scholarly journals Results of the Use of Accelerated Rehabilitation Protocols after Surgery in Patients with Cystic Pancreatic Formations Undergoing Resection and Resection-Draining Interventions

2020 ◽  
Vol 13 (3) ◽  
pp. 167-176
Author(s):  
Andrey Petrovich Koshel ◽  
Evgenij Drozodv ◽  
Sergey Sergeevich Klokov ◽  
Tat'yana Dibina ◽  
Oksana E Kusakina
Keyword(s):  
Perioperative Management ◽  
Total Duration ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Rehabilitation Protocol ◽  
Number Of Patients ◽  
Accelerated Rehabilitation ◽  
Rehabilitation Protocols ◽  
Hospital Bed ◽  
Experimental Group

Introduction. The number of patients with cystic formations of the pancreas has increased significantly recently. Some of the patients need open or minimally invasive surgery. The implementation of ERAS (Enhanced recovery after surgery) protocols has been proved to be effective in orthopedics, bariatric and colorectal surgery. However, safety and feasibility of implementation of accelerated rehabilitation protocols in patients with cystic formations of the pancreas who underwent resection and resection-drainage interventions have not been sufficiently studied.The aim of the study was to assess the effectiveness and safety of implementation of the developed accelerated rehabilitation protocol in patients with cystic pancreatic formations who have undergone resection and resection-draining interventions.Material and methods. This research is a retrospective-prospective, single-center study. The study included 110 patients with cystic formations of the pancreas of various etiologies. All patients were divided into two groups: the control group consisted of 55 patients, their perioperative management was carried out according to standard protocols, and the experimental group consisted of 55 patients, their perioperative management was carried out according to the accelerated rehabilitation protocol developed in the clinic. All patients included in the study were exposed to surgery: resection and resection-draining interventions in various modifications were performed.Results. Patients in the studied groups were comparable by gender, age, body mass index, ASA score, preoperative albumin level. No statistically significant differences were found in the duration of the operation, intraoperative blood loss, or the frequency of blood transfusions. The overall complication rate was significantly lower in the experimental group compared with the control group (38,2% versus 58,2%, p = 0,03). Postoperative recovery of the gastrointestinal function was also faster in the experimental group. Thus, in the experimental group, the average time to the gas discharge was 2,1 0,8 days; in the control group - 3,1 1,1 days (p = 0,01); the average time to the first stool was 3,2 1,9 and 4,2 1,2 days, respectively (p 0,001). The total duration of the postoperative hospital bed per day was significantly lower in the experimental group compared with the control group (11,8 7,7 vs 16,2 13,2 days, respectively, p = 0,02).Conclusions. The study demonstrated safety and effectiveness of implementation of accelerated rehabilitation protocols in patients with cystic pancreatic formations who have undergone resection and resection-draining interventions. Implementation of the protocols allows reducing the duration of the postoperative hospital bed per day, incidence rate of complications, and also accelerating the gastrointestinal function recovery.

scholarly journals Application of Accelerated Activation in Retroperitoneal Video Endoscopic Adrenalectomy for Cushing Syndrome

2019 ◽  
Vol 15 (3) ◽  
pp. 19-30
Author(s):  
M. I. Neimark ◽  
R. V. Kiselev
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Analgesia ◽  
Perioperative Management ◽  
Control Group ◽  
Rehabilitation Protocol ◽  
Duration Of Stay ◽  
Endoscopic Adrenalectomy ◽  
Accelerated Rehabilitation ◽  
Rehabilitation Protocols

Purpose.To improve the immediate results of surgical treatment of endogenous hypercorticism throughoptimizing the perioperative management of patients using accelerated rehabilitation protocols.Materials and methods.A randomized prospective study of 53 patients with a body mass index 35 kg/m2 was carried out. In the control group (n=27), TIVA based on propofol was used with postoperative analgesia by systemic administration of opioids. In the accelerated rehabilitation protocol group (n=26), we used anesthesia based on low-flow inhalation of desflurane with sympatholytic mixture infusion in intra- and postoperative periods, multimodal postoperative analgesia, and use of accelerated rehabilitation protocol in the perioperative period. The time of patients' achievement of BIS90 index, time of extubation, time of achievement of 10 points by the Aldrete scale and 0 points by the Bidway test, duration of stay in the in-patient hospital, number of postoperative complications were assessed. Effectiveness of analgesia was evaluated by the time of the first analgesia requirement, consumption of narcotic analgesic, VAS and Verbal Descriptor scale.Results.The study revealed that the time of awakening and reaching 10 points by the Aldrete scale in patients of group 2 was significantly shorter than in group 1: 3 (2; 6) and 6.5 (3.5; 9) min respectively (P=0.046). They had fewer postoperative complications, shorter hospitalization time — 58 (39; 71) hours compared to the control group with 74.5 (58.5; 87) hours (P=0.032).Conclusion.Perioperative management of obese patients after retroperitoneal video endoscopic adrenalectomy with the use of accelerated rehabilitation protocols contributed to earlier mobilization, reduction of the number of complications in the early postoperative period, reduction of the duration of stay in the in-patient hospital, which together facilitates improving the immediate results of surgical treatment of endogenous hypercorticism.

Reproductive traits and blood biochemical parameters of sows when using a vitamin feed additive “LipoCar”

2020 ◽  
pp. 25-31
Author(s):  
I. A. Pushkaryev ◽  
N. M. Kostomakhin ◽  
S. V. Burtseva ◽  
N. A. Novikov
Keyword(s):  
Blood Serum ◽  
Biochemical Parameters ◽  
Total Duration ◽  
Reproductive Traits ◽  
Feed Additive ◽  
Control Group ◽  
Large White ◽  
Basic Diet ◽  
Blood Biochemical ◽  
Experimental Group

The reproductive traits of sows are of paramount importance in the production of high-quality pork. The world experience of pig farming shows the need to solve first of all the feed problem. Diets unbalanced in the content of vitamins restrain the manifestation of genetically inherent high prolificacy of sows. The purpose of the research was to study the influence of feeding the vitamin feed additive “LipoCar” on the reproductive traits of sows and the biochemical parameters of blood serum. The results of research on the introduction of vitamin feed additive “LipoCar” into the diet of pregnant sows have been presented in the article. The experiment has been carried out in the production conditions in JSC “Linevsky pedigree farm” on sows of Large White breed. Pregnant sows have received a basic diet, balanced for all the normalized elements of nutrition. Sows of the experimental group in the composition of the basic diet fed the feed additive “LipoCar”. The dosage of the drug “Lipocar” was 2,1 g/head/day. “Lipocar” has been fed for 20 days. The total duration of the experiment was 3 months. When introducing the vitamin feed additive “LipoCar” into the main diet of sows in the second half of pregnancy the increase in the number of piglets in the litter by 1,6-6,8 % and the weight of the litter – by 5,6-56,2 % (P ≤ 0,001) have been revealed in comparison with the control group of animals. There was a higher content of carotene in the blood serum of sows of the experimental group by 50,0 % (P ≤ 0,01), vitamin A - by 48,7 % (P ≤ 0,05), and total protein – by 4,9 % (P ≤ 0,05).

THE APPLICATION OF STATISTICAL METHODS IN EVALUATING THE RESULTS OF CLINICAL FINDINGS OF THE DRUG BOVHUALONIDASE AZOXIMER IN CATS WITH UROLOGICAL DISEASES

2020 ◽  
pp. 212-218
Author(s):  
А. V. Nazarova ◽  
◽  
B. S. Semenov ◽  
Т. Sh. Kuznetsova ◽  
◽  
...  
Keyword(s):  
Relative Risk ◽  
Side Effects ◽  
Risk Reduction ◽  
Absolute Risk ◽  
Control Group ◽  
Control Groups ◽  
Saint Petersburg ◽  
Number Of Patients ◽  
And Control ◽  
Experimental Group

In the period from November 2018 to August 2020, we conducted a randomized blind placebo-controlled confirmatory clinical trial in parallel groups on the basis of network of veterinary clinics in Saint Petersburg and Saint Petersburg state university of veterinary medicine. The purpose of the study: to evaluate the effectiveness of Bovhualonidaze azoximer(BA) in patients subjected to surgical intervention on the urethra and bladder, to prevent postoperative complications and relapses of the underlying disease. The frequency of complications was taken as an indicator of effectiveness. 80 cats were evaluated according to the criteria for inclusion in the study, after evaluation and randomization, 53 patients (24 and 29 cats in the experimental and control groups, respectively) who had indications for surgery on the urethra and/or bladder were included in the study. After the withdrawal of some patients, 38 cats were analyzed (17 and 23 cats in the experimental and control groups, respectively). Animals in the experimental group received BA drugs in addition to conventional therapy, and animals in the control group received placebo. The rate of complications in the experimental group was 11.8 %, in the control group-61.9 %. The relative risk was 19.0 %, and the relative risk reduction was 80.9 %. The chance of developing complications in the animals of the experimental group is 12.2 times lower than in animals of the control group.. Absolute risk reduction — 50.1 %, and the number of patients to be treated — 2 patients. The confidence interval for the risk of side effects of BA drugs in cats was 0.0-10.1 %. Based on the results of our clinical study, we proved that the use of BA drugs is effective for preventing complications during surgical interventions on the urethra and bladder, and the risk of side effects when using BA drugs in cats is insignificant

scholarly journals Effect of a telephonic intervention on the adherence of patients

2003 ◽  
Vol 59 (1) ◽  
Author(s):  
A. V. Stewart
Keyword(s):  
Health Behaviour ◽  
Salt Intake ◽  
Health Care Practitioner ◽  
Control Group ◽  
Behaviour Modification ◽  
Risk Factor Modification ◽  
Number Of Patients ◽  
Experimental Group ◽  
Factor Modification ◽  
Better Than

The effectiveness of a telephonic intervention in increasingpatients’ adherence to a health behaviour modification programme was tested. Patients were randomly assigned to two groups, the Experimental group receiving the telephonic intervention. Patients in the Experimental group showed greater adherence to the programme than the Control group (p=0.007). Their knowledge of hypertension improved (p=0.001) and was better than the control group (p=0.03), their exercise capacity improved (p=0.003) but not significantly more than the control group (p=0.09). They had a greater reduction in weight (p=0.004) which was significantly different from the Control group (p= 0.03). They were significantly less tired than the Control group (p=0.008). The Experimental group showed a reduction inthe number of patients with headaches (p=0.05) and dizziness (p=0.001). These changes were significant within the Experimental group but not between the two groups. The self reported risk factor modification revealed that more patients in the Experimental group could control their stress (p=0.05); more were controlling their salt intake (p=0.02) and more knew and were adhering to their medication regime (p=0.05). Both groups showed small reductions in blood pressure. The telephonic intervention involving the support of a health-care practitioner and a family member appeared to be effective in changing aspects of health behaviour.

scholarly journals Oxygen Sorption Treatment in the Treatment of Soft Tissue Wounds

2019 ◽  
Vol 12 (4) ◽  
pp. 248-253
Author(s):  
Dmitry Valerievich Arkhipov ◽  
Alexander Alekseevich Andreev ◽  
Dmitry Andreevich Atyakshin ◽  
Anton Petrovich Ostroushko
Keyword(s):  
Soft Tissue ◽  
Group Treatment ◽  
Local Treatment ◽  
Control Group ◽  
Wound Surface ◽  
Oxygen Sorption ◽  
Air Jet ◽  
Number Of Patients ◽  
Treatment Of Wounds ◽  
Experimental Group

Background. The number of patients with soft tissue wounds does not tend to decrease, which is largely due to the growth of patients with injuries, ulcerative defects, skin tumors, comorbid pathology, including diabetes mellitus, antibiotic-resistant strains and other causes. New methods of local treatment of wounds based on the application of the latest achievements of science are constantly being introduced into the work of surgical departments. High efficiency is demonstrated by the use of sorbents and oxygen, which enhance the reparative processes in wounds.The aim of the study was to study in experimental conditions the effectiveness of the method of surgical treatment of soft tissue wounds, based on the use of jet oxygen sorption treatment (SCS).Materials and methods. The study was performed on 150 white Wistar rats in 5 groups of animals. In the 1st control group treatment was not carried out. In the 2nd and 3rd control groups, the wound surface was treated with a jet of air and oxygen, respectively; in the 4th control group, sorbent was applied to the wound surface. In the 1st experimental group conducted scso wound surface. The study of the effectiveness of SCS was carried out using objective, planimetric, histological and histochemical research methods. Results. The use of sorbent (4th control group) and the method of jet oxygen sorption treatment (1st main group) led to the most pronounced positive changes-acceleration of relief of the studied symptoms by 1.1-1.3 times and 1.2 1.5 times, respectively, compared with the data obtained in the 1st control group. Treatment of wounds with oxygen jet (3rd control group) had practically no advantages in comparison with treatment with air jet (2nd control group).Conclusion. Indirectly, the highest activity of reparative processes during the observation period in the 4th control and 1st main groups was confirmed by the average optical density of RNA and SH-groups, and their desire to normalize to 10 days could indicate the completion of processes of stratification in the wound area. In total, the average area of wounds was minimal in the 1st experimental group, where this figure was by the 3rd and 10th days-74.0% and 99.5% compared to the baseline data.

scholarly journals The effect of three-component antihypertensive treatment on the structural and functional state of the heart and daily blood pressure profile in patients with hypertension grade 3

2019 ◽  
Vol 100 (6) ◽  
pp. 885-891
Author(s):  
N R Azaeva
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Functional State ◽  
Fixed Combination ◽  
Statistical Significance ◽  
Control Group ◽  
Daily Monitoring ◽  
Number Of Patients ◽  
Grade 3 ◽  
Experimental Group

Aim. To study the effect of a fixed combination of perindopril arginine (10 mg) + indapamide (2.5 mg) + amlodipine (5 mg) on the daily profile of blood pressure and the structural and functional state of the heart in patients with hypertension grade 3. Methods. 80 patients with hypertension receiving various variants of treatment [50 patients (experimental group) receiving fixed combination of perindopril arginine (10 mg) + indapamide (2.5 mg) + amlodipine (5 mg) and 30 patients (control group) receiving combination of lisinopril with hydrochlorothiazide (10/12.520/25 mg) and amlodipine (5 mg)] underwent electrocardiography, Doppler echocardiography, daily monitoring of blood pressure at there points: at the beginning, after 2 weeks and 6 months of the treatment. Statistical significance of the indicators was determined by Students t-test. To compare the double changes, 2 was used. Statistical difference between the groups was considered significant if p 0.05. Results. In 86% of patients from the experimental group, a decrease in systolic blood pressure by 20 mm Hg or more and/or diastolic blood pressure by 10 mm Hg was noted, which persisted for 6 months. After 6 months of treatment, according to daily monitoring of arterial pressure, the average daily systolic and diastolic blood pressure significantly decreased by 15.9 and 18.6% (р 0.001), and the values of variability of average systolic and average diastolic pressure at night and daytime by 4 and 4.2%, respectively (р 0.001). A decrease in the morning rise rate of systolic and diastolic blood pressure was also achieved (р 0.001). During treatment, a number of patients with a daily curve of the dipper type increased due to a decrease in non-dippers and night pickers (р 0.001). Conclusion. Positive antihypertensive result after treatment with a combination of perindopril arqinine + indapamide + amlodipin was achieved in the early stages of treatment and was observed as a long-term stable hypotensive effect; a number of patients with normal daily rhythm of blood pressure increased, decrease of the severity of hypertrophy and size of the left ventricle was observed and its diastolic function became normal.

scholarly journals Immunohistochemical Analysis of the Expression of the Glycodelin Cytokine in Endometrial Tissue and the Endometrial Polyp, Before and After Hysteroscopy, in Infertile Female Patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Aleksandar Dević ◽  
Ana Dević ◽  
Marija Šorak ◽  
Goran Zajić ◽  
Slobodanka Mitrović
Keyword(s):  
Immunohistochemical Analysis ◽  
Endometrial Tissue ◽  
Endometrial Polyp ◽  
Control Group ◽  
Immunohistochemical Expression ◽  
Female Patients ◽  
Number Of Patients ◽  
Before And After ◽  
Experimental Group ◽  
Infertile Patients

Abstract An endometrial polyp is most commonly a benign, localized proliferation of the glands and the endometrial stroma, covered with epithelium and protruding above the level of the mucosa. These polyps are most often diagnosed during investigation into the causes of irregular menstrual bleeding or infertility. It is produced in the highest concentration during the secretory phase of the endometrial cycle. The level of glycodelin reaches its peak 12 days after ovulation. The aim of this paper was to determine the changes in the immunohistochemical expression of glycodelin at the level of the endometrium and in the tissue of the polyp, before and after hysteroscopic polypectomy, in infertile female patients with an endometrial polyp, and in the endometrial tissue of female patients without an endometrial polyp. The study included 82 infertile female patients. The infertile patients were divided into two groups. The first was the experimental group which included 56 infertile female patients who had an endometrial polyp. The second group was the control group, composed of 26 infertile female patients who did not have an endometrial polyp. The results obtained primarily indicate the existence of changes in the immunohistochemical expression of the cytokine glycodelin in the female patients from both the experimental and the control group, not only prior to but also after hysteroscopy. A larger number of patients who have an endometrial polyp show a lack of glycodelin expression, more pronouncedly so in the bioptate of the endometrium than in the endometrial polyp.

Idiopathic coccygodynia as a ‘mask’ of lesions caused by overload in sports associated with the art of movement

2021 ◽  
Vol 16 (3) ◽  
pp. 110-114
Author(s):  
O.S. Vasilyev ◽  
◽  
S.P. Levushkin ◽  
E.E. Achkasov ◽  
O.A. Sultanova ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Indirect Evidence ◽  
Physical Rehabilitation ◽  
Pain Severity ◽  
Control Group ◽  
Rhythmic Gymnastics ◽  
Number Of Patients ◽  
Significant Difference ◽  
Muscle Hypertonia ◽  
Experimental Group

In this study, we analyzed specific manifestations of idiopathic coccygodynia in children and adolescents involved in rhythmic gymnastics and choreography. The experimental group consisted of 34 individuals aged 10 to 14 years with complaints of discomfort and/or pain in the pelvis, sacrum, coccyx, and hip joints, increasing during professional movements and who had no history of injuries. The control group comprised 12 healthy adolescents from the same teams. We evaluated local muscle hypertonia, pain severity (using a visual analog scale) in all study participants. In addition to that, they have undergone sports and choreographic testing and isokinetic examination (using the multiarticular complex ‘Biodex System 4 Pro’). Individuals in the experimental group had a 2-week rehabilitation course that included modification of training; intramuscular injections of 2.0 mL of 0.1% lidocaine solution into the area of muscle hypertonia; application of ointment (2.2 mL); manual therapy; special exercises to relax spasmed muscles). We identified significant difference in pain severity when performing basic choreographic elements between the two groups in the beginning of the study. We also observed a significant decrease in pain in the experimental group after the rehabilitation course. We obtained an indirect proof of the hypothesis that local muscle hypertonia is the leading cause of discomfort and pain. The results of isometric examination suggest that the number of patients with a bilateral difference (according to two of the three parameters studied) significantly differed between participants in the experimental group after a course of physical rehabilitation and controls. This fact can serve as an indirect evidence that hypertonia affects functional activation of muscles, and a 2-week course of physical rehabilitation is not sufficient. The introduction of the concept of ‘sports coccygodynia’ will allow orthopedic traumatologists and sports medicine doctors to focus on several therapeutic and diagnostic measures and to avoid unnecessary instrumental examination, which will significantly increase the effectiveness of patient rehabilitation. Key words: children and adolescents, muscle hypertonia, coccygodynia, lesions caused by overload, choreography, rhythmic gymnastics

scholarly journals Effectiveness of Integrated Education to Reduce Postoperative Nausea, Vomiting, and Dizziness after Abdominal Surgery under General Anesthesia

2021 ◽  
Vol 18 (11) ◽  
pp. 6124
Author(s):  
Yoonhee Seok ◽  
Eunyoung E. Suh ◽  
Soo-Young Yu ◽  
JeongYun Park ◽  
Hyunjin Park ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
General Anesthesia ◽  
Education Program ◽  
Postoperative Nausea ◽  
Rating Scale ◽  
Nursing Intervention ◽  
Control Group ◽  
Integrated Education ◽  
Number Of Patients ◽  
Experimental Group

This study presents an anticipatory integrated education program for nausea, vomiting, and dizziness prevention (anti-NVD education program) for patients undergoing abdominal surgery under general anesthesia. The anti-NVD education program for nephrectomy patients consisted of the following: the causes of postoperative nausea, vomiting, and dizziness; effective deep breathing and how to use an inspirometer; postoperative nausea and vomiting; effective methods of patient-controlled analgesia; and the stepwise standing up method to prevent dizziness. A study was conducted among 79 adults (experimental group: n = 40, control group: n = 39). The degree of nausea and dizziness was measured using a numerical rating scale (NRS), and vomiting and the frequency of antiemetic use were measured in terms of the number of patients. The experimental group, which received the anti-NVD education, showed remarkably lower levels of nausea (p = 0.013) and dizziness (p < 0.001) than the control group. The frequency of antiemetic use 48 hours after surgery was significantly lower in the experimental group (p = 0.03). This study proved the efficacy of the anti-NVD education program for reducing postoperative nausea and dizziness. This program can be used as a noninvasive nursing intervention to prevent nausea, vomiting, and dizziness among patients undergoing abdominal surgery.

scholarly journals INFLUENCE OF PIG STOCKING DENSITY ON PRODUCTIVITY DURING REARING

2020 ◽  
pp. 56-64
Author(s):  
Vita Buchkovska ◽  
Yulia Ievstafiieva
Keyword(s):  
Total Duration ◽  
Stocking Density ◽  
Live Weight ◽  
Climatic Conditions ◽  
Control Group ◽  
Livestock Density ◽  
Preparation Period ◽  
Feed Costs ◽  
Growth Energy ◽  
Experimental Group

The article presents the results of studying the effect of stocking density on the productivity of pigs while rearing.The research was conducted in PE "Kalynsky Klyuch" p. Kalyna Kamyanets, Podilskyi district, Khmelnytsky region. The scientific and economic experiment was performed by the method of analogous pairs, with a total duration of 73 days. The experiment was performed on young pigs for rearing. Animals were selected into groups based on age, life weight, health status, sex, fatness and growth energy during the preparation period. Four groups of pigs were formed. During the experiment, the animals were weighed, feed intake was taken into account, and their health was monitored. The productivity of young animals was determined according to the monthly individual weighing of animals, which were carried out 1-2 hours before morning feeding, and feed costs - based on group accounting. All data obtained in the experiment were processed biometrically. According to the results of the research, it was found that the most optimal is the density of pigs at the rate of 2.58 heads / m2. Analysis of the dynamics of live weight of experimental animals showed that with the same weight of piglets since the beginning of the rearing period and till the end of it, the weight of the animals differed significantly. The highest average live weight was recorded in the second experimental group, where there are 2.58 heads per 1 m2 of pigsty - 27.4 kg, and the lowest in the fourth experimental group, with a livestock density of 3.42 heads / m2, - 25.4 kg. The animals of the first control group (1.75 heads / m2) have a live weight of 27.3 kg, and the animals of the third experimental group (3.42 heads / m2) - 4.0% less. For farms in the fodder with natural and climatic conditions of the region, ready to use fodder as efficiently as possible and to obtain the maximum productivity of 4-breed hybrid piglets during the rearing period, we suggest using the livestock density at the level of 2.58 heads / m2 of the pigsty. Taking the recommendations into account is the way to achieve successful results in pig farming.

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