scholarly journals The Protocol-Personalized Perioperative Hemodynamic Management as Part of the ERAS Protocol in Abdominal Surgeries

2021 ◽  
Vol 18 (4) ◽  
pp. 55-61
Author(s):  
K. Е. Kharlamov ◽  
M. Ya. Yadgarov ◽  
V. V. Likhvantsev
Keyword(s):  
Perioperative Period ◽  
Control Group ◽  
Hemodynamic Management ◽  
Surgical Interventions ◽  
Abdominal Organs ◽  
Standard Management ◽  
Standard Patient ◽  
Group 2 ◽  
Personalized Approach ◽  
Eras Protocol

One of the options for solving the problem of a “non-standard” patient undergoing a major and traumatic operation, perhaps, is the protocol-personalized approach to hemodynamic management.The objective: to study the efficacy and safety of using a modified protocol-personalized approach to hemodynamic management during surgical interventions on abdominal organs in elderly and senile patients.Subjects and Methods. A randomized prospective-retrospective clinical trial was conducted in parallel groups: Group 1 (control) - standard management of the perioperative period; Group 2 - standard management supplemented by the protocol-personalized approach to hemodynamic management.Results. Patients in the main group had the best parameters as per MACE outcomes (RR: 0.462, [95% CI: 0.251-0.850] p = 0.038). In the intra- and postoperative period, patients in the control group had a relatively higher risk of arrhythmias (RR: 2.517 [95% CI: 1.218; 5,200] p = 0.017).Conclusion. The use of the protocol-personalized approach results in better MACE outcomes (RR: 0.462, 95% CI: 0.251-0.850; p = 0.038) during surgical interventions on the abdominal organs in elderly and senile patients, and also, reduces the risk of arrhythmias (RR: 2.517, 95% CI:1.218; 5.200) p = 0.017.

Assessment of myocardial remodeling in the perioperative period of coronary artery bypass grafting: effects of prehabilitation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Argunova ◽  
A Korotkevich ◽  
E Moskin ◽  
S Pomeshkina ◽  
O Barbarash
Keyword(s):  
Coronary Artery ◽  
Myocardial Perfusion ◽  
Postoperative Period ◽  
Artery Bypass ◽  
Perioperative Period ◽  
Control Group ◽  
Bypass Grafting ◽  
Myocardial Remodeling ◽  
Group 2 ◽  
Group 1

Abstract Purpose To assess serial changes in the morphological and functional parameters, and indicators of myocardial perfusion in the perioperative period of coronary artery bypass grafting (CABG), depending on the preoperative management strategy. Methods 60 male patients with stable coronary artery disease (CAD) were randomized into two groups before on-pump CABG. Group 1 patients (n=30, aged of 61.5 [56; 63] years) underwent treadmill training at 80% of VO2max for a 7-day period. Group 2 patients (n=30, aged of 62.0 [56; 64] years) underwent routine management without prehabilitation. Cardiac morphological and functional parameters were evaluated using echocardiography in the preoperative period and 5–7 days after CABG. Adenosine loading single-photon emission computed tomography (SPECT) was used to measure the parameters of myocardial perfusion before and after the indexed CABG. Data were processed using the QPS program (Cedars Sinai Medical Center (USA)) and the 17-segment polar mapping. Statistical analysis was performed using commercially available Statistica 10.0 software package (Statsoft, USA). Results Both groups demonstrated a decrease in LVEF in the postoperative period. However, an LVEF decline in Group 1 patients was less significant (p=0.00015) than in the control group (p=0.000003). LV end-systolic dimension increased by 8.5% and LV end-systolic volume by 18% in patients who underwent prehabilitation as compared to the baseline, whereas these changes were more pronounced in the control group (17% (p=0.00029) and 41% (p=0.00028), respectively). Group 1 patients demonstrated better myocardial perfusion parameters in the postoperative period. Patients in the prehabilitation group reported higher accumulation levels of radiopharmaceuticals in the basal (75.0 [72.5; 80] and 72.0 [70; 75]%, p=0.036), middle (87.0 [83; 91] and 81.0 [77; 84]%, p=0.012) and apical (86.0 [82; 89] and 82.0 [78; 86]%, p=0.037) myocardium as compared with those in the control group. The stress-induced ischemia (SDS) was less pronounced in Group 1 compared to Group 2 (p=0.025). Conclusion Optimized myocardial remodeling parameters and improved myocardial perfusion in the postoperative period have proved the effectiveness of high intensity physical trainings introduced in the prehabilitation program for CABG. Funding Acknowledgement Type of funding source: None

Radiation Monitoring of the State of the Internal Organs in Newborns with General Therapeutic Hypothermia

2020 ◽  
Vol 65 (1) ◽  
pp. 48-53
Author(s):  
N. Vorotynceva ◽  
V. Orlova
Keyword(s):  
Therapeutic Hypothermia ◽  
Perinatal Asphyxia ◽  
The State ◽  
Control Group ◽  
Observation Group ◽  
X Rays ◽  
Internal Organs ◽  
Abdominal Organs ◽  
Negative Effect ◽  
Group 2

Purpose: Learning the state of the internal organs in newborns with severe perinatal asphyxia after general therapeutic hypothermia. Material and methods: 80 newborns with severe perinatal asphyxia born from January 2014 to May 2019 in Kursk were under observation. In the first 6 hours of life, 52 patients were started with general therapeutic hypothermia (1st observation group), 28 newborns did not perform hypothermia (2nd control group). All children underwent a dynamic complex radiological examination, included ultrasound of the brain, abdominal organs and retroperitoneal space, echocardiography with Doppler, chest X-rays. Results and discussion: In both groups of observations, radiation symptoms of liver and gallbladder changes were identified: a uniform increase in the echogenicity of the hepatic parenchyma (98.1 % of cases in group 1 and 100 % of cases in group 2, p > 0.05), visual “impoverishment” of the vascular pattern (98.1 % and 100 %, p > 0.05), hepatomegaly (19.2 % and 21.4 %, p > 0.05), thickening of the gallbladder walls, loose sediment or suspension in its lumen (7.7 % and 10.7 %, p > 0.05). All 80 examined patients showed a bilateral increase in echogenicity of the renal parenchyma with visual impoverishment of intraorgan blood flow and impaired corticomedullary differentiation. The described internal organs changes were reversible and due, in our opinion, mainly to the effect of asphyxiation and resuscitation measures. According to the results of chest X-ray, we did not reveal the effect of therapeutic hypothermia on the incidence of hospital pneumonia: it was found in 34.6 % newborns from the 1st group and in 42.9 % – from the 2nd one (p > 0.05). However, in the first 14 days of life the respiratory failure caused by edematous and hemorrhagic changes in patient’s lungs was detected more often in patients from observation group then in patients from control group: respectively 76.9 % and 42.8 % of cases (p <0.05). This indicates a negative effect of general therapeutic hypothermia on the respiratory system of newborns with severe perinatal asphyxia.

Otitis media with effusion in children and its association with deformity of the vomero-ethmoid suture

1983 ◽  
Vol 97 (3) ◽  
pp. 203-212 ◽  
Author(s):  
W. D. McNicoll
Keyword(s):  
Otitis Media ◽  
Surgical Intervention ◽  
Otitis Media With Effusion ◽  
Head Injuries ◽  
Control Group ◽  
Secretory Otitis Media ◽  
Surgical Interventions ◽  
History Of ◽  
Group 2 ◽  
Group 1

AbstractFifty children aged between five and eight years of age who have had proven otitis media with effusion have been retrospectively assessed. Twenty-five children who had attended the Casualty Department with head injuries, who have had X-radiography of their skulls as part of their investigation, acted as controls. All the children in this group were selected because they had no otological history.The 50 Children comprising the retrospective survey were split into two groups: Group 1, with recurrent secretory otitis media requiring surgical intervention on more than three occasions; Group 2, comprising 25 children who had had up to three surgical interventions.All the children had PA X-radiography of their skulls in order to demonstrate the bony nasal septum. In Group 1, a septal deformity was found to be sited at the middle third of the bony septum at the vomero-ethmoid suture. In Group 2, the deformity was found to involve the whole of the middle third of the bony septum, plus portions of the upper and lower thirds of the bony septum.In the control group, in whom there was no history of otological disease, there was no deformity sited at the middle third of the bony septum.

scholarly journals Combined multimodal anesthesia for abdominal surgeries in children

2020 ◽  
Vol 24 (3) ◽  
pp. 188-193
Author(s):  
T. S. Agzamxodjaev ◽  
Otabek Ya. Fayziev ◽  
A. S. Yusupov ◽  
N. N. Turaevna
Keyword(s):  
Epidural Anesthesia ◽  
Anesthetic Management ◽  
Medical Problem ◽  
Epidural Block ◽  
Control Group ◽  
Early Enteral Nutrition ◽  
Inhalation Anesthesia ◽  
Surgical Interventions ◽  
Gradual Development ◽  
Group 2

Introduction. The article presents findings which may be useful for solving an urgent medical problem on the adequacy of anesthetic management during planned surgical interventions in children with abdominal pathology. Purpose. To compare the effectiveness of combined multimodal anesthesia and multicomponent neuroleptanalgesia in abdominal interventions in children by evaluating central and peripheral hemodynamics. Material and methods. 96 children, aged 1-17, who had various surgical pathologies and were operated on, were examined. In 52% of patients (n = 50), a combined multimodal anesthesia with Propofol, Fentanyl, epidural anesthesia and Sevoflurane was used (main group 1); and in 48% of patients (n = 46), a multicomponent neuroleptanalgesia with Droperidol and Fentanyl combined with epidural anesthesia was used (control group 2) . Results. Trial findings showed that hemodynamics stability is determined by a differential blockade of sympathetic fibers and by a gradual development of epidural block at the level of segmental innervation of surgical intervention zone, thus preventing disorders in parameters of central hemodynamics. Conclusion. The combined multimodal anesthesia as a part of epidural block and inhalation anesthesia with Sevoflurane contributes to a high controllability of anesthesia, to the smooth course of the most traumatic stage, early enteral nutrition, early activation and rehabilitation of patients, starting from the first hours in the intensive care unit, which is an important factor in the prevention of postoperative complications.

scholarly journals Change in the value of the QT interval at various stages of the perioperative period in patients with coronary ischemic heart disease under general anesthesia

2021 ◽  
Vol 24 (3) ◽  
pp. 22-32
Author(s):  
Vadim P. Mikhin ◽  
Sergey A. Sumin ◽  
Natalja A. Volkova ◽  
Elena N. Bogoslovskaya ◽  
Pavel A. Eremin ◽  
...  
Keyword(s):  
Qt Interval ◽  
Open Cholecystectomy ◽  
Perioperative Period ◽  
Control Group ◽  
Qtc Interval ◽  
Perioperative Therapy ◽  
Qtc Interval Prolongation ◽  
The Status ◽  
Group 2

Objective. To evaluate the status of QT interval derivatives in patients with chronic IHD during different perioperative periods of planned open cholecystectomy under general anaesthesia and to determine the possibility of using meldonium for prevention of QT interval dysfunction. Materials and methods. Patients with the diagnosis of cholelithiasis with verified forms of chronic CHD (angina I and II AC) were divided into 2 groups: Group 1 was the control group with conventional perioperative therapy, and Group 2 was the main group with additional meldonium. The dynamics of the corrected QT interval (QTc) and the variance of the QT interval (DQT) were assessed. Analysis was performed by means of daily Holter ECG monitoring, in which 6 time periods were singled out: 1 - the day before the operation (18 hours); 2 - hours before the operation; 3 - induction into anesthesia; 4 - maintenance of anesthesia; 5 - withdrawal from anesthesia; 6 - the day 2 after the operation (18 hours). Results. The increase in QTc and DQT values during induction, maintenance and withdrawal from anesthesia was detected only in the control group. The inclusion of meldonium in perioperative therapy in patients with CHD was accompanied by the absence of QTc interval prolongation and an increase in DQT values in the periods of induction, exit and maintenance of anaesthesia. Conclusion. The perioperative period was accompanied by a prolongation of the QTc interval and an increase in DQT values in the group receiving conventional therapy. The inclusion of meldonium was accompanied by no increase in QTc and DQT during most follow-up periods.

Liver, Kidney Function Tests and Oxidative Damage During and after Treatment of Salmonella typhimurium Infection in Experimental Local Rabbits

2018 ◽  
Vol 9 (4) ◽  
Author(s):  
Mustafa Salah Hasan ◽  
Ayman Barzan Abdulgafor ◽  
Maher Saber Owain ◽  
Mohammed Ali Hussein ◽  
Qusay Mohammed Aboud ◽  
...  
Keyword(s):  
Single Dose ◽  
Oxidative Damage ◽  
Salmonella Typhimurium ◽  
Infected Group ◽  
Post Treatment ◽  
Kidney Damage ◽  
Control Group ◽  
Post Inoculation ◽  
Group 5 ◽  
Group 2

This study aimed to evaluate the liver, kidney damage caused by S. typhimurium and to estimate the oxidative damage in association with this bacteria. A highly virulent isolates of S. typhimurium were obtained from the department of internal and preventive medicine/ College of Veterinary Medicine/ University of Baghdad. A twenty five local rabbits of both genders with age range (2-4 months) weeks old were used for this study, the rabbits were divided randomly into five groups each group contains 5 rabbits :- group 1: drenched orally with 5 ml of normal saline and consider as control group, group 2: were drenched orally with (5 ml) suspension which contain (5��109 CFU) of Salmonella typhimurium and regarded as infected group, group 3 were drenched orally with (5 ml) suspension which have (5��109 CFU) of Salmonella typhimurium then treated with a single dose of gentamicin alone at 0.05ml/kg (5mg/ml) orally after presence of signs (after 24hrs. post inoculation), group 4 were drenched (5 ml) suspension having (5��109 CFU) of Salmonella typhimurium then treated with a single dose of Ca-EDTA alone at 40mg/kg orally after presence of signs (after 24hrs. post inoculation) and group 5 were drenched (5 ml) suspension that contain (5��109 CFU) of Salmonella typhimurium then treated with a single dose of combined gentamicin at 0.05ml/kg (5mg/ml) orally after presence of signs (after 24hrs. post inoculation) and Ca-EDTA 40mg/kg after presence of signs (after 24hrs. post inoculation).The results of biochemical profile showed a significant increase (p less than 0.05) in ALT, creatinine and urea levels in infected group as compared with control group, while, the treated groups especially group 5 showed a significant improvement in ALT, Urea and creatinine levels which returned to relative normal levels as compared with infected group after 96hrs. post treatment. Also, the results of oxidative stress showed a significant increase in the levels of MDA in G2, G3, G4 and G5 after 48 hrs. post treatment, while the level of GSH showed a significant decrease in the level at 48hrs., both were returned to relative normal levels after 96hrs.post treatment especially in group 5.In conclusion, S. typhimurium can causing liver and kidney damage which is manifested by increase ALT, Urea and Creatinine. Also, MDA and GSH is increased due to salmonellosis.

Clinical-Reported Outcomes Of Deferoxamine Versus Deferasirox In The Treatment Of Homozygous BetaThalassemia

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Zeina A Munim Al-Thanoon ◽  
Zeina A Munim Al-Thanoon ◽  
Mustafa Basil ◽  
Nasih A Al-Kazzaz
Keyword(s):  
Serum Ferritin ◽  
Iron Chelation ◽  
Iron Chelator ◽  
Beta Thalassemia ◽  
Control Group ◽  
Current Standard ◽  
Cross Sectional ◽  
Significant Difference ◽  
Multiple Blood ◽  
Group 2

Iron chelation therapy with deferoxamine (DFO),the current standard for the treatment of iron overload in patients with betathalassemia,requires regular subcutaneous or intravenous infusions. This can lead to reduced quality of life and poor adherence,resulting in increased morbidity and mortality in iron-overloaded patients with beta-thalassemia. Deferasirox (DFX) is an orally administered iron chelator that has been approved for use in many countries. The requirement of an effective,well tolerated iron chelator with a less demanding mode of administration has led to the development of deferasirox. The present study was aimed to compare the satisfaction and compliance with deferoxamine versus deferasirox (Exjade®),a novel oral iron chelator in patients with transfusion - dependent beta- thalassemia. A cross-sectional,single-center investigation study was carried out in the Thalassemia Center of Ibn-Atheer Teaching Hospital in Nineveh province,Iraq. One hundred and eight thalassemic patients aged between 2- 20 years old having received multiple blood transfusions and a serum ferritin greater than 1500 ng/ml. Patients were randomised into two groups. Group 1 received deferoxamine at a dose of 20-50mg/kg/day and group 2 received deferasirox at the dose of 10-30 mg/kg/day. Another 56 apparently healthy volunteers were used as a control group. The assessment of chelation was done during the period between November 2013 and February 2014 by measurement of serum ferritin. Satisfaction and compliance was assessed by using a special questionnaire prepared by the researcher. Out of the 108 thalassemic patients enrolled there was no discontinuation in treatment with the two drugs under study. The serum ferritin did not change significantly in any of the chelation groups. In comparison with the patients who were treated with DFO,those receiving DFX reported a significantly higher rate of compliance and satisfaction (P < 0.05). However,no significant difference was observed between the two groups regarding their satisfaction (P > 0.05).Compliance with deferasirox (50 %) was more than that with deferoxamine (20 %). Satisfaction with deferoxamine was significantly lower than deferasirox (p= 0.00).

Antiurolithiatic effect of Cymbopogon Proximus, Alhagi Maurorum, on Sulfadimidine induced urolithiasis in male New Zealand rabbits

2019 ◽  
Vol 20 (1) ◽  
pp. 12-18
Author(s):  
Sameh El-Nabtity
Keyword(s):  
New Zealand ◽  
Intramuscular Injection ◽  
Negative Control Group ◽  
Negative Control ◽  
Control Group ◽  
Aqueous Extracts ◽  
Blood And Urine Samples ◽  
Group 2 ◽  
New Zealand Rabbits ◽  
Group 1

The present study aimed to investigate the prophylactic effect of Cymbopogon proximus and Alhagi maurorum on Sulfadimidine induced urolithiasis in rabbits . Thirty New Zealand male rabbits were allocated into six equal groups (each of five): Group (1) was used as a negative control. Group(2) were administered sulfadimidine (200mg/kg) by intramuscular injection.Groups(3) and (4) were administered sulfadimidine(200mg/kg) by intramuscular injection and 330mg/kg of Cymbopogon proximus alcoholic and aqueous extracts respectively orally.Groups(5) and (6) were administered sulfadimidine(200mg/kg) by intramuscular injection and 400mg/kg of Alhagi maurorum alcoholic and aqueous extracts respectively orally. The period of experiment was 10 days. Blood and urine samples were collected from rabbits on the 10th day. The results recorded a significant decrease in serum creatinine, urea, uric acid and crystalluria in Cymbopogon proximus and Alhagi maurorum groups compared to sulfadimidine treated group.We conclude that Cymbopogon proximus and Alhagi maurorum have a nephroprotective and antiurolithiatic effects against sulfadimidine induced crystalluria.

Influence of Removable Denture Cleaning Agents on Adhesion of Oral Pathogenic Microflora In Vitro: A Randomized Controlled Trial

2021 ◽  
Vol 14 (1) ◽  
pp. 656-664
Author(s):  
I.R. Volchkova ◽  
A.V. Yumashev ◽  
V.V. Borisov ◽  
V.I. Doroshina ◽  
E.A. Kristal ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Candida Albicans ◽  
Test Group ◽  
Control Group ◽  
Removable Dental Prostheses ◽  
Removable Denture ◽  
Group 2 ◽  
Adhesion Index ◽  
Group 1

Introduction: Removable dentures are used by 20% of the population. These may be accompanied by denture stomatitis in 15-70% of patients. The choice of the optimal cleansing agent for removable dental prostheses is of high significance. Aim: The aim of our research was to study the influence of removable denture cleansing products on the adhesion of microorganisms and yeast. Materials and Methods: We manufactured 144 specimens of standardized round shape with a diameter of 10 mm from 4 types of modern polymeric materials used by prosthetic dentistry to produce removable dentures, 12 specimens of each material were placed into suspensions of bacterial cultures of Staphylococcus aureus, Escherichia coli, Candida albicans, then into “ClearaSept” (Test group 1), “Рrotefix active cleanser” (Test group 2), saline solution (Control group), followed by nutrient media. The adhesion index was calculated and analyzed. Results: There was no reliable lowering of adhesion index of Staphylococcus Aureus to all materials detected in Test group 1 (U=6, p>0.05 for Bio XS; U=8, p>0.05 for Dental D, Denotokeep Peek, Vertex Rapid Simplified). In Test group 2, the adhesion index of Staphylococcus Aureus reliably decreased to all materials compared to the Control group (U=0, p≤0.01). The adhesion index of Candida albicans and Escherichia coli to all materials in Test group 1 had a minor to moderate reliable reduction compared to the Control group (U=0, p≤0.01). Test group 2 showed a significant reliable decrease in Candida albicans and Escherichia coli adhesion index to all materials in comparison with the Control group (U=0, p≤0.01). Conclusion: The research showed an unreliable or minor and moderate reliable decrease in microorganisms adhesion index depending on the microorganism species after treatment of denture material specimens by antibacterial soap “ClearaSept” and a reliable significant decrease in microbial and yeast adhesion after application of Protefix active cleaner solution, which demonstrates a more significant antimicrobial effect in comparison to “ClearaSept” against Staphylococcus aureus, Escherichia coli, and Candida albicans.

scholarly journals Resistance to Fracture of Dental Roots Obturated with Different Materials

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Berkan Celikten ◽  
Ceren Feriha Uzuntas ◽  
Kamran Gulsahi
Keyword(s):  
Fracture Resistance ◽  
Testing Machine ◽  
Negative Control Group ◽  
Positive Control ◽  
Negative Control ◽  
Positive Control Group ◽  
Control Group ◽  
Root Canal Filling ◽  
Filling Materials ◽  
Group 2

The aim of this study was to compare the vertical fracture resistance of roots obturated with different root canal filling materials and sealers. Crowns of 55 extracted mandibular premolar teeth were removed to provide root lengths of 13 mm. Five roots were saved as negative control group (canals unprepared and unfilled). Fifty root canals were instrumented and then five roots were saved as positive control group (canals prepared but unfilled). The remaining 45 roots were randomly divided into three experimental groups (n=15root/group) and obturated with the following procedures: in group 1, glass ionomer-based sealer and cone (ActiV GP obturation system); in group 2, bioceramic sealer and cone (EndoSequence BC obturation system); and in group 3, roots were filled with bioceramic sealer and cone (Smartpaste bio obturation system). All specimens were tested in a universal testing machine for measuring fracture resistance. For each root, the force at the time of fracture was recorded in Newtons. The statistical analysis was performed by using Kruskal-Wallis and post hoc test. There were no significant differences between the three experimental groups. The fracture values of three experimental and negative control groups were significantly higher than the positive control group. Within the limitations of this study, all materials increased the fracture resistance of instrumented roots.

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