ABSTRACT
A review of literature presents up-to-date information on the prevalence, incidence, clinical manifestations, diagnosis, and classification of malignant primary skull base tumors (MPSBTs). In the structure of total cancer incidence, malignant head and neck tumors account for 5% of all annual cancer deaths in the USA and are among the 5 most common groups of tumors in males worldwide. These tumors develop most often in the sixth decade of life, occurring 2 times more often in males than in females. In Russia, the MPSBT incidence (as of 2012) was 0.62% out of all newly diagnosed malignant tumors. The incidence rate amounts to 0.66 per 100 000 population and is significantly higher than the global rate (0.44 per 100 000). About half of all malignant skull base tumors have the epithelial nature and affect the anterior parts of the skull base. The most frequent histological types of malignant skull base tumors are squamous cell carcinoma, adenocarcinoma, and non-Hodgkin's B cell lymphoma. Treatment of skull base tumors is an interdisciplinary problem and the area of interest of otolaryngologists, dentists, ophthalmologists, neurosurgeons, plastic surgeons, radiologists, and chemotherapists. Physical and endoscopic examinations, endoscopic transnasal biopsy, CT, MRI, PET/CT, and ultrasound are typically used for verification of the diagnosis, tumor staging, and selection of the treatment approach. The review describes the criteria for TNM staging of malignant tumors of the nasal cavity and paranasal sinuses in accordance with the 7th version of the TNM recommendations of the American Joint Committee on Cancer (AJCC). The TNM-based staging depends on the location (maxillary sinus, nasal cavity, or ethmoid labyrinth) and histological structure of the tumor, which, in turn, determines the tactics of comprehensive treatment and a prognosis group.
Subject(s)
Skull Base Neoplasms , Humans , Skull Base Neoplasms/classification , Skull Base Neoplasms/diagnosis , Skull Base Neoplasms/epidemiology , Skull Base Neoplasms/pathologyABSTRACT
Chronic recurrent inflammatory diseases of the small pelvis are known to be responsible for the development of the adhesive process and infertility. Therefore, they require surgical treatment and increase the risk of obstetric and perinatal pathology. The present study was focused on the assessment of therapeutic and prophylactic effectiveness of the application of natural and preformed physical factors for the pre-gravid preparation of the patients presenting with gynecological problems and pregnant women at high risk of obstetric and perinatal pathology based at the spa and health resort facilities of the Krasnodar Krai (region). The treatment included aero-, helio-, and thalassotherapy, transcranial electroneural stimulation, UHF therapy, hydrogen sulfide or iodine-bromine therapy. A total of 267 women were included in the study. Pregnancy was documented in 52% of the 144 patients who comprised the main group and underwent a course of rehabilitative treatment; it developed within 3-5 months after therapeutic and prophylactic laparoscopic procedures. The frequency of obstetric and perinatal pathology in this group significantly decreased in comparison with that among the control patients which allowed to greatly reduce material and financial expenditures.
Subject(s)
Balneology/methods , Health Resorts , Physical Therapy Modalities , Pregnancy Complications/prevention & control , Adult , Balneology/economics , Female , Humans , Pregnancy , Pregnancy Complications/physiopathologyABSTRACT
This paper reports the results of analysis of the psycho-emotional status and pain syndrome in the women presenting with endometriosis of external genitalia treated with a combination of hormonal preparations and balneotherapy. A total of 216 infertile patients were involved in the study. The duration of the infertility period varied from 1.5 to 19 years. All the patients underwent surgical intervention. The influence of rehabilitative therapy on the quantitative vital indices (psycho-emotional adaptation to the social environment and pain intensity) was estimated before and after the treatment. The patients were divided into 3 groups. Those of group 1 received an oral contraceptive (30 mcg of ethinylestradiol plus 2 mg dienogest) as a continuous three-cycle course (63 tablets) followed by its discontinuation for the 7 day menstrual period and the final three-cycle course (total duration of therapy 6 months). The patients of group 2 were treated with injections of agonists of gonadotropin releasing hormone (GnRH) at a dose of 3.75 mg once every 4 weeks (total duration 6 months). In group 3, the injections of GnRH agonists (3.75 mg once every 4 weeks, total duration 6 months) were combined with a course of balneotherapy using radon. All the three rehabilitative modalities produced a well-apparent positive effect. Chronic pelvic pain before treatment was reported by 90,3% of the patients. After the treatment, the number of such women in groups 1, 2, and 3 decreased to 20,8%, 12,5%, and 30,6% respectively Dyspareunia in the pre-treatment period was diagnosed in 66,7% of the patients. After treatment, this pathology persisted only in 23,6%, 18,1%, and 31,9% of the patients in groups 1, 2, and 3 respectively. Psycho-emotional disorders before treatment were documented in 90,3% of the patients compared with 27,8%, 25%, and 30,6% after therapy. It is concluded that all the three therapeutic modalities markedly improved health conditions of the patients presenting with endometriosis of external genitalia, but the combination of GnRH agonists with radon therapy produced the most pronounced clinical effect.
Subject(s)
Balneology/methods , Contraceptives, Oral, Hormonal/administration & dosage , Endometriosis/rehabilitation , Ethinyl Estradiol/administration & dosage , Gonadotropin-Releasing Hormone/therapeutic use , Hormone Replacement Therapy/methods , Infertility, Female/rehabilitation , Adult , Endometriosis/physiopathology , Endometriosis/psychology , Female , Humans , Infertility, Female/physiopathology , Infertility, Female/psychology , Time FactorsABSTRACT
The authors report the results of the study on the hormonal and psychovegetative status, functional activity of the vegetative nervous system, the level of activity of the protective and adaptive hemostatic mechanisms, and the clinical features of concomitant extragenital pathology in 90 adolescent girls suffering uterine bleeding. All the patients had gone through in-patient and out-patient phases of therapy, sixty of them were selected for the spa and resort rehabilitative treatment. The use of rehabilitative technologies on an individual basis at a spa and resort facility made it possible to ensure rather high efficacy of the combined therapeutic and preventive treatment of reproductive system pathology and concomitant psycho-vegetative disorders. It helped to decrease the frequency of relapses of uterine bleeding and exacerbation of the accompanying extragenital diseases.
Subject(s)
Autonomic Nervous System/physiopathology , Balneology/methods , Health Resorts , Hormones , Uterine Hemorrhage/psychology , Uterine Hemorrhage/therapy , Adaptation, Physiological , Adolescent , Autonomic Nervous System/metabolism , Combined Modality Therapy , Emotions , Ethinyl Estradiol/administration & dosage , Ethinyl Estradiol/therapeutic use , Female , Hormones/metabolism , Humans , Progesterone/administration & dosage , Progesterone/therapeutic use , Russia , Treatment Outcome , Uterine Hemorrhage/metabolism , Uterine Hemorrhage/physiopathologyABSTRACT
AIMS: To determine the occurrence of the human pathogen, Vibrio vulnificus, in south Texas coastal waters. METHODS AND RESULTS: Coastal waters were sampled monthly between August 2006 and July 2007. Water temperature, dissolved oxygen, pH, salinity, conductivity and turbidity were measured during each sampling event. Culture-based techniques utilizing Vibrio vulnificus agar (VVA) and membrane-Enterococcus indoxyl-beta-D-glucoside agar (mEI) were used to assess the occurrence and levels of V. vulnificus and the faecal contamination indicator group, enterococci, respectively. Vibrio vulnificus isolates were confirmed using colony-blot hybridization with the species-specific VVAP probe. Vibrio vulnificus was isolated at all sites throughout the year even when the water temperature dropped to 9.71 degrees C. Significant correlations were found between concentrations of V. vulnificus and the abiotic factors, water temperature (P = 0.002) and dissolved oxygen (P = 0.028), as well as between concentrations of V. vulnificus and enterococci (P < 0.001). CONCLUSIONS: This study demonstrated the year-round presence of V. vulnificus in coastal waters of south Texas. SIGNIFICANCE AND IMPACT OF THE STUDY: These findings indicate that the potential for human exposure to the pathogen, V. vulnificus, exists throughout the year. It also suggests that routinely monitored data might be used to predict the occurrence of the pathogen.