scholarly journals Long-term results of treatment of pharmacoresistant temporal lobe epilepsy

2021 ◽  
Vol 23 (3) ◽  
pp. 23-29
Author(s):  
V. V. Krylov ◽  
A. B. Gekht ◽  
I. S. Trifonov ◽  
O. O. Kordonskaya ◽  
M. V. Sinkin

The aim of the study wasto evaluate the long-term results ofsurgicaltreatment of patients with pharmacoresistant epilepsy.Materials and methods. A retrospective analysis of treatment outcomes in patients with drug-resistant temporal lobe epilepsy was performed. According to the inclusion and exclusion criteria, 96 patients were selected for the study. Group 1 contained 49 operated patients with MR-positive epilepsy and Group 2 contained 47 operated patients with MR-ne‑ gative epilepsy. The control group consisted of 53 unoperated patients. The outcomes ofsurgical treatment were assessed after 6, 12, and 24 months. Results. Unfavorable outcomes occurred more frequently among nonoperated patients compared to both surgical groups (p <0.001). The probability of the 2-year remission after surgery in operated MRI positive patients was 60 %, in MRI negative group was 45 %, and in conservative group – only 2 %. The mean duration of the seizures-free period was greatest̆in the MRI positive surgical group (15.4 ± 1.5 months), and shortest in the control group (3.3 ± 0.9 months).Conclusion. The presented results prove the effectiveness and safety of surgical treatment of patients with temporal lobe epilepsy.

2020 ◽  
Vol 73 (2) ◽  
pp. 329-331
Author(s):  
Serhiy I. Savolyuk ◽  
Valentyn A. Khodos ◽  
Roman A. Herashchenko ◽  
Vladyslav S. Horbovets

The aim: To analyze and evaluate the efficacy of CDLLV treatment, using high-frequency endovascular welding (EVW), endovenous laser coagulation (EVLC) and catheter microfoam echosclerotherapy. Materials and methods: We have treated 329 patients with CDLLV C2-C6 functional classes according to the Clinical Etiological Anatomical Pathophysiology. Of these, 102 patients had vertical reflux eliminated by EVW, in 112 – by EVLC, and in 115 – by catheter microfoam echosclerotherapy. Results: In the EVW group 3 patients (2.94%) had a partial recanalization of coagulated veins 3 months after the procedure. In EVLC group 2 patients (1.79%) also had partial recanalization group after 6 months. In the group of catheter microfoam echosclerotherapy partial recanalization occurred in 3 patients during 3 months of observation, in the period of 6 months – in 2, in the period of 12 months – in 9, in total – in 14 patients (12.17%). The EVW and EVLC methods showed high efficacy of vertical reflux elimination on the great and small subcutaneous veins (GSV/SSV) in CDLLV and have no fundamental differences in the immediate and long-term results of treatment. Microfoam catheter echosclerotherapy leads to a greater number of recanalisations, compared with EVW and EVLC. Conclusions: High-frequency endovenous welding results in complete fibrotic GSV/SSV transformation in 97.06% of patients. Endovascular laser coagulation results in complete fibrotic GSV/SSV transformation in 98.21% of patients. Elimination of vertical reflux by microfoam echosclerotherapy results in complete fibrotic GSV/SSV transformation in 87.83% of patients.


2019 ◽  
Vol 65 (3) ◽  
pp. 414-421
Author(s):  
Yuliya Gavrish ◽  
Anna Artemeva ◽  
Yu. Trifanov ◽  
A. Nyuganen ◽  
Anna Sidoruk ◽  
...  

On the basis of the Department of Oncogynecology together with the pathoanatomical department of the N.N. Petrov Research Institute of Oncology conducted a comparative assessment of age-related features of endometrial cancer. The study included 309 patients, which were divided into two groups: group 1 - from 50 to 69 years (n = 150), group 2 - 70 years and older (n = 159). The article presents a comparative assessment of treatment, morphological characteristics of the tumor and the prevalence of the tumor process in two age groups, as well as the long-term results of treatment.


Epilepsia ◽  
2009 ◽  
Vol 50 (9) ◽  
pp. 2061-2071 ◽  
Author(s):  
Zdeněk Vojtěch ◽  
Vilibald Vladyka ◽  
Miroslav Kalina ◽  
Evžen Nešpor ◽  
Kateřina Seltenreichová ◽  
...  

2021 ◽  
Vol 22 (24) ◽  
pp. 13355
Author(s):  
Tatyana Y. Postnikova ◽  
Georgy P. Diespirov ◽  
Dmitry V. Amakhin ◽  
Elizaveta N. Vylekzhanina ◽  
Elena B. Soboleva ◽  
...  

Status epilepticus (SE) causes persistent abnormalities in the functioning of neuronal networks, often resulting in worsening epileptic seizures. Many details of cellular and molecular mechanisms of seizure-induced changes are still unknown. The lithium–pilocarpine model of epilepsy in rats reproduces many features of human temporal lobe epilepsy. In this work, using the lithium–pilocarpine model in three-week-old rats, we examined the morphological and electrophysiological changes in the hippocampus within a week following pilocarpine-induced seizures. We found that almost a third of the neurons in the hippocampus and dentate gyrus died on the first day, but this was not accompanied by impaired synaptic plasticity at that time. A diminished long-term potentiation (LTP) was observed following three days, and the negative effect of SE on plasticity increased one week later, being accompanied by astrogliosis. The attenuation of LTP was caused by the weakening of N-methyl-D-aspartate receptor (NMDAR)-dependent signaling. NMDAR-current was more than two-fold weaker during high-frequency stimulation in the post-SE rats than in the control group. Application of glial transmitter D-serine, a coagonist of NMDARs, allows the enhancement of the NMDAR-dependent current and the restoration of LTP. These results suggest that the disorder of neuron–astrocyte interactions plays a critical role in the impairment of synaptic plasticity.


2018 ◽  
Vol 3 (2) ◽  
pp. 54-59
Author(s):  
SV V Kozlov ◽  
OI I Kaganov ◽  
AE E Orlov ◽  
AM M Kozlov

Aim - to improve the long-term results of cytoreductive treatment of patients with simultaneous multiple bilobar liver metastases of colorectal cancer by the use of RFTA. Materials and methods. The study presents the results of treatment of 168 patients diagnosed with colorectal cancer of stage IV with simultaneous bilobar metastases in the liver. In the main group, cytoreductive tumor removal was accompanied by radiofrequency thermal ablation (RFTA) of metastatic formations. In the control group only the primary tumor was removed. Results. The use of RFTA during cytoreductive surgery does not worsen the immediate results of surgical treatment, in comparison with patients, where the effect on liver metastases has not been performed, but allows to increase medians of uneventful and overall survival from 9 and 22 months to 17 and 29 months, respectively. Conclusions. The use of RFTA for simultaneous multiple bilobar metastases in the liver during cytoreductive surgery makes it possible to achieve 22.7% of the three-year uneventfulness and 4.3% of the five-year overall survival.


2020 ◽  
Vol 16 (3) ◽  
pp. 147-154
Author(s):  
konstantin Koshelev ◽  
Nikolay Belousov ◽  
Ekaterina Pushkareva ◽  
Ilya Baranov

Background. Predicting the immediate and long-term results of treatment is an urgent problem of modern medicine. The prognosis of complex dental treatment is influenced by many factors. Among the main ones: features of the individual's anatomy and physiology, the type and method of the chosen treatment, the doctor's qualification, features of the patient's psychological profile, the presence of concomitant pathology, and so on. Each of the factors must be considered separately to understand the mechanism and the strength of its impact. Relevance. Finding out the influence of diseases of the hepatobiliary system on the prognosis of dental orthopedic treatment. Objectives. We studied the indicators of patients who re-applied for replacement of an existing dental prosthesis. The study group consisted of patients with liver and biliary tract diseases, and the control group consisted of patients without concomitant General somatic pathology. The terms of use of the prosthesis, the number and severity of treatment complications, and the state of the prosthetic bed were evaluated. Standard clinical and paraclinical diagnostic methods, corresponding pathology, cone-beam computed tomography and statistical analysis methods were used as research methods. Results. The correlation of the terms of use of various types of dentures with the presence of liver and biliary tract diseases in the anamnesis was determined. The dependence of the structure of bone tissue and its density on the presence of the considered pathology was revealed. Conclusion. The obtained data can be applied by orthopedic dentists in the near and long-term prognosis of the result of treatment of patients with partial loss of teeth and concomitant diseases of the hepatobiliary system.


2010 ◽  
Vol 16 (3) ◽  
pp. 21-27
Author(s):  
R. M. Tikhilov ◽  
A. V. Kazemirsky ◽  
P. M. Preobrazhensky ◽  
I. I. Kroitoru ◽  
T. A. Kulyaba ◽  
...  

From 1999 to the present time in the Russian RITO n.a. R.R. Vreden 28 knee joint replacements were performed using bone autoplasty in patients with stage V aseptic necrosis of the tibial condyles. The control group included 150 patients who underwent knee arthroplasty using a standard technique. All the patients were monitored in the preoperative and postoperative periods in time from 3 to 7 years. Results of treatment were assessed using a 100-point Josef and Kaufman scale, as well as the scale of WOMAC. Among the patients were 128 (71,9%) women and 50 (28,1%) males, mean age was 67 years old. If comparing experimental and control groups in the preoperative period showed a significant difference, the postoperative results were identical. Bone autotransplantation during arthroplasty of the knee is a simple and effective method used in large defects condyles of the femur and tibia (more than 1/3 of the condyle, the depth of the defect over 10 mm).


2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Pedro Neves Cardoso ◽  
Ana Fernanda Pinheiro ◽  
Jorge Meira ◽  
Ana Catarina Pedrosa ◽  
Manuel S. Falcão ◽  
...  

Purpose. To report the long-term clinical outcomes after switching from intravitreal bevacizumab or ranibizumab to aflibercept therapy in eyes with AMD. Methods. Retrospective analysis of changes in BCVA, SD-OCT image, and frequency of injections after 1, 2, and 3 years of follow-up. Results. 164 eyes were analyzed, 101 eyes switched from bevacizumab (group 1) and 63 from ranibizumab (group 2). One year after the switch, there was an overall nonsignificant mean decrease of 2 ETDRS letters in BCVA. Three years after, there was an overall mean decrease of 7 ETDRS letters, which was statistically significant. A significant improvement in the mean CRT was found at 1, 2, and 3 years. There was a significant decrease in the mean number of injections per year (7.8 to 6.5, p<0.005) between the first and third year. Conclusion. Aflibercept can be useful in the management of refractory neovascular AMD, with a good morphological response. However, in the long-term, BCVA stabilization was not achieved.


2021 ◽  
Vol 33 (10) ◽  
pp. 271-276
Author(s):  
Serhat Şibar ◽  
Kemal Findikcioglu ◽  
Kirdar Guney ◽  
Serhan Tuncer ◽  
Suhan Ayhan

Introduction. Pressure injuries (PIs) continue to be a substantial problem and burden for the present-day health care system and are the leading cause of chronic wounds worldwide. There is no current consensus on the long-term results of the use of flaps in sacral PI reconstruction and optimal flap choice. Objective. This study aimed to evaluate whether flap selection influences postoperative results in sacral PI reconstruction. Materials and Methods. Patients who underwent surgery for PIs in the authors’ clinic between 2002 and 2016 were retrospectively analyzed. A total of 63 patients with stage 3/stage 4 sacral PIs and who underwent reconstruction with fasciocutaneous (FC) flaps (group 1), musculocutaneous (MC) flaps (group 2), or perforator (P) flaps (group 3) were included in the study. The mean duration of the follow-up period was 14.4 months, and patients were evaluated in terms of their demographic data, length of hospital stay, complications, and recurrence. Results. The mean age, sex distribution, and ambulatory status were similar between the groups. In group 2 (MC), the mean length of hospital stay and mean drain removal time were significantly longer. The mean daily drainage amount was significantly higher in group 2 (MC) than in the other groups, and long-term relapses were less frequently observed in group 3 (P). A significant difference was observed between groups 2 (FC) and 3 (MC) in terms of wound dehiscence. The authors determined that P flaps were associated with a reduced mean length of hospital stay and daily drainage. Conclusions. For these patients, P flaps appear to be the optimal flap choice for sacral area reconstruction. However, new prospective randomized studies are needed to support these findings.


2021 ◽  
Vol 19 (4) ◽  
pp. 434-443
Author(s):  
E. V. Mohiliavets ◽  

Background. Transabdominal gastroesophageal devascularization is a technically feasible backup operation for most general surgeons in case of failure of endoscopic prophylaxis of bleeding from esophageal varices. There is an emerging trend in the development of laparoscopic technologies in the surgical correction of complications of portal hypertension. Purpose. Assessment of the clinical efficacy of laparoscopic esophagogastric devascularization in its own modification. Material and methods. In the period from 2009 to 2020, the results of treatment of 31 patients were studied. The patients were divided into 2 groups by the method of simple randomization. In the control group, surgery was performed in a standard way, in the main group - in the modification we proposed. Results. The use of our proposed technological methods when performing the stage of transection of the abdominal esophagus during laparoscopic esophagogastric devascularization in its own modification reduced the frequency of technical difficulties at this stage, which caused conversions, anastomotic leakage and other intra and postoperative complications. In the long-term period, there was a decrease in the degree of esophageal varices, a decrease in the frequency of recurrent bleeding and mortality, as well as an improvement in the quality of life in patients after a modified operation in comparison with the standard technique. Laparoscopic esophagogastric devascularization in our modification shows better results as a method of secondary prevention of bleeding from esophageal varices in cirrhosis of the liver in patients with a high risk of recurrence than the use of endoscopic sclerosis of esophageal varices, is characterized by a lower incidence of repeated episodes of bleeding from esophageal varices and less lethality. Conclusions. Based on the analysis of the immediate and long-term results of the use of laparoscopic esophagogastric devascularization in its own modification in the clinic, it should be noted the reproducibility of the surgical intervention, its effectiveness and safety.


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