Epidemiological features of the course of non-tumor mechanical jaundice (comparative clinical and statistical review)

2019 ◽  
pp. 102-109
Author(s):  
M. V. Kukosh ◽  
V. E. Fedorov ◽  
O. A. Logvina
Keyword(s):  
Old Age ◽  
Average Rate ◽  
Pathological Process ◽  
High Tech ◽  
Women Patients ◽  
Extrahepatic Cholestasis ◽  
Epidemiological Features ◽  
Number Of Patients ◽  
Complications Of Cholelithiasis ◽  
Complications And Mortality

The epidemiology of mechanical jaundice (MJ) caused by complications of cholelithiasis has its own specific historical characteristic: the first successes before the period associated with the accumulation of primary material, then – the development of additional methods of diagnosis of cholecystitis and its complications. The modern stage is connected with the introduction and development of high-tech minimally invasive technologies. The average rate of this disease is gradually increasing. This is primarily due to the introduction to the work of the surgeon, ultrasound and endoscopic diagnostics, allowing to separate a mechanical jaundice at the stage of the pathological process: extrahepatic cholestasis, stones in the bile ducts with hepatocytes and purulent cholangitis with septic manifestations. The percentages of frequency of each stage began to differ depending on the sex, age and severity of the syndrome of mutual aggravation of concomitant diseases. Complications in the form of MJ began to occur more often in men, although previously they prevailed in women. Patients with MJ in old age and old age often began to be hospitalized in surgical hospitals for operations. This led to a sharp increase in the number of patients with severe comorbidities or a combination of one or more decompensated diseases. At high figures remain indicators of complications and mortality, which do not tend to decrease.

scholarly journals WAYS TO IMPROVE THE RESULTS OF TREATMENT OF PATIENTS WITH CHOLELITHIASIS AND MECHANICAL JAUNDICE.

ASJ. ◽  
2021 ◽  
Vol 1 (56) ◽  
pp. 33-39
Author(s):  
R. Kalibatov ◽  
O. Logvina ◽  
R. Kalmykova
Keyword(s):  
Bile Ducts ◽  
Surgical Intervention ◽  
Pathological Process ◽  
Control Group ◽  
Results Of Treatment ◽  
Different Types ◽  
Complications Of Cholelithiasis ◽  
Personalized Approach ◽  
Complications And Mortality ◽  
Medium Weight

Purpose. To create a personalized tactic of surgical treatment of patients with BSD and MJ considering the stage of the pathological process and thereby improve the results of treatment. Materials and methods. The experience of diagnosis and treatment of 537 patients with complications of cholelithiasis, manifested by mechanical jaundice, was analyzed. The first stage was 537 minimally invasive decompressions of the biliary tract, the second-500 different types of endosurgical interventions. Results. Depending on the tactical principles, all the subjects were divided into two groups. In one (control) group (n = 249), patients were admitted from 2010 to 2014. Their treatment was empirical: decompression of the bile tree was performed at different times, and surgery was performed without taking into account the stages of the pathological process and the severity of the patients. In the other analyzed group (n = 251), patients were admitted to the hospital from 2015 to 2019. Their treatment tactics were personalized: taking into account the stages of mechanical jaundice. individual terms of decompression of the bile ducts and the choice of surgical intervention were determined. When comparing the results obtained, the advantage of the personalized approach was established: a decrease in the percentage of postoperative complications and mortality was revealed. Conclusion. In patients with cholelithiasis and jaundice, the severity of the condition is due to hyperbilirubinemia. Stage 2 of mechanical jaundice-determined by the severity of cytolysis in hepatic insufficiency, manifested by hypertransaminasemia. The severity of cholangitis is determined by purulent-inflammatory, as well as septic signs of the disease, characterized by leukocytosis, circulating immune complexes and medium-weight molecules. In the cholestatic stage of jaundice development, treatment is planned, in the cytolytic stage — urgent, and in cholangitis-emergency. The use of personalized tactics for the treatment of patients with breast cancer has reduced the number of complications and mortality.

Meaning of innovative technologies for improvement of results in treating burned patients

2020 ◽  
pp. 44-47
Author(s):  
A. A. Alekseev ◽  
A. E. Bobrovnikov ◽  
V. V. Bogdanov
Keyword(s):  
Clinical Practice ◽  
Medical Care ◽  
Clinical Effectiveness ◽  
High Tech ◽  
Comprehensive Treatment ◽  
Case Histories ◽  
Innovative Technologies ◽  
Treatment Technologies ◽  
Burn Disease ◽  
Complications And Mortality

In order to include innovative technologies in clinical recommendations, confirmation of their clinical effectiveness in comprehensive treatment of burned patients is necessary. 1,696 case histories of patients with burns were audited, which are divided into two groups depending on peculiarities of treatment. The use of innovative treatment technologies for burned patients has reduced the incidence of burn disease complications and mortality. Introduction of innovative technologies in treating burned patients into broad clinical practice improves results of provision of specialized, high-tech medical care for victims of burns.

COGNITIVE DEFICIENCY AT ISCHEMIC OM STROKE

2020 ◽  
Vol 1 (1) ◽  
pp. 55-57
Author(s):  
Dildora Khaydarova ◽  
◽  
Hilola Davronova ◽  
Asliddin Akbarov ◽  
Keyword(s):  
Social Problems ◽  
Cerebrovascular Diseases ◽  
Cerebral Stroke ◽  
Number Of Patients ◽  
High Prevalence ◽  
The World ◽  
Cognitive Deficiency ◽  
Complications And Mortality

Cerebrovascular diseases remain one of the most pressing medical and social problems in many countries of the world, due to their high prevalence, severity of complications and mortality. In Uzbekistan, the number of patients with cerebral stroke is quite large -about 40-45 thousandcases of cerebral stroke are registered annually

scholarly journals A comparative two-cohort study of pediatric patients with long term stay in ICUs

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julia García Mancebo ◽  
Sara de la Mata Navazo ◽  
Estíbaliz López-Herce Arteta ◽  
Rosario Montero Mateo ◽  
Isabel María López Esteban ◽  
...  
Keyword(s):  
Healthcare Resources ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Number Of Patients ◽  
Single Center Study ◽  
High Flow Oxygen ◽  
Hospital Acquired ◽  
Complications And Mortality ◽  
Second Period

AbstractDuring the last decades, the number of patients with long stay admissions (LSA) in PICU has increased. The purpose of this study was to identify factors associated with PICU LSA, assessing healthcare resources use and changes in the profile of these patients. A retrospective, observational, single-center study was carried out. Characteristics of LSA were compared between two periods (2006–2010 and 2011–2015). During the earlier period there were 2,118 admissions (3.9% of them LSA), whereas during the second period, there were 1,763 (5.4% of them LSA) (p = 0.025). LSA accounted for 33.7% PICU stay days during the first period and 46.7% during the second (p < 0.001). Higher use of non-invasive ventilation (80.2% vs. 37.8%, p = 0.001) and high-flow oxygen therapy (68.8% vs. 37.8%, p = 0.005) was observed in the 2011–2015 cohort, whereas the use of arterial catheter (77.1% vs. 92.6%, p = 0.005), continuous infusion of adrenaline (55.2% vs. 75.9%, p = 0.004), and hemoderivative transfusion (74% vs. 89.2%, p = 0.010) was less frequent. In the 2006–2010 cohort, hospital-acquired infections were more common (95.2% vs. 68.8%, p < 0.001) and mortality was higher (26.8% vs. 13.8%, p = 0.026). The number of long-stay PICU admissions have increased entailing an intensive use of healthcare resources. These patients have a high risk for complications and mortality.

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 ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Mucous Membrane ◽  
Recurrent Abdominal Pain ◽  
Pathological Process ◽  
Morphometric Study ◽  
Control Group ◽  
Epithelial Layer ◽  
Intestinal Villi ◽  
Postcholecystectomy Syndrome ◽  
Number Of Patients

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.

ULTRASOUND DIAGNOSTICS OF CHRONIC CONSTIPATION IN CHILDREN: RESULTS OF A CLINICAL STUDY

2021 ◽  
Vol 100 (6) ◽  
pp. 59-65
Author(s):  
L.N. Tsvetkova ◽  
◽  
M.M. Kolisnichenko ◽  
O.A. Goryacheva ◽  
◽  
...  
Keyword(s):  
Clinical Study ◽  
Anal Sphincter ◽  
Chronic Constipation ◽  
Diagnostic Method ◽  
Age Distribution ◽  
Age Groups ◽  
Pathological Process ◽  
Number Of Patients ◽  
Ultrasound Diagnostics ◽  
Sphincter Insufficiency

Chronic constipation (CC) is an important medical and social problem, as it can lead to the development of complications, fecal intoxication, social disadaptation and self-isolation of a child, as well as significantly reduce the quality of life. The article presents the results of a clinical study of CC in children using a new diagnostic method - transabdominal and transperianal ultrasound examination (US) of the colon and anorectal zone. The objective of the study was to analyze the course of CC in children depending on the mechanism of its formation according to US of the colon and anorectal zone. Materials and methods of research: the prospective cohort study included 470 children with an established diagnosis of CC at the age of 1 month to 17 years old. The patients were divided into 3 age groups: 1 month. – 3 years (n=166), 4–10 years (n=102), 11–17 years (n=202). The median follow-up was 48 months. The age distribution of children with CC was carried out on the basis of the frequency of visits, against the background of the beginning of attending kindergarten and/or elementary school groups, and the emergence of psychological problems due to the difficulty of going to a public toilet. An evaluation of analysis of the dynamics of US changes in the colon and anorectal zone was carried out by the method of ultrasound diagnosis of Hirschsprung's disease in children (patent № 2547614, authors M.I. Pykov, M.M. Kolisnichenko, I.V. Poddubny). Results: in children aged 1 month to 3 years, 66.9% of cases are statistically significantly dominated by proctogenic constipation type of constipation with US signs of anus spasm and anal sphincter insufficiency. In children aged 4 to 10 years, the mixed mechanism of CC formation prevails (41.1%), and in patients aged 11 to 17 years – cologenic (77.7%), for which the most typical ultrasound signs are dolichocolon (22.8%), anus spasm (8.7%), anal sphincter insufficiency (4.7%). It has been established that despite adequate therapy, the number of patients with the above-described mechanisms of formation of CC increases, which indicates the recurrence and progression of pathological process in children of different age groups. Conclusion: the proposed diagnostic method – transabdominal and transperianal US of the colon and anorectal zone is a highly informative, pathogenetically substantiated method for examining the state of the colon and anorectal zone in children with CC, built on precise objective criteria that are available at any age.

Experience with Continuous Ambulatory Peritoneal Dialysis in Belgium

1980 ◽  
Vol 1 (5) ◽  
pp. 54-58 ◽  
Author(s):  
Norbert H. Lameire ◽  
Marc De Paepe ◽  
Raymond Vanholder ◽  
Johan Verbanck ◽  
Severin Ringoir
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Average Rate ◽  
Sodium Concentration ◽  
Risk Category ◽  
Diabetic Patients ◽  
Serum Triglycerides ◽  
Number Of Patients ◽  
Stage Renal Disease ◽  
End Stage

This paper has reviewed experience in Belgium with 99 patients on CAPD. They represent 6-7% of all dialysis patients in this country. The principle reasons for selecting CAPD were old age, problems with vascular access and major cardiovas cular complications. Hemoglobin and hematrocrit values increased in all patients but preliminary measurements of red cell volume in some of them showed no change. Most patients showed moderate increases in serum triglycerides. In three non-diabetic patients with marked elevation in triglyceride levels, insulin, given intraperitoneally, prevented further increases. The frequency of peritonitis was still high; the average rate was one episode every 7.6 patient months. Other major complications included hypotension, which improved after the substitution of dialysate with a higher sodium concentration, severe respiratory disease and gangrene of the legs. After a mean follow-up of seven months, the death rate was 18% and the rate of technical success was 70%. The fact that most of our patients were in the high-risk category should be kept in mind when comparing these results with those obtained with other modes of treatment. At the end of 1978, a total of 1195 patients with end-stage renal disease (ESRD) were treated on either home or hospital dialysis in Belgium. There were 50 dialysis centers for a total population of 9.8 million. Of these 1195 patients, only seven were treated with either continuous ambulatory peritoneal dialysis (2-4) or intermittent peritoneal dialysis. Since then and until July 1, 1980 the number of patients treated with CAPD in Belgium has increased to 99 and this paper describes our experience with these patients.

P213 PROGNOSTIC SIGNIFICANCE OF CHANGES IN LYMPH NODE MORPHOLOGY ON SURVIVAL IN ESOPHAGEAL CANCER AFTER NEOADJUVANT THERAPY: A SYSTEMATIC REVIEW AND META-ANALYSES

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Hagens Eliza ◽  
Tukanova Karina ◽  
Jamel Sara ◽  
van Berge Henegouwen Mark ◽  
B Hanna George ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Tumor Regression ◽  
Average Rate ◽  
Prognostic Significance ◽  
Number Of Patients ◽  
Meta Analyses ◽  
The Impact

Abstract Aim To assess the prognostic significance of lymph node regression or downstaging following neoadjuvant therapy for esophageal cancer. Background and methods The prognostic value of histomorphologic regression in the primary esophageal cancer has been established, whilst the impact of lymph node response on survival still remains unclear. An electronic search was performed to identify articles evaluating lymph node regression or downstaging after neoadjuvant chemo- or chemoradiotherapy. Random effects meta-analyses were performed for regression and downstaging and primary outcome was the hazard ratio (HR) for overall mortality. Survival data were compared between patients with complete regression and those with partial or no response. Histopathological tumor regression in lymph nodes was defined by the absence of viable cells or degree of fibrosis. Furthermore, survival of patients with downstaged lymph nodes to N0 were compared to those with positive nodes following treatment. Results Eight articles were included, 4 of which assessed tumor regression (number of patients=789) and 4 assessing downstaging (number of patients=1937). Complete tumor regression (average rate of 30.0%) in the lymph nodes was associated with higher survival [HR= 0.63, 95% CI (confidence interval) = 0.43 – 0.92; p=0.017] (figure 1). Lymph nodes downstaging (average rate of 47.6%) had improved survival compared to node positivity (HR = 0.38, 95% CI = 0.29 – 0.50; p<0.0001) (figure 2). Conclusion A prognostic benefit was seen in patients with good lymph node response to neoadjuvant therapy, suggesting this should be used as an important additional prognostic marker in staging and in comparative evaluation of different neoadjuvant regimes.

Proton Accelerators for Radiation Therapy

2019 ◽  
pp. 11-22 ◽  
Author(s):  
А. Черняев ◽  
A. Chernyaev ◽  
Г. Кленов ◽  
G. Klenov2 ◽  
Андрей Бушманов ◽  
...  
Keyword(s):  
Proton Therapy ◽  
Statistical Data ◽  
The United States ◽  
Annual Number ◽  
High Tech ◽  
Extensive Experience ◽  
Number Of Patients ◽  
The World ◽  
New Ideas

Purpose: To make an analysis (including statistical data) of accelerator equipment for proton therapy (PT) in Russia and the world; to identify the main trends and directions of development in this area. Material and methods: Currently, proton therapy is developing rapidly in the world. Every year new proton centers are built. The number of commercial companies and research institutes, that are included in this high-tech sector, grows every year. Physicists and doctors together actively develop and introduce new ideas and technologies that are able to increase the efficiency and quality of proton therapy and also make it less costly. This review is an analysis of both publications in refereed publications, and reports made at relevant conferences and seminars. In addition, the data presented in the review are based on the information from the companies-manufacturers of equipment for proton therapy, which is open or provided for non-commercial use, with an indication of the sources. Results: In recent years, the main trends in the development of accelerators for proton therapy are: reducing the size and weight of machines, using of active pencil scanning as a standard method of dose delivering, reducing the time spent by patients in treatment rooms, using modulated radiation intensity in proton therapy. There is a transition from the construction of multi-cabin PT centers with an annual number of patients about 1000 people (due to their high cost and need to have an infrastructure for such big number of patients), to the creation of small-sized single-cabin complexes with an annual flow of several hundred people. Conclusion: Despite proton therapy has a good promotion and popularization activities, it is still an inaccessible method for most cancer patients with the exception of the United States, Japan and Europe. The lack of PT centers, the price per course of treatment, the lack of specialists in this area, and the attitude of most clinicians to PT as an experimental method of treatment is acute. In Russia, proton therapy does not receive enough support, despite the enormous potential and extensive experience that has been used for half a century of using PT. The last open proton center is private, and the only local manufacturer of equipment for PT exists only thanks to foreign contracts. Nevertheless, research and development continues. Moreover, the development is equal to the level of leading countries.

Hand Gesture Recognition Algorithm: A Real-Time Human-Body-Based Approach

2013 ◽  
Vol 303-306 ◽  
pp. 1338-1343
Author(s):  
Xin Xiong Li ◽  
Yi Xiong ◽  
Zhi Yong Pang ◽  
Di Hu Chen
Keyword(s):  
Real Time ◽  
Gesture Recognition ◽  
Human Body ◽  
Skin Color ◽  
Average Rate ◽  
Vital Role ◽  
Recognition Algorithm ◽  
Hand Gesture Recognition ◽  
High Tech ◽  
Hand Gesture

Despite the appearance of high-tech human computer interface (HCI) devices, pattern recognition and gesture recognition with single camera are still playing vital role in research. A real-time human-body based algorithm for hand gesture recognition is proposed in this paper. The basis of our approach is a combination of moving object segmentation process and skin color detector based on human body structure to obtain the moving hands from input images, which is able to deal with the problem of complex background and random noises, and a rotate correction process for better finger detection. With ten fingers detected, more than 1000 gestures can be recognized before concerning motion paths. This paper includes experimental results of five gestures, which can be extended to other conditions. Experiments show that the algorithm can achieve a 99 percent recognition average rate and is suitable for real-time applications.

Sign in / Sign up

Export Citation Format

Share Document