scholarly journals Clinical and laboratory features of the lower respiratory pathology caused by COVID-19 and bacterial pneumonia in children

2022 ◽  
pp. 56-61
Author(s):  
N. A. Ilenkova ◽  
N. S. Konurkina ◽  
E. S. Sokolovskaya ◽  
S. U. Pastuhova ◽  
A. A. Kolodina ◽  
...  
Keyword(s):  
Bacterial Pneumonia ◽  
Common Symptom ◽  
Respiratory Noises ◽  
Breath Sounds ◽  
Laboratory Features ◽  
Respiratory Pathology ◽  
Coronavirus Infection ◽  
Group 2 ◽  
Medical Histories ◽  
Group 1

Objective: Conducting comparative analysis of the clinical and laboratory features of the course of community-acquired bacterial pneumonia and pneumonia in the presence of laboratory-confirmed coronavirus infection (COVID-19) in children in Krasnoyarsk.Methods: A retrospective clinical and laboratory analysis of 68 medical histories of children having a laboratory-confirmed diagnosis of a new coronavirus infection (COVID-19) complicated by pneumonia (2020), as well as 52 medical histories of children having community-acquired bacterial pneumonia (2019) is presented.Results: More than half of the cases fall on children older than 7 years. Boys prevailed in both groups. The majority of children in group 1 had a moderate form of COVID-19 course. Cough is the most common symptom in children having bacterial pneumonia. Children having COVID-19 pneumonia had symptoms that were not present in children of group 2: headache – in 19.1% of cases, myalgia – 7.4%, various dyspeptic disorders. In more than 80% of cases of bacterial pneumonia, there were percussion sound dullness and local decreased breath sounds, and more frequent detection of adverse respiratory noises. Changes in the peripheral blood in children with COVID-19 were non-specific.Conclusions: Clinical course of pneumonia in the presence of laboratory-confirmed coronavirus infection (COVID-19) in children has its specific clinical features. The most common symptoms are headache, myalgia, dyspeptic disorders. Children with bacterial pneumonia were more likely to suffer from cough and a strongly marked intoxication syndrome.

scholarly journals Efficacy and Safety of Human Placental Extract Solution on Fatigue: A Double-Blind, Randomized, Placebo-Controlled Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Kang-Kon Lee ◽  
Whan-Seok Choi ◽  
Keun-Sang Yum ◽  
Sang-Wook Song ◽  
Sun-Myeong Ock ◽  
...  
Keyword(s):  
Placebo Group ◽  
Controlled Study ◽  
Common Symptom ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Extract Solution ◽  
Group 2 ◽  
Fatigue Recovery ◽  
Placental Extract ◽  
Group 1

Introduction. Fatigue is a common symptom, but only a few effective treatments are available. This study was conducted to assess the efficacy and safety of the human placental extract solution, which has been known to have a fatigue recovery effect.Methods. A total of 315 subjects were randomly assigned to three groups: group 1 (with Unicenta solution administration), group 2 (with exclusively human placental extract administration, excluding other ingredients from the Unicenta solution), and the placebo group. Subsequently, solutions were administered for four weeks.Results. The fatigue recovery rate was 71.00% in group 1, 71.72% in group 2, and 44.21% in the placebo group, which show statistically significant differences between the group 1 and the placebo group (Pvalue = 0.0002), and between group 2 and the placebo group (Pvalue = 0.0001).Conclusion. The human placental extract solution was effective in the improvement of fatigue.

scholarly journals SELECTION AND DETERMINATION OF THE OPTIMAL CONCENTRATION OF THE PLATELET AGGREGATION INDUCER IN INTENSIVE THERAPY OF PATIENTS WITH COVID-19 INFECTION

2021 ◽  
Vol 20 (3) ◽  
pp. 16-24
Author(s):  
A.V. Marochkov ◽  
◽  
◽  
A.L. Lipnitski ◽  
A.G. Starovoitov ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Intensive Therapy ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Chi Square ◽  
Coronavirus Infection ◽  
High Concentrations ◽  
Group 2 ◽  
Group 1

The change in platelet function that occurs in patients during treatment for a new coronavirus infection can be determined using the platelet aggregation method. Objectives. To determine optimal inducer of platelet aggregation and to assess its prognostic significance in intensive therapy of patients with COVID-19 infection. Material and methods. 34 patients with new coronavirus infection were included in group 1, and 30 healthy women were included in group 2. The study of platelet aggregation was carried out by the turbidimetric method with AP2110 analyzer (SOLAR, Results. The area under the aggregation curve was statistically significantly greater in patients in group 1 when using an ADP inducer at a dose of 0.3 μg/ml (69.1 (27.3; 164.4) unit in comparison with 55.3 (31.5; 68.2) units in group 2, p<0.001). When using an ADP inducer in high concentrations of 1.25 and 2.5 μg/ml and an adrenaline inducer in concentrations of 2.5 and 5 μM, the area under the curve in patients with COVID-19 infection was statistically significantly lower compared to group 2. The area under the aggregation curve according to the Hosmer-Lemeshov criterion has been found to be an independent predictor of death in the intensive care unit (Chi-square=5.074, p=0.06 for ADP 0.3 μg/ml and Chi square=15.121, p=0.057 for ADP 0.6 μg/ml). Conclusions. A comparative analysis of platelet aggregation using inducers of ADP, adrenaline and collagen has shown that in patients with new coronavirus infection, the degree of coagulation imbalance should be determined according to the indications obtained with an ADP inducer at a dose of 0.3 and 0.6 μg/ml.

scholarly journals Clinical and laboratory features of acute intestinal infections with hyemocolitis syndrome in children

2019 ◽  
Vol 11 (3) ◽  
pp. 54-60
Author(s):  
O. I. Klimova ◽  
N. V. Gonchar ◽  
L. A. Alekseeva ◽  
Yu. V. Lobzin
Keyword(s):  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Urinary Infections ◽  
Intestinal Infections ◽  
Laboratory Features ◽  
Complicated Course ◽  
Group 2 ◽  
Severity Of The Disease ◽  
Inflammatory Changes ◽  
Group 1

The acute intestinal infections (AII) with a haemocolitis syndrome represent group of a serious illness at children that defines relevance of studying of their etiology and pathogenesis. The purpose of the work is to study the clinical and laboratory features of AII with hemocolitis syndrome depending on the etiology and complications. Materials and methods. Observed 77 patients of AII aged from 3 months up to 16 years. The etiological diagnosis verified using bacteriological and PCR studies of feces with AmpliSens® OKA screen-FL reagents and serological methods. Hemocolitis syndrome was observed in all patients. Patients with AII of a clarified etiology formed group 1 (n = 59), with AII of unclarified etiology – group 2 (n = 18). Intercurrent diseases were detected as non-specific complications of acute intestinal infections: respiratory (RI) and urinary infections (UI). AII severity was determined by the Clarke-index, the severity of dehydration – according to the WHO clinical scale. To evaluate the data of a research, the Mann-Whitney U-test and Pearson correlation coefficients were used. Results. There was a difference in the age of children in group 1 (3.9 ± 4.2 g) and group 2 (2.2 ± 2.6 g; p = 0.03) and in the frequency of complications: RI is diagnosed in group 1 for 54.5% of children, in group 2 for 83.3% (p=0.001); UI – at 45.5% and 16.7% respectively (p=0.03). In complicated course of AII, macroscopic signs of hemocolitis and inflammatory changes in the hemogram with the inclusion of platelet hemostasis in group 1 observed significantly more often than in group 2. In children of group 1, with uncomplicated acute intestinal infections, there was a significant correlation of signs of inflammation with dehydration and a higher severity of the disease according to the Clarke-index than with a complicated course. Conclusion. The age of children with AII of a clarified etiology was 3.9 ± 0.6 years, with AII of an unclarified etiology – 2.2 ± 0.6 years. AII of a clarified etiology preceded more hard, than AII of unclarified etiology. Complicated course of AII with hemocolitis syndrome characterized by expressiveness of signs of the local and system inflammatory answer.

Clinical laboratory and radiation parameters associated with different outcomes of severe new coronavirus infection (COVID­19) with pneumonia in patients receiving tocilizumab

MedAlliance ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 35-42
Keyword(s):  
Lung Tissue ◽  
Tissue Damage ◽  
Ferritin Level ◽  
High Morbidity ◽  
Neutrophil Lymphocyte Ratio ◽  
Coronavirus Infection ◽  
Anti Inflammatory ◽  
Group 2 ◽  
Lung Tissue Damage ◽  
Group 1

ntroduction. Coronavirus infection 2019 (COVID-19) is characterized by high morbidity and mortality. Interleu- kin-6 receptor inhibitors, including tocilizumab, are used for the anti-inflammatory therapy of COVID-19. The aim of the study was to compare the clinical, lab and radia- tion characteristics of surviving and deceased patients with severe COVID-19 and pneumonia caused by SARS- CoV-2 who received tocilizumab and identify features that were associated with various outcomes. Methods. The medical records of 31 hospitalized COVID-19 pa- tients were stu died. All patients received a single dose of tocilizumab 400 mg. Two groups were created. Group 1 included 17 patients who were discharged with improve- ment, Group 2–14 fatal cases. The methods of parametric and nonparametric statistics were used for processing. Results. The condition of patients from Group 2 more often than in Group 1 was assessed as severe already at admission, p=0.022. Only 4 patients from Group 1 and all patients from Group 2 were allocated to the intensive care unit; the mechanical ventilation was used exclusively in group 2, p <0.001. The groups differed in terms of the SpO2 le vel, p=0.023, and the concentration of C-reactive protein (CRP) at admission, p=0.047, as well as in the vo- lume of lung tissue damage, p=0.027. Tocilizumab was admi nistered to all patients within a comparable period from the onset of the disease. There was an increase in the neutrophil/lymphocyte ratio in peripheral blood (NLR) by the day of its administration in Group 2, p=0.026. The NLR le vel increased even more significantly within 5–7 days after administration, p=0.045 (p=0.007 compared to baseline). The NLR value in Group 2 changed insigni- ficantly. The blood ferritin level in patients from Group 1 by the day of tocilizumab administration was lower than in Group 2, p=0.014, and decreased after the treatment, p=0.01, in contrast to Group 2. The decrease in the CRP concentration after the appointment of tocilizumab in Group 1 was also significant, p=0.001. Conclusions. The deceased COVID-19 patients who received tocilizu- mab were characterized, compared with the survivors, by the initially more severe course of the disease, more pronounced hypoxemia, as well as the volume of lung tissue damage and laboratory abnormalities, inclu ding the le vels of NLR, CRP and ferritin. Monitoring of these in- dicators appears to be necessary to assess the course of COVID-19 and make a decision on the anti-inflammatory therapy with tocilizumab.

Procalcitonin Level at 24 Hours of Age May be Predictive for Transient Tachypnea of the Newborn

2020 ◽  
Vol 15 (06) ◽  
pp. 307-311
Author(s):  
Nuriye Tarakcı ◽  
Hüseyin Altunhan ◽  
Eyüp Sarı ◽  
Mehmet Uyar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Distress ◽  
Bacterial Pneumonia ◽  
Neonatal Intensive Care ◽  
Initial Study ◽  
Procalcitonin Level ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Objective It is an important problem to differentiate transient tachypnea of the newborn (TTN) from bacterial pneumonia or other conditions in patients admitted to Neonatal Intensive Care Unit. The aim of this study was to evaluate the predictive value of procalcitonin (PCT) for TTN. Methods A total of 52 infants were contained in the study. The patients were divided into three groups. Group 1 consisted of patients with pronounced grunting at more than 2 hours postnatal age (n = 16). Group 2 consisted of patients whose grunt was reduced or gone at 2 hours postnatal age but in whom tachypnea persisted until 24 hours postnatal age (n = 18). Group 3 consisted of patients with minimal or no respiratory distress at 24 hours postnatal age (n = 18). In all groups, PCT concentrations were determined at birth and 24 hours postnatal age. Results PCT concentrations at birth were significantly higher in Group 1 than other groups, but there was no difference between Groups 2 and 3. PCT concentrations at 24 hours postnatal age were significantly higher in Groups 1 and 2 than Group 3. No difference was found between Group 1 and Group 2 at 24 hours postnatal age. All PCT concentrations in Group 3 were significantly lower than other groups. PCT thresholds for the diagnosis of TTN were 0.44 ng/mL at birth (sensitivity 58%, specificity 50%) and 5.11 ng/mL at 24 hours postnatal age (sensitivity 79.4%, specificity 89.1%). Conclusion Serial PCT measurements at birth and postnatal 24 hours may be helpful in differentiating between pneumonia and TTN. Further researches are needed to confirm this initial study.

scholarly journals Vyresnio amžiaus žmonių apendicito ypatumai

2003 ◽  
Vol 1 (1) ◽  
pp. 0-0
Author(s):  
Donatas Venskutonis ◽  
Virmantas Daubaras ◽  
Juozas Kutkevičius ◽  
Jelena Kornej
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Elderly Patients ◽  
Age Groups ◽  
Perforated Appendicitis ◽  
The Mean ◽  
Group 2 ◽  
Medical Histories ◽  
Complications And Mortality ◽  
Group 1

Donatas Venskutonis1, Virmantas Daubaras1, Juozas Kutkevičius1, Jelena Kornej21 Kauno medicinos universiteto Bendrosios chirurgijos klinika, 2-oji Kauno klinikinė ligoninė2 Kauno medicinos universitetas Įvadas / tikslas Apendicitas yra viena iš dažniausių ūminių chirurginių pilvo ligų. Per gyvenimą ūminiu apendicitu suserga apie 7 % visos populiacijos. Literatūros duomenimis, ūminis apendicitas sudaro apie 5 % visų ūminių pilvo ligų vyresnio amžiaus grupėje. Šio darbo tikslas – išanalizuoti KMU Bendrosios chirurgijos klinikoje (II KKL) 1991–2000 metais gydytų vyresnio amžiaus žmonių apendicito formas, diagnostinio laikotarpio trukmę, bendrą gulėjimo stacionare laiką, komplikacijų ir baigčių aspektus, šiuos duomenis palyginti su jaunesnių kaip 65 metų ūminiu apendicitu sergančių ligonių grupe. Metodai Tyrimo metu retrospektyviai buvo išanalizuotos 1991–2000 m. gydytų nuo įvairių ūminio apendicito formų asmenų ligos istorijos, siekiant įvertinti ligos trukmę, diagnostinio laikotarpio trukmę, ligos formą, gulėjimo stacionare trukmę, komplikacijas, mirštamumą ir palyginti šiuos duomenis dviejų amžiaus grupių: iki 65 metų ir daugiau kaip 65 metų. Tiriant istorijas buvo kreipiamas dėmesys į diagnostinio laikotarpio trukmę iki operacijos, operacijos metu nustatytą apendicito formą, stacionarinio gydymo trukmę, buvusias komplikacijas ir baigtį. Rezultatai 1991–2000 m. nuo įvairių ūminio apendicito formų iš viso buvo gydyti 2378 ligoniai: pirmoje grupėje (iki 65 m.) buvo 2220 ligonių (92,51 %), antroje – 158 ligoniai (7,49 %). Pirmos grupės operuota 2130 ligonių (95,94 %), antros – 145 ligoniai (91,7 %). Vertinant apendicito formas, antroje amžiaus grupėje buvo gerokai daugiau gangreninių perforacinių nei pirmoje grupėje (p = 0,0014), o šioje – daugiau flegmoninių (p < 0,0010). Pirmos grupės ligoniai iki operacijos ligoninėje gulėjo 2,3 val., antros – 4,11 val. (p < 0,05). Bendras gulėjimo laikas pirmos grupės ligonių buvo 6,77 paros, antros – 11,14 paros (p < 0,05).Pooperacinių komplikacijų pirmoje grupėje buvo 151 (7,1 %), antroje – 31 (21,3 %), (p = 0,0151). Mirštamumas antroje grupėje sudarė 3,4 %, pirmoje grupėje mirusių nebuvo. Išvados Vyresnio amžiaus žmonės serga sunkesnėmis apendicito formomis, jų ikioperacinis ir bendras gulėjimo laikas yra ilgesnis (skirtumas statistiškai patikimas), pooperacinės komplikacijos sunkesnės ir dažnesnės (skirtumas statistiškai patikimas), visi mirusieji buvo vyresnio amžiaus žmonės, sirgę sunkiomis perforacinio apendicito formomis. Prasminiai žodžiai: apendicitas, vyresnio amžiaus ligoniai. Appendicitis - peculiarities in elderly patients Donatas Venskutonis1, Virmantas Daubaras1, Juozas Kutkevičius1, Jelena Kornej2 Background / objective Appendicitis is one of the most prevailing acute surgical abdominal diseases. According to literature data, acute appendicitis makes 5% of all acute diseases among elderly patients. The aim is to analyse the forms of appendicitis among elderly patients treated in KMU General Surgery Clinic (II KKL) in 1991–2000, as well as the duration of the diagnostic period, general duration of patients’ stay in hospital, the aspects of complications and mortality as compared to those in patients under 65 years of age. Methods Medical histories of the patients treated for acute appendicitis in 1991–2000 were analysed retrospectively. The patients were divided into two age groups: group 1 – under 65 years of age; group 2 – older than 65. The following criteria were evaluated: form of the disease, duration of diagnostic period; duration of stay in hospital; complications, mortality. These data were compared in both age groups. Results In 1991–2000, a total of 2378 patients were treated for various forms of acute appendicitis. There were 2220 patients (91.1%) in group 1 and 158 (7.49%) in group 2. In group 1, 2130 patients (95.94%) and in group 2, 145 (91.7%) were operated on. In group 2 there were more gangrenous perforated acute appendicitis forms than in group 1 (p = 0.0014) and in group 1 there were more phlegmonic forms of appendicitis (p < 0.001). As to the time of stay in hospital before operation, in group 1 it was 2.3 h and in group 2 4.11 h (p < 0.05). The mean stay in hospital in group 1 was 6.77 days and in group 2 11.14 days (p < 0.05). The number of postoperative complications was 151 (7.1%) in group 1 and 31 (21.3 %) in group 2 (p = 0.0151). Mortality in group 2 was 3.4%, while in group 1 nobody died. Conclusions Elderly people fall ill with more grave forms of appendicitis; their stay in hospital before the operation and total stay in hospital is longer, the postoperative complications are more severe and more fequent; the differences are statistically reliable; all lethal cases were elderly patients ill with severe forms of perforated appendicitis. Keywords: appendicitis, elderly patients.

Prevention of ARVI in newborns and their mothers under pandemic conditions of new coronavirus infection

2021 ◽  
Vol 20 (2) ◽  
pp. 66-74
Author(s):  
I.I. Bocharova ◽  
◽  
N.V. Zarochentseva ◽  
A.N. Aksenov ◽  
V.V. Malinovskaya ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Maximum Effect ◽  
Interferon Α ◽  
Study Results ◽  
Group 3 ◽  
Coronavirus Infection ◽  
Group 2 ◽  
Local Use ◽  
Key Words Prevention ◽  
Group 1

Objective. To study the prophylactic effectiveness of the intranasal application of VIFERON®, the gel for external and local use (interferon α-2b) 36,000 IU/g, against ARVI in newborns and their mothers during the COVID-19 pandemic. Patients and methods. A total of 227 mother–newborn couples were examined, randomized into three groups: Group 1 (n = 63) – the VIFERON® gel was used according to the instructions; Group 2 (n = 50) – the VIFERON® gel was used in violation of the recommended scheme; Group 3 (control, n = 114) – did not use the medication. The main criteria for the effectiveness of prevention were: the incidence of ARVI in a mother–child couple for 3 months after inclusion in the study; the duration and severity of clinical symptoms of the disease; evaluation of the frequency of adverse events associated with the use of the drug under study. Results. The use of the VIFERON® gel led to a decrease in the number of ARVI cases in mothers (11.1 and 14.9%) and newborns (7.9 and 20.2%; p = 0.034) in Group 1 compared with Group 3, respectively, as well as to a significant reduction in the duration of the disease (p = 0.001), a decrease in the severity of clinical symptoms: the level of hyperthermia (p = 0.015), the duration of febrile (p = 0.021), cough (p = 0.032), rhinitis (p = 0.033). There were no statistically significant differences between these indicators in Groups 2 and 3, which requires to follow drug instructions in order to achieve the maximum effect. The timing of onset of diseases in Group 1 in the third month of observation from the beginning of drug administration makes it possible to justify the need for repeated courses of prophylaxis at high risk of respiratory diseases. In 100% of cases, the drug was well tolerated, and there were no adverse effects. Conclusion. The high preventive efficacy and safety of interferon α-2b with antioxidants in the form of gel for external and local use (VIFERON®, gel) in newborns and their mothers against ARVI were proved, which makes it possible to recommend its use to prevent the new coronavirus infection COVID-19 in newborns and confirms the validity of its inclusion in clinical guidelines for the treatment of COVID-19 in children. Key words: prevention, ARVI, interferon α-2b with antioxidants, VIFERON® gel, mother–newborn, COVID-19

scholarly journals Clinical and laboratory features of primary acute myocardial infarction in patients with non-obstructive atherosclerotic lesions of the coronary arteries.

2018 ◽  
Vol 96 (6) ◽  
pp. 520-526
Author(s):  
N. V. Dyatlov ◽  
V. V. Zhelnov ◽  
Yu. V. Lykov ◽  
L. I. Dvoretskiy
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Myocardial Ischemia ◽  
Troponin I ◽  
Clinical Manifestations ◽  
Atherosclerotic Lesion ◽  
Common Symptom ◽  
Laboratory Features ◽  
Acute Mi ◽  
Group 2

Currently, the pathogenetic mechanisms of myocardial infarction (MI) in non-obstructive coronary artery disease (CA) are being actively studied, but such clinical situations still cause difficulties due to conflicting information about the clinical manifestations of myocardial ischemia, the dynamics of laboratory parameters, electrocardiographic and echocardiographic picture in this category of patients. Purpose. To study clinical and laboratory features ofprimary MI development and course in patients with non-obstructive CA lesions. Material and methods. The study included patients hospitalized with a diagnosis of “primary acute MI” in 2015-2016 : patients with acute MI and 100% acute occlusion of the only heart attack-responsible KA - obstructive atherosclerotic lesion of KA-and patients with acute MI and non-obstructive atherosclerotic lesion of KA, according to coronary angiography. Results. Surveyed 1,240 patients; the 1st group was 21.9%, 2nd group-7.7% of patients. The mean age of patients in groups 1 and 2 was 56.59±11.6 and 67.9±11.5 years, respectively (p<0.001). Among patients with non-obstructive atherosclerotic lesion of SC, the comorbid background was marked as burdened compared to patients with obstructive atherosclerotic lesion of SC: diabetes mellitus-20.8% vs. 7.4%, chronic kidney disease-25% vs. 11.8%, chronic obstructive pulmonary disease-25% vs. 11.8%. The most common symptom of myocardial ischemia in groups 1 and 2 was chest pain (89.7% vs. 54.2%, p<0.05). In 37.5% of patients of group 2 non-specific symptoms were revealed. ST segment elevation was recorded in 76.5 and 37.5% (p<0.01) patients, respectively. Non-specific electrocardiographic changes were registered in 33.3% of patients of group 2. In the analysis echocardiographically indicators of significant differences indicators in the groups were not observed. Analysis of cardiospecific enzymes showed consistent dynamics of the concentration of troponin I in the 1st and 2nd groups at admission - 0.13 ng/ml (95% CI 0,03 0,31-) against 0.20 ng/ml (95% CI 0,04 - 3,23, p=0,8); after 6 h -20,21 ng/ml (95% CI 8,25 - 45,25) against 1.8 ng/ml (95% CI 0.87 to - of 7.06, p<0.0001). The natural dynamics of the level of creatine kinase and its MB fraction were detected only in patients of the 1st group. Significant changes in the 2nd group is not marked. Elderly patients, mostly women, with a burdened General somatic history are subject to primary MI with non-obstructive atherosclerotic lesion of SC. In the clinical picture of myocardial ischemia, 54.2% ofpatients have chest pain, in other cases-shortness of breath and nonspecific symptoms. In 33.3% of patients on the ECG revealed nonspecific changes that complicate the diagnosis of THEM.

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

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

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

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

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