scholarly journals HEMORRHOIDS IN THE PEDIATRIC POPULATION: CLINICAL MANIFESTATIONS, DIAGNOSTICS AND TREATMENT

2019 ◽  
Vol 23 (3) ◽  
pp. 119-123
Author(s):  
Pyae Swe Aung ◽  
Viktoria V. Kholostova

Introduction. Hemorrhoids in childhood is a rare disease. That is why one can find only few works on this problem. Material and methods. 56 children with diagnosed hemorrhoids aged 4-18 were taken into the study. They had various clinical manifestations of the disease: perianal protrusion (76.4%), bleeding (82.3%), pain syndrome (71.5%). 51 patient (91.1%) had external hemorrhoids; 3 children (5.3%) - internal; 2 children (3.6%) - combined. Patients, by their clinical course, were distributed as follows: acute hemorrhoids - 33 children (58.9%), chronic one - 23 (41.1%). Ultrasound examination and sigmoidoscopy were used for diagnostics. Different curative techniques followed the developed curative algorithm: conservative therapy and surgery (open surgery and with the LigaSure apparatus) as well as sclerotherapy. Results. The most effective technique, having better cosmetic and clinical outcomes, was hemorrhoidectomy. Conservative treatment (more than 80%) can be a method of choice at early stages of the disease and at younger age groups. Outcomes after sclerotherapy are comparable with outcomes of conservative and surgical treatment. Sclerotherapy is recommended at the internal stages of hemorrhoids and in case of any contraindications to surgical treatment.

2020 ◽  
Vol 7 (4) ◽  
pp. 961
Author(s):  
Zosangliani . ◽  
Avishek Datta ◽  
Rukuwe Thele ◽  
Bishal Gurung ◽  
T. Kambiakdik

Hypothalamic Hamartoma (HH) may have diverse clinical manifestations. Its hallmark association is with gelastic seizures. Gelastic epilepsy is characterized by episodes of loud, hollow, mirthless, stereo-typed, forced laughter. The patient may stare and giggle briefly without any other motor manifestations. Hypothalamic hamartoma is most often the cause of gelastic seizures. Here, authors report a case of gelastic seizure with hypothalamic hamartoma in a 14-month-old boy with an associated tonic clonic seizure.  This case highlights the possibility of underdiagnosed hypothalamic hamartoma in younger age groups among pediatric population.


GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 6-10
Author(s):  
Sergey A. Martynov

The aim of the review was to summarize information on clinical manifestations, diagnostic features, as well as methods for correction of scar defects after cesarean section (CS) outside pregnancy. Lack of the scar after CS, niche, isthmocele are a myometrium defect in the area of scar after CS, which is most often detected by ultrasound, sonohysterography or magnetic resonance imaging and is manifested by postmenstrual bleeding from the genital tract. In some cases, it can cause menorrhagia, dyspareunia, pelvic pain, infertility, uterine rupture during subsequent pregnancy and childbirth. Conservative therapy or surgical treatment with laparoscopy, laparotomy or vaginal approach is carried out depending on the symptoms, size of the defect, the thickness of the residual myometrium, as well as the womans reproductive plans.


2007 ◽  
Vol 6 (3) ◽  
pp. 43-50
Author(s):  
V. A. Koubyshkin ◽  
I. A. Kozlov ◽  
N. I. Yashina ◽  
T. V. Shevchenko

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.


2022 ◽  
pp. 62-71
Author(s):  
T. V. Khorobrykh ◽  
A. A. Voevodina ◽  
D. A. Efremov ◽  
V. I. Korotkiy ◽  
N. R. Khusainova ◽  
...  

Introduction. Hernia of the esophageal opening of the diaphragm in 90% of cases is the main cause of the development of reflux esophagitis. The doctrine highlighted a large group of extraesophageal manifestations of reflux esophagitis, including gastrocardiac syndrome.Аim. The purpose of this publication is to evaluate the effectiveness of antireflux surgery in patients with hiatal hernia through the prism of its effectiveness in the dynamics of gastrocardial syndrome regression.Material and мethods. The paper presents the results of diagnostics and surgical treatment of 101 patients with hiatal hernia.Results. According to the data of instrumental research methods, cardiac hernias of the esophageal opening of the diaphragm were detected in 45 (44.5%) patients, cardiofundal in 40 (39.6%), subtotal in 15 (14.8%), total in 1 (0.9%). The main place in the clinical picture of gastrocardial syndrome was occupied by the pain syndrome behind the breastbone (83.1%). Thus, arrhythmias were found in 16 (40.0%) patients with cardiofundal, in 10 (66.6%) subtotal and in 1 (100.0%) total hiatal hernia, and angina pectoris is characteristic of cardiac hernias and was observed in 20 (44.4%) patients. The clinical manifestation of reflex angina pectoris and arrhythmias depended on the degree of shortening of the esophagus. Thus, arrhythmias were more common in patients with cardiofundal (50.0%), subtotal (71.4%), total (100.0%) hiatal hernia with II degree of shortening of the esophagus, and angina pectoris characteristic of cardiac (75.0%) hiatal hernia. with II degree of shortening of the esophagus. Reflex angina is typical for patients of the older age group, and manifestations of arrhythmia are recorded at a younger age. Heart rate variability was considered, according to electrocardiogram and Holter ECG monitoring before and after surgical treatment, where the parameters significantly (p> 0.05) decreased.Conclusions. The phenomena of gastrocardial syndrome regressed after antireflux surgery in 44 (43.5%) patients. Surgical treatment from the endovideosurgical approach did not worsen the results of surgical treatment.


PEDIATRICS ◽  
1960 ◽  
Vol 26 (1) ◽  
pp. 12-26
Author(s):  
Martha Lipson Lepow ◽  
David H. Carver ◽  
Frederick C. Robbins

A clinical, epidemiologic and laboratory study was undertaken in a housing development during an epidemic of illness due to ECHO virus, type 9. The clinical manifestations varied with age. The younger children exhibited an exanthem while older persons frequently had evidence of irritation of the central nervous system. Multiple cases occurred within families, with the incidence of illness highest in the younger age groups. No serious consequences of the illness were seen. Echo 9 virus was recovered with greater frequency from the intestinal contents of young children with illness than from ill adults, although serologic evidence of recent infection in these adults could be demonstrated. The rate of inapparent infection with ECHO 9 virus was low. Virus rarely persisted in the feces beyond 14 days after onset of illness. Group B Coxsackie viruses, type 4 and type 5, were found also to be the cause of many infections within the same population at the same time. Illnesses due to these viruses were similar to those due to ECHO 9 virus, except that no eruption was observed. The rate of inapparent infection was higher than that observed with ECHO 9 virus. Simultaneous infection with ECHO 9 virus and Coxsackie B4 or B5 virus was rare.


2019 ◽  
Vol 21 (2) ◽  
pp. 63-69
Author(s):  
M N Kravtsov ◽  
D V Pomet'ko ◽  
V I Leonov ◽  
B V Gaydar ◽  
D V Svistov

The results of the conservative and surgical treatment of 12 patients at the Neurosurgery Clinic of the Military medical academy. CM. Kirov, in the period 2016-2018, about the paraarticular and disc cysts of the lumbar spine. Performed open microsurgical and full-endoscopic operational aids. Evaluation of the effectiveness of surgical treatment was carried out using the subjective assessment scale and magnetic resonance imaging over time. The follow-up period ranged from 6 to 24 months. Most often, extradural cysts were located at the level of the LIV-LV segment. Clinical manifestations were characterized by radiculopathy and local back pain. The average duration of pain syndrome was 3±0,7 months. Conservative treatment led to a regression of pain and resorption of a disk cyst in one patient. In other cases, surgical treatment was required. The average duration of a microsurgical operation was 131,6±73,4 minutes, video endoscopic - 80±10,8 minutes. The hospitalization period in the group of microsurgical treatment was 10,4 days, in the group of video endoscopy - 4,7 days. Control magnetic resonance imaging revealed the recurrence of paraarticular cysts in the area of the previous operation in 3 patients. Relapse in patients with disc cysts is not marked. Necessity in repeated operations did not arise in one supervision. It has been established that the main clinical manifestations of extradural cysts of the lumbar spine are local moderate pain, radiculopathy, and intermittent claudication. Microsurgical and percutaneous video endoscopic treatment of lumboischialgia due to extradural cysts is significantly more effective compared with conservative therapy. Full-endoscopic interventions in comparison with microsurgical ones are less invasive and long-lasting and can reduce the time of inpatient treatment.


1988 ◽  
Vol 22 (12) ◽  
pp. 999-1002 ◽  
Author(s):  
Joseph O. Olubadewo ◽  
Ann Ikponmwamba

This retrospective study describes the prescription medication profile in an outpatient pediatric population (n = 510) retrieved from a hospital pharmacy computer file. The survey covers a three-month period. The study population included 281 male and 229 female patients divided according to age into three groups: infant (age 0–12 months); children (age 1–12 years); and adolescents (age 13–18 years). Medications prescribed were classified according to their pharmacotherapeutic properties as described in the American Hospital Formulary Service Drug Information 87. The findings pointed out that three pharmacotherapeutic categories (the antiinfective/chemotherapeutic, central nervous system (CNS), and respiratory agents) constituted 78.1 percent of the 1402 prescribed medications. The most frequently prescribed agents in each of these categories were, respectively, amoxicillin, aminophylline, and acetaminophen. These agents represent recent advances in drug usage because they became most frequently used only within the past ten years. The age-dependent medication profile indicated that there was a higher prescription rate of antiinfectives and respiratory disorder agents in the younger age groups; in the adolescent group CNS agents were more often prescribed.


2018 ◽  
Vol 20 (1) ◽  
pp. 111-116
Author(s):  
I A Solovev ◽  
A M Pershko ◽  
D P Kurilo ◽  
M V Vasilchenko ◽  
E S Silchenko ◽  
...  

Possibilities and options of surgical treatment of complications of Crohn’s disease in the general surgical hospital are considered. Patients underwent various surgical interventions: ileum resection with «side-to-side» anastomosis (4 patients), resection of ileocecal department with the formation of ileoascendoanastomosis (2 patients), total coloproctectomy with the formation of ileostomy (2 patients), right-sided hemicolectomy (1 patient), obstructive resection of transverse colon (1 patient), obstructive resection of sigmoid colon (2 patients). Postoperative complications developed in 3 patients (25%), among them: postoperative wound suppuration - 2, dehiscence of anastomosis in 1 patient, which led to the formation of internal intestinal fistula and death. It was found that with limited lesions of colon in Crohn’s disease (less than a third of the colon) can be limited to resection of the affected segment with formation of intestinal anastomosis in the limits of healthy tissues. In the presence of lesions in the ascending department of colon proximal border of resection should be at the level of middle colic vessels with preservation of the latter. In long Crohn’s disease of colon with severe clinical manifestations of the operation of choice is a subtotal resection of colon with the imposition of single-barrel ileostomy. Surgical treatment of complicated forms of Crohn’s disease is in all cases performed in surgical profile hospitals, taking patients by ambulance. Most often, patients have delayed indications for operations, which gives the opportunity to carry out a comprehensive preoperative preparation. In all cases, complications of Crohn’s disease requires an individual approach, which combines conservative and surgical treatment. Surgical intervention is determined by the shape and characteristics of the course of complications of Crohn’s disease.


2019 ◽  
Vol 16 (1) ◽  
pp. 38-47 ◽  
Author(s):  
V. P. Snishchuk ◽  
A. Yu. Mushkin

Objective.To analyze epidemiological and clinical features of degenerative disease of the spine complicated by radicular syndrome in children, as well as the effectiveness of its treatment on the example of one of the largest regions of the Russian Federation.Material and Methods.Design of the study corresponds to a retrospective cohort clinical and epidemiological study for 17 years. The study included 201 patients aged 10–17 years with degenerative changes in the spine complicated by radicular syndrome. An epidemiological analysis included the assessment of the regional incidence of degenerative diseases of the spine in children, and clinical analysis – the effectiveness of conservative and surgical treatment. The age and sex structure of the cohort, the level of pathology, the effectiveness of surgical treatment, and age-related features of early spinal discosis in children as compared with degenerative lesions of the spine in adults were analyzed.Results.The epidemiological frequency of degenerative diseases accompanied by clinical manifestations and requiring special treatment in the Leningrad Region was assessed as 8.7 per 100 thousand children aged 10–17 years. Conservative treatment was effective in 172 patients, and 29 patients were treated with surgery. Surgical results were followed up for 1 to 16 years after surgery and were evaluated as excellent, good, and satisfactory respectively in 4 (14 %), 20 (69 %), and 5 (17 %) cases. Complications were reported in two cases: migration of the interbody stabilizing implant and positional neuropathy of the peroneal nerve associated with the position on the operating table.Conclusion. The epidemiological analysis conducted on a regional cohort of the Leningrad Region can be used in assessing the potential need for conservative and surgical treatment of children with degenerative pathology in other regions of Russia. Conservative treatment of this pathology is quite effective, and surgical decompression of nerve roots was required only in 14.4 % of cases.


2018 ◽  
Vol 6 (4) ◽  
pp. 155-161
Author(s):  
O. N. Tkacheva ◽  
A. P. Pereverzev ◽  
N. K. Runikhina ◽  
Yu. V. Kotovskaya

Abstract. Elderly patients are at higher risk of developing infectious diseases that might have more severe progression than those of younger age groups, accompanied by an increased risk of death. These medical conditions in elderly may also present difficulties for diagnosis due to a «blurred» clinical picture. By WHO recommendations the vaccination against influenza is one of the most effective ways to prevent this type of infection in elderly patients. However the use of vaccines may be associated with a risk of adverse drug reactions. In most cases, they have subclinical manifestations and/or non-severe clinical manifestations (adverse reactions), but in a relatively small percentage of cases, the use of vaccines may be associated with a risk of developing serious post-vaccination complications (anaphylaxis, Guillain-Barre syndrome etc.). This article represents data on the safety of influenza vaccines in patients over 60 years old, with due regard to immunosenescence. According to the authors opinion, this will improve the safety of vaccination against influenza patients 60 years and older. At the end of the article, the authors conclude that despite the potential risks, the by the benefits of the use of influenza vaccines continue to overweight potential risks and vaccination of elderly people is effective and safe way to prevent influenza. To improve the effectiveness of vaccination of patients 60 years and older the use of high dose vaccines and adjuvants can be recommended.


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