Bainhess6916

Open microdiscectomy is the standard surgical treatment for herniated discs at the lumbar level. However, with open operations on the spine, the risk of developing postoperative instability of the spine and the occurrence of chronic back pain is quite high. Biportal endoscopic spinal surgery is a new method in minimally invasive spinal surgery, which has several advantages over open surgery. The aim of the study was to analyze the results of treatment of patients with hernias of the intervertebral discs who underwent biportal endoscopic discectomy and compare them with the results of treatment with open microdiscectomy. The analysis of the results of treatment of 155 patients who underwent a diskectomy operation from March 2019 to October 2019 was performed 67 patients were operated by biportal endoscopy in the spine surgery clinic of the Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine, while 88 - The first patient was operated on by open microdiscectomy in the of patients after open microdisectomy (141.1±56.5) and (6.6±1.3), respectively. However, the duration of the operation (71.3±21.9) was longer in the biportal discectomy group than in the group after open microdisectomy (62.2±14.6), the difference was statistically significant. Biportal endoscopic spinal surgery is an effective method for the treatment of hernias of the intervertebral intervertebral discs of the lumbar region, which has several advantages over open surgery, namely less tissue trauma, less blood loss, faster back pain regression after surgery, higher patient satisfaction with the result of treatment, and reduced hospital stay.The aim of the study is to justify the "balanced" approach to brain debridement (BD) in surgical treatment of combat-related penetrating craniocerebral gunshot wound (PCGW) patients and assess immediate and long-term treatment results. The analysis of applied surgical BD techniques was performed in PCGW military personnel with admission Glasgow Coma Scale (GCS) score of 4 or above. The study included 81 injured patients. Average GCS score at admission was 10±3. Blunt injuries were predominant (n=51, 62.9%). Bone fragments were removed in 78 (92.8%) and metal foreign bodies were removed in 32 (38.1%)cases. Demographic and clinical characteristics, nature of brain injury, presence of foreign bodies and depth of their location, surgery extent, and occurrence of complications in postoperative period were taken into account. The outcome data included a Glasgow Outcome Scale (GOS) score at discharge, in 6 and 12 months, grade of speech disorders, extremities strength, and occurrence of convulsive attacks from the time of admission to 12 months. Meningitis developed in 11 (13.6%) cases. 11 (13.6%) patients died. Good recovery (GOS score 4-5) in 12 months was in 8 (38.1%) patients, moderate disability (GOS score 4) in 10 (47.6%) patients. Adverse outcome (GOS score 1-3) was associated with axial dislocation (p=0.015), diametric wound (p less then 0.001), and purulent-septic complications (PSC) (p less then 0.05). Intracranial PSCs are statistically significantly associated with duration of subdural space inflow and outflow drainage of 4+ days (p less then 0.05), bone fragments left in the brain matter (p=0.008), and ventricular hemorrhage on HCT (p=0.016). The choice of a BD technique depended on severity of patient's condition, brain injury, and presence of foreign bodies. Availability of an equipped operating room allowed for thorough surgery. Good outcome indicators testify to appropriateness of the chosen tactic.The aim of the research - to study the effect of carbopneumoperitoneum on the possibility of laparoscopic surgery in patients with cardiac rhythm disorders and conduction disturbances. We conducted analysis of 940 patients who underwent laparoscopic surgery. The patients were divided into two groups. The first group included 630 patients (67,0%) with cardiac arrhythmias; the second group included 310 (33,0%) patients with heart rhythm disturbance that arose during carbopneumoperitoneum. In all patients of the first group in the preoperative period, heart rhythm disturbance was observed sinus tachycardia - 30 (4,8%); sinus bradycardia - 50 (7,9%); paroxysmal tachycardia with a narrow QRS complex - 5 (0,8%); complete blockage of the right leg of the bunch Gis - 12 (1,9%); complete blockage of the left leg of the bunch Gis - 21 (3,3%), AV- blockade of the I degree - 23 (3,7%), the AV- blockade of the II degree Mobitz I - 12 (1,9%), AV- II degree blockade Mobits II - 8 (1,3%), complete AV- blockade - 5 (0,8%), suisodes of AV blockade of II degree Mobitz II, episodes of complete AV block are more often recorded. Patients possibly holding laparoscopic surgery after a course of antiarrhythmic treatment and taking into account the risk of cardiac arrhythmias, where intraoperative intra-abdominal pressure plays a major role. Carbopneumoperitoneum increases the risk of sinus bradycardia (up to 26,5% of cases), all episodes during CO2 insufflation. The incidence of ventricular extrasystole was 2 times higher than that of supraventricular extrasystole (31,0% and 15,2% respectively). Including early ventricular extrasystoles (type "R on T") - in 3,8% of cases. Increases the likelihood of occurrence of both unstable (4,5%) and stable (2,6%) ventricular tachycardia, including "pirouette" -tachycardia (2,9%). SEL120-34A concentration There is also an increased risk of episodes of second degree AV-blockade Mobitz II (1,6%) and episodes of complete AV-blockade (1,0%).Autophagy has been reported to play a dual "double-edged sword" role in the occurrence and development of Alzheimer's disease (AD). link2 To assess the relationship between AD and autophagy, the dynamic changes of autophagic flux in the brain of postmortem AD patients, animal models and cell models were studied. The results showed that autophagosomes (APs) accumulation and expression of lysosomal markers were decreased in the brains of AD patients. In the brain of APP/PS1 double transgenic mice, APs did not accumulate before the formation of SPs but accumulated along with the deposition of SPs, as well as the level of lysosomal markers cathepsin B and Lamp1 protein decreased significantly. In the brains of APP/PS1/LC3 triple - transgenic mice, the number of APs increased with age, but the number of ALs did not increase accordingly. The activation of autophagy is mainly due to the increase in Aβ rather than the overexpression of mutated APP gene. However, both the treatment with exogenous Aβ25-35 and the mutation of the endogenous APP gene blocked the fusion of APs with lysosomes and decreased lysosomal functioning in AD model cells, which may be the main mechanism of autophagy dysregulation in AD.Data obtained from genetically modified mouse models suggest a detrimental role for p16High senescent cells in physiological aging and age-related pathologies. Our recent analysis of aging mice revealed a continuous and noticeable accumulation of liver sinusoid endothelial cells (LSECs) expressing numerous senescence markers, including p16. At early stage, senescent LSECs show an enhanced ability to clear macromolecular waste and toxins including oxidized LDL (oxLDL). Later in life, however, the efficiency of this important detoxifying function rapidly declines potentially due to increased endothelial thickness and senescence-induced silencing of scavenger receptors and endocytosis genes. This inability to detoxify toxins and macromolecular waste, which can be further exacerbated by increased intestinal leakiness with age, might be an important contributing factor to animal death. Here, we propose how LSEC senescence could serve as an endogenous clock that ultimately controls longevity and outline some of the possible approaches to extend the lifespan.NKG2D is implicated in autoimmune diabetes. However, the role of this receptor in diabetes pathogenesis is unclear owing to conflicting results with studies involving global inhibition of NKG2D signaling. We found that NKG2D and its ligands are present in human pancreata, with expression of NKG2D and its ligands increased in the islets of patients with type 1 diabetes. To directly assess the role of NKG2D in the pancreas, we generated NOD mice that express an NKG2D ligand in β-islet cells. Diabetes was reduced in these mice. The reduction corresponded with a decrease in the effector to central memory CD8+ T cell ratio. Further, NKG2D signaling during in vitro activation of both mouse and human CD8+ T cells resulted in an increased number of central memory CD8+ T cells and diabetes protection by central memory CD8+ T cells in vivo. Taken together, these studies demonstrate that there is a protective role for central memory CD8+ T cells in autoimmune diabetes and that this protection is enhanced with NKG2D signaling. These findings stress the importance of anatomical location when determining the role NKG2D signaling plays, as well as when developing therapeutic strategies targeting this pathway, in type 1 diabetes development.This essay examines the implications of the COVID-19 pandemic for health inequalities. link3 It outlines historical and contemporary evidence of inequalities in pandemics-drawing on international research into the Spanish influenza pandemic of 1918, the H1N1 outbreak of 2009 and the emerging international estimates of socio-economic, ethnic and geographical inequalities in COVID-19 infection and mortality rates. It then examines how these inequalities in COVID-19 are related to existing inequalities in chronic diseases and the social determinants of health, arguing that we are experiencing a syndemic pandemic It then explores the potential consequences for health inequalities of the lockdown measures implemented internationally as a response to the COVID-19 pandemic, focusing on the likely unequal impacts of the economic crisis. The essay concludes by reflecting on the longer-term public health policy responses needed to ensure that the COVID-19 pandemic does not increase health inequalities for future generations.Background Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms. Methods We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price. Results Our model suggests that improving attitudes towards the bus (eg, campaigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre. Conclusion Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.