scholarly journals Реостеосинтез грудины в лечении хронического послеоперационного стерномедиастинита

2019 ◽  
pp. 70-73
Keyword(s):  
Thoracic Surgery ◽  
Clinical Case ◽  
Second Stage ◽  
Postoperative Osteomyelitis

Postoperative osteomyelitis of the sternum and sternomediastinitis are in the group of the most severe purulent complications in thoracic surgery. The authors indicated the possibility of preserving the sternum tissue in the second stage of the treatment of postoperative sternomediastinitis. This approach is supported by the description of the clinical case of successful use of sternum reosteosynthesis in a patient with postoperative sternomediastinitis.

scholarly journals Surgical treatment of a patient with combined lesion of the coronary and carotid arterial systems

2021 ◽  
pp. 21-28
Author(s):  
V. Yu. Ridel ◽  
K. M. Mikhailov ◽  
M. D. Sentsova ◽  
N. M. Mikhailov
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Clinical Case ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Second Stage ◽  
Staged Surgery ◽  
Combined Lesions ◽  
Carotid Arterial ◽  
Vessel Coronary Artery

A clinical case of surgical treatment of a patient with atherosclerotic combined lesions of the coronary and carotid areas is presented. A staged surgery was performed. The first stage was carotid endarterectomy sequentially on both sides. The second stage is three-vessel coronary artery bypass grafting. The patient was examined 2 years after the operation. There are no data on restenosis of the reconstruction zone of the carotid system. The return of angina pectoris is not noted.

scholarly journals Surgical management of a patient with biliodigestive anastomosis stricture complicated by multiple intrahepatic lithiasis

2021 ◽  
Vol 180 (4) ◽  
pp. 82-85
Author(s):  
A. Yu. Korolkov ◽  
D. N. Popov ◽  
A. O. Tantsev ◽  
T. O. Nikitina ◽  
S. F. Bagnenko
Keyword(s):  
Small Bowel ◽  
Surgical Management ◽  
Clinical Case ◽  
Surgical Intervention ◽  
Biliodigestive Anastomosis ◽  
Second Stage ◽  
Intrahepatic Lithiasis ◽  
Iatrogenic Damage ◽  
The Right ◽  
Upper Abdomen

A clinical case of surgical management of patient with biliodigestive anastomosis stricture complicated by multiple intrahepatic lithiasis is presented. The patient was 57 years old woman. Anamnesis of the disease: in 2016, biliodigestive anastomosis was performed due to iatrogenic damage of the biliary tract. She was admitted to the hospital with complaints of the right upper abdomen pain, accompanied by chills, jaundice, and fever up to 39°C. The examination revealed a stricture of a previously formed biliodigestive anastomosis complicated by multiple intrahepatic cholelithiasis. Surgical intervention was performed: at the first stage – percutaneous transhepatic cholangiostomy; at the second stage – laparotomy, separation of hepaticojejunoanastomosis, intraoperative cholangioscopy with lithoextraction, resection of a small bowel section with a Brownian anastomosis, post-colon hepaticojejunostomy on a disconnected loop and replaceable transhepatic drains (Smith-Praden-Saypol-Kurian).

scholarly journals Surgical treatm ent of dento maxillary anomalies class III angle. Clinical case

2021 ◽  
Vol 3 (59) ◽  
pp. 26-34
Author(s):  
Mihaela Ciuclea ◽  
◽  
Dumitru Sirbu ◽  
Stanislav Strisca ◽  
Stanislav Eni ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Class Iii ◽  
Virtual Planning ◽  
Second Stage ◽  
Occlusal Splints ◽  
Surgical Guides ◽  
Modern Methods ◽  
Digital Scanning ◽  
Dental Photography

Dento-maxillary anomalies are relatively widespread among the population, eventually leading to serious psychological and lifestyle deterioration. The purpose of this paper is to evaluate the complex orthodontic-surgical treatment in the dento-maxillary anomaly class III Angle. We aim to present the clinical case of a female patient suffering from skeletal third-class, gnathic form, who came to „Omni Dent” clinic in order to complete the second stage of associate orthodontic and surgical treatment. Medical investigations: OPG, CBCT, TRG, digital scanning, dental photography, digital programs, used at collecting data for virtual planning, establishing a complex diagnosis and choosing the best surgical technique for this case, subsequently, with the transfer of the virtual plan in the operating room through surgical guides and occlusal splints. Postoperatively, there was an obvious improvement of the facial appearance, supported by the comparison of pre- and postoperative cephalometric indices: SNA (from 76,6° to 84°), SNB (from 80,6° to 78,8°), ANB (from -4° to 5,2°), Wits (from -9,6° to 0°). Early diagnosis and detailed planning by using modern methods of examination may ensure an efficient rehabilitation of patients suffering from dento-maxillary anomalies.

scholarly journals Multistage treatment of a patient with spontaneous rupture of the esophagus in a multidisciplinary hospital setting

2019 ◽  
Vol 11 (3) ◽  
pp. 93-95
Author(s):  
Andrey E. Demko ◽  
Georgii I. Sinenchenko ◽  
Vladimir I. Kulagin ◽  
Vladimir I. Ivanov ◽  
Aleksandr I. Babich
Keyword(s):  
Elderly Patient ◽  
Severe Sepsis ◽  
Minimally Invasive ◽  
Spontaneous Rupture ◽  
Clinical Case ◽  
Pleural Cavity ◽  
Hospital Setting ◽  
Surgical Trauma ◽  
Digestive Tube ◽  
Second Stage

The article presents a clinical case of 2-stage treatment of an elderly patient with spontaneous rupture of the esophagus. Exclusion the esophagus in the first stage of treatment with the use of minimally invasive technologies (endoscopy, laparoscopy, drainage of the pleural cavity) allowed to minimize surgical trauma and create conditions for the recovery of the patient, relief of mediastinitis, sepsis and restore the natural passage of food through the digestive tube during the second stage of treatment. The presented clinical case demonstrates the feasibility of the multistage approach using minimally invasive technology in the treatment of eldery patients with spontaneous rupture of the esophagus and severe sepsis.

scholarly journals MULTIMODAL APPROACH IN THE RECONSTRUCTION OF FIRING DEFECTS OF THE LOWER LIMBS (CLINICAL CASE)

2020 ◽  
Author(s):  
І. П. Хоменко ◽  
К. В. Гуменюк ◽  
С. О. Король ◽  
Є. В. Цема ◽  
Р. М. Михайлусов ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Thermal Imaging ◽  
Clinical Case ◽  
Soft Tissues ◽  
Gunshot Wounds ◽  
Left Thigh ◽  
Lower Limbs ◽  
Wound Area ◽  
Superficial Femoral Vein ◽  
Second Stage

According connection with the global trends, manifested by an increase in the number of illegal firearms, an increase in social, political, ethnic, racial and religious conflicts, accompanied by the use of firearms, the problem of treating gunshot wounds is becoming increasingly important. It is especially acute during local and widespread hostilities, during peacekeeping missions, anti-terrorist operations, in cases of massive gunshot wounds. The aim of the work is to improve the surgical tactics in the reconstruction of severe wounded with soft tissue gunshot defects due to the multimodal scheme. Improvement of dynamic audio and thermal imaging diagnostics of the damaged anatomical area, analysis and modeling of the shape and direction of movement of the donor flap. A clinical case of closure of a bullet-through bullet wound of the left thigh (03.25.19 year) with a gunshot multi-fragment fracture of the left femoral pigtail in the middle third, damage to the superficial femoral vein and marginal damage to the superficial femoral artery was demonstrated.In the preoperative period, the first stage was dynamic digital thermography of the surface of wounds and surrounding soft tissues, which allowed thermal imaging to assess the state of damaged structures, to identify areas of preservation of blood supply. The second stage was the audio control of the identified areas of the "supply" - perforating vessels with a comparison of the blood flow velocity. The results obtained formed the basis for modeling the donor zone and monitoring its movement. The described clinical case of soft tissue defect closure consisted of three stages: The first stage - preparatory (diagnostics and cleaning) - (9 days of inpatient treatment) - repeated surgical treatment of wounds using low-frequency ultrasound (cavitation of the wound surface), controlled negative pressure (in a pulsed mode - 125 mm Hg), the imposition of secondary early sutures, due to which the wound area decreased by 35% compared to the wound area at the time of admission to the VICC of the Southern region. The second stage - the final (reconstructive) - (12 days after the injury) - plastic reconstruction of the defect of the posterior surface of the middle third of the left thigh by moving a ball-and-socket flap from the outer surface of the thigh using the Keystone technique. Conclusions: A multimodal algorithm with dynamic control of changes in the perfusion of the defect zone and surrounding structures is at the heart of the successful reconstruction of a gunshot defect in the soft tissues of the lower extremities, which reduces the treatment time by 1.5 times.

scholarly journals SURGICAL TREATMENT FOR A PATIENT WITH TWO RECTOVAGINAL FISTULAS (case report)

2020 ◽  
Vol 19 (3) ◽  
pp. 92-96
Author(s):  
F. S. Aliev ◽  
R. F. Aliev ◽  
A. Ya. Ilkanich ◽  
V. F. Aliev ◽  
I. A. Matveev
Keyword(s):  
Clinical Case ◽  
Titanium Nickelide ◽  
Complete Recovery ◽  
Stoma Closure ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Fistula Recurrence ◽  
Rectovaginal Fistulas

The article describes clinical case of a patient with two rectovaginal fistulas of high and low level. The first stage included diverting loop sigmostomia and latex seton for low fistula. Three months later, on the second stage, fistulectomy with invagination of the fistula to rectal lumen with compression of invaginated part by titanium nickelide clamp was done. The fistulectomy with sphincteroplasty was done for the lower fistula. No postoperative complications developed; the complete recovery was detected. Seven months later, on the third stage, the stoma closure was done. No complications and fistula recurrence were obtained in 2 months of follow-up.

scholarly journals Case report of chondrosarcoma of the larynx

2020 ◽  
Vol 19 (6) ◽  
pp. 87-93
Author(s):  
A. A. Makhonin ◽  
◽  
T. Yu. Vladimirova ◽  
A. G. Gabrielyan ◽  
A. I. Sinotin ◽  
...  
Keyword(s):  
Total Laryngectomy ◽  
Clinical Case ◽  
Cricoid Cartilage ◽  
Vocal Folds ◽  
Malignant Tumour ◽  
Low Grade ◽  
Rare Tumour ◽  
Second Stage ◽  
Clinical Observations ◽  
Ct Data

The chondrosarcoma of the larynx is a poorly understood and rare malignant tumour. It accounts for only 1% of malignant neoplastic pathology of the larynx, but at the same time it is the most common non-epithelial neoplasm of the larynx. More often occurs in the area of the cricoid cartilage, namely the inner plate, less often in the area of the vocal folds and the epiglottis. There are no clinical guidelines for the treatment of chondrosarcoma of the larynx, therefore each clinical case describing clinical observations of this rare tumour is of interest. A clinical case of chondrosarcoma of the larynx is presented in a 55-year-old man who complained of hoarseness for 3 months. The patient underwent a complete clinical and instrumental examination, but computed tomography (CT) is of the greatest value. According to CT data, a calcified mass is visualized in the cricoid cartilage. At the first stage, the patient underwent resection of the cricoid cartilage in order to verify the diagnosis. Histological examination: low-grade chondrosarcoma. At the second stage, a radical surgical treatment was performed - laryngectomy. 8 months after the operation, the patient has no data on the relapse and progression of the disease according to the survey data. Currently, total laryngectomy is preferred for patients with recurrent low-grade chondrosarcoma. However, a literature review and our case show that the inability to restore the cricoid cartilage of the larynx, which is affected in most cases, often leads to laryngectomy

Use of ICF in Rehabilitation: a Clinical Case

2021 ◽  
pp. 145-155
Author(s):  
N.V. Kozlova ◽  
◽  
T.E. Levitskaya ◽  
E.A. Tsekhmejstruk ◽  
I.V. Atamanova ◽  
...  
Keyword(s):  
Environmental Factors ◽  
Multidisciplinary Team ◽  
Clinical Case ◽  
Recovery Period ◽  
Medical Rehabilitation ◽  
Psychological Status ◽  
Clinical Psychologist ◽  
Early Recovery ◽  
Second Stage ◽  
Early Recovery Period

The article describes a clinical case of a patient with an acute cerebrovascular accident (CVA) at the second stage of medical rehabilitation, conducted by a psychologist as part of a multidisciplinary team. It presents the main concepts and content of the International Classi-fication of Functioning, Disability and Health (ICF). Attention is drawn to a unified language of its application, available to all members of such a multidisciplinary team implementing the process of rehabilitation. The importance of psychological evaluation within the ICF catego-ries for effective interaction between this team’s specialists has been shown. A specific fea-ture of this case was a possibility of using categories belonging to almost all the ICF sections. The purpose of this work is to introduce psychologists to a clinical psychologist’s com-petencies and possibilities of applying the ICF in the rehabilitation of patients with an acute CVA at the second stage of medical rehabilitation. Materials and methods. The article focuses on a clinical case of a female patient with an acute CVA during the early recovery period at the second stage of medical rehabilitation with a description of the dynamics of her psychological status, using the ICF categories. Results. The article provides a list of psychological domains presented in the following ICF sections: "Body Functions", "Activity and Participation", and "Environmental Factors", which can be used by a clinical psychologist within rehabilitation activities. The rehabilitation diagnosis for this patient with an acute CVA in her early recovery period was provided by means of the ICF categories based on her individual characteristics and impairments, and the dynamics of recovery has been revealed. The ICF domains are presented with an indication of the content aspect and the degree of impairment. Discussion of results. The clinical case demonstrates the importance of taking into ac-count personal and environmental factors when describing one’s rehabilitation diagnosis and organizing the rehabilitation process. Applying the ICF categories makes the patient's features and problems clear to all the multidisciplinary team members. The main difficulties of working with the ICF are related to the selection of domains due to the discrepancy between the conceptual apparatus of foreign and domestic psychology. The importance of understanding the semantic component of the domain has been shown. Limitations of screening tests have been noted, and the need to conduct a qualitative analysis of mental disorders within the framework of a personality-oriented approach has been updated. Conclusions. Applying the ICF allows one to maintain a productive interaction with all the members of the multidisciplinary team, describe the patient’s current problems and visually assess the dynamics of recovery. At the same time, its use in the practice of a clinical psychologist requires a specialist to have a deep understanding of the content of the ICF psychological domains and skills to select them for each specific case.

The effectiveness of neoadjuvant chemotherapy in the treatment of cervical cancer (clinical case)

2020 ◽  
pp. 28-39
Author(s):  
V. N. Zhurman ◽  
I. V. Pezhenin ◽  
I. V. Sayapina ◽  
L. S. Matyushkina ◽  
Eliseeva Eliseeva
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Clinical Case ◽  
Dynamic Monitoring ◽  
Cervical Tumor ◽  
Pelvic Mri ◽  
Type Iii ◽  
Positive Effects ◽  
Second Stage ◽  
Ovarian Transposition

For the treatment of stage 2 cervical cancer, surgical treatment, chemoradiotherapy or neoadjuvant chemotherapy in combination with paclitaxel and carboplatin followed by extended uterine extirpation of type III can be used. The positive effects of a combination of neoadjuvant chemotherapy with surgery are shown. A clinical case of treatment of a 43-year-old patient with a diagnosis of: cervical cancer IB2 stage T2a2N0M0. At the first stage of treatment, the patient was prescribed 3 courses of neoadjuvant chemotherapy in a combination of paclitaxel and carboplatin. There was a decrease in the size of the cervical tumor by 25 % on the RECIST scale. At the second stage of treatment, extended uterine extirpation was performed with the removal of the upper third of the vagina, fallopian tubes, parotid tissue and regional lymph nodes with ovarian transposition. The patient’s prognosis is favorable, and further dynamic monitoring is recommended. The presented clinical case demonstrates the possibility of using neoadjuvant chemotherapy in combination with paclitaxel and carboplatin and subsequent extended extirpation of the uterus type III with ovarian transposition in the treatment of stage IIA2 cervical cancer in a woman of reproductive age. After the first stage of treatment 3 courses of neoadjuvant chemotherapy, patient S. had a decrease in the size of the cervical tumor by 25 % on the RECIST scale according to pelvic MRI data, which later allowed to proceed to the second stage surgical intervention. Taking into account the known prognostic factors, the patient has a favorable prognosis for life and requires further dynamic monitoring.

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