Differential Protein Expression in Polystichum Acrostichoides Due to Metal Exposure

Plants are considered the most cost effective and environmentally sound way to clean up the soils and water contaminated with toxic metals. We focused our studies on the fern species Polystichum acrostichoides. A total of 17 protein spots were up regulated and 3 proteins were down regulated upon various metal exposures, and are arranged to be subjected to liquid chromatography-tandem mass spectrometry for further identification.https://engagedscholarship.csuohio.edu/u_poster_2012/1018/thumbnail.jp

Differential Protein Expression in Polystichum Acrostichoides Due to Metal Exposure

Plants are considered the most cost effective and environmentally sound way to clean up the soils and water contaminated with toxic metals. We focused our studies on the fern species Polystichum acrostichoides. A total of 17 protein spots were up regulated and 3 proteins were down regulated upon various metal exposures, and are arranged to be subjected to liquid chromatography-tandem mass spectrometry for further identification.https://engagedscholarship.csuohio.edu/u_poster_2012/1018/thumbnail.jp

Analysis of the factors affecting the state of the rectal closure system in ostomy patients at the stages of surgical rehabilitation

There are few publications in scientific literature devoted to the assessment of the rectal closure apparatus at the stages of surgical rehabilitation of ostomy patients. Aim of the study was to investigate the factors influencing the change in the functional activity of the rectal closure apparatus in patients with intestinal stomas. Material and methods. A single- center retrospective and prospective analysis of the results of changes in the function of the rectum closure system in 83 patients before and after reconstructive operation was performed. For the period from 2016 to 2018, 42 (50.6 %) men and 41 (49.4 %) women were examined, the average age in the group was 51.8 ± 12.6 years. Results and discussion. In all ostomy patients, anal sphincter incontinence was revealed. In this case, the relationship between the degree of impaired functional activity of the closure system of rectum, the duration of stoma wearing, and the age of the patient was determined. Conclusions. An analysis of the results allows us to evaluate the dynamics of the restoration of the function of the rectum closure apparatus and determine the optimal time for performing the restorative intervention from the standpoint of prophylaxis of dysfunction of the rectum closure system

Modern management of acute non-variceal upper gastrointestinal bleeding

Acute, non-varicose bleeding from the upper gastrointestinal tract remains a common clinical problem. Bleeding episodes are associated with high mortality and a significant economic burden on the health care system. Despite the continuing improvement in endoscopic treatment, recurrent bleeding and associated mortality are still a pressing issue. In addition to the well-established modalities of endoscopic hemostasis: injection, thermal, mechanical, used both as mono therapy and as part of a combination therapy, the review discusses the use of novel types of endoscopic devices. The results of the use of over-the-scope clips, coagrasper, hemostatic sprays, endoscopic angiography, radiofrequency ablation, cryotherapy and endoscopic suturing device are described. The technical aspects of their application, the issues of efficacy and safety, the advantages and limitations of methods for achieving final endoscopic hemostasis are considered. The methods of initial assessment and treatment strategies for recurrent bleeding and unsuccessful endoscopic hemostasis were also analyzed. Material and methods. Literature search was carried out using the following electronic information resources: CyberLeninka, PubMed, Nature Pathology, MEDLINE, PLoS ONE. Results. Сombined endoscopic hemostasis is a standard therapy in the treatment of gastrointestinal tract cerebral infections with an efficiency of 95-98 %, new modalities of endoscopic hemostasis are able, in some cases, to achieve final endoscopic hemostasis both in primary endoscopic treatment and in recurrent bleeding

Preparing the upper gastrointestinal tract for an esophagogastroduodenoscopy to identify the source of acute bleeding

Esophagogastroduodenoscopy (EGDS) is the main way to diagnose bleeding from the upper gastrointestinal tract. Diagnostic accuracy of the study depends on the preparation. Aim of the study was to evaluate the preparation of the upper parts of the digestive tract in case of esophagogastroduodenal bleeding. Material and methods. The retrospective analysis of 2570 case histories was carried out. Gastric lavage through nasogastric tube was carried out in the main group (1299 patients). Preparation for the primary EGDS was not carried out in the control group (1271 patients). A comparison of the number of EGDS performed and the detection of the bleeding source in the control and the main groups as well as the period of investigation up to the detection of the bleeding source were performed. Results. EGDS without preparation of the upper gastrointestinal tract in case of acute bleeding and determination of the diagnosis is possible in 85,6 % of patients. Preparation of the upper gastrointestinal tract for EGDS prolongs the study period by 30–60 minutes, but allows establishing the diagnosis in 93.7 % of cases that is by 8.1 % more than without preparation

Роль консервативной терапии в лечении осложненного колоректального рака

Objective: to evaluate the possibilities of conservative treatment of patients with complications of colorectal cancer.Materials and methods. The study included the results of treatment of 105 patients with complications of colorectal cancer treated on the basis of the District Clinical Hospital of Surgut for the period 2012—2017. Of these, 86 (81.9 %) patients with acute obstructive intestinal obstruction, 11 (10.5 %) patients with bleeding from colon tumors, and 8 (7.6 %) patients with purulent-septic complications of colon cancer.Results. The complex of conservative measures, including colon stenting, provides restoration of the passage through the digestive tract in 79.1 % of patients, which allows preparing the patient to perform surgery, thereby reducing the risk of complications. Twenty-eight (27.6 %) patients were operated on an emergency basis: due to the lack of effect from conservative therapy for acute intestinal obstruction — 18 (17.1 %) patients, due to peritonitis — 8 (7.6 %), due to recurrent colonic bleeding — 3 (2.9 %) patients. The death rate was 13.8 % (n = 4). In the delayed order after successful conservative therapy, 70 (66.7 %) patients underwent surgical treatment in the surgical and oncology departments. Postoperative mortality was 1.4 % (n = 1).Conclusion. The complex of conservative measures, which allows avoiding emergency surgical intervention at the urgent stage of treatment, is the basis for carrying out a full-fledged surgical intervention in a delayed procedure in a specialized hospital, observing the principles of oncological radicalism.Цель исследования — оценка возможности консервативного лечения больных с осложнениями колоректального рака. Материалы и методы. Исследование обобщает результаты лечения 105 больных с осложнениями колоректального рака, пролеченных на базе Окружной клинической больницы г. Сургута за период 2012—2017 гг. В их числе 86 (81,9 %) пациентов с острой обтурационной кишечной непроходимостью, 11 (10,5 %) — с кровотечением из опухоли толстой кишки, 8 (7,6 %) — с гнойно-септическими осложнениями рака толстой кишки.Результаты. Комплекс консервативных мероприятий, включающих стентирование толстой кишки, обеспечил восстановление пассажа по пищеварительному тракту у 79,1 % пациентов, что позволило подготовить их к выполнению хирургического вмешательства, тем самым уменьшив риск развития осложнений. В экстренном порядке были оперированы 29 (27,6 %) пациентов: в связи с отсутствием эффекта от консервативной терапии при острой кишечной непроходимости — 18 (17,1 %), в связи с перитонитом — 8 (7,6 %), в связи с рецидивом толстокишечного кровотечения — 3 (2,9 %). Частота летальных исходов составила 13,8 % (п = 4). В отсроченном порядке после успешной консервативной терапии 70 (66,7 %) больных подвергнуты хирургическому лечению в условиях хирургического и онкологического отделений. Послеоперационная летальность составила 1,4% (п = 1).Выводы. Комплекс консервативных мероприятий, позволяющий избежать экстренного хирургического вмешательства на ургентном этапе лечения, обеспечивает возможность проведения полноценного хирургического вмешательства в отсроченном порядке в специализированном стационаре с соблюдением принципов онкологического радикализма

Association of mechanical bowel preparation with oral antibiotics and anastomotic leak following left sided colorectal resection:an international, multi-centre, prospective audit

Introduction: The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed. Patients undergoing elective left sided colonic or rectal resection with primary anastomosis between 1 January 2017 and 15 March 2017 by any operative approach were included. The primary outcome measure was anastomotic leak. Results: Of 3676 patients across 343 centres in 47 countries, 618 (16.8%) received MBP+ABx, 1945 MBP (52.9%) and 1099 patients NBP (29.9%). Patients undergoing MBP+ABx had the lowest overall rate of anastomotic leak (6.1%, 9.2%, 8.7% respectively) in unadjusted analysis. After case-mix adjustment using a mixed-effects multivariable regression model, MBP+Abx was associated with a lower risk of anastomotic leak (OR 0.52, 0.30–0.92, P = 0.02) but MBP was not (OR 0.92, 0.63–1.36, P = 0.69) compared to NBP. Conclusion: This non-randomised study adds ‘real-world’, contemporaneous, and prospective evidence of the beneficial effects of combined mechanical bowel preparation and oral antibiotics in the prevention of anastomotic leak following left sided colorectal resection across diverse settings. We have also demonstrated limited uptake of this strategy in current international colorectal practice

Evaluating the incidence of pathological complete response in current international rectal cancer practice

The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR by conventional pre-operative imaging.A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 audit was performed. Patients treated by elective rectal resection were included. A pCR was defined as a ypT0 N0 EMVI negative primary tumour; a partial response represented any regression from baseline staging following chemoradiotherapy. The primary endpoint was the pCR rate. The secondary endpoint was agreement between post-treatment MRI restaging (yMRI) and final pathological staging.Of 2572 patients undergoing rectal cancer surgery in 277 participating centres across 44 countries, 673 (26.2%) underwent chemoradiotherapy and surgery. The pCR rate was 10.3% (67/649), with a partial response in 35.9% (233/649) patients. Comparison of AJCC stage determined by post-treatment yMRI with final pathology showed understaging in 13% (55/429) and overstaging in 34% (148/429). Agreement between yMRI and final pathology for T-stage, N-stage, or AJCC status were each graded as 'fair' only (n = 429, Kappa 0.25, 0.26 and 0.35 respectively).The reported pCR rate of 10% highlights the potential for non-operative management in selected cases. The limited strength of agreement between basic conventional post-chemoradiotherapy imaging assessment techniques and pathology suggest alternative markers of response should be considered, in the context of controlled clinical trials