scholarly journals Pediatric Blunt Renal Trauma. A Single Institution’s 20 Years Experience with Surgically Treated Patients.

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kenan Karavdić
Keyword(s):  
Surgical Treatment ◽  
Renal Injury ◽  
The Body ◽  
Hospital Length Of Stay ◽  
Renal Trauma ◽  
Exclusion Criterion ◽  
Abdominal Muscles ◽  
Solid Organ ◽  
Fatty Tissue ◽  
Female Ratio

Background: Kidney is the most common site of genitourinary trauma. 50% of all urinary injuries is kidney.Kidney is also affected in 8-12% of all blunt and penetrating trauma to abdomen. 80-90% of renal injury is caused by blunt injury GY. Children,  compared to adults, have  at a higher risk of renal injury from blunt trauma due to a variety of anatomic factors including decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. While there are strong trends toward non-operative management of blunt renal trauma, there are no explicit guidelines for high grade injuries. Organ preservation in children is always a primary goal with solid organ injury. Aim of the work: The aim of the retrospective study is to show the specificity of kidney injury in children as well as the specificity of surgical treatment. Material and Methods: All 19 patients under the age of 18 who were admitted to Clinic for Pediatic surgery in Sarajevo with a diagnosis of renal trauma were retrospectively reviewed .The Echo an CT were used to identify patients with a renal injury. The time period examined was between January 1, 1999- 2019. Inclusion criteria were either a diagnosis of renal trauma or a diagnosis of blunt abdominal trauma and hematuria. Exclusion criterion was death due to an additional traumatic injury. The mechanism of injury (fall, car accident , assault) injury grade (I-V), the presence of hematuria, and demographic data to include age, weight, and sex, were recorded and reviewed.  In addition, amount of blood product required, hematocrit nadir prior to transfusion to assist in ascertaining whether transfusion was necessary, surgical interventions performed, and hospital length of stay were also retrospectively analyzed. Due to the low sample size we used descriptive as opposed to inferential statistics in our analysis. Result: Demographics include male to female ratio of 13:6 and the average age of patients was 11.9 + 4.6 years. Of the nineteen patients who underwent review, eleven (57,89%) children presented with a grade III renal injury, five  with a grade IV injury and three with  grade V injury. Six patients presented with gross hematuria and 3 with microscopic hematuria. Only four patients (22%) required blood transfusions, with the average hematocrit nadir being 31 + 5.3% (24.8-37.8). One of the two patients transfused had a concomitant grade IV splenic laceration with a hematocrit nadir of 24.8% and clinical symptoms consistent with shock. Conclusions:The specificity of the child's anatomy is an aggravating prognostic factor (the kidney is larger in relation to the body cavity than in adults, less protected against the ribs, the muscles of the body and the lower abdomen, the less developed peritoneal and retroperitoneal fatty tissue).It is recommended to initiate conservative treatment (leaching, infusion solution, monitoring) and possibly delayed surgical treatment.Indications for early surgicaly treatment are reserved only for patients with bleeding (absolute) and extravasation (relative).If it is necessary surgical treatment sould be  maximally preserve kidney tissue.

scholarly journals Multi detector computed tomography imaging in penetrating injuries

2020 ◽  
Vol 8 (6) ◽  
pp. 2259
Author(s):  
Namrita Sachdev ◽  
Yashvant Singh ◽  
Sana . ◽  
Dipshi Mehta
Keyword(s):  
Penetrating Trauma ◽  
Trauma Centre ◽  
Penetrating Injury ◽  
The Body ◽  
Initial Assessment ◽  
Emergency Laparotomy ◽  
Solid Organ ◽  
Penetrating Injuries ◽  
Cross Sectional ◽  
Female Ratio

Background: Penetrating injuries forms an important component of surgical emergencies. Penetrating trauma typically involves the violation of the body by a gunshot wound (GSW) or stab wound. Emergency laparotomy is the accepted management in patients with a penetrating injury who are not hemodynamically stable. However, selective non-operative management has been shown to decrease the rate of unnecessary surgery. Plain radiographs and FAST are useful for initial assessment of these patients. Multi detector CT is an indispensable tool in the evaluation of patients who are stable and are candidates for conservative treatment.Methods: A cross sectional observational study was carried out on 40 patients admitted with penetrating injury to the trauma centre of PGIMER and Dr RML hospital. Of the 40 patients, 14 were taken for emergency laparotomy. In 26 cases, MDCT was done to evaluate for solid organ, hollow organ and vascular injuries.Results: The mean age of patients was 38 years, with male to female ratio of 5:1. Stab injury was the commonest type of injury, followed by gunshot wounds. Liver was the commonest solid organ involved, followed by kidneys and spleen. Other organs involved were diaphragm, small bowel and colon.Conclusions: Penetrating injuries can be life-threatening, making prompt diagnosis essential. Recognizing key abnormalities on MDCT ensures patients are triaged appropriately. Multi-detector CT is thus widely used to evaluate penetrating injuries in stable patients.

scholarly journals XXVI.—Treatment of Aneurysm by Electrolysis.

1908 ◽  
Vol 28 ◽  
pp. 400-402
Author(s):  
Dawson Turner
Keyword(s):  
Surgical Treatment ◽  
Blood Serum ◽  
The Body ◽  
The Other ◽  
Difficult Question ◽  
Actual Effect

MANY attempts have been made to utilise electrolysis in aneurysms, especially in those thoracic ones that are not amenable to ordinary surgical treatment; it has been hoped that the clotting which occurs around the poles might serve as a nucleus for further coagulation and deposits of fibrin, and that the aneurysm cavity might in this way become partially filled up. Such attempts have not met with much success hitherto, and the purpose of this research has been to endeavour to determine by experiments on blood serum outside the body what the actual effect of electrolysis is so far as regards clotting. Various methods of electrolysing the blood in an aneurysm have been used by surgeons. Ciniselli introduced needles connected with both poles, and reversed the direction of the current every five minutes; of 38 cases so treated, 27 were ameliorated, but none were cured. In the unipolar method one pole only was introduced, and the other was connected with an indifferent pad placed in the vicinity. The difficult question was which pole to introduce. The positive pole gave the firmest clot, but it was thought that it might be difficult to withdraw, and that hæmorrhage or even rupture of the vessel might follow.

scholarly journals Clinicopathological study of soft tissue sarcoma-retrospective study of tertiary cancer institute in eastern India

2020 ◽  
Vol 8 (11) ◽  
pp. 4075
Author(s):  
Kunhi Mohammed K. P. ◽  
Snehasis Pradhan ◽  
Supratim Bhattacharyya ◽  
Prafulla Kumar Das ◽  
Muhammed Navas N. K.
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Malignant Tumors ◽  
Soft Tissue Sarcomas ◽  
The Body ◽  
Female Ratio ◽  
Pleomorphic Sarcoma ◽  
Frequent Variety ◽  
Male To Female

Background: Soft tissue sarcomas are a rare and heterogeneous group of malignant tumors of mesenchymal origin that comprise less than 1 percent of all adult malignancies. Although they occur anywhere in the body, they involve most commonly in extremities, trunk, retroperitoneum and head and neck. The aim of the study was to analyze clinical and histopathological features of various soft tissue sarcomas.Methods: This was a retrospective study, conducted in tertiary cancer centre in Odisha during the period 2015 to 2018. We collected clinical parameters like age, sex, site of swelling, any associated pain and biopsy reports and these variables were correlated with final histopathology reports.Results: A total of 107 patients were included in the study, with male to female ratio of 2:1(71 and 36) and average age of 43.45 years. All of them presented with a swelling. The lower extremities were the most common sites i.e. 44.62%. Pleomorphic sarcoma was the most frequent histologic variety comprising 43% and less frequent variety were angiosarcoma, and myxoid sarcoma.Conclusions: Soft tissue sarcoma are predominant in males and middle aged population are frequently affected. Most common affected site is lower extremity and pleomorphic sarcoma is the prominent histologic type.

scholarly journals Immediate and Long-Term Results of the Spleen-Preserved Operations in the Surgical Treatment of Gastric Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 227-232
Author(s):  
Marina I. Rogozianskaia ◽  
Alexander Nikolayevich Redkin ◽  
Ivan Petrovich Moshurov
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Total Gastrectomy ◽  
The Body ◽  
Long Term Results ◽  
D2 Lymphadenectomy ◽  
Spleen Preserving ◽  
Cardiac Region ◽  
Clinically Significant

ntroduction. Currently, total gastrectomy with D2 lymphadenectomy is the standard surgical treatment for proximal gastric cancer at the resectable stages (I-III). The issue of advisability of splenectomy as a component of lymphadenectomy remains a controversial one, especially when the tumor is localized in the region of the body or cardiac region of the stomach.The aim of the study was to compare immediate and long-term outcomes, including the quality of life, between spleen preserving and spleen removing surgeries.Methods. The study included 363 patients with gastric cancer II-III stages, localized in the upper and/or the middle third of the stomach, who underwent surgery at the Voronezh Regional Clinical Oncology Hospital and the Voronezh Clinical Hospital of the Russian Railway-Medicine in 2015-2017. All patients were conditionally divided into 2 groups for comparative retrospective analysis. All patients of the first (experimental or spleen-preserved) group (144 patients) were performed R0 total gastrectomy with D2 lymphadenectomy, including splenic hilar nodes (№ 10,11) removal without splenectomy. Patients of the second (control or splenectomy) group (219 patients) were performed R0 total gastrectomy with D2 lymphadenectomy and prophylactic splenectomy (for splenic hilar nodes removal).Results. The average duration of the operation and the volume of blood loss did not differ in both groups. The incidence of early postoperative surgical complications was lower in the spleen-preserved group. Splenectomy was associated with more severe complications of class 4 and 5 according to the Clavien-Dindo classification. Conclusion. Parameters of the 1- and 3-year overall survival rate did not differ in both groups. The results of the GSRS questionnaire were similar in both groups, excluding reflux-esophageal symptoms scale. The reflux scale demonstrated a statistically and clinically significant advantage of spleen preservation.

scholarly journals The Disease Girshprunga Beside Adult: Modern Approaches To Diagnostics, Treatment.

2010 ◽  
Vol 1 ◽  
Author(s):  
M Mirzahmedov ◽  
M Ahmedov ◽  
D Sapaev
Keyword(s):  
Surgical Treatment ◽  
Large Intestine ◽  
The Body ◽  
Radical Operation ◽  
Unsatisfactory Result ◽  
Main Complaint

The Material of the study has formed 78 sick, found on stationary treatment in Republican Scientific Centre Coloproktologii since 1992 on 2010. As it is seen, from table, from 78 sick mans was 58(74,3%), womans 20(25,7%).  19(24,3), sick were at age from 15 before 20 years, 49(60,2%) at age from 21 before 40 years and 13 (16,6%) sick from 41 before 60 years.         The Main complaint sick at arrival were a stubborn constipations, which noted beside 70 (89,7%) sick, including absence of the independent chair existed - beside 55(70,5%), but beside 54(69,2%) sick were noted periodic stomachache, growing on measure of the absence of the chair. The Ballooned belly existed beside all 78 (100%) sick moreover beside 20(25,6%) of them flatulence was constant. The Sickness and retching existed beside 24(30,7%), weakness, reduction to capacity to work beside 52(66,6%), increasing of the temperature of the body beside 10(12,8%), paradoxical diarrhoeas beside 6(7,6%) sick. Endoskopicheskiy method (rectoromonoscopy, colonoscopy) turned out to be else less informations - 51,8% coincidences of the diagnosis. So we biopsy on Svensonu executed beside all sick, entered with suspicion on disease Girshprunga. In our observations from 78 sick beside 42(53,8,1%) were aboveanalni, beside 20(25,6%) sick - rectalis, beside 13(16,6%)- rectosigmoideys , beside 2(2,5%) leftside and beside 1(1,2%) sick - subtotalis  form hipoganglios. At biopsies on Svensonu on observations, from 78 sick, beside 44(56,4%) is revealled hipoganglios, but beside 35(44,8%) - аganglios rectum. As can be seen from presented tables, from 78 sick beside 68(87,2%) us is executed onemoments radical operation, 10(12,8%) sick is as far as possible made resection hipo- or aganglionarnaya of the zone, decompensate part of the large intestine and is formed colostomy. In all events at operations. The Remote results executed radical operation on cause disease Girshprunga прослежены from 1 before 10 years beside 57(73%) sick. The Results of the surgical treatment were valued on scale Vezika: good, satisfactory and unsatisfactory.  In our observations beside 46(80,7%) sick results came in well, beside 10(17,5%) - satisfactory and beside 1(1,8%) sick was an unsatisfactory result. 

scholarly journals Future of Solid Organ Transplantation: Organ-Specific Tolerance

KIDNEYS ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 130-136
Author(s):  
Yusuf Ercin Sonmez
Keyword(s):  
Immune System ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Immunological Tolerance ◽  
The Body ◽  
Solid Organ ◽  
Donor Organ ◽  
Organ Specific ◽  
Specific Tolerance

A transplant between two people who are not genetically identical is called an allotransplant and the process is called allotransplantation. Donor organs and tissues can be from people who are living, or people who have died because of a significant brain injury or lack of circulation. Allotransplantation can create a rejection process where the immune system of the recipient attacks the foreign donor organ or tissue and destroys it. The recipient may need to take immunosuppressive medication for the rest of their life to reduce the risk of rejection of the donated organ. In general, deliberately induced immunosuppression is performed to prevent the body from rejecting an organ transplant. The adverse effects associated with these agents and the risks of long-term immunosuppression present a number of challenges for the clinician. Immune tolerance, or immunological tolerance, or immunotolerance, is a state of unresponsiveness of the immune system to substances or tissue that have the capacity to elicit an immune response in a given organism.

scholarly journals The key role of pancreatic fibrosis severity in the surgical treatment algorithm of patients with chronic pancreatitis

2020 ◽  
Vol 73 (2) ◽  
pp. 235-238
Author(s):  
Oleh E. Kanikovskiy ◽  
Ihor V. Pavlyk ◽  
Iryna V. Oliinyk ◽  
Vasyl V. Mosondz
Keyword(s):  
Chronic Pancreatitis ◽  
Surgical Treatment ◽  
Treatment Algorithm ◽  
Pathological Process ◽  
The Body ◽  
Nutrition Status ◽  
Tissue Pressure ◽  
Surgical Interventions ◽  
Computer Morphometry ◽  
Definition Of

The aim of the work was to improve the results of surgical treatment of complicated forms of chronic pancreatitis. Materials and methods: The results of surgical treatment of 181 patients with complicated forms of chronic pancreatitis have been analyzed. All these patients were treated in surgical clinic of 2 nd medical faculty of National Pyrogov Memorial Medical University in Vinnytsya. Results: It is possible preoperative indirectly assess the severity of fibro- degenerative changes in pancreas, that includes 1 – the definition of pain type; 2 – CT or MRI (Marseilles- Rome classification); 3 – assessment of the stage of chronic pancreatitis (Büchler classification); 4 – patient's nutrition status and preoperative differential diagnosis with pancreatic cancer; 5 – assessment of the fibrosis severity (elastomers). The key point in treatment depended on intraoperative examination: detection of strictures of the main pancreatic duct (pacemaker of chronic pancreatitis); the tissue pressure resistance to the liquid, which is the maximum value> 200 mmHg, in the region of stricture and falls in other parts of the pancreas; pressure in the main pancreas duct, which rises only in 59.5% of patients. The head of the pancreas was involved in the pathological process in 83.8%, in 16.2% it was isolated in the isthmus or the body and tail of the pancreas. In general, the distal pancreas was involved in 37.8%. At computer morphometry of histological samples, the area of connective tissue fields reached 81.4 ± 6.62%, preserved exocrine part in 4.87 ± 1.62%, endocrine – 1.92 ± 0.12%, total area of ducts – 6 , 47 ± 1.12%. Conclusions: The combined Frey-Izbickiy local resection provides a wide excision of the pacemaker (stricture) of chronic pancreatitis. In case of extrapancreatic complications or repeated surgical interventions on the pancreas due to chronic pancreatitis, this effect can be achieved by pancreatoduodenal resection.

scholarly journals ANALYSIS OF THE EFFECTIVENESS OF IMMUNOTHERAPY USING AN AUTOLOGOUS COMPLEX OF IMMUNOPEPTIDES IN THE SURGICAL TREATMENT OF PERIODONTITIS

2020 ◽  
Vol 17 (35) ◽  
pp. 381-390
Author(s):  
Andrei SEVBITOV ◽  
Alla DAVIDYANTS ◽  
Roman BALYKIN ◽  
Anton TIMOSHIN ◽  
Mariya KUZNETSOVA
Keyword(s):  
Innate Immunity ◽  
Surgical Treatment ◽  
Bone Tissue ◽  
Pathogenic Bacteria ◽  
Alveolar Bone ◽  
The State ◽  
The Body ◽  
Immunological Methods ◽  
Periodontal Tissues ◽  
Antimicrobial Protection

Periodontal disease in the adult population is one of the most pressing problems of dentistry around the world. Thanks to the introduction of modern technologies in practice, it was possible to identify the main mechanisms of the development of this disease at the molecular and genetic level. The interaction of periodontal pathogens with immune factors of antimicrobial protection of the body is the basis of periodontal tissue inflammation and further leads to the destruction of the alveolar bone. Epithelial cells of the gum mucosa play a crucial role against periodontal pathogenic bacteria. Factors of innate immunity play a role not only in antimicrobial protection, but they also support the conditions necessary for the healing and regeneration of periodontal tissues. Therefore, various therapeutic approaches that affect the factors of innate immunity are considered as effective and promising. Clinical examination and determination of factors of innate immunity were performed in 115 patients. Healthy individuals made up a group of 30 people. Patients with chronic generalized periodontitis with varying degrees of severity were 85 people. Each patient underwent orthopantomography on the orthopantomograph Orthophosis XG DS/Ceph (SIRONA Dental System GmbH, Germany) in order to assess the state of the bone tissue of the jaws (the degree of destruction of the cortical layer, the degree of resorption of the interalveolar partitions). Targeted intraoral radiographs were used to assess the state of bone tissue and the quality of surgical treatment. Immunological methods of research were carried out in several stages. The findings of this article make the claim that the use of autologous complex immunopeptides in the surgical treatment of periodontitis reduces the time of achieving a therapeutic effect 2 times, resulting in the rapid relief of the symptoms of inflammation and acceleration of reparative processes.

scholarly journals Latent Factors Limiting the Performance of sEMG-Interfaces

2018 ◽  
Author(s):  
Sergey Lobov ◽  
Nadia Krilova ◽  
Innokentiy Kastalskiy ◽  
Victor Kazantsev ◽  
Valeri A. Makarov
Keyword(s):  
The Body ◽  
Fine Tuning ◽  
Fatty Tissue ◽  
Latent Factors ◽  
Individual Subject ◽  
Training Strategy ◽  
Real Time Analysis ◽  
Signal Processing Algorithms ◽  
Gaming Environment

Recent advances in recording and real-time analysis of surface electromyographic signals (sEMG) have fostered the use of sEMG human-machine interfaces for controlling personal computers, prostheses of upper limbs, and exoskeletons among others. Despite a relatively high mean performance, sEMG-interfaces still exhibit strong variance in the fidelity of gesture recognition among different users. Here we systematically study the latent factors determining the performance of sEMG-interfaces in synthetic tests and in an arcade game. We show that the degree of muscle cooperation and the amount of the body fatty tissue are the decisive factors in synthetic tests. Our data suggest that these factors can only be adjusted by a long-term training, which promotes fine-tuning of low-level neural circuits driving the muscles. A short-term training has no effect on synthetic tests, but significantly increases the game scoring. This implies that it works at a higher decision-making level, not relevant for synthetic gestures. We propose a procedure that enables quantification of the gestures’ fidelity in a dynamic gaming environment. For each individual subject the approach allows identifying “problematic” gestures that decrease gaming performance. This information can be used for optimizing the training strategy and for adapting the signal processing algorithms to individual users, which could be a way for a qualitative leap in the development of future sEMG-interfaces.

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