scholarly journals THEORETICAL MODEL OF STERNUM EXTERNAL FIXATION FUNCTIONING IN PHYSICAL THERAPY OF PATIENTS FOLLOWING CARDIAC SURGERY VIA STERNOTOMY

2020 ◽  
pp. 203-209
Author(s):  
V. ‌V. Vitomskyi
Keyword(s):  
Cardiac Surgery ◽  
Theoretical Model ◽  
Pulmonary Function ◽  
External Fixation ◽  
Subcutaneous Fat ◽  
Chest Circumference ◽  
Lateral Direction ◽  
Sternal Dehiscence ◽  
Function Recovery ◽  
The Impact

Abstract. The purpose is to develop and analyze a theoretical model of sternum external fixation functioning as sternal precaution after cardiac surgery via sternotomy. Methods: theoretical modeling based on literature data. Results. The literature data, measuring the impact of sternum external fixation on the development of complications after cardiac surgery via sternotomy, do not present a proper report of the functioning mechanism or mechanical model of the interaction between the sternum and sternum external fixation. The first stage of theoretical model development included selecting the criteria based on the sternum anatomy, physiology of respiration, results of scientific research, which enabled to define key aspects of the theoretical model.The second stage included studying interaction of non-elastic SEF and sternum during a deep breath and a cough acting as main elements of inspiratory muscle training after cardiac surgeries; performing a similar algorithm of studying elastic type of SEF, which enabled to investigate and analyze preventive potential of SEF in relation to sternal dehiscence in the lateral direction. The third stage included the analysis of SEF restricting potential for anteroposterior stabilisation of the sternum. Since the use of sternum external fixation should not impede pulmonary function recovery after cardiac surgery and cannot restrict chest circumference increase with inhalation, sternum external fixation cannot properly function as sternal precaution when chest circumference is increased due to sternal edge dehiscence as well. The restricting effect of inelastic sternum external fixation will be possible only in case of a large dehiscence, when its size is bigger than the chest circumference increase during normal and deep breathing. Only when the circumference of inelastic sternum external fixation corresponds to the chest circumference after a full exhalation, the effect restricting dehiscence development will be possible. However, this condition is not practically feasible and does not comply with the need for pulmonary function recovery. As an example a barrel with iron rings that prevent it from expanding and emerging of dehiscence between the boards. However, this is not practically possible and is inconsistent with physiology of respiration. The restricting effect of elastic sternum external fixation will be possible in case the force of compression is greater than the force expanding the sternum during a cough, which will completely restrict inhaling and disable its practical use. The use of sternum external fixation must be biomechanically justified. The fact that the sternum is covered with soft tissues (muscles, which are joined with the bones of the sternum, shoulder blade and humerus; subcutaneous fat, which increases with excessive body weight) also reduces sternum external fixation effectiveness, as the existence of a soft and movable layer between the fixing parts and fixing means is a negative factor. On the other hand, dehiscence is a rare case among patients who do not use SEF. This confirms the priority of the sternal closure stability after sternotomy and the factors affecting it: the strength of bone tissue, the diameter of the wire, used during sternotomy, and the number of sutures. Conclusions. The theoretical model analyzed in this study confirms either the insignificant role of sternum external fixation or its complete absence in the prevention of sternal dehiscence in the lateral direction and anteroposterior displacement of sternum edges after sternotomy.

The impact of protocolized communication during cardiac surgery

2009 ◽  
Author(s):  
S. Henrickson Parker ◽  
R. Wadhera ◽  
D. Wiegmann ◽  
T. M. Sundt
Keyword(s):  
Cardiac Surgery ◽  
The Impact

Investment climate and government turnover in russian regions

2014 ◽  
pp. 88-117 ◽  
Author(s):  
G. Syunyaev ◽  
L. Polishchuk
Keyword(s):  
Economic Development ◽  
Theoretical Model ◽  
Private Sector ◽  
Authoritarian Regimes ◽  
Russian Regions ◽  
Investment Climate ◽  
Regional Data ◽  
Endogenous Property Rights ◽  
The Impact

We study the impact of Russian regional governors’ rotation and their affiliation with private sector firms for the quality of investment climate in Russian regions. A theoretical model presented in the paper predicts that these factors taken together improve “endogenous” property rights under authoritarian regimes. This conclusion is confirmed empirically by using Russian regional data for 2002—2010; early in that period gubernatorial elections had been canceled and replaced by federal government’s appointments. This is an indication that under certain conditions government rotation is beneficial for economic development even when democracy is suppressed.

Assessment of factors affecting short-term pulmonary functions following cardiac surgery: A prospective observational study

2021 ◽  
pp. 021849232110100
Author(s):  
Neetika Katiyar ◽  
Sandeep Negi ◽  
Sunder Lal Negi ◽  
Goverdhan Dutt Puri ◽  
Shyam Kumar Singh Thingnam
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Function ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Complications ◽  
Operative Morbidity ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Significant Impairment

Background Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV1) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery. Methods This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained. Results The FEV1 and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV1 was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV1 and forced vital capacity. Discussion This study observed a significant impairment in FEV1 and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV1 and forced vital capacity were pre-operative FEV1, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.

The impact of exogenous nitric oxide during cardiopulmonary bypass for cardiac surgery

Perfusion ◽  
2021 ◽  
pp. 026765912110148
Author(s):  
Joseph Mc Loughlin ◽  
Lorraine Browne ◽  
John Hinchion
Keyword(s):  
Nitric Oxide ◽  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Troponin I ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
High Quality Research ◽  
Low Cardiac Output Syndrome ◽  
The Impact

Objectives: Cardiac surgery using cardiopulmonary bypass frequently provokes a systemic inflammatory response syndrome. This can lead to the development of low cardiac output syndrome (LCOS). Both of these can affect morbidity and mortality. This study is a systematic review of the impact of gaseous nitric oxide (gNO), delivered via the cardiopulmonary bypass (CPB) circuit during cardiac surgery, on post-operative outcomes. It aims to summarise the evidence available, to assess the effectiveness of gNO via the CPB circuit on outcomes, and highlight areas of further research needed to develop this hypothesis. Methods: A comprehensive search of Pubmed, Embase, Web of Science and the Cochrane Library was performed in May 2020. Only randomised control trials (RCTs) were considered. Results: Three studies were identified with a total of 274 patients. There was variation in the outcomes measures used across the studies. These studies demonstrate there is evidence that this intervention may contribute towards cardioprotection. Significant reductions in cardiac troponin I (cTnI) levels and lower vasoactive inotrope scores were seen in intervention groups. A high degree of heterogeneity between the studies exists. Meta-analysis of the duration of mechanical ventilation, length of ICU stay and length of hospital stay showed no significant differences. Conclusion: This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations.

Farm wages and public works

2015 ◽  
Vol 8 (1) ◽  
pp. 19-72 ◽  
Author(s):  
Kanika Mahajan
Keyword(s):  
Theoretical Model ◽  
Wage Rate ◽  
Fixed Effects ◽  
Positive Impact ◽  
Wage Growth ◽  
State Level ◽  
Random Allocation ◽  
Farm Sector ◽  
Content Type ◽  
The Impact

Purpose – The purpose of this paper is to examine the impact of National Rural Employment Guarantee Scheme (NREGS) on farm sector wage rate. This identification strategy rests on the assumption that all districts across India would have had similar wage trends in the absence of the program. The author argues that this assumption may not be true due to non-random allocation of districts to the program’s three phases across states and different economic growth paths of the states post the implementation of NREGS. Design/methodology/approach – To control for overall macroeconomic trends, the author allows for state-level time fixed effects to capture the differences in growth trajectories across districts due to changing economic landscape in the parent-state over time. The author also estimates the expected farm sector wage growth due to the increased public work employment provision using a theoretical model. Findings – The results, contrary to the existing studies, do not find support for a significantly positive impact of NREGS treatment on private cultivation wage rate. The theoretical model also shows that an increase in public employment work days explains very little of the total growth in cultivation wage post 2004. Originality/value – This paper looks specifically at farm sector wage growth and the possible impact of NREGS on it, accounting for state specific factors in shaping farm wages. Theoretical estimates are presented to overcome econometric limitations.

The impact of age on outcome of adult cardiac surgery patients

2004 ◽  
Vol 21 (Supplement 33) ◽  
pp. 14-15
Author(s):  
C. Naughton ◽  
J. Roxburgh ◽  
R. O. Feneck
Keyword(s):  
Cardiac Surgery ◽  
The Impact ◽  
Adult Cardiac Surgery

Investigation on penetration model of shaped charge jet in water

2016 ◽  
Vol 30 (02) ◽  
pp. 1550268 ◽  
Author(s):  
Jinwei Shi ◽  
Xingbai Luo ◽  
Jinming Li ◽  
Jianwei Jiang
Keyword(s):  
Numerical Simulation ◽  
Theoretical Model ◽  
Model Simulation ◽  
Theoretical Models ◽  
Theoretical Research ◽  
Water Medium ◽  
Simulation Results ◽  
Jet Penetration ◽  
The Impact ◽  
Penetration Velocity

To analyze the process of jet penetration in water medium quantitatively, the properties of jet penetration spaced target with water interlayer were studied through test and numerical simulation. Two theoretical models of jet penetration in water were proposed. The theoretical model 1 was established considering the impact of the shock wave, combined with the shock equation Rankine–Hugoniot and the virtual origin calculation method. The theoretical model 2 was obtained by fitting theoretical analysis and numerical simulation results. The effectiveness and universality of the two theoretical models were compared through the numerical simulation results. Both the models can reflect the relationship between the penetration velocity and the penetration distance in water well, and both the deviation and stability of theoretical model 1 are better than 2, the lower penetration velocity, and the larger deviation of the theoretical model 2. Therefore, the theoretical model 1 can reflect the properties of jet penetration in water effectively, and provide the reference of model simulation and theoretical research.

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