scholarly journals MORPHOLOGY AND MORPHOMETRIC INDICATORS OF THE MUCOUS MEMBRANE OF VARIOUS PARTS OF THE INTESTINE OF PATIENTS WITH POSTCHOLECYSTECTOMY SYNDROME

2020 ◽  
Vol 28 (3) ◽  
pp. 58-64
Author(s):  
Ivan T. Shcherbakov ◽  
Nina I. Leontieva ◽  
Nina M. Grachiova ◽  
Alina I. Soloviova ◽  
Nikolay A. Vinogradov ◽  
...  

The actuality of the problem is associated with an increase in the number of patients with cholelithiasis of working age and a significant increase in cholecystectomies not only in Russia, but throughout the world. It is known that more than 2,5 million are performed annually. Moreover, 5-40% of operated patients develop postcholecystectomy syndrome, which is manifested by recurrent abdominal pain and cholegenic diarrhea. The aim of the study is to assess morphofunctional changes in the mucous membrane of various parts of the intestine in patients with postcholecystectomy syndrome. Histological, histochemical, morphometric and bacterioscopic, parasitological methods were used to study 42 biopsy specimens of the mucous membrane of various parts of the intestines of patients who underwent cholecystectomy. The control group consisted of 18 biopsies of practically healthy individuals. To objectify the study, a morphometric study of the mucous membrane of the duodenum according to 34 parameters, of the cecum and sigmoid colon according to 22 parameters was carried out. In the mucous membrane of the duodenum, chronic duodenitis of varying degrees of activity of the pathological process and atrophy of the intestinal villi were revealed, the intestinal glands were shortened, the intestinal villi are less wide. The epithelial layer of intestinal villi and intestinal glands was abundantly infiltrated with neutrophilic granulocytes. The density of the inflammatory cellular infiltrate in the stroma of the intestinal villi and intestinal glands increased. On the surface of the epithelial layer of the intestinal villi and between the intestinal glands, campylobacters were often found, less often - cryptosporidia. In the mucous membrane of the cecum and sigmoid colon, chronic colitis of varying degrees of activity of the pathological process and atrophy of the intestinal glands were revealed. The thickness of the mucous membrane and the depth of the intestinal glands were lower than normal. Thus, in patients with postcholecystectomy syndrome, pronounced morphometric and histological changes were revealed in the mucous membrane of various parts of the intestine, while the depth and degree of its damage were more significant in its proximal parts.

2021 ◽  
Vol 11 (3) ◽  
pp. 46-49
Author(s):  
Galina Reva ◽  
Stanislav Ichenko ◽  
Igor Sementsov ◽  
Aleksandr Kim ◽  
Oksana Voskanyan ◽  
...  

Analysis of the HPV positive papilloma structures at different levels of pathological process development was carried out. Classical staining of preparations with hematoxylin and eosin was used for immunohistochemical determination of Ki67-positive cells and phenotyping of CD positive cells. We found that the process of papilloma formation begins with a local increase in the proliferative activity of keratinocytes which contributes to the formation of a local epithelial convex above the surface of the oropharyngeal mucosa (OPM) in the form of papilloma. The connective tissue of the OPM adjacent to the epithelium grows at the second stage. At the same time here is a decrease in immunocytes/macrophages number of the oral epithelium not only in the growth zone of the papilloma but in the adjacent neoplasm tissue. The third stage is characterized by the destruction of the basal membrane of the OPM. Apoptotic cells in the cambial layer and forming leukocytes infiltrate the OPM lamina propria. Virus-infected keratinocytes are phagocytized by macrophages or exfoliated from the surface of the epithelial layer. The emerging in the middle layers defect of tissue of the epithelial layer and the absence of Langerhans cells indicate a relationship between the migration of antigen-presenting cells expressing CD68 with impaired differentiation and specialization of keratinocytes. The conclusion is based on the analogy of "leukemic failure" in leukemia and on the absence of differentiating epithelial cells between the cambium and the specialized surface layer in the long-existing papilloma. The disappearance from the epithelium of CD68-positive cells specific to the epithelial layer is a prognostic sign of malignization in the mucous membrane of the oropharynx.


2012 ◽  
Vol 15 (2) ◽  
pp. 84 ◽  
Author(s):  
Canturk Cakalagaoglu ◽  
Cengiz Koksal ◽  
Ayse Baysal ◽  
Gokhan Alici ◽  
Birol Ozkan ◽  
...  

<p><b>Aim:</b> The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).</p><p><b>Materials and Methods:</b> We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.</p><p><b>Results:</b> The 2 groups were not significantly different with respect to demographic and operative data (<i>P</i> > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (<i>P</i> < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (<i>P</i> < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (<i>P</i> = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.</p><p><b>Conclusion:</b> Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.</p>


Author(s):  
Iskander I. Zaidullin ◽  
Denis O. Karimov ◽  
Lilija K. Karimova ◽  
Milyausha F. Kabirova ◽  
Rasima R. Galimova ◽  
...  

The susceptibility to the development and progression of inflammatory periodontal diseases, which depends on genetic and external factors (smoking, stress, oral hygiene), varies widely. In the development of these diseases, an important role is played not only by the presence of periodontal pathogenic microorganisms, but also by the presence of congenital or acquired immunodeficiency, immunoregulatory defects. The immune system plays a key role in the physiological and pathological processes of periodontal tissues. In this regard, IL17, produced by CD4+ Th cells, which has both Pro-inflammatory and protective activity, is of particular interest in the pathogenesis of periodontitis. The aim of study was to identify the relationship between polymorphic loci of the IL-17A (rs2275913) and MMP-1 (rs1799750) genes and clinical manifestations of chronic periodontitis in petrochemical workers. Dental examination was performed in 92 ethylene oxide production workers with chronic periodontitis and 74 patients with chronic periodontitis who did not come into contact with chemical factors (control group). Genotyping of polymorphisms rs2275913 of the IL17A gene and rs1799750 of the MMP1 gene was performed by allele-specific real-time polymerase chain reaction (PCR). Hygienic assessment of the degree of air pollution of the working area with harmful substances was carried out by gas chromatography according to the guidelines for the determination of harmful substances in the air № 5098-89, № 3119-84. When comparing the results of studies of both groups, there were no statistically significant differences in the frequency distributions of allelic variants and genotypes of the IL-17A and MMP-1 genes. The AA/AG genotypes of the IL-17A gene were associated with an increased risk of severe disease compared to the GG genotype in workers in the main group (OR=6.1; 95% CI 1.33-28.5; p=0.021) and in the control group (OR=7.26; 95% CI 1.34-39.25; p=0.016). Carriers of the A allele in the control group increased the risk of severe chronic periodontitis by 2.4 times compared to carriers of the G allele (OR=2.41; 95% CI 1.19-4.87; p=0.014). During the dental examination of employees of the ethylene oxide plant, the clinical course of periodontal diseases was more severe in comparison with the control group, and the number of patients with severe periodontitis was twice as high. It was found that the AA/AG genotypes of the IL-17A gene and the carrier of the A allele are associated with increased susceptibility to the development of severe chronic periodontitis. The association between the MMP-1 gene polymorphism and the risk of severe forms of chronic periodontitis has not been established. A risk factor for the development of inflammatory periodontal diseases in employees of the petrochemical complex is a complex of harmful production factors.


2011 ◽  
pp. 36-42
Author(s):  
Hung Viet Bui ◽  
Thi Cu Nguyen

Objective: In Vietnam, obesity is increasing particularly in many large cities. Adult cardiovascular diseases are often derived from cardiovascular disorders during the children period. The implementation of early measures to prevent atherosclerosis, such as weight control, better lipid control will reduce the cardiovascular complications, such as hypertension (HTA), coronary heart diseases and some other diseases. Materials and Methods: Overweight - obese children from 5 to 15 years old who visited the Children's Hospital in Can Tho from May 2009 to May 2010. Total number of patients were chosen as 50 children. Method: Descriptive cross-sectional. Children in the study underwent Doppler ultrasound exam to evaluate cardiac morphology and cardiac function. Results: There were increases in left ventricular systolic diameter, left ventricular diastolic diameter, LV mass in overweight-obese children in the study compared with controls at all ages (p <0.05 ). Left ventricular ejection fraction in overweight-obese children in the study was lower than the control group at all ages (p> 0.05). The average rate of left ventricular shortening of overweight-obese children in the study was 34.8 ± 4.5(%). There was no difference in the rate of shortening of the left ventricle in overweight-obese children in the study compared with controls (p>0.05). There was no relationship between variation in morphology and left ventricular function with the degree of overweight-obesity in this study. Conclusion: The study showed that disturbances in morphology and left ventricular function in overweight-obese children but did not find a strong association with the disorder degree of overweight-obesity.


2021 ◽  
Vol 11 (8) ◽  
pp. 3365
Author(s):  
Benjie Law ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rama Krsna Rajandram ◽  
Abd Jabar Nazimi ◽  
...  

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.


Respiration ◽  
2021 ◽  
pp. 1-11
Author(s):  
Xiao Tang ◽  
Ying-Mei Feng ◽  
Ji-Xiang Ni ◽  
Jia-Ying Zhang ◽  
Li-Min Liu ◽  
...  

<b><i>Background:</i></b> There is still no clinical evidence available to support or to oppose corticosteroid treatment for coronavirus disease 2019 (COVID-19) pneumonia. <b><i>Objective:</i></b> To investigate the efficacy and safety of corticosteroid given to the hospitalized patients with COVID-19 pneumonia. <b><i>Methods:</i></b> This was a prospective, multicenter, single-blind, randomized control trial. Adult patients with COVID-19 pneumonia who were admitted to the general ward were randomly assigned to either receive methylprednisolone or not for 7 days. The primary end point was the incidence of clinical deterioration 14 days after randomization. <b><i>Results:</i></b> We terminated this trial early because the number of patients with COVID-19 pneumonia in all the centers decreased in late March. Finally, a total of 86 COVID-19 patients underwent randomization. There was no difference of the incidence of clinical deterioration between the methylprednisolone group and control group (4.8 vs. 4.8%, <i>p</i> = 1.000). The duration of throat viral RNA detectability in the methylprednisolone group was 11 days (interquartile range, 6–16 days), which was significantly longer than that in the control group (8 days [2–12 days], <i>p</i> = 0.030). There were no significant differences between the 2 groups in other secondary outcomes. Mass cytometry discovered CD3<sup>+</sup> T cells, CD8<sup>+</sup> T cells, and NK cells in the methylprednisolone group which were significantly lower than those in the control group after randomization (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> From this prematurely closed trial, we found that the short-term early use of corticosteroid could suppress the immune cells, which may prolong severe acute respiratory syndrome coronavirus 2 shedding in patients with COVID-19 pneumonia. <b><i>Trial Registration:</i></b> ClinicalTrials.gov, NCT04273321.


Metabolites ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 204
Author(s):  
Anissa Aharaz ◽  
Jens Henning Rasmussen ◽  
Helle Bach Ølgaard McNulty ◽  
Arne Cyron ◽  
Pia Keinicke Fabricius ◽  
...  

Medication deprescribing is essential to prevent inappropriate medication use in multimorbid patients. However, experience of deprescribing in Danish Subacute Medical Outpatient Clinics (SMOCs) is limited. The objective of our pilot study was to evaluate the feasibility and sustainability of a collaborative deprescribing intervention by a pharmacist and a physician to multimorbid patients in a SMOC. A randomized controlled pilot study was conducted, with phone follow-up at 30 and 365+ days. A senior pharmacist performed a systematic deprescribing intervention using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, the Danish deprescribing list, and patient interviews. A senior physician received the proposed recommendations and decided which should be implemented. The main outcome was the number of patients having ≥1 medication where deprescribing status was sustained 30 days after inclusion. Out of 76 eligible patients, 72 (95%) were included and 67 (93%) completed the study (57% male; mean age 73 years; mean number of 10 prescribed medications). Nineteen patients (56%) in the intervention group and four (12%) in the control group had ≥1 medication where deprescribing status was sustained 30 days after inclusion (p = 0.015). In total, 37 medications were deprescribed in the intervention group and five in the control group. At 365+ days after inclusion, 97% and 100% of the deprescribed medications were sustained in the intervention and control groups, respectively. The three most frequently deprescribed medication groups were analgesics, cardiovascular, and gastrointestinal medications. In conclusion, a collaborative deprescribing intervention for multimorbid patients was feasible and resulted in sustainable deprescribing of medication in a SMOC.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Menglu Jiang ◽  
Jiawei Ji ◽  
Xin Li ◽  
Zhenqing Liu

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.


Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Claudius Thomé ◽  
Ali Araghi ◽  
Jason Inzana ◽  
Jonathan Stieber ◽  
Joshua M Ammerman

Abstract INTRODUCTION Lumbar discectomy patients with large annular defects are at significantly greater risk for symptom recurrence and revision. Previous studies suggest that outcomes following revision surgery are less positive than outcomes from primary discectomy. This analysis aimed to assess the clinical and socioeconomic outcomes associated with postdiscectomy reoperations and the utility of a bone-anchored annular closure device (ACD) for avoiding reoperations. METHODS This study was a retrospective analysis of a prospective randomized controlled trial (RCT). Lumbar discectomy patients with large (>6 mm) annular defects were treated with discectomy alone (Control; n = 278) or discectomy with an ACD (n = 272). Patient-reported outcomes included visual analog scale (VAS) for ipsilateral leg or back pain and Oswestry Disability Index (ODI). At 3 yr, clinical outcomes were available for 75% of the patients. Comparisons of outcomes were made between reoperated (n = 64) and nonreoperated (n = 351) patients, regardless of ACD or Control treatment, at 3 yr following the primary surgery. RESULTS Reoperated patients had significantly worse scores for ODI (24 ± 19 vs 11 ± 13; P < .0001), VAS leg pain (28 ± 30 vs 12 ± 19; P < .0001), and VAS back pain (36 ± 31 vs 17 ± 21; P < .0001). Significantly more nonreoperated patients were working at 3 yr (97% vs 84%; P < .001). Based on Kaplan-Meier analysis, the proportion of subjects experiencing at least 1 index-level reoperation in 3 yr was 11% in the ACD group and 19% in the Control group (P = .007). CONCLUSION Index-level reoperations following lumbar discectomy are associated with worse outcomes and greater socioeconomic burden in patients with large annular defects (>6 mm). These findings are consistent with reports from large registry analyses, including the Spine Patient Outcomes Research Trial (SPORT) and the Swedish National Spine Registry (Swespine). The ACD reduced the number of patients experiencing index-level reoperation by 43%.


2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
A Chernova ◽  
SY Nikulina ◽  
OO Kuznecova

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University Aim. To evaluate the Association of rs1801252 polymorphism of the ADRB1 gene with dilated idiopathic cardiomyopathy (DCMP) and myocardial dilation of ischemic origin (DMI). Subjects and methods. The study included patients with ICMP and MD IG in the number of 221 people. The average age of the subjects was in the range of 55.30 ± 9.69 years. We divided the patients into 2 groups: the first – patients diagnosed with idiopathic dilatation cardiomyopathy and the second-patients with myocardial dilatation of ichemic origin. The number of patients in the first group was 111, including 99 men (89.2%) and 12 women (10.8%). The average age of patients in this group is 51.73 ± 9.74 years, in men 51.00 ± 8.96 years, in women 57.75 ± 3.71 years. The second group included patients with myocardial dilatation of ischemic origin. Their number is 110 people, including 100 men (91.5%) and 10 women (8.5%). The average age of respondents is 58.68 ± 8.38 years, for men 58.29 ± 8.46 years, for women 62.90 ± 6.29 years. The control group included patients who had no manifestations of cardiovascular diseases. Their number is 121 people (average age 53.6 ± 4.8 years). The patients underwent laboratory and instrumental studies, as well as molecular and genetic studies of the A145G polymorphism of the ADRB1 gene (rs1801252 ). All patients underwent coronary angiography. Based on the anamnesis data and instrumental studies, those patients who could be said to have no risk factors for the development of dilatation of the heart cavities were identified in the first group. And those patients who were reliably diagnosed with CHD were in the second group, that is, dilatation of the heart cavities is due to a previous myocardial infarction, existing angina pectoris. Results. In the group with DCMP 70.3% of patients were carriers of the common homozygous A145A genotype, the heterozygous A145G genotype-27.0%, and the rare homozygous G145G genotype-2.7%. In the control group 71.9% of patients were identified as carriers of a homozygous genotype by a common allele, and 25.3% were carriers heterozygous genotype, and homozygous genotype for a rare allele – 2.7%. Statistical analysis showed no achievement of statistical significance level across any of the genotypes. In the group with DM IG, there was no association with the rs1801252 polymorphism of the ADRB1 gene. Conclusion. A statistically significant association of rs1801252 of the ADRB1 gene with DCMP was not found. The association of DM IG c rs1801252 could not be confirmed.


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