scholarly journals Analysis of the Existing Treatment Methods of Musculoskeletal Disorders in Adult Patients with Mucopolysaccharidosis (Literature Review)

2020 ◽  
Vol 99 (5) ◽  
pp. 101-106
Author(s):  
M.A. Eremushkin ◽  
D.I. Otvetchikova ◽  
I.N. Otvetchikov ◽  
V.A. Kolyshenkov

Need for optimal treatment approaches for adult patients with mucopolysaccharidosis is an urgent problem today. This happened dueto the fact that previously patients with MS rarely lived to adulthood and were observed mainly by pediatricians. But with the evolution of medical technologies and the emergence of modern methods of treatment and rehabilitation of such patients, the number of adult patients with MS is increasing. Clinicians have more and more questions in choosing a strategy for managing each specific clinical case. Currently, a comprehensive approach to treatment allows for the use of a multidisciplinary team to pay due attention to concomitant diseases that occur in patients with impaired GAG metabolism. Due to the rarity of this disease in the modern literature, there are as mall number of publications that cover only certain aspects of the disease, but there are no works devoted to a comprehensive approach to the treatment and rehabilitation of such patients. The analysis of literature data on diagnostics, methods of examination,options for conservative and surgical treatment depending on the type of detected pathology and functional needs of a patient with different types of MS is carried out. Recommendations for testing and evaluating functional status are described, and the most common options for conservative and surgical treatment that take into account specific problems that reduce the patient’s quality of life are presented. It is necessary to study the problem of MPs in adult patients in more detail, as well as to coordinate specialists who have experience in managing patients with metabolic disorders, in order to improve the results of treatment and rehabilitation of patients with this pathology.

2020 ◽  
pp. 90-93
Author(s):  
V. V. Bojko ◽  
V. V. Makarov ◽  
V. V. Tsodikov ◽  
L. G. Tarasenko

Summary. Aim. Decrease the amount of postoperative complications and improve quality of life for patients by a chronic hemorrhoid (CH). Materials and methods. Both international and national foreign clinical protocols are analysed. The obtained data are confronted with our clinical experience. Results and their discussion. Materials and methods. In the looks of foreign colleagues to tactics of treatment of patients with CH are analysed. The obtained data are confronted from positions of the best medical practice of providing of medicaid to the patients with a CH. Results and their discussion. In spite of insignificant differences in the volume of operative treatment of patients of CH, international practice adheres to single approach on tactics of surgical decision of this problem. Among the radical methods of treatment recommend next methodologies as an operation of choice: hemorrhoidectomy Milligan - Morgan, Ferguson and Parks, that in all researches were marked as high-efficiency. Clinical experience of our clinic, that Milligan–Morgan hemorrhoidectomy is the operation of choice for patients with 3-4 degrees of fall of knots, and applications of modern methodologies allows to bring down lacks of this operation and to attain the level of complications less than 1 %. Conclusions. The necessity of development of compatible clinical protocol of medicare to the patients takes place with CH. Introduction of single home standards of providing of medicare to the patients with CH will allow to bring down the risk of development of complications and improve the results of treatment. The got results of own researches on providing of medicare to the patients with CH are comparable with the results of foreign colleagues.


2018 ◽  
Vol 20 (2) ◽  
pp. 8-16 ◽  
Author(s):  
A. V. Kalinovskiy ◽  
S. V. Chernov ◽  
A. V. Zotov ◽  
A. R. Kasymov ◽  
E. V. Gormolysova ◽  
...  

The study objectiveis analysis of surgical treatment results of adult patients with tumors of the fourth ventricle and determination of predictors of unsuccessful outcomes.Materials and methods.In the present study we review results of treatment of 33 adult patients with tumors of the fourth ventricle, which were operated via telovelar approach in Federal Neurosurgical Center (Novosibirsk). The most common symptoms included hydrocephalus (54.5 %), cerebellar dysfunction (33.3 %), cranial nerve deficits (30.3 %). The tumor size was more than 40 mm in 22 cases (66.7 %). The brain stem invasion was occurred in 21 cases (63.6 %).Results.23 tumors were removed totally (69.7 %). Hydrocephalus was regressed in 17 cases (94.5 %). Cerebellar mutism did not occur in any patient. Conclusion.Predictors of poor result may be brain stem invasion, non-radical resection of tumor and preoperative hydrocephalus. We suggest, that the preoperative hydrocephalus should not been operated in the most cases of the fourth ventricular tumors.


2020 ◽  
Vol 8 (B) ◽  
pp. 226-230
Author(s):  
Gulnara Zhetebaevna Sakhipova ◽  
Nurgul Abdullaevna Abenova ◽  
Tlesh Nabievna Zhumabaeva ◽  
Aniya Nurmakhanbetovna Seypenova ◽  
Dina Orynbasarovna Shamshaeva

PURPOSE OF RESEARCH: The main objective of the study was to analyze the results of treatment of patients with cervical erosion and ectopia without surgical treatment. MATERIALS AND METHODS: To this end, a complete clinical examination of women with cervical erosion and ectopia was carried out: A smear for oncocytology, PCR for HPV 16–18, herpes simplex virus, chlamydia, colposcopy extended, and bacteriological study to identify the vaginal microflora. As a result of examinations, 30% of women without specific symptoms and complaints were diagnosed with cervical ectopia and assigned to the first group (practically healthy women). About 68% of women were assigned to the second group – with cervical erosion, who need conservative treatment, 2% – to the third group – women with invasive cervical cancer, who were sent to the oncology center. About 82% of L-SIL developed against the background of infection with highly oncogenic types of HPV, most often HPV 16, with 30% of them infected with more than 1 type of HPV. To eliminate concomitant inflammation of the cervix and vagina, hexicon was used in this group. After the rehabilitation of the vagina and cervix, the next step was to connect the drug depantol. RESULTS: The use of hexicon and depantol in the treatment of cervical erosion led to the regeneration of the defect of the cervical vaginal mucosa, bypassing the surgical treatment of cervical erosion. THE NOVELTY OF THE RESEARCH: As a result of the treatment of uncomplicated ectopia, there was no need to apply a surgical method of treatment in connection with the healing of ectopia. PRACTICAL APPLICATION OF THE STUDY: Such an approach to the treatment of women with cervical erosion among obstetrician-gynecologists would lead to the prevention of relapse and improve the quality of life of patients. After treating the cervix with solkovagin, healthy tissues begin to recover under these dead tissues, which in the process completely replace patients without scarring on the cervix.


Author(s):  
Sergey M. Pukhlik ◽  
Anatoly P. Shchelkunov ◽  
A.A. Shchelkunov

Relevance: Styloid process syndrome – a disease which is caused by irritation of the styloid process of the temporal bone surrounding the nerve, vascular and muscle structures. The syndrome is manifested by chronic painin deep division of the facial area referred to the root of the tongue, throat and ear, dysphagia, symptoms of circulatory disorders of the brain. Because of the low awareness of the disease practical specialists usually miss the diagnoses. Patients with different diagnoses are treated by different specialists; most often the prescribed symptomatic treatment is ineffective or does not give any result at all. The syndrome causes severe suffering to patients, reduces the quality of life. Purpose of the study: Assess the most significant clinical signs of the disease, mutual work between hypertrophied styloid process with the neurovascular neck formations, the effectiveness of conservative and surgical treatment. Materials and methods: 144 people were examined and treated by us. Of these, 103 women (71,5%), 41 men (28,5%), aged 25 to 70 years. The disease lasts from one year until 10-15 years. Tomography of the styloid processes with 3D reconstruction and contrasting of the main vessels of the neck was used. Results of the study and the discussion: we proposed a grading scale for the quality of the treatment, the five-point scale. The quality of the treatment was assessed by the number of reduction in scores and, accordingly, patient complaints. Of the total number of patients – 144 people, the success of the treatment by 0 points was assessed by 60 people (that is, absence of any symptomatology) (41,7%), 1 point – 44 (30,5%), 2-3 points – 27 (18,7%), 4-5 points – 13 (9%), that is significant effect of the treatment was not achieved. To all those people with the result of the treatment was estimated at 4-5 points, respectively, was proposed an operative method of the treatment – the resection of the styloid process from the corresponding side. Conclusions: Because of the lack of knowledge of such important topic it is necessary to improve diagnostic methods. Hypertrophy of the styloid process is not the main reason of the development of styloid syndrome; the degree of deviation of the process is important. Conservative treatment in most cases has a lasting effect, but has repeated symptoms after a certain period of time; surgical treatment should be directed to the maximal resection of styloid process for decreasing the axis pressure on the neurovascular bundle of the neck.


2017 ◽  
Vol 7 (1) ◽  
pp. 25 ◽  
Author(s):  
Yuliya S Moscaleva ◽  
Igor A Korneyev

Surgical methods of treatment of Peyronie’s disease by plication corporoplasty proved to be effective in the near and distant postoperative periods in the examined group of patients. These methods made it possible to quickly achieve the normalization of the shape of the penis without affecting the erectile function which enabled for patients to restore copulative activity and improve the quality of life.


Author(s):  
Maksim Shilyuk ◽  
Evgenii Kalinin ◽  
Timur Nasyrov ◽  
Azer Samedli ◽  
Artem Antonenko ◽  
...  

The trauma of the anterior cruciate ligament is one of the most prevalent kinds of trauma among sportsmen. It is necessary to determine the degree of trauma of the ligament as accurately as possible which will allow appointing the optimal tactic of treatment. But nowadays there are a lot of different kinds of conservative and surgical treatment and also various complexes of rehabilitation. In this work authors introduce analysis and systematization of modern methods of treatment and rehabilitation of patients with injuries of anterior cruciate ligament with the goal to study evolution and modern condition of tactical and technological ways of rehabilitation of patients with injuries of the anterior cruciate ligament.


2011 ◽  
Vol 17 (3) ◽  
pp. 137-145
Author(s):  
V. V. Umnov ◽  
V. A. Novikov ◽  
A. V. Zvozil

In article authors describe the isolated data of the foreign and domestic literature concerning a problem of conservative and surgical treatment of the upper limb extremity at patients with cerebral palsy. In the publication the features of various techniques gained the greatest distribution and actively applied now are considered. Besides, the analysis of results of treatment is carried out and problems up to the end not solved are sounded till now.


2019 ◽  
Vol 27 (1) ◽  
pp. 66-74
Author(s):  
Aleksey V. Mikheev ◽  
Sergey N. Trushin

Background. Spontaneous rupture of the esophagus (Boehaave syndrome, BS) is a rare pathology in the surgical practice. Esophageal rupture makes no more than 2-3% of all cases of damage to the esophagus and is associated with a significant number of diagnostic errors and with high mortality. Aim. The aim of the study was to analyze the quality of diagnostics and the results of treatment of patients with spontaneous rupture of the esophagus. Materials and Methods. We performed a retrospective analysis of medical histories and of treatment results of 10 patients with Boerhaave syndrome hospitalized in the department of thoracic surgery of the Ryazan Regional Clinical Hospital, Ryazan in 2007-2018. Results. Four of ten patients were transferred from other medical institutions. At the primary care stage six patients were misdiagnosed; two of them underwent diagnostic laparoscopy for suspicion of acute pancreatitis and perforated gastric ulcer. The average time from the onset of the disease to surgery was 71.723.4 hours. Closure of the esophageal perforation was performed in all cases. Regarding the timing of surgery, all patients with Boerhaave syndrome were divided into 2 groups: patients with early intervention (4 patients operated within 24 hours); patients with late intervention (5 patients operated after 48 hours from the onset of the disease). One patient underwent surgical treatment within 24 hours in a medical facility outside the Ryazan region. In nine out of ten patients the rupture was localized in a typical place in the lower third of the esophagus along the left lateral wall. In the postoperative period eight patients had complete or partial esophageal suture failure, which required prolonged inpatient treatment (54.712.1 days). Postoperative mortality was 10% (1 patient of 10) and was caused by the progressive multi-organ failure and the development of cerebral ischemic stroke. Conclusion. The quality of diagnostics of Boerhaave syndrome remains unsatisfactory: due to rare occurrence of this pathology, most specialists of primary care settings, including surgeons, are not well acquainted with the etiopathogenesis and peculiarities of clinical presentation of Boerhaave syndrome. Diagnostic and treatment errors in rendering primary medical assistance reaches 60%. Results of surgical treatment directly correlate with the time from the moment of perforation and development of septic complications. Even with early surgical intervention performed within 24 hours from the moment of perforation, esophageal suture failure may occur in up to 75% of cases. Thus, the success of treatment is determined by early diagnosis, timely hospitalization in a specialized facility, and adequate surgical intervention.


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