional ones. The majority of participants consumed their first drink between 16:00 and 20:00. On average, among the 104 patients who drank prior to sustaining an injury, the total amount of alcohol consumed was 6.9 drinks, the duration of drinking was 2.6 h, the rate of drinking was 6.0 drinks/hour, and the BAC was 0.119 gm%. Every drink increased the BAC by 0.012 gm% and each year of increasing age increased the BAC by 0.003 gm%. People who were older, less educated, and drank more frequently tended to have their first drink earlier than other drinkers. An earlier start to their drinking resulted in a faster pace of drinking and a higher BAC. Conclusions: BAC increased with the total amount of alcohol consumed and the age of the drinker. Different groups of people had their first drink at different times of the day, resulting in differences in the rate of drinking, the BAC, the time of injury, and the time they presented to the ED after injury.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. Evaluation of the morbidity structure and demonstration CT-semiotics of the main diseases in patients with nontraumatic acute abdomen. Materials and methods. 905 studies of the abdomen performed in 2016 in the State Clinical Hospital named after S.P. Botkin in patients with acute abdomen. The studies were conducted natively, with contrasting per os, with intravenous enhancement, depending on the expected pathology. Results. The most common causes of acute abdomen were: acute intestinal obstruction (27%), pancreatitis (9%), urolithiasis and its complications (8%), oncology directly and its complications (7%), inflammatory changes in the gallbladder and diliary ducts (4%), inflammatory changes in the kidneys (3%). Also significant weight in the structure of morbidity was perforation of the bowel (2.5%), mesenteric thrombosis (2%), extraorganic inflammatory changes (2%). Only 5% of cases failed to reliably detect signs of a pathological process in the presence of a clinical picture. The main characteristics of the risk group for the emergence of acute abdominal pathology, such as the age of 32-67 years, the male sex, are revealed. A more detailed analysis of risk factors within the statistically most significant nosological groups was also carried out. The diagnostic efficiency index of multislice computed tomography (CT) for the above diseases varied from 95% to 97%, the sensitivity and specificity of the method depending on the disease were 95-97.8% and 93.2-97%, respectively, p> 0.05. Conclusions. CT allows to determine the nature of the disease quite accurately in emergency medical care in patients with nontraumatic urgent abdominal pathology. The identification of a risk group in the structure of acute nontraumatic abdominal pathology facilitates early diagnosis and timely treatment.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This scientific review of the literature presents the most relevant discussions in the world community, aimed at improving the implementation of the diagnostic algorithm in patients with severe combined trauma. Materials and methods: The work deals with the main traumatic injuries of various anatomical zones, the criteria of the Advanced Trauma Life Support (ATLS) protocol and diagnostic methods aimed at detecting acute traumatic pathology. Conclusion: The authors consider unsolved issues, as well as the improvement of the multislice computed tomography (MSCT) algorithm in the "whole body" mode, to optimize diagnostic activities aimed at managing patients with severe combined trauma.