scholarly journals Value of ultrasound in grading the severity of sarcopenia in patients with hepatic cirrhosis

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Nevien Ezzat El-Liethy ◽  
Heba Ahmed Kamal
Keyword(s):  
Liver Cirrhosis ◽  
Hospital Stay ◽  
Muscle Mass ◽  
Quadriceps Muscle ◽  
Prognostic Scores ◽  
Thigh Muscle ◽  
Control Group ◽  
Upper Arm ◽  
Duration Of Hospital Stay ◽  
Hand Grip

Abstract Background Ultrasound is emerging as an efficient significant method for measuring muscle mass in patients with liver cirrhosis. It has been applied in numerous studies as an accurate measuring tool for the muscles of the limbs. This study was conducted to assess the severity of sarcopenia in liver cirrhosis patients, through utilizing ultrasound in measuring the cross-sectional area and consequently estimating the muscle mass of both the upper and lower limb muscles, than correlating the results with hand grip strength as representative of functional status. Also, the severity of sarcopenia was correlated with conventional prognostic scores for liver cirrhosis, like Child or MELD scores and detecting its effect on the duration of hospital stay and mortality. Results This study was conducted on 101 liver cirrhosis patients who were admitted to the internal medicine hospital, 30 healthy participants were added as a control group. Using the FNIH (Foundation for the national Institutes of health) cuff off of hand grip (< 26 kg in male and < 16 kg in female, Quadriceps muscle index cutoff was estimated to be(1.67 cm/m2 for male and 1.58 cm/m2 for female). Ultrasound (mid upper arm, mid-thigh and Quadriceps muscle index) showed significant indirect correlation with (Child even in Child A and MELD) scores, as well as with the duration of hospital stay. Also, they showed a direct correlation with HGS. Conclusion Sarcopenia in cirrhotic patients assessed by ultrasonography of (mid upper arm, mid-thigh muscle thickness) and HGS are independent predictors of disease severity and poor outcome, which is assessed by high Child and MELD scores. Also, ultrasound and HGS are straightforward bedside techniques used for assessment of sarcopenia.

scholarly journals Evaluating efficacy of oral zinc as adjuvant therapy in acute diarrhea in children.

2020 ◽  
Vol 27 (08) ◽  
pp. 1626-1630
Author(s):  
Nathumal Maheshwari ◽  
Nadeem Noor ◽  
Adnan Bashir ◽  
Bilawal Hingorjo ◽  
Arshad Ali ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Hospital Stay ◽  
Acute Diarrhea ◽  
Control Group ◽  
Study Group ◽  
Once Daily ◽  
Medical College ◽  
Duration Of Hospital Stay ◽  
Control Study ◽  
Stool Volume

Objectives: To evaluate the efficacy of oral zinc as adjuvant therapy in acute diarrhea comparing frequency and volume of stool and duration of diarrhea in children. Study Design: Case Control study. Setting: Department of Paediatrics, Shaheed Muhtrama Benazir Bhutto Medical College Layari General Hospital, Karachi. Period: September 2017 to August 2018. Material & Methods: A sample of 200 children, age 5- 15 years, suffering from acute diarrhea was divided into control and cases (study group). Oral zinc therapy (20 mg once daily) was given 14 days and its efficacy was observed in terms of stool frequency, stool volume and duration of diarrhea. Variables were noted at 24 hours and 48 hours and on 7th day of hospitalization. Data was analyzed on SPSS statistical software (version 22.0) at 95% confidence interval (P≤ 0.05). Results: Mean ± SD age in control and study group was noted as 9.1± 5.43 years and 9.5±6.02 years respectively (P=0.053). 89% of children of study group were discharged on 3rd day of hospitalization compared to only 45% from control group.  Zinc treated study group shows significant decrease in frequency of loose stools, stool volume and lesser duration of hospital stay. Conclusion: Oral zinc therapy was effective in decreasing the frequency of loose stools and volume and lesser duration of hospital stay in children.

Intrathecal Anesthesia and Recovery from Radical Prostatectomy

2004 ◽  
Vol 100 (4) ◽  
pp. 926-934 ◽  
Author(s):  
Daniel R. Brown ◽  
Roger E. Hofer ◽  
David E. Patterson ◽  
Paul J. Fronapfel ◽  
Pamela M. Maxson ◽  
...  
Keyword(s):  
Hospital Stay ◽  
General Anesthesia ◽  
Functional Status ◽  
Intrathecal Administration ◽  
Radical Retropubic Prostatectomy ◽  
Control Group ◽  
Anesthetic Care ◽  
Duration Of Hospital Stay ◽  
Intravenous Morphine ◽  
Intrathecal Analgesia

Background Previous studies suggest that intraoperative anesthetic care may influence postoperative pain and recovery from surgery. The authors tested the hypothesis that the addition of intrathecal analgesia to general anesthesia would improve long-term functional status and decrease pain in patients undergoing radical retropubic prostatectomy. Methods One hundred patients received either general anesthesia supplemented with intravenous fentanyl or general anesthesia preceded by intrathecal administration of bupivacaine (15 mg), clonidine (75 microg), and morphine (0.2 mg). Patients and providers were masked to treatment assignment. All patients received multimodal pain management postoperatively. Primary outcomes included pain and functional status over the first 12 postoperative weeks. Results Patients receiving intrathecal analgesia required more intravenous fluids and vasopressors intraoperatively. Pain was well controlled throughout the study (mean numerical pain scores &lt; 3 in both groups at all times studied). Intrathecal analgesia decreased pain and supplemental intravenous morphine use over the first postoperative day but increased the frequency of pruritus. Pain and functional status after discharge from the hospital did not differ between groups. Intrathecal analgesia significantly decreased the duration of hospital stay (from 2.8 +/- 2.0 to 2.1 +/- 0.5 days; P &lt; 0.01) as a result of five patients in the control group who stayed in the hospital more than 3 days. Conclusions The benefits of improved immediate analgesia and decreased morphine requirements resulting from intrathecal analgesia must be weighed against factors such as pruritus, increased intraoperative requirement for fluids and vasopressors, and resources needed to implement this modality. Further studies are needed to determine the significance of the decrease in duration of hospital stay.

scholarly journals N-acetylcysteine treatment in viral-induced acute liver failure

2019 ◽  
Vol 6 (3) ◽  
pp. 106
Author(s):  
Tauseef Nabi ◽  
Nadeema Rafiq
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Hospital Stay ◽  
Case Control Study ◽  
Length Of Hospital Stay ◽  
Case Control ◽  
Control Group ◽  
Duration Of Hospital Stay ◽  
Baseline Characteristics ◽  
Control Study

<p class="abstract"><strong>Background:</strong> Acute liver failure (ALF) is characterized by acute derangement of liver function and carries high mortality. Viral hepatitis is still one of the main causes of ALF in the India as well in world. A prospective case control study was carried with the aim to determine the effect of N-acetylcysteine (NAC) on survival of viral-ALF patients.</p><p class="abstract"><strong>Methods:</strong> 37 patients with a diagnosis of viral-ALF were included in the study. 18 patients received NAC infusion for 72 hrs whereas 19 patients in control group received placebo. The variables evaluated were demographic, biochemical, outcome and length of hospital stay.</p><p class="abstract"><strong>Results:</strong> Out of 37 viral-ALF patients, acute HEV-induced ALF (48.6%) was most common followed by HBV (24.3%) and HAV (21.6%). The two groups were comparable for the various baseline characteristics (age, INR, bilirubin, ALT, creatinine, albumin, grade of encephalopathy, mean grade of coma etc.). Use of NAC was associated with a shorter length of hospital stay of survived patients (p=0.024). A total of 20 of 37 (54.1%) patients died with ALF complications; 7 (38.9%) patients belonged to NAC group and 13 (68.4%) patients to control group (p=0.079). HEV induced ALF showed significant improved in survival than Non HEV induced ALF with NAC administration (p=0.022).</p><p><strong>Conclusions: </strong>HEV was the most frequently cause of viral-ALF. Overall survival was not improved by NAC. HEV induced ALF showed significant improved in survival than Non HEV induced ALF with NAC administration. NAC reduced duration of hospital stay.</p>

scholarly journals MUSCLE TISSUE MORPHOLOGY OF BROILER CHICKENS WHEN SUBSTITUTING FEED ANTIBIOTICS WITH A BIOLOGICALLY ACTIVE SUPPLEMENT

2021 ◽  
pp. 79-85
Author(s):  
U.I. Kundryukova ◽  
◽  
Ye.V. Shatskikh ◽  
L.I. Drozdova ◽  
◽  
...  
Keyword(s):  
Muscle Mass ◽  
Broiler Chickens ◽  
Live Weight ◽  
Biologically Active ◽  
Thigh Muscle ◽  
Control Group ◽  
Growth Promoter ◽  
Promoting Effect ◽  
Basic Diet ◽  
Active Supplement

This paper discusses the outcomes of the production experiment carried out on one of the poultry farms in the Sverdlovsk Region and at the departments of the Ural State Agricultural University. The experiment was carried out on cross Ross-308 broiler chickens in the number of 80 female and 80 male chickens with an average live weight of 43 g. During the research, the chickens were housed in different cages; the experiment continued throughout the entire rearing period - 38 days. The control group formed of comparable chickens was fed with the basic diet used on the farm with the nutritional value required for this cross, and during rearing, from the 1st to 10th day, the Albac feed antibiotic (500 g per t) was administered; it was substituted with Fortrazin (600 g t) from the 11th to 30th day. From the first day of rearing to the end of fattening, the trial group received the basic diet but the antibiotic was substituted with an alternative safe growth promoter SafMannan in the amount of 0.5 kg per t of compound feed. Comparative zootechnical indices of the control and trial groups showed that the introduction of the SafMannan supplement into the compound feed did not affect the chicken survival rates, and had a promoting effect on the growth and development of broilers accompanied by live weight gains. Histological examination of the breast and thigh muscle groups of the control and trial chickens did not reveal any pathological processes neither with the addition of feed antibiotics or with the introduction of the biologically active supplement SafMannan; the muscle mass increased due to young un-differentiated muscle fibers that were in the process matu-ration, but the final differentiation of the entire muscle mass by the end of the technological cycle did not occur.

SO018NON-INVASIVE ASSESSMENT AND MONITORING OF SKELETAL MUSCLE MASS IN CRITICALLY ILL PATIENTS WITH AKI BY QUADRICEPS MUSCLE ULTRASOUND

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alice Sabatino ◽  
Giuseppe Regolisti ◽  
Chiara Cantarelli ◽  
Andrea Palladini ◽  
Tommaso Di motta ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Hospital Stay ◽  
Critically Ill ◽  
Muscle Mass ◽  
Critically Ill Patients ◽  
Skeletal Muscle Mass ◽  
Muscle Wasting ◽  
Quadriceps Muscle ◽  
Invasive Technique ◽  
Icu Stay

Abstract Background and Aims Critically ill patients undergo important muscle wasting during ICU stay, and a significant loss of muscle mass still occurs in the first few days of hospital stay. This may delay both functional recovery and weaning from mechanical ventilation, being also a well-known predictor of mortality. Quite often, muscle wasting is masked by fluid overload, increasing the risk for underestimating the presence of malnutrition, as frequently occurs in critically ill patients with AKI. An important concern in this clinical setting is the lack of adequate tools for routine bedside evaluation of the skeletal muscle mass. Lately, the use of ultrasound (US) for the assessment of muscle mass has aroused considerable interest. It is a non-invasive technique, applicable at the bedside and even in non-collaborative patients, it is economically viable, safe and do not require specialized staff. Recently, its reliability and validity have been demonstrated in critically ill patients with AKI. On this premise, in the present study, we aimed to evaluate the clinical application of US for both evaluation and monitoring of quadriceps muscle thickness in critically ill patients with AKI. Method This is an observational study, conducted in the renal ICU of the Parma University Hospital. All adult patients with AKI, with no distinction regarding the severity of AKI, admitted in the renal ICU from 15/03/2017 to 15/03/2018, with previous hospital stay less than 72h, with a likely ICU stay of at least 5 days were eligible for entering the study. The diagnosis of AKI was made according to KDIGO. Quadriceps rectus femoris and vastus intermedius thickness (QRFT and QVIT) were measured at the midpoint and at the border between the upper third and lower two-thirds between the anterior superior iliac spine (ASIS) and the upper pole of the patella. US was performed twice during ICU stay, i.e., at baseline (within 72h from admission) and after 5 days since the first measurement. Results We enrolled 30 patients, 70% (n= 21/30) were male, mean age ± SD age 74±11 years, APACHE II mean ± SD, 22 ± 5. Ultrasonography took less than 10 minutes to set up and complete image acquisition and less than 10 minutes per image to complete measurement analysis in all patients. A total of 472 images were analyzed across the 30 subjects.

The Use of Lympho-Venous Anastomoses to Prevent Complications from Ilio-Inguinal Dissection

1988 ◽  
Vol 74 (3) ◽  
pp. 347-351 ◽  
Author(s):  
Sergio Orefice ◽  
Alberto Rudy Conti ◽  
Massimo Grassi ◽  
Bruno Salvadori
Keyword(s):  
Hospital Stay ◽  
Lower Limb ◽  
Surgical Procedure ◽  
Radical Mastectomy ◽  
Control Group ◽  
Nodal Involvement ◽  
Duration Of Hospital Stay ◽  
Nodal Dissection ◽  
The Mean ◽  
Inguinal Dissection

Lympho-venous anastomoses (LVA) were performed in 30 patients, immediately after the completion of ilio-inguinal dissection for metastatic nodal involvement. This surgical procedure, originally devised to treat post-mastectomy lymphedema from radical mastectomy, was intended in this series of cases to prevent complications from ilio-inguinal nodal dissection. Actually, when compared to another group of 84 patients previously operated on by ilioinguinal nodal dissection without lympho-venous anastomoses, the series showed a lower rate of local-regional complications (38% vs 65.9%). The mean duration of hospital stay was also reduced (18.5 vs 34.7 days). Distant lymphedema of the lower limb was observed in 7 of 23 patients who had received LVA, whereas in the control group, lymphedema was recorded in 39 of 52 patients who were regularly followed-up (30% vs 75%). LVA should be routinely used, as a useful surgical procedure, to prevent or reduce the occurrence of local-regional complications following ilio-inguinal nodal dissections.

scholarly journals PERIARTICULAR REGIONAL ANALGESIA REDUCES PAIN AND HOSPITAL STAY AFTER TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE, RANDOMIZED, AND DOUBLE-BLINDED CONTROLLED TRIAL

2020 ◽  
pp. 154-159
Author(s):  
PULIN BIHARI DAS ◽  
ANAND KUMAR SINGH ◽  
ARINDAM CHATTERJEE ◽  
ANURAG SINGH
Keyword(s):  
Total Knee Arthroplasty ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Local Infiltration ◽  
Periarticular Injection ◽  
Duration Of Hospital Stay ◽  
Post Operative Pain ◽  
Total Knee ◽  
Pain At Rest

Objective: There are multiple post-operative pain protocols for patients who undergo total knee arthroplasty (TKA). Post-operative analgesia with opioids or epidural analgesia has its side effect. We compared the duration of hospital stay, pain score, and range of motion of a control group who had no local infiltration with a group who had local infiltration analgesia following TKA. Methods: Randomization was done in 60 patients who underwent TKA in two groups, one who did not receive and the other who received a multimodal cocktail periarticular injection containing 30 ml of 0.5% bupivacaine, 1 ml of 30 mg ketorolac, 1 ml of 1 in 1000 adrenaline, 2 ml of 80 mg gentamycin, 5 ml of 750 mg cefuroxime, and rest 0.9% of normal saline. Visual analog score (VAS) for pain at rest was recorded and assessed preoperatively and postoperatively at 2, 6, 12, 24, 36 h, 2, 3, and 7 days and during an activity at 24 h, 36 h, 2, 3, and 7 days. Results: The patient who had received the local injection used very few analgesics over the first 24 h of surgery. Moreover, patients, where local infiltration was used, showed lower VAS for pain (at rest and during activity). They also showed higher VAS for patients’ satisfaction. Conclusion: Due to the reduced post-operative pain with periarticular injection analgesia, it was observed that the pain and duration of hospital stay were significantly reduced.

scholarly journals Effects of Combined Remote Ischemic Pre-and Post-Conditioning on Neurologic Complications in Moyamoya Disease Patients Undergoing Superficial Temporal Artery-Middle Cerebral Artery Anastomosis

2019 ◽  
Vol 8 (5) ◽  
pp. 638 ◽  
Author(s):  
Eun-Su Choi ◽  
Yoon-Sook Lee ◽  
Byeong-Seon Park ◽  
Byung-Gun Kim ◽  
Hye-Min Sohn ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Middle Cerebral Artery ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Superficial Temporal Artery ◽  
Temporal Artery ◽  
Control Group ◽  
Neurologic Complication ◽  
Neurologic Complications ◽  
Duration Of Hospital Stay

Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the most commonly used treatment for Moyamoya disease. During the perioperative period, however, these patients are vulnerable to ischemic injury or hyperperfusion syndrome. This study investigated the ability of combined remote ischemic pre-conditioning (RIPC) and remote ischemic post-conditioning (RIPostC) to reduce the occurrence of major neurologic complications in Moyamoya patients undergoing STA-MCA anastomosis. The 108 patients were randomly assigned to a RIPC with RIPostC group (n = 54) or a control group (n = 54). Patients in the RIPC with RIPostC group were treated with four cycles of 5-min ischemia and 5-min reperfusion before craniotomy and after STA-MCA anastomosis (RIPostC). The incidence of postoperative neurologic complications and the duration of hospital stay were determined. The overall incidence of neurologic complication was significantly higher in the control group than in the RIPC with RIPostC group (13 vs. 3, p = 0.013). The duration of hospital stay was significantly longer in the control group than in the RIPC with RIPostC group (17.8 (11.3) vs. 13.8 (5.9) days, p = 0.023). Combined remote ischemic pre- and post-conditioning can be effective in reducing neurologic complications and the duration of hospitalization in Moyamoya patients undergoing STA-MCA anastomosis.

scholarly journals Proximal, Local, and Distal Muscle Morphology in Women With Patellofemoral Pain

2021 ◽  
Vol 37 (2) ◽  
pp. 120-131
Author(s):  
Klauber Dalcero Pompeo ◽  
Emmanuel Souza da Rocha ◽  
Mirella Ayres Melo ◽  
Nathalia Trevisol de Oliveira ◽  
Daniel Fernandes Oliveira ◽  
...  
Keyword(s):  
Muscle Mass ◽  
Gluteus Medius ◽  
Quadriceps Muscle ◽  
Patellofemoral Pain ◽  
Control Group ◽  
Flexor Muscle ◽  
Muscle Morphology ◽  
Distal Muscle ◽  
Flexor Digitorum Brevis ◽  
Flexor Digitorum

Objective: The objective of this study was to compare proximal, local, and distal muscle morphology in women with and without patellofemoral pain (PFP). Materials and Methods: Proximal, local, and distal muscle thicknesses (MTs) were obtained with B-mode sonography in healthy (control group [CG], n = 20) and PFP (PFP group, n = 20) women. In addition, muscle mass was measured by the sum of the synergistic MTs. Data were analyzed by independent t-test, Mann-Whitney U test, and effect size. Results: PFP women had smaller gluteus medius ( P = .02, d = 0.7), vastus medialis ( P < .01, d = 1.0), and flexor digitorum brevis ( P < .01, d = 1.0) MT and greater gastrocnemius medialis ( P = .04, d = 0.6) MT than CG. Quadriceps muscle mass ( P = .01, d = 0.8) and foot muscle mass ( P = .008, d = 0.9) were smaller, while plantar flexor muscle mass was greater in the PFP group than in CG ( P = .01, d = 0.8). Conclusion: PFP women have proximal, local, and distal MT alterations in comparison with CG, which may explain possible changes in muscle strength and functionality.

scholarly journals Correlation between PCT, 25(OH)D, PTX-3, AMS levels and the severity of diabetic ketoacidosis complicated by pancreatitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Songtao Lu ◽  
Dongmei Wei ◽  
Chao Yin ◽  
Juwen Xiong ◽  
Lishuang Zhu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Diabetic Ketoacidosis ◽  
Disease Severity ◽  
Control Group ◽  
Blood Levels ◽  
Healthy Controls ◽  
Pentraxin 3 ◽  
Duration Of Hospital Stay ◽  
Physical Examinations ◽  
And Control

Abstract Background This study aims to explore the correlation between procalcitonin (PCT), 25-hydroxyvitamin D3 (25(OH)D), pentraxin-3 (PTX-3), amylase (AMS) levels and severity of diabetic ketoacidosis complicated by pancreatitis. Methods A retrospective analysis of 198 patients with diabetic ketoacidosis admitted to our hospital from January 2015 to February 2020 were included. According to whether the patients with pancreatitis, subjects were divided into diabetic ketoacidosis with pancreatitis (DKA-AP) group and diabetic ketoacidosis (DKA) group. Healthy controls admitted to the hospital for physical examinations were included as a control group. Clinical outcomes were collected. Results On the first day after admission, the levels of PCT, PTX-3, and AMS in DKA-AP group were significantly higher than those in DKA group and control group, and 25(OH)D levels in DKA-AP group were lower than those in DKA group and control group. PCT, PTX-3, and AMS levels were significantly increased, and 25(OH)D levels were decreased in the DKA group compared with the control group. Furthermore, the levels of PCT, 25(OH)D, PTX-3, and AMS in the DKA-AP group were correlated with the disease severity of of diabetic ketoacidosis complicated by pancreatitis. The levels of PCT, PTX-3, and AMS in the DKA-AP group on day 1 were significantly higher and 25(OH)D levels were significantly lower than those on days 3–7 after admission. The levels of PCT, PTX-3, and AMS in the DKA group on day 1 were significantly higher and 25(OH)D levels were significantly lower than those on days 2–7 after admission. The levels of these indicators returned to normal levels on day 3 or day 7 in DKA or DKA-AP group, respectively. PCT, PTX-3, and AMS levels in the DKA-AP group were significantly increased, while 25(OH)D levels in the DKA-AP group were decreased compared with DKA group on days 1–6 after admission. The duration of hospital stay, patients of ICU care, duration of ICU stay, and cost in DKA-AP group were all higher than those in the DKA group. Conclusion Blood levels of PCT, 25(OH)D, PTX-3, and AMS were correlated with diabetic ketoacidosis complicated by pancreatitis, and have certain application value in assessment of the disease severity.

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