31 research outputs found

    ΠžΠΏΡ‹Ρ‚ ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ³ΠΎ лСчСния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° с синдромом Π’ΡŽΡ€ΠΊΠΎ

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    We report a case of successful treatment of a 15-year-old female patient (body mass index 16) diagnosed with Turcot syndrome (familial adenomatous polyposis of the colon) combined with multiple primary malignant tumors, including anaplastic astrocytoma (received combination therapy in 2007), metachronous cecal cancer (underwent subtotal colectomy and 12 courses of polychemotherapy in 2016–2017), and metachronous stage III pT3N1M0 rectal cancer at 8 cm. The patient underwent laparoscopic low resection with extirpation of the ileosigmoid anastomosis, creation of a reservoir-rectal anastomosis, and preventive ileostomy. The patient had minimal intraoperative blood loss and uneventful postoperative period (with an accelerated rehabilitation protocol). She was discharged from a hospital on day 9. Considering previous treatment episodes and the disease stage, we also included into the treatment regimen adjuvant FOLFOX polychemotherapy in a reduced dose for 6 months. During one-year follow up, there was no evidence of disease progression. Later, the patient underwent ileostomy closure with forming a side-to-side mechanical anastomosis. The patient is fully rehabilitated in term of her social activity.Π’ клиничСском наблюдСнии продСмонстрировано ΡƒΡΠΏΠ΅ΡˆΠ½ΠΎΠ΅ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠΈ Π‘. Π² возрастС 15 Π»Π΅Ρ‚ (индСкс массы Ρ‚Π΅Π»Π° – 16), Ρƒ ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠΉ диагностирован синдром Π’ΡŽΡ€ΠΊΠΎ – сСмСйный Π°Π΄Π΅Π½ΠΎΠΌΠ°Ρ‚ΠΎΠ·Π½Ρ‹ΠΉ ΠΏΠΎΠ»ΠΈΠΏΠΎΠ· толстой кишки, ΡΠΎΡ‡Π΅Ρ‚Π°ΡŽΡ‰ΠΈΠΉΡΡ с ΠΏΠ΅Ρ€Π²ΠΈΡ‡Π½ΠΎ-мноТСствСнными злокачСствСнными опухолями (анапластичСская астроцитома Π³ΠΎΠ»ΠΎΠ²Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ·Π³Π°, состояниС послС ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ лСчСния (2007 Π³.); ΠΌΠ΅Ρ‚Π°Ρ…Ρ€ΠΎΠ½Π½Ρ‹ΠΉ Ρ€Π°ΠΊ слСпой кишки, Ρ€T3N1M0, состояниС послС ΡΡƒΠ±Ρ‚ΠΎΡ‚Π°Π»ΡŒΠ½ΠΎΠΉ колэктомии ΠΈ 12 курсов ΠΏΠΎΠ»ΠΈΡ…ΠΈΠΌΠΈΠΎΡ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Π² 2016–2017 Π³Π³.; ΠΌΠ΅Ρ‚Π°Ρ…Ρ€ΠΎΠ½Π½Ρ‹ΠΉ Ρ€Π°ΠΊ прямой кишки Π½Π° 8 см, Ρ€T3N1M0, III стадия). Π‘ΠΎΠ»ΡŒΠ½ΠΎΠΉ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΎ хирургичСскоС Π²ΠΌΠ΅ΡˆΠ°Ρ‚Π΅Π»ΡŒΡΡ‚Π²ΠΎ Π² объСмС лапароскопичСской Π½ΠΈΠ·ΠΊΠΎΠΉ Ρ€Π΅Π·Π΅ΠΊΡ†ΠΈΠΈ прямой кишки с экстирпациСй илСосигмоанастомоза, Ρ„ΠΎΡ€ΠΌΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Ρ€Π΅Π·Π΅Ρ€Π²ΡƒΠ°Ρ€ΠΎ-Ρ€Π΅ΠΊΡ‚Π°Π»ΡŒΠ½ΠΎΠ³ΠΎ анастомоза, ΠΏΡ€Π΅Π²Π΅Π½Ρ‚ΠΈΠ²Π½ΠΎΠΉ илСостомиСй. Π˜Π½Ρ‚Ρ€Π°ΠΎΠΏΠ΅Ρ€Π°Ρ†ΠΈΠΎΠ½Π½Π°Ρ кровопотСря минимальна. Π’Π΅Ρ‡Π΅Π½ΠΈΠ΅ послСопСрационного ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π° Π³Π»Π°Π΄ΠΊΠΎΠ΅, с ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΏΡ€ΠΎΡ‚ΠΎΠΊΠΎΠ»Π° ускорСнной Ρ€Π΅Π°Π±ΠΈΠ»ΠΈΡ‚Π°Ρ†ΠΈΠΈ. ΠŸΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ° выписана Π½Π° 9-Π΅ сутки. Π‘ ΡƒΡ‡Π΅Ρ‚ΠΎΠΌ Π°Π½Π°ΠΌΠ½Π΅Π·Π° ΠΈ стадии заболСвания ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»Π°ΡΡŒ Π°Π΄ΡŠΡŽΠ²Π°Π½Ρ‚Π½Π°Ρ полихимиотСрапия ΠΏΠΎ схСмС FOLFOX Π² Ρ€Π΅Π΄ΡƒΡ†ΠΈΡ€ΠΎΠ²Π°Π½Π½ΠΎΠΉ Π΄ΠΎΠ·Π΅ Π² Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 6 мСс. Π—Π° 1 Π³ΠΎΠ΄ наблюдСния Π΄Π°Π½Π½Ρ‹Ρ…, ΡƒΠΊΠ°Π·Ρ‹Π²Π°ΡŽΡ‰ΠΈΡ… Π½Π° прогрСссированиС основного заболСвания, Π½Π΅ ΠΏΠΎΠ»ΡƒΡ‡Π΅Π½ΠΎ. Π’ дальнСйшСм ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΊΠ΅ Π²Ρ‹ΠΏΠΎΠ»Π½Π΅Π½ΠΎ Π·Π°ΠΊΡ€Ρ‹Ρ‚ΠΈΠ΅ илСостомы с Ρ„ΠΎΡ€ΠΌΠΈΡ€ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π°ΠΏΠΏΠ°Ρ€Π°Ρ‚Π½ΠΎΠ³ΠΎ анастомоза Β«Π±ΠΎΠΊ Π² Π±ΠΎΠΊΒ». Π‘ΠΎΠ»ΡŒΠ½Π°Ρ ΠΏΠΎΠ»Π½ΠΎΡΡ‚ΡŒΡŽ Ρ€Π΅Π°Π±ΠΈΠ»ΠΈΡ‚ΠΈΡ€ΠΎΠ²Π°Π½Π° Π² ΡΠΎΡ†ΠΈΠ°Π»ΡŒΠ½ΠΎΠΌ аспСктС

    Atopic dermatitis in children

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    Infant's skin is very sensitive and susceptible to irritants and allergens. Combined with precipitating factors, genetic predisposition plays the key role. Chronic skin inflammation, or atopic dermatitis, is one of the most common pathologies which hinders and limits every day life of the baby and its parents. In the therapy of atopic dermatitis the focus should be on timely and adequate skin care aimed at reducing irritation, preserving the integrity of the child's skin and preventing complications, thereby improving the quality of life

    Successful treatment of a patient with Turcot syndrome

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    We report a case of successful treatment of a 15-year-old female patient (body mass index 16) diagnosed with Turcot syndrome (familial adenomatous polyposis of the colon) combined with multiple primary malignant tumors, including anaplastic astrocytoma (received combination therapy in 2007), metachronous cecal cancer (underwent subtotal colectomy and 12 courses of polychemotherapy in 2016–2017), and metachronous stage III pT3N1M0 rectal cancer at 8 cm. The patient underwent laparoscopic low resection with extirpation of the ileosigmoid anastomosis, creation of a reservoir-rectal anastomosis, and preventive ileostomy. The patient had minimal intraoperative blood loss and uneventful postoperative period (with an accelerated rehabilitation protocol). She was discharged from a hospital on day 9. Considering previous treatment episodes and the disease stage, we also included into the treatment regimen adjuvant FOLFOX polychemotherapy in a reduced dose for 6 months. During one-year follow up, there was no evidence of disease progression. Later, the patient underwent ileostomy closure with forming a side-to-side mechanical anastomosis. The patient is fully rehabilitated in term of her social activity
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