A comparative analysis of the intellectual–mental disorders in patients with brain gliomas and meningiomas after surgical treatment

2021 ◽  
pp. 576 (651)-585 (659)
Author(s):  
Maria Yuryevna Kurnukhina ◽  
Yulianna Vladimirovna Mukhitova ◽  
Vladislav Yuryevich Cherebillo ◽  
Elena Rudolfovna Isayeva
Keyword(s):  
Surgical Intervention ◽  
Laboratory Data ◽  
Brain Glioma ◽  
Memory Impairments ◽  
Wechsler Memory Scale ◽  
Number Of Patients ◽  
High Intelligence ◽  
Instrumental Methods ◽  
Brain Gliomas ◽  
Early Late

We performed study of 61 patients with brain glioma and meningioma. The diagnosis of the studied patients was based on clinical and laboratory data, data of radiation and instrumental methods of research. The analysis of patientsquality of life was carried out in the preoperative and early, late postoperative periods. The patient age ranged from 25 to 65 years; the median age was 56,5 year. We used the intelligence tests (Amthauer test (for persons under 60 years), Raven test); memory tests (10 word memorization test, Wechsler memory scale). Results. Regression of mnestic disorders after surgery was found in both groups. Three months after surgery — mnestic disorders were observed in 96.7 % of subjects with glioma, and in 64.5 % — of meningioma. After 3–6 months, the number of patients with high intelligence in both groups increased (from 32.3 % to 45.2 % — in patients with glioma and from 30 % to 40 % among meningioma patients). Conclusion. On examination of intelligence and memory before and resection brain glioma and meningioma, it was found that surgical intervention leads to regression of intellectual and memory impairments. English version of the article on pp. 651-659 is available at URL: https://panor.ru/articles/sravnitelnyy-analiz-intellektualno-mnesticheskikh-narusheniy-u-bolnykh-s-gliomami-i-meningiomami-golovnogo-mozga-posle-operativnogo-lecheniya/70264.html

scholarly journals Study on Guillain-Barré Syndrome in A Tertiary Level Military Hospital

2021 ◽  
Vol 16 (2) ◽  
pp. 44-46
Author(s):  
Md Helal Uddin ◽  
ATM Humayun Kabir ◽  
Md Ismail Chowdhury ◽  
Farzana Zafreen
Keyword(s):  
Mechanical Ventilation ◽  
Electrophysiological Study ◽  
Laboratory Data ◽  
Guillain Barre Syndrome ◽  
Military Hospital ◽  
Upper Respiratory Tract ◽  
Intravenous Immunoglobulin Therapy ◽  
Number Of Patients ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Guillain-Barre Syndrome (GBS) is an acute, frequently severe and fulminant polyradiculopathy that is autoimmune in nature and that causes acute neuromascular failure. The condition is quite common in Bangladesh. GBS is an autoimmune and post-infectious immune disease. Objectives: To see the different presentation and outcome of GBS in combined military hospital (CMH) Dhaka. Materials and Methods: This was a retrospective observational study conducted on all the GBS patients admitted in the Neurology Ward of CMH Dhaka from January 2005 to July 2010. Total 25 patients clinical and laboratory data including CSF analysis, electrophysiological study data were collected from patients’ case sheet. Results: Among the 25 GBS patients male was 22 (88%) and female 03(12%) and most common age group affected was 31-40 years comprising of 09(36%) patients. The most common types of GBS patients were acute inflammatory demyelinating polyneuropathy (AIDP) 17(68%) patients and 10(40%) patients were found to have history of upper respiratory tract infection (URTI). Albuminocytological dissociation was found in 20(80%) patients in CSF study. Intravenous immunoglobulin therapy was given to 13(52%) patients, of them 09(36%) patient needed mechanical ventilation; rest 12(48%) patients were treated conservatively. The final outcome was full recovery 22(88%) patients, 02(8%) patients had residual disability and only one patient died after 2 years of GBS. Conclusion: GBS is an important cause of peripheral neuropathy. Patient should be monitored carefully because a significant number of patients ultimately require mechanical ventilation for respiratory failure which may be of sudden onset. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 44-46

scholarly journals Enthesitis Related Arthritis: A Single Center Experience

Acta Medica ◽  
2021 ◽  
pp. 1-6
Author(s):  
Selcan Demir ◽  
Müşerref Kasap Cüceoğlu ◽  
Yelda Bilginer
Keyword(s):  
Laboratory Data ◽  
Inflammatory Back Pain ◽  
Hla B27 ◽  
Female Ratio ◽  
Enthesitis Related Arthritis ◽  
Spinal Involvement ◽  
Therapeutic Decisions ◽  
Number Of Patients ◽  
Spinal Mri

Objective: Enthesitis-related arthritis is a subtype of juvenile idiopathic arthritis category, characterized by enthesitis, arthritis, and the risk of axial involvement. We aimed to summarize the demographics, clinical, and laboratory findings of enthesitis-related arthritis patients and to identify the distinguishing features of enthesitis-related arthritis patients with HLA B27 positive compared to the patients who were HLA B27 negative. Materials and Methods: This retrospective study included patients with Enthesitis-related arthritis who followed up between 2015 and 2018. Demographical, clinical, and laboratory data were retrospectively reviewed from the patient files and computerized medical charts. Results: A total of 72 patients diagnosed with enthesitis-related arthritis were included in the study. The male/female ratio was 2.1/1. Fifty-three (73%) of them presented with peripheral arthritis. The most commonly affected joint was knee (81.1%), followed by the ankle (43%), hips (32%), and wrist (5%). HLA B27 was positive in 36 (50%) patients. During follow-up, the number of patients who developed enthesitis-related arthritis -associated uveitis was 8 (11.1%). During follow-up, 56 patients with inflammatory back pain and/or sacroiliac tenderness underwent spinal MRI. Ten (17.8%) patients had only thoracal and/or lumbar involvement, 18 (32%) had only sacroiliitis, and 9 (16%) patients had both of them on spinal MRI. In comparison with HLA-B27-negative children, HLA-B27-positive patients were more likely to have enthesitis (16 (44.4%) vs 8 (22.2%), p=0.046), MRI proven sacroiliitis (19 (52.7%) vs 8 (22.2%), p=0.031), MRI proven spinal involvement (13 (36.1%) vs 6 (16.6%), p=0.031), and uveitis (8 (100%) vs 0(0%), p=0.014). During follow up, 65/72 (90.2 %) of them needed disease-modifying antirheumatic drugs (DMARD), and 51/72 (70.8%) needed anti-tumor necrosis factor-α (TNF-α) therapy. Conclusion: We found that patients who were HLA-B27- positive had significantly more enthesitis, MRI-proven sacroiliitis, MRI-proven spinal involvement, and acute anterior uveitis, in comparison to patients who were HLA B27 negative. It is crucial to carefully assess those patients with concern for enthesitis-related arthritis to determine the expected prognosis and make therapeutic decisions appropriately.

scholarly journals Polyarthritis associated with COVID-19 (clinical case)

2021 ◽  
Vol 15 (5) ◽  
pp. 76-79
Author(s):  
E. S. Aronova ◽  
B. S. Belov
Keyword(s):  
Clinical Data ◽  
Laboratory Tests ◽  
Clinical Case ◽  
Clinical Observation ◽  
Laboratory Data ◽  
Careful Study ◽  
Instrumental Methods

The article describes the clinical observation of the onset of polyarthritis after COVID-19. Clinical data, laboratory tests' and instrumental methods results in dynamics, as well as approaches to therapy are presented. The discussion reflects modern views on the causes of the development of articular syndrome after SARS-CoV-2, with special attention to the need for a careful study of the history, clinical and laboratory data of patients with COVID-19.

scholarly journals A national study of practice patterns in UK renal units in the use of dialysis and conservative kidney management to treat people aged 75 years and over with chronic kidney failure

2015 ◽  
Vol 3 (12) ◽  
pp. 1-186 ◽  
Author(s):  
Paul Roderick ◽  
Hugh Rayner ◽  
Sarah Tonkin-Crine ◽  
Ikumi Okamoto ◽  
Caroline Eyles ◽  
...  
Keyword(s):  
Kidney Failure ◽  
Older Patients ◽  
Practice Patterns ◽  
Laboratory Data ◽  
National Study ◽  
Service Development ◽  
Renal Unit ◽  
Number Of Patients ◽  
Wide Range ◽  
The Way

BackgroundConservative kidney management (CKM) is recognised as an alternative to dialysis for a significant number of older adults with multimorbid stage 5 chronic kidney disease (CKD5). However, little is known about the way CKM is delivered or how it is perceived.AimTo determine the practice patterns for the CKM of older patients with CKD5, to inform service development and future research.Objectives(1) To describe the differences between renal units in the extent and nature of CKM, (2) to explore how decisions are made about treatment options for older patients with CKD5, (3) to explore clinicians’ willingness to randomise patients with CKD5 to CKM versus dialysis, (4) to describe the interface between renal units and primary care in managing CKD5 and (5) to identify the resources involved and potential costs of CKM.MethodsMixed-methods study. Interviews with 42 patients aged > 75 years with CKD5 and 60 renal unit staff in a purposive sample of nine UK renal units. Interviews informed the design of a survey to assess CKM practice, sent to all 71 UK units. Nineteen general practitioners (GPs) were interviewed concerning the referral of CKD patients to secondary care. We sought laboratory data on new CKD5 patients aged > 75 years to link with the nine renal units’ records to assess referral patterns.ResultsSixty-seven of 71 renal units completed the survey. Although terminology varied, there was general acceptance of the role of CKM. Only 52% of units were able to quantify the number of CKM patients. A wide range reflected varied interpretation of the designation ‘CKM’ by both staff and patients. It is used to characterise a future treatment option as well as non-dialysis care for end-stage kidney failure (i.e. a disease state equivalent to being on dialysis). The number of patients in the latter group on CKM was relatively small (median 8, interquartile range 4.5–22). Patients’ expectations of CKM and dialysis were strongly influenced by renal staff. In a minority of units, CKM was not discussed. When discussed, often only limited information about illness progression was provided. Staff wanted more research into the relative benefits of CKM versus dialysis. There was almost universal support for an observational methodology and a quarter would definitely be willing to participate in a randomised clinical trial, indicating that clinicians placed value on high-quality evidence to inform decision-making. Linked data indicated that most CKD5 patients were known to renal units. GPs expressed a need for guidance on when to refer older multimorbid patients with CKD5 to nephrology care. There was large variation in the scale and model of CKM delivery. In most, the CKM service was integrated within the service for all non-renal replacement therapy CKD5 patients. A few units provided dedicated CKM clinics and some had dedicated, modest funding for CKM.ConclusionsConservative kidney management is accepted across UK renal units but there is much variation in the way it is described and delivered. For best practice, and for CKM to be developed and systematised across all renal units in the UK, we recommend (1) a standard definition and terminology for CKM, (2) research to measure the relative benefits of CKM and dialysis and (3) development of evidence-based staff training and patient education interventions.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass

2019 ◽  
Vol 23 (2) ◽  
pp. 267-276
Author(s):  
K. A. Khyzhniak ◽  
Y. V. Volkova ◽  
K. Y. Sharlai ◽  
M. V. Khartanovych
Keyword(s):  
Cardiopulmonary Bypass ◽  
Hospital Stay ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Infusion Therapy ◽  
The Third ◽  
Group I ◽  
Aortic Pathology ◽  
Number Of Patients ◽  
Group Ii

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.  

scholarly journals Considerations on accuracy, pattern and possible underlying factors of brain microbleed progression in older adults with absence or mild presence of vascular pathology

2018 ◽  
Vol 46 (9) ◽  
pp. 3518-3538 ◽  
Author(s):  
Alice M Harper ◽  
Lauren Clayson ◽  
Joanna M Wardlaw ◽  
Maria del C Valdés Hernández ◽  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Laboratory Data ◽  
Magnetic Resonance Images ◽  
Vascular Pathology ◽  
Older Individuals ◽  
Cognitively Normal ◽  
Time Points ◽  
Number Of Individuals ◽  
Early Late

Objective To analyse brain microbleed (BMB) progression, its possible underlying factors, and the influence of inter-observer differences, in older individuals with none or mild vascular pathology. Methods This study analysed magnetic resonance images, cognitive, demographic and laboratory data from all individuals from the Alzheimer’s Disease (AD) Neuroimaging Initiative database who had the required sequences for identifying BMBs over three consecutive years at the time the database was accessed (January 2016). BMBs were assessed independently by two observers with similar levels of experience. Results A total of 291 patients were included in the study. The number of individuals with BMBs and the number of BMBs per individual slightly and nonsignificantly increased across three consecutive years (Y1: 55/291 [19%]; Y2: 61/291 [21%]; Y3: 66/291 [23%]) with 1–2 BMBs and (Y1: 11/291 [4%]; Y2: 12/291 [4%]; Y3: 14/291 [5%]) with ≥ 3 BMBs. Both observers identified a similar pattern of BMB prevalence and progression in each cognitive group (normal < early/late mild cognitive impairment (MCI) > AD patients) despite inter-observer differences (1.5 BMBs, 95% confidence interval –3.7, 6.2], κ=0.543), which were mainly in the cortex. Serum cholesterol was the main predictor of change in BMB count between time-points but did not predict overall progression. Conclusions Inter-observer differences are always present and it is difficult to ascertain their influence in the analysis of BMB progression, which was observed in cognitively normal and MCI individuals, but not in AD patients. This should be confirmed in further studies.

The incidence of occult endocrinopathies in patients with cancer undergoing immunotherapy in community practice.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e14571-e14571
Author(s):  
Ahmed Abdalla ◽  
Aditi Singh ◽  
Hussein Gharib ◽  
Benjamin Huber ◽  
Sindhu Janarthanam Malapati ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Testosterone Level ◽  
Single Agent ◽  
Laboratory Data ◽  
Endocrine Function ◽  
Hormone Levels ◽  
Primary Indication ◽  
Number Of Patients ◽  
The Mean ◽  
Stimulating Hormone

e14571 Background: Immune checkpoint blockade (IO) can induce inflammation of the pituitary, thyroid or adrenal glands. This usually results in non-specific symptoms such as headache, low-energy, nausea and vomiting, which can be difficult to differentiate from symptoms associated with cancer and therapy-related symptoms. Therefore, the exact incidence of endocrinopathies is exceedingly difficult to estimate in community practices. Also, the variable methods of assessment, diagnosis, and monitoring used in different clinical trials make it challenging to precisely measure the incidence of endocrinopathies. Methods: This is a single-center retrospective chart review of patients diagnosed with cancer receiving immunotherapy for cancer treatment who had routine hormone levels checked during their treatment. Data collected includes tumor types and the types of IO agents used. Laboratory data collected included thyroid-stimulating hormone (TSH), testosterone level, follicular stimulating hormone (FSH), luteinizing hormone (LH), cortisol levels. Results: In total, 75 patients were included in the study. The primary indication for IO was lung cancer in 43 patients (57%), genitourinary tumors (12%), melanoma (12%) and head & neck cancers (5.3%). Single-agent nivolumab (39 patients) was the most common IO agent used followed by single-agent pembrolizumab (22 patients), ipilimumab (11 patients), atezolizumab (3 patients), avelumab (1 patient) (There was one patient who got nivolumab initially and then pembrolizumab). Nine patients were treated with ipilimumab/nivolumab combination. The mean number of cycles received was 9.1. The total number of patients who developed at least one abnormal hormone level was 57(76%), with 33 out of 74 (45%) patients had at least one abnormal TSH, 29 out of 44 (66%) patients had at least one abnormal testosterone level, 10 out of 49 (20.4%) patients had at least one abnormal FSH and/or LH level, 36 out of 52 (69%) patients had at least one abnormal cortisol level. The mean number of days from starting IO to develop the first abnormal laboratory result was 106 days. Conclusions: The incidence of endocrinopathy was significantly high in patients receiving IO in this study, which is higher than what is reported in previous clinical trials. This could be due to frequent testing in asymptomatic patients and strict laboratory cut-off values which is not always clinically meaningful. This finding may highlight the importance of routine monitoring of the endocrine function during IO treatment. Routine measurement of hormone levels can detect asymptomatic endocrinopathy which may warrant further work-up and treatment. These findings should be validated in a larger prospective study.

Impact of COVID-19 Lockdown on Ocular Trauma in Benghazi, Libya

2021 ◽  
pp. 53-57
Author(s):  
Mariam Gebril ◽  
Bahjah Esehiyb ◽  
Suliman Masoud
Keyword(s):  
Statistical Difference ◽  
Surgical Intervention ◽  
Ocular Trauma ◽  
Public Health Problem ◽  
P Value ◽  
Eye Trauma ◽  
Number Of Patients ◽  
The World ◽  
The Impact ◽  
Similar Incidence

Background. COVID-19 is a new pandemic that spread over the world in 2020, for which most countries imposed rigorous lockdown to reduce its upsurge and thus its socioeconomics’ sever effects. Global measures include isolation, social distancing, lockdown any nonemergency facilities, local and international travelling restrictions. But these rules are implacable in case of trauma in general and more with ocular trauma, which represents a serious public health problem and leading cause of visual impairment. The aim of this study was to evaluate the impact of COVID -19 lock down on number of ocular traumas acquiring surgery. Methods. A retrospective study in Aljala trauma hospital in the period from 18 March to 18 April 2020 on patients who underwent surgical intervention for non-war eye trauma. Results. A total number of patients seen in emergency department were 350 patients in 2020 with four patients needed hospital admission and surgical intervention making a 1.14% of total number. While number of patients seen at the same time in 2019 were 965 patients and three patients needed surgical intervention (0.31%). There was no statistical difference in the amount of patient acquiring surgical intervention in the two periods with the P value of >0.05 Conclusion. Although total emergency eye visits decreased during the covid-19 lockdown period, similar incidence of surgery needed ocular trauma persisted.

scholarly journals Seasonal variations in the occurrence of acute appendicitis and their relationship with the presence of fecaliths in children

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yao-Jen Hsu ◽  
Yu-Wei Fu ◽  
Taiwai Chin
Keyword(s):  
Acute Appendicitis ◽  
Medical Records ◽  
Laboratory Data ◽  
Lymphoid Hyperplasia ◽  
Clinical Findings ◽  
Number Of Patients ◽  
Computed Tomography Scans ◽  
Pathology Reports ◽  
Operative Notes ◽  
Surgical Condition

Abstract Background Acute appendicitis (AA) is the most common surgical condition in children. Although a higher incidence of AA in summer has been reported, the reason for this observation remains unclear. The purpose of this study was to compare the clinical findings of AA patients who underwent appendectomies during the summer months with those who underwent the procedure during the non-summer months. Methods The clinical data of 171 patients who underwent appendectomy from January 2013 to December 2016 were reviewed. The patients were divided into a summer group (from May to October) and a non-summer group (from November to April) based on the month when appendectomy was performed. All patients were under 18 years of age at the time of surgery. The medical records including laboratory data, computed tomography scans, pathology reports and operative notes were reviewed. Results The number of patients with AA was higher in the summer group than in the non-summer group (101 vs. 70 patients). No significant differences in the laboratory results between the two groups of patients were observed. The percentage of AA patients who presented with a fecalith was significantly lower in the summer group (33.6%) than in the non-summer group (55.7%). No significant differences in the incidence of appendiceal perforations and abscesses, as well as postoperative complications were observed between the two groups. Conclusions The percentage of AA patients with fecaliths in summer was lower than that in the non-summer months. The increase in the number of AA patients in summer may be due to the increased occurrence of lymphoid hyperplasia, which may be correlated with the yearly outbreak of enterovirus infection during this period.

scholarly journals Hypercoagulation and Antithrombotic Treatment in Coronavirus 2019: A New Challenge

2020 ◽  
Vol 120 (06) ◽  
pp. 949-956 ◽  
Author(s):  
Francesco Violi ◽  
Daniele Pastori ◽  
Roberto Cangemi ◽  
Pasquale Pignatelli ◽  
Lorenzo Loffredo
Keyword(s):  
Multiorgan Failure ◽  
Laboratory Data ◽  
Clinical Severity ◽  
The Novel ◽  
Antithrombotic Treatment ◽  
Clotting System ◽  
Thrombotic Risk ◽  
Number Of Patients ◽  
Coronary Ischemia ◽  
Novel Coronavirus

AbstractThe novel coronavirus 2019 (COVID-19) is clinically characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for a high number of patients needing mechanical ventilation or intensive care units treatment and for the elevated mortality risk. A link between COVID-19 and multiorgan failure may be dependent on the fact that most COVID-19 patients are complicated by pneumonia, which is known to be associated with early changes of clotting and platelet activation and artery dysfunction; these changes may implicate in thrombotic-related events such as myocardial infarction and ischemic stroke. Recent data showed that myocardial injury compatible with coronary ischemia may be detectable in SARS-CoV-2 patients and laboratory data exploring clotting system suggest the presence of a hypercoagulation state. Thus, we performed a systematic review of COVID-19 literature reporting measures of clotting activation to assess if changes are detectable in this setting and their relationship with clinical severity. Furthermore, we discussed the biologic plausibility of the thrombotic risk in SARS-CoV-2 and the potential use of an antithrombotic treatment.

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