Evaluation of Thrombotic Events in Haemophiliacs Undergoing Major Orthopaedic Surgery without Thrombosis Prophylaxis.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4072-4072
Author(s):  
Manuela Krause ◽  
Charis von Auer ◽  
Andreas Kurth ◽  
Martina Boehm ◽  
L. Hovy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Replacement ◽  
Postoperative Period ◽  
The Body ◽  
Treatment Center ◽  
Major Surgery ◽  
Thrombosis Prophylaxis ◽  
Compression Stockings ◽  
Surgical Interventions ◽  
Apc Resistance

Abstract Introduction:Major orthopaedic procedures and the presence of thrombophilia are risk factors of thrombotic events. In patients with haemophilia undergoing hip or knee replacement the importance of thrombosis prophylaxis with heparin in the postoperative period is still unknown. The aim of the present study was to evaluate the occurence of thrombotic events in haemophiliacs undergoing major surgery without thrombosis prophylaxis. Patients: A total of 32 pts with haemophilia A (severe:27 pts, moderate:4 pts, mild:1pt; median age:47yrs, range:27–73yrs) undergoing hip (n=9)or knee (n=35) replacement were analysed in our haemophilia treatment center. Pts with inhibitors were excluded. Surgical interventions were performed using recombinant (n=37) or plasma-derived (n=7) FVIII for 12 to 15 postoperative days. The median initial dose of FVIII was 82 IU/Kg−1, followed by median FVIII doses of 54 IU/kg−1over the first four days. All pts received thrombosis prophylaxis with graduated compression stockings only. In addition to factor VIII activity, APC resistance, FV G1691A mutation and the FII G20210A variant (FII) were investigated. Results: No thrombotic events in the postoperative period was dokumented. The median FVIII activity was 153% (range:85–347%), the Body mass index (BMI:kg/m2) was 23.1(range:18.2–30.5). During the first four postoperative days FVIII levels >150% were measured in 24/44 (55%) operative procedures. BMI>25 were shown in 12/32 (38%) pts, and age >40yrs was documented in 23/32 (72%) pts. In 1/30 (3%) pt APC resistance and none of our pts FII were identified. Conclusion: In our study group elevated FVIII levels and additional risk factors (BMI>25, age>40years) seems not to influence relevantly the occurrence of thrombotic events in pts with haemophilia undergoing hip or knee replacement without thrombosis prophylaxis. Further studies are required to confirm whether a thrombosis prophylaxis with heparin is needed in haemophiliacs undergoing high risk surgery.

Zur Inzidenz von Phlebothrombosen nach einer Thorakotomie

VASA ◽  
2001 ◽  
Vol 30 (4) ◽  
pp. 259-261 ◽  
Author(s):  
Jukka Saarinen ◽  
T. Kallio ◽  
T. Sisto
Keyword(s):  
Postoperative Period ◽  
Small Sample Size ◽  
Screening Method ◽  
Early Mobilization ◽  
Small Sample ◽  
Major Surgery ◽  
Low Molecular Weight ◽  
Thromboembolic Events ◽  
Compression Stockings ◽  
Duplex Imaging

Background: Incidence of deep venous thrombosis (DVT) after thoracotomy has not been widely studied. DVT is a frequent complication in major surgery involving abdominal and pelvic areas and lower extremities. The aim of the present study was to evaluate the rate of postoperative DVTs after surgery of the lung. Methods: In this prospective study with 25 patients undergoing thoracotomy both legs were studied with venous duplex imaging (VDI) preoperatively and on the second postoperative day. Clinically manifest thromboembolic events during one-month postoperative period were reviewed from the patients’ records. DVT prophylaxis included compression stockings and early mobilization without low-molecular weight heparin. Results: Frequency of postoperative DVTs was 4%. There were no clinically manifest thromboembolic events during one-month postoperative period. In 8% of the patients an old DVT was found preoperatively. Conclusions: Based on this material, incidence of DVT is low after thoracotomy. Early mobilization and the use of compression stockings may be a sufficient form of prophylaxis in these patients. The relatively small sample size and the use of ultrasound as a screening method should be noted in judging the results.

scholarly journals Analysis of risk factors for different types of anesthetic support of newborns and infants with surgical pathology

2020 ◽  
pp. 28-34
Author(s):  
V.I. Snisar ◽  
◽  
O.O. Vlasov ◽  
I.A. Makedonskyy ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Logistic Regression ◽  
Surgical Treatment ◽  
Postoperative Period ◽  
Congenital Malformations ◽  
Fatal Case ◽  
The Body ◽  
Surgical Correction ◽  
Simple Logistic

High-quality anesthetic support during surgical correction of congenital malformations of internal organs and the postoperative period in newborns and infants is complicated by concomitant diseases, significantly affects the processes of metabolism, gas exchange, homeostasis, cerebral, peripheral hemodynamics, etc. before, during and after the surgical intervention. Purpose — to identify the leading risk factors associated with death in various types of anesthetic support for newborns and infants during surgical correction of congenital malformations. Materials and methods. The retrospective study included newborns with congenital malformations of the surgical profile, as well as infants who received and continued stepwise surgical treatment for congenital malformations, depending on the chosen combined anesthetic accompaniment (inhalation + regional anesthesia and inhalation + intravenous anesthesia). The study was carried out in the following stages: 1) to conduct surgical treatment and anesthetic support, 2) introduction of the child into anesthesia, 3) the traumatic stage of the operation, 4) within 1 hour after the operation, 5) 24 hours after the operation. Risk factors were determined by simple logistic regression with the calculation of the odds ratio, 95% confidence interval (95% CI). Results. Among the functional indicators of the vital functions of the body of children with congenital disorders before, during, immediately and 24 hours after surgery against the background of combined anesthesia, with a simple logistic regression analysis, the chance of a fatal case increases with deviations from the norm of peripheral saturation — at all stages of surgical support (7.8–15.0 times); cerebral oxygenation of the child — at the moments of induction into anesthesia and in the postoperative period (10.8 at the stage 2, 72.0 times at the stage 4); increased diastolic blood pressure at the stage of induction of the child into anesthesia (1.6 times). Conclusions. To prevent the chances of death under various types of anesthesia for children with congenital malformations during surgical treatment, it is advisable to more closely monitor blood pressure, cerebral, peripheral oximetry and promptly correct the impaired condition of the child. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: newborns, infants, congenital malformations, anesthesia, risk factors.

scholarly journals Effects of low level laser therapy on the cicatricial dehiscence in the postoperative period of lipoabdominoplasty. Case Report

2020 ◽  
pp. 1-4
Author(s):  
Vanessa Siqueira Roque ◽  
Rodrigo Marcel Valentim da Silva ◽  
Maria Karolina Ferreira de Sousa ◽  
Julio Davi Costa e Silva ◽  
Eneida de Morais Carreiro ◽  
...  
Keyword(s):  
Low Power ◽  
Laser Therapy ◽  
Postoperative Period ◽  
The Body ◽  
Low Level Laser Therapy ◽  
Power Laser ◽  
Invasive Approach ◽  
Surgical Interventions ◽  
Level Laser ◽  
The Aesthetic

Introduction: The surgical procedure is used for the treatment of external and internal injuries and diseases, performed through operations. In this context, the plastic surgery has the purpose of artificially reconstructing a part of the body. Among the various types of surgical interventions, lipoabdominoplasty is more accomplished, correcting the aesthetic and functional deformities of the abdomen, adding a better and more harmonious abdominal contour. Objective: To analyze the effect of the application of the low power laser in the repair of the cicatricial dehiscence in the postoperative period of lipoabdominoplasty in one patient. Methodology: A 25-year-old female patient who underwent lipoabdominoplasty surgery sought physical therapy in March 2017. She had cicatricial dehiscence, and started the pharmacological and physiotherapeutic treatment with low-power laser, AsGa, 12 s, 6J, non-contact. Results: It was observed improvement of the dehiscence progressively, with reduction of the local inflammation, reorganization of the tissue and closure of the wound, presenting in the end only the surgical scar. Conclusion: This study demonstrated positive effect of laser therapy, recovering the injured tissue, signaling a new non-invasive approach to a safe and beneficial treatment.

scholarly journals Assessment of Risk Factors in the Causation & Outcomes of Diabetic Foot

2021 ◽  
pp. 264-270
Author(s):  
Chava Aravind Kumar ◽  
Chandrashekhar Mahakalkar ◽  
Meenakshi Yeola (Pate)
Keyword(s):  
Risk Factors ◽  
Diabetic Foot ◽  
The Body ◽  
Treatment Modalities ◽  
Foot Ulcers ◽  
Tissue Destruction ◽  
Metabolic Complications ◽  
Surgical Interventions ◽  
Peripheral Arterial Diseases ◽  
Peripheral Arterial

Background: Diabetic foot identifies   a Diabetic patient foot that has a potential risk of pathological risk effects that includes inflammation, ulceration and deep tissue destruction consistent with neurological   disorders, differing degrees of Peripheral arterial disease , and lower limb with  metabolic complications. An ulcer is a breach of the continuity of skin, epithelium of mucous membrane in the body which is caused by removal of necrotic tissue . Foot ulcers may be caused by numerous medical conditions. The key to treatment is daily sterile dressing till the formation of healthy granulation tissue, infection control by appropriate use of antibiotics, surgical interventions such as debridement or amputation if needed. Methods: It will be a observational study, done on the patients with Diabetic foot . It will be conducted at Dept. of General Surgery, J.N.M.C. and AVBRH, Sawangi (Meghe), Wardha of DMIMS (DU). The study will be conducted on patients of foot ulcers. Objectives: To evaluate the microbiological and clinical characteristics of diabetic foot infection To analyze the outcomes of a patient with diabetic foot with underlying risk factors HBA1c, Hypertension, Smoking, Diabetic Neuropathy, Recurrence, Obesity, Peripheral arterial diseases. To analyze the association of Risk factors in the causation of Diabetic foot. To predict outcome parameters based on Risk factors and its treatment modalities. Results: The results will be analyzed after data collection in SPSS software. Conclusion: Conclusion will be drawn on findings of study.

scholarly journals Rehabilitation of women after conservative and surgical treatment

2021 ◽  
Author(s):  
R. S. Moldassarina ◽  
G. K. Manabayeva ◽  
Z. Ye. Akylzhanova ◽  
A. M. Rashidova
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Healing Process ◽  
Psychological Trauma ◽  
The Body ◽  
Medical Rehabilitation ◽  
Practical Significance ◽  
Modern World ◽  
Surgical Interventions ◽  
Conservative And Surgical Treatment

The relevance of the study is due to the increase in the volume of conservative and surgical care for women who need mandatory rehabilitation measures in the postoperative period. Until relatively recently, there were very few rehabilitation facilities in the country where women could recover under the supervision of a nurse. Therefore, rehabilitation could drag on for many months and it was very difficult to fully return to normal life. In the modern world, it has become possible to undergo all the necessary analyzes and conduct treatment using the latest scientific methods on high-precision equipment, and then perform a full course of postoperative regeneration. After all, medical centers have great technological capabilities today and control the healing process as soon as possible. The nature of the measures for the recovery of women depends on the changes in the body, which are due to the individual background at the time of treatment. It is important to understand the dependence of a woman's position at the time of recovery: the duration of taking medications, the presence of psychological trauma, the development of chronic diseases, the frequency of repeated interventions. The aim of the study is a step-by-step volumetric study of the implementation of various measures aimed at the rehabilitation of women after conservative and surgical treatment. Modern approaches require responsibility, high qualifications of medical personnel and the direct participation of the patient himself in this process. Timely start of rehabilitation ensures productive restoration of lost functions. The main principle of success is the use of standardized methods, informing the patient at all stages of treatment, using techniques with minimal consequences and maximum impact, and analyzing the course of the postoperative period. The need for an in-depth study of the features of providing medical care to patients with gynecological diseases, including after surgical interventions, is confirmed. The practical significance of the material lies in the high-quality and effective organization of medical rehabilitation, which is of key importance for the full restoration of the functions of the woman's reproductive system.

scholarly journals The Effect of the Anomalous Magnetic Fields on Malignant Diseases

2020 ◽  
Vol 2 (1) ◽  
pp. 1-12
Author(s):  
Trifunovic Nikola ◽  
Keyword(s):  
Magnetic Field ◽  
Risk Factors ◽  
Medical Literature ◽  
Stage Iv ◽  
Medical Intervention ◽  
The Body ◽  
Psychiatric Clinic ◽  
Surgical Interventions ◽  
Medical Risk ◽  
Short Period

Introduction Natural earth’s magnetic field (EMF) is the promoter of mother cell division into two daughter cells. Cancer is the cell which divides unlimitedly and destroys the body. Show that cancer (Ca) occurs in anomalous magnetic field (AMF) located in diseased people’s beds. Move the diseased away from the AMF and follow their health conditions. Explain etiopathologic unclearances from medical literature and improve therapy. Explain that the risk factors, as causes of Ca, are interpreted incorrectly in medical literature, prove that these are effects of the AMF existence in dwelling places. The Materials and Methods Measuring of AMF in patients’ beds was performed by a proton magnetometer, (precision 100 nano Teslas). Measuring points are on square net, 10x10 cm. The results are shown with contour lines on the drawings. The health status of residence in the Earth’s natural magnetic field (EMF) was monitored. The etiological data from the literature are explained. An experiment was performed in a psychiatric hospital with 40 patients. Results and Discussion Research lasted more than 25 years. The AMF were measured in 2000 patients’ beds. There was a correlation between the AMF and the location of the diseased organ. The AMF surfaces were shown in beds where the diseased organ is, on the contrary, there were natural values of the EMF in the rest of the bed surface. Furthermore, the results found that three cases of breast cancer with metastases survived after surgical interventions and subsequent removal into the natural EMF in contrast to 26 cases with the same diagnosis and surgical interventions who died after a short period and staying in the AMF. Another example was brain malignancy (gliobastroma multiform, stage IV), which was decreased by living in the natural EMF for six years. In the same clinic, with the same diagnosis, three patients died because they were not moved away from the AMF. Those presented are the cases of breast malignant disease with metastases. The patients refused chemotherapy, accepted only surgical operation and removal of the AMF. They have all recovered. Three patients with head, prostate tumors and breast Neo are presented, who, after removing of the AMF, recovered with no medical intervention at all. Conclusion There was a visible improvement of health with patients who stayed in the natural EMF. The correlation between Az and the diseased organ was determined by measuring the AMF. Knowing the effects of the AMF and the natural EMF, all the literature ambiguities from etiopathology were explained. It was concluded that the medical risk factors are not causes of cancer. It is necessary to improve the treatment of the patients with Ca with construction of hospitals with no AMF and introduce hyperthermia therapy in the natural EMF. The AMF located in the patients’ beds are the sole cause of Ca. This conclusion is suggested in the experiment done in the psychiatric clinic, too.

Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

2020 ◽  
pp. 51-56
Author(s):  
V.М. Аntonyuk-Kysil ◽  
◽  
І.Y. Dziubanovskyi ◽  
V.М. Yenikeeva ◽  
S.І. Lichner ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Postpartum Period ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Vascular Surgeon ◽  
Surgical Interventions ◽  
Perinatal Center ◽  
Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

PREP — The Preoperative Risk Education Package: an online educational resource for primary care clinicians to encourage community based prehabilitation prior to major surgery

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697277
Author(s):  
James Durrand ◽  
F McHardy ◽  
E Land ◽  
Z Llewellyn ◽  
C Norman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Perioperative Risk ◽  
Perioperative Outcomes ◽  
Major Surgery ◽  
Educational Resource ◽  
Major Step ◽  
Early Evaluation ◽  
Risk Education ◽  
Primary Care Clinicians

BackgroundPrehabilitation prior to major surgery mandates cross-sector working. Utilising the preoperative window from referral requires clinician engagement. Awareness of perioperative risk factors is crucial. A national survey uncovered gaps in knowledge and understanding.AimCreate an open-access, online educational resource for primary care clinicians.MethodOur multidisciplinary team developed a focused CPD resource targeting lifestyle factors and chronic health conditions influencing perioperative risk (www.prepwell.co.uk).ResultsPREP highlights seven risk factors influencing perioperative risk: Smoking, alcohol, inactivity, anaemia, cognitive impairment, frailty and low BMI. A case study frames each factor alongside perioperative impact and prehabilitation strategies.ConclusionPREP is the first educational resource of its type. Early evaluation through local clinicians, the RCGP and RCOA has resulted in very positive feedback. We are working with Royal College representatives to gain formal endorsement and facilitate wider scale rollout, a major step towards raised clinician awareness and enhanced collaboration for improved perioperative outcomes.

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