scholarly journals Application of Desmopressin and conjugated estrogens to reduce the volume of blood loss during arthroplsty of the hip joint in patients with end stage renal disease

2020 ◽  
Vol 26 (3) ◽  
pp. 57-63
Author(s):  
N. E. Mushtin ◽  
A. N. Tsed ◽  
A. K. Dulaev ◽  
A. A. Lednev ◽  
K. G. Iljushenko ◽  
...  
Keyword(s):  
Body Weight ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Blood Loss ◽  
Replacement Therapy ◽  
Hip Joint ◽  
Conjugated Estrogens ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

The objective was to determine the possibilities of using desmopressin and conjugated estrogens during primary hip joint arthroplasty in patients receiving renal replacement therapy.Methods and materials. The material for the study was data on 53 patients with pathology of the hip joint, who underwent primary arthroplasty from 2016 to 2018. All patients were divided into 2 groups. Group 1 (n=23) – patients not suffering from kidney diseases. Group 2 (n=30) – patients receiving renal replacement therapy. Each group was divided into 2 subgroups: 1 subgroup – comparisons, where the combination of desmopressin/conjugated estrogens was not used. 2 subgroup – control, where desmopressin was used at a dosage of 0.4 mg/kg 2 hours before the incision, conjugated estrogens was used at a dosage of 0.6 mg / kg of body weight within 5 days before the operation.Results. In group 1 (patients not suffering from kidney disease), there was no statistically significant difference between the subgroups. In group 2 (patients receiving hemodialysis), there was a statistically significant difference in the volume of blood loss. Thus, in the subgroup without using additional techniques, the volume of intraoperative blood loss was 769.5±389.3 ml; in the second subgroup (using desmopressin and estrogens) – 479.1±245.2 ml. The difference was statistically significant, p<0.05. The efficiency was 27.9 %.Conclusion. The additional use of conjugated estrogens at a dose of 0.6 mg/kg of body weight within 5 days before the operation, desmopressin at a dose of 0.4 mg/kg of body weight 2 hours before the incision reduced blood loss by 27.9 %. The use of combination of conjugated estrogens and desmopressin in patients not suffering from kidney disease did not affect the amount of blood loss.

Effect of Sustained Uterine Compression versus Uterine Massage on Blood Loss after Vaginal Delivery: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Labib M. Ghulmiyyah ◽  
Alaa El-Husheimi ◽  
Ihab M. Usta ◽  
Cristina Colon-Aponte ◽  
Ghina Ghazeeri ◽  
...  
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Primary Outcome ◽  
Dropout Rate ◽  
Significant Difference ◽  
Uterine Massage ◽  
Secondary Outcomes ◽  
Group 2 ◽  
Group 1

Objective This study aimed to compare the effectiveness of sustained uterine compression versus uterine massage in reducing blood loos after a vaginal delivery. Study Design This was a prospective randomized trial conducted at the American University of Beirut Medical Center (AUBMC) between October 2015 and October 2017. Inclusion criteria were women with a singleton pregnancy at ≥36 weeks of gestation, with less than three previous deliveries, who were candidates for vaginal delivery. Participants were randomized into two groups, a sustained uterine compression group (group 1) and a uterine massage group (group 2). Incidence of postpartum hemorrhage (blood loss of ≥500 mL) was the primary outcome. We assumed that the incidence of postpartum hemorrhage at our institution is similar to previously published studies. A total of 545 women were required in each arm to detect a reduction from 9.6 to 4.8% in the primary outcome (50% reduction) with a one-sided α of 0.05 and a power of 80%. Factoring in a 10% dropout rate. Secondary outcomes were admission to intensive care unit (ICU), postpartum complications, drop in hemoglobin, duration of hospital stay, maternal pain, use of uterotonics, or of surgical procedure for postpartum hemorrhage. Results A total of 550 pregnant women were recruited, 273 in group 1 and 277 in group 2. There was no statistically significant difference in baseline characteristics between the two groups. Type of anesthesia, rate of episiotomy, lacerations, and mean birth weight were also equal between the groups. Incidence of the primary outcome was not different between the two groups (group 1: 15.5%, group 2: 15.4%; p = 0.98). There was no statistically significant difference in any of the secondary outcomes between the two groups, including drop in hemoglobin (p = 0.79). Conclusion There was no difference in blood loss between sustained uterine compression and uterine massage after vaginal delivery. Key Points

Single-center experience with intraoperative extracorporeal membrane oxygenation use in lung transplantation

2017 ◽  
Vol 41 (2) ◽  
pp. 89-93 ◽  
Author(s):  
Tugba Cosgun ◽  
Sandra Tomaszek ◽  
Isabelle Opitz ◽  
Markus Wilhelm ◽  
Macé M. Schuurmans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Replacement Therapy ◽  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplantation ◽  
Replacement Therapy ◽  
Support Group ◽  
Ecmo Support ◽  
Independent Risk Factors ◽  
Group 2 ◽  
Group 1

Background: Studies have shown that survival after lung transplantation is impaired if extracorporeal membrane oxygenation (ECMO) support is implemented. We investigated the outcome and potential independent risk factors on survival in recipients undergoing lung transplantation with intraoperative ECMO support. Materials and methods: Medical records of recipients were retrospectively evaluated (January 2000-December 2014). Retransplantation and bridge to transplantation on ECMO were excluded. Recipients (n = 291) were divided into 2 groups: those who needed intraoperative ECMO support (Group 1, n = 134) and those who did not receive intraoperative ECMO support (Group 2, n = 157). Independent risk factors were identified by a stepwise backward regression analysis. Results: 1-year survival was 84.2% in Group 1 vs. 90.4% in Group 2, and 5-year survival was 52.8% in Group 1 vs. 70.5% in Group 2 (p = 0.002). Multivariate analysis indicated that recipient age (p = 0.001), renal replacement therapy (p = 0.001) and intraoperative ECMO support (p = 0.03) were significant risk factors for overall survival. The rate of postoperative early surgical complications was comparable between the two groups (p = 0.09). The number of patients requiring renal replacement therapy and experiencing late pulmonary complications was significantly higher in Group 1 (p = 0.02). Conclusions: Our data showed that lung transplantation with intraoperative ECMO support is associated with poor outcomes.

scholarly journals Native Nephrectomy before and after Renal Transplantation in Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD)

2019 ◽  
Vol 8 (10) ◽  
pp. 1622 ◽  
Author(s):  
Andreas Maxeiner ◽  
Anna Bichmann ◽  
Natalie Oberländer ◽  
Nasrin El-Bandar ◽  
Nesrin Sugünes ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Polycystic Kidney ◽  
Post Transplant ◽  
Significant Difference ◽  
Autosomal Dominant Polycystic Kidney ◽  
Group 2 ◽  
Group 1

The aim of this study was 1) to evaluate and compare pre-, peri-, and post-operative data of Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients undergoing native nephrectomy (NN) either before or after renal transplantation and 2) to identify advantages of optimal surgical timing, postoperative outcomes, and economical aspects in a tertiary transplant centre. This retrospective analysis included 121 patients divided into two groups—group 1: patients who underwent NN prior to receiving a kidney transplant (n = 89) and group 2: patients who underwent NN post-transplant (n = 32). Data analysis was performed according to demographic patient details, surgical indication, laboratory parameters, perioperative complications, underlying pathology, and associated mortality. There was no significant difference in patient demographics between the groups, however right-sided nephrectomy was performed predominantly within group 1. The main indication in both groups undergoing a nephrectomy was pain. Patients among group 2 had no postoperative kidney failure and a significantly shorter hospital stay. Higher rates of more severe complications were observed in group 1, even though this was not statistically significant. Even though the differences between both groups were substantial, the time of NN prior or post-transplant does not seem to affect short-term and long-term transplantation outcomes. Retroperitoneal NN remains a low risk treatment option in patients with symptomatic ADPKD and can be performed either pre- or post-kidney transplantation depending on patients’ symptom severity.

scholarly journals Clinical chemistry of farmed red deer (<i>Cervus elaphus</i>) yearling hinds reared on grass or <i>papillonaceous</i> pasture paddocks in Hungary

2013 ◽  
Vol 56 (1) ◽  
pp. 443-454 ◽  
Author(s):  
A. Szabó ◽  
J. Nagy ◽  
J. Bokor ◽  
H. Fébel ◽  
R. Romvári ◽  
...  
Keyword(s):  
Body Weight ◽  
Cervus Elaphus ◽  
Red Deer ◽  
Body Weight Gain ◽  
Clinical Chemistry ◽  
Serum Triglyceride ◽  
Final Body Weight ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract. Yearling red deer (Cervus elaphus) hinds of identical initial body weight were reared on a monocotyledonous grass (group 1) or on a papillonaceous plant pasture (group 2) for 212 days. At the end of the experiment (when deer were shot) blood was taken from ten animals of each group for serum biochemical analysis. Hinds of group 2 provided higher final body weight (90±3.5 vs. 101±6.6 kg) and higher daily body weight gain (105.7±10.7 vs. 153.8±26.8 g/day). Within serum nitrogenous compounds group 2 provided higher total protein concentrations, while from the lipids only serum triglyceride levels were higher in this group. Serum potassium was in both groups higher than the reference range with a superposed slight hyperkalaemia in group 2. Higher lactate dehydrogenase and alkaline phosphatase activities were found in group 2 and lower aspartate aminotransferase activity values. Inorganic phosphate concentration showed a significant difference (group 1 provides higher values). Results refer to an expressed venison growth as a result of the rich dietary protein supply of group 2. Findings were evaluated as well with discriminant factor analysis, outlining the relative importance of the single blood biochemical parameters in shaping the inter-group differences.

scholarly journals Acetylsalicylic acid (Aspirin®) and liver regeneration: experimental study in rats

2021 ◽  
Vol 48 ◽  
Author(s):  
MARIA DE LOURDES PESSOLE BIONDO-SIMÕES ◽  
VICTOR CEZAR DE AZEVEDO PESSINI ◽  
CAROLINA AYUMI ICHI ◽  
ROGÉRIO RIBEIRO ROBES ◽  
SÉRGIO IOSHII
Keyword(s):  
Body Weight ◽  
Acetylsalicylic Acid ◽  
Partial Hepatectomy ◽  
Daily Administration ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Experimental Group ◽  
Group 1

ABSTRACT Objective: to evaluate the influence of acetylsalicylic acid (ASA) on cell proliferation after partial hepatectomy in rats. Methods: 40 male Wistar rats were separated into four groups of ten rats each. Groups 1 and 2 (controls): undergoing 30% partial hepatectomy and, after one day (group 1) and seven days (group 2), to euthanasia; daily administration of 0.9% saline solution (1mL per 200g of body weight). Groups 3 and 4 (experimental): undergoing 30% partial hepatectomy and, after one day (group 3) and seven days (group 4), to euthanasia; daily administration of ASA (40mg/mL, 1mL per 200g of body weight). The absolute number of cells stained with PCNA was counted in photomicrographs, in five fields, and it was calculated the mean of positive cells per animal and per group. Results: the final mean of PCNA+ cells per group was: in group 1, 17.57 ± 6.77; in group 2, 19.31 ± 5.30; in group 3, 27.46 ± 11.55; and, in group 4, 12.40 ± 5.23. There was no significant difference at the two evaluation times in the control group (p=0.491), but there was in the experimental group (p=0.020), with a lower number of PCNA+ cells on the seventh day. The comparison between the two groups, on the first day, showed more PCNA+ cells in the livers of the animals that received ASA (p=0.047), and on the seventh day the number was lower in the experimental group (p=0.007). Conclusion: ASA induced greater hepatocyte proliferation.

scholarly journals Functional outcome of long proximal femoral nail versus short proximal femoral nail in peritrochanteric fractures

2021 ◽  
Author(s):  
Sanjeev Gupta ◽  
Pallav Gupta ◽  
Gagandeep Singh Raina ◽  
Manoj Kumar ◽  
Gagandeep Singh
Keyword(s):  
Blood Loss ◽  
Functional Outcome ◽  
Proximal Femoral Nail ◽  
Surgical Time ◽  
Femoral Nail ◽  
Significant Difference ◽  
Intramedullary Implant ◽  
Group 2 ◽  
Surgical Duration ◽  
Group 1

Background: Proximal femoral nail (PFN) is an intramedullary implant which has been commonly used in the fixation of intertrochanteric fractures. However, controversy comes about the effect of nail length on fracture union and other complications. A comparative evaluation of surgical treatment and functional outcome of patients with peritrochanteric fractures treated with short versus long PFN.Methods:  Total of 100 patients have been included in study out of which 57 belonged to group 1 and were operated with short PFN and rest 43 were group 2 operated with long PFN. Patients were followed up for 6 months and were compared on various parameters.Results: There is no significant difference noted in the two group. However, the surgical duration and blood loss for short PFN was significantly less as compared to long PFN.Conclusions: Short PFN is better implant for peritrochantric fractures both stable and unstable with quicker surgical time and lesser blood loss.

scholarly journals Comparative study to identify the safety, effectiveness and ease of obstetric forceps for delivery of floating head in cesarean section

2018 ◽  
Vol 7 (5) ◽  
pp. 1760 ◽  
Author(s):  
Sonali Jitendra Ingole ◽  
Saloni Manwani
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Apgar Score ◽  
Uterine Artery ◽  
Fetal Head ◽  
Uterine Incision ◽  
Assisted Delivery ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: Difficulty is frequently encountered in extraction of floating fetal head. This study will focus on comparison of Forceps assisted fetal head extraction during Lower segment caesarean section (LSCS) with manual method of extraction in LSCS.Methods: The ANC patients attending antenatal OPD and admitted for elective caesarean section fulfilling the inclusion criteria were randomly divided into two groups each of 400 patients: Group 1 of patients undergoing manual extraction of fetal head during LSCS; and Group 2 consisting of patients with forceps assisted delivery of fetal head in LSCS. Following factors will be evaluated in patients: maternal blood loss, any extension of uterine incision, difference in pre and post op hemoglobin levels of the patient and Apgar score of baby at 1 and 5 minutes.Results: Patients in both the groups were matched demographically. The demographic variables such as maternal age, weight, parity and MGA (Mean Gestational age) were comparable in both the groups. Blood loss was significant in Group 1 (manual delivery) as compared with Forceps assisted delivery. This is also reflected in difference in pre and post op Hemoglobin levels. Although baby outcome in terms of Apgar score was similar in both groups, however morbidity in terms of uterine artery trauma, extension of uterine incision was much less in group 2 (Forceps assisted LSCS delivery)Conclusions: Although there was no statistically significant difference in outcome of babies (APGAR score), complication(s) were less (blood loss, uterine artery trauma) in Forceps assisted LSCS delivery group. Proper selection of patient(s), early anticipation for application for Forceps can help for better outcome of caesarean delivery.

Modified Stapled Transanal Rectal Resection Procedure for Limited Rectal Prolapse: A Viable Alternative to the Delorme Operation

2020 ◽  
pp. 155335062092947
Author(s):  
Hua-Xian Chen ◽  
Zu-Qing Chen ◽  
Liang Huang ◽  
Chang-Peng Han ◽  
Ruo-Xu Dou ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rectal Prolapse ◽  
Operative Time ◽  
Rectal Resection ◽  
Stapled Transanal Rectal Resection ◽  
Significant Difference ◽  
Delorme’S Procedure ◽  
Group 2 ◽  
Delorme's Procedure ◽  
Group 1

Purpose. The optimal surgical approach for full-thickness rectal prolapse (FTRP) remains controversial. In China, patients with limited FTRP (<5 cm in length) are usually managed by perineal surgery. We retrospectively assessed the outcome of Delorme’s procedure and compared it with modified stapled transanal rectal resection (STARR). Methods. The study was conducted in 2 public tertiary referral centers in China with modified STARR or Delorme's procedure performed by experienced surgeons. Outcomes assessed recurrence, operative times, blood loss, complications, length of hospital stay, and continence and constipation scoring. Results. Between December 2012 and May 2019, 65 patients were assessed, including 48 with modified STARR (group 1) and 17 with Delorme’s procedure (group 2). The median follow-up was 22 months (range, 3-86 months). The mean operative time for group 1 was 37.4 ± 17.5 minutes vs 74.3 ± 30.6 minutes for group 2 ( P < .001). The blood loss for group 1 was significantly lower than that for group 2 (17.4 ± 15.9 mL vs 27.8 ± 16.7 mL, respectively; P = .028). There was no significant difference between groups in recurrence (group 1 18.8% vs group 2 23.5%; P = .944) with no effect of operation type. Both procedures showed improvement in constipation and continence scoring with a similar impact. Conclusions. Modified STARR and the Delorme operation are comparable in managing limited FTRP with superior results in operative time and blood loss for STARR.

scholarly journals Endothelin-1 Level in Patients with Simple Renal Cyst

Folia Medica ◽  
2019 ◽  
Vol 61 (4) ◽  
pp. 545-550 ◽  
Author(s):  
Selahattin Çalişkan ◽  
Mustafa Sungur ◽  
Bariş Eser ◽  
Mustafa Kanbay ◽  
Hüseyin Kocan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Kidney Disease ◽  
Renal Cyst ◽  
Renal Cysts ◽  
Systemic Hypertension ◽  
Simple Renal Cyst ◽  
Endothelin 1 ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Introduction: Endothelin-1 (ET-1) is potent vasoconstrictive peptide and elevated ET-1 levels are associated with hypertension, endothelial dysfunction and atherosclerosis. Research on (ET-1) has demonstrated that elevated ET-1 levels in autosomal dominant polycystic kidney disease leads to systemic hypertension. The prevalence of simple renal cysts increases with age and the association with simple renal cyst and hypertension is not clear. The aim of this study was to investigate the ET-1 levels in patients with simple renal cyst and compare them with those in healthy adults. Materials and methods: The study included patients that underwent laparoscopic renal cyst decortication in the Department of Urology and healthy controls. Serum and urinary ET-1 levels were measured before surgery and one month after it in the patients with simple renal cyst. Serum ET-1 levels were measured in healthy adult patients. Ambulatory blood pressure was measured in all patients. Glomerular filtration rate was measured according to the chronic kidney disease epidemiology collaboration formula. Results: Thirty-two patients were included in the present study. Of these, 16 patients with simple renal cyst were allocated into group 1 and 16 healthy patients - in group 2. There was no significant difference between systolic and diastolic blood pressure between the groups (p=0.820 and p=0.618, respectively). Serum EL-1 levels were significantly lower in group 1 than those in group 2 (p=0.036). Interestingly, serum EL-1 levels were increased after laparoscopic cyst decortication and there was no significant difference with healthy patients (p=0.429). Conclusions: The present study demonstrated that serum EL-1 level in patients with simple renal cyst was lower than that in healthy people. Further studies are needed to investigate the EL-1 levels in simple renal cyst patients.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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