scholarly journals Cystoscopic features of the ureteral orifices in children with vesicoureteral reflux

2021 ◽  
pp. 36-42
Author(s):  
R.A. Nakonechnyy ◽  
◽  
A.Y. Nakonechnyi ◽  
Keyword(s):  
Informed Consent ◽  
Vesicoureteral Reflux ◽  
Conflict Of Interest ◽  
Positive Association ◽  
Ethics Committee ◽  
Healthy Children ◽  
Ureteral Orifice ◽  
Bladder Mucosa ◽  
Topographic Characteristics ◽  
Helsinki Declaration

Purpose – to establish cystoscopic prognostic criteria for vesicoureteral reflux (VUR) in children. Materials and methods. Clinical material covers 270 patients with VUR II–IV grades aged 9 months to 14 years and 22 healthy children. The study included patients with VUR in the period of clinical and laboratory remission without symptoms of neurogenic bladder. During cystoscopy, the condition of the bladder mucosa was assessed; location, shape, hydrodistention degree, and ureteral orifices contractility. Results. Patients with VUR were diagnosed ureteral orifices in the form of: horseshoes – 127 (47.04%) patients, stadium – 106 (39.26%) and golf holes – 37 (13.7%). They were in the zones: A – 13 (4.81%) children, B – 154 (57.04%), C – 67 (24.81%), D – 36 (13.33%), and were characterized by the hydrodistention degree: H0 – 7 (2.59%) patients, H1 – 173 (64.07%), H2 – 60 (22.22%) and H3 – 30 (11.11%). In children with VUR, sluggish peristalsis of the ureter orifices clearly prevailed – 252 (93.33%) cases, relative to active peristalsis in only 18 (6.67%) patients. Conclusions. For ureteral orifices in the form of a stadium and with more pronounced signs of deepening, which are shifted to zone B and laterally to the sidewall of the bladder, with a hydrodistention degree above H1 has a positive association with VUR at the highest specificity of tests. Unfavorable prognostic diagnostic markers for effective minimally invasive interventions in patients with VUR should be considered ureteral orifices, which combine such morpho-topographic characteristics as pronounced signs of deepening to the shape of a golf hole, lateralization to the sidewall of the bladder in zone D, and hydrodistention H3 degree. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: vesicoureteral reflux, ureteral orifice, cystoscopy, children.

scholarly journals Features of the treatment of secretory evacuation disorders in acute bronchitis in children with impaired respiratory function

2020 ◽  
pp. 52-58
Author(s):  
L.S. Ovcharenko ◽  
◽  
A.A. Vertehel ◽  
T.G. Andrienko ◽  
I.V. Samokhin ◽  
...  
Keyword(s):  
Conflict Of Interest ◽  
Respiratory Function ◽  
Acute Bronchitis ◽  
Ethics Committee ◽  
Key Words Children ◽  
External Respiration ◽  
Minimal Effect ◽  
Good Tolerance ◽  
Helsinki Declaration ◽  
Respiration Function

Objective: to increase the efficiency and safety of the treatment of the bronchi secretory-evacuation disorders in acute bronchitis with impaired respiratory function in children by using a medication with minimal effect on the cardiovascular system. Materials and methods. Under observation were 60 children aged 6 to 11 years. 2 observation groups were formed (30 children in each group): 1st group — children receiving the Bronchipret® for 10 days with acute bronchitis with impaired respiratory function; 2nd group — children who do not receive the Bronchipret in acute bronchitis with impaired respiratory function. Results. In the group of patients taking Bronchipret®, in addition to faster clinical dynamics, according to spirography, there was an improvement in the parameters of the external respiration function, characterizing the obstructive component of the obstruction of the air flow. After therapy with Bronchipret®, normalization of the functioning of the autonomic nervous system and the predominance of eutonia were observed against the background of a decrease in the number of registration of parasympathicotonia. Conclusion. The good tolerance and safety of Bronchipret® during 7-day use in patients aged 6–11 years allows us to recommend this drug as a highly effective treatment for bronchi secretory-evacuation disorders in acute bronchitis in children. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: children, bronchitis, spirography, treatment, thyme, ivy.

scholarly journals Positional installation of contrast cystography: A new approach in the diagnosis of vesicoureteral reflux

2008 ◽  
Vol 136 (11-12) ◽  
pp. 617-620
Author(s):  
Milan Paunovic ◽  
Polina Pavicevic ◽  
Vladimir Radlovic ◽  
Vojkan Vukadinovic
Keyword(s):  
Contrast Medium ◽  
Vesicoureteral Reflux ◽  
Diagnostic Procedures ◽  
Voiding Cystourethrography ◽  
Ureteral Orifice ◽  
Endoscopic Appearance ◽  
New Approach ◽  
Normal Finding ◽  
Normal Limits ◽  
Grade Ii

INTRODUCTION Positional installation of contrast cystography (PIC cystography) represents a new method to identify vesicoureteral reflux (VUR) that is unrevealed by standard diagnostic procedures. It is performed by radiological examination of the vesicoureteral junction during cystoscopic installation of the contrast medium at the ureteral orifice. OBJECTIVE We studied the significance of PIC cystography to demonstrate VUR that failed to be revealed by standard voiding cystourethrography (MCUG), as well as the degree of the correlation of such a finding with endoscopic appearance and the position of the ureteral orifice (UO). METHOD The aim of the paper was to analyze a sample of 5 children (4 girls and 1 boy), aged 6-15 years (mean 9.8 years) with recurrent febrile urotract infections, complicated with scarring changes of the renal parenchyma and normal findings on MCUG. The grade of VUR demonstrated by PIC cystography was classified using the standard hydrodistensional scale. RESULTS All 5 patients had VUR, disclosed by PIC cystography, of whom in 4 it was unilateral and in one bilateral. Of 5 patients, 4 had VUR grade I and one grade II. All the children with VUR detected by PIC cystography also had evident cystoscopic abnormalities in the position and/or configuration of the ureteral orifice at the same side, while at the side with normal finding on PIC cystography, the endoscopic finding was also within normal limits. CONCLUSION PIC cystography is the method of choice in the confirmation of VUR as the cause of recurrent urotract infection and its complications in children with a normal finding on standard MCUG. In all our patients with VUR verified by PIC cystography, at the same side we also revealed endoscopic changes in the position and/or configuration of UO.

scholarly journals The combined use of proximal and distal protection devices uring carotid stenting: A case report

2019 ◽  
Vol 23 (2) ◽  
pp. 73
Author(s):  
D. U. Malaev ◽  
D. A. Redkin ◽  
V. I. Baystrukov ◽  
A. A. Prokhorikhin ◽  
A. A. Boykov ◽  
...  
Keyword(s):  
Blood Flow ◽  
Informed Consent ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Conflict Of Interest ◽  
Internal Carotid ◽  
Carotid Stenting ◽  
Protection System ◽  
Combined Use ◽  
Proximal Protection

<p>Despite the development of modern medical technologies, cerebrovascular disease remains a major health and social issue. Among all the cases of ischemic stroke, approximately 20% are attributable to stenotic lesions in the carotid artery. The main drawback of carotid stenting is the risk of embolic complications during the procedure. To resolve this problem, various devices that protect against embolism have been developed. In this clinical case, we describe the ability to minimize the risk of operative stroke through a combined application of the distal and proximal protection systems in carotid stenting.</p><p>In our patient, a 65-year-old woman, angiography of the carotid arteries revealed an ulcerated atherosclerotic plaque of the right internal carotid artery, with stenosis of the lumen of up to 95%. Considering the high risk of distal embolism, the Mo MaUltra (Italy) proximal protection system was used. When evaluating the installation of the Mo MaUltra system, the preserved blood flow through the superior thyroid artery and, therefore, the antegrade blood flow in the internal carotid artery was revealed. Considering the identified risk and the anatomy of the plaque surface, we decided on the additional use of the distal SpiderFX (USA) protection device.</p><p>The combined use of proximal protection system and distal protective device for carotid stenting is technically possible and may reduce the risk of embolic complications.</p><p>Received 23 January 2019. Revised 18 March 2019. Published 23 April 2019.</p><p><strong>Informed consent:</strong> The patient’s informed consent to use the records for medical purposes is obtained.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals A clinical case of repeated correction of Ebstein’s anomaly using the ‘cone reconstruction’ method

2020 ◽  
Vol 24 (2) ◽  
pp. 102
Author(s):  
N. M. Troshkinev ◽  
E. A. Svyazov ◽  
O. V. Mochula ◽  
N. A. Shmakova ◽  
I. V. Ivanova ◽  
...  
Keyword(s):  
Informed Consent ◽  
Conflict Of Interest ◽  
Ebstein’S Anomaly ◽  
Reconstruction Method ◽  
Hemodynamic Parameters ◽  
Resonance Imaging ◽  
Ebstein's Anomaly ◽  
Mean Pressure ◽  
Critical Revision ◽  
The Right

<p>We report the case of a 16-year-old child with Ebstein’s anomaly who successfully underwent recorrection via the ‘cone reconstruction’ method using a tricuspid valve-in-ring implant. Because the patient had high-grade atrioventricular block, a pacemaker was implanted. Ultrasound and magnetic resonance imaging were conducted to determine the anatomy of the right ventricle and its hemodynamic parameters. Echocardiography performed at the time of discharge revealed an improvement in the hemodynamic parameters of the patient after the correction: triuspid valve regurgitation is mild and peak/mean pressure gradient 10/5 mmHg.</p><p>Received 9 January 2020. Revised 16 March 2020. Accepted 17 March 2020.</p><p><strong>Informed consent:</strong> The patient’s informed consent to use the records for medical purposes is obtained.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Drafting the article: N.M. Troshkinev, O.V. Mochula, O.A. Egunov<br />Literature review: N.A. Shmakova, I.V. Ivanova<br />Illustrations: N.M. Troshkinev, O.V. Mochula<br />Critical revision of the article: E.V. Krivoshchekov, E.A. Svyazov<br />Surgical treatment: E.V. Krivoshchekov, O.A. Egunov, N.M. Troshkinev<br />Final approval of the version to be published: N.M. Troshkinev, E.A. Svyazov, O.V. Mochula, N.A. Shmakova, I.V. Ivanova, O.A. Egunov, E.V. Krivoshchekov</p>

scholarly journals Use of Polyvinyl Alcohol Sponge Cubes for Vagal Nerve Stimulation: A Suggestion for the Wrapping Step. Technical Note and Step-by-Step Operative Technique

2019 ◽  
Vol 18 (5) ◽  
pp. 487-495 ◽  
Author(s):  
Hussein Hamdi ◽  
Giorgio Spatola ◽  
Stanislas Lagarde ◽  
Aileen McGonigal ◽  
Armando Paz-Paredes ◽  
...  
Keyword(s):  
Informed Consent ◽  
Polyvinyl Alcohol ◽  
Nerve Stimulation ◽  
Ethics Committee ◽  
Technical Note ◽  
Vagal Nerve ◽  
Vagal Nerve Stimulation ◽  
Surgical Microscope ◽  
Key Points ◽  
Surgical Field

Abstract BACKGROUND Vagal nerve stimulation (VNS) is an approved treatment for epilepsy and depression. Wrapping the helical electrodes around the nerve can prove technically challenging. However, a quick and efficient method to slightly elevate the nerve can highly facilitate this part of the procedure. OBJECTIVE To provide useful surgical tips to facilitate the procedure. METHODS Based on experience of more than 150 adult cases for mainly epilepsy (primary lead implant), the authors share their surgical technique to provide the experienced surgeons or newcomers to the field of VNS with some useful tips. All patients signed informed consent according to the local ethics committee guidelines. RESULTS The article consists of a detailed step-by-step description of the whole procedure illustrated through high-resolution colored photographs of the surgical field. Special reference is made to the usefulness of polyvinyl alcohol (PVA) sponge cubes to elevate the nerve instead of the commonly used silicon vessel loops. CONCLUSION The use of surgical microscope and PVA sponge cubes to elevate the nerve constitute key points to make VNS an easy surgery.

Informed consent: Commentary on the ACOG ethics committee statement

1993 ◽  
Vol 3 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Thomas E. Elkins ◽  
Douglas Brown
Keyword(s):  
Informed Consent ◽  
Ethics Committee

Progressive post-traumatic syringomyelia: a clinical case

2019 ◽  
Vol 21 (4) ◽  
pp. 81-88
Author(s):  
F. A. Bushkov ◽  
M. A. Bzhylyanskiy ◽  
A. Yu. Kordonskiy
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Informed Consent ◽  
Conflict Of Interest ◽  
Clinical Case ◽  
Spinal Injury ◽  
Spinal Column ◽  
Cord Injury ◽  
Post Traumatic ◽  
The Right

The objective of the present article is to describe a rare clinical case of progressive post-traumatic cervical syringomyelia after spinal cord injury with fracture of proximal metaepiphysis of the right humerus. The patient had a progressive neurological loss after spinal cord injury.Materials and methods. The patient underwent surgical treatment: decompression and stabilization of spinal column, surgical technique of spinal cord detethering, cyst shunting.Results. In the postoperative period the patient had increased spasticity in the lower extremities, increased weakness in the muscles of the upper extremities, aggravation of orthostatic hypotension, and inability to flex the first and the fifth fingers of the right hand. Magnetic resonance imaging of the cervical spine revealed progression of syringomyelia.Conclusion. This case demonstrates differentiation between cervical myelopathy and plexus paresis in a patient with combination spinal injury and reveals the mechanisms underlying late progression of neurological deficit.Conflict of interest. The authors declare no conflict of interest.Informed consent. The patient gave written informed consent to the publication of his data.

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