scholarly journals Assessment of the Algorithms for Diagnostics and the Possibilities of Treating Patients with a Penile Dysmorphie Disorder

Health of Man ◽  
2021 ◽  
pp. 8-14
Author(s):  
Oleksii Kornyenko ◽  
Mariia Scherbak ◽  
Mykola Turchak
Keyword(s):  
Tunica Albuginea ◽  
Aesthetic Surgery ◽  
State Institution ◽  
Subjective Perception ◽  
Superficial Fascia ◽  
Medical Sciences ◽  
Penile Implants ◽  
Personal Experiences ◽  
Surgical Tactics ◽  
Sliding Technique

The article discusses issues related to the choice of diagnostic algorithms and planning tactics for treating patients with penile dysmorphophobia. The psychological characteristics of this group of patients, methods of diagnosis, psychotherapy correction and the choice of surgical tactics are sounded. The manifestations of penile dysmorphophobia and dysmorphomania, as disorders of a deeper level, are considered as an integrative problem solved from the standpoint of urology, psychotherapy, and aesthetic surgery. In conjunction with an andrologist, the involvement of a psychotherapist and, if necessary, a psychiatrist is required. At the initial stages of working with a patient, narrowly focused psychotherapy is used. The next level of correction is cognitive behavioral psychotherapy (CBT) with the technique of “exposure and prevention of reactions” or “cognitive restructuring”. The “mindfulness CBT” technique is considered important for teaching the patient the ability to stop subjective perception of personal experiences. To consolidate the result, individual hypnosuggestational therapy and group (family) psychotherapy are used. The indications for surgical enlargement of the penis are divided into medical, functional and aesthetic. Penile dysmorphophobia is an aesthetic indication for surgery. Contradictions in carrying out such interventions include the lack of standardized methods with a high positive prognosis, overestimated patient expectations, and the lack of a result to improve a man’s self-esteem even with a positive result of the operation. The clinic of the Department of Sexopathology and Andrology of the State Institution «Institute of Urology of the National Academy of Medical Sciences of Ukraine» uses a ligamentotomy technique to lengthen the penis and implant a polypropylene mesh under the superficial fascia of the penis to thicken it. For patients with manifestations of penile dysmorphophobia simultaneously with severe forms of erectile dysfunction, a number of operations have been proposed for the simultaneous installation of penile implants and augmentation of the tunica albuginea using a graft: corporoplasty with a circular graft, Sliding Technique, modification of the sliding technique (MoST), Multiple-slid-Technique (MuST) augmentation technique. These techniques are not included in the list of recommendations offered by the urological community; they have high predictable risks of complications requiring urgent explantation of the prosthesis and irreversible loss of penile length.

scholarly journals Children in Situation of Intra-Family Violence: Concepts, Personal Experiences and Feelings of Undergraduate Medical Students

2020 ◽  
Vol 44 (1) ◽  
Author(s):  
Nilma Lazara de Almeida Cruz Santos ◽  
Isabel Maria Sampaio Oliveira Lima ◽  
Rosely Cabral de Carvalho
Keyword(s):  
Medical Students ◽  
Medical Training ◽  
Social Issues ◽  
The State ◽  
Subjective Perception ◽  
Undergraduate Medical Students ◽  
Medical Undergraduate ◽  
Personal Experiences ◽  
The Subject ◽  
Different Dimensions

ABSTRACT: Introduction: The objective of the study was to learn about the concepts of violence among medical undergraduate students in the state of Bahia, their personal experiences with the phenomenon and advice regarding case referral. Method: a qualitative research was carried out with 20 undergraduate medical students from public institutions in the state of Bahia. The data were collected via the web through an electronic file made available by Google Forms. The students were informed about the page address through an e-mail. Results: Most of the students said that the topic of “Violence against Children” was addressed during their undergraduate years. Shared conceptions by most of the students on the subject are related to the definitions of violence as physical injuries inflicted on the victims, but broader definitions of social and subjective perception, encompassing different dimensions of the phenomenon were also identified. The most frequently cited feelings experienced in situations of violence were the following: helplessness, fear, sadness, unpreparedness, compassion, empathy, anger and rage. The difficulties that the students encountered in approaching the victims of violence stem from the lack of preparation in the training and from the positions related to the physicians themselves, such as fear of involvement and accountability. The inherent characteristics of children and distrust in protective services were also mentioned. Conclusion: Although the students reported having contact with the topic during graduation, most of them evaluated the training as insufficient. The lack of professional preparation to approach the medical-social issues, such as violence, has been partially attributed to the biologicist bias of the medical training. In this sense, we highlight the understanding of violence as an essentially social and historical phenomenon, to the detriment of the different dimensions of the illness that imply in the health-disease process. From this perspective, this bias obscure the recognition of the different manifestations of violence as objects of healthcare work, suggesting a need for a broader approach in medical education, which can help to contemplate the complexity of the subject.

scholarly journals Right-sided congenital diaphragmatic hernia – the experience of the neonatal surgery center

2020 ◽  
pp. 13-23
Author(s):  
O. Sliеpov ◽  
◽  
O. Ponomarenko ◽  
M. Migur ◽  
L. Sliеpova ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Low Frequency ◽  
State Institution ◽  
Medical Sciences ◽  
Results Of Treatment ◽  
The Difference ◽  
Surgery Center ◽  
Diaphragmatic Hernias

Congenital right-sided diaphragmatic hernias are a special form of diaphragmatic hernias. A relatively low frequency and features of anatomy, diagnosis clinical course, and survival characterize them. Objective: to analyze the results of treatment of right-sided diaphragmatic hernias in newborns. Materials and methods: a retrospective analysis of the medical records and autopsy protocols of 22 newborns with right-sided diaphragm defect, who were in the clinics of the State Institution «IPAG named after academician O.M. Lukyanova of the National Academy of Medical Sciences of Ukraine», was carried out for the last 37 years. Results: in 3 cases stillbirth was stated, in all live-born children (n=19) with right-sided СDH the defect was symptomatic. Moreover, in 84.2% (n=16) of them, symptoms of the disease occurred immediately after birth, in 10.5% (n=2) – from the first to 6 hours of life, in 5.3% (n=1) – after 24 hours, from birth. Signs of pulmonary hypertension were determined based on the difference between pre- and postductal peripheral blood saturation. Thus, in 62.5% (n=5) of operated children and in 63.6% (n=7) who died at the stages of stabilization, the difference in pre- and postductal saturation was more than 10%, whichindicated the presence of 100% pulmonary hypertension, and blood shunting from right to left, through fetal communications. The time of preoperative stabilization ranged from 1 to 23 days, on average 7.25 days. 8 children were operated. The surgical approach was right-sided subcostal laparotomy (n=5) or right-sided thoracotomy (n=2). In one case, there was a combined approach: right-sided laparotomy + right-sided thoracotomy. 5 children survived, 3 died. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. No conflict of interest was declared by the authors. Key words: congenital diaphragmatic hernia, right-sided, herniation of the liver, critical hypoplasia of the lungs, surgical correction, newborn baby.

scholarly journals State Institution «Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine» celebrates the 70th anniversary!

2020 ◽  
Vol 26 (3) ◽  
pp. 5-12
Author(s):  
Eugene G. Pedachenko ◽  
Leonid D. Pichkur ◽  
Vadym V. Biloshitsky ◽  
Valentyna A. Rudenko
Keyword(s):  
State Institution ◽  
70Th Anniversary ◽  
Medical Sciences

scholarly journals Clinical and Morphological Analysis of Adrenal Glands Pathology in Kharkiv Region (according to Archival Material for the Period 2015-2019)

2020 ◽  
Vol 5 (6) ◽  
pp. 84-87
Author(s):  
I. V. Sorokina ◽  
V. D. Markovskyi ◽  
N. I. Goidenko ◽  
O. V. Kaluzhyna
Keyword(s):  
Adrenal Glands ◽  
Malignant Tumors ◽  
Diagnostic Procedures ◽  
State Institution ◽  
Adrenocortical Adenoma ◽  
Medical Sciences ◽  
Malignant Paraganglioma ◽  
Adrenocortical Adenomas ◽  
Cell Variant ◽  
The Right

The adrenal glands play an important role in the functioning of the human body. There are more opportunities for early tumors detection of these endocrine glands thanks to modern diagnostic procedures, but the problem is very relevant. Morphological investigation is the basis for differentiating adrenocortical adenoma from carcinoma. Material and methods. The article presents the clinical and morphological features of the adrenal glands pathology in Kharkiv region in the period 2015-2019 by analyzing the archival histological material of 77 patients who were operated in hospitals of the State Institution "Institute of General and Emergency Surgery named after V. T. Zaitsev of National Academy of Medical Sciences of Ukraine" and "V. Danilevsky Institute for Endocrine Pathology Problems of the National Academy of Medical Sciences of Ukraine". Results and discussion. The study established that in 2015 there were 18 cases (including 8 malignant tumors), in 2016 – 16 cases (2 cases with bilateral damage, 1 malignant tumor), in 2017 – 12 cases, in 2018 – 20 cases, in 2019 – 11 cases. All tumors were benign in the last 3 years of the study. We calculated that 48.6 years was the average age of patients with this localization tumor processes (20-75 years). Women suffered more often than men (61.03% and 38.97%, respectively). Both adrenal glands had pathological changes in 2 people. The left gland is most often affected. The vast majority of the formations in 2015-2019 were benign (88.61%). Adrenocortical adenomas (45 cases, mostly clear cell variant, leftward, in women) and mature pheochromocytomas (13 cases, uncomplexed variant, leftward, in men), adrenal cysts (6 cases, more often on the right, in men, with a dense fibrous capsule), hyperplasia of the cortical, cerebral or both layers (4 cases), ganglioneuroma of the adrenal medulla (1 case) and a combination of pheochromocytoma with two adrenocorticosteromas (1 case) were among them. Conclusion. Malignant tumors were represented by malignant corticosteromas (5 cases out of 9, leftward, various sizes, with secondary changes in tumor tissue), malignant pheochromocytomas (3 cases out of 9, right, different size) and malignant paraganglioma (1 case). The larger size of the tumor did not always correlate with the nature of the process

THE SYSTEM OF DIFFERENTIATED MEDICAL NEUROREHABILITATION IN THE TRAUMATIC POST-COMA CONDITIONS OF LONG-TERM DISORDERS OF CONSCIOUSNESS

2019 ◽  
Vol 17 (1) ◽  
pp. 9-24
Author(s):  
Alexandr Vasylyovych Kulyk
Keyword(s):  
Patient Activation ◽  
State Institution ◽  
Underlying Disease ◽  
Disorders Of Consciousness ◽  
Medical Sciences ◽  
Rehabilitation Treatment ◽  
Restorative Treatment ◽  
Rehabilitation Programs ◽  
Medical Institutions

The study focuses on achieving the proper degree of daily patient activation, the minimization of the manifestations, the consequences of post-coma immobilization syndrome, especially the syndromes of repressed consciousness, highlighting the key importance of the type of individual rehabilitation programs’ content. The main aim of this study was to develop and justify a system of differentiated medical (physical) rehabilitation of patients with post-traumatic post-coma long-term disorders of consciousness, identify key principles for the functioning of this system, and highlight the basic guidelines for specialized rehabilitation medical institutions. The work is based on the results of diagnosis, rehabilitation and restorative treatment of 220 patients with traumatic post-coma disorders of consciousness, who were examined and underwent neurorehabilitation (NR) treatment at the State Institution Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine and the "Nodus" Practical Center for Neuro Rehabilitation from January 2007 to July 2018 inclusive. All patients after courses of rehabilitation treatment were discharged for outpatient monitoring or continued treatment of somatic complications of the underlying disease at their place of residence. During the rehabilitation treatment conducted over the study period, none of the patients died. The conclusion as to the applied effectiveness of the established system of rehabilitation is made after comparing the expected results of the rehabilitation and rehabilitation with the real achievements, carrying out a detailed analysis of the implemented individual programs at each stage of the restoration of consciousness, as well as clarifying the design of daily exercises and the principles of the distribution of loads in order to solve the set clinical problems, and both general and current goals.

Subjective perception of radioactivity

2009 ◽  
Vol 48 (03) ◽  
pp. 84-88 ◽  
Author(s):  
S. P. Müller ◽  
T. Beyer ◽  
A. Bockisch ◽  
L. S. Freudenberg
Keyword(s):  
Radioiodine Therapy ◽  
Treatment Success ◽  
Subjective Perception ◽  
Therapy Regimen ◽  
Patient Interviews ◽  
Medicine Physician ◽  
Personal Experiences ◽  
Before And After ◽  
Abstract Term ◽  
System 1

Summary Aim: We assess the attitude of patients with thyroid disease towards radiation and radioactivity before and after radioiodine therapy by means of a cultural-anthropological approach. We evaluate in patient interviews how their subjective attitude towards radioactivity as an abstract term and towards radioactivity in the medical context on the basis of their personal experiences with radionuclide therapy. Patients, methods: 29 patients with autonomously functioning thyroid lesions (17 women, 12 men, 35–79 years) were included in this study. All patients were interviewed prior to and 22–27 month post radioiodine therapy in an open dialogue with the principal investigator. Patients were asked to describe their attitude towards radioactivity in general and towards radioiodine therapy in particular. Patients were asked to use a scoring system (1: positive, 5: negative) to quantify their perception of radioactivity. Results: The personal perception of radio - activuty as an abstract term does not change significantly (p = 0.15) before and after radioiodine therapy. This perception is linked to mostly negative impressions of radiactivity. However, patients become more positive when assessing the value of radioactivity as part of their therapy regimen. Thus, we observe a significant increase in percepted value of radioactivity post radioiodine therapy (p = 0.03). Conclusion: Patients continue to view radioactivity as something negative despite treatment success following radioiodine therapy. Our results provide useful information for patient information by the nuclear medicine physician prior to a radioiodine therapy.

scholarly journals Anatomic variations of the extrathoracic course of the intercostobrachial nerve and its clinical significance

2018 ◽  
Vol 9 (5) ◽  
pp. 77-80 ◽  
Author(s):  
Soubhagya Ranjan Nayak ◽  
Smita Singh Banerjee
Keyword(s):  
Peripheral Nerves ◽  
Clinical Importance ◽  
Intercostal Nerve ◽  
Lateral Branch ◽  
Superficial Fascia ◽  
Breast Cancers ◽  
Medical Sciences ◽  
Nerve Blocks ◽  
Indian Origin ◽  
Intercostobrachial Nerve

Background: The intercostobrachial nerve (ICBN) can present anatomic alterations in its course, but in general it originates as a lateral branch of the second intercostal nerve and penetrates the axilla, in the mid axillary line. Its communication with brachial plexus (BP) is of clinical importance. Neurotization and nerve grafting procedures have renewed interest in the communications of peripheral nerves, like that of between BP and ICBN. Aims and Objective: The current study was conducted with an aim to observe the variation in the origin of extra thoracic course of the ICBN and its connection with the components of BP.Materials and Methods: One hundred thirty hemi-thoraxes of 65 adult cadavers (35male & 30 female) of Indian origin were dissected. After removal of the skin and superficial fascia, the ICBN was identified from its origin. The point of emergence from the intercostal space and its communication with BP was noted and photographed.Results: Extrathoracically, ICBN originated from the 2nd intercostals space in 100% specimens. Additionally ICBN originated from the 1st intercostals space in 3.8% specimens, from 3rd intercostals space in 20.7% cases. The ICBN communicated more frequently with medial cutaneous nerve of the arm (MCN) in 63% cases and with other BP branches in 44.6% cases.Conclusion: In the present study we observed ICBN and BP are coherently linked anatomically. The anatomical knowledge of ICBN origin and its variable communication with BP branchesis significant in the event of surgical treatment of breast cancers, lymph node clearance, anaesthetic nerve blocks and traction injuries to the brachial plexus.Asian Journal of Medical Sciences Vol.9(5) 2018 77-80

scholarly journals Current aspects of the progress of labor in healthy women according to the data of the retrospective analysis

2021 ◽  
Vol 25 (2(98)) ◽  
pp. 109-113
Author(s):  
N. Skrypchenko ◽  
Yu. Nevyshnа
Keyword(s):  
Pregnant Women ◽  
Fetal Distress ◽  
State Institution ◽  
Partner Support ◽  
Training Algorithms ◽  
Medical Sciences ◽  
Birth Canal ◽  
Healthy Women ◽  
Early Postpartum ◽  
Narrow Pelvis

Purpose of the work – to study the current aspects of the course of labor in healthy women using retrospective indicators.Material and methods. To study this topic, an analysis of 1.078 births of women who were born on the basis of the maternity ward for pregnant women with obstetric pathology of the State Institution «Institute of Pediatrics,Obstetrics and Gynecology named after acad. O.M. Lukyanova National Academy of Medical Sciences of Ukraine». It was found that of all births, the proportion of first-borns was 602 (55.8 %) women, of whom 451 (41.8 %) were pregnant, and only 86 (8 %) were healthy pregnant women, which we will study in the future.Results. It was found that among 86 births, the frequency of physiological births was 64 %, of which in 47.7 % of cases childbirth was complicated, and pathological – 36 %. The most common complications during childbirth were: premature rupture of membranes (PRPO), episio- and perineotomy, trauma to the birth canal. The causes of pathological childbirth in the examined women were: abnormalities of labor, fetal distress, defect of manure and membranes, clinically narrow pelvis, malposition of the fetus and early postpartum hemorrhage. All children were born alive. It should be noted that all births, where the Apgar score was ≤ 6 points, had no partner support, and the women themselves did not undergo any preparation for childbirth. Conclusions. According to our data, in almost healthy women who gave birth for the first time and had no perinatal loss in the anamnesis, did not undergo prenatal training and did not have partner support during childbirth, the number of complications during childbirth is increasing. Therefore, this group of healthy pregnant women needs more detailed study and analysis, development of prenatal training algorithms to improve perinatal indicators.

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