Achalasia cardia (“cardiospasm”, “phrenospasm”, “dolichoesophagus”, “megaesophagus”, “stenosis of cardia”) represents a primary impairment of esophageal motor function associated with impaired lower esophageal sphincter relaxation and peristalsis defects of the thoracic esophagus. It is diagnosed at the age of 25 to 60 years, making up to 20% of all diseases of the esophagus, and is characterized by a triad of symptoms: dysphagia, regurgitation and chest pain when swallowing. In most cases the first manifestations of achalasia are preceded by stress situations in the anamnesis that complicates the differential diagnosis of psychogenic esophageal spasm. The presented clinical case illustrates difficulties of early diagnosis of achalasia cardia in a young femalepatient with severe anxiety and depressive symptoms which develop under conditions of chronic stressful situations in the family or at work. The issues of interdisciplinary interaction of health professionals (physician, gastroenterologist, psychiatrist, psychotherapist, and surgeon) on the course of examination and management of patients with comorbid physical and mental pathology are discussed. The efficiency of the integrative approach to treatment and rehabilitation with the use of modern reconstructive surgical interventions as well as conservative methods of therapy, psychopharmacotherapy and personality-oriented psychotherapy proves the relevance of studying psychosomatic aspects of achalasia cardia.
The study objective – to evaluate the feasibility of correcting eating disorders in patients undergoing surgery for oral and oropharyngeal cancers using various reconstructive techniques to restore postoperative defects.Materials and methods. Between 2012 and 2019, a total of 56 patients with stage II–IV oral and oropharyngeal cancer underwent reconstructive surgery after either hemiglossectomy or glossectomy. The patients ranged in age from 26 to 70 years. The patients were divided into two groups. Group I consisted of 36 (64.3 %) patients who underwent tongue reconstruction using rotation flaps. For reconstruction of hemiglossectomy defects, a chin flap was used, and for reconstruction of glossectomy defects, a pectoral flap was used. Group II comprised 20 (35.7 %) patients who underwent tongue reconstruction using free revascularized flaps. For the tongue reconstruction after hemiglossectomy, the radial flap, medial sural perforator flap and fasciocutaneous anterolateral thigh flap were used. For the tongue reconstruction after glossectomy, the fasciocutaneous anterolateral thigh flap was used. The acts of chewing and swallowing were restored during speech rehabilitation due to the activation and coordination of the work of the muscles of the cheeks, lips, soft palate, pharynx, and the reconstructed tongue. Eating disorders were assessed by interviewing patients. A comparative analysis of eating disorders included mobility and coordination of facial muscles and reconstructed tongue, increased sensitive in the oral cavity, the presence of aspiration and nasal regurgitation, and subjective difficulties of patients. The time before the start of rehabilitation and its duration were taken into account. Patients were interviewed before the start of the combined treatment, at the beginning and after the completion of rehabilitation.Results. After the completion of rehabilitation, all patients received food by the oral route. The best outcomes were achieved in group 2a patients, who underwent tongue reconstruction with free revascularized flaps. This group of patients had a lower percentage of the asymmetry of facial muscles and limited mobility of the tongue compared to other groups of patients.In the subgroups of patients undergoing glosssectomy, most of the studied parameters did not have statistically significant differences in values. However, it should be noted that in group 2b, the period from the date of surgical treatment to the beginning of rehabilitation was significantly longer than in group 1b.Conclusion. The use of the microvascular surgical techniques using various donor flaps creates the basis for a more complete functional recovery and expands the rehabilitation potential of patients after surgical treatment of oral and oropharyngeal cancer.
The number of patients diagnosed with cervical cancer continues to increase all over the world. Despite the intensive development of diagnostic and therapy methods, the phenomenon of relapses in the absence of a clear explanation for their occurrence, and of metastasis are observed, which complicates treatment and affects the survival of patients. In this regard, there is a need to develop new research methods for a more detailed study of the occurrence and development of the disease at the molecular and cellular levels, as well as the effectiveness of treatment and the causes of relapses. In this paper, nanoparticles are studied on the surface of red blood cells, which were revealed by the authors using scanning electron microscopy previously, and results of the study of blood samples of patients with cervical cancer using a new sample preparation method and immunofluorescence analysis for their identification are presented on the basis of the assumption that these nanoparticles are viral particles. With the combination of immunofluorescence and electron microscopy methods, we were able to confirm our hypothesis of the viral nature of nanoparticles attached to the surface of red blood cells of patients diagnosed with cervical cancer. With this approach, it was found that the particles of human papillomavirus 16 and 18 are located on the cytoplasmic membrane of red blood cells. The results of this study indicate that viruses circulate in the patient's blood, and are attached to the surface of red blood cells. This apparently affects the development of cervical cancer, its relapse, and metastasis.
Currently, cervical cancer (CC) is one of the most common oncological diseases. In this regard, it is necessary to develop new research methods for a more detailed study of the occurrence and development of the disease at the molecular and cellular levels, as well as to improve the effectiveness of treatment and form a deeper understanding of the causes of relapses. The aim of this work was to study nanoparticles localized on the erythrocyte membrane—presumably HPV 16, 18, before and after radiation therapy, in patients with cervical cancer (CC). To study the surface of red blood cells by the SEM method, venous blood samples from 17 patients with a confirmed diagnosis of CC were prepared in thin layers evenly applied to a dry, fat-free glass slide, which was dried at room temperature. To detect nanoparticles on the surface of erythrocytes by the immunofluorescence analysis, we developed a special protocol for preparing erythrocyte masses from patients diagnosed with CC. As a result of using a new method of sample preparation for immunofluorescence assay and using SEM, the hypothesis of the viral nature of nanoparticles localized on the surface of the blood erythrocytes of patients with CC was confirmed: Particles of HPV 16 and 18 are located on the cytoplasmic membrane of erythrocytes. Studies suggest that viruses attach to the erythrocyte membrane, which seems to influence the development of CC, its recurrence, and metastasis.
Using the method of SEM in patients with cervical cancer (CC) during radiation therapy (RT) revealed differences in the size and morphology of nanoparticles (NP) localized on the outer surface of the erythrocyte membrane. We found that NP-V (“viruses”) objects localized on the surface of the erythrocyte membrane of CC patients before RT have more distinct contours and are smaller in comparison with the number of NP-EV (extracellular vesicles) arising during RT. Our previous study showed that NP-V objects are evenly distributed not only on the surface of erythrocytes but also in blood plasma, and that during the RT the amount of NP-V decreases, while NP-EV both increases and decreases. The linear size of the NP-EV is characterized by a Gaussian distribution, while the NP-V has a normal size distribution in certain ranges with different mean values. We found that the number of NP-Vs having different linear dimensions differ significantly. Using X-ray radiation, we established characteristic elemental composition of NP. The PCR method was used to determine the HPV DNA in blood samples from CC patients. The revealed differences in the morphology and composition of NP, as well as the data of PCR analysis, possibly indicate their different nature and can be used as a criterion for assessing the effectiveness of RT and the recovery period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.