scholarly journals Effects of Arteriovenous Thrombolysis Combined with Mechanical Thrombectomy on Efficacy and Neurological Function of Acute Cerebral Infarct Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tao Ding ◽  
Liwen Tang ◽  
Bohong Hu ◽  
Junxin Yuan ◽  
Xiangdong Li ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Mechanical Thrombectomy ◽  
Length Of Hospital Stay ◽  
Neurological Function ◽  
Nihss Score ◽  
Group A ◽  
Group B ◽  
Acute Cerebral Infarct

Objective. To investigate the effects of arteriovenous thrombolysis combined with mechanical thrombectomy on clinical efficacy, neurological function, and the changes of nerve injury markers of acute cerebral infarct (ACI) patients. Methods. A total of 143 cases with ACI admitted to our hospital from June 2017 to June 2019 were elected as research subjects. Among them, 69 cases of patients who received treatment of arteriovenous thrombolysis were considered as group A, and 74 cases of patients who received treatment of arteriovenous thrombolysis combined with mechanical thrombectomy were considered as group B. NIHSS score, clinical efficacy, vascular recanalization, adverse reactions, hemodynamics, neurological injury indexes, duration of coma, length of hospital stay, and prognosis of patients in the two groups were compared. Results. After treatment, the NIHSS score of group A was higher than that of group B (P<0.05), the clinical efficacy of group B was better than that of group A, and the incidence of adverse reactions was lower than that of group A (P<0.05). There was no difference in vascular recanalization rate, duration of coma, and prognosis between the two groups (P>0.05). Length of hospital stay, maximum peak velocity after treatment (Vs), and mean flow rate (Vm) of group A were lower than those of group B, while vascular resistance index (RI), pulsatility index (PI), serum glutamic acid (Glu), neuron-specific enolase (NES), and S100β protein detected by enzyme-linked immunosorbent assay (ELISA) of group A were higher than those of group B (P<0.05). Conclusion. Arteriovenous thrombolysis combined with mechanical thrombectomy has a significant effect on ACI, with high safety and quick effect. In addition, it has a stronger effect on improving and protecting the neurological function of patients, which is worth promoting in clinical practice.

Effects of Edaravone on Neurological Function and Tumor Necrosis Factor Alpha and Interleukin 8 Levels in Patients with Cerebral Infarction

2020 ◽  
Vol 83 (1) ◽  
pp. 73-79
Author(s):  
Xiushan Li ◽  
Dongzhou Ma ◽  
Guozhu Sun
Keyword(s):  
Cerebral Infarction ◽  
Adverse Reactions ◽  
Pearson Correlation ◽  
Neurological Function ◽  
Nihss Score ◽  
Tnf Α ◽  
Group A ◽  
Pearson Correlation Analysis ◽  
Group B ◽  
Necrosis Factor

Objective: The present study aimed to explore the effects of edaravone on neurological function, tumor necrosis factor α (TNF-α), and interleukin (IL)-8 levels in patients with cerebral infarction. Methods: A total of 96 patients with cerebral ­infarction who were admitted to the department of neurology in our hospital were enrolled in the present study, and they were randomly assigned to Group A (n = 48) and Group B (n = 48). Group A was treated with conventional therapy plus edaravone for 2 weeks and Group B with conventional therapy alone for 2 weeks. Enzyme-linked immunosorbent assay was used to determine serum TNF-α and IL-8 levels before and after treatment, and Pearson correlation analysis was conducted to analyze the correlation between serum TNF-α and IL-8 levels as well as National Institutes of Health Stroke Scale (NIHSS) score. Results: After treatment, Group A had a lower NIHSS score and serum TNF-α and IL-8 levels as well as higher activities of daily living score than Group B (all p < 0.05). In addition, after treatment, no significant differences were observed between the 2 groups in terms of the presence of adverse reactions (p > 0.05). Pearson correlation analysis revealed a significant positive correlation between serum TNF-α and IL-8 levels as well as NIHSS score (r = –0.567 and r = –0.556, both p < 0.05). Conclusion: Edaravone can improve the neurological function of patients without causing evident adverse reactions, thereby improving quality of life, which may be correlated to decreased serum TNF-α and IL-8 levels.

scholarly journals Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

2019 ◽  
Vol 6 (3) ◽  
pp. 1182
Author(s):  
Pragalatha Kumar A. ◽  
Indhuja Rajarathinam ◽  
Aruna Gowdra
Keyword(s):  
Hospital Stay ◽  
Severity Score ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Clinical Severity ◽  
Controlled Study ◽  
Acute Bronchiolitis ◽  
Clinical Severity Score ◽  
Group A ◽  
Group B

Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.

scholarly journals Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Quanyi Li ◽  
Yongchun Zhou
Keyword(s):  
Hospital Stay ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Bed Rest ◽  
Intraoperative Blood Loss ◽  
Postoperative Length ◽  
Group A ◽  
Group B ◽  
Endoscopic Lumbar Discectomy

Abstract Purpose To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods The clinical data of 1100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

scholarly journals Adrenaline and Dexamethasone, vs Adrenaline and Fluticasone, vs Adrenaline alone in Bronchiolitis: A Randomized Controlled Trial

2020 ◽  
pp. 20-28
Author(s):  
Jayendra R. Gohil ◽  
Atul M. Sheladiya ◽  
N. B. Adithya ◽  
Ratna D. Bhojak
Keyword(s):  
Hospital Stay ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Primary Objective ◽  
Assessment Instrument ◽  
Clinical Severity ◽  
Group A ◽  
The Difference ◽  
Group B

Background and Objectives: There is no consensus over which drug best reduces symptoms in Bronchiolitis syndrome. The primary objective of our study is to establish comparative effect of adrenaline nebulisation alone and combination of adrenaline nebulisation plus injectable dexamethasone and adrenaline nebulisation plus fluticasone nebulisation in the treatment of clinical cases of bronchiolitis. Methods: 100 patients diagnosed clinically as bronchiolitis were enrolled in study from 1 month to 24 months of age. Patients were enrolled by purposive sampling. Patients with respiratory distress assessment instrument score [RDAI] of 4 to 15 were chosen, randomized into three groups and treatment given till patient fullfilled discharge criteria. Group A (n=33) were given nebulised adrenaline alone, Group B (n=34) were given nebulised adrenaline plus injectable dexamethasone and Group C (n=33) were given nebulised adrenaline plus nebulised fluticasone. Results: The mean reduction in clinical severity-RDAI score was 1.75 ±0.86 in Group A, 2.30 ± 0.68 in Group B and 1.42 ± 0.9 in Group C when measured in terms of difference in clinical scores between day 1 and 2 (p=0.0003). Mean duration of hospital stay in the group A was (4.93±1.95 days), Group C (4.78±1.83) and Group B (3.91 ±1.37 days). The difference of stay between the Groups A and B was 1.02±0.58 days vs 0.87± 0.46 days in groups B and C (p-0.0048). Reduction in the length of hospital stay in group B was 22% compared to Group A & 19% compared to Group C (p-0.0048). Side effects were tachycardia in six patients. Conclusion: Combination of adrenaline nebulization and injectable dexamethasone was found significantly better as compared to nebulised adrenaline plus nebulised fluticasone and nebulised adrenaline alone in patients of clinical bronchiolitis in reducing severity of clinical symptoms and duration of hospitalization.

Observation of clinical efficacy and survival of lung cancer patients with UMIPIC combined with low-dose chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21605-e21605
Author(s):  
Jianbin Feng ◽  
Peng Jing ◽  
Feng Gao ◽  
Jian Liu ◽  
Wei Han ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Time ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Low Dose ◽  
Survival Rates ◽  
Lung Cancer Patients ◽  
Group A ◽  
Group B ◽  
Low Dose Chemotherapy

e21605 Background: To observe the clinical efficacy and survival of UMIPIC combined with low-dose chemotherapy in patients with lung cancer. Methods: 840 patients with lung cancer underwent UMIPIC treatment from January 2011 to December 2015 were selected as the study subjects, 341 cases combined with low-dose chemotherapy in group A and 499 cases not combined with chemotherapy in group B. All patients were diagnosed with lung cancer and signed a consent form for treatment. The patients were treated according to the UMIPIC treatment guidelines. This study was mainly to observe the adverse reactions, clinical efficacy, survival time and survival rate of lung cancer patients after receiving UMIPIC combined with or without low dose chemotherapy. Results: The common adverse reactions in group A were fever 38.12%, followed by pain 9.38%, hemoglobin 7.94%, white blood cells 5.01%, nausea 2.35%, liver function damage 1.19%, vomiting 1.17%, and kidney function damage 0.30%; Common adverse reactions in group B were fever 38.68%, followed by pain 13.23%, hemoglobin reduction 12.87%, white blood cell reduction 5.29%, nausea 2.00%, vomiting 2.00%, liver function damage 1.92%. The hemoglobin reduction in group A was significantly lower than that in group B (P < 0.05), and there was no difference in the other adverse reactions (P > 0.05). Clinical efficacy of the two groups revealed that the benefit rate of group A was 95.45% higher than that of group B 93.47% (P > 0.05). After follow-up, it was found that the average survival time and median survival time of patients in group A were 20.744 and 13.270 months, respectively, which were significantly higher than those of group B at 19.514 and 10.070 months (P < 0.05). The survival rates of the two groups of patients, The 1-year, 2-year, and 5-year survival rates of group A patients are 52.48%, 23.60%, and 16.95%, and the 1-year, 2-year, and 5-year survival rates of group B patients are 42.96% and 17.07 % And 10.26%, the one-year survival rate of group A was significantly higher than that of group B (P < 0.05). Conclusions: UMIPIC combined with low-dose chemotherapy has a good clinical effect in treating lung cancer without increasing the incidence of adverse reactions, and a significant effect on extending survival time and improving survival rate of lung cancer patients.

Alvimopan as an essential component of ERAS protocol to decrease length of hospital stay.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 517-517
Author(s):  
Peter Hanna ◽  
Arveen Kalapara ◽  
Subodh Regmi ◽  
Kalyana Srujana ◽  
Joseph Zabell ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Hospital Stay ◽  
Radical Cystectomy ◽  
Smoking Status ◽  
Length Of Hospital Stay ◽  
Significant Difference ◽  
Bowel Movements ◽  
Group A ◽  
Group B ◽  
Eras Protocol

517 Background: Radical cystectomy for muscle invasive bladder cancer is the gold standard. However, it is frequently associated with a prolonged length of hospital stay (LOS). We study the effect of ERAS protocol implementations and Alvimopan use in patients undergoing radical cystectomy and its impact on length of hospital stay (LOS). Methods: Retrospective cohort study involving consecutive patients undergoing radical cystectomy for bladder cancer at our institution from 2010 through 2018. We evaluated Alvimopan use plus an ERAS protocol post radical cystectomy versus patients who underwent ERAS protocol alone versus those who were managed prior to ERAS protocol implementation. Primary outcome of interest was LOS, controlling for age, sex, smoking status and Charleson comorbidities index. Results: 146 patients (49.32 %) received standard care (non-ERAS) (group A), 102 patients (34.45 %) underwent ERAS protocol alone (group B) and 47 patients (15.87 %) underwent ERAS protocol plus Alvimopan (group C). There was no significant difference in length of stay between group A and group B (p=0.856). However, group C experienced a shorter LOS (16.6%) compared to group A (p=0.015). Similarly, group B was not significantly associated with the days to bowel movements compared to group A (p=0.112), however, group C demonstrated a significantly shorter time (16.3%) to bowel movements compared to group A (p=0.015). On other hand, group c wasn’t significantly associated with time tolerance to regular diet (p=0.068). Limitations include retrospective nature of some of the data, non-randomized approach and confounders such as a mix of robot and open approaches to cystectomy. Conclusions: Of all ERAS protocol components, Alvimopan appeared to be the most significant contributor in accelerating GI recovery and decrease LOS in our cohort.

The Improvement Effect of Different Doses of Gamma Globulin on the Disease Condition of Infants with Hemolytic Disease of Newborn and Their Effects on Immune Factors in Serum

2020 ◽  
Author(s):  
Shuwen HUANG ◽  
Lin LIU ◽  
Guanglei QIAN ◽  
Wenxue LIU ◽  
Jialiang WANG ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Gamma Globulin ◽  
Length Of Hospital Stay ◽  
High Dose ◽  
Serum Total Bilirubin ◽  
Hemolytic Disease ◽  
Group A ◽  
Immune Factors ◽  
Group B ◽  
Different Doses

Background: To explore the effect of different doses of Gamma Globulin (GG) on the condition of children with Hemolytic Disease of Newborn (HDN) and the influence of immune factors in serum. Methods: Overall, 180 infants with hemolytic disease of newborn in the People’s Hospital of Zhangqiu Area, Jinan, China from April 2016 to August 2018 were divided into group A (88 cases) and group B (92 cases). Group A was given intravenous low-dose GG on the basis of phototherapy, and group B was given intravenous high-dose GG on the basis of phototherapy. The level of serum total bilirubin of the infants, the levels of CD3+, CD4+, CD8+, IgA, IgG and IgM of the infants, the time of jaundice disappearance and the length of hospital stay, hemoglobin and reticulocyte levels were recorded before treatment and after treatment. The number and condition of adverse reactions were recorded. Results: After treatment, the levels of TBiL, hemoglobin and reticulocyte, the time of jaundice disappearance and hospital stay in group B were significantly lower than those in group A. The level of immune cells in group B was significantly higher than that in group A after 7 days of treatment, and the levels of IgA / IgG / IgM in group B were significantly higher than those in group A after 28 days of treatment. Conclusion: Intravenous high-dose GG has a better effect on the condition of neonatal hemolytic disease patients, and more effectively improve the immune function of children.

The clinical effect of Chitosan nanoparticles against Helicobacter pylori

2020 ◽  
Vol 10 (7) ◽  
pp. 1116-1121
Author(s):  
Jing Wang ◽  
Xinhong Wang ◽  
Min Li ◽  
Suxiang Fan
Keyword(s):  
Triple Therapy ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Chitosan Nanoparticles ◽  
High Dose ◽  
Significant Difference ◽  
Oral Liquid ◽  
Group A ◽  
The Difference ◽  
Group B

The objective of this study was to observe the clinical effect of Chitosan nanoparticles therapy on Helicobacter pylori (HP) infection. Three treatment groups (A, B, and control group C) were randomly assigned with 60 cases of HP each, making 180 cases. Group C received standard triple therapy (omeprazole + amoxicillin + clarithromycin), group A got a routine dose of Chitosan nanoparticles plus triple therapy, and group B got a high dose of Chitosan nanoparticles plus triple therapy. The course of treatment in each group was 7 days. The eradication rate, clinical efficacy and adverse reactions were observed. Up to 172 patients finished the experiment, with 59 patients in Group A, 57 in Group B and 56 in Group C. In a total analysis set (FAS), the eradication rates of HP in Group A, Group B and Group C were 80.00%, 80.70%, and 71.67%, respectively. There was no significant difference between the two groups (P > 0.05). In accordance with the PPS, the HP eradication rates of group A, B, and C were 81.36%, 80.70% and 76.79%, respectively, and there was no significant difference between the two groups (P > 0.05). The clinical efficacy of group A, B, and C were 91.67%, 91.23%, and 70.00%, respectively. The differences among the three groups were statistically significant (P < 0.05). In accordance with the PPS, the clinical efficacy of group A, B and C was 93.22%, 91.23%, and 75.00%, respectively. With a P-value of less than 0.05, the results indicated that the difference between the two groups was statistically significant. There were 21 adverse reactions in the experiment, including 3 in group A, 6 in group B, and 12 in group C. The difference was statistically significant (P < 0.05) between group A and B compared with group C, the difference was statistically significant (P < 0.05); the difference between group A and group B was statistically significant (P < 0.05). In conclusion the therapeutic effect of Chitosan nanoparticles and oral liquid, combined with triple therapy on HP infection is satisfactory, with less adverse reactions are. However, the findings suggest that it is not desirable to use a high dose Chitosan nanoparticles and oral liquid.

Comparison of 3% saline and 0.9% normal saline nebulization as diluent in children with bronchiolitis

2020 ◽  
pp. 1-10
Author(s):  
Shobha Sapkota ◽  
Ammara Kaleem ◽  
Suffura Huma ◽  
Muhammad Aleem Ud-Din ◽  
Shabbir Ahmad ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Prospective Study ◽  
Hospital Stay ◽  
Normal Saline ◽  
Saline Solution ◽  
Length Of Hospital Stay ◽  
Group A ◽  
Key Words 3 ◽  
Group B ◽  
Mean Time

Abstract Objective: To compare the outcome in terms of mean time to disappearance of cough, wheezing, crackles and length of hospital stay in patients treated with sodium chloride 3% with sodium chloride 0.9% as nebulisation diluent in children for suffering from bronchiolitis. Methods: The prospective study was conducted at the Department of Paediatric Medicine Sheikh Zayed Hospital, Lahore, Pakistan, from November 2014 to April 2015, and comprised children aged between 6 weeks and 24 months having bronchiolitis. Group A received 3% sodium chloride and Group B received 0.9% of the same solution. Duration of cough, wheezing, crackles and duration of stay at hospital were compared between the groups. Data was analysed using SPSS 17. Results: Of the 100 patients, there were 50(50%) in Group A with a mean age of 7.17±4.46, and as many in Group B with a mean age of 6.6±3.74. Overall, there were 55(55%) boys and 45(45%) girls. Mean cough and wheezing remission time as well as length of hospital stay was significantly different between the groups (p<0.05). Conclusion: In children having bronchiolitis, 3% saline as nebuliser solution was found to be more effective than 0.9% saline solution. Key Words: 3% saline solution, Bronchiolitis, Wheezing, Crepitations, Hospital stay.

Routine Ultrasound Control after Successful Intussusception Reduction in Children: Is It Really Necessary?

2020 ◽  
Author(s):  
Carlos Delgado-Miguel ◽  
Antonella García ◽  
Bonifacio Delgado ◽  
Antonio Jesús Muñoz-Serrano ◽  
Miriam Miguel-Ferrero ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Recurrence Rate ◽  
Oral Tolerance ◽  
Length Of Hospital Stay ◽  
Asymptomatic Patients ◽  
Intussusception Reduction ◽  
Group A ◽  
Laboratory Variables ◽  
Group B ◽  
Enema Reduction

Abstract Introduction Recurrence of ileocolic intussusception (ICI) has been related to residual bowel wall edema after enema reduction. Early oral tolerance has been associated with a higher risk of re-intussusception, so an imaging test (ultrasound) has traditionally been performed before restarting oral tolerance. Our aim is to analyze the cost-effectiveness of performing a routine ultrasound in patients who remain asymptomatic after successful enema reduction. Materials and Methods A retrospective observational study was performed in patients with ICI who underwent a successful enema reduction between 2005 and 2019 and distributed in two groups according to whether or not a routine ultrasound was performed before restarting oral tolerance: group A (ultrasound) or B (no ultrasound). We analyzed demographic, clinical and laboratory variables, length of hospital stay, and recurrence rate. Results We included 366 patients who presented 373 ICI episodes (165 in group A and 208 in group B), without significant differences in gender and age. Group A patients presented a higher percentage of vomiting and bloody stools than those in group B without differences in the other clinical features studied, time of evolution, or laboratory variables. Group A presented a higher length of hospital stay than group B (36 vs. 24 hours), although it was not statistically significant (p = 0.30). No statistically significant differences were observed in the recurrence rate between both groups (10.3% A vs. 10.8% B; p = 0.83). Conclusion Performing routine ultrasound before restarting oral tolerance in asymptomatic patients after successful ICI reduction does not decrease the risk of re-intussusception and should not be routinely encouraged.

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