RETROSPECTIVE ANALYSIS OF FEATURES OF DETECTION OF NEW CORONOVIRAL INFECTION COVID-19 IN PATIENTS WITH SURGICAL PROFILE ARRIVING IN A EMERGENCY

2021 ◽  
pp. 139-148
Author(s):  
Дмитрий Валериевич Судаков ◽  
Евгений Владимирович Белов ◽  
Олег Валериевич Судаков ◽  
Ольга Игоревна Гордеева ◽  
Оксана Александровна Андросова
Keyword(s):  
Clinical Symptoms ◽  
Positive Impact ◽  
Clinical Manifestations ◽  
Reactive Protein ◽  
Group 4 ◽  
Group 3 ◽  
Ct Data ◽  
Group 2 ◽  
Group 1

В статье рассматриваются особенности своевременного выявления новой короновирусной инфекцией (НКИ) у пациентов хирургического профиля на уровне приемного отделения областной клинической больницы. Представленная работа является в настоящее время крайне актуальной, в виду продолжающейся в мире пандемии НКИ - Covid-19. Важное значение данному исследованию придает то, что оно направлено на как можно более раннюю диагностику Covid-19, уже на уровне нахождения в приемном отделении при поступлении в многопрофильный стационар. Подобные меры могут существенно помочь в сохранении здоровья медицинских работников и могут оказать положительное влияние на эпидемиологическую обстановку в целом. Интересной составляющей данного исследования является и то, что диагностика Covid-19 основывается лишь на тех лабораторных анализах, которые можно быстро определить в условиях приемного отделения. Объектами исследования послужило 200 пациентов, поступающих в приемное отделение БУЗ ВО ВОКБ №1 исключительно с хирургической патологией. Все больные были подразделены на 4 группы по 50 человек, всем им был поставлен сопутствующий диагноз Covid-19. В 1 группу вошли пациенты, поступающие в приемное отделение без сознания, сбор анамнеза и сбор жалоб у которых был невозможен. 2 группу составили пациенты, у которых НКИ была диагностирована непосредственно после оперативного вмешательства. В 3 группу вошли пациенты, у которых была выявлена НКИ, но объем оперативного вмешательства и объем поражения легких позволял им дальнейшее амбулаторное лечение. 4 группу составили пациенты, у которых Covid-19 выявлялся в течение 3 дней после оперативного вмешательства. У всех больных подробно собирался анамнез жизни и эпидемиологический анамнез (за исключением 1 группы), анализировались наиболее частые клинические проявления и показатели общего и биохимического анализа крови, обрабатывались данные КТ легких. Были определены основные клинические симптомы НКИ, такие как: повышенная температура тела, кашель, слабость и утомляемость. Наиболее важными лабораторными показателями стало определение уровня лейкоцитоза, с уровнем нейтрофилов и лимфоцитов, а также СОЭ, D-димера, С-реактивного белка. Представленная статья представляет большой интерес для врачей, работающих в условиях приемных отделений многопрофильных стационаров. По результатам работы планируется продолжение исследования с большей выборкой пациентов и большим количеством изучаемых параметров The article discusses the features of the timely detection of a new coronavirus infection (NCI) in surgical patients at the level of the admission department of a regional clinical hospital. The presented work is currently extremely relevant, in view of the ongoing NСI pandemic in the world - Covid-19. The importance of this study is attached to the fact that it is aimed at the earliest possible diagnosis of Covid-19, already at the level of being in the admission department upon admission to a multidisciplinary hospital. Such measures can significantly help preserve the health of medical workers and can have a positive impact on the epidemiological situation in general. An interesting component of this study is the fact that the diagnosis of Covid-19 is based only on those laboratory tests that can be quickly determined in the conditions of the admission department. The objects of the study were 200 patients admitted to the admission department of BUZ VO VOKB № 1 exclusively with surgical pathology. All patients were divided into 4 groups of 50 people, all of them were diagnosed with a concomitant Covid-19 diagnosis. Group 1 consisted of patients admitted to the emergency department unconscious, and it was impossible to collect anamnesis and collect complaints. Group 2 consisted of patients in whom NCI was diagnosed immediately after surgery. Group 3 included patients who had NCI, but the volume of surgery and the volume of lung lesions allowed them further outpatient treatment. Group 4 consisted of patients in whom Covid-19 was detected within 3 days after surgery. In all patients, a detailed life history and epidemiological history were collected (except for group 1), the most frequent clinical manifestations and indicators of general and biochemical blood tests were analyzed, and CT data of the lungs were processed. The main clinical symptoms of NCI were identified, such as: fever, cough, weakness and fatigue. The most important laboratory indicators were the determination of the level of leukocytosis, with the level of neutrophils and lymphocytes, as well as ESR, D-dimer, C-reactive protein. The presented article is of great interest to doctors working in the admission departments of multidisciplinary hospitals. Based on the results of the work, it is planned to continue the study with a larger sample of patients and a large number of studied parameters

scholarly journals Fever as a predictor of adverse outcomes in COVID-19

QJM ◽  
2021 ◽  
Author(s):  
N W Chew ◽  
J N Ngiam ◽  
S M Tham ◽  
Z Y Lim ◽  
T Y W Li ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
Adverse Outcomes ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
End Point ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Design And Methods ◽  
Group 1

Summary Background/Introduction There are little data on outcomes of COVID-19 patients with the presence of fever compared to the presence of symptoms. Aim We examined the associations between symptomology, presence of fever and outcomes of a COVID-19 cohort. Design and Methods Between 23 January and 30 April 2020, 554 COVID-19 patients were admitted to a tertiary hospital in Singapore. They were allocated into four groups based on symptomology and fever—Group 1: asymptomatic and afebrile, Group 2: symptomatic but afebrile, Group 3: febrile but asymptomatic and Group 4: symptomatic and febrile. The primary outcomes were intensive care unit (ICU) admissions and mortality. The composite end-point included ICU admissions, mortality or any COVID-19 related end-organ involvement. Results There were differences in ferritin (P=0.003), C-reactive protein (CRP) levels (P<0.001) and lymphopenia (P=0.033) across all groups, with the most favourable biochemical profile in Group 1, and the least in Group 4. Symptomatic groups (Groups 2 and 4) had higher ICU admissions (1.9% and 6.0%, respectively, P=0.003) than asymptomatic groups (Groups 1 and 3). Composite end-point was highest in Group 4 (24.0%), followed by Group 3 (8.6%), Group 2 (4.8%) and Group 1 (2.4%) (P<0.001). The presence of fever (OR 4.096, 95% CI 1.737–9.656, P=0.001) was associated with the composite end-point after adjusting for age, pulse rate, comorbidities, lymphocyte, ferritin and CRP. Presence of symptoms was not associated with the composite end-point. Discussion/Conclusion In this COVID-19 cohort, presence of fever was a predictor of adverse outcomes. This has implications on the management of febrile but asymptomatic COVID-19 patients.

scholarly journals Association of Haemoglobin and C-Reactive Protein level with Different Risk Factors among Acute Coronary Syndrome Patients

2019 ◽  
Vol 5 (2) ◽  
pp. 156-160
Author(s):  
Md Mahboob Morshed ◽  
Md Joynul Islam ◽  
ATM Ashadullah ◽  
Khondker Shaheed Hussain ◽  
Mohammad Ahtashamul Haque
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Group 4 ◽  
History Of ◽  
Study Population ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Different risk factors may be related with the haemoglobin and CRP level among the acute coronary syndrome patients. Objective: The purpose of the present study was to see the association of haemoglobin and CRP level with different type of risk factors among the acute coronary syndrome patients. Methodology: This cross-sectional study was conducted in the Department of Cardiology at Mymensingh Medical College, Mymensingh, Bangladesh from December 2010 to November 2011 for a period of two (02) years. Patients of ACS who were presented within 12 hours of chest pain were included as study population. Study population were categorized in four groups according to the level of hemoglobin and C-reactive protein. Age, cardiovascular risks factor, history, family history of cardiovascular disease, treatment history and ECG were taken during admission. Blood sample was collected for baseline laboratory investigations like Troponin-I, Random Blood Sugar (RBS), Blood urea, Serum creatinine, lipid profile, Hemoglobin & CRP level. Sample were then send to standard laboratory/Biochemistry department of MMCH. Result: The mean age of the population was 52.18±8.88 years. Smoking was the highest percentage in Group 1 which was 54(50.0%) cases (P=0.001). Hypertension was found most common in group 1 (47.6%), Group 2 (33.3%), Group 3 (10.7%) and Group 4 (8.3%). Smoking (p=0.001) and hypertension (p=0.016) was found statistically significant. Diabetes was found in Group 1 (37.7%), Group 2 (43.5%), Group 3 (11.6%) and Group 4 (7.2%). Group 1 (50%) and Group 2 (50%) patients were dyslipidaemic. Family history of IHD was present group-1 (36.8%), Group 2 (44.7%), Group 3 (73.2%) and Group 4 (53%). Among the smoker patient 65.6% cases had CRP level ˃12 mg/l; 39.8% cases had CRP level ˂12mg/L. Among the nonsmoker 34.4% cases had CRP level ˃12mg/l and 60.2% cases had CRP level ˂12mg/L. The finding was statistically significant. Conclusion: In conclusion haemoglobin and CRP level is associated with different type of risk factors among the acute coronary syndrome patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 156-160

The Role of Procalcitonin in Gynaecological Surgery

2009 ◽  
Vol 37 (3) ◽  
pp. 918-926 ◽  
Author(s):  
B Gorišek ◽  
NG Miksić ◽  
P Krajnc ◽  
M Pakiž ◽  
Z Turk
Keyword(s):  
Infectious Complications ◽  
Postoperative Sepsis ◽  
Gynaecological Surgery ◽  
Malignant Tumours ◽  
Reactive Protein ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Tissue Trauma ◽  
Group 1

We evaluated postoperative concentrations of inflammatory indicators, including procalcitonin, after gynaecological operations for benign and malignant tumours in patients with a normal postoperative course and assessed the utility of procalcitonin in differentiating between non-bacterial inflammation and bacteraemic complications in the postoperative period. This prospective study included 99 patients: 47 after a standard gynaecological operation (Piver I) and no postoperative infectious complications (group 1), 35 after a major procedure (Piver II or III) and no postoperative infectious complications (group 2), and five with postoperative sepsis after Piver II or III procedures (group 3). We also studied serum procalcitonin concentrations in a group of 12 patients (group 4) with terminal forms of gynaecological cancer who were hospitalized for palliative treatment but did not undergo surgery. Postoperative C-reactive protein (CRP) concentration corresponded with extent of tissue trauma in groups 1 and 2 and was significantly lower in group 1 than group 2. Inflammatory indicators were highest in groups 1 and 2 on postoperative day 2. In group 3, in which sepsis developed, values were highest on postoperative day 4. In particular, procalcitonin was > 2 ng/ml in all patients with postoperative sepsis by postoperative day 2 but was always ≤ 2 ng/ml in patients without sepsis. In contrast, high procalcitonin levels were noted in the patients in group 4 compared with group 3, with two-thirds of group 4 patients having levels > 2 ng/ml, with no signs of infection or raised CRP. It is concluded that, for early detection of postoperative infectious complications after gynaecological surgery, procalcitonin levels > 2 ng/ml are more specific than CRP.

scholarly journals Influence of cervical preflaring on apical file size determination in maxillary lateral incisors

2007 ◽  
Vol 18 (2) ◽  
pp. 102-106 ◽  
Author(s):  
Guilherme Siqueira Ibelli ◽  
Juliana Machado Barroso ◽  
Alexandre Capelli ◽  
Júlio César Emboava Spanó ◽  
Jesus Djalma Pécora
Keyword(s):  
Root Canal ◽  
Apical Region ◽  
File Size ◽  
Group 4 ◽  
Major Discrepancy ◽  
Group 3 ◽  
Group 2 ◽  
Passive Movements ◽  
Group 1

The purpose of this study was to investigate the influence of cervical preflaring on determination of the initial apical file in maxillary lateral incisors. Forty human lateral incisors with complete root formation were used. After standard access cavities, a size 06 K-file was inserted into each canal until the apical foramen was reached. The WL (WL) was set 1 mm short of the apical foramen. Four groups (n=10) were formed at random, according to the type of cervical preflaring performed. Group 1 received the initial apical instrument without previous preflaring of the cervical and middle root canal thirds. Group 2 had the cervical and middle root canal thirds enlarged with nickel-titanium Orifice Opener instruments. Group 3 had the cervical and middle root canal thirds enlarged with Gates-Glidden drills. Titanium-nitrite treated, stainless steel LA Axxess burs were used for preflaring the cervical and middle root canal thirds of group 4. Each canal was sized using manual K-files, starting with size 08 files with passive movements until the WL was reached. File sizes were increased until a binding sensation was felt at the WL, and the instrument size was recorded for each tooth. The apical region was then observed under a stereoscopic magnifier, images were recorded digitally and the differences between root canal and maximum file diameters were recorded (in mm) for each sample. Significant differences were found between the groups regarding the anatomical diameter at the WL and the first file to bind the canal (p = 0.01). The major discrepancy was found when no preflaring was performed (0.1882 mm average). Canals preflared with Orifice Opener instruments (0.0485 mm average) and Gates-Glidden drills (0.1074 mm average) also showed great discrepancy. The LA Axxess burs produced the smallest differences between anatomical diameter and first file to bind (0.0119 mm average). Instrument binding technique for determining anatomical diameter at WL was not accurate. Preflaring of the cervical and middle thirds of the root canal improved anatomical diameter determination; the instrument used for preflaring played a major role on determination of the anatomical diameter at the WL. Canals preflared with LA Axxess burs created a more accurate relationship between file size and anatomical diameter.

scholarly journals Impact of Dietary Diversification on the Prognostic Inflammatory and Nutritional Index in School-Age Children in the Nawa Region (Côte d’Ivoire)

2021 ◽  
Vol 10 (4) ◽  
pp. 154-161
Author(s):  
Allico Mousso Jean Maurel ◽  
Agbo Adouko Edith ◽  
Séri Kipré Laurent ◽  
Boyvin Lydie ◽  
Kouamé Christophe ◽  
...  
Keyword(s):  
Sweet Potato ◽  
Positive Impact ◽  
Phase 1 ◽  
School Age Children ◽  
Group 4 ◽  
Nutritional Index ◽  
Group 3 ◽  
Group 2 ◽  
The Impact ◽  
Group 1

The objective of this work was to study the impact of food diversification based on sweet potato, soybean, and cowpea on the prognostic inflammatory and nutritional index (PINI) in school-aged children in the Nawa region. This study took place from October 2017 to May 2018 among 240 pupils aged 6 to 12, divided into four groups of 60. Four types of meals were proposed: rice with tomato soup and fish (group 1), sweet potato porridge enriched with green soybeans (group 2), sweet potato porridge enriched with white cowpea (group 3), or sweet potato porridge accompanied by white cowpea with green soybeans (group 4). There were three blood samples: before eating meals (phase 0), the end of the first trimester (phase 1), and the end of the second trimester (phase 2). Blood assay for C-reactive protein (CRP), orosomucoid, albumin, and prealbumin was performed using COBAS c311 analyzer. PINI was calculated. Groups 3 and 4 showed a slight increase in albumin values (42.24 ± 0.95 g/L and 41.51 ± 1.71 g/L, respectively) compared to group 1. CRP decreased from phase 1 for group 1 (2.06 ± 0.26 mg/L) and group 4 (2.38 ± 0.36 mg/L). Orosomucoid increased insignificantly (p > 0.05) in group 3 (0.74 ± 0.04 g/L) and group 4 (0.71 ± 0.04 g/L). PINI was reduced by 0.37 (group 1), 0.36 (group 2), 0.46 (group 3) and 0.44 (group 4). Food diversification based on sweet potato and white cowpea has a positive impact on PINI in more than 80% of pupils.

Pre-Engraftment Syndrome After Myeloablative Umbilical Cord Blood Transplantation: Risk Factors and How To Stratify

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5482-5482
Author(s):  
Zimin Sun ◽  
Maojing Guan ◽  
Huilan Liu ◽  
Liangquan Geng ◽  
Xingbing Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Symptoms ◽  
Cord Blood Transplantation ◽  
Group 4 ◽  
Significant Difference ◽  
Engraftment Syndrome ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
Group 1

Abstract Introduction Pre-engraftment syndrome (PES) is a group of symptoms occurred after hematopoietic stem cell transplantation especially unrelated cord blood transplantation(UCBT) before the engraftment, including unexplained fever higher than 38.3°CAunexplained erythematous skin rashAdiarrheaAhepatic dysfunction Anon-cardiogenic edemaApulmonary infiltrates and weight gain. Severe PES can be fatal, however there’s no criteria to define it. We retrospectively analyzed the incidence, risk factors, manifestations and clinical outcomes of PES in CBT recipients, who had been treated for hematologic malignancies. All patients received TBI(12GY)/Ara-c(8g/ m2)/CY(120mg/kg) without ATG or Flu(120mg/ m2)/Ara-c(8g/ m2)+BU(12.8mg/kg)+CY (120mg/kg) myeloablative conditioning. Methods From April 2010 to July 2011, 61 patients underwent UCBT at our transplantation center and 40 patients(65.6%) developed PES at a median of 7 d (range 5–13) post-transplant. We analyze 8 factors related to treatment-related mortality (TRM) within 180 days : occurrence timeAthe maximum temperatureAclinical symptomsAconcentration of CyclosporinAthe initial dose of MPAmethylprednisolone (MP) effective daysAdays till MP reduced and reoccurrence after symptoms under control. Univariate analysis identified early occurrence time( day +5 or +6 ) AMP effective days and clinical symptoms as significant risk factors for higher TRM. In a multivariate analysis, we found these three factors are independent and have no interactions. We retrospectively analyze all the patients who developed PES from April 2010 to December 2012. Results There were 94 cases and we scored them based on these three factors. The patient got one score for each factor if he/she got a fever on day 5-6 after UCBT or had more than two clinical symptoms or not under control after 7 days of MP. We added the three scores together and divide the patients into four groups according to the total score(zero for Group 1Aone score for Group 2Atwo score for Group 3Athree for Group 4). The number of patients for Group 1-4 was 32A32A18 and 12. There is a significant difference for the TRM within 180 days between Group 4(58%) and Group 1(18.7%)AGroup 2(22.2%) (P<0.01). The TRM of Group 4 in one year is 66.7%, which is significantly higher than Group 1( 22.7%), Group 3(22.2%) (P<0.01), but shows less significant difference compared with TRM of group 2, which is 33%. The relapse rate of one year for each group from 1 to 4 was 9%A16.7%A5.5%A8.3%. The probability of one-year disease-free survival (DFS) was much higher in Group 1 (71.7%) and 3(72.2%) than Group 4(25%) (P<0.01). The difference was apparent as to the probability of one-year overall survival (OS) between Group 1 (74.8%) and 4(25%), the same is true whith Group 3 (71.3%) and 4(25%). The difference between Group 2(55.4%) and Group 4 was not clearly significant (P=0.06). Conclusions Recognizing and treating immediately severe PES will significantly reduce the TRM of UCBT. Our analyze confirmed that these three factors are crucial to define severe PES .We therefore put forward this ranking method to help to diagnosis and take effective treatment. Disclosures: No relevant conflicts of interest to declare.

Endothelial and Autonomic Functions in Patients with Migraine

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e222-e231 ◽  
Author(s):  
Mehmet Tolga Dogru ◽  
Ergin Dilekoz ◽  
Murat Alpua ◽  
Oguz Eroglu ◽  
Hüseyin Kandemir ◽  
...  
Keyword(s):  
Endothelial Dysfunction ◽  
Randomized Study ◽  
Clinical Manifestations ◽  
Noninvasive Evaluation ◽  
Control Group ◽  
Autonomic Functions ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Objective It has been shown that patients with migraine have endothelial dysfunction. Migraine patients with aura, especially, have more clinical manifestations of autonomic nervous system dysfunction. We aimed to evaluate the endothelial and autonomic functions in migraine patients during both migraine headache attack and headache-free periods. Design This was a cross-sectional, randomized study. Subjects and Methods A total of 130 participants (67 male and 63 female patients, minimum age = 19 years, maximum age = 71 years, mean age = 38.8 ± 12.2 years) were enrolled into the study. For the statistical evaluation of data, we classified the participants of the study as follows: group 1: headache (+) aura (+); group 2: headache (+) aura (−); group 3: headache (−) aura (+); group 4: headache (−) aura (−). Noninvasive evaluation of endothelial function was performed by flow-mediated dilation (FMD) and pulse wave analysis methods. Heart rate variability measurements were used for noninvasive evaluation of autonomic functions. Results Group 1 had a higher FMD ratio than the control group, group 3, or group 4 (P &lt; 0.001, P &lt; 0.001, and P = 0.003, respectively). Group 4 had lower FMD ratio levels than the other migraine groups and or the control group (P &lt; 0.001). Group 3 had the highest high-frequency (HF) power levels among all migraine groups (P &lt; 0.001). Group 2 had higher low-frequency/HF ratio values than other migraineurs (P &lt; 0.001). Conclusions We concluded that endothelial dysfunction and headache are closely related. Additionally, higher parasympathetic tonus might be associated with the presence of aura.

scholarly journals Anaesthesia and the Acute Phase Protein Response in Children Undergoing Circumcision

2005 ◽  
Vol 2005 (5) ◽  
pp. 312-315 ◽  
Author(s):  
Unase Buyukkocak ◽  
Fatma Caglayan ◽  
Osman Caglayan ◽  
Murat Basar ◽  
Murat Cakmak ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Acute Phase ◽  
Acute Phase Proteins ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Protein Response ◽  
Group 1

Concentrations of acute phase proteins (CRP: C-reactive protein, albumin) change during surgery. We investigated the acute phase response to circumcision and the effects of anaesthesia on this response. The children were divided into four groups; group 1 (intratracheal general anaesthesia,n=40), group 2 (general anaesthesia with mask,n=20), group 3 (ketamine,n=20), group 4 (local anaesthesia,n=35). Blood samples were obtained, 24 hours before circumcision, after premedication, and 24 hours after circumcision. CRP and albumin before circumcision were comparable for all groups. There was no increase in CRP, and albumin remained steady throughout the study. No difference was observed among the groups, and related to anaesthesia. No responsiveness may be explained with the size of injured tissue or anatomical and histological type of preputium.

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.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

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