scholarly journals Clinical study of intra-abdominal pressure in the acute surgical abdomen

2017 ◽  
Vol 4 (8) ◽  
pp. 2512
Author(s):  
Kumari Neelam ◽  
Amit Kumar ◽  
Vineet Singh ◽  
Surjeet Kumar Yadav

Background: Intra-abdominal pressure (IAP) is the steady-state pressure concealed within the abdominal cavity. Early recognition of rising abdominal pressure is critically important, because it allows prompt intervention which will prevent Abdominal compartment syndrome (ACS) from developing, leading to a much better prognosis for the patient. This prospective case-control study was aimed at characterisation of this entity in the commonly encountered acute surgical abdomen i.e. perforation peritonitis, intestinal obstruction and the blunt abdominal trauma. The stress was laid upon the detection of the intra-abdominal pressure in the patients and the effect of this entity upon the routinely available clinical and laboratory parameters of organ functions. The organ systems studied were the renal, cardiovascular and the pulmonary systems. The clinical outcome was also analysed.Methods: This is a prospective study conducted in Rajendra Institute of Medical Sciences, Ranchi, Jharkhand over a period of one and half year (January 2014 to June 2015). A total of 120 patients were studied, including 30 as controls. The intra-vesicular pressure was measured in all the subjects, which indirectly gives intraabdominal pressure.Results: Initial intra-abdominal pressure ranged from 0-31 cm of saline with the mean of 13.77±8.46. The mean values of the intra-abdominal pressure in the study groups i.e acute surgical cases were found to be significantly higher, as compared to that of the control group (p<0.01). Highest mortality was observed in the IAP range of >25 cm of saline (33.33%, 4 out of 12).Conclusions: Raised intraabdominal pressure significantly affects outcome and increases mortality.

Author(s):  
Mesut A. Ünsal ◽  
Ülkü İnce ◽  
Sevil Cengiz ◽  
S. Caner Karahan ◽  
Turhan Aran

<p><strong>OBJECTIVE:</strong> We aimed to measure abdominal pressure and placental levels of malondialdehyde in patients with preeclampsia and investigate the relationship between intraabdominal pressure and clinical features of preeclampsia.<br /><strong>STUDY DESIGN:</strong> Study was conducted at a tertiary referral clinic. Study group consisted of patients with preeclampsia and control group consisted of normotensive pregnant women. Both placental malondialdehyde and intraabdominal pressure levels were studied in all patients. Intraabdominal pressure was assessed indirectly via a Foley bladder catheter both antepartum and postpartum period. Statistical comparisons among groups were made using the Mann-Whitney U test, independent T test and Chi-square test. Statistical significance was set as p&lt;0.05.<br /><strong>RESULTS:</strong> Study and control group consisted of 35 pregnant patients. The mean patients’ age, gravidity, parity, weight and BMI were not different between study and control groups. In the study group, Caesarean, preterm delivery and abdominal hypertension rate were significantly higher whereas the mean neonatal birth weight was lower. The mean antepartum and postpartum intraabdominal pressure levels were significantly higher in study group. The mean intraabdominal pressure was highest in patients with oliguria (19.8±1.8 cmH2O). Abdominal hypertension was detected in 30 (86%) patients in study group and in 3 (9%) patients in control group. The mean placental malondialdehyde level was significantly higher in patients with intraabdominal hypertension.<br /><strong>CONCLUSION:</strong> Abdominal hypertension rate is very high in patients with preeclampsia. Abdominal hypertension may have an additional role in preeclampsia.</p>


Author(s):  
D. Belyi ◽  
◽  
O. Nastina ◽  
G. Sydorenko ◽  
Z. Gabulavichene ◽  
...  

Objective. Analysis of comorbid pathology based on the use of methods for its quantitative assessment in persons who were exposed to radiation because of the Chornobyl accident. Materials and methods. Comorbid pathology was studied in 608 men, including 420 clean-up workers (CW) of the accident consequences at the Chornobyl NPP (main group) and 188 non-irradiated persons (control group – CG). All patients had cardiovascular diseases as their main pathology and were examined in the cardiology department of the NRCRM hospital during 2011–2019. The groups did not differ by age, either at the beginning of the accident or at the time of their last examination. Patients of both groups before the accident were practically healthy people and were not registered at the dispensary. The Cumulative Illness Rating Scale (CIRS) was used to quantify comorbid pathology. Results. Comorbid pathology was detected in 418 CW (99.5 %) and 183 patients of CG (99.3 %). The total score in CW (10.3 ± 2.9) units significantly (р = 0.000) exceeded the same index in non-irradiated patients (8.8 ± 3.0) units, as well as the mean number of CIRS categories, whose level severity was 1 point (3.3 ± 1.7 vs. 2.6 ± 1.5, р = 0.000), 2 points (1.8 ± 1.0 vs. 1.6 ± 1.0, p = 0.032) and 3–4 points (1.2 ± 0.8 vs. 1.0 ± 0.9, р = 0.062). In contrast, the mean value of the categories with zero score, i.e. without diseases, was more common in CG (7.8 ± 1.8 vs. 8.8 ± 1.7, р = 0.000). The most common pathology in CW and CG were heart (98.3 % vs. 94.7 %, р < 0.05) and vascular diseases (92.9 % vs. 87.8 %, р > 0.05), followed by diseases of nervous system (79.0 % vs. 57.4 %, р <0.001), musculoskeletal system and skin (69.8 % vs. 56.9 %, р < 0.01), endocrine (56.0 % vs. 49,5 %, р > 0.05) and the respiratory system (53.8 % vs. 53.7 %, р > 0.05) and liver (51.2 % vs. 36.2 %, р < 0.001), which were detected more than in half patients of the main group. Diseases of the kidneys (3.3 % vs. 4.8 %, р > 0.05) and lower gastrointestinal tract (3.3 % vs. 0.5 %, р < 0.01) were quite rare. The incidence of the other four CIRS categories was 18.6–34 %. The total score in subgroups with different ages varied in descending order of mean values as follows: CW > 65 years (10.5 ± 2.9) units, CW < 65 years (9.9 ± 2.8) units, CG > 65 years (9.5 ± 2.8) units and CG < 65 years (7.8 ± 2.9) units with significant differences both between age subgroups in each of the groups and between CW and CG older subgroups. Conclusions. Quantitative assessment of comorbidity by CIRS showed that in persons irradiated during their emergency work due to the Chornobyl accident, the incidence of combined pathology of such organ systems as cardiovascular, nervous, endocrine, hematopoietic, urogenital, musculoskeletal, gastrointestinal, liver and kidneys was significantly higher than in non-irradiated patients. In irradiated patients, the course of comorbid pathology was more severe for each system and in general, reflecting higher values of the total CIRS score. Both among CW and non-irradiated controls, higher values of the total comorbidity score were observed in patients 65 years and older, compared with younger individuals. In both age subgroups of CW the total score was higher than in patients of the control group. Key words: clean-up workers of the accident consequences at the Chornobyl NPP, ionizing radiation, comorbid pathology, chronic diseases.


Author(s):  
Ashraf Albrakati

Tramadol, a broadly in recent years, is an effective analgesic agent for the treatment of moderate to acute pain. Its metabolites are excreted by the kidney which may cause nephrotoxicity. Moringa oleifera leaves are commonly used to provide herbal and plant-derived medicinal products especially in developing nations. The present study was carried out to determine the biochemical and histopathological changes in the kidney of tramadol-treated albino mice and to evaluate the possible protective role of Moringa oleifera leaves against tramadol-induced nephrotoxicity. Twenty adult albino mice were divided into four groups. Control group (group i) received daily intraperitoneal injection of normal saline only, group ii received oral dose of Moringa oleifera leaves extract (20 mg/kg/bw) for three weeks, group iii received daily intraperitoneal dose of tramadol (0.3 mg/kg/bw) for the same period, group iv, received daily oral dose of Moringa oleifera leaves extract, (20 mg/kg/bw) three hours before injecting intraperitoneal dose of tramadol (0.3 mg/kg/bw), for the same period. Blood samples were withdrawn at the end of the experiment for kidney function tests and specimens from the kidney were processed for histological study. No significant differences in the mean values of the kidney function tests were noticed between Moringa oleifera group and control group. However, there was highly significant increase in the mean values of serum, urea and creatinine in tramadol-treated group as compared to the control group. Although tramadol + Moringa oleifera group revealed significant difference in the mean values of urea and creatinine when compared with tramadol-treated group. So, Moringa oleifera leaves extract have been shown to attenuate the renal dysfunction, improve the renal architecture, with nearly normalization of serum urea and creatinine levels which indicate improvement of renal function. In conclusion, in the light of biochemical results and histological findings, co-administration of Moringa oleifera leaves lessened the negative effects of tramadol-induced nephrotoxicity; possibly by its antioxidant action. Further investigation of these promising protective effects of Moringa oleifera leaves against tramadol-induced renal injury may have considerable impact on developing an adjunct therapy aiming to improve the therapeutic index of some nephrotoxic drugs.


2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.


2017 ◽  
Vol 3 (1) ◽  
pp. 24-28
Author(s):  
Claudiu Puiac ◽  
Janos Szederjesi ◽  
Alexandra Lazăr ◽  
Codruța Bad ◽  
Lucian Pușcașiu

Abstract Introduction: Elevated intraabdominal pressure (IAP) it is known to have an impact on renal function trough the pressure transmitted from the abdominal cavity to the vasculature responsible for the renal blood flow. Intraabdominal pressure is found to be frequent in intensive care patients and also to be a predictor of mortality. Intra-abdominal high pressure is an entity that can have serious impact on intensive care admitted patients, studies concluding that if this condition progresses to abdominal compartment syndrome mortality is as high as 80%. Aim: The aim of this study was to observe if a link between increased intraabdominal pressure and modification in renal function exists (NGAL, creatinine clearance). Material and Method: The study enrolled 30 critically ill patients admitted in the Intensive Care Unit of SCJU Tîrgu Mures between November 2015 and August 2016. The study enrolled adult, hemodynamically stable patients admitted in intensive critical care - defined by a normal blood pressure maintained without any vasopressor or inotropic support, invasive monitoring using PICCO device and abdominal pressure monitoring. Results: The patients were divided into two groups based on the intraabdominal pressure values: normal intraabdominal pressure group= 52 values and increased intraabdominal group= 35 values. We compared the groups in the light of NGAL values, 24 hours diuresis, GFR and creatinine clearance. The groups are significantly different when compared in the light of NGAL values and GFR values. We obtained a statistically significant correlation between NGAL value and 24 hour diuresis. No other significant correlations were encountered between the studied items. Conclusions: NGAL values are increased in patients with high intraabdominal pressure which may suggest its utility as a cut off marker for patients with increased intraabdominal pressure. There is a significant decreased GFR in patient with elevated intraabdominal pressure, observation which can help in early detection of renal injury in patients due to high intraabdominal pressure. No correlation was found between creatinine clearance and increased intraabdominal pressure.


2009 ◽  
Vol 28 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Irena Kafeđiska ◽  
Dejan Spasovski ◽  
Todor Gruev ◽  
Mane Grličkov ◽  
Kočo Cakalaroski ◽  
...  

Association Between Osteoarticular Scores and Acute Phase Reactant Levels in Rheumatoid Arthritis The aim of this prospective control study was a quantitative evaluation of the activity of rheumatoid arthritis (RA) in certain time intervals, using articular indexes (set of 28 sensitive and 28 swollen joints), laboratory parameters (Hb, Hct, Er, Le and Plt) and acute phase reactants (ESR, RF, CRP); to determine which of the acute phase reactants is the most useful biochemical marker for the evaluation of disease activity in RA; to quantify the therapeutical and laboratory differences in certain time intervals in the group with and without immunomodulatory therapy with Methotrexate. Sixty patients with RA were included, 27 of who were treated with non-steroid antiinflammatory drugs (NSAIDs) and Methotrexate (MTX). The control group consisted of 33 patients treated only with NSAIDs because of irregular controls. In the first group of patients the disease activity was estimated at four time intervals, and in the control group of patients at three time intervals following the scores of the articular indexes, blood cell counts, ESR and CRP in every patient. In the first group of patients decreased activity of RA was found upon every following control with a consecutive decrease in mean values of the scores of articular indexes with statistically significant differences at the four time intervals. Considering laboratory parameters, there were statistically significant differences in the mean values of Hb, Er, Plt, ESR, (p=0.0462, p=0.0076, p= 0.0058, p= 0.0003). Mean values of CRP did not show statistically significant differences, but the number of patients who were CRP negative increased (there were great standard deviations). In the group of patients treated only with NSAIDs, there were statistically significant differences in the mean values of the scores of articular indexes with an increse at every following control (in favour of progression of the disease). There were no statistically significant differences considering blood cell counts, ESR and CRP (in favour of permanently active disease). In conclusion, CRP is the most useful marker for the prospective follow-up of patients with RA.


2020 ◽  
pp. 028418512093837
Author(s):  
Sunay Sibel Karayol ◽  
Kudret Cem Karayol

Background The aim of this study is to investigate the role of diffusion-weighted imaging (DWI) in the differential diagnosis of sacroiliitis. Purpose To compare the sacroiliac magnetic resonance imaging (MRI) examinations of patients with suspected active sacroiliitis with patients with acute SpA MR findings and the DWI examinations of patients with acute brucella sacroiliitis, and thereby determine whether DWI can contribute to the differential diagnosis. Material and Methods A total of 84 patients were included in the study and were separated into three groups: group 1 (13 women, 6 men) comprised cases with brucella positive for sacroiliitis; group 2 (17 women, 19 men) comprised cases negative for brucella but with sacroiliitis; and group 3 (16 women, 13 men) comprised cases negative for brucella and sacroiliitis. Results The mean bone marrow apparent diffusion coefficient (ADC) values independently of edema were determined as 0.71 × 10−3 in sacroiliitis and brucella-positive patients, as 0.53 × 10−3 in brucella-negative and sacroiliitis-positive patients, and as 0.43 × 10−3 in the control group of brucella-negative sacroiliitis-negative patients. In the ADC measurements taken from areas of evident edema in patients with sacroiliitis, the mean values were 0.13 × 10−3 in the brucella-positive group and 0.12 × 10−3 in the brucella-negative group. Conclusion By adding DWI, which is a rapid MR sequence, to sacroiliac joint MR examination, normal bone marrow and bone marrow with sacroiliitis can be objectively differentiated with ADC measurements in addition to visual evaluation.


2020 ◽  
Vol 10 (2) ◽  
pp. 82-86
Author(s):  
Mushtaq Hussain Lashari ◽  
Sumbel Sumera ◽  
Umer Farooq ◽  
Zia Ur Rehman ◽  
Nuzhat Sial ◽  
...  

Background: Health problem are culturally associated with smoking in developing countries. Many hazardous chemicals are taken up by direct or passive smoking causing lipid peroxidation resulting in oxidative stress. Objectives: To estimate the occurrence of smoking and its effects on the lipid profile in populations of Hasilpur, Pakistan. Methodology: The current study was conducted from April - August 2014. Out of 247 apparently healthy subjects of both genders (male=220; female=27), 134 were smokers and 113 were non-smokers. In order to analyze lipid profile, blood samples were collected in early morning hours from the selected members who were asked to fast all night. By using Chem-100 chemistry analyzer, cholesterol, triglyceride, HDL, LDL and VLDL were analyzed. Results: The overall prevalence of smokers was 54.25%. The results showed 60.9% prevalence in males and 0% in females. The mean value of serum triglyceride in control, light smokers and heavy smokers was 147.4±11.7mg/dl, 190.8±41.4 and 205.3±29.7mg/dl, respectively. The results of cholesterol in control, light smokers and heavy smokers were 147.38±7.99mg/dl, 136.8 ±12. 8mg/dl and 173.44±8.63mg/dl, respectively. There was a considerable distinction in the mean level of serum triglyceride and cholesterol between the control group, light smokers and heavy smoker groups (P<00.5). The mean value of HDL of control, light smokers and heavy smokers was 30.93±1.30mg/dl, 31.10±2.45 and 34.58±1.55mg/dl, respectively. The mean values of LDL and VLDL of control, light smokers and heavy smokers were 110.46±3.63mg/dl, 106.00±4.52mg/dl, 117.19±3.48mg/dl and 33.54±3.11mg/dl, 49±9.02mg/dl, 41.06±5.34mg/dl, respectively. There was significant difference in the mean level of HDL, LDL and VLDL between the control group, light smokers and heavy smoker groups (P<0.05). Conclusion: This study concluded that smoking is the reasons of variation in the lipid profile. Elevated period of smoking and the number of smoked cigarettes/day reason the alteration in serum lipid levels and is probably related with increased danger for coronary artery disease.


2004 ◽  
Vol 16 (2) ◽  
pp. 207 ◽  
Author(s):  
A. Castro Neto ◽  
B.V. Sanches ◽  
S.H.V. Perri ◽  
M.M. Seneda ◽  
J.F. Garcia

The aim of the present study was to evaluate the effects of uterine double flushing on embryo recovery rates (total structures and viable embryos), after a resting period with the uterus filled with PBS. There were 210 embryo recovery procedures conducted using the uterine double flushing method, and the results were compaired with 432 conventional single flushing procedures. All procedures were conducted with Limousin (n=403) and Guzerá (n=239) cows, following the same superovulation protocol. Cyclic donors received a progestagen implant (CIDR) and 1mL of oestradiol benzoate (Estrogin®) at Day 0. Between Day 5 and Day 9 animals received doses ranging from 200 to 300UI (zebu cows) and 300 to 500UI (taurine cows) of FSH (Pluset® – Serono) in decreasing doses. Between Day 6 and Day 8 PGF2a (Ciosin®) was administered, followed by withdrawal of the progestagen after 24h. Artificial insemination was performed between 14 and 26h after the beginning of treatment. For the double flushing procedure, after the first uterine flushing of both horns with 1L DPBS (Nutricell), a Foley catheter was positioned in the uterine body in order to fill the uterus with the same solution (80 to 150mL). After this procedure the catheter was closed with a disposable 5-mL syringe gasket, and the animals were allowed to rest in the surroundings of the work place for 30min. After this period, a second flush was performed in order to recover the remaning liquid used during manipulation of the uterus. Animals from the control group (group A) were subjected to a single uterine flushing procedure. From 210 double flushing procedures (group B – test), 1409 viable embryos were produced, classified as grades I, II, III and IV (IETS), (average of 6.7 embryos per procedure), whereas, in the 432 single flushing procedure (group A – control), 1993 embryos were produced (average of 4.6). Statistical analysis showed the increase of viable embryo recovery rate. When consecutive double flushing was performed, the average of recovered embryos increased from 8.3 to 12.7 (P&lt;0.05) in Limousin cows, and from 7.9 to 11.5 (P&lt;0.05) in Guzerá cows. Comparing recovery after single flushing with that after double flushing, the mean number of viable embryos increased from 4.7 to 6.9 (P&lt;0.05) in Limousin cows and from 4.5 to 6.4 (P&lt;0.05) in Guzerá cows. In order to assure the nonexistence of negligence effects or operator influence on results, the mean values of total embryo recovery rate after single flushing (control group) was compared to the mean values of the same rate after the first uterine flushing on test group. Results indicated no difference between recovery rates. The present work showed the viability of using the uterine double flushing procedure for improvement of embryo recovery rates in cattle.


2020 ◽  
Author(s):  
Obeagu Emmanuel Ifeanyi

The hematological features of Gongronema latifolium, aqueous leaves extract was evaluated using standard methods. After 10 days of consecutive infusions into 9 experimental animals (rabbits). The rabbits were monitored and the following parameters determined; hemoglobin (HB), PCV, Platelet, WBC, Differential White Blood Cell. The Rabbits were grouped into 4, one consisting of control (group A), group B was fed with 0.5 mg/kg, group C with 1.0 mg/kg, and Group D with 1.5mg/kg of the aqueous extract of Gongronemalatifolium. The mean values obtained for hemoglobin estimation for the control group is 5.9 ± 4.1 g/dl, 9.1 ± 2.9 g/dl for group B 10.2 ± 1.8 g/dl for group C and 12.8 ± 0.1 g/dl for group D with no significant increase on the PCV estimation, the mean value for the control (group A) is 17.7 ± 12.3%, 27.3 ± 8.7% for group B, group C (30.6 ± 5.4%) and D (28.4 ± 0.3) show increase that statistically significant (p > 0.01). the platelet counts of group C (600 ± 0 x 109/L) and D(600 ± 0 x 109/L) show significant increase (p > 0.01) when compared with the control (600 ± 00). But the platelet value of group B (550 ± 50 x 109/L) shows no difference. No significant changes were observed in the White Blood Counts of the test groups B (3.5 ± 0.5 x 109/L), C (1.9 + 2.1 x 109/L) and D(3.6 ± 0.4) when compared with the control group (2.9 ± 1.9). The values obtained from the differential White Blood Counts (Neutrophils, Lymphocytes, Eosinophils and Monocytes) were not significant. Therefore, Gongronemalatifolium, when properly taken as a nutritional diet, causes beneficial changes on hemoglobin, packed cell volumes and platelet counts of consumers.


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