Diseases of cardiovascular system in patients with moderate-to-severe and severe forms of psoriasis

Psoriasis is one of the most common chronic immune-mediated skin diseases. One of the widely discussed gastroenterological comorbidities of psoriasis is chronic inflammatory diseases of the gastrointestinal tract. The article presents the results of the analysis of the case histories of patients with moderate-to-severe and severe forms of psoriasis and concomitant pathology – inflammatory bowel diseases (Clinical Dermatovenerologic Dispensary, Krasnodar, Russia). The analysis of 16 case histories of patients with moderate-to-severe and severe psoriasis has been carried out, where one can see the clinical and practical significance of the combined pathology – psoriasis and inflammatory bowel diseases. From the analysis, one can conclude that there is a direct relationship between the severity of the course of the skin pathological process and the development of intestinal diseases, as well as the influence of ustekinumab on the course of combined pathology – psoriasis, ulcerative colitis and Crohn’s disease.

EPIDEMIOLOGICAL ASPECTS OF ACUTE APPENDICITIS ACCORDING TO THE CENTRAL CITY CLINICAL HOSPITAL OF ALMATY

В статье проанализировано 1759 случаев острого аппендицита по данным историй болезней пациентов, проходивших лечение на базе Центрального городской клинической больницы с 2015 по 2017 гг. Выявлены основные эпидемиолгические аспекты данной патологии. The article analyzes 1759 cases of acute appendicitis according to the case histories of patients treated at the Central City Clinical Hospital from 2015 to 2017. The main epidemiological aspects of this pathology have been identified.

Preventive esophagomyobronchoplasty as a method to prevent the failure of the bronchial stump in pneumonectomy for lung cancer

Aim. Comparative analysis of insufficiency rate of bronchial stump sutures in pneumonectomy for lung cancer, depending on suturing techniques. Methods. A patented technique for bronchial stump suturing has been introduced into the practice of the GOBUZ clinic Novgorod Regional Clinical Hospital based on the Department of thoracic surgery since 2015 for pneumonectomy for lung cancer. Before the introduction of the developed technique, various generally accepted methods of bronchial stump forming were used (mechanical suture, manual suture, their combination, bronchial stump coverage with mediastinal pleura, pericardial flap). A retrospective analysis of 173 case histories and operational protocols of patients with lung cancer who underwent pneumonectomy was carried out for the failure of bronchial stump sutures when using conventional suturing techniques between 2010 and 2014 (the first group of patients). We also performed a retrospective and prospective analysis of 204 case histories and operational protocols of patients in a similar clinical group when using a patented suturing technique between 2015 and 2020 (the second group of patients). Statistical analysis was carried out by using Statistica 10.0 software (StatSoft, Inc. 2011). The qualitative and quantitative indicators were analyzed by using the Pearsons 2-test with Yatess correction. Results. A retrospective analysis shows that the failure rate in the use of generally accepted bronchial stump suturing techniques for 20102014 was 10.4%. After the implementation of the method of preventive esophagobronchomyoplasty, complications as bronchial stump suture failure were not detected in any case between 2015 and 2020. Conclusion. The study shows high efficiency, a decrease in the incidence of complications as the failure of bronchial stump sutures in the use of the developed method of preventive esophagomyobronchoplasty in pneumonectomy for lung cancer.

SUPPORT FOR OFFSHORE MONOPILE INSTALLATION THROUGH THE TRENCH CUTTER TECHNOLOGY

Europe is currently facing an energetic revolution. Several offshore wind farm projects are currently under construction or under planning in North and Baltic Sea. Typical foundation structures for offshore wind farms are steel open-ended monopiles with large diameters up to 6 m. Currently, the monopiles are installed by driving with large impact hammers. However, there are many situations where pile refusal is reached, due to hard soil layers or erratic blocks. Driving and drilling technique is therefore applied. This manuscript briefly describes the trench cutter technology normally used for foundation works on land. Three case histories onshore and one offshore project are discussed and the evolution of the trench cutter technology for supporting the installation of offshore monopile is described.

Recent Case Histories of Multilateral Systems Enabling Thru Tubing Intervention in the Middle East

Historically, the ability to perform intervention on multilateral wells has been limited. While multilateral (ML) well construction technologies have progressed to a high level of reliability, multilateral systems that enabled intervention during the life of well had a more limited track record. Intervention outcomes after prolonged periods of production were less consistent. This lack of technologies with sufficient intervention case histories meant that generally multilateral well architecture was not selected in applications where thru tubing intervention was a requirement. In recent years, multilateral well architecture has continued to increase in demand, with more ML wells drilled and completed in the last five years than any other five-year period in the technology's history. With this increased demand has come industry enthusiasm to further mature its intervention capabilities. This paper will review two recent case histories of separate multilateral well completion systems that enable intervention. This opens up new potential for the industry to take advantage of the cost reductions achieved with multilaterals in a much larger scope of well applications. Two separate completion systems will be covered in this paper, System A installed in a cemented multilateral junction and system B, a completion that creates a hydraulically isolated junction via either a dual string completion or a single string completion that splits into two strings. These case histories were exectuted in 2017 to 2019, and interventions were performed after one to two years of production. Detailed in each case study will be an overview of the equipment, the operational sequence, intervention outcome, and any lessons learned or improvements. The systems have demonstrated themselves as a reliable method to access laterals in non-ideal downhole environments where debris is present after the well has been on production. The tubing sizes for the case studies are 3-1/2" and 4-1/2". In each of these wells, the following operations have been successfully performed: drift testing, acid stimulation through coil tubing and breaking of a ceramic disc. Both slickline and coil tubing have been used for the interventions and in some cases with tractors. Junction inclinations range from 1 to 43 degrees. Plans for ongoing installations for the systems are being executed in the Middle East Region. Further, expansion of the system A capabilities by integrating it with other existing technologies is also planned. This will enable projects such as the installation of a trilateral well with flow control and intervention for each individual leg, and also the conversion of existing single bore wells to multilateral with intervention capability.

Micro-Fabric Transformations of Ball Clay in Alkaline Environment

Based on the strong evidence of case histories, this study focused on mineralogical and morphological changes of an artificial kaolinitic soil -Ball clay, when exposed to different concentrations of sodium hydroxide (0.1N, 1N, 4N, and 8N) under different curing periods (7, 28 and 100 days). Sediment volume tests are conducted on Ball clay with all combinations and results are analyzed with the help of analytical techniques. XRD and SEM studies are analyzed to understand the micro-level changes of alkali contaminated Ball clay. Mineralogical and morphological transmutations of Ball clay are investigated for 7, 28, and 100 days curing period. Results revealed new mineral formations like Sodalite under 4N and 8N concentrations of NaOH with 100 days interactions are well observed. The morphological transformation from needle shape to pellet shape is clear evidence of the rate of dissolution and precipitation of minerals under 100 days curing periods.

Unreliable Semiology from Frankenstein to Freud

Examining how prose fiction and the case history share certain formal features, this chapter turns to the medical field of semiology to investigate how the Romantic-era case history models a diagnostic reading practice that extends from medicine to the novel. Mary Shelley’s Frankenstein (1818) is a notable, even parodic, literary case history informed by conventional protocols of medical reporting, visible both in Romantic-era case histories, and, at the end of the nineteenth century, in the case histories of Sigmund Freud. The Romantic case history captures fundamental tensions between the physician’s scientific report and the patient’s autobiography, which compromise the physician’s ability to trace a semiotic relationship between external symptom and underlying condition. The case history proves to be a site of disciplinary quarrel between literature and medicine: not only does it anticipate many of the epistemological problems that attend our modern attempts to read “symptomatically” or “deeply,” it also interrogates the notions of authority, personhood, and normality that continue to sustain modern medical discourse and literary criticism. As the case history reveals the unreliability of the diagnostician’s production of narrative, it also shows the limitations of interpretation in the emergent medical and literary fields of semiology.

The ABCs of Teaching Family Counseling: Putting “Fun” into the Fundamentals of the Profession

Becoming a family counselor requires knowledge of the history, theories, techniques, and trends within the profession. These tasks are not easy to accomplish and require a dedication of learning where the field has been as well as where it appears to be going. Multiple-choice tests, essay questions, term papers, case histories, internships, special projects, and class presentations are some of the means used to teach and evaluate student’s mastery of the field. However, another way that is fun and effective is class exercises and games. One such game titled “The ABCs of Family Counseling” is explained here. This article examines the rationale for using this teaching tool and how the pedagogy tied to this exercise can help students become more aware of what they have learned, as well as help students develop a readiness to begin working with couples and families.