scholarly journals Advantages of modern methods of prevention of thrombotic complications in patients with critical ischemia of lower limbs after reconstructive operations

2020 ◽  
Vol 27 (4) ◽  
pp. 487-494
Author(s):  
Ivan I. Katelnitskiy ◽  
Igor I. Katelnitskiy ◽  
Ekaterina S. Livadnyaya
Keyword(s):  
Anticoagulant Therapy ◽  
Statistical Significance ◽  
Diagnostic System ◽  
Heparin Therapy ◽  
Lower Limbs ◽  
Critical Ischemia ◽  
Additional Control ◽  
Reconstructive Operations ◽  
Thrombotic Complications ◽  
Selection Of

Aim. To evaluate and improve the results of reconstructive operations in patients with obliterating atherosclerosis with critical ischemia of the lower limbs through reduction of the rate of thrombotic complications by improvement of diagnosis of risk factors for thrombosis on the basis of coagulogram and Thrombodynamics T-2 test data. Materials and Methods. In the I group of patients (n=48) reconstructive operations were performed on the arteries of lower limbs and anticoagulant therapy with unfractionated heparin (UFH) with control of hemostasiogram before the operation, in 6 hours and 6 days after the operation and with additional control of APTT 30 minutes before introduction of UNH. In the II group (n=34) reconstructive operations were performed with selection of anticoagulant therapy using parameters of hemostasiogram and laboratory-diagnostic system Thrombodynamics Recorder T-2 with control before the operation, in 6 hours, 6 days after the operation and with additional control of APTT in 30 minutes before introduction of UFH. Results. Analysis of the data of coagulogram and Thrombodynamics T-2 test showed statistical significance of APTT, fibrinogen, delay and initial speed of clot growth, a combination of which permits a possibility for correction of heparin therapy for prevention of thrombosis. Conclusions. The dynamics of the parameters of Thrombodynamics T-2 test in selection of UFH dose proves high effectiveness of this method for selection of adequate doses of anticoagulant drugs for prevention of postoperative thromboses in patients with critical ischemia of the lower limbs.

scholarly journals PROGRESS IN SURGICAL TREATMENT OF CHRONIC LOWER LIMB ISCHEMIA

2018 ◽  
Vol 25 (6) ◽  
pp. 14-18
Author(s):  
O. A. Alukhanyan ◽  
X. G. Маrtyrosya ◽  
I. V. Poluektova ◽  
V. A. Avakimyan
Keyword(s):  
Surgical Treatment ◽  
Pain Syndrome ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Chronic Ischemia ◽  
Critical Ischemia ◽  
Surgical Interventions ◽  
Bypass Patency ◽  
Thrombotic Complications ◽  
Male Patients

Aim. The study was conducted to expand the variety of ways for surgical treatment of chronic ischemia of lower limbs complicated by the involvement of the femoropopliteal and pedidial arterial segment. Materials and methods. The experience of surgical interventions in 43 male patients aged 52-75 suffering from chronic ischemia of lower limbs complicated by the atherosclerotic involvement of the femoropopliteal and pedidial segment has been summarized. According to the classification by A.V. Pokrovskiy, ischemia of the 3rd stage has been determined in 24 patients (55,8%), while ischemia of the 4th stage complicated by necrosis of the toes (critical ischemia) has been determined in other 19 patients (44,2%). All examined patients have undergone the reconstructive interventions using the prepared lateral subcutaneous vein of the upper extremity as a shunt.Results. During the first day after the operation, the regression of pain syndrome as well as the warming of the lower extremity was indicated in 93% of patients. In 8-12 days after the reconstructive operation, the patients have undergone the 15 necrectomy or toe amputation. In the nearest postoperative period (less than 6 months) no thrombotic complications in the reconstructed segment have been determined. Within the observation period from 6 months to 5 years the bypass patency has been preserved in 71% of patients; ischemia of the 2nd B type has been revealed in all patients with the preserved bypass patency by the clinical examination.Conclusion. Despite the “forced” character of usage of the prepared V. cephalica due to the absence of “traditional” venous shunts as well as the labor intensity of the method, it allows to expand the variety of ways for surgical treatment of patients suffering from chronic ischemia of lower limbs of the 3rd-4th stages complicated by occlusive involvements of the femoropopliteal and pedidial segment.

Prospective Study on the Usefulness of Lung Scan in Patients with Deep Vein Thrombosis of the Lower Limbs

2001 ◽  
Vol 85 (05) ◽  
pp. 771-774 ◽  
Author(s):  
Joan Ruiz ◽  
Manuel Fraile ◽  
Montserrat Bonet ◽  
Ester Davant ◽  
Jordi Muchart ◽  
...  
Keyword(s):  
Prospective Study ◽  
Anticoagulant Therapy ◽  
Vena Cava ◽  
Blood Gases ◽  
Heparin Therapy ◽  
Clinical Suspicion ◽  
Lower Limbs ◽  
Common Finding ◽  
Arterial Blood ◽  
Lung Scan

Summary Background: Asymptomatic pulmonary embolism (PE) is a common finding in patients with deep venous thrombosis (DVT) of the lower limbs, but the usefulness of seeking for silent PE in patients with acute DVT has not been evaluated. Patients and methods: This was a prospective study involving consecutive patients with acute symptomatic proximal DVT (confirmed by objective methods) and no clinical suspicion of PE. All patients underwent chest X-ray, ventilation-perfusion lung scan and arterial blood gases on admission, and received anticoagulant therapy. Those with scintigraphic evidence of PE underwent repeated lung scan and blood gases 7 days later. The aim of the study was to assess how many patients with silent PE develop symptoms while on heparin therapy, and in how many of them such symptoms are due to recurrent PE. Results: 946 consecutive patients with acute, proximal DVT had no contraindications to full-dose anticoagulant therapy. Baseline lung scan revealed high-probability defects (silent PE) in 200 (21%). Seven of these 200 patients had symptomatic recurrences during the 7-day study period, and an inferior vena cava filter was inserted. Besides, 6 patients developed PE symptoms, but no new perfusion defects were found on repeated scan. They switched to coumarin therapy, and they did not develop any further complications. Conclusions: Lung scan in patients with symptomatic DVT and no clinical suspicion of PE may be useful, since some patients with silent PE may develop symptoms while on heparin therapy. Without a baseline scintigraphy all these patients would have been considered to have recurrent PE, and vena cava interruption could have been performed.

PERSONIFICATION OF STUDENTS INDEPENDENT WORK ON THE FORMATION OF THE ABILITY TO SOLVE COMPUTATIONAL PROBLEMS ON THE BASIS OF AUTOMATED TRAINING AND DIAGNOSTIC SYSTEM

2018 ◽  
pp. 26-32
Author(s):  
N. I. Pak ◽  
E. V. Asaulenko
Keyword(s):  
Diagnostic System ◽  
Educational Process ◽  
Box Model ◽  
Self Management ◽  
Practical Implementation ◽  
Learning Tools ◽  
Theoretical Rationale ◽  
E Learning ◽  
Independent Work ◽  
Selection Of

The relevance of the study under consideration is due to the need to increase the efficiency of students independent work in solving computational problems. A theoretical rationale is proposed and the practical implementation of an automated training and diagnostic system for the formation of skills to solve problems according to the “white box” model is described. The leading idea of the study is the construction of mental schemes for a given topic, which allow to visualize the dynamics of changes in the learner’s level of ability to solve computational problems. The methods of accounting for forgetting educational information and methods of personalized selection of tasks are substantiated. The site for self-management of user independent work is available at the link: http://msbx.ru. The materials of the article are of practical value for teachers who use e-learning tools in the educational process.

scholarly journals Tetracycline-Resistant Bacteria Selected from Water and Zebrafish after Antibiotic Exposure

2021 ◽  
Vol 18 (6) ◽  
pp. 3218
Author(s):  
Ana Rita Almeida ◽  
Marta Tacão ◽  
Joana Soares ◽  
Inês Domingues ◽  
Isabel Henriques
Keyword(s):  
Statistical Significance ◽  
Recovery Period ◽  
Antibiotic Resistance Genes ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Antibiotic Resistant ◽  
Potential Impact ◽  
Susceptibility Profiles ◽  
Selection Of ◽  
Significant Mortality

The emergence of antibiotic-resistant pathogens due to worldwide antibiotic use is raising concern in several settings, including aquaculture. In this work, the selection of antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) was evaluated after exposure of zebrafish to oxytetracycline (OTC) for two months, followed by a recovery period. The selection of ARB in water and fish was determined using selective media. The abundance of tetA genes was estimated through qPCR. Higher prevalence of ARB was measured in all samples exposed to the antibiotic when compared to control samples, although statistical significance was only achieved five days after exposure. Isolates recovered from samples exposed to the antibiotic were affiliated with Pseudomonas and Stenotrophomonas. Various antibiotic susceptibility profiles were detected and 37% of the isolates displayed multidrug resistance (MDR). The selection of the tetA gene was confirmed by qPCR at the highest OTC concentration tested. Two MDR isolates, tested using zebrafish embryos, caused significant mortality, indicating a potential impact on fish health and survival. Overall, our work highlights the potential impact of antibiotic contamination in the selection of potential pathogenic ARB and ARGS.

scholarly journals Two-Segment Foot Model for the Biomechanical Analysis of Squat

2017 ◽  
Vol 2017 ◽  
pp. 1-11
Author(s):  
E. Panero ◽  
L. Gastaldi ◽  
W. Rapp
Keyword(s):  
Body Weight ◽  
Inverse Dynamics ◽  
Statistical Significance ◽  
Lower Limbs ◽  
Biomechanical Analysis ◽  
Wide Range ◽  
Foot Model ◽  
Partial Body ◽  
The One ◽  
Midtarsal Joint

Squat exercise is acquiring interest in many fields, due to its benefits in improving health and its biomechanical similarities to a wide range of sport motions and the recruitment of many body segments in a single maneuver. Several researches had examined considerable biomechanical aspects of lower limbs during squat, but not without limitations. The main goal of this study focuses on the analysis of the foot contribution during a partial body weight squat, using a two-segment foot model that considers separately the forefoot and the hindfoot. The forefoot and hindfoot are articulated by the midtarsal joint. Five subjects performed a series of three trials, and results were averaged. Joint kinematics and dynamics were obtained using motion capture system, two force plates closed together, and inverse dynamics techniques. The midtarsal joint reached a dorsiflexion peak of 4°. Different strategies between subjects revealed 4° supination and 2.5° pronation of the forefoot. Vertical GRF showed 20% of body weight concentrated on the forefoot and 30% on the hindfoot. The percentages varied during motion, with a peak of 40% on the hindfoot and correspondently 10% on the forefoot, while the traditional model depicted the unique constant 50% value. Ankle peak of plantarflexion moment, power absorption, and power generation was consistent with values estimated by the one-segment model, without statistical significance.

The use of multifunctional statistical criteria in the development of technological aspects of self-design of students’ educational and professional activities

2020 ◽  
pp. 23-30
Author(s):  
Tatyana A. Erina ◽  
Natalya N. Motkina
Keyword(s):  
Statistical Significance ◽  
Statistical Processing ◽  
Automated System ◽  
Statistical Hypothesis ◽  
Self Management ◽  
Professional Activities ◽  
Selection Of ◽  
Angular Transformation ◽  
Statistical Criteria

Researchers in the humanities almost always have to deal with the problem of statistical processing of results and their interpretation. This is a rather laborious and painstaking work, which can be greatly simplified through the use of multifunctional statistical criteria. Within the framework of the study related to the problem of self-design of educational and professional ac-tivities of students, the analysis of the effectiveness of the introduction of technological elements using multifunctional criteria was carried out: φ* criterion – Fisher’s angular transformation and binomial criterion m. The statistical significance of the results of the introduction at a certain stage of the technology of the workshop is revealed, which makes it possible to study and apply the ele-ments of self-management in the educational and professional activities of students. For promising purposes, it is proposed to create an automated system that implements the selection of the appropriate criterion for the problem to be solved and the verification of the statistical hypothesis put forward by the researcher.

Use of intravenous alprostadil in patients with severe critical ischemia of the lower limbs

Vascular ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 318-323
Author(s):  
Jorge Enrique Machado-Alba ◽  
Manuel E Machado-Duque
Keyword(s):  
Critical Limb Ischemia ◽  
Adverse Reactions ◽  
Limb Ischemia ◽  
Cross Sectional Study ◽  
Lower Limbs ◽  
Critical Ischemia ◽  
Cross Sectional ◽  
Potential Benefits ◽  
Advanced Stages ◽  
Clinical Records

Objectives To determine the indications for the use, potential benefits, and adverse reactions of alprostadil in a group of Colombian patients. Methods A retrospective cross-sectional study was conducted in patients diagnosed with critical limb ischemia who received alprostadil in five hospitals in Colombia between September 2011 and July 2017. We reviewed the clinical records of each patient to obtain the sociodemographic and pharmacological variables, clinical stages, complications, comorbidities, reported effectiveness and adverse reactions. Results Sixty-one patients treated with alprostadil were evaluated; 50.8% of patients were men, and the average age of 72.5 ± 10.7 years. A total of 86.9% of patients were hypertensive, and 65.6% were diabetic. A total of 77.0% presented ulceration, and this condition was considered as a diabetic foot in 57.4% of patients. A total of 81.9% of patients were classified as Fontaine stage 4; 60.7% received therapy as initially indicated, with an average of 19 days of alprostadil use. Regarding the therapy results, 58.0% of the patients with ulcers or trophic lesions showed improvement, 86.2% showed improvement of pain, and the limb was saved in 72.1% of patients. Conclusions Critical limb ischemia was presented by patients with advanced age and high cardiovascular risk who were treated during severe and advanced stages where therapeutic options are limited. Treatment with alprostadil achieved satisfactory results with improvement in ulcers, pain, and limb salvage rates in this series of patients.

scholarly journals Three Evidence Based Methods to Compensate for a Lack of Subject Background when Ordering Chemistry Monographs

2008 ◽  
Vol 3 (3) ◽  
pp. 3
Author(s):  
Robert A. Wright
Keyword(s):  
Statistical Analysis ◽  
Statistical Significance ◽  
Evidence Base ◽  
Circulation Rate ◽  
Evidence Based ◽  
Practical Application ◽  
Present Evidence ◽  
Library System ◽  
Over Time ◽  
Selection Of

Objective – The aim of this article is to present evidence based methods for the selection of chemistry monographs, particularly for librarians lacking a background in chemistry. These methods will be described in detail, their practical application illustrated, and their efficacy tested by analyzing circulation data. Methods – Two hundred and ninety-five chemistry monographs were selected between 2005 and 2007 using rigorously-applied evidence based methods involving the Library's integrated library system (ILS), Google, and SciFinder Scholar. The average circulation rate of this group of monographs was compared to the average circulation rate of 254 chemistry monographs selected between 2002 and 2004 when the methods were not used or were in an incomplete state of development. Results – Circulations/month were on average 9% greater in the cohort of monographs selected with the rigorously-applied evidence based methods. Further statistical analysis, however, finds that this result can not be attributed to the different application of these methods. Conclusion – The methods discussed in this article appear to provide an evidence base for the selection of chemistry monographs, but their application does not change circulation rates in a statistically significant way. Further research is needed to determine if this lack of statistical significance is real or a product of the organic development and application of these methods over time, making definitive comparisons difficult.

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