Combined Treatment Method Research Articles

Применение комбинированного метода лечения при сочетании гиперпластического процесса эндометрия с аденомиозом

Применение комбинированного метода лечения при сочетании гиперпластического процесса эндометрия с аденомиозом

Комбинированный способ хирургического лечения при паралитическом лагофтальме с применением имплантатов из политетрафторэтилена

The purpose is to develop a combined method of paralytic lagophthalmos treatment using polytetrafluoroethylene (PTFE) implants. Material and methods. The clinical group consisted of 20 patients (8 males, 12 females) aged 31-69 (44.7 ± 5.3 years) with facial nerve paralysis, who were treated within the last 3 years. The onset of paralytic lagophthalmos took place 1-9 years (3.3 ± 2.1 years) before surgical treatment. A typical clinical picture was as follows: lagophthalmos 9-16 mm (13.3 ± 3.1 mm), retraction of the upper eyelid 3-6 mm (4.1 ± 1.1 mm), atony and ectropion of the lower eyelid, epitheliopathy (11 cases), leucoma (9 cases). Visual acuity was 0.01-1.0 (0.3 ± 0.15). All patients had surgery for lagophthalmos with the use of a PTFE implant. In 5 patients, surgery was performed in two stages (separately for the upper and the lower eyelids), in 15 cases it was performed simultaneously, using a combined method The implant was a porous PTFE tape 200-300 μm thick, either solid or with perforations. The follow-up period was 6 months to 3 years (1.9 ± 0.9 years). Results. No complications have been revealed either in the early or late follow-up periods. All patients had positive dynamics of the following parameters: the size of lagophthalmos, the presence of ectropion of the lower eyelid, retraction of the upper eyelid, the condition of the cornea. The evaluation was conducted 6 months after surgery or later. In all cases, lagophthalmos decreased significantly, the residual lagophthalmos was 2-5 mm (3.1 ± 1.3 mm). The condition of the cornea in patients with keratopathy improved, vision increased to reach 0.1 1.0 (0.5 ± 0.25). Conclusion. In the proposed method, the lagophthalmos is eliminated by lower eyelid strengthening and upper eyelid recession. PTFE implants provide a stable effect. For citation: Filatova I.A., Shemetov S.A. Combined method of surgical treatment for paralytic lagophthalmos with polytetrafluoroethylene (PTFE) implants. Russian ophthalmological journal. 2018; 11 (2): 27-34. doi: 10.21516/2072-0076-2018-11-2-27-34 (In Russian).

Combined Treatment Method Comparison Of Medical And Surgical Treatment In Idiopathic Granulomatous Mastitis

Aim: Our aim in conducting this study was to ascertain the clinical, pathological, and radiological characteristics of patients diagnosed with idiopathic granulomatous mastitis in our clinic and to contribute to related literature by creating a therapy algorithm for granulomatous mastitis.
 Method: A total of 62 patients diagnosed with granulomatous mastitis in our clinic were classified into three groups as per the mode of treatment they received. Among these, 20 patients who had only been administered corticosteroids were allocated to Group I, while 18 patients who had received surgical treatment in addition to corticosteroid treatment were allocated to Group II, and 24 patients who had only received surgery were allocated to Group III.
 Results: All the cases were female patients. The mean age of the patients was 33.67 ± 6.35 (21-48). No statistically significant difference was found among the groups as per the mean age figures, pregnancy, breastfeeding, oral contraceptive administration, smoking and alcohol use, and family history (p>0.05). 49 (77.4%) patients were diagnosed with granulomatous mastitis by thick-needle biopsy, 7 (11.2%) by incisional biopsy, 4 (6.4%) by excisional biopsy, and 3 (4.8%) by fine-needle aspiration biopsy (FNAB) before the onset of treatment. The median value for the follow-up of the patients was 40 (6-81) months and there was no statistically significant difference among follow-up periods (p: 0.51). 15 (24.1%) patients among all the cases had recurrence. There was a statistically significant difference among the groups with regards to recurrence (p: 0.015).
 Conclusion: Granulomatous mastitis may simulate breast cancer both clinically and radiologically. Recurrence is observed in patients who only received corticosteroid or surgical treatment. The combination of corticosteroid and surgical treatment significantly reduces the rate of recurrence. Therefore, this combination can be recommended as selective treatment.

Evaluation of the effects of occlusal splint, trigger point injection and arthrocentesis in the treatment of internal derangement patients with myofascial pain disorders

PurposeIn temporomandibular disorders (TMDs), unless splints are effective, combined therapies are performed. The aim of this study is to show the effectiveness of the local anaesthethic injections (trigger point injections) to the masticatory muscles. Materials and methodsThe study was composed of TMD patients and the predictor variables were therapy combinations including stabilization splint (SS) therapy, SS+trigger point injection therapy (TPI) and arthrocentesis. The primary outcome variables were pain and jaw movements. The follow-ups were done at 1st and 3rd months. 56 patients who were treated for TMD with only SS or combined therapies were included in the study. The effects of additional TPIs were compared to SS therapy alone. Also the effect of arthrocentesis was evaluated too. ResultsAll groups revealed significant decreases in pain scores. Decreases in mouth openings were observed in some of the patients in the injection groups. ConclusionThe combined treatment method in which the injections were applied at shorter time intervals, was a more effective method for decreasing VAS scores in TMD patients in this study but further studies are required.

Application and Research Twin Roll Casting-Extruding Process for Production Longish Deformed Semi-Finished Products from Aluminum Alloys

At present, Russia is actively developing methods of combined treatment of aluminum alloys, one of which is the method of twin roll casting-extruding. It is very suitable for processing aluminum alloys having a relatively low melting point. The method consists in pouring a melt into the rotating rolls, crystallizing it on the roll surfaces, rolling with a predetermined reduction amount, pressing out in front of the die and squeezing out the product of the predetermined configuration and dimensions through it with drawing ratio in the range of values 10-40. Analysis of technical and economic indicators showed that this method has a number of advantages in comparison with traditional technologies of semicontinuous extruding and continuous casting-rolling. So the output of a good metal at high production volumes can reach 95-97% at a productivity of up to 3-4 tons per hour. In addition, it is possible to quickly move from one profile size to another by changing the matrix. The authors proposed and patented various designs and methods for producing solid and hollow press products from non-ferrous alloys. On their basis, laboratory and pilot-industrial units for combined processing have been created, on which experimental studies have been carried out to obtain long-dimensioned deformed semi-finished products from aluminum alloys series 5xxx, 6xxx, 8xxx and others. The energy-power parameters of the process are determined and found that they are significantly smaller in comparison with traditional technologies (in 10-50 times). Investigations of the mechanical characteristics of press products have been carried out, which showed that when implementing such a treatment scheme, even when producing extruded products from low-plastic alloys, they have a high level of plastic and strength properties. Developed technologies based on the method twin roll casting-extruding now are tested in a laboratory of combined treatment methods in School of Non-ferrous Metals and Material Science in Siberian federal university and industrial conditions of a number of metallurgical plants.

Olive mill wastewater treatment in Jordan: A Review

The environmental impact of olive mill wastewater (OMW) pollution is a public concern. OMW contains high levels of phenols, organic compounds, chemical oxygen demand (COD), biological oxygen demand (BOD), microorganisms, nutrients, and toxic compounds. The treatment of OMW has been investigated by many researchers in the Mediterranean region, using several treatment techniques to remove contaminants from OMW. These techniques include chemical, biological, physiochemical, and biophysical techniques. Surfactants and some adsorbents were used in chemical techniques, anaerobic and aerobic in biological techniques, while the combined treatment methods used Electroosmosis, ozonation and electrocoagulation processes as physiochemical methods, and ultrasonic irradiation combined with aerobic biodegradation as biophysical method. The effects of OMW, whether treated or untreated, have been evaluated on both plants’ growth and soil properties. The treatment methods as well as the environmental impact of OMW in Jordan were summarized in this review.

CURRENT TREATMENT OF PATIENTS WITH MALIGNANT TUMOR OF OROFARYNGEAL REGION

Head and neck cancer is the sixth most common cancer worldwide. It is a complex problem due to the high incidence, which is increasing. Disturbances in the oropharyngeal region lead to persistent morphological and functional disorders, affect food intake, speech, breathing, hearing, vision, facial expressions and the appearance of patients. However effective treatment is available only in the early stages of the disease. Treatment of locallY., relapsing and disseminated tumors unsatisfactory despite the interdisciplinary approach. Invalidation of patients causes irreparable psychological damage to person and leads to rejection of the necessary surgical treatment. In this connection the choice of treatment is based on the maximum preservation of the form and function of the organ, localization and spread of the process, pathomorphological examination, the age of patients, and concurrent general diseases. However the combined method of treatment is the most effective regardless the morphological variant of malignant tumor of oropharyngeal region.

Papillomatosis of the larynx in children: the current state of the problem

There is the authors have considered variants of modern methods of medical and surgical treatment of laryngeal papillomatosis in children in the review, based on the etiology of the disease. The analysis of the effectiveness of new methods of combined treatment with the use of modern technologies, taking into account their advantages and disadvantages. The possible prospects for further study problems and develop new methods of adjuvant therapy.

The Analysis of the Treatment of Rhabdomyolysis by Snake Bites

Objective: To explore the treatment measure of rhabdomyolysis caused by snake bites, and provide guidance for further prevention and control of snake bites. Methods: To retrospectively analyze the 841 cases of serpentine bites in our hospital from January 2006 to July 2017; 127 cases of patients with rhabdomyolysis syndrome were screened out, and their clinical manifestations, laboratory results, related treatment and prognosis were analyzed. Results: 127 cases patients were rhabdomyolysis out of 841 cases, 28 cases patients developed acute renal failure; treatment measures included local wound treatment, application of tetanus antitoxin, anti-snake venom serum, anti-infection, fluid “hydration” and diuretic, alkaline urine and hybrid renal replacement therapy. 112 cases were cured, improved conditions in 9 cases, 3 cases of death, 3 cases uncured. The improvement rate of is 95.26% after treatment. Conclusion: The rhabdomyolysis had a high incidence in snake bite patients, severe cases often developed acute renal failure. Serum myopsin and related biochemical blood tests could be used to diagnose rhabdomyolysis quickly. Combined treatment methods are the main measure to increase the cured rate and decrease the death rate.

Use of combined methods of treatment to obtain artificial roughness on the parts’ surfaces

Opportinities of combined treatment field of use expanding for obtaining of artificial roughness on the parts’ surfaces are unveiled. The way of assurance of process stability and rise of technological parameters are shown, which allowed to expand the application field of high-efficiency dimensional combined treatment with the use of precision impulse optical fiber laser as a part of laser complex. Such a task is resolved for the first time and its results contribute to creation of items of new generation of equipment, which is relevant for mechanical industry.

Application of two-component technological media for surface processing with a high degree of curvature

The final dimensional combined treatment with the application of an electric field by a tool in the form of unbound metal pellets of complex profile components used in aviation, rocket and space technology and in the oil and gas industry is considered. Such parts include impellers and the flowing component of the turbo-pump units, augers, impellers, where there are sections of variable curvature with limited access of the tool to the processing area. It is shown that the combination in a combined process of two-component technological media from current-carrying granules and an electrically conductive liquid medium supplied at high speed to the treatment zone allows to provide the required technological and operational processing parameters; the action of an electric field from a source with an increased voltage makes it possible to remotely perform a final dimensional processing of the pieces of metal parts with the creation of the required coldhardening against the impacts of solid granules; a combination of mechanical, chemical and magnetic impacts ensures obtaining a given profile accuracy, surface roughness. As a result, it is possible to increase the action and durability of important units of aerospace engineering and oil and gas equipment, and also to expand the area of technological use of the combined treatment method with unbound granules to component parts that are not accessible for processing by an integral tool. In the method under consideration, a universal granule tool is used which does not have a constant geometric shape and is capable of being delivered to the treatment zone through openings into parts whose dimensions are commensurable with the cross-section of the granules.

Use of Noninvasive Cerclage in Combination of Micronized Progesterone in Miscarriage Of Multifetal Pregnancy

We represent the results of the combined method of treatment and prevention of miscarriage in women with a multiple pregnancy and a high risk of the threat of termination the pregnancy because of using the obstetric unloading pessaries, combined with micronized progesterone. The efficiency of this method of treatment is evidenced by the rapid elimination of clinical symptoms of threatened abortion, accelerating the regression of ultrasound markers, reducing the number of complications in of pregnant women and reducing the time of their stay in hospital.Goal: To evaluate the effectiveness of the handling the obstetric pessary in combination with micronized progesterone at women with multifetal pregnancy and a high risk of miscarriage.Materials and methods. We analyzed 120 cases of multifetal pregnancies with signs of miscarriage within the terms from 16 to 28 weeks. The first group of the examined women was: 40 pregnant women with twins and signs of miscarriage, who in the scheme of treatment and prophylactic measures were offered to use the unloading obstetric pessaries in combination with continuous therapy by natural micronized progesterone until 36 weeks of pregnancy. The second group included 40 pregnant women with twins, who were laid seam on the cervix because of istmicocervical insufficiency and were applied short-term courses of therapy by gestagens. The control group comprised 40 pregnant women with twins at the age of 16-28 weeks of pregnancy who were conducted the therapy about the threat of miscarriage according to the current clinical protocols (Order of the Ministry of Health of Ukraine No. 624). It was carried out the analysis of the course of pregnancy, childbirth, the postpartum period and the state of neonatal adaptation in the surveyed groups.Results of the research and their discussion. In the first group, urgent childbirth occurred in 34 (85%) cases, in group II in 29 (72.5%) cases, in control group – in 25 (62.5%) cases. Cesarean delivery was performed in 7 (17.5%) patients of group I pregnant women, in 9 (22.5%) of group II patients and in 11 (27.5%) in the pregnant group. When studying the state of neonatal adaptation of newborns in the examined groups, the following results were obtained. The average weight of the newborns in group I was 3245 ±280 g, in group II 2865 ±365 g, in the control group - 2975 ±325 g (p>0.05). The evaluation of the state of newborns on the Apgar scale, respectively at the 1st and 5th minutes, was respectively: in newborns of the I group, 7.5 ± 1.4 and 8.4 ± 1.3 points, in group II - 7.3 ± 1.6 and 8.2 ± 1.1 points, in the control group – 7.2 ± 1.6 and 8.6 ± 1.2 (р 1-р 2> 0.05).Conclusions. Comprehensive prophylaxis of non-pregnancy in multiple pregnancies, combining the use of a traumatic cardiac cervix with the help of unloading obstetric pussies with progesterone preparations, allows prolonging pregnancy, preventing the development of prematurity, contributes to the improvement of perinatal indicators.

Oxidation of azo and anthraquinonic dyes by peroxymonosulphate activated by UV light

ABSTRACTThe photochemical degradation of two azo and two anthraquinonic dyes was performed using potassium peroxymonosulphate (Oxone®) activated by UV radiation. The fast decolourization of all dyes was observed within 6 min of UV irradiation, with corresponding dye decays higher than 80%. The kinetic rate constants of the dyes' decay were determined, along with the energetic efficiency of the photochemical treatment, taking into account the influence of a few anions commonly present in real wastewaters (i.e., chloride, nitrate, carbonate/bicarbonate and phosphate ions). Chloride and carbonate/bicarbonate ions enhanced dye degradation, whereas phosphate ions exerted an inhibitory effect, and nitrates did not have a predictable influence. The dye decolourization was not associated with efficient mineralization, as suggested by the lack of a significant total organic carbon (TOC) decrease, as well as by the low concentrations of a few detected low molecular weight by-products, including nitrate ions, formaldehyde and organic acids. High molecular weight by-products were also detected by mass spectrometry analysis. The investigated process may be proposed as a convenient pre-treatment to help dye degradation in wastewater during combined treatment methods.

COMBINED APPLICATION OF MICRONEEDLE RF-THERAPY AND INJECTIONS BY PLATELET-RICH PLASMA ACTIVATED BY AUTOLOGICAL THROMBIN IN AESTHETIC MEDICINE

A retrospective assessment of the effectiveness of the application of a combination of radio-frequency radiation (needle lifting) and injections of platelet-enriched autologous human plasma was made in the correction of involuntary changes in the skin of the face and neck of 57 patients aged 40-65 years with signs of chronic aging and photodamage of the skin. Dermatological status was assessed before and after the reparative correction of involuntary changes in the skin through morphostructural analysis of the skin using the method of ultrasonography, visual analog scales, photography, studying the quality of life, and assessing patients’ satisfaction with the used treatment. To objectify the results, they were compared according to age: in the group of patients up to 49 years old and over 49 years of age. As a result of the application of the combined treatment method, the degree of manifestation of clinical signs of skin aging (the qualitative characteristics of the skin and the degree of wrinkles) markedly decreased, which contributed to an improvement in the quality of life of this category of patients. More than 90% of patients regardless of age noted good/very good efficacy and comfort of the combined method. Combined method of correction of involuntary changes in the face and neck skin, based on a combination of cellular technology with platelet activation by autologous thrombin and effect on the skin by needle lifting is a highly effective method of correcting involuntary skin changes.

Comparison of the Effect of Cold Drink and Dexamethasone, and their Combined Effect on Children with Croup.

Croup is a clinical syndrome which included inspiratory stridor, coughing with a dog-like sound, noise obstruction and respiratory distress symptoms. This present study was conducted to compare the effects of cold drink and dexamethasone, and the effects of their co-administration on children's croup. In this study, all patients with croup admitted to the emergency ward of Madani Hospital Khorramabad were divided through the simple randomized method into 3 groups after informed consents were taken from their parents. The first group was given cold drink, second group with dexamethasone (DM), and the third group were given the combined treatment simultaneously. The patients in the first and second groups who did not show signs of improvement received the simultaneous treatment similar to the third group. The data were analyzed using the SPSS software through descriptive statistics and inferential statistics including multi-field variance analysis and co-variance analysis. The results of the study indicated a statistically significant between the 3 group in terms of improvement time-scale of croup clinical symptoms (P=0.001). There was no significant difference observed between the effects of other variables on improvement time-scale of croup clinical symptoms. The cold drink has less treating effect than DM and combined simultaneous treatment method. Also, DM had more influence than simultaneous treatment method. In addition, other variables including age, sex, birth weight, BMI, respiratory allergy and previous croup history did not influenced improvement time-scale and only type of intervention influenced improvement time-scale of croup clinical symptoms.

Improved Oral Bioavailability and Liver Targeting of Sorafenib Solid Lipid Nanoparticles in Rats.

Minimal information is available on the oral bioavailability and liver-targeting properties of sorafenib solid lipid nanoparticles (SRF-SLNs) in rats. In this study, SRF-SLNs were prepared via the combined methods of high-speed shearing and ultrasonic treatment. SRF-SLN formulations were also optimized. Particle size, zeta potential, entrapment efficiency (EE), and drug loading (DL) were used as indices for the evaluation of the as-prepared SRF-SLNs. SRF concentration was determined by the high-performance liquid chromatography method. Results showed that the average EE and DL of SRF-SLNs were 89.87 and 5.39%. The average particle size, polydispersity index, and zeta potential of SRF-SLNs were 77.16nm, 0.28, and - 18.1mV, respectively. The results of the stability test showed that SRF-SLNs remained stable for more than 1month at room temperature. After oral administration to rats (7.5mg/kg), the liver-targeting evaluation results showed that the average drug selectivity index value of SRF-SLNs was 2.20 times higher, than that of the SRF-suspension. Furthermore, the area under the concentration-time curve of SRF increased by 66.7% in the SRF-SLN group comparing with that in the SRF-suspension. Our results suggested that SLNs were a promising approach for the oral delivery of SRF.

One Step Surgery for Cutaneous Melanoma: "We Cannot Solve Our Problems with the Same Thinking We Used When We Created Them?"

One step melanoma surgery is, in fact, an innovative combined method for diagnosis and treatment of cutaneous melanoma (at the same time). The methodology allows an accurate assessment of the actual status of the affected patients by 1) clinical status, dermatoscopy, high-frequent ultrasonography (HFUS) of the pigmented lesion (eventually in combination with normal lymph nodes ultrasonography), followed by a single surgical intervention. Within this intervention, the primary tumour is removed with the appropriate surgical field, with or without parallel detection and draining lymph node biopsy (depending on the established tumour thickness). Removal of the lymph node may, in turn, be associated with or without locoregional lymphadenectomy, which is determined by its macroscopic appearance, established intraoperatively or after the histopathological evaluation. The methodology is sparing, innovative, easy to apply, tested in its functionality and logically justified. For an unknown reason, this methodology is not applicable in melanoma treatment’s guidelines in Europe and America. In Bulgaria and France, however, there are centres and hospitals that apply the technique mentioned above with enormous results, in particular in Bulgaria, the methodology is getting more and more improved to the current moment. Based on the above, as well as on the scant experience, we may share the opinion that the current melanoma treatment’s guidelines need major corrections in their recommendations, which are not optimal for patients due to the following facts: (1) the adverse effects on patients as a result of the necessity of at least 2 surgical interventions; (2) the frequent occurrence of changes in the lymph flow after the primary excision; (3) the frequent non-obtaining of the suggested in the guidelines terms for re-excisions with or without sentinel lymph node removal; and (4) the creation of additional financial difficulties for the patients in the framework of two unneeded hospitalizations.

Comparing Two Combined Treatment Method For Clbp: Pt With Lllt and Pt With Dry Needling

Comparing Two Combined Treatment Method For Clbp: Pt With Lllt and Pt With Dry Needling

Our own method of combined treatment of acute purulent pyelonephritis: first results

The article describes the author’s method of retroperitoneoscopic decapsulation of the kidney with removal of purulent foci, sanitation and drainage of the retroperitoneal space with subsequent catheterization of the renal artery with continuous intraarterial infusion of alprostadil in combined treatment of patients with acute purulent pyelonephritis. The results of treatment of 13 patients showed high efficiency as described above. The possibility and expediency of using of described technique is shown. (For citation: Anan’ev VA, Antonov AV. Our own method of combined treatment of acute purulent pyelonephritis: first results. Urologicheskie vedomosti. 2017;7(3):34-37. doi: 10.17816/uroved7334-37).

New views on the treatment of uterine leiomyoma in women of reproductive age

Uterine leiomyoma is the most common reproductive system disease in women of fertile age, which takes the leading place in frequency among tumors of the female sexual sphere. It is diagnosed in 20–70% of women of reproductive age. The uterine leiomyoma is still often treated surgically, and is the most common cause of hysterectomies.The article examines the issues of increasing the effectiveness of treatment of uterine leiomyoma and its complications in women of reproductive age by using combined methods of conservative treatment. The results of examination and treatment of 55 patients aged 27–45 with different forms of leiomyoma are presented: intramural nodes (18–32.7%), intramuralsubserous (21–38.3%) and intramural-submucous (16–29.0%). The size of the dominant node varied from 4.5 to 12 cm. Clinical manifestations of leiomyoma was hyperpolimenorrhea (82.3%), lower abdominal pain (34.7%), frequent urination (15%). Also, 86% of women suffered from a decrease in hemoglobin in the blood.In respect of all patients, organ-preserving surgical treatment was planned in connection with the desire of women to giving birth to a child. Patients took ulipristal acetate in a continuous regimen of 5 mg per day and indole-3-carbinol with epigallocatechin-3-gallate 1 tablet 2 times a day for 12 weeks. Women with anemia concurrently with this basic therapy took iron preparations inside.43 (78.3%) women had amenorrhea since the beginning of treatment within a month. The mean decrease in the size of the uterus was 40.7%. After the end of treatment, 49 (89.0%) patients successfully underwent conservative myomectomy, and in 6 (11.0%) patients after the termination of treatment surgical intervention was avoided. During the year after the termination of the course of treatment 13 women became pregnant.In using the combination therapy with ulipristal acetate in combination with indole-3-carbinol and epigallocatechin-3-gallate for 3 months the hemoglobin level was normalized, and the size of the leiomyoma was decreased, which is important for the safe operation. This therapy is a method of choice for the treatment of young women, who intend to exercise their reproductive function.