scholarly journals Surgical treatment of the small intestine atresia under conditions of different postoperative follow-up

2020 ◽  
pp. 7-12
Author(s):  
O. Bodnar ◽  
◽  
L. Vatamanesku ◽  
B. Bodnar ◽  
M. Khoma ◽  
...  
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Small Bowel ◽  
Parenteral Nutrition ◽  
Surgical Department ◽  
Significant Difference ◽  
End To End ◽  
The Difference ◽  
Bowel Atresia ◽  
The City

Introduction. Small intestine atresia is one of the most common causes of low bowel obstruction in newborns. Mortality in this pathology ranges from 5 to 60%, depending on the country. Modern views about surgical correction are rather contradictory. Purpose. To analyze the surgical treatment of small intestine atresia in the surgical department of the City Children’s Hospital No. 1 ССH) (Chernivtsi, Ukraine) and the surgical department Saint Damien Pediatric Hospital NPH (SDH) (Port-o-Prence, Haiti). To determine the best methods of surgery. Materials and methods. The surgical treatment of 15 children under the conditions of SDH (Haiti) and 12 children under conditions of the city children’s clinical hospital (CCH, Chernivtsi) with atresia of the small intestine was analyzed. Determined the effectiveness of closed (oblique «end-to-end» anastomosis, taping with «end-to-end» anastomosis, Denis-Brown and Louw anastomoses), discharging (U- and T-shaped, taping with anostomosing and suspended proximal enterostoma), anastomoses and stomas (end, double, according to Mikulich). Mortality with limited parenteral nutrition was 40% (SDH), with the presence of parenteral nutrition – 33.33% (ССH, Chernivtsi). Results. According to the analyzed data, we believe that the use of the method of surgical treatment should correspond to the type of atresia, the distance of the blind proximal end from the Treitz ligament, the difference in the diameters of the adducting and abducting sections, the possibility of parenteral nutrition, and the threat of short bowel syndrome (SCS). Conclusions. Y-shaped discharging anastomosis «side-to-side» with the removal of the proximal area in the form of a stoma, can be the method of choice in case of significant difference between the intestinal diameters. It provides a wide area of the small bowel junction, chyme abduction until the fistula heals, and can be used for different types of small bowel atresia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Keywords: small intestine atresia, surgical treatment, children.

scholarly journals Effects of oral parenteral nutrition solution on the morphology and mechanical resistance of the small bowel in rats

1997 ◽  
Vol 12 (3) ◽  
pp. 159-162 ◽  
Author(s):  
José E. Aguilar-Nascimento ◽  
Stenio A. Lima ◽  
Alexandre C. C. Pereira
Keyword(s):  
Small Bowel ◽  
Parenteral Nutrition ◽  
Elemental Diet ◽  
Bursting Pressure ◽  
Mechanical Resistance ◽  
Wall Width ◽  
Significant Difference ◽  
Male Wistar Rats ◽  
The Difference ◽  
Loss Of Mass

The objective of this study was to investigate the effect of an elemental diet (ED) on the strength and on the morphology of the small bowel. Male Wistar rats were randomized to two groups to receive during 14 days either standard laboratory rat chow (N=16) or ED (N=16) containing total parenteral nutrition (TPN) solution. After this period they were killed and necropsied. The small bowel was measured and weighted with and without the contents. Bursting pressure (BP) was taken from the jejunum and ileum and histological sections of these two portions was performed to register the crypt depth (CD), vilus height (VH) and wall width (WW). All animals significantly gain weight. The bowel of animals fed with TPN solution had significantly less weight when compared with the controls either with (9.9 ± 1.9g x 7.8 ± 1.5g, p<0.05) or without (8.3 ± 1.3g x 6.5 ± 0.8g; p<0.05) the luminal contents. BP was lower in animals receiving TPN solution compared with controls in both studied segments but the difference only reached significance at the ileum (287 ± 60 x 234 ± 46 mm of Hg; p<0.05). VH, CD and WW were significantly shorter at the ileum in TPN-fed animals when compared to controls (p<0.05). This contrast was also seen at the jejunum though without significant difference. The small bowel looses mass and become less resistant when rats are fed with elemental diet though the nutritional state is maintained. The loss of mass appeared to be not only at the mucosa layer but through all the bowel wall. This occurs predominantly at the terminal part of the small bowel.

Histological examination of rat small intestine after surgical removal of obturation small bowel obstruction and peptide stimulation of lymph flow

2018 ◽  
pp. 157-162
Author(s):  
А.А. Коваленко ◽  
Г.П. Титова ◽  
В.К. Хугаева
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Small Bowel ◽  
Goblet Cells ◽  
Intestinal Wall ◽  
Structure And Function ◽  
Lymph Flow ◽  
Intestinal Lumen ◽  
And Function

Оперативное лечение различных заболеваний кишечника сопровождается осложнениями в виде нарушений микроциркуляции в области анастомоза кишки. Ранее нами показана способность лимфостимуляторов пептидной природы восстанавливать нарушенную микроциркуляцию, что послужило основой для настоящего исследования. Цель работы - оценка влияния стимуляции лимфотока в стенке кишки на процессы восстановления микроциркуляции, структуры и функции тонкой кишки в области оперативного вмешательства. Методика. В экспериментах на наркотизированных крысах (хлоралгидрат в дозе 0,6 г/кг в 0,9% растворе NaCl) моделировали различные поражения тонкой кишки (наложение лигатуры, перевязка 1-3 брыжеечных артерий, перекрут петли кишки вокруг оси брыжейки, сочетание нескольких видов повреждений). Резекция поврежденного участка через 1 сут. с последующим созданием тонкокишечного анастомоза завершалась орошением операционного поля раствором пептида-стимулятора лимфотока (40 мкг/кг массы животного в 1 мл 0,9% раствора NaCl). На 7-е сут. после операции проводили гистологическое исследование фрагмента кишки в области анастомоза. Результаты. На 7-е сут. после резекции у выживших животных (летальность вследствие кишечной непроходимости составляла 30%) имеют место морфологические признаки острых сосудистых нарушений стенки кишки, изменений кровеносных и лимфатических микрососудов, интерстициальный отек всех слоев стенки кишки, дилатация просвета кишки, повреждение всасывающего эпителия ворсин с истончением щеточной каемки клеток, морфологические признаки гиперфункции бокаловидных клеток. Использование лимфостимулятора пептидной природы после операции увеличивало выживаемость животных на 24%. У части животных отмечалось уменьшение расширения просвета кишки, у других практически полная его нормализация. Восстанавливалась форма кишечных ворсин и распределение бокаловидных клеток. Отсутствовали признаки внутриклеточного и межмышечного отека. Отмечено умеренное полнокровие венул. Заключение. Использование лимфостимулятора при хирургическом лечении кишечной непроходимости увеличивает выживаемость животных на 24% по сравнению с контролем, способствует более раннему восстановлению структуры и функции тонкой кишки. Полученные результаты свидетельствуют о перспективности использования стимуляции лимфотока при операциях на кишечнике. Surgical treatment of bowel diseases is associated with complications that cause microcirculatory disturbances in the anastomosis area and may lead to a fatal outcome. This study was based on our previous finding that peptide-type lymphatic stimulators are able to restore impaired microcirculation. The aim of this work was stimulating the lymph flow in the intestinal wall to facilitate recovery of microcirculation, structure and function of the small intestine in the area of surgical intervention. Methods. In experiments on anesthetized rats (0.6 g/kg chloral hydrate in 0.9% NaCl), various small bowel lesions were modeled (bowel ligation, ligation of 1-3 mesenteric arteries, gut torsion, combination of several lesion types). In 24 h, the damaged area was resected, and a small intestine anastomosis was creased. The surgery was completed with irrigation of the operative field with a solution of lymph flow stimulating peptide (40 мg/kg body weight in 1 ml of 0.9% NaCl). A gut fragment from the anastomosis area was examined histologically on day 7 after the surgery. Results. On the 7th day after removing the intestinal obstruction, the surviving animals (lethality 30%) had morphological signs of acute vascular disorders in the intestinal wall; changes in blood and lymphatic microvessels; interstitial edema of all intestinal wall layers; dilatation of the intestinal lumen; damage to the absorptive epithelium of villi with thinning of the brush border, and hyperfunction of mucous (goblet) cells. The use of the peptide after surgery increased the survival rate of animals by 24% and provided a smaller dilatation of the intestinal lumen in some animals. In other animals, the lumen recovered. The shape of intestinal villi and distribution of goblet cells were restored. Signs of intracellular and intermuscular edema were absent. Moderate venular congestion was noticed. Conclusion. Using the lymphatic stimulator in surgical treatment of intestinal obstruction increases the survival rate of animals by 24% compared to the control, facilitates earlier restoration of the small intestine structure and function. The obtained results indicated the effectiveness of lymphatic stimulation in intestinal surgery.

scholarly journals RARE CASE OF SHORT BOWEL SYNDROME

2019 ◽  
Vol 49 ◽  
pp. 6-8
Author(s):  
Azmaiparashvili G. აზმაიფარაშვილი გ. ◽  
Tomadze G. თომაძე გ. ◽  
Megreladze A. მეგრელაძე ა.
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Rare Case ◽  
Postoperative Management ◽  
Hepatic Flexure ◽  
Postoperative Treatment ◽  
Extensive Resection ◽  
Short Bowel

Short bowel syndrome is characterized by malabsorption following extensive resection of the small bowel. It may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel remains.  Successful postoperative management of short bowel syndrome has been discussed. Patient was operated because of cancer of hepatic flexure of large bowel with invasion in stomach, pancreas, retroperitoneal space, mesentery of small bowel. Right sided colectomy and excessive resection of small bowel with limphodissection was performed and only 80 cm of small bowel was left together with the left part of the colon. Ileotransversoanastomosis was performed. After the adequate course of chemotherapy and partial parenteral nutrition patient’s general condition became satisfactory. Patient started to gain weight. Adequate postoperative treatment determined postoperative period without surgical and nutritional complication.

scholarly journals Modern aspects of surgical treatment of patients with adhesive small bowel obstruction

2021 ◽  
Vol 12 (4) ◽  
pp. 47-54
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Sergey V. Petrov ◽  
Diyora H. Qalandarova
Keyword(s):  
Small Intestine ◽  
Surgical Treatment ◽  
Small Bowel ◽  
Mortality Rate ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Diagnostic Algorithm ◽  
Diagnostic Methods ◽  
Adhesive Small Bowel Obstruction ◽  
Surgical Interventions

Despite the ongoing preventive measures aimed at reducing the formation of adhesions in the abdominal cavity with an increase in the number of surgical interventions on the abdominal organs, the number of patients admitted to surgical hospitals with adhesions of the small intestine is also increasing. It should be noted that annually about 12% of previously operated patients undergo treatment in surgical departments while the exceptional fact is that 5070% are patients with acute adhesive ileus of the small intestine and the mortality rate in this group ranges from 13 to 55%. In recent years the literature has been actively discussing the advantages of minimally invasive technologies in the treatment of adhesive small bowel obstruction since the use of traditional methods often leads to the development of complications with repeated (in 60% of cases) surgical interventions. The purpose of this study was the development and implementation of an improved therapeutic and diagnostic algorithm in patients with adhesive small bowel obstruction which made it possible to improve the results of treatment. A comparative analysis of 338 patients with adhesive small bowel obstruction who were treated in the surgical departments of the St. Elizabeth Hospital in St. Petersburg in the period from 2016-2019 was carried out. All the patients were divided into 2 groups: the main (I) group (2018-2019), which consisted of 198 patients who received the improved diagnostic and treatment algorithm as well as the comparison group (II) (2016-2017) which included 140 cases these are patients examined according to the standard protocol and operated on in the traditional way. Moreover, in 98 cases, it was possible to resolve acute adhesive small intestinal obstruction in a conservative way, and 240 patients underwent surgical treatment. The developed diagnostic algorithm is based on the consistent application of the most informative diagnostic methods. At the same time the indications and the sequence of their application were established which ultimately made it possible to shorten the preoperative time interval as well as to determine the optimal treatment strategy with the choice of the type of surgical treatment (laparotomy or laparoscopy). The proposed treatment and diagnostic algorithm allowed to reduce the complication rate from 46.5% (53) to 22.2% (28) (р 0,001), and the mortality rate from 14.9% (17) to 3.9% (5) (p 0,01).

Dispersal of Silver Gulls, Larus novaehollandiae Stephens, from Breeding Colonies in South Australia

1985 ◽  
Vol 12 (2) ◽  
pp. 279 ◽  
Author(s):  
JR Ottaway ◽  
R Carrick ◽  
MD Murray
Keyword(s):  
South Australia ◽  
High Status ◽  
Dispersal Patterns ◽  
North West ◽  
Significant Difference ◽  
Rubbish Dumps ◽  
The Difference ◽  
Dispersal Distances ◽  
Almost All ◽  
The City

Dispersal of Larus novaehollandiae Stephens, from 10 colonies in South Australia, was studied during 1968-8 1 by means of bands designed for identification of free-living, uncaptured individuals. Dispersal patterns were characteristic of each colony, even for three colonies which were, at most, 10 km apart. Almost all dispersal records came from the area between Adelaide and Melbourne, and within 30 km of the coast. After breeding, the majority of gulls disperse eastwards; however, dispersal from each colony was correlated with a shift of gull population into areas where food was available from human sources such as rubbish dumps. From colonies 80 km south-east of Adelaide, a major human population, the predominant winter dispersal of these gulls was north-west, into the city and suburbs. The maximum direct-line dispersal distances recorded for 95% of the 3133 resighted gulls were <458 km. The greatest direct-line distance recorded was 1430 km. Overall, there was no significant difference in the mean dispersal distances of juveniles and adults, although at distances >480 km significantly more juveniles (<2y) were seen than adults (>2y). This involved only 2.5% of the total number of birds resighted. It is suggested that older, dominant birds maintain high status at preferred feeding places, and juveniles are possibly more erratic in their movements, as they search for food. This would account for the difference in the dispersal ofjuveniles and adults from a particular colony, and also for the significantly higher proportion of juveniles found at extreme distances from their natal colonies.

scholarly journals Studi Komparasi PHBS Warga Sekolah Dasar Di Kota Dan Di Desa Tahun 2015

2016 ◽  
Vol 5 (2) ◽  
Author(s):  
Athanasia Budi Astuti ◽  
Sunarsih Rahayu ◽  
Sri Mulyanti
Keyword(s):  
Elementary School ◽  
Standard Deviation ◽  
Active Role ◽  
School Life ◽  
Healthy Environment ◽  
Health Community ◽  
Significant Difference ◽  
The Difference ◽  
The Village ◽  
The City

Abstract: PHBS, Resident Of Elementary School. Life Behavior to Clean of Healthy Life (PHBS) will be done to improve the health community. PHBS at school is a group on which was put into practice by the students, teachers and schools community on the basis awareness as learning outcomes so independently to be able to prevent disease, improve their health and play an active role in providing a healthy environment. (Indonesian Ministry of Health, 2007).The aim of the Research is knowing the difference between Elementary School PHBS residents in the City and in the village in 2015. This research is a descriptive comparison. The population of this research is the elementary school in the City and in the village. Sample taken carried out by means purposive sampling. Data Analysis using the tests t independently. The results showed there is a significant difference between elementary school PHBS in the city elementary school with PHBS residents in the village with the p=0,000. Average PHBS respondents elementary school in the city was 35.01 with the standard deviation 6,299, while PHBS elementary school at the village respondents average 30.29 with the standard deviation 7,653. Nurses should work together with the related institution to provide information or health education continually about PHBS in schools.

Pengetahuan dan pelaksanaan Kemahiran Proses Sains (KPS) dalam dalam kalangan guru

2017 ◽  
Vol 7 (1) ◽  
pp. 56-67
Author(s):  
Saniah Sembak ◽  
Norazilawati Abdullah
Keyword(s):  
Science Teachers ◽  
School Teacher ◽  
Secondary Science Teachers ◽  
School Based ◽  
Significant Difference ◽  
Level Of Knowledge ◽  
The Mean ◽  
The Difference ◽  
Manova Analysis ◽  
The City

This study aims to assess the level of knowledge and the implementation of five Integrated Science Process Skills (ISPS) comprising Build hypothesis, control variables, redefinition In operation, interpreting data and experimenting in School Based Assessment (PBS). In addition, this study is to identify the difference between knowledge and implementation of the ISPS gender and school location. The sample consisted of 407 lower secondary science teachers in Melaka and randomly selected from 66 schools. Quantitative data analysis using SPSS version 19. The instrument consists of a questionnaire (Cronbach Alpha 0.884), and Knowledge Test ISPS and implementation checklist ISPS. Descriptive statistics as a whole that the level of knowledge and implementation of ISPS is moderate (Mean = 3.11 and 32.81). MANOVA analysis found no significant difference in terms of the mean scores of Knowledge and implementation between male and female teachers. While the mean score of knowledge Build hypothesis teachers in rural schools, higher and significantly different than the city school teacher. A number of recommendations put forward to improve the knowledge and implementation of the ISPS teachers. This is expected to meet the goals of the Malaysia Education Blueprint 2013-2025 that is to achieve the vision and aspirations of the student’s education system that can meet the needs of the country in the field of science and technology.

Epidemiology and survival of metastatic gastrointestional stromal tumor: A Surveillance, Epidemiology, and End Results (SEER) database review.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 86-86
Author(s):  
Srinath Sundararajan ◽  
Abhijeet Kumar ◽  
Mohammed Nawaf Kanaan ◽  
Haiyan Cui ◽  
Emad Elquza ◽  
...  
Keyword(s):  
Small Intestine ◽  
Primary Tumor ◽  
Stromal Tumor ◽  
Rank Test ◽  
Seer Database ◽  
Female Ratio ◽  
Significant Difference ◽  
Age Of Diagnosis ◽  
The Difference ◽  
Cox Proportional Hazard Regression

86 Background: Metastatic gastrointestinal stromal tumor (MGIST) is a rare disease with limited data available on its epidemiology and survival. We aimed to study the epidemiology and survival pattern of M-GIST by reviewing the Survival, Epidemiology and End Result (SEER) database. Methods: SEER database was reviewed for patients (pts) with histologically confirmed GIST between 2002 and 2007. Variables included were age, race, gender, date of diagnosis (DOD), stage, location of primary tumor, and disease specific survival (DSS). The association between survival and race, gender, and site of disease for metastatic GIST patients was investigated. Primary outcome was 3-year DSS. Survival rate was estimated using the Kaplan–Meier method and the difference in 3-years survival was tested by log-rank test. Cox proportional hazard regression model was employed to test the association between survival and age. Results: A total of 653 patients with MGIST pts were identified and 602 were included for analyses. The distribution of MGIST according to primary site was as follows: gastric (42%), small intestine (26.2%), colorectal (4.6%), peritoneal (4.5%), NOS (17%) and other sites (5.9%). The mean age of diagnosis was 61 years. Caucasians to African-American (AA) ratio was 3.5:1 and male to female ratio was 1.3:1. Three-year DSS was 56.5% for Caucasians compared to 62.9% in AA (p = 0.25). Three-year DSS was 57.8% for males compared to 58.6% in females (p = 0.88). Small intestine MGIST had the best 3-Year DSS of 73.8% compared to gastric MGIST, which had a 3-year DSS of 50.7%(p < 0.0001). Peritoneal MGIST had the worst prognosis with 3-year DSS of 34.4%. Conclusions: MGIST had significant difference in survival based on the location of primary tumor. In contrary to the findings of previous studies, small intestine MGIST had superior 3-year DSS compared gastric primary M-GIST. There was no statistically significant difference in survival based on gender or race. [Table: see text]

scholarly journals Preventive effect of ursodeoxycholic acid on parenteral nutrition-associated liver disease in infants

2014 ◽  
Vol 142 (3-4) ◽  
pp. 184-188 ◽  
Author(s):  
Dusica Simic ◽  
Irina Milojevic ◽  
Dragana Bogicevic ◽  
Miodrag Milenovic ◽  
Vladimir Radlovic ◽  
...  
Keyword(s):  
Birth Weight ◽  
Parenteral Nutrition ◽  
Ursodeoxycholic Acid ◽  
Average Duration ◽  
Surgical Patients ◽  
Control Group ◽  
Surgical Patient ◽  
Significant Difference ◽  
The Difference

Introduction. Parenteral nutrition-associated cholestasis is well recognized phenomenon in the term and preterm infant receiving long-term parenteral nutrition. Objectives. The aim of this study was to evaluate the effect of ursodeoxycholic acid (UDCA) use on cholestasis in newborns on prolonged TPN. Methods. A total of 56 infants were enrolled in this retrospective study: control group consisted of lower (1500 g) birth weight infants (n=30), as well as the group of pediatric (n=11) and surgical patients (n=15) treated with UDCA. Blood chemistries were obtained two times weekly. Results. All of 56 newborns developed cholestasis but duration of parenteral nutrition (PN) before onset of cholestasis was significantly longer in UDCA treated patients. Average duration of PN before the onset of cholestasis in control group of patients was 25 days in distinction from treated pediatric and surgical patients (39 and 34 days, respectively). The peak serum conjugated bilirubin (CB), AST, ALT and alkaline phosphatase (AP) levels were significantly lower in the treated groups. There was no significant difference among treated pediatric and surgical patients and between lower and higher birth weight infants considering the CB, ALT, AST and AP peak. Duration of cholestasis was significantly decreased in all treated groups. There was a significant difference in time needed to achieve complete enteral intake between pediatric and surgical patient group. Conclusion. Cholestasis developed significantly later in treated groups than in the controls. UDCA appears to be very successful in reducing the symptoms of cholestasis. The difference in efficacy of UDCA treatment between lower and higher birth weight infants could not be proven.

scholarly journals A Study of Psychological Well-Being of Senior Citizens from Community and Non Community Living

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Suprithy Paliwal ◽  
Neha Singh
Keyword(s):  
Senior Citizens ◽  
Senior Citizen ◽  
Well Being ◽  
Community Living ◽  
Psychological Well Being ◽  
Significant Difference ◽  
Need To Evaluate ◽  
The Difference ◽  
Multiple Challenges ◽  
The City

Rise in the share of elderly in total population of India posses multiple challenges viz., improving their wellbeing through providing family support, medical assistance and social support, reducing their negative aspect of life. There is an increasing interest worldwide in the study of well-being as a means to assess and need to evaluate positive dimensions of health aspects of senior citizens. In a study on the psychological well being of senior citizens residing in community and non community living, the objective was to see the difference in their psychological well being of senior citizens from community and non community living. A sample of 100 senior citizens was taken randomly from different areas in the city of Jaipur, for non community living and the sample for community living was taken from Ashiana Utsav (senior citizen homes).Out of the entire sample 50 were from community living and 50 from non community living and out of them, 25 were males and 25 were females respectively for both the groups. Standardized tool used for the study was Psychological well being scale by Dr. D.S.Sisodia and Pooja Singh. Statistical analysis used was mean, SD and‘t’ test. The results revealed that there was a significant difference in the psychological well being of senior citizens living in community living and non community living. There was also a significant difference between males and females in the different types of housing.

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