scholarly journals Photodynamic therapy for periprosthetic joint infection

2021 ◽  
Vol 25 (1) ◽  
pp. 9-15
Author(s):  
A. I. Guseynov ◽  
А. V. Baranov ◽  
A. A. Radzhabov ◽  
V. A. Derbenev ◽  
V. I. Karandashov ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Clinical Medicine ◽  
Joint Infection ◽  
Surgical Techniques ◽  
Main Group ◽  
Control Group ◽  
Actual Problem ◽  
Rapid Resolution ◽  
Primary Arthroplasty ◽  
Number Of Patients

Introduction. The increase in the number of patients with joint and hip diseases is an actual problem in the clinical medicine. Objective: to improve outcomes of the combined surgical treatment of patients with deep periprosthetic infection (PPI) by developing and improving surgical techniques using spacers and laser technologies.Material and methods. Thirty-five patients with suppurated large joints as a complication after their replacement were examined and treated. In 9 (25.7 %) patients, PPI developed within 3–12 months after the primary arthroplasty. Twenty (57.1 %) patients developed PPI within 1–2 years after the surgery. In 4 (11.4 %) cases, suppuration in the endoprosthetic area developed in 2–3 years, and in 2 (5.7 %) patients – in 3–3.5 years. The age of the patients was 47–70 years. The main group consisted of 20 patients, the control group – of 15 patients. Patients from the main group had laser photodynamic therapy (PDT) session after the removal of endoprosthetic elements and devitalized tissues.Results. Patients from the main group had uneventful postoperative course – less pain syndrome, rapid resolution of the infl ammatory process, wound healing by the primary tension.Conclusion. Application of a new intraoperative PDT technique, developed by the authors, promotes rapid resolution of purulent-infl ammatory process and better healing of postoperative wounds by primary tension.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals Impact of rehabilitation measures on cognitive dysfunction in older patients after surgical treatment of nuclear cataract

2020 ◽  
Vol 22 (12) ◽  
pp. 89-92
Author(s):  
Evgenia V. Popova ◽  
◽  
Evgenia V. Popova ◽  
Evgenia V. Popova ◽  
◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Abilities ◽  
Older Patients ◽  
Cognitive Status ◽  
Main Group ◽  
Control Group ◽  
Nuclear Cataract ◽  
Number Of Patients ◽  
Moderate Cognitive Impairment ◽  
Rehabilitation Measures

Background. The high prevalence of nuclear cataracts in older age groups is accompanied by a simultaneous decrease in cognitive abilities as a result of this ophthalmic disease, and other General somatic polymorbid pathology. Aim. To study the cognitive abilities of elderly and senile patients with nuclear cataracts during medical rehabilitation. Materials and methods. In clinical conditions, 68 elderly and senile patients with nuclear cataract underwent femtolaser-assisted cataract phacoemulsification with intraocular lens implantation, and in the postoperative period, medical and non-drug rehabilitation was performed (the main group). The control group con-sisted of 65 patients with nuclear cataract of the same age who also underwent the above-mentioned surgery without rehabilitation measures. The MMSE scale was used to assess cognitive impairment. Results. 9 months after surgical treatment, the cognitive status of patients in the main group improved from 17.4±0.2 to 20.7±0.3 points (p>0.05). Moderate initial cognitive dysfunction in patients of the main group changed to mild after 9 months, while in the control group it remained the same. At the same time, the proportion of patients with moderate cognitive impairment decreased significantly in the main group from 61.71±5.9% before rehabilitation to 13.2±4.1% after it was completed, and the number of patients with no cognitive deficit increased (p<0.001). In the control group, the number of patients with moderate cognitive impairment decreased from 60.0±6.0 to 46.2±6.2% (p>0.05). Conclusion. The implementation of rehabilitation measures in the postoperative period helps to improve the cognitive status of older patients with nuclear ca-taracts.

Treatment Methods for Different Variations Syndrome Mirizzi

2021 ◽  
Vol 04 (04) ◽  
Author(s):  
Omarov N.B., Aimagambetov M. Zh. ◽  
◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Bile Ducts ◽  
Gallstone Disease ◽  
Main Group ◽  
Mirizzi Syndrome ◽  
Long Term Results ◽  
Control Group ◽  
Type Iii ◽  
Type Iv ◽  
Number Of Patients

The number of patients with complicated forms of cholelithiasis of cholelithiasis is progressively growing. One of the complications of gallstone disease is Mirizzi syndrome (SM). The reason for the development of which is the spread of the inflammatory - destructive process from the gallbladder to the bile ducts with the formation of pressure ulcers in the common bile duct, as a result of which the formation of a cholecystobiliary fistula occurs, through which stones from the gallbladder enter the main bile ducts. The analysis of the surgical treatment of patients with cholelithiasis (GSD) treated in the UH NJSC "MUS" was carried out. There were 3842 patients in total, Patients were in the period from January 2012. to July 2018 The analysis revealed that of all these patients with gallstones, Mirizzi SM type III and IV syndrome was diagnosed in 25 (0.7%). In 14 (56%) patients with type III SM and type IV SM, 11 (44%). The main group consisted of 10 (40%) patients and 15 (60%) patients included in the control group. The main group completed: 1) In type III SM (only 4 (40%) patients). One patient underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 3 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1); 2) In type IV SM (a total of 6 (60%) patients). 4 patients underwent hepaticojejunostomy according to the clinic method (2017/0423.1). In 2 patients, cholecystohepaticocholedochoplasty was performed with U-shaped interrupted sutures on the drainage according to Vishnevsky (2017 / 0980.1). The developed and tested methods of surgical treatment of Mirizzi syndrome of types III and IV make it possible to improve the immediate and long-term results of surgical treatment of patients with this pathology. These methods of surgical treatment allow preserving the physiology of the bile outflow without postoperative complications typical for traditional hepaticojejunostomy (incompetence of the anastomotic sutures, stricture of hepaticojejunostomy).

scholarly journals Experience of the original endocardial electrode use for temporary pacing of cardiac function

2016 ◽  
Vol 97 (2) ◽  
pp. 177-181
Author(s):  
A N Osmolovsky ◽  
L V Babenkova
Keyword(s):  
Myocardial Infarction ◽  
Artificial Heart ◽  
Heart Rhythm ◽  
Cardiac Pacing ◽  
Main Group ◽  
Rhythm Control ◽  
Control Group ◽  
Original Design ◽  
Number Of Patients ◽  
Endocardial Electrode

Aim. To assess the effectiveness of the original puncture transvenous temporary endocardial springy electrode use in patients with myocardial infarction complicated by bradyarrhythmias.Methods. The study included 126 patients with myocardial infarction complicated by acute bradyarrhythmias. The original endocardial electrode was used in 38 patients (main group). Temporary artificial heart rhythm control was performed using endocardial springy temporary puncture electrode in 88 cases of bradyarrhythmias (control group). Written informed consent was taken from all patients who underwent the procedure, and in the absence of contact with the patient decision to perform temporary cardiac pacing was made by a council of physicians.Results.. Spontaneous pacing interruption occurred in 13 patients of the main group and 32 control group patients at various times of the artificial pacing. Thanks to the used original electrode constructional features, fatal cases were prevented in 11 (84.6%) patients of the main group. In 9 of 32 patients of the control group with impaired pacemaker, cardiac pacing was restored by the electrode re-fixation to the heart right ventricular endocardium. In 23 patients of the control group artificial rhythm was restored by the method of endocardial electrode reposition. The number of patients with a spontaneous interruption of temporary artificial heart rhythm control had a strong correlation with the number of patients with the identified new changes in the electrocardiogram (ST segment elevation with acute recurrent myocardial infarction; r=0.84, pConclusion. In case of spontaneous interruption of temporary cardiac pacing caused by the loss of myocardial electrical conduction function in the area of the contact with the electrode, for effective and safe fatal cases prevention endocardial electrodes of the original design use is recommended.

scholarly journals Influence of ICG-technology on the results of surgical treatment of early forms of breast cancer

2021 ◽  
Vol 26 (2) ◽  
pp. 67-72
Author(s):  
J. Masia ◽  
O.Y. Savenkov
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Surgical Treatment ◽  
Sentinel Lymph Node ◽  
Intraoperative Imaging ◽  
Surgical Techniques ◽  
Main Group ◽  
Control Group ◽  
Subcutaneous Mastectomy ◽  
Tumor Spread

Breast cancer (BC) is one of the most common causes of death in women up to 50 years old. For today the choice of an adequate methods of surgical intervention and the need for an adequate surgical adjuvant therapy, quality of life of patients after surgeryis are important. The aim of our study was to select the volume of surgery for breast cancer using the technique of intraoperative identification of the sentinel lymph node (intraoperative ICG technology) and to evaluate the results of its urgent histological examination. It was shown that the most common method of surgery in patients who underwent intraoperative ICG technology was quadrantectomy, which was performed in 27 cases (54%), rarely subcutaneous mastectomy was performed (30%) and radical mastectomy (by Madden) – 16%. In the control group, priority was given to radical removal of the breast (63.2% of cases); partial resection (by U. Veronesi) was performed in 33.3% of patients, and subcutaneous mastectomy – in 3.5%. Pathomorphological examination of the sentinel lymph node during its intraoperative imaging using ICG-technology established metastatic lesion in 10 of 50 cases (20%) in the main group. The obtained results of the assessment of the regional lymph dissection size in the main group indicate its adequate nature to ensure the radicality of surgical treatment. In our opinion, this is one of the important preliminary conclusions of this study, because to assess the clinical significance of signal lymph node (SLN) analysis as a marker of regional tumor spread, firstly it is necessary to be sured that existing surgical techniques provide radical tumor removal.

P-450 Effects of rheumatoid arthritis and methotrexate therapy on ovarian reserve in infertile women

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
G Vlasova ◽  
S Perminova
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Ovarian Reserve ◽  
Small Sample Size ◽  
Genetic Material ◽  
Main Group ◽  
Small Sample ◽  
Control Group ◽  
Proliferating Cells ◽  
Number Of Patients

Abstract Study question Do patients with infertility and rheumatoid arthritis (RA) treated with methotrexate (MTX) have ovarian reserve alterations? Summary answer Women with infertility and RA treated with MTX were found to have statistically significant decrease of ovarian reserve. What is known already Rheumatoid arthritis (RA) is one of the most prominent inflammatory diseases affecting women of child-bearing age [Brouwer J. et al, 2014]. RA and its treatment may interfere with the female reproductive physiology. The vast majority of patients with RA are treated with methotrexate (MTX) which is a folate antagonist that inhibits DNA synthesis. MTX, which is the anchor drug in RA, targets actively proliferating cells including the oocytes and granulosa cells which may impair the ovarian reserve [Min Tun Kyaw et al, 2020]. Study design, size, duration A prospective case-control study that enrolled 72 female patients with infertility was conducted in the 2-year time period of September 2018 to October 2020. Participants/materials, setting, methods The main group comprised 32 patients with infertility and RA; the control group consisted of 40 women with infertility only. Patients with RA were stratified into subgroups based on whether or not they received MTX. To investigate ovarian reserve measurement of serum anti-Müllerian hormone (AMH) was used. The level of AMH was evaluated concerning RA duration and activity, as well as the age at initiation of MTX therapy, dosage, and treatment duration. Main results and the role of chance The mean age of the study population was 36±3 years. The duration of RA was 4 [3;11] years. The low disease activity based on DAS28-ESR (disease activity score based on 28 joints using the erythrocyte sedimentation rate) prevailed(56.2%). In the main group 19(59.4%) women received MTX therapy. The MTX dosage was 15 [15;20]mg /wk, the duration of MTX therapy by the day of inclusion in the study was 18.7[1;15]months. The AMH level was significantly lower in the main group (2.1 n /ml vs 2.73ng /ml, p = 0.043). The number of patients with decreased ovarian reserve (AMH level&lt;1.0ng/ml) significantly prevailed in the group of patients with RA (25% vs 5%, p = 0.015). When assessing the AMH level in patients with RA who received MTX (n = 19) and patients in the control group, there was a tendency towards a decrease in the indicator in the first subgroup, but no statistically difference was found (p = 0.074). Correlation analysis of the dependence of AMH level on the patient age showed the most significant decrease in AMH in the patients with RA receiving MTX compared to the patients with RA who did not, and compared to all patients with RA regardless of the therapy received (rs=-0.563)(p &lt; 0.05). Limitations, reasons for caution The lack of statistically significant data in certain cases may be due to the small sample size. Wider implications of the findings RA and MTX administration are associated with a significant decrease in AMH levels. The age of initiation of the therapy is negatively correlated with the AMH level. In this regard, patients with already compromised reproductive function who are planning to receive MTX should be advised to preserve the genetic material. Trial registration number 567890

Preliminary Outcome of Treatment of Postoperative Primarily Closed Sternotomy Wounds Treated Using Negative Pressure Wound Therapy

2015 ◽  
Vol 86 (10) ◽  
Author(s):  
Anna Witt-Majchrzak ◽  
Piotr Żelazny ◽  
Jadwiga Snarska
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Therapy Group ◽  
Artery Bypass ◽  
Surgical Techniques ◽  
Group Versus ◽  
Control Group ◽  
Wound Therapy ◽  
Number Of Patients

AbstractHospital infections, and in particular infections of the surgical site are a common problem of the procedural departments. Due to continuous progress of surgical techniques and patient population getting older with multiple co-morbidities, multidirectional actions need to be taken to avoid these infections or, if they do occur, achieve optimal treatment outcomes. Vacuum wound therapy is one of the directions that has been developed over the recent years.evaluate wound healing in patients after an off-pump coronary artery bypass grafting procedure, using the internal mammary artery, treated with negative pressure wound therapy system.This prospective, open label study evaluated healing of postoperative sternotomy wounds after their primary closure with negative pressure wound therapy, using continuous negative pressure of -80 mmHg in 40 patients and 40 patients in a control group in whom conventional dressings were applied in the postoperative period.The number of patients in whom primary wound healing occurred without complications was significantly higher in the negative pressure wound therapy group versus the control group (xNegative pressure wound therapy after primary wound closure reduces the risk of superficial infections in the population with multiple risk factors of complications in the sternotomy wound healing.

scholarly journals Use of PlateletRich Autoplasma in Complex Therapy of Knee Osteoarthrosis

2016 ◽  
pp. 40-45 ◽  
Author(s):  
A. I. Gorbatenko ◽  
N. O. Kostyanaya
Keyword(s):  
Pain Syndrome ◽  
Main Group ◽  
Control Group ◽  
Joint Function ◽  
Analog Scale ◽  
Number Of Patients ◽  
Pain Visual Analog Scale ◽  
Inflammatory Drugs ◽  
Efficacy Of Treatment

Efficacy of platelet-rich autoplasma (PRA) in treatment of osteoarthrosis was evaluated. Prospective study included 120 patients (83 females, 37 males, mean age 52.8±4.5 years) with clinical and roentgenologic diagnosis of II-IV stage osteoarthrosis by Kellgren-Lawrence classification. The patients from the main group (n=60) were on courses of PRA intraarticular injections (3 injections with 1-2 weeks interval). In the control group the patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and periodically injections of glucocorticoids when indicated. Results were assessed by the verbal efficacy scale, Lequesne index and the pain visual analog scale. Follow up period made up 6 months. Use of PRA enabled to eliminate pain syndrome and improve knee joint function without adverse effects. In 6 months the number of patients who noted the efficacy of treatment was 31% higher in the main group than in the control one. The obtained results allow recommending PRA use for knee osteoarthrosis treatment as an alternative to NSAIDs especially in contraindications to the latter.

scholarly journals Genetic and biochemical aspects of formation of professional chronic dust bronchitis

2019 ◽  
pp. 342-347
Author(s):  
A. S. Kazitskaya ◽  
N. I. Panev ◽  
T. K. Yadykina ◽  
O. N. Gulyaeva ◽  
N. A. Evseeva
Keyword(s):  
Respiratory System ◽  
Coal Industry ◽  
Main Group ◽  
The Body ◽  
Control Group ◽  
Immunological Parameters ◽  
Actual Problem ◽  
Functional Parameters ◽  
Increased Risk ◽  
The Impact

Introduction. Th e actual problem of modern occupational health is the study of the role of exogenous and endogenous factors in the development of occupational pathology of the bronchopulmonary system. То identify groups at increased risk of developing a dusty pathology of the bronchopulmonary system, it is necessary to conduct a comprehensive study of clinical and genetic factors, as well as to determine the most signifi cant diagnostic markers of the development of this pathology.The aim of the study was to study the genetic status of a set of biochemical and molecular genetic markers, as well as biochemical parameters of blood and respiratory function in coal industry workers with chronic dust bronchitis and persons of the control group.Materials and methods. 115 workers of coal mines from the South of Kuzbass aged from 39 to 58 years were examined in the Clinic of the Institute. Among them — 71 people with a previously established diagnosis of chronic dust bronchitis (the main group) and 44 people of the control group of persons working in the same sanitary conditions, but not having this pathology. A complex of clinical, biochemical and genetic methods of research was used in the study, and functional parameters of the bronchopulmonary system were evaluated. Statistical processing of the results was carried out using IBM SPSS Statistics 22 soft ware. Results. Statistically signifi cant diff erences between biochemical (increase in the concentration of ceruloplasmin and α–1antitrypsin) and immunological parameters (increase in the total number of leukocytes and ESR, increase in the concentration of IgG) in miners with chronic dust bronchitis and coal industry workers without this pathology were revealed. The dependence of the functional changes of the respiratory system with the development of professional pathology is determined. Th e persons of the main group showed a statistically signifi cant decrease in functional parameters (forced exhalation per second and lung capacity), increased respiratory failure. A predisposition to the development of dust bronchitis in the owners of the HP 1–1 genotype and resistance to the formation of this pathology in persons with the HP 2–2 genotype were found. Th e study of GSTT 1 deletion polymorphism revealed that carriers of the GSTT 1 «+» variant are most susceptible to the development of chronic dust bronchitis, and owners of the GSTT 1 variant are» resistant to its formation. Th ere was a positive аssociation with the development of dust bronchitis of the holders of the MM phenotype (MN).Conclusions. When working in similar conditions, some workers have a deviation of biochemical and immunological parameters fr om the norm, as well as a violation of the respiratory system, while others have no changes. Th e response of the body to the impact of certain external adverse factors may be due to genetic predisposition or resistance to the development of the disease. 

scholarly journals EFFECTIVENESS OF APPLICATION OF TELEMONITORING OF BLOOD PRESSURE IN PATIENTS WITH NORMAL WEIGHT AND OVERWEIGHT

2021 ◽  
Vol 121 (1) ◽  
pp. 32-42
Author(s):  
Inna Berdnyk
Keyword(s):  
Blood Pressure ◽  
Primary Care Physicians ◽  
Antihypertensive Drugs ◽  
Blood Pressure Monitoring ◽  
Normal Weight ◽  
Main Group ◽  
Control Group ◽  
Adherence To Treatment ◽  
Pressure Monitoring ◽  
Number Of Patients

The article summarizes the arguments and counterarguments within the scientific discussion on the methods of diagnosing hypertension and features of blood pressure control. The main purpose of this study is to evaluate the effectiveness of blood pressure monitoring in patients with normal weight and overweight and to determine their level of adherence to treatment. The relevance of the study about this pathology is that hypertension is the leading cause of cardiovascular disease and premature death worldwide. The prevalence of hypertension among the adult population is 30-45%, in 2018 the number of patients with hypertension in the world was about 1.38 billion, with more than 165 million living in Central and Eastern Europe. Systematization of literature data showed that despite the widespread use of antihypertensive drugs, only about 30% of patients have optimal blood pressure. The methodology of the study is to evaluate the use of telemedicine technologies for self-monitoring of blood pressure in patients with normal weight and overweight and increase their compliance. The study was conducted in Kyiv, Ukraine during 2018-2020, and included 111 patients aged 18 to 65 years with a previously diagnosed hypertension. By randomization, they were divided into the main group (used blood pressure monitoring) and the control group (used office and home blood pressure monitoring). The article presents the results that in the patients of the main group at the end of the study the average daily systolic and diastolic blood pressure were significantly lower in comparison with both the initial level of the group and in comparison with the control. The baseline adherence to treatment in patients in both groups was low. However, at the end of the study, the adherence of patients in the main group to treatment increased by 40.3%, while in the control group no significant changes were detected. In addition, a correlation was found between patients with overweight and less adherence to regular medication, more frequent skipping of the drug and self-withdrawal with improvement compared to patients with normal body weight. It was also noted that the patients in the main group at the end of the study significantly reduced the level of anxiety compared with the control. The study empirically confirms and theoretically proves that the use of blood pressure telemonitoring can be considered as an alternative to the standard approach that increases adherence to treatment. The results of the study will be useful for primary care physicians, cardiologists, therapists.

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