scholarly journals Surgical treatment of diffuse toxic goiter and the possibility of predicting its results

2000 ◽  
Vol 46 (4) ◽  
pp. 34-38
Author(s):  
M. I. Balabolkin ◽  
P. S. Vetshev ◽  
N. A. Petunina ◽  
L. V. Trukhina
Keyword(s):  
Surgical Treatment ◽  
Western Europe ◽  
Clinical Symptoms ◽  
Low Frequency ◽  
Treatment Method ◽  
Antithyroid Drugs ◽  
Minimal Risk ◽  
Cancer Breast ◽  
The Usa ◽  
Toxic Goiter

Most of the most respected researchers in the field of thyroidology agree that the ideal treatment for diffuse toxic goiter (DTZ) should ensure the rapid elimination of the clinical symptoms of thyrotoxicosis and be accompanied by a minimal risk of complications for the patient [1, 2, 7]. Unfortunately, at present, clinical practice does not have a treatment method that fully meets these requirements. The choice of treatment method for DTZ is largely determined by the commitment of specialists and their experience in the application of a particular treatment method, the characteristics of national endocrinological and surgical schools, the capabilities of a particular medical institution, as well as the sex, age of the patient, options for the clinical course of the disease, the patient’s wishes and some others factors. It can be noted that the recommendations given by experts in Europe, the USA and Japan are different. Conservative therapy with antithyroid drugs is quite widespread in European countries, but the low frequency of achieving stable remission of the disease does not satisfy endocrinologists [1,5, 32, 40, 42]. Radioactive iodine therapy, which is widely used in the USA and Western Europe, which is a rather effective method of treating DTZ, over time leads to the development of hypothyroidism in almost all patients [16, 20], it is also necessary to take into account the risk of developing thyroid cancer, breast, infertility and severe osteoporosis in women in the premenopausal period [10, 13, 18, 19]. Surgical treatment occupies a significant place in the treatment of DTZ, providing the patient with the most rapid achievement of the euthyroid state, however, like any surgical intervention, it is accompanied by a number of characteristic complications [2, 46]. Nevertheless, in Japan, thyroidectomy is considered the main treatment for DTZ.

scholarly journals Problems of diagnostics and treatment of diffuse — toxic goiter (Graves’ disease)

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Saydiganikxodja I. Ismailov ◽  
Komila Kh. Khayitboyeva
Keyword(s):  
Surgical Treatment ◽  
Iodine Deficiency ◽  
Diagnostic Methods ◽  
Graves Disease ◽  
Minimal Risk ◽  
Familial Predisposition ◽  
Advantages And Disadvantages ◽  
Radioiodine Ablation ◽  
Treatment Indications ◽  
Toxic Goiter

The article is devoted to prevalence, contemporary diagnostic methods and treatment of Grave’s disease. Advantages and disadvantages of different treatment options are discussed. The cause of the disease can be environmental conditions, infectious diseases, severe operational intervention, drugs, trauma, especially brain traumas, iodine deficiency and radiation damage of thyroid in iodine deficiency conditions, familial predisposition. The ideal treatment of Graves’ disease should ensure a fairly rapid elimination of clinical symptoms of thyrotoxicosis, return to an euthyroid state, with minimal risk of complications. The relapse rate of the disease can reach up to 80 %, using conservative treatment. The radioiodine ablation is relatively simple, non-invasive, effective and cheap. There are special indications for surgical treatment. Indications for surgical treatment: 1) large goiter (the volume of the thyroid gland is more than 45 ml); 2) frequent recurrences of thyrotoxicosis and failure of the drug and RIT; 3)malignancy of goiter; 4) allergic and toxic (leukopenic) reactions to thyreostatics. Patients with Graves’ disease should referred to a specialized center with multidisciplinary team.

scholarly journals Riedel's Thyroiditis. A Clinical Review.

2020 ◽  
Vol 13 (3) ◽  
pp. 133-140
Author(s):  
Elena V. Pokrovskaya ◽  
Dmitriy G. Beltsevich ◽  
Aleksandr Yu. Abrosimov ◽  
Sergey V. Lishchuk ◽  
Valeriy V. Voskoboynikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thyroid Gland ◽  
Clinical Symptoms ◽  
Subsequent Development ◽  
Final Diagnosis ◽  
Treatment Method ◽  
Unknown Etiology ◽  
Dense Adhesion ◽  
Morphological Diagnosis ◽  
Thyroid Gland Tissue

Riedel`s thyroiditis is a rare disease with an unknown etiology, which is characterized by replacement of the thyroid gland tissue with a fibrous connective tissue, the main characteristic sign is the stony-hard texture of the gland, extending to the surrounding structures (trachea, esophagus, blood vessels and nerves). Dense adhesion causes clinical symptoms of tracheal compression, such as shortness of breath, hoarseness, coughing and dyspnoea. Regarding functional activity, both euthyroidism and thyrotoxicosis with the subsequent development of hypothyroidism can be observed. A difficult preoperative diagnosis allows only to suspect this disease, as well as differentiate it with some aggressive forms of cancer, and therefore the final diagnosis is possible only after histological and immunohistochemical examinations of postoperative material. The conservative treatment (mainly glucocorticoid drugs) and surgical intervention can be applied. It is necessary to be meticulous about the choice of a treatment method, taking into account the firmly adhesion with surrounding structures and a high risk of complications of surgical treatment of the thyroid gland. This case report describes a patient with a confirmed morphological diagnosis of Riedelapos;s thyroiditis after thyroidectomy. The peculiarity of this case is a clear positive correlation of the occurrence of subfebrile fever with the onset of the disease and its resolution after surgical treatment and a 11-month follow-up period.

scholarly journals A questionnaire survey concerning the most favourable treatment for Graves' disease in children and adolescents

2004 ◽  
pp. 155-156 ◽  
Author(s):  
GE Krassas ◽  
Z Laron
Keyword(s):  
Children And Adolescents ◽  
Radioactive Iodine ◽  
High Rate ◽  
Treatment Modalities ◽  
Antithyroid Drugs ◽  
Graves Disease ◽  
Toxic Adenoma ◽  
Or Groups ◽  
The Usa ◽  
Toxic Goiter

Graves' disease (GD) is the most common cause of juvenile thyrotoxicosis in children and adolescents (1, 2). Three treatment modalities are now available for the treatment of Graves' thyrotoxicosis in childhood: antithyroid drugs (ATD), surgery and radioactive iodine (RAI). However, none of these treatments has been shown to be ideal or clearly superior to the others. Physicians in different countries have different approaches concerning the optimal treatment of juvenile GD.In a European questionnaire study (3), which was conducted by the European Thyroid Association in 1993 and in which 99 individuals or groups from 22 countries participated, it was found that 22 out of 99 physicians from nine countries would consider RAI treatment as the treatment of choice for children with recurrent thyrotoxicosis after surgery, or with recurrent thyrotoxicosis 2 years after ATD. However, RAI is preferred by only a small percentage of physicians for this group of patients in Europe. Hardly any of the respondents chose RAI for the patients with a toxic adenoma or a multinodular toxic goiter (3). On the other hand, in view of the difficulties with medical therapy in children and adolescents, including poor compliance, a high rate of relapse, drug toxicity and continued thyroid enlargement, some eminent American physicians emphasize the safety, simplicity and economic advantages of (131)I ablation which should be considered more commonly in children (4, 5).We had the opportunity to conduct a similar study during a pediatric thyroidology symposium, which was organized by Professors Buyugkebiz and Laron in Izmir (Smyrna) Turkey from 30 October to 1 November 2003. During the congress a questionnaire with the following four questions was circulated among the 120 participants from eight countries who were mainly paediatric endocrinologists. Most of them were from Turkey and the rest, except for one who came from the USA, were Europeans. Sixty-one out of the 120 physicians responded.

Myxoid variant of sarcomatous pleural mesothelioma

2020 ◽  
pp. 69-75
Author(s):  
Roman Petrovich Stepchenkov
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Western Europe ◽  
Pleural Mesothelioma ◽  
History Taking ◽  
Primary Tumors ◽  
China And India ◽  
The Usa ◽  
Mri Diagnosis

Pleural mesothelioma is a malignant, aggressively growing tumor that occurs during the transformation of mesothelial cells. The incidence of pleural mesothelioma varies significantly from 8 cases per 100,000 population in England to 3.1 — in Australia, 1 — in the USA, Spain, and Poland. PM frequency has been increasing in recent years in Russia, Western Europe, China, and India. Diagnosis of pleural mesothelioma includes history taking, physical examination, computed tomography or MRI (diagnosis of PM cannot be made on conventional radiographs), then thoracoscopy with biopsy is desirable. Differential diagnosis is made between metastases in the pleura of different primary tumors (lung, colon, ovary, breast, etc., as well as synovial sarcoma). The diagnosis of PM can be considered 100 % proven only after immunohistochemistry (IHC). When establishing the operable stage, the question of surgical treatment is decided. If it is impossible to perform surgery, chemotherapy is used.

scholarly journals Surgical treatment of 125 cases with congenital diaphragmatic eventration in a single institution

2020 ◽  
Author(s):  
Shengliang Zhao ◽  
Zhengxia Pan ◽  
Yonggang Li ◽  
Yong An ◽  
Lu Zhao ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Open Surgery ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Operation Time ◽  
Treatment Method ◽  
Diaphragmatic Eventration ◽  
Time To Peak ◽  
Surgical Methods ◽  
Better Than

Abstract Background:This study sought to investigate the clinical characteristics of congenital diaphragmatic eventration (CDE) and to compare the efficacy of thoracoscopy and traditional open surgery in infants with congenital diaphragmatic eventration.Methods: We retrospectively analyzed the clinical data of 125 children with CDE(90 boys, 35girls; median age:12.2 months, range 1h-7years;body mass1.99-28.5kg,median body mass 7.87±4.40kg) admitted to our hospital in recent 10years,and statistically analyzed their clinical manifestations and surgical methods. Results:108 children in this group underwent surgery, of which 67 underwent open surgery and 41 underwent thoracoscopic diaphragmatic Plication.107 patients recovered well postoperatively, except for 1 patient with hiatal hernia died of respiratory distress after surgery.Followed up for 1-9.5 years,107 patients had significantly improved preoperative symptoms.Eleven of the 17 children who did not undergo surgical treatment did not see a significant decrease in diaphragm position after 1-6 years of follow-up.In the thoracoscopy group, the lung function values of 13 children before operation and 3 year after operation was compared. The difference in percent of expiratory time to peak tidal time (tPTEF%tE) and percentage of tidal volume to peak tidal expiratory flow(VPEF%VE) was significant (P<0.05).In the thoracoscopy group, the index data on the operation time, intraoperative blood loss, chest drainage time, postoperative mechanical ventilation time, postoperative hospital stay and postoperative CCU admission time were better than those in the open group.The difference between the two groups was statistically significant (P＜0.05). Conclusions: Clinical symptoms of congenital diaphragmatic eventration varied in severity. Patients with severe symptoms should be operated early. All kinds of surgical methods can achieve better results.The clinical symptoms of children after diaphragm Plication operation are better than those before operation.We believe that the continuous suture of barbed wire thread applied to thoracoscopy diaphragm Plication surgery has quick operation time, less trauma, and quick recovery should be the preferred treatment method for infants with congenital diaphragmatic eventration.

Surgical treatment of transmissible venereal tumor (sticker sarcoma)

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Bougherara Hithem ◽  
Boukhechem Saïd ◽  
Aguezlane Abdelaziz ◽  
Benelhadj Khouloud ◽  
Aissi Adel
Keyword(s):  
Surgical Treatment ◽  
Cancer Cells ◽  
Treatment Method ◽  
High Rate ◽  
Surgical Removal ◽  
Characteristic Appearance ◽  
Recurrent Tumors ◽  
External Genital Organs

Background: Sticker sarcoma, also called venereal sarcoma or venereal lymphosarcomatosis, is a tumor of the external genital organs in females and males. In male animals the penis and foreskin (prepuce) are affected, in the female, it happens in vagina (vagina) and labia (vulva). The diagnosis of sticker sarcoma is based on the chronic discharge, the typical locations and the characteristic appearance of the tumor. Methods: We have relied on the treatment method on the complete surgical removal of all cancer cells that we can access. Results: After surgery, we notice recurrent tumors about six months after surgical treatment, indicating the need for other treatments in addition to surgery. Conclusion: Although spontaneous regressions of sticker sarcoma are documented (with permanent immunity), chemotherapy is the treatment of choice today. Irradiation should also be effective. If the tumor is only removed surgically, there is a high rate of recurrence, and this is what happened with the case that we treated, as the tumor reappeared after less than six months.

EPIZOOTOLOGICAL FEATURES OF MODERN CATTLE LEUKEMIA

1970 ◽  
pp. 53-58
Author(s):  
V. V. Makarov ◽  
D. A. Lozovoy
Keyword(s):  
Dairy Cattle ◽  
Western Europe ◽  
Control Programs ◽  
Foreign Countries ◽  
Negative Order ◽  
Dairy Cattle Breeding ◽  
The Usa ◽  
Epizootic Process ◽  
National Programs

  Enzootic bovine leucosis (EBL) has been known for more than a century and a half. Its occurrence and registration may have historically been associated with intensive breeding of dairy cattle in Western Europe to increase target productivity. It is known that any limiting intervention in the nature of the animal organism is always accompanied by an uncontrolled and unpredictable change in the genotype of a wider range than the required, particularly negative order. In particular, a decrease in the resistance to macroorganisms and the possibility of the new diseases emergence, including infectious ones (for example, immunodeficiencies such as BLAD syndrome of black-motley cattle and stress syndrome in pigs, the occurrence of scrapie and other slow sheep infections). In the last two decades of the last century, in many disadvantaged countries, primarily Western European, national programs for the eradication of EBL have been developed and subsequently successfully implemented. First of all the motivation was the economy of dairy cattle breeding (mainly the extension of productive age, as well as the tightening of requirements in international trade in cattle and bull products, breeding, pricing, etc.). In an analytical article are reviewed the elements of epizootology of EBL in the foreign countries with special attention to the situation in the USA, scenarios of various control programs, and promising methods for assessing the role of infected animals in the epizootic process. A critical assessment of the problem of EBL in the Russian Federation is given, the reasons for the ineffectiveness of against leucosis measures are discussed.

Concept of Power Decentralization in Political Science and Approaches to its Methodological Study

2017 ◽  
pp. 229-235
Author(s):  
Halyna Kuzub
Keyword(s):  
Political Science ◽  
Moral Education ◽  
Symbolic Interactionism ◽  
Western Europe ◽  
Central Government ◽  
Local Level ◽  
Perfect State ◽  
Political Ideas ◽  
The Usa ◽  
Structural Functionalism

The problem of power decentralization is up to date in a modern political science. We can trace its historical genesis first in European and further in the USA political ideas. Decentralization of power was considered along with the study of a perfect state system, civil society and local self-government. It is argued that the major part of successful process of power decentralization in the Western Europe was due to the idea nature for their political culture. The article attempts to retrace the history of the idea of power decentralization. As a background of the investigations of such thinkers as J. Bodin, J. Althusius, J. Locke, J.-J. Rousseau, C.-L. Montesquieu, R. Owen, C. Fourier, J. S.Mill, T. Jefferson, A. de Tocqueville and M. Dragomanov were thoroughly investigated. The paper also considers the modern definitions of power decentralization. Likewise the value of structural functionalism, symbolic interactionism and constructivism are argued in terms of further surveys of power decentralization. To conclude, the author opines that civil servants training, their theoretical teaching and moral education have to become the main objectives in perspective investigations. Furthermore, the success of power decentralization depends not only on devoting authority by central government, but also on capacity of its implementation by deputies on the local level. Keywords: Decentralization of power, deconcentration of power, administrative and political decentralization, classical and non-classical philosophy, structural functionalism, symbolic interactionism, construc-tivism

scholarly journals “A debriefer must be neutral” and other debriefing myths: a systemic inquiry-based qualitative study of taken-for-granted beliefs about clinical post-event debriefing

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Julia Carolin Seelandt ◽  
Katie Walker ◽  
Michaela Kolbe
Keyword(s):  
Interpersonal Relationships ◽  
Western Europe ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Clinical Event ◽  
Clinical Settings ◽  
Healthcare Organizations ◽  
The Usa ◽  
Open Coding ◽  
Healthcare Administrators

Abstract Background The goal of this study was to identify taken-for-granted beliefs and assumptions about use, costs, and facilitation of post-event debriefing. These myths prevent the ubiquitous uptake of post-event debriefing in clinical units, and therefore the identification of process, teamwork, and latent safety threats that lead to medical error. By naming these false barriers and assumptions, the authors believe that clinical event debriefing can be implemented more broadly. Methods We interviewed an international sample of 37 clinicians, educators, scholars, researchers, and healthcare administrators from hospitals, universities, and healthcare organizations in Western Europe and the USA, who had a broad range of debriefing experience. We adopted a systemic-constructivist approach that aimed at exploring in-depth assumptions about debriefing beyond obvious constraints such as time and logistics and focused on interpersonal relationships within organizations. Using circular questions, we intended to uncover new and tacit knowledge about barriers and facilitators of regular clinical debriefings. All interviews were transcribed and analyzed following a comprehensive process of inductive open coding. Results In total, 1508.62 min of interviews (25 h, 9 min, and 2 s) were analyzed, and 1591 answers were categorized. Many implicit debriefing theories reflected current scientific evidence, particularly with respect to debriefing value and topics, the complexity and difficulty of facilitation, the importance of structuring the debriefing and engaging in reflective practice to advance debriefing skills. We also identified four debriefing myths which may prevent post-event debriefing from being implemented in clinical units. Conclusion The debriefing myths include (1) debriefing only when disaster strikes, (2) debriefing is a luxury, (3) senior clinicians should determine debriefing content, and (4) debriefers must be neutral and nonjudgmental. These myths offer valuable insights into why current debriefing practices are ad hoc and not embedded into daily unit practices. They may help ignite a renewed momentum into the implementation of post-event debriefing in clinical settings.

scholarly journals Energy loss separation in NiFeMo compacts with smoothed powders according to Landgraf’s and Bertotti’s theories

2021 ◽  
Author(s):  
Denisa Olekšáková ◽  
Peter Kollár ◽  
Miloš Jakubčin ◽  
Ján Füzer ◽  
Martin Tkáč ◽  
...  
Keyword(s):  
Energy Loss ◽  
Mechanical Treatment ◽  
Positive Impact ◽  
Core Loss ◽  
Low Frequency ◽  
Treatment Method ◽  
Effective Dimension ◽  
Loss Analysis ◽  
Innovative Method ◽  
Individual Particles

AbstractThis submitted paper presents the detailed description of the energy loss separation for dc and ac low-frequency magnetic fields of NiFeMo (supermalloy) compacted powder prepared by innovative method of smoothing the surfaces of individual particles. The positive impact of mechanical treatment method on domain wall displacement is explained on the basis of Landgraf approach for dc loss analysis, and the effective dimension for eddy current in ac magnetic field is explained according to Bertotti approach for core loss analysis.

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