Evaluation of suitability of simultaneous laparoscopic surgery for the treatment of diseases of the hepatobiliary system

Annotation. Aim of work - to investigate the impact of the developed technique of simultaneous laparoscopic operations on the results of treatment of surgical hepatobiliary pathology, to analyze and compare the main indicators of efficiency and safety of own technique with the "French" technique of cholecystectomy. During period from 2013 to 2019, 253 patients with combined hepatobiliary pathology and gallstone disease were treated using our own simultaneous surgery technique (group 1) and 328 patients with only gallstone disease treated using standard 'French technique' (group 2). The comparison was made through the analysis and comparison of such indicators as the duration of treatment, duration of surgery, serum creatinine concentration, glycemia, blood pressure. Shapiro-Wilk statistical methods, Mann-Whitney criteria or U-test were used. The following results were obtained: the duration of the operation was 66.14±6.21 minutes in the first group against 42.6±4.72 minutes in the second and did not exceed 2 hours; blood creatinine concentration did not exceed the allowable 2 mg/dl in both groups and differed slightly (p = 0.937), normalized in the period 6-12 h; glycemia also did not differ between the study and control groups and normalized during the recovery period of oral nutrition (p=0.822); Blood pressure was monitored to maintain normotony, the difference between intraoperative parameters in both groups was insignificant (p=0.912); the length of stay had no statistically significant difference between the groups (p=0.784) and was 3.53 days for the first and 3.45 for the second group. The method is valid for modern requirements, and the technique justifies its use.

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Cardiovascular, lactate and appetite response to light and spicy music tempo after an endurance swimming protocol in young girls

Pedagogy of Physical Culture and Sports ◽

10.15561/26649837.2020.0407 ◽

2020 ◽

Vol 24 (4) ◽

pp. 195-202

Author(s):

Javad Mehrabani ◽

Soodabeh Bagherzadeh ◽

Abuzar Jorbonian ◽

Eisa Khaleghi-Mamaghani ◽

Maryam Taghdiri ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Recovery Period ◽

Young Girls ◽

Significant Difference ◽

Before And After ◽

Lactate Levels ◽

The Impact

Background and Study Aim. During exercise, the effects of music on the performance have been previously evaluated. However, the superiority of the type of music and during recovery is not yet clear. Therefore the aim of this study was to determine the impact of music with a spicy and light beat on changes in lactate levels, blood pressure, heart rate, and appetite during the recovery period after the endurance swimming. Material and Methods. Thirteen healthy young girls participate in three control and experimental sessions. The participants performed a swimming. Immediately after swimming, they listened to music. Also, evaluations before and after (several times) swimming were performed.Results. Five minutes after swimming there was also a significant difference between the non-sound group with the music groups (p<0.05). Two and 5 minutes after swimming, there was a significant difference between the spicy and light music groups compared to the non-sound group. There was a significant difference between spicy and light music groups at time 10, 15 and 25 minutes. In the 25 minutes after the swim, reducing the heart rate in light music was more than spicy. Also, 10 minutes after swimming, the spicy music group could not cope with the increase in heart rate (p<0.05). There was a significant difference between the two music groups in minutes 5, 10 and 15 after swimming (p<0.05).Conclusions. listening to light music during recovery from endurance swimming was associated with decreased lactate levels and heart rate, but listening to spicy music increased heart rate and desire for food.

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The Impact of a Dedicated “Hot List” on the In-Patient Management of Patients With Acute Gallstone-Related Disease

Frontiers in Surgery ◽

10.3389/fsurg.2021.643077 ◽

2021 ◽

Vol 8 ◽

Author(s):

Saurabh Jamdar ◽

Vishnu V. Chandrabalan ◽

Rami Obeidallah ◽

Panagiotis Stathakis ◽

Ajith K. Siriwardena ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gallstone Disease ◽

Operating Theatre ◽

Index Admission ◽

Biliary Disease ◽

Time Period ◽

Significant Difference ◽

Duration Of Surgery ◽

Time Periods ◽

The Impact

Background: Index admission laparoscopic cholecystectomy is the standard of care for patients admitted to hospital with symptomatic acute cholecystitis. The same standard applies to patients suffering with mild acute biliary pancreatitis. Operating theatre capacity can be a significant constraint to same admission surgery. This study assesses the impact of dedicated theatre capacity provided by a specialist surgical team on rates of index admission cholecystectomy.Methods: This clinical cohort study compares the management of patients with symptomatic gallstone disease admitted to a tertiary care university teaching hospital over two equal but chronologically separate time periods. The periods were before and after service reconfiguration including a specialist HPB service with dedicated operating theatre time allocation.Results: There was a significant difference in the number of admissions over the two time periods with a greater proportion of patients having index admission surgery in the second time period with correspondingly fewer having more than one admission during this latter time period. In the second time period 43% of patients underwent index admission cholecystectomy compared to 23% in the first (P < 0.001). The duration of surgery was shorter for patients undergoing surgery during the second time period [135 (102–178) min in the first period and in the second period 106 (89–145) min] (P = 0.02).Discussion: This paper shows that the concentration of theatre resources and surgical expertise into regular theatre access for patients undergoing urgent laparoscopic cholecystectomy is an effective and safe model for dealing with acute biliary disease.

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Modifying effects of the R389G β1-adrenoceptor polymorphism on resting heart rate and blood pressure in patients with obstructive sleep apnoea

Clinical Science ◽

10.1042/cs20050244 ◽

2005 ◽

Vol 110 (1) ◽

pp. 117-123 ◽

Cited By ~ 10

Author(s):

Jan Börgel ◽

Tino Schulz ◽

Nina K. Bartels ◽

Jörg T. Epplen ◽

Nikolaus Büchner ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Obstructive Sleep Apnoea ◽

Nervous Activity ◽

Sleep Apnoea ◽

Cpap Therapy ◽

Pressure Therapy ◽

Obstructive Sleep ◽

Significant Difference ◽

The Impact

OSA (obstructive sleep apnoea) stimulates sympathetic nervous activity and elevates resting HR (heart rate) and BP (blood pressure). In the present study in a cohort of 309 untreated OSA patients, the resting HR and BP during the daytime were correlated with AHI (apnoea/hypopnea index) and compared with patients with R389R (n=162), R389G (n=125) and G389G (n=22) genotypes of the β1-adrenoreceptor R389G polymorphism. We analysed the impact of the genotype on the decline of HR and BP in a subgroup of 148 patients (R389R, n=86; R389G, n=54; G389G, n=8) during a 6-month follow-up period under CPAP (continuous positive airway pressure) therapy during which cardiovascular medication remained unchanged. In untreated OSA patients, we found an independent relationship between AHI and resting HR (β=0.096, P<0.001), systolic BP (β=0.09, P=0.021) and diastolic BP (β=0.059, P=0.016). The resting HR/BP, however, did not differ among carriers with the R389R, R389G and G389G genotypes. CPAP therapy significantly reduced HR [−2.5 (−1.1 to −4.0) beats/min; values are mean difference (95% confidence intervals)] and diastolic BP [−3.2 (−1.5 to −5.0) mmHg]. The decline in HR was more significantly pronounced in the R389R group compared with the Gly389 carriers [−4.1 (−2.3 to −5.9) beats/min (P<0.001) compared with −0.2 (2.1 to −2.6) beats/min (P=0.854) respectively; Student's t test between groups, P=0.008]. Diastolic BP was decreased significantly (P<0.001) only in Gly389 carriers (R389G or G389G) compared with R389R carriers [−5.0 (−2.3 to −7.6) mmHg compared with −2.0 (0.4 to −4.3) mmHg respectively]. ANOVA revealed a significant difference (P=0.023) in HR reduction between the three genotypes [−4.1 (±8.4) beats/min for R389R, −0.5 (±9.3) beats/min for R389G and +1.9 (±7.2) beats/min for G389G]. In conclusion, although the R389G polymorphism of the β1-adrenoceptor gene did not influence resting HR or BP in untreated OSA patients, it may modify the beneficial effects of CPAP therapy on these parameters.

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Effects of a Meal Replacement on Body Composition and Metabolic Parameters among Subjects with Overweight or Obesity

Journal of Obesity ◽

10.1155/2018/2837367 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Xiaohui Guo ◽

Yifan Xu ◽

Hairong He ◽

Hao Cai ◽

Jianfen Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Body Composition ◽

Total Energy ◽

Intervention Group ◽

Overweight And Obesity ◽

Metabolic Parameters ◽

Control Group ◽

Meal Replacement ◽

Significant Difference ◽

The Impact

Meal replacement plans are effective tools for weight loss and improvement of various clinical characteristics but not sustainable due to the severe energy restriction. The aim of the study was to evaluate the impact of meal replacement, specifically 388 kcal in total energy, on body composition and metabolic parameters in individuals with overweight and obesity from a Chinese population. A parallel, randomized controlled trial was performed with 174 participants (ChiCTR-OOC-17012000). The intervention group (N=86) was provided with a dinner meal replacement, and the control group (N=88) continued their routine diet as before. Body composition and blood parameters were assessed at 0, 4, 8, and 12 weeks. A post hoc analysis (least significant difference (LSD) test), repeated measurements, and pairedT-test were used to compare each variable within and between groups. Significant (p<0.001) improvements in body composition components were observed among the intervention group, including body weight (−4.3 ± 3.3%), body mass index (−4.3 ± 3.3%), waist circumference (−4.3 ± 4.4%), fat-free mass (−1.8 ± 2.9%), and body fat mass (−5.3 ± 8.8%). Body composition improvements corresponded with significant metabolic improvements of blood glucose (−4.7 ± 9.8%). Further improvements in visceral fat area (−7.7 ± 10.1%), accompanying with improvements in systolic (−3.7 ± 6.9%) and diastolic (−5.3 ± 7.7%) blood pressure, were only found in male subjects. To conclude, meal replacement intake with 388 kcal in total energy at dinner time for 12 weeks contributed to improvement in body composition and clinically significant metabolic parameters in both male and female participants with overweight/obesity. Additionally, glucose and blood pressure reduction were gender-specific highlighting the importance of gender stratification for design of nutritional intervention studies for improvement of health.

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Impact of body mass index on blood pressure levels in patients with polycystic ovary syndrome

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302007000700013 ◽

2007 ◽

Vol 51 (7) ◽

pp. 1104-1109 ◽

Cited By ~ 10

Author(s):

Cristiano R.G. Barcellos ◽

Michelle P. Rocha ◽

Sylvia A.Y. Hayashida ◽

Décio Mion Junior ◽

Silvia G. Lage ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Polycystic Ovary Syndrome ◽

Body Mass ◽

Polycystic Ovary ◽

Present Moment ◽

Model Assessment ◽

Ovary Syndrome ◽

Significant Difference ◽

The Impact

As there is controversy about the prevalence of hypertension in patients with polycystic ovary syndrome (PCOS) and, up to the present moment, no studies have evaluated the impact of body mass index (BMI) on blood pressure levels (BP) in these patients, we studied retrospectively sixty-nine patients with PCOS, with BMI of 29.0 ± 6.7 kg/m² and aged 25.6 ± 5.6 yr, subdivided into three groups according to BMI (normal, overweight and obese) and evaluated regarding BP (mercury sphygmomanometer), basal hormonal profile, fasting glucose, and insulin sensitivity (HOMA-IR). Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were normal (118.1 ± 17.0 and 74.7 ± 11.5 mmHg, respectively), with a hypertension prevalence of 20.3%. Of these patients, 78.6% were obese and 21.4% were overweight. When the groups were compared according to BMI, a significant increase in SBP and DBP was observed (higher in overweight and obese patients for SBP and higher in obese for DBP), as well as a significant progressive increase in glucose, insulin, homeostatic model assessment, and a significant progressive decline in LH levels. When the patients were subdivided as normotensive or hypertensive, a significant difference was observed only for BMI (28.2 ± 6.1 and 34.7 ± 8.6 kg/m², respectively; p = 0.007). In conclusion, we observed a significant and progressive impact of BMI on blood pressure levels in our patients with polycystic ovary syndrome.

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Routine intraoperative jejunostomy placement and minimally invasive oesophagectomy: an unnecessary step?†

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz063 ◽

2019 ◽

Vol 56 (4) ◽

pp. 746-753 ◽

Cited By ~ 5

Author(s):

Tiuri E Kroese ◽

Leonidas Tapias ◽

Jacqueline K Olive ◽

Lena E Trager ◽

Christopher R Morse

Keyword(s):

Weight Loss ◽

Minimally Invasive ◽

Relative Weight ◽

Patient Characteristics ◽

Perioperative Outcomes ◽

P Value ◽

Oral Nutrition ◽

Significant Difference ◽

Minimally Invasive Oesophagectomy ◽

The Impact

Abstract OBJECTIVES: Adequate nutrition is challenging after oesophagectomy. A jejunostomy is commonly placed during oesophagectomy for nutritional support. However, some patients develop jejunostomy-related complications and the benefit over oral nutrition alone is unclear. This study aims to assess jejunostomy-related complications and the impact of intraoperative jejunostomy placement on weight loss and perioperative outcomes in patients with oesophageal cancer treated with minimally invasive Ivor Lewis oesophagectomy (MIE). METHODS: From a prospectively maintained database, patients were identified who underwent MIE with gastric reconstruction. Between 2007 and 2016, a jejunostomy was routinely placed during MIE. After 2016, a jejunostomy was not utilized. Postoperative feeding was performed according to a standardized protocol and similar for both groups. The primary outcomes were jejunostomy-related complications, relative weight loss at 3 and 6 months postoperative and perioperative outcomes, including anastomotic leak, pneumonia and length of stay, respectively. RESULTS: A total of 188 patients were included, of whom 135 patients (72%) received a jejunostomy. Ten patients (7.4%) developed jejunostomy-related complications, of whom 30% developed more than 1 complication. There was no significant difference in weight loss between groups at 3 months (P = 0.73) and 6 months postoperatively (P = 0.68) and in perioperative outcomes (P-value >0.999, P = 0.591 and P = 0.513, respectively). CONCLUSIONS: The use of a routine intraoperative jejunostomy appears to be an unnecessary step in patients undergoing MIE. Intraoperative jejunostomy placement is associated with complications without improving weight loss or perioperative outcomes. Its use should be tailored to individual patient characteristics. Early oral nutrition allows patients to maintain an adequate nutritional status.

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The impact of using BASNEF model on self-control behaviors among Patients with hypertension

Internal Medicine And Medical Investigation Journal ◽

10.24200/imminv.v3i3.127 ◽

2018 ◽

Vol 3 (3) ◽

pp. 112

Author(s):

Moradali Zareipour ◽

Mousa Ghelichi Ghojogh ◽

Masoumeh Mahdi-akhgar ◽

Sarvin Abbasi ◽

Nooshin Yoshany ◽

...

Keyword(s):

Blood Pressure ◽

Intervention Group ◽

Public Health Problem ◽

Developed Countries ◽

Self Control ◽

Control Group ◽

Validity And Reliability ◽

Important Public Health Problem ◽

Significant Difference ◽

The Impact

Background: High blood pressure is the most important public health problem in developed countries. It is one reason for early mortality and risk factors for cardiovascular diseases like stroke and kidney failure. This study aimed to determine the effect of educational intervention based on BASNEF in blood pressure control in 1395.Methods and Materials: This study was a quasi-experimental study on 160 patients in two groups (each n = 80) suffering from hypertension in urban health centers of Urmia. Data collection questionnaire included: demographic questions, knowledge base questions, self-control behaviors questions and structures of BASNEF model. Validity and reliability were respectively 80% and 79%. Intervention group had taken three 45 minutes sessions using speeches, questions and answers, posters, booklets, pamphlets and whiteboard. Before training, information collected through questionnaires and after training questionnaires were completed again after 3 months. The data were analyzed in SPSS software with chi-square tests, Fisher, independent and paired sample t-test.Results: The average age of case and control group were 99.11 ± 01.56 and 75.12 ± 66.53 years. That there was no statistically significant difference (p=0.1). After intervention average systolic blood pressure significantly decreased in the intervention group from 43.157 to 24.147 mm Hg and diastolic blood pressure significantly decreased from 21.93 to 52.87 mm Hg (P <0.05)Conclusion: The training program using BASNEF model has provided better results in controlling blood pressure than conventional trainings.

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Impact of hand dominance on effectiveness of chest compressions in a simulated setting: a randomised, crossover trial

Australasian Journal of Paramedicine ◽

10.33151/ajp.16.672 ◽

2019 ◽

Vol 16 ◽

Author(s):

Jamie Cross ◽

Tommy Lam ◽

Joel Arndell ◽

John Quach ◽

Buck Reed ◽

...

Keyword(s):

Primary Outcome ◽

Crossover Trial ◽

Recovery Period ◽

Outcome Data ◽

Dominant Hand ◽

Hand Dominance ◽

Modest Improvement ◽

Significant Difference ◽

Secondary Outcomes ◽

The Impact

Aim External cardiac compressions (ECC) are a critical component in determining the effectiveness of cardiopulmonary resuscitation (CPR). Guidelines prior to the 2010 International Liaison Committee on Resuscitation directed rescuers to place the heel of the dominant hand directly on the chest when performing ECC, however current guidelines are silent on this issue. Existing research is inconsistent in findings, and heterogeneous in design and participants. The aims of this pilot study were to: 1) investigate the impact of hand dominance on effectiveness of ECC; and 2) generate outcome data to inform sample size calculations for a larger future study.Methods This study utilised a single blinded, prospective randomised crossover trial design. Each participant was allocated to a ‘dominant hand on chest’ (DHOC) or ‘non-dominant hand on chest’ (NDHOC) group. On a simulation manikin, participants in the DHOC group performed 3 minutes of ECC with dominant hand on the chest and non-dominant hand supporting, followed by a ‘rest and recovery’ period and then a second 3-minute period of ECC with the hand reversed such that the non-dominant hand was on the chest. The NDHOC group performed the same series of compressions but in reverse order. The primary outcome measure was effectiveness of ECC, determined by a percentage-based ‘CPR score’ (‘CS’). Secondary outcomes were compression depth, rate and release. The Wilcoxon rank-sum (Mann-Whitney) test was used due to the non-normal distribution of the data. Due to the crossover design, hierarchical linear regression was used to assess for a period or cross over effect. Results For the primary outcome of this study, we have found no significant difference in CS between DHOC and NDHOC (69.9% (SD=29.9) vs. 69.1% (SD=34.1); p=0.92), respectively. There were no differences in the secondary outcomes of compression rate and depth, though compression release was improved in the DHOC group (53% vs. 42%; p=0.02).ConclusionIn this randomised crossover study conducted in a simulation context there was no difference in ECC effectiveness measured by an overall effectiveness outcome according to placement of the dominant or non-dominant hand on the chest during compressions. A modest improvement in ECC release was seen in the dominant hand on chest group. While the study was underpowered, the results support an approach involving rescuers placing whichever hand they are most comfortable with on the chest irrespective of handedness.

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Persistence of circadian variation in arterial blood pressure in β1/β2-adrenergic receptor-deficient mice

AJP Regulatory Integrative and Comparative Physiology ◽

10.1152/ajpregu.00074.2008 ◽

2008 ◽

Vol 294 (5) ◽

pp. R1427-R1434 ◽

Cited By ~ 17

Author(s):

Soo Mi Kim ◽

Yuning Huang ◽

Yan Qin ◽

Diane Mizel ◽

Jurgen Schnermann ◽

...

Keyword(s):

Blood Pressure ◽

Locomotor Activity ◽

Arterial Pressure ◽

Adrenergic Receptor ◽

Circadian Variation ◽

Arterial Blood ◽

Significant Difference ◽

Β2 Adrenergic Receptor ◽

The Impact ◽

Deficient Mice

The β-adrenergic pathway has been considered one important effector of circadian variation in arterial pressure. Experiments were performed in β1/β2-adrenergic receptor-deficient mice (β1/β2ADR−/−) to assess whether this pathway is required for circadian variation in mean arterial pressure (MAP) and to determine the impact of its loss on the response to changes in dietary salt. Twenty-four-hour recordings of MAP, heart rate (HR), and locomotor activity were made in conscious 16- to 17-wk-old mice [wild-type, (WT), n = 7; β1/β2ADR−/−, n = 10] by telemetry. Both WT and β1/β2ADR−/− mice demonstrated robust circadian variation in MAP and HR, although 24-h mean MAP was 10% lower (102.02 ± 1.81 vs. 92.11 ± 2.62 mmHg) in β1/β2ADR−/− than WT, HR was 16% lower and day-night differences reduced. Both WT and β1/β2ADR−/− mice adapted to changed salt intake without changed MAP. However, the β1/β2ADR−/− mice demonstrated a striking reduction in locomotor activity in light and dark phases of the day. In WT mice, MAP was markedly affected by locomotor activity, resulting in bimodal distributions in both light and dark. When MAP was analyzed using only intervals without locomotor activity, bimodality and circadian differences were reduced, and there was no significant difference between the two genotypes. The results indicate that there is no direct effect or role for the β-adrenergic system in circadian variation of arterial pressure in mice, aside from the indirect consequences of altered locomotor activity. Our results also confirm that locomotor activity contributes strongly to circadian variation in blood pressure in mice.

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The Impact of Frailty on the Effectiveness and Safety of Intensive Glucose Control and Blood Pressure-Lowering Therapy for People With Type 2 Diabetes: Results From the ADVANCE Trial

10.2337/figshare.14485251.v1 ◽

2021 ◽

Author(s):

Tu N Nguyen ◽

Katie Harris ◽

Mark Woodward ◽

John Chalmers ◽

Mark Cooper ◽

...

Keyword(s):

Blood Pressure ◽

Type 2 Diabetes ◽

Glucose Control ◽

Severe Hypoglycaemia ◽

Intensive Glucose Control ◽

Vascular Events ◽

Significant Difference ◽

Secondary Outcomes ◽

The Impact

Objective. To develop a frailty index (FI) and explore the relationship of frailty to subsequent adverse outcomes on the effectiveness and safety of more intensive control of both blood glucose and blood pressure (BP), amongst participants with type-2 diabetes in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Research Design and Methods. Cox proportional-hazard models were used to estimate the effectiveness and safety of intensive glucose control and BP intervention according to frailty (defined as FI>0.21) status. The primary outcomes were macrovascular events and microvascular events. The secondary outcomes were all-cause mortality, cardiovascular mortality, severe hypoglycaemia, and discontinuation of BP treatment due to hypotension/dizziness. Results. There were 11140 participants (mean age 65.8, 42.5% female, 25.7% frail). Frailty was an independent predictor of all primary outcomes and secondary outcomes. The effect of intensive glucose treatment on primary outcomes showed some evidence of attenuation in the frail: HRs for combined major macro- and micro-vascular events 1.03, 95%CI 0.90-1.19 in the frail vs 0.84, 95%CI 0.74-0.94 non-frail (p=0.02). A similar trend was observed with BP intervention. <a>Severe hypoglycaemia rates (per 1000 person-years) were higher in the frail: 8.39 (6.15–10.63) vs. 4.80 (3.84–5.76) in non-frail</a> (p<0.001). There was no significant difference in discontinuation of BP treatment between frailty groups. Conclusions. It was possible to retrospectively estimate frailty in a trial population, and this FI identified those at higher risk of poor outcomes. Participants with frailty had some attenuation of benefit from intensive glucose lowering and BP lowering treatments.

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