scholarly journals Art, craft and science of limb amputation Part 2. Сraft of amputation: from Ambroise Pare to Pierre Dionis (late XVI century – early XVIII century)

2021 ◽  
Vol 8 (2) ◽  
pp. 6-27
Author(s):  
S. P. Glyantsev
Keyword(s):  
Soft Tissues ◽  
Local Treatment ◽  
Legal Framework ◽  
Postoperative Management ◽  
Postoperative Treatment ◽  
Limb Amputation ◽  
Xvii Century ◽  
Before And After ◽  
Tissue Flap ◽  
Soft Tissue Flap

Since the XVI century until the beginning of the XVII century an operation of limb amputation has undergone changes and improvements that have affected all its aspects: preparation for carrying out, the technique of performing and postoperative treatment of patients. The invention of the ligature (1552) and the tourniquet (1674) became revolutionary. Wet and dry gangrene, extensive trauma to soft tissues and bones, traumatic limb amputation and osteomyelitis were considered of indications for amputation. The deontological and legal framework for amputation was developed, including the patient’s consent to the operation and the awareness of relatives about its outcomes. The article presents an instrumental and dressing apparatus of the XVII century for the operation; medicines used for general and local treatment of the patient before and after truncation of the stump; sedation and pain relief issues; technique of circular and one soft tissue flap (1679) amputation; the choice of tissue dissection level; methods of stopping bleeding (astringents, pressure bandage, cauterization, ligation and stitching of blood vessels); a method of stitching a stump wound, applying a bandage on it and strengthening it; postoperative management (regimen and diet, dressing change, staged wound treatment, complications); the phenomenon and causes of “phantom limbs”.

scholarly journals Clinical, pathomorphological and immunohistochemical evaluation of tissue repair in diabetic foot ulcers

2019 ◽  
Vol 21 (6) ◽  
pp. 490-496 ◽  
Author(s):  
Alla Y. Tokmakova ◽  
Ekaterina L. Zaitseva ◽  
Iya A. Voronkova ◽  
Marina V. Shestakova
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Tissue Repair ◽  
Chronic Wounds ◽  
Soft Tissues ◽  
Local Treatment ◽  
Surgical Debridement ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Before And After

Background: It is known that wound healing is Impaired in diabetes mellitus. Possible reasons are widely being searched. However, despite all the available data, reliable markers of reparative processes in diabetes mellitus are needed to be found. Aim: To study morphological and some immunohistochemical markers of tissue repair in patients with diabetic foot ulcers after local treatment. Materials and methods: 70 patients with diabetic foot ulcers before and after surgical debridement were included. Histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) characteristics of tissue repair processes in soft tissues of the lower extremities in patients with diabetes mellitus were analyzed. Histological and immunohistochemical examination of soft tissues were performed in 63 patients before and after surgical debridement and 10 days after local treatment. Results: After the surgical debridement a significant reduction in the area of wounds was registered by 23.4% (p 0.05), wound depth by 29.4% (p 0.05). Based on the results of the morphological study, the presence of mature granulation tissue in the wounds was confirmed. Immunohistochemical study of wound biopsies demonstrated a significant decrease in proteolytic activity in the wound as a decrease in MMP-9 expression (p 0.05). Statistically significant changes in the number of macrophages against the initial data were not found, as well as increased expression of TIMP-1 was observed (p 0.05 and 0.05, respectively). Conclusion: According to the data, there was a significant decrease in the area and depth of wounds during local treatment. The intensity of tissue repair was confirmed by the results of histological and immunohistochemical studies. However, the absence of a statistically significant change in the amount of macrophages on the background of treatment suggests that this repair link is disrupted in diabetes mellitus, which is the reason for the "chronic" wounds and requires further studies.

Local Treatment of Recent Arterial Thromboembolic Occlusions with Brinase

1975 ◽  
Vol 34 (02) ◽  
pp. 498-503 ◽  
Author(s):  
D Nyman ◽  
M. A da Silva ◽  
L. K Widmer ◽  
F Duckert
Keyword(s):  
Side Effects ◽  
Local Treatment ◽  
Before And After ◽  
Local Side

SummaryBrinase was administered intra-arterially in 16 patients with thrombotic or embolic arterial occlusions. Angiography could be performed before and after treatment in 13 patients. Thrombolysis was obtained in 3 of 9 patients with thrombotic and in 3 of 4 patients with embolic occlusions. In 3 patients severe local side effects occurred.

The influence of osteopathic correction on the viscoelastic characteristics of the lower leg muscles

2019 ◽  
pp. 93-98
Author(s):  
E. M. Timanin ◽  
N. S. Sydneva ◽  
A. A. Zakharova
Keyword(s):  
Viscoelastic Properties ◽  
Gastrocnemius Muscle ◽  
Soft Tissues ◽  
Subjective Assessment ◽  
Lymphatic Drainage ◽  
Intercellular Substance ◽  
Leg Muscles ◽  
Before And After ◽  
Viscoelastic Characteristics ◽  
Instrumental Methods

Introduction. To date there is a lack of studies dedicated to the objectification of the palpation data obtained by a specialist during the osteopathic examination. The issue of the evidence of the results of osteopathic correction still remains important. Search for instrumental methods allowing to register and to measure various palpation phenomena and manifestations of somatic dysfunctions is very relevant for the development of osteopathy as a science. It is also very important to find objective characteristics of these methods.Goal of research — to study viscoelastic characteristics of the soft tissues of the lower legs by palpation and instrumental methods before and after osteopathic correction.Materials and methods. 22 volunteers (12 women and 10 men) aged 18–23 years without complaints of the musculoskeletal system were examined. Osteopathic diagnostics and measurement of the viscoelastic properties of muscles were carried out by the method of vibration viscoelastometry before and after osteopathic correction.Results. Correlation analysis by Spearman showed that the subjective assessment of an osteopath positively correlated with both elasticity (r=0,43, p<0,05) and viscosity of soft issues (r=0,29, p<0,05). For the gastrocnemius muscle, this pattern was even more pronounced — for elasticity r=0,51, p<0,05, for viscosity =0,34, p<0,05. After osteopathic correction no changes in the elasticity of the soft tissues were observed. The viscosity of the tissues reduced, but in the projection of the gastrocnemius muscle, these changes were not statistically significant (p=0,12), whereas in the projection of the soleus muscle statistically significant changes (p=0,034) were observed.Conclusion. Changes in the viscoelastic properties of tissues demonstrated that the effects of osteopathic correction with the use of myofascial mobilization techniques, articulation mobilization techniques, and lymphatic drainage techniques were not obvious. The elasticity of soft tissues of the lower legs did not change, while the viscosity decreased, especially in the projection of the soleus muscles. This effect of the osteopathic correction can be associated with the effect of thixotropy — the transformation of gel-like intercellular substance into sol. Thus, the research showed that vibration viscoelastometry can be used for the objectifi cation of the condition of soft tissues and of the effects of osteopathic correction.

Clinical and microbiological aspects of vaginal microbiota at pregnant with threat of late miscarriages during treatment with vaginal gestagens forms

2017 ◽  
pp. 68-73
Author(s):  
I.P. Polishchuk ◽  
Keyword(s):  
Pregnant Women ◽  
Therapeutic Effect ◽  
Local Treatment ◽  
Vaginal Microbiota ◽  
Control Group ◽  
Before And After ◽  
Low Efficiency ◽  
Late Miscarriage ◽  
Microbiological Aspects ◽  
Micronized Progesterone

The objective: was to examine the effectiveness of treatment of late miscarriage threat by micronized form of progesterone for 100 mg – 3 times a day in the form of gelatin pills and vaginal tablets with lactose. Patients and methods. Under our supervision there were 70 pregnant women with normocenosis of vagina (NCV) without extragenital pathology, which were not performed systemic or local treatment with antibacterial drugs in the last 4 weeks. Among them 25 pregnant women with TLSM treated by gelatin tablets of micronized progesterone (GTP) (group 1); 25 pregnant women with TLSM, treated by vaginal micronized progesterone tablets (VPT) (2nd group) and 20 healthy women with physiological pregnancy – PV (control group). The distribution of women in the group adhered to the principles of randomization. The age of examined women ranged from 19 to 32 years, most pregnant women were aged under 30 years (89.02%). General clinical examination was carried out according to the standard scheme according to the Order MH of Ukraine № 620. Results. During the research we have determined the colpocytologcal dynamics and state of vaginal microbiota in pregnant women with threatened late miscarriage with initial vaginal normocenosis before and after treatment whit vaginal forms of progesterone. Conclusion. The received results showed low efficiency of micronized progesterone gelatin dragee at threat of the late miscarriage that at small therapeutic effect has led to the development of vaginal dysbiosis in all surveyed. In contrast, the use of micronized progesterone vaginal tablets – the maximally rapid therapeutic effect without disturbance of vaginal normocenosis. Key words: the threat of a late miscarriage, vaginal micronized forms of progesterone.

scholarly journals Using Bidimensional Multiscale Entropy Analysis of Ultrasound Images to Assess the Effect of Various Walking Intensities on Plantar Soft Tissues

Entropy ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. 264
Author(s):  
Ben-Yi Liau ◽  
Fu-Lien Wu ◽  
Keying Zhang ◽  
Chi-Wen Lung ◽  
Chunmei Cao ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Linear Analysis ◽  
Multiscale Entropy ◽  
Ultrasound Images ◽  
Entropy Analysis ◽  
Nonlinear Complexity ◽  
Human Movements ◽  
Before And After ◽  
Walking Performance ◽  
Linear And Nonlinear

Walking performance is usually assessed by linear analysis of walking outcome measures. However, human movements consist of both linear and nonlinear complexity components. The purpose of this study was to use bidimensional multiscale entropy analysis of ultrasound images to evaluate the effects of various walking intensities on plantar soft tissues. Twelve participants were recruited to perform six walking protocols, consisting of three speeds (slow at 1.8 mph, moderate at 3.6 mph, and fast at 5.4 mph) for two durations (10 and 20 min). A B-mode ultrasound was used to assess plantar soft tissues before and after six walking protocols. Bidimensional multiscale entropy (MSE2D) and the Complexity Index (CI) were used to quantify the changes in irregularity of the ultrasound images of the plantar soft tissues. The results showed that the CI of ultrasound images after 20 min walking increased when compared to before walking (CI4: 0.39 vs. 0.35; CI5: 0.48 vs. 0.43, p < 0.05). When comparing 20 and 10 min walking protocols at 3.6 mph, the CI was higher after 20 min walking than after 10 min walking (CI4: 0.39 vs. 0.36, p < 0.05; and CI5: 0.48 vs. 0.44, p < 0.05). This is the first study to use bidimensional multiscale entropy analysis of ultrasound images to assess plantar soft tissues after various walking intensities.

scholarly journals Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among polish arthroscopy society members

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Paweł Bąkowski ◽  
Kamilla Bąkowska-Żywicka ◽  
Tomasz Piontek
Keyword(s):  
Knee Arthroscopy ◽  
Full Range ◽  
Postoperative Management ◽  
Meniscus Repair ◽  
Postoperative Treatment ◽  
Meniscus Tear ◽  
Postoperative Rehabilitation ◽  
Meniscus Suture ◽  
Surgical Expertise ◽  
Almost All

Abstract Background Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists. Methods A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care. Results The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1–2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p = 0.007) and were more likely to use objective physical tests (p = 0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p = 0.001) and admitted that patient age does matter for meniscus repair qualification (p = 0.002). Conclusions There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.

CERVICAL CORPECTOMY AND STRUT GRAFTING

Neurosurgery ◽  
2007 ◽  
Vol 60 (suppl_1) ◽  
pp. S1-137-S1-142 ◽  
Author(s):  
Andrea F. Douglas ◽  
Paul R. Cooper
Keyword(s):  
Selection Criteria ◽  
Soft Tissues ◽  
Simple Procedure ◽  
Postoperative Management ◽  
Neoplastic Disease ◽  
Cervical Corpectomy ◽  
Patient Selection Criteria ◽  
Spine Disorders ◽  
Adequate Decompression ◽  
Attention To Detail

Abstract CERVICAL CORPECTOMY AND strut grafting is a deceptively simple procedure that has been performed for many years for a variety of cervical spine disorders (infection, neoplastic disease, and trauma) but most commonly for cervical spondylosis. The procedure requires attention to detail to ensure adequate decompression of the neural structures and avoiding injury to the soft tissues of the neck and the vertebral artery in the transverse foramina. The following description of the technique is one we have successfully used for cervical corpectomy and strut grafting. We also discuss patient selection criteria, avoidance of common complications, and postoperative management.

scholarly journals MODERN TRANSFORMATION AND PROBLEMATIC ASPECTS OF TAXATION OF THE FINANCIAL RESULTS OF INSURERS IN UKRAINE

2017 ◽  
pp. 19-33 ◽  
Author(s):  
Oleksandr KVASOVSKYI ◽  
Mykola STETSKO
Keyword(s):  
Financial Performance ◽  
Income Tax ◽  
Legal Framework ◽  
Insurance Companies ◽  
Pension Insurance ◽  
Effective Tax Rate ◽  
Tax Rate ◽  
Direct Taxation ◽  
Legal Provisions ◽  
Before And After

Introduction. Today the problem of establishing an effective taxation technology of domestic insurers' financial results has not been finally solved. That technology would ensure achieving fiscal objectives of budget revenues improvement and the implementation of the regulatory capacity of the tax regime to enhance the development of the insurance market in Ukraine on the principles of transparency and legitimacy of the business. Purpose. The purpose of the article is critical analysis of recent transformations in the method of taxation of the financial performance of insurance companies in Ukraine, assessment of their impact on the dynamics of national insurance organizations budget revenues in recent years, a clear identification of legal conflicts and problematic aspects of the insurers' profit and income tax collecting procedures with a view to their elimination. Results. The article looks into the major differences in innovation and methodological approaches to taxation of the financial performance of domestic insurers before and after January 1, 2015. The work characterizes the dynamics of absolute and relative indicators of income tax on profits from insurance companies to the consolidated budget of Ukraine in 2012-2016 (compared to banks) from a position of impact of changes in tax regime for insurers. The research also revealed a number of legal contradictions and problematic issues in the current procedure for determining taxable profits of insurance organizations in the consideration of tax differences, calculating the income tax of taxable item in the neglecting of the revenues and transmission of insurance payments (contributions, premiums) for reinsurance operations and so on. Conclusion. A number of recommendations to improve the technology of direct taxation of insurance companies' corporate income tax and indirect taxes on insurance premiums, namely: clear distinction of mentioned fiscal duties; revision of the legal framework regarding the collection of insurers’ income tax (detailed definition of the list of costs for the calculation of financial results of the insurer before tax, establishing a list and approval of scientifically based methods of calculating insurance reserves for the calculation of taxable income, specification of legal provisions regarding taxation of insurance companies that specialize in life insurance, and longterm pension insurance); the introduction of preferential tax treatment of small profit insurance organizations through the establishment of progressive tax rates; gradual reduction of the effective tax rate for insurance companies.

scholarly journals RARE CASE OF SHORT BOWEL SYNDROME

2019 ◽  
Vol 49 ◽  
pp. 6-8
Author(s):  
Azmaiparashvili G. აზმაიფარაშვილი გ. ◽  
Tomadze G. თომაძე გ. ◽  
Megreladze A. მეგრელაძე ა.
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Parenteral Nutrition ◽  
Short Bowel Syndrome ◽  
Rare Case ◽  
Postoperative Management ◽  
Hepatic Flexure ◽  
Postoperative Treatment ◽  
Extensive Resection ◽  
Short Bowel

Short bowel syndrome is characterized by malabsorption following extensive resection of the small bowel. It may occur after resection of more than 50% and is certain after resection of more than 70% of the small intestine, or if less than 100 cm of small bowel remains.  Successful postoperative management of short bowel syndrome has been discussed. Patient was operated because of cancer of hepatic flexure of large bowel with invasion in stomach, pancreas, retroperitoneal space, mesentery of small bowel. Right sided colectomy and excessive resection of small bowel with limphodissection was performed and only 80 cm of small bowel was left together with the left part of the colon. Ileotransversoanastomosis was performed. After the adequate course of chemotherapy and partial parenteral nutrition patient’s general condition became satisfactory. Patient started to gain weight. Adequate postoperative treatment determined postoperative period without surgical and nutritional complication.

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