scholarly journals EVALUATION OF EFFECTIVENESS OF COMPREHENSIVE TREATMENT OF DUODENAL ULCER IN CHILDREN

2021 ◽  
Vol 19 (4) ◽  
Author(s):  
T.V. Sorokman ◽  
N.Ya. Cherney
Keyword(s):  
Duodenal Ulcer ◽  
Relative Risk ◽  
Nitrogen Oxide ◽  
Treatment Regimen ◽  
Nitrogen Monoxide ◽  
Comprehensive Treatment ◽  
Risk Of Recurrence ◽  
Complex Therapy ◽  
Donor Nitrogen ◽  
Late Stages

In the structure of pathology of the digestive organs 1.7–16% constitute peptic ulcerdisease, which in 90% of cases is associated with H.pylori infection.The aim is to evaluate the effectiveness of comprehensive treatment of duodenal ulcer inchildren.Material and methods: The study included 60 children at the age of 10 -18 years withHelicobacter pylori-associated duodenal ulcer (DU), who were divided into three groupsof 20 people depending on the treatment regimen (protocol, including the donor of nitrogen monoxide and capillary stabilizing preparation).Results. Complex therapy of the disease in children provides faster positive dynamics ofclinical and endoscopic symptoms, increases the frequency of eradication of Helicobacterpylori, the relative risk of recurrence will decrease by 0.57 times when included in thetreatment regimen of nitrogen oxide donor and 0.66 times when used along with theprotocol scheme of the donor nitrogen oxide and capillarotropic drug.Conclusion. Comprehensive treatment of DU provides more stable results of treatmentand decreases the disease recurrences both in the early and late stages of observation.

Overexpression of UBE2C in Esophageal Squamous Cell Carcinoma Tissues and Molecular Analysis

2021 ◽  
Author(s):  
Rong Li ◽  
xingfeng pang ◽  
Zhiguang Huang ◽  
Lihua Yang ◽  
Zhigang Peng ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Analysis ◽  
Survival Rate ◽  
Comprehensive Evaluation ◽  
Synergistic Effects ◽  
Comprehensive Treatment ◽  
Rna Seq ◽  
Mrna Expression Data ◽  
Risk Of Recurrence ◽  
Lower Survival Rate

Abstract Background: The treatment of esophageal cancer is mainly based on a combination of traditional surgery and radiotherapy/chemotherapy. Some new progress has been made in multidisciplinary comprehensive treatment and imaging diagnosis in recent years, but the 5-year survival rate for esophageal cancer is much lower than 30% due to its invasiveness and pronounced metastasis ability, as well as the difficulty in early diagnosis. This study aimed to elucidate the molecular mechanism of UBE2C in ESCC.Methods: In this study, we conducted a comprehensive evaluation of the UBE2C expression in ESCC by collecting the protein and mRNA expression data (including in house RNA- seq, in hosue IHC, TCGA-GTEx RNA-seq and tissue microarray) to calculate a combined SMD and sROC. K-M method was used for survival analysis. We also explored the mechanism of UBE2C in ESCC by combing the DEGs of ESCC, related-genes of UBE2C in ESCC and the putative miRNAs and lncRNAs which may regulate UBE2C.Results: UBE2C protein and mRNA were highly expressed in ESCC tissues. The pooled SMD of UBE2C expression values was 1.98 (95% CI: 1.51–2.45, P < 0.001), and the the AUC of the sROC was 0.93 (95% CI: 0.90–0.95). The results of survival analysis suggested an association between high expression of UBE2C and a poor prognosis and a higher risk of recurrence. Pathways anaylsis showed that UBE2C mainly influenced the biological function of esophageal cancer by synergistic effects with CDK1, PTTG1 and SKP2. We also constructed a potential UBE2C-related ceRNA network for ESCC (HCP5/hsa-mir-139-5p/UBE2C).Conclusion: UBE2C mRNA and protein level were highly expressed in ESCC and a higher UBE2C expression generally predicts a lower survival rate and a higher risk of recurrence.

THE NONOPERATIVE TREATMENT OF SURGICAL CONDITIONS IN CHILDREN

PEDIATRICS ◽  
1973 ◽  
Vol 51 (3) ◽  
pp. 435-453
Author(s):  
Mark M. Ravitch
Keyword(s):  
Duodenal Ulcer ◽  
Nonoperative Treatment ◽  
Exophthalmic Goiter ◽  
The Past ◽  
Manual Worker ◽  
Good For ◽  
Surgical Conditions ◽  
Late Stages

As the derivation of the word surgeon from its Greek roots indicates–however much to the dismay of today's cerebral practitioners of the craft–the surgeon is a manual worker. The operative act is so central to surgery and to the life of the surgeon that it has come almost to be equated with surgery and, although I decry it, the word surgery frequently replaces the word operation. The fact is, nevertheless, that operation, being the application of a mechanical technique to disease, is properly employed in the solution of mechanical problems. It is true that, in the past and in the present, some of the most brilliant achievements of surgery have been in the cure or correction of dangerous diseases certainly not mechanically caused, for which there was no nonoperative treatment. This was certainly true until recently for exophthalmic goiter and for that matter, while all would agree that ultimately some nonoperative method will prevail, there are many patients still–and children specifically–in whom I, among others, think hyperthyroidism is still best treated by operation. Nothing else is quite so successful as operation in the treatment of duodenal ulcer or most forms of cancer, yet all of us will accept the fact that in the end, since these are, except in their late stages, not mechanical diseases, specific and nonoperative treatments will be devised which will aim at directly reversing the causative mechanisms. It is precisely in this sort of a search that surgeons are constantly engaged. True enough, as surgeons, we believe that operations are unequivocally good for people.

1137A life support based comprehensive treatment regimen dramatically lowers the in-hospital mortality of patients with fulminant myocarditis —- a multiple center study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Chen ◽  
S Li ◽  
G L Cui ◽  
N Zhou ◽  
J G Jiang ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Treatment Regimen ◽  
Life Support ◽  
Length Of Hospital Stay ◽  
Fulminant Myocarditis ◽  
Circulatory Support ◽  
Positive Pressure ◽  
Hospital Death ◽  
Comprehensive Treatment ◽  
Positive Pressure Respiration

Abstract Background Fulminant myocarditis (FM) is characterized by rapid onset and progression to cardiac and circulatory failure. It has high mortality; however, patients may benefit from short-term circulatory support. This study evaluated the therapeutic efficacy of a life support–based comprehensive treatment regimen (LSBCTR) for FM and demonstrated that it saved the lives of FM patients. Methods One hundred and fourteen FM patients were recruited from January 2007 to October 2017 were divided into two groups: those who received LSBCTR (65 cases), including management of fluids and nutrients, use of antiviral drugs and large doses of glucocorticoids (methylprednisolone over 200 mg) and immunoglobulins, continuous renal replacement therapy (CRRT), and life support (artificial positive pressure respiration, intra-aortic balloon pump [IABP] with or without extracorporeal membrane oxygenation [ECMO]), and those who received traditional methods (74 cases). The primary endpoints were in-hospital death and length of hospital stay for survivors. Results Of the population, 41 patients (36.0%) died in the hospital. In-hospital mortality rates were 3.0% (2/65) for the LSBCTR group and 52.7% (39/74) for the traditional treatment group (P<0.001). Early life support (IABP with or without ECMO and a respirator) and early applications of CRRT, antiviral therapy, and sufficient doses of glucocorticoids and immunoglobulins individually contribute to the efficiency of reducing in-hospital mortality. Vasoactive agents did not improve prognosis, especially noradrenaline, which dramatically increased the incidence of death. Conclusion Our data described comprehensive treatment for patients with FM that can dramatically reduce in-hospital mortality. Its generalization and application in clinical practice will efficiently save lives. Clinical Trial: NCT03268642.

ASSESSMENT OF THE IMPACT OF ANTIREFLUX THERAPY ON THE COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
Vol 74 (10) ◽  
pp. 2580-2584
Author(s):  
Olesya I. Liakh ◽  
Mariya A. Derbak ◽  
Yelyzaveta S. Sirchak ◽  
Mariana I. Tovt-Korshуnska ◽  
Yana V. Lazur
Keyword(s):  
Clinical Symptoms ◽  
Clinical Signs ◽  
Chronic Obstructive ◽  
Comprehensive Treatment ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Basic Therapy ◽  
Complex Therapy ◽  
Antireflux Therapy ◽  
The Impact

The aim: To examine the effect of antireflux therapy on the course of COPD. Materials and methods: Under observation were 60 patients who were hospitalized in the «Transcarpathian Regional Clinical Hospital named after Andrei Novak» with a diagnosis of COPD II gr B in combination with GERD and 36 patients diagnosed with GERD who were treated on an outpatient basis. To study the effectiveness of antireflux therapy and its impact on the course of COPD, patients are divided into 2 groups: 1 group (main) (n = 60) – patients with COPD in combination with GERD, group 2 (control) (n = 36) – patients with isolated GERD. Patients with positive Helicobacter pylori status received antihelicobacter therapy. Patients in group 1 were divided into subgroups: 1a (n = 34) – COPD in combination with esophageal manifestations of GERD and 1b (n = 26) – COPD in combination with extraesophageal manifestations of GERD. Group 1a received complex therapy, which consisted of basic therapy of COPD in combination with antireflux and with rebapimide, group 1b – only basic therapy of COPD in combination with antireflux. Results: After treatment, the clinical signs of GERD significantly decreased in all patients receiving complex therapy, improved the course of respiratory symptoms of COPD. After treatment, patients showed a clinically significant reduction in systemic inflammation, which is best seen in the group with the use of rabipimide. Conclusions: Comprehensive treatment of combined pathology with the use of antireflux therapy has a positive effect not only on the clinical symptoms of the disease, but also on the indicators of external respiratory function in patients with combined COPD and GERD.

No Difference in Risk of Recurrent Venous Thrombosis between Men and Women. Results from a Family Cohort Study in 3356 Subjects.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 130-130
Author(s):  
Willem M. Lijfering ◽  
Michiel Coppens ◽  
Nic J.G.M. Veeger ◽  
Saskia Middeldorp ◽  
Karly Hamulyak ◽  
...  
Keyword(s):  
Relative Risk ◽  
Venous Thrombosis ◽  
Life Time ◽  
Recurrent Event ◽  
First Episode ◽  
Anticoagulant Treatment ◽  
Men And Women ◽  
Risk Of Recurrence ◽  
Recurrent Venous Thrombosis

Abstract Recent studies have suggested that men are at higher risk of recurrent venous thrombosis than women. It has been proposed to continue anticoagulant treatment after the first episode of thrombosis for a longer period in men, and to search for unidentified prothrombotic abnormalities in men that could explain these findings. However, men and women differ with respect to hormonal risk factors (pregnancy, oral contraceptives), and known thrombophilic defects did not show to increase the risk of recurrence. Moreover, follow-up in previous studies was relatively short (maximum 8 years). We analyzed sex differences in risk of recurrence in a family cohort of 3356 subjects (877 probands, 2479 relatives), who enrolled 5 studies to assess the absolute risk of venous thrombosis associated with currently known thrombophilic defects. Life-time risk of recurrence was calculated, related to sex, follow-up time, type of first and recurrent event (provoked, idiopathic), and thrombophilic defects. Of 816 subjects with a first episode of venous thrombosis, 337 (41%) had a recurrence after discontinued anticoagulant treatment. Overall relative risk of recurrence was 1.8 (95% CI, 1.5–2.3) in men compared to women. Women were younger at time of their first event (mean 34 years vs. 44 years, P< 0.001) and at time of recurrence (40 years vs. 48 years, P< 0.001). Excluding provoked (recurrent) venous thrombosis, the relative risk was 1.2 (95% CI, 0.8–1.7), while mean age at recurrence was comparable in men and women (50 years vs. 49 years, P= 0.595). Women revealed recurrence after a longer period than men (P=0.003), but this difference was not demonstrated if only idiopathic events were considered (P=0.938) (Figure). Recurrences were observed in 111/187 subjects (59%) with antithrombin, protein C or protein S deficiency, compared to 159/479 subjects (33%) with factor V Leiden, prothrombin G20210A or high factor VIII levels (P< 0.001). Within these subgroups, the risk of recurrence after an idiopathic event was comparable in men and women. We conclude that life-time risk of recurrent venous thrombosis is not different between men and women. A difference can be observed when the follow-up period is relatively short and is explained by a younger age of women at time of the first episode of venous thrombosis due to pregancy/puerperium and oral contraception and a longer interval between provoked first episode and recurrence in women. Figure Figure

High long-term absolute risk of recurrent venous thromboembolism in patients with hereditary deficiencies of protein S, protein C or antithrombin

2009 ◽  
Vol 101 (01) ◽  
pp. 93-99 ◽  
Author(s):  
Jan-Leendert Brouwer ◽  
Willem Lijfering ◽  
Min Ki ten Kate ◽  
Hanneke Kluin-Nelemans ◽  
Nic Veeger ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Relative Risk ◽  
Protein C ◽  
Absolute Risk ◽  
Protein S ◽  
Annual Incidence ◽  
Antithrombin Deficiency ◽  
S Protein ◽  
Risk Of Recurrence ◽  
Recurrent Venous Thromboembolism

SummaryHereditary deficiencies of protein S, protein C and antithrombin are known risk factors for first venous thromboembolism. We assessed the absolute risk of recurrence, and the contribution of concomitant thrombophilic defects in a large cohort of families with these deficiencies. Annual incidence of recurrence was estimated in 130 deficient patients, with separate estimates for those with each of protein S, protein C, and antithrombin deficiency, and in eight non-deficient patients with prior venous thromboembolism. All patients were also tested for factor V Leiden, prothrombin G20210A, high levels of factors VIII, IX and XI, and hyperhomocysteinemia. There were 81 recurrent events among 130 deficient patients. Median follow-up was 4.6 years. Annual incidences (95% confidence interval) of recurrent venous thromboembolism were 8.4% (5.8–11.7) for protein S deficiency, 6.0% (3.9–8.7) for protein C deficiency, 10.0% (6.1–15.4) for antithrombin deficiency, and overall 7.7% (6.1–9.5). Relative risk of recurrence in patients with a spontaneous versus provoked first event was 1.5 (0.95–2.3). Cumulative recurrence rates at 1, 5 and 10 years were 15%, 38% and 53%. Relative risk of recurrence with concomitant defects was 1.4 (0.7–2.6) (1 defect) and 1.4 (0.8–2.7) (≥2 defects). Annual incidence was 1.0% (0.03–5.5) in eight non-deficient patients. Annual incidence of major bleeding in deficient patients on oral anticoagulant treatment was 0.5% (0.2–1.0). We conclude that patients with a hereditary protein S, protein C or antithrombin deficiency appear to have a high absolute risk of recurrence. This risk is increased after a first spontaneous event, and by concomitance of other thrombophilic defects.

scholarly journals Low-Speed Marine Diesel Engine Modeling for NOx Prediction in Exhaust Gases

Energies ◽  
2021 ◽  
Vol 14 (15) ◽  
pp. 4442
Author(s):  
Branko Lalić ◽  
Andrijana Poljak ◽  
Gojmir Radica ◽  
Antonija Mišura
Keyword(s):  
Diesel Engine ◽  
Nitrogen Oxides ◽  
Nitrogen Dioxide ◽  
Nitrogen Oxide ◽  
Fuel Consumption ◽  
Compression Ratio ◽  
Fuel Injection ◽  
Nitrogen Monoxide ◽  
Exhaust Emissions ◽  
Injection Timing

Knowing the process of generating exhaust emissions and the determination of influential parameters are important factors in improving two-stroke slow-speed marine engines, particularly for further reductions in fuel consumption and stringent regulations on the limitation of nitrogen oxide emissions. In this article, a model of a marine low-speed two-stroke diesel engine has been developed. Experimental and numerical analyses of the nitrogen monoxide formations were carried out. When measuring the concentration of nitrogen oxides in the exhaust emissions, the amount of nitrogen dioxide (NO2) is usually measured, because nitrogen monoxide is very unstable, and due to the large amount of oxygen in the exhaust gases, it is rapidly converted into nitrogen dioxide and its amount is included in the total emission of nitrogen oxides. In this paper, the most significant parameters for the formation of nitrogen monoxide have been determined. Model validation was performed based on measured combustion pressures, engine power, and concentrations of nitrogen oxides at 50% and 75% of maximum continuous engine load. The possibilities of fuel consumption optimization and reduction in nitrogen monoxide emissions by correcting the injection timing and changing the compression ratio were examined. An engine model was developed, based on measured combustion pressures and scavenging air flow, to be used on board by marine engineers for rapid analyses and determining changes in the concentration of nitrogen oxides in exhaust emissions. The amount of nitrogen oxide in exhaust emissions is influenced by the relevant features described in this paper: fuel injection timing and engine compression ratio. The presented methodology provides a basis for further research about the simultaneous impact of changing the injection timing and compression ratio, exhaust valve opening and closing times, as well as the impact of multiple fuel injection to reduce consumption and maintain exhaust emissions within the permissible limits.

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