Combination of Mucocele of the Appendix and Chronic Calculous Cholecystitis: Case Report

Background: The analysis of the data presented in the foreign and national literature shows that a combination of the appendix mucocele and calculous cholecystitis is extremely rare, and the implementation of simultaneous surgical treatment in the laparoscopic version is the optimal approach. Clinical case description. Here, we present a clinical case of chronic calculous cholecystitis in combination with mucocele of the appendix in an 84-year-old patient. The main complaint was pulling pain in the right iliac region. The diagnosis was made on the basis of the main and additional methods of examination: clinical picture, ultrasound, multispiral computed tomography and magnetic resonance imaging of the abdominal organs. In a planned manner, a simultaneous surgical intervention was performed consisting of laparoscopic appendectomy and cholecystectomy. The operation duration was 1 hour 15 minutes. The morphological examination confirmed the diagnosis of calculous cholecystitis and mucocele of the appendix. The patient was discharged in a satisfactory condition on the 4th day. Conclusion. This clinical case shows that the dynamic observation of mucocele of the appendix, even in elderly patients with a comorbid pathology, is unjustified. A simultaneous surgical intervention in the form of laparoscopic appendectomy and cholecystectomy treats the two nosologies and prevents repeated hospitalization and surgery

Drainage methods in patients with unformed intestinal fistulas during the preparation to the surgical treatment

The aim of the study is to analyze the data of the modern foreign and domestic literature on intestinal fistulas, including high unformed small intestinal fistulas, their classification, treatment methods, drainage methods, their types and effectiveness. Research method: the search in the elibrary, CyberLeninka, PubMed and SpringerLink databases. Intestinal fistulas, often found in the surgical practice, appear due to a number of reasons (errors in the surgical technique and conservative treatment, tactical errors, the presence of severe concomitant diseases, etc.) and present a high-risk factor for death. Clinically, intestinal fistulas can differ depending on their localization, etiology, morphology, function, complications, etc., that causes certain difficulties in choosing the treatment method and reduces its success. Special attention is paid to high unformed small intestinal fistulas, which are accompanied by pronounced impairment of the body's homeostasis system, on the one hand, and the need for a multi-stage treatment, on the other hand. The treatment regimen for high unformed small intestinal fistulas includes both conservative and surgical approaches. The conservative method of treatment includes an intensive infusion therapy, control of the source of infectious complications, reduction of irretrievable losses, nutritional therapy, and a local treatment, which consists in protecting the tissues from the aggressive intestinal content and various methods of adequate drainage of the wound. The drainage methods used for intestinal fistulas differ depending on the principle of their operation, the surgical drain material, the configuration of the wound, the fistula morphology, the number of fistulas, etc. Active and vacuum methods seem to be used most frequently and efficiently in the local treatment of high unformed small intestinal fistulas. So far, according to the (very limited) modern literature, there has been a diversity in the effectiveness of the drainage treatment approaches in patients with high unformed small intestinal fistulas, thus, further studies are needed to study and evaluate their pathogenetic role and effectiveness

Total hip revision in patients with isolated aseptic loosening of the acetabular component

Introduction Aseptic loosening of the acetabular component is one of the most common late complications of total hip arthroplasty. Current principles of its treatment consist in replacement of the loosened cup and of the head-and-liner friction couple. There is no unified opinion regarding the stem if it is stable and well-aligned. Methods We have analyzed examination and treatment results of 16 patients with isolated aseptic loosening of the acetabular component that underwent total revision. The results of treatment were assessed using the Harris Hip Score and Oxford Hip Score questionnaires on the 10th postoperative day, and then at follow-ups after three, six and 12 months. Results The average duration of the operation was 132.5 [115; 150] minutes. Intraoperative blood loss ranged from 600 to 2500 ml and averaged 900 ml [750; 1450]. Analysis of hematological parameters (RBC, HGB, HCT) showed moderate anemia in 14 patients (87.5 %) and only two patients (12.5 %) had mild anemia on the 10th postoperative day. The mean volume of erythrocyte mass transfusion was 450 ml [300; 775]. The final results of treatment were assessed as fair with Harris Hip Score after 12 months. The Oxford Hip Score results of treatment were in the range from 30 to 39 points after 12 months that confirmed the need for additional conservative measures for hip joint stability. Conclusion Surgical treatment of isolated aseptic loosening of the acetabular component requires differentiated tactical solutions for defining the scope of hip revision

Effect of Cross-Linking Cations on In Vitro Biocompatibility of Apple Pectin Gel Beads

The study aimed to compare the in vitro biocompatibility of pectin gels formed by different cross-linking cations. Hydrogel beads named CaPG, ZnPG, FePG, and AlPG were prepared from 4% solutions of apple pectin using ionotropic gelling with CaCl2, ZnCl2, FeCl3, and AlCl3, respectively. Cations influenced the gel strength of the wet gel beads in the following order (least strong) Ca2+ < Zn2+ < Fe3+~Al3+ (most strong). The swelling degree of the CaPG beads after 24 h of incubation in the RPMI-1640 medium was 104%, whereas the ZnPG, FePG, and AlPG beads swelled by 76, 108, and 134%, respectively. The strength of the pectin gel decreased significantly after incubation in the RPMI-1640 medium for 24 h, regardless of the cross-linking cation, although the FePG beads remained the strongest. All the pectin beads adsorbed serum proteins to a low degree, however the serum protein adsorption by the ZnPG and FePG beads (1.46 ± 0.87 and 1.35 ± 0.19 µg/mm2) was more than the CaPG and AlPG beads (0.31 ± 0.36 and 0.44 ± 0.25 µg/mm2). All the pectin beads reduced the production of TNF-α and IL-10 by hPBMCs in response to LPS stimulation. The IL-1β response of cells to LPS was significantly reduced by the CaPG, ZnPG, and FePG beads, whereas the AlPG beads enhanced it twofold. The CaPG, FePG, and AlPG beads had no cytotoxicity. The viability of hPBMCs and human fibroblasts incubated with ZnPG beads was 5.3 and 7.2%, respectively. Thus, the use of different cross-linking cations changed the properties of the pectin gel, which is important for biocompatibility

Oxidation Resistance of γ-TiAl Based Alloys Modified by C, Si and Y₂O₃ Microdopants

This work aimed to study the oxidation resistance of γ-TiAl based alloy, doped with small concentrations of carbon, silicon, and yttrium oxide in air at 800 and 1100 °C for 30 h. The TNM-B1 alloy samples were produced via high-energy ball milling, self-propagating high-temperature synthesis, and hot isostatic pressing techniques. The microstructure, oxidation kinetics at 800–1100 °C, scale structure, and oxidation mechanism were studied. The oxidation of alloys modified with carbon and silicon at 1100 °C was characterized by the formation of a three-layer coating. The Y2O3 modified alloy performed the greatest oxidation resistance at 1100 °C and promoted the formation of a dense Al2O3 interlayer

Mesenchymal stem cells and exosomes in bone defects treatment

Introduction Bone defect management is a critical stage of treatment and rehabilitation that still remains a challenging problem for traumatologists and orthopaedists. The need for tissue engineering techniques is due to limited abilities of the human body to correct bone tissue autoregeneration, especially in comorbid and elderly patients with osteoporosis. Bone autografts is a gold standard in those cases but is associated with certain restrictions. Regenerative medicine and stem cell biology development opened up capabilities to employ new methods for enhancement of bone tissue repair. A special interest of researchers is focused on mesenchymal stem cells and extracellular vesicles for bone tissue regeneration optimization. Purpose of this review was to show mesenchymal stem cells and exosomes effeciency in bone defect treatment. Materials and methods Open electronic databases of scientific literature, PubMed and e-Library, were used. The literature data search was carried out using the keywords: regenerative medicine, bone defects, exosomes, mesenchymal stem cells. Results and discussion The review presents current ideas about mesenchymal stem cells, their microenvironment and exosomes influence on bone tissue repair. Clinical need in effective bone regeneration is still high. Mesenchymal stem cells and acellular regenerative treatments have shown good results in bone defects repair and are perspective directions. Productive use of mesenchymal stem cells and exosomes in bone defects treatment requires further study of their mechanisms of action, the regenerative techniques efficacy and safety evaluation in preclinical and clinical studies. Conclusion The use of mesenchymal stem cells and cell-free regenerative approaches has demonstrated good results in the restoration of bone tissue defects and is a promising direction

Use of Probiotics in Treatment and Rehabilitation of Patients after a New Coronavirus Infection

As of January 2022, 343 million cases of SARS-CoV-2 were reported globally. COVID-19 is a multi-faceted, multi-systemic illness in whichall age groups are susceptible. A number of research findings have shown that COVID-19 is associated with dysbiosis, leading to thedevelopment of local and systemic pathologies. It was found that the use of probiotics in the complex therapy of patients with COVID-19 reduces the severity of the disease and the development of complications. According to the researchers, several mechanisms couldexplain the therapeutic effect of probiotics, including the ability to suppress pro-inflammatory cytokine formation and modulate thefunctional activity of the immune system. In Russia, probiotics in the treatment of COVID-19 patients are only used to correct diarrhea,while literature suggests that probiotics have much greater therapeutic potential. Introducing oral bacterial therapy into the treatmentand rehabilitation of COVID-19 patients requires further clinical trials

Isobornyl and Isocamphyl Photostabilizers in Poly(lactic acid)-Based Electrospun Fibers

In this work, electrospun polylactide fibers with new photostabilizing additives, 4-methyl-2,6-diisobornylphenol (DIBP) and N-isocamphylaniline (NICA), have been tested under the influence of UV-C radiation (254 nm). The changes in the polymers’ chemical structure under UV-C radiation were revealed through the increase in absorption in the 3600–3100 cm−1 region in regard to the FTIR spectra. In the samples that were irradiated for 1 h, the stabilizing effect of the photoprotectors became most noticeable as the difference in the content of the hydroxyl groups in stabilized and the pure PLA reached a maximum. The TG–DSC method revealed that the most sensitive indicator of the irradiation effect was the glass transition temperature (Tg), which persisted after 2 h of irradiation when using photostabilizers and their combinations. The PLA/DIBP(1) and PLA/NICA(1) samples showed the best results in protecting PLA from UV-C radiation based on the Tg values; although, the mixture of DIBP and NICA was not as effective. The chemical structure of the photostabilized PLA samples was studied using NMR, GPC, and Py–GC/MS analysis. The electrospun polylactide fibers were mechanically tested and the effects of the electrospun samples on cell viability were studied