scholarly journals Анализ развития стернальной инфекции у кардиохирургических больных

2020 ◽  
pp. 51-54
Keyword(s):  
Risk Factor ◽  
Soft Tissues ◽  
Average Duration ◽  
Pulmonary Ventilation ◽  
Chronic Obstructive ◽  
Sternal Infection ◽  
Group A ◽  
Artificial Pulmonary Ventilation ◽  
Operation Duration ◽  
Duration Of Operation

A clinical study including 68 patients of a cardiac profile who developed sternal infection in the postoperative period was conducted. Patients were divided into two groups: 1 group – 42 patients with a sternal infection of soft tissues and the 2nd group – the 26th patient with a sternal infection of a breast. The received results were processed statistically. The received data confirmed that patients of both groups had an accompanying pathology: diabetes mellitus and chronic obstructive diseases of lungs. The risk factor for infection development during sternotomy were an average duration of operation that in the 1st group was 280,9 minutes and in the 2nd group the operation duration was 270,4 minutes. Another risk factor was duration of use of the device of artificial blood-flow; cardiac support was used for 24nd group. A prolonged artificial pulmonary ventilation was used in 39 (92,9 %) patients of the 1st group and 22 (84,6 %) patients of the 2nd group.

scholarly journals The nature of COPD revealed by self-tracking, PRO-data and analysis of contact pattern for participants in a personalized health centered living lab organized according to the Epital Care Model. A longitudinal study. (Preprint)

2020 ◽  
Author(s):  
Klaus Phanareth ◽  
Astrid Laura Dam ◽  
Martin ABC Hansen ◽  
Signe Lindskrog ◽  
Søren Vingtoft ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pulmonary Function ◽  
Oxygen Saturation ◽  
Healthcare Professionals ◽  
Factor Group ◽  
Chronic Obstructive ◽  
Care Model ◽  
Copd Patients ◽  
Group A ◽  
Group D

BACKGROUND Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death and is characterized by a progressive loss of pulmonary function over time with intermittent episodes of exacerbations. Rapid and proactive interventions may reduce the burden of the condition for the patients. Telehealth solutions involving self-tracking of vital parameters such as pulmonary function, oxygen saturation, heart rate and temperature with synchronous communication of health data may become a powerful solution as they enable healthcare professionals to react with a pro-active and adequate response. We have taken this idea to the next level in the Epital Care Model (ECM) and organized a person-centered technology assisted ecosystem to provide health services to COPD patients. OBJECTIVE The objective is to reveal the nature of COPD by combining technology with a person-centered design aimed to benefit from interactions based on PRO data and to assess the needed kind of contacts to best treat exacerbations. We wanted to know: 1) What is the incidence of mild, moderate and severe exacerbations in a mixed population of COPD patients? 2) What is the course of the mild, moderate and severe exacerbations? And 3) How is the activity and pattern of contacts to health professionals related to the participants condition? METHODS Convenience sampling during the period November 2013 to December 2015. The participants’ sex, age, FEV1, pulse rate and oxygen saturation were registered at entry. During the study, we registered number of days, number of exacerbations, number of contact notes coded into care and treatment notes. Each participant was classified according to GOLD I-IV and risk factor group A-D. Participants reported their clinical status using a tablet by answering four questions and sending three semi-automated measurements. RESULTS Of the 87 participants, 11 were in risk factor group A, 24 in B, 13 in C and 39 in D. The number of observed days was 31801 days with 12470 measurements and 1397 care notes and 1704 treatment notes. A total of 254 exacerbations were treated and only 18 caused hospitalization. Those in risk factor group D have the highest number of hospitalizations (16), exacerbations (151), and contacts (1910) The initial contacts during the first month declined within three months to 1/3 for care contacts and 1/2 for treatment contacts and reached a plateau after four months. CONCLUSIONS The majority of COPD patients in risk factor group D can be managed virtually and only 13% of those with severe exacerbations required hospitalization. Contact to the healthcare professionals decreases markedly within the first months after enrollment. These results provide a new and detailed insight into the course of COPD. We propose a resilience index for virtual clinical management making it easier to compare results across settings.

Advantages and faults of laparoscopic operations in treatment of ventral hernias

2020 ◽  
Vol 87 (3-4) ◽  
pp. 35-39
Author(s):  
V. V. Grubnik ◽  
R. P. Nikitenko ◽  
O. M. Stepanovichus ◽  
K. O. Vorotyntseva
Keyword(s):  
Average Duration ◽  
Comparison Analysis ◽  
Hernia Defect ◽  
Method Choice ◽  
Clinical Hospital ◽  
Laparoscopic Procedures ◽  
Laparoscopic Hernioplasty ◽  
Operation Duration ◽  
Duration Of Operation ◽  
Ventral Hernias

Objective. To conduct a comparison analysis of modern open, classic laparoscopic and separation laparoscopic hernioplastic procedures in treatment of ventral and postoperative ventral hernias. Materials and methods. During 2009 - 2019 yrs on the base of Odessa Regional Clinical Hospital 193 patients, suffering ventral and postoperative ventral hernias were operated. Depending on the hernioplasty method applied all the patients were divided on two groups. In the first one 100 patients were exposed to laparoscopic hernioplasty, including 91 patients - the standard laparoscopic operations. In the second group in 93 patients open hernioplasty was performed. Results. In the first group while using a standard laparoscopic procedures of hernioplasty the average duration of operation have constituted (114.0 ± 7.4) min, recurrence was revealed in 7 patients with large hernias (W3). In the second group the operation duration have constituted (130.0 ± 6.1) min, and recurrence was revealed in 8 patients. Conclusion. The operation method choice ought to be individually adjusted, taking into account the patient general status and age, presence of concurrent pathology, as well as the hernia defect dimensions and localization, in particular.

Midterm Results of Routine Bilateral Internal Thoracic Artery Grafting

2005 ◽  
Vol 6 (5) ◽  
pp. 348 ◽  
Author(s):  
A. Kramer ◽  
R. Mohr ◽  
O. Lev-Ran ◽  
R. Braunstein ◽  
D. Pevni ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Regression Analysis ◽  
Pulmonary Disease ◽  
Internal Thoracic Artery ◽  
Chronic Obstructive ◽  
Midterm Results ◽  
Obstructive Pulmonary Disease ◽  
Sternal Infection ◽  
Repeat Operation

Background: Skeletonized dissection of the internal thoracic artery (ITA) decreases the occurrence of sternal devascularization, thus decreasing the risk of postoperative sternal complications in patients undergoing bilateral ITA grafting. Methods: From April 1996 to July 1999, 1000 consecutive patients underwent bilateral skeletonized ITA grafting. Of the 770 male and 230 female patients, 420 were older than 70 years, and 312 had diabetes. Results: Operative mortality was 3.3%. Follow-up (4078 months) revealed 79 late deaths, and the Kaplan-Meier 6-year survival rate was 88%. Cox regression analysis revealed increased overall mortality (early and late) in patients with preoperative congestive heart failure (risk ratio [RR], 2.13; 95% confidence interval [CI], 1.31-3.45), in patients with peripheral vascular disease (RR, 5.52; 95% CI, 3.31-9.19), and in patients older than 70 years (RR, 2.18; 95% CI, 1.37-3.47). Early postoperative morbidity included sternal infection (2.2%), cerebrovascular accident (1.6%), and perioperative myocardial infarction (1%). Multiple regression analysis showed repeat operation (odds ratio [OR], 7.5; 95% CI, 1.77-31.6) and chronic obstructive pulmonary disease (OR, 3.6; 95% CI, 1.27-10.75) to be independent predictors of sternal infection. During follow-up, angina returned in 95 patients, 24 of whom required reintervention (20 cases of percutaneous balloon angioplasty and 4 reoperations). Postoperative coronary angiography performed in 87 patients revealed an ITA patency rate of 91%. Conclusions: Bilateral skeletonized ITA grafting is associated with satisfactory early and midterm results. We do not recommend the use of this surgical technique in patients with chronic obstructive pulmonary disease.

scholarly journals An Assessment of Snail-Farm Systems Based on Land Use and Farm Components

Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 272
Author(s):  
Konstantinos Apostolou ◽  
Alexandra Staikou ◽  
Smaragda Sotiraki ◽  
Marianthi Hatziioannou
Keyword(s):  
Open Field ◽  
Geographical Location ◽  
Farming Systems ◽  
Annual Production ◽  
Categorical Variables ◽  
Mixed System ◽  
Continuous Variables ◽  
Sustainable Food ◽  
Operation Duration ◽  
Duration Of Operation

In this study, the structural and management characteristics of snail farms in Greece were analyzed to maximize sustainable food production. Objectives, such as the classification of farming systems and assessing the effects of various annual production parameters, were investigated. Data were collected (2017) via a questionnaire, and sampling was conducted in 29 snail farms dispersed in six different regions (Thrace, Central Macedonia, West Macedonia, Thessaly, Western Greece, and the Attica Islands). Descriptive statistics for continuous variables and frequencies for categorical variables were calculated. The similarity between farms was analyzed using nonmetric multidimensional scaling (nMDS). The average farm operation duration exceeded eight months and the mean annual production was 1597 kg of fresh, live snails. Results recorded five farming systems: elevated sections (7%), net-covered greenhouse (38%), a mixed system with a net-covered greenhouse (10%), open field (38%), and mixed system with an open field (7%). Snail farms differ in the type of substrate, available facilities, and equipment (60% similarity between most of the open field farms). The geographical location of a farms’ settlement affects productivity but also influences the duration of operation, especially in open field farms, due to their operation under a wide assortment of climatic types.

Anxiety and Depression among Patients with Chronic Obstructive Pulmonary Diseases in Pulmonology Unit of Nobel Medical College Teaching Hospital

2021 ◽  
Vol 6 (1) ◽  
pp. 1285-1290
Author(s):  
Nilam Kumari Jha ◽  
Komal Kant Jha
Keyword(s):  
Risk Factor ◽  
Teaching Hospital ◽  
College Teaching ◽  
Pulmonary Diseases ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Early Assessment ◽  
Medical College ◽  
Copd Patients ◽  
Chronic Obstructive Pulmonary Diseases

Introduction: Anxiety and Depression is a common comorbidity in chronic obstructive pulmonary disease patients. Impaired lung function is a risk factor for depression In COPD patients, reduced recreational activities and social Isolation is a major risk factor resulting in anxiety and depression.  Objective: The objective of this study is to evaluate the prevalence of Anxiety and Depression among the COPD patients at Pulmonology unit of Nobel Medical College Teaching Hospital.  Methodology: A hospital based cross- sectional research design was used for the study. A total of 185 patients with previously diagnosed COPD. Data were collected by using a face to face interview technique in patients to evaluate anxiety and depression using Nepali version of Hospital Anxiety and Depression Scale questionnaire at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from May to August 2020. Data analysis were done by descriptive and inferential statistics.  Results: A total of 185 patients participated in the study, 157 patients (84.9%) had anxiety, 107 patients (57.8%) had depression and 102 patients (55.1%) had both anxiety and depression. There was statistically significant association of anxiety and depression in COPD patients with age, religion, occupation, smoking status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, type of family, domiciliary oxygen therapy.  Conclusion: The study concluded that anxiety and depression had been most prevalent in COPD patients. Therefore health personnel working in the Pulmonology unit should be aware the early assessment and treatment of anxiety and depression of chronic obstructive pulmonary diseases patients. 

CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND COMORBIDITIES: MANAGEMENT OF SOMATOFORM DISORDERS

2021 ◽  
Vol 74 (6) ◽  
pp. 1401-1404
Author(s):  
Liliia V. Burya ◽  
Anna A. Kapustianska ◽  
Nataliia V. Moiseieva ◽  
Andrii V. Vakhnenko ◽  
Mariia O. Rumiantseva ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Somatoform Disorders ◽  
Comprehensive Evaluation ◽  
Pulmonary Ventilation ◽  
Multidisciplinary Care ◽  
Step Test ◽  
Chronic Obstructive ◽  
Copd Exacerbations ◽  
Group D ◽  
Severe Copd

The aim: To perform a comprehensive evaluation of the effect of paroxetine on the degree of somatoform disorders in exacerbation of severe COPD in women. Materials and methods: The study involved 53 female patients with severe COPD (Group D), confirmed by instrumental methods of study. At hospitalization, patients were divided into 2 groups. Patients of Group 1 (n = 21; aged 52.5 ± 0.8 years old) underwent basic exacerbation therapy. Patients of Group 2 (n = 22; aged 57.9 ± 0.4 years old) underwent basic exacerbation therapy supplemented with paroxetine for 14 days, 1 tablet (0.20 g) once a day. Results: The basic therapy for treatment of COPD exacerbations, supplemented with paroxetine, led to a positive clinical effect, confirmed by increase in skeletal and respiratory muscular system, increased parameters of pulmonary ventilation, increased tolerance to physical load, increased oxygen saturation, decreased heart rate and breathing rate. Conclusions: The strategy for choosing an antidepressant to provide multidisciplinary care for somatoform disorders in women with exacerbation of severe COPD (group D) should take into account the efficacy and favorable safety profile and personalization of the drug. In exacerbation of severe COPD, the degree of somatoform disorders in patients correlates with the severity of the main criteria: FVC1, the distance walked during the 6-minute step test, oxygen saturation after the 6-minute step test, end-expiratory pressure in the oral cavity.

scholarly journals A Strong Graded Relationship between Level of Obesity and COPD: Findings from a National Population-Based Study of Lifelong Nonsmokers

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Esme Fuller-Thomson ◽  
Kaitlyn E. N. Howden ◽  
Lilia R. Fuller-Thomson ◽  
Senyo Agbeyaka
Keyword(s):  
Risk Factor ◽  
Representative Sample ◽  
Future Research ◽  
Chronic Obstructive ◽  
Healthy Weight ◽  
Research Attention ◽  
Nationally Representative ◽  
Never Smokers ◽  
The Impact ◽  
Hispanic White

Factors associated with chronic obstructive pulmonary disease (COPD) among never-smokers have received little research attention. One potential risk factor for COPD is obesity, which is of particular importance in light of the global obesity epidemic. The objective of this study was to investigate the association between COPD and levels of obesity in a nationally representative sample of non-Hispanic white never-smokers. Data were drawn from the 2012 Center for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS). Pearson’s chi-square tests and logistic regression analyses were conducted in a large nationally representative sample of non-Hispanic white respondents aged 50 and over (76,004 women; 37,618 men) who reported that they had never smoked. A dose-response relationship was observed for both men and women: the prevalence of COPD increased from 2.5% in men and 3.5% in women who were of a healthy weight (BMI < 25) to 7.6% in men and 13.4% in women who had a BMI of 40 or higher. Even after adjusting for 7 potential confounds (e.g., age, education, and income), the odds of COPD were 3.21 higher for men (95% CI = 2.46, 4.20) and 4.00 higher for women with class III obesity (95% CI = 3.52, 4.55) in comparison with those of healthy weight. Regular screening for COPD is warranted in never-smoking obese patients who are aged 50 and over. Future research is needed to investigate plausible mechanisms for this association, including (1) the role of chronic inflammation associated with obesity and (2) the impact of central obesity on respiratory system mechanics.

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