scholarly journals O28 APPLICATION OF MICROPOROUS POLYSACCHARIDE HEMOSPHERES DURING TRANSVERSUS ABDOMINAL RELEASE TO REDUCE SEROMAS AND HEMATOMAS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Wegdam Johannes ◽  
Dite de Jong ◽  
Simon Nienhuijs ◽  
Ellis Schipper ◽  
Elske Berkvens ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Intervention Group ◽  
Transversus Abdominis ◽  
Wound Complications ◽  
Control Group ◽  
Base Line ◽  
Transversus Abdominis Release ◽  
Hernia Surgery ◽  
Vessel Sealing ◽  
Microporous Polysaccharide Hemospheres

Abstract Aim Wound complications, like seromas and hematomas, occur in 23% after transversus abdominis release (TAR). Hemostat agents like fibrin glue have potential to reduce this rate, by vessel sealing and tissue bonding. But these are expensive. A topical hemostatic, like microporous polysaccharide hemospheres (MPH), is much cheaper, but its potential to reduce seromas and hematomas has never been analyzed in ventral hernia surgery. Material and Methods After the first 25 consecutive TAR patients (Control group, 2016-2018), MPH was introduced as an adjunct in a consecutive group of 25 TAR patients (Intervention group, 2019-2020). MPH was sprinkled in the TAR planes and subcutaneous tissue. Groups were compared. Results Pre-operative base-line characteristics and the overall complexity of the hernia patients and operations did not differ between the two groups. Postoperatively, the overall rate of surgical site occurrences (SSO) differed (CG:60%;IG:32%), but not significantly. Seromas (CG:5%;IG: 3%) and hematomas (CG:28%;IG:8%) did not differ significantly between the two groups. Medical complications (CG:13%;IG:10%) and two-year recurrence rate (CG:12%;IG:16%) also did not differ. Conclusions This study did not demonstrate a clear effect of MPH on the incidence of SSO, seromas or hematomas after a transversus abdominis release, despite the high incidence of wound complications in the first group of TAR patients (presumably, reflecting the learning curve of TAR). The fact that MPH does not glue tissue layers and minimize dead space, may be causative. MPH is not advised as an adjunct to reduce SSO.

scholarly journals Open transversus abdominis plane block and analgesic requirements in patients following right hemicolectomy

2012 ◽  
Vol 94 (5) ◽  
pp. 327-330 ◽  
Author(s):  
RR Brady ◽  
NT Ventham ◽  
DM Roberts ◽  
C Graham ◽  
T Daniel
Keyword(s):  
Enhanced Recovery ◽  
Intervention Group ◽  
Right Hemicolectomy ◽  
Transversus Abdominis ◽  
Control Group ◽  
Complication Rates ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Post Operative Period ◽  
Early Return

INTRODUCTION Reducing exogenously administered opioids in the post-operative period is associated with early return of bowel function and decreased post-operative complication rates. We evaluated the effectiveness of a surgeon-delivered open transversus abdominis plane (TAP) block as a method to reduce post-operative opioid requirements, sedation and inpatient stay. METHODS The patient cohort was identified from those who had undergone a right hemicolectomy for colonic cancer. Patients received either an open TAP block and post-operative patient controlled anaesthesia (PCA) (n=20) or were part of a control group who received subcutaneous local anaesthetic infiltration and PCA (n=16). RESULTS PCA morphine use was reduced within the first 24 hours post-operatively in the TAP block group compared with controls (42.1mg vs 72.3mg, p=0.002). Sedation was also reduced significantly in the early post-operative period (p<0.04). There was a non-significant trend towards reduced length of stay in the intervention group (8.2 vs 8.73 days). There were no recorded complications attributable to the open TAP block. CONCLUSIONS Open TAP blocks are safe and reduce post-operative opioid requirements and sedation after right hemicolectomies. They should be considered as part of a multimodal enhanced recovery approach to patients undergoing abdominal surgery via a transverse incision.

Imparting Self Control Skills for Reducing Aggression among Adolescence

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
T. Ronen
Keyword(s):  
Intervention Program ◽  
Negative Emotion ◽  
Intervention Group ◽  
Self Control ◽  
Learned Resourcefulness ◽  
Control Group ◽  
Base Line ◽  
Control Intervention ◽  
Children's Coping ◽  
Ninth Grade Students

The lecture describes a school-based aggression reduction learning intervention. The intervention program aimed to impart children with learned resourcefulness repertoire for reducing aggressive behavior. Based on the self-control intervention model developed by Ronen and Rosenbaum (2001), and in light of positive psychology theory the intervention focused on increasing children's coping, teach them to work toward positive goals such as increasing social relationships, and help themselves change.447 ninth grade students participated in this study. 167 students participated in the intervention groups and 280 students from the same schools who received no intervention and served as a control group.The outcomes point to the efficacy of the model in reducing aggression. The rate of aggression in the intervention group decreased significantly in compare with their base-line grade and in compare with the control group. Also hostile thought and negative emotion did not change - the child could control those and not behave in an aggressive way. Analysis showed that the changed in reducing aggression results from the increase in self-control skills.

scholarly journals Fostering Resilience over Multiple-losses for Nursing Staff in the Palliative Care Unit: Whole Person Approach – Part 1

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Minako Munesada ◽  
Yukie Kurihara ◽  
Satoe Takahashi ◽  
Keiko Tanaka
Keyword(s):  
Palliative Care ◽  
Nursing Staff ◽  
Self Efficacy ◽  
Sense Of Self ◽  
Intervention Group ◽  
Palliative Care Unit ◽  
Support Program ◽  
Control Group ◽  
Base Line ◽  
Whole Person

Objectives: “Bereavement overload” due to multiple losses is one of the stressors for the nursing staff working at Palliative Care Unit (PCU), which may be especially tough to those with less exposure to such situation. A support program was developed for the nursing staff of newly-opened PCU (April 2011) in order to foster resilience and wellness despite multiple losses. We conducted a study to evaluate the effectiveness of the support program with “whole person approach” – consisting of 3 modules; 1) lecture on grief and bereavement (mind), 2) experiential workshop on body awareness and relaxation (body/spirit), and 3) group discussion (mind/spirit), for the increased sense of self-efficacy, awareness of their inner healing power, and fostering mutual understanding and support.Methods: 20 nurses were randomly assigned to two groups for the action research project. Data included participant observation, individual and focus group interviews with one of the investigators. The support program package was offered from October to December 2012 (A) and from January to March 2013 (B) respectively, using wait-list control method. Self-efficacy scale was used at the base line, at the completion of package A, and at the completion of package B. Participants also answered brief survey after each module, followed by semi-structured interview.Results: The self-efficacy score initially showed decline of both groups (intervention/control) , reflecting the “tough two months” with the highest number of the total deaths as well as deaths within 5 days post admission. However, intervention group showed more gradual decline comparing to the control group, plus higher elevation 3 months later, which may indicate some effect of the program.Conclusions: The support program was positively received and contributed to the nursing staff’s increased sense of self-efficacy and resilience over “bereavement overload.” Continued program development is in progress based on the feedback.

scholarly journals Effect of Tocilizumab on ventilator free days composite outcome in SARS-CoV-2 patients. A retrospective competing risk analysis.

2021 ◽  
Author(s):  
Ahmed F. Mady ◽  
Basheer Abdulrahman ◽  
Omar E. Ramadan ◽  
Shahzad A. Mumtaz ◽  
Mohammed A. Al-Odat ◽  
...  
Keyword(s):  
Risk Analysis ◽  
Intervention Group ◽  
Hazard Ratio ◽  
Competing Risk ◽  
Control Group ◽  
Base Line ◽  
Composite Outcome ◽  
Competing Risk Analysis ◽  
Mechanically Ventilated ◽  
Wide Range

Background: SARS CoV 2 infection demonstrates a wide range of severity, the more severe cases demonstrate a cytokine storm with elevated serum interleukin 6, hence IL 6 receptor antibody Tocilizumab was tried for the management of severe cases. Objectives: The effect of Tocilizumab treatment on the composite outcome of ventilator free days, among critically ill SARS CoV 2 patients. Method: Retrospective observational propensity score matching study, comparing mechanically ventilated patients upon ICU admission who received Tocilizumab to a control group. Utilizing competing risk analysis method, and reporting subdistributional hazard ratio of a composite outcome of ventilator free days at day 28. Results: 29 patients in the intervention group were compared to 29 patients in the control group. Matched groups were similar at base line. The primary outcome of ventilator free days was higher in the intervention group (SHR 2.7, 95% CI: 1.2 to 6.3; p = 0.02), crude ICU mortality rate was not different between Tocilizumab and control groups (37.9% versus 62% respectively, p = 0.1), actual ventilator free days were significantly longer in Tocilizumab group (mean difference 4.7 days, 95% CI 1.1 to 8.3; p = 0.02). Sensitivity analysis by Cox regression showed a significantly lower hazard ratio of death in Tocilizumab group (HR 0.49, 95% CI: 0.25 to 0.97; p = 0.04). While there was no difference in grown positive cultures among groups (55.2% in Tocilizumab group versus 34.5% in the control, 95% CI of difference: -7.11% to 54.4%; p = 0.1). Conclusion: Tocilizumab may improve the composite outcome of ventilator free days at day 28 among mechanically ventilated SARS-CoV-2 patients, it is associated with significantly longer actual ventilator free days, and insignificantly lower mortality and superinfection.

scholarly journals A comparative study of two different techniques of subcutaneous tissue closure in abdominal surgery

2017 ◽  
Vol 6 (12) ◽  
pp. 5512
Author(s):  
Jyotsna S. Dwivedi ◽  
Alka S. Gupta ◽  
Sachin H. Pardeshi
Keyword(s):  
Subcutaneous Tissue ◽  
Tertiary Care ◽  
Total Duration ◽  
Wound Complications ◽  
Control Group ◽  
Tertiary Care Centre ◽  
Surgical Access ◽  
Suction Drain ◽  
The Difference

Background: Surgical access to abdomen is required for many operative procedures. The subcutaneous tissue of the anterior abdominal wall can either be sutured or left unsutured with drain in situ. The purpose of this study was to compare the two methods of closure of the subcutaneous tissue and determine the benefit of one over the other.Methods: The study was conducted in a tertiary care centre with sample size of 30 each in study and control group. Patients fulfilling the inclusion criteria were selected and depending on the randomisation the closure of subcutaneous tissue was done either by polyglactin 910, 2-0 or left unsutured with indigenously designed syringe suction drain kept in situ. The patients were followed up till the day of suture removal and further in case of any complications.Results: Total duration taken for the procedure was significantly increased in the study group. There was a significant level of discomfort among the participants due to drain. The rate of surgical site infection, hospital readmission morbidity was significantly higher in the study group.Conclusions: The type of drain studied was indigenously designed where the closed system was not maintained during charging the drain, hence further studies need to be conducted which will compare this with the other closed suction drains to determine the difference in the risk of wound complications.

Effects of a nine-month occupational intervention on health-related quality of life

2017 ◽  
Vol 45 (4) ◽  
pp. 452-458
Author(s):  
Birgitta Ojala ◽  
Clas-Håkan Nygård ◽  
Heini Huhtala ◽  
Seppo T. Nikkari
Keyword(s):  
Quality Of Life ◽  
Intervention Group ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Base Line ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

The aim of this study was to evaluate the effectiveness of vocationally outpatient oriented rehabilitation on an intervention group, compared with a control group that did not take part in the intervention. The groups were compared for health-related quality of life (HRQoL) by the quantitative indicator RAND 36. Data were obtained by a self-report at baseline and at nine months follow-up. Differences between base-line and follow-up were analyzed within group and between the groups. The study population consisted of 751 municipal employees aged between 26 and 64 years; an intervention with 463 women and 115 men ( n = 578), and a control group with 138 women and 35 men ( n = 173). In this study we focused on those who had answered to all questions in RAND 36, thus 581 remained. Of these, 388 were in the intervention group (mean age 49.0 years) and 110 in the control group (mean age 48.4 years). Intervention was based on cognitive behavioral therapy. Participants in the 9-month outpatient intervention group showed statistically significant increase in all eight RAND 36 areas. Most improvement was seen in the psychosocial functioning index ( p = 0.002). Although there were no statistically significant changes in RAND 36 components in the control group, difference in changes between groups were seen in energy and fatigue ( p < 0.001), social functioning ( p = 0.032) and general health perceptions 0.027 in favor of the intervention group. The results suggest that a cognitive behavioral intervention as an early rehabilitation program is effective in increasing employees’ quality of life, as measured by RAND 36.

scholarly journals Evaluation the effects of pycnogenol (French maritime pine bark extract) supplementation on the inflammatory biomarkers, nutritional and clinical status in traumatic brain injury patients, in Intensive Care Unit; A Randomized Clinical Trial protocol

2019 ◽  
Author(s):  
Mahsa Malekahmadi ◽  
Omid Moradi Moghaddam ◽  
Sheikh Mohammed Shariful Islam ◽  
Kiarash Tanha ◽  
Mohsen Nematy ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Nutritional Status ◽  
Organ Failure ◽  
Intervention Group ◽  
Control Group ◽  
Base Line ◽  
Inflammatory Status ◽  
And Oxidative Stress

Abstract Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patient. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: surveying the effect of pycnogenol on the clinical, nutritional and inflammatory status of TBI patients. Methods: This is double-blind, randomized controlled trial . Block randomization will be used. Intervention group will receive pycnogenol supplementation of 150 mg for 10 days. Control group will receive placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (Malondialdehyde, total antioxidant capacity), at the base line, at the 5 th day and at the end of the study (10 th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. SOFA (sequential organ failure assessment) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index and body composition will be measured. All analyses will be conducted by initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients.

scholarly journals Prevention of large and giant postoperative ventral hernia prosthetic hernioplasty postoperative complications

2013 ◽  
Vol 94 (3) ◽  
pp. 417-420
Author(s):  
O T Alishev ◽  
R S Shaimardanov ◽  
Y R Makhmutova
Keyword(s):  
Ventral Hernia ◽  
Comparison Group ◽  
Subcutaneous Tissue ◽  
Main Group ◽  
Wound Complications ◽  
Control Group ◽  
Abdominal Pressure ◽  
Narcotic Analgesics ◽  
Wound Irrigation ◽  
Average Pain

Aim. To evaluate the effectiveness of regional prolonged irrigation with ropivacaine ozonated solution at large and giant postoperative ventral hernia prosthetic hernioplasty. Methods. 77 patients who underwent a planned surgery for large and giant postoperative ventral hernia from 2010 to 2012 were examined. All patients were distributed to two groups. The main group included 26 patients in whom a polyvinyl chloride catheter was installed in periprosthetic tissue for the wound irrigation using anesthetic (ropivacaine) ozonated solution for regional prolonged anesthesia and wound complications prevention as well as for preoperative preparation and intra-abdominal pressure monitoring for abdominal compression syndrome prevention using the technique developed by authors. The comparison group consisted of 51 patients in whom prevention of wound complications was carried out conventionally, and who received narcotic analgesics. Ultrasonography of postoperative wound area was used for local inflammation intensity assessment. Pain was assessed using numeric visual analogue scale in both groups. Results. 4 (15.4%) patients of the main group developed subcutaneous tissue seroma at the 5-6th day. In comparison group wound complications were registered in 15 (29.4%) patients, including 11 cases of seromas, 2 cases of suppurative inflammation, 1 case of ischemic necrosis of the wound edges, and also an isolated case of limphorrhea which occurred on the first day. The observations showed that the average pain level among patients of the main group was 3.8±0.4 points, compared to the control group - 5.3±0.4 points. Conclusion. Periprosthetic irrigation with ropivacaine ozonated solution provides adequate anesthesia, reduces the number of wound complications and promotes early rehabilitation.

scholarly journals Anti-tumoral Effect of a Cell Penetrating and Interfering Peptide Targeting PP2A/SET Interaction

Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 31-36
Author(s):  
Laura Andrini ◽  
Gustavo H. Marin ◽  
Ana Maria Inda ◽  
Heriberto Bruzzoni-Giovanelli ◽  
Marcela Garcia ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Intervention Group ◽  
Study Groups ◽  
Treated Group ◽  
Breast Adenocarcinoma ◽  
Control Group ◽  
Test Analysis ◽  
Histological Changes ◽  
Cell Penetrating

Objective: To test cell penetrating and interfering peptide Mut3DPT-PP2A/SET in interaction between serine threonine phosphatase PP2A and its physiological inhibitor, the oncoprotein SET.Materials and methods: Adult male C3H/S-strain mice, 60 days old, were given a graft of breast adenocarcinoma cells (TN60) into subcutaneous tissue. Mut3DPT-PP2A/SET peptide was used to block PP2A and SET oncoprotein interaction. The graft-bearing animals were divided into a control group (injected with saline buffer), and an intervention group injected intraperitoneally with Mut3DPT-PP2A/SET peptide (5 mg/kg) every day from day 5 to day 37. The variables we used to compare the outcome in both groups were tumor size in mm (length&times;width) and histological changes. In the statistical analysis we used ANOVA and Student-Keuls multiple comparisons test and Tuckey for the post-test analysis.Results: 48 mice were grafted at day 0 with breast UNLP-C3H/S tumor cells, and after randomization, they were assigned to one of the two study groups. At day 5 all mice were injected either with placebo or with the peptide. The treated group showed significant tumor reduction (p<0.07). Histological changes showed presence of apoptosis and necrosis of tumor in treated group.Conclusion: The peptide Mut3DPT-PP2A/SET has demonstrated anti-tumor activity by reduction in vivo of tumor growth becoming a promising future in anticancer therapy.&nbsp;

scholarly journals Differences in post-placental intra uterine device acceptance with and without couples counseling in private practice midwifery clinics, West Denpasar

2018 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Putu Ayu Ratna Darmayanti ◽  
Dewa Nyoman Wirawan ◽  
Komang Ayu Kartika Sari ◽  
Mangku Karmaya ◽  
Ni Luh Putu Suariyani
Keyword(s):  
Maternal Education ◽  
Controlled Trial ◽  
Intervention Group ◽  
Primary Objective ◽  
Control Group ◽  
Base Line ◽  
Couples Counseling ◽  
Before And After ◽  
Post Placental ◽  
Iud Uptake

Background and purpose: The post-placental intra uterine device (IUD) program is one intervention  to increase IUD uptake however the acceptance remains low. Contraceptive counseling during pregnancy is expected to increase IUD uptake. The primary objective of this study is to determine the efficacy of counseling by involving the husband in order to improve post-placental IUD uptake. The secondary objective is to compare knowledge and perceptions of IUD before and after intervention.Methods: A randomized controlled trial was conducted with 58 pregnant women at 37-40 weeks' gestation in three private midwifery clinics in Denpasar, Bali. Subjects were divided into two groups: 29 intervention groups that were given couples counseling and 29 control groups that were given counseling without involving husbands. Base line interview was conducted during enrollment and follow up interview was carried out immediately after delivery.Results: Acceptance of post-placental IUD was found in 21 women (72.41%) in the intervention group and 10 women (34.48%) in the control group (RR=2.2; 95%CI: 1.23-3.84). The mean difference in pretest and post-test scores of knowledge, perceptions of susceptibility and benefits were found to be higher in the intervention group but not statistically significant. The result of multivariate analysis indicated that the variables influencing post-placental IUD acceptance were the child's gender (AOR=45.9, 95%CI: 4.53-465.25), couples counseling with husband (AOR=17.4, 95%CI: 2.55-119.56) and maternal education (AOR =7.1; 95%CI: 1.17-43.40).Conclusions: Couples counseling was found to increase post-placental IUD uptake. In addition, post-placental IUD acceptance is also influenced by the child's gender and maternal education levels. To increase uptake of post-placental IUDs there is a need for upscalling of couples counseling at the time of antenatal care.

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