scholarly journals Exceptional case of surgical treatment of huge inguinal hernia at the woman

2019 ◽  
Vol 21 (2) ◽  
pp. 52-57
Author(s):  
I A Solovyov ◽  
D V Cherkashin ◽  
M V Vasilchenko ◽  
B B Bromberg ◽  
O V Balyura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inguinal Hernia ◽  
Postoperative Period ◽  
Clinical Case ◽  
Exceptional Case ◽  
Self Service ◽  
Surgical Tactics ◽  
The Right ◽  
First Time

Despite significant progress in a health care system the started cases of huge inguinal hernias still meet. For successful treatment of such patients objective diagnostics, preoperative preparation, the choice of suitable tactics of surgery and treatment in the postoperative period is important. The clinical case of treatment by not reducible huge inguinal hernia at the patient of 73 years is presented in article. The patient showed complaints to presence of the big sizes of the hernia in the bottom of a stomach limiting movement of the patient and self-service reducing quality of life. For the first time hernial protrusion in inguinal area has appeared in 2008 which gradually increased in sizes. Since 2015 I have noted the intensive growth of hernia. I didn’t ask for medical care. To clinic it is brought by an ambulance crew with the diagnosis of The Restrained Inguinal Hernia direction. At the time of survey data for infringement weren’t. After comprehensive examination to the patient surgery in volume has been executed: a gryzhesecheniye on the right, plasticity across Liechtenstein. The postoperative period proceeded without complications. The patient is written out for the 13th days after operation. Extremely exceptional clinical case, the choice of adequate stage-by-stage preoperative inspection and treatment, optimum surgical tactics and postoperative kuration is shown. The chosen approach led to prevention of development of a cascade of the complications including a compartment syndrome, to elimination of cosmetic defect and restoration of quality of life.

scholarly journals The surgical procedure for esophagogastric junction cancer — discussing the tactics

2020 ◽  
Vol 10 (4) ◽  
pp. 109-114
Author(s):  
Roman V. Ischenko ◽  
Rostislav V. Pavlov ◽  
O. A. Kuznetsova
Keyword(s):  
Quality Of Life ◽  
Lymph Nodes ◽  
Esophagogastric Junction ◽  
Resection Margins ◽  
Gastric Stump ◽  
Esophagogastric Junction Cancer ◽  
Surgical Tactics ◽  
The Right ◽  
Lesser Curvature

Introduction. Currently, there is no standardized surgical tactics for the esophagogastric junction cancer treatment. The issues of the resection margin, volume of lymphodissection and the optimal size of the gastric stump are still being discussed. This article analyzes the influence of these parameters on the recurrence-free survival and postoperative quality of life for patients, according to the literature data. Objective. Analysis of the treatment outcomes for patients with esophagogastric junction cancer, depending on the surgical tactics. Materials and Methods. The article analyzes the literature data evaluating various approaches in the surgical treatment of esophagogastric junction cancer. We present an example (from the Yasuyuki Seto study) of a patient with proximal gastric adenocarcinoma with a depth of T3 invasion and the surgical tactics regarding the size of the gastric stump. a A great advantage of the resection margin located at 2 cm from the proximal margin and at 5 cm from the distal margin has been shown. According to the results of our own observations, a patient with proximal gastric adenocarcinoma with an invasion depth of T3 underwent a resection with the proximal and distal resection margins of 13 and 65 mm, respectively. Negative resection margins were diagnosed intraoperatively. The patient's recurrence -free survival was 6 years. A total gastrectomy or esophagectomy are not the operations of choice because of the worsening of the patient's quality of life. When analyzing the depth of invasion according to the literature data, it has been found that an invasion in the esophagus of more than 30 mm is associated with an increased risk of metastatic lymph nodes of the superior and middle mediastinum. With a gastric invasion length of more than 40 mm, lymph nodes of lesser curvature along the right gastric artery are affected. According to the literature, a gastric stump with the size of more than two-thirds of the organ size was favorable in terms of the postoperative quality of life. Many authors indicate the positive effect of maintaining the gastroesophageal sphincter and cardia of the stomach. In the study by Yasuyuki Seto, proximal gastric resection was applied only if it was possible to maintain more than 12 cm in the small curvature and 25 cm in the large curvature. Conclusion. When choosing the surgical tactics for the esophagogastric junction cancer, one needs to focus on the patient's quality of life after the surgery. It is necessary to achieve negative resection margins in each case. The resection margins should be more than 2 and 5 cm for the proximal and distal margins, respectively. Dissection of the lymph nodes of the middle and superior mediastinum should be carried out with invasion of the tumor into the esophagus by more than 30 mm, removal of the lymph nodes of the lesser curvature of the stomach along the right gastric artery must be carried out if the tumor invasion into stomach is more than 40 mm. It is optimal to keep the gastric stump equal to two-thirds of the size of the organ. The issue of the surgical tactics in cancer of the esophageal-gastric transition is of great practical importance and requires a further study.

DESCRIPTION OF THE CASE OF METACHRONOUS CANCER OF THE CERVICAL ESOPHAGUS AFTER EXTIRPATION OF THE ESOPHAGUS WITH PRE-STERNUM ESOPHAGOPLASTY BY THE RIGHT HALF OF THE COLON

2018 ◽  
Vol 64 (2) ◽  
pp. 249-252
Author(s):  
Oleg Kit ◽  
Yevgeniy Kolesnikov ◽  
Aleksey Maksimov ◽  
Aleksandr Snezhko ◽  
Mikhail Averkin
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Metachronous Cancer ◽  
High Quality ◽  
Individual Approach ◽  
Patients With Cancer ◽  
Metachronous Tumor ◽  
Surgical Tactics ◽  
The Right

Repeated development of a metachronous tumor in the esophagus resected because of cancer is usually observed in later periods. The period of time between the plasticity of the esophagus and the appearance of tumor can reach several tens of years. Optimal for patients with cancer of their own esophagus after esophagoplasty is early and radical surgical treatment with an individual approach to choosing surgical tactics to achieve the possible high quality of life.

Combined Extended High Spinal Anesthesia and Endotracheal Narcosis: a Clinical Case

2019 ◽  
Vol 4 (2) ◽  
pp. 152-154
Author(s):  
A. B. Yakushevsky ◽  
A. N. Plekhanov ◽  
A. B. Ayusheev
Keyword(s):  
Abdominal Surgery ◽  
Spinal Anesthesia ◽  
Postoperative Period ◽  
Initial Dose ◽  
Clinical Case ◽  
Central Hemodynamics ◽  
Narcotic Analgesics ◽  
Spinal Catheter ◽  
The Right ◽  
Endotracheal Anesthesia

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

Resveratrol: A new potential therapeutic agent for melanoma?

2019 ◽  
Vol 26 ◽  
Author(s):  
Mohamad Hossein Pourhanifeh ◽  
Kazem Abbaszadeh-Goudarzi ◽  
Mohammad Goodarzi ◽  
Sara G.M. Piccirillo ◽  
Alimohammad Shafiee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Therapeutic Agent ◽  
Current Knowledge ◽  
Treatment Resistance ◽  
Anti Cancer ◽  
Apoptosis Inducer ◽  
Life Threatening ◽  
First Time

: Melanoma is the most life-threatening and aggressive class of skin malignancies. The incidence of melanoma has steadily increased. Metastatic melanoma is greatly resistant to standard anti-melanomatreatments such as chemotherapy, and 5-year survival rate of cases with melanoma who have metastatic form of disease is less than 10%. The contributing role of apoptosis, angiogenesis and autophagy in the pathophysiology of melanoma has been previously demonstrated. Thus, it is extremely urgent to search for complementary therapeutic approachesthat couldenhance the quality of life of subjects and reduce treatment resistance and adverse effects. Resveratrol, known as a polyphenol component present in grapes and some plants, has anti-cancer properties due to its function as an apoptosis inducer in tumor cells, and anti-angiogenic agent to prevent metastasis. However, more clinical trials should be conducted to prove resveratrol efficacy. : Herein, for first time, we summarize current knowledge of anti-cancerous activities of resveratrol in melanoma.

scholarly journals Evaluation of the efficacy of hearing aids in older adults: a multiparametric longitudinal study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Domenico Cuda ◽  
Sara Ghiselli ◽  
Alessandra Murri
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Speech Perception ◽  
Hearing Aids ◽  
Assessment Tools ◽  
Elderly Subjects ◽  
Single Subject ◽  
Measurement Tools ◽  
First Time

Abstract Background Prevalence of hearing loss increases with age. Its estimated prevalence is 40–50 % in people over 75 years of age. Recent studies agree that declinein hearing threshold contribute to deterioration in sociality, sensitivity, cognition, and quality of life for elderly subjects. The aim of the study presented in this paper is to verify whether or not rehabilitation using first time applied Hearing Aids (HA) in a cohort of old people with hearing impairment improves both speech perception in a noisy environment over time and the overall health-related quality of life. Methods The monocentric, prospective, repeated measurements, single-subject, clinical observational study is to recruit 100 older adults, first-time HA recipients (≥ 65 years).The evaluation protocol is designed to analyze changes in specific measurement tools a year after the first HA usage in comparison with the evaluation before HA fitting. Evaluations will consist of multiparametric details collected through self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in speech perception in noise to be used is the Italian version of Oldenburg Satz (OLSA) test whereas the indicator of changes in overall quality of life will be the Assessment of Quality of Life (AQoL) and Hearing Handicap Inventory for the Elderly (HHIE) questionnaires. The Montreal Cognitive Assessment (MoCA) will help in screening the cognitive state of the subjects. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare the effects of HA rehabilitation in the older adults immediately before first HA usage (Pre) and after 1 year of experience (Post). This broad approach will lead to a greater understanding of how useful hearing influences the quality of life in older individuals, and therefore improves potentials for healthy aging. The data is to be analyzed by using an intrasubject endpoint comparison. Outcomes will be described and analyzed in detail. Trial registration This research was retrospectively registered underno. NCT04333043at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.

Advantages of a mini right axillary thoracotomy for congenital heart defect repair in children

2021 ◽  
pp. 1-6
Author(s):  
Jannika Dodge-Khatami ◽  
Ali Dodge-Khatami
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Global Health ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Median Sternotomy ◽  
Axillary Approach ◽  
Post Operative Pain ◽  
The Right

Abstract Objectives: The mini right axillary thoracotomy is an alternative surgical approach to repair certain congenital heart defects. Quality-of-life metrics and clinical outcomes in children undergoing either the right axillary approach or median sternotomy were compared. Methods: Patients undergoing either approach for the same defects between 2018 and 2020 were included. Demographic details, operative data, and outcomes were compared between both groups. An abbreviated quality of life questionnaire based on the Infant/Toddler/Child Health Questionnaires focused on the patient’s global health, physical activity, and pain/discomfort was administered to all parents/guardians within two post-operative years. Results: Eighty-seven infants and children underwent surgical repair (right axillary thoracotomy, n = 54; sternotomy, n = 33) during the study period. There were no mortalities in either group. The right axillary thoracotomy group experienced significantly decreased red blood cell transfusion, intubation, intensive care, and hospital durations, and earlier chest tube removal. Up to 1 month, parents’ perception of their child’s degree and frequency of post-operative pain was significantly less after the right axillary thoracotomy approach. No difference was found in the patient’s global health or physical activity limitations beyond a month between the two groups. Conclusions: With the mini right axillary approach, surrogates of faster clinical recovery and hospital discharge were noted, with a significantly less perceived degree and frequency of post-operative pain initially, but without the quality of life differences at last follow-up. While providing obvious cosmetic advantages, the minimally invasive right axillary thoracotomy approach for the surgical repair of certain congenital heart lesions is a safe alternative to median sternotomy.

scholarly journals Quality of life in patients at first time visit for sleep disorders of breathing at a sleep centre

2013 ◽  
Vol 11 (1) ◽  
pp. 207 ◽  
Author(s):  
Serena Iacono Isidoro ◽  
Adriana Salvaggio ◽  
Anna Lo Bue ◽  
Salvatore Romano ◽  
Oreste Marrone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Sleep Disorders ◽  
First Time
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