scholarly journals Therapeutic tactics in cholelithiasis in children

2020 ◽  
Vol 10 (6) ◽  
pp. 53-57
Author(s):  
Vyacheslav G. Svarich ◽  
Ilya M. Kagantsov ◽  
Violetta A. Svarich
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Gall Bladder ◽  
Research Methods ◽  
Hemolytic Anemia ◽  
Gallstone Disease ◽  
Research Result ◽  
Diagnosis And Treatment ◽  
Subsequent Formation ◽  
Long Time

There are still many questions concerning the choice of tactics for the treatment of cholelithiasis in childhood. For a long time, cholelithiasis traditionally considered a pathology of adults. Accordingly, virtually all research was devoted to the diagnosis and treatment of this pathology in the above group of patients. Purpose of research. Justification of tactics in surgical treatment of cholelithiasis in children. Patients and research methods. The work formed observations on 135 children aged from 2 to 17 years with cholelithiasis. In 70.4% of cases the disease is observed in girls and boys, respectively at 29.6%. 7.8% of patients have children disease arose against the backdrop of hemolytic anemia. One patient, who received urgent indications, had manifestations of mechanical jaundice: an increase in the level of common bilirubin and its direct fraction, pronounced jaundice of the skin. In the second group, 140 children with chronic stoneless cholecystitis were compared. Research result. All patients with cholelithiasis identified different ways deformation in the area of gallbladder duct. One of the major causes of cholelithiasis in children are changes in the gallbladder duct. No patient has ever been found in concretions extrahepatic biliary passages. In patients with chronic stone-free cholecystitis pathology in the area of bladder flow was not found. Conclusion. One of the major causes of gallstone disease in children are changes in the gallbladder duct, that most likely leads to obstruction of outflow of bile from the gall bladder, with the subsequent formation of concrements. Therefore, the conduct of conservative treatment of cholelithiasis in children appear to be ineffective and the method of choice in the treatment of this pathology can be a cholecystectomy.

scholarly journals Post-traumatic coccygodynia: current issues. Review of foreign literature

2021 ◽  
Vol 24 (2) ◽  
pp. 12-20
Author(s):  
Ildar I. Khidiyatov ◽  
Nazhip M. Galimov ◽  
Aitbai A. Gumerov ◽  
Maxim V. Gerasimov
Keyword(s):  
Surgical Treatment ◽  
Radiofrequency Ablation ◽  
Conservative Treatment ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Scientific Publications ◽  
Optimal Method ◽  
Current State ◽  
Post Traumatic ◽  
Conservative And Surgical Treatment

There are no clear clinical recommendations for the diagnosis and treatment of patients with coccygodynia, and there are still debates about the choice of the best method of diagnosis, the effectiveness of blockades, the indications for surgical treatment and the most appropriate method of surgical treatment, and the need for antibiotics. The aim of the study is to evaluate the current state of the problem of diagnosis, conservative and surgical treatment of patients with post-traumatic coccygodynia based on the analysis of scientific publications. Materials and methods. A review of the literature data published on the problem of diagnosis and treatment of patients with post-traumatic coccigodenia is presented. The features of the anatomical structure of the coccyx are considered. Radiation methods for the diagnosis of coccygodynia, publication materials on the evaluation of the effectiveness of conservative and surgical treatment, and methods of surgical treatment of patients with coccygodynia are presented. The indications for surgical treatment and the results of surgical treatment of patients with coccygodenia are considered. Results. In coccygodynia, surgical treatment is indicated only in patients in whom comprehensive conservative treatment, the combined repeated blockades or radiofrequency ablation of the unpaired sympathetic ganglion are ineffective. Surgical treatment should only be carried out after the diagnosis has been precisely established, including the use of modern radiological diagnostic methods such as CT, MRI. The best method of coccyx resection is subperiosteal total proximal coccygectomy according to Key, with antibiotic therapy. The effectiveness of surgical treatment in patients with idiopathic coccygodynia is lower than in post-traumatic coccygodynia. Conclusion. Complex conservative treatment of patients with coccygodynia in most cases leads to recovery. Steroid blockades or radiofrequency ablation of the impair ganglion prove to be effective. Surgical treatment of post-traumatic coccygodynia is indicated only in cases of resistance to complex conservative treatment and ineffectiveness of blockades. The most optimal method of surgical treatment is subperiosteal proximal complete resection of the coccyx against the background of antibiotics.

scholarly journals Clinical care of acanthamoeba keratitis patients

2017 ◽  
Vol 10 (4) ◽  
pp. 24-31 ◽  
Author(s):  
Yelena V Skryabina ◽  
Yuriy S Astakhov ◽  
Yanina S Konenkova ◽  
Tatiana S Varganova ◽  
Vladimir P Petukhov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Care ◽  
Acanthamoeba Keratitis ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
City Hospital ◽  
Visual Functions ◽  
Corneal Confocal Microscopy ◽  
Long Time ◽  
Ophthalmologic Examination

Recently, akanthamoeba keratitis (AK) is seen more and more often in ophthalmological practice. However, today there are no standard guidelines concerning diagnosis and treatment of patients with AK. In the article, the experience in care for such patients is presented. Purpose: to estimate the efficiency of diagnosis and treatment of patients with AK. Materials and methods. Case histories of patients, who received treatment for akanthamoeba keratitis in the Eye Microsurgery Department No. 4, City Ophthalmologic Center of the City Hospital No. 2, from 2011 to 2016, were analyzed. Under observation, there were 25 patients (26 eyes) with akanthamoeba keratitis aged from 18 to 77 years; there were 15 men and 10 women. Patients were observed during 1 year. Full ophthalmologic examination was conducted in all patients. Additional diagnostic methods included microbiological investigation of corneal scrapes and washings, culturing them on innutritious agar (with E. сoli covering), confocal corneal microscopy (HRT 3 with cornea module, Heidelberg Retina Tomograph Rostock Cornea Module). A superficial punctate keratits (AK stage 2) was found in one patient. All other patients were divided into two groups. Stromal ring-shaped keratitis was diagnosed in patients of the first group (7 patients, AK stage 3). The 2nd group consisted of 17 patients with corneal ulcer (AK stage 4). All patients received medicamentous treatment. However patients of the 2nd group required different kinds of surgical treatment. Results. In AK diagnosis, corneal confocal microscopy is the most informative method. In patients with AK stages 2 and 3, there was an improvement in visual functions as a result of medicamentous therapy. As a result of treatment at the discharge from the hospital, the best corrected visual acuity was 0.5-1.0 for most patients. In the 2nd group patients, who were subjects to different types of surgical treatment visual functions stabilized. However non-compliance with recommendations led to disease recurrences with worse outcomes in four cases. Conclusion. It is possible to stop the inflammatory process preserving at the same time high visual functions only when patients are addressed in time, and when appropriate AK therapy is prescribed and patients are compliant with it for a long time. (For citation: Skryabina YeV, Yu.S. Astakhov YuS, Konenkova YaS, et al. Clinical care of acanthamoeba keratitis patients. Ophthalmology Journal. 2017;10(4):24-31. doi: 10.17816/OV10424-31).

Síndrome da Anca de Ressalto

2018 ◽  
Vol 9 (1) ◽  
pp. 8
Author(s):  
Bernardo Almeida
Keyword(s):  
Surgical Treatment ◽  
Hip Joint ◽  
Scientific Literature ◽  
Therapeutic Targets ◽  
Clinical History ◽  
Disease Diagnosis ◽  
Diagnosis And Treatment ◽  
Snapping Hip ◽  
Predominant Symptom ◽  
Snapping Hip Syndrome

Snapping hip syndrome is a condition in which the predominant symptom is the snapping feelingaround the hip joint caused by a dynamic impingement between muscles or tendons and boneprominences. The etiology of the snapping hip types and consequently the therapeutic targets havebeen subjects of discussion and controversy along the years. A careful clinical history and physicalexamination is frequently enough for this disease diagnosis. Treatment is typically conservative,however when it is not successful surgical treatment is indicated, consisting on the snapping muscleor tendons lengthening. The authors review in this paper the current scientific literature about functionalanatomy, physiopathology, symptoms, diagnosis and treatment of snapping hip.

Chemical Ablation in Adenoid Surgery

2018 ◽  
Vol 69 (10) ◽  
pp. 2722-2724
Author(s):  
Teodora Ioana Ghindea ◽  
Alexandru Dumitras Meius ◽  
Dragos Cristian Stefanescu ◽  
Catalina Pietrosanu ◽  
Irina Ionita ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Chronic Inflammation ◽  
Lymphatic Tissue ◽  
Tissue Mass ◽  
Surgical Method ◽  
Endoscopic Control ◽  
Chemical Ablation ◽  
Pharyngeal Tonsil

The pharyngeal tonsil is a lymphatic tissue mass located in the roof of the nasopharynx. The function of the pharyngeal tonsil is to prevent infections with the help of antibodies. Chronic inflammation and allergies lead to hyperplasia of the adenoids that is found almost exclusively in children. The treatment of choice is surgical treatment; conservative treatment is only indicated preoperatively or if surgery is contraindicated. In this paper, we will present a new surgical method for adenoidectomy performed trans-orally with coblation, under endoscopic control.

scholarly journals Efficacy and safety of condylectomy with minimally invasive surgery in the treatment of interdigital corns of the lesser toes compared to conservative treatment

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Luis M. Marti-Martinez ◽  
Rubén Lorca-Gutierrez ◽  
Salvador Pedro Sánchez-Pérez ◽  
Jonatan Garcia-Campos ◽  
Nadia Fernández Ehrling ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Minimally Invasive ◽  
Functional Status ◽  
Invasive Surgery ◽  
Joint Stiffness ◽  
Efficacy And Safety ◽  
Clinical And Functional Status

Abstract Background Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes. Methods This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for more than a year, with one or more recurrences in the last year following conservative treatments were eligible. The recruited patients were classified according to their treatment: conservative or surgical (condylectomy with MIS) and were compared. Patient satisfaction, pain, the clinical and functional status of the foot and the appearance of sequelae were assessed at 3 and 6 months after treatment. Results At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p <  0.001). They also improved clinical and functional status of the foot, reaching values comparable to those of the standard population. No paresthesia, joint stiffness or instability, toe malalignment, or corn transfer to a contiguous site resulted from the surgical treatment. Conclusions Condylectomy with MIS is effective and safe to treat interdigital corns of the lesser toes.

scholarly journals The long-term course of fatigue following breast cancer diagnosis

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Karin Biering ◽  
Morten Frydenberg ◽  
Helle Pappot ◽  
Niels Henrik Hjollund
Keyword(s):  
Breast Cancer ◽  
Time Course ◽  
Breast Cancer Diagnosis ◽  
Patient Characteristics ◽  
Repeated Measurements ◽  
Diagnosis And Treatment ◽  
Persistent Problem ◽  
Treatment Regimens ◽  
Long Time

Abstract Purpose Fatigue following breast cancer is a well-known problem, with both high and persistent prevalence. Previous studies suffer from lack of repeated measurements, late recruitment and short periods of follow-up. The course of fatigue from diagnosis and treatment to the long-time outcome status is unknown as well as differences in the level of fatigue between treatment regimens. The purpose of this study was to describe the long-time course of fatigue from the time of clinical suspicion of breast cancer, its dependence of patient characteristics and treatment regimens and the comparison with the course of fatigue among women with the same suspicion, but not diagnosed with breast cancer. Methods Three hundred thirty-two women referred to acute or subacute mammography was followed with questionnaires from before the mammography and up to 1500 days. Fatigue was measured by the Multidimensional Fatigue Inventory (MFI-20). The women reported their initial level of fatigue before the mammography and thus without knowledge of whether they had cancer or not. Both women with and without cancer were followed. Women with cancer were identified in the clinical database established by Danish Breast Cancer Cooperative Group (DBCG) to collect information on treatment regimen. Results Compared to fatigue scores before diagnosis, women with breast cancer reported a large increase of fatigue, especially in the first 6 months, followed by a slow decrease over time. Despite the long follow-up period, the women with breast cancer did not return to their level of fatigue at time of the mammography. Women without breast cancer, experienced a rapid decrease of fatigue after disproval of diagnosis followed by a steadier period. Conclusions Fatigue is a persistent problem in women diagnosed with breast cancer, even several years following diagnosis and treatment. The women with breast cancer were most affected by fatigue in the first 6 months after diagnosis.

scholarly journals Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Normal Weight ◽  
Medical Community ◽  
Overweight Children ◽  
Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

Surgical treatment of acute abscesses and gangrene of the lungs

1982 ◽  
Vol 63 (1) ◽  
pp. 28-31
Author(s):  
E. A. Wagner ◽  
V. M. Subbotin ◽  
V. D. Firsov ◽  
V. A. Cherkasov ◽  
V. I. Ilchishin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Surgical Interventions

Abstract. The experience of treating 263 patients with acute abscesses and lung gangrene is generalized. Acute abscesses are mainly subject to conservative treatment; surgical interventions were performed in 13%. With gangrene of the lung, conservative treatment and palliative operations are futile. Preference is given to early radical operations performed before dangerous complications occur. Possible ways to reduce mortality in acute pulmonary suppuration are indicated.

Features of surgical treatment of Brown's syndrome in children

2021 ◽  
pp. 11-16
Author(s):  
N.A. Malinovskaya ◽  
◽  
E.V. Semyonova ◽  
A. Toriya ◽  
P.A. Nikonorova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Binocular Vision ◽  
Rectus Muscle ◽  
Oblique Muscle ◽  
Double Vision ◽  
Inferior Rectus ◽  
Inferior Oblique Muscle ◽  
Straight Position ◽  
Third Stage

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.

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