Effectiveness Of Treatment Research Articles

Comparative Effectiveness of In-Person and Virtual Picture-Naming Treatment for Poststroke Anomia

Purpose: In light of COVID-19, telepractice for speech therapy has been increasingly adopted. Telepractice promotes accessibility to therapy services for those in rural environments, lowers the frequency of missed appointments, and reduces the costs of rehabilitation. The efficacy of telepractice has been scarcely explored in the aphasia literature. Preliminary research has demonstrated comparable results of telepractice and in-person therapy for people with aphasia, but the current scope of research is insufficient to guide clinical practice. The present study examined whether the virtual administration of a picture-naming therapy paradigm was as effective as in-person administration. Method: The treatment effects of two similar clinical trials, one completed in-person ( n = 13) and one completed virtually ( n = 13), are compared. Participants were adults with chronic (> 6 months) poststroke aphasia. Both clinical trials administered Cued Picture-Naming Therapy 4 days a week for 2 weeks (eight treatment sessions). Treatment outcomes were analyzed using Tau- U effect sizes and Mann–Whitney U tests. Results: Weighted Tau- U averages showed an advantage of telepractice over in-person treatment in the acquisition effects of trained words, with participants demonstrating a very large effect (0.84, p < .01) following telepractice and a large effect (0.75, p < .01) following in-person treatment. Both telepractice and in-person rehabilitation demonstrated significant treatment effects and were not significantly different from each other per Mann–Whitney U independent-samples t tests. Conclusions: The present study demonstrated that telepractice of a picture-naming paradigm is as effective as in-person treatment administration. This justifies the use of telepractice to overcome accessibility and cost barriers to speech therapy administration and justifies taking patient preference into account. Future research should explore the efficacy of telepractice for treatments that promote greater generalizability to functional communication. Supplemental Material: https://doi.org/10.23641/asha.27641031

Nonfacial Skin Rejuvenation of the Neck, Chest, and Hands. Part Two: Using Laser Techniques.

Interest in aesthetic procedures that help maintain a youthful look is on the rise. While many nonsurgical techniques focus on facial rejuvenation, there is a need for a detailed review of treatments, specifically for nonfacial areas. This review explores various clinic-based methods for revitalizing the neck, chest, and hands, with a particular emphasis on different laser treatments. For this second part of the review, we conducted a comprehensive search on PubMed to evaluate the effectiveness of various laser treatments. The review covers treatment parameters such as wavelength, fluence, and pulse, along with outcomes, follow-up care, and potential side effects. A discussion on the role of sclerotherapy in treating these areas was also included. This article compiles recent findings on the safety and effectiveness of these treatments, showcasing progress in laser technologies and the growing trend of noninvasive body rejuvenation. It offers practical insights for both practitioners and patients looking for reliable options in nonsurgical body treatments.

Subclinical Congestion Evaluated by Point of Care Ultrasound (POCUS) at Discharge Predicts Readmission in Patients with Acute Heart Failure: Prognostic Cohort Study

Background: Heart failure (HF) is a complex entity that increases the risk of adverse outcomes. Point of care ultrasound (POCUS) allows easy lung and systemic venous congestion identification. Using ultrasound to detect sub-clinical congestion at discharge may help predict readmissions and mortality. Outcomes: The primary outcome was to address 30-day rehospitalization, and as a secondary outcome we investigated readmission and mortality in patients with residual congestion assessed with POCUS. Methods: A prospective prognostic cohort study was conducted at a tertiary-level institution in Colombia. Patients with acute decompensated heart failure (ADHF) at discharge were evaluated using POCUS through lung ultrasound (LUS), portal vein pulsatility (PVP), and a composite assessment of residual congestion. Inclusion criteria were ADHF, over 18 years old, with a “warm-wet” clinical profile. POCUS was performed using an ultraportable device using LUS and PVP. Statistical analysis used logistic regression models to estimate the association between ultrasound congestion and outcomes. Results: A total of 100 patients were included. The population was mostly female, with a median age of 78 years; 59% were hypertensive, and 39% had type 2 diabetes. Median NT-ProBNP was 3878 pg/ml. At discharge, 55% of patient had an inferior vena cava (IVC) over 2 cm, 54% had interstitial syndrome, and 41% had PVP >30%. Regarding 30-day readmission, we found an odds ratio (OR) 7.22 (95% CI 2.7-19.3) for interstitial syndrome; for PVP >30%, an OR 24.61 (95% CI 7.7-78.1) and an OR 13.19 (95% CI 2.7-62.6) for composite of residual congestion. Conclusion: Patients with ADHF and sub-clinical congestion, evidenced in LUS and PVP, were more likely to have readmission within 30 days of discharge. These findings should be confirmed with clinical trials to assess the effectiveness of a POCUS-guided treatment.

Harnessing the power of targeted metal nanocarriers mediated photodynamic and photothermal therapy.

The treatment of cancer has become a profoundly intricate procedure. Traditional treatment methods, including chemotherapy, surgery and radiotherapy, have been utilized, while notable progress has been achieved in recent years. Among targeted therapies for cancer, folic acid (FA) conjugated metal-based nanoparticles (NP) have emerged as an innovative strategy, namely for photodynamic therapy (PDT) and photothermal therapy (PTT). These NP exploit the strong attraction between FA and folate receptors, which are excessively produced in several cancer cells, in order to enable precise administration and improved effectiveness of treatment. During PDT, metal-based NP functionalized with FA are used as photosensitizers which are activated by light, and produce reactive oxygen species that cause cancer cells to undergo apoptosis. Within the framework of PTT, these NP effectively transform light energy into concentrated heat, specifically targeting and destroying tumor cells. This review examines the fundamental mechanisms by which these NP improve the effectiveness of PDT and PTT while simultaneously presenting important findings that demonstrate the effectiveness of FA-functionalized MNP in laboratory and animal models. In addition, the paper also discusses the problems and potential directions for their clinical translation.

Enhancing the drug addiction treatment service by introducing a new residential treatment model in the Philippines: A qualitative study.

There is an increased demand for quality treatment and rehabilitation services for people who use drugs (PWUDs) in the Philippines. In response, the Philippines Government's Department of Health (DOH) has established a new residential treatment model, Intensive Treatment and Rehabilitation Program for Residential Treatment and Rehabilitation Centers (INTREPRET), and integrated it into the existing treatment service platform of 21 DOH-owned Treatment and Rehabilitation Centers (TRCs). We conducted a qualitative study to identify the changes engendered by the implementation of this treatment model. Data were collected through individual face-to-face interviews. We interviewed purposefully selected 29 patients and 35 facilitators of INTREPRET group sessions in seven TRCs. We transcribed the interview records and organized the narrative information into key themes using thematic analysis during the coding process. The changes perceived by the study participants included the attitude and behavior of patients, attitude and competency of facilitators, relationship between facilitators and patients, treatment planning and review process, efficient and standardized treatment services, and monitoring mechanisms of the patient's recovery process. Participants also noted challenges in INTREPRET implementation, including family participation in therapy sessions, lack of facilitators, securing a conducive place for conducting sessions, and reproducing workbooks. The results imply that the introduction of INTREPRET could improve treatment service quality and the effectiveness of treatment, which were primarily associated with behavioral changes in patients, improved relationship between patients and facilitators, and INTREPRET's alignment with key international treatment standards. However, despite the positive changes perceived by the participants, certain challenges pertaining to family participation in therapy sessions and the lack of resources were identified. These criticisms must be addressed by DOH, along with an integration of INTREPRET into its policy and strategic framework, to ensure the effectiveness and sustainability of the new treatment model.

A screen-and-treat strategy for eradication of Helicobacter pylori among patients with family history of gastric cancer in a diverse U.S. population.

Screening and eradication of Helicobacter pylori (H. pylori) reduce the risk of gastric cancer in patients with family history. We assessed patient perspectives on H. pylori screening and treatment within a diverse regional U.S. Between July and August 2022, we conducted a cross-sectional study among patients with ≥1 first-degree relative with gastric cancer. Eligible patients were between 18-75 years of age without history of H. pylori infection or gastric cancer. A survey assessed interest in testing and willingness to complete treatment for H. pylori. Interested patients were offered H. pylori testing and treatment. We examined interest and effectiveness of treatment by race and ethnicity. We identified 15,255 eligible patients and 1,500 patients were randomly selected for the survey; 280 (19%) patients, including 2 relatives not initially invited but asked to participate, responded following outreach. Respondents were 65% male and averaged 57 years (SD=13) with 36% Hispanic, 36% non-Hispanic White, 15% Asian/Pacific Islander, 9% non-Hispanic Black. Overall, 223 (80%) were interested in H. pylori screening; of these, 89% would take antibiotics as prescribed. Willingness to screen was consistent across racial and ethnic groups. Among 223 respondents interested in screening, 128 (57%) completed testing with 15 screen-detected cases; all 15 completed treatment and 11 had confirmed eradication. Patients with family history of gastric cancer had a high level of interest in H. pylori screening and successful eradication when detected. A screen-and-treat strategy for H. pylori may be considered for patients with family history of gastric cancer.

De novo strategy of organic semiconducting polymer brushes for NIR-II light-triggered carbon monoxide release to boost deep-tissue cancer phototheranostics.

The integration of photoacoustic imaging (PAI) and photothermal therapy (PTT) within the second near-infrared (NIR-II) window, offering a combination of high-resolution imaging and precise non-invasive thermal ablation, presents an attractive opportunity for cancer treatment. Despite the significant promise, the development of this noninvasive phototheranostic nanomedicines encounters challenges that stem from tumor thermotolerance and limited therapeutic efficacy. In this contribution, we designed an amphiphilic semiconducting polymer brush (SPB) featuring a thermosensitive carbon monoxide (CO) donor (TDF-CO) for NIR-II PAI-assisted gas-augmented deep-tissue tumor PTT. TDF-CO nanoparticles (NPs) exhibited a powerful photothermal conversion efficiency (43.1%) and the capacity to trigger CO release after NIR-II photoirradiation. Notably, the liberated CO not only acts on mitochondria, leading to mitochondrial dysfunction and promoting cellular apoptosis but also hinders the overexpression of heat shock proteins (HSPs), enhancing the tumor's thermosensitivity to PTT. This dual action accelerates cellular thermal ablation, achieving a gas-augmented synergistic therapeutic effect in cancer treatment. Intravenous administration of TDF-CO NPs in 4T1 tumor-bearing mice demonstrated bright PAI signals and remarkable tumor ablation under 1064nm laser irradiation, underscoring the potential of CO-mediated photothermal/gas synergistic therapy. We envision this tailor-made multifunctional NIR-II light-triggered SPB provides a feasible approach to amplify the performance of PTT for advancing future cancer phototheranostics.

Nanoplatform-based synergistic cancer Immuno-Chemodynamic therapy.

Immunotherapy has made excellent breakthroughs in the field of cancer treatments, but faces challenges with low immunogenicity of tumor cells and an immunosuppressive tumor microenvironment (ITME). The emerging chemodynamic therapy (CDT) based on the Fenton/Fenton-like reaction can induce immunogenic cell death (ICD) to enhance tumor immunogenicity, facilitating the transition from immune-cold to immune-hot tumors. Synergistic CDT and immunotherapy based on advanced nanotechnology have shown immense promise for improving therapeutic efficacy while minimizing side effects in cancer treatment. This review summarizes and discusses recent advances in the field, with the goal of designing a high-quality nanoplatform to enhance synergistic CDT in combination with immunotherapy and lay the foundation for its future clinical translation.

Factors Affecting Appearance after Thumb Polydactyly Reconstruction - A Caregiver's Perspective in an Asian Population.

Background: Current research on thumb polydactyly reconstruction focusses primarily on clinical evaluations. Details on aesthetic outcomes are relatively lacking. This study aims to address this gap by: (1) investigating the effectiveness of surgical treatment in achieving symmetrical thumb size, length and girth; (2) assessing aesthetic outcomes from a caregiver's perspective and (3) identifying key factors that influence aesthetic outcomes to inform strategies to improve surgical reconstruction. Methods: Patients who underwent thumb polydactyly reconstruction were recalled for assessment. Objective measurements of both the reconstructed and unaffected thumbs were taken. Surgical scars were evaluated by measuring their length and using the Vancouver Scar Scale (VSS). To assess the appearance of the reconstructed thumbs, we used the Visual Analogue Scale (VAS) through surveys completed by the primary caregiver of each patient. Caregivers also provided reasons for any unsatisfactory appearance outcomes and we correlated these with objective factors. Results: This study included 26 paediatric patients with 29 reconstructed thumbs. The mean VAS score for overall thumb appearance was 7.8 ± 2.2. While surgical treatment achieved symmetry in most anthropometric measures, reconstructed thumbs had smaller nail plates and greater joint angulation. Caregiver assessment of thumb width was closely related to the objective interphalangeal joint (IPJ) girth measurements, and perceived excessive angulation was related to the IPJ angle. Symmetry was not associated with nail fold width or scar location. However, perceived scar prominence was linked to VSS score and scar location. Conclusions: Thumb polydactyly reconstruction achieves symmetry in size, length and girth, but nail plate size and joint angulation remain significant challenges. Despite this, caregivers are generally satisfied with the overall appearance. Attention should be focussed on improving thumb IPJ girth, IPJ angulation and scar location to enhance overall aesthetic outcomes. Level of Evidence: Level IV (Therapeutic).

Light-Activable Inhibitor Overcomes Antimicrobial Resistance and Regulates Antibacterial Activity.

Overuse of antibiotics and the widespread environmental accumulation of antibiotics drive the evolution and spread of antimicrobial resistance, posing a significant global health threat by reducing the effectiveness of available treatments and increasing the risk of untreatable infections. We designed and synthesized PhoPS, a novel photocaged β-lactamase inhibitor, which incorporates the pharmacophore of sulbactam caged with a photoresponsive moiety of o-nitrobiphenyl derivative. Experimental results demonstrate its rapid photoactivation, good stability in solution, and light-activated β-lactamase inhibition in vitro. PhoPS displays synergy with a cephalosporin antibiotic cefoperazone against both susceptible and resistant strains of Escherichia coli and biofilm formation. Additionally, PhoPS treatment demonstrates the potential to suppress the development of resistance in E. coli. These findings suggest that PhoPS offers a promising approach for restoring the efficacy of existing antibiotics and mitigating the emergence of AMR.

An antimicrobial drug recommender system using MALDI-TOF MS and dual-branch neural networks.

Timely and effective use of antimicrobial drugs can improve patient outcomes, as well as help safeguard against resistance development. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is currently routinely used in clinical diagnostics for rapid species identification. Mining additional data from said spectra in the form of antimicrobial resistance (AMR) profiles is, therefore, highly promising. Such AMR profiles could serve as a drop-in solution for drastically improving treatment efficiency, effectiveness, and costs. This study endeavors to develop the first machine learning models capable of predicting AMR profiles for the whole repertoire of species and drugs encountered in clinical microbiology. The resulting models can be interpreted as drug recommender systems for infectious diseases. We find that our dual-branch method delivers considerably higher performance compared to previous approaches. In addition, experiments show that the models can be efficiently fine-tuned to data from other clinical laboratories. MALDI-TOF-based AMR recommender systems can, hence, greatly extend the value of MALDI-TOF MS for clinical diagnostics. All code supporting this study is distributed on PyPI and is packaged at https://github.com/gdewael/maldi-nn.

Systematic Review of Deep Learning Techniques in Skin Cancer Detection

Skin cancer is a serious health condition, as it can locally evolve into disfiguring states or metastasize to different tissues. Early detection of this disease is critical because it increases the effectiveness of treatment, which contributes to improved patient prognosis and reduced healthcare costs. Visual assessment and histopathological examination are the gold standards for diagnosing these types of lesions. Nevertheless, these processes are strongly dependent on dermatologists’ experience, with excision advised only when cancer is suspected by a physician. Multiple approaches have surfed over the last few years, particularly those based on deep learning (DL) strategies, with the goal of assisting medical professionals in the diagnosis process and ultimately diminishing diagnostic uncertainty. This systematic review focused on the analysis of relevant studies based on DL applications for skin cancer diagnosis. The qualitative assessment included 164 records relevant to the topic. The AlexNet, ResNet-50, VGG-16, and GoogLeNet architectures are considered the top choices for obtaining the best classification results, and multiclassification approaches are the current trend. Public databases are considered key elements in this area and should be maintained and improved to facilitate scientific research.

PANoptosis: A new era for anti-cancer strategies.

Cancer cells possess an extraordinary ability to dodge cell death through various pathways, granting them a form of immortality-a key obstacle in oncotherapy. Thus, it's vital to unravel the intricate mechanisms behind newly discovered types of cell death that drive tumor suppression, going beyond apoptosis alone. The emergence of PANoptosis, a form of cell death intertwining necroptosis, pyroptosis, and apoptosis, offers a fresh perspective, integrating these pathways into one cohesive process. When cells detect damage signals, they assemble PANoptosome complexes that disrupt their balance, trigger immune responses, and lead to their eventual collapse. PANoptosis has been associated with multiple cellular pathways, including ferroptosis. Mitochondrial dysfunction also plays a critical role in sparking and advancing PANoptosis. In this review, we map out the molecular machinery and regulatory web controlling PANoptosis. We explore cutting-edge research and future trends in PANoptosis-centered tumor therapies, spotlighting promising innovations that could amplify cancer treatment effectiveness through harnessing this multifaceted cell death pathway. The development of nanomedicines and nanomaterials provides solutions to the therapeutic challenges of clinical drugs. Developing novel tumor nano-PANoptosis inducers by leveraging the advantages of nanomedicine is of research value. Traditional Chinese medicine (TCM) treatment is characterized by multiple targets, and it has distinct advantages in triggering PANoptosis through multiple pathways. Additionally, photodynamic Therapy (PDT) may offer new insights into promoting PANoptosis in tumor cells by increasing oxidative stress and reactive oxygen species levels. These will establish a solid theoretical groundwork for the development of integrated treatment methodologies.

Clinical impact of customised positive airway pressure (PAP) therapy interfaces versus usual care in the treatment of patients with sleep-disordered breathing (3DPiPPIn): a randomised controlled trial protocol

IntroductionSleep-disordered breathing affects 1.6 million people in the UK. The recognised treatment is positive airway pressure (PAP) therapy, delivered via a generic conventional interface (mask). PAP therapy improves morbidity, mortality...

Iron Sucrose versus Ferric Carboxymaltose: Effectiveness in Treatment of Postpartum Anaemia following Caesarian Section

Background: Postpartum anemia is a leading cause of maternal mortality and morbidity throughout the world, particularly in developing countries.The most common causes of postpartum anemia are antepartum iron deficiency anemia and blood loss during childbirth. Treatment of anemia with ferric carboxymaltose during labor can considerably reduce maternal and newborn morbidity. The aim of the study is to compare the effectiveness of iron sucrose and ferric carboxymaltose in the treatment of postpartum anaemia following caesarian section. Materials and methods: A comparative cross-sectional study was carried out among the 234 outdoor patients of the Department of Obstetrics and Gynecology at Sheikh Hasina Medical College Hospital, Tangail during the period from July 2017 to June 2020. Results: The pre-transfusion mean of hemoglobin level was 8.9±0.5 gm/dl and the post-transfusion mean of hemoglobin level was 10.4±0.4 gm/dl in group A. The pre-transfusion mean of hemoglobin level was 8.7±0.7 gm/dl and the post-transfusion mean of hemoglobin level was 11.0±0.4 gm/dl in group B. The mean of increased hemoglobin level was 1.5±0.4 gm/dl and 2.3±0.5 gm/dl respectively in both groups. The pre-transfusion mean of ferritin level was 46.3±16.1 ng/mL and the post-transfusion mean of ferritin level was 171.5±25.8 ng/mLin group A. The pre-transfusion level was 46.5±16.2 ng/mL and the post-transfusion mean ferritin level was ±24.9 ng/mLin group B. The mean of increased ferritin level was 125.2±22.2 ng/mL and 149.0± 20.5 ng/mL respectively in both groups. These differences were statistically significant within the study groups (p<0.05). Conclusions: The study revealed that serum ferritin levels increased significantly in the FCC group than ISC group. Ferric carboxymaltose are more effective and safe for the treatment of iron deficiency anemia in postpartum patients. IAHS Medical Journal Vol 7(1), June 2024; 8-12

HPB SO37 - GTN Patch for Medical Relaxation of the Sphincter of Oddi: “A Safe and Effective Pre-ERCP Treatment for Controlled Bile Leak Post-Cholecystectomy"

Abstract Background Bile leak is a frequent complication following laparoscopic total, subtotal cholecystectomy, and bile duct exploration (BDE) with an incidence up to 2.8%. It can contributing significantly to postoperative morbidity and mortality. GTN has demonstrated efficacy in reducing papillary muscle contraction and Sphincter of Oddi pressure. Similarly GTN might promote healing and closure of bile leaks post total or subtotal cholecystectomy. This study aims to assess the safety and effectiveness of GTN in treating bile leaks post total, subtotal cholecystectomy or bile duct exploration. Method Data was prospectively collected from patients who developed bile leaks after total or subtotal cholecystectomy between June 2020 and June 2024. Inclusion criteria were patients with a bile leak post-surgery during this period. Exclusion criteria included unstable patients, uncontrolled bile leaks, the presence of biliary obstruction, or major bile duct injuries. Suitable patients were treated with a GTN patch as first line management before potential ERCP. A 5 mg GTN skin patch was applied every 24 hours, starting at least 48 hours post-surgery if drain output exceeded 100 ml/hour. Patients were consented about side effects including hypotension and headache. Results Seven patients were treated with GTN, with mean age of 51 years, four were females. Four cases were emergencies and four had subtotal cholecystectomies, one in the elective group. Bile leaks occurred after biloma drainage and one after removal of trans-cystic drain post trans-cystic BDE. All patients experienced significant drain output reduction the day after starting GTN. There were no complications during or after treatment. One required ERCP two months later for persistent low-volume bile leak of 5-10 ml per day. Headaches occurred in two cases, treatment was discontinued in one. The average time to GTN treatment was 3.4 days. Conclusion This study demonstrates GTN treatment's safety and effectiveness for managing bile leaks following total, subtotal cholecystectomy or BDE. We recommend GTN as the primary therapy for controlled bile leaks, barring biliary obstruction or major injury. Response can be evaluated within 24-48 hours through significant output reduction. Implementing local protocols can minimize variations in GTN treatment initiation times. GTN should be prioritized over ERCP to prevent complications like perforation, pancreatitis, and bleeding. We aim for this study to underscore GTN's efficacy to surgeons and promote multicentre research initiatives.

Application of platelet transcriptomics for assessing treatment effectiveness and predicting long-term platelet counts recovery in aplastic anemia.

Aplastic anemia (AA) is a bone marrow failure disease for which the means of assessing and predicting the therapeutic effectiveness are still relatively limited. Thrombocytopenia is often the earliest and most severe symptom in patients newly diagnosed with AA (Dx-AA). While clinical consideration is usually given to the quantitative changes in platelets during treatment, there is little focus on the resolution of the molecular characteristics of platelets in AA. To investigate the changes in platelet molecular characteristics throughout the treatment process of AA, and to explore the use of transcriptomics for monitoring and predicting treatment outcomes. We comprehensively analyzed platelet transcriptomic changes in AA patients at initial diagnosis and different stages of treatment effectiveness using bulk transcriptome sequencing. Genes associated with cell proliferation, erythroid function, and amino acid transport were elevated in Dx-AA. Conversely, genes linked to histones, thrombosis, mitochondrial energy metabolism, and signaling pathways were significantly downregulated. 60.6% of the differentially expressed genes were substantially restored following complete remission. Furthermore, through the examination of longitudinal samples, we identified recovery ascending genes (RAG) that could serve as viable biomarkers for assessing treatment effectiveness in AA. Besides, we observed that higher expression levels of RAG may predict superior long-term platelet counts recovery six months in advance in patients with partial response. The platelet transcriptome undergoes profound changes and can serve as a potential indicator for assessing treatment effectiveness and predicting long-term platelet counts recovery in AA.

Individual approach to the treatment of patients with stage III–IV laryngeal and laryngopharyngeal cancer in the Altai territory

Laryngeal and laryngopharyngeal cancer is the most common malignancy within the head and neck. Although there are many treatments for laryngeal and laryngopharyngeal cancer, the treatment still faces great challenging.The aim of the study was to evaluate the effectiveness of personalized treatment and one-year recurrence-free survival in patients with stage III–IV laryngeal and laryngopharyngeal, including postoperative complications (VTE, bleeding) within a year.Material and Methods. From July 2022 to October 2023, 100 patients with stage III–IV laryngeal and laryngopharyngeal cancer were treated in the Department of Head and Neck Tumors at the Altai Regional Oncology Center (AROC), Barnaul. There were 95 men (95 %) and 5 women (5 %). Patients were divided into two groups. Group I patients (n=50) with locally advanced laryngeal cancer underwent laryngectomy followed by radiation therapy with a total dose of 54 Gy delivered to the bed of the removed tumor and lymph node drainage region. Group II patients (n=50) received 3 courses of chemotherapy followed by radiation therapy at a dose of 70–74 Gy.Results. In group I patients, clinically insignifcant bleeding from the upper third of the trachea (in the area of contact with the tracheostomy tube) was observed in 3 patients (6.0 %) 3–4 days after surgery. No VTE during hospital stay and within 6–12 months after completion of treatment was observed. The 1-year cumulative survival rate in this group of patients was 90.0 %. In group II patients receiving chemotherapy, bleeding from a pharyngeal tumor was detected in 4 (8.0 %) patients. There were no signs of VTEO in this group. The 1-year cumulative survival rate of these patients was 70 %.Conclusion. Patients with laryngeal/laryngopharyngeal cancer require an individual approach not only in determining therapeutic strategies, but also in the prevention of VTE and hemorrhagic complications.

Use of blue laser in a patient with postop restenosis of the choana after multiple surgical interventions for congenital choanal atresia

One of the most common complications following surgical interventions in nasal cavity is synechiae and scarring, which often leads to restenosis, particularly in cases of choanal atresia. Laser technologies, especially blue laser (wavelength 445 nm), represent a promising opportunity in rhinology for addressing these complications. Objective: to study the effectiveness and safety of blue laser for nasal synechiae and stenosis surgery in patients with congenital choanal atresia after multiple surgical interventions. In ENT department of Veltishev Institute 4 children have undergone choanal reconstruction following multiple attempts of choanoplasty. A clinical case of a 6-year-old girl diagnosed with bilateral complete choanal atresia, who underwent six surgical interventions within two years and was admitted with complete choanal restenosis is presented. The most common cause of restenosis after surgery for hoan atresia is the formation of synechiae in the surgical area. Traditional dissection of the synechiae in most cases leads to repeated stenosis. To reduce the recurrence rate in the patient, the authors used a blue laser. The blue laser demonstrated high effectiveness in the surgical treatment of postop restenosis, minimizing surgical trauma, preventing recurrences, and improving the patient’s quality of life. The results confirm the feasibility of using lasers in rhinology as a preferred method for treating restenosis and enhancing respiratory function.

Algorithm of surgical treatment of resistant forms of pulmonary tuberculosis

Objective. To improve the effectiveness of surgical treatment of multidrug–resistant pulmonary tuberculosis and extensively drug–resistant pulmonary tuberculosis. Materials and Methods. The work is based on the analysis of the results of treatment of 316 patients. The sequence of actions to determine the optimal type and extent of surgical intervention is regulated. Results. An algorithm for the surgical treatment of multidrug–resistant pulmonary tuberculosis and extensively drug–resistant pulmonary tuberculosis was developed and implemented, based on the results of a study of this complex category of patients who underwent preoperative preparation, a sequence of actions for surgical intervention, and postoperative management technology, taking into account current specific therapy regimens. Conclusions. The application of the developed algorithm of surgical treatment allowed to reduce the incidence of pulmonary tuberculosis recurrence and postoperative complications from (14.4 ± 2.3) to (7.0 ± 1.3)% and cure 92.5% of patients.