Serum Hs-CRP level and clinical significance of patients with stress ulcer caused by massive blood loss after trauma

Stress ulcer refers to a specific type of irritation of the inner wall of the gastrointestinal tract that occurs rapidly due to acute physiological stress such as severe disease, infection, or trauma. This study investigated the serum Hs-CRP level and clinical significance of patients with stress ulcers caused by massive blood loss after trauma. For this purpose, we studied 113 patients with enormous blood loss after trauma. During the study, 26 patients developed stress ulcers. Therefore, patients with massive blood loss after trauma were divided into two groups with and without stress ulcers. In addition to clinical and demographical evaluations, serum Hs-CRP levels were measured by ELISA test method in all patients at baseline, 6, and 12 days after starting the study. Results showed that 24 patients were excluded from the study due to termination of cooperation or death. Finally, 89 patients participated in the final analysis. Of these 89 patients, 26 developed stress ulcers. There was a significant difference between the two groups with stress and non-stress ulcers in terms of mean age (P=0.001) and gender (P=0.041). Also, there was a significant difference between the two groups regarding re-bleeding (P=0.012), the number of hospitalization days (P=0.001), and a decrease in hemoglobin (P=0.035). But there was no difference between the two groups regarding the need for re-surgery (P=0.276). The results of this study showed that increased serum hs-CRP levels are directly related to stress ulcers. Patients with higher serum Hs-CRP levels were more likely to develop stress ulcers than patients without stress ulcers during six days (P=0.04) and twelve days after starting the study (P=0.001). Current research results also show that the prevalence of stress ulcers occurs in men more than women. The risk of stress ulcers increases among older patients. People with stress ulcers also lose more hemoglobin, and finally, patients with more trauma and more extended hospital stays have a higher chance of developing stress ulcers.

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Examining Metabolic Profiles in Opioid-‎Dependent Patients ‎

International Journal of Medical Toxicology and Forensic Medicine ◽

10.32598/ijmtfm.v10i3.28681 ◽

2020 ◽

Vol 10 (3) ◽

pp. 28681

Author(s):

Nader Molavi ◽

Amir Ghaderi ◽

Hamid Reza Banafshe

Keyword(s):

Control Group ◽

Study Group ◽

Metabolic Profiles ◽

Opioid Use ◽

Serum Samples ◽

Social Burden ◽

Study Results ◽

Significant Difference ◽

Hs Crp ◽

Opioid Users

Background: Drug abuse is a social burden and a public health disorder. Previous evidence suggested numerous illicit substances (e.g., opioids, amphetamines, cocaine, & cannabis) affect immune system functions, oxidative stress mechanisms, inflammatory cytokines, and reactive oxygen species production. This study aimed to determine the extent of these metabolic parameters in opioid-dependent patients. We also compared these patients with a healthy control group. Methods: This study was conducted in Amirie Clinic, Kashan, Iran. Plasma and serum samples from 50 illicit opioid users (study group) and 50 non-opioid users (control group) were studied. Metabolic levels for MDA, NO, TAC, GSH, Insulin, HOMA-IR, and hs-CRP were assessed in both research groups (N=100). Results: There was a significant difference in the status of MDA (P=0.003), NO (P=0.01), TAC (P=0.003), GSH (P=0.001), insulin (P=0.04), HOMA-IR (P=0.02), and hs-CRP (P=0.001) between the study and control groups. Furthermore, there was a significant correlation among the duration of illicit opioid use and MDA concentrations (r=-0.424, P=0.002), as well as TAC levels (r=0.314, P=0.02). Conclusion: The study results suggested metabolic profiles were impaired in the study group, compared to the controls.

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Impact of SSKI vs. Corticosteroids on Total Thyroidectomy for Graves Disease: A Retrospective Review

Proceedings of IMPRS ◽

10.18060/24523 ◽

2020 ◽

Vol 3 ◽

Author(s):

Timothy Baumgartner ◽

Hannah Allison ◽

Alexandria McDow

Keyword(s):

Blood Loss ◽

Sample Size ◽

Total Thyroidectomy ◽

Retrospective Review ◽

Graves Disease ◽

Intraoperative Blood Loss ◽

Equal Distribution ◽

Study Results ◽

Significant Difference ◽

The Impact

Background: Graves disease is an autoimmune disorder resulting in overproduction of thyroid hormone. While medical management can be used to reestablish euthyroid state, definitive management includes radioactive iodine or total thyroidectomy. For patients undergoing thyroidectomy, SSKI is frequently prescribed preoperatively to decrease thyroid vascularity and intraoperative blood loss. However, corticosteroids is often given when rapid preparation is necessary prior to surgery. This study explores the impact of SSKI compared to corticosteroids and hypothesizes that replacement of SSKI with corticosteroid will improve surgical outcomes. Methods: We performed a retrospective review of 26 Graves patients undergoing total thyroidectomy from 2015-2020. 18 patients received SSKI prior to surgery, 2 received a corticosteroid in addition to SSKI, 1 received a corticosteroid alone, and 5 received neither. Symptomatology, length of stay, intraoperative blood loss, transient hypoparathyroidism, and thyroid weight were compared. Results: Patients receiving corticosteroids experienced shorter stays (1.0 day vs 1.3 days), greater postoperative parathyroid hormone levels (43.0 pg/mL vs 28.9 pg/mL), less intraoperative blood loss (14.4 mL vs 41.4 mL), and presented with smaller thyroid glands (30 g vs 47 g) compared to those who received SSKI. There was a statistically significant difference in estimated blood loss between the groups (p = 0.0348). For some patients, the addition of a steroid to SSKI decreased surgery time (1.98 hours vs 2.32 hours). Conclusion: Despite limitations in sample size and the retrospective nature of this study, results suggest a positive impact of corticosteroid use on surgical and patient outcomes compared to SSKI alone. Future examination may benefit from greater sample size and equal distribution of patients among groups. We propose further exploration with a prospective study to evaluate the impact of SSKI vs. corticosteroids on surgical difficulty and postoperative complications for Graves disease patients.

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PENGARUH MODEL PEMBELAJARAN PROBING PROMPTING BERBANTUAN MULTIMEDIA TERHADAP HASIL BELAJAR IPA

Jurnal Imiah Pendidikan dan Pembelajaran ◽

10.23887/jipp.v2i3.16232 ◽

2018 ◽

Vol 2 (3) ◽

pp. 336

Author(s):

Ni Pt Rasni Karwati ◽

Km Ngurah Wiyasa ◽

I Kt Ardana

Keyword(s):

Elementary School ◽

Elementary Schools ◽

Science Learning ◽

Learning Model ◽

Test Method ◽

Fifth Grade ◽

Control Group ◽

Fifth Grade Students ◽

School Year ◽

Significant Difference

This research aims to determine the significance of the difference in science learning results between the group of fifth-grade students in Gugus I Elementary Schools, North Kuta District, in the school year of 2017/2018, that take lessons with the multimedia-assisted probing-prompting learning model and the group of students that take lessons with the conventional learning. The design of this research is a quasi-experimental research with the nonequivalent control group design. The population of this research are all the fifth-grade students of Gugus I Elementary Schools in North Kuta District that still implement the KTSP, which consists of 10 classes with a total of 339 students. The sampling is conducted using the random sampling technique. The sample in this research are the students of class VB in SD (Elementary School) No.7 Dalung, with 36 students as the experiment group and the students of class VB in SD No.4 Dalung with 28 students as the control group. The data collection is conducted using the test method in the form of the multiple choice objective test. The science learning results are analyzed using the t-test. Based on the average the experiment groups =80,89 > the control group =72,85, which means that the multimedia-assisted probing-prompting learning model has an influence on the science learning result. Based on the hypothesis test, tvalues =4,517> ttable =2,000, with dk=62 and a significance level of 5%. Based on the test criteria, H0 is rejected and Ha is accepted. Thus, it can be interpreted there is a significant difference the science learning result between the group of students that were taught using the multimedia-assisted probing-prompting learning model and the students that were taught using the conventional learning. It can be concluded that the the multimedia-assisted probing-prompting learning model has an influence on the science learning result of the fifth-grade students in Gugus I Elementary School, North Kuta District, in the school year of 2017/2018. Keywords : probing prompting, multimedia, science learning result

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Environmental Flow Assessment Considering Inter- and Intra-Annual Streamflow Variability under the Context of Non-Stationarity

Water ◽

10.3390/w10121737 ◽

2018 ◽

Vol 10 (12) ◽

pp. 1737 ◽

Cited By ~ 3

Author(s):

Kang Ren ◽

Shengzhi Huang ◽

Qiang Huang ◽

Hao Wang ◽

Guoyong Leng

Keyword(s):

Kendall Test ◽

Environmental Flow ◽

Mean Value ◽

Test Method ◽

Stationary Condition ◽

Annual Streamflow ◽

Riverine Ecosystems ◽

Study Results ◽

Wide Range ◽

Streamflow Variability

A key challenge to environmental flow assessment in many rivers is to evaluate how much of the discharge flow should be retained in the river in order to maintain the integrity and valued features of riverine ecosystems. With the increasing impact of climate change and human activities on riverine ecosystems, the natural flow regime paradigm in many rivers has become non-stationary conditions, which is a new challenge to the assessment of environmental flow. This study presents a useful framework to (1) detect change points in runoff time series using two statistical methods (Mann-Kendall test method and heuristic segmentation method), (2) adjust data of the changed period against the original flow series into a stationary condition using a procedure of reconstruction; and (3) incorporate inter- and intra-annual streamflow variability with adjusted streamflow to evaluate environmental flow. The Jialing to Han inter-basin water transfer project was selected as the case study. Results indicate that a change point of 1994 was identified, revealing that the stationarity of annual streamflow series is invalid. The variations of reconstructed streamflow series are roughly consistent with original streamflow series, especially in the maximum/minimum values and rise/fall rates, but the mean value of reconstructed streamflow series is increased. The reconstructed streamflow series would further serve to eliminate the non-stationary of original streamflow, and incorporating the inter- and intra-annual variability would upgrade the ecosystem fitness. Selecting different criteria for the conservation of riverine ecosystems can have significantly different consequences, and we should not focus on the protection of specific objectives that will inevitably affect other aspects. This study provides a useful framework for environmental flow assessment and can be applied to a wide range of instream flow management approaches to protect the riverine ecosystem.

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Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1403-7 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yuan-Wei Zhang ◽

Xin Xiao ◽

Wen-Cheng Gao ◽

Yan Xiao ◽

Su-Li Zhang ◽

...

Keyword(s):

3D Printing ◽

Blood Loss ◽

Three Dimensional ◽

Operation Time ◽

Varus Deformity ◽

Conventional Group ◽

Intraoperative Blood Loss ◽

Cubitus Varus ◽

Guide Plate ◽

Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

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Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes

Head & Face Medicine ◽

10.1186/s13005-020-00253-z ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Yonghuan Bian ◽

Changhao Liu ◽

Zhaojiang Fu

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Chronic Periodontitis ◽

Root Planing ◽

Tnf Α ◽

Significant Difference ◽

Hs Crp

Abstract Background Our study attempted to observe the value of periodontal curettage combined with root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Methods There involved 72 patients with type 2 diabetes mellitus complicated with moderate-to-severe chronic periodontitis who were diagnosed and treated in our hospital from January 2019 to December 2019. The patients enrolled were randomly divided into four groups using a computer-generated table: root planing and periodontal curettage combined group (n = 18), root planning group (n = 18), periodontal curettage group (n = 18) and cleansing group (n = 18). Blood glucose, plaque index (PI), gingival index (GI), probing depth (PD), attachment loss (AL), serum levels of inflammatory factors (Tumor Necrosis Factor Alpha [TNF- α] and hypersensitive C-reactive protein [hs-CRP]) were observed before and after treatment. The collecting dates were analyzed by the chi-square χ 2 test, repeated measurement analysis of variance, or t-test according to different data types and research objectives. Results Before treatment, there was no significant difference in PI, GI, PD and AL among the four groups (P> 0.05), while after 3-month treatment, the levels of PI, GI, PD and AL in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, with both root planing group and periodontal curettage group significantly lower than cleansing group (P< 0.05). The fasting blood glucose, 2-h postprandial blood glucose and glycosylated hemoglobin in the combined group, root planing group, periodontal curettage group and cleansing group were significantly lower than those before treatment (P < 0.05). Before treatment, there was no significant difference in TNF- α and hs-CRP among the four groups (P> 0.05), but the levels of TNF- α and hs-CRP in the four groups decreased significantly after 3-month treatment (P< 0.05). The levels of TNF- α and hs-CRP in the combined group were lower than those in the root planing group, periodontal curettage group and cleansing group, and those in the root planing group and periodontal curettage group were significantly lower than those in the cleansing group (P< 0.05). Conclusion The combination therapy of periodontal curettage and root planing exerted beneficial effects on moderate-to-severe chronic periodontitis in patients with type 2 diabetes mellitus, which holds the potential to maintain the level of blood glucose and improve the quality of life of the patients.

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Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-019-0125-4 ◽

2019 ◽

Vol 55 (1) ◽

Author(s):

Mohamed I. Refaat ◽

Amr K. Elsamman ◽

Adham Rabea ◽

Mohamed I. A. Hewaidy

Keyword(s):

Patient Satisfaction ◽

Blood Loss ◽

Minimally Invasive ◽

Invasive Technique ◽

Decompression Surgery ◽

Microsurgical Decompression ◽

Significant Difference ◽

Duration Of Surgery ◽

Group A ◽

Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

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Ayurveda Body–Mind Constitutional Types and Role of Yoga Intervention Among Type 2 Diabetes Mellitus Population of Chandigarh and Panchkula Regions

Annals of Neurosciences ◽

10.1177/09727531211000040 ◽

2021 ◽

pp. 097275312110000

Author(s):

Madhava Sai Sivapuram ◽

Vinod Srivastava ◽

Navneet Kaur ◽

Akshay Anand ◽

Raghuram Nagarathna ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Lipid Profiles ◽

Control Groups ◽

Yoga Intervention ◽

Positive Effects ◽

Study Results ◽

Significant Difference ◽

And Control

Background: Type 2 diabetes needs a better understanding of etiological factors and management strategies based on lifestyle and constitutional factors, given its high association rate with many cardiovascular, neurological disorders, and COVID-19 infection. Purpose: The present study was undertaken to investigate the effect of Diabetes-specific integrated Yoga lifestyle Protocol (DYP) on glycemic control and lipid profiles of diabetic adults. Along with the DYP intervention, the individuals residing in Chandigarh and Panchkula union territories in the northern part of India were assessed for Ayurveda-based body–mind constitutional type. Ayurveda describes body–mind constitution as “ prakriti,” which has been discussed from two angles, namely physiological and psychological as body and mind are correlated. Methods: Cluster sampling of waitlist control study subjects was used as the sampling method for the study. A total of 1,215 registered subjects (81 diabetic) responded in randomly selected clusters in Chandigarh and Panchkula. Ayurveda physicians did Ayurveda body–mind constitutional assessment called prakriti assessment (physiological body–mind constitution assessment) in 35 participants (23 diabetic, 12 prediabetic) as a part of the study. Results: A group of 50 subjects was randomly selected for yoga intervention out of 81 diabetes mellitus adults, and 31 subjects were enrolled as waitlist controls. A significant decrease in the glycosylated hemoglobin levels from 8.49 ± 1.94% to 7.97 ± 2.20% in the intervention group was noticed. The lipid profiles of the DYP intervention and control groups were monitored. Three-month follow-up results of lipid profile diagnostic tests in intervention and control groups showed a significant difference between the two groups ( P < 0.05). Most diabetic and prediabetic individuals were found to have pitta dosha ( pitta controls all heat, metabolism, and transformation in the mind and body) as dominant constitution type. Conclusion: The study results demonstrated significant positive effects of yoga in diabetic individuals. This study has indicated the evidence for the safety and efficacy of the validated DYP for community-level interventions to prevent maladies like brain damage and stroke.

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A Meta-Analysis of Extracorporeal Anticoagulants in Pediatric Continuous Kidney Replacement Therapy

Journal of Intensive Care Medicine ◽

10.1177/0885066621992751 ◽

2021 ◽

pp. 088506662199275

Author(s):

Rupesh Raina ◽

Nirav Agrawal ◽

Kirsten Kusumi ◽

Avisha Pandey ◽

Abhishek Tibrewal ◽

...

Keyword(s):

Replacement Therapy ◽

Meta Analysis ◽

Kidney Injury ◽

Electrolyte Imbalance ◽

Therapeutic Modality ◽

Regional Citrate Anticoagulation ◽

Increased Risk ◽

Study Results ◽

Significant Difference ◽

Kidney Replacement Therapy

Objective: Continuous kidney replacement therapy (CKRT) is the primary therapeutic modality utilized in hemodynamically unstable patients with severe acute kidney injury. As the circuit is extracorporeal, it poses an increased risk of blood clotting and circuit loss; frequent circuit losses affect the provider’s ability to provide optimal treatment. The objective of this meta-analysis is to evaluate the safety and efficacy of the extracorporeal anticoagulants in the pediatric CKRT population. Data Sources: We conducted a literature search on PubMed/Medline and Embase for relevant citations. Study Selection: Studies were included if they involved patients under the age of 18 years undergoing CKRT, with the use of anticoagulation (heparin, citrate, or prostacyclin) as a part of therapy. Only English articles were included in the study. Data Extraction: Initial search yielded 58 articles and a total of 24 articles were included and reviewed. A meta-analysis was performed focusing on the safety and effectiveness of regional citrate anticoagulation (RCA) vs unfractionated heparin (UFH) anticoagulants in children. Data Synthesis: RCA had statistically significantly longer circuit life of 50.65 hours vs. UFH of 42.10 hours. Two major adverse effects metabolic alkalosis and electrolyte imbalance seen more commonly in RCA compared to UFH. There was not a significant difference in the risk of systemic bleeding when comparing RCA vs. UFH. Conclusion: RCA is the preferred anticoagulant over UFH due to its significantly longer circuit life, although vigilant circuit monitoring is required due to the increased risk of electrolyte disturbances. Prostacyclin was not included in the meta-analysis due to the lack of data in pediatric patients. Additional studies are needed to strengthen the study results further.

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Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

BMC Surgery ◽

10.1186/s12893-021-01057-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shou-qian Dai ◽

Rong-qing Qin ◽

Xiu Shi ◽

Hui-lin Yang

Keyword(s):

Blood Loss ◽

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Intraoperative Blood Loss ◽

Surgical Time ◽

Significant Difference ◽

Neurologically Intact ◽

Operation Cost

Abstract Background Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD. Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference. Conclusion PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.

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