bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renal Neoformation: A Diagnosis to Consider
Authors: Miranda João , Coelho Paula , Rosinha Céu , Marques Eduarda 
Published: September 2022

Renal granulomas related to suture material are rare and usually accidental findings in imagiological studies. A 12-year-old boy, followed-up after Anderson-Hynes pyeloplasty 7 years before, was submitted to an ultrasonography that described a solid nodular lesion, possibly in the dependence of the left kidney. Subsequently, magnetic resonance imaging was performed, which reported a lesion with non-specific features, suggesting neoformation with predominant fibrous peripheric component and myxomatous center. Percutaneous biopsy was morphologically compatible with chronic xanthogranulomatous inflammatory process. Anatomopathological examination of the surgical excised lesion described histiocytic cells with frequent participation of foreign body type giant cells and granulomatous reaction in relation to exogenous suture-like material. He remains asymptomatic since then. Foreign body granulomatous pseudotumors are difficult to diagnose regarding the absence of specific imagiological features distinctive from neoplasms, requiring histological examination to confirm the diagnosis.
Reconciliação Terapêutica: Um Processo Complexo
Authors: Campos de Sousa Ana 
Published: September 2022

O envelhecimento demográfico, as múltiplas patologias e a polimedicação reforçam a importância da reconciliação terapêutica: um processo complexo e contínuo que visa a manutenção da lista de medicação atualizada e completa, durante as várias transições entre cuidados do doente. A segurança do doente é um objetivo primordial da reconciliação terapêutica que procura diminuir erros na medicação, riscos e possíveis danos a ela associados, como sejam a duplicação, omissão ou interações medicamentosas. O presente artigo consiste numa reflexão sobre a importância da reconciliação terapêutica, as suas implicações na saúde do doente, os riscos associados à sua não realização, bem como possíveis soluções e adaptações dos cuidados de saúde necessárias à qualidade em saúde.
Tecnologias e Brincadeiras: Uma Infância a Mudar?
Authors: Rocha Teixeira Sofia , Dias Sandrine , Sousa Ana Rita , Gomes Amorim Joana 
Published: September 2022

Brincar é a forma mais natural e espontânea de a criança se expressar e assume um papel relevante no desenvolvimento infantil. O boom tecnológico e digital que vem marcando posição nos últimos anos está a mudar o modo de brincar das crianças, substituindo o tempo ao ar livre por horas em frente a ecrãs – televisão, tablets, smartphones, computadores.Como potenciais riscos do uso excessivo das tecnologias contam-se não só o sedentarismo, excesso de peso e obesidade, mas também o comprometimento do desenvolvimento cognitivo e intelectual, da linguagem e até das interações sociais e relações. Já as brincadeiras interpares promovem uma aprendizagem ativa, baseada na aquisição de competências de interação social e emocional.A informação aos cuidadores das nossas crianças é essencial e as mais recentes orientações vão no sentido de limitar o tempo diário de uso de ecrãs, desaconselhando o seu uso a menores de 24 meses.Embora as opiniões não sejam totalmente consensuais em relação ao impacto positivo ou negativo no desenvolvimento das crianças, as tecnologias acabam por estar naturalmente presentes nas suas vidas e nas suas brincadeiras.Nesse sentido, o ideal será um equilíbrio entre a utilização de dispositivos eletrónicos e as brincadeiras tradicionais.Tais resultados só poderão ser atingidos com a íntima colaboração do médico assistente não só com as famílias e encarregados de educação, professores e educadores, mas também com a própria criança, constituindo o tempo de consulta uma oportunidade para esclarecimento de riscos e promoção de hábitos de vida saudáveis, para um desenvolvimento pleno e uma infância feliz.
Treatment of Bilateral Venous Thrombosis in a Patient with Aplasia of the Inferior Vena Cava
Authors: Khrebtiy Yaroslav V. , Tsyhalko Denys V. , Melnychuk Mykola O. 
Published: September 2022

The aim. In the treatment of venous thromboembolism, a special place is occupied by patients with congenital anomalies of the development of the inferior vena cava (IVC). To date, only single cases of treatment of this pathology have been described in the literature. Studying the experience of treating patients with congenital anomalies of the IVC will allow to improve the results of treatment of this category of patients.
Materials and methods. Patient B., a 36-year-old man, applied to the vascular surgery clinic of the Vinnytsia Regional Pyrohov Clinical Hospital in July 2010 with complaints of pain, swelling, cyanosis of both lower extremities, which bothered the patient for about 10 days. The patient had no history of venous insufficiency of both lower extremities.
An objective examination revealed cyanosis and swelling of both lower extremities.
A duplex scan of both lower extremities revealed hyperechoic iliofemoral thrombosis of both lower extremities. Aplasia of the IVC was diagnosed. The common iliac veins on both sides formed a collateral that flowed into the left renal vein. The infrarenal segment of the inferior vena cava was absent. Thrombosis spread from tibial to popliteal, femoral, iliac veins with venous collateral thrombosis up to the level of the left renal vein.
The patient received enoxaparin at a dose of 1 mg per kg of body weight twice a day for 7 days with subsequent transition to warfarin under the control of international normalized ratio. Warfarin was prescribed from a starting dose of 5 mg with subsequent control of international normalized ratio in the range of 2.0-3.0. Venotonic and anti-inflammatory drugs were also prescribed. In combination with drug therapy, class 2 elastic compression stockings were recommended.
After the treatment, the patient’s condition improved, swelling and cyanosis of both lower extremities regressed. Repeated duplex scanning at the discharge of the patient from the hospital after 7 days showed signs of initial recanalization of the affected venous segments and no progression of thrombosis.
Conclusions. Thus, this clinical case showed that the use of anticoagulant therapy allows to obtain satisfactory results in the treatment of patients with congenital anomalies of the development of IVC, to avoid the development of pulmonary embolism and other life-threatening conditions. At the same time, such patients need regular follow-up examinations in order to adjust the treatment and prevent the development of IVC syndrome.
Complete Reconstruction of the Left Heart with Atriomegaly and Ventriculomegaly: Clinical Case
Authors: Popov Volodymyr V. , Boukarim Valery Zh. , Bolshak Oleksandr O. , Khoroshkovata Olena V. , Yuvchyk Olena V. 
Published: September 2022

Implementation of the principles of medical preparation, comprehensive reconstruction of the left heart in patients with atriomegaly and ventriculomegaly and combined mitral-tricuspid valve diseases leads to improvement of myocardial function and morphometric parameters of the left atrium (LA) and left ventricle (LV).
Case description. Patient R., male, 67 years old, underwent examination and treatment from April 22 to May 25, 2021 at the department of surgical treatment of acquired heart diseases of the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with the diagnosis of stage IV mitral regurgitation, stage IV tricuspid insufficiency, high grade pulmonary hypertension, permanent atrial fibrillation (lasting 10 years since 2011), IIB heart failure with reduced left ventricular ejection fraction (LVEF), secondary hypothyroidism (state of drug subcompensation). Upon admission, the patient was in a state of circulatory decompensation, which required long-term medical preparation for the operation. After his condition was improved, the patient underwent surgery: mitral valve replacement with complete preservation of the valve apparatus, triangular plasty of LA, tricuspid valve plasty with the imposition of a support ring and resection of the right atrium. There were no complications during the intraoperative period. The postoperative period was characterized by symptoms of hyperbilirubinemia, increased exudation from drainages on the first day after surgery. After appropriate treatment, the patient’s condition was stabilized. The patient was discharged on the 13th day after surgery with improvement.
Conclusion. Given the initial severe condition of the patient with advanced heart disease with reduced LVEF, left atriomegaly 9.5x12.3 cm, high grade pulmonary hypertension (peak systolic pressure = 70 mm Hg) and comorbidities, comprehensive reconstruction of the left heart with atriomegaly and ventriculomegaly leads to improvement of functional state of the myocardium and morphometric parameters of LA and LV.
İNANÇ TURİZM KORİDORUNDA YER ALAN KONAKLAMA İŞLETMELERİ WEB SİTESİ İÇERİKLERİNİN DEĞERLENDİRİLMESİ
Authors: ÇAVUŞ Ahmet , KADIRHAN Gökhan 
Published: September 2022

Bilişim teknolojisinin gelişmesiyle birlikte hizmet sektöründe faaliyet gösteren işletmelerde iletişim biçimleri değişiklik göstermiştir. İnternet teknolojisinin yaygınlaşmasıyla birlikte konaklama işletmeleri değişime ayak uydurmak için kurumsal web siteleri kurarak müşterilerine doğrudan ulaşım imkanına sahip olmuşlardır.
Araştırmanın amacı, inanç turizm koridorunda yer alan illerdeki (Mersin, Hatay, Gaziantep, Şanlıurfa, Mardin) konaklama işletmelerinin web sitelerinin içeriklerini incelenmesi, sitelerin kullanım durumlarının ve eksiklerinin ortaya konması ve geliştirilmesi hususunda otel yöneticilerine öneriler sunulmasıdır. İnanç turizm koridorunda yer alan 102 konaklama işletmesinin internet sayfaları değerlendirme kriterleri kapsamında, içerik analizine tabi tutulmuştur. Analizler sonucunda konaklama işletmelerinin web sitesi değerlendirme kriterlerine göre 3 yıldızlı otellerin büyük bir kısmında web sitelerinde e-broşür ve dergi, sanal tur, mobil uygulamaların ve online üyelik uygulamalarının bulunmadığı tespit edilmiştir. Çıkan sonuçlar yorumlanarak konaklama işletmeleri sahipleri, araştırmacılar ve otel yöneticileri için daha etkin web sayfası kullanma koşulları hakkında öneriler sunulmuştur.
Methods for diagnosing Helicobacter pylori infection at the present stage: advantages and disadvantages for practical application
Authors: Fadieienko G. D. , Nikiforova Y. V. 
Published: September 2022

To date, the diagnosis of Helicobacter pylori infection (H. pylori) remains a topical issue. Current data show that worldwide incidence of H. pylori infection is over 50 % of the world’s population. The prevalence of H. pylori varies in different countries as well as within these countries. Seropositivity to H. pylori progressively increases with age. In developing countries, H. pylori infection is more pronounced among young people than in developed countries. Despite the advances of modern medicine, H. pylori continues to be a serious medical and social problem in the health care system worldwide, causing significant consequences due to the relatively high incidence and mortality from complications of peptic ulcer disease and gastric cancer.
The article presents modern data on the features of diagnostic methods for H. pylori infection, a comparison of invasive and non‑invasive research methods. Recommendations for the choice of diagnostic methods for H. pylori in patients with gastroduodenal pathology are given.
Unfortunately, there is no universal method of diagnosis — each method has its advantages and disadvantages. Each method has different sensitivity and specificity. Quite often the choice of diagnostic method depends on its availability and cost. For more accurate diagnosis of H. pylori infection, the use of two or more methods, a combination of invasive and non‑invasive techniques is recommended. Histological method was and is considered the «gold standard» for the diagnosis of H. pylori infection. For screening in the population, it is recommended to use a serological method of diagnosis. Non‑invasive methods (urease breath test or stool test) should be preferred to control H. pylori irradiation. Polymerase chain reaction is the most accurate modern method of H. Pylori diagnosis to determine the molecular — genetic characteristics of the microorganism, assess its virulence, the formation of ideas about the further course and prognosis of the disease.
Reflections about acid suppression therapy: choosing the optimal proton pump inhibitor, or the Captain’s Saga. Clinical case
Authors: Gubergrits N. B. 
Published: September 2022

The author presented a clinical case of the combined course of gastric ulcer, gastroesophageal reflux disease against the background of significant increase in the fecal calprotectin level in the absence of endoscopic, histological confirmation of Crohn’s disease.Multiple erosive and ulcerative lesions of the upper gastrointestinal tract may result from various reasons, one of the possible explanations may be a common form of Crohn’s disease. A 32‑year‑old patient independently applied for a consultation with complaints of a «chill» in the throat, some heaviness in the stomach after eating. The endoscopic examination revealed signs of reflux esophagitis, multiple erosive and ulcerative lesions of the stomach and duodenum with negative urease test, as well as, presumably, healed solitary rectal ulcer. Gastrinoma and neuroendocrine tumor were excluded. A 10‑fold increase in the level of fecal calprotectin has been revealed. The results of histological examination of polypositional biopsies of the esophagus, stomach, duodenum, large intestine, rectum did not reveal signs of a tumor process, inflammatory bowel diseases. The erosive and ulcerative lesions of the upper parts of the digestive tube, not associated with Helicobacter pylori, cicatricial changes in the rectum have been found. Acid‑suppressive therapy with dexlansoprazole promoted the repair of the esophageal mucosa without a positive effect on the stomach. Replacement of the proton pump inhibitor and administration of pantoprazole in combination with bismuth was accompanied by complete healing of erosive and ulcerative changes in all parts of the stomach, duodenum, as well as a decrease in the level of fecal calprotectin.
Recurrence of bilateral polysegmental pneumonia associated with COVID-19 (clinical case)
Authors: Hryshchuk L.A. , Lopushanska N.M. 
Published: September 2022

COVID-19 (clinical case)We describe a clinical case of long-term follow-up of a patient who had experienced bilateral polysegmental pneumonia associated with COVID-19 twice within 16 months.Patient, 52 years old, resident of the countryside. He fell ill acutely on 01/06/2020. He turned to the rural outpatient clinic with a paramedic complaining of an increase in body temperature up to 39.0 °С, shortness of breath with little physical exertion, cough with massive sputum production. He began treatment at the regional hospital, later continued at the Ternopil Regional Phthisiopulmonology Medical Center. A clinical diagnosis was made — community-acquired bilateral polysegmental pneumonia, severe course, group III. COPD, group B (GOLD 2) infectious exacerbation. P I II, intoxication syndrome. After inpatient treatment, a partial improvement was clinically determined, and radiographically, the resorption of inhomogeneous infiltration, but an increase in matte consolidation fields. It was during this period that a lockdown was introduced in the country in connection with the COVID-19 pandemic. Considering certain clinical and, in particular, radiological features of the course of the disease in a patient, COVID-19 can be suspected, at that time a PCR test was not yet performed. Until August 2020, the patient received outpatient treatment and was observed by a family doctor at the place of residence. In August 2020, the patient underwent a follow-up examination. Clinical and radiological improvement was noted. But the condition deteriorated sharply in the second half of November 2020. From 11/27/2020 to 12/14/2020, he was treated at the regional CRH for COVID-19, PCR+, severe course of community-acquired bilateral pneumonia. On the control CT scan (December 30, 2020) — in dynamics from August 13, 2020, progression — an increase in the area of ​​the lesion. Treatment continued at the Ternopil Regional Phthisiopulmonological Medical Center, and after discharge on an outpatient basis. At the control examination (06/16/2021), in the dynamics from 12/30/2020, the resorption of fibrous seals, a decrease in the intensity of consolidation areas. Conclusion: CT picture of chronic fibrosing lung disease, resorption phase.The patient was diagnosed with bacterial-viral pneumonia, which clinically and radiologically resembled pneumonia associated with COVID-19. Clinical and radiographic findings showed improvement after 7 months of treatment. After 10 months from the date of the first detection of the disease, the patient was re-diagnosed with pneumonia associated with COVID-19. Long-term inpatient and outpatient treatment was carried out, as a result of which it was possible to achieve clinical and radiological stabilization of the process and resorption of changes in the lungs.
Structure of the incidence of extrapulmonary tuberculosis in Sumy region
Authors: Duzhiy I.D. , Oleshchenko G.P. , Shevchenko Yu.Yu. , Shevchenko M.Yu. , Yarkova N.V. 
Published: September 2022

Objective — to clarify the peculiarities of the course of extrapulmonary tuberculosis to improve its diagnosis by studying the trend of this form of tuberculosis in Sumy region.
Materials and methods. The structure of the incidence of extrapulmonary tuberculosis of the Sumy region among residents during 2004—2020 was analyzed.
Results and discussion. During the period from 2004 to 2020, 1414 new cases of extrapulmonary tuberculosis were registered in the region. The largest number of patients with this form of tuberculosis — 142 (24.3 %) was registered in 2004. The lowest — in 2020 — 33 (9.8 %) patients, ie decreased by 2.5 times. In the study period in Sumy in 2020, 3.1 patients per 100,000 population were diagnosed with extrapulmonary tuberculosis, which is almost 3 times less than in 2004 (11.3 patients per 100,000 population). 68 % of cases were registered in children. Among children with extrapulmonary tuberculosis, the incidence ranged from 13 cases per 100,000 children in 2004 to 0.7 per 100,000 in 2020. At the same time, the decrease in the incidence of extrapulmonary tuberculosis occurred with a sharp decrease to 0.7 per 100,000 in 2013—2014 and increase to 4.8 per 2015 and 7.0 per 100,000 children in 2016. And in 2020 again a sharp drop to 0.7 per 100,000 children. Compared to 2019, when the incidence of extrapulmonary tuberculosis was 6.3 per 100,000 children, this figure decreased by 9 times. The reduction in the number of BCG vaccinations in the region during the study period more than 2 times (in 2004 — 14,564 vaccinations, and in 2019 — 6,154) has an impact on changing the incidence of extrapulmonary tuberculosis among children.
Conclusions. The number of patients with extrapulmonary tuberculosis decreased 3.6 times during 2004—2020: from 11.3 to 3.1 patients per 100,000 population. Extrapulmonary forms of tuberculosis predominated in children (68 %). The incidence of such forms of tuberculosis at the age of 0—14 years during 2004—2020 decreased from 13 to 0.7 cases per 100,000.Extrapulmonary tuberculosis of the respiratory organs accounted for 57.4 %, tuberculosis of the bones and joints — 21.6 %, tuberculosis of the genitourinary system — 15.1 %.The incidence of osteoarticular tuberculosis in children (30.6 %) exceeded the corresponding figure in adults (21.1 %) and was 2.6 higher than the corresponding figure in Ukraine (11.7 %). Detection of peripheral lymph node tuberculosis in children of Sumy region (0.7 %) was significantly lower than in Ukraine (7.3 %).In adolescents, extrapulmonary respiratory tuberculosis significantly prevailed between all localiza­tions — 82.2 %. The incidence of tuberculosis of bones and joints was 4.4 %, which is 4.8 times less than in adults and 7 times less than in children. The last indicator in Sumy region was 2 times less than the corresponding indicator in Ukraine (9.0 %).
Experience of primary thoracoplastics in the treatment of resistant tuberculosis of the lungs
Authors: Opanasenko M.S. , Tereshkovych O.V. , Konik B.M. , Shalagay S.M. , Shestakova O.D. , Kalenychenko M.I. , Stepaniuk A.M. , Lysenko V.I. , Levanda L.I. , Bilokon S.M. 
Published: September 2022

Objective — to present the own results of the use of extrapleural thoracoplasty (ET) for the treatment of resistant pulmonary tuberculosis.
Materials and methods. A retrospective analysis of the results of the use of extraleural thoracoplasty (EPTP) in patients with multidrug-resistant pulmonary tuberculosis and tuberculosis with extensively drug resistance, operated in the NIFP clinic of NAMNS in the period from 01.01.2004 to 01.07.2022 was conducted. Patients were divided into two clinical groups: the main — 28 patients who underwent a modified EPTP technique, and the control group — 13 patients who underwent EPTP according to the traditional Bogush technique. When evaluating the results of surgical treatment, each group was divided into subgroups according to the resistance profile of Mycobacterium tuberculosis: A — patients with multidrug-resistant pulmonary tuberculosis, B — patients with tuberculosis with extensively drug resistance. Male patients predominated in both groups. The age range of patients is from 21 to 44 years. The groups did not differ statistically significantly in terms of mean age. Operative treatment was more often performed on the right side. The duration of the period from the onset of the disease to the operation varied from 16 to 60 months (main group — (24.6 ± 1.1) months, control group — (22.8 ± 2.6) months).
Results and discussion. Extrapleural thoracoplasty (EPTP) is a rather traumatic surgical intervention with a significant cosmetic defect and certain functional losses. Recently, such operations are performed less often, thanks to the development of new schemes of anti-tuberculosis therapy, and the associated better outcome of treatment of patients with resistant forms of tuberculosis. But if there are indications, the use of EPTP makes it possible to achieve results unattainable when using only conservative treatment. When performing EPTP, a complex of preoperative preparation measures, operational and technical features of the modified EPTP technique, measures to prevent postoperative complications and recurrences of TV was developed, which allowed to improve the results of surgical treatment in patients of the main group compared to the control group by 12.9 and 11.8 % and reduce the level of postoperative mortality.
Conclusions. Performing EPTP, in the presence of widespread forms of tuberculosis, when it is not possible to perform resection interventions, is the method of choice, which allows improving the effectiveness of treatment of this category of patients.