scholarly journals Problemy lecheniya patsientov s morbidnym ozhireniem

2011 ◽  
Vol 8 (1) ◽  
pp. 57-66 ◽  
Author(s):  
E G Starostina
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Surgical Intervention ◽  
Surgical Interventions ◽  
Patient Dissatisfaction ◽  
Treatment And Prevention ◽  
High Prevalence ◽  
Selection Of Patients ◽  
Selection Of

The article describes evidence-based approaches to treatment of morbid obesity, including surgical interventions designated for bodyweight reduction and provides comparative analysis of efficacy and safety of lifestyle interventions, medical treatment and various types of bariatric surgery. Detailed description of diagnosis, treatment and prevention of post-surgical vitamin and mineral deficiencies is given. Special attention is paid to high prevalence of mental disorders in patients with morbid obesity, their role in its development, their influence on outcomes of surgical intervention and potential patient dissatisfaction with its results. Necessity of thorough selection of patients for bariatric surgery is emphasized, with assessment of their mental state and proper organization of subsequent life-long follow-up after operation

scholarly journals The Long-Term Follow-Up of Patients with Cystine Stones: A Single-Center Experience for 13 Years

2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Median Number ◽  
Small Sample ◽  
Age At Diagnosis ◽  
Surgical Interventions ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Cystine Stones

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.

scholarly journals Active surveillance in patients with a PSA >10 ng/mL

2014 ◽  
Vol 8 (9-10) ◽  
pp. 702 ◽  
Author(s):  
Paul Toren ◽  
Lih-Ming Wong ◽  
Narhari Timilshina ◽  
Shabbir Alibhai ◽  
John Trachtenberg ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Specific Antigen ◽  
Sufficient Evidence ◽  
Hazard Ratios ◽  
Diagnostic Biopsy ◽  
Selection Of Patients ◽  
Baseline Psa ◽  
Selection Of

Introduction: The use of prostate-specific antigen (PSA) in active surveillance (AS) for prostate cancer is controversial. Some consider it an unreliable marker and others as sufficient evidence to exclude patients from AS. We analyzed our cohort of AS patients with a PSA over 10 ng/mL.Methods: We included patients who had clinical T1c–T2a Gleason ≤6 disease, and ≤3 positive cores with ≤50% core involvement at diagnostic biopsy and ≥2 total biopsies. Patients were divided into 3 groups: (1) those with baseline PSA >10 ng/mL, (2) those with a PSA rise >10 ng/mL during follow-up; and (3) those with a PSA <10 ng/mL throughout AS. Adverse histology was defined as biopsy parameters exceeding the entry criteria limits. We further compared this cohort to a concurrent institutional cohort with equal biopsy parameters treated with immediate radical prostatectomy.Results: Our cohort included 698 patients with a median follow-up of 46.2 months. In total, 82 patients had a baseline PSA >10 ng/mL and 157 had a PSA rise >10 ng/mL during surveillance. No difference in adverse histology incidence was detected between groups (p = 0.3). Patients with a PSA greater than 10 were older and had higher prostate volumes. Hazard ratios for groups with a PSA >10 were protective against adverse histology. Larger prostate volume and minimal core involvement appear as factors related to this successful selection of patients to be treated with AS.Conclusion: These results suggest that a strict cut-off PSA value for all AS patients is unwarranted and may result in overtreatment. Though lacking long-term data and validation, AS appears safe in select patients with a PSA >10 ng/mL and low volume Gleason 6 disease.

Upfront cytoreductive surgery versus neoadjuvant chemotherapy in advanced epithelial ovarian cancer in Indian patients

2021 ◽  
Author(s):  
Mukur Dipi Ray ◽  
Suryanarayana S.V. Deo ◽  
Lalit Kumar ◽  
Manish Kumar Gaur
Keyword(s):  
Ovarian Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Ovarian Carcinoma ◽  
Cytoreductive Surgery ◽  
Advanced Ovarian Cancer ◽  
Advanced Stages ◽  
Selection For ◽  
Selection Of Patients ◽  
Selection Of

In cases of ovarian carcinoma, primary cytoreductive surgery (CRS) is the standard treatment up to stage IIIB, but patient selection for neoadjuvant chemotherapy (NACT) in selected cases is controversial. A total of 200 patients with advanced ovarian cancer were analyzed retrospectively, according to specific selection criteria. Primary CRS was performed in 95 patients (47.5%) and interval CRS after 3–6 cycles of NACT was performed in 105 patients (52.5%). After median follow-up of 35 months, 5-year overall survival was 53.7% in the upfront CRS group and 42.2% in the NACT group. Primary CRS is the standard in advanced stages of ovarian carcinoma, but in certain subset of patients, NACT is preferred. Identifying that group is challenging but feasible. Proper selection of patients is key to successful outcomes.

Selection of patients with breast cancer for routine follow-up bone scans

1990 ◽  
Vol 2 (6) ◽  
pp. 328-332 ◽  
Author(s):  
R.E. Coleman ◽  
I. Fogelman ◽  
F. Habibollahi ◽  
W.R.S. North ◽  
R.D. Rubens
Keyword(s):  
Breast Cancer ◽  
Bone Scans ◽  
Selection Of Patients ◽  
Selection Of

Endoscopic Treatment of Subglottic and Tracheal Stenosis by Radial Laser Incision and Dilation

1987 ◽  
Vol 96 (6) ◽  
pp. 661-664 ◽  
Author(s):  
Stanley M. Shapshay ◽  
Roger L. Hybels ◽  
John F. Beamis ◽  
R. Kirk Bohigian
Keyword(s):  
Carbon Dioxide ◽  
Tracheal Stenosis ◽  
Endoscopic Treatment ◽  
Mechanical Trauma ◽  
Careful Selection ◽  
Tracheal Collapse ◽  
Laser Incision ◽  
Selection Of Patients ◽  
Selection Of

Five patients with severe fibrous subglottic and tracheal stenosis were treated by endoscopic radial laser incision and dilation using both carbon dioxide and neodymium:yttrium aluminum garnet lasers. Good results were noted without complications in all patients in a follow-up period of at least 1 year. Careful selection of patients, excluding those with tracheal collapse or tracheomalacia, and preservation of tracheal epithelium with minimal heat and mechanical trauma are considered essential for good results.

Guided Growth Technique for Correction of Lower Extremity Deformities in Children

2013 ◽  
Vol 20 (4) ◽  
pp. 50-55
Author(s):  
V. M Kenis ◽  
I. Yu Klychkova ◽  
E. V Mel’nichenko ◽  
S. V Ivanov ◽  
A. V Sapogovskiy
Keyword(s):  
Surgical Intervention ◽  
Skeletal Maturity ◽  
Neuromuscular Disorders ◽  
Valgus Knee ◽  
Guided Growth ◽  
Growth Technique ◽  
Systemic Pathology ◽  
Simultaneous Intervention ◽  
Selection Of Patients ◽  
Selection Of

Guided growth technique with temporary epiphysiodesis is used for the correction of lower extremities axial deformities in children before skeletal maturity. From 2009 to 2013 one hundred fifty epiphysiodesis procedures were performed in 93 children aged 3–15 years. Technique was performed both in patients with idiopathic deformities and in patients with severe systemic pathology (skeletal dysplasias, neuromuscular disorders, metabolic nephropathies). Treatment results were assessed at terms from 12 to 48 months after surgical intervention. Good results were achieved in 67 (72%), satisfactory — in 18 (19.3) and poor — in 8 (8.6%) patients. Mean rate of correction made up 0.81±0.17° per 1 month of epiphyseodesis with its maximum in valgus knee and ankle deformities. Advantages of the procedure included low invasiveness and simplicity of performance, low complication rate, possibility of simultaneous intervention on several levels as well as combination with other interventions. Thorough selection of patients, proper intervention technique and regular postoperative followup enable to avoid complications and unsatisfactory results.

Six-Months, Fixed-Term, Once Weekly Psychotherapy: A Report on 20 Cases with Follow-ups

1972 ◽  
Vol 121 (563) ◽  
pp. 425-435 ◽  
Author(s):  
Harold Stewart
Keyword(s):  
Mode Of Action ◽  
Brief Psychotherapy ◽  
Maximum Period ◽  
Therapeutic Results ◽  
Psychotherapeutic Techniques ◽  
Selection Of Patients ◽  
Selection Of

The difficulties in providing adequate psychotherapy facilities in the N.H.S. are well known, and various psychotherapeutic techniques have been used to try to cope with them. Of these the most important have been variants of group and brief psychotherapy, and it is with the latter that this paper is concerned. The technique I have used in this series is to offer patients once-weekly psychotherapy for a maximum period of 6 months and then to terminate no matter what progress has been made, the patient having been informed of these conditions from the start. In this paper I shall consider the criteria used in the selection of patients, the technique and probable mode of action, a brief account of the cases with the therapeutic results obtained, and the follow-up on these cases.

The Psychiatric Consultation Patient

1970 ◽  
Vol 1 (3) ◽  
pp. 251-257 ◽  
Author(s):  
John J. Schwab ◽  
Helga Kuch
Keyword(s):  
Emotional Distress ◽  
Prevalence Rate ◽  
Psychiatric Services ◽  
Surgical Patients ◽  
Psychiatric Consultation ◽  
General Hospitals ◽  
High Prevalence ◽  
Important Challenge ◽  
Selection Of Patients ◽  
Selection Of

Growing numbers of psychiatric services in general hospitals emphasize the importance of psychiatric consultation as part of comprehensive medical care. The literature supports the high prevalence rate of emotional distress in general medical and surgical patients. This paper underscores the need for appropriate selection of patients for consultation, and the means of referral. The psychiatrist is faced with the important challenge of bringing the humanizing force of consultation to forms of medical treatment which are becoming increasingly technological.

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