scholarly journals A Method for Assessing the Severity of Obstructive Jaundice of Non-Neoplastic Origin

2021 ◽  
Vol 10 (1) ◽  
pp. 174-180
Author(s):  
A. P. Vlasov ◽  
N. S. Sheyranov ◽  
O. V. Markin ◽  
T. I. Vlasova ◽  
T. A. Muratova ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Severity Index ◽  
Blood Parameters ◽  
Early Postoperative Period ◽  
Toxicity Index ◽  
Medical Institutions ◽  
Malondialdehyde Content ◽  
Laboratory Index ◽  
Severe Degree ◽  
Normal Albumin

AIM OF STUDY To develop a method for assessing the severity of obstructive jaundice (OJ) of non-neoplastic orogin on the basis of functional parameters of the liver and the activity of pathogenetic agents of hepatodepression.MATERIAL AND METHODS Clinical and laboratory studies of 142 patients with breast cancer of non-tumor origin. The indicators of the functional state of the liver, the index of plasma toxicity for albumin, and the content of malondialdehyde (MDA) were evaluated.RESUlTS Based on the assessment of a number of blood parameters - the content of total bilirubin (TB), the plasma toxicity index for albumin, the MDA level — the severity index of obstructive jaundice of non-neoplastic origin (SIOJ) was developed:SIOJ = IT1/ITn + TB1/TB + 5(MDA1/MDAn)where IT 1 is the plasma albumin toxicity index at the current moment, ITn is the normal albumin plasma toxicity index, TB1 is the current bilirubin  content, TBn is the normal bilirubin content, MDA1 is the current malondialdehyde content, MDAn is the normal value. The index less than 13 indicates a mild severity, 14–21 is moderate severity, 22 and higher indicates a severe degree of OJ. The method increases the objectivity of determining the severity of non-neoplastic origin by establishing the severity of liver damage and the processes underlying it.CONClUSiON The suggested clinical and laboratory index allows the severity of obstructive jaundice to be objectively and quickly determined upon admission of a patient to the hospital and also adequate therapy to be initiated in case of severe degree for anticipation of possible post-operative complications, so the treatment should be focused on managing triggers of hepatodepression. The method is simple and available in medical institutions of various levels. The method is especially valuable when used in the dynamics of the early postoperative period.

scholarly journals Effect of selective plasmadsorption on systemic inflammatory response and cytokine levels in obstructed jaundice

2021 ◽  
Vol 18 (5) ◽  
pp. 40-46
Author(s):  
А. M. Fomin
Keyword(s):  
Obstructive Jaundice ◽  
Liver Failure ◽  
Total Bilirubin ◽  
Perioperative Period ◽  
Early Postoperative Period ◽  
Initial Increase ◽  
Tnf Α ◽  
Plasma Cytokines ◽  
Anti Inflammatory ◽  
Α Level

Objective: to study the effect of selective plasmadsorption (SPS) on the level of pro-inflammatory and anti-inflammatory plasma cytokines, markers of liver failure in patients with obstructive jaundice.Material and Methods. The study was conducted in 23 patients with prolonged obstructive jaundice. The baseline level of total bilirubin ranged from 285 μmol/L to 589 μmol/L. All patients were exposed to selective plasmadsorption before biliodigistic surgery and twice in the early postoperative period. Selective plasmosorption was carried using OctoNova by Asahi Kasei Medical (Japan) with the use of the sorbent based on the Plasorba BR-350 anion exchange resin. In one procedure, about two volumes of circulating plasma were treated.Results. Initial increase in the level of pro-inflammatory TNF-α, IL-1β, IL-6 cytokines as well as anti-inflammatory IL-10 cytokine was established.Following SPS, TNF-α level signifcantly decreased by 42.4% (p < 0.05). The decrease in IL-1β and IL-6 was 38.9% and 34.0%, respectively. The level of IL-10 signifcantly decreased by 30.7% (p < 0.05). A signifcant decrease in the levels of total bilirubin by 39.8 ± 3.8%, conjugated bilirubin (by 38.2%), unconjugated bilirubin (by 32.5%), ALT (by 23.5%), AST (by 37%), and bile acids (by 31.4%) was revealed by the end of the procedure. There were no hemorrhagic complications associated with SPS.Conclusions. Selective plasmosorption in complex treatment of patients with mechanical jaundice with hepatic insufciency in perioperative period reduces endotoxicosis level not only due to correction of biochemical markers of liver failure but also due to reduction of proinflammatory and anti-inflammatory cytokines.

scholarly journals The acute peritonitis treatment optimizing in early postoperative period

2021 ◽  
Vol 179 (5) ◽  
pp. 57-62
Author(s):  
E. K. Dzidzava ◽  
A. P. Vlasov ◽  
O. V. Markin ◽  
I. V. Fedoseykin ◽  
I. V. Gluchova ◽  
...  
Keyword(s):  
Functional Status ◽  
Treatment Regimen ◽  
Abdominal Cavity ◽  
Laboratory Data ◽  
Blood Parameters ◽  
Early Postoperative Period ◽  
Control Group ◽  
Acute Peritonitis ◽  
Endogenous Intoxication ◽  
Purulent Peritonitis

The Objective was to evaluate the effectiveness of original physiotherapeutic methods in the treatment of patients with acute spread purulent peritonitis.Methods and Materials. We done a treatment approach analysis of 72 patients with peritonitis after programmed sanitation of the abdominal cavity. The control group included 42 patients with standardized treatment regimen. The main group consisted of 35 patients. Their treatment included low-intensity laser radiation of the abdominal cavity, electrical stimulation of the duodenum according to the original methods. We evaluated dynamic changes of the blood parameters, endogenous intoxication markers, the functional status of the liver, kidneys, and intestines.Results. The use of original physiotherapeutic methods in the treatment of patients with acute peritonitis leads to a significant improvement in clinical and laboratory data. The functional status of the liver, kidneys and intestine restored rapidly. Mortality rate decreased from 28.7 to 17.1 % (χ2=1.392, p=0.238), hospital stay decreased by 5.7 hospital days (p<0.05).Conclusion. The treatment regimen for severe peritonitis leads to a relatively rapid relief of the inflammatory process in the abdominal cavity, as well as the restoration of the functional status of the liver, kidneys and intestine. It largely determines the correction of homeostatic indicators, including reducing the severity of endogenous intoxication. 

scholarly journals Altered oxidative stress levels in Indian Parkinson's disease patients with PARK2 mutations.

2011 ◽  
Vol 58 (2) ◽  
Author(s):  
Monika Vinish ◽  
Akshay Anand ◽  
Sudesh Prabhakar
Keyword(s):  
Oxidative Stress ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Peripheral Blood ◽  
Blood Parameters ◽  
Sod Activity ◽  
Disease Evolution ◽  
Chronic Oxidative Stress ◽  
Malondialdehyde Content

The aim of this pilot study was to determine the baseline state of oxidative stress indices in patients with Parkinson's disease (PD). Peripheral blood samples of 15 PD subjects were analyzed and compared with ten age matched healthy controls. Patients with PARK2 mutations were also compared with PD patients without mutations. There was significant increase in malondialdehyde content and superoxide-dismutase (SOD) activity in peripheral blood parameters in PD patients (p < 0.05) in comparison to controls. These findings suggest an important role of oxidative stress in Parkinson's disease evolution and progress. No changes were observed in glutathione peroxidase and nitric oxide levels. We found significant correlation between SOD activity and lipid peroxidation when the biochemical data was further analyzed. In addition, significant increase in the levels of SOD among the PD patients with PARK2 mutations was observed, which can be ascribed to chronic oxidative stress induced by PARK2 mutations.

SIGNS OF THROMBOTIC READINESS IN PATIENTS WITH STABLE ANGINA PECTORIS AFTER CORONARY BYPASS SURGERY

2017 ◽  
Author(s):  
Н. Морова ◽  
В. Цеханович ◽  
Н. Никитин ◽  
И. Файль
Keyword(s):  
Angina Pectoris ◽  
Stable Angina ◽  
Bypass Surgery ◽  
Coronary Bypass ◽  
Blood Parameters ◽  
Early Postoperative Period ◽  
Coronary Bypass Surgery ◽  
Stable Angina Pectoris ◽  
Coronary Bypass Grafts ◽  
Von Willebrand

Введение. После коронарного шунтирования (КШ) все больные получают антиагрегантную терапию; несмотря на это тромбоз коронарных шунтов является основной проблемой коронарной хирургии. Цель работы. Выявить лабораторные признаки протромботической готовности у больных, перенесших операцию КШ по поводу стабильной стенокардии напряжения. Материалы и методы. Обследовано 47 мужчин (в возрасте 57,9H±H1,2 лет), страдавших стабильной стенокардией напряжения, через неделю после операции коронарного шунтирования (КШ). Отбор проб крови для исследования гемостаза осуществляли через 7–8 дней после операции, через 5 дней после отмены гепарина. Результаты. По сравнению с группой из 26 здоровых мужчин у пациентов с ишемической болезнью сердца установлено существенное повышение содержания фибриногена (более чем в 2 раза), растворимых фибрин-мономерных комплексов (почти в 20 раз), Д-димеров (в 6 раз). Выявлены признаки активации сосудисто-тромбоцитарного гемостаза в виде значительного увеличения уровня фактора Виллебранда; у 29 пациентов из 47 обнаружен волчаночный антикоагулянт; у 27 пациентов найдены лабораторные признаки резистентности к ацетилсалициловой кислоте. Заключение. Пациенты, перенесшие плановую операцию КШ, в раннем послеоперационном периоде имеют признаки протромботической готовности. Introduction. All patients receive antiplatelet therapy after coronary bypass surgery (CBS); nonetheless thrombosis of coronary bypass grafts is the main problem of coronary surgery. The aim of study: to identify laboratory signs of prothrombotic readiness in patients with stable angina pectoris undergoing CBS. Materials and methods. We examined 47 men (57,9H±H1,2 years old) with stable angina pectoris one week after CBS. Hemostasis blood parameters were measured 7–8 days after surgery, 5 days after heparin withdrawal. Results. Compared with group of 26 healthy men in patients with ischemic heart disease we found signifi cantly elevated levels of fibrinogen (more than 2-fold), soluble fibrin monomer complexes (almost 20 times), D-dimers (by 6 times). Considerable increasing of von Willebrand factor level was revealed as a sign of vascular-platelet hemostasis activation; in 29 (from 47) patients lupus anticoagulant was detected; in 27 patients laboratory signs of resistance to acetylsalicylic acid were found. Conclusion. Patients after planned CBS have signs of prothrombotic readiness in early postoperative period.

scholarly journals HYPOALBUMINEMIA IN MICROSURGICAL FLAPS OF THE MUSCULOSKELETAL APPARATUS

2020 ◽  
Vol 28 (4) ◽  
pp. 168-171
Author(s):  
Ana Carolina Oliveira da Silva ◽  
Gustavo Bersani Silva ◽  
Alvaro Baik Cho ◽  
Teng Hsiang Wei ◽  
Rames Mattar Junior ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Early Postoperative Period ◽  
Serum Total Protein ◽  
Level Of Evidence ◽  
Limb Reconstruction ◽  
Reconstruction Methods ◽  
Limb Injuries ◽  
Prolonged Hospital ◽  
Normal Albumin ◽  
Complex Injuries

ABSTRACT Objective: To evaluate if the levels of serum total protein and serum albumin are risk factors for surgical complications of free flap limb reconstruction. Methods: Consecutive inclusion of all patients undergoing microsurgical flaps for limb reconstruction of complex injuries. We recorded epidemiological and laboratory data, including total proteins and fractions, for descriptive and analytical statistics. Results: Our study analyzed one microsurgical flap from 35 patients that underwent complex injuries of the limbs. In total, 23 patients were men, and mean age of all patients was 35 years. After statistical analysis, no influence of pre or postoperative hypoalbuminemia was observed on the incidence of complications. Patients with hypoalbuminemia had a higher length of stay than those with normal albumin levels (p = 0.008). Conclusion: We observed that 71% of patients had hypoalbuminemia in early postoperative period and we suggest a nutritional support for patients requiring complex traumatic limb reconstruction. Hypoalbuminemia in patients subjected to microsurgical flaps for the treatment of complex traumatic limb injuries did not influence the complications that required surgical reintervention; However, it was associated with prolonged hospital stay. Level of Evidence II, Retrospective study.

scholarly journals The results of periodontal aid for patients with periodontosis in Samara State dentistry clinics (terms and conditions).

2020 ◽  
Vol 16 (1) ◽  
pp. 75-80
Author(s):  
Aleksandr Nesterov ◽  
Mukatdes Sadykov ◽  
Svetlana Chigarina ◽  
Maksim Haykin ◽  
Dmitriy Trunin
Keyword(s):  
Chronic Periodontitis ◽  
Medical Records ◽  
Statistical Processing ◽  
Positive Outcome ◽  
Treatment Protocols ◽  
Mild Degree ◽  
Dental Clinics ◽  
Medical Institutions ◽  
Statistical Program ◽  
Severe Degree

Subject. Data on the prevalence and epidemiology of chronic periodontitis are presented. The main treatment protocols for this pathology and the most common complications arising from its neglect or inadequate treatment are presented. The goal is to conduct a retrospective analysis of the incidence of chronic generalized periodontitis in the period from 2015 to 2019 in medical institutions of the dental profile of the city of Samara Methodology. During the study 21368 medical records were studied in the period from 2015 to 2019, and errors in filling out 2910 medical records of primary patients were analyzed. The quality of conducting 18458 medical records was assessed in the provision of dental care for patients with a diagnosis of chronic periodontitis. Statistical processing of the material was carried out using the statistical program package “Statistica” for the formation of clear approaches in the diagnosis, treatment methods and prevention of this pathology. Results. An analysis of medical records showed that the highest prevalence of chronic periodontitis was observed in the 55―64-year-old age group (29.82 % of those examined), while 67.5 % of the patients showed a generalized form of chronic periodontitis, and 32.5 % localized. The treatment of such patients was carried out comprehensively and included both conservative methods of treatment, as well as surgical and orthodontic treatment. Stabilization in chronic generalized and localized periodontitis of mild degree occurred in 45 % of patients, in medium ― in 33.4 %, and in severe ― in 8.5 %. Conclusions. The frequency of occurrence of patients with a diagnosis of "chronic periodontitis" by referral to dental clinics is about 86 %. At the same time, the positive outcome of the treatment currently remains at an extremely low level, especially in the treatment of patients with a severe degree of development of chronic periodontitis. This is largely due to the neglect by the dentists of the proposed treatment protocols.

scholarly journals Painless Obstructive Jaundice Secondary to a Common Bile Duct Abscess: A Delayed Sequela of Cholecystectomy

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Katherine Fairhurst ◽  
Andrew Strickland ◽  
Franklin H. G. Bridgewater ◽  
Guy J. Maddern
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Clinical Presentation ◽  
Open Cholecystectomy ◽  
Early Postoperative Period ◽  
Unique Case ◽  
Bile Duct Wall ◽  
Delayed Complications ◽  
The Common

Complications related to cholecystectomy are well described. Most occur in the early postoperative period and are recognised either at the time of, or shortly after surgery. Clinical sequelae occurring years following cholecystectomy are rare and infrequently reported. In addition, most delayed complications are related to the continuing presence or new formation of gallstones. In this paper we present a unique case of an abscess of the common bile duct wall, presenting with painless obstructive jaundice more than 30 years following an open cholecystectomy, without the presence of gallstones. The clinical presentation, investigations, and treatment are discussed with a review of other relevant reported cases in the literature.

scholarly journals Volume of surgical intervention in renal cancer, complicated by invasion of tumoral thrombus into venous wall

2021 ◽  
Vol 88 (5-6) ◽  
pp. 28-35
Author(s):  
S. Sh. S. Boiko ◽  
V. І. Rusin ◽  
S. O. Boiko ◽  
V. V. Rusin
Keyword(s):  
Surgical Treatment ◽  
Renal Cancer ◽  
Renal Vein ◽  
Surgical Intervention ◽  
Vena Cava ◽  
Early Postoperative Period ◽  
Vena Cava Inferior ◽  
Vein Wall ◽  
Radical Method ◽  
Severe Degree

Objective. To determine the volume of surgical intervention on vena cava inferior in renal cancer, complicated by invasion of tumoral thrombus into the vein wall. Materials and methods. Into the investigation were included 147 patients, suffering renal cancer, complicated by tumoral venous thrombosis, who were treated surgically in the Zakarpattya Regional Clinical Hospital named after Andriy Novak or in the Zakarpattya Antitumoral Centre in 2005 - 2020 yrs. The patients’ age varied from 27 to 79 yrs old, their average age have constituted 58 yrs old. There were 97 (66%) men and 50 (34%) women. The null level of venous spread of tumoral thrombus was diagnosed in 55 (37.4%), І – in 32 (21.8%), ІІ – in 30 (20.4%), ІІІ – in 22 (15.0%), and IV - in 8 (5.4%) patients. The tumor was localized in right kidney in 51 (34.7%) patients. Surgical treatment in all the patients was performed - nephrectomy and various interventions on the vein. Longitudinal resection of the vein was performed in 55 (37.4%), resection with suturing of alloflap - in 5 (3.4%), circular resection with prosthesis “end-to-end” - in 4 (2.7%) patients. In the tumoral thrombus localization, including a renal vein, the uxtaosteum resection was performed in 100% of the patients. Results. Average duration of the operation was 165 (102 - 292) min, average volume of the blood loss - 780 (240 - 2250) ml. Mild and moderate postoperative complications in accordance to classification of Clavien-Dindo (Degree I - II) was registered in 38 (21.8%), and the severe (Degree ІІІ - V) - in 6 (4.1%) patients. Surgical complications of Degree III or complications, which demanded urgent relaparotomy, were not observed. In early postoperative period 1 patient died. General postoperative lethality have constituted 0.7%. In all the patients a laminar blood flow was preserved. In no one patient the prosthesis thrombosis, recurrence of the prosthesis thrombus, recurrence of tumoral venous thrombus or pulmonary thromboembolism. Conclusion. Radical method of surgical treatment of renal cancer, complicated by tumoral thrombosis of vena cava inferior, must include nephrectomy, cavatomy, thrombectomy, various variants of resection and prosthesis of the vein. In the null level of the tumoral thrombus venous spread the performance of uxtaosteum resection of renal vein is obligatory.

scholarly journals Novel laboratory index, based on fasting blood parameters, accurately reflects insulin sensitivity

2021 ◽  
Author(s):  
Monika Karczewska-Kupczewska ◽  
Agnieszka Nikołajuk ◽  
Magdalena Stefanowicz ◽  
Natalia Matulewicz ◽  
Maria Arnoriaga-Rodriguez ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Weight Loss ◽  
Insulin Sensitivity ◽  
Validation Cohort ◽  
Principal Component ◽  
Accurate Method ◽  
Blood Parameters ◽  
Metabolic Disturbances ◽  
Laboratory Assessment ◽  
Laboratory Index

Abstract Context Simple and reliable measurement of insulin sensitivity may be important for the prevention of insulin-resistance related diseases. Surrogate indices of insulin sensitivity are of limited utility in population without signs of metabolic syndrome. Objective The aim of our study was to provide simple and accurate index of insulin sensitivity. Design The study group comprised 150 young healthy participants. Hyperinsulinemic-euglycemic clamp was performed. Regression models with different laboratory parameters were constructed. Validation cohort 1 comprised independent group of 110 subjects, including individuals with prediabetes and newly diagnosed type 2 diabetes. Validation cohort 2 comprised 38 obese subjects before and after diet-induced weight loss. Validation cohort 3 comprised 60 nondiabetic subjects from an independent center. Results The supervised principal component model established optimal set of variables correlated with insulin sensitivity. This model (Fasting Laboratory Assessment of Insulin Sensitivity, FLAIS) used red blood cell count, alanine aminotransferase activity, serum C-peptide, SHBG, IGF-binding protein 1 and adiponectin concentrations. FLAIS exhibited strong correlation with clamp-derived insulin sensitivity. The sensitivity of the model was 90% and the specificity was 68%. In the validation cohort 1, differences in FLAIS among the groups paralleled those observed with the clamp, with the lowest values in prediabetes and diabetes. In the validation cohort 2, FLAIS reflected the change in insulin sensitivity after weight loss. The main findings were confirmed in the validation cohort 3. Conclusion We provide simple and accurate method of assessing insulin sensitivity, which allows to identify insulin resistance even in the population without overt metabolic disturbances.

scholarly journals Selected Biochemical Blood Parameters and a Risk of Pressure Ulcers in Patients Receiving Treatment in Intensive Care Units

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 177
Author(s):  
Dariusz Bazaliński ◽  
Beata Midura ◽  
Anna Wójcik ◽  
Paweł Więch
Keyword(s):  
Intensive Care ◽  
Pressure Ulcers ◽  
Venous Blood ◽  
Blood Parameters ◽  
Albumin Level ◽  
Albumin Concentration ◽  
Braden Scale ◽  
The Mean ◽  
Observation Protocol ◽  
Normal Albumin

Background and Objectives: This study aimed to assess the level of selected biochemical parameters in venous blood and their potential effects on the development of pressure ulcers in patients treated in intensive care settings. Materials and Methods: Fifty patients hospitalised in an intensive care unit (ICU) were enrolled for the study. The methods used included controlled observation, literature review and medical record analysis. The observation protocol applied in the study consisted of two parts comprising the basic information, sociodemographic data, results of laboratory tests (CRP, PCT, albumin, protein and haemoglobin concentrations) as well as the Braden Scale for Predicting Pressure Ulcer Risk. Results: The subjects presented moderate to high risk of pressure ulcers, reflected by the mean score of 8.18 ± 1.3 points, with minimum and maximum scores of 6 and 12 points, respectively. Normal albumin level was identified in only five subjects (10.0%) while 45 subjects (90.0%) were found with results below the norm. A statistical relationship was observed between such variables as albumin concentration (p < 0.01) and total protein level (p = 0.007). The findings show a strong correlation between the score in the Braden Scale and the level of albumins (R = 0.55). Conclusions: In our study, lower concentrations of albumins and total proteins correspond to a greater risk of pressure ulcers.

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