Afferent Loop syndrome with associated perforation 15 years after gastrectomy and Roux-En-Y Reconstruction

An elderly patient presented to our institution with abdominal pain, nausea and vomiting. She had an extensive surgical background including gastrectomy with Roux-en-y reconstruction undertaken 15 years earlier. A CT abdomen demonstrated a small bowel obstruction proximal to the jejunojejunostomy with features suggestive of afferent loop syndrome (ALS), a rare but known complication following Roux-en-y reconstruction. Initial surgery identified a band adhesion and an associated ischemic small bowel segment, which was resected with primary anastomosis. A further operation was required at post-operative day five due to clinical deterioration. A retroperitoneal collection was identified secondary to perforation of the afferent loop

Деякі чинники адаптації студентів-першокурсників в умовах класичного університету

The paper deals with peculiarities of adaptation features to the educational process of first-year students and the some factors (aids) which help them overcome emerging difficulties. Among the main tasks at this stage are the development of a questionnaire and conducting an electronic questionnaire among first-year students, identifying the main difficulties and analyzing positive and negative factors of student adaptation in the higher institutions. Some mains aids have been found to help first-year students overcome emerging difficulties. They are electronic resources in libraries, living conditions in the dormitories, relationships in student groups, receiving help from parents, relatives, fellow students, senior students, etc. Using electronic questionnaires, the diagnostics of adaptation of students to the educational process in conditions of the classical university has been conducted among 200 students in 2016 and 750 students in 2018. Most students have established relationships in their student group and think that the atmosphere in their group is favorable. Students get help from parents, relatives, fellow students, senior students and teachers, and students themselves help others as well. There should be more involvement of curators and teachers in adaptation of first-year students. It has been established that the renewed social environment, new living conditions are sufficiently favorable for the successful adaptation of students to the educational process in higher education. Some difficulties in the process of adaptation of first-year students to the university have both objective nature (unfamiliar lifestyle, new learning process, new forms and methods of studies, the need to study more by themselves, etc.), as well as subjective nature (poor school preparation, stress, fatigue caused by lectures, students’ own lack of organizational skills, and laziness, poor study skills, inability to prioritize, etc.). The empirical study proves that in the university conditions there are various factors during the adaptation of first-year students.Проведено діагностику адаптації першокурсників до освітнього процесу в умовах класичного університету шляхом електронного анкетування 200 студентів у 2016 р. і 750 студентів у 2018 р. Виявлено чинники, які сприяють подоланню труднощів, які виникають у першокурсників, як-от: електронні ресурси бібліотеки, умови проживання в гуртожитку, стосунки в студентській групі, допомога від батьків, родичів, однокурсників, студентів старших курсів та ін. Отримані результати анкетування добре узгоджуються для обох років, або показують покращення дії більшості досліджених чинників адаптації; виняток – потребує певної активізації діяльність академнаставників і викладачів щодо адаптації першокурсників