• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 22
  • 14
  • 8
  • 4
  • 4
  • 2
  • 1
  • 1
  • Tagged with
  • 58
  • 58
  • 10
  • 10
  • 8
  • 8
  • 7
  • 6
  • 6
  • 6
  • 5
  • 5
  • 5
  • 5
  • 5
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
41

Lung Cancer : Epidemiological and Clinical Studies with Special Reference to Surgical Treatment

Myrdal, Gunnar January 2003 (has links)
<p>From being a rare disease in the early 1900s, lung cancer is today the most common forms of cancer worldwide. This development is due to the gradual uptake of cigarette smoking in different populations and birth cohorts during the past 75 years. In spite of different modes of treatment, survival is still poor and surgery remains the prerequisite for cure. </p><p>National data from the Swedish Cancer Register for the 35-year period 1958-1994 were analysed to estimate the effects of birth cohort, year of diagnosis (period) and age at diagnosis on the time trends in lung cancers. Early mortality, complications, major morbidity during the first 30 days, quality of life and long term survival after lung cancer surgery were assessed to estimate the significance of pre-surgical and tumour-related risk factors. Also, effects of delay in diagnosis and treatment among patients with non-small cell lung cancer were examined.</p><p>The main results indicate that the overall age-adjusted incidence of lung cancer in Sweden has stabilised in men during the last two decades but has been increasing continuously in women. The fastest rate increase was noted among the youngest women and the incidence of adenocarcinoma is increasing in both sexes. Our results show low early mortality and morbidity after lung cancer surgery. Furthermore, quality of life was comparable with that of CABG patients postoperatively. However, patients with reduced lung capacity and those undergoing pneumonectomy should be treated with great care, as they run a considerable risk of major complications, impaired quality of life or death during the first 30 days postoperatively. Tumour stage (TNM) is the best prognostic indicator for long-term survival following radical surgery, underlying the importance of accurate surgical staging. Factors such as impaired preoperative lung function, older age, and major complications after surgery all negatively influence survival. Current smokers as a group run a significant risk of an adverse outcome (major complication or death), impaired mental health and shortened survival after lung cancer surgery. Waiting time for diagnosis and treatment of lung cancer was longer than recommended; especially among those surgically treated, but prolonged delay did not influence survival adversely.</p>
42

Lung Cancer : Epidemiological and Clinical Studies with Special Reference to Surgical Treatment

Myrdal, Gunnar January 2003 (has links)
From being a rare disease in the early 1900s, lung cancer is today the most common forms of cancer worldwide. This development is due to the gradual uptake of cigarette smoking in different populations and birth cohorts during the past 75 years. In spite of different modes of treatment, survival is still poor and surgery remains the prerequisite for cure. National data from the Swedish Cancer Register for the 35-year period 1958-1994 were analysed to estimate the effects of birth cohort, year of diagnosis (period) and age at diagnosis on the time trends in lung cancers. Early mortality, complications, major morbidity during the first 30 days, quality of life and long term survival after lung cancer surgery were assessed to estimate the significance of pre-surgical and tumour-related risk factors. Also, effects of delay in diagnosis and treatment among patients with non-small cell lung cancer were examined. The main results indicate that the overall age-adjusted incidence of lung cancer in Sweden has stabilised in men during the last two decades but has been increasing continuously in women. The fastest rate increase was noted among the youngest women and the incidence of adenocarcinoma is increasing in both sexes. Our results show low early mortality and morbidity after lung cancer surgery. Furthermore, quality of life was comparable with that of CABG patients postoperatively. However, patients with reduced lung capacity and those undergoing pneumonectomy should be treated with great care, as they run a considerable risk of major complications, impaired quality of life or death during the first 30 days postoperatively. Tumour stage (TNM) is the best prognostic indicator for long-term survival following radical surgery, underlying the importance of accurate surgical staging. Factors such as impaired preoperative lung function, older age, and major complications after surgery all negatively influence survival. Current smokers as a group run a significant risk of an adverse outcome (major complication or death), impaired mental health and shortened survival after lung cancer surgery. Waiting time for diagnosis and treatment of lung cancer was longer than recommended; especially among those surgically treated, but prolonged delay did not influence survival adversely.
43

Lėtinio pankreatito chirurginio gydymo būdų ir gyvenimo kokybės lyginamasis vertinimas / Comparitive evaluation of surgical treatment methods and quality of life in chronic pancreatitis

Jurevičius, Saulius 20 December 2013 (has links)
Dvylikapirštę žarną išsauganti kasos rezekcija Frey būdu yra standartinė operacija gydant sergančiuosius komplikuotu lėtiniu pankreatitu. Kasos ir plonosios žarnos jungtis įprastai atliekama dviejų aukštų siūlėmis. Disertacinio darbo tikslas – palyginti Frey operacijos, naudojant vieno arba dviejų aukštų kasos – tuščiosios žarnos siūlę, rezultatatus, taip pat įvertinti operuotų pacientų gyvenimo kokybės pokyčius, praėjus 12 mėn. po operacijos. Perspektyviniame atsitiktinių imčių klinikiniame tyrime dalyvavo aštuoniasdešimt pacientų. Tiriamieji prieš operaciją atsitiktine tvarka suskirstyti į dvi grupes: pirmos grupės pacientams atlikta operacija, formuojant kasos – tuščiosios žarnos jungtį vieno aukšto ištisine siūle; antros grupės pacientams, kasos – tuščiosios žarnos jungtis suformuota dviejų aukštų pavienėmis siūlėmis. Tyrime nustatėme, kad bendras operacijos laikas (208±46 min ir 255±58 min), bei pankreojejunoanastomozės siuvimo laikas (19±6 min. ir 51±18 min.) buvo statistiškai reikšmingai mažesnis „vieno aušto siūlės“ grupėje nei „dviejų aukštų pavienių siūlių“ grupėje. Pooperacinės komplikacijos, kasos fistulės dažnis, pooperacinė hospitalizavimo trukmė abiejose grupėse nesiskyrė. Vertinant gyvenimo kokybės pokyčius, praėjus 12 mėn. po operacijos, nustatytas statistiškai reikšmingas gyvenimo kokybės pagerėjimas abiejose pacientų grupėse. / The duodenum-preserving pancreatic resection according to Frey is a standard operation for patients with complicated chronic pancreatitis. The pancreatojejunostomy is usually performed using two layer suture. The aim of doctoral dissertation was to compare single- and two-layer suture in pancreatojejunostomy performed in duodenum-preserving pancreatic resection according to Frey modification and to assess the changes of the quality of life 12 months after operation. A total of 80 patients were enrolled in the prospective randomized clinical. They were randomly allocated into two groups. In the first group of patients, pancreatojejunostomy was constructed by using single-layer continuous suture. In the second group of patients, pancreatojejunostomy was constructed by using two-layer interrupted suture. Overall time of the operation (208 ± 46 min. and 255 ± 58 min.) and the suturing time (19 ± 6 min. and 51 ± 18 min.) were significantly shorter in the single layer anastomosis group. Postoperative complications, the prevalence of pancreatic fistula, the length of stay did not differ in both groups. There was a statistically significant improvement of the quality of life 12 months after operation in the both groups of patients.
44

Comparitive evaluation of surgical treatment methods and quality of life in chronic pancreatitis / Lėtinio pankreatito chirurginio gydymo būdų ir gyvenimo kokybės lyginamasis vertinimas

Jurevičius, Saulius 20 December 2013 (has links)
The duodenum-preserving pancreatic resection according to Frey is a standard operation for patients with complicated chronic pancreatitis. The pancreatojejunostomy is usually performed using two layer suture. The aim of doctoral dissertation was to compare single- and two-layer suture in pancreatojejunostomy performed in duodenum-preserving pancreatic resection according to Frey modification and to assess the changes of the quality of life 12 months after operation. A total of 80 patients were enrolled in the prospective randomized clinical. They were randomly allocated into two groups. In the first group of patients, pancreatojejunostomy was constructed by using single-layer continuous suture. In the second group of patients, pancreatojejunostomy was constructed by using two-layer interrupted suture. Overall time of the operation (208 ± 46 min. and 255 ± 58 min.) and the suturing time (19 ± 6 min. and 51 ± 18 min.) were significantly shorter in the single layer anastomosis group. Postoperative complications, the prevalence of pancreatic fistula, the length of stay did not differ in both groups. There was a statistically significant improvement of the quality of life 12 months after operation in the both groups of patients. / Dvylikapirštę žarną išsauganti kasos rezekcija Frey būdu yra standartinė operacija gydant sergančiuosius komplikuotu lėtiniu pankreatitu. Kasos ir plonosios žarnos jungtis įprastai atliekama dviejų aukštų siūlėmis. Disertacinio darbo tikslas – palyginti Frey operacijos, naudojant vieno arba dviejų aukštų kasos – tuščiosios žarnos siūlę, rezultatatus, taip pat įvertinti operuotų pacientų gyvenimo kokybės pokyčius, praėjus 12 mėn. po operacijos. Perspektyviniame atsitiktinių imčių klinikiniame tyrime dalyvavo aštuoniasdešimt pacientų. Tiriamieji prieš operaciją atsitiktine tvarka suskirstyti į dvi grupes: pirmos grupės pacientams atlikta operacija, formuojant kasos – tuščiosios žarnos jungtį vieno aukšto ištisine siūle; antros grupės pacientams, kasos – tuščiosios žarnos jungtis suformuota dviejų aukštų pavienėmis siūlėmis. Tyrime nustatėme, kad bendras operacijos laikas (208±46 min ir 255±58 min), bei pankreojejunoanastomozės siuvimo laikas (19±6 min. ir 51±18 min.) buvo statistiškai reikšmingai mažesnis „vieno aušto siūlės“ grupėje nei „dviejų aukštų pavienių siūlių“ grupėje. Pooperacinės komplikacijos, kasos fistulės dažnis, pooperacinė hospitalizavimo trukmė abiejose grupėse nesiskyrė. Vertinant gyvenimo kokybės pokyčius, praėjus 12 mėn. po operacijos, nustatytas statistiškai reikšmingas gyvenimo kokybės pagerėjimas abiejose pacientų grupėse.
45

A holistic view of urinary stress incontinence in women

Berglund, Anna-Lena January 1995 (has links)
The present study group consists of 45 women with genuine stress incontinence who were selected for surgical treatment and randomized either to retropubic urethrocystopexy (n=30) or pubococcygeal repair (n=15). The preoperative assessment included medical history, gynecological examination, urine analysis and culture, residual urine, pad test, frequency-continence charts, water urethrocystoscopy, continence test and cystometry with analysis of micturition. Moreover, five semistructured interviews were performed with the women and two with their partner. The following questionnaires were used measuring a) personality characteristics: Karolinska Scales of Personality (KSP), Eysenck Personality Inventory (EPI), b) depression: Beck Depression Inventory (BDI) and c) social support: Interview Schedule for Social Interaction (ISSI). The results have shown that there was no difference in the subjective cure rate between the two surgical methods (73% vs. 80 % respectively). The bladder volume had increased in both groups and the intravesical pressure of the bladder filled to maximum had increased in the pubococcygeal repair group. Other urodynamic variables were unchanged by the operation. Pad tests have demonstrated that 67 % of the women in the urethrocystopexy group and 47 % in the pubococcygeal repair group ceased to leak urine. Postoperatively, 63 % of the women in the urethrocystopexy group needed high doses of analgesics compared with only 33 % in the pubococcygeal repair group. Among the women experiencing severe to very severe pain dysphoric subjects were overrepresented. Postoperative residual urine was a minor nursing problem in both groups. Women with SUI of long duration scored significantly higher than controls on the KSP scales of somatic anxiety, psychic anxiety, psychasthenia, suspicion and on the EPI lie-scale. There was no significant difference in sexual activity before and after surgery. One or two sexual dysfunctions within the desire, excitement, orgasmic and resolution phase were reported by the majority of women both before and after surgical intervention. The cured women reported a higher level of overall activities before surgery than the improved (i.e. not cured) women, whereas post surgery both the cured and the improved women obtained about the same level of activities. Regarding social support, no differences between the cured or improved women occured as concerns attachment. The cured women showed a higher degree of adequacy of social integration compared with the improved women. In order to delineate predictive factors for the surgical outcome the following variables were investigated: age of patient, duration of urine leakage, parity, personality, psychological and social factors. The following predictors of the outcome of surgical treatment emerged: duration of stress incontinence, neuroticism and age of patient. The results of the present study indicate the ecessity of a multidisciplinary approach to the treatment and nursing of women with SUI. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1995</p> / digitalisering@umu
46

Role sestry v následné péči o bariatrického pacienta / The Role of a Nurse in after care about bariatric patient

DUŠIČKOVÁ, Tereza January 2015 (has links)
Current status Obesity is a disease characterized by the increased proportion of fat in the body over a certain limit (Müller 2009). According to the World Health Organization in 2014, more than 1.9 billion people suffered from overweight, of which more than 600 million people were obese (WHO 2015). Subject The aim of the work is the definition of competence nurses have in the aftercare of bariatric patients. Determination of preparation, care, patient awareness and procedures for patients undergoing bariatric treatment. And findings of specific needs of bariatric patients undergoing treatment for obesity. Three research questions have served towards these targets: What competences do nurses have in the aftercare of bariatric patients? How are patients informed throughout the bariatric treatment? What are the needs of patients undergoing bariatric treatment of obesity? Methods Qualitative research techniques were used to obtain the necessary data for the practical part. The practical part was realized through individual semi-structured interviews with nurses working on surgical wards and patients who had undergone bariatric treatment. At the beginning of each interview, the nurse and the patient were apprised of the reason of the research conducted and were assured of anonymity in the processing of the dialogue. The central theme was the assertion of nurses in the subsequent care of bariatric patients and to determine the specifics of these patients. Participants The sample consisted of nine nurses working in a specialized center, where bariatric procedures are performed and seven patients who had undergone bariatric surgery. The survey was conducted from February to March 2015 Results: Before the operation patients undergo surgical, internal, nutritional and psychological examinations. Blood is collected for hematological and biochemical laboratory tests. Among other examinations clients go through gastroenterology, pulmonary testing, also examination in a sleep laboratory and swabs are taken from the throat and nose. Before the particular operation clients should reduce weight on a doctor's recommendation. It was also found that patients are informed about the preoperative and postoperative care, as well as about the need for dispensarisation, the frequency of follow-ups and possibilities of participation in bariatric clubs and associations. Nurses cover the following competences. Before the surgery, the nurse educates the clients about the preoperative and postoperative care, takes their blood, fulfills what the doctor prescribes and motivates the patient. After the surgery, the nurse provides general nursing care, monitors physiological functions, and educates patients about their diet and carries out the doctor´s prescriptions. The nurse must know the dietary restrictions, when it is determined by the general procedure, which varies in some detail according to the type of surgery and the patient's condition. The research showed that nurse cares more about the biological needs of the patients, rather than their psychosocial needs. Patients lack psychological support and motivation in aftercare. Patients undergoing bariatric treatment need to prepare for surgery (weight loss) and acquire post operation eating habits. Their other needs are psychological support and motivation conveyed by nurses. Conclusion: As the number of people suffering from overweight and obesity at present is constantly growing, obesity treatment becomes a necessity. Currently, bariatric surgery is widely used for patients suffering from obesity of the II. and higher degree, so it is advisable to know the needs, knowledge, practices in patient care before and after such an operation and, ultimately, which competences do nurses have during them.
47

"Contribuição das medidas volumétricas das estruturas temporais mesiais e neocorticais ao tratamento cirúrgico da epilepsia do lobo temporal" / Contribution of magnetic resonance volumetry of mesial and neocortical temporal structures in the surgical treatment of temporal lobe epilepsy

David Araújo Junior 24 April 2003 (has links)
Resumo ARAÚJO, D Contribuição das medidas volumétricas das estruturas temporais mesiais e neocorticais ao tratamento cirúrgico das epilepsias do lobo temporal. 2003. 120 p. Tese de doutorado. Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto. A epilepsia do lobo temporal é a forma mais comum de epilepsia focal sintomática e a esclerose mesial temporal a sua causa mais freqüente. A volumetria por ressonância magnética pode ser útil na investigação da epileptogênese na epilepsia temporal, bem como na lateralização das alterações hipocampais em pacientes candidatos à cirurgia, como já relatado em diversas séries. Realizamos a volumetria das estruturas do lobo temporal em 69 pacientes com suspeita clínica de epilepsia mesial temporal, avaliados consecutivamente no Centro de Cirurgia de Epilepsia do Hospital de Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo. As estruturas medidas foram o pólo temporal, o lobo temporal, a amígdala, o hipocampo e o giro parahipocampal. Estas medidas foram comparadas às variáveis clínicas e neurofisiológicas dos pacientes, buscando fatores de bom prognóstico para o tratamento cirúrgico, bem como de variáveis clínicas que permitissem a correlação entre comprometimento estrutural e funcional. Nossos resultados mostraram uma importância central do hipocampo na epileptogênses temporal, embora não esteja elucidado se este papel é primário e independente ou secundário a alterações conjuntas com as outras estruturas. Todos os nossos casos apresentaram comprometimento hipocampal absoluto, relativo ou de assimetria. O pólo temporal foi a estrutura neocortical mais comprometida e houve uma correlação entre sua perda volumétrica e o tempo de epilepsia, sugerindo um dano progressivo. Seu comprometimento correlacionou-se ainda a déficits cognitivos, com menor quociente geral de inteligência. A amígdala e o giro parahipocampal estiveram relacionados à presença de crises parciais simples evoluindo para complexas, correlacionando dados clínicos e estruturais. Palavras chave: Epilepsia temporal; Volumetria; Tratamento cirúrgico. / Temporal lobe epilepsy is the most commom form of focal epilepsy. Mesial temporal sclerosis is the usual etiology. Magnetic resonance volumetry may be a useful research tool, and may be used to lateralize hippocampal changes in surgical candidates, according to several reports. We performed temporal lobe volumetry in 69 consecutive patients of the Epilepsy Surgery Center of the Hospital of Ribeirão Preto of the University of São Paulo. We measured temporal pole, posterior segment of the temporal lobe, amygdala, hippocampus, and parahippocampal gyrus. The volumes were compared to clinical and neurophysiologic variables, as an attempt to find variables that could predict surgical outcome. We also sought correlations between structural (volume), and functional (epileptogenesis and clinical features) changes. Our data suggest that the hippocampus has a very important role in temporal lobe epilepsy. The question as to wether this role is primary or secundary to changes in other structures remains to be solved. In all of our cases the hippocampal volume was altered, either as absolute or relative volumes, or as asymmetry index. The only variable that correlated with postsurgical outcome was the hippocampal asymmetry index, being greater in the group with best postsurgical evolution. The most involved neocortical structure was the temporal pole. There was a correlation between temporal pole and amygdala volume and duration of epilepsy. This suggests a progressive damabe, added to the initial precipitating injury (IPI). There was also significant difference between mesial structures contralateral to the surgery side and those of the controls. These data shows more widespread and bilateral damage, even in patients with unilateral epilepsy by EEG and clinical criteria.
48

The results of surgical treatment of abdominal aortic aneurysm: influence and evaluation of comorbidities, demographic and surgical risk factors / Pilvinės aortos aneurizmų chirurginio gydymo rezultatai: gretutinių ligų ir demografinių bei chirurginių veiksnių įtaka ir vertinimas

Janušauskas, Tomas 02 November 2011 (has links)
Aim of the study was to analyze the influence of comorbidities, demographic and surgical risk factors on early and late results of non-ruptured and ruptured abdominal aortic aneurysm. In the introduction the aim of the study and objectives are listed. In the review of the literature main problems of pending topic are analyzed. The methodology is described in a special chapter. The results of 373 patients’ surgical treatment of abdominal aortic aneurysm were analyzed. Eighty-four of them were operated due to the abdominal aortic aneurysm rupture. Follow-up results of 153 patients were analyzed in a special chapter. The influence of comorbidities, demographic and surgical risk factors on mortality and complication rate after operations for ruptured abdominal aortic aneurysm were assessed. Analysis of follow-up results clarified risk factors influencing survival after operation of abdominal aortic aneurysm. Assessment of the results showed that mean age of patients is lower and comorbidities is more severe as compared with the data presented for Western countries. The patients’ age, condition of cardiac and pulmonary systems, volume of operation were the most influencing risk factors on the outcome of surgical treatment of the abdominal aortic aneurysm. / Tyrimo tikslas – išanalizuoti gretutinių ligų ir demografinių bei chirurginių rizikos veiksnių įtaką neplyšusios bei plyšusios pilvinės aortos aneurizmos artimiems bei atokiesiems chirurginio gydymo rezultatams. Įvade išdėstomi tyrimo tikslai bei uždaviniai, pateikiama literatūros apžvalga, kurioje apibendrinamos pagrindinės su nagrinėjama tema susijusios problemos. Atskirame skyriuje aprašyta tyrimo metodika. Disertacijoje išnagrinėti 373 pacientų, operuotų dėl pilvinės aortos aneurizmos, gydymo rezultatai. Aštuoniasdešimt keturi jų gydyti dėl plyšusios pilvinės aortos aneurizmos. Atskirai išnagrinėta 153 pacientų vėlyvieji gydymo rezultatai. Nustatyta mirtingumo ir komplikacijų po plyšusių pilvinės aortos aneurizmų operacijų priklausomybė nuo įvairių rizikos veiksnių artimuoju pooperaciniu laikotarpiu. Skyriuje, kur analizuojami vėlyvieji operacijų rezultatai, nustatyti svarbiausieji veiksniai, nulemiantys išgyvenamumą. Išsamūs šių tyrimų rezultatai pateikti dviejuose disertacijos skyriuose. Nustatyta, kad tiriamųjų pacientų amžiaus vidurkis buvo mažesnis, o gretutinės patologijos buvo daugiau palyginus su duomenimis, pateiktais Vakarų šalių literatūroje. Taip pat nustatyta, kad didžiausią įtaką gydymo rezultatams darė paciento amžius, širdies bei plaučių patologija, operacijos apimtis.
49

Pilvinės aortos aneurizmų chirurginio gydymo rezultatai: gretutinių ligų ir demografinių bei chirurginių veiksnių įtaka ir vertinimas / The results of surgical treatment of abdominal aortic aneurysm: influence and evaluation of comorbidities, demographic and surgical risk factors

Janušauskas, Tomas 02 November 2011 (has links)
Tyrimo tikslas – išanalizuoti gretutinių ligų ir demografinių bei chirurginių rizikos veiksnių įtaką neplyšusios bei plyšusios pilvinės aortos aneurizmos artimiems bei atokiesiems chirurginio gydymo rezultatams. Įvade išdėstomi tyrimo tikslai bei uždaviniai, pateikiama literatūros apžvalga, kurioje apibendrinamos pagrindinės su nagrinėjama tema susijusios problemos. Atskirame skyriuje aprašyta tyrimo metodika. Disertacijoje išnagrinėti 373 pacientų, operuotų dėl pilvinės aortos aneurizmos, gydymo rezultatai. Aštuoniasdešimt keturi jų gydyti dėl plyšusios pilvinės aortos aneurizmos. Atskirai išnagrinėta 153 pacientų vėlyvieji gydymo rezultatai. Nustatyta mirtingumo ir komplikacijų po plyšusių pilvinės aortos aneurizmų operacijų priklausomybė nuo įvairių rizikos veiksnių artimuoju pooperaciniu laikotarpiu. Skyriuje, kur analizuojami vėlyvieji operacijų rezultatai, nustatyti svarbiausieji veiksniai, nulemiantys išgyvenamumą. Išsamūs šių tyrimų rezultatai pateikti dviejuose disertacijos skyriuose. Nustatyta, kad tiriamųjų pacientų amžiaus vidurkis buvo mažesnis, o gretutinės patologijos buvo daugiau palyginus su duomenimis, pateiktais Vakarų šalių literatūroje. Taip pat nustatyta, kad didžiausią įtaką gydymo rezultatams darė paciento amžius, širdies bei plaučių patologija, operacijos apimtis. / Aim of the study was to analyze the influence of comorbidities, demographic and surgical risk factors on early and late results of non-ruptured and ruptured abdominal aortic aneurysm. In the introduction the aim of the study and objectives are listed. In the review of the literature main problems of pending topic are analyzed. The methodology is described in a special chapter. The results of 373 patients’ surgical treatment of abdominal aortic aneurysm were analyzed. Eighty-four of them were operated due to the abdominal aortic aneurysm rupture. Follow-up results of 153 patients were analyzed in a special chapter. The influence of comorbidities, demographic and surgical risk factors on mortality and complication rate after operations for ruptured abdominal aortic aneurysm were assessed. Analysis of follow-up results clarified risk factors influencing survival after operation of abdominal aortic aneurysm. Assessment of the results showed that mean age of patients is lower and comorbidities is more severe as compared with the data presented for Western countries. The patients’ age, condition of cardiac and pulmonary systems, volume of operation were the most influencing risk factors on the outcome of surgical treatment of the abdominal aortic aneurysm.
50

Interactions visuo-proprioceptives dans les pathologies dégénératives du rachis cervical relevant d'un traitement chirurgical / Visuo-proprioceptive interactions in degenerative cervical spine diseases requiring surgery

Freppel, Sébastien 12 December 2013 (has links)
La proprioception cervicale joue un rôle important dans le contrôle postural, mais la nature exacte de sa contribution est controversée. Dans certains cas de « coup du lapin », une atteinte posturale a été démontrée, sans que l'atteinte du rachis cervical puisse être tenue pour seule responsable. Malgré la forte prévalence des pathologies cervicales dégénératives, leurs conséquences posturales ont été peu étudiées dans la littérature scientifique. Il n'existe aucune publication centrée sur les deux types de pathologie responsables de névralgies cervicobrachiales : les hernies discales cervicales et l'arthrose cervicale. Cette étude a eu pour but d'évaluer le contrôle postural de deux groupes de patients présentant une pathologie cervicale dégénérative avec et sans stimulation optocinétique avant et après traitement chirurgical. Dix-sept patients présentant une radiculalgie ont été inclus dans cette étude et répartis en deux groupes selon l'origine arthrosique ou discale de la compression neurologique. Tous les patients ainsi que 31 témoins ont été soumis à un examen de posturographie statique comprenant 12 enregistrements : les quatre premiers enregistrements ont été réalisés la tête dans l'axe (à 0°) : yeux fermés, yeux ouverts sans stimulation optocinétique, yeux ouverts avec stimulation optocinétique dans le sens horaire, puis antihoraire. Ces quatre situations sensorielles ont été répétées tête tournée 30° à gauche, puis 30° à droite. Les patients ont à nouveau été soumis à ces 12 enregistrements six semaines après l'intervention. Aucun patient ne s'est plaint de sensations vertigineuses que ce soit en pré ou en postopératoire. Avant intervention, les yeux fermés, le groupe hernie discale était plus stable que le groupe arthrose. Après intervention, la contribution visuelle au contrôle postural avait diminué dans les deux groupes dans un environnement visuel dynamique, alors que dans un environnement visuel stable, elle n'avait diminué que dans le groupe arthrose. L'importance relative des informations visuelles et proprioceptives pour le contrôle postural varie selon le type de pathologie et la chirurgie tend à réduire la contribution visuelle surtout pour les patients présentant une arthrose cervicale / Cervical proprioception plays a key role in postural control, but its specific contribution is controversial. Postural impairment was shown in whiplash injuries without demonstrating the sole involvement of the cervical spine. The consequences of degenerative cervical spine diseases are underreported in posture-related scientific literature in spite of their high prevalence. No report has focused on the two different mechanisms underlying cervicobrachial pain: herniated discs and spondylosis. This study aimed to evaluate postural control of two groups of patients with degenerative cervical spine diseases with or without optokinetic stimulation before and after surgical treatment. Seventeen patients with radiculopathy were recruited and divided into two groups according to the spondylotic or discal origin of the nerve compression. All patients and a control population of 31 healthy individuals underwent a static posturographic test with 12 recordings; the first four recordings with the head in 0° position: eyes closed, eyes open without optokinetic stimulation, with clockwise and counter clockwise optokinetic stimulations. These four sensorial situations were repeated with the head rotated 30° to the left and to the right. Patients repeated these 12 recordings 6 weeks postoperatively. None of the patients reported vertigo or balance disorders before or after surgery. Prior to surgery, in the eyes closed condition, the herniated disc group was more stable than the spondylosis group. After surgery, the contribution of visual input to postural control in a dynamic visual environment was reduced in both cervical spine diseases whereas in a stable visual environment visual contribution was reduced only in the spondylosis group. The relative importance of visual and proprioceptive inputs to postural control varies according to the type of pathology and surgery tends to reduce visual contribution mostly in the spondylosis group

Page generated in 0.0804 seconds