scholarly journals ASSESSMENT OF EFFICACY OF THE METHOD OF PROGRAMMED IRRIGATION ASPIRATION SANATION IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC OSTEOMYELITIS OF THE LONG BONES

2016 ◽  
Vol 175 (3) ◽  
pp. 40-43
Author(s):  
A. A. Glukhov ◽  
V. A. Sergeev

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.

2014 ◽  
Vol 2 (4) ◽  
pp. 20-31
Author(s):  
Irina Yurievna Klychkova ◽  
Yuri Alexeevich Lapkin ◽  
Mikhail Pavlovich Konyukhov ◽  
Yulia Aleksandrovna Stepanova ◽  
Vladimir Markovich Kenis

Conservative treatment of congenital clubfoot is generally accepted standard in the world orthopedic practice. There are many techniques that basically include functional methods and techniques of passive correction of the deformity. We analyzed 10 years of experience in the treatment of primary clubfoot according to three techniques - Zatsepin’s method, author’s method and Ponseti method. The evaluation of treatment results in the short and long terms was carried out. Analysis of long-term results showed a statistically significant advantage of Pontseti method over the other used techniques.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Céline De Cuyper ◽  
Tristan Pauwels ◽  
Eric Derom ◽  
Michel De Pauw ◽  
Daniël De Wolf ◽  
...  

Background. A patent foramen ovale (PFO) is a rare cause of hypoxemia and clinical symptoms of dyspnea. Due to a right-to-left shunt, desaturated blood enters the systemic circulation in a subset of patients resulting in dyspnea and a subsequent reduction in quality of life (QoL). Percutaneous closure of PFO is the treatment of choice. Objectives. This retrospective multicentre study evaluates short- and long-term results of percutaneous closure of PFO in patients with dyspnea and/or reduced oxygen saturation. Methods. Patients with respiratory symptoms were selected from databases containing all patients percutaneously closed between January 2000 and September 2018. Improvement in dyspnea, oxygenation, and QoL was investigated using pre- and postprocedural lung function parameters and two postprocedural questionnaires (SF-36 and PFSDQ-M). Results. The average follow-up period was 36 [12–43] months, ranging from 0 months to 14 years. Percutaneous closure was successful in 15 of the 16 patients. All patients reported subjective improvement in dyspnea immediately after device deployment, consistent with their improvement in oxygen saturation (from 90 ± 6% to 94 [92–97%] on room air and in upright position) (p<0.05). Both questionnaires also indicated an improvement of dyspnea and QoL after closure. The two early and two late deaths were unrelated to the procedure. Conclusion. PFO-related dyspnea and/or hypoxemia can be treated successfully with a percutaneous intervention with long-lasting benefits on oxygen saturation, dyspnea, and QoL.


Author(s):  
A. D. Yamkovoi ◽  
V. I. Zorya

Treatment results for 61 patients with diaphyseal fractures of long bones of the extremities are presented. Fractures of the humerus were diagnosed in18 (29.5%) patients, femur - in 22 (36.1%) and tibia - in 21 (34.4%) patients. In most cases fractures of A1, A2, A3 and B1 were observed. For osteosynthesis blocking and non-blocking Fixion intramedullary nails were used. Long-term results (1 - 1.5 years) were analyzed for 42 patients and showed excellent and good results in 93% of patients. Nonunion and deformity was observed in 7% of observations. The advantages of the technique included low traumatization, short duration of surgical intervention, minimum (up to 200 ml) blood loss.


2014 ◽  
Vol 21 (3) ◽  
pp. 34-39
Author(s):  
A. D Yamkovoi ◽  
V. I Zorya

Treatment results for 61 patients with diaphyseal fractures of long bones of the extremities are presented. Fractures of the humerus were diagnosed in18 (29.5%) patients, femur - in 22 (36.1%) and tibia - in 21 (34.4%) patients. In most cases fractures of A1, A2, A3 and B1 were observed. For osteosynthesis blocking and non-blocking Fixion intramedullary nails were used. Long-term results (1 - 1.5 years) were analyzed for 42 patients and showed excellent and good results in 93% of patients. Nonunion and deformity was observed in 7% of observations. The advantages of the technique included low traumatization, short duration of surgical intervention, minimum (up to 200 ml) blood loss.


2021 ◽  
Vol 12 ◽  
Author(s):  
Henrik Giese ◽  
Jennifer Antritter ◽  
Andreas Unterberg ◽  
Christopher Beynon

Objective: An increased interest in the surgical procedures of decompressive craniectomy (DC) and subsequent cranioplasty (CP) has emerged during the last decades with specific focus on mortality and complication rates. The aim of the present study was to evaluate long-term neurological and cosmetic outcomes as well as Quality of Life (QoL) after CP surgery.Methods: We retrospectively reviewed the medical records of CP patients treated at our institution between 2004 and 2014 and performed a follow-up examination, with evaluation of neurological outcome using the modified Rankin Scale (mRS) and the Glasgow outcome scale (GOS), QoL (SF-36 and EQ-5D-3L). Furthermore, the cosmetic results after CP were analyzed.Results: A total of 202 CP-patients were included in the present study. The main indications for DC and subsequent CP were space-occupying cerebral ischemia (32%), traumatic brain injury (TBI, 26%), intracerebral or subarachnoid hemorrhage (32%) and infection (10%). During a mean follow-up period of 91.9 months 46/42.6% of patients had a favorable neurological outcome (mRS ≤ 3/GOS ≥ 4). Patients with ischemia had a significant worse outcome (mRS 4.3 ± 1.5) compared with patients after TBI (3.1 ± 2.3) and infectious diseases requiring CP (2.4 ± 2.3). The QoL analysis showed that &lt;1/3rd of patients (31.2%) had a good QoL (SF-36) with a mean EQ-5D-VAS of 59 ± 26. Statistical analysis confirmed a significant worse QoL of ischemia patients compared to other groups whereas multivariate regression analysis showed no other factors which may had an impact on the QoL. The majority (86.5%) of patients were satisfied with the cosmetic result after CP and regression analysis showed no significant factors associated with unfavorable outcomes.Conclusion: Long-term outcome and QoL after CP were significantly influenced by the medical condition requiring DC. Early detection and evaluation of QoL after CP may improve the patient's outcome due to an immediate initiation of targeted therapies (e.g., occupational- or physiotherapy).


2021 ◽  
Vol 10 (5) ◽  
pp. 321-327
Author(s):  
Nike Walter ◽  
Markus Rupp ◽  
Katja Hierl ◽  
Christian Pfeifer ◽  
Maximilian Kerschbaum ◽  
...  

Aims We aimed to evaluate the long-term impact of fracture-related infection (FRI) on patients’ physical health and psychological wellbeing. For this purpose, quality of life after successful surgical treatment of FRIs of long bones was assessed. Methods A total of 37 patients treated between November 2009 and March 2019, with achieved eradication of infection and stable bone consolidation after long bone FRI, were included. Quality of life was evaluated with the EuroQol five-dimension questionnaire (EQ-5D) and German Short-Form 36 (SF-36) outcome instruments as well as with an International Classification of Diseases of the World Health Organization (ICD)-10 based symptom rating (ISR) and compared to normative data. Results With a mean follow-up of 4.19 years (SD 2.7) after the last surgery, the mean SF-36 score was 40.1 (SD 14.6) regarding the physical health component and 48.7 (SD 5.1) regarding the mental health component, compared to German normative values of 48.4 (SD 9.2) (p < 0.001) and 50.9 (SD 8.8) (p = 0.143). The mean EQ-5D index reached 0.76 (SD 0.27) with a mean EQ-5D visual analogue scale (VAS) rating of 65.7 (SD 22.7) compared to reference scores of 0.88 (p < 0.001) and 72.9 (p < 0.001). Mean scores of the ISR did not reveal significant psychological symptom burden, while an individual analysis showed moderate to severe impairments in 21.6% (n = 8) of the patients. Conclusion Even a mean 4.2 years (SD 2.7) after surgically successful treatment of FRI of long bones, patients report significantly lower quality of life in comparison to normative data. Future clinical studies on FRIs should focus on patient-related outcome measures enabling best possible shared treatment decision-making. Prevention methods and interdisciplinary approaches should be implemented to improve the overall quality of life of FRI patients. Cite this article: Bone Joint Res 2021;10(5):321–327.


Author(s):  
Oleg N. YAMSHCHIKOV ◽  
Nikita I. VORONIN ◽  
Dmitry A. MARKOV ◽  
Ksenia P. Zvereva

Today, the main method of surgical treatment of dysplastic coxarthrosis among adults is total hip prosthetics. Distant positive results according to foreign authors are 76–89%. One method of rehabilitation is physiotherapeutic treatment. The absence of standardized physiotherapeutic treatment protocols leads to a sharp reduction in the prescription of this type of rehabilitation measures. The aim of the study is to assess the long-term results of hip joint endoprosthetics among patients with dysplastic coxarthrosis using the developed physiotherapeutic treatment technique. Research materials and methods. For the period from 2010 to 2014, 205 patients were performed an operation with dysplastic coxarthrosis 1, 2, 3 degrees of Crowe. In the pre- and postoperative periods, patients of the main group were prescribed physiotherapeutic treatment according to the developed methodology. Evaluation of the results was carried out 12 months after surgical treatment using clinical and radiological methods, questionnaires using the Harris scale, SF-36. The obtained data were processed using statistical methods: Student coefficient, Pearson coefficient, correlation method. Results. When analyzing distant results, the average Harris score in the main group 85.82 (84.93–86.71) was significantly higher than in the comparison group 83.01 (82.02–84.00). The average score of the SF-36 questionnaire in the main group was significantly higher than in the comparison group (p < 0.001). Mental health indicators of patients were not significantly different from those of the postoperative period and were at a high level. Conclusions. Prescription of physiotherapeutic treatment promotes rapid healing of postoperative wounds and improves results of surgical treatment.


2021 ◽  
Vol 19 (1) ◽  
pp. 36-39
Author(s):  
Yu. A. Sheifer ◽  
◽  
I. S. Gelberg ◽  

Background. In destructive forms of pulmonary tuberculosis, especially in the presence of drug resistance of mycobacteria, one of the ways to increase the effectiveness of therapy is the use of collapse therapeutic techniques in various modifications. Purpose of the study: to develop and substantiate an algorithm for complex treatment of destructive forms of pulmonary tuberculosis, using artificial pneumothorax (AP). Material and methods: A cohort of 84 people with destructive pulmonary tuberculosis was formed. It was divided into two groups: 42 patients in the main group (chemotherapy (ChT) + AP) and 42 in the comparison group (ChT). Results: an algorithm for the treatment of patients with destructive forms of pulmonary tuberculosis was formulated. Within a period of up to 6 months, abacillation was achieved in 61.9% of cases in the main group (MG), and in 18.9% (p <0.05) in the comparison group (CG). By the 10th month of treatment, the closure of decay cavities was achieved in 78.7% of cases in the MG and in 42.8% (p <0.05) in the CG. By 12 months the closure of decay cavities was observed in 92.1 and 52.4% of cases respectively (p <0.05). Conclusions: The use of the algorithm for the complex treatment of destructive forms of pulmonary tuberculosis makes it possible to achieve abacillation at an earlier time (up to 6 months - in 61.9%). It also allows to increase the frequency of cavity closure by 39.6% as well as achieve an increase in clinical cure (according to long-term results of treatment) by 23.8% and a decrease in the amplification of drug resistance and mortality by 14.3% and 11.9% correspondingly.


2020 ◽  
Vol 9 (1) ◽  
pp. 35-45
Author(s):  
A. R. Propp ◽  
E. N. Degovtsov ◽  
S. A. Nikulina

RELEVANCE. The dependency results of draining operations on the efficcacy of drainig of ductal system of the pancreas and adequate outflow of the pancreatic juce through anastomosis are undoubtful, therefore the development of new techniques of longitudinal pancreatojejunostomy (LPJ) extending area of anastomosis is an actual challenge.AIM OF STUDY. To compare the immediate and long-term results of longitudinal pancreatojejunostomy with the expansion of the area of anastomosis in patients with chronic pancreatitis.MATERIAL AND METHODS. We analysed immediate and long-term results of LPJ in 58 patients with chronic pancreatitis with impaired patency of the major pancreatic duct (MPD) without the head enlargement.RESULTS. All patients were divided into two groups: comparison group ( n=26, operated up to 2008 ) and main group (n=32, operated stumps during the MPD diastasis and posterior pancreatic surface (n=3) into anastomosis, with resection of the anterior pancreatic surface in the form of triangular fragments (n=11), with circulation of the small intestine loop during the recovery phase (n=19). The original LPJ in the study group of patients did not lengthened the surgery (160 [135, 185]) and intraoperative blood loss (265 [175, 340]). In the main group of patients there was no postoperative complications and fatal outcomes, but the average duration postoperative hospital treatment (18 [16; 20.5]) exceeded some data of foreign and domestic authors. Pain within 5 years after surgery in patients of the main group exceeded 26.6% and the appearance of diarrheal syndrome with dependance from reception of enzyme preparations was twice lower than in patients og the comparison group. According to questionnaire EORTC QLQ-C30, 5 years after surgery statistically significant differences between groups in terms of scales CF, NV, DY (p=0.03, 0.02, 0.006 respectively), indicating the advantage of intervention performed in the mail group.CONCLUSIONS. 1. An indication for longitudinal pancreatojejunostomy in chronic pancreatitis is impaired patency of the main pancreatic duct in the absence of an increase and inflammatory mass in the pancreatic head.2. The width of the main pancreatic duct is less than 5 mm and the presence of diastasis between its proximal and distal stumps with the posterior surface of the pancreas preserved, is not a reason for refusing longitudinal pancreatic jujunostomy in favor of the resection method.3. The expansion of pancreatojejunal anastomosis when performing longitudinal pancreatojejunostomy can improve the immediate and longterm results of surgical treatment for chronic pancreatitis.


2016 ◽  
Vol 175 (2) ◽  
pp. 101-104
Author(s):  
V. I. Pomazkin ◽  
V. V. Khodakov

The work evaluated the long-term treatment results of 103 patients with complicated diverticular disease, who underwent the elective surgery in the volume of left hemicolectomy. The first group included 53 patients with recurrent diverticula. The second group consisted of 50 patients, who underwent the operation on diverticula of sigmoid colon with formation of sigmostoma on the first stage. The number of patients with functional gastro-intestinal and psyco-emotional disorders was more significant in the first group compared with the second group and it was associated with presence of these disorders before the operation. There was noted the reliable decrease of quality of life rates according to questionnaire scales MOS-SF 36 in the first group. The average indices of scales had some matching to the rates of health people in the patients of the second group. The authors came to conclusion, that indications for elective surgery should be determined very carefully in case of recurrent diverticula.


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