Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 148
Filtrar
1.
Appl Radiat Isot ; 212: 111431, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-39013328

RESUMO

Thе paper describes a new E-ΔE detection module which includes a position-sensitive double-sided strip detector (DSSD) and a low-pressure pentane-filled ΔE chamber for detection of Evaporation Residues (ERs) in complete fusion reactions. The goal is to synthesize superheavy isotopes at the new DC-280 (Dubna Cyclotron) cyclotron of the Joint Institute for Nuclear Research (JINR). With the 48Ca ion beam intensity of about 5-7 pµA (particle micro ampere) and the ΔE counter count rate of approximately 104 sec-1, we observe a decrease in the overall registration efficiency of the gas ΔE counter. The paper proposes a solution to this problem: introduction of an additional negatively biased electrode, which results in the stabilization of the ΔE detector operation.

2.
Khirurgiia (Mosk) ; (2): 14-23, 2024.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-38344956

RESUMO

OBJECTIVE: To study the results of surgical treatment in patients with perihilar tumors. MATERIAL AND METHODS: We analyzed 98 patients with perihilar tumors who underwent surgery. RESULTS: We prefer percutaneous transhepatic biliary drainage (n=58) for jaundice. Retrograde interventions were performed in 18 cases (20.5%), complications grade III-IV were more common (p=0.037) in the last group. Postoperative mortality was 12%. Complications developed in 81 patients (82.7%), grade ≥3 - in 39 (39.8%) cases. Portal vein resection (n=26) increased the incidence of complications grade ≥III (p=0.035) and portal vein thrombosis (p=0.0001). Chemotherapy after surgery was performed in 47 patients (48.0%), photodynamic therapy - in 7 (7.1%) patients. A 5-year overall survival was 28.1%, the median survival - 29 months. R2 resection and/or M1 stage (n=12) significantly worsened the prognosis and overall survival (16.5 vs. 31 months, p=0.0055). Lymph node (LN) lesion, microscopic status (R0 vs. R1) of resection margin, technique of decompression and isolated resection of extrahepatic bile ducts did not affect the prognosis, and we combined appropriate patients (n=72) for analysis. SI resection and excision of ≥6 lymph nodes were independent positive factors for disease-free survival (p=0.042 and p=0.007, respectively). Blood transfusion and high preoperative neutrophil-lymphocyte index (NLI ≥2.15) worsened overall (p=0.009 and p=0.002, respectively) and disease-free survival (p=0.002 and 0.007, respectively). The absence of adjuvant therapy worsened disease-free survival alone (p=0.024). CONCLUSION: SI liver resection, adequate lymph node dissection and adjuvant therapy should be used for perihilar tumors. Isolated resection of extrahepatic bile ducts is permissible in some cases. Blood transfusion and NLI ≥2.15 are independent negative prognostic factors.


Assuntos
Neoplasias dos Ductos Biliares , Colangiocarcinoma , Humanos , Colangiocarcinoma/patologia , Prognóstico , Resultado do Tratamento , Neoplasias dos Ductos Biliares/diagnóstico , Neoplasias dos Ductos Biliares/cirurgia , Hepatectomia/efeitos adversos , Hepatectomia/métodos , Ductos Biliares Intra-Hepáticos/patologia , Estudos Retrospectivos
3.
Sud Med Ekspert ; 66(6): 24-27, 2023.
Artigo em Russo | MEDLINE | ID: mdl-38093425

RESUMO

OBJECTIVE: To find a way and form of presenting impedance metrics data to clarify prescription of death coming in a comprehensive assessment. MATERIAL AND METHODS: The impedance of biological objects was measured depending on prescription of death coming in standardized conditions (air temperature +4 °C, humidity 45%). The main examined postmortem period was 1 months. Measurements were made on 3 diagnostic zones of biological object and for 5 current frequency of the study. A total of 2100 readings were taken. RESULTS AND CONCLUSION: The studies performed in standardized conditions have showed that using impedance metrics method to diagnose prescription of death coming is possible. The analysis of only absolute impedance values is not sufficient to clarify prescription of death coming due to its undulating changes. The additional use of relative coefficients, characterizing impedance dispersion, is suggested. The study of possible using the impedance indicators of corpse's tissues to determine prescription of death coming should be performed with consideration to pathomorphology of degradation. Further study of impedance dynamics when corpse is under different conditions is necessary for development of a working algorithm to determine prescription of death coming based on tissue impedance.


Assuntos
Mudanças Depois da Morte , Humanos , Impedância Elétrica , Cadáver , Temperatura
4.
Khirurgiia (Mosk) ; (10): 29-38, 2023.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-37916555

RESUMO

OBJECTIVE: To determine the feasibility of irreversible electroporation (IRE) for locally advanced pancreatic adenocarcinoma. MATERIAL AND METHODS: Twenty-three patients underwent IRE after chemotherapy for locally advanced pancreatic cancer between 2015 and 2022. IRE was performed during laparotomy as a rule (n=22). In one case, IRE was combined with palliative pancretoduodenectomy. Nineteen (86.3%) patients received adjuvant chemotherapy after the procedure. The follow-up examination included contrast-enhanced CT/MRI of the abdomen, chest X-ray or CT, analysis of CA 19-9 marker one month after surgery and then every three months. RESULTS: Complications after IRE developed in 5 (21.7%) patients. Three patients (13.0%) had arrhythmia, two (8.7%) ones had pancreatic necrosis. A 90-day mortality after the procedure was 4.3% (n=1), the cause was pancreatic necrosis. According to intraoperative data and the first examination (CT/MRI), the entire tumor infiltrate was treated in 21 (91.3%) cases. Median follow-up was 19 months. Median period until local recurrence was 15 months. Isolated local recurrence was observed in 7 patients. Of these, 3 ones underwent radiotherapy, one patient underwent repeated IRE. Distant metastases were found in 11 patients; systemic therapy was restarted. Median time to progression was 7 months after IRE and 14 months after initiation of chemotherapy. The median overall survival was 16 months after electroporation and 25 months after chemotherapy. CONCLUSION: Irreversible electroporation may be useful in carefully selected patients with unresectable locally advanced pancreatic adenocarcinoma after successful induction chemotherapy. This procedure provides local control, but the impact on long-term outcomes and feasibility of routine use should be analyzed in randomized trials.


Assuntos
Adenocarcinoma , Neoplasias Pancreáticas , Pancreatite Necrosante Aguda , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/terapia , Resultado do Tratamento , Adenocarcinoma/diagnóstico , Adenocarcinoma/terapia , Eletroporação/métodos , Neoplasias Pancreáticas
5.
Vavilovskii Zhurnal Genet Selektsii ; 27(6): 676-683, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-38023809

RESUMO

Ectodermal dysplasia (ED) is a heterogeneous group of hereditary diseases of the skin and its appendages, which are characterized by impaired development and/or homeostasis of two or more ectoderm derivatives, including: hair, teeth, nails, sweat glands and their modifications (mammary glands, for instance). The overall prevalence of ectodermal dysplasia remains precisely unknown not only in Russia, but also in the world, nor is known the contribution of individual genes to its structure. This complicates the DNA diagnosis establishment of this disease due to the lack of an accurate diagnostic algorithm and a universal cost-effective method of analysis. To date, the most highly-researched genes involved in the development of anhydrous or hypohidrotic forms of ED are EDA, EDAR, EDARADD and WNT10A. The ectodysplasin A (EDA) gene is the cause of the most common X-linked form of ED, a gene from the Wnt family (WNT10A) is responsible for the autosomal recessive form of the disease, and two other genes (EDAR and EDARADD) can cause both autosomal recessive and autosomal dominant forms. This review provides the characteristics of the genes involved in ED, their mutation spectra, the level of their expression in human tissues, as well as the interrelation of the aforementioned genes. The domain structures of the corresponding proteins are considered, as well as the molecular genetic pathways in which they are involved. Animal models for studying this disorder are also taken into consideration. Due to the cross-species genes conservation, their mutations cause the disruption of the development of ectoderm derivatives not only in humans, but also in mice, cows, dogs, and even fish. It can be exploited for a better understanding of the etiopathogenesis of ectodermal dysplasias. Moreover, this article brings up the possibility of recurrent mutations in the EDA and WNT10A genes. The review also presents data on promising approaches for intrauterine ED treatment.

6.
Khirurgiia (Mosk) ; (6): 108-113, 2023.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-37313708

RESUMO

Portal annular pancreas is a little-known anatomical variant of annular pancreas. In these patients, pancreatic parenchyma encircles the portal vein annularly. This anomaly is associated with high risk of postoperative pancreatic fistula in pancreatic surgery. Considering small incidence of anomaly and characteristics of surgery, we describe laparoscopic distal pancreatectomy with preservation of spleen and splenic vessels in a patient with solid pseudopapillary tumor combined with portal annular pancreas. A 33-year-old woman underwent laparoscopic surgery for cystic-solid pancreatic tumor. Spleen-sparing distal pancreatectomy was performed. Portal annular pancreas was visualized intraoperatively and confirmed retrospectively after analysis of MR data. Ventral and dorsal parts of portal annular pancreas were transected using stapler device. Pancreatic fistula developed in postoperative period. The patient was discharged after 6 days with a drainage tube. Surgeons need to be aware of portal annular pancreas. This anomaly increases the risk of postoperative fistula. Transection of ventral and dorsal parts of annular pancreas using stapler device is the most acceptable option to reduce the risk of postoperative fistula.


Assuntos
Laparoscopia , Pancreatectomia , Feminino , Humanos , Adulto , Pancreatectomia/efeitos adversos , Fístula Pancreática/diagnóstico , Fístula Pancreática/etiologia , Fístula Pancreática/prevenção & controle , Estudos Retrospectivos , Laparoscopia/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle
7.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-37325832

RESUMO

The authors present a patient with petroclival meningioma complicated by trigeminal neuralgia. Resection of tumor via anterior transpetrosal approach with microvascular decompression of the trigeminal nerve was performed. A 48-year-old female patient presented with left-sided (V1-V2) trigeminal neuralgia. Magnetic resonance imaging revealed a tumor 33´27´25 mm with a base adjacent to the top of petrous part of the left temporal bone, tentorium cerebelli and clivus. Intraoperative examination revealed true petroclival meningioma extending to trigeminal notch of petrous part of temporal bone. There was additional compression of trigeminal nerve by caudal branch of superior cerebellar artery. Total resection of tumor was followed by disappearance of vascular compression of trigeminal nerve and regression of trigeminal neuralgia. Anterior transpetrosal approach provides early devascularization and resection of true petroclival meningioma, as well as wide imaging of anterolateral surface of the brainstem, identification of neurovascular conflict and vascular decompression.


Assuntos
Neoplasias Meníngeas , Meningioma , Cirurgia de Descompressão Microvascular , Neoplasias da Base do Crânio , Neuralgia do Trigêmeo , Feminino , Humanos , Pessoa de Meia-Idade , Meningioma/complicações , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Neuralgia do Trigêmeo/diagnóstico por imagem , Neuralgia do Trigêmeo/etiologia , Neuralgia do Trigêmeo/cirurgia , Cirurgia de Descompressão Microvascular/métodos , Imageamento por Ressonância Magnética , Neoplasias da Base do Crânio/complicações , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/cirurgia , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia
8.
Sud Med Ekspert ; 66(2): 20-25, 2023.
Artigo em Russo | MEDLINE | ID: mdl-37078672

RESUMO

The aim of the scientific work is to analyze the prospects of using the impedance monitoring method to determine the prescription of death coming. The conducted exploratory analysis allows hypothesizing the dependence of impedance values and dispersion factors for the diagnostic zones studies on the postmortem interval; it also suggests that it is possible to determine this interval for the objects (pig corpses) studies with a combination of impedance values and the corresponding factors. Among large mammals, a swine is the closest to a human from the point of analyzing the postmortem period process, and it can be recommended as an adequate human corpse model. When determining the correlation between the postmortem interval and the impedance parameters, it is the simplicity and reproducibility of the method, the absence of expensive equipment, its portability and the rapid receipt of results that allow this method to be applied at the scene, reinforcing traditional forensic methods for determining the prescription of death coming. Interpretation of impedance monitoring results can be used to analyze the biological nature of the postmortem period processes.


Assuntos
Mudanças Depois da Morte , Prescrições , Humanos , Suínos , Animais , Impedância Elétrica , Reprodutibilidade dos Testes , Autopsia/métodos , Cadáver , Mamíferos
9.
Sud Med Ekspert ; 66(2): 26-29, 2023.
Artigo em Russo | MEDLINE | ID: mdl-37078673

RESUMO

THE AIM OF THE STUDY: Is to justify using the corpses of large mammals as model objects for studying the postmortem period. Similarities in processes occurring postmortem in human and swine corpses (decomposition stages and the structure of dominant necrophilic organisms inhabiting the corpse), as well as similar changes of relative impedance parameters for the cartilaginous tissue and musculoskeletal flap of swine and human corpses have been established. The results obtained allow recommending the swine corpse as an adequate human corpse model both for scientific studies and for solving specific scientific and practical issues arising in the practice of forensic examination when determining the prescription of death coming and the postmortem period conditions.


Assuntos
Mamíferos , Mudanças Depois da Morte , Humanos , Suínos , Animais , Cadáver , Autopsia
10.
Vestn Oftalmol ; 138(5): 80-86, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36288421

RESUMO

Gyrate chorioretinal atrophy (GCA) is a rare hereditary disease with certain complications; one extremely rare complication of GCA is foveoschisis. For the first time in Russian ophthalmology, a 10-year-old female child has been described to have genetically verified GCA associated with the OAT gene in combination with ornithinemia and foveoschisis. The diagnosis was made on the basis of fundus examination, perimetry data, autofluorescence, optical coherence tomography, fluorescence angiography, electroretinography, mass spectrometry with confirmation by molecular genetic research. The presented clinical case illustrates the need for an interdisciplinary approach to the diagnosis of GCA with diagnostic algorithm involving various examination methods and doctors of different specialties.


Assuntos
Atrofia Girata , Retinosquise , Criança , Feminino , Humanos , Atrofia Girata/etiologia , Atrofia Girata/complicações , Corioide/patologia , Retina/diagnóstico por imagem , Retina/patologia , Angiofluoresceinografia , Retinosquise/etiologia , Retinosquise/complicações , Atrofia
11.
Bull Exp Biol Med ; 173(4): 553-559, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36094593

RESUMO

In squamous cell carcinoma of the larynx, the population of epithelial cells in the tumor tissue is initially heterogeneous and, in addition to tumor cells invading the organ mucosa, includes normal epithelial cells of protein-mucous glands and cells of the stratified epithelium covering the mucous membrane. A search for differential markers to separate these subpopulations was carried out. The surface marker CD44 and cytokeratins 5 and 17 that are often used to verify carcinoma cells, are common markers for all epithelial cells of the larynx. In highly differentiated carcinoma, subpopulations of normal and tumor epithelial cells can be separated by the level of expression of cytokeratins 10 and 18 and nuclear markers Ki-67 and p63. However, in moderately differentiated carcinoma, tumor cells and normal cells of the basal layer of the stratified epithelium covering the mucous membrane of the larynx have similar phenotypes, which should be taken into account when conducting experimental studies.


Assuntos
Carcinoma de Células Escamosas , Laringe , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Carcinoma de Células Escamosas/patologia , Células Epiteliais/metabolismo , Epitélio/metabolismo , Humanos , Antígeno Ki-67/metabolismo , Laringe/metabolismo
12.
Artigo em Russo | MEDLINE | ID: mdl-35758079

RESUMO

OBJECTIVE: To present a patient with brainstem abscess treated by microsurgical resection. CASE PRESENTATION: A 53-years-old female patient admitted to the neurosurgical department in a severe condition with symptoms of intracranial hypertension, hyperthermia, general infectious signs and laboratory manifestations of infectious process. Contrast-enhanced MRI revealed a large brainstem lesion (abscess). Retrosigmoid craniotomy with total microsurgical resection of the abscess was performed. External ventricular drainage was incerted on the second postoperative day due to progressive hydrocephalus with clinical deterioration, it was removed in 8 days. Slow positive dynamics was observed in postoperative period. The patient was discharged in 2 weeks after surgery. CONCLUSION: There are no established algorithm for the treatment of brainstem abscesses. Therapeutic approach is advisable for small abscesses. There are 2 neurosurgical options for this lesion: stereotactic drainage and microsurgical resection with or without external ventricular drainage. Treatment strategy depends on location and size of abscess, as well as clinical state of the patient.


Assuntos
Abscesso Encefálico , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/cirurgia , Tronco Encefálico/diagnóstico por imagem , Tronco Encefálico/cirurgia , Craniotomia , Drenagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade
13.
Front Genet ; 13: 863157, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35571017

RESUMO

Nephropathic cystinosis is a rare autosomal recessive disorder characterized by amino acid cystine accumulation and caused by biallelic mutations in the CTNS gene. The analysis methods are as follows: tandem mass spectrometry to determine the cystine concentration in polymorphonuclear blood leukocytes, Sanger sequencing for the entire coding sequence and flanking intron regions of the CTNS gene, multiplex PCR to detect a common mutation-a 57 kb deletion, and multiplex ligation-dependent probe amplification to analyze the number of exon copies in the CTNS gene. Haplotype analysis of chromosomes with major mutations was carried out using microsatellite markers D17S831, D17S1798, D17S829, D17S1828, and D17S1876. In this study, we provide clinical, biochemical, and molecular genetic characteristics of 40 Russian patients with mutations in the CTNS gene, among whom 30 patients were selected from a high-risk group of 85 people as a result of selective screening, which was carried out through cystine concentration measurement in polymorphonuclear blood leukocytes. The most common pathogenic variant, as in most described studies to date, was the 57 kb deletion, which represented 25% of all affected alleles. Previously non-described variants represented 22.5% of alleles. The founder effect in the Karachay and Chechen ethnic groups was shown for the following major variants: c.1015G > A and c.518A > G.

14.
Sud Med Ekspert ; 65(3): 42-44, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35613447

RESUMO

A case of suicide using technical electricity is presented. The fact of electrical injury is confirmed by the typical macroscopic and microscopic picture of an electric mark. The location of the conductors on the body indicated the victim's knowledge of the effect of electric current on the human body, the ways of its propagation through the body through the vital organs, preparation and determination in the implementation of suicidal intentions. The interest of this case lies in the fact that electrical injury as a method of suicide is extremely rare in expert practice.


Assuntos
Traumatismos por Eletricidade , Suicídio , Traumatismos por Eletricidade/etiologia , Humanos
15.
Int J Pediatr Otorhinolaryngol ; 157: 111140, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35452909

RESUMO

INTRODUCTION: Nowadays, due to universal newborn hearing screening (UNHS) the number of children with mild-to-moderate hearing loss diagnosed in the first year of life has increased significantly. Aside from that, identification of the genetic cause improves the genetic counselling of the families and allows to reveal possible comorbidities which may need a special approach. OBJECTIVE: To present the characteristics of the early audiologic phenotype in hearing impaired patients with biallelic mutations in the USH2A gene based on systematic analysis of the audiological data. PATIENTS AND METHODS: 13 patients with mutations in the USH2A gene underwent audiological examination. Most of them were found among a large group of infants with bilateral nonsyndromic sensorineural hearing loss (SNHL) examined under 12 months. RESULTS: Eight out of eleven children failed UNHS and were initially diagnosed as having bilateral nonsyndromic SNHL. Seven children underwent an audiological assessment before the age of 9 months. The earliest audiological examination was carried out at 1 and 3 months. The children with pathogenic variants in the USH2A gene in our examined group were identified in the first year of life via UNHS. The hearing threshold levels (HTL) for the USH2A group are compactly distributed between 51.25 dB and 66.25 dB, quartiles are 54 dB and 63.4 dB, with a median of 60 dB. The audiological profile of patients with biallelic USH2A mutations differs from audiograms of patients who had STRC-related hearing loss. We have not found any significant elevation in hearing thresholds in the first decade of life. We also estimated the prevalence of the USH2A and STRC mutations among GJB2-negative infants with bilateral nonsyndromic SNHL examined under 12 months, and it was 7.5% and 16.1%, respectively. CONCLUSION: According to our results, the early hearing phenotype in pediatric patients with biallelic mutations in the USH2A- gene is characterized by nonsyndromic mild-to-moderate SNHL in the first decade of life. Our results indicate that the presence of mutations in the USH2A or STRC genes can be expected in a child with congenital mild-to-moderate nonsyndromic SNHL. This information is of practical importance for parents, as they have to know the prognosis of hearing loss for their child from the very beginning. Post-screening follow-up should include adequate clinical, genetic, and social support for children and their parents.


Assuntos
Proteínas da Matriz Extracelular , Perda Auditiva Neurossensorial , Audiometria , Proteínas da Matriz Extracelular/genética , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/genética , Humanos , Lactente , Peptídeos e Proteínas de Sinalização Intercelular/genética , Mutação , Fenótipo
16.
Front Genet ; 12: 686800, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34777456

RESUMO

Merosine deficient congenital muscular dystrophy is one of the most common forms of congenital muscular dystrophy. This disease is caused by a primary deficiency or a functionally inactive form of the protein merosin in muscle tissue. The type of inheritance of this disease is autosomal recessive. De novo variants with this type of inheritance are rare, and it is quite possible that the de novo variant may hide a mosaic form in the parent of an affected child. We present a birth family with two affected children who inherited a previously undescribed pathogenic variant c.1755del from their mother and a previously described pathogenic variant c.9253C > T in the LAMA2 gene from their mosaic father. LAMA2 gene mutation analysis was performed by mass parallel sequencing and direct sequencing of genomic DNAs.

17.
Sud Med Ekspert ; 64(5): 53-56, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34644035

RESUMO

Objective - to present a comparative analysis of the specialized literature on the possibility of using a luminol solution to detect blood traces when examining the scene of an incident. The use of this sample at the incident scene is only preliminary, since its high sensitivity connected with nonspecific properties. Information about the possibility of identifying the species, group and DNA belonging of blood traces after their treatment with a luminol solution is contradictory, therefore, its use at the scene should be careful with the preservation of intact (not treated with luminol) blood traces available for their study by traditional forensic biological methods. The possibility of laboratory determination of the properties of blood after processing its traces with a luminol solution can be proved by a special scientific and experimental forensic biological work.


Assuntos
Manchas de Sangue , Luminol , Medicina Legal
18.
Hum Reprod ; 36(7): 1854-1861, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-33942073

RESUMO

STUDY QUESTION: What is the prevalence and pattern of IVF add-on use in Australia? SUMMARY ANSWER: Among women having IVF in the last 3 years, 82% had used one or more IVF add-on, most commonly acupuncture, preimplantation genetic testing for aneuploidy and Chinese herbal medicine. WHAT IS KNOWN ALREADY: IVF add-ons are procedures, techniques or medicines which may be considered nonessential to IVF, but usually used in attempts to improve the probability of conception and live birth. The use of IVF add-ons is believed to be widespread; however, there is little information about the prevalence and patterns of use in different settings. STUDY DESIGN, SIZE, DURATION: An online survey was distributed via social media to women in Australia who had undergone IVF since 2017. Women were excluded if they were gestational surrogates, used a surrogate, or underwent ovarian stimulation for oocyte donation or elective oocyte cryopreservation only. The survey was open from 21 June to 14 July 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS: Survey questions included demographics, IVF and medical history, and use of IVF add-ons including details of the type of add-on, costs and information sources used. Participants were also asked about the relative importance of evidence regarding safety and effectiveness, factors considered in decision-making and decision regret. MAIN RESULTS AND THE ROLE OF CHANCE: A total of 1590 eligible responses were analysed. Overall, 82% of women had used one or more add-ons and these usually incurred an additional cost (72%). Around half (54%) had learned about add-ons from their fertility specialist, and most reported that the decision to use add-ons was equally shared with the specialist. Women placed a high level of importance on scientific evidence for safety and efficacy, and half (49%) assumed that add-ons were known to be safe. Most women experienced some regret at the decision to use IVF add-ons (66%), and this was more severe among women whose IVF was unsuccessful (83%) and who believed that the specialist had a larger contribution to the decision to use add-ons (75%). LIMITATIONS, REASONS FOR CAUTION: This retrospective survey relied on patient recall. Some aspects were particularly prone to bias such as contributions to decision-making. This approach to capturing IVF add-on use may yield different results to data collected directly from IVF clinics or from fertility specialists. WIDER IMPLICATIONS OF THE FINDINGS: There is a very high prevalence of IVF add-on use in Australia which may be generalisable to other settings with similar models of IVF provision. Although women placed high importance on scientific evidence to support add-ons, most add-ons do not have robust evidence of safety and effectiveness. This suggests that IVF patients are not adequately informed about the risks and benefits of IVF add-ons, or are not aware of the paucity of evidence to support their use. STUDY FUNDING/COMPETING INTEREST(S): This research was supported by a McKenzie Postdoctoral Fellowship Grant (University of Melbourne), a Department of Obstetrics and Gynaecology Innovation Grant (University of Melbourne) and an NHMRC Investigator Grant (APP1195189). A.P. declares that he provides fertility services at Melbourne IVF (part of Virtus Health). J.W. reports grants from Wellcome Trust, during the conduct of the study, and that publishing benefits his career. The remaining authors report no conflict of interest. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Fertilização in vitro , Nascido Vivo , Austrália , Coeficiente de Natalidade , Feminino , Humanos , Masculino , Indução da Ovulação , Gravidez , Estudos Retrospectivos
19.
Khirurgiia (Mosk) ; (4): 29-33, 2021.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-33759465

RESUMO

OBJECTIVE: To improve the treatment outcomes in patients with primary and metastatic liver tumors localized in segments VII-VIII involving the right hepatic vein and its branches. MATERIAL AND METHODS: There were 16 surgical interventions including resection of liver segment VII and/or VIII with resection of the right hepatic vein and its branches without reconstruction. All procedures were carried out at the Department of Liver and Pancreatic Tumors of the Blokhin National Medical Cancer Research Center for the period 2016-2020. The cause of surgery was colorectal cancer liver metastases in 8 patients, hepatocellular carcinoma in 2 cases, angiomyolipoma in 1 case and metastases of uterine cancer in 1 patient. Minor liver resection was additionally performed in 5 cases. RESULTS: Median surgery time was 150 (80-220) min, intraoperative blood loss - 400 (100-2000) ml. Afferent blood flow was blocked in 4 patients for 14 (12-25) min. None patient had intraoperative signs of impaired venous outflow. Biliary fistula in postoperative period occurred in 1 patient. No complications were noted in other cases. Median postoperative hospital-stay was 13 (9-19) days. There were no specific complications in long-term postoperative period that could be associated with venous outflow blockade through the right hepatic vein. CONCLUSION: Existing vessels and intrahepatic collaterals de novo can provide adequate venous outflow into the middle hepatic vein and short hepatic veins during resection of liver segments VII and/or VIII with resection of the right hepatic vein and its branches without reconstruction and the absence of inferior right hepatic vein.


Assuntos
Carcinoma Hepatocelular , Hepatectomia , Veias Hepáticas/cirurgia , Neoplasias Hepáticas , Carcinoma Hepatocelular/cirurgia , Hepatectomia/efeitos adversos , Hepatectomia/métodos , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Procedimentos Cirúrgicos Vasculares , Insuficiência Venosa/etiologia , Insuficiência Venosa/cirurgia
20.
Sud Med Ekspert ; 64(2): 40-42, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33739068

RESUMO

An unusual case of suicide by hanging on the door inside the cab of a truck (truck) «MAN¼ is presented: the neck is squeezed between the edge of the movable glass and the edge of the frame of the car door from the driver's seat. The above observation supplements the existing variants about the possibility of hanging with a kind of one-sided open «loop¼.


Assuntos
Lesões do Pescoço , Suicídio , Asfixia/etiologia , Humanos , Masculino , Veículos Automotores
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...