scholarly journals Influence of mandibular fracture on the dynamics of cytolytic and hepatodepressive syndromes among wounded people with massive external bleeding and usage of a tourniquet

2021 ◽  
Vol 11 (1) ◽  
pp. 313-325
Author(s):  
I. I. Horban ◽  
M. I. Badiuk ◽  
A. A. Hudyma ◽  
I. V. Antonyshyn ◽  
M. A. Pasichnyk
Keyword(s):  
Blood Loss ◽  
Soft Tissues ◽  
Serum Bilirubin ◽  
Ischemia Reperfusion ◽  
Gunshot Wounds ◽  
The Body ◽  
Total Serum ◽  
Mandible Fracture ◽  
Serum Activity ◽  
Time Of Admission

Introduction. Injuries in today's urban society are an urgent problem. In modern trauma, along with the lesion of various anatomical parts of the body increases the frequency of damages of the extremities main vessels with the development of massive external bleeding. Under these conditions, the only way to escape is to apply a tourniquet lasting up to two hours. At the same time in the structure of militant trauma and injuries in peacetime there is a tendency to increase the frequency of injuries of the maxillofacial area. The main cause of the injured people death is the development of systemic disorders with secondary lesions of tissues and organs remote from the site of direct injury. However, the role of mandible fracture in the development of systemic disorders in the case of acute blood loss and ischemia-reperfusion of the limb is insufficiently studied.Purpose: to establish peculiarities of the liver dysfunction indicators among wounded people under conditions of mandible fracture, gunshot damage of the lower extremity soft tissues with massive external bleeding.Materials and methods. Extracts from the electronic database of Medical Cards of inpatients military personnel who were treated at the National Military Medical Clinical Center "General Military Clinical Hospital" and were injured during the anti-terrorist operation / joint force operation from 2014 to 2019 were retrospectively analyzed. Among them the results of examinations and treatment of 10 wounded patients were selected, they had isolated gunshot wounds of soft tissues of the thigh with massive external blood loss and 8 wounded patients with similar gunshot wounds, and they had additional non-gunshot fractures of the mandible. All the wounded people were immediately provided with hemostatic tourniquet proximal on the injured hip.Shock index, indicators of cytolytic syndrome (activity of serum alanine and aspartate aminotransferases (ALT, AST), the content of total and conjugated serum bilirubin) and hepatodepressive syndrome (serum total protein and albumin) were taken into account from the medical records. Indicators were recorded at the time of admission to the hospital, after 6-7 days and at the time of discharge from the hospital. Additionally, the duration of patients staying in the hospital in each of the examination groups was analyzed.Research results and their discussion. At the time of admission to the hospital wounded patients of both observation groups had a significant increase of the shock index, serum activity of ALT and AST, the content of total and direct bilirubin. During treatment of the wounded patients with additional mandible fractures up to 6-7 days, serum activity of ALT, AST and direct serum bilirubin was significantly higher, and total serum protein content was lower compared to wounded patients without mandible fracture.Conclusion. Additional mandible fracture among wounded people with gunshot damage of the thigh, massive blood loss and ischemia-reperfusion of the limb significantly impairs the functional state of the liver with a maximum of 6-7 days in hospital and is an important factor in systemic manifestations of traumatic disease, which should be considered in clinical conditions.

scholarly journals Status of Serum bilirubin, Serum Proteins and Prothrombin time in babies with Perinatal Asphyxia

2013 ◽  
Vol 18 (2) ◽  
pp. 43-46
Author(s):  
Md Tariqul Islam ◽  
Seikh Azimul Hoque ◽  
Fahmida Nazir ◽  
Md Mostafizur Rahman Bhuiyan ◽  
Md Nazrul Islam
Keyword(s):  
Prothrombin Time ◽  
Serum Bilirubin ◽  
Serum Proteins ◽  
Perinatal Asphyxia ◽  
The Body ◽  
The Other ◽  
Total Serum ◽  
Multi Centre Study ◽  
Other Hand ◽  
Organ Systems

Background and Objectives: Because of hypoxemia, different organ systems of the body are affected in perinatal asphyxia. This study was carried out to see the status of Serum bilirubin, Serum Proteins and Prothrombin time in asphyxiated babies and to know any correlation existing between hepatic dysfunction and the severity of perinatal asphyxia. Methods: A total of 70 full-term asphyxiated newborns (study group) were studied during January ‘2008 to December ‘2008 in the department of Paediatrics, Mymensingh Medical College Hospital. After enrolment these babies were grouped according to Sarnat & Sarnat stages of HIE as stage I, II & III (Sarnat & Sarnat’ 1976). Babies who are small for gestational age, having severe jaundice, sepsis or congenital anomalies of the hepatobiliary system were excluded from the study. A total of 50 healthy newborns were also studied as reference group. Two c.c. of venous blood were taken both from asphyxiated and healthy babies between 2nd and 5th day of life to estimate Total serum bilirubin (TSB), Serum Total protein (STP), Serum Albumin and Prothrombin time (PT). Data were analyzed by computer software SPSS version 15. Unpaired student’s ‘t’ test was used to measure the level of significance and Spearman’s rank correlation was done to see the correlation and at P < 0.05 the results were considered significant. Results: The mean TSB, STP & S. Albumin of asphyxiated babies were 5.52 ± 2.01mg/dl, 55.74 ± 8.84 & 32.60 ± 5.48 g/L respectively and those of normal babies were 4.51 ± 1.19 mg/dl, 66.30 ± 10.36 & 40.90 ± 6.45 g/L respectively and these differences were statistically significant (P < 0.001). On the other hand no significant changes were noted in prothrombin time. The rise of PT showed a significant positive correlation with the severity of perinatal asphyxia. On the other hand STP, S. Albumin & TSB showed no significant correlation. Conclusion: This study concludes that TSB, STP & S. Albumin significantly elevated and this elevation was proportional to the severity of perinatal asphyxia. On the other hand no significant changes were noted in prothrombin time. Recommendation: A large scale multi-centre study is recommended to establish this finding. DOI: http://dx.doi.org/10.3329/jdnmch.v18i2.16022 J. Dhaka National Med. Coll. Hos. 2012; 18 (02): 43-46

STUDY OF CLINICAL AND SUBCLINICAL CHARACTERISTICS IN NEONATAL HYPERBILIRUBINEMIA

2017 ◽  
pp. 84-89
Author(s):  
Thi Thanh Binh Nguyen ◽  
Thi Phuong Thao Tran ◽  
Hung Viet Phan
Keyword(s):  
Serum Bilirubin ◽  
Clinical Problem ◽  
The Body ◽  
Neonatal Hyperbilirubinemia ◽  
Total Serum Bilirubin ◽  
High Rate ◽  
Total Serum ◽  
Term Infants ◽  
Cross Sectional ◽  
Hands And Feet

Background: Neonatal hyperbilirubinemia is a common clinical problem encountered during the neonatal period, especially in the first week of life. It is a multifactorial disorder with many symptoms. Most of these cases are benign but it is important to identify those babies at risk of acute bilirubin encephalopathy and kernicteurs or chronic encephalopathy. Jaundice may also be a sign of a serious underlying illness. Objectives: Describe and examine the relationship between clinical characteristics with laboratory tests of indirect hyperbilirubinemia in neonatal. Methods: A cross-sectional descriptive. A convenient sample includes 124 patients under 28 days old had jaundice and were treated at Neonatal room, Hospital of Hue University of Medicine and Pharmacy from 05/2015 to 06/2016. Results: The proportion of male/female is 1.3/1. 66.9% is in term infants. 73.4% onset of jaundice in 24 - 72 hours of age. 67.7% had jaundice all the body before were taken to neonatal room. 47.6% cases were caused by neonatal infection. 93.5% cases had total serum bilirubin < 340 µmol/L. It has a weak positive correlation between the degree of clinical jaundice with level of total serum bilirubin. 31/124 cases suspected ABO incompatibility but Coombs test were negative, however they had high rate of anemia than the others is 13.2 times (p<0.01). Conclusions: Indirect hyperbilirubinemia in neonatal is usually detected when the baby had jaundice to hands and feet. Therefore precautionary measure should be adopted by both parents and clinicians to diagnose and treat the disease properly. Key words: jaundice, hyperbilirubinemia, neonatal

Hand-assisted laparoscopic nephrectomy in morbidly obese patients

2020 ◽  
Vol 99 (6) ◽  
pp. 271-276
Keyword(s):  
Body Weight ◽  
Surgical Technique ◽  
Blood Loss ◽  
Hospital Stay ◽  
Kidney Cancer ◽  
The Body ◽  
Laparoscopic Nephrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbid Obese

Introduction: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. Methods: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were analyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. Results: The patient age was 38−67 years; the cohort included 2 females and 5 males, the body weight was 117−155 kg and the BMI was 40.3−501 kg/m2. Surgery time was 73−98 minutes, blood loss was 20−450 ml, and hospital stay was 5−7 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48–110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

Two Different UGT1A1 Mutations causing Crigler–Najjar Syndrome types I and II in an Iranian Family

2015 ◽  
Vol 24 (4) ◽  
pp. 523-526 ◽  
Author(s):  
Yoshihiro Maruo ◽  
Mahdiyeh Behnam ◽  
Shinichi Ikushiro ◽  
Sayuri Nakahara ◽  
Narges Nouri ◽  
...  
Keyword(s):  
Serum Bilirubin ◽  
Total Serum Bilirubin ◽  
Total Serum ◽  
Compound Heterozygous ◽  
Type I ◽  
Syndrome Type ◽  
Type Ii ◽  
Wild Type ◽  
Iranian Family ◽  
Udp Glucuronosyltransferase

Background: Crigler–Najjar syndrome type I (CN-1) and type II (CN-2) are rare hereditary unconjugated hyperbilirubinemia disorders. However, there have been no reports regarding the co-existence of CN-1 and CN-2 in one family. We experienced a case of an Iranian family that included members with either CN-1 or CN-2. Genetic analysis revealed a mutation in the bilirubin UDP-glucuronosyltransferase (UGT1A1) gene that resulted in residual enzymatic activity.Case report: The female proband developed severe hyperbilirubinemia [total serum bilirubin concentration (TB) = 34.8 mg/dL] with bilirubin encephalopathy (kernicterus) and died after liver transplantation. Her family history included a cousin with kernicterus (TB = 30.0 mg/dL) diagnosed as CN-1. Her great grandfather (TB unknown) and uncle (TB = 23.0 mg/dL) developed jaundice, but without any treatment, they remained healthy as CN-2. Results: The affected cousin was homozygous for a novel frameshift mutation (c.381insGG, p.C127WfsX23). The affected uncle was compound heterozygous for p.C127WfsX23 and p.V225G linked with A(TA)7TAA. p.V225G-UGT1A1 reduced glucuronidation activity to 60% of wild-type. Thus, linkage of A(TA)7TAA and p.V225G might reduce UGT1A1 activity to 18%–36 % of the wild-type. Conclusion: Genetic and in vitro expression analyses are useful for accurate genetic counseling for a family with a history of both CN-1 and CN-2. Abbreviations: CN-1: Crigler–Najjar syndrome type I; CN-2: Crigler–Najjar syndrome type II; GS: Gilbert syndrome; UGT1A1: bilirubin UDP-glucuronosyltransferase; WT: Wild type; TB: total serum bilirubin.

scholarly journals The Effect of Dietary Intake and Nutritional Status on Anthropometric Development and Systemic Inflammation: An Observational Study

2021 ◽  
Vol 18 (11) ◽  
pp. 5635
Author(s):  
Roxana Maria Martin-Hadmaș ◽  
Ștefan Adrian Martin ◽  
Adela Romonți ◽  
Cristina Oana Mărginean
Keyword(s):  
Serum Proteins ◽  
Caloric Intake ◽  
Saturated Fat ◽  
The Body ◽  
Total Serum ◽  
Fat Intake ◽  
Trans Fats ◽  
Study Objective ◽  
Inflammatory Status ◽  
Total Fat

(1) Background: Daily caloric intake should aim to reduce the risk of obesity or poor anthropometric development. Our study objective was to analyze the association between food consumption, inflammatory status and anthropometric development; (2) Methods: We performed a prospective observational analytical research during September 2020 and April 2021 on a group of 160 healthy subjects, aged between 6 and 12 years old, by analyzing food ingestion, the basal metabolic rate, anthropometric development and the inflammatory status; (3) Results: IL-6 was significantly correlated to the sum of skinfolds, along with both serum proteins and triglycerides. The skin folds were significantly correlated with the caloric intake and with total fat intake, next to saturated and trans fats. Unlike the skin folds, the body weight was significantly correlated with the caloric intake along with some vitamins, such as Vitamin A and Vitamin B12. Inactive mass increased with excessive folic acid, Vitamin E, Vitamin K and saturated fat intake; (4) Conclusions: The inflammatory status was influenced by the ingestion of micronutrients, total serum lipids and proteins. The anthropometric development was associated with the ingestion of carbohydrates, energy balance and energy intake. We can conclude that daily menu and nutrition imbalances can influence both the risk of obesity and the inflammatory status.

scholarly journals Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice

2017 ◽  
Vol 57 (1) ◽  
pp. 8 ◽  
Author(s):  
Andra Kurnianto ◽  
Herman Bermawi ◽  
Afifa Darmawanti ◽  
Erial Bahar
Keyword(s):  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Subcutaneous Tissue ◽  
Correlation Coefficients ◽  
Total Serum Bilirubin ◽  
Blood Sampling ◽  
Total Serum ◽  
Transcutaneous Bilirubin ◽  
Non Invasive ◽  
Transcutaneous Bilirubinometry

Background The gold standard for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement. This method, however, is invasive, painful, and costly in terms of workload, time, and money. Moreover, repeated blood sampling may lead to significant blood loss, which is of particular concern in preterm infants. To overcome these drawbacks, non-invasive methods of bilirubin measurement have been proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the subcutaneous tissue of a newborn infant by measuring the difference between optical densities for light in the blue and green wavelength regions.Objective To evaluate the accuracy of transcutaneous bilirubinometry for estimating TSB levels in neonatal jaundice.Methods Subjects were infants aged < 28 days with jaundice who had never been treated with phototherapy or exchange transfusion. The study was done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15 minutes between tests.Results One hundred fifty patients were included in this study. The TcB values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity and 83.3% specificity. This cut-off point was obtained from a receiver-operator characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The correlation coefficients (r) for TSB and TcB measurements on the forehead were 0.897 (P<0.001).Conclusion Transcutaneous bilirubinometry can be used to accurately estimate TSB levels in neonatal jaundice, and may be useful in clinical practice as a non-invasive method to reduce blood sampling.

Magnetic Resonance Imaging in the Diagnosis of Disruption of the Posterior Tibial Tendon

Foot & Ankle ◽  
1987 ◽  
Vol 8 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Ian J. Alexander ◽  
Kenneth A. Johnson ◽  
Thomas H. Berquist
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Diagnostic Technique ◽  
Clinical Findings ◽  
The Body ◽  
Posterior Tibial Tendon ◽  
Resonance Imaging ◽  
Posterior Tibial ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI), a useful technique of studying soft tissues of the body, can be very effective in assessing the integrity of tendons. Usually a patient with a complete tear of the posterior tibial tendon has characteristic physical findings. In the patient presented, MRI demonstrated a complete disruption of the posterior tibial tendon, despite the absence of the commonly associated clinical findings. In view of the difficulties encountered with attempted tenography of the completely torn posterior tibial tendon, MRI provides a sensitive alternative diagnostic technique.

Computerized Tomography: A Perspective in the Pediatric Patient

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 305-308
Author(s):  
Derek Harwood-Nash ◽  
Herman Grossman ◽  
Alvin Felman ◽  
John Kirkpatrick ◽  
Leonard Swischuk
Keyword(s):  
Computerized Tomography ◽  
Soft Tissues ◽  
Conventional Radiography ◽  
The United States ◽  
The Body ◽  
Whole Body ◽  
Central Research ◽  
X Ray ◽  
Whole Body Ct

Computerized tomography (CT), a technique conceptualized by Oldendorf in 19611 and developed by Hounsfield2 of EMI-Tronics Inc. (EMI) Central Research Laboratories, has proven to be a successful innovation in neuroradiology. Reviews by Ambrose3 in England and by Baker et al.4 and by New et al.5 in the United States have clearly demonstrated the value of this new modality in neuroradiological diagnosis. In 1975 Houser et al.6 and Harwood-Nash et al.7 provided the initial clinical and radiological data about CT in infants and children. More recently this technique has been extended to the study of tissues and organs in the body other than those in the head. This has been accomplished by modification of the original machine into a whole-body CT system. Early reviews by Ledley et al.8 and by Alfidi et al.9 suggest a significant potential for diagnosis of lesions in the abdomen, pelvis, and thorax. The advantages of CT are that it is less invasive than standard special diagnostic radiological procedures and that for the first time it provides in vivo information regarding the content and the characteristics of tissue composing organs and masses. DESCRIPTION OF EQUIPMENT In conventional radiography an image is made on radiographic film by an attenuated X-ray beam. In passing through a core of tissue, each ray of the beam is attenuated as it is absorbed and scattered by the tissue in its path. The intensity of the transmitted ray depends on the sum total of X-ray attenuation by all the different soft tissues in its path.

The reaction of the soft tissues of the anterior abdominal wall to various suture material

1982 ◽  
Vol 63 (4) ◽  
pp. 72-74
Author(s):  
V. P. Nefedov ◽  
R. M. Ramazanov
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Soft Tissues ◽  
Suture Material ◽  
Anterior Abdominal Wall ◽  
The Body ◽  
Reactive Changes ◽  
Healing Processes

The healing processes of sutured wounds of soft tissues in most cases depend on the type and quality of the suture material. Any kind of suture material in the tissues of the body is a foreign body that causes various reactive changes from the tissues. The nature of these changes, all other things being equal, is mainly determined by the type of suture material, its thickness and the method of sterilization of the tissues on which the sutures are applied, the trauma of surgery, the infection of the wound and the irritating effect of the threads on the tissues.

Practice Parameter: Management of Hyperbilirubinemia in the Healthy Term Newborn

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 558-565
Author(s):  
◽  
Keyword(s):  
Serum Bilirubin ◽  
Elevated Serum ◽  
The United States ◽  
Total Serum ◽  
Brain Cells ◽  
Albumin Concentration ◽  
Specific Level ◽  
Term Newborn ◽  
Term Newborns ◽  
The Brain

Each year approximately 60% of the 4 million newborns in the United States become clinically jaundiced. Many receive various forms of evaluation and treatment. Few issues in neonatal medicine have generated such long-standing controversy as the possible adverse consequences of neonatal jaundice and when to begin treatment. Questions regarding potentially detrimental neurologic effects from elevated serum bilirubin levels prompt continuing concern and debate, particularly with regard to the management of the otherwise healthy term newborn without risk factors for hemolysis. Although most data are based on infants with birth weights ≥2500 g, "term" is hereafter defined as 37 completed weeks of gestation. Under certain circumstances, bilirubin may be toxic to the central nervous system and may cause neurologic impairment even in healthy term newborns. Most studies, however, have failed to substantiate significant associations between a specific level of total serum bilirubin (TSB) during nonhemolytic hyperbilirubinemia in term newborns and subsequent IQ or serious neurologic abnormality (including hearing impairment). Other studies have detected subtle differences in outcomes associated with TSB levels, particularly when used in conjunction with albumin binding tests and/or duration of exposure. In almost all published studies, the TSB concentration has been used as a predictor variable for outcome determinations. Factors influencing bilirubin toxicity to the brain cells of newborn infants are complex and incompletely understood; they include those that affect the serum albumin concentration and those that affect the binding of bilirubin to albumin, the penetration of bilirubin into the brain, and the vulnerability of brain cells to the toxic effects of bilirubin.

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