scholarly journals Clinical implications of the neurosegmental level of injury in the treatment of hip dislocation and subluxation in children with spina bifida

2016 ◽  
Vol 4 (4) ◽  
pp. 6-11 ◽  
Author(s):  
Alexei G. Baindurashvili ◽  
Stanislav V. Ivanov ◽  
Vladimir M. Kenis
Keyword(s):  
Surgical Treatment ◽  
Spina Bifida ◽  
Pediatric Patients ◽  
Hip Dislocation ◽  
Control Group ◽  
Clinical Implications ◽  
Saint Petersburg ◽  
Hip Stabilization

Background. Hip dislocation and subluxation are common in children with spina bifida.Aim. To determine the influence of the neurosegmental level on surgical treatment of hip dislocation and subluxation in children with spina bifida.Materials and methods. A total of 114 pediatric patients with spina bifida and hip dislocation and subluxation were treated at The Turner Scientific and Research Institute for Children’s Orthopedics (Saint Petersburg, Russia) from 2006 to 2015. The patients were divided into two groups according the Sharrard classification of neurosegmental lesions: a study group of 62 patients who underwent hip stabilization surgery and a control group of 52 patients who did not undergo hip stabilization procedures.Results. For patients with a high neurosegmental level (thoracic and L1-L2), surgical treatment for hip dislocation and subluxation, which included most cases (72%), led to motor deterioration (retrospective study). Of 40 patients with a neurosegmental level of L3-L4 and L5-S1, motor level improved in 13 (32.5%) but deteriorated in 10 (36%) of 28 patients in the control group.Conclusion. Determination of the neurosegmental level enables the prediction of motor level and reveals indication for surgical treatment.

scholarly journals Usage of 0.4% sodium hyaluronate in complex treatment of pediatric patients with dry eye syndrome against the background of allergic diseases of the organ of vision

2021 ◽  
Vol 9 (2) ◽  
pp. 21-24
Author(s):  
L.S. Vasilyeva ◽  
O.V. Nesterenko ◽  
K.A. Rylkova
Keyword(s):  
Anterior Chamber ◽  
Dry Eye ◽  
Pediatric Patients ◽  
Sodium Hyaluronate ◽  
Allergic Diseases ◽  
Dry Eye Syndrome ◽  
Control Group ◽  
Film Rupture ◽  
Topical Glucocorticoids

Background. In recent years, the prevalence of allergic diseases of the anterior chamber of the eye has increased. They are often accompanied by the development of dry eye syndrome, which can complicate their course. Therefore, it is important to take a comprehensive approach to their diagnosis and treatment. The purpose was to study the effectiveness of 0.4% sodium hyaluronate (Gilays) in children with dry eye syndrome on the background of allergic diseases of the conjunctiva. Materials and methods. The study involved 42 patients (84 eyes) aged 3 to 18 years, who were examined and treated on the basis of Regional Eye Clinic. Patients were treated with local H-1 histamine blockers twice a day for 14 days, f necessary — with topical glucocorticoids by the scheme for 12 days. In the first group (21 patients, 42 eyes), the main treatment was added with the drugs containing 0.2% sodium hyaluronate, used topically 4 times a day for 14 days. In the second group (21 patients/42 eyes), 0.4% sodium hyaluronate (Gilays) was added to the treatment regimen. H-1 histamine blockers were not used systemically. Before starting therapy and 2 weeks later, the following values were evaluated: the changes in the anterior chamber of the eye using biomicroscopy, determination of lacrimal film rupture time, Schirmer 1 test, questionnaire. Conclusions. The use of sodium hyaluronate in the complex therapy of dry eye syndrome in allergic eye diseases is quite effective. The use of 0.4% sodium hyaluronate was more effective compared to the control group. It is advisable to use a questionnaire to communicate with the child, but it is necessary to refine the form of questions to eliminate as much as possible the subjectivity of the data.

scholarly journals Cerebrospinal fluid neopterin as a biomarker of neuroinflammatory diseases

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Marta Molero-Luis ◽  
Didac Casas-Alba ◽  
Gabriela Orellana ◽  
Aida Ormazabal ◽  
Cristina Sierra ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Discriminant Analysis ◽  
Bacterial Infections ◽  
Pediatric Patients ◽  
Canonical Discriminant Analysis ◽  
Control Group ◽  
Csf Biomarkers ◽  
Molecular Testing ◽  
Respiratory Pathogens

Abstract The elevation of neopterin in cerebrospinal fluid (CSF) has been reported in several neuroinflammatory disorders. However, it is not expected that neopterin alone can discriminate among different neuroinflammatory etiologies. We conducted an observational retrospective and case–control study to analyze the CSF biomarkers neopterin, total proteins, and leukocytes in a large cohort of pediatric patients with neuroinflammatory disorders. CSF samples from 277 subjects were included and classified into four groups: Viral meningoencephalitis, bacterial meningitis, acquired immune-mediated disorders, and patients with no-immune diseases (control group). CSF neopterin was analyzed with high-performance liquid chromatography. Microbiological diagnosis included bacterial CSF cultures and several specific real-time polymerase chain reactions. Molecular testing for multiple respiratory pathogens was also included. Antibodies against neuronal and glial proteins were tested. Canonical discriminant analysis of the three biomarkers was conducted to establish the best discriminant functions for the classification of the different clinical groups. Model validation was done by biomarker analyses in a new cohort of 95 pediatric patients. CSF neopterin displayed the highest values in the viral and bacterial infection groups. By applying canonical discriminant analysis, it was possible to classify the patients into the different groups. Validation analyses displayed good results for neuropediatric patients with no-immune diseases and for viral meningitis patients, followed by the other groups. This study provides initial evidence of a more efficient approach to promote the timely classification of patients with viral and bacterial infections and acquired autoimmune disorders. Through canonical equations, we have validated a new tool that aids in the early and differential diagnosis of these neuroinflammatory conditions.

scholarly journals ACTUAL ISSUES OF ONCOPLASTIC ORGAN-PRESERVING SURGERY OF BREAST CANCER

2019 ◽  
Vol 178 (5) ◽  
pp. 36-46
Author(s):  
D. A. Ryabchicov ◽  
I. K. Vorotnikov ◽  
I. A. Dudina ◽  
A. M. Kazakov ◽  
D. A. Denchik
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Resection Margins ◽  
The People ◽  
Past Half Century ◽  
New Variant ◽  
Positive Resection Margins ◽  
Medical University

Surgical treatment of breast cancer (BC) has undergone significant changes over the past half century. Oncoplastic operations are a relatively new variant of organ-preserving surgical treatment of breast cancer. Its idea is to combine the principles of oncology and plastic surgery in order to obtain oncological safe and cosmetic acceptable results. Despite the widespread implementation of these operations, high-quality studies on the benefits of oncoplastic operations in comparison with other methods are not enough. Actual issues of breast cancer oncoplastic surgery was considered in this literature review, such as indications for surgery, classification of oncoplastic techniques, determination of positive resection margins, evaluation of recurrence and survival, postoperative complications, cosmetic result.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study (Conclusion of the local Ethics Committee at Northern State Medical University of 08.04.2015, Protocol No. 02/4-15). Author Guidelines contains the detailed information.

STATISTICAL ANALYSIS OF VERATRUM ACUTE POISONINGS DURING 2014-2018 IN MOSCOW, SAINT PETERSBURG, OMSK, CHITA, AND KHANTY-MANSIYSK AUTONOMOUS OKRUG – UGRA

2020 ◽  
pp. 32-37
Author(s):  
E. V. Melnik ◽  
M. V. Belova ◽  
A. N. Lodyagin ◽  
A. V. Sabaev ◽  
B. B. Yatsinyuk ◽  
...  
Keyword(s):  
Russian Federation ◽  
Clinical Symptoms ◽  
Acute Poisoning ◽  
Age Composition ◽  
Saint Petersburg ◽  
Gender And Age ◽  
Icd 10 ◽  
The Russian Federation

Acute hellebore poisoning is characteristic for the Russian Federation because of the use of this plant for the treatment of alcoholism at home. The varying severity of clinical symptoms, which sometimes become lifethreatening, the lack of anamnestic reliable information about the use of hellebore and the difficulties of chemical and toxicological confirmation of its use complicate the diagnosis of acute poisoning, and do not allow timely medical care. In addition, there is no classification of hellebore poisoning in ICD-10, block (T51-T65), which also affects the assessment of the actual frequency of this acute intoxication. The purpose of this work is to clarify the number of acute hellebore poisoning in the Russian Federation. The analysis of medical records of patients hospitalized with acute hellebore poisoning in toxicological departments of a number of subjects of the Russian Federation for 2014 - 2018 was carried out. The dynamics of such acute poisoning over the specified period, the gender and age composition of victims, and the circumstances of poisoning were revealed. The relevance of developing methods of chemical and toxicological analysis for the determination of hellebore alkaloids is confirmed, which will increase the reliability of diagnosis and detection of cases of hellebore poisoning.

The results of surgical treatment of the patients with a cochlear form of otosclerosis

2019 ◽  
Vol 18 (5) ◽  
pp. 46-53
Keyword(s):  
Surgical Treatment ◽  
Bone Conduction ◽  
Functional Results ◽  
Main Group ◽  
Differential Diagnostics ◽  
Control Group ◽  
Efficient Treatment ◽  
And Control

Despite the progress in otosurgery, the efficient treatment of patients with the cochlear form of otosclerosis (according to the classification of N.A. Preobrazhensky, 1962) remains an important task. The authors have developed and implemented an advanced stapedoplasty method, providing the improvement of hearing in this category of patients. and described the methods of differential diagnostics for selection of patients according to the developed method. The article describes in details the early and long-term functional results of surgical treatment of 60 patients with cochlear and mixed II forms of otosclerosis, divided into the main and control groups. The main group is represented by 30 patients who underwent a cartilage-on-vein stapedoplasty according to the improved method. The control group included 30 patients, in which 18 people underwent a cartilage-on-vein stapedoplasty according to the method developed by Lenin Prize winner V. F. Nikitina, and 12 people who underwent V. T. Palchun’s piston stapedoplasty. The results demonstrate a statistically significant improvement of bone conduction in the main group in average by 15–20 dB throughout the entire tone scale (except for high frequencies in some patients) and the complete closure of the bone-air interval with subsequent preservation of the results. Based on the obtained data, the authors present the expediency and perspectivity of implementation of the advanced stapedoplasty method.

New approach to surgical treatment of primary progressive pterygium

2021 ◽  
pp. 13-17
Author(s):  
A.N. Bochkareva ◽  
◽  
O.V. Kolenko ◽  
V.V. Egorov ◽  
G.P. Smoliakova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Disease Index ◽  
Tear Fluid ◽  
Control Group ◽  
Initial Growth ◽  
Ocular Surface Disease Index ◽  
New Approach ◽  
Primary Progressive ◽  
Recurrent Pterygium

Purpose. To evaluate effectiveness of new method of barrier amnioplasty in surgical treatment of primary progressive pterygium. Material and methods. The study included 64 patients (64 eyes) with primary progressive pterygium. All patients were divided into two groups depending on method of barrier amnioplasty. The main group consisted of 32 people (32 eyes) who underwent barrier amnioplasty in the area of initial growth of pterygium. The control group consisted of 32 patients (32 eyes) who underwent barrier amnioplasty in the limbus area. The main criterions for clinical efficacy of surgical treatment of pterygium was dynamics of the wound process, the Ocular Surface Disease Index (OSDI) and the osmolarity of the tear fluid in the compared groups. Also, after 1 year, the frequency of pterygium recurrence was assessed. In addition to standard ophthalmological examinations, special methods were used in the work: determination of the osmolarity of the tear fluid, pH of tears, cytological assessment of the wound process, and also assessed the OSDI. Results. The results of pH-metric, osmometric, cytological studies have provided evidence of the ability of the anatomical and topographic approach described by us to positively influence the course of inflammatory and reparative processes in the operation area, preventing the development of recurrent pterygium and cicatricial deformities. Conclusion. A new effective method of surgical treatment of primary progressive pterygium, including moving the area of the barrier amnioplasty from the limbus area to the area of initial growth of blood vessels of pterygium - the area of the lunate fold, has been developed and introduced into clinical practice. Key words: pterygium, inflammatory and reparative processes, recurrence.

Autoinflation: Historical Highlights and Clinical Implications

1998 ◽  
Vol 77 (9) ◽  
pp. 737-742 ◽  
Author(s):  
Sven-Eric Stangerup
Keyword(s):  
Surgical Treatment ◽  
Otitis Media ◽  
Transient Condition ◽  
Control Group ◽  
Clinical Implications ◽  
Line Treatment ◽  
First Line ◽  
Secretory Otitis Media ◽  
Ventilation Tubes ◽  
First Line Treatment

In 1563, Eustachius first described the tube that came to be named for him. In 1704, Valsalva described the maneuver that bears his name, and in 1836 Deleau became one of the first to advocate infusion of pure air through the eustachian tube using a catheter. Politzer devised his own method for actively inflating the middle ear without using a catheter in 1863. Most modern studies examining the use of autoinflation in the treatment of secretory otitis media have shown a beneficial effect, with effusion being cleared in 52 to 62% of ears up to nine months after the treatment. In two studies, no effect of autoinflation could be demonstrated, and in one publication the autoinflation group had deteriorated compared to the control group. In light of the fact that secretory otitis media is a benign and transient condition, that treatment with antibiotics or insertion of ventilation tubes is not without problems, and that the chance of improving the condition by autoinflation is approximately 50%, it is concluded that autoinflation should be considered first-line treatment, before antibiotic or surgical treatment is planned.

scholarly journals Evaluation of Different Methods Used to Calculate Ideal Body Weight in the Pediatric Population

2019 ◽  
Vol 24 (5) ◽  
pp. 421-430
Author(s):  
Kai Kang ◽  
Randy Absher ◽  
Elizabeth Farrington ◽  
Renee Ackley ◽  
Tsz-Yin So
Keyword(s):  
Body Weight ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Accurate Determination ◽  
Age Groups ◽  
Ideal Body Weight ◽  
Mean Difference ◽  
Ideal Body

OBJECTIVES Accurate determination of ideal body weight (IBW) in pediatric patients is important for the proper dosing of many medications and the classification of nutritional status. There is no consensus on the best method to calculate IBW. The purpose of this study is to evaluate and compare 7 different methods used to calculate IBW in the pediatric population. METHODS This was a retrospective observational study. All subjects were pediatric inpatients at a 536-bed community teaching hospital between January 1, 2016, and June 30, 2017. Subjects were divided into 2 cohorts: cohort 1 was aged 12 months and 0 day to 35 months and 30 days, and cohort 2 was aged 36 months and 0 day to 17 years and 364 days. The McLaren method was used as the reference to compare with 6 other methods: Moore method, Devine method, American Dietetic Association (ADA) method, body mass index (BMI) method, Traub equation, and simplified Traub equation. RESULTS For cohort 1 (n = 347), the Moore method was not statistically different from the McLaren method with a mean difference of −0.07 kg (95% CI: −0.14 to 0.01, p = 0.07). For cohort 2 (n = 1095), the BMI method was not statistically different from the McLaren method with a mean difference of 0.17 kg (95% CI: −0.07 to 0.40, p = 0.17). CONCLUSIONS In both cohorts, the majority of methods used to calculate IBW in pediatric patients leads to statistically different results when compared with the McLaren method. For certain methods, these differences become pronounced at high and low height percentiles and in older age groups.

scholarly journals Immediate results of surgical treatment of peripheral hepatic cholangiocarcinoma in elderly and senile patients

2020 ◽  
Vol 87 (9-10) ◽  
pp. 48-53
Author(s):  
O. Yu. Usenko ◽  
O. V. Hrynenko ◽  
A. І. Zhylenko ◽  
O. O. Popov ◽  
A. V. Husiev
Keyword(s):  
Surgical Treatment ◽  
International Study ◽  
Main Group ◽  
Control Group ◽  
Results Of Treatment ◽  
Peripheral Cholangiocarcinoma ◽  
Acute Pulmonary Thromboembolism ◽  
Clinically Significant ◽  
Selection Of

Objective. To estimate immediate results of surgical treatment of peripheral cholangiocarcinoma in elderly and senile patients. Materials and methods. In 2004-2018 yrs period in the Department of Transplantation and Surgery of the Liver of the Shalimov National Institute of Surgery and Transplantology 84 patients, suffering peripheral cholangiocarcinoma, were radically operated: 31 (36.9%) patients older than 60 yrs (the main Group), and 53 (63.1%) patients, younger than 60 yrs (control Group). Results. Postoperative clinically significant (IIIa-IV degree in accordance to classification of Clavien-Dindo) complications during 90-days of postoperative period were noted in 29.1% patients of the main Group and in 32.1% patients of a control Group (p=0.262), postoperative hepatic insufficiency, in accordance to The International Study Group of Liver Surgery criteria, - in 16.1 and 22.6% accordingly (p=0.473); reoperation was performed in 9.6 and 9.4% patients, accordingly (p=0.973). The causes of postoperative lethality in 2 patients of the main Group were an acute myocardial infarction (1) and an acute pulmonary thromboembolism (1). Conclusion. Hepatic resection is characterized by satisfactory immediate results of treatment of peripheral cholangiocarcinoma in elderly and senile patients, if performed in highly-specialized multidisciplinary centre and thorough selection of patients.

scholarly journals Surgical approaches in the treatment of patients with acute acetabular fractures

2021 ◽  
Vol 27 (5) ◽  
pp. 610-619
Author(s):  
N.V. Zagorodny ◽  
◽  
A.I. Kolesnik ◽  
A.F. Lazarev ◽  
E.I. Solod ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Open Reduction ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Surgical Approaches ◽  
Acetabular Fractures ◽  
Online Library

Abstract. Introduction According to the overwhelming majority of Russian and foreign authors, orthopedic traumatologists have been striving to improve the results of surgical treatment of acetabular (AC) fractures over the past decades. First of all, this is due to an increase in the number and severity of this injury, persisting complications and dissatisfaction of researchers with their own results of surgical treatment. Purpose Study of the rationale used by traumatologists for certain surgical approaches in the treatment of acute acetabular fractures. Materials and methods Literature sources were searched for information in the systems and databases Pubmed, Embase, Scopus, Medline, Cochran Library, eLibrary, Wiley Online Library using the keywords: acetabular fractures, surgical treatment, acetabular approach, open reduction and fixation of acetabular fractures, duration and blood loss, hip arthroplasty. Results The incidence of AC fractures, according to different authors, ranges from 2 to 23.4 %. The cause of this injury is road traffic accidents in up to 83 % of all cases. A significant increase in the number of AC fractures was noted. AC fractures in the vast majority of cases are classified according to AO/ASIF. Displaced AC fractures and multiplanar fractures are subject to surgical treatment. Open reduction and internal fixation still remain the standard treatment for AC fractures. The choice of the surgical approach is carried out more often taking into account the classification of AC fractures, and the type of fracture dictates the choice of approach to the acetabulum. It was found that the authors are forced to use surgical approaches taking into account the fractures of the AC columns. Discussion Adherence of traumatologists to the standards regarding indications for the choice of surgical approaches for complex AC fractures was noted. Surgical approaches for the treatment of two-column acetabular fractures are still often extended and traumatic, prolonged and accompanied by blood loss. Conclusion In the surgical treatment of pelvic and AC fractures, most authors adhere to standards in the choice of approach and fixation of columns and AC fragments. There is unanimity in the recognition of the trauma and "expansion" of the approaches used, accompanied by blood loss reaching up to 2000 ml and more, and the duration of the operation is on average 3 hours 50 minutes. For the surgical treatment of acute AC fractures, the researchers used both classical and modified anterior and posterior surgical approaches with the obligatory consideration of the classification of AC fractures. The rationale for choosing an operative approach, as a rule, was the determination of the type of AC fracture according to the AO/ASIF classification. The most effective approach in the surgical treatment of AC fractures is the combined anterior and posterior approach.

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