scholarly journals Comparison of the effectiveness of various conservative treatment options for trophic ulcers and varicose eczema

2021 ◽  
Vol 18 (2) ◽  
pp. 133-143
Author(s):  
E. V. Ivanov ◽  
E. P. Burleva
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Optimal Algorithm ◽  
Healing Process ◽  
Complete Healing ◽  
Venous Ulcers ◽  
Therapeutic Algorithms ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction. It has been for a long time considered that treatment of trophic venous ulcers and varicose eczema should be operative only. However, practice shows that such treatment doesn’t guarantee the complete healing of an ulcer or eczema and doesn’t always prevent the recurrence of pathological processes. It suggests the need for an integrated approach to the treatment of trophic venous ulcers and varicose eczema.Aim. Analyze the effectiveness of various methods of non-surgical treatment of venous trophic ulcers (TU) and varicose eczema (VE) to create an optimal algorithm for managing this category of patients in outpatient practice.Materials and methods. A prospective comparative cohort study of 252 patients with C4-C6 CVD classes (CEAP) was conducted. 178 people (71%) had venous TU , 74 (29%) – VE. 3 groups of patients were formed: 1 gr. – (n = 68) was treated with traditional medicines and standard topical therapy (control); 2 gr. – (n = 90) received MOFF, elastic compression (Pütterbinde bandage), systemic antibiotic therapy for TU and corticosteroids for VE, dressings using Hartmann wound coverings; 3 gr. – (n = 94) in addition to the treatment similar to group 2, sclerotherapy (ST) of pathological venous reflux was performed. The follow-up lasted 6 months (8 visits) with a comprehensive clinical, laboratory and instrumental assessment. Statistical processing of the results was carried out using the STATISTICA software package (StatSoft, Inc., 2001, version 6.0).Results. By the end of the study, the following positive trends were registered in group 2 compared to group 1: the total VCSS index was 1.5 times lower, and according to the 10 – point VAS – 3 times; TU healing/ VE remission occurred 2 months earlier, complete healing of TU was noted in 75% of patients vs 63%, remission of VE-in 81% vs 47%. The combination of elimination of pathological reflux by CT and MOFF therapy (group 3 patients) was particularly effective. When comparing group 1 with group 3, it turned out that in the latter, by the end of the study, the total VCSS index was 3 times lower; the total indicator for the 10 – point VAS was 5.5 times lower for TU, 10 times higher for VE; TU healing/VE remission occurred 4 months earlier, complete healing was noted in TU in 88% of patients vs 63%, remission of VE in 96% vs 47%. Based on the obtained data, therapeutic algorithms were proposed for the management of patients with venous TU and VE in outpatient settings.Conclusions. Conservative treatment of venous TU and VE can be an alternative to surgical treatment, or an addition to it. MOFF is the most effective venotonic of complex action prescribed for the treatment of TU/VE in the form of monotherapy. Sclerosing therapy is a full-fledged element of the complex treatment of venous TU. The use of the proposed treatment algorithms makes it possible to speed up the healing process of venous TU and achieve remission of VE by three times. 

The management of sinogenic orbital complications

1995 ◽  
Vol 109 (4) ◽  
pp. 300-303 ◽  
Author(s):  
Bharath Singh
Keyword(s):  
Conservative Treatment ◽  
Eye Movement ◽  
Late Stage ◽  
Stage Disease ◽  
Intravenous Antibiotics ◽  
Late Stage Disease ◽  
Group 3 ◽  
Group 2 ◽  
Orbital Complications ◽  
Group 1

AbstractThe place of conservative treatment in sinogenic orbital complications has not been fully explained in the literature. The question that remains unresolved is – at which stage of the disease is surgery indicated?A study was undertaken in 240 patients with sinogenic orbital complications, to determine this. The patients were divided into three groups according to the stage of the disease as determined clinically: Group 1 (52 patients) with early stage disease, as detected by cellulitis only; Group 2 (76 patients) with intermediate stage, as detected by periorbital cellulitis and proptosis, but with full range of eye movement and unaltered vision: Group 3 (122 patients) with late stage disease, as detected by periorbital cellulitis and gross proptosis. with limitation of eye movement and altered vision.Group I and Group 2 patients were treated conservatively, with intravenous antibiotics and antral lavage. Group 3 patients were treated with intravenous antibiotics and surgery. External frontoethmoidectomy was performed in 31 (bilateral in two), ethmoidectomy in 91 (bilateral in five), sphenoidectomy in 15 and bilateral antral washout in all (122 patients). There was 100 per cent success with conservative treatment in Group 1 patients, whilst in Group 2 there was 98.6 per cent failure. The 75 patients in whom conservative treatment failed were successfully treated with surgery: frontoethmoidectomy was performed in 66 and ethmoidectomy in nine. In Group 3 patients, 100 per cent success was achieved with intravenous antibiotics and surgery.Sinogenic orbital complications can be treated conservatively and surgically, depending on the stage of the disease on presentation. Conservative treatment is only suitable for early complications, i.e. patients with periorbital cellulitis only. For disease beyond this stage i.e. intermediate and late stage disease, surgery is the treatment of choice.

Contemporary aspects of pathogenetically substantiated therapy of adenomyosis

2016 ◽  
Vol 7 (3) ◽  
pp. 92-97 ◽  
Author(s):  
Arutyun F Arutyunyan ◽  
Sergey N Gaydukov ◽  
Vitaly N Kustarov
Keyword(s):  
Blood Flow ◽  
Conservative Treatment ◽  
Survey Data ◽  
Clinical Symptoms ◽  
Uterine Blood Flow ◽  
Uterine Arteries ◽  
Group 3 ◽  
Group 2 ◽  
Pathogenic Effects ◽  
Group 1

The purpose of our study was to assess the effectiveness of the use of drugs containing indole-3-carbinol and epigallocatechin-3 gallate in combination with effective natural methods (TES-therapy and hirudotherapy) depending on the degree of morphological adenomyosis. The study involved 205 women with diffuse adenomyosis. Based on survey data from 205 women surveyed in 67 verified adenomyosis first degree (Group 1), 79 - second degree adenomyosis (group 2), and 59 - third degree adenomyosis (group 3). Doppler results showed that in patients with adenomyosis first degree nizkorezistentny uterine blood flow was observed. Improvement of clinical symptoms of the disease, increasing the numerical values of R & D in the uterine arteries at the first degree adenomyosis indicates pathogenic effects of the proposed treatment. At the same time in patients with adenomyosis II-III degree was observed with highly bloodstream, indicating the deterioration of blood flow in the uterine vascular basin, as evidenced by some of hemostasis. Thus, studies have provided credible evidence pathogenesis mediated relations between the characteristics of the circulation of the uterus, the processes of neoangiogenesis, proliferation in the myometrium and the extent of spread of the disease, which will choose the appropriate methods of conservative treatment. Using drugs and Indinol epigallat affecting the basic pathogenetic mechanisms of adenomyosis, opens a new direction in the treatment of this disease, and effective natural methods - new opportunities in the treatment of adenomyosis.

scholarly journals Long-term results of surgical treatment of thyroid adenomas

2019 ◽  
Vol 100 (6) ◽  
pp. 892-897
Author(s):  
Stanislav Olegovich Artyukhin ◽  
Vladimir Georgievich Aristarhov ◽  
Denis Anatolyevich Puzin
Keyword(s):  
Surgical Treatment ◽  
Needle Aspiration ◽  
Long Term Results ◽  
Fine Needle ◽  
Thyroid Adenomas ◽  
Follicular Tumor ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To study the long-term results of surgical treatment of patients with thyroid adenomas. Methods. From 2004 to 2006, 667 patients with follicular adenomas of the thyroid gland, including 134 (20.1%) men and 533 (79.9%) women, were operated on in the surgical department №2 of city clinical hospital №11 of Ryazan. 3 groups of patients were defined: group 1 operated on for solitary adenomas of the thyroid gland, 103 patients, hemithyreoidectomy performed; group 2 operated on for multiple adenomas of the thyroid in both lobes, 101 patients, thyroidectomy performed; group 3 32 patients operated on for multiple adenomas of the thyroid in the same lobe, hemithyreoidectomy performed. Patients were examined 14 years after the surgery. Results. Hypothyroidism was diagnosed in: group 1 18 (17.5%) patients, group 2 101 (100%), group 3 0. All patients with hypothyroidism were compensated with hormone replacement therapy. Permanent hypoparathyroidism was diagnosed only in group 2 8 (4.8%) patients. Unilateral laryngeal paralysis was found in group 1 in 1 (0.9%) patient, group 2 in 2 (1.9%) patients, group 3 contained no such patients. Recurrence (node more than 1 cm according to ultrasound) was observed in group 1 in 12 (11.7%) patients; fine-needle aspiration found colloidal nodes in 8 (7.8%) patients (Bethesda II), in 4 (3.9%) follicular tumor (IV). Group 2 had no recurrences. In group 3 11 (34.3%) patients had recurrence; fine-needle aspiration found colloidal nodes in 1 (3.1%) patient (Bethesda II), in 10 (31.3%) follicular tumor (Bethesda IV). Conclusion. In solitary adenomas it is possible to perform organ-saving operations, which reduces the percentage of postoperative complications; in multiple adenomas, the optimal volume of surgery is thyroidectomy; when multiple adenomas are localized in one lobe, the chance of recurrence of the disease (31.3%) is high leading to re-surgery.

Fibrin gel versus papain gel in the healing of chronic venous ulcers: A double-blind randomized controlled trial

2016 ◽  
Vol 32 (7) ◽  
pp. 488-495 ◽  
Author(s):  
Illymack CF de Araújo ◽  
Elenice Defune ◽  
Luciana PF Abbade ◽  
Hélio A Miot ◽  
Matheus Bertanha ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Efficacy And Safety ◽  
Fibrin Gel ◽  
Double Blind ◽  
Randomized Controlled ◽  
Carbopol Gel ◽  
Venous Ulcers ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives Compare the efficacy and safety of fibrin gel to 8% papain gel for wound dressing of venous ulcers. Method Patients with chronic venous ulcers were randomly assigned to one in three groups: Group 1—fibrin gel; Group 2—8% papain gel; Group 3—carbopol gel (control). Patients were seen every 15 days during 2 months, verifying reduction of the ulcer area, local infection, exudation, and epithelization. All serious or nonserious adverse events were recorded. Results Fifty-five patients (total of 63 ulcers) were randomly distributed in three groups (G1 = 21; G2 = 19; G3 = 23). No patient was excluded or discontinued treatment throughout the study. The areas of the ulcers were similarly reduced in all groups (14.3%, 21.1%, and 30.4% in groups 1, 2, and 3, respectively), and all had significant reduction in exudation and contamination. Conclusion The data demonstrate that neither fibrin gel nor papain gel were able to improve the process of ulcer-healing, as compared to control.

scholarly journals Usefulness of Tokuhashi Score in Survival Prediction of Patients Operated for Vertebral Metastatic Disease

2017 ◽  
Vol 7 (3) ◽  
pp. 260-265 ◽  
Author(s):  
Marcelo Gruenberg ◽  
Maximiliano E. Mereles ◽  
Gastón O. Camino Willhuber ◽  
Marcelo Valacco ◽  
Matias G. Petracchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Spinal Metastasis ◽  
Survival Prediction ◽  
Survival Times ◽  
Primary Tumor Site ◽  
Tokuhashi Score ◽  
Group 3 ◽  
Group 2 ◽  
Almost All ◽  
Group 1

Study Design: Retrospective study. Objective: Spinal metastasis can produce pain, deformity, neurological compromise and can decrease life expectancy. Surgical management is usually indicated for pain control, neurological decompression, and to avoid deformity progression. Tokuhashi et al created a scoring system to estimate survival and stratify surgical treatment based on established parameters. Our objective was to evaluate the usefulness of Tokuhashi scoring (TS) system by comparing the predicted and real survival times and analyze the survival time according to the type of tumor. Methods: From 2004 to 2014, 105 patients with vertebral metastasis who underwent surgical treatment were enrolled and retrospectively analyzed. Preoperative TS was performed in all cases. Patients were classified into 3 groups according to TS; group 1 (TS 0-8), group 2 (TS 9-11), and group 3 (TS 12-15). Patients’ average age was 61.5 years, main primary tumor site were as follows: kidney (23%), lung (19%), and breast (18%). Results: The Tokuhashi general concordance was 67.6%. Per group concordance was as follows: group 1 80%, in group 2, only 33% of concordance was observed. In group 3, 100% of concordance was observed. In group 2, the most common primary sites were breast and kidney and the mean survival was 20 and 22.3 months, respectively, both longer than that expected for this group. Conclusions: Tokuhashi concordance was acceptable in our study, particularly in lower and higher scores. The lesser concordance observed in group 2 (33.3%) was observed in almost all tumors. For our practice, TS constitutes an acceptable tool to define survival, particularly in lower and higher scores.

scholarly journals Is electrosurgery fulguration a better procedure for Bartholin’s gland cyst?

2020 ◽  
Vol 66 (2) ◽  
pp. 201-209
Author(s):  
Marcia Farina Kamilos ◽  
Celso Luiz Borrelli ◽  
Ruben Sciuto ◽  
Fernanda Pereira Cotrim ◽  
Eduardo Carvalho de Arruda Veiga ◽  
...  
Keyword(s):  
Conventional Technique ◽  
Treatment Session ◽  
Complete Healing ◽  
Lower Percentage ◽  
Control Group ◽  
Bartholin’S Gland ◽  
Surgical History ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SUMMARY OBJECTIVE To evaluate the effectiveness of electrosurgery fulguration as a treatment for Bartholin’s gland cysts. DESIGN Retrospective study with a comparative control group performed on Hospital Brigadeiro and in the Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo from February 2005 to March 2009. Patients: Patients with Bartholin’s gland cyst were divided into three treatment groups: group 1 electrosurgery (n=169 cases); group 2 - gland excision with the conventional technique using a cold scalpel (n = 51 cases); group 3 - marsupialization (n=11 cases). We reviewed the clinical and surgical history, physical examination, description of the surgical technique, postoperative results (success and complications), and follow-up data. RESULTS There is no difference between groups in relation to intraoperative bleeding, hematoma, and complete healing in a single treatment session. However, electrosurgery shows the lower percentage of recurrences 18 (10,7%) compared to the Marsupialization technique (group 3, p=.031). Recurrences occurred in 18 (10,7%), 3 (5,9%), and 4 (36,4%) cases. After retreatment by the same technique, there was a complete cure rate of 90% (152/169) for group 1, and 98% (50/51) for group 2. The cost of group 1 was lower than that of other groups. CONCLUSION The fulguration with electrosurgery of the capsule of Bartholin’s cyst is an effective method of treatment, andthe cost of this technique is lower than the conventional technique and marsupialization.

scholarly journals THE EFFECT OF PHOTODYNAMIC THERAPY AND PLATELET-ENRICHED PLASMA ON THE HEALING OF SKIN RADIATION ULCERS INFECTED BY STAPHYLOCOCCUS AUREUS

2020 ◽  
Vol 25 ◽  
pp. 338-352
Author(s):  
M. Krasnoselsky ◽  
◽  
O. Pushkar ◽  
L. Simonova ◽  
M. Myroshnychenko ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Photodynamic Therapy ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Radiation Ulcer ◽  
Group 3 ◽  
Group 2 ◽  
Radiation Ulcers ◽  
Infected Skin ◽  
Group 1

Objective. To determine in experiment the quality of healing of skin radiation ulcers infected with Staphylococcus aureus (S. aureus) under the photodynamic therapy (PDT) administration and the use of platelet-rich plasma (PRP). Materials and methods. The experiment was performed on 95 male WAG rats of 6 months of age, which were divided into three groups. Group 1 included animals in whom a skin radiation ulcers in the thigh area was simulated, followed by application of a 0.2 ml suspension of reference strain of S. aureus to its surface on the 7th day after irradiation. Group 2 included animals with S. aureus-infected skin radiation ulcers, in whom the PET was administered a day after infection contamination. Group 3 included animals with S. aureus-infected skin radiation ulcers, in whom the PDT was administered a day after infection in the morning, and the PRP was manifold injected in periwound area in the afternoon. The skin with underlying soft tissues from the area of radiation damage were the material for morphological examination. The hematoxylin and eosin, picrofuxin according to van Gizon, Mallory staining were applied to micropreparations. A morphometric study was conducted. Results. In animals with skin radiation ulcers, in whom the PDT was administered upon infection with S. aureus (group 2), compared with animals with simulated infected skin radiation ulcers without treatment (group 1), The activation (i.e. accelerating) of the healing occurred for the period from the 14th to the 52nd day of experiment due to the active processes of wound cleansing from necrotized tissues, less pronounced inflammatory changes in the lesion, and active of appearance and maturation of granulation tissue, less pronounced hemodynamic, ischemic and alternative disorders in the dermis, hypodermis, muscle tissue surrounding the wound cavity, activation of proliferative processes in epithelial layer localized in the marginal parts of the wound. Formation of pathological (hypertrophic or keloid) scar of the skin was the result of healing of skin radiation ulcer infected with S. aureus. In animals with radiation ulcers infected with S. aureus, in the case of PDT and PRP (group 3) the regenerative process was directed not only at accelerating the rate of healing, but also on restoration of original structure of the lost parts of the skin compared with only PDT administration (group 2). Acceleration of the healing of the infected skin radiation ulcer in animals of groups 2 and 3 was due to similar processes. Conclusions. Photodynamic therapy activates and accelerates the healing process of skin radiation ulcers infected with S. aureus and leads to formation of a pathological scar (hypertrophic or keloid). Healing of the infected S. aureus radiation ulcers occurs more actively upon the photodynamic therapy administration in combination with multiple periwound injections of the platelet-enriched plasma, compared with only photodynamic therapy administration, and finishes with an organotypic regeneration and almost complete skin recovery. Key words: photodynamic therapy, platelet-rich plasma, radiation skin ulcer, Staphylococcus aureus, morphology.

scholarly journals Comparative Evaluation of Aortic Valve Replacement Methods in Patients Over 70 with Aortic Stenosis

2018 ◽  
Vol 7 (3) ◽  
pp. 227-233 ◽  
Author(s):  
V. V. Sokolov ◽  
M. V. Parkhomenko ◽  
A. I. Kovalyov ◽  
V. V. Vladimirov ◽  
O. L. Shiryayeva ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Hospital Mortality ◽  
Heart Diseases ◽  
Surgical Techniques ◽  
Results Of Treatment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

BackgroundAs life expectancy and quality of health improve, more and more people reach old age, and so does the number of heart diseases. One of the most urgent problems among elderly patients is degenerative stenosis of the aortic valve (AV). The conservative treatment of symptoms of chronic heart failure with AV stenosis improves the patient’s condition only for a while, whereas surgical treatment such as replacement of AV is recognized as the main effective method of treating a defect. Recently, alternative technologies for prosthetic AV have been developed, aimed at reducing adverse effects of artificial circulation (AC) in high-risk patients and minimizing the scope of surgical intervention.Aim of studyThe aim of the study was to evaluate the immediate results of surgical treatment of aortic stenosis using different methods in patients over 70.Material and methodsThe article presents the results of treatment of 64 patients over 70 with isolated AV stenosis, operated with different surgical techniques from July, 2016 to January, 2018. All patients were divided into three groups, differing in the severity of the initial condition and the method treatment. Group 1 (transcatheter implantation of the prosthetic AV, EuroSCORE II — 21.81%) consisted of 19 patients, Group 2 (non-suture implantation of a Perceval prosthetic valce under the AC, EuroSCORE II — 13.81%) consisted of 13 patients and Group 3 (“standard” prosthetics, EuroSCORE II — 9.89%) consisted of 32 patients.ResultsIn Group 1, two patients died, the hospital mortality was 10.5%. In Group 2 and Group 3, one patient died, the hospital mortality was 7.6 and 3.1%, respectively. Implantation of a permanent pacemaker was required in three patients (15.7%) from the TAVI group after installation of Medtronic Core Valve and two patients (15.3%) from the Perceval group.ConclusionThe obtained results of AV replacement by various methods allowed to expand indications for the management of AV stenosis in patients of the older age group with a high surgical risk of operation under AC conditions who had not previously been considered candidates for surgical treatment of aortic malformation due to the age and severity of the concomitant pathology.

scholarly journals Histopathological effect of platelet-rich plasma on cranial dura mater defects

2021 ◽  
Vol 38 (4) ◽  
pp. 525-528
Author(s):  
Kemal PAKSOY ◽  
Kerameddin AYDIN
Keyword(s):  
Dura Mater ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Female Rats ◽  
Wound Healing Process ◽  
Surface Areas ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

There are many new studies in the selection of materials used in dura material repair. Platelet has important function in hemostasis and coagulation. Also, activated platelets initiate the wound healing process. They provide regeneration of tissue with the appropriate type of tissue. In this experimental study, we used platelet-rich plasma (PRP) on dura mater defect due to these properties. Materials and method: Our study started after we got the approval of Ondokuz Mayıs University Animal Experiments Local Ethics Committee. Thirty Wistar Albino female rats were used. The rats were divided into three groups, each one includes ten. Results: No significant difference was observed in the thickness and surface areas of dura mater in group 1 and group 2. Significant increase was observed in the thickness and surface areas of dura mater in the PRP applied group (Group 3) compared to other groups. New bone areas and new vasculature were observed more frequently in the PRP rooms group (Group 3). Statistical analysis of the data was done by using SPSS 21.0 for Mac (IBM Corporation) statistical package program and based on 0.05 significance level. A significant difference was observed between Group 1 and Group 3 (p> 0.05), a significant difference was observed between both Group 1 and Group 3 and between Group 2 and Group 3 (p <0.05). Conclusion: Providing the regeneration of dura mater in defect situations will contribute to the protection of the barrier feature. In line with this idea, it is thought that PRP can be beneficial for us to reach this goal.

scholarly journals Sperm phenotypes in varicocele

2019 ◽  
Vol 20 (4) ◽  
pp. 24-33
Author(s):  
O. B. Zhukov ◽  
E. E. Bragina ◽  
A. V. Levin
Keyword(s):  
Surgical Treatment ◽  
Treatment Group ◽  
Conservative Treatment ◽  
Control Group ◽  
Sperm Ultrastructure ◽  
Study Objective ◽  
Sperm Analysis ◽  
Before And After ◽  
Group 2 ◽  
Group 1

The study objective is to microscopically evaluate the morphology of sperm in patients with varicocele after surgical treatment and therapy with Prostatilen® AC.Materials and methods. The treatment group included 20 males between 26 and 45 years of age (mean age 31.6 ± 6.1 years) with various stages of varicocele and fertility problems; among them, 10 patients with subclinical stages of varicocele received conservative treatment with Prostatilen® AC (group 1) and were examined before and after the treatment; 10 males with infertility caused in part by varicocele of the spermatic cord veins were examined 6 months to 3 years after surgical treatment (group 2). Standard clinical and lab tests, sperm analysis, electron microscopy of the ejaculate were performed. The control group included 65 fertile males whose sperm samples were obtained from a bank of reproductive cells and tissues and used for comparison in microscopic examination.Results. In patients who received conservative treatment the number of sperm with immature chromatin decreased (p = 0.045) compared to the control group. This characteristic differed in patients after varicocelectomy and patients after conservative treatment (p = 0.037). Compared to control, the number of sperm with excess residual cytoplasm in the head and neck was higher in patients after varicocelectomy (p = 0.011). After conservative treatment, the number of sperm with excess residual cytoplasm was close to the control number and lower than in patients after varicocelectomy (р = 0.028).Conclusion. In patients with subclinical varicocele, conservative treatment with Prostatilen® AC leads to significant improvement in sperm ultrastructure compared to patients who underwent surgery to treat this pathology. 

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