Experience in a comprehensive pre-test risk assessment of thromboembolic complications in surgical patients with a high risk of congenital thrombophilia.

2021 ◽  
Author(s):  
Л.К. Каражанова ◽  
С.А. Исаханова
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Group Testing ◽  
Age Groups ◽  
Surgical Patients ◽  
Control Group ◽  
Thromboembolic Complications ◽  
Test Assessment ◽  
Venous Thromboembolic ◽  
Prevention Method

Введение. Каждый год около трети летальных исходов от венозных тромбоэмболических осложнений (ВТЭО) в мире приходится на долю пациентов, перенесших хирургические вмешательства. Традиционные подходы в оценке рисков не всегда подходят пациентам хирургического профиля в связи с широкой разрозненностью возрастных групп, наличием пациентов с различными тромбофилическими состояниями, высокими рисками предстоящих вмешательств и низкой настороженностью персонала. Выходом из этой ситуации является поиск лучших инструментов для проведения предтестовой диагностики. Цель исследования: анализ результатов комплексной предтестовой оценки риска развития ВТЭО у пациентов хирургического профиля с высоким риском наличия врожденных тромбофилий. Материалы и методы. Обследовано 35 пациентов с одним из проявлений ВТЭО (основная группа) и 55 пациентов, указавшие на наличие ВТЭО у себя в прошлом или у родственников первой кровной линии в возрасте до 50 лет (контрольная группа). Проведено тестирование по шкалам Geneva, Wells, Caprini с последующим анализом. Для выявления нарушений в системе протеина С применяли «Парус-тест». Результаты. Предтестовая оценка с применением шкалы Caprini и нормализованного отношения (НО) «Парус-теста» показала высокий риск развития ВТЭО у пациентов обеих групп. Заключение. Тестирование с помощью шкалы Caprini и НО «Парус-теста» показало хорошие результаты для оценки рисков развития ВТЭО и качественного подбора метода профилактики ВТЭО у пациентов хирургического профиля. Background. Every year, about a third of deaths from venous thromboembolic complications (VTEC) in the world occur among surgical patients. Traditional risk assessment is not always suitable for surgical patients due to the wide disparity of age groups, the presence of patients with various thrombophilic conditions, high risks of forthcoming interventions, and low medical staff alertness. The solution is to find the best tools for pre-test diagnostics. Objectives: to analyze the results of a comprehensive pre-test assessment of VTEC risk in surgical patients with a high risk of congenital thrombophilia. Patients/Methods. We examined 35 patients with one of VTEC manifestations (main group) and 55 patients who had a history of VTEC or VTEC episode in first blood line relatives under the age of 50 (control group). Testing was carried out according to Geneva, Wells, and Caprini scales with subsequent analysis. Parus-test was used to detect the disturbances in protein C system. Results. The pre-test assessment using the Caprini scale and the normalized ratio (NR) of Parus-test showed a high risk of VTEC in patients of both groups. Conclusions. Testing with the Caprini scale and NR of Parus-test showed good results for assessment of VTEC risks and for a qualitative selection of VTEC prevention method in surgical patients.

POLYMORPHISM OF GENE IL2-330Т>>G AND EXPRESSION OF INTERLEUKIN-2 IN PATIENTS WITH VENOUS THROMBOEMBOLIC COMPLICATIONS OF POLYTRAUMA

2017 ◽  
Author(s):  
А. Мироманов ◽  
В. Доржеев ◽  
Н. Мироманова ◽  
Ю. Витковский
Keyword(s):  
Molecular Genetic ◽  
Interleukin 2 ◽  
Clinical Manifestations ◽  
Molecular Genetic Analysis ◽  
Control Group ◽  
Thromboembolic Complications ◽  
Inclusion Criteria ◽  
Study Results ◽  
Venous Thromboembolic ◽  
Analysis Point

Введение. Политравма отличается особой тяжестью клинических проявлений, сопровождается значительным нарушением жизненно важных функций организма, трудностью диагностики и лечения, частым развитием разнообразных осложнений, длительным периодом пребывания в стационаре и высокой инвалидизацией. Тромбоэмболические осложнения при политравме встречаются в 40–77% случаев и характеризуются скрытым клиническим течением, трудностью лечения и высокой летальностью. Цель исследования. Изучить влияние полиморфизма гена IL2-330T{>{G на экспрессию интерлейкина-2 (IL-2) у пациентов с венозными тромбоэмболическими осложнениями (ВТЭО) политравмы в Забайкальском крае. Материалы и методы. В исследование включено 114 пациентов (71,9% мужчин и 28,1% женщин) в возрасте от 20 до 40 лет с политравмой. Критерий включения в исследование: политравма с индексом по шкале ISS более 9. Первая группа — 73 пациента с неосложнённым течением политравмы, вторая группа — 41 пациент с ВТЭО политравмы. Контрольную группу составили 100 практически здоровых мужчин и женщин в возрасте от 20 до 40 лет. Материалом для молекулярно-генетического анализа служили образцы ДНК, выделенные из периферической крови. Для исследования выбрана точковая мутация IL-2 в позиции 330 (Т{>{G). Результаты. У пациентов с ВТЭО политравмы регистрировали более частое носительство генотипа -330T/T гена IL2; наличие этого генотипа сопровождалось увеличением продукции IL-2. Заключение. Идентификация генов и раскрытие их влияния на экспрессию кодируемых молекул способствует более глубокому пониманию патогенетических механизмов развития осложнений. Introduction. Polytrauma is characterized by a specifi c severity of clinical manifestations, is accompanied by a signifi cant impairment of vital body functions, the diffi culty of diagnosis and treatment, frequent development of various complications, prolonged period of hospitalization and high disability. Thromboembolic complications of polytrauma occur in 40–77% of cases and characterized by latent clinical course, diffi culties in treatment and high mortality. The aim was to study the eff ect of gene IL2-330T{>{G polymorphism on the expression of interleukin-2 (IL-2) at patients with venous thromboembolic complications (VTE) of polytrauma in Zabaykalskiy Krai. Materials and methods. The study included 114 patients (71,9% men and 28,1% women) with polytrauma aged from 20 to 40 years. Inclusion criteria: polytrauma with index according ISS scale more than 9. First group — 73 patients with uncomplicated polytrauma, second group — 41 patients with VTE of polytrauma. Control group consisted of 100 practically healthy men and women aged from 20 to 40 years. DNA samples isolated from the peripheral blood were the material for molecular genetic analysis. Point mutation of IL-2 at position 330 (T{>{G) was selected for study. Results. Genotype -330T/T of IL2 gene was registered more frequently at patients with VTE of polytrauma; the presence of this genotype was accompanied by increased production of IL-2. Conclusion. Identifi cation of genes and their eff ects on the expression of encoded molecules assists more overall understanding of pathogenetic mechanisms of complications development.

Absence of Beneficial Effect of Acute Normovolemic Hemodilution Combined with Aprotinin on Allogeneic Blood Transfusion Requirements in Cardiac Surgery

2002 ◽  
Vol 96 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Laurent Höhn ◽  
Alexandre Schweizer ◽  
Marc Licker ◽  
Denis R. Morel
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Blood Transfusion ◽  
Allogeneic Blood ◽  
Surgical Patients ◽  
Control Group ◽  
Acute Normovolemic Hemodilution ◽  
Normovolemic Hemodilution ◽  
Normal Cardiac Function

Background The efficacy of acute normovolemic hemodilution (ANH) in decreasing allogeneic blood requirements remains controversial during cardiac surgery. Methods In a prospective, randomized study, 80 adult cardiac surgical patients with normal cardiac function and no high risk of ischemic complications were subjected either to ANH, from a mean hematocrit of 43% to 28%, or to a control group. Aprotinin and intraoperative blood cell salvage were used in both groups. Blood (autologous or allogeneic) was transfused when the hematocrit was less than 17% during cardiopulmonary bypass, less than 25% after cardiopulmonary bypass, or whenever clinically indicated. Results The amount of whole blood collected during ANH ranged from 10 to 40% of the patients' estimated blood volume. Intraoperative and postoperative blood losses were not different between control and ANH patients (total blood loss, control: 1,411 +/- 570 ml, n = 41; ANH: 1,326 +/- 509 ml, n = 36). Allogeneic blood was given in 29% of control patients (median, 2; range, 1-3 units of packed erythrocytes) and in 33% of ANH patients (median, 2; range, 1-5 units of packed erythrocytes; P = 0.219). Preoperative and postoperative platelet count, prothrombin time, and partial thromboplastin time were similar between groups. Perioperative morbidity and mortality were not different in both groups, and similar hematocrit values were observed at hospital discharge (33.7 +/- 3.9% in the control group and 32.6 +/- 3.7% in the ANH group; nonsignificant) Conclusions Hemodilution is not an effective means to lower the risk of allogeneic blood transfusion in elective cardiac surgical patients with normal cardiac function and in the absence of high risk for coronary ischemia, provided standard intraoperative cell saving and high-dose aprotinin are used.

P01-303-Vegetative status in infants of high-risk for schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 305-305
Author(s):  
M.A. Kalinina ◽  
G.N. Schimonova
Keyword(s):  
High Risk ◽  
Mental State ◽  
Motor Development ◽  
Prognostic Significance ◽  
Age Groups ◽  
Control Group ◽  
First Year ◽  
Autonomic Tone ◽  
Autonomic Disorders ◽  
First Year Of Life

IntroductionThe study of clinical features and prognostic significance of autonomic disorders are among the most pressing problems of modern medicine.ObjectivesDynamically within 5 years were observed 50 children at high risk for schizophrenia and 40 children with hypoxic-ischemic encephalopathy of the general population. Aims. Evaluation of prognostic significance of autonomic disorders in infancy for mental health in older age groups.MethodsAll patients were examined by clinical methods and EEG, neurosonografia, original screening tables for early childhood.ResultsIn the first year of life in children at high risk for schizophrenia observed mental and motor development within the syndrome of PDD.In infancy the vagotonic orientation prevailed 72, 5%. By 3 years it changed to the amphotonic orientation reaching 76, 0% of children, while the 10, 0% acquired sympathotony, the rest remained vagotonic.The mental state of 37 children to 5 years qualified as schizotipical disorder (F 21.8). In 13 children it was diagnosed schizophrenia, children's type (F20.8). Frequent and sudden changes in the type of tonus correlated with the deterioration of the mental state of a different nature.In the control group at the first year of life prevailed vagotonic orientation, which gradually to age of one year changed by eutonic. During the first 3–5 months of infancy revealed some unstable circulatory, sleep disorders.ConclusionsThe instability of autonomic tone and an abundance of vegetative violations indicate the risk of mental pathology.

scholarly journals Treatment and secondary prevention of venous thromboembolism in cancer patients

Kardiologiia ◽  
2020 ◽  
Vol 60 (3) ◽  
pp. 71-79
Author(s):  
G. A. Shakaryants ◽  
D. A. Budanova ◽  
K. V. Lobastov ◽  
N. V. Khabarova ◽  
Yu. Yu. Kirichenko ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Secondary Prevention ◽  
Cancer Patients ◽  
Risk Group ◽  
High Risk Group ◽  
Efficacy And Safety ◽  
Thromboembolic Complications ◽  
Oncological Patients ◽  
Venous Thromboembolic

Oncological patients are a high-risk group for venous thromboembolic complications. These complications significantly impair the outcome of antitumor treatment and take a leading place in the structure of mortality. Treatment of venous thromboembolic complications in oncological patients is a serious challenge. When selecting an anticoagulant, the physician should consider its efficacy and safety and possible drug interactions. Based on results of multiple studies presented in this article, physicians will be able to choose an optimum therapeutic tactics and secondary prevention of thromboembolic complications for this group of patients.

scholarly journals Indirect Electroimpulse Myostimulation and Its Role in Treatment of Patients with Shin Bone Fractures

2015 ◽  
Vol 22 (4) ◽  
pp. 21-25
Author(s):  
V. N Obolenskiy ◽  
A. V Karpenko ◽  
N. V Zagorodniy
Keyword(s):  
Bone Fractures ◽  
Plate Osteosynthesis ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Thromboembolic Complications ◽  
Randomized Controlled ◽  
Electric Muscle Stimulation ◽  
Venous Thromboembolic

Prospective randomized controlled study to evaluate the efficacy of electric muscle stimulation (EMS) of calf muscles in prevention of venous thromboembolic complications (VTEC), shortening of treatment and rehabilitation terms in patients with shin bones fractures was performed. The study included 60 patients, aged 19-67 years, with isolated shin bones fractures. All patients were admitted at early (from 0.5 to 3 hours) terms after injury. For final fixation either intramedullary or plate osteosynthesis were used. All patients were on anticoagulant therapy for VTEC prevention. In the study group ( n =30) 2 séances of EMS, 3 hours each, were performed daily from the first day of hospitalization. In 30 patients from the control group EMS was not performed. It was shown that application of EMS ensured the shortening of treatment and rehabilitation terms, better quality of life and enabled to avoid VTEC development. Achieved preliminary data are indicative of the expediency of EMS application in traumatologic patients at early hospital stage.

Investigation of constipation condition of surgical patients

2021 ◽  
Vol 11 (1) ◽  
pp. 31-35
Author(s):  
Eda Dolgun ◽  
Yelda Candan Dönmez
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Groups ◽  
High Risk Group ◽  
Assessment Scale ◽  
University Hospital ◽  
Surgical Patients ◽  
Scale Scores ◽  
Rome Iii ◽  
The Mean

Purpose: The study was planned to examine the constipation condition of surgical patients. Materials and methods: The universe of this descriptive study consisted of patients who underwent surgery between May 2016 - 2017 in a university hospital general surgery clinic. Patients (n=57) who were operated on this clinic at the specified dates and agreed to participate in the study constituted the sample of the study. A questionnaire about the identity information of the patients and Constipation Risk Assessment Scale are used collecting the data. A written permission was obtained from the Scientific Ethics Board and the institution where the study was conducted for the investigation to be carried out. The data was evaluated in numbers and percentage in SPSS 16.0 software package. Results: The mean age of the patients was 53.43±12.75 years and 63.2% of them were female. When the defecating of the patients was examined in accordance with the ROME III constipation diagnoses criteria, it was determined that the 24.6% of the patients had one, 15.8% of them had two and 7.0% of them had three of the criteria. The mean score of the Constipation Risk Assessment Scale of the patients was found to be 8.49 points. When the scale scores of the patients were examined, it was seen that 73.7% had <10 low risk, 19.3% 11-15 moderate risk and 7.0%>16 high risk group. Conclusions: Some of the patients were found to have constipation problems, and patients were also seen in the middle and high-risk groups according to the results of the risk assessment scale.

PREVENTION OF THROMBOEMBOLIC COMPLICATIONS OF SURGICAL PATIENTS.

2021 ◽  
pp. 35-37
Author(s):  
V. V. Liesnyi ◽  
V. O. Filonenko ◽  
A. S. Liesna
Keyword(s):  
Medical Records ◽  
Surgical Patients ◽  
Clinical Group ◽  
Thromboembolic Complications ◽  
Compression Stockings ◽  
Moderate Risk ◽  
Surgical Department ◽  
The Third ◽  
Retrospective Assessment ◽  
Venous Thromboembolic

Summary. Aim. To analyze the clinical significance of the Caprini scale for the prevention of venous thromboembolic complications (VTEС) in urgent surgical patients. Materials and methods. The study is based on a retrospective assessment of inpatient medical records of 58 patients in the surgical department, who were divided into three clinical groups according to the characteristics of the Caprini scale. The results. The first clinical group - 11 (19%) patients with low risk VTEС. Prevention of VTEС was carried out only using compression stockings. The second clinical group consisted of 25 (43.1%) patients with moderate risk of VTEС. Prevention of VTEС was performed using compression stockings for (4.4 ± 0.6) days and the introduction of enoxaparin at a dose of 2000 anti-Xa IO 1 time per day for 5 days. The third clinical group consisted of 22 (37.9%) patients at high risk of VTEС. Prevention of VTEС was performed using compression stockings, the use of enoxaparin by subcutaneous injection at a dose of 4000 anti-Xa IO 1 time per day for 7 days. Conclusions. The study found that the Caprini scale is effective for assessing the risk of VTEС and allows you to choose rational tactics for the prevention of thromboembolic complications in urgent surgical patients.

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