Comparative Analysis of the Efficiency, Safety, Predictability of Wavefront-Guided and Conventional FemtoLASIK Procedures in Low to Moderate Myopia

Purpose: to evaluate the effectiveness, safety, and predictability of the wavefront-guided FemtoLASIK using the Platoscan computer program and data from the KR-1W aberrometer, in comparison with the conventional algorithm FemtoLASIK in patients with low to moderate myopia.Patients and methods. There were 62 eyes of 62 patients with low to moderate myopia who had undergone FemtoLASIK procedure using an excimer laser ‘Microscan Visum” (Russia) and a femtosecond laser Femto LDV Z6 (Switzerland) in the study. In the “Wavefront” group which included 31 eyes with a mean spherical equivalent (SE) -=3,32 ± 1,23 D (M ± SD) was performed a wavefront-guided Femtosecond LASIK using aberrometer KR-1W (Japan) and a program for calculating the operation’s parameters “Platoscan” (Russia). “Standard” group included 31 eyes with an average SE –3.51 ± 1.21 D (M ± SD), who received the conventional FemtoLASIK. The “Wavefront” and “Standard” groups were comparable in terms of pre-operative data (age, sex, corneal curvature, central thickness of the cornea, sphere, cylinder, SE) (p > 0.05). All patients underwent complete ophthalmological examination before refractive laser surgery, and also patients were examined on the 1st day and 1 month after FemtoLASIK.Results. One month postoperatively, in the “Wavefront” group the UDVA 1.0 or better (20/20 or better by Snellen) was achieved in 93.5%, in the “Standard” group — in 96,8% (p > 0.05). There wasn’t observed a loss of the CDVA lines in both groups. In the “Wavefront” group, gain of one or more lines of the CDVA was in 38.7%, in the “Standard” group — in 12.9% (p = 0.04, Fisher’s exact test). In the “Wavefront” group the predictability of targeted refraction within ±0.5 D was in 93.5%, within ±1.0 D — in 100%, in the “Standard” group — in 90,3 and 100%, respectively (p > 0.05). The efficiency index in the “Wavefront” group was 1.00 (1.00; 1.20) (Me (Q25; Q75)), in the “Standard” group — 1.00 (1.00; 1,00) (Me (Q25; Q75)) (p > 0.05). The safety index in the “Wavefront” group was 1.00 (1.00; 1.20) (Me (Q25; Q75)), in the “Standard” group — 1.00 (1.00; 1,00) (Me (Q25; Q75)) (p > 0.05).Conclusions. The FemtoLASIK procedure, performed according to the conventional and wavefront-guided algorithms using the “Platoscan” computer program and data from the KR-1W aberrometer, is an effective, safe and predictable method for correcting low to moderate myopia, there is no statistically significant difference between two algorithms (p > 0.05).

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Time trend of axial length and associated factors in 4- and 5-year-old children in Shanghai from 2013 to 2019

International Ophthalmology ◽

10.1007/s10792-020-01637-5 ◽

2020 ◽

Author(s):

Tao Li ◽

Ting Wan ◽

Xiaoqian Yao ◽

Huihong Qi ◽

Xuefeng Chen ◽

...

Keyword(s):

Risk Factors ◽

Axial Length ◽

Associated Factors ◽

Time Trend ◽

Multivariate Analyses ◽

Body Height ◽

Spherical Equivalent ◽

Corneal Curvature ◽

Significant Difference ◽

The Relationship

Abstract Purpose To evaluate the time trend of axial length (AL) and associated factors in 4- and 5-year-old children in Shanghai from 2013 to 2019. Methods This was a 7-year observational study of 985 four-year-old and 1059 five-year-old children in Shanghai. AL, horizontal and vertical corneal curvature, spherical equivalent (SE), and body height and weight were measured. Furthermore, a questionnaire was collected, including time outdoors and bad eyesight habits. Results In 4-year-old children, no significant difference was found in AL (P = 0.526), but significant differences were observed in SE (P = 0.001), horizontal corneal curvature (P = 0.006), vertical corneal curvature (P = 0.004), height (P < 0.001), and weight (P = 0.022) from 2013 to 2019. In 5-year-old children, no significant differences were found in AL (P = 0.304), SE (P = 0.200), or weight (P = 0.292), but significant differences were observed in horizontal corneal curvature (P = 0.040), vertical corneal curvature (P = 0.015), and height (P < 0.001) from 2013 to 2019. Multivariate analyses revealed that AL was mainly significantly associated with boys and time outdoors in the 4- and 5-year-old children. Conclusions The AL of 4- and 5-year-old children remained relatively stable in Shanghai from 2013 to 2019. Longitudinal studies are needed to confirm the relationship between AL elongation and environmental risk factors.

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Method of the Cyclotorsion Error Compensation for Myopic Astigmatism during SMILE Surgery

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-3-351-360 ◽

2020 ◽

Vol 17 (3) ◽

pp. 351-360

Author(s):

G. A. Gamidov ◽

I. A. Mushkova ◽

S. V. Kostenev ◽

A. A. Gamidov

Keyword(s):

Functional Results ◽

Standard Group ◽

Spherical Equivalent ◽

Safety Index ◽

Safe Method ◽

Image Guided ◽

Astigmatism Correction ◽

The Mean ◽

Myopic Astigmatism ◽

Target Refraction

Purpose: to develop an effective and safe method of cyclotorsion compensation, to improve the clinical and functional results of the of myopic astigmatism correction with SMILE surgery.Patients and methods: Two equivalent groups of 30 people (30 eyes) were formed with cyclotorsion from ±5 degrees («Standard» and «Verion»). The correction for cyclotorsion was carried out only in the «Verion» group. Before the laser-refraction surgery, all eyes were examined using «Verion» image guided system (Alcon, USA) to determine cyclotorsion. In the «Verion» group, the obtained cyclotorsion data was used to aligement the astigmatism axis by Introducing into the «Visumax» femtolaser system. Further, the operation was carried out according to the standard protocol. At 3 months after SMILE surgery, all patients were examined by a UDVA, CDVA, objective refraction. Furthermore, efficiency and safety, as well as vector analysis of corneal astigmatism according to Alpins were calculated indices at 3 months after surgery.Results: The mean and standard deviation of cyclotorsion of the «Standard» and «Verion» groups was 6.16 ± 1.31 D and 6.30 ± 1.36 degrees, respectively (p > 0.05). The increasement of 1 or more UDVA lines was noted at 20 % and 7 %, respectively after 3 months in the «Standard» and «Verion» groups. The safety index (postoperative UDVA / preoperative UDVA) in both groups was not statistically significantly different (p > 0.05). The predictability of the spherical equivalent within ±0.5 D relative to the target refraction (emmetropia) in the «Standard» and «Verion» groups was 70 % and 100 %, respectively. The predictability of the cylindrical component of refraction within ±0.5 D relative to the target refraction (emmetropia) was 40 % and 90 % for the «Standard» and «Verion» groups, respectively (p < 0.05). Difference vector was 1.01 ± 0.59 D in the group «Standard» and 0.64 ± 0.33 D in the «Verion» group (p < 0.05). Correction index was 0.80 ± 0.43 in the «Standard» group and 0.99 ± 0.04 in the «Verion» group (p < 0.05).Conclusions: Сyclotorsion compensation using the «Verion» image guided system is a safe method. It improves the efficiency and predictability of correction myopic astigmatism in patient undergoing to SMILE surgery. This method recommended for patients with cyclotorsion from ±5 degrees and myopic astigmatism from –0.75 D.

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Mildly Reduced Doses of Adrenaline Do Not Affect Key Hemodynamic Parameters during Cardio-Pulmonary Resuscitation in a Pig Model of Cardiac Arrest

Journal of Clinical Medicine ◽

10.3390/jcm10204674 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4674

Author(s):

Deborah Jaeger ◽

Jonathan Koger ◽

Helene Duhem ◽

Caroline Fritz ◽

Victor Jeangeorges ◽

...

Keyword(s):

Cardiac Arrest ◽

Near Infrared ◽

Pig Model ◽

Wilcoxon Test ◽

Categorical Variables ◽

Standard Group ◽

Coronary Perfusion ◽

Exact Test ◽

Significant Difference ◽

Adrenaline Injection

Adrenaline is recommended for cardiac arrest resuscitation, but its effectiveness has been questioned recently. Achieving return of spontaneous circulation (ROSC) is essential and is obtained by increasing coronary perfusion pressure (CPP) after adrenaline injection. A threshold as high as 35 mmHg of CPP may be necessary to obtain ROSC, but increasing doses of adrenaline might be harmful to the brain. Our study aimed to compare the increase in CPP with reduced doses of adrenaline to the recommended 1 mg dose in a pig model of cardiac arrest. Fifteen domestic pigs were randomized into three groups according to the adrenaline doses: 1 mg, 0.5 mg, or 0.25 mg administered every 5 min. Cardiac arrest was induced by ventricular fibrillation; after 5 min of no-flow, mechanical chest compression was resumed. The Wilcoxon test and Kruskal–Wallis exact test were used for the comparison of groups. Fisher’s exact test was used to compare categorical variables. CPP, EtCO2 level, cerebral, and tissue near-infrared spectroscopy (NIRS) were measured. CPP was significantly lower in the 0.25 mg group 90 s after the first adrenaline injection: 28.9 (21.2; 35.4) vs. 53.8 (37.8; 58.2) in the 1 mg group (p = 0.008), while there was no significant difference with 0.5 mg 39.6 (32.7; 52.5) (p = 0.056). Overall, 0.25 mg did not achieve the threshold of 35 mmHg. EtCO2 levels were higher at T12 and T14 in the 0.5 mg than in the standard group: 32 (23; 35) vs. 19 (16; 26) and 26 (20; 34) vs. 19 (12; 22) (p < 0.05). Cerebral and tissue NIRS did not show a significant difference between the three groups. CPP after 0.5 mg boluses of adrenaline was not significantly different from the recommended 1 mg in our model of cardiac arrest.

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Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

Current Dentistry ◽

10.2174/2542579x02999200503032916 ◽

2020 ◽

Vol 2 (1) ◽

pp. 36-44

Author(s):

Satyawan G. Damle ◽

Ritika Bansal ◽

Dhanashree D. Sakhare

Keyword(s):

Success Rate ◽

Study Groups ◽

Primary Molars ◽

Control Group ◽

Second Primary ◽

Chi Square ◽

Exact Test ◽

Root Canals ◽

Significant Difference ◽

Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p>0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

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COVD-26. TELEPHONE CONSULTATIONS IN NEURO-ONCOLOGY DURING THE COVID-19 PANDEMIC: LEVELS OF PATIENT SATISFACTION AND COMPARISON WITH TRADITIONAL FACE-TO-FACE CONSULTATIONS

Neuro-Oncology ◽

10.1093/neuonc/noaa215.107 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii26-ii26

Author(s):

Emma Toman ◽

Claire Goddard ◽

Frederick Berki ◽

William Garratt ◽

Teresa Scott ◽

...

Keyword(s):

Patient Satisfaction ◽

University Hospitals ◽

Health Crisis ◽

Patient Satisfaction Questionnaire ◽

Telephone Consultation ◽

Exact Test ◽

Face To Face ◽

Significant Difference ◽

The Face ◽

The University

Abstract INTRODUCTION Controversy exists as to whether telephone clinics are appropriate in neurosurgical-oncology. The COVID-19 pandemic forced neuro-oncology services worldwide to re-design and at the University Hospitals Birmingham UK, telephone clinics were quickly implemented in select patients to limit numbers of patients attending hospital. It was important to determine how these changes were perceived by patients. METHODS A 20-question patient satisfaction questionnaire was distributed to patients who attended neuro-oncology clinic in person (“face-to-face”), or via the telephone. Fisher’s exact test was used to determine significance, which was set at p< 0.05. RESULTS Eighty questionnaires were distributed between June 2020 and August 2020. Overall, 50% (n=40) of patients returned the questionnaire, 50% (n=23) of face-to-face and 50% (n=17) telephone patients. Of those who received telephone consultations, 88% (n=15) felt the consultation was convenient, 88% (n=15) were satisfied with their consultation and 18% (n=3) felt they would have preferred to have a face-to-face appointment. Of those who attended clinic in person, 96% (n=22) felt their consultation was convenient, 100% (n=23) were satisfied with their consultation and 13% (n=3) would have preferred a telephone consultation. Within the face-to-face clinic attendees, only 13% (n=3) were concerned regarding the COVID risk associated with attending hospital. There was no significant difference in patient convenience or satisfaction (p=0.565 and p=0.174 respectively) between face-to-face and telephone clinics. There was no significant difference in whether patients would’ve preferred the alternative method of consultation (p > 0.999). CONCLUSION Our study suggests that careful patient selection for neuro-oncology telephone clinic is not inferior to face-to-face clinic. Telephone clinic during COVID-19 pandemic proved to be convenient, safe and effective. This global health crisis has transformed telephone neuro-oncology consultations from an experimental innovation into established practice and should be continued beyond the pandemic in select cases.

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AB0009 ASSOCIATION OF STAT4 RS7574865, RUNX1 RS9979383, IL6 RS1800795, IL6R RS2228145, IL6R RS4845618 WITH SYSTEMIC LUPUS ERYTHEMATOSUS SUSCEPTIBILITY AND SOME LUPUS MANIFESTATIONS IN BELARUSIAN POPULATION

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2523 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1039.2-1040

Author(s):

N. Dostanko ◽

V. Yagur ◽

R. Goncharova ◽

E. Siniauskaya ◽

T. Zybalova

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Diagnostic Odds Ratio ◽

Protective Role ◽

Fisher Exact Test ◽

Systemic Lupus ◽

Exact Test ◽

American College Of Rheumatology ◽

Healthy Donors ◽

Significant Difference

Background:Systemic lupus erythematosus (SLE) has a significant genetic predisposition. Many genetic variants of susceptibility to SLE have been published and analyzed, but the clinical and functional significance of the various genotypes has not yet been clearly defined [1].Objectives:To estimate the association between some of non-HLA gene polymorphisms such as STAT4 rs7574865, RUNX1 rs9979383, IL6 rs1800795, IL6R rs2228145, IL6R rs4845618 and susceptibility to SLE in Belarusian population as well as some disease manifestations.Methods:We examined 383 healthy blood donors and 54 SLE patients (18-72 years old, median age 35) classified according to the 1997 American College of Rheumatology (ACR) revised classification criteria [2]. Deoxyribonucleic acid was extracted from peripheral blood samples by phenol-chloroform method. Genotyping was performed by real-time PCR with fluorescent probes. Differences of distribution of all the single nucleotide polymorphism (SNP) genotypes and their associations with secondary antiphospholipid syndrom (APS) and lupus arthritis were analyzed using Pearson χ2 (χ2) and two-way Fisher exact test (F, p2-t). Diagnostic odds ratio (dOR), likelihood ratio of positive (LR +) and negative (LR –) tests and corresponding 95% confidence intervals (CI) were also calculated.Results:We revealed significant difference in STAT4 rs7574865 genotypes in SLE patients and healthy donors (χ2=8,27, р=0,016) with significant increase of ТТ genotype frequency in SLE patients vs healthy donors (χ2=6.83 p=0.009; p2-t =0.020; dOR=3.78 (CI95% 1.36-10.55); LR+ =3.44 (CI95% 1.35-8.71); LR– =0.91 (CI95% 0.83-0.98)). Lupus arthritis was more common in risk TT-genotype SLE carriers than in other SLE patients (χ2=5.902 p=0.015; p2-t =0.027).We revealed significant increase of СТ genotype (RUNX1 rs9979383) in healthy donors vs SLE patients (χ2=4.14; p=0.042; dOR=0.53 (CI95% 0.29-0.98); LR+ =0.69 (CI95% 0.45-0.99); LR– =1.3 (CI95% 1.01-1,56)). Lupus arthritis was more common in SLE СТ-genotype carriers than in other SLE patients (χ2=4.66 p=0.031; p2-t =0.058).Significant differences in IL6 rs1800795, IL6R rs2228145 and IL6R rs4845618 genotypes distribution between studied groups were not found (χ2, p=0.427, p=0.559 and p=0.407, correspondingly) but GG-genotype (IL6 rs1800795) carriership in SLE patients was associated with increased APS frequency (χ2=4.45, p=0.035; dOR=0.19 (CI95% 0.04-0.9); LR+ =0.28 (CI95% 0.07-0.93); LR– =1.41 (CI95% 1.03-1.64).Conclusion:Our data suggest the susceptibility to SLE in ТТ genotype of STAT4 rs7574865 polymorphism, protective role of СТ genotype of RUNX1 rs9979383 for SLE and association between GG-genotype of IL6 rs1800795 and APS in SLE patients in Belarusian population. Lupus arthritis was associated with ТТ genotype of STAT4 rs7574865 and СТ genotype of RUNX1 rs9979383.References:[1]Chen L, Morris DL, Vyse TJ. Genetic advances in systemic lupus erythematosus: an update. Curr Opin Rheumatol 2017;29:423–33.[2]Hochberg MC. Updating the American College of Rheumatology Revised Criteria for the classification of Systemic Lupus Erythematosus. Arthritis Rheum 1997;40:1725.Disclosure of Interests:None declared

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Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: a randomized controlled trial

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03329-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rémi Etienne ◽

Myriam Laurent ◽

Aline Henry ◽

Antoine Bioy ◽

Julia Salleron ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Neuropathic Pain ◽

Rating Scales ◽

Controlled Trial ◽

Standard Group ◽

Randomized Controlled ◽

Significant Difference ◽

Numerical Rating ◽

Reduction Of Pain ◽

The Impact

Abstract Background Neuropathic pain is characterized by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment. Methods In a randomized, controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the “Standard group” (no intervention), “Hypnosis group”, in which a standardized hypnotic message was played during application, or the “Music group” in which relaxing music was played during application of the patch. Results Sixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423). Conclusions Listening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures. Trial registration NCT02822625.

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Detection of AZF microdeletions and reproductive hormonal profile analysis of infertile sudanese men pursuing assisted reproductive approaches

BMC Urology ◽

10.1186/s12894-021-00834-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hassan Osman Alhassan Elsaid ◽

Tarteel Gadkareim ◽

Tagwa Abobakr ◽

Eiman Mubarak ◽

Mehad A. Abdelrhem ◽

...

Keyword(s):

Y Chromosome ◽

Klinefelter Syndrome ◽

Semen Analysis ◽

Control Group ◽

Male Factor ◽

Exact Test ◽

Fisher's Exact Test ◽

Infertile Men ◽

Significant Difference ◽

Fisher’S Exact Test

Abstract Background Male factor is the major contributor in roughly half of infertility cases. Genetic factors account for 10–15% of male infertility. Microdeletions of azoospermia factors (AZF) on the Yq region are the second most frequent spermatogenesis disorder among infertile men after Klinefelter syndrome. We detected in our previous study a frequency of 37.5% AZF microdeletions which investigated mainly the AZFb and AZFc. We attempted in this study for the first time to evaluate the frequencies of all AZF sub-regions microdeletions and to analyze reproductive hormonal profiles in idiopathic cases of azoospermic and oligozoospermic men from Sudan. Methods A group of 51 medically fit infertile men were subjected to semen analysis. Four couples have participated in this study as a control group. Semen analysis was performed according to WHO criteria by professionals at Elsir Abu-Elhassan Fertility Centre where samples have been collected. We detected 12 STSs markers of Y chromosome AZF microdeletions using a multiplex polymerase chain reaction. Analysis of reproductive hormone levels including Follicle Stimulating, Luteinizing, and Prolactin hormones was performed using ELISA. Comparisons between outcome groups were performed using Student’s t-test Chi-square test or Fisher’s exact test. Results AZF microdeletion was identified in 16 out of 25 Azoospermic and 14 out of 26 of the Oligozoospermic. Microdeletion in the AZFa region was the most frequent among the 30 patients (N = 11) followed by AZFc, AZFd (N = 4 for each) and AZFb (N = 3). Among the Oligozoospermic participants, the most frequent deletions detected were in the AZFa region (N = 10 out of 14) and was significantly associated with Oligozoospermic phenotype, Fisher's Exact Test (2-sided) p = 0.009. Among the Azoospermic patients, the deletion of the AZFc region was the most frequent (N = 9 out of 16) and was significantly associated with Azoospermia phenotype Fisher's Exact Test p = 0.026. There was a significant difference in Y chromosome microdeletion frequency between the two groups. The hormonal analysis showed that the mean levels of PRL, LH, and FSH in Azoospermic patients were slightly higher than those in oligozoospermic. A weak negative correlation between prolactin higher level and Azoospermic patients was detected. (AZFa r = 0.665 and 0.602, p = 0.000 and 0.0004, AZFb r = 0.636 and 0.409, p = 0.000 and 0.025, and AZFd r = 0.398 and 0.442, p = 0.029 and 0.015). The correlation was positive for AZFa and negative for AZFb and AZFd. Conclusions We concluded in this study that the incidences of microdeletions of the Y chromosome confined to AZF a, b, c and d regions is 58.8% in infertile subjects with 31.4% were Azoospermic and 27.5% were Oligozoospermic. This might provide a piece of evidence that these specified regions of the Y chromosome are essential for controlling spermatogenesis. These findings will be useful for genetic counseling within infertility clinics in Sudan and to adopt appropriate methods for assisted reproduction.

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To study or not to study abroad? students’ decision in perspective of motivations, barriers and attachment

Human Affairs ◽

10.1515/humaff-2021-0015 ◽

2021 ◽

Vol 31 (2) ◽

pp. 175-193

Author(s):

Filip Sulejmanov ◽

Klára Seitlová ◽

Martin Seitl ◽

Barbora Kasalová

Keyword(s):

Attachment Style ◽

Thematic Analysis ◽

Secure Attachment ◽

Thematic Structure ◽

Exact Test ◽

Studying Abroad ◽

Significant Difference ◽

Post Hoc ◽

Attachment Dimensions ◽

Inductive Thematic Analysis

Abstract The aim of this study is to explore the antecedents of studying abroad. First, we explore motivations for and barriers against studying abroad in two groups of students (who had studied abroad, and who had not studied abroad). Second, differences in attachment dimensions and styles are examined in both groups. A deductive thematic analysis supported the thematic structure identified by Krzaklewska (2008) in regard to motivations. Furthermore, five barriers were identified using inductive thematic analysis. Although the same motivational and barrier themes were found in both groups, there were some notable qualitative differences in meaning attached to them. A one-way MANOVA showed non-significant differences between the two groups of students and attachment dimensions. Finnaly, Fisher’s exact test was conducted, and the post hoc comparison showed that there was a statistically significant difference in the proportion of students who had studied abroad and had a secure attachment style compared to students who had not studied abroad.

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Επίδραση αναλόγου της προστακυκλίνης στην επούλωση αναστομώσεων του παχέος εντέρου επίμυων σε συνθήκες αποφρακτικού ειλεού

10.12681/eadd/33184 ◽

2012 ◽

Author(s):

Γεώργιος Γαλανόπουλος

Keyword(s):

Analysis Of Variance ◽

Anova Analysis ◽

Exact Test ◽

Fisher's Exact Test ◽

Significant Difference ◽

Fisher’S Exact Test

Στόχος της παρούσας διδακτορικής διατριβής ήταν η πειραματική μελέτη της επίδρασης της ιλοπρόστης (ανάλογο της προστακυκλίνης) στην επούλωση αναστομώσεων του παχέος εντέρου επίμυων σε συνθήκες αποφρακτικού ειλεού. Για τη μελέτη χρησιμοποιήθηκαν 80 άρρενες επίμυες, οι οποίοι χωρίστηκαν τυχαιοποιημένα σε 4 (1, 2, 3, 4) ομάδες, με 2 (α, β) ισοδύναμες υποομάδες έκαστη. Στην ομάδα 1 (ελέγχου) και 3 (ιλοπρόστη) διενεργήθηκε τμηματική εντερεκτομή και τελικοτελική αναστόμωση. Στην ομάδα 2 (ειλεός) και 4 (ειλεός και ιλοπρόστη) επιτεύχθηκαν αρχικά συνθήκες αποφρακτικού ειλεού και 24 ώρες μετά διενεργήθηκε τμηματική εντερεκτομή και τελικοτελική αναστόμωση. Η ιλοπρόστη χορηγήθηκε στις ομάδες 3 και 4 σε δόση 2μg/kg Β.Σ. σε 3ml διαλύματος NaCl 0,9% ενδοπεριτοναϊκά, διεγχειρητικά και κάθε ημέρα μέχρι τη θυσία, ενώ αντίστοιχα στις ομάδες 1 και 2 στα πειραματόζωα χορηγούνταν 3ml διαλύματος NaCl 0,9%. Σε κάθε ομάδα τα μισά πειραματόζωα (υποομάδα 1α, 2α, 3α, 4α) θυσιάστηκαν την 4η μετεγχειρητική ημέρα και τα υπόλοιπα (υποομάδα 1β, 2β, 3β, 4β) την 8η. Κατά τη νεκροτομή γινόταν μακροσκοπικός έλεγχος για ρήξη της αναστόμωσης, ύπαρξη περιτονίτιδος ή περιαναστομωτικού αποστήματος καθώς και ποσοτική αξιολόγηση των συμφύσεων σύμφωνα με την κλίμακα Van der Hamm. Ακολουθούσε μέτρηση της πίεσης διάσπασης και στη συνέχεια τμήμα της αναστόμωσης αποστέλλονταν για ιστολογική εξέταση κατά την οποία αξιολογούνταν η φλεγμονώδης αντίδραση (διήθηση από ουδετερόφιλα), η νεοαγγειογένεση, ο αριθμός των ινοβλαστών και η εναπόθεση νεοκολλαγόνου. Η ταξινόμηση των μικροσκοπικών ευρημάτων έγινε σύμφωνα με την κλίμακα Ehrlich και Hunt με τις τροποποιήσεις κατά Phillips. Επιπλέον, προσδιορίστηκε βιοχημικά η συγκέντρωση υδροξυπρολίνης και κολλαγενάσης I επί της αναστόμωσης. Για την συνοπτική παρουσίαση των αποτελεσμάτων υπολογίστηκαν απόλυτες και σχετικές συχνότητες (ποσοστά %), δείκτες κεντρικής τάσης (μέσοι όροι, διάμεσες τιμές) και δείκτες διασποράς (ελάχιστες τιμές, μέγιστες τιμές, τυπικές αποκλίσεις). Για τη σύγκριση των μέσων όρων χρησιμοποιήθηκε το κριτήριο της Ελάχιστης Σημαντικής Διαφοράς (Least Significant Difference-LSD), μετά από την εφαρμογή της μεθόδου ANOVA (Analysis of Variance). Για τις συγκρίσεις των ποσοστών, εφαρμόστηκε ο ακριβής έλεγχος του Fisher (Fisher’s Exact Test). Από την ανάλυση των πειραματικών δεδομένων προέκυψε ότι η ενδοπεριτοναϊκή χορήγηση ιλοπρόστης σε συνθήκες αποφρακτικού ειλεού, έχει ως αποτέλεσμα τον περιορισμό της αρνητικής δράσης του ειλεού στην επούλωση των αναστομώσεων του παχέος εντέρου. Συγκεκριμένα, την 4η και 8η μετεγχειρητική ημέρα ελαττώνει σημαντικά την απώλεια σωματικού βάρους. Επίσης, προάγει τη νεοαγγειογένεση, ενώ συγχρόνως αυξάνει τον πολλαπλασιασμό των ινοβλαστών και τη συγκέντρωση υδροξυπρολίνης. Επιπλέον, την 4η μετεγχειρητική ημέρα ελαττώνει τη φλεγμονώδη αντίδραση και μειώνει τη συγκέντρωση κολλαγενάσης Ι. Σταδιακά, την 8η μετεγχειρητική ημέρα αυξάνει τη σύνθεση νεοκολλαγόνου στην περιοχή της αναστόμωσης. Οι παραπάνω δράσεις έχουν ως αποτέλεσμα την αύξηση της μηχανικής ισχύος των αναστομώσεων, κατά την 4η και 8η μετεγχειρητική ημέρα, όπως αυτή προκύπτει από τη μέτρηση των πιέσεων διάσπασης. Συμπερασματικά, η άμεση μετεγχειρητική ενδοπεριτοναϊκή χορήγηση ιλοπρόστης ενισχύει τους μηχανισμούς επούλωσης και αντισταθμίζει την αρνητική δράση του ειλεού στην επούλωση των αναστομώσεων του παχέος εντέρου.

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