RESUMEN
The number of victims with damage to the great vessels has increased in recent years due to escalation of armed conflicts. Vascular damages comprise 3% of traumatic injuries in peacetime, and their incidence increases to 15% during hostilities. False aneurysms and traumatic arteriovenous fistulas follow vascular injury in 48.9-68.7% of cases. We present open surgical treatment of traumatic arteriovenous fistulas. The issues of diagnosis, surgical tactics, algorithm of intervention and options for successful treatment are described.
Asunto(s)
Fístula Arteriovenosa , Procedimientos Quirúrgicos Vasculares , Lesiones del Sistema Vascular , Humanos , Fístula Arteriovenosa/cirugía , Fístula Arteriovenosa/etiología , Fístula Arteriovenosa/diagnóstico , Lesiones del Sistema Vascular/cirugía , Lesiones del Sistema Vascular/diagnóstico , Lesiones del Sistema Vascular/etiología , Procedimientos Quirúrgicos Vasculares/métodos , Masculino , Resultado del Tratamiento , Adulto , Extremidades/irrigación sanguínea , Extremidades/lesionesRESUMEN
The aim of this study was to identify variants of retroperitoneal vascular structure during systematic paraaortic lymphadenectomy in patients with early-stage cervical cancer and to investigate the effects of these anomalies in surgical procedures. 79 patients who had undergone systematic paraaortic and bilateral pelvic lymph node dissection between 2006 and 2013 were included. Normal architecture and structural anomalies of inferior vena cava, renal arteries and veins, common iliac vein and ovarian vessels were studied. Variants of major retroperitoneal vascular structure were present in 10 patients (12.7%). Variants of renal vessels were identified in 8 patients (10.1%): supernumerary renal arteries and veins observed in 5 patients (6.3%); retroaortic left renal vein type I and II - in 3 patients (3.8%). A rare variant as double vena cava inferior was detected in 1 patient (1.3%). Vessel injury was present no one case in patients with variants of vascular structures and in 1 of 69 (1.4%) patients without variants of retroperitoneal vascular structure. There was no difference in intraoperative hemorrhage, transfusion red blood cell and rate of intraoperative hemoglobin between the groups. Thus the acquisition of knowledge and visualization of vascular variations decrease complications during systematic paraaortic and bilateral pelvic lymphadenectomy.
Asunto(s)
Escisión del Ganglio Linfático , Espacio Retroperitoneal/irrigación sanguínea , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/cirugía , Adulto , Aorta , Femenino , Humanos , Vena Ilíaca/anomalías , Ganglios Linfáticos/patología , Ganglios Linfáticos/cirugía , Persona de Mediana Edad , Estadificación de Neoplasias , Ovario/irrigación sanguínea , Pelvis , Arteria Renal/anomalías , Venas Renales/anomalías , Vena Cava Inferior/anomalíasRESUMEN
We report a case of a 35-year-old, non-HIV-infected male diagnosed simultaneously with a disseminated form of Kaposi's sarcoma (KS; skin, stomach and colon are involved) and Hodgkin's lymphoma. There is no sign of changes in the immune status, but three herpes viruses were detected in the patient's blood (EBV, HHV6 and HHV8). He received ABVD chemotherapy and achieved complete metabolic remission for Hodgkin's lymphoma. Moreover, the signs of the disseminated KS were resolved. Our observations indicate that a combination of distinct types of viruses may play an important role in triggering the development of angio- and lymphoproliferative disorders in the same person. In addition, treatment with chemotherapy cycles, which included doxorubicin and vinblastine, led to the stable remission of both diseases.
RESUMEN
Autopsy records, case histories, and archival organ and tissue samples were studied in 109 Soviet military men during the Afghanistan war, who had died of typhoid fever in 1980-1986. Morphological and statistical studies demonstrated that the current pattern and frequency of complications and immediate causes of death with the epidemic incidence in the endemic focus largely corresponded to those in the preantibiotic period. The specific features were the higher rate and early development of enteric complications, infectious myocarditis, and infectious-toxic shock, the higher, as compared with the past years, proportion of deaths from circulatory diseases and a reduction of cases of total intoxication. Acute cardiovascular insufficiency associated with infectious myocarditis and infectious-toxic shock was one of the main causes of death in the first 2 weeks of typhoid fever. Most patients died of perforative peritonitis and pneumonia in the later period.
Asunto(s)
Miocarditis/mortalidad , Miocarditis/patología , Choque Séptico/mortalidad , Choque Séptico/patología , Fiebre Tifoidea/mortalidad , Fiebre Tifoidea/patología , Adolescente , Adulto , Afganistán , Humanos , Masculino , Miocarditis/etiología , Estudios Retrospectivos , Choque Séptico/etiología , Fiebre Tifoidea/complicaciones , GuerraRESUMEN
Archives specimens of the heart, autopsy protocols and disease histories of 16 soldiers and officers of Soviet army who died in Afghanistan of typhoid fever were studied. It is concluded on the basis of morphology and statistics that interstitial myocarditis and sometimes pancarditis develop on the 2nd week of the basic disease. Characteristic features of typhoid fever myocarditis are inflammation of the heart intramural vessels, microcirculatory disturbances, edema and lymphocytic-macrophogeal infiltration of the stroma, sometimes with formation of granulomas, dystrophic and necrotic changes of cardiomyocytes.
Asunto(s)
Personal Militar , Miocarditis/patología , Fiebre Tifoidea/complicaciones , Adolescente , Adulto , Humanos , Masculino , Miocarditis/etiologíaRESUMEN
The article explains the development of toxic infective myocarditis and, in many cases, pancarditis, in patients with severe typhoid fever (TF) with lethal outcome. The authors present the most frequently found symptoms and ECG signs, the main histological features and possibilities of clinical diagnostics of myocarditis. The latter is of special importance, because a significant number of patients do not have typical clinical presentation. The work is based on the data from 109 autopsy records and 42 case histories as well as the results of morphological study of the heart in archive samples received from 47 military men who died of TF.
Asunto(s)
Miocarditis/etiología , Fiebre Tifoidea/complicaciones , Adolescente , Adulto , Afganistán , Electrocardiografía , Resultado Fatal , Humanos , Masculino , Personal Militar , Miocarditis/patología , Miocarditis/fisiopatología , Miocardio/patología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Fiebre Tifoidea/patología , Fiebre Tifoidea/fisiopatologíaRESUMEN
The article is based on the results of studies of protocols of 65 autopsies, 42 medical histories and morphological studies of contemporary records of 47 hearts of the deceased servicemen from the Soviet troops in Afghanistan who died of typhoid. It was found out that myocarditis was developed in 61.9 7.3% of cases regardless of the existence and character of complications. The inalienable features of myocarditis were inflammatory changes (vasculitis, basically mononuclear infiltration of stroma, granulomas), vascular malfunctions (microcirculatory disorders, enhanced permeability of vessels, edema of stroma), dystrophic and necrotic changes in cardiomyocytes. Vasculitis had predominant significance in cardiac morphogenesis. Besides myocardium the inflammatory process had proliferated also on epicardium and mural endocardium, i.e. pancarditis.
Asunto(s)
Personal Militar , Miocardio/patología , Fiebre Tifoidea/patología , Guerra , Adolescente , Adulto , Afganistán , Autopsia , Humanos , Masculino , Miocarditis/etiología , Miocarditis/patología , Fiebre Tifoidea/complicaciones , U.R.S.S.RESUMEN
For comparative evaluation of patient life quality we selected 3 groups depending on methods of surgical treatment of prostate benign hyperplasia. The groups of comparison included the patients who underwent prostate transurethral resection (n = 36), postpubic extravesical adenomectomy (n = 31) and transvesical adenomectomy (n = 35). It was established that informative clinical indices in evaluation of life quality were urination maximal rate, time of urination delay, urination time. Informative psychodiagnostical methods for evaluation of life quality in patients with benign hyperplasia of prostate are "MCF scale", "Asthenia scale", Test for differential self-appraisal of functional state, "Scale of reactive and personal anxiety", "Risk of coronary behavior" and Izenk's questionnaire. Total algorithm was developed permitting to predict the patient life quality with rather high accuracy.
Asunto(s)
Miocarditis/diagnóstico , Miocarditis/microbiología , Biomarcadores/sangre , Biopsia , Cardiomiopatía Dilatada/diagnóstico , Cardiomiopatía Dilatada/microbiología , Cardiomiopatía Dilatada/patología , Cardiomiopatía Dilatada/fisiopatología , Diagnóstico Diferencial , Electrocardiografía , Humanos , Miocarditis/patología , Miocarditis/fisiopatología , Miocardio/patología , NecrosisRESUMEN
The article analyses the 65 lethal cases by typhoid in the period 1980-1986 during an outbreak of infection among the servicemen of the 40-th Army. All the deceased had the age of 18-37, 79.8% of them were 18-20 years old. The most frequent complications were: myocarditis (84.6%), pneumonia (75.4%), hemorrhagic syndrome (50.8%), intestinal perforation (49.2%), intestinal ulcer hemorrhage (21.5%), pleuritis (20.0%), purulent complications (11.7%), endotoxic shock (12.3%). The structure of proximate causes of death was as following: perforative peritonitis (30.8%), pneumonia (20.0%), acute heart failure (13.8%), intestinal ulcer hemorrhage (12.3%), suprarenal hemorrhage (7.7%). The results obtained during this study prove the fact that this outbreak of epidemic infection had the features of classical typhoid.