Vol. 5 No. 11 (2023): Volume 05 Issue 11

to study the pathophysiological aspects of cerebral edema and compare the effectiveness of using 15% mannitol solution and hypertonic 3.5%, 7%, 10% sodium chloride solution in the complex treatment of patients with head injury. Material and methods: 90 patients from 18 years old to 68 years old with various traumatic brain injuries and inhibition of consciousness level from 4 to 13 points on the Glasgow coma scale were examined.

Results: infusion of mannitol at the indicated dosage reduced ICP after 30 minutes by 42, 3%, and after 120 minutes it remained below the initial data by 23.9%. Infusion of a 3.5% NaCl solution already by the 30th minute led to a decrease of ICP by 48.6%, and by the end of 120 minutes the ICP remained below the initial data by 35.9%. Infusion of a 7% NaCl solution already by the 30th minute led to a decrease in ICP by 55.4%, and by the end of 120 minutes the ICP remained below the initial data by 39.9%. Infusion of a 10% NaCl solution already by the 30th minute led to a decrease in ICP by 58.4%, and by the end of 120 minutes the ICP remained below the initial data by 45.9%.

Conclusions: the decrease in ICP within 30 and 120 minutes after the introduction of hyperosmolar solutions is more pronounced with iv administration of 3.5%, 7%, 10% NaCl solution relative to 15% Mannitol in calculated dosages, which should be borne in mind in patients with concomitant cardiac and renal pathology.

Combined injury of the maxillofacial region remains one of the topical problems of maxillofacial traumatology. Combined trauma to the maxillofacial region requires joint medical care by several specialists.  Trauma of the upper and middle zones of the face is often accompanied by trauma of the eye socket, paranasal sinuses. They are difficult to diagnose, in case of untimely diagnosis and rendered assistance lead to secondary defects and deformities. Damage to the walls of the orbit, leads to scarring changes in the fiber of the eye socket, eye muscles, persistent diplopia, ocular nerve impingement, persistent eye asymmetry, decreased or loss of vision is the cause of frequent disability.

To compare the incidence of femur fractures (ICD S72) in patients aged 15 to 49 in Brazil, in the period before (March to December 2019) and during the COVID-19 pandemic (March to December 2020), based on data from DATASUS, as well as to assess the impact of social isolation on the incidence and demographic profile of affected individuals. An ecological study with data from individuals aged 15 to 49 who had a femur fracture before and during the COVID-19 pandemic, extracted from the DATASUS database. We calculated the incidence and demographic profile of femur fractures and the type of hospitalization. There was a significant increase in the incidence of femur fractures among individuals aged 15 - 49 in Brazil during the period of social isolation due to COVID-19. The incidence was 165/100,000 inhabitants during the pandemic and 163/100,000 inhabitants in the same period of 2019 (main increase observed in the 15 - 34 age group and decline in the 35 - 49 age group). The North and Northeast regions showed an increase in the incidence of femur fractures and an increase in emergency hospitalizations related to this condition. On the other hand, there was a decrease in incidence in the Central-West region and in the type of hospitalization described as elective. We conclude that during the COVID-19 pandemic in Brazil there has been an increase in femur fractures in young adults, which may be related to the failure of social isolation measures.

Pain is a difficult to understand and multifactorial condition, defined by the International Association for the Study of Pain (IASP) as "an unpleasant sensory and emotional experience associated with a real injury or described in such terms." When acute, it has an important biological value in preserving the integrity of the individual by alerting them to the occurrence of an injury, while chronic pain does not have this characteristic. It is considered a public health problem because it causes temporary or permanent disability, absenteeism, high costs to the health system and morbidity. It is estimated that the prevalence of chronic pain in the world is around 10.1 to 55.5%, with an average of 35.5%.Several studies have investigated the causal nature of this association and point to a bidirectional relationship. This is a literature review with the application of an anonymous questionnaire.Orthopaedic surgeons and musculoskeletal clinicians have given importance to mental health in patient recovery after injury or orthopaedic surgery, since pain after these events is common, and can trigger a new mental illness or its worsening. We therefore conclude that interventions to assess pain and mental health should be prioritized, in addition to the greater involvement of psychiatrists and psychologists in this process.

To study hepatic encephalopathy caused by endogenous intoxication in patients with diabetes mellitus (DM) complicated by necrotic soft tissue lesion (PNSTL) and ways of their correction.

The article analyzes the experience of palliative treatment of 68 patients with dysphagia due to esophageal obstruction. In 61 patients, stenting was performed as planned, and 7 patients were operated on for emergency indications due to progressive dysphagia of the III-VI degree with damage to the upper 5 (7.3%) patients, the middle 24 (35.29 %) patients and the lower third of the esophagus of 39 (57.3 %) patients. Among them, esophageal tracheal and esophageal bronchial fistulas were detected in 28 patients with esophageal cancer. In 9 (32.14 %) patients, a fistula appeared after radiation therapy on the area of the primary tumor, in 19 (67.85 %) it was the result of the collapse of the primary tumor. According to our study of patients with esophageal cancer with dysphagia, men were 43 (63.2%), and women – 25 (36.7%), the average age was 65-85 years. Of the 68 patients with esophageal cancer with dysphagia, the urban population was 23 (33.82 %) patients and the rural population was 45 (66.17 %) patients.

All patients were recanalized and self-expanding stents with a company coating (FLEXTENT) were installed.

The study of morphological variants of the tumor showed: that 39 (57.35%) patients had adenocarcinoma and 29 (42.640%) squamous cell carcinoma.

Based on our analysis, endoscopic stenting should be recognized as the leading method of palliative treatment of patients with esophageal cancer complicated by dysphagia.

Postoperative pain results from the nociceptive stimulus caused by the surgical aggression, coming from direct or indirect mechanisms. Its intensity and duration depends on several factors, mainly the type of surgical approach, surgical access and anatomy. Orthopaedic surgeries are considered one of the most painful, due to the intense nociceptive stimulation of the musculoskeletal tissue.The prevalence of post-operative pain is described in 73% of patients who experience moderate to severe pain on the first day after surgery. A lower prevalence is observed in developed countries, due to pain protocols, the presence of acute pain services and advanced general anesthesia techniques. Numerous protocols have been tested, and opioids are often the drugs of choice, but the events are considered the biggest drawback. Pain control can be achieved through the use of certain medications, the use of physical means and interventions related to cognitive behavior, such as educational techniques and relaxation. Even though it is difficult to treat pain, analgesic methods are essential to reduce the incidence of persistent pain, avoiding and alleviating future chronic pain conditions that are difficult to treat.

This study presents an exploratory investigation into the potential correlation between head size and Intelligence Quotient (IQ) in elementary school students. With a diverse sample of elementary school children, we measured head circumference and administered age-appropriate IQ tests to gather comprehensive data. Our findings shed light on the intricate relationship between cranial dimensions and cognitive performance in the early educational years. The research contributes to our understanding of neurodevelopment and factors influencing cognitive abilities during childhood.