scholarly journals ACOUSTIC ANALYSIS OF VOICE MEAS- URES IN CHRONIC LARYNGITIS PATIENTS

2021 ◽  
Vol 67 (6) ◽  
pp. 46-51
Author(s):  
P.M. Kovalchuk ◽  
◽  
T.A. Shydlovska ◽  
Keyword(s):  
Significant Proportion ◽  
Harmonic Component ◽  
Noise Component ◽  
Acoustic Measures ◽  
Voice Signal ◽  
Chemical Factors ◽  
Chronic Laryngitis ◽  
Group 2 ◽  
The Voice ◽  
Group 1

We aimed to analyse voice signals in 40 patients with chronic laryngitis elicited by exposure to chemical factors. We ex- amined 20 people with catarrhal chronic laryngitis (group 1), 20 people with subatrophic chronic laryngitis (group 2) and 15 healthy volunteers as controls. All subjects underwent acoustic examination of the voice signal using the software Praat V 4.2.1. We studied acoustic measures as follows: Jitter, Shimmer and NHR (noise-to-harmonics ratio). The analysis of the obtained data revealed statistically significant differ- ences in the average values of Jitter and Shimmer measures, as well as in the ratio of nonharmonic (noise) and harmonic component in the spectrum ( NHR) in patients with chronic laryngitis (groups 1 and 2) compared with controls. In group 1 (chronic catarrhal laryngitis), the average values of acoustic measures such as Jitter, Shimmer and NHR were as follows: Jitter - 0.92 ± 0.1%, Shimmer - 5.31 ± 0.5%, NHR - 0.078 ± 0.04. In group 2 (subatorophic laryngitis), the average values of acoustic measures were: Jitter - 0.67 ± 0.6%, Shimmer - 6.57 ± 0.7% and NHR - 0.028 ± 0.003. The obtained data indicate a pronounced instability of the voice in frequency and amplitude, a significant proportion of the noise component in the spectrum of the voice signal in the examined patients with chronic laryngitis exposed to chemical factors. The most pronounced alterations were found in patients with catarrhal chronic laryngitis. We conclude that the quantitative values of spectral analysis of the voice signal Jitter, Shimmer, NHR may serve as valuable criteria of the degree of voice impair- ment. This may be helpful in determining the effectiveness of rehabilitation measures.

scholarly journals Values of laryngeal stroboscopy in patients with chronic laryngitis exposed to occupational factors

2021 ◽  
pp. 19-26
Author(s):  
Tetiana A. Shidlovskaya ◽  
Petro M. Kovalchuk
Keyword(s):  
Chemical Exposure ◽  
Functional Condition ◽  
Control Group ◽  
Production Environment ◽  
Occupational Factors ◽  
Vocal Apparatus ◽  
Chemical Factors ◽  
Chronic Laryngitis ◽  
Group 2 ◽  
Group 1

Topicality: Chronic laryngitis occupies one of the leading positions in the structure of laryngeal pathology. Among other things in the etiology of chronic laryngitis, occupational factors, including a chemical exposure, play an important role. Laryngeal storoboscopy is one of the most informative methods of examination of the vocal apparatus in phoniatrics that allows observing rapid oscillating motion of the vocal folds during phonation, which cannot be seen without instrumental methods. Aim: to investigate the functional condition of the vocal apparatus based on the values of laryngeal storoboscopy in patients with chronic laryngitis who were exposed to chemical factors. Materials and methods: Seventy-five patients with chronic laryngitis and 15 healthy individuals of the control group were examined. The patients were divided into groups based on the type of chronic laryngitis (group 1 one was made up of those who had a catarrhal type, group 2 had subatrophic type patients) and the intensity of chemical factors in the production of nitrogen compounds (subgroup A included patients who worked in manufacturing workshops where the level of chemicals in the air did not exceed maximum allowable levels, whereas subgroup B experienced an exposure to elevated chemical levels). Groups 1A and 2A included 23 and 20 patients, respectively; groups 1 B and 2B were composed of 17 and 15 patients, respectively. The patients underwent a specialized phoniatric examination and they were determined the maximum phonation time (MPT). We performed a video laryngeal stroboscopic examination on the equipment complex of «Karl Storz» (Germany). The results were evaluated by calculating the integrated score of phonator oscillations recorded during a stroboscopic study. Results and discussion: Patients with chronic laryngitis – employees of the public joint-stock company «AZOT» were examined. This is a large chemical production with several manufacturing workshops involved into various technological processes. According to the intensity of the influence of chemical factors, the manufacturing workshops differ significantly; therefore the intensity of the influence of the factors of the production environment on the upper respiratory tract varies in those working in the production of nitrogen-containing compounds. We compared the results of the survey of patients included in subgroups A and B. The MPT in patients of group 1A was 18.6±1.6 sec versus 13.6±1.2 sec in group 1B; in group 2A, it was 13.4±1.1 sec versus 10.8±0.8 sec in group 2B and 21.2±1.6 sec in the control group. Values in all study groups significantly (p<0.05) differed from the control. Also in groups 1B, 2A and 2B, the MPT was significantly lower than in group 1A. Thus, in patients with chronic laryngitis, who worked in conditions of increased exposure to chemicals present in the air of the production environment, the recorded MPT was significantly lower than in the controls, which is indicative of the impaired function of the vocal apparatus. Based on laryngeal stroboscopy findings, voice dysfunction revealed in patients with chronic laryngitis was more often manifested by changes in the vibratory cycle, desynchronized vocal apparatus and weakened amplitude of oscillations. According to the average score of video laryngeal stroboscopy in all groups of examined patients with chronic laryngitis, a significant (p &lt;0.05) difference was revealed in comparison with controls, as well as between some groups. In particular, in group 1A the integrated score of laryngeal stroboscopy data was 7.9±0.2, in 1B – 8.8±0.6, in 2A – 10.5±0.8 and in 2B – 12.1±1.0. The normal value is 5.010±0.001. Patients with higher scores had more severe laryngeal impairments and disease course. In group 2 (both A and B subgroups), changes according to video laryngeal stroboscopy were significantly more pronounced than in group 1A. In group 2B, the impairments were more severe as compared with both subgroups of group 1 and group 2A. Thus, in all studied groups of patients with chron ic laryngitis there are seen significant impairments of the vocal apparatus. At the same time, based on the findings of clinical methods and objective instrumental examination, there is a tendency to the deterioration in the functional condition of the vocal apparatus with increased chemical exposure in production. In particular, in groups B, compared with groups A, there is a marked increase in the desynchronization of vibrational oscillations, the number of cases with lack of stroboscopic comfort increases, the number of cases of hypertonia of the vestibular larynx increases. Similar trends apply to other parameters of video laryngeal stroboscopy in groups. On the whole, a quantitative assessment with the help of scores of integrated laryngeal stroboscopy allows accurate determining the severity of changes in the phonatory activity of the vocal apparatus and objectifying the diagnosis of chronic laryngitis against the background of chemical factors. The obtained data will be useful for improving the quality of diagnosis of voice disorders in chronic laryngitis, they can also be beneficial for vocational selection and addressing issues of occupational examination. Conclusions: 1. An impaired voice function according to laryngeal stroboscopy in patients with chronic laryngitis was manifested by changes in the vibratory cycle, mainly by desynchronized vocal apparatus and weakened amplitude of oscillations. 2. With the help of video laryngeal stroboscopy it is possible to objectify, quantify and determine the severity of phonatorial disorders in chronic laryngitis against the background of the exposure to chemical factors. 3. The degree of voice dysfunction according to laryngeal stroboscopy in patients with chronic laryngitis depends on the level of chemical exposure.

Activation of the PI3K/AKT signal transduction pathway is inversely associated with estrogen receptor levels and correlates with survival in hormone receptor-positive Her2/neu-negative breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10588-10588
Author(s):  
A. M. Gonzalez-Angulo ◽  
B. T. Hennessy ◽  
F. Meric-Bernstam ◽  
Y. Lu ◽  
W. F. Symmans ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Pik3ca Mutation ◽  
Significant Proportion ◽  
Stage I ◽  
Akt Pathway ◽  
Breast Cancers ◽  
Hormone Receptor Positive ◽  
Group 2 ◽  
Group 1

10588 Background: Hormone receptor-positive is the most common subtype of breast cancer. Despite the successes of antihormone therapy alone or combined with chemotherapy, a significant proportion of patients (30–40%) will have primary or acquired resistance to this treatment. There is a need to identify molecular markers to distinguish patients unlikely to benefit from therapy as well as novel targeted therapeutics that increase the response rate. Methods: We used a novel functional proteomics technology, reverse phase protein array (RPPA), to quantify expression and activation of 42 steroid and kinase signaling proteins in 64 hormone receptor-positive-Her2/neu-negative breast cancers from patients with stage I to III tumors managed with non-steroidal aromatase inhibitors ± chemotherapy. Unsupervised clustering analysis was used to molecularly group the tumors. Recurrence-free survival (RFS) was estimated with the Kaplan Meier product limit method and comparison was made using the Log-rank test. Correlation coefficients were used to look at the relationships between two variables. Results: Median age was 57 years (23–79). Sixteen patients (25%) had stage I tumors, 32 (50%) had stage II tumors and 16 (25%) had stage III tumors. There were two well-defined and distinct clusters of tumors: Group 1: ER high (n=25) and Group 2: PI3K/AKT activated (n=39). 3-year RFS estimates were 100% for group 1 and 59% for group 2 (p=0.04). There were thus clear inverse correlations between markers of activation of PI3K pathway and expression of ER (R for pAKT vs ER = -0.26, p=0.03). PIK3CA mutation was detected in 12/58 (21%) of hormone receptor-positive breast cancers and these tumors were found to have a proteomic signature distinct from PTEN loss with the former signature associated with a trend to improved RFS (p=0.06). Conclusion: Activation of the PI3K/AKT pathway in hormone receptor- positive-Her2/neu-negative breast cancer is inversely correlated with ER levels and associated with adverse outcome. At least in some cases, PI3K/AKT pathway activation, may be under the control of genomic aberrations. A validation set of 100 tumors treated with tamoxifen is on- going. No significant financial relationships to disclose.

scholarly journals The Utility of Capsule Endoscopy in Patients under 50 Years of Age with Recurrent Iron Deficiency Anaemia: Is the Juice Worth the Squeeze?

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Prabhjot Singh Sidhu ◽  
Mark E. McAlindon ◽  
Kaye Drew ◽  
Reena Sidhu
Keyword(s):  
Iron Deficiency ◽  
Capsule Endoscopy ◽  
Iron Deficiency Anaemia ◽  
Significant Proportion ◽  
Deficiency Anaemia ◽  
Significant Pathology ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background and Aims. The role of capsule endoscopy (CE) in the <50 years of age patients with iron deficiency anaemia (IDA) remains unclear. We aim to assess its utility in this cohort.Methods. All patients referred for CE for recurrent IDA were included retrospectively. Patients were divided into Group 1 (<50 years) and Group 2 (≥50 years).Results. There were 971 patients with recurrent IDA and 28% belonged to Group 1. The mean age was 40 years in this group with a DY of 28% (n=76). Significant diagnoses included erosions and ulcers (26%;n=71), small bowel (SB) angioectasia (AE) (10%;n=27), SB tumours (3%;n=7), Crohn’s disease (3%;n=7), SB bowel strictures (1%;n=3), and SB varices (1%;n=2). On logistic regression, the presence of diabetes (P=0.02) and the use of warfarin (P=0.049) was associated with increased DY. The DY in Group 2 was 38% which was significantly higher than in Group 1 (P=0.02). While SB tumours were equally common in both groups, AE was commoner in Group 2 (P<0.001).Conclusion. A significant proportion of patients <50 years are referred for CE. Although the DY is lower compared to those ≥50 years, significant pathology is found in this age group. CE is advisable in patients <50 years old with recurrent IDA and negative bidirectional endoscopies.

A Methodological Study of Perturbation and Additive Noise in Synthetically Generated Voice Signals

1987 ◽  
Vol 30 (4) ◽  
pp. 448-461 ◽  
Author(s):  
James Hillenbrand
Keyword(s):  
Additive Noise ◽  
Signal To Noise Ratio ◽  
Measurement Techniques ◽  
Voice Quality ◽  
Large Body ◽  
General Purpose ◽  
Measured Signal ◽  
Acoustic Measures ◽  
Voice Signal ◽  
The Voice

There is a relatively large body of research that is aimed at finding a set of acoustic measures of voice signals that can be used to: (a) aid in the detection, diagnosis, and evaluation of voice-quality disorders; (b) identify individual speakers by their voice characteristics; or (c) improve methods of voice synthesis. Three acoustic parameters that have received a relatively large share of attention, especially in the voice-disorders literature, are pitch perturbation, amplitude perturbation, and additive noise. The present study consisted of a series of simulations using a general-purpose formant synthesizer that were designed primarily to determine whether these three parameters could be measured independent of one another. Results suggested that changes in any single dimension can affect measured values of all three parameters. For example, adding noise to a voice signal resulted not only in a change in measured signal-to-noise ratio, but also in measured values of pitch and amplitude perturbation, These interactions were quite large in some cases, especially in view of the fact that the perturbation phenomena that are being measured are generally quite small. For the most part, the interactions appear to be readily explainable when the measurement techniques are viewed in relation to what is known about the acoustics of voice production.

scholarly journals THE USE OF MOLECULAR AND BIOCHEMICAL MARKERS OF BONE METABOLISM FOR SCREENING OF DENTAL HEALTH OF THE POPULATION

2020 ◽  
pp. 24-28
Author(s):  
O.O. Sydorenko ◽  
S.V. Pavlov ◽  
O.V. Voznyi
Keyword(s):  
Oral Cavity ◽  
Immunosorbent Assay ◽  
Oral Fluid ◽  
Clinical Laboratory ◽  
Periodontal Diseases ◽  
Enzyme Linked Immunosorbent Assay ◽  
Organic Components ◽  
Chemical Factors ◽  
Group 2 ◽  
Group 1

At present, the research interests of both dentists and clinical laboratory diagnosticians lie in the field of using oral fluid as an object of diagnostic estimation of molecular and biochemical markers in oral cavity diseases. It is commonly known that oral fluid has both organic and non-organic components. Non-organic components of saliva are represented by macro- and microelements that can be parts of various compounds or stay in the ionized form. Organic components are represented by proteins, carbohydrates, lipids, essential nitrogenous compounds (urea and uric acid), vitamins, hormones, organic and nucleic acids. Compared with the traditional method of blood testing, the identification of markers in the oral fluid has several advantages. They are non-invasiveness, atraumatic character for the patient, the absence of stress typical of venipuncture; simpler conditions of storage and transportation due to the liquid state (unlike whole blood, which tends to coagulate); being able to take biological material an unlimited number of times; no need for qualified personnel and special equipment when taking oral fluid. The introduction of biological markers into the complex of dental checkups is one of the topical tasks of modern dentistry and clinical laboratory diagnostics. This is particularly important for those dental patients whose living or working conditions are accompanied by harmful chemical factors. The authors have performed complex research of lactoferrin, cathelicidin, and MMP8 present in the oral fluid of 50 patients who worked under harmful conditions (group 1), and of other 50 patients whose work is not associated with the harmful influence of chemical factors (group 2). The oral fluid was collected on an empty stomach in the morning by spitting into a sterile glass tube. The biomass was centrifuged and stored at 300C, and the amount of lactoferrin (Hycto Biotech, the Netherlands), cathelicidin (Hycult Biotech, the Netherlands), and MMP8 (Matrix Metalloproteinase-8) was determined in the test samples. The analysis was performed by enzyme-linked immunosorbent assay based on the use of a "sandwich" variant of solid-phase enzyme-linked immunosorbent assay. The procedure was performed on the enzyme-linked immunosorbent assay ImmunoChem-2100 (USA). The analysis was performed in 96-well microplates, the bottom of the wells was covered with monoclonal antibodies to the corresponding molecular marker. The analysis of the oral cavity condition in patients of both groups demonstrated the presence of caries (100 % of group 1 patients, 80% of group 2 patients) and partial adentia (75% of group 1 patients, 60% of group 2 patients). Secondary to the above-mentioned abnormalities, group 1 and 2 patients had periodontal diseases. Such abnormalities were registered in 87% of group 1 patients; in group 2 patients, such changes were less explicit and were present in 67% of the patients. On the contrary, it was established that the patients of both groups presented with a statistically significant increase of lactoferrin in the oral fluid (on average, 81% and 40% higher, respectively, in groups 1 and 2) and MMP8 (64% and 24% higher), as well as a decrease in cathelicidin concentration (87% and 42% lower) in comparison with the patients of group 3. The established pathological biochemical changes indicate pathological processes in the oral cavities of the research groups of patients. In modern practice, Lf is used as an organ-specific marker of the activation of a pathological process to diagnose and predict the course of mucosal and periodontal diseases. At the same time, the decrease in oral cathelicidin LL37 reflects the suppression of local immunity in the oral cavity and is regarded as a pathogenic chain in the progression of diseases of the mucosa, periodontium, including dental caries in patients. Similar dynamics of cathelicidin in group 1 patients, in our opinion, explains the intensity of oral disease development in this category of patients. Thus, neutrophils and macrophages die under the action of aggressive chemical factors, as a result of which the pool of antimicrobial peptides, including cathelicidin, decreases. The present markers determine the topicality and great potential of further research of the given molecular markers for both fundamental investigations and understanding the pathogenesis of oral cavity diseases in this category of patients. Besides, these indices can be used as independent markers for diagnosis, screening, and effective treatment of oral cavity diseases.

scholarly journals Neurodegenerative Disease and the Experience of Homelessness

2021 ◽  
Vol 11 ◽  
Author(s):  
Stefanie Danielle Piña-Escudero ◽  
Lucía López ◽  
Sandeepa Sriram ◽  
Erika Mariana Longoria Ibarrola ◽  
Bruce Miller ◽  
...  
Keyword(s):  
Older Adults ◽  
Direct Relationship ◽  
Age Distribution ◽  
Significant Proportion ◽  
Case Series ◽  
Homeless Population ◽  
Research Participants ◽  
Age Related ◽  
Group 2 ◽  
Group 1

Introduction: Today, half of the American homeless population is older than 50 years of age. This shift in age distribution among people experiencing homelessness has challenged our long-held views of the causes of homelessness. Age-related neurological diseases, especially neurodegenerative diseases of the brain (NDDB), may play a role eliciting homelessness in a significant proportion of vulnerable older adults. This article aims to explore relationships between homelessness and NDDB in a cohort of research participants enrolled in observational studies on NDDB at an academic center.Methods: We reviewed charts of the Memory and Aging Center (MAC) of the University of California, San Francisco's database searching for research participants with NDDB that had direct relationship to homelessness. We reviewed all research visits conducted between 2004 and 2018 (N = 5,300). Research participants who had any relationship to homelessness were included in this analysis. NDDB was diagnosed via comprehensive neurological, functional, neuropsychological, and biomarker assessments. Non-parametric tests were used for analysis. Thirteen participants were found to have a direct relationship with homelessness. Seven were female and the median of education was 16 (IR: 12.0–19.5) years. Participants were divided into two groups: Those who experienced homelessness while symptomatic from a NDDB but before formal diagnosis (n = 5, Group 1); and participants with formally diagnosed NDDB who exhibited a new propensity toward homelessness (n = 8, Group 2). Compared to Group 2, participants in Group 1 were younger (p = 0.021) and showed similar results in the neuropsychological evaluation. In both groups, the most prevalent diagnosis was frontotemporal dementia. In Group 1, the majority of participants became homeless in the setting of a fragile socioeconomic situation and informants believed that NDDB contributed or caused their homeless state. In Group 2, a new propensity toward homelessness became manifest in different ways and it stood out that all of these participants were well-supported by family and friends during their illness.Conclusions and Relevance: This case series highlights the role that NDDB may have in precipitating homelessness among vulnerable older adults, particularly in the setting of challenging socioeconomic circumstances and unsupportive living environments. Social ramifications of these findings, particularly pertaining to challenges around rehousing these individuals is discussed.

scholarly journals Is it Necessary to Recommend Iodine Supplement to Pregnant Women Living in Areas with Adequate Iodine Intake?

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mahmood Sovid ◽  
Maryam Bahmani ◽  
Alamtaj Aamsami
Keyword(s):  
Pregnant Women ◽  
Significant Proportion ◽  
Urinary Iodine ◽  
Iodine Concentration ◽  
Iodine Intake ◽  
Thyroid Stimulating Hormone ◽  
Urinary Iodine Concentration ◽  
Cross Sectional ◽  
Group 2 ◽  
Group 1

Background: Iodine need is increased during pregnancy and its deficiency can lead to complications in mother and fetus. The latest international guidelines have recommended a higher intake of iodine. Iran has implemented a national salt iodization program since 25 years ago, and the general population is iodine-sufficient. However, recent studies have shown that a significant proportion of pregnant women have urinary iodine concentration (UIC) below the recommended range of 150 - 250 µg/L. Based on the results of these studies, iodine supplement during pregnancy is widely used, but this practice is controversial. Objectives: The aim of this study was to evaluate the necessity for iodine supplementation in pregnant women living in Shiraz, an iodine-replete area. Methods: In this cross-sectional case-control study, UIC and thyroid-stimulating hormone of 174 pregnant women taking 150 µg/day iodine (group 1) were compared with 124 pregnant women not taking the supplement (group 2). The proportion of women with UIC below the recommended level in each group was also determined. UIC of the women in different trimesters in each group was also investigated and compared. Results: Mean UIC in groups 1 and 2 was 175.71 ± 56.43 µg/Land 122.5 ± 44.37 µg/L and this difference was significant (P = 0.006). Also, 56% of women in group 2 and 24 % in group 1 had UIC below the recommended value (P < 0.01). Mean UIC in both groups decreased with advancing gestational age. In group 1, mean UIC remained in the recommended range, whereas in group 2, it decreased to less than 100 µg/L. Conclusions: In areas covered by the national salt iodine implementation program, it is necessary to recommend iodine supplement to pregnant women to prevent iodine insufficiency.

scholarly journals MEDICAL-SOCIAL PECULIARITIES OF CHRONIC INFLAMMATORY PROCESSES OF THE INTERNAL GENITAL ORGANS IN WOMEN AGAINST THE BACKGROUND OF VARICOSITY OF PELVIS MINOR

2021 ◽  
pp. 43-50
Author(s):  
N. V. Drohomyretska
Keyword(s):  
Physical Activity ◽  
Sexual Dysfunction ◽  
Negative Impact ◽  
Varicose Veins ◽  
Color Doppler ◽  
Significant Proportion ◽  
Control Group ◽  
Inflammatory Processes ◽  
Group 2 ◽  
Group 1

Aim of the research. Study the peculiarities of chronic inflammatory processes of the internal genital organs in women against the background of varicose veins of the pelvis minor. Materials and methods. In the comparative aspect, the main points of the clinical characteristics of 30 women of the control and 120 patients of the main groups (with chronic inflammatory processes of the internal genital organs against the background of varicose veins of the pelvis, isolated chronic inflammatory processes of the internal genital organs) are represented in the work. Results. Performed researches have shown that the vast majority of women in the group 1 were engaged in manual labor, of which 32 were workers ((47,1±6,1) %), 13 – were housewives ((19,1±4,8) %). The proportion of unemployed among patients of the group 2 was 1.2-fold higher than of the group 1, prolonged static load in a standing or sitting position was observed in 38 ((55,9±6,0) %) and in 7 ((10,5±3,7) %) cases, respectively; excessive physical activity, especially related to the lifting of loads – in 12 (23,1±4,6) %) and in 6 (11,05±4,4) %) cases, respectively; and this definitely made the negative impact on the venous hemodynamics. Statistical calculations showed that the risk of VPM (varicosity of pelvis minor) in female workers was significantly higher compared to the control group (OR 3,56; 95 % CI 1,29-9,80; p=0,02) and group 2 (OR 2,67; 95 % CI 1,21-5,86; p=0,02). Analysis of the peculiarities of genital function has shown that the early sexual activity (up to 18 years) was started by 19 ((27,9±5,4) %) women of the group 1, by 22 women ((42,3±6,9) %) – of the group 2, that was 1,8-fold more than in patients of the control group (7; (23,3±4,7) %). The women of the group 1 were found to have a significantly higher risk of sexual dysfunction compared to the group 2: dyspareunia (OR 2,39; 95 % CI 1,14-5,04; p=0,03) and anorgasmia (OR 2,60; 95 % CI 1,12-6,06; p=0,04). Regarding the use of contraceptives, it was found that almost half of the patients of the first group resorted to interrupted sexual intercourse, which adversely affects the venous hemodynamics of the pelvis and significantly increases the risk of VPM against the background of CIPIGO (chronic inflammatory processes of the internal genital organs) (OR 2,41; 95 % CI 1,11-5,24; p=0,04). Studying the reproductive history of patients, it was determined that women in the group 1 have had 3,4-fold higher birth parity compared to the group 2 (p<0,05), which can also be considered a leading risk factor for VPM. In addition, in the research groups there was a significant proportion of miscarriages (4,7-fold more in the group 1; p<0,05) and stillbirths, which may be a consequence of the past acute inflammatory diseases of specific etiology. Conclusions. Anamnestic data (static lifestyle and physical activity, miscarriages, high parity of childbirth), as well as peculiarities of the clinical course of chronic inflammatory processes of the internal genital organs in women against the background of varicose veins of the pelvis minor (severe chronic pelvic pain, swelling and aching fornices, dyspareunia, sexual dysfunction) should be the leading factors in the selection of patients for the use of an advanced diagnostic algorithm (ultrasound examination of the lesser pelvic veins in combination with color Doppler examination).

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

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