RESUMEN
BACKGROUND: Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by a parathyroid tumor or hyperplasia, which is often accompanied with quality of life (QoL) impairment. A parathyroidectomy (PTX) is the preferred standard treatment for PHPT patients. In this single center study we aimed to evaluate the impact of PHPT on patient's QoL and identify QoL changes at early and long-term follow-up after surgery. METHODS: All the patients underwent routine PTX with the removal of the suspected hyperparathyroid gland(s). Patients filled out generic QoL questionnaire RAND SF-36, specific questionnaire PHPQoL and specific symptom assessment questionnaire PAS upon admission to the hospital before surgery, at 3 months, 12 months and 24 months after surgery. RESULTS: A total of 92 patients with PHPT (median age was 56 years, 95.7% females) were included in the study. Before PTX patient's QoL by SF-36 scores was significantly lower as compared to healthy controls (p < 0.01). Almost 40% of patients had poor or very poor QoL. The most frequent symptoms by PAS before surgery were as follows: tiredness (97.8% of patients), weakness (94.6%), forgetfulness (94.6%), mood changes (90%), feeling "blue"/depression (88%), joint pains (83.3%), headaches (80.2%), constant irritability (77.2%), bone pains (75%), thirst (70.7%) and trouble getting out of a chair (67.4%). The half of the patients had moderate-to-severe (≥ 40 scores) tiredness, weakness, joint pains, forgetfulness, as well as mood changes. Post-operative QoL changes were analysed in the group of 72 patients. After surgery there was significant improvement in QoL by all scales of SF-36 questionnaire, excluding bodily pain, and the PHPQoL total score (GEE, p < 0.01) as compared with their values before surgery. Also severity of tiredness, mood changes, weakness and forgetfulness significantly decreased after surgery as compared to their baseline values (GEE, p < 0.05). Decreased mental component of QoL by PHPQoL (OR = 0.927, 95%CI = 0.874-0.984, p = 0.013) predicted improved QoL after surgery. CONCLUSIONS: Patients with PHPT demonstrated significantly impaired QoL in physical, psychological and social functioning as well experienced a wide profile of common PHPT symptoms. Successful PTX was accompanied with remarkable QoL improvement and decrease in subjective symptoms for at least 24 months after surgery.
Asunto(s)
Hiperparatiroidismo Primario , Neoplasias de las Paratiroides , Femenino , Humanos , Persona de Mediana Edad , Masculino , Calidad de Vida , Hiperparatiroidismo Primario/complicaciones , Hiperparatiroidismo Primario/cirugía , Paratiroidectomía , Neoplasias de las Paratiroides/cirugía , EmocionesRESUMEN
The relevance of the research is determined by the growth of cases of abdominal tuberculosis (AT), which is difficult to diagnose. AIM: Identify clinical features and possibilities of timely AT diagnosis. MATERIALS AND METHODS: Medical reports of 116 AT patients. The results of clinical, microbiological, immunological, radiological, endoscopic and morphological studies were analyzed. THE RESULTS: AT proceeded under the mask of ulcerative colitis and Crohn's disease (26.3%), alcoholic and biliary hepatitis (11.8%), lymphoproliferative and oncological diseases (61.8%), often generalized against the background of HIV-infection. The duration of the diagnostic search for disease verification exceeded 3 months due to incorrect (erroneous) interpretation of intoxication (26.3%) and radiological pattern in the lungs (23.7%), non - application and late application of laparoscopy (39.5%). CONCLUSION: When diagnosing AT, it is necessary to consider the peculiarities of its clinic and to conduct timely laparoscopy.
Asunto(s)
Colitis Ulcerosa , Enfermedad de Crohn , Médicos Generales , Infecciones por VIH , Tuberculosis , Diagnóstico Diferencial , HumanosRESUMEN
This review elucidates the data on etiology and pathogenesis of functional (unulcerous) dyspepsia, clinical features, diagnostic, therapeutic and prophylactic approaches to this pathology.
Asunto(s)
Dispepsia , Ácido Gástrico/metabolismo , Motilidad Gastrointestinal/efectos de los fármacos , Estómago/fisiopatología , Antiácidos/uso terapéutico , Antidepresivos/uso terapéutico , Diagnóstico Diferencial , Dispepsia/diagnóstico , Dispepsia/tratamiento farmacológico , Dispepsia/etiología , Mucosa Gástrica/metabolismo , Motilidad Gastrointestinal/fisiología , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Mecanorreceptores/metabolismo , Inhibidores de la Bomba de Protones/uso terapéutico , Estómago/efectos de los fármacosRESUMEN
This article presents the basic hypotheses of cardiospasm etiology and pathogenesis, examines diagnostic standards for inspection of patients with suspected cardiospasm, and describes principles of treatment.
Asunto(s)
Acalasia del Esófago/diagnóstico , Acalasia del Esófago/terapia , Acalasia del Esófago/fisiopatología , HumanosRESUMEN
The clinical observation of the liver cirrhosis patients who has got the magnetoinfraredlaser therapy (MILT) with an irradiation of lien projection is presented. It was shown the positive MILT effect on the pancytopenia syndrome. The use of magnetoinfraredlaser therapy in the patients with the hypersplenia syndrome is recommended.
Asunto(s)
Hiperesplenismo/terapia , Rayos Infrarrojos , Rayos Láser , Cirrosis Hepática/complicaciones , Magnetismo , Adulto , Terapia Combinada , Femenino , Humanos , Hiperesplenismo/complicaciones , Hiperesplenismo/patología , Cirrosis Hepática/patologíaRESUMEN
There are observations of 37 pregnant women with cholestasis. The study of the level of bile acids, b2-microglobuline, ferritin and ultrasound echography was shown to be the most valuable diagnostic test. Absolute and relative contraindications to the maintenance of pregnancy are suggested for this group of patients. It was proved that the long-term cholemia considerably aggravates the course of the disease. The problem of the maintenance of pregnancy in each case must be solved on an individual basis and with the use of adequate therapy.