Video laparoscopic diagnostics and surgical tactics for acute diseases of abdominal organs

2021 ◽  
pp. 17-24
Author(s):  
A. S. Ermolov ◽  
V. T. Samsonov ◽  
P. A. Yartsev ◽  
A. A. Gulyaev
Keyword(s):  
Clinical Diagnosis ◽  
Definitive Diagnosis ◽  
Concomitant Disease ◽  
Group Iii ◽  
Abdominal Organs ◽  
Group I ◽  
Number Of Patients ◽  
Video Laparoscopy ◽  
Surgical Tactics ◽  
Diagnosis Of Diseases

The article presents the results of video laparoscopy (VLS) performed in 2008–2019 in 5,599 patients in order to diagnose acute diseases of the abdominal organs requiring emergency surgery, identify competing and concomitant diseases, and determine treatment tactics. 2,442 (43.6 %) of them made up group I, with no doubt; 2,656 (47.4 %) – II group, with presumptive reliability; and 501 (9.0 %) – group III, with an unclear clinical diagnosis of the disease. In 2,326 (95.2 %) patients of group I with VLS, the clinical diagnosis was confirmed, in 100 (4.1 %) other diseases were revealed, and in 16 (0.7 %) the diagnosis was not established. Competing diseases were found in 8 patients and concomitant diseases in 4. In 1,641 (61.8 %) patients of group II, VLS made it possible to clarify and differentiate the clinical diagnosis of diseases, in 929 (35.0 %) – to identify other diseases, and in 86 (3.2 %) the diagnosis was not possible. When performing differential diagnosis, 126 other diseases were identified more than the number of patients. Competing diseases were found in 6 patients and concomitant diseases in 6 patients. 356 (71.0 %) patients of group III with VLS were diagnosed with major diseases, 75 (15.0 %) had other diseases, and 70 (14.0 %) were not diagnosed. In 4 patients, competing diseases were found, and in 1 – concomitant disease. Of the 5,427 (96.9 %) patients with the definitive diagnosis of the disease established with VLS, 3,828 (70.5 %) were found to be able to perform VLS operations, in 10 (0.3 %) of them – simultaneous with competing diseases.

scholarly journals A comparative study to ascertain the efficacy of intravenous dexmedetomidine versus intravenous tramadol to prevent post-operative shivering after laparoscopic surgery

2019 ◽  
Vol 6 (3) ◽  
pp. 713
Author(s):  
Kishore K. ◽  
Syed Ali Aasim ◽  
Manish Kumar J.
Keyword(s):  
Laparoscopic Surgery ◽  
Side Effects ◽  
Comparative Study ◽  
General Anaesthesia ◽  
Power Number ◽  
Group Iii ◽  
Group I ◽  
Number Of Patients ◽  
Envelope Method ◽  
Level Of Significance

Background: Shivering is commonly encountered both after regional and general anaesthesia (GA) with a little higher incidence in patients receiving GA. The aim of study was to compare the effectiveness of dexmedetomidine and tramadol in decreasing postoperative shivering in patients undergoing laparoscopic surgery.Methods: Total 120 patients were included in this study. In order to get a 5% level of significance and 80% power number of patients required in each group was 40, with a total of 120 patients. Randomization of groups was done based on closed envelope method. Patients were allocated into three groups group I, II and III of 40 patients each. Patients in group I and group II were administered 0.75 μg/kg of dexmedetomidine and 1.5 mg /kg of tramadol in 100 ml NS respectively half a before extubation, while patients in group III did not receive any pharmacological intervention.Results: All three groups were comparable regarding distribution of age, gender, ASA grade and temperature at beginning and end of surgery and were non-significant.Conclusions: Dexmedetomidine seems to possess anti-shivering properties and was found to reduce the occurrence of shivering in patients undergoing general anaesthesia with minimal side effects although its anti-shivering effect was not superior to tramadol.

scholarly journals AB0797 THE ROLE OF ULTRASOUND CRITERIA IN ASSESSING PAIN SYNDROME IN THE KNEE JOINT IN PATIENTS WITH RHEUMATOID ARTHRITIS AND OSTEOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1423.1-1423
Author(s):  
N. Aleksandrova ◽  
A. Aleksandrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Knee Joint ◽  
Synovial Membrane ◽  
Pain Syndrome ◽  
Synovial Proliferation ◽  
Group Iii ◽  
Joint Cavity ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii

Background:Pain syndrome and pathological changes in the synovium detected by ultrasound can be early signs of various diseases of the joints [1].Objectives:the use of ultrasound criteria for changes in the synovial membrane of the joint cavity to assess the severity of pain in patients with rheumatoid arthritis (RA) and osteoarthritis (OA).Methods:The study included 36 patients with RA (32 women and 4 men aged 22 to 55 years old) and 38 patients with OA (30 women and 8 men aged 30 to 50 years old) with lesions of the knee joints. A visual analogue scale (VAS) was used to determine the severity of pain. The severity of pain in the knee when walking was at least 40 mm according to the VAS in all examined patients. Joint ultrasound examination was carried out according to the standard technique using a linear transducer with a frequency of 5–12 MHz on an Accuvix V10 ultrasound diagnostic system (Samsung Medison, South Korea). The evaluation of ultrasound changes in the upper inversion of a knee joint was carried out according to the following criteria: the severity of intra-articular effusion (1), synovial proliferation (2), local vascularization of the synovial membrane using power Doppler (3) (Table 1).Table 1.Parameters of ultrasound criteria for assessing changes in the synovial membrane of the joint cavityNormal indicators1 - width of the suprapatellar turn is 6 mm2 - thickness of the synovial membrane is 3 mm (from the anterior approach)3 - lack of vascularization lociMinimum changes1 - delamination of the suprapatellar curl leaves from 7 to 9 mm2 - thickness of the synovial membrane 3.1–4.5 mm3 - appearance of single loci of vascularization (1-2 in the Doppler field)Moderate changes1 - delamination of the leaves of the suprapatellar twist 10-14 mm2 - thickness of the synovial membrane is 4.6–6.4 mm3 - appearance of moderate (> 5) vascularization lociSevere changes1 - delamination of suprapatellar folds of more than 15 mm2 - thickness of the synovial membrane is more than 6.5 mm3 - multiple foci of vascularization (> 5, merging in places)Results:Correlations of various severity were found between pain indices according to VAS and the thickness of the synovial membrane of the knee joint (r = 0.33, p = 0.019) and the number of vascularization foci (rS = 0.29, p = 0.04) in RA patients, as well as between pain according to VAS and the severity of intra-articular effusion (r = 0.28, p <0.002) in patients with OA.The patients were divided into three groups according to the severity of pain in the knee joint: group I - 41-59 mm (12 patients with OA and 9 patients with RA), group II - 60-79 mm (16 patients with OA and 12 patients with RA), group III - 80–100 mm on the VAS scale (10 patients with OA and 15 patients with RA). Group I was dominated by OA patients with minimal changes in intra-articular effusion and local vascularization of the synovial membrane, with moderate synovial proliferation (28.6% of the total number of patients in the group). In group II patients with OA with moderate severity of intra-articular effusion and local vascularization (21.4%) and patients with RA with moderate changes in the thickness of the synovium and local vascularization (25%) were equally common. Group III was dominated by RA patients with severe synovial proliferation and moderate local vascularization (28%), as well as patients with OA with moderate intra-articular effusion (20%).Significant differences in the thickness of the synovium in patients with RA in the first and third groups were noted (H-test = 5.9, p = 0.025).Conclusion:The additional use of ultrasound criteria for changes observed in the synovial membrane of the joint cavity in patients with RA and OA can help predict pain in the knee joint. The manifestation of pain syndrome in patients with OA is most associated with the severity of synovitis in the joint, and in patients with RA - with the severity of synovial proliferation.References:[1]Sarmanova A et al. Arthritis Res Ther. 2017;19(1):281.Disclosure of Interests:None declared

scholarly journals Lymphoproliferative and Cytokine Responses to Cryptosporidium parvum in Patients Coinfected with C. parvum and Human Immunodeficiency Virus

2008 ◽  
Vol 16 (1) ◽  
pp. 116-121 ◽  
Author(s):  
Kirti Kaushik ◽  
Sumeeta Khurana ◽  
Ajay Wanchu ◽  
Nancy Malla
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cryptosporidium Parvum ◽  
Positive Group ◽  
Group Iii ◽  
Cytokine Responses ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Immunodeficiency Virus ◽  
Hiv Seropositive

ABSTRACT We compared the lymphoproliferative and cytokine responses to Cryptosporidium parvum in human immunodeficiency virus (HIV)-seropositive and -seronegative patients. The lymphoproliferative and cytokine responses (interleukin-2 [IL-2], IL-4, IL-5, IL-10, gamma interferon, and tumor necrosis factor alpha) were assessed for 11 HIV-seropositive, Cryptosporidium-positive (group I) patients; 20 HIV-seropositive, Cryptosporidium-negative (group II) patients; 10 HIV-seronegative, Cryptosporidium-positive (group III) patients, including four post-renal transplant (group IIIa) and 6 presumably immunocompetent (group IIIb) patients; and 20 HIV-seronegative, Cryptosporidium-negative healthy individuals (group IV). No significant difference was observed in the number of patients showing positive lymphoproliferative responses in group I compared to group III (post-renal transplant [group IIIa] or immunocompetent [group IIIb]) patients, while a comparison of the median stimulation indices shows that responses were significantly lower in Cryptosporidium-infected, immunosuppressed (group I and IIIa) patients than in immunocompetent (group IIIb) patients. The number of patients showing positive responses and median stimulation indices was significantly higher for Cryptosporidium-infected (HIV-seropositive and -seronegative) individuals than for uninfected individuals, suggesting that Cryptosporidium induces significant in vitro lymphoproliferative responses in infected individuals. Cytokine levels, except for that of IL-5, were significantly higher in Cryptosporidium-infected (groups I and III) individuals than in uninfected (groups II and IV) individuals. There was no significant difference between the group I and III patients and between Cryptosporidium-infected immunosuppressed (group I or IIIa) and immunocompetent (group IIIb) patients.

scholarly journals RECEPTION TIMES AND CLINICAL DIAGNOSTICS OF DISEASES OF ORNAMENTAL AND EXOTIC ANIMALS

2021 ◽  
Vol 245 (1) ◽  
pp. 120-125
Author(s):  
I.N. Nikitin ◽  
◽  
E.N. Trofimova ◽  
N.A. Nikiforova ◽  
◽  
...  
Keyword(s):  
Guinea Pig ◽  
Clinical Diagnosis ◽  
Ultrasound Examination ◽  
Clinical Diagnostics ◽  
Working Time ◽  
X Ray ◽  
Exotic Animals ◽  
Abdominal Organs ◽  
Diagnosis Of Diseases

The article presents materials on the regulation of labor of veterinary specialists who provide services to decorative and exotic animals. As an example for calculating the norms of time for ad-mission and clinical diagnostics, the calculations of the costs of working time for the clinical exami-nation of a rabbit, chinchilla, guinea pig, rat are presented; X-ray examination of the chest in a bird in 2 projections, ultrasound examination of the abdominal organs in a rat, taking blood from large and medium-sized parrots. There have been established 24 norms of time for admission and clinical diagnosis of diseases of decorative and exotic animals.

scholarly journals Incidence of tuberculosis of bones and joints in Sumy region

2021 ◽  
pp. 95-99
Author(s):  
I.D. Duzhyi ◽  
G.P. Oleshchenko ◽  
K.L. Serdiuk
Keyword(s):  
Negative Consequences ◽  
Tuberculous Spondylitis ◽  
Ability To Work ◽  
Group Iii ◽  
Osteoarticular Tuberculosis ◽  
Group I ◽  
Number Of Patients ◽  
Long Time ◽  
First Time ◽  
Significant Lesion

Bones and joints, among other extrapulmonary organs, are most often affected by tuberculosis. The clinical picture is often «hidden», the diagnosis of the disease is delayed for a long time with all the negative consequences. Objective — to study the trend in the incidence of tuberculosis of the bone and joint localization of the Sumy region residents in recent years and draw the attention of general practitioners to the urgent problem of today. Materials and methods. We analyzed the incidence of tuberculosis of bones and joints of the Sumy region residents during 2007—2019. During this period, 200 patients with osteoarticular tuberculosis registered in the region. Results and discussion. Over the past 13 years, the number of patients with tuberculosis of the bone and joint localization averaged 2.5 % of all newly detected processes. Tuberculosis of the spine (spondylitis) occurred in 119 (59.5 %) patients, specific inflammation of the hip joint in 49 (24.5 %), knee — in 11 (5.5 %), ankle — in 6 (3.0 %). Tuberculosis of other bones and joints was found in 15 (7.5 %) patients, 60 (50.4 %) patients with tuberculous spondylitis were recognized as disabled for the first time. Of these, the group I was found in 19 (31.7 %), II — in 25 (41.7 %), III — in 16 (26.6 %). Conclusions. In recent years, there has been an increase in the proportion of patients with CST among all newly diagnosed patients in the Sumy region. The spine is most often affected by tuberculosis of the bones and joints (59.5 %). At the same time, a significant lesion (3—4 vertebrae) was recorded in 23 (19.3 %) persons, five and more vertebrae — in 19 (16.0 %) patients. Patients with tuberculous spondylitis in 50.4 % of cases permanently lost their ability to work. Most patients of groups I and II of disability and a significant number of patients of group III require surgical intervention; without its implementation, there are irreversible changes in the vertebrae, which lead to increased medical, biological, and social disability.

scholarly journals Role of total leukocyte count in diagnosis of pediatric acute appendicitis: effect of antibiotic administration and duration of onset of symptoms

2017 ◽  
Vol 5 (1) ◽  
pp. 296
Author(s):  
Arun M. Ainippully ◽  
Sarath Kumar Narayanan ◽  
Vysakh C. N. ◽  
Arun Preeth V. ◽  
Prathap Somnath
Keyword(s):  
Leukocyte Count ◽  
Total Leukocyte Count ◽  
Symptom Duration ◽  
Antibiotic Administration ◽  
Group Iii ◽  
Group I ◽  
Routine Work ◽  
Number Of Patients ◽  
Group A ◽  
Group B

Background: Appendicitis is one of the most common pediatric surgical emergencies. The aim of the study is to determine the significance of total leukocyte count (TLC) in diagnosing appendicitis in the present era of rampant and injudicious antibiotic usage, and its relation to the duration of onset of symptoms.Methods: Study population consists of 148 pediatric patients who had confirmed appendicitis and underwent appendicectomy between January 2015 and December 2015. TLC was performed in all these patients as part of the routine work up. The population was categorized as: group I <24hrs, group II 24 to 4hrs and group III >48 hrs, based on symptom duration and group A and B based on antibiotics received or not respectively.Results: 64.9% (n = 96) were males and 35.1% (n = 52) were females. The ages ranged from 2.1 to 12.9 years (mean/SD being 8.3±1.2). The number of patients with elevated TLC was significantly lesser in Group B (62.2%, n = 92) when compared to the group A (37.8%, n = 56) which did not receive antibiotics (P <0.017). Significantly higher number of patients showed rise in TLC if it was done within 24 hours of onset of symptoms (66.6%, n =40).Conclusions: Our study shows that TLC proved more useful if it is performed within 24 hours of the onset of symptoms and is relevant only if antibiotics have not been administered.

scholarly journals Clinical profile and pattern of bacterial isolates from bile aspirates of cholecystectomy patients

2019 ◽  
Vol 7 (11) ◽  
pp. 4010
Author(s):  
Shewtank Goel ◽  
Pooja Tripathi Pandey ◽  
Abhay Kumar ◽  
Deval Kumar Arora ◽  
Nidhish Kumar ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Bacterial Growth ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Bacterial Isolates ◽  
Group Iii ◽  
Group I ◽  
Number Of Patients ◽  
Group Ii ◽  
Study Participants

Background: Antibiotic policy and appropriate antibiotic prophylaxis cannot be designed unless data is available about bacteria colonizing the bile associated with gall bladder disease.  Authors aim was to assess the clinical profile and pattern of bacterial isolates from bile aspirates of cholecystectomy patients seeking care at a tertiary care teaching hospital.Methods: Patients who underwent cholecystectomy for various hepatobiliary ailments during year 2017-18 formed the study population. Bile aspirates were collected during cholecystectomy and sent to the microbiology laboratory. Ultrasonography, computed tomography and MRCP were done to confirm the gall bladder pathology before surgery.Results: Out of total eighty-six patients, bacterial growth was observed in 28 (32.56%) subjects. As per division of bile samples, maximum number of study participants (39.29%) having bactibilia were seen in Group II. Group with second highest number of patients showing bactibilia was Group III with 9 subjects (32.14%). Eight subjects (28.57%) exhibited bacterial growth in bile aspirates in Group I subjects. Three patients (10.71%) showed bile infected with multiple bacteria i.e. polymicrobial infection. The gram-negative preponderance was seen in all the three groups with Escherichia coli being most common in group I and II. Pseudomonas aeruginosa was isolated in majority of the patients in group II and III.Conclusions: It is advised that all patients undergoing cholecystectomy must have their bile aspirated during cholecystectomy and sent for microbiological examination and culture. It will help in choosing appropriate antibiotic to prevent infection.

scholarly journals SOME CHARACTERISTICS OF THE COURSE OF CORONARY HEART DISEASE WITH A COMORBID PATHOLOGY

2020 ◽  
Vol 24 (1-2) ◽  
pp. 8-11
Author(s):  
Т.А. Trybrat ◽  
S.V. Shut ◽  
Z.O. Borisova ◽  
V.D. Sakevych ◽  
O.O. Goncharova
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Clinical Medicine ◽  
Nyha Class ◽  
Severe Disease ◽  
Age Group ◽  
Comorbid Conditions ◽  
Group Iii ◽  
Group I ◽  
Number Of Patients

Nowadays, scientists and doctors are increasingly paying attention to the study of the cardinal problem of modern clinical medicine, comorbidity and polymorbidity, which may arise as a result of common etiology, pathogenesis, cause and effect influences (the syntopic impairments) or as an accidental combination of disease (the accompanying impairments) with age factor, anatomical closeness of the affected organs or accidental combination of diseases. The aim: to define the concomitant diseases and their course, which are most often observed in patients with CHD. The prospective study involved 100 patients with coronary heart disease: stable angina, І-ІV NYHA Class, І-II HF. Results and discussion. The incidence of combined pathology in patients with CHD increases with age: in group I, one of the comorbid conditions prevails (mainly gastrointestinal tract diseases), in group II and III, there are two or more concomitant diseases. Among the total number of patients, 95% live in the city, hence the result of the urbanization process, and only 5% live in the village. The analysis of medicines prescriptions, used in the treatment of patients with CHD revealed an increased use of larger amounts of drugs in age group III (≥60) as compared to groups I (≤40) and II (41-60). Adequate combined prescriptions of medicines to patients with comorbid conditions will allow us not only to prevent progression of each disease, but also to improve the long-term prognosis. Essential hypertension is the «leader» in the total number of comorbid diseases, which makes up 77% of patients among the total number of subjects, with the highest incidence in the II (41-60) and III (≥60) age group. Thus, the obtained results indicate differences in the course and clinical presentation of coronary heart disease, depending on the presence of comorbid pathology, which leads to a more severe disease course, a greater number of comorbidities with increasing age of patients.

scholarly journals Are we closing the gaps in the management of osteoporosis following fragility fractures of the femur?

2019 ◽  
Vol 47 (5) ◽  
pp. 1843-1847 ◽  
Author(s):  
Mir Sadat-Ali ◽  
Sulliman M AlShammari ◽  
Fares Z Uddin ◽  
Fawaz M Alani ◽  
Omar S Dahduli
Keyword(s):  
Vitamin D ◽  
Femoral Fracture ◽  
Fragility Fractures ◽  
Fracture Liaison Service ◽  
Group Iii ◽  
Group I ◽  
Number Of Patients ◽  
Closing The Gaps ◽  
Treatment Plans

Objective The objective of this study was to identify deficiencies in initiating anti-osteoporotic treatment following a fragility femoral fracture. Methods All patients ≥55 years of age treated for a fragility femoral fracture between June 2012 and May 2017 were enrolled. Medications at discharge and at 90 days and 1 year of follow up were analyzed. Patients were classified into 4 groups: Group I did not receive any treatment for osteoporosis; Group II received only calcium and vitamin D3; Group III received an anabolic agent, calcium, and vitamin D3; and Group IV received bisphosphonates, calcium, and vitamin D3. Results A total of 167 patients with an average age of 65.81±12.55 years were included. There were 88 (52.7%) males and 79 (47.3%) females. At discharge, 107 patients (64.1%) were not prescribed optimal treatment for osteoporosis, and this reduced to 55 (32.9%) at the 90-day follow up. At 1 year, the number of patients receiving suboptimal treatment was further reduced to 25.74%. Conclusions Although the number of patients with fragility fractures receiving insufficient treatment was lower in the present study than in previous reports, increased efforts and coordinated treatment plans initiated by a fracture liaison service should be of high priority.

scholarly journals Stage surgical tactics in patients with obstructive jaundice complicated of the acute cholangitis and biliary sepsis

2019 ◽  
Vol 41 part 3 (2) ◽  
pp. 51-55
Author(s):  
O. Ye. Kanikovskiy ◽  
Ya. V. Karyi ◽  
Yu. V. Babiichuk
Keyword(s):  
Alkaline Phosphatase ◽  
Obstructive Jaundice ◽  
Acute Cholangitis ◽  
Transaminase Level ◽  
Biliary Decompression ◽  
Group Iii ◽  
Group I ◽  
Biliary Sepsis ◽  
Group Ii ◽  
Surgical Tactics

Purpose of the study. Improve treatment results of the patients with obstructive jaundice complicated of the acute cholangitis and biliary sepsis.Materials and methods. We analyzed the outcomes of surgical treatment of 200 patients with obstructive jaundice of the non-tumor genesis. The acute cholangitis was observed in 35 patients, which was caused of the biliary sepsis in 10 cases. The patients were divided into three groups: group I (n = 95), where endoscopic methods of biliary decompression were used; group II (n = 48), where biliodigestive anastomoses were formed; and group III (n = 57), where the external drainage of bile ducts was conducted.Results. The patients of the group I demonstrated a gradual decrease of bilirubin and alkaline phosphatase levels, which reached the normal readings on Day 7. The patients of the group II demonstrated normal levels of bilirubin and alkaline phosphataseon Day 14. The patients of the group III demonstrated rapid decrease of bilirubin and alkaline phosphatase levels, which reached the normal readings on Day 28. The transaminase level in each group of patients had reached the norm earlier.Conclusions. Priority is given to stage surgical tactics in patients with obstructive jaundice complicated of the acute cholangitis and biliary sepsis. Single-stage correction is recommended for patients with hyperbilirubinemia of less than 200 mcmol/l and duration of jaundice for less than 14 days, in the presence of compensated or subcompensated co-occurring pathology as well as in the absence of acute cholangitis.Keywords:obstructive jaundice, acute cholangitis, biliary sepsis, biliary decompression.

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