Optimization of medical support of patients with partial absence of teeth in the pre- and postoperative period

2019 ◽  
Vol 24 (1) ◽  
pp. 73-79
Author(s):  
M. V. Kannoeva ◽  
E. V. Zoryan ◽  
A. I. Ushakov
Keyword(s):  
Postoperative Period ◽  
Early Postoperative Period ◽  
Research Topic ◽  
Bone Augmentation ◽  
Surgical Wound ◽  
Medical Support ◽  
Medical Preparation ◽  
Dental Implantation ◽  
Surgical Preparation

The relevance of the research topic. Despite of the improvement of methods of dental implantation the frequency of infectious and inflammatory complications caused mainly by infection of the surgical wound with the microflora of the oral cavity remains relatively high.Purpose. Improving of the effciency of surgical treatment of patients with partial secondary adentia during dental implantation and reducing the risk of development and the volume of complications by changing the protocol of medical support in the pre-and postoperative period.Methods. A comparative analysis of the results of the use of various schemes of medical support including the inclusion of antihomotoxic drugs in 346 patients during intraosseous dental implantation with preliminary surgical preparation of bone tissue in the period 2010-2017 was done. In accordance with the nature of the therapy, all patients were divided into 2 groups. Patients of the 1st group (140 people – 40,5%) underwent standard medical preparation in combination with antihomotoxic medicines. Patients of the 2nd group (139 people – 40,2%) received pre - and postoperative medication without the inclusion of antihomotoxic drugs according to the above scheme. There was also a separate group of patients who were contraindicated antibacterial therapy (67 people – 19,3%), who were prescribed antiseptic and antihomotoxic medicines.Results. In the early postoperative period, inflammatory complications were signifcantly more common in the group of patients received standard therapy in contrast to the groups in which antihomotoxic drugs were included (p < 0.05). In the long-term postoperative period the complications of bone augmentation operations were revealed in 29 cases out of 346, the rate of complications was 8.4% (frequency 10.0%; confdence interval: 5.6-16.4%).Summary. On the basis of our research we made a conclusion about the usefulness of homeopathic medicines in the standard scheme of the pre - and postoperative medical support of patients during dental implantation and related operations.

scholarly journals Features of postoperative healing after osteoplasty of alveolar applications in patients with a galvanic pathology

2020 ◽  
Vol 102 (3) ◽  
pp. 54
Author(s):  
O. Tymofieiev ◽  
◽  
V. Kohut ◽  
Keyword(s):  
Postoperative Complications ◽  
Oral Cavity ◽  
Polylactic Acid ◽  
Postoperative Period ◽  
Severe Pain ◽  
Early Postoperative Period ◽  
Metal Alloys ◽  
Dental Implantation ◽  
Surgical Preparation

Purpose. The features of healing of postoperative wounds after osteoplasty of alveolar processes of jaws with the use of titanium and bioresorbable membranes in patients with galvanic pathology were studied. Methods. There were examined 120 patients, aged 19 to 35 years, with or without metal dentures. In the course of surgical preparation of alveolar processes of jaws for further dental implantation (osteoplasty of alveolar processes), bioresorbable membranes based on polylactic acid and membranes made of titanium were used. Depending on the presence or absence of galvanic pathology, all patients were divided into 4 groups. Results. It was found that in patients without galvanic pathology, postoperative healing occurs without inflammatory complications. In patients with galvanic (compensated and/or decompensated form) in the early postoperative period, 51.6 % of the examined patients appeared complications in the form of severe pain and other inflammatory complications. In patients with galvanosis (atypical and typical forms) both early (82.8 %) and late (10.4 %) postoperative complications occurred in the postoperative period. All postoperative complications were equally common in the subjects who were using titanium membranes and in patients with bioresorbable membranes. Conclusions. It was established that in the presence of non-removable metal dentures in the oral cavity made of base of ignoble metal alloys, leading to the development of galvanism or galvanosis, there are early and late inflammatory complications in the preparation of alveolar processes for dental implantation, which significantly prolongs the time of healing of postoperative wounds.

scholarly journals Long-term postoperative opioid prescription after cholecystectomy or gastric by-pass surgery: a retrospective observational study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Viktoria Larsson ◽  
Cecilia Nordenson ◽  
Pontus Karling
Keyword(s):  
Observational Study ◽  
Postoperative Period ◽  
Medical Records ◽  
Early Postoperative Period ◽  
Retrospective Observational Study ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Post Surgery ◽  
Gastric By Pass

Abstract Objectives Opioids are commonly prescribed post-surgery. We investigated the proportion of patients who were prescribed any opioids 6–12 months after two common surgeries – laparoscopic cholecystectomy and gastric by-pass (GBP) surgery. A secondary aim was to examine risk factors prior to surgery associated with the prescription of any opioids after surgery. Methods We performed a retrospective observational study on data from medical records from patients who underwent cholecystectomy (n=297) or GBP (n=93) in 2018 in the Region of Västerbotten, Sweden. Data on prescriptions for opioids and other drugs were collected from the patients` medical records. Results There were 109 patients (28%) who were prescribed opioids after discharge from surgery but only 20 patients (5%) who still received opioid prescriptions 6–12 months after surgery. All 20 of these patients had also been prescribed opioids within three months before surgery, most commonly for back and joint pain. Only 1 out of 56 patients who were prescribed opioids preoperatively due to gallbladder pain still received prescriptions for opioids 6–12 months after surgery. Although opioid use in the early postoperative period was more common among patients who underwent cholecystectomy, the patients who underwent GBP were more prone to be “long-term” users of opioids. In the patients who were prescribed opioids within three months prior to surgery, 8 out of 13 patients who underwent GBP and 12 of the 96 patients who underwent cholecystectomy were still prescribed opioids 6–12 months after surgery (OR 11.2; 95% CI 3.1–39.9, p=0,0002). Affective disorders were common among “long-term” users of opioids and prior benzodiazepine and amitriptyline use were significantly associated with “long-term” opioid use. Conclusions The proportion of patients that used opioids 6–12 months after cholecystectomy or GBP was low. Patients with preoperative opioid-use experienced a significantly higher risk of “long-term” opioid use when undergoing GBP compared to cholecystectomy. The indication for being prescribed opioids in the “long-term” were mostly unrelated to surgery. No patient who was naïve to opioids prior surgery was prescribed opioids 6–12 months after surgery. Although opioids are commonly prescribed in the preoperative and in the early postoperative period to patients with gallbladder disease, there is a low risk that these prescriptions will lead to long-term opioid use. The reasons for being prescribed opioids in the long-term are often due to causes not related to surgery.

Use of morning serum cortisol level after transsphenoidal resection of pituitary adenoma to predict the need for long-term glucocorticoid supplementation

2009 ◽  
Vol 111 (3) ◽  
pp. 540-544 ◽  
Author(s):  
Nicholas F. Marko ◽  
Vivek A. Gonugunta ◽  
Amir H. Hamrahian ◽  
Ali Usmani ◽  
Marc R. Mayberg ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Cortisol Level ◽  
Postoperative Period ◽  
Serum Cortisol ◽  
Early Postoperative Period ◽  
Serum Cortisol Level ◽  
Total Serum ◽  
Total Cortisol ◽  
Hpa Function

Object Accurate assessment of the hypothalamic-pituitary-adrenal (HPA) axis is critical for appropriate management of the disease in patients with pituitary adenoma after transsphenoidal resection. The authors examine the role of the morning total serum cortisol level in the early postoperative period as a predictor of long-term HPA function. Methods Morning total serum cortisol was measured in 83 patients on postoperative Day 1 (or Day 2 if the patient received glucocorticoids during surgery) after transsphenoidal surgery for pituitary adenoma. These results were compared with those of definitive assays of HPA function performed at 1–3 months postoperatively, including cortrosyn/synacthen stimulation test (CST), insulin tolerance test (ITT), and metyrapone test (MTT). The ability of the early-postoperative morning cortisol level to predict HPA function was determined using standard confusion matrix calculations and receiver-operator control curve analysis. Results The authors found that an early postoperative morning total cortisol level ≥ 15 μg/dl is a sensitive and accurate predictor of normal HPA function in the postoperative period (sensitivity 80.5%, specificity 66.7%, positive predictive value 96.9%). Conclusions A morning total cortisol level ≥ 15 μg/dl in the early postoperative period after transsphenoidal surgery for pituitary adenomas is a good predictor of normal HPA function. This test has good sensitivity and accuracy and correlates well with the results of additional, definitive assays of HPA function (CST, ITT, and MTT) performed at 1–3 months postoperatively. Accordingly, it is the authors' practice to avoid exogenous perioperative glucocorticoid supplementation in patients with normal preoperative HPA function and postoperative morning total cortisol levels ≥ 15 μg/dl 1–2 days after transsphenoidal pituitary adenomectomy.

scholarly journals Cerebral arteriovenous malformations: features of the functioning of the blood circulation system after endovascular treatment with long-term monitoring

2020 ◽  
Vol 33 (3) ◽  
pp. 19-28
Author(s):  
S.V. Chebanyuk ◽  
O.E. Svyrydyuk ◽  
O.F. Sydorenko ◽  
M.Yu. Mamonova
Keyword(s):  
Computed Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Endovascular Treatment ◽  
Postoperative Period ◽  
Arteriovenous Malformations ◽  
Circulatory System ◽  
Early Postoperative Period ◽  
Dynamic Observation

Objective ‒ to determine the features of the functioning of the circulatory system in patients with arteriovenous malformations (AVM) of the brain after endovascular operations with long-term observation.Materials and methods. 479 patients with cerebral AVM were examined and treated, of which 377 (78.7 %) were men and 102 (21.3 %) were women. The average age of patients was (27.5±3.5) years. Patients aged 18‒30 years predominated (75.4 %). A dynamic observation of 347 patients after endovascular treatment after 3, 6, 12 and 24 months and more was carried out. Patients underwent cerebral angiography, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, echocardiography, Doppler cardiography, electrocardiography, duplex scanning of cerebral vessels.Results. The study shows the effect of arteriovenous shunting on cerebral and systemic hemodynamics in general. Switching off AVM from the cerebral blood flow improved cerebral hemodynamics already in the early postoperative period, the changes were more significant after 3‒6 months of observation and in some cases reached values ​​in healthy individuals 2 years after the operation. In 52.8 % of patients with AVM, systemic circulation disorders occurred due to an increase in heart rate, minute and stroke blood volumes, left ventricular ejection fraction with an increase in mechanical load on the heart, which led to changes in systolic contraction and diastolic relaxation of the left ventricle of the heart with the development of heart failure. Switching off the AVM from the cerebral blood flow did not cause significant changes in heart functions in the early postoperative period; positive changes occurred over a long period. Dynamic observation showed a positive restructuring of the functioning of the circulatory system in patients after endovascular exclusion of the malformation.Conclusions. Arteriovenous malformations are hemodynamically active systems that lead to hemodynamic-perfusion changes, both at the local and at the general hemodynamic level. The exclusion of the malformation from the bloodstream contributes to the regression of disorders of cerebral and intracardiac blood flow caused by the anatomical and functional characteristics of the malformation itself and its clinical course.

scholarly journals One-Stage Repair of Aortic Arch Hypoplasia Associated With Ventricular Septal Defect

2020 ◽  
pp. 52-56
Author(s):  
Y. Truba ◽  
R. Sekelyk ◽  
I. Dzyurii ◽  
L. Prokopovych ◽  
O. Golovenko ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Postoperative Period ◽  
Balloon Dilation ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
One Stage ◽  
The Mean ◽  
Aortic Arch Hypoplasia

  Background. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by ground. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by hemodynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypoplasia combined ynamically significant narrowing of one or more segments of the aortic arch. Aortic arch hypop with ventricular septal defect (VSD) characterizes a special category of children who are in serious condition and need ptal defect (VSD) characterizes a special category immediate surgery. Despite the improvement in the results of surgical treatment of this abnormality in recent years, the gery. Despite the imp issue of choosing treatment tactics remains debatable. g The aim. To analyze immediate and long-term results of one-stage aortic arch hypoplasia repair and VSD repair in infants. Materials and methods. From 2011 to 2019, 55 infants underwent simultaneous aortic arch hypoplasia repair in ypoplasia rep conjunction with VSD repair at the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine and junction with VSD repair at the National Amosov Institute of Cardiovascular Surgery Ukrainian Children’s Cardiac Center. There were 30 (55%) male patients and 25 (45%) female patients. The mean age of (55%) male patients and 25 (45%) female patients. The mean ag the patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg (from 2.4 to 8.7 patients was 1.3 ± 1.2 months (from 0.1 to 9.1 months), the average body weight was 3.9 ± 1.3 kg ( kg). The mean body surface area was 0.27 ± 0.1 m2. Antegrade selective cerebral perfusion was performed in 23 (42%) g). The mean body patients during the aortic arch reconstruction. g Results.The hospital mortality rate was 1.8% (n = 1). The average duration of artificial circulation was 108.5 ± 38.6 minpital mortality rate was 1.8% (n = 1). The averag utes (from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes), the time of selec(from 55 to 204 minutes), aortic clamping time was 56.9 ± 36.4 minutes (from 21 to 126 minutes) tive cerebral perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was spread perfusion was 26.4 ± 11.5 minutes (14 to 49 minutes). In eight patients (14.5%) the sternum was sp apart in the early postoperative period. Echocardiography before discharge revealed the average pressure gradient at the part in the early postoperative period. Echocardiograp site of plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. plasticity of the aortic arch of 20.5 ± 14.9 mm Hg. The mean long-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years). There were no fatal cases in the reg-term follow-up was 2.6 ± 2.1 years (from two months to 8.1 years) mote period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully treated period. In 5 (9.1%) patients aortic arch restenosis occurred in the postoperative period; it was successfully endovascularly by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long-term y by balloon dilation in 3 patients, the other 2 of them underwent repeated aortic arch repair. Long follow-up of other patients showed good results with respect to the pressure gradient at the aortic arch. There were p of other patients showed good results with respect to the pressure g no hemodynamically significant gradient after VSD closure. There were no neurological complications in the long-term follow-up. p Conclusions. One-stage complete repair is an effective and safe treatment for infants which provides good immedige complete repair is an effective and safe treatment for infants which provides g ate and long-term results. This surgical strategy may be an acceptable alternative to two-stage surgical treatment of this g complex pathology.

scholarly journals A 6-year experience of the Ross procedure in children with congenital aortic valve disease

2020 ◽  
Vol 48 (4) ◽  
pp. 240-245
Author(s):  
D. S. Akatov ◽  
V. A. Belov ◽  
D. E. Khomich ◽  
O. N. Bukhareva ◽  
A. A. Makarov ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Pulmonary Artery ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Ross Procedure ◽  
Optimal Method ◽  
Advantages And Disadvantages ◽  
The Mean

Background: The choice of an optimal method for correction of aortic valve stenosis or insufficiency remains the matter of debate. Some clinicians prefer transluminal balloon angioplasty, some would perform an open type commissurotomy, or aortic valve replacement, or to valve leaflets repair with various materials, while others opt for the Ross procedure. Each of these techniques has its advantages and disadvantages both in the early postoperative period and in the long-term.Aim: To assess the results of the Ross procedure, its complications, survival, and probability of reoperations in the long-term.Materials and methods: We retrospectively analyzed the results of 32 Ross procedures performed from the end of 2012 to the beginning of 2019 in children aged from 3 days to 18 years. Eight children were below 1 year of age, including one newborn. A pulmonary autograft was placed into the aortic position in all children. In 31 children, a homograft was placed into the pulmonary artery. In one patient, an aortic autograft was implanted instead of the pulmonary artery valve. The mean patient age was 6.8 years, mean bodyweight 27.7 kg (range, 3.9–74.6 kg).Results: Two patients died in the early postoperative period (mortality 6.25%). We examined 26 patients at the follow-up, with its mean duration of 2.5 years. There were no indications for replacement of the homograft during the follow-up. One patient, in whom we had implanted an aortic autograft into the pulmonary position, required its replacement after 4.5 years. We have no data on death rates in the long-term.Conclusion: The Ross procedure provides satisfactory results in the early and intermediate postoperative period. Continuous follow-up is needed to determine the time points and the proportion of repeated interventions with a pulmonary homograft and aortic valve.

scholarly journals TYPE OF FUNDOPLICATION FOR LAPAROSCOPICHIATAL HERNIA REPAIR, COMPLICATED BY GASTROESOPHAGEAL REFLUX DISEASE

2021 ◽  
pp. 29-39
Author(s):  
A. G. Grintcov ◽  
R. V. Ishenko ◽  
I. V. Sovpel ◽  
I. E. Sedakov ◽  
O. V. Sovpel ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Postoperative Period ◽  
Reflux Disease ◽  
Intraoperative Complications ◽  
Early Postoperative Period ◽  
Long Term Outcomes

Purpose. To analyze short-term and long-term outcomes of surgical treatment of the patients with hiatal hernia complicated by gastroesophageal reflux disease, depending on the choice of fundoplication method.Materials and methods. A retrospective analysis of the short and long-term outcomes of the treatment of 171 patients suffering hiatal hernia complicated by gastroesophageal reflux disease was performed. All patients were underwent laparoscopic hiatal hernia repair supplemented by Nissen fundoplication - 109 patients or Toupet fundoplication – 62 patients.Results. In the Nissen fundoplication group the incidence of intraoperative complications was 9.2% (11 patients), postoperative complications – 8.3% (9 patients), dysphagia in the early postoperative period was noted in 24 (22%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 6 (5.5%) patients, anatomical recurrence in 13 (11.9%) patients. Dysphagia in the late postoperative period was noted in 7.3% (8 patients). In the Toupet fun doplication group the incidence of intraoperative complications was 11.3% (7 patients), the incidence of postoperative complications was 6.5% (4 patients), functional dysphagia in the early postoperative period was noted in 8 (12.9%) patients. In 5 years after surgery, gastroesophageal reflux was observed in 8 (12.9%) patients, anatomical relapse in 13 (11.9%) patients. Persistent long-term dysphagia in the late postoperative period was noted in 2(3.2%) patients.Findings. The choice of fundoplication method did not significantly affect on the duration of surgery, the frequency of intraoperative and postoperative complications, duration hospital stay, the incidence of early functional postoperative dysphagia, the number of unsatisfactory results in the long term period, including recurrence and dysphagia.

scholarly journals The Long-Term Change of Arrhythmias after Transcatheter Closure of Perimembranous Ventricular Septal Defects

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hongyan Zheng ◽  
Aiwen Lin ◽  
Li Wang ◽  
Yukai Xu ◽  
Zhiwei Zhang
Keyword(s):  
Postoperative Period ◽  
Transcatheter Closure ◽  
Conduction Block ◽  
Early Postoperative Period ◽  
Bundle Branch Block ◽  
Conduction Abnormality ◽  
Severe Arrhythmia ◽  
Term Change

Objectives. To observe and analyze the long-term change of different types of arrhythmias after transcatheter closure of perimembranous ventricular septal defect (pmVSD). Methods. We retrospectively collected the data of patients who underwent pmVSD closure in our institution from March 2002 to December 2010. Results. One hundred thirty-nine patients met the inclusion criteria, of which 265 (25.5%) had early arrhythmia. They were classified into two categories: conduction abnormality (191/1039; 18.4%) and origin abnormality (94/1039; 9.0%), including 20 patients with both types of arrhythmias. The median follow-up time was 84.5 months, and 103 patients (103/191; 53.9%) with early conduction block got permanent arrhythmias, while only three patients (3/94; 3.2%) with early anomalous origin arrhythmias still had an abnormal electrocardiogram. Serious arrhythmias (28/1039; 2.7%), including II° atrioventricular block (AVB), III° AVB, and complete left bundle branch block (CLBBB), can appear immediately in the early postoperative period (21 patients) or in the late outset (seven patients) after several months or even years (6 months to 8.3 years). Twenty patients (20/21; 95.2%) with serious arrhythmia in the early postoperative period improved after early treatment, but six patients relapsed or worsened during follow-up. At the endpoint, severe arrhythmia persisted in 13 patients, of which four patients got permanent pacemaker implanted, and one patient with recurrent CLBBB died from heart failure. Conclusions. The probability of delayed CAVB or bundle branch block after VSD closure is low but often occurs several years after surgery. Therefore, long-term ECG follow-up should last for several years or even decades. Serious arrhythmias that appear early after transcatheter pmVSD closure may impose a risk of recurrence although they have been cured already. Close attention should be paid to the changes of cardiac function in patients with CLBBB after VSD closure, and the severity of such arrhythmia should be taken seriously and reexamined.

Clinical and microbiological evaluation of the effectiveness of modern phyto- and antibacterial drugs in the early postoperative period after dental implantation

2015 ◽  
Vol 9 (4) ◽  
pp. 0-0
Author(s):  
Ромащенко ◽  
V. Romashchenko ◽  
Мануйлов ◽  
B. Manuylov ◽  
Дробышев ◽  
...  
Keyword(s):  
Postoperative Period ◽  
High Efficiency ◽  
Early Postoperative Period ◽  
Water Soluble ◽  
Herbal Drugs ◽  
Degree Of Contamination ◽  
Antibacterial Drugs ◽  
Dental Implantation ◽  
Medicinal Plant Extracts ◽  
Clinical Healing

Prescription of antibacterial drugs for patients after operation of dental implantation remains the main method of prevention of postoperative complications. Despite the correct the postoperative period, these drugs have several side effects, and in some cases the use of antibiotics is contraindicated due to the presence of allergic reactions. The study involved 20 patients of different ages (from 25 to 70 years) without the comorbidity or at the stage its compensation accompanied allergic history and of odontogenic infection foci. Dental implantation was carried out due to the complete or partial absence of teeth. In the postoperative period antibiotic therapy and modern herbal drugs were prescribed to patients. The modern herbal drugs were the &#34;Tonzinal&#34; and the plates «ЦМ-1», consisting of medicinal plant extracts obtained using innovative technologies that allow to select targeted water-soluble therapeutic substances at the molecular level. The study consists of evaluation the dynamics of subjective feelings of patients, clinical healing, as well as the degree of contamination of the wound pathogenic microflora. In the early postoperative period after dental implantation, the healing occurred by primary intention, without dehiscence and inflammation in patients of both groups (in the first – antibiotics therapy, in the second - application of modern herbal drugs). The analysis of microbiological studies in patients of both groups proved the reduction in the degree of contamination of the wound surface by opportunistic pathogens. The results defined high efficiency of modern herbal drugs.

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