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OBJECTIVE: To analyze the early results of pancreatoduodenectomies with different methods of pancreatic isthmus transection. MATERIAL AND METHODS: There were 82 pancreatoduodenectomies for cancer of pancreatic head or major duodenal papilla for the period 2010-2019. The control group comprised 38 patients with pancreatic isthmus transection and no preliminary suturing of local vessels. The study group consisted of 44 patients who underwent preliminary intersection of pancreatic isthmus vessels. Inclusion/exclusion criteria were used for grouping. We evaluated total intraoperative blood loss and blood loss following pancreatic isthmus transection, incidence and structure of postoperative complications. RESULTS: Total intraoperative blood loss was 755.12±108.61 vs. 698.45±92.87 ml, respectively (p>0.05). Intraoperative blood loss following pancreatic isthmus transection was 48.21±9.11 vs. 7.83±1.72 ml, respectively (p<0.01). Incidence of postoperative complications and redo surgeries was similar. Postoperative bleeding occurred in 5 (13.15%) patients of the 1st group (class A - 2.63%; B - 5.26%; C - 5.26%) and 2 (4.54%) patients of the 2nd group (A - 4.54%; B and C - 0%). There were no significant differences in the incidence of other complications and postoperative mortality. CONCLUSION: Pre-stitching of arterial vessels of the pancreatic isthmus reduces blood loss following intersection (p<0.01), as well as the incidence of postoperative bleeding class B and C (p<0.05).
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Neoplasias Pancreáticas , Pancreaticoduodenectomia , Artérias , Perda Sanguínea Cirúrgica/prevenção & controle , Humanos , Pâncreas/cirurgia , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controleRESUMO
OBJECTIVE: To study the effectiveness of pharmacotherapy for perforated gastric ulcer in a surgical hospital. MATERIAL AND METHODS: A retrospective analysis of the treatment of 693 patients with perforated gastric and duodenal ulcers was carried out. Laparoscopic and open surgeries were performed. Statistical analysis was performed using the Statistica and MS Excel software packages. Student t-test was applied for independent samples and Fisher's F-test was calculated. RESULTS: Combined therapy included surgical treatment (suturing of the ulcer as a rule) and medication with proton pump inhibitors, antibacterial drugs. Over the past 5 years, postoperative quality of life has been significantly improved in patients with perforated ulcers. Stomach resection and vagotomy for perforated ulcers will become historical in the near future. Laparoscopic and open procedures ensure similar periods of ulcer closure. CONCLUSION: Currently, successful treatment of perforated gastric and duodenal ulcers requires an integrated approach at all levels of specialized care and is impossible without modern pharmacotherapy.
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Úlcera Duodenal , Úlcera Péptica Perfurada , Úlcera Gástrica , Antibacterianos/uso terapêutico , Terapia Combinada , Úlcera Duodenal/complicações , Úlcera Duodenal/tratamento farmacológico , Úlcera Duodenal/cirurgia , Humanos , Úlcera Péptica Perfurada/diagnóstico , Úlcera Péptica Perfurada/tratamento farmacológico , Úlcera Péptica Perfurada/etiologia , Úlcera Péptica Perfurada/cirurgia , Inibidores da Bomba de Prótons/uso terapêutico , Qualidade de Vida , Estudos Retrospectivos , Úlcera Gástrica/complicações , Úlcera Gástrica/tratamento farmacológico , Úlcera Gástrica/cirurgia , Resultado do TratamentoRESUMO
Endometriosis is a functioning endometrial tissue outside the inner layer of the uterine wall. Liver endometriosis is one of the rarest forms of atypical endometriosis. In this article, we report a patient with this disease. A 59-year-old patient complained of heaviness and periodic pain in the right hypochondrium for more than a year. Previous contrast-enhanced CT revealed signs of cystic-solid hypovascular mass lesion in the right liver lobe. Histological examination revealed no reliable signs of tumor growth. According to control CT after 8 months, no significant changes were observed. Surgical treatment was indicated and atypical liver resection was performed. Histological examination revealed cystic endometrioid lesion. Liver endometrioma is a rare disease with unclear pathogenesis. Diagnosis is difficult due to uncharacteristic clinical manifestations and no specific markers. Liver endometriosis should be considered in differential diagnosis of liver lesion. Surgical treatment is preferable due to the risk of malignant transformation.
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Endometriose , Hepatopatias , Endometriose/diagnóstico por imagem , Endometriose/patologia , Endometriose/cirurgia , Feminino , Hepatectomia , Humanos , Hepatopatias/diagnóstico por imagem , Hepatopatias/patologia , Hepatopatias/cirurgia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
The results of a comparative assessment of the state of hemomicrocirculation and oxygen metabolism in the mucous membrane of the alveolar crest after contour plastics of the gums during dental implantation using a connective tissue graft from the upper jaw, a connective tissue transplant from the palate and the collagen matrix collagen matrix are presented. During contouring with the use of connective tissue graft (CTG) from the upper jaw and collagen matrix in the mucous membrane of the alveolar mandible, the level of tissue blood flow decreases, which characterizes the development of ischemia, which is stopped after 3 weeks, when using a connective tissue graft (CTG) from the palatine, the level of tissue blood flow rises, which indicates the development of hyperemia, which is stopped for more than 3 weeks. According to oximetry data after contouring with the use of various surgical techniques, the level of oxygenation and oxygen metabolism is reduced by 8-38%, which characterizes the development of hypoxia, which is stopped after 3 weeks when using CTG from the hillock of the upper jaw and collagen matrix for more than 3 weeks when applying CTG from the palatine.
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Retração Gengival , Processo Alveolar/cirurgia , Tecido Conjuntivo , Implantação Dentária , Retração Gengival/cirurgia , Humanos , MucosaRESUMO
AIM: To evaluate and to compare the intensity of the inflammatory response to zinc-oxide-eugenol based filling material in rabbit's soft and bone tissue. MATERIAL AND METHODS: The study employed 20 chinchilla rabbits. The artificial defects were formed in jaw and in soft tissues and filled by zinc-oxide-eugenol based filling material. After 14 or 30 days the animals were euthanized, and tissue samples were analyzed with microscope. RESULTS: Histological analysis revealed that zinc-oxide-eugenol based filling material support inflammation reaction in the tissue, but bone tissue showed statistically lower inflammatory response in comparison to soft tissue (p<0,05). CONCLUSION: Extrusion of zinc-oxide-eugenol based filling material from root canal is undesirable as it leads to complex unfavorable tissue reaction for its elimination, more pronounced in soft tissues.
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Eugenol , Materiais Restauradores do Canal Radicular , Animais , Óxidos , Coelhos , Zinco , Cimento de Óxido de Zinco e EugenolRESUMO
One of the challenges in the field of quantum sensing and information processing is to selectively address and coherently manipulate highly homogeneous qubits subject to external perturbations. Here, we present room-temperature coherent control of high-dimensional quantum bits, the so-called qudits, associated with vacancy-related spins in silicon carbide enriched with nuclear spin-free isotopes. In addition to the excitation of a spectrally narrow qudit mode at the pump frequency, several other modes are excited in the electron spin resonance spectra whose relative positions depend on the external magnetic field. We develop a theory of multipole spin dynamics and demonstrate selective quantum control of homogeneous spin packets with sub-MHz spectral resolution. Furthermore, we perform two-frequency Ramsey interferometry to demonstrate absolute dc magnetometry, which is immune to thermal noise and strain inhomogeneity.
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We develop a theory of electron-photon interaction for helical edge channels in two-dimensional topological insulators based on zinc-blende-type quantum wells. It is shown that the lack of space inversion symmetry in such structures enables the electro-dipole optical transitions between the spin branches of the topological edge states. Further, we demonstrate the linear and circular dichroism associated with the edge states and the generation of edge photocurrents controlled by radiation polarization.
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Pancreatoenterostomy is one of the key moments in pancreatic surgery. It was proposed invaginative pancreatojejunostomy in end-to-side fashion by using of two continuous single-row purse-string sutures. This technique may be used in pancreatoduodenectomy and Beger's procedure. This method will be useful in cases of edematous and erupting pancreatic parenchyma and hard-to-differentiate lumen of pancreatic duct. It is followed by reduced trauma of tissue and bleeding, allows to avoid sutures failure and to achieve sealed anastomosis.
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Pâncreas/cirurgia , Pancreatectomia/métodos , Pancreaticojejunostomia/métodos , Humanos , Pâncreas/patologia , Ductos Pancreáticos/patologia , Ductos Pancreáticos/cirurgia , Pancreaticoduodenectomia/métodos , Técnicas de SuturaRESUMO
It reports the results of primary basal blood flow in partially edentulous bone tissue with atrophy, as well as comparative evaluation of haemomicrocirculation level of the alveolar bone mucosa after bone augmentation via tunneling and conventional methods. The results of the initial state of microcirculation in the mucous membrane of the alveolar process in the partially edentulous area show a 45% decrease of blood flow (M), its intensity (s) by 60%. Microcirculatory shifts in blood flow levels indicators, its intensity, vasomotor activity are more evident when using the conventional method, where revascularization takes more than five months. When using the tunnel method, there is an improvement in haemodynamic mechanisms of tissue blood flow regulation. Microcirculation is restored 4 months after surgery.
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Processo Alveolar/irrigação sanguínea , Aumento do Rebordo Alveolar/métodos , Arcada Parcialmente Edêntula/cirurgia , Microcirculação , Atrofia , Velocidade do Fluxo Sanguíneo , Hemodinâmica , Humanos , Mandíbula/patologia , Mandíbula/cirurgia , Maxila/patologia , Maxila/cirurgia , Mucosa Bucal/irrigação sanguíneaRESUMO
AIM: To justify ligation of vascular branches of anterior pancreateroduodenal arterial arch or gastroduodenal artery prior to bifurcation. MATERIAL AND METHODS: This method was tested on sufficient clinical material: 147 patients with recurrent chronic pancreatitis. The interventions are presented by Frey, Beger procedures and its Berne variant. RESULTS: Comparative analysis showed reliable advantages of vascular ligation during pancreatectomy.
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Perda Sanguínea Cirúrgica/prevenção & controle , Duodeno , Hemostasia Cirúrgica/métodos , Pâncreas , Pancreaticoduodenectomia , Pancreatite Crônica , Procedimentos Cirúrgicos Vasculares , Adulto , Duodeno/irrigação sanguínea , Duodeno/patologia , Duodeno/cirurgia , Feminino , Humanos , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pâncreas/irrigação sanguínea , Pâncreas/patologia , Pâncreas/cirurgia , Pancreaticoduodenectomia/efeitos adversos , Pancreaticoduodenectomia/métodos , Pancreatite Crônica/diagnóstico , Pancreatite Crônica/patologia , Pancreatite Crônica/fisiopatologia , Pancreatite Crônica/cirurgia , Fluxo Sanguíneo Regional , Procedimentos Cirúrgicos Vasculares/métodosRESUMO
Hemostatic disorders are typically associated with prolonged bleeding after or during surgical procedures. The aim of the study was to increase the efficiency of oral surgery in these patients using erbium laser. Selected 46 patients receiving oral surgery were randomly divided in 2 groups: 43 patients with thrombocytopenia, trombocytemia and other platelet disorders treated with erbium laser and a control group of 43 patients without concomitant pathology determined for conventional surgical treatment. No postoperative bleeding was seen in group 1. Conventional procedures were associated with significantly more postoperative pain and epithelization took 1-3 days longer. Erbium laser radiation is an up-to-date method which can be successfully used for oral surgery in patients with hemostatic disorders.
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Transtornos Plaquetários/complicações , Lasers de Estado Sólido , Procedimentos Cirúrgicos Bucais/instrumentação , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/prevenção & controle , Transtornos Plaquetários/patologia , Humanos , Hemorragia Pós-Operatória/patologia , Trombocitopenia/complicaçõesRESUMO
The study presents scientific data about surgical preparation of the alveolar bone before dental implantation by applying synthetic osteoplastic materials. The review analyzed the results of experimental and clinical studies on structural features and the efficiency of these materials, the time for replacement of new-formed bone tissue and contains comparative analysis of the efficiency of synthetic bone substitutes and other types of osteoplastic materials.
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Perda do Osso Alveolar/terapia , Aumento do Rebordo Alveolar , Cementoplastia , Cimentos Dentários , Implantação Dentária , Perda do Osso Alveolar/cirurgia , Regeneração Óssea , HumanosRESUMO
The article is aimed to analyze the advantages of the tunnel operative approach in dental surgery. It is shown that the application of the tunnel technique can enhance tissue regeneration and revascularization, achieve better aesthetic and functional results, offer higher treatment quality.
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The article presents a comparative analysis of therapeutic and diagnostic measures aimed at eliminating jaundice complicating diseases hepatopancreatoduodenal zone as tumor and benign etiology. Patients with obstructive cholestasis were represented by two groups: the main and control, including 858 and 869 patients, respectively. Therapeutic and diagnoctic tactics in the study group was based on the principles of the proposed algorithm. Using the proposed diagnostic and treatment algorithm led to better outcomes: significantly lower mortality and the incidence of postoperative complications
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Algoritmos , Icterícia Obstrutiva/diagnóstico , Icterícia Obstrutiva/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Mobile health technologies improve the quality of health care service. The information and communication technology is developed and applied to remind patients with arterial hypertension to follow medical recommendations. The feedback system from general practitioners was developed (the reminder system for patients sending the feedbacks). It helped to supervise follow-up patients online. Suggested system provides for forming the database for summarized analysis of online survey of the patients, who receive medical care at health care institution, to take managerial decisions concerning the improvements of medical services quality. Evaluation of efficiency of the applied technology assured that the number of patients, who checked regularly his/her arterial pressure, increased by 31.00%. The number of patients, who visited doctors for preventive purpose two or more times during given year, rose by 18.24%. The number of patients with target pressure grew by 24.51% and composed 38.55±4.26%.
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Hipertensão/terapia , Internet , Qualidade da Assistência à Saúde/normas , Algoritmos , Anti-Hipertensivos/uso terapêutico , Comunicação , Feminino , Clínicos Gerais , Pesquisas sobre Atenção à Saúde , Humanos , Hipertensão/prevenção & controle , Masculino , Cooperação do Paciente , Software , UcrâniaRESUMO
We report on the observation of magnetic quantum ratchet effect in metal-oxide semiconductor field-effect-transistors on silicon surface (Si-MOSFETs). We show that the excitation of an unbiased transistor by ac electric field of terahertz radiation at normal incidence leads to a direct electric current between the source and drain contacts if the transistor is subjected to an in-plane magnetic field. The current rises linearly with the magnetic field strength and quadratically with the ac electric field amplitude. It depends on the polarization state of the ac field and can be induced by both linearly and circularly polarized radiation. We present the quasi-classical and quantum theories of the observed effect and show that the current originates from the Lorentz force acting upon carriers in asymmetric inversion channels of the transistors.
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Monitoring results of current awareness level of dispensary patients with arterial hypertension are presented in the article. Awareness-raising activities for patients with arterial hypertension were developed by information and education work and communications increasing; effective target medical and social programs developing and implementing.
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Assistência Ambulatorial , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão , Educação de Pacientes como Assunto/métodos , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Hipertensão/prevenção & controle , Educação de Pacientes como Assunto/estatística & dados numéricos , Educação de Pacientes como Assunto/tendênciasRESUMO
In this review the modern ideas of the cell-like immune pathogenesis mechanism of Lichen planus)LP) are described. The special attention is paid to molecular diagnostics methods ( immunohistochemical and others). Communication of emergence of oral LP with infectious diseases is shown.
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Líquen Plano Bucal/imunologia , Linfócitos T/imunologia , Candida albicans/imunologia , Candidíase/complicações , Candidíase/imunologia , Enterobacter/imunologia , Infecções por Enterobacteriaceae/complicações , Infecções por Enterobacteriaceae/imunologia , Humanos , Líquen Plano Bucal/microbiologia , Boca/imunologia , Boca/microbiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/imunologia , Staphylococcus aureus/imunologiaRESUMO
The article highlights various techniques of biliodigestive anastomises, used for the treatment of high-level blockages of biliary ducts. The novel author method of tetrahepaticojejunostomy, possessing less insufficiency risk and less traumaticity was suggested. 38 patients have been operated on using the hepaticoenterostomy; 5 patients received the described method of tetrahepaticojejunostomy with positive outcome.
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Colestase/cirurgia , Ducto Hepático Comum/cirurgia , Jejunostomia/métodos , Idoso , Anastomose Cirúrgica/métodos , Colestase/diagnóstico , Colestase/etiologia , Constrição Patológica/complicações , Constrição Patológica/diagnóstico , Constrição Patológica/cirurgia , Feminino , Seguimentos , HumanosRESUMO
The paper presents studies on nutritional foramina of the mandible. Some nutritional foramina located in the frontal mandibular region on the lingual surface and containing significant blood vessels and nerves are found to be more typical for teeth-bearing mandible. In retromolar area in case of third molars presence intraosseous canals were revealed leading to inferior alveolar nerve canal. One should consider intraligamental and lingual anesthesia by lower incisors extraction. Intraosseous anesthesia and retromolar area infiltration significantly increase anesthesia efficiency by third molar extraction.