scholarly journals Dynamics of Serum Cytokines During Resection Surgery for Malignant Neoplasms in the Lungs

2020 ◽  
Vol 16 (2) ◽  
pp. 12-21
Author(s):  
A. O. Soloviev ◽  
V. T. Dolgikh ◽  
O. N. Novichkova ◽  
N. V. Govorova ◽  
O. V. Leonov ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Comparison Group ◽  
Main Group ◽  
Malignant Neoplasms ◽  
Reference Limit ◽  
Serum Cytokines ◽  
Post Surgery ◽  
Group I ◽  
Mechanical Lung Ventilation ◽  
Upper Reference Limit

Purpose — to carry out a comparative assessment of inflammation based on evaluation of intraoperative and early postoperative dynamics of blood serum cytokines in pulmonary malignant neoplasm patients in different anesthesia and analgesia settings.Material and methods. 24 patients of 45 to 50 years of age divided into 2 groups were examined. All patients suffered from verified new onset malignant neoplasms without true signs of metastases. Tumor differentiation by morphology was not undertaken since that was beyond the study design. Patients did not receive radio- or chemotherapy. In Group I (the main group, n=12), a multimodal combined anesthesia [1] followed by extended postoperative epidural analgesia was applied. In Group II (the comparison group, n=12), a combined general anesthesia including mechanical lung ventilation followed by morphine analgesia was used. 4 study points were determined: prior to induction, and one, 12, and 24 hours post-surgery.Results. 12 hours after surgery completion, the concentration of TNFα in the main group was lesser by 57.1% vs. the comparison group; by the end of the first 24 hours, it fell down by 64.3%. Within the same period, in both groups IL-6 turned out to be significantly higher than the upper reference limit. By the end of the first 24 hours, IL-6 tend to decrease in both groups; however, in the comparison group, this parameter was 15% higher than in the main group. Serum IL-10 was within the reference range in both groups. One hour after surgery, concentrationof IL-10 was exponentially growing in both groups and exceeded multifold the upper reference limit, whereas the content of IL-10 in the main group remained reliably higher: the difference amounted to 35.6% percent.Conclusion. During the postoperative period, patients undergone lung resection displayed significant changes in cytokines concentrations demonstrating an inflammation reaction. Inflammation was significant in patients who received epidural analgesia as evidenced by an altered content of anti-inflammatory cytokines.

PECULIARITY OF ADAPTATION OF BABIES ARE BORN PREMATURELY FROM MOTHERS WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA

2021 ◽  
Vol 74 (10) ◽  
pp. 2566-2568
Author(s):  
Tunzala V. Ibadova ◽  
Vitalii V. Maliar ◽  
Volodymyr V. Maliar ◽  
Vasyl V. Maliar
Keyword(s):  
Connective Tissue ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Main Group ◽  
Phenotypic Markers ◽  
Group I ◽  
Neonatal Respiratory Distress ◽  
Connective Tissue Dysplasia

The aim: To evaluate the peculiarity of clinical manifestations of neonatal respiratory distress syndrome (NRDS) in deeply premature infants from mothers with phenotypic markers of undifferentiated connective tissue dysplasia (UCTD). Materials and methods: The study represent the results of a retrospective clinical and statistical analysis of 268 premature birth report card and newborn report sheet. .The main (1 group) included 50 pregnants with obvious phenotypic markers of UCTD, the comparison group (group 2) consisted of 50 pregnant women without phenotypic markers of UDCTD. Results: According to the study, in 12 (24%) pregnant women of the main group at the time of admission to the clinic had contractions,which required specific therapy. Cervical cerclage was performed in 38 (76%) patients of the main group due to the presence of cervical insufficiency (CI). In these cases, the severity of the CI on the Steinber scale was 7.2 ± 0.4 points in the main group against 4.4 ± 0.2 points in the comparison group (p <0.05). Group I patients were more likely to have complications of labor such as:premature rupture of membranes, uterine contraction abnormalities and fetal distress, which required in most cases cesarean delivery (7% and 2%), respectively (p <0.05). The incidence of neonatal complications requiring respiratory support was 67% in group I and 48% in group II. According to our observations, the clinical manifestations of bronchopulmonary dysplasia were twice as high in infants of the main group (66%) against (44%) of the comparison group (p <0.05). Conclusions:1.Neonatal respiratory distress syndrome in premature infants is more often associated from mothers with UDCTD. 2. The high importance of steroid prophylaxis of NRDS and antioxidant therapy in reducing the frequency of mechanical ventilation and the development of bronchopulmonary pathology, especially in infants from mothers with UDCTD syndrome, has been proven. 3. The possibility of diagnosing disorders of functional maturation of the lungs in the fetal period using a non-invasive method of ultrasonography has been confirmed.

scholarly journals Evaluation of Dexmedetomidine Co-Administered with Neostigmine and Bupivacaine for Postoperative Epidural Analgesia in Lower Limb Orthopaedic Surgeries – A Study from Maharashtra, India

2021 ◽  
Vol 10 (32) ◽  
pp. 2634-2639
Author(s):  
Parag Yashawant Dongre ◽  
Aruna Vijay Chandak ◽  
Amol P. Singam
Keyword(s):  
Side Effects ◽  
Epidural Analgesia ◽  
Lower Limb ◽  
Rescue Analgesia ◽  
Post Surgery ◽  
Group I ◽  
Post Operative Pain ◽  
Key Words Epidural ◽  
Spinal Epidural

BACKGROUND Addition of adjuvants to the neuro axial blocked helps prolongate the duration and quality of analgesia and anaesthesia. The safety and efficacy of drugs dexmedetomidine and neostigmine have been less commonly studied. We wanted to compare post-operative analgesia, haemodynamics, and side effects if any in this study. METHODS Combined spinal - epidural anaesthesia was performed in 60 patients who underwent lower limb surgeries of less than 2 hrs. The patients were given the drug epidurally post-surgery. Group I, II and III were given 10 ml of 0.25 % bupivacaine alone, with 1 microgram per kg of neostigmine and with 0.5 milligram per kg of dexmedetomidine and 1 microgram per kg of neostigmine, respectively. 50 mg tramadol intravenous was kept as rescue analgesic. Parameters which predict haemodynamics, assessment of pain, period of analgesia, demand for rescue analgesia and the chances of side effects were noted over the next ten hrs. RESULTS To conclude, epidural analgesia is the most preferred analgesia these days in management of lower limb orthopaedic surgery’s post-operative pain. When bupivacaine was combined with neostigmine and dexmedetomidine as a neuraxial adjuvant, it prolonged the post-operative analgesia significantly without increasing the side effects of those drugs. The combination of two drugs proved better than the use of single drug alone. CONCLUSIONS Combination of neostigmine and dexmedetomidine when used as a neuraxial adjuvant, significantly prolonged the duration of post-operative analgesia by 274.13 4.539 in lower limb orthopaedic cases compared to neostigmine alone that was 176.23 ± 3.441. KEY WORDS Epidural, Neostigmine, Dexmedetomidine, Orthopaedic Surgeries, Post-Operative Analgesia

scholarly journals PROLONGED EPIDURAL ANALGESIA AFTER COLORECTAL SURGERY IN ELDERLY PATIENTS

2018 ◽  
Vol 12 (3) ◽  
pp. 175-182
Author(s):  
Alexander V. Savushkin ◽  
E. A Khachaturova ◽  
E. V Balykova
Keyword(s):  
Elderly Patients ◽  
Epidural Analgesia ◽  
Comparison Group ◽  
Enhanced Recovery ◽  
Randomized Study ◽  
Early Mobilization ◽  
Main Group ◽  
Bolus Administration ◽  
Surgical Interventions ◽  
On Demand

Objective: to compare the effectiveness of prolonged epidural analgesia by continuous infusion or bolus administration on demand, as well as the timing and volume of early mobilization with two methods of postoperative analgesia. Material and methods: prospective randomized study enrolled 161 patients with colorectal cancer aged from 60 to 89 years, operated by means of laparotomy and laparoscopy. In the main group (n=80), postoperative prolonged epidural analgesia was carried out using individual pumps with an initial rate of 0.2% ropivacaine solution of 4-6 ml/h. In the comparison group, epidural analgesia was provided by bolus administration of 4-6 ml of 0.2% ropivacaine solution on demand. Results: In the main group with open surgical interventions, in contrast to the comparison group, prolonged epidural analgesia provided a decrease in the intensity of pain on the second (2.7 ± 1.8 and 4.1 ± 1.4 score, p < 0.001), third (2.6 ± 1.6 and 3.9 ± 1.1 score, p < 0.001), fourth day (2.3 ± 1.7 and 3.5 ± 1.2 score, p < 0.001). Prolonged epidural analgesia in the main group allowed more patients to be activated on the second (64.2% (52 of 81), p < 0.001), third (97.5% (79 of 81), p < 0.001) and fourth (100%, p < 0.002) days. The average time of activity in the main group was three times higher on the third day and twice - on the fourth day (p < 0.001). Conclusion: Postoperative prolonged epidural analgesia is highly effective in elderly patients during their treatment with enhanced recovery methods.

scholarly journals Peculiarities of treatment and healing of trophic ulcers of the lower extremities of the mixed genesis

2019 ◽  
Vol 86 (7) ◽  
pp. 36-41
Author(s):  
V. I. Liakhovskyi ◽  
O. M. Bezkorovaynyy ◽  
A. V. Sydorenko
Keyword(s):  
Blood Supply ◽  
Comparison Group ◽  
Healing Process ◽  
Local Treatment ◽  
Lower Extremities ◽  
Main Group ◽  
Local Temperature ◽  
Group I ◽  
Group Ii ◽  
The Impact

Objective. To study the impact of sulodexide on the healing process of trophic ulcers of the mixed genesis in the lower extremities. Materials and methods. Analysis of the medical cards data was done for 105 patients, who in 2015 - 2019 yrs have had treated the trophic ulcers of the mixed genesis of the ankles in Department of Vascular Surgery of the Poltava Regional Clinical Hospital. The causes of development of trophic ulcers were confirmed by data of ultrasonographic color angioscanning of the lower extremities and pelvis with measurement of the ankle-brachial pressure index and arteriography. All the patients did not accepted the proposal for performing of correcting and restoration surgical treatment on the lower extremities vessels. Depending on the treatment prescribed the patients were divided into two groups. Into the Group I (comparative) 53 (50.5%) patients were included, who obtained a casual conservative treatment, directed to improvement of the lower extremities blood supply, as well as the blood rheological properties, which included venotonic, analgesic, antibacterial preparations and local treatment, depending on the wound process stage. Into the Group II (the main) 52 (49.5%) patients were included, who on the background of typical treatment have obtained sulodexide in a dose 600 LU (lipoproteidlipase units) on 200 ml of physiological solution of sodium chloride up to 15 days long with subsequent therapy in the dose of 1 capsule twice a day (500 LU) during up to 60 days. In the Group I there were 32 (60.4%) men and 21 (39.6%) women, and in the Group II – 30 (57.7%) men and 22 (42.3%) women. Average age of patients in the Group I have constituted (65.8 ± 4.38), and in the Group II – (66.2 ± 5.04) yrs old. The pain intensity in accordance to the ten-point numerical rating scale was checked before the treatment beginning, in 7 and 14 - 15 days, the trophic ulcers square was measured, local temperature of the patient’s body, pН-metry and cytological investigations of the wounds exudate were done in all the patients before the treatment. Besides this, 38 (71.7%) patients of the comparison group and 40 (76.9%) patients of the main group were followed during 90 - 120 days after leaving a stationary. Results. In the patients, who have obtained sulodexide additionally, reparative processes in the trophic ulcers regions of the lower extremities have become accelerated, the pain syndrome have been lowered rapidly, the water index normalized, the blood supply improved, the ankle-brachial index enhanced, a local temperature raised, cytological picture of the wound exudate improved, what promoted more rapid healing of ulcers and reduction of the stationary stay duration. During the planned visits of the patients in 90 - 120 days a complete healing of trophic ulcers of the lower extremities in 31 (77.5%) patients of the main group and in 24 (63.2%) patients of the comparison group was proved. Conclusion. Application of sulodexide in the treatment dosage is expedient to include into complex of treatment for trophic ulcers of the mixed origin in the lower extremities.

scholarly journals Morphological signs of the effectiveness of application sorbent in the treatment of purulent wounds (experimental study)

Morphologia ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 7-15
Author(s):  
O. O. Bilyayeva ◽  
O. O. Dyadyk ◽  
V. I. Zaritsʹka ◽  
Ye. Ye. Kryzhevskyi
Keyword(s):  
Wound Healing ◽  
Comparison Group ◽  
Morphological Changes ◽  
Main Group ◽  
Group Iii ◽  
Group I ◽  
Purulent Wounds ◽  
Comparison Groups ◽  
New Generation ◽  
Connective Tissue Repair

Objective. To prove experimentally the effectiveness of a new generation of application sorbent by studying the morphological changes during the wound process. Methods. Depending on the drug used to treat purulent wounds, we divided the animals into three groups. In the main group (group I) the study was performed on 20 rats, they used an application sorbent, which includes aerosil with immobilization on its matrix ornidazole (Patent of Ukraine for utility model № 115228). The comparison group (group II) consisted of 10 rats, which used the known sorbent "Gentaxan", which includes: gentamicin sulfate, L-tryptophan and zinc sulfate. The comparison group (group III) was 10 rats. In this group for the treatment of purulent wounds used 10% sodium chloride solution, followed by a transition to ointment "Levomekol", which includes chloramphenicol and methyluracil. Results. The results of the study show that in the main group already on the seventh day in comparison with the comparison groups was found granulation tissue with a large number of newly formed vessels of the microcirculatory tract and pronounced proliferation of fibroblasts, indicating acceleration of wound healing. In the comparison groups, the regeneration process was slower. Conclusion. Pathomorphological examination revealed that drugs with sorption properties contribute to a faster reduction of edema and inflammation, and treatment with application sorbent used in the main group, significantly accelerates the processes of connective tissue repair and wound epithelization, ie accelerates wound healing processes with comparison groups.

scholarly journals The Effectiveness Of The Use Of Transtrachial Sanitation In The Treatment Of Patients With Lung Abscess Complicated By Bronchial Fistula

2020 ◽  
Vol 02 (10) ◽  
pp. 137-144
Author(s):  
Safoev B.B. ◽  
◽  
Khasanov A.K. ◽  
Rakhimov A.Ya. ◽  
Mirsoliev Sh.G. ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Soft Tissues ◽  
Comparison Group ◽  
Lung Abscess ◽  
Main Group ◽  
State Institute ◽  
Bronchial Fistula ◽  
Surgical Department ◽  
Group I ◽  
Methods Of Treatment

The results of the research of 44 patients with lung abscesses complicated by bronchial fistula of various etiology, who were treated in the purulent surgical department in the clinical base of the Bukhara State Institute in 2010-2019, were analyzed. All patients, depending on the method of treatment, were divided into 2 groups: I - comparison group and II - main. The controlled group I consisted of 31 (70.4%) patients who received traditional (conservative) methods of treatment. The II - main group included 13 (29.5%) patients who, in addition to conservative treatment, underwent transtrachial drainage of a purulent focus with sanitation with antibacterial and diluting drugs (trypsin, chymotrypsin). The analysis of the obtained results revealed that although transtrachial drainage of a purulent focus of the lung is a more effective method than conservative treatment, it also has its drawbacks in the form of complications such as: tracheobronchitis 23.1%, suppuration of soft tissues in the area of microtrachestomy 15.4%, bronchospasm 7.6%, self-extradition of the catheter 23.1%, from the purulent cavity and loss of microdrainage 7.6%.

scholarly journals Ozonotherapy influence on hormonal status of pregnant women of older reproductive age

2019 ◽  
Vol 36 (4) ◽  
pp. 27-32
Author(s):  
R. B. Safarova
Keyword(s):  
Pregnant Women ◽  
Comparison Group ◽  
Preventive Therapy ◽  
Main Group ◽  
Reproductive Age ◽  
Control Group ◽  
Hormonal Status ◽  
Group Iii ◽  
Group I ◽  
Medical Ozone

Aim. To study the hormonal status in pregnant women of older reproductive age and estimate the influence of administration of medical ozone on the course of pregnancy. Materials and methods. Ninety pregnant women aged 3544 years were examined over the period from 2013 to 2015. They were randomized by their age, social factors, associated gynecological and extragenital diseases. The main group (group I) joined 30 patients, the group of comparison (group II) 30 patients and the control (group III) 30 patients. All the patients underwent clinical and laboratory investigations according to the existing standards of obstetric examination. In the main group, complex treatment included therapy with medical ozone. In the comparison group, a standard medico-preventive therapy by the protocol №05 (20.02.2014 MH of AR) was implemented. In the control group, estrogen indices were studied in dynamics. Results. Pregnant women aged 35 years and older have an unfavorable background of extragenital and gynecological pathology that is confirmed by hormonal background. Conclusions. Planning of pregnancy, timely prevention and correction of clinicolaboratory indices permit to reduce the frequency and severity of pregnancy and delivery complications and improve the perinatal indices among patients of this age group.

scholarly journals Nutritional problems and factors of forming the health of children of the first year

2021 ◽  
pp. 23-29
Author(s):  
Saida Nuraddin Rustamaova ◽  
Keyword(s):  
Weight Gain ◽  
Breast Milk ◽  
Young Children ◽  
Comparison Group ◽  
Physical Development ◽  
Main Group ◽  
First Year ◽  
Standard Mixture ◽  
Group I ◽  
First Year Of Life

Evaluation of the type of nutrition, which is one of the important components that ensure the physical growth, development and health of a child in the first year of life, and that forms metabolic processes at an older age, has been the subject of research and discussion of domestic and foreign scientists over the past decades. Purpose — to study the influence of the nature of feeding on the incidence and physical development of infants. Materials and methods. During the year, 250 children (118 girls and 132 boys) of the first year of life were under observation, who received various types of feeding (breast milk and milk formulas, differing in composition). The main (I) group (n=130) included children (62 girls and 68 boys) who were breastfed; and in the comparison group — children receiving artificial feeding: in group II (n=60) (27 girls and 33 boys) received a standard mixture with a prebiotic; in group III (n=60) (29 girls and 31 boys) — a standard mixture without a prebiotic. Physical development was assessed according to the generally accepted measurement technique in terms of absolute values, monthly increases in anthropometric indicators and mass-growth indices. Outpatient records of children, protocols of examination of a 1-year-old child were studied (accounting and reporting documentation was analyzed). The criteria for inclusion in the main group of infants were: breastfeeding for at least 9 months; the age of children from up to 1 year of age. The second comparison group included children who were fed mixed with the addition of probiotic means. Results. In girls of the second group, who were artificially fed with the addition of a probiotic — 7100.0±95.9 g, the weight gain in the first year of life was significantly higher than the weight gain of girls who received breast milk and standard formula — 6671.0±72.6 g and 6733.3±91.8 g, respectively. Despite the fact that there were no significant differences in the medians of body weight and height in children of the main group and the comparison groups, it was found that children in the main group were overweight/obese at 12 months had two or more times less indicators than children who received artificial nutrition. Children who are breastfed began to sit independently much earlier, on average 7.6±0.05 months after birth, and children of the other two groups who are bottle-fed, on average, 8.0±0.13 and 8.1±0.12 months, respectively (p<0.05). When studying the structure of the most common diseases of children in the first year of life, depending on the type of feeding, it was revealed that the greatest percentage both in group I (group) and in group II (claim) are children with acute intestinal infections — in group I (group 1)) group in 7.7±2.34% of children, in subgroup II (claim) in 11.7±2.93% of children (p=0.3905). Conclusions. The results obtained indicate a positive effect of breastfeeding on anthropometric indicators and the formation of basic skills in young children. The incidence of infectious diseases (ARI and OCI) revealed in children who received breast milk, compared with children who are bottle-fed, indicates that breastfeeding has the ability to create conditions for reducing the incidence of diseases in young children. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the author. Key words: types of feeding, physical development, motor skills, morbidity, children under 1 year old.

scholarly journals Kariological indicators of buccal epitelia in newborns under sepsis, which parents have constantly lived in the conditions of various ecological conditions

2020 ◽  
Vol 19 (1) ◽  
pp. 13-19
Author(s):  
O. V. Vlasova
Keyword(s):  
High Risk ◽  
Neonatal Sepsis ◽  
Comparison Group ◽  
Main Group ◽  
The Body ◽  
Low Risk ◽  
Clinical Group ◽  
Average Risk ◽  
Buccal Epithelium ◽  
Group I

The generally accepted and accessible method of cytogenetic assessment of the mutagenic effect of factors of various nature is the micronucleus test. Now this test is one of the non-invasive methods of population survey, which are influenced by environmental pollution. Objective: to establish the characteristics of karyological indicators of buccal epithelium in children of patients with neonatal sepsis, whose parents constantly lived in different environmental conditions. Material and methods. To study this goal, a comprehensive examination of 260 newborns who underwent neonatal sepsis in 2015-2018 was carried out. A suggested feature of a comprehensive assessment of the long-term load on the body of parents of newborns of anthropogenic pollution of air, water and soil in the regions of the region was the proposed environmental risk coefficient (CER) taking into account the environmental situation in the regional centers. So, the first clinical group (the main one) included patients with neonatal sepsis, whose parents constantly lived for months with a CER of 2,0 or more and with an unfavorable ecological characterization of the regional center. The second group (comparisons) was formed by newborns with sepsis, whose parents lived permanently in areas with a low risk of adverse effects of these environmental factors on their bodies (CER<2,0). A micronuclear test of exfoliative buccal epithelium in patients with neonatal sepsis was performed and evaluated in the immunological laboratory of the Department of Pediatrics and Pediatric Infectious Diseases of the Bukovynian State Medical University according to the method of V.N. Kalaev. Results and its discussion. In the main group, children with a high risk of cytogenetic disorders significantly prevailed with a slight decrease in the quota of patients with low risk. So, in group I with a low risk of cytogenetic disorders there were 42,1 % of cases, with an average risk of 5,3 %, and with a high risk of 52,7 % of cases. In the comparison group, respectively, with a low risk of cytogenetic disorders there were 54,5 %, (P>0,05) cases, with an average risk of – 12,1 %, (P>0,05), and with a high risk of – 33,3 %, (P=0,05) cases. Conclusions. As a result of the karyological test of exfoliate buccal epithelium, it can be noted that in newborns of the main group, compared with children of the comparison group, cytogenetic disturbances and, in some cases, violation of cell kinetics in the form of proliferation and apoptosis were significantly more often detected. The accumulation index of cytogenetic disorders was also significantly higher in group I patients due to the predominance of patients with a high risk of cytogenetic disorders in them

Thromboembolic complications prevention in the obstetric practice

2017 ◽  
pp. 19-24
Author(s):  
O.V. Grishchenko ◽  
◽  
V.V. Bobrytska ◽  
Keyword(s):  
Pulmonary Embolism ◽  
Comparison Group ◽  
Main Group ◽  
Control Group ◽  
Efficacy And Safety ◽  
Thromboembolic Complications ◽  
Moderate Risk ◽  
Obstetric Practice ◽  
Thrombotic Complications ◽  
And Control

The objective: To evaluate the clinical efficacy and safety of Enoxaparin-Pharmex for the prevention of thrombotic complications (pulmonary embolism) in the postoperative period in patients with moderate risk of these complications. Patients and methods. The study included 50 women after a caesarean section had an average degree of risk of pulmonary embolism. Patients were divided into the main group (n=25) and control group (n=25) in accordance with the treatment: patients of the main group received postoperative Еnoxaparin- Pharmex, group comparisons enoxaparin sodium (brand foreign manufacturer’s). Patients in both groups received the drug at a dose of 20 mg for 5 days, 1 time per day subcutaneously. Results. The research data analysis showed identity results of hemostasiogram of patients in the main group and the comparison group, no side effects after treatment in both groups. Conclusion. The clinical studies suggest the drug Enoxaparin-Pharmex is effective, safe LMWH, which can be used to prevent troboembolic complications, including post-operative treatment in obstetric practice. Spectrum of Enoxaparin-Pharmex can be extended to the prevention and treatment of thromboembolic conditions of varying severity with appropriate doses of the drug. Key words: Enoxaparin-Pharmex, prevention of pulmonary embolism.

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