scholarly journals Efficacy of Different Concentrations of Chlorhexidine Mouthwash on Plaque Accumulation and Periodontal Parameters

2016 ◽  
Vol 8 (1) ◽  
pp. 8-11
Author(s):  
Ali Zarandi ◽  
Sina Salahaddin ◽  
Masoumeh Faramarzi
Keyword(s):  
Statistical Significance ◽  
Clinical Parameters ◽  
Chemical Agents ◽  
Probing Depth ◽  
Before And After ◽  
Chi Squared ◽  
Plaque Control ◽  
Group 2 ◽  
Antibacterial Potential ◽  
Group 1

Background and aims. Dental plaque and gingivitis were controlled by administration of chemical agents such as chlorhexidine (CHX) which is recognized as a gold standard of chemical agents. The aim of this study was to compare the effects of two mouthwashes (0.2% CHX and Kin Gingival) on clinical parameters. Materials and methods. A total of 88 subjects were included in this interventional‒experimental study. The subjects were divided into two groups of 44 (group 1: 0.2% CHX and group 2: Kin Gingival). The study involved no mechanical plaque control methods. Patients used the mouthwashes twice a day for two weeks. Clinical parameters included plaque index (PI), gingival index (GI), probing depth (PD) and bleeding on probing (BOP), which were measured before and after the use of mouthwashes. The results were analyzed by Man-Whitney U and chi-squared tests. Statistical significance was set at P < 0.05. Results. The results indicated that PI, GI and PD significantly decreased in group 2 (Kin Gingival) in comparison with group 1 (0.2% CHX) (P < 0.05). However, the two mouthwashes did not differ significantly from each other in relation to BOP (P > 0.05). Conclusion. Based on the results it can be concluded that Kin Gingival and 0.2% CHX mouthwashes decrease the clinical parameters in patients significantly. However, Kin Gingival is more effective than 0.2% CHX, which might be attributed to the synergic antibacterial potential of Kin Gingival ingredients like sodium fluoride.

scholarly journals Evaluation of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries

2017 ◽  
Vol 65 (3) ◽  
pp. 249-253
Author(s):  
Natália Karol de ANDRADE ◽  
Juliana Cama RAMACCIATO ◽  
Paulo Sérgio Perri de CARVALHO ◽  
Francisco Carlos GROPPO ◽  
Rogério Heládio Lopes MOTTA
Keyword(s):  
Oral Administration ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedure ◽  
Adverse Reactions ◽  
Statistical Significance ◽  
Clinical Parameters ◽  
Inclusion Criteria ◽  
Implant Placement ◽  
Group 2 ◽  
Group 1

ABSTRACT Objective The aim of this study was to evaluate the effectiveness of two amoxicillin protocols for antibiotic prophylaxis in implant placement surgeries. Methods A clinical study was performed with 66 volunteers of both genders (mean 51,9 ± 2,5 years) that met the inclusion criteria and were randomly assigned into 2 groups: Group 1 (n=35) - oral administration of amoxicillin (2g) 1 hour before the surgical procedure and Group 2 (n=31) oral administration of amoxicillin (2g) 1 hour before the surgical procedure and 500mg every 8 hours during 7 days after the surgeries. The following clinical parameters were evaluated: adverse reactions, pain and implants failure. The pain was evaluated in the surgery day (before, immediately after and at night), 24h, 48h, 72h and one week after the surgery and other clinical parameters were evaluated in daily appointments until the third postoperative day, 7 days and three months after the surgeries. Data were analyzed and statistical significance was 5%. Results Adverse reactions (headache, diarrhea, stomachache and nauseas) and implant failure occurred only in G2 (4 volunteers and 3 implants, respectively). Regarding pain, higher values for G2 on “at the night (p=0.0043), 24h (p=0.0013), 48h (p=0.0187) e 72h (p=0.0445) were observed. Conclusion The present study showed that a single dose of amoxicillin was effective in antibiotic prophylaxis in implant placement surgeries, suggesting that the use of amoxicillin in the postoperative period did not bring additional benefit.

Efficacy of antibiotic versus probiotics as adjuncts to mechanical debridement for managing peri-implant mucositis

2021 ◽  
Author(s):  
Fawaz Alqahtani ◽  
Maha AlShaikh ◽  
Abid Mehmood ◽  
Nasser Alqhtani ◽  
Fahad Alkhtani ◽  
...  
Keyword(s):  
Bone Loss ◽  
Antibiotic Therapy ◽  
Statistical Significance ◽  
Probing Depth ◽  
Crestal Bone Loss ◽  
Group 3 ◽  
Baseline Values ◽  
Group 2 ◽  
Group 1

The objective was to compare the efficiency of probiotic (PT) versus antibiotic therapy (AT) as adjuvants to non-surgical-mechanical debridement (NSMD) in the treatment of peri-implant mucositis (Pi-M). Volunteers with Pi-M were encompassed. Therapeutically, patients were randomly divided into 3-groups: (a) Group-1: NSMD + PT; (b) Group-2: NSMD + AT; and (c) Group-3: NSMD alone. Peri-implant plaque index (P.I), bleeding on probing (B.O.P), probing depth (P.D) and crestal-bone-loss (C.B.L) were recorded at baseline and at 3-and 6-months follow-up. P&lt;0.05 was selected as the indicator of statistical significance. Forty-two male individuals (14, 14 and 14 in groups 1, 2 and 3, respectively) were included. At 3- and 6-months of follow-up, P.I (P&lt;0.01), B.O.P (P&lt;0.01) and P.D (P&lt;0.01) were higher in Group-2 than Group-1. At 3-months of follow-up, P.I (P&lt;0.01), B.O.P (P&lt;0.01) and P.D (P&lt;0.01) were higher in Group-3 than Group-2. At 6-months of follow-up, P.I, B.O.P and P.D were comparable in groups 2 and 3. In Group-3, P.I, B.O.P and P.D were comparable with the respective baseline values at 6-months of follow-up. The C.B.L in all groups remained unchanged up to 6-months of follow-up. The NSMD with adjuvant PT is more effective than adjunct AT in the treatment of Pi-M for up to 3-months.

Comparison of 24-Hour Electrocardiogram Parameters in Patients with Graves Disease Before and After Anti-Thyroid Therapy

2020 ◽  
Vol 20 ◽  
Author(s):  
Gamze Akkuş ◽  
Yeliz Sökmen ◽  
Mehmet Yılmaz ◽  
Özkan Bekler ◽  
Oğuz Akkuş
Keyword(s):  
Treatment Group ◽  
Medical Treatment ◽  
Surgical Therapy ◽  
Graves Disease ◽  
Before And After ◽  
Euthyroid Status ◽  
Ectopic Beats ◽  
Group 2 ◽  
Electrocardiographic Parameters ◽  
Group 1

Background: We aimed prospectively investigate the laboratory and electrocardiographic parameters (hearth rate, QRS, QT, QTc, Tpe, Tpe/QTc, arrhythmia prevalance) in patients with graves disease before and after antithyroid therapy. Methods: 71 patients (48 female, 23 male), age between 18-50 (mean±SD: 36.48±12.20 ) with GD were included into the study. Patients treated with antithyroid therapy (thionamids and/or surgical therapy) to maintain euthyroid status. Patients were examined in terms of electrocardiographic parameters before and after the treatment. Results: Mean TSH, free thyroxin (fT4) and tri-iodothyrionine (fT3) levels of all patients were 0.005±0.21, 3.27± 1.81, 11.42±7.44, respectively. While 9 patients (group 2) underwent surgical therapy, had suspicious of malignant nodule or large goiter and unresponsiveness to medical treatment; the other patients (n=62, group 1) were treated with medical therapy. Patients with surgical therapy had more increased serum fT4 (p=0.045), anti-thyroglobulin value (p=0.018) and more severe graves orbitopathy (n=0.051) before treatment when compared to medical therapy group. Baseline Tpe duration and baseline Tpe/QTc ratio and frequency of supraventricular ectopic beats were found to be significantly higher in group 2 when compared to group 1 (p=0.00, p=0.005). Otherwise baseline mean heart rate, QRS duration, QTc values of both groups were similar. Although the patients became their euthyroid status, group 2 patients had still suffered from more sustained supraventricular ectopics beats than group 1. Conclusion: Distinct from medical treatment group, surgical treatment group with euthyroidism at least 3 months had still suffered from an arrhythmia (Tpe, Tpe/QTc, supraventricular and ventricular ectopic beats).

CD34 immunostain increases sensitivity of the diagnosis of fetal vascular malperfusion in placentas from ex-utero intrapartum treatment

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Jerzy Stanek
Keyword(s):  
Statistical Significance ◽  
Treatment Procedure ◽  
Fetal Survival ◽  
Ex Utero Intrapartum Treatment ◽  
Life Threatening ◽  
Group 2 ◽  
Cd34 Immunostain ◽  
The Impact ◽  
Diaphragmatic Hernias ◽  
Group 1

AbstractShort CommunicationsEXIT (ex-utero intrapartum treatment) procedure is a fetal survival-increasing modification of cesarean section. Previously we found an increase incidence of fetal vascular malperfusion (FVM) in placentas from EXIT procedures which indicates the underlying stasis of fetal blood flow in such cases. This retrospective analysis analyzes the impact of the recently introduced CD34 immunostain for the FVM diagnosis in placentas from EXIT procedures.Objectives and MethodsA total of 105 placentas from EXIT procedures (48 to airway, 43 to ECMO and 14 to resection) were studied. In 73 older cases, the placental histological diagnosis of segmental FVM was made on H&E stained placental sections only (segmental villous avascularity) (Group 1), while in 32 most recent cases, the CD34 component of a double E-cadherin/CD34 immunostain slides was also routinely used to detect the early FVM (endothelial fragmentation, villous hypovascularity) (Group 2). 23 clinical and 47 independent placental phenotypes were compared by χ2 or ANOVA, where appropriate.ResultsThere was no statistical significance between the groups in rates of segmental villous avascularity (29 vs. 34%), but performing CD34 immunostain resulted in adding and/or upgrading 12 more cases of segmental FVM in Group 2, thus increasing the sensitivity of placental examination for FVM by 37%. There were no other statistically significantly differences in clinical (except for congenital diaphragmatic hernias statistically significantly more common in Group 2, 34 vs 56%, p=0.03) and placental phenotypes, proving the otherwise comparability of the groups.ConclusionsThe use of CD34 immunostain increases the sensitivity of placental examination for FVM by 1/3, which may improve the neonatal management by revealing the increased likelihood of the potentially life-threatening neonatal complications.

scholarly journals POS0888 EPIDEMIOLOGICAL AND CLINICAL DIFFERENCES BETWEEN ANTI-MDA5 PHENOTYPES: DATA FROM A LARGE COHORT (MEDRA5) STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 700.1-700
Author(s):  
E. Trallero-Araguás ◽  
F. Romero ◽  
I. Castellví ◽  
V. Ortiz-Santamaria ◽  
S. Castañeda ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Statistical Significance ◽  
Disease Onset ◽  
Amyopathic Dermatomyositis ◽  
Clinically Amyopathic Dermatomyositis ◽  
San Sebastian ◽  
Group 3 ◽  
Group 2 ◽  
Hospital General ◽  
Group 1

Background:Idiopathic inflammatory myopathies are a heterogenous group of systemic autoimmune diseases. Several phenotypes have been linked to specific autoantibodies. Clinically amyopathic dermatomyositis with rapidly progressive interstitial lung disease, the most severe form of ILD, is associated with the anti-MDA5 antibodies. However not all the patients with dermatomyositis and anti-MDA5 positive antibodies develop this severe condition.Objectives:We aim to define different phenotypes from a large cohort of patients diagnosed with dermatomyositis who were positive to anti-MDA5 antibodies.Methods:We retrospective analyzed the clinical and immunological data of 90 anti-MDA5 patients [50 female, 55.6%, mean (SD) age at diagnosis 47 (15.4) yrs.] with dermatomyositis recruited from a multicenter register in Spain (MEDRA5) including 30 hospitals. All the patients fulfill de International Myositis Classification Criteria (EULAR/ACR) for dermatomyositis (score >90%). Anti-MDA5 were detected by means of commercial immunoblot (EUROIMMUN©). The chi-square test was used to assess the relationships between qualitative variables. The Kruskal-Wallis test was used to compared medians between groups.Results:Sixty-six patients (73.3%) were diagnosed with clinically amyopathic dermatomyositis. Three different phenotypes linked with the anti-MDA5 antibody were identified. Group 1: patients with rapidly-ILD phenotype (28 patients, 31.1%), group 2: antisynthetase-like phenotype (23 patients, 25.5%), and group 3: non-ILD phenotype (39 patients, 43.3%). Clinical and immunological comparison between the groups disclosed that age at disease onset was higher (median, IQR) in patients from group 1 [53 (43-60)] vs. group 2 [46 (40-56)] or group 3 [42(41-51)] (p=0.01); disease onset was more frequent in spring in patients from group 1 (46.5%) than in the rest of the groups (21.7% and 28.9%) (p<0.01). Cancer was detected in 7 patients, only associated with myositis in 3 cases (3 years interval between cancer and dermatomyositis) without significant differences between phenotypes. Vasculitis (one case ANCA positive) was detected in 9 cases (6 limited to skin, 1 renal and 1 intestinal), 6 of them in the group 3 (statistical significance, in comparison with group 1 and 2, p<0.01). Mortality rate was higher in group 1 (51.9%, 16 out of 17 due to refractory respiratory failure) vs group 2 (12.5%) or 3 (0%) (p<0.001). Anti Ro52 positivity was more frequent in group 1 (65.4%) vs. group 2 (25%) or 3 (35.5%) (p<0.017), although it did not reach statistical significance in terms of mortality (p=0.173) or patients admitted in the intensive care unit (p=0.173). Mechanic hands were more frequent in group 2 (40.6%) than in groups 1 (25%) and 3 (34.4%) (p=0.05). Fever was significantly most frequent in group 1(52.6%) than in group 2 (21.1%) and 3 (26.3%) (p=0.001). Other clinical or immunological features such as arthritis, myositis, or the number of characteristic skin lesions among others were not more frequent in one group or another.Conclusion:Three different phenotypes of patients positive to anti-MDA5 were identified. The presence or not of ILD, or the different type (rapidly progressive or not) of ILD were the main feature that allow to differentiate these phenotypes, which are relevant in clinical practice.References:[1]Allenbach Y, Uzunhan Y, Toquet S, et al; French Myositis Network. Different phenotypes in dermatomyositis associated with anti-MDA5 antibody: Study of 121 cases. Neurology. 2020;95: e70-e78.Acknowledgements:List of contributors of MEDRA5 group: Aguilar-García J (Internal Medicine, Hospital Costa del Sol, Marbella), Carrión-Barberá I (Rheumatology, Hospital del Mar, Barcelona), Cobo-Ibañez T (Rheumatology, Hospital Infanta Sofía, San Sebastián de los Reyes), de Escalante-Yangüela B (Internal Medicine, Hospital Clínico Lozano Blesa, Zaragoza), Fonseca-Aizpuru EM (Internal Medicine, Hospital de Cabueñes, Gijón), González-Cubillo L (Intensive Medicine, Hospital Universitario de Cruces, Barakaldo), González-Gay MA (Rheumatology, Hospital Marqués de Valdecilla, Santander), Prieto-González S (Internal Medicine, Hospital Clinic, Barcelona), Ruiz-Román A (Rheumatology, Hospital Universitario Virgen del Rocío, Sevilla), Calero-Paniagua I (Internal Medicine, Hospital Virgen de la Luz, Cuenca), Callejas-Rubio JL (Internal Medicine, Hospital Clínico San Cecilio, Granada), Gil-Vila A (Internal Medicine, Hospital Vall d’Hebron, Barcelona), de Miguel-Campo B (Internal Medicine, Hospital Doce de Octubre, Madrid), García-Sevilla R (Pneumology, Hospital General Universitario de Alicante, Alicante), Iriarte-Fuster A (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat), Jovani-Casano V (Rheumatology, Hospital General Universitario de Alicante, Alicante), Lozano-Rivas N (Rheumatology, Hospital Virgen de la Arritxaca, Murcia), Martín-Gascón M (Internal Medicine, Hospital Morales Meseguer, Murcia), Martinez-González O (Rheumatology, Hospital Universitario de Salamanca, Salamanca), Monteagudo-Jiménez M (Internal Medicine, Hospital Parc Taulí, Sabadell), Mora-Ortega GM (Pneumology, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes), Moral-Moral Pedro (Internal Medicine, Hospital Universitari i Politecnic La Fe, Valencia), Pérez-De Pedro I (Interna Medicine, Hospital Regional Universitario de Málaga, Málaga), Picazo-Talavera MR (Rheumatology, Hospital del Sureste, Madrid), Rubio-Rivas M (Internal Medicine, Hospital de Bellvitge, Hospitalet de Llobregat)Disclosure of Interests:None declared

scholarly journals MRI Spectrum of Japanese Encephalitis in Northeast India: A Cross-Sectional Study

2021 ◽  
Vol 12 (02) ◽  
pp. 281-289
Author(s):  
Pranjal Phukan ◽  
Kalyan Sarma ◽  
Barun Kumar Sharma ◽  
Deb K. Boruah ◽  
Bidyut Bikash Gogoi ◽  
...  
Keyword(s):  
Japanese Encephalitis ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mri Findings ◽  
Mri Scan ◽  
Cross Sectional ◽  
Adc Value ◽  
Group 2 ◽  
Group 1

Abstract Objective Japanese encephalitis (JE) is an arthropod-borne flavivirus infection having high mortality and morbidity. This study was performed to evaluate the conventional magnetic resonance imaging (MRI) findings in JE and to find out any difference between pediatric and adult JE. Materials and Methods This retrospective study was performed on serologically positive 54 JE patients presented to a tertiary care hospital with acute encephalitic symptoms between April 2016 and October 2019. Relevant neurological examination, cerebrospinal fluid analysis, and MRI scan of the brain were performed. Results Fifty-four JE patients (n = 31 males and n = 23 females) having 32 pediatric and 22 adult JE were included in the study sample. Group 1 JE (n = 16) patients had encephalitic symptoms with duration less than 15 days up to the day of MRI scan and group 2 JE (n = 38) had symptoms more than 15 days. Group 1 JE had mean apparent diffusion coefficient (ADC) value of 0.563 ± 0.109 (standard deviation [SD]) × 10–3 mm2/sec and group 2 JE had 1.095 ± 0.206 (SD) × 10–3 mm2/sec. The mean ADC value of pediatric JE was 0.907 ± 0.336 (SD) × 10–3 mm2/sec and adult JE was 0.982 ± 0.253 (SD) × 10–3 mm2/sec. Conclusion The majority of the JE patient shows abnormal signal alterations in bilateral thalami and substantia nigra. Diffusion-weighted imaging with ADC mapping helps in evaluating the stage of the JE. No statistical significance of the various conventional MRI findings was found between the pediatric JE and adult JE.

scholarly journals Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Statistical Significance ◽  
Semen Parameters ◽  
Male Factor ◽  
Percutaneous Embolization ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

scholarly journals The use of an antagonist 5-HT2a/c for depression and motor function in Parkinson' disease

2009 ◽  
Vol 67 (2b) ◽  
pp. 407-412 ◽  
Author(s):  
Antonio Luiz dos Santos Werneck ◽  
Ana Lucia Rosso ◽  
Maurice Borges Vincent
Keyword(s):  
Parkinson Disease ◽  
Motor Function ◽  
Rating Scale ◽  
Statistical Significance ◽  
Psychotic Symptoms ◽  
Initial Moment ◽  
The Mean ◽  
Group 2 ◽  
To Receive ◽  
Group 1

OBJECTIVE: To test the ability of a 5HT2a/c (trazodone) antagonist, to improve depression and motor function in Parkinson' disease (PD). METHOD: Twenty PD patients with and without depression were randomly assigned to receive trazodone (group 1) or not (group 2). They were evaluated through UPDRS and Hamilton Depression Rating Scale (HAM-D). RESULTS: For the UPDRS the mean score of group 2 was 33.1 ± 19.7 and 37.1 ± 18.0 at the end. For the group 1, the corresponding scores were 31.4 ± 11.3 and 25.9 ± 13.7. The variations in the Mann-Whitney test were 0.734 at the initial moment and 0.208 at the final moment. The variation in the comparison of the initial moment with the final moment was 0.005 providing statistical significance. For the HAM-D, the mean score went up 4 points in group 2, contrary to a 5.5 points decrease in group 1. CONCLUSION: Data analysis shows that this agent significantly improves depression, but the motor function improved only in the depressed patients. Because of the known anti-dopaminergic property of the 5-HT2c receptors, a possible approach for depression in PD could be the use of 5-HT2c antagonists, similarly to the use of atypical neuroleptics in case of psychotic symptoms.

scholarly journals Adaptive functional change of the contralateral kidney after partial nephrectomy

2017 ◽  
Vol 313 (2) ◽  
pp. F192-F198 ◽  
Author(s):  
Se Young Choi ◽  
Sangjun Yoo ◽  
Dalsan You ◽  
In Gab Jeong ◽  
Cheryn Song ◽  
...  
Keyword(s):  
Renal Function ◽  
Partial Nephrectomy ◽  
Functional Change ◽  
Functional Changes ◽  
Contralateral Kidney ◽  
Before And After ◽  
Group 2 ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Group 1

Partial nephrectomy aims to maintain renal function by nephron sparing; however, functional changes in the contralateral kidney remain unknown. We evaluate the functional change in the contralateral kidney using a diethylene triamine penta-acetic acid (DTPA) renal scan and determine factors predicting contralateral kidney function after partial nephrectomy. A total of 699 patients underwent partial nephrectomy, with a DTPA scan before and after surgery to assess the separate function of each kidney. Patients were divided into three groups according to initial contralateral glomerular filtration rate (GFR; group 1: <30 ml·min−1·1.73 m−2, group 2: 30–45 ml·min−1·1.73 m−2, and group 3: ≥45 ml·min−1·1.73 m−2). Multiple-regression analysis was used to identify the factors associated with increased GFR of the contralateral kidney over a 4-yr postoperative period. Patients in group 1 had a higher mean age and hypertension history, worse American Society of Anesthesiologists score, and larger tumor size than in the other two groups. The ipsilateral GFR changes at 4 yr after partial nephrectomy were −18.9, −3.6, and 3.9% in groups 1, 2, and 3, respectively, whereas the contralateral GFR changes were 10.8, 25.7, and 38.8%. Age [β: −0.105, 95% confidence interval (CI): −0.213; −0.011, P < 0.05] and preoperative contralateral GFR (β: −0.256, 95% CI: −0.332; −0.050, P < 0.01) were significant predictive factors for increased GFR of the contralateral kidney after 4 yr. The contralateral kidney compensated for the functional loss of the ipsilateral kidney. The increase of GFR in contralateral kidney is more prominent in younger patients with decreased contralateral renal function.

Abstract 14213: Injury Characteristics of Chest Compressions in a Swine Model of Infant Asphyxial Cardiac Arrest Using Either 1.5 inch or 1/3 Anterior-Posterior Diameter Depth Targets

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
David D Salcido ◽  
Allison C Koller ◽  
Ericka L Fink ◽  
Robert A Berg ◽  
James J Menegazzi
Keyword(s):  
Spontaneous Circulation ◽  
Swine Model ◽  
Chest Compressions ◽  
Injury Characteristics ◽  
Group Assignment ◽  
Chi Squared ◽  
Group 2 ◽  
Vessel Dissection ◽  
Anterior Posterior ◽  
Group 1

Background: Current AHA guidelines for the delivery of chest compressions (CC) for infants and children are largely consensus based, and recommended depths of 1.5 inches or 1/3 anterior-posterior chest diameter (APD). It is unclear whether these have equal potential for injury. Objectives: We sought to examine and compare injury characteristics of CC delivered at 1.5 inches or 1/3 APD in an infant-sized model of asphyxial OHCA. Methods: Thirty-six juvenile swine weighing 10.6kg +/- 0.84 (approximating the 50 th percentile for a 12-month-old) were anesthetized, paralyzed, intubated, and mechanically ventilated (FiO2 21%). APD was measured and by two investigators via a sliding T-square. After instrumentation, the endotracheal tube was manually occluded to induce asphyxia, and occlusion was maintained for 9 minutes. Animals with an organized rhythm after 8 minutes 45 seconds of asphyxia received a single, 3-second transthoracic shock to induce ventricular fibrillation. At 9 minutes, each was then randomized to receive CC with a depth of 1.5 inches (Group 1) or 1/3 APD (Group 2), both with a rate of 100 per minute. ALS drugs were administered after 13 minutes, followed by initial defibrillation attempt at 14 minutes. Resuscitation continued until return of spontaneous circulation (ROSC) or 20 minutes of failed resuscitation. Survivors were sacrificed with KCl after 20 minutes of observation. Veterinary staff blinded to group assignment conducted necropsies to assess lung injury, rib fracture, hemothorax, airway bleeding, great vessel dissection, and heart/liver/spleen contusion. Characteristics were compared via Chi-Squared test or Mann-Whitney U-test using an alpha = 0.05. Results: Group 1 had n=18 and Group 2 had n=18 animals. Mean (SD) APD overall was 5.58 (0.22) inches, yielding a mean 1/3 APD depth of 1.86 inches. APD did not differ between groups. ROSC rates did not differ between groups (Group 1: 66.7% vs Group 2: 83.33%; p = 0.248. No injury characteristics differed significantly between groups. Airway bleeding rates were noteworthy though not different between groups (Group 1: 18.8% vs Group 2: 42.1%; p = 0.219). Conclusions: In a swine model of infant OHCA and resuscitation, both CC depth strategies had similar injury characteristics.

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