scholarly journals Didžiosios taukinės naudojimas pūliniam mediastinitui po vidurinės sternotomijos gydyti

2007 ◽  
Vol 5 (3) ◽  
pp. 0-0
Author(s):  
Gediminas Kundrotas ◽  
Vilija Jakumaitė
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Median Sternotomy ◽  
Morbidity And Mortality ◽  
Omental Flap ◽  
Greater Omentum ◽  
High Morbidity ◽  
Open Drainage ◽  
Hospital Department ◽  
Omental Transfer

Gediminas Kundrotas, Vilija JakumaitėKlaipėdos jūrininkų ligoninės Kardiochirurgijos skyrius, Liepojos g. 45, LT-92288 KlaipėdaEl paštas: [email protected] Įvadas / tikslas Mediastinitas po širdies operacijų lemia sunkią ligonių būklę ir didelį mirštamumą. Žinomi keli šios komplikacijos chirurginio gydymo metodai. Šiame darbe vertinami tarpuplaučio plastikos didžiąja taukine (omentoplastikos) rezultatai. Ligoniai ir metodai Klaipėdos jūrininkų ligoninėje nuo 2002 m. lapkričio 15 d. iki 2007 m. kovo 1 d. atliktos 1629 širdies operacijos per vidurinės sternotomijos pjūvį. 29 (1,8%) ligoniams operacija komplikavosi pūliniu mediastinitu, kuris buvo gydomas atviru būdu, uždaru būdu arba omentolpastika. Operacijos metodas priklausė nuo chirurgo pasirinkimo. Rezultatai Ligonių, kuriems atlikta omentoplastika, pooperacinė būklė buvo lengvesnė negu ligonių, kurie gydyti atviru ar uždaru būdu, trumpesnis jų gulėjimo laikas, mažesnis mirštamumas, rečiau prireikė pakartotinės chirurginės intervencijos. Omenpolastika sėkmingai atlikta ir tiems ligoniams, kuriems anksčiau laparoskopiškai buvo pašalinta tulžies pūslė. Išvados Omentoplastika yra geresnis mediastinitų gydymo metodas už atvirąjį ir uždarąjį metodus. Didžiąją taukinę omentoplastikai galima naudoti po buvusių laparoskopinių cholecistektomijų. Pagrindiniai žodžiai: vidurinė sternotomija, mediastinitas, omentoplastika The role of greater omentum in treating poststernotomy mediastinitis GEDIMINAS KUNDROTAS, VILIJA JAKUMAITĖKlaipėda Seamen’s Hospital, Department of Cardiac Surgery,Liepojos str. 45, LT-92288 Klaipėda, LithuaniaE-mail: [email protected] Background / objective Mediastinitis following median sternotomy causes high morbidity and mortality. Several mediastinitis treatment methods are known. We analyzed the results of plastic procedure with omental flap. Patients and methods Between November 15, 2002, and March 3, 2007, 1629 open heart procedures were performed using median sternotomy. Mediastinitis developed in 29 (1.8 %) patients. Open drainage, closed irrigation or omental transfer were used to treat mediastinitis. The choice of the procedure was made according to the surgeon’s preference. Results The patients treated by omental transfer had reduced morbidity and mortality as well as shorter treatment duration. The number of reoperations was also lower in this group. The omental flap was also successfully applied to patients who have previously undergone laparoscopic cholecystectomy. Conclusions The mediastinitis treatment by omental transfer is superior to open drainage or closed irrigation. The omental flap can be successfully used in patients who have previously undergone laparoscopic cholecystectomy. Key words: median sternotomy, mediastinitis, omental transfer

scholarly journals ROLE OF CARDIAC MARKERS IN CHRONIC RENAL FAILURE PATIENTS.

2020 ◽  
pp. 81-82
Author(s):  
Ramesh Chandra Thanna ◽  
B K Agarwal ◽  
Rakesh Romday ◽  
Neha Sharma
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Positive Association ◽  
Morbidity And Mortality ◽  
Control Group ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hs Crp

Introduction: Cardiovascular diseases (CVD) are known as important reasons of the increased morbidity and mortality observed in patients with chronic renal failure (CRF). The association of serum Interlukin-6 , homocysteine as well as other cardiovascular risk factors in relation to existence and cause of CVD were investigated. Method: In this study 200 CRF patients were recruited and further stratified into group with Male and Female as case groups. Those without renal failure were assigned as control group (n=200). Results: The patients with CRF showed a significant increase in plasma levels of Cpk-MB homocysteine and C-reactive protein (CRP) compared to control. The positive association were observed between homocysteine, Urea and Hs-CRP, IL_6 . It shows a significant Association of parameters in CRF . Conclusion: The results demonstrated elevation in plasma values IL-6 , homocysteine and HS-CRP in patients with CRF . However, these modifications may be lead to atherosclerosis and consequence CVD event. These parameters may be important with respect to the high morbidity and mortality of CVD found in patients with CRF.

scholarly journals The role of zinc supplementation for diarrhoea in children: a critical review

2019 ◽  
Vol 18 (2) ◽  
pp. 190-195
Author(s):  
Wulandari Berliani Putri ◽  
Syaefudin Ali Akhmad ◽  
Sufi Desrini
Keyword(s):  
Developing Countries ◽  
Zinc Supplementation ◽  
Controlled Trial ◽  
Medical Science ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Double Blind ◽  
Sanitation And Hygiene ◽  
Study Selection

Background: Nearly 1.7 million children suffer from diarrhoea and around 760,000 die each year. The high prevalence of diarrhoea in the developing countries is closely related to lack of safe drinking water, inadequate sanitation and hygiene, and poor health and nutritional status. These environmental conditions facilitate the spread of infectious disease easily. The great morbidity and mortality of this preventable and treatable disease raise concern on how to save children from this fatal disease by improving management of diarrhoea. Several studies suggest that zinc deficiency contribute towards high morbidity and mortality in diarrhoea. Further, there is an area of uncertainty regarding how significant zinc supplementation will help to reduce the duration and severity of diarrhoea in children compared to the diarrhoea management without zinc? Objective: To critically analyse the current evidences of zinc supplementation in diarrhoea. Data Sources: Keywords searching through MEDLINE Ovid database and additional references from retrieved articles. Study Selection: Limited to randomized controlled trial(RCT) study design and systematic review studies which were conducted from 2006 to 2016. However, there is one prospective cohort study included as it is a follow-up of subjects who participated in the previous double-blind randomized placebo-controlled trial. Data Synthesis: This review involves a summary of 10 articles that have been appraised on their relevance in evaluating the role of zinc in reducing severity and duration of diarrhoea in children. Further, the literature found is synthesised through method used in the studies and the effectiveness of zinc therapy Conclusion: Zinc is relatively safe to be used and it can improve diarrhoea management especially in developing countries. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.190-195

scholarly journals MDCT prior to median re-sternotomy in cardiovascular surgery: our experiences, infrequent findings and the crucial role of radiological report

2019 ◽  
Vol 92 (1101) ◽  
pp. 20170980 ◽  
Author(s):  
Tullio Valente ◽  
Giorgio Bocchini ◽  
Giovanni Rossi ◽  
Giacomo Sica ◽  
Hannah Davison ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Multidetector Ct ◽  
Recovery Period ◽  
Median Sternotomy ◽  
Graft Patency ◽  
Adverse Outcomes ◽  
High Morbidity ◽  
Increased Risk ◽  
Operative Strategies

Resternotomy (RS) is a common occurrence in cardiac surgical practice. It is associated with an increased risk of injury to old conduits, cardiac structures, catastrophic hemorrhage and subsequent high morbidity and mortality rate in the operating room or during the recovery period. To mitigate this risk, we evaluated the role of multidetector CT (MDCT) in planning repeat cardiac surgery. We evaluated sternal compartment abnormalities, sternal/ascending aorta distance, pre-reoperative assessment of the aorta (wall, diameters, lumen, valve), sternal/right ventricle distance, diaphragm insertion, pericardium and cardiac chambers, sternal/innominate vein distance, connection of the grafts to the predicted median sternotomy cut, graft patency and anatomic course, possible aortic cannulation and cross-clamping sites and additional non-cardiovascular significant findings. Based on the MDCT findings, surgeons employed tailored operative strategies, including no-touch technique, clamping strategy and cardiopulmonary bypass (CPB) via peripheral cannulation assisted resternotomy. Our experience suggests that MDCT provides information which contributes to the safety of re-operative heart surgery reducing operative mortality and adverse outcomes. The radiologist must be aware of potential surgical options, including in the report any findings relevant to possible resternotomy complications.

scholarly journals Vector Control of Zoonotic Arbovirus Disease in Indonesia

2017 ◽  
Vol 26 (4) ◽  
pp. 151
Author(s):  
Fitrine Ekawasti ◽  
Eny Martindah
Keyword(s):  
Economic Development ◽  
Vector Control ◽  
Behavioral Changes ◽  
Advanced Technology ◽  
Morbidity And Mortality ◽  
Global Trade ◽  
High Morbidity ◽  
Tropical Countries ◽  
Arbovirus Diseases

Zoonotic Arbovirus diseases which are caused by the genus of Flavivirus, Alphavirus, and Bunyavirus, are transmitted through potential vectors. These diseases are commonly occurred, especially in tropical countries, including Indonesia. They can affect the economic development because of the high morbidity and mortality. This paper describes the incidence of zoonotic Arbovirus in Indonesia and the strategy to control its vector. Factors that support the occurrence of zoonotic Arbovirus diseases are environmental, demographic and behavioral changes, as well as advanced technology, transportation and global trade. These diseases would not occur without the role of vectors. Vector control can be carried out effectively through longitudinal surveillance to identify types of potential vectors in the area. Therefore to prevent the increased incidence of the diseases, controlling the vector is necessary.

scholarly journals Role of β2 Integrins in Neutrophils and Sepsis

2020 ◽  
Vol 88 (6) ◽  
Author(s):  
Koichi Yuki ◽  
Lifei Hou
Keyword(s):  
Targeted Therapy ◽  
Adhesion Molecules ◽  
Therapeutic Intervention ◽  
Tissue Injury ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Β2 Integrin ◽  
Future Direction ◽  
Β2 Integrins

ABSTRACT Sepsis remains medically challenging, with high morbidity and mortality. A novel intervention is urgently needed in the absence of specific, targeted therapy. Neutrophils act as double-edged swords in sepsis; they can help to eradicate microbes, but they also contribute to tissue injury. β2 integrins are critical adhesion molecules that regulate a number of neutrophil functions. β2 integrins consist of four members, namely, αLβ2, αMβ2, αXβ2, and αDβ2. Here, we review the role of each β2 integrin in neutrophils and sepsis and consider future direction for therapeutic intervention.

scholarly journals Prophylactic antibiotics in acute pancreatitis: endless debate

2017 ◽  
Vol 99 (2) ◽  
pp. 107-112 ◽  
Author(s):  
MM Mourad ◽  
RPT Evans ◽  
V Kalidindi ◽  
R Navaratnam ◽  
L Dvorkin ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Multiple Organ ◽  
Prophylactic Antibiotics ◽  
Morbidity And Mortality ◽  
Current Evidence ◽  
High Morbidity ◽  
Antibiotic Administration ◽  
Infected Necrosis ◽  
Pancreatic Infection

INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis. RESULTS Mixed evidence was found to support and refute the role of prophylactic antibiotics in acute pancreatitis. Most studies have failed to demonstrate much benefit from its routine use. Data from our unit suggested little benefit of their routine use, and showed that the mortality of those treated with antibiotics was significantly higher compared with those not treated with antibiotics (9% vs 0%, respectively, P = 0.043). In addition, the antibiotic group had significantly higher morbidity (36% vs 5%, respectively, P = 0.002). CONCLUSIONS Antibiotics should be used in patients who develop sepsis, infected necrosis-related systemic inflammatory response syndrome, multiple organ dysfunction syndrome or pancreatic and extra-pancreatic infection. Despite the many other factors that should be considered, prompt antibiotic therapy is recommended once inflammatory markers are raised, to prevent secondary pancreatic infection. Unfortunately, there remain many unanswered questions regarding the indications for antibiotic administration and the patients who benefit from antibiotic treatment in acute pancreatitis.

Management of oesophageal anastomosis dehiscence after oesophagectomy for oesophageal cancer

2020 ◽  
Vol 99 (5) ◽  
pp. 200-206
Keyword(s):  
Oesophageal Cancer ◽  
Surgical Procedure ◽  
Anastomotic Dehiscence ◽  
Gastric Conduit ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Therapeutic Algorithm

Oesophagectomy is being used in treatment of several oesophageal diseases, most commonly in treatment of oesophageal cancer. It is a major surgical procedure that may result in various complications. One of the most severe complications is anastomotic dehiscence between the gastric conduit and the oesophageal remnant. Anastomotic dehiscence after esophagectomy is directly linked to high morbidity and mortality. We propose a therapeutic algorithm of this complication based on published literature and our experience by retrospective evaluationof 164 patients who underwent oesophagectomy for oesophageal cancer. Anastomotic dehiscence was present in 29 cases.

scholarly journals Tumor microenvironment and immune evasion in head and neck squamous cell carcinoma

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Areeg Elmusrati ◽  
Justin Wang ◽  
Cun-Yu Wang
Keyword(s):  
Squamous Cell Carcinoma ◽  
Immune System ◽  
Tumor Microenvironment ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
High Morbidity ◽  
Advanced Therapies

AbstractHead and neck squamous cell carcinoma (HNSCC), an aggressive malignancy, is characterized by high morbidity and low survival rates with limited therapeutic options outside of regional surgery, conventional cytotoxic chemotherapy, and irradiation. Increasing studies have supported the synergistic role of the tumor microenvironment (TME) in cancer advancement. The immune system, in particular, plays a key role in surveillance against the initiation, development, and progression of HNSCC. The understanding of how neoplastic cells evolve and evade the immune system whether through self-immunogenicity manipulation, or expression of immunosuppressive mediators, provides the foundation for the development of advanced therapies. Furthermore, the crosstalk between cancer cells and the host immune system have a detrimental effect on the TME promoting angiogenesis, proliferation, and metastasis. This review provides a recent insight into the role of the key inflammatory cells infiltrating the TME, with a focus on reviewing immunological principles related to HNSCC, as cancer immunosurveillance and immune escape, including a brief overview of current immunotherapeutic strategies and ongoing clinical trials.

scholarly journals Genetic and epigenetic mechanisms in the development of congenital heart diseases

2021 ◽  
Vol 4 (2) ◽  
pp. e000196
Author(s):  
Yue Wu ◽  
Xiaosi Jin ◽  
Yuhao Zhang ◽  
Jing Zheng ◽  
Rulai Yang
Keyword(s):  
Congenital Heart ◽  
Heart Diseases ◽  
Gene Mutations ◽  
Morbidity And Mortality ◽  
Molecular Medicine ◽  
Epigenetic Mechanisms ◽  
Epigenetic Factors ◽  
Near Future

Congenital heart disease (CHD) is the most common of congenital cardiovascular malformations associated with birth defects, and it results in significant morbidity and mortality worldwide. The classification of CHD is still elusive owing to the complex pathogenesis of CHD. Advances in molecular medicine have revealed the genetic basis of some heart anomalies. Genes associated with CHD might be modulated by various epigenetic factors. Thus, the genetic and epigenetic factors are gradually accepted as important triggers in the pathogenesis of CHD. However, few literatures have comprehensively elaborated the genetic and epigenetic mechanisms of CHD. This review focuses on the etiology of CHD from genetics and epigenetics to discuss the role of these factors in the development of CHD. The interactions between genetic and epigenetic in the pathogenesis of CHD are also elaborated. Chromosome abnormalities and gene mutations in genetics, and DNA methylations, histone modifications and on-coding RNAs in epigenetics are summarized in detail. We hope the summative knowledge of these etiologies may be useful for improved diagnosis and further elucidation of CHD so that morbidity and mortality of children with CHD can be reduced in the near future.

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