scholarly journals CONSERVATIVE TREATMENT EXPERIENCE SEVERE PERIODONTITIS USING MODERN METHODS DESTRUCTION OF BIOFILM AND TECHNOLOGY PLASMOLIFTING

2014 ◽  
Vol 10 (1) ◽  
pp. 13-18
Author(s):  
Р. Буляков ◽  
R. Bulyakov ◽  
Р. Сабитова ◽  
R. Sabitova ◽  
О. Гуляева ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Standard Therapy ◽  
Conservative Therapy ◽  
High Efficiency ◽  
Clinical Signs ◽  
Severe Periodontitis ◽  
Modern Methods ◽  
Non Surgical Treatment ◽  
Observation Period

<p>With the purpose of search of new effective methods of non-surgical treatment of chronic generalized severe periodontitis we carried out a complex conservative treatment of 27 patients, includes in addition to the standard therapy following combination:  hardware remo val  subgingival bio films  and  t e chnology Plasmolifting.</p><p>The absence of clinical signs of inflammation, stable level values hygienic indexes for the whole observation period and the reduction of the depth of periodontal pockets, confirmed the high efficiency of conservative therapy  of severe periodontitis, developed by  our therapeutic complex.</p>

scholarly journals Nonsurgical Management of Acute Uncomplicated Appendicitis in Children: the Analysis of Treatment Outcome in Relationship with Antimicrobial Regimens and Adverse Prognostic Factors

2016 ◽  
Vol 16 (2) ◽  
pp. 12-16
Author(s):  
Elina Silina ◽  
Asnate Jurgele ◽  
Arturs Viksne ◽  
Zane Abola ◽  
Arnis Engelis ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Clinical Signs ◽  
Drug Combinations ◽  
Antimicrobial Drug ◽  
Nonsurgical Management ◽  
Unsuccessful Treatment ◽  
Significant Difference ◽  
Non Surgical Treatment

SummaryIntroduction.For acute appendicitis - the most frequent condition to perform an urgent abdominal operation in pediatric surgery - surgical appendectomy still remains the gold standard regarding treatment, nevertheless nonsurgical management has become more and more recognized as a treatment method for uncomplicated acute appendicitis (UAA). However there are still many unanswered questions regarding possible factors that could predict the treatment outcome as well as appropriate antimicrobial drug regimens.Aim of the Study.The aim was to investigate if there is a possible association between factors such as C-reactive protein (CRP) level, presence of appendicolith, the diameter of the appendix and treatment outcome; as well as to identify most successfully used antimicrobial drug combinations.Material and methods.A retrospective analysis of hospital cases, admitted to a single reference center during the time period from 2013 to 2015. Patients with clinical signs of acute appendicitis, elevated inflammatory markers and radiological findings suggestive for acute appendicitis were included in the study. Nonsurgical treated patients were divided in two groups based on the treatment outcome - successful or unsuccessful. Analysis of the three factors (CRP level, presence of appendicolith and the diameter of the appendix) and most commonly used antimicrobial drug regimen association with treatment outcome was performed.Results.Overall 384 children medical records with acute appendicitis were registered and non-surgical treatment was initiated in 147/384 (38 %) cases. Successful treatment outcome of nonsurgical management was identified in 114/147 (78 %) cases. Analyzing prognostic adverse factors results presents no statistically significant difference in association with CRP level >25 mg/l (p=0,479), presence of appendicolith (p=0,183) and the diameter of appendix >1 cm (p=0,183) with successful or unsuccessful treatment outcome. The two most commonly used antimicrobial drug combinations were - Ampicillin/Metronidazole for 49 patients and Ampicillin/Gentamicin for 44 patients. No relevance with treatment outcome and used antimicrobial agents was detected (p=0,597).The overall recurrence rate after initial presentation is 15 % (17/114). In 3 cases (3 %) recurrent appendicitis developed one month after discharge and in 14 cases (12 %) up to one year after discharge.Conclusions.Prognostic adverse factors - CRP, presence of appendicolith and diameter of appendix - were not statistically reliable in association with initial non-surgical treatment outcome. The success rate of conservative treatment with narrow spectrum antibiotics was 78 %, which is just as high as in cases treated conservatively with broad-spectrum antibiotics from previous studies. Therefore the question of which factors and antimicrobial drug combinations influence the course of treatment still remains unanswered and further studies are required.

scholarly journals CONSERVATIVE TREATMENT OF HEMORRHOIDS. AN ALTERNATIVE TO SURGICAL METHODS OR COMPONENTS? CHORUS PROGRAM RESULTS

2018 ◽  
pp. 27-35
Author(s):  
E. A. Zagryadskiy ◽  
A. M. Bogomazov ◽  
E. B. Golovko
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Clinical Manifestations ◽  
Entire Observation Period ◽  
Surgical Methods ◽  
Micronized Purified Flavonoid Fraction ◽  
Flavonoid Fraction ◽  
Observational Group ◽  
Grade Iii ◽  
Observation Period

OBJECTIVE. Determine the frequency of clinical manifestations of hemorrhoids and constipation in people seeking advice about hemorrhoids. In the course of the treatment of patients with hemorrhoids phlebotropic evaluate the effectiveness of therapy micronized purified flavonoid fraction (MPFF). MATERIALS AND METHODS. This multicenter study, including screening and observation part, which is part of the International Research «CHORUS» (Chronic venous and hemorrhoid diseases evaluation and scientific research), conducted in nine centers in different regions of Russia, 80 doctors of Coloproctology. In the screening group included 2668 patients who had investigated the incidence of constipation, as a risk factor for hemorrhoids. Conservative treatment, the foundation of which was, Moffitt therapy, received 1952 patients with stage I-IV hemorrhoids. Evaluating the effectiveness of the treatment was evaluated on the basis of a questionnaire. RESULTS. The questionnaire shows that constipation suffered - 766 (28,8 %) patients. Violation of defecation patterns and changes in stool consistency was observed in 1155 (43,9%) and 633 (25.5 %), respectively. At the same time, 288 (11,1 %) indicated a tendency to loose stools and diarrhea. Conservative treatment, the foundation of which is phlebotropic MPFF therapy conducted in patients of observational group has shown its efficiency in all grades of hemorrhoids. During the entire observation period of conservative treatment was effective in 1489 (76,3 %) patients. Surgical treatment was performed in 463 (23 %) patients grade I-IV hemorrhoids, the main part of patients with grade III -199 (43,1 %) and grade IV hemorrhoids - 68 (64,2 %). CONCLUSION. Conservative treatment of hemorrhoid disease, which is the basis on phlebotropic MPFF therapy, is effective at all stages of hemorrhoids, but in patients with grade III and grade IV disease requires surgical treatment.

scholarly journals Who Needs Surgical Stabilization for Pyogenic Spondylodiscitis? Retrospective Analysis of Non-Surgically Treated Patients

2021 ◽  
pp. 219256822110394
Author(s):  
Ronen Blecher ◽  
Sven Frieler ◽  
Bilal Qutteineh ◽  
Clifford A. Pierre ◽  
Emre Yilmaz ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
De Novo ◽  
Vertebral Osteomyelitis ◽  
Case Series ◽  
Spinal Instability ◽  
Radiographic Outcome ◽  
Retrospective Case ◽  
Posterior Element ◽  
Non Surgical Treatment

Study Design: Retrospective case series analysis. Objective: To identify relevant clinical and radiographic markers for patients presenting with infectious spondylo-discitis associated with spinal instability directly related to the infectious process. Methods: We evaluated patients presenting with de-novo intervertebral discitis or vertebral osteomyelitis /discitis (VOD) who initiated non-surgical treatment. Patients who failed conservative treatment and required stabilization surgery within 90 days were defined as “ failed treatment group” (FTG). Patients who experienced an uneventful course served as controls and were labeled as “ nonsurgical group” (NSG). A wide array of baseline clinical and radiographic parameters was retrieved and compared between 2 groups. Results: Overall 35 patients had initiated non-surgical treatment for VOD. 25 patients had an uneventful course (NSG), while 10 patients failed conservative treatment (“FTG”) within 90 days. Factors found to be associated with poorer outcome were intra-venous drug abuse (IVDA) as well as the presence of fever upon initial presentation. Radiographically, involvement of the same-level facets and the extent of caudal and rostral VB involvement in both MRI and CT were found to be significantly associated with poorer clinical and radiographic outcome. Conclusions: We show that clinical factors such as IVDA status and fever as well as the extent of osseous and posterior element involvement may prove to be helpful in favoring surgical treatment early on in the management of spinal infections.

scholarly journals Effect of cryoprecipitate on neoangiogenesis in patients with purulent pyelonephritis

2020 ◽  
Vol 10 (1) ◽  
pp. 43-49
Author(s):  
Yuliya G. Chernova ◽  
Aleksandr I. Nejmark ◽  
Andrey P. Momot
Keyword(s):  
Surgical Treatment ◽  
Blood Vessels ◽  
Inflammatory Process ◽  
Conservative Therapy ◽  
High Efficiency ◽  
Control Group ◽  
Healthy Donors ◽  
Group 2 ◽  
Angiopoietin 2 ◽  
Group 1

The aim of the study is to investigate the effectiveness of conservative therapy with the inclusion of cryoprecipitate in its composition and its effect on the angiogenesis of renal blood vessels in patients with purulent pyelonephritis. Materials and methods. The study included 30 patients aged from 20 to 45 years (6 men, 24 women) with acute purulent pyelonephritis. All patients were assessed for markers of angiogenesis in blood plasma: vascular endothelial growth factor (VEGF-A), angiopoietin 1 (Ang1) and angiopoietin 2 (Ang2). The patients were divided into two groups. Patients of group 1 (n = 15) received conservative therapy with the inclusion of cryoprecipitate, patients of group 2 (n = 15) received surgical treatment. The control group consisted of 10 healthy donors aged 2035 years, whose blood angiogenesis markers were determined to obtain reference values. Results. In the course of preliminary studies, the blood content of angiogenesis markers was determined in 10 healthy donors. The level of VEGF-A in patients of both groups and the level of Ang1 in patients of group 1 at admission to the hospital significantly exceeded the corresponding values in the control group. In group 2 patients, the level of VEGF-A and Ang1 remained elevated during treatment, which indirectly indicated an ongoing inflammatory process. The level of Ang2 in patients of both groups did not change significantly. Conservative treatment of group 1 patients showed high efficiency, which was confirmed by positive dynamics of clinical and laboratory indicators, as well as data from instrumental examination. Conclusions. The results obtained indicate the effectiveness of conservative therapy with the administration of cryoprecipitate in patients with purulent pyelonephritis, and the effectiveness of such treatment is comparable to the effectiveness of surgical treatment . The use of cryoprecipitate has an endothelioprotective and anti-inflammatory effect on blood vessels, stabilizes the processes of angiogenesis, which contributes to limiting the inflammatory process and its regression.

scholarly journals CHOLELITHIASIS IN INFANTS – CONSERVATIVE OR SURGICAL TREATMENT?

2018 ◽  
Vol 63 (4) ◽  
pp. 63-68
Author(s):  
N. G. Lupash ◽  
K. A. Shakaryan ◽  
S. Yu. Matalayeva ◽  
L. A. Kharitonova
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Conservative Therapy ◽  
Treatment Effectiveness ◽  
Contractile Function ◽  
Morphological Changes ◽  
Gallbladder Wall ◽  
Priority Method ◽  
Second Year ◽  
Dissolution Of Gallstones

The aim of the research: to optimize the treatment strategy of cholelithiasis in infants by studying the conservative therapy and surgical treatment effectiveness.Children with cholelithiasis were divided into three groups: 60 children received conservative treatment; 14 children were not treated; 22 children underwent cholecystectomy. Conservative treatment was carried out by administration of Ursofalk suspension (Dr. Falk Farma, Germany) on the daily dose basis – 20 mg/kg of body weight per day once a day – at bedtime. Duration of litholysis ranged from 6 to 24 months. The therapeutic effect was controlled every 3 months by ultrasound examination of the bile ducts and biochemical analysis of blood serum.Results. Contractile function of the gallbladder normalized after 6 months, biochemical markers of cholestasis after 3 weeks, lipidogram by the end of  the second year of conservative treatment. All children tolerated therapy well. No side effects were found. No spontaneous dissolution of gallstones was observed in 14 children who did not receive litholytic therapy. In 22 children, who underwent surgery, morphological changes in the gallbladder wall were reversible, but most of them formed post-cholecystectomy syndrome. In view of the aforesaid, conservative therapy should be considered the priority method of cholelithiasis treatment in children under 3 years of age. Surgical treatment should be performed only according to vital indications. 

scholarly journals Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251294
Author(s):  
Hirotaka Sato ◽  
Daisuke Ichikawa ◽  
Eri Okada ◽  
Tomo Suzuki ◽  
Shiika Watanabe ◽  
...  
Keyword(s):  
Renal Function ◽  
Conservative Treatment ◽  
Iga Nephropathy ◽  
Conservative Therapy ◽  
Spontaneous Remission ◽  
Adult Patients ◽  
High Power Field ◽  
Renal Function Decline ◽  
Lower Egfr ◽  
Observation Period

Background There are few studies describing the clinical course and spontaneous remission of IgA nephropathy (IgAN) in adult patients receiving conservative treatment. Method Data from 62 adult patients with biopsy-diagnosed IgAN, who received conservative treatment at least 5 years prior, were retrospectively investigated. No patients received corticosteroids, other immunosuppressants, or tonsillectomy. Remission of proteinuria and hematuria were defined as proteinuria <0.3 g/gCr and urine red blood cells (RBC) <5 / high power field (HPF) on three consecutive urinalyses obtained during an observation period of ≥6 months. Result Thirty-eight (61.3%) patients had remission of hematuria, 24 (38.7%) had remission of proteinuria, and 19 (30.6%) had remission of both. Remission rates increased in patients with proteinuria <0.5 g/g Cr at diagnosis. The median time to remission of hematuria was 2.8 years and that of proteinuria was 2.6 years. Patients who showed renal function decline (defined as 30% decline of estimated glomerular filtration rate [eGFR] from baseline) were older, had significantly lower eGFR, and higher proteinuria at diagnosis. Two patients with preserved renal function and normal proteinuria at diagnosis experienced renal function decline. Renal function did not decline within 3 years of diagnosis in patients with proteinuria <1 g/gCr at diagnosis. Conclusions Relatively high rates of spontaneous remission were observed. Remission of both hematuria and proteinuria were frequent within 3 years after diagnosis, and renal function was well preserved during this period. These data indicate that it is rational to use conservative treatment for 3 years after the diagnosis instead of aggressive treatments.

scholarly journals Outpatient management of patients with discogenic lumbosacral radiculopathy

2021 ◽  
pp. 420-425
Author(s):  
V. S. Prokopovich
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Muscle Relaxant ◽  
Conservative Therapy ◽  
Surgical Intervention ◽  
Outpatient Management ◽  
Lumbosacral Radiculopathy ◽  
Intravenous Drip ◽  
Outpatient Practice ◽  
Group B

Disсоgenic lumbosacral radiculopathy (DLSR) is less common than lumbar musculoskeletal pains, but has a worse forecast and is more often accompanied by a long disabilities. Most patients with DLSR can effectively be treated under polyclinic conditions, but it is not clear how effective conservative methods of DLSR therapy are used in real outpatient practice. This study was carried out in order to analyze the outpatient maintenance of patients with DLSR, which were surgical treatment (lumbar microdiskectomy) due to the ineffectiveness of conservative therapy.Materials and methods. 90 patients (33 men, 57 women, average age – 59.78 ± 12) years suffered surgical treatment (microdiskectomy) due to the ineffectiveness of conservative DLSR. The duration of the disease to operation ranged from 2 to 14 weeks and was an average of 6 ± 3 weeks.Results. Patients were not informed about the favorable course of the DLSR, the possibilities of natural (without surgical intervention) of the regression of the disk hernia, as well as expediency to maintain all types of activity, avoid a long bed mode. Only half of the patients were conducted by therapeutic gymnastics. 94.4% of patients received non-steroidal anti-inflammatory funds, 92.2% – muscle relaxant, 79.8% – a complex of vitamins of group B, and epidural blockade with anesthetics and corticosteroids were not used. Relatively widely used ineffective methods of therapy of the DLSR: paravertebral blockade of analgesics (42.2%), intravenous drip administration of actovegin and/or pentoxyfalline (26.7%), magnetotherapy and/or laser and therapy (36.7%).Conclusion. In an outpatient practice, patients with DLSR do not receive effective conservative treatment, which may be a reason for the early (after 6 weeks) directions for surgical treatment. Polyclinic doctors are poorly informed about the effective conservative methods of DLSR therapy.

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