scholarly journals The state of erection in a patient with craniopharyngioma, panhypopituitarism and diencephalic obesity

2019 ◽  
Vol 16 (2) ◽  
pp. 83-88
Author(s):  
Yuliya G. Sidneva ◽  
Ludmila I. Astafyeva ◽  
Boris A. Kadashev ◽  
Pavel L. Kalinin ◽  
Maxim A. Kutin ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Psychiatric Symptoms ◽  
Early Postoperative Period ◽  
Reproductive Age ◽  
Endocrine Disorders ◽  
New Information ◽  
Current Events ◽  
History Of ◽  
Spontaneous Erection ◽  
Secondary Hypogonadism

The article presents a clinical case from the practice of a patient with craniopharyngioma. The man of reproductive age with diencephalic obesity (BMI 35 kg/m2), recurrent craniopharyngioma, a long history of endocrine disorders (panhypopituitarism, including secondary hypogonadism, with the corresponding sexual function disorders and the lack of sexual activity), with visual disorders and psychiatric symptoms in the early postoperative period after shunting surgery and reducing the volume of the craniopharyngioma cyst, erection conditions arose against the background of episodes of disorders of consciousness within the framework of sleep dissociation. After the operation (installation of the Ommaya system), the patient had a state of spontaneous erection lasting up to 30 minutes against the background of dream-oneiric states of impaired consciousness with erotic experiences. These states were observed for 3 nights, the patient remembered the experiences and events that occurred to him in a dream, and could tell about them to others on the next morning. The identity of the patient remained intact, he was active in the department, ordered in behavior; memory for current events and new information was intact. These disorders in the patient did not require specialized treatment, regressed independently on the 6th day of the postoperative period.

Rehabilitation of infertile patients after reconstructive plastic surgery on the pelvic organs

2021 ◽  
Vol 50 (3) ◽  
pp. 47-51
Author(s):  
E. M. Bakuridze ◽  
L. V. Dubnitskaya ◽  
T. A. Fedorova
Keyword(s):  
Postoperative Period ◽  
Reproductive Function ◽  
Early Postoperative Period ◽  
Reproductive Age ◽  
Comparative Group ◽  
Reconstructive Plastic Surgery ◽  
Methods Of Treatment ◽  
Reconstructive Plastic ◽  
Adaptive Reactions ◽  
Infertile Patients

The research aims at studying the effectiveness of plasmapheresis and ozonotherapy in treatment of women of reproductive age in early postoperative period after reconstructive-plastic operations. 110 patients with different factors of infertility who passed surgical laparoscopy were examined. All the patients were rehabilitated applying medicinal plasmapheresis (70 patients) and ozonotherapy (40 patients). The results of the study showed the advantages of these methods of treatment in comparison with traditional therapy (antibacterial and physiotherapy in comparative group, 72 patients). So, early rehabilitation of patients including medicinal plasmapheresis and ozonotherapy makes it possible to increase essentially the course of postoperative period, to stabilize adaptive reactions, to recover reproductive function in considerable amount of infertile women.

Assessment of the frequency and possible risk factors for paroxysmal atrial fibrillation in the early postoperative period after transapical implantation of the MedLab-CT valve

2021 ◽  
Vol 27 (4) ◽  
pp. 5-11
Author(s):  
O. V. Popylkova ◽  
S. S. Durmanov ◽  
A. B. Voevodin ◽  
V. V. Bazylev
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Postoperative Period ◽  
Intraoperative Complications ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Early Postoperative Period ◽  
Echocardiographic Parameters ◽  
History Of

Aim. To study the incidence and possible risk factors for atrial fibrillation (AF) in the early postoperative period after transapical implantation of the first domestic aortic valve (TAVI) “MedLab-CT”.Material and methods. The study included 118 patients after successful TAVI. The study did not include patients with open aortic valve replacement due to dislocation of the prosthesis, with severe intraoperative complications leading to the death of the patient, and patients with permanent AF. The mean age of the patients was 71.1 ± 4.9 years, body mass index was 31.1 ± 5.9 kg/m2, men were 39.8%, hypertension was in 93.2%, diabetes mellitus (DM) was in 27.9%, paroxysmal AF was in 12.7%, coronary heart disease (CHD) was in 56.7%, smoking was noted in 8.4% cases. The median follow-up time corresponded to the hospital stay - 9.5 days. To identify cardiac arrhythmias, daily regular ECG recordings in 12 leads were assessed from the first day after TAVI. In the presence of palpitations, 24-hour ECG monitoring was performed. Indicators such as age, male gender, DM, history of AF, interatrial block before surgery, CHD, and echocardiographic parameters were studied as possible predictors of AF development in the early postoperative period after TAVI. There were no significant differences in the studied parameters in patients with AF paroxysms and sinus rhythm.Results. In the early postoperative period, AF episodess occurred in 46 (39%) patients. New-onset AF occurred in 38 (32.2%) patients. The only statistically significant risk factor for AF in the postoperative period in our series of observations was CHD (OR 5.756; 95% CI 1.009-8.132; p = 0.048).Conclusion. Patients with paroxysmal AF in the early postoperative period were not detected cerebrovascular events. In the early postoperative period, the only significant predictor of AF was the presence of proven CHD in patients.

scholarly journals Effect of routine duloxetine administration in the early postoperative period on postprostatectomy stress incontinence in patients undergoing laparoscopic radical prostatectomy

2021 ◽  
Vol 38 (3) ◽  
pp. 336-339
Author(s):  
Gökhan SONMEZ ◽  
Sevket TOMBUL ◽  
Deniz DEMİRCİ ◽  
Numan BAYDILLI ◽  
Turev DEMIRTAS ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Stress Incontinence ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Laparoscopic Radical Prostatectomy ◽  
Urinary Continence ◽  
Group I ◽  
Important Health ◽  
History Of ◽  
Group Ii

Post-prostatectomy stress incontinence (PPI) is an important health problem for patients with radical prostatectomy history. Duloxetine is a common drug, used in PPI with the out of indications in most countries. In this study, we aimed to evaluate the prophylactic effect of duloxetine administration in PPI during the early postoperative period in patients undergoing laparoscopic radical prostatectomy (LRP). The retrospective study included 209 patients who underwent LRP. Patients were divided into two groups: Group I (n=96) was initiated on pelvic floor exercises (PFE) + duloxetine in the early postoperative period and continued this regimen for a total of 12 weeks and Group II (n=113) only performed PFE for 12 weeks after surgery. Exclusion criteria were as follows: a history of neuromuscular dysfunction of bladder, post-prostatectomy urge incontinence, receiving adjuvant radiotherapy during the 12- week period, prior anti-incontinence surgery, and post-voiding urine>100 ml. The prevalence rates of urinary incontinence measured at the time of urinary catheter removal (baseline) and at weeks 3, 6, and 12 after surgery and the number of wet pads per day were compared. The study included 209 patients with a mean age of 60.68 ± 7.16 years. Baseline urinary continence rates were similar in Group I and Group II (29.2% vs. 35.4%, p=0.338). At 12 weeks, although PPI rates have decreased in both groups, there was no difference between Group I and Group II (15.6% vs. 24.8%, p=0.103). Administration of prophylactic duloxetine in the early postoperative period, which started without regard to the positivity of PPI, is not significantly effective to early postoperative urinary continence recovery.

scholarly journals Neuropsychological features of patients of reproductive age diagnosed with breast cancer at the stage of surgical treatment using xenon-oxygen therapy

2021 ◽  
Vol 8 (3) ◽  
pp. 10-20
Author(s):  
D. A. Rozenko ◽  
A. I. Shikhlyarova ◽  
L. N. Vaschenko ◽  
N. N. Popova ◽  
Yu. Yu. Arapova ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Oxygen Therapy ◽  
Early Postoperative Period ◽  
Reproductive Age ◽  
Control Group ◽  
Newly Diagnosed ◽  
Beta Rhythm ◽  
Psychophysiological State

Purpose of the study. To study functional changes in the neuropsychological status of reproductive age patients with newly diagnosed breast cancer and to assess the possibility of using xenon-oxygen therapy to correct disorders.Patients and methods. This study included 60 reproductive age patients with newly diagnosed breast cancer who were undergoing surgical treatment at the Department of Bone, Skin, Soft Tissue and Breast Tumors of the National Medical Research Centre for Oncology of the Ministry of Health of Russia from 2018 to 2020. The main group included 30 patients with breast cancer diagnosed at the surgical stage of combined treatment, who underwent a rehabilitation course of xenon-oxygen therapy in the early postoperative period. The control group was formed from patients with the same diagnosis, without the use of this therapy. The functional state of the central nervous system in all patients was assessed by the parameters of the electroencephalography (EEG) bioelectrical activity. For the final assessment of the physiological and psychological state of the patients, a standardized questionnaires of the quality of life – ESAS, MOS-SF‑36, were used. Statistical data processing was performed using the Statistica 10 software package. Results. During the study, statistically significant differences were found in the assessment of subjective indicators, so in the group of patients using xenon-oxygen therapy, there was an improvement in well-being by 2.6 times, a decrease in depression by 2.3 times, a decrease in symptoms of nausea by 3 times, anxiety 1.9 times (p < 0.05). Against the background of an improvement in the psychophysiological state, the EEG showed a significant increase in the power of slow delta and theta rhythms, an increase in the power of the alpha rhythm and a decrease in the power of the beta rhythm, while in the patients of the control group only a decrease in the power of the beta rhythm was noted.Conclusion. The early postoperative period in patients with newly diagnosed breast cancer is characterized by the formation of a depressive symptom complex. The use of a course of xenon-oxygen therapy contributes to the normalization of the subjective feeling of physical and psychological health, increasing vital and social activity. Changes in the indicators of brain bioelectric activity and an improvement in psychophysiological state occur against the background of changes in brain activity caused by the normalizing effect of xenon.

Structure of cognitive disorders and predictors of their occurrence in patients after cardiac surgery

2021 ◽  
Author(s):  
A. V. Belinsky ◽  
L. V. Rasputina ◽  
Y. M. Mostovoy ◽  
O. P. Mostova ◽  
T. D. Danilevich
Keyword(s):  
Cardiac Surgery ◽  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Postoperative Period ◽  
Cognitive Disorders ◽  
Early Postoperative Period ◽  
Profile Data ◽  
History Of

Objective — to determine the presence and severity of moderate cognitive disorders (CD) in patients before and after cardiac surgery in the early postoperative period Methods and subjects.  56 patients were examined, including 19 (33.9 %) men and 37 (66,1 %)  women  , mean age  60.86 ± 8.86. Cardiac surgery was performed for ischemic heart disease in 37 (66.1 %) patients, for valvular heart disease — in 19 (33.9 %, p = 0.02). Assessment of cognitive functions was performed before surgery, on the 3rd and 7th day of the postoperative period using the Montreal Cognitive Test. Results. Before surgery, most patients (75.0 %) had mild CRs, 5.4 % had moderate CRs (p <0.01), and 19.6 % had no CRs (p = 0.02). In general, the distribution by the severity of CR in the early postoperative period did not differ from that before surgery, but there were patients with severe CR (3.6 and 1.8 %, respectively, on the 3rd and 7th days, p = 0.05) ...In the structure of CD, on the 3rd day of the postoperative period, there was a significant decrease in visually constructive skills (4.07 versus 3.7; p < 0.001), a deterioration in the ability to consistently calculate (2.66 versus 2.45; p = 0.02), repetition phrases (1.16 versus 1.0; p = 0.02). On the 7th day of the postoperative period, there was a significant decrease in verbal speed (0.48 versus 0.32; p = 0.006) and an improvement in memory (1.79 versus 2.29; p = 0.01). Probable predictors of the onset of cognitive disorders in the early postoperative period are: a history of stroke — r = –0.282; p = 0.04. There was a correlation with the presence of atherosclerotic lesions of the coronary arteries according to coronary angiography (r = –0.259; p = 0.05), surgery performed under cardiopulmonary bypass (r = 0.29; p = 0.03), and a tendency towards statistical  significance of correlation with the presence of signs of dyslipidemia according to lipid profile data (r = –0.227; p = 0.09).  Conclusions. It was found that 75 % of patients had mild CR before surgery. The distribution according to the severity of CR in the early postoperative period differed from that before surgery by the appearance of patients with severe CR. In the CR structure, on the 3rd day of the postoperative period, a statistically significant decrease in visual‑constructive skills, a deterioration in the ability to consistently calculate and repeat a phrase were observed. On the 7th day, a statistically significant decrease in verbal speed and an improvement in memory were noted. Probable predictors of CR in the early postoperative period are a history of acute cerebrovascular accident, atherosclerotic lesion of the coronary arteries according to coronary angiography, surgery performed under cardiopulmonary bypass, the presence of signs of dyslipidemia according to lipid profile data.  

Evaluation of concomitant gynecological pathology in group of patients of reproductive age with tumors and tumor formations

2020 ◽  
pp. 10-14
Author(s):  
N. V. Spiridonova ◽  
A. A. Demura ◽  
V. Yu. Schukin
Keyword(s):  
Diagnostic Errors ◽  
Ovarian Tumors ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Predisposing Factor ◽  
Ovarian Tumours ◽  
Preoperative Diagnostic ◽  
Neoplastic Process ◽  
History Of ◽  
The Moment

According to modern literature, the frequency of preoperative diagnostic errors for tumour-like formations is 30.9–45.6%, for malignant ovarian tumors is 25.0–51.0%. The complexity of this situation is asymptomatic tumor in the ovaries and failure to identify a neoplastic process, which is especially important for young women, as well as ease the transition of tumors from one category to another (evolution of the tumor) and the source of the aggressive behavior of the tumor. The purpose of our study was to evaluate the history of concomitant gynecological pathology in a group of patients of reproductive age with ovarian tumors and tumoroid formations, as a predisposing factor for the development of neoplastic process in the ovaries. In our work, we collected and processed complaints and data of obstetric and gynecological anamnesis of 168 patients of reproductive age (18–40 years), operated on the basis of the Department of oncogynecology for tumors and ovarian tumours in the Samara Regional Clinical Oncology Dispensary from 2012 to 2015. We can conclude that since the prognosis of neoplastic process in the ovaries is generally good with timely detection and this disease occurs mainly in women of reproductive age, doctors need to know that when assessing the parity and the presence of gynecological pathology at the moment or in anamnesis, it is not possible to identify alarming risk factors for the development of cancer in the ovaries.

Clinical and anamnestic characteristics of patients with adenomyosis, accompanied by pelvic pain syndrome

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 77-80
Author(s):  
M R Orazov ◽  
V E Radzinsky ◽  
M B Khamoshina ◽  
A O Dukhin ◽  
L R Toktar ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Common Disease ◽  
Contributing Factors ◽  
High Prevalence ◽  
Inflammatory Processes ◽  
History Of

Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

An audit and insights from clinical exome sequencing in psychiatry: genotype-phenotype correlation

2020 ◽  
Author(s):  
Jayant Mahadevan ◽  
Reeteka Sud ◽  
Ravi Kumar Nadella ◽  
Vani P ◽  
Anand G Subramaniam ◽  
...  
Keyword(s):  
Exome Sequencing ◽  
Psychiatric Symptoms ◽  
Pathogenic Variant ◽  
Clinical Exome Sequencing ◽  
Mapt Gene ◽  
Nf1 Gene ◽  
Novel Variant ◽  
History Of ◽  
Atypical Presentations ◽  
Minor Physical Anomalies

BACKGROUND:Psychiatric syndromes have polymorphic symptomatology, and are known to be heritable. Psychiatric symptoms (and even syndromes) often occur as part of the clinical presentation in rare Mendelian syndromes. Clinical exome sequencing reports may help with refining diagnosis and influence treatment decisions, in addition to providing a window into the biology of brain and behaviour. We describe a clinical audit of 12 individuals who sought treatment at our hospital, and for whom targeted sequencing was ordered. Three cases are discussed in detail to demonstrate correlations between genotype and phenotype in the clinic.METHODS:Targeted Next-Generation Sequencing (NGS) was done using Clinical Exome Panel (TruSight One, Illumina) covering coding exons and flanking intronic sequences of 4811 genes associated with known inherited diseases. Variants detected were classified according to the American College for Medical Genetics (ACMG) recommendation for standards of interpretation and reporting of sequence variations.RESULTS:Ten out of twelve cases had at least one pathogenic variant. In one of these cases, we detected a known pathogenic variant in MAPT gene in a suspected FTD case, which helped us to confirm the diagnosis. In another case, we detected a novel variant predicted to be deleterious in NF1 gene. Identification of this mutation suggested a change in treatment for the patient, that was of benefit. The same patient also harboured a novel variant in the TRIO gene. This gene may be involved in biological processes that underlie the patient’s psychiatric illness.CONCLUSIONS:The cases discussed here exemplify different scenarios under which targeted exome sequencing can find meaningful application in the clinic: confirming diagnosis (MAPT variant), or modifying treatment (NF1). We suggest that clinical exome sequencing can be a helpful addition to a clinician’s toolkit when there are expediting factors to consider— such as early-onset, strong family history of mental illness, complex/atypical presentations and minor physical anomalies or neurocutaneous markers.

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