Can Education and Enhanced Medical Director Oversight Improve Definitive Airway Control in the Prehospital Environment?

Background Endotracheal intubation (ETI) is the most definitive technique for airway management. However, supraglottic airway (SGA) may be used when ETI is not feasible. The purpose of this study was to determine the effect of updated field sedation protocols, simulation teaching, robust Quality Assurance/Continuing Quality Improvement (QA/CQI) program, and enhanced emergency medical services (EMSs) medical director oversight on ETI and SGA usage at a Level 1 trauma center. Methods After the transition of EMS directors in May 2016, field sedation protocols were updated, a new QA/CQI was instituted, and multiple teaching and simulation sessions were conducted. A retrospective review of EMS data was conducted on all prehospital airway interventions performed by EMS personnel. Intubations occurring from July 2013 to May 2016 served as controls. Intubations from May 2016 to December 2017 served as the comparison group. Data collected included intubation type/indication, age, and successful or unsuccessful. Results There were 967 ETI and SGA performed on 84% and 15% of patients, respectively. Success rates were 75% for ETI and 82% for SGA. ETI increased from 83% in the control group to 88% in the study group, and SGA decreased from 16% in the control group to 11% in the study group ( P = .029). The success rate for ETI increased by 2% in the study group ( P = .539). Discussion This study showed that definitive airway control could be positively impacted by incorporating education and medical director oversight into EMS training. ETI increased and SGA decreased after implementation.

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Outcome of using a modified surgical technique for the repair of complex vesicovaginal fistulas in Nigeria

Urogynaecologia ◽

10.4081/uij.2017.196 ◽

2017 ◽

Vol 30 (1) ◽

Author(s):

Aniefiok J. Umoiyoho ◽

Emmanuel C. Inyang-Etoh

Keyword(s):

Obstetric Fistula ◽

Conventional Technique ◽

Control Group ◽

Study Group ◽

Success Rates ◽

Modified Technique ◽

Repair Technique ◽

Significant Difference ◽

The Mean ◽

Repair Techniques

The relatively low effectiveness of available surgical repair techniques for complex obstetric fistula has justified the need for continued exploration of more effective repair techniques. Subjects who presented at a vesicovaginal fistula referral centre in Nigeria were randomized into the study group (modified technique) and the control group (conventional technique). Success rates between the two groups were compared. The study comprised 29 patients in each arm of the study. The mean age of patients in the study group was 23.9 ± 9.6 years and 24.4 ± 2.1 years among patients in the control group with the vast majority of the patients in the both groups being married, 75.9% and 86.2% respectively. In both groups, the majority were secundipara, 55.2% in the study group and 44.8% in the control group. The majority (41.4% in the study group and 44.8% in the control group) of the patients in both groups had attained primary level of education. The mean duration of the fistulas among patients in the study population was 1.1 ± 0.3 years with over half (50.0% among patients in the study group and 53.5% of patients in the control group) of the patients had their fistula for less than one year. A highly statistically significant difference in success rate between patients in the study group and patients in the control group was obtained (p=0.0004). The modified repair technique presented by this study has proved to produce superior results when compared to the conventional repair technique in the management of complex obstetric fistulas in Nigeria.

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Evaluation of Intensity of Sleep Bruxism in Arterial Hypertension

Journal of Clinical Medicine ◽

10.3390/jcm7100327 ◽

2018 ◽

Vol 7 (10) ◽

pp. 327 ◽

Cited By ~ 7

Author(s):

Helena Martynowicz ◽

Pawel Dymczyk ◽

Marzena Dominiak ◽

Klaudia Kazubowska ◽

Robert Skomro ◽

...

Keyword(s):

Arterial Hypertension ◽

Muscle Activity ◽

Oral Care ◽

Sleep Bruxism ◽

Control Group ◽

Study Group ◽

Group Data ◽

Independent Risk Factors ◽

Normotensive Subjects

Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or non-rhythmic (tonic). The recent hypothesis on the etiology of SB supports the role of the central and autonomic nervous systems. Therefore, in this study, we aimed to assess the intensity of SB in patients with arterial hypertension. A total of 70 adults participated in this study: 35 patients with hypertension (study group) and 35 normotensive subjects (control group). Data were recorded using home portable cardiorespiratory polygraphy. The bruxism episode index (BEI) in the study group was found to be significantly higher compared to the control group (3.4 ± 3.25 vs. 2.35 ± 2.29, p = 0.04). Hypertension, higher body mass index (BMI), lower values of mean oxygen saturation (SpO2), and a higher percentage of SpO2 < 90% constituted independent risk factors for increased BEI. These results suggest the need for special oral care in hypertensive patients, patients with higher BMI, lower values of SpO2 and a higher percentage of SpO2 < 90%.

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The first experience of arthroscopy in the case of aseptic necrosis of the femoral head

ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS ◽

10.15674/0030-59872021239-44 ◽

2021 ◽

pp. 39-44

Author(s):

Maxim Golovakha ◽

Vadym Kirichenko ◽

Olexandra Grytsenko ◽

Rostyslav Tytarchuk ◽

Stanislav Bondarenko

Keyword(s):

Femoral Head ◽

Avascular Necrosis ◽

Hip Joint ◽

Comparison Group ◽

Long Term Results ◽

Control Group ◽

Study Group ◽

Hip Joint Replacement ◽

Therapeutic Exercises

Observation of patients with avascular necrosis of the femoral head formed a hypothesis about inability to eliminate the hip contracture by tunneling the femoral head on the background of drug therapy and therapeutic exercises, which causes an unsatisfactory outcomes. Therefore, the was idea to use arthroscopy for performing capsulotomy, synovectomy and removal of free cartilage and bone fragments. Objective. To evaluate efficiency of arthroscopy in patients with avascular necrosis of the femoral head. Methods. In the period from 2010 to 2018, 60 patients were observed. With the I–II stages, absence of inflammatory processes in the joint, body mass index less than 35. In the comparison group (28 patients) we made only tunneling of the femoral head, in the study group (32) at first we performed arthroscopy of the hip joint, capsulotomy, synovectomy, removal of cartilage fragments, and only then — tunneling. We analyzed the proportion of hip joint replacement that was performed in the long term follow up and the intensity of pain by visual analog scale. Results. During arthroscopy we often revealed the joint cartilage lesions — 30 %, articular labrum lesions — 5 %, synovitis — 100 %, CAM impingement — 90 %. In the study group in the first 2 weeks after surgery, the pain was severe more than in the comparison group. Then the pain rate became the same in both groups. In the control group in the period from 3 to 5 years after tunneling of the femoral head, arthroplasty was performed in 11 patients (39.3 %), in the study group for 2 to 3 years after surgery — 8 (25.0 %). Conclusions. Analysis of long-term results of tunneling of the femoral head with arthroscopy of the hip joint in patients with avascular necrosis of the femoral head showed improvement in hip function, no disease progression in 60–75 % patients in 2–3 years after surgery.

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Intrauterine Insemination Success Rates Between Patients TSH Level of 2.5 mIU/L and 2.5-4.5 mIU/L

Tropical Health and Medical Research ◽

10.35916/thmr.v3i1.38 ◽

2021 ◽

Vol 3 (1) ◽

pp. 27-35

Author(s):

Gizem Berfin Uluutku ◽

Basak Ergin ◽

İbrahim Kale ◽

Rahime Nida Bayık

Keyword(s):

Intrauterine Insemination ◽

Threshold Value ◽

Control Group ◽

Study Group ◽

Success Rates ◽

Ongoing Pregnancy ◽

Cross Sectional ◽

Significant Difference ◽

The Mean ◽

Infertility Patients

The aim of this study to assess whether there is a need to decrease the TSH level below 2.5 mIU/L in unexplainable infertility patients who were undergoing intrauterine insemination and determining the difference between patients with a TSH level of 2.5 mIU / L and patients with a TSH level of 2.5-4.5 mIU/L in terms of the success of intrauterine insemination. This study conduct via cross-sectional examinations of the 272 patients who applied to Ümraniye Training and Research Hospital infertility outpatient clinic between 01.06.2017-01.10.2019, who underwent intrauterine insemination with the diagnosis of unexplained infertility. Results research the mean age of the cases participating in our study is 31.65 ± 5.28, and the mean BMI measured as 24.17 ± 4.30 kg / m2. TSH values range from 0.3 to 5.2, with an average of 1.84 ± 0.93; while TSH value of 174 cases (77.3%) is below 2.5 mIU/L, TSH value of 51 cases (22.7%) is between 2.5-4.5mIU/L. Within the control group with TSH <2.5 mIU/L, the cycle was canceled in 13 cases (7.5%), pregnancy did not occur in 143 cases (82.2%). While ongoing pregnancy was achieved in 17 cases (9.8%), clinical pregnancy was achieved in 1 case (0,6%). Also, within the study group with a TSH value of 2.5-4.5 mIU/L, cycles were canceled in 7 cases (13.7%), pregnancy did not occur in 40 cases (78.4%), and ongoing pregnancy was achieved in 4 patients (7.8%). There was no statistically significant difference in terms of intrauterine insemination success between the control group with TSH <2.5 mIU / L and the study group with TSH 2.5-4.5 mIU/L. Widespread randomized controlled prospective studies need to determine the optimal TSH threshold value before TSH treatment of the women receiving infertility treatment.

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Novel methodological approaches in the system of early diagnosis of mastopathy with the use of computer dermography

Kazan medical journal ◽

10.17816/kmj2019-117 ◽

2019 ◽

Vol 100 (1) ◽

pp. 117-124

Author(s):

G A Merkulova ◽

E V Pegova

Keyword(s):

Prognostic Model ◽

Comparison Group ◽

Methodological Approach ◽

Risk Groups ◽

Control Group ◽

Study Group ◽

Health State ◽

Non Invasive ◽

Basic Functions ◽

Diagnostic Complex

Aim. Optimization of the early detection of mastopathy on screening examinations due to the inclusion of data received with the use of computer dermography into the algorithm of complex diagnosis. Methods. Integral evaluation of the health state was performed with the use of computer dermography as part of the diagnostic complex DgKTD-01. Fertile females (n=107) were divided into three groups. The study group (n=36) included the female patients with differentiated mastopathy. The control group (n=51) united the females complaining of discomfort in breasts, engorgement and tenderness. Parameters of the baseline level in the study group and the control group were studied; a prognostic model of mastopathy was developed. Comparative analysis of identified characteristics was performed in the comparison group. Results. Females from the study group are in the group of adaptation risk with formation of premorbid states and diseases. The prognostic model of mastopathy was consistent disorder of the tonic activity of basic functions F2' and F3', functions F5-1', F5-2', F5-3' with the extremum in segments Th4-6 in regimen 2 which allowed determining females with the risk of the development of this pathology in comparison group. Conclusion. Method of computer dermography serves as a methodological approach to revealing pre-nosological states which alllows using it as an additional non-invasive diagnostic screening test to determine mastopathy risk groups; the obtained results give ground to continue the further studies and improvement of the diagnosis on a large clinical material and to development of computed system for interpretation of the obtained data.

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Differentiated approach to radical surgical treatment of elderly patients with tumor diseases of the pancreatoduodenal zone

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov70149 ◽

2021 ◽

Vol 13 (2) ◽

pp. 49-56

Author(s):

Badri V. Sigua ◽

Vyacheslav P. Zemlyanoy ◽

Alexey V. Gulyaev ◽

Malkhaz Yu. Tsikoridze ◽

Evgeny A. Zakharov

Keyword(s):

Surgical Treatment ◽

Postoperative Complications ◽

Comparison Group ◽

Main Group ◽

Control Group ◽

Study Group ◽

Tumor Diseases ◽

Results Of Treatment ◽

Repeated Surgery ◽

Pancreatic Fistulas

BACKGROUND: In recent years, there has been a widespread increase in the incidence of tumors of the pancreatoduodenal zone, especially noticeable in the older age group. A decrease in the incidence of postoperative complications and mortality after pancreatoduodenal resection made it possible to expand the indications for surgical treatment of elderly and senile patients. AIM: Improvement of the immediate results of pancreatoduodenal resection in the treatment of elderly and senile patients suffering from tumor diseases of the pancreatoduodenal zone. MATERIALS AND METHODS: Pancreatoduodenal resection was performed in 61 elderly and senile patients with tumors of the pancreatoduodenal zone. The main group consisted of 32 patients, whose treatment was carried out in accordance with the developed algorithm for choosing a method for forming a pancreatodigestive anastomosis based on a scale for assessing the risk of developing pancreatic fistulas. The comparison group consisted of 29 patients in whom the method of forming a pancreatodigestive anastomosis was carried out in accordance with the preferences of the operator without taking into account the risk of developing a pancreatic fistula. RESULTS: In the main group, compared with the control group, pylorus-saving interventions were performed significantly more often 27 (84.4%) and 14 (48.3%) (p 0.01). There was also a decrease in the frequency of performing pancreaticojejunostomy 16 (50%) and 22 (75.9%) (p 0.05), due to the use of reservoir terminolateral pancreatojejunostomy 8 (25%) and 0, respectively (p 0.01). Postoperative complications were observed in 14 (43.8%) of the study group and in 21 (72.4%) patients of the comparison group (p 0.05). There was also a decrease in the incidence of postoperative pancreatic fistulas from 8 (27.6%) to 2 (6.2%) (p 0.05) in the study group. Repeated surgery was required in 5 (15.6%) patients of the main group and 11 (37.9%) in the comparison group (p 0.05). The lethal outcome was recorded in 3 (9.4%) patients of the main group and in 7 (24.1%) in the comparison group (p 0.05). CONCLUSIONS: The results of performing pancreatoduodenal resection in the treatment of elderly and senile patients can be comparable with the results of treatment of the general population. The use of the developed algorithm made it possible to reliably reduce the incidence of complications from 72.4 to 43.8% (p 0.05), postoperative pancreatic fistulas from 27.6 to 6.2% (p 0.05), as well as the frequency of repeated interventions. from 37.9 to 15.6 % (p 0.05). In addition, a downward trend in mortality was achieved from 24.1% to 9.4%.

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Immediate Restoration of NobelActive Implants Placed Into Fresh Extraction Sites in the Anterior Maxilla

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00254 ◽

2014 ◽

Vol 40 (4) ◽

pp. 455-458 ◽

Cited By ~ 15

Author(s):

Christopher Bell ◽

Robert E Bell

Keyword(s):

Success Rate ◽

Oral Surgery ◽

Control Group ◽

Study Group ◽

Success Rates ◽

Anterior Maxilla ◽

Implant Placement ◽

Tissue Healing ◽

High Torque ◽

Torque Values

The aim of this study is to compare the success rates of immediately placed and loaded NobelActive implants with the success rate of immediately placed implants that were allowed to osseointigrate prior to loading. The charts of all patients in a private oral surgery office receiving single-unit dental implants in the maxillary anterior region in fresh extraction sites from 2008–2011 were evaluated. All patients receiving NobelActive implants and immediate restorations were included in the study group, while those receiving implants with delayed restorations were included in the control group. Patient records were evaluated for variables such as age, gender, torque values at time of implant placement, smoking habits, use of bisphosphonates, and other significant diseases such as diabetes. The success rate of the study group was 92.9%, whereas the success rate of the control group was 97.6%. This was not statistically significant. Torque values of the failed implants of the study group were similar to those of successful implants in the study group. All implants placed in patients scheduled for immediate loading achieved high torque values and were able to be restored immediately. NobelActive implants were able to obtain high torque values for predictable immediate restoration in fresh extraction sites. Acceptable success rates with excellent soft tissue healing were achieved.

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Changes in organic mental disorders features in persons who have repeatedly committed socially dangerous acts

Kazan medical journal ◽

10.17750/kmj2015-157 ◽

2015 ◽

Vol 96 (2) ◽

pp. 157-161

Author(s):

S N Popov ◽

I N Vinnikova

Keyword(s):

Mental Disorders ◽

Mental Disorder ◽

Disease Duration ◽

Comparison Group ◽

Clinical Manifestations ◽

Main Group ◽

Control Group ◽

Study Group ◽

Organic Mental Disorder ◽

Organic Mental Disorders

Aim. Comparative analysis of the changes in clinical manifestations of organic mental disorders in persons who have repeatedly committed socially dangerous acts, and in patients without recurrence of misconduct.Methods. 93 patients with organic mental disorders who have committed socially dangerous acts and were declared as mentally insane and in whom compulsory medical measures assigned to them by the court were used were examined. Patients who have committed repeated socially dangerous acts after treatment were included in the main group (30 persons), patients who does not commit repeated socially dangerous acts were allocated to the comparison group (63 persons).Results. In the main group, patients with organic delusional disorder (F06.2, 20% vs 11.1%) dominated. In the control group, the share of patients with dementia of mixed origin (F02) was 22.2%, and in the main group - only 3.3%. In the main group, the prevalence of patients with psychotic conditions within the organic mental disorder was 43.3% versus 30.2% in the comparison group. At that, the rate of progression varied only slightly. The proportion of patients with no previously recorded episodes of decompensation was higher in the control group - 46.0% versus 13.3% in the study group. A few patients in both groups (10%) were supervised and regularly visited a psychiatrist. The number of patients who were not supervised or who attended psychiatrist rare was almost the same (46.7 and 47.6% in the study group and control group, respectively). At that, in the control group 12.7% of patients were not supervised due to the short disease duration (patients with dementia). There were a few more patients with a disease duration of more than 10 years in the comparison group - 54.0%, whereas in the study group - 43.3%.Conclusion. There is a number of differences in clinical manifestations of organic mental disorder and their changes over time, affecting the criminogenic risk of this population; an integrated approach to disease prevention, which can lead to an improvement in the criminal forecast, is needed.

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Health and fertility of ICSI-conceived young men: study protocol

Human Reproduction Open ◽

10.1093/hropen/hoaa042 ◽

2020 ◽

Vol 2020 (4) ◽

Author(s):

S R Catford ◽

S Lewis ◽

J Halliday ◽

J Kennedy ◽

M K O’Bryan ◽

...

Keyword(s):

Young Men ◽

Reproductive Hormones ◽

Medical Director ◽

Trial Registration ◽

Metabolic Parameters ◽

Semen Parameters ◽

Control Group ◽

Study Group ◽

Obstructive Azoospermia ◽

Metabolic Data

Abstract STUDY QUESTIONS What are the long-term health and reproductive outcomes for young men conceived using ICSI whose fathers had spermatogenic failure (STF)? Are there epigenetic consequences of ICSI conception? WHAT IS KNOWN ALREADY Currently, little is known about the health of ICSI-conceived adults, and in particular the health and reproductive potential of ICSI-conceived men whose fathers had STF. Only one group to date has assessed semen parameters and reproductive hormones in ICSI-conceived men and suggested higher rates of impaired semen quality compared to spontaneously conceived (SC) peers. Metabolic parameters in this same cohort of men were mostly comparable. No study has yet evaluated other aspects of adult health. STUDY DESIGN, SIZE, DURATION This cohort study aims to evaluate the general health and development (aim 1), fertility and metabolic parameters (aim 2) and epigenetic signatures (aim 3) of ICSI-conceived sons whose fathers had STF (ICSI study group). There are three age-matched control groups: ICSI-conceived sons whose fathers had obstructive azoospermia (OAZ) and who will be recruited in this study, as well as IVF sons and SC sons, recruited from other studies. Of 1112 ICSI parents including fathers with STF and OAZ, 78% (n = 867) of mothers and 74% (n = 823) of fathers were traced and contacted. Recruitment of ICSI sons started in March 2017 and will finish in July 2020. Based on preliminary participation rates, we estimate the following sample size will be achieved for the ICSI study group: mothers n = 275, fathers n = 225, sons n = 115. Per aim, the sample sizes of OAZ-ICSI (estimated), IVF and SC controls are: Aim 1—OAZ-ICSI: 28 (maternal surveys)/12 (son surveys), IVF: 352 (maternal surveys)/244 (son surveys), SC: 428 (maternal surveys)/255 (son surveys); Aim 2—OAZ-ICSI: 12, IVF: 72 (metabolic data), SC: 391 (metabolic data)/365 (reproductive data); Aim 3—OAZ-ICSI: 12, IVF: 71, SC: 292. PARTICIPANTS/MATERIALS, SETTING, METHODS Eligible parents are those who underwent ICSI at one of two major infertility treatment centres in Victoria, Australia and gave birth to one or more males between January 1994 and January 2000. Eligible sons are those aged 18 years or older, whose fathers had STF or OAZ, and whose parents allow researchers to approach sons. IVF and SC controls are age-matched men derived from previous studies, some from the same source population. Participating ICSI parents and sons complete a questionnaire, the latter also undergoing a clinical assessment. Outcome measures include validated survey questions, physical examination (testicular volumes, BMI and resting blood pressure), reproductive hormones (testosterone, sex hormone-binding globulin, FSH, LH), serum metabolic parameters (fasting glucose, insulin, lipid profile, highly sensitive C-reactive protein) and semen analysis. For epigenetic and future genetic analyses, ICSI sons provide specimens of blood, saliva, sperm and seminal fluid while their parents provide a saliva sample. The primary outcomes of interest are the number of mother-reported hospitalisations of the son; son-reported quality of life; prevalence of moderate-severe oligozoospermia (sperm concentration <5 million/ml) and DNA methylation profile. For each outcome, differences between the ICSI study group and each control group will be investigated using multivariable linear and logistic regression for continuous and binary outcomes, respectively. Results will be presented as adjusted odds ratios and 95% CIs. STUDY FUNDING/COMPETING INTERESTS This study is funded by an Australian National Health and Medical Research Council Partnership Grant (NHMRC APP1140706) and was partially funded by the Monash IVF Research and Education Foundation. L.R. is a minority shareholder and the Group Medical Director for Monash IVF Group, and reports personal fees from Monash IVF group and Ferring Australia, honoraria from Ferring Australia, and travel fees from Merck Serono, MSD and Guerbet; R.J.H. is the Medical Director of Fertility Specialists of Western Australia and has equity in Western IVF; R.I.M. is a consultant for and a shareholder of Monash IVF Group and S.R.C. reports personal fees from Besins Healthcare and non-financial support from Merck outside of the submitted work. The remaining authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER Not applicable. TRIAL REGISTRATION DATE Not applicable. DATE OF FIRST PATIENT’S ENROLMENT Not applicable.

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FIRST EXPERIENCE IN SYSTEMIC ADMINISTRATION OF EVEROLIMUS IN RENAL TRANSPLANTATION FROM EXPANDED CRITERIA DONORS IN RUSSIAN FEDERATION

Russian Journal of Transplantology and Artificial Organs ◽

10.15825/1995-1191-2016-4-77-86 ◽

2017 ◽

Vol 18 (4) ◽

pp. 77-86

Author(s):

I. V. Uliyankina ◽

A. E. Skvortsov ◽

A. N. Ananiev ◽

A. A. Kutenkov ◽

D. O. Kuzmin ◽

...

Keyword(s):

Serum Creatinine ◽

Serum Creatinine Level ◽

Creatinine Level ◽

Comparison Group ◽

Control Group ◽

Study Group ◽

Renal Transplant Recipients ◽

Target Concentration ◽

Expanded Criteria ◽

Expanded Criteria Donors

Introduction. Kidney transplant (KTx) with reduced functional reserve is more sensitive to the toxic effects of calcineurin inhibitors (CNI). Immunosuppressive therapy (IST) approach with m-TOR inhibitors in case of KTx from expanded criteria donors (ECD) leads to decreasing levels of cyclosporine (CsA) in the blood. Despite the presence of international pilot studies we do not have yet clear recommendation as to combination of CsA and Everolimus. In this article, we presented 5-year results of the fi rst Russian experience of systematic administration of Everolimus as a basic IST in KTx from ECDs.Materials and methods.The group of recipients (n = 41) having received bilateral kidney transplants from the same ECDs was analyzed. Comparison group (n = 19) received standard IST consisting of CsA, MMF and steroids. Study group included 22 recipients who received kidneys from the same ECDs and IST based on early (starting from the 90th day after transplantation) conversion from MMF to Everolimus – 1.5 mg/day (target concentration – 3–6 ng/mL). Simultaneously with the administration of Everolimus, dosing of Neoral dropped immediately by 50%, and then, in accordance with the target concentration (C0 30–50 ng/mL). Dosage of steroids in patients of the study group was gradually minimized.Results.Both groups were comparable in terms of serum creatinine level and glomerular fi ltration rate (GFR) up to 3 months after transplantation. As a result of the introduction of a new IST scheme in the study group, serum creatinine level in 60 months after KTx was 149.27 ± 42.68 μmol/L, in the comparison group – 209.87 ± 39.56 μmol/L; р < 0.05. In the control group GFR reduced to 27.50 ± 7.39 mL/min/1.73 m2, in the study group it was 46.21 ± 15.17 mL/min/1.73 m2, p < 0.05.Conclusion.Early administration of Everolimus is strongly recommended in all cases of ECD KTx. This approach helps minimize CNI nephrotoxicity, provides the prevention of chronic allograft nephropathy, enables the stable renal function, and contributes to the survival of renal transplant recipients.

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