Costs of conservative treatment of patients with cholangitis and cholesystitis

Introduction. There are no guidelines for treating bacterial infections in our country. Antibacterial drugs are selected empirically, which is not always in accordance with the recommended therapy coming from the countries that have their own pharmacotherapy protocols. This study reviews the differences between the standard conservative treatment of cholangitis/cholecystitis and treatment implemented in accordance with current pharmacotherapy guidelines of other countries. The assessment of the therapeutic efficacy of antibacterial drugs implemented in the treatment of cholangitis/cholecystitis and economic viability of that implementation was one of the aims of this study, and another one was comparison of the efficiency and cost of medical treatment using physician?s therapy of choice and treatment according to pharmacotherapy guidelines. Material and Methods. The study was carried out over a threeyear period at the Department of Infectious Diseases of the Clinical Center of Vojvodina. It included 72 patients with the diagnosis of cholangitis/cholecystitis who were divided into two groups. The control group was treated according to the physician?s therapy of choice, while the test group was treated in accordance with pharmacotherapy guidelines. The efficiency and cost of medical treatment were determined for both groups. Results. The comparison of the efficiency and costs of medical treatment of cholangitis/cholecystitis before and after introducing pharmacotherapy guidelines showed no significant differences in the efficiency of administered therapies. However, the cost of medical treatment carried out in accordance with pharmacotherapy guidelines showed a decrease of 17.24%. Conclusion. Medical treatment using physician?s antibacterial therapy of choice and the one which is in accordance with pharmacotherapy guidelines for treating cholangitis/cholecystitis show no differences in terms of efficiency. However, medical treatment proved to be more affordable in the group of patients treated in accordance with pharmacotherapy guidelines of other countries.

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Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan

Journal of Personalized Medicine ◽

10.3390/jpm11060478 ◽

2021 ◽

Vol 11 (6) ◽

pp. 478

Author(s):

Ching Chang ◽

Chien-Hao Huang ◽

Hsiao-Jung Tseng ◽

Fang-Chen Yang ◽

Rong-Nan Chien

Keyword(s):

Hepatic Encephalopathy ◽

Real World ◽

Ammonia Level ◽

Decompensated Cirrhosis ◽

Control Group ◽

Multivariable Logistic Regression Model ◽

Before And After ◽

One Year ◽

The One ◽

Serum Ammonia

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.

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Abstract 722: Treatment of Acute and Chronic Limb Ischemia with Intermedin (IMD) in Mouse Models

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.722 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Luyu Yao ◽

Honglin Dong ◽

Allen Gu ◽

Xin Gu ◽

Kai Yao ◽

...

Keyword(s):

Femoral Artery ◽

Blood Perfusion ◽

Limb Ischemia ◽

Control Group ◽

Silk Suture ◽

Hindlimb Ischemia ◽

Occlusion Model ◽

Before And After ◽

Artery Disease ◽

The One

Objectives: This experiment proposes a novel mouse model to simulate long-term chronic ischemia caused by peripheral artery disease (PAD) using a partial ligation method to narrow down the femoral artery lumen in C57Bl/6 mice. This model will be compared to the typical occlusion model while testing Intermedin (IMD) as a possible treatment for ischemia. Methods: Partial hindlimb ligation technique: we use a strand of 11-0 nylon sutures to pierce the middle of the artery and suture half of the artery shut at both the proximal and distal end of the femoral artery. The typical occlusion model: we use a 7-0 silk suture to completely ligate the distal and proximal femoral artery. Hindlimb blood flow was monitored daily by Laser Doppler perfusion monitor before and after the surgery. IMD was administered at 150 μg/kg, ip, immediately following ligation and twice daily afterwards for up to one week, while in the control group saline was injected instead of IMD. Gastrocnemius muscle samples were collected at day 3 and day 7 for histology and molecular biology study. Results: Ischemic/non-ischemic leg blood perfusion ratio in the partial ligation model is significantly higher than in the typical model. It is also significantly increased in IMD-treated groups in both models. Compared to the tissue in complete ligation models, it is apparent that partial ligation model tissue is less severely affected upon initial ligation but maintains ischemia over the one week testing period as would be expected. Compared to the untreated ischemia groups in acute and chronic hindlimb ischemia models, IMD-treated animals had less severe ischemic injuries. Conclusion: Our study indicates that our chronic hindlimb ischemia model was successful with expected less ischemia status than complete occlusion. The partial occlusion model presented here more closely mimics human PAD, where atherosclerotic plaque builds up slowly, resulting in a lower pressure difference between the proximal and distal artery preventing adequate shunting of the blood into collateral circulation. Moreover, our study suggests that IMD has promise as a therapeutic treatment in acute and chronic hindlimb ischemia models to prevent necrosis in muscle tissue following ischemic events.

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Nurses’ perspectives about communication with patients in an intensive care setting using a communication board: A pilot study

Health SA Gesondheid ◽

10.4102/hsag.v24i0.1162 ◽

2019 ◽

Vol 24 ◽

Author(s):

Martelize Gropp ◽

Ensa Johnson ◽

Juan Bornman ◽

Rajinder Koul

Keyword(s):

Intensive Care ◽

Care Setting ◽

Test Group ◽

Control Group ◽

Intensive Care Setting ◽

Before And After ◽

Post Test ◽

Quasi Experimental ◽

Communication Needs ◽

Communication Board

Background: Communication in the intensive care setting (ICS) is critical for both the patient and the medical staff to provide efficient care and thus alleviate possible patient adverse effects. Persons with complex communication needs are particularly vulnerable in ICSs and therefore require additional communication support.Aim: This study focused on the perspectives of nurses about communication with patients with communication needs in ICSs using paper-based communication boards, namely the translated Vidatak EZ Board, before and after a training session.Setting: A 1650-bed public hospital with a 26-bed ICS in a semi-urban, low socio-economic area in South Africa served as the research setting.Methods: A quasi-experimental pre-test post-test group design with withdrawal and a control group was used. Data were gathered using a custom-designed questionnaire completed by ICS nurse participants recruited from a public hospital.Results: Responses of some nurses did not change in post-test 1, but their responses did change in post-test 2. Some of the nurses’ perspectives changed, as expected from the pre-test to post-test 1. Nurses recommended specific adaptations to the communication board.Conclusions: Most nurses agreed that communication is crucial in ICSs and that a communication board can be implemented; however, limited success was observed implementing the board following a short training. The inter-professional collaboration between nurses and speech-language therapists to provide optimal health care to patients in ICS is emphasised.

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Effect of short-chain fructooligosaccharide-enriched energy-restricted diet on weight loss and serum haptoglobin concentration in Beagle dogs

British Journal Of Nutrition ◽

10.1017/s0007114511004107 ◽

2011 ◽

Vol 106 (S1) ◽

pp. S120-S123 ◽

Cited By ~ 4

Author(s):

Rebecca Ricci ◽

Isabelle Jeusette ◽

Jean-Marie Godeau ◽

Barbara Contiero ◽

Marianne Diez

Keyword(s):

Weight Loss ◽

Test Group ◽

Blood Parameters ◽

Short Chain ◽

Control Group ◽

Beagle Dogs ◽

Restricted Diet ◽

Serum Haptoglobin ◽

Before And After ◽

Haptoglobin Concentration

The effects of the dietary inclusion of two levels of short-chain fructooligosaccharides (sc-FOS) on weight loss, biochemical parameters and serum haptoglobin concentration were investigated in twelve experimental obese Beagle dogs. Dogs were randomised into two groups and submitted to a weight loss program (WLP): the control group (C) received a commercial energy-restricted high-protein diet containing 1 % DM sc-FOS, whereas the test group (T) received the same diet enriched with sc-FOS to attain a 3 % DM content. Body weight (BW) and body condition score were weekly assessed in each dog and blood was collected before and after WLP to measure total plasma cholesterol (CHOL), TAG, NEFA, glucose (GLUC), insulin, serum leptin and haptoglobin. Groups showed similar BW and blood parameters before treatment. When values before and after treatment of the dogs were compared, significant reductions were observed for all parameters, with the exception of NEFA and GLUC. However, when these reductions were compared between C and T groups, significant differences were detected only for haptoglobin (T before v. T after: 1545 v. 605 mg/l, P = 0·03; C before v. C after: 1635 v. 1400 mg/l, P = NS). Positive correlations between haptoglobin and CHOL and between haptoglobin and TAG were observed before but not after WLP. In conclusion, feeding obese dogs with the energy-restricted diet caused significant weight loss and reduction of blood parameters, irrespective of the sc-FOS content included. However, serum haptoglobin level, and the subclinical inflammatory condition associated with it, was significantly lowered in the T but not in the C group.

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INVESTIGATING THE EFFECT OF REFLEXOLOGY IN INTENSITY OF PAIN AND ANXIETY AMONG PATIENTS SUFFERING FROM METASTATIC CANCER IN ADULTS’ HEMATOLOGY WARD

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2018.v11i6.25212 ◽

2018 ◽

Vol 11 (6) ◽

pp. 401 ◽

Cited By ~ 5

Author(s):

Simin Jahani ◽

Fatemeh Salari ◽

Nasrin Elahi ◽

Bahman Cheraghian

Keyword(s):

Cancer Patients ◽

Metastatic Cancer ◽

Test Group ◽

Control Group ◽

Anxiety Management ◽

Patients With Cancer ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

And Control

Objective: Findings suggest dissatisfaction of half of the cancer patients regarding pain and anxiety management. This study aimed to determine the effect of reflexology on the intensity of pain and anxiety among patients with metastatic cancer hospitalized inadulthematology ward. Methods: In this study, the samples were selected from adult hematology ward in Baghaei 2 hospital in Ahwaz, Iran, according to the inclusion criteria. They were then assigned into treatment and control groups. In the treatment group, reflexology protocol was performed following manual reflexology method by Fr Josef Eugster based on Ingham method on the patient’s bed. In the control group, sole touching was used as the placebo. Reflexology was performed for three days, 30 min per day. Spielberger questionnaire were provided to the samples and completed in the first and third days, and Spielberger questionnaire was provided to the samples and completed. The data obtained from this study were then analyzed by SPSS 20.Results: The two groups did not show a significant difference in terms of demographic characteristics (p>0.05). Based on the obtained results, it was found that in the test group, there was a significant difference between the mean intensity of pain before and after the treatment across all 3 days as well as the mean anxiety of the 1st and 3rd days (p<0.05). However, in the control group, there was no significant difference in terms of mean pain intensity before and after the treatment across 3 days (p>0.05). No significant difference was observed between the mean anxiety of the 1st and 3rd days either (p>0.05).Conclusion: Considering the findings of this research, it can be concluded that reflexology has a positive effect on mitigating the intensity of pain and anxiety in metastatic cancer patients. Therefore, it is recommended that nurses employed in cancer centers benefit from the findings of this research to further help patients with cancer. It is also suggested that further research be conducted on the effect of reflexology on the pain and anxiety of other patients.

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The Parkinsonian Gait Spatiotemporal Parameters Quantified by a Single Inertial Sensor before and after Automated Mechanical Peripheral Stimulation Treatment

Parkinson s Disease ◽

10.1155/2015/390512 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 13

Author(s):

Ana Kleiner ◽

Manuela Galli ◽

Maria Gaglione ◽

Daniela Hildebrand ◽

Patrizio Sale ◽

...

Keyword(s):

Repeated Measures ◽

Stride Length ◽

Inertial Sensor ◽

Gait Velocity ◽

Control Group ◽

Peripheral Stimulation ◽

Before And After ◽

Spatiotemporal Parameters ◽

The One ◽

One Way Anova

This study aims to evaluate the change in gait spatiotemporal parameters in subjects with Parkinson’s disease (PD) before and after Automated Mechanical Peripheral Stimulation (AMPS) treatment. Thirty-five subjects with PD and 35 healthy age-matched subjects took part in this study. A dedicated medical device (Gondola) was used to administer the AMPS. All patients with PD were treated in off levodopa phase and their gait performances were evaluated by an inertial measurement system before and after the intervention. The one-way ANOVA for repeated measures was performed to assess the differences between pre- and post-AMPS and the one-way ANOVA to assess the differences between PD patients and the control group. Spearman’s correlations assessed the associations between patients with PD clinical status (H&Y) and the percentage of improvement of the gait variables after AMPS (α<0.05for all tests). The PD group had an improvement of 14.85% in the stride length; 14.77% in the gait velocity; and 29.91% in the gait propulsion. The correlation results showed that the higher the H&Y classification, the higher the stride length percentage of improvement. The treatment based on AMPS intervention seems to induce a better performance in the gait pattern of PD patients, mainly in intermediate and advanced stages of the condition.

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C – reactive protein in saliva of non-smoking patients with periodontitis (a pilot study)

Journal of Health Sciences ◽

10.17532/jhsci.2021.1327 ◽

2021 ◽

Author(s):

Zerina Hadžić ◽

Ivan Puhar

Keyword(s):

Pilot Study ◽

Test Group ◽

Periodontal Therapy ◽

Control Group ◽

C Reactive Protein ◽

Inflammatory Biomarker ◽

Reactive Protein ◽

Before And After ◽

Oral Hygiene Instructions ◽

And Control

Introduction: C-reactive Protein (CRP) as an inflammatory biomarker can be easily determined in saliva, but the values of salivary CRP in periodontitis are not well-studied. The aim of this study was to analyze and determine the values of salivary CRP in non-smokers with periodontitis stage 3 or 4 before and after supragingival and subgingival full-mouth periodontal therapy.Methods: Standard periodontal parameters and saliva samples were collected in 12 non-smoking patients. Patients in the test group (n = 6) underwent supragingival and subgingival full-mouth periodontal therapy, and the control group (n = 6) received only supragingival full-mouth therapy. Both groups received the same oral hygiene instructions in addition to therapy. After 3 months, re-registration of periodontal parameters and re-sampling of saliva for analysis of salivary CRP were done for both groups.Results: Statistical analysis revealed large differences in the values of clinical periodontal parameters and CRP levels in the test group after therapy. Values of salivary CRP in the test and control groups were lower 3 months the therapy; however, the results were not statistically significant. The correlation of clinical periodontal parameters and salivary CRP varied in both groups.Conclusion: Our pilot study reveals decreased concentrations of salivary C-reactive protein in non-smoking patients following non-surgical periodontal therapy. Further studies are needed to prove the reliability of salivary CRP as a biomarker for periodontitis.

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Functional training vs traditional training benefits for martial arts practitioners

Scientific Bulletin of Naval Academy ◽

10.21279/1454-864x-18-i1-056 ◽

2018 ◽

Vol XIX (1) ◽

pp. 366-374

Author(s):

Olaru Florina

Keyword(s):

Martial Arts ◽

Test Group ◽

Training Group ◽

Control Group ◽

Muscular Fitness ◽

Anthropometric Measures ◽

Functional Training ◽

Traditional Training ◽

Before And After ◽

Traditional Resistance Training

Both functional and traditional resistance training increase muscular fitness. This study aims at highlighting the benefits of functional training compared to traditional training. Thus, we analyze the effects of functional training on muscular fitness in terms of endurance, agility, strength, flexibility and balance. A group of 40 martial arts practitioners, aged 18-30 years, was divided in a functional training experimental group (n = 20) and a traditional resistance control group (n = 20). Anthropometric measures were done to the test group of martial arts practitioners which were tested before and after the training study period of 7 weeks. The results showed an important improvement (p < 0.05) in endurance, push-ups, 1-RM bench press and squat, one-leg balance and back extension. Functional training group had a significant increase in flexibility and shoulder girth (p < 0.05). The main difference comparing the two test groups was in flexion time and forearm girth. In conclusion, functional training increases endurance, shoulder girth and flexibility

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MICROMORPHOLOGY OF TEGUMENT OF EURYTREMA PANCREATICUM BEFORE AND AFTER ANTHELMINTICS

10.31016/978-5-6046256-1-3.2021.22.85-90 ◽

2021 ◽

pp. 85-90

Author(s):

Bibik ◽

Nacheva ◽

Nesterok

Keyword(s):

Outer Part ◽

Expert Assessment ◽

Control Group ◽

Comparative Effect ◽

Comparative Aspect ◽

Before And After ◽

After Effect ◽

Outer Cover ◽

The One

The article describes micromorphological features of the tegument of the trematode of the species Eurytrema pancreaticum (Janson, 1899), Loos, 1907, family Dicrocoelliidae Odhner, 1911. The parasites were collected by dissection of spontaneously infected animals (cattle) with Eurytrema and with formed chronic eurythrematosis. Some of the trematodes were collected from the control group of animals, and some after deworming with anthelmintics. Using histological methods in a comparative aspect with the control, changes in the morphological features of the tegument of Eurytrema after effect of hexachloroparaxylol and oxinid were shown. It has been established that the toxic effect of anthelmintics causes destruction of the tegument. This increases the permeability of the drug and its metabolites through the outer cover of the trematodes into their body. There is a complete atrophy of the outer part of the tegument, and in the inner part of the tegument there is a decrease in the number of degenerative cells with hexachloroparaxylol and their increase with oxinid. The comparative effect by two anthelmintics of the old generation on the tegument is described to emphasize the effectiveness of their use in trematodiases, on the one hand, and to show the quality of histological methods in the expert assessment of drugs, on the other.

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Acute effect of foot orthotics on drag area and perceived comfort in cyclists affected by an anatomic asymmetry in time trial position

Journal Of Science & Cycling ◽

10.28985/0620.jsc.01 ◽

2020 ◽

Vol 9 (1) ◽

pp. 5-12

Author(s):

Anthony Bouillod ◽

Marc Retali ◽

Georges Soto-Romero ◽

Emmanuel Brunet ◽

Maxim Frémeaux ◽

...

Keyword(s):

Effect Size ◽

Test Group ◽

Time Trial ◽

Acute Effect ◽

Control Group ◽

Small Effect Size ◽

Before And After ◽

Limb Length Inequality ◽

Elite Cyclists ◽

Drag Area

The aim of this study was to analyse the acute effect of biomechanical foot orthotics on drag area (ACd) and perceived comfort in elite cyclists affected by a lower limb length inequality (LLLI) in TT position. Twenty-nine cyclists performed two discontinuous incremental exercises (before and after orthopaedic correction) using their personal TT bicycle and equipment on a 250-m indoor velodrome. The ACd was unchanged in both the test group (TG) (‑0.5%, p = 0.707) and the control group (CG) (-1.4%, p = 0.276), whereas the perceived comfort was improved in the TG (+6.2%, p = 0.002) and stabilised in the CG (+0.7%, p = 0.546), after the fitting of the foot orthotics. Pelvis movements were decreased (small effect size) in the TG (-6.2%, p = 0.093, ES = 0.251), whereas they were increased (small effect size) in the CG (+5.2%, p= 0.159, ES = 0.215). TT position was slightly improved by compensating for a LLLI, as the ACd was stabilised and the level of comfort was improved. Thus, cyclists affected by a LLLI are recommended to compensate with foot orthotics in order to improve their level of comfort and consequently their performance in TT position.

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