ОСОБЛИВОСТІ ІМУНОЛОГІЧНИХ ЗМІН У ХВОРИХ ПІСЛЯ МАСТЕКТОМІЇ

Postoperative period after surgical interventions on the breast are determined by the level of physiological reserve and by the statement of immunоlogical and physiological parameters. The purpose of this research was to determine the risk prediction of postmastectomy lymphorrhea markers. A retrospective analysis of laboratories results of 78 patients with breast cancer after mastectomy during 2006 till 2011 years was made. Group I included patients without postoperative lymphorrhea. Group II included patients with prolongated postoperative lymphorrhea. Before operation patients of the II group had: PhI level decrease (73,1 ± 9,0), PhA level increase (4,3 ± 0,4) and higher, level decrease of completion of index of phagocytosis (0,8 ± 0,08), CRP rate increase (4,1 ± 3,34). In the early postoperative period patients of the II group had: the preservation of downward trends the PhI and PhA level increase, level decrease of completion of index of phagocytosis (0,8 ± 0,08), CRP rate increase +25% and more. In the early postoperative period patients of the I group had normal phagocytosis activity parameters and tendency to normalization of the PhA level. Using advanced laboratory researches in patients with breast cancer to determine the risk prediction of markers of postmastectomy lymphorrhea allows the use of additional preventive and curative interventions in the future.

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Effectiveness of the concept of fast-trak surgery for simultaneous laparoscopic hernioplastics and cholecistectomy

The Journal of V. N. Karazin Kharkiv National University, Series "Medicine" ◽

10.26565/2313-6693-2021-41-10 ◽

2021 ◽

Keyword(s):

Postoperative Period ◽

Inpatient Treatment ◽

Fast Track ◽

Early Postoperative Period ◽

Wound Complications ◽

Fast Track Surgery ◽

Surgical Interventions ◽

Group I ◽

Laparoscopic Hernioplasty ◽

Group Ii

The aim of the research was to study the feasibility and effectiveness of simultaneous laparoscopic hernioplasty and cholecystectomy in patients with combined abdominal pathology. Material and methods. Simultaneous laparoscopic hernioplasty and cholecystectomy during 2015–2019 performed on 70 patients, including 49 (70 %) women, mean age 57.3 ± 6.5 g. In 37 patients the principles of Fast-track surgery were applied (group I), including thorough examination for diagnostics of combined abdominal pathology and clinically significant general somatic pathology; if necessary a course of therapy for full compensation of general somatic pathology was prescribed; during the operation of epidural prolonged anesthesia; choice in favor of laparoscopic technology; at the end of the operation – irrigation of the subdiaphragmatic space with local anesthetic; postoperatively: early drainage removal; withdrawal from opioids by prescribing parenteral paracetomol; activation of the patient 6-8 hours after surgery; on the day of surgery – use of chewing gum and fluid intake. In 33 patients the standard complex of perioperative management (group II) is applied. The immediate results of surgical interventions have been studied. Results. There were no significant complications during the operation and in the early postoperative period. In the first group, seroma (after open alloplasty) was detected in 2 (5 %) cases, and in the second group, small wound complications were detected in 4 (12 %) cases (p > 0.05 according to the χ2 criterion). The duration of inpatient treatment in patients of group I is 4.4 ± 1.2 months, in group II – 7.0 ± 1.3 days (р < 0.001 by Student’s test). Conclusion. Application of the principles of Fast-track surgery and accelerated recovery at all stages of simultaneous laparoscopic hernioplasty and cholecystectomy (preparation for surgery, during the operation and in the postoperative period) does not increase the number of postoperative complications and decreased duration of inpatient treatment from 7,0 ± 1,3 in patients with traditional postoperative management to 4,4 ± 1,2 days.

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Estimation of variants of the pancreatic gland pathology in patients, suffering complicated forms of chronic pancreatitis in late postoperative period

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2019.07.18 ◽

2019 ◽

Vol 86 (7) ◽

pp. 18-22

Author(s):

V. M. Ratchyk ◽

D. V. Orlovsky ◽

A. V. Tuzko ◽

O. P. Petishko

Keyword(s):

Chronic Pancreatitis ◽

Surgical Treatment ◽

Postoperative Period ◽

Surgical Interventions ◽

Group I ◽

Group Ii ◽

Surgical Tactics ◽

Pancreatic Pathology ◽

Late Postoperative Period ◽

Pancreatic Gland

Objective. Estimation of variants of the pancreatic gland pathology and rate of the unfavorable results occurrence in late postoperative period in patients, suffering complicated forms of chronic pancreatitis, depending on the procedures of surgical treatment. Materials and methods. Results of surgical treatment of complicated forms of chronic pancreatitis in department of the gut surgery in 2007 - 2017 yrs were studied in 107 patients, who were divided into two groups: the Group I – 67 (62.7%) patients, in whom pancreato- and virsungodigestive operations were performed, and the Group II – 40 (37.4%) patients, in whom duodenum—preserving resection-drainage surgical interventions were done. Results. Unfavorable variants of pancreatic pathology were observed significantly more frequently in patients of the Group I – in 34/67 (50.7%) in comparison with patients of the Group II – in 6/40 (15.0%) (χ2=9.49, p=0.002). Conclusion. Analysis of rate of the unfavorable results occurrence in late postoperative period, depending on surgical tactics appled, have shown a trustworthy advantage of the resection-drainage operations.

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ADVANTAGES OF INTRATHECAL BUPIVACAINE AND DEXMEDETOMIDINE COMBINATION OVER BUPIVACAINE AND CLONIDINE: A COMPARATIVE ANALYSIS IN GYNAECOLOGICAL INTERVENTIONS

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i4.1416 ◽

2020 ◽

Vol 4 (4) ◽

Author(s):

Aruna Mahanta ◽

Keshav Saran Agrawal

Keyword(s):

Regional Anaesthesia ◽

Motor Block ◽

Surgical Intervention ◽

Average Duration ◽

Sensory Block ◽

Lower Side ◽

Regional Analgesia ◽

Surgical Interventions ◽

Group I ◽

Group Ii

Background: most of the gynaecological interventions are generally done under regional anaesthesia. Currently dexmedetomidine came out as a beneficial adjunct for regional analgesia as well as anaesthesia. It is a highly selective α-2 agonist. Aims & objectives: to compare the effects & behavior of dexmedetomidine with clonidine when both are used with bupivacaine for spinal analgesia. Material and Methods: 100 cases of ASA grade 1 & 2 who were undergoing elective gynaecological surgical intervention were studied. They were divided into two groups (50 each). Group I received combination of bupivacaine & clonidine while group II received combination of bupivacaine + dexmedetomidine. Results: Average duration of onset of sensory block was earlier in group II. Arrival of motor block in Group I was slightly on lower side than Group II. Ten cases in Group I and eighteen cases from group II had notable bradycardia and hypotension. Discussion: Our study concludes that dexmedetomidine when used in combination with bupivacaine is very effective in gynaecological surgical interventions that demand longer duration & have comparatively lesser side effects. Keywords: dexmedetomidine, clonidine, Bupivacaine, gynaecological procedures.

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Sonographic Study of Female Pelvic Organs in Breast Cancer Patients Taking Tamoxifen: Clinical Correlation

Journal of Current and Advance Medical Research ◽

10.3329/jcamr.v7i1.46425 ◽

2020 ◽

Vol 7 (1) ◽

pp. 17-23

Author(s):

Rafia Parveen ◽

Shaikh Shofiur Rahman ◽

Taposhi Sarker ◽

Syed Muhammad Baqui Billah ◽

Zakir Hossain Habib

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Endometrial Thickness ◽

Tamoxifen Therapy ◽

Tamoxifen Treatment ◽

Breast Cancer Patients ◽

Group Iii ◽

Group I ◽

Group Ii ◽

Uterine Volume

Background: As most of breast cancer patients are treated with Tamoxifen, different effects of this drug in patients should be evaluated since no such study is carried out in Bangladesh till date. Objective: The purpose of the present study was to evaluate sonographic changes of female genital organs in breast cancer patients treated with Tamoxifen and to correlate these changes with duration of Tamoxifen treatment and gynecological symptoms. Methodology: This randomized double-blind clinical trial was carried out in Delta Medical College Hospital, Dhaka, Bangladesh from May 2017 to April 2018 for a period of one (1) year. The participants were breast cancer patients which were divided into three groups named as group I patients. The patients of these group were on Tamoxifen therapy. The patients of group II were without Tamoxifen therapy. The patients of group III had completed Tamoxifen therapy. All participants underwent ultrasonography. Results: Patients receiving Tamoxifen therapy had significantly more thickened endometrium compared to other groups (26.6% in group I, 5% in group II and3% in group III). Similarly, abnormal sonographic findings and mean uterine volume were higher in group I compared to other two groups. Endometrial thickness and uterine volume showed significant positive correlation with duration of Tamoxifen therapy (p <0.0001). The endometrial thickness and uterine volume greatly increased after two years of Tamoxifen therapy while it was reverse in group III. Gynecological symptoms had no significant relations with sonographic abnormalities and thickened endometrium. Conclusion: Tamoxifen therapy is associated with increased endometrial thickness, uterine volume and abnormal sonographic findings, compared to patients without Tamoxifen or completing Tamoxifen therapy. Journal of Current and Advance Medical Research 2020;7(1): 17-23

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Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2019-23(2)-16 ◽

2019 ◽

Vol 23 (2) ◽

pp. 267-276

Author(s):

K. A. Khyzhniak ◽

Y. V. Volkova ◽

K. Y. Sharlai ◽

M. V. Khartanovych

Keyword(s):

Cardiopulmonary Bypass ◽

Hospital Stay ◽

Postoperative Period ◽

Surgical Intervention ◽

Infusion Therapy ◽

The Third ◽

Group I ◽

Aortic Pathology ◽

Number Of Patients ◽

Group Ii

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.

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Study on Comparison Between Lignocaine and Lignocaine-Xylazine on Caudal Epidural Injection on Fogera Breed Cow in Gondar University Dairy Farm

10.21203/rs.3.rs-134135/v1 ◽

2021 ◽

Author(s):

Endalkachew hailu ◽

Gashaw Kasse

Keyword(s):

Heart Rate ◽

Respiratory Rate ◽

Rectal Temperature ◽

Epidural Anesthesia ◽

Physiological Parameters ◽

Additive Effect ◽

Group I ◽

Significant Difference ◽

Group Ii ◽

Caudal Epidural

Abstract Background: Caudal epidural anesthesia commonly utilized in veterinary practice to allow diagnostic, obstetrical, and surgical interventions in the perineal region of cows. An experimental study conducted on epidural anesthesia from October 2018 to March 2019 on 6 cows with repeated treatments after one week by two groups of anesthetic drugs. Methods and materias First Lignocaine is given for Group-I of cows in the first intercoccygeal space and then the same animals after one week injected Lignocaine-Xylazine together in the intercoccygeal space. The Clinical-physiological parameters such as the onset of analgesia, duration of analgesia, ataxia, sedation, heart rate, respiratory rate, and rectal temperature between the two groups studied by compression. Finally, the significance of the change in the study unit between Lignocaine and Lignocaine-Xylazine analyzed according to SPSS version 19 for t-test and P-value <0.05 taken as statistically significant. Results: There was no significant change that appeared between the onset of analgesia of Lignocaine (4.3±0.6min) alone and Lignocaine-Xylazine (4.9±1.1min) injection together (t=1.17; P>0.05). This indicates that the addition of Xylazine to Lignocaine does not significantly delay the onset of anesthesia. However, there was a significant difference observed in the duration of analgesia between two groups (t=13.2; P<0.05) with Lignocaine-Xylazine (259.5±12.38min) longer duration than Lignocaine alone (84±4.05min). This indicates that Lignocaine and Xylazine have an additive effect on the duration of analgesia. In the case of physiological parameters, there were significant variations in heart rate (t=7.5; P<0.05) with Group II cows lower in heart rate than Group I cows. Statistically, a significant difference was also observed on respiratory rate (t=2.13; P<0.05) in which the addition of Xylazine on Lignocaine significantly lower breathing rate than Lignocaine injection alone. Finally, on rectal temperature, there was no statistically significant difference appeared (t=1.7; P>0.005) with rectal temperature in Group I cows (0.15± 0.28 OC) and in Group II cows (0.9±0.31 OC) which indicate that addition of Xylazine to Lignocaine lower rectal temperature similar to Lignocaine injection alone. Mild ataxia was observed in three groups I, cows, and there was no sedation and salivation noted at all. In Group II, cows mild to severe ataxia, deep sedation, salivation, and falling observed. In both groups, there was no anesthetic complication during epidural analgesia and after recovery noted.Conclusion: generally this study showed that, combination of Lignocaine and Xylazine have an additive effect on the duration and quality of analgesia.

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Phase II trial of paclitaxel by 3-hour infusion as initial and salvage chemotherapy for metastatic breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.10.2575 ◽

1995 ◽

Vol 13 (10) ◽

pp. 2575-2581 ◽

Cited By ~ 131

Author(s):

A D Seidman ◽

A Tiersten ◽

C Hudis ◽

M Gollub ◽

S Barrett ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Peak Plasma ◽

Therapy Group ◽

Metastatic Breast ◽

Salvage Chemotherapy ◽

Median Response ◽

Visual Symptoms ◽

Group I ◽

Group Ii

PURPOSE To evaluate the efficacy and safety of paclitaxel administered by 3-hour infusion as initial and salvage chemotherapy for metastatic breast cancer. PATIENTS AND METHODS Forty-nine patients with metastatic breast cancer received paclitaxel via 3-hour intravenous infusion after standard premedication. Prophylactic granulocyte colony-stimulating factor (G-CSF) was not used, and chemotherapy was cycled every 3 weeks. For 25 patients who received paclitaxel as initial therapy (group I), the starting dose was 250 mg/m2. Twenty-four patients who had received two or more prior regimens, including an anthracycline (group II), started at 175 mg/m2. Paclitaxel pharmacokinetics were evaluated in 23 patients in group I. RESULTS Grade 3 and 4 toxicities included (groups I/II) neutropenia (36%/33%), thrombocytopenia (0%/8%), anemia (0%/13%), neuropathy (8%/0%), arthralgia/myalgia (16%/4%), and mucositis (4%/4%). No significant hypersensitivity-type reactions or cardiac arrhythmias were seen. Six patients who received paclitaxel at > or = 250 mg/m2 experienced transient photopsia, without apparent chronic neuro-ophthalmologic sequelae. The mean peak plasma paclitaxel concentration was 5.87 mumol/L (range, 1.99 to 7.89) for these patients, and 6.08 mumol/L (range, 0.81 to 13.81) for 17 of 19 patients who did not experience visual symptoms. In 25 assessable patients in group I at a median follow-up time of 12 months, one complete response (CR) and seven partial responses (PRs) have been observed, for a total response rate of 32% (95% confidence interval [CI], 15% to 53%). In group II, five PRs were noted in 24 assessable patients (20.8%; 95% CI, 7% to 42%). Median response durations were 7 months for group I and 4 months for group II. CONCLUSION Paclitaxel via 3-hour infusion, without prophylactic G-CSF, is active and safe as initial and subsequent therapy for metastatic breast cancer. The transient visual symptoms noted at higher doses seem unrelated to peak plasma paclitaxel concentration. Further studies that compare 3- and 24 hour (or other) infusion schedules are necessary to determine the optimal administration of paclitaxel in metastatic breast cancer.

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Method of Enteral Insufficiency Syndrome Correction in Patients with Generalized Peritonitis

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2021-14-3-182-192 ◽

2021 ◽

Vol 14 (3) ◽

pp. 182-192

Author(s):

Evgeny A. Korymasov ◽

Sergey A. Ivanov ◽

Mariya Kenarskaya ◽

Maxim U. Khoroshilov

Keyword(s):

Rating Scale ◽

Study Groups ◽

Albumin Level ◽

C Reactive Protein ◽

Surgical Interventions ◽

Reactive Protein ◽

Generalized Peritonitis ◽

Group I ◽

Group Ii ◽

Insufficiency Syndrome

Introduction. Mortality in generalized peritonitis (GP) reaches 30%, and with the development of multiple organ failure, the lethal outcome is observed in 80-90% of cases. Enteral insufficiency syndrome (EIS) plays a leading role in the progression of generalized peritonitis. The aim of the study was to develop a differentiated approach of enteral insufficiency syndrome correction in patients with generalized peritonitis. Material and methods. This research was a retrospective prospective study. The study included 50 patients with GP, who received treatment at the Surgery Department of the Samara Regional Clinical Hospital in the period from 2017 to 2019. Depending on the chosen treatment tactics, the patients were divided into two clinical groups. Group I included 29 patients, admitted in the period from 2017 to 2018, who had received the standard GP treatment. A long-term endogenous intoxication in patients of this group associated with the progressive enteric failure led to the repeated surgeries; at the same time, a high frequency of postoperative complications was preserved. The analysis of the results in patients of Group I necessitated development of the therapeutic and diagnostic algorithm aimed at early diagnostics and timely correction of EIS. Group II included 21 patients with GP, admitted in the period from 2018 to 2019, who was treated using the new algorithm. Results. The objective criteria for the relief of EIS in GP in patients of the study groups were a decrease in the level of serum albumin and C-reactive protein, a significant decrease in the amount and qualitative change in the intestinal discharge via an intestinal tube, a decrease in the recovery time of the functions of the small intestine and start of defecation. On the 6th postoperative day, in patients of Group II there was no significant albumin level reduction in comparison with the 1st day of monitoring (28.310.77 g/l vs 37.334.69 g/l). Whereas in Group I the albumin level was significantly lower (19.30.51 g/l) than the same parameter in Group II, and in comparison with the 1st day of monitoring (19.30.51 g/l vs 39.56.05 g/l; р = 0.00001). On the 6th postoperative day, the C-reactive protein level differed significantly between the groups as well: Group I 104.7613.49 mg/l, Group II - 58.0029.05 mg/l, p = 0.003. The control of GP in patients of the Group I was reached after 4.52.5 repeated abdominal interventions, while in patients of Group II generalized peritonitis was arrested after 2.30.9 surgical interventions (p = 0.000171), which is 1.9 times less. Conclusions. The proposed algorithm of EIS control is based on the individual approach to the treatment of patients with GP. The developed EIS rating scale allows determining not only the degree and dynamics of the pathological process, but also monitoring the effectiveness of treatment options applied in a particular patient.

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Comprehensive Treatment of Patients with Constricted Hernias and Metabolic Syndrome Signs

Galician Medical Journal ◽

10.21802/gmj.2016.3.44 ◽

2016 ◽

Vol 23 (3) ◽

Author(s):

I. V. Melnyk

Keyword(s):

Metabolic Syndrome ◽

Postoperative Period ◽

Abdominal Hernia ◽

Wound Complications ◽

Comprehensive Treatment ◽

Clinical Group ◽

Hernia Defect ◽

Group I ◽

Group Ii ◽

Methods Of Treatment

57 patients with constricted abdominal hernia and diagnosed metabolic syndrome were examined. They were performed the urgent hernia defect plastics with polypropylene mesh Linteks-Esfil (St. Petersburg). Patients were divided into two clinical groups: clinical group I (20) included patients in the postoperative period treated with conventional comprehensive conservative treatment. Clinical group II (37) consisted of patients treated with 2.5% solution of 2 ml tiotriazolini in muscle and metformin in a dose of 500 mg / day for metabolic syndrome correction in addition to above mentioned conventional treatment. Lipid metabolism indices improved on the 7th day in 59.2% of patients in clinical group II and only in 15% of patients in clinical group I.Postoperative wound complications such as seromas and infiltrations developed in 6.3% of patients and were eliminated by conservative methods of treatment. Patients of group II tolerated postoperative period better. Average duration of hospital stay decreased by 2.03±0.2 bed days. Thus, the treatment of patients with constricted hernia of anterior abdominal wall and metabolic syndrome should be in complex with hernia defect plastics by propylene mesh and medicamentous correction of metabolism disorders.

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