bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIAGNOSIS OF GERM CELL TUMORS OF EXTRAGONADAL LOCALIZATION IN TERMS OF ALGORITHMS FOR DETECTING METASTASIS OF CARCINOMAS OF UNKNOWN PRIMARY LOCALIZATION
Authors: Poslavska О.V. 
Published: July 2019

The analysis of cases of extragonadal teratomas makes it clear that tumours derived from germ cells and mainly characteristic of adult gonads can also occur in other areas, such as the anterior mediastinum (thymus) and midline brain (germinomas of the epiphysis and the area above the Turkish saddle), that requires differential diagnosis with metastases of carcinomas of other origin. Accurate diagnosis of estrogenic germ-cell tumours by only routine staining with haematoxylin-eosin requires high expertise and experience due to their non-specific clinical symptoms and variability of morphological characteristics. Tumour morphologists consider that immunohistochemical investigation plays an important role in accurate histological diagnosis of these tumours. The goal of this study is to explore the expression features of immunohistochemical markers and morphometric parameters of the area, perimeter and "roundness" of the nuclei in various types of extragonadal germ-cell tumours compared to similar primary ovarian / testicular tumours in order to improve diagnostic algorithms. A study was conducted on biopsy or postoperative samples taken from 8 patients (group 1) with extragonadal germ-cell tumours and from 16 patients with primary germ cell tumours of testicles / ovaries (group 2). The diagnoses were confirmed by immunohistochemical investigation on the basis of the pathologic department of the “Pharmacy of Medical Academy” Diagnostic Centre for 2015 to 2018. PLAP and CD117 had the highest percentage of expression in seminomas and gerninomas of both studied groups; morphological parameters were 3-fold higher in area and ̴2-fold higher around the perimeter then the values of normal lymphocytes (p<0.05). Expression of markers CD30, EMA and CK AE1/3 was diagnostically significant in samples of embryonic carcinoma, and morphological parameters ̴were ̴ 2.1 times higher in area and ̴ 1.7 along the perimeter that exceeded the values of normal lymphocytes (p<0.05). αFP-positive staining was indicative of yolk sac tumours, which morphological parameters were more than ̴ 1.7 times higher in the area and ̴ 1.5 times higher along the perimeter compared with the normal lymphocytes (p<0.05). Taking into account the variability of morphological characteristics and the possibility of extragonadal location of tumours derived from germ cells, immunohistochemical research supported by morphometry is an important tool in the differential diagnosis of carcinomas of unknown primary localization.
MEDICAL BLOG IN GENRISTIC DIMENTION
Authors: Levchenko K.I. 
Published: July 2019

Nowadays there is growing popularity of medical blogs as new communicative environment and one of the promising areas of linguistic knowledge. However, in Ukrainian linguistic studies, there are few works devoted to exploring their genre characteristics that predetermines the relevance of this research. The purpose of the work is to analyze the medical blog as a genre of Internet communication. To achieve this aim, we designed and fulfilled the following objectives: to clarify the criteria for identifying a medical blog as an independent genre and to describe its genre characteristics. The methodology of this research included general scientific and linguistic methods and techniques: a descriptive method, observation techniques, comparisons and generalizations, discourse analysis, conversational analysis. The genre characteristics of medical blogs have been analyzed based on T.V. Shmeleva’s genre model. The communicative purpose, the author’s role and representation as a test addressor and the characteristics of potential addressee, the image of the past, the image of the future, and the type of dictum context and the linguistic tools for their implementation into the texts. The communicative goal of a medical blog is to convey the professional opinion of a specialist to readers, highlight issues that most often arise in medical practice, and disseminate medical and scientific knowledge among Internet users that is typical of information genres. Medical blogs also promote a healthy lifestyle and illustrate the nuances of medical procedures to help readers choose the right strategy for keeping fit and healthy. This type of communicative behaviour implements the informative and imperative goals of blogging. The author is presented from the standpoint of education, professionalism, responsibility, unselfishness and morality. Another distinctive feature is no phenomena of author’s anonymity, “virtual” and speech masks inherent in the diary blogs. The medical blog provides an unlimited number of recipients: fellow doctors and patients. This is an initial genre, providing for the extension of the communication of the addressor-addressee in the future. Dictum context of a medical blog is focused on reality, with a clear scientific position and rationality. The authors mainly use standard speech patterns within this type of genre.
IMPACT OF RESTRICTIVE REGIMEN OF INFUSION THERAPY ON THE PERIOPERATIVE PERIOD IN PATIENTS WITH URGENT ABDOMINAL PATHOLOGY
Authors: Kravets O.V. 
Published: July 2019

One of the leading pathogenetic processes that is specific for emergency abdominal pathology is hypovolemia. The primary method of its treatment is infusion therapy. The purpose of the study is to evaluate the effectiveness of the restrictive regimen of infusion therapy in patients with emergency abdominal pathology.
Materials and methods. We examined 50 patients who were performed on emergency laparotomy. Perioperative infusion therapy in all patients was carried out in a restrictive regimen with balanced crystalloid solutions. We studied the indicators of water metabolism: daily and cumulative water balances, the percentage of fluid excess. We determined water sectors of the body by the method of non-invasive bioelectric rheography. Results. The study has found out the presence of the initial depletion of the extracellular fluid volume due to a decrease in both interstitial and intravascular volumes in patients with urgent abdominal pathology. Intravascular deficiency was due to a decrease in plasma volume. Replenishment of extracellular deficiency by restrictive regimen of infusion therapy restored the plasma volume to normal values since one day after surgery; interstitial volume started restoring on the 7th days of observation, compared to the normal intracellular volume on the 3 days of the postoperative period. Conclusions: restrictive infusion therapy regimen enables to completely and safely restore extracellular volume depletion on the 7 days of the preoperative period by correcting plasma deficiency since the 1 day of the post-operative period; to replenish interstitial volume on the 7 days and to prevent the development of oedema during “zero” daily water balance, as well as to slightly increase the cumulative water balance and the percentage of excess fluid.
PROGNOSTIC VALUE OF BIOCHEMICAL MARKERS IN PURULENT-CEPTIC COMPLICATIONS OF ACUTE SEVERE PANCREATITIS
Authors: Cherkun O.Yu. , Sheyko V.D. , Sytnik D.A. , Kryzhanovsky O.A. 
Published: July 2019

One of the most pressing issues of urgent abdominal surgery is acute pancreatitis. The incidence of pancreatitis increases annually by 2.5 - 3.1%, ranging from 15 to 70 cases per 100,000 population in Europe and North America. About 40% of patients die within the first 7 days after hospitalization, most in the first 3 days. Patients with acute severe pancreatitis who are experiencing the first wave of the disease have a high risk of secondary infection of the pancreatic necrosis foci that is an indication for surgical intervention. This article presents the analysis of the treatment results in 22 patients with acute severe pancreatitis, 7 (31.8%) men and 15 (68.2%) women. Age of patients ranged from 22 to 79 years (46,9 ± 1,5 years). 2-7 days was the time from the onset of the disease to hospital admission. Purulent-septic complications developed in 22 (100.0%) patients, the presence of sequestrate was detected in 9 of them (40.9%). The average period of hospital staying for this group of patients was 48.3 ± 4.4 days; the mortality rate was 27.3% (6 patients). Having analyzing the biochemical markers obtained, we can state that the increase in the level of procalcitonin and C-reactive protein indicates the development of purulent-septic complications in patients with acute severe pancreatitis, while the decrease in the free T3 concentration at normal T4 and TSH levels in 6 (27.3%) of patients, suggests the development of their lowT3 syndrome that in turn suggests an unfavourable course of the disease.
Percutaneous Cholecystostomy as an Alternative to Cholecystectomy in High-Risk Patients with Acute Cholecystitis
Authors: Tosun Salih , Yener Oktay , Ekinci Ozgur , Gapbarov Aman , Asik Murat , Eren Tunc , Alimoglu Orhan 
Published: July 2019

Background: Cholecystectomy is the standard treatment for patients with acute cholecystitis. On the other hand, percutaneous cholecystostomy (PC) is an alternative for patients at high-risk for surgery. The aim of this study was to evaluate the clinical outcomes of PC.
Methods: Surgically high-risk patients with acute cholecystits having undergone PC at our institution between January 2014 – January 2017 were evaluated. Data including the indications for PC, route of insertion, technical success, clinical improvement, length of hospital stay, mortality rates, procedure related complications, subsequent admissions and performance of interval cholecystectomy were recorded and analyzed.
Results: The study group consisted of 30 patients with a mean age of 75.3 ( range: 49–99) years. The indications for PC were acute calculous cholecystitis in 28 (93.3%) and acalculous cholecystitis in 2 (6.7%) patients. All procedures were performed via the transhepatic route. Twenty-five PCs (84.4%) resulted in clinical improvement within five days. A repeated PC was performed in two (6.7%) patients. Seven (23.3%) patients underwent a subsequent cholecystectomy after 6 weeks. An emergent cholecystectomy was performed in one (3.3%) patient. Five (16.7%) patients died from underlying comorbid diseases, unrelated to the biliary system, during the follow-up.
Conclusions: Patients with acute cholecystitis were promptly relieved from their symptoms following PC. There were only minor complications following the procedure and an interval cholecystectomy was necessary in only 23.3% of the patients. PC is a safe alternative to choecystectomy in high-risk patients with acute cholecystitis with satisfactory results.
Retrospective Study of Surgical Repair of Gunshot Injuries of Peripheral Nerves.
Authors: Alimehmeti Ridvan , Brace Gramoz , Pajaj Ermira , Cecia Arba , Kalefi Thoma , Kerxhaliu Jetmira , Rroji Arben , Bardhi Norik , Seferi Arsen 
Published: July 2019

Background: Shotgun injuries of the peripheral nerves are presented frequently during the last decades at the Service of Neurosurgery of UHC “Mother Theresa” in Tirana. In such cases the surgical repair of brachial plexus and peripheral nerves constitutes a challenge with relation to difficulties related with mechanism of injury, coexistence of other vascular damage, bone, soft tissue and visceral lesions.
Materials and methods: A retrospective study of operated cases with shotgun injuries treated in our Department from 1997 to 2012 was conducted getting information from clinical charts, surgical registries, intraoperative photos and videos of the surgical repair of peripheral nerves. We performed a thorough analysis of the most influencing factors of surgical outcome such as: age, severity of injury, site of injury with relation to the innervated muscles, type of necessary nerve repair, presence of causalgia before operation, concomitant compromise of vascularization and/or locomotor apparatus. Follow-up of the patient was conducted through out-patient visits and phone interviews going back 10 years from surgical repair.
Results: 68 cases operated for shotgun injury of brachial plexus or peripheral nerves were revised. There were different ages and both sexes involved. The type of nerve repair went from interfascicular neurolysis to direct end-to-end microsuture and nerve grafting. Timely repair of the nerve injury proved to be yielding better result than late repair in terms of pain relief and sensory motor improvement of the preoperative neurological deficit. The degree and the quality of improvement after surgery is related to the type of repair (neurolysis improves better and faster than grafting), the distance from site of injury to the effector muscle (the longer the distance more time it takes for the function to recover). The recovery of the brachial plexus was followed up for many years and further surgery proved to be necessary and of further improvement.
Conclusions: From our long term experience dealing with surgical repair of shotgun injury of peripheral nerves we have learnt that early surgical repair is more efficacious in treating pain and gives better results in terms of motor and sensitive recovery than six months after injury as it was usually done. Long term follow-up is necessary to help with further surgery in case of distal decompressive surgery in anatomical tunnels.
Unexplained Severe Lactic Acidosis in Young Patient.
Authors: Ibrahimi Alfred , Kuci Saimir , Bejko Ervin , Llazo Stavri , Llambro Maksim 
Published: July 2019

Case report: A 27-year-old previously healthy man was admitted to the ICU complaining nausea, vomiting and disorientation, after he ingested 1500 mg paracetamol, but its relatives explained that they possess in the house only metformin (maybe he ingested metformin instead of paracetamol). First blood gas showed moderate, and hours later severe lactic acidosis Ph 7,01, Lac 25 m mol/L, BE -26,4. Aggressive rehydration and hemofiltration was started, until full recovery after 24 hours of hospital admission. He was discharged after three days in healthy condition.
Discussion: Lactic acidosis is a common cause of metabolic acidosis at the ICU. Type A is most common and caused by hypoperfusion or hypoxia, whilst type B has other causes including use of the antidiabetic drug metformin. Metformin associated lactic acidosis (MALA) is an important treatment-associated condition, and although rare, it is very serious.
Conclusion: MALA should be strongly suspected in patients presenting with wide anion gap metabolic acidosis and high blood lactate concentration. Bicarbonate hemodialysis or continuous renal replacement therapy should be urgently arranged for patients with MALA.
Surgical Treatment of Rectal Prolaps in 83 Year Old Patient. A Case Report.
Authors: Arslani Nuhi , Lenjani Basri 
Published: July 2019

Background: Prolapse of the rectum is an uncommon problem. It is defined as a protrusion of the rectum through the anus and can cause disability. There is no concensus in literature which surgical approach is the most appropriate. The aim of our case report is to share our experiance and results of the Altemeier procedure.
Case report: 83 years old female patient was admited to the department for general and abdominal surgery. She was diagnosed with rectal prolapse, which could not be reponated. She felt pain and was incontinent.
Results: We decided that optimal treatment for the patient was operation. Altemeier approach was performed. In our opinion, we achieved a favorable outcome.
Conclusion: As stated above there is no clear concensus on which treatment is the most appropriate for rectal prolaps. In our case after careful consideration, we decided that the Altemeier approach was the best solution for the patient.
Anastomotic Leak after Colorectal Surgery. Our Experience in three Years.
Authors: Haxhirexha Kastriot , Dogjani Agron , Zylbehari Lutfi , Baftiu Nehat , Dika – Haxhirexha Ferizat 
Published: July 2019

Background: One of the most severe complication after intestinal resection, often with catastrophic consequence for the patient is leakage from the anastomosis. The severity of complications after anastomotic leak may range from a small localized peritonitis or abscess formation without sepsis, to a development of a four quadrant peritonitis with septic shock. Until now despite the seriousness of this complications, the cause of anastomotic leakage are not yet definitively clear. Aim: The aim of this study is to submit our experience in treatment of patients with anastomotic leakage after intestinal resection and their outcome.
Materials and Methods: The study included 63 patients with colorectal cancer operated in the Department of Surgery at the Clinical Hospital of Tetova. In all patients intestinal resection with end to end anastomosis was performed.
Conclusions: Anastomotic leak after large bowel resection is a very serious complication with a great impact on patient’s morbidity and mortality. Multiple risk factors are associated with occurrence of this complication whereas the more suspected are: preoperative anaemia, hypoalbuminemia, emergent surgery without adequate preparation of patient, intraoperative blood loss and blood transfusion during surgery etc. Early detection of AL is very important and helpful to improve the outcome of patients and to minimize postoperative rate of morbidity and mortality.
Keywords: anastomotic leaks, colorectal surgery, risk factors
MAC Anesthesia during Endoscopic Percutaneous Gastrostomy (PEG) in a Patient with Amyotrophic Lateral Sclerosis (ALS). A Case Report.
Authors: Naço Majlinda , Gani Haxhire , Dibra Arvin , Naço Eden , Mukaj Suzana 
Published: July 2019

Background: Amyotrophic lateral sclerosis (ALS) is a serious disease in which some brain and spinal cells die slowly. These nerve cells are called motor neurons and control the muscles that allow the body parts to move. Initially, the disease causes bodily fatigue and muscular weakness through degeneration of the upper and lower motor neurons, leading to loss of ability to initiate and control the voluntary bodily functions. In late stages this disease causes difficulty in the normal swelling and eating that causes the need for PEG in patients with ALS. This clinical picture increases the difficulty and the anesthetic risk used during the PEG application.
Case presentation: We are describing our experience in a 56-year-old male patient, ASA III suffering from ALS and being admitted to our clinic to insert PEG. The patient presented BMI =15.6. After the patient provide informed consent, we were monitoring him for detect changes in pulse oximetry, noninvasive blood pressure, heart rate and visual assessment of ventilator activity, level of consciousness and discomfort. We used balanced propofol for moderate sedation (BPS), loading dose 1mg midazolam, 0.1 mg of fentanyl, and 5-15 mg propofol in smaller bolus dose were applied for more precise dose titration. The operation was performed after the patient lost the consciousness and had no pupil reflex. The EGD entered to the stomach. Fistula was localized after the visualization of light from the tube. Local lidocaine was applied and 1cm incision on the abdominal wall gave the possibility for application of fistula and gastro stoma placement. The patient wakes up 10 minutes after the end of the procedure without using antidotes. The patient after treatment went home in two days using gastro stoma for enteral feeding.
Considerations and Evaluations on Abdominal Trauma in Pediatric Age.
Authors: Dogjani Agron , Haxhirexha Kastriot , Selmani Edvin , Bendo Hysni , Blloshmi Amarildo , Craga Briselda 
Published: July 2019

Background: Trauma is the leading cause of morbidity and mortality in pediatric age.
Abdominal trauma is the third most frequent cause of trauma injuries in children.
The purpose of our study is to discuss BATp epidemiology and its relationship with polytrauma, , to recognize and describe the mechanisms of blunt abdominal trauma in pediatric age and to identify the signs and symptoms that associate it.
Material and methods: In this retrospective study we reviewed all patients with blunt abdominal trauma in pediatric age who presented in Emergency Department at the University Hospital of Trauma in Tirana, Albania in the period between December 1-st 2017 and June 24-th 2018. The sample in the study was taken randomly. The Injury Severity Score, Revised Trauma Score were used as important points to evaluate gravity of injuries, and method of treatment.
The data was introduced in absolute and percentage values and Kendal's tau b correlation coefficient and the regression analysis was used to analyze and to find out any association among the dependent versus independent variable. The type of study is case control with two components; descriptive and analytical.
Results: In the time period that we studied, about 25200 patients were presented in Emergency department and 6.68% of these cases were hospitalized. Most frequent causes were motor vehicle accidents (35.4%) and abdominal trauma comprised 25.8% of cases, whereas in children it comprised 13.7% of total pediatric trauma. We have found correlation between the injury severity score and complications rate (r = 0.254, n = 49, p <0.001), and injury severity score with length of hospital stay (r = 0279, n = 49, p <0.001).
Conclusions: Blunt Abdominal Trauma in pediatric age is a serious threat to the health of the children. Their treatment should be carried out not only in tertiary trauma centers but in every regional hospital. The trauma score is very valuable to determine the gravity of the injury, method of treatment and is a predictive tool in trauma outcomes.
Our Experience in Epidural Analgesia Following Large Abdominal Surgeries.
Authors: Bafti Nehat , Baftiu R. 
Published: July 2019

Background: Epidural analgesia is a gold standard in post-operative pain control in patients undergoing large abdominal interventions. Different studies report a failure ratio of epidural analgesia of 20-32%.
The aim of this study is to analyze the success rate of epidural analgesia and its consequences in patients that have been subject to large abdominal surgeries.
Materials and methods: We have prospectively collected the data of 50 patients that were subject to open abdominal surgeries during a 2 year timeframe (September 2015 – September 2017) at University Clinical Center of Kosovo. Experienced anesthesiologists inserted the epidural catheters. A dedicated team used the Verbal Scale to collect the data regarding post-operative pain during coughing or moving. The success rate of eidural catheter was measured in terms of: the scale of pain, pulmonary post-operative infection and length of hospital stay.
Results: The study group included 33 males and 17 females, most of whom were subject to liver surgery. The secondary liver formations (70%), primary tumours (20%) as well as beningn liver disorders(10%) were an indication for liver resection. Large resections (≥3 segments) were completed in 44% of patients, small liver resections were (≤2 segments) completed in 48% of patients, while 8% of patients were considered inoperative. Epidural analgesia was successful in 46 patients (92%). Bacterial colonisation of the catheter was observed in only one case. There were no neurological complications. 5 (10%) patients showed radiologicalsigns of a pulmonary infection. Three patients (6%) had surgical wound infection. One patient died of hepatic insufficiency after massive right liver resection and cholecystectomy due to gallbladder carcinoma. The average length of hospital stay was 6 days.
Conclusions: Our experience concludes that epidural analgesia is a safe and effective way of pain relief after abdominal surgeries.