RESUMEN
Chronic migraine is a neurological disorder characterized by 15 or more headache days per month of which at least 8 days show typical migraine features. The process that describes the development from episodic migraine into chronic migraine is commonly referred to as migraine transformation or chronification. Ample studies have attempted to identify factors associated with migraine transformation from different perspectives. Understanding CM as a pathological brain state with trigeminovascular participation where biological changes occur, we have completed a comprehensive review on the clinical, epidemiological, genetic, molecular, structural, functional, physiological and preclinical evidence available.
Asunto(s)
Progresión de la Enfermedad , Trastornos Migrañosos/diagnóstico por imagen , Trastornos Migrañosos/fisiopatología , Enfermedad Crónica , Epigénesis Genética/fisiología , Humanos , Trastornos Migrañosos/genética , Neuroimagen/tendenciasRESUMEN
Morphological signs of small hernias (protrusion) of intervertebral discs (IVD), the results of a neurovisualizing methods of investigation and clinico-neurological features of osteochondrosis as well, were summarized. In young and middle age patients morphological chatacteristics of small hernias (protrusion) of IVD, data of neurovisualizing methods of investigation have had correlated with clinico-neurological features of the disease and were the key determinants while performance of the puncture laser microdiscectomy. In a middle age and elderly patients a weak correlation was noted between the IVD protrusion dimensions and intensity of a lumbar and radicular pain syndromes, functional activity (Osvestry index), what have had permitted to apply a pathogenetically substantiated method of a durable epidural pharmacotherapy. The investigation results witness the necessity of differentiated application of the puncture methods of treatment for the pain discogenic syndromes in patients of different age.
Asunto(s)
Desplazamiento del Disco Intervertebral/complicaciones , Disco Intervertebral/patología , Dolor de la Región Lumbar/etiología , Vértebras Lumbares/patología , Raíces Nerviosas Espinales/patología , Adolescente , Adulto , Factores de Edad , Anciano , Analgesia Epidural/métodos , Discectomía/métodos , Femenino , Humanos , Disco Intervertebral/cirugía , Degeneración del Disco Intervertebral/complicaciones , Degeneración del Disco Intervertebral/tratamiento farmacológico , Degeneración del Disco Intervertebral/patología , Degeneración del Disco Intervertebral/cirugía , Desplazamiento del Disco Intervertebral/tratamiento farmacológico , Desplazamiento del Disco Intervertebral/patología , Desplazamiento del Disco Intervertebral/cirugía , Terapia por Láser/métodos , Dolor de la Región Lumbar/tratamiento farmacológico , Dolor de la Región Lumbar/patología , Dolor de la Región Lumbar/cirugía , Vértebras Lumbares/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Adulto JovenRESUMEN
The prevalence of refractory arterial hypertension in Russia is estimated at 15%. We report the first experience with surgical treatment of this pathology. The method is based on the reduction of activity of the sympathetic nervous system by selective breaking of connections between of neurons with the help of interventional intravascular radiowave ablation. Renal endovascular sympathetic denervation allows to more effectively control AP and optimize antihypertensive therapy but does not ensure recovery from AH.
Asunto(s)
Cateterismo Periférico/métodos , Desnervación/métodos , Procedimientos Endovasculares/métodos , Hipertensión/cirugía , Arteria Renal , Adulto , Antihipertensivos/uso terapéutico , Resistencia a Medicamentos , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/fisiopatología , Masculino , Arteria Renal/inervación , Arteria Renal/cirugía , Resultado del Tratamiento , Sistema Vasomotor/cirugíaRESUMEN
The investigation involved 307 patients operated on for gastric adenocarcinoma. Nutritional support was given enterally (50), parenterally (98) and by standard methods (159). Enteral nutrition should be recommended because it was followed by relatively higher total protein and serum albumin levels.
Asunto(s)
Adenocarcinoma/dietoterapia , Apoyo Nutricional , Neoplasias Gástricas/dietoterapia , Adenocarcinoma/sangre , Adenocarcinoma/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Nutrición Enteral , Femenino , Humanos , Hipoproteinemia/dietoterapia , Hipoproteinemia/etiología , Masculino , Persona de Mediana Edad , Apoyo Nutricional/métodos , Nutrición Parenteral , Desnutrición Proteico-Calórica/dietoterapia , Desnutrición Proteico-Calórica/etiología , Estudios Retrospectivos , Albúmina Sérica/metabolismo , Neoplasias Gástricas/sangre , Neoplasias Gástricas/cirugía , Factores de Tiempo , Resultado del TratamientoRESUMEN
The paper presents early and late outcomes of treatment in 62 patients undergone paracentetic laser "diskectomy" for discogenic compressed syndromes of the neck. It shows the efficiency of surgery for radicular (92.9%) and myelopathic (92.8%) syndromes. Patients were selected for these interventions on the basis of clinical and neurological examinations, spondylography, MRI, and electric neuromyography. The main stages of an operation were as follows: local anesthesia, right-sided anterolateral access, X-ray guidance of the position of a needle, one-stage removal of herniated disks during multi-levelled injury during an intervention. The operation lasted 18 +/- 2.4 minutes. The mean hospital stay was 12 +/- 1.4 hours. The interventions were performed in 16 of 62 cases in the outpatient setting.
Asunto(s)
Vértebras Cervicales/cirugía , Osteocondritis/cirugía , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/patología , Discectomía Percutánea/métodos , Electromiografía , Estudios de Seguimiento , Humanos , Terapia por Láser , Imagen por Resonancia Magnética , Osteocondritis/diagnóstico por imagen , Osteocondritis/patología , Tomografía Computarizada por Rayos XRESUMEN
The results of radical surgical and combined treatment of 124 cases of esophageal and cardioesphageal tumors are presented. Extensive local disease (stage III, T2-4N0-2M0) was diagnosed in 113 patients (91.1%). Esophagoectomy with transmediastinal esophagogastroplasty and cervical esophagostomy proved most useful for esophageal tumor, while extensive surgery after Lewis in combination with extirpation or proximal resection of the stomach--for proximal gastric disease involving the esophagus. Combined surgery with resection of adjacent organs was carried out in 50%. Post-operative mortality rates were reduced to 7.1% due to application of effective surgical, anesthetic and intensive care procedures. The 3-year survival rate was 26.5%. Prognosis improved significantly when radiation was used prior to dissection of lymph nodes.
Asunto(s)
Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Neoplasias Esofágicas/cirugía , Neoplasias Gástricas/cirugía , Cardias , Procedimientos Quirúrgicos del Sistema Digestivo/mortalidad , Neoplasias Esofágicas/mortalidad , Neoplasias Esofágicas/patología , Neoplasias Esofágicas/radioterapia , Esofagectomía , Esofagoplastia , Esofagostomía , Femenino , Gastrectomía , Gastroplastia , Gastrostomía , Humanos , Escisión del Ganglio Linfático , Masculino , Estadificación de Neoplasias , Pronóstico , Radioterapia Adyuvante , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Neoplasias Gástricas/radioterapia , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
The puncture laser discectomy was conducted in 273 patients with discogenic lumbosacral radiculitis while the conservative therapy inefficacy, pain syndrome in a lumbago stage present and lumboischialgia with absent prominent locomotive disorders and if the intervertebral disc hernia has the size up to 0.6 cm.
Asunto(s)
Desplazamiento del Disco Intervertebral/cirugía , Terapia por Láser/métodos , Radiculopatía/cirugía , Punción Espinal/métodos , Adolescente , Adulto , Femenino , Humanos , Región Lumbosacra/cirugía , Masculino , Persona de Mediana EdadAsunto(s)
Neoplasias de la Mama/complicaciones , Carcinoma Ductal de Mama/complicaciones , Neoplasias del Colon/complicaciones , Linfoma/complicaciones , Anciano , Colon/patología , Neoplasias del Colon/patología , Neoplasias del Colon/cirugía , Femenino , Humanos , Metástasis Linfática , Linfoma/patología , Linfoma/cirugía , Metástasis de la NeoplasiaRESUMEN
The data on the morbidity, time of diagnosis and results of treatment of esophageal cancer in St. Petersburg and Leningrad Region (1992-1994) were analyzed. The morbidity rates were higher in women than in men, the predominant age being over 60. Morphological verification data were not available in almost half the cases. Stage I-II tumors were detected in 15.7-26.5%. Specialized treatment was given to 25%, combination one-to nearly 2%. To raise the standards of medical aid, it is suggested that measures be taken to ensure stable operation of the Cancer Register, St. Petersburg, and to offer treatment to esophageal cancer patients at specialized medical facilities.
Asunto(s)
Neoplasias Esofágicas , Calidad de la Atención de Salud , Distribución por Edad , Terapia Combinada , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Federación de Rusia , Distribución por SexoRESUMEN
The data on 120 cases of primary multiple cancer of the large bowel and 91 cases of diffuse polyposis are discussed. The development, duration and morphological features of metachronous and primary cancer arising after resection of the bowel varying in type and extent were studied. The results pointed to a high risk of cancer in such cases. The study also pointed to disturbances in the enterohepatic system and bile acid circulation as a factor of carcinogenesis in the bowel.
Asunto(s)
Neoplasias del Colon/etiología , Neoplasias del Colon/cirugía , Neoplasias Primarias Múltiples/etiología , Neoplasias Primarias Secundarias/etiología , Pólipos del Colon/etiología , Pólipos del Colon/cirugía , HumanosAsunto(s)
Traumatismos del Brazo/mortalidad , Lesiones Encefálicas/mortalidad , Fracturas Óseas/mortalidad , Traumatismos de la Pierna/mortalidad , Traumatismo Múltiple/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Causas de Muerte , Femenino , Humanos , Masculino , Persona de Mediana Edad , UcraniaRESUMEN
A study is presented of 212 elderly patients with associated head injuries. This type of trauma in the elderly is characterized by several features complicating its diagnosis. Knowledge of the anatomo-physiological aspects of the elderly and old, assessment of the injury mechanism, determination of the dominating and concomitant trauma, adequate use of adjunctive diagnostic methods are of importance in the choice of treatment tactics and in the improvement of treatment results.
Asunto(s)
Lesiones Encefálicas/diagnóstico , Anciano , Conmoción Encefálica/diagnóstico , Urgencias Médicas , Humanos , Persona de Mediana Edad , Factores de TiempoRESUMEN
An analysis of 463 patients operated upon for severe cranio-cerebral traumas has shown that one of the main factors improving results of treatment is using the methods of neurosurgical prophylactics of intracranial hemorrhages in the postoperative period. A considerably less incidence of intracranial hemorrhages can be achieved by using the inflow-outflow dialysis system, removing the crushed brain substance, suturing the dura mater to the periosteum at the borders of the bone defect. The ends of the ligature are taken out onto the skin through the holes in the center of the osseous flap.