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Sample records for early postoperative period

  1. Carotid thromboses in the early postoperative period after carotid endarterectomy.

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    Pokrovskiĭ, A V; Kuntsevich, G I; Beloiartsev, D F; Timina, I E; Kolosov, R V

    2005-01-01

    demonstrated postoperative progression of neurological symptomatology and coma with fatal outcome. The last patient, for whom a reoperation was contraindicated, died due to aggravation of cerebral coma. Dynamic follow-up in early postoperative period after CEA, especially in the first 6 hours, as well as an urgent duplex scanning of the reconstructed area in case of neurological symptoms development, provides timely diagnosis of postoperative thrombosis and the success of reoperations. Adjustments to patient's cardiac status and appropriate intraoperative heparinization can decrease the risk of this complication. An urgent reoperation aimed at the restoration of carotid blood flow, immediately after the diagnosis of thrombosis (provided the absence of deep coma), promotes a complete or partial regression of neurological symptoms and helps to prevent a progression of cerebrovascular disturbances.

  2. Serial MRI in the early postoperative period after lumbar discectomy

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    Annertz, M. [Dept. of Radiology, University Hospital, Lund (Sweden); Joensson, B. [Dept. of Orthopaedics, University Hospital, Lund (Sweden); Stroemqvist, B. [Dept. of Orthopaedics, University Hospital, Lund (Sweden); Holtaas, S. [Dept. of Radiology, University Hospital, Lund (Sweden)

    1995-04-01

    The aim of this study was to determine MRI findings in patients successfully operated upon for lumbar disc herniation. We investigated 20 patients with a successful outcome after L4-5 or L5-S1 disc operations clinically and with MRI preoperatively, and at 5 days, 6 weeks, and 4 months after surgery. Postoperatively, T1- and T2-weighted images were obtained. At 4 months gadolinium-enhanced images were added. Pronounced intraspinal MRI changes were seen during follow-up. Deformation of the dural sac was seen in 13 patients preoperatively, in 19 at 5 days after operation, in 15 at 6 weeks, and in 12 at 4 months. Nerve root involvement was seen in all cases both preoperatively and at 5 days after operation, in 17 at 6 weeks, and in 15 at 4 months. No correlation between symptoms or the straight leg raising test and the size or nature of the abnormal tissue in the spinal canal postoperatively could be demonstrated. It was concluded that early postoperative MRI after lumbar discectomy must be interpreted carefully, and that oedema and scar formation are probable reasons for difficulties in interpretation. (orig.)

  3. Effect of Tributyrin on Electrical Activity in the Small Intestine during Early Postoperative Period.

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    Tropskaya, N S; Kislyakova, E A; Popova, T S

    2015-12-01

    The effect of enteral administration of tributyrin on electrical activity in the upper segments of the small intestine was examined in rats on the model of postoperative ileus. This postoperative state is characterized with pronounced and long-term disturbances in generation of migrating myoelectric complex of the small intestine. The enteral administration of tributyrin in the early postoperative period aimed to suppress the non-adrenergic non-cholinergic influences and activation of the cholinergic anti-inflammatory pathways is an effective procedure to normalize the migrating myoelectric complex and therefore the coordinated propulsive peristalsis in the small intestine.

  4. Biliopancreatic diversion with duodenal switch modifies plasma chemerin in early and late post-operative periods.

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    Parlee, Sebastian D; Wang, Yan; Poirier, Paul; Lapointe, Marc; Martin, Julie; Bastien, Marjorie; Cianflone, Katherine; Goralski, Kerry B

    2015-06-01

    Bariatric surgery remains the most effective treatment for obesity and metabolic syndrome. Surgical benefit arises from early-phase resolution of hyperglycemia and late-phase weight loss. The adipokine chemerin is of interest given its roles in immunity, adipogenesis, and metabolism. The study objective was to examine the effects of biliopancreatic diversion with duodenal switch (BPD-DS) on plasma chemerin in the early and late post-operative stages. 83 adults with obesity undergoing BPD-DS, 45 obese non-surgical controls, and 9 lean surgical controls were enrolled. Plasma parameters and anthropometric measures were obtained at baseline and at, early (24 h, 5 D) and late (6 months and 12 months) post-operative stages. Plasma chemerin dropped from 176±49 ng/mL at baseline to 132±52 ng/mL 24 h after BPD-DS, rebounded to 200±66 ng/mL after 5 D, and declined to 124±51 and 110±34 ng/mL after 6 and 12 months. Plasma chemerin correlated negatively with measures of inflammation and hepatic injury and positively with measures of obesity, metabolic syndrome, and inflammation in the early and late post-operative periods, respectively. Chemerin has a novel role in surgical injury but not hyperglycemia resolution early after BPD-DS. Over the long term, plasma chemerin declines to a new set point that is partially determined by body fat reductions. © 2015 The Obesity Society.

  5. Affect of surgical approaches on functional results of total hip arthroplasty in early postoperative period

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    D. V. Andreyev

    2013-01-01

    Full Text Available Minimally invasive approaches implies a less soft tissue damage and, therefore, more rapid recovery of the patient in the early postoperative period. The present study is a comparison of minimally invasive and standard approaches using biomechanical analysis of standing and walking patients before and after total hip arthroplasty, as well as an analysis of clinical outcomes in the early postoperative period. Fifty patients undergoing primary total hip arthroplasty using a minimally invasive and conventional techniques were divided into three groups. The first group consisted of patients operated on using the MIS AL (modified minimally invasive approach Watson-Jones (n = 17, the second - MDM (minimally invasive approach to the modified Mueller (n = 16 and in the third - with the use of transgluteal conventional approach by Harding (n = 17. The estimation of biomechanical parameters in static and dynamic patients before surgery and at 8-10 days after surgery. Also assessed clinical outcome postoperative visual analogue scale (VAS and Harris scale on day 10, 6 and 12 weeks and 1 year. When comparing the three groups of patients stabilometry best results were observed in groups of minimally invasive approaches MIS AL and MDM. When comparing the three groups significantly better (a moderate increase in the duration of the step, rolling the contralateral limb and a slight increase in the duration of the step the operated limb by increasing the duration of the roll-over were identified in the minimally invasive group MIS AL and MDM. In assessing the scale of Harris in the early postoperative period, higher rates were observed in groups of minimally invasive approaches. A year after the operation functional results become similar in all groups.

  6. Cardiac catheterization in the early post-operative period after congenital cardiac surgery.

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    Nicholson, George T; Kim, Dennis W; Vincent, Robert N; Kogon, Brian E; Miller, Bruce E; Petit, Christopher J

    2014-12-01

    This study sought to demonstrate that early cardiac catheterization, whether used solely as a diagnostic modality or for the use of transcatheter interventional techniques, can be used effectively and with an acceptable risk in the post-operative period. Cardiac catheterization offers important treatment for patients with congenital heart disease. Early post-operative cardiac catheterization is often necessary to diagnose and treat residual anatomic defects. Experience with interventional catheterization to address post-operative concerns is limited. This was a retrospective cohort study. The medical and catheterization data of pediatric patients who underwent a cardiac catheterization ≤30 days after congenital heart surgery between November 2004 and July 2013 were reviewed. Patients who underwent right heart catheterization and endomyocardial biopsy after heart transplantation were excluded. A total of 219 catheterizations (91 interventional procedures, 128 noninterventional catheterizations) were performed on 193 patients. Sixty-five interventions (71.43%) were dilations, either balloon angioplasty or stent implantation. There was no difference in survival to hospital discharge between those who underwent an interventional versus noninterventional catheterization (p = 0.93). One-year post-operative survival was comparable between those who underwent an intervention (66%) versus diagnostic (71%) catheterization (p = 0.58). There was no difference in the incidence of major or minor complications between the interventional and diagnostic catheterization cohorts (p = 0.21). Cardiac catheterization, including transcatheter interventions, can be performed safely in the immediate post-operative period after congenital heart surgery. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. CLINICAL EFFECTIVENESS OF OSMOTIC LAXATIVE DRUGS IN EARLY POSTOPERATIVE PERIOD IN CHILDREN WITH CHRONIC COLON STASIS

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    P.V. Ivanov

    2010-01-01

    Full Text Available The clinical effectiveness of osmotic laxative drugs based on lactulose in restoration of gastrointestinal tract function in early postoperative period after transanal interventions and laparoscopic operations in 53 children 2–17 years old was studied. All patients had non-functional (cologenic and proctogenic constipation. Patients underwent full-thickness laparoscopic or transanal biopsy due to suspicion of gastrointestinal malformation presence. Children from base group (n = 28 used lactulose (Duphalac from the second day of postoperative period (dose complied with the age once daily, in the morning. The control group (n = 25 received subcutaneous or intramuscular proserinum for the stimulation of peristalsis. Blood tests with serum potassium control were performed on 2nd and 4th day. The study showed clinical effectiveness of lactulose in treatment of postoperational hypotonic constipation in children with colon malformations. Key words: children, gastrointestinal malformations, postoperative period, chronic constipation, lactulose.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(1:122-125

  8. Endothelial dysfunction in the early postoperative period after major colon cancer surgery

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    Ekeløf, Sara; Larsen, Mikkel Hjordt; Schou-Pedersen, Anne Marie Voigt

    2017-01-01

    Background. Evidence suggests that endothelial dysfunction in the early postoperative period promotes myocardial injury after non-cardiac surgery. The aim of this study was to investigate the impact of colon cancer surgery on endothelial function and the association with the l-arginine-nitric oxide...... pathway postoperatively. Methods. Patients undergoing elective colon cancer surgery (n = 31) were included in this prospective observational cohort study. Endothelial function, as measured using the reactive hyperaemia index (RHI), was assessed non-invasively using digital pulse tonometry. RHI and plasma...... was attenuated in the first days after colon cancer surgery indicating acute endothelial dysfunction. Endothelial dysfunction correlated with disturbances in the L-arginine – nitric oxide pathway. Our findings provide a rationale for investigating the hypothesized association between acute endothelial...

  9. Postural control in patients with lumbar disc herniation in the early postoperative period.

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    Sipko, Tomasz; Chantsoulis, Marzena; Kuczyński, Michał

    2010-03-01

    Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for the lower limbs loading impairs proprioception and deteriorates postural stability, particularly when the vision is occluded. The standard surgical treatment improves biomechanical conditions in the lumbar spine, reduces pain, yet does it reduce the stability deficit in the upright position? An answer to the latter question would help work out targeted therapy to improve postural stability. We hypothesized that the standard surgical treatment would improve postural stability reflected by decreased sway variability accounting for better use of proprioceptive inputs postoperatively. Thirty-nine patients with lumbar disc herniation participated in the study. Their postural sway was recorded in anterior/posterior and medial/lateral planes with their eyes open or closed (EC) before and after surgery. The variability, range, mean velocity of the recorded time series and the area of the ellipse enclosed by the statokinesiogram were used as measures of postural stability. Preoperatively, EC condition resulted in an increased variability and mean velocity of postural sway, while postoperatively it caused an increase in sway mean velocity and sway area only with no effect on sway variability and range. The comparison of the balance before and after the surgery in the EC condition showed significant decrease in all parameters. In the early postoperative period, the patients recover the ability to control their postural sway in EC within normal limits, however, at the expense of significantly increased frequency of corrective torques. It is probably a transient short-term strategy needed to compensate for the recovery phase when the normal weighting factors for all afferents are being reestablished. We propose that this transient postoperative period may be the best timing of therapeutic intervention targeted at facilitating and reinforcing the

  10. Evaluation of Coronary Artery Bypass Grafts in the Early Postoperative Period Using 64-Slice MDCT

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    Jeong, Yu Mi; Kim, Jeong Ho; Park, Chul Hyun; Park, Kook Yang; Byun, Sung Su; Hwang, Hee Young; Park, Chul Hi; Kim, Hyung Sik [Gachon University Hospital, Incheon (Korea, Republic of)

    2009-05-15

    The aim of this study was to evaluate the accuracy of 64-slice multidetector row CT (MDCT), as compared with conventional coronary angiography (CCA), for assessing coronary artery bypass grafts (CABG) in the early (< 1 month) postoperative period. Twenty-four patients underwent both 64-slice MDCT (0.6 mm collimation, 0.37s gantry rotation) and CCA within 15 days after CABG. Sixty-five bypass grafts (20 venous grafts and 45 arterial grafts) and 67 distal runoff arteries in 24 patients were included in the analysis. The bypass grafts and distal runoffs were evaluated for the presence of significant stenosis, including obstruction. The CT findings were compared with the CCA findings. CCA confirmed that 62 of the 65 grafts were patent and that 3 had significant stenosis or obstruction. Sixty of the 62 patent grafts were correctly identified by MDCT. One of the three grafts that had significant stenosis was misinterpreted on the MDCT images. The sensitivity, specificity and positive and negative predictive values for detecting stenosis were 67%, 97%, 50% and 98%, respectively, with an overall diagnostic accuracy of 95%. MDCT also correctly detected all the stenotic distal runoff arteries (4 of 67). 64-slice MDCT is a promising alternative diagnostic modality for evaluating a CABG in the early postoperative period.

  11. [Usefulness of upper gastrointestinal series to detect leaks in the early postoperative period of bariatric surgery].

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    Medina, Francisco J; Miranda-Merchak, Andrés; Martínez, Alonso; Sánchez, Felipe; Bravo, Sebastián; Contreras, Juan Eduardo; Alliende, Isabel; Canals, Andrea

    2016-04-01

    Postoperative leaks are the most undesirable complication of bariatric surgery and upper gastrointestinal (GI) series are routinely ordered to rule them out. Despite the published literature recommending against its routine use, it is still being customarily used in Chile. To examine the usefulness of routine upper GI series using water-soluble iodinated contrast media for the detection of early postoperative leaks in patients undergoing bariatric surgery. A cohort of 328 patients subjected to bariatric surgery was followed from October 2012 to October 2013. Most of them underwent sleeve gastrectomy. Upper GI series on the first postoperative day were ordered to 308 (94%) patients. Postoperative leaks were observed in two patients, with an incidence of 0.6%. The sensitivity for upper GI series detection of leak was 0% and the negative predictive value was 99%. Routine upper GI series after bariatric surgery is not useful for the diagnosis of postoperative leak, given the low incidence of this complication and the low sensitivity of the technique.

  12. Filtering bleb activation in the early post-operative period after fistulizing surgery

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    S. Yu. Petrov

    2014-10-01

    Full Text Available The article presents a case report of a patient with a cystic bleb in the early postoperative period after trabeculectomy. Patient complained of discomfort in a recently (4 weeks operated eye. Medical regimen administered previously had been taken irregularly. Biomicroscopy revealed a high, encapsulated cystic bleb with thin walls and hyperemia. Intraocular pressure at the moment of examination was 27 mmHg. Local hypotensive therapy had been neglected by the patient. A local anti-inflammatory (tobramycin / dexamethasone fixed combination and hypotensive (brimonidine / timolol fixed combination therapy was administered. 24 hours later, when intraocular pressure decreased to 20 mmHg, a needle revision procedure was conducted for partial bleb wall destruction and subconjunctival injection of dexamethasone, fluorouracil and ranibizumab. During the next day examination the bleb was diffuse, with less hyperemia and an abundance of conjunctival microcysts in the central bleb’s zone. Intraocular pressure was 10.2 mmHg. No choroidal detachment was noted during ophthalmoscopy and OCT examination. The patient continued anti-inflammatory therapy. Another needling procedure with the same drug combination was repeated two weeks after due to an increased hyperemia. At the end of the four-week follow-up period the filtering bleb remained diffuse and the intraocular pressure was 13.2 mmHg. Dexamethasone drops were prescribed to be instilled 1‑2 times a day for a month. This case report demonstrates the method of restoring a functioning filtering bleb by the needle revision with antiinflammatory, cytostatic and anti-VEGF therapy for prolonging the hypotensive effect of a trabeculectomy in the presence of wound healing.

  13. Filtering bleb activation in the early post-operative period after fistulizing surgery

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    S. Yu. Petrov

    2014-01-01

    Full Text Available The article presents a case report of a patient with a cystic bleb in the early postoperative period after trabeculectomy. Patient complained of discomfort in a recently (4 weeks operated eye. Medical regimen administered previously had been taken irregularly. Biomicroscopy revealed a high, encapsulated cystic bleb with thin walls and hyperemia. Intraocular pressure at the moment of examination was 27 mmHg. Local hypotensive therapy had been neglected by the patient. A local anti-inflammatory (tobramycin / dexamethasone fixed combination and hypotensive (brimonidine / timolol fixed combination therapy was administered. 24 hours later, when intraocular pressure decreased to 20 mmHg, a needle revision procedure was conducted for partial bleb wall destruction and subconjunctival injection of dexamethasone, fluorouracil and ranibizumab. During the next day examination the bleb was diffuse, with less hyperemia and an abundance of conjunctival microcysts in the central bleb’s zone. Intraocular pressure was 10.2 mmHg. No choroidal detachment was noted during ophthalmoscopy and OCT examination. The patient continued anti-inflammatory therapy. Another needling procedure with the same drug combination was repeated two weeks after due to an increased hyperemia. At the end of the four-week follow-up period the filtering bleb remained diffuse and the intraocular pressure was 13.2 mmHg. Dexamethasone drops were prescribed to be instilled 1‑2 times a day for a month. This case report demonstrates the method of restoring a functioning filtering bleb by the needle revision with antiinflammatory, cytostatic and anti-VEGF therapy for prolonging the hypotensive effect of a trabeculectomy in the presence of wound healing.

  14. Respiratory complications in the early post-operative period following elective craniotomies

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    Sachidanand J Bharati

    2015-01-01

    Full Text Available Background and Aims: Respiratory complications are of major concern after intracranial procedures. The objective of the study was to assess the incidence of respiratory complications in the initial 72 hours after elective craniotomies and to identify the associated risk factors. Materials and Methods: Patients undergoing elective craniotomies were studied prospectively. Information pertinent to history, physical examinations, investigation reports, perioperative events and outcome at discharge of the patients were recorded. Occurrence of any sign or symptom of respiratory system, need for reintubation/increased ventilatory support within 72 hours of surgery were considered as post-operative respiratory complication. Relationships of numerical variables and categorical variables with post-operative respiratory complications (PRCs were assessed via T test and Chi-square (or Fisher′s exact. Multivariate analysis using multiple logistic regression was performed for finding independent risk factors for respiratory complications. Results: Out of 961 patients, 137 (14.3% patients developed PRC within 72 hours of surgery. Ninety-nine (10.3% patients developed purulent tracheobronchitis. The patients who had PRC had longer hospital stays and poor Glasgow Outcome Scale at hospital discharge. The variables found as independent risk factors were tachycardia, blood transfusion in the intraoperative period and Glasgow Coma Scale (GCS deterioration, hypokalemia and fever in the post-operative period. Conclusions : Respiratory complications within first 72 hours of elective craniotomies were common and were associated with prolonged hospital stay and poor neurological outcome. The variables which were found as independent risk factors were tachycardia, blood transfusion in the intraoperative period and GCS deterioration, hypokalemia and fever in the post-operative period.

  15. Heart rhythm and conduction disturbances in early postoperative period after surgical correction for congenital heart defects in infants

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    Bockeria L. A.

    2012-03-01

    Full Text Available Objective. The study aimed to determine the range of rhythm and conduction disturbances in early postoperative period in infants and prove the prognostic value of some pre- and intraoperative factors for development of such complications. Material and methods. The study included 235 children aged from 1 to 3 years who underwent surgeries for congenital heart diseases (CHD under cardiopulmonary bypass (CPB. Exclusion criteria were: age less than 1 year or more than 3 years, presence of confirmed heart rhythm disturbances before surgery except incomplete or complete right bundle branch block in presence of right ventricular myocardial hypertrophy, left anterior bundle branch block in presence of partial or complete atrioventricular canal defect and sinus tachycardia equal to circulatory failure (CF. Results. Ventricular arrhythmias such as premature ventricular contraction (PVC of different character were frequently seen in early postoperative period after surgical correction of CHD. They were noted in 36% of overall number postoperative arrhythmias. Supraventricular extrasystole occurred in 29% cases, different types of supraventricular tachycardias – in 17%, AV-blocks of different grades – in 10%. We noted the following predictors for postoperative rhythm disturbance development: age more than 25 months at the moment of surgery, prolonged CPB and aortic cross-clamping during ventricular septal defect (VSD (70 and 39 minutes, respectively and Fallot’s tetralogy correction (100 and 60 minutes, respectively and exceeding the critical end-point of aortic cross-clamping during atrial septal defect correction (ASD (24 minutes, presence of IIA and IIb grade for CF before surgery, surgical correction of ASD under hypothermia of less than 32 °C. Exceeding the critical end-points of CPB and aortic clamping in patients with Fallot’s tetralogy and exceeding the critical end-points of aortic clamping in children with VSD and ASD were shown to be the

  16. [Protein malnutrition in patient in the early postoperative period after uncomplicated removal of the brain tumors].

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    Krylov, K Iu; Savin, I A; Goriachev, A S; Emel'ianov, V K; Oshorov, A V; Polupan, A A; Sychev, A A; Tabasaranskiĭ, T F; Sokolova, E Iu; Moshkin, A V; Tnedieva, V D; Mochenova, N N; Aref'rva, I A; Lasunin, N V; Mezentseva, O Iu

    2012-01-01

    Malnutrition leads to adverse effects and may worsen clinical outcome. Surgery as a stress factor activates pathological reactions changing metabolism structure. The aim of this study was to evaluate changes of protein metabolism in patients after elective neurosurgical operation. 24 patients were prepared for elective surgery and were enrolled in this study. Evaluation of each patient included: measurement of anthropometric indices--height, weight, arm circumference and the triceps skinfold thickness, the definition of protein loss by determining the loss of nitrogen in the urine, assessment of protein catabolism, determining the violations of nutritional status upon the base of laboratory parameters. During the course of the conducted investigation significant (p < 0.05) decrease in the indices of total protein, albumin, transferrin and the absolute numbers of lymphocytes in the postoperative period was revealed. All the patients developed severe protein catabolism. It became clear that uncomplicated elective surgical intervention, together with the adopted scheme of the nutritional therapy leads to severe protein catabolism in all patients.

  17. Severe dengue in the early postoperative period after kidney transplantation: two case reports from Hospital Geral de Fortaleza

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    Samuelson Hugo Félix Maia

    2015-12-01

    Full Text Available Abstract: Dengue is an arbovirosis that ranges from an asymptomatic presentation to a more severe disease, which is characterized by a vascular leakage syndrome where abdominal pain is a major symptom. Transplant recipients are immunosuppressed and are less likely to develop a severe form of the disease because of a reduction in immune-mediated responses that trigger plasma extravasation events. Herein, we report two cases of severe dengue in the early postoperative period of two kidney transplant recipients. Considering the severity of the cases, we emphasize the importance of dengue screening immediately before transplantation in areas endemic for the disease.

  18. RHEOLOGICAL PROPERTIES OF BLOOD AT PATIENTS WITH BOWEL OBSTRUCTION OF TUMORAL GENESIS IN THE EARLY POSTOPERATIVE PERIOD

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    V. V. Maslyakov

    2014-01-01

    Full Text Available Introduction. Microcirculation plays an important role in early postoperative period in colorectal cancer patients. At the same time the question connected with studying of rheological properties of blood as one of microcirculation indicators in literature it studied insufficiently.Materials and methods. We studied rheological properties of blood in 30 patients operated for bowel obstruction caused by right colon cancer. 17 (56,7 % patients were male, 13 (43,3 % – female. Average age was 57 ± 3 years. Time from the moment of manifestation of the first clinical signs before admission to a hospital and the beginnings of carrying out medical and diagnostic actions was 12 ± 0,5 h. The stage of a disease was T3N0–1M0. The group of comparison consisted of 20 healthy volunteers of the same age. Changes of a rheology of blood were measured by means of the accounting of viscosity of blood, change of an index of deformation and aggregation of erythrocytes. Studying of viscosity of blood was carried out by means of the rotational viscometer at shift speeds: 200; 100; 150; 50 and 20 MPas. Measures were conducted at the time of receipt, on the first, third, fifth, seventh and tenth postoperative day.Results. In patients with bowel impassability at the time of receipt the increase in indicators of viscosity of blood is noted at all speeds of the shift, analyzed indicators increase by the third postoperative day, decrease on the seventh and are partially restored for the tenth postoperative days. Complications developed in 16,6 % of cases, in all cases – pneumonia. By comparison of the obtained laboratory data to a clinical picture it is established that complications developed on 3–5th postoperative days.

  19. CLINICAL AND IMMUNOLOGICAL FEATURES OF KIDNEY TRANSPLANT RECIPIENTS WITH CYTOMEGALOVIRUS INFECTION MANIFESTATION IN THE EARLY POSTOPERATIVE PERIOD

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    L. V. Limareva

    2013-01-01

    Full Text Available Aim. To optimize the management of postoperative renal allograft recipients through the introduction of methods for predicting risk of manifestation of cytomegalovirus infection on the basis of a comprehensive assessment of the clinical and immunological status. Materials and methods. We retrospectively analyzed the medical records of 303 patients with end-stage renal disease, among them – were the recipients of renal allograft – 136, among whom 29 within 2 months after the operation had clinical signs of CMV infection. Assessable "CMV syndrome", laboratory evidence of CMV infection, the incidence of antigens (genes of HLA A, B and DRB *1, calculated goodness of fit χ2 and relative risk RR, changes MCP-1 in urine. Results. In renal allograft recipients with clinical and laboratory evidence of CMV infection in the early postoperative period, significantly more (χ2 > 3,8 met antigen B35. A positive association with CMV infection was detected also for DRB1 * 08, B21, B22, B41, A24 (9, B51 (5, DRB1*14 and DRB1*15. Protective effects possessed antigens / alleles of genes A26 (10, B14, B38 (16 B61 (40 and DRB1*16. MCP-1 levels in this group of recipients were raised to 2174,7 ± 296,3 pg/ml with a strong negative correlation with the levels of urea and creatinine in serum (r = 0,9, p < 0.001. Conclusion. Immunological markers of risk manifestation of CMV infection in recipients of kidneys in the early postoperative period are: the carriage of В35 и В55,56(22, В49(21, В41, DRB1*08 и DRB1*15, an increase of levels of MCP-1 in urine without increasing the levels of urea and creatinine in the serum. 

  20. Efficacy of drainage blood reinfusion in early postoperative period after total hip arthroplasty in patients with rheumatoid arthritis

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    N B Shelokova

    2008-01-01

    Full Text Available To study effect of drainage blood reinfusion in early postoperative period (EPP after total hip arthroplasty (THA in patients with rheumatoid arthritis (RA. Material and methods. Primary THA was performed in 51 RA pts with hip damage (49 female, 2 male aged from 26 to 68 years. 42 THA were performed with “Endosystems and Implants” (ESI endoprosthesis, and 21 — with “Mathys” endoprosthesis. The pts were divided into two groups. Standard infusion-transfusion therapy with donor blood components was performed in group 1 pts (n=26 to compensate blood loss in EPP. In group 2 pts (n=25 drainage blood reinfusion was done with active aspiration system Handy Vac TM ATS (Unomedical. Group 1 pts had more prominent circulatory and neurologic disturbances in EPP: hypodynamic variant of circulation with elevation of peripheral vascular resistance till 5-7 day of postoperative period, prominent hypersympathicotonia and a large number of posttransfusion reactions. Evaluation of hemodynamic and vegetative disturbances showed advantage of blood loss compensation and vegetative disturbances normalization with drainage blood reinfusion in EPP after THA in comparison with standard pts management.

  1. Interobserver agreement on the echocardiographic parameters that estimate right ventricular systolic function in the early postoperative period of cardiac surgery.

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    Olmos-Temois, S G; Santos-Martínez, L E; Álvarez-Álvarez, R; Gutiérrez-Delgado, L G; Baranda-Tovar, F M

    2016-11-01

    To know the variability of transthoracic echocardiographic parameters that assess right ventricular systolic function by analyzing interobserver agreement in the early postoperative period of cardiovascular surgery. To assess the feasibility of these echocardiographic measurements. A cross-sectional study, double-blind pilot study was carried out from May 2011 to February 2013. Cardiovascular postoperative critical care at the National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico. Consecutive, non-probabilistic sampling. Fifty-six patients were studied in the postoperative period of cardiac surgery. The first echocardiographic parameters were obtained between 6-8hours after cardiac surgery, followed by blinded second measurements. Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity on tissue Doppler imaging (VSPAT), diameters and right ventricular outflow area, tract fractional shortening. The agreement was analyzed by the Bland-Altman method, and its magnitude was assessed by the intraclass correlation coefficient (95% confidence interval). Both observers evaluated TAPSE and VSPAT in 48 patients (92%). The average TAPSE was 11.68±4.53mm (range 4-27mm). Right ventricular systolic dysfunction was observed in 41 cases (85%) and normal TAPSE in 7 patients (15%). The average difference and its limits according to TAPSE were -0.917±2.95 (-6.821, 4.988), with a magnitude of 0.725 (0.552, 0.837); the tricuspid annular peak systolic velocity on tissue Doppler imaging was -0.001±0.015 (-0.031, 0.030), and its magnitude 0.825 (0.708, 0.898), respectively. VSPAT and TAPSE were estimated by both observers in 92% of the patients, these parameters exhibiting the lowest interobserver variability. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  2. Physical health problems experienced in the early postoperative recovery period following total knee replacement

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    Szötz, Kirsten; Pedersen, Preben Ulrich; Hørdam, Britta

    2015-01-01

    BACKGROUND: The length of stay in hospital following total knee replacement is markedly shortened due to fast-track programmes. Patients have to be responsible for their recovery at a very early stage. The aim of this study was to investigate the prevalence of physical health problems and the level...

  3. Mitral restenosis in the early postoperative period of a patient with systemic lupus erythematosus

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    Pomerantzeff Pablo Maria Alberto

    1999-01-01

    Full Text Available A forty eight year old woman, who had undergone mitral comissurotomy and subsequently developed early restenosis, presented with major comissural fusion and verrucous lesions on the cuspid edges of the mitral valve, with normal subvalvar apparatus. Patient did well for the first six months after surgery when she began to present dyspnea on light exertion. A clinical diagnosis of restenosis was made, which was confirmed by an echocardiogram and cardiac catheterization. She underwent surgery, and a stenotic mitral valve with verrucous lesions suggesting Libman-Sacks' endocarditis was found. Because the diagnosis of systemic lupus erythematosus (SLE had not been confirmed at that time, a bovine pericardium bioprosthesis (FISICS-INCOR was implanted. The patient did well in the late follow-up and is now in NYHA Class I .

  4. Liver graft hyperperfusion in the early postoperative period promotes hepatic regeneration 2 weeks after living donor liver transplantation

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    Byun, Sung Hye; Yang, Hae Soo; Kim, Jong Hae

    2016-01-01

    vascular velocities and a small-sized graft in the early postoperative period contributes to hepatic regeneration 2 weeks after LDLT. PMID:27861381

  5. Pneumomediastinum, Subcutaneous Emphysema, and Tracheal Tear in the Early Postoperative Period of Spinal Surgery in a Paraplegic Achondroplastic Dwarf

    Directory of Open Access Journals (Sweden)

    Sinan Kahraman

    2013-01-01

    Full Text Available Achondroplasia was first described in 1878 and is the most common form of human skeletal dysplasia. Spinal manifestations include thoracolumbar kyphosis, foramen magnum, and spinal stenosis. Progressive kyphosis can result in spinal cord compression and paraplegia due to the reduced size of spinal canal. The deficits are typically progressive, presenting as an insidious onset of paresthesia, followed by the inability to walk and then by urinary incontinence. Paraplegia can be the result of direct pressure on the cord by bone or the injury to the anterior spinal vessels by a protruding bone. Surgical treatment consists of posterior instrumentation, fusion with total wide laminectomy at stenosis levels, and anterior interbody support. Pedicle screws are preferred for spinal instrumentation because wires and hooks may induce spinal cord injury due to the narrow spinal canal. Pedicle lengths are significantly shorter, and 20–25 mm long screws are appropriate for lower thoracic and lumbar pedicles in adult achondroplastic There is no information about the appropriate length of screws for the upper thoracic pedicles. Tracheal injury due to inappropriate pedicle screw length is a rare complication. We report an extremely rare case of tracheal tear due to posterior instrumentation and its management in the early postoperative period.

  6. Quantitative Tc-99m DTPA renal transplant scintigraphy predicts graft survival in the very early postoperative period.

    Science.gov (United States)

    Gupta, Sandeep K; Lewis, Guy; Rogers, Kerry; Attia, John

    2012-12-01

    Early evaluation of renal allograft prognosis is important for identification and targeted management of 'at-risk' grafts but is difficult in the absence of established tests. Tc-99m diethylene triamine pentaacetic acid renal transplant scintigraphy is a useful noninvasive method for assessing graft function. We aimed to assess the relative role of quantitative scintigraphic parameters in the immediate postoperative period for the assessment of short-term and long-term prognoses. Data from 290 dynamic renal transplant scintigraphy procedures, performed on 161 recipients on day 1 (D1) or day 4 (D4) after transplantation, were analysed to derive various perfusion parameters [Kirchner's Index, Hilson's Index (HI), kidney-to-aorta ratio and ΔP] as well as nonperfusion parameters (graft washout t (1/2), P : PI ratio, P : U ratio, R20/3, T10 and T20) using regions of interest within the whole renal graft and iliac artery. Information on graft survival up to 1 year (as a measure of short-term prognosis) and serum creatinine at 1 year (regarded as a predictor for longer-term prognosis) was collected. Mann-Whitney tests, receiver-operating characteristic curve analyses and odds ratios were used to assess the utility of each parameter in stratifying the risk for graft failure within 1 year. Correlations between each parameter and 1-year serum creatinine were tested using Spearman's rank correlation. Eleven grafts failed within 1 year. All perfusion parameters on both D1 and D4 showed significant differences between the failure and survival groups (P=0.026-0.0005). No significant between-group differences were observed for nonperfusion parameters except for R20/3 on D1 (P=0.0298). Receiver-operating characteristic analysis showed moderate accuracy for HI and ΔP on both D1 and D4 (area under the curve: 0.73-0.84); ΔP of longer than 6.0 s on D4 was associated with 24.9 times higher relative risk for graft failure within 1 year (sensitivity 88% and specificity 83%). For the

  7. The utility of erythrocyte sedimentation rate values and white blood cell counts after spinal deformity surgery in the early (≤3 months) post-operative period.

    Science.gov (United States)

    Kuhn, Margaret G; Lenke, Lawrence G; Bridwell, Keith H; O'Donnell, June C; Luhmann, Scott J

    2012-03-01

    The erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count are frequently obtained in the work-up of post-operative fever. However, their diagnostic utility depends upon comparison with normative peri-operative trends which have not yet been described. The purpose of this study is to define a range of erythrocyte sedimentation rates and white blood cell counts following spinal instrumentation and fusion in non-infected patients. Seventy-five patients underwent spinal instrumentation and fusion. The erythrocyte sedimentation rate and white blood cell count were recorded pre-operatively, at 3 and 7 days post-operatively, and at 1 and 3 months post-operatively. Both erythrocyte sedimentation rate and white blood cell count trends demonstrated an early peak, followed by a gradual return to normal. Peak erythrocyte sedimentation rates occurred within the first week post-operatively in 98% of patients. Peak white blood cell counts occurred with the first week in 85% of patients. In the absence of infection, the erythrocyte sedimentation rate was abnormally elevated in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively. The white blood cell count was abnormally elevated in only 6% of patients at 1 month post-operatively. Longer surgical time was associated with elevated white cell count at 1 week post-operatively. The fusion of more vertebral levels had a negative relationship with elevated erythrocyte sedimentation rate at 1 week post-operatively. The anterior surgical approach was associated with significantly lower erythrocyte sedimentation rate at 1 month post-operatively and with lower white cell count at 1 week post-operatively. In non-infected spinal fusion surgeries, erythrocyte sedimentation rates are in the abnormal range in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively, suggesting that the erythrocyte sedimentation rate is of limited diagnostic value in the early post-operative

  8. Restricted Crystalloid Fluid Therapy during Orthotopic Liver Transplant Surgery and its Effect on Respiratory and Renal Insufficiency in the Early Post-operative Period: A Randomized Clinical Trial

    OpenAIRE

    Sahmeddini, M. A.; Janatmakan, F.; Khosravi, M. B.; Ghaffaripour, S.; Eghbal, M. H.; Nickeghbalian, S.; Malek-Hosseini, S. A.

    2014-01-01

    Background: Respiratory and renal insufficiencies are common dysfunctions during post-liver transplantation period that increase post-operative mortality and morbidity rates. Intra-operative fluid therapy is an important factor associated with pulmonary and renal insufficiency. Objective: To evaluate the relation between intra-operative fluid therapy and early renal and respiratory insufficiency after liver transplantation. Methods: In this randomized clinical study, 67 adult patients with en...

  9. Analysis of the Causes of Elevated C-Reactive Protein Level in the Early Postoperative Period After Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Kim, Tae Won; Kim, Dong Hwan; Oh, Won Seuk; Sim, Jae Ang; Lee, Yong Seuk; Lee, Beom Koo

    2016-09-01

    Measurement of C-reactive protein (CRP) levels as a screening test for acute periprosthetic joint infection has high sensitivity and low specificity. We performed the present study to analyze the causes of elevated CRP levels in the early postoperative period after primary total knee arthroplasty (TKA). This study is intended to help the postoperative care of patients through understanding the factors associated with postoperative elevation of CRP. The records for 627 patients who underwent primary TKA between January 2005 and May 2013 were examined. We excluded 50 patients for whom TKA with inflammatory arthritis or revision TKA was performed. We measured serial CRP levels during the 4-week early postoperative period in all included cases to find the cases that showed a CRP pattern of elevation-depression-elevation (a bimodal pattern). We analyzed the causes of re-elevated CRP levels in patients with a bimodal pattern of CRP change. Of the 577 included patients, 76 showed bimodal CRP elevation patterns. Eighteen elevations were caused by postoperative infections (periprosthetic infection), 10 by cardiovascular problems, 11 by gastrointestinal problems, 12 by urologic problems, 10 by respiratory problems, and 15 had unknown origins. Our study shows that elevated CRP levels after TKA can have various causes. Although there may be other causes for an elevated CRP, it is essential to perform a work-up for prosthetic joint infections. In addition, there seems to be a need to evaluate noninfectious causes and infection of other sites, in addition to periprosthetic infection. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The Benefit of Sirolimus Maintenance Immunosuppression and Rabbit Antithymocyte Globulin Induction in Liver Transplant Recipients That Develop Acute Kidney Injury in the Early Postoperative Period

    Directory of Open Access Journals (Sweden)

    Benjamin T. Duhart

    2015-01-01

    Full Text Available Published data are limited describing renal outcomes in orthotopic liver transplant (OLT recipients prescribed sirolimus (SRL maintenance immunosuppression (MIS and rabbit antithymocyte globulin (rATG induction. We investigated whether SRL MIS and rATG induction facilitated recovery of acute kidney injury in the early postoperative period. This retrospective descriptive study screened 308 consecutive OLTs performed between 2006 and 2009. All patients received rATG induction with steroid avoidance. MIS consisted of SRL or TAC with mycophenolate mofetil. A total of 197 patients were included: 168 (85% received TAC and 29 (15% received SRL for a median of 365 days. Demographics were similar between groups except for a higher incidence of pretransplant renal dysfunction in the SRL recipients (SRL 59% versus TAC 21%; P<0.05. The eGFR was significantly (P<0.05 higher for all time points in the TAC group with the exception of month 2. However, improvement in eGFR was significantly (P<0.05 greater in the SRL group postoperatively. Our study suggests that rATG induction and SRL maintenance immunosuppression facilitate renal recovery for liver transplant recipients that develop acute kidney injury in the early postoperative period.

  11. The benefit of sirolimus maintenance immunosuppression and rabbit antithymocyte globulin induction in liver transplant recipients that develop acute kidney injury in the early postoperative period.

    Science.gov (United States)

    Duhart, Benjamin T; Ally, Winston A; Krauss, Amy G; Hudson, Joanna Q; Eason, James D; Rao, Vinaya; Vanatta, Jason M

    2015-01-01

    Published data are limited describing renal outcomes in orthotopic liver transplant (OLT) recipients prescribed sirolimus (SRL) maintenance immunosuppression (MIS) and rabbit antithymocyte globulin (rATG) induction. We investigated whether SRL MIS and rATG induction facilitated recovery of acute kidney injury in the early postoperative period. This retrospective descriptive study screened 308 consecutive OLTs performed between 2006 and 2009. All patients received rATG induction with steroid avoidance. MIS consisted of SRL or TAC with mycophenolate mofetil. A total of 197 patients were included: 168 (85%) received TAC and 29 (15%) received SRL for a median of 365 days. Demographics were similar between groups except for a higher incidence of pretransplant renal dysfunction in the SRL recipients (SRL 59% versus TAC 21%; P < 0.05). The eGFR was significantly (P < 0.05) higher for all time points in the TAC group with the exception of month 2. However, improvement in eGFR was significantly (P < 0.05) greater in the SRL group postoperatively. Our study suggests that rATG induction and SRL maintenance immunosuppression facilitate renal recovery for liver transplant recipients that develop acute kidney injury in the early postoperative period.

  12. The development of a small bowel volvulus in the early postoperative period following a distal gastrectomy: report of a case.

    Science.gov (United States)

    Sakamoto, T; Miyata, M; Nakamuro, M; Izukura, M; Kamiike, W; Matsuda, H

    1994-01-01

    A 51-year-old Japanese man who underwent a standard distal gastrectomy for cancer of the stomach developed abdominal pain when oral intake was commenced on the 6th postoperative day after an uneventful postoperative course. Complete obstruction of the jejunum led to a sudden deterioration in his general condition and a laparotomy was performed, revealing counterclockwise rotation of the mesenterium. The necrotic portion of the small intestine was removed, while 10 cm of the upper jejunum and 100 cm of the terminal ileum were preserved. His second postoperative course was uneventful apart from the development of "intestinal hurry," which is now under medical control 9 months after his second laparotomy.

  13. Takotsubo Syndrome as a Cause of False Acute Abdomen in the Early Postoperative Period After Bariatric Surgery-a Report of Two Cases.

    Science.gov (United States)

    Viegas, Fabio; Viegas, Carla; França, Enio; Kleuser, Klaus; de Barros, Fernando

    2016-10-01

    Takotsubo syndrome, also known as broken-heart syndrome, stress-induced cardiomyopathy or transient apical ballooning syndrome, is a transient disorder characterized by segmental left ventricular failure in the absence of obstructive coronary artery disease. Most cases of Takotsubo syndrome are caused by acute stress that leads to a sudden, temporary weakening of the cardiac musculature. This stress triggers a rise in circulating catecholamine levels that results in acute ventricular dysfunction. In this report, we describe two cases of Takotsubo syndrome in the early postoperative period after bariatric surgery.

  14. Evaluation of the quality of life of women treated due to breast cancer using amputation or breast conserving surgery in the early postoperative period.

    Science.gov (United States)

    Nowicki, Andrzej; Licznerska, Bernardeta; Rhone, Piotr

    2015-04-01

    Selection of the treatment method in breast cancer patients and its consequences may affect their quality of life through somatic, psychical, and social factors. The aim of the study was early evaluation of the quality of life of women after mastectomy vs. breast conserving surgery. The study included 100 women aged 31 to 79 years (mean: 57) who underwent surgery due to breast cancer (amputation: 52; breast conserving surgery: 48 women) at the Cancer Centre in Bydgoszcz in 2014. The QLQ C-30 and QLQ BR-23 questionnaires were used to evaluate the quality of life of the patients 3 months after surgery. In the Global Health Status/QoL domain, the mean score for women after amputation and breast conserving surgery was 49 and 53, respectively; for Physical Functioning, the scores were 70 and 75, and for Role Functioning, 62 and 68, respectively. For Cognitive Functioning, the mean score was 74 and 73; for Emotional Functioning - 62 and 68, and for Social Functioning 64 and 60, respectively. The difference in the arm symptoms domain was significant at 46 and 33 points, respectively (p = 0.004). The patients treated with breast conserving surgery had a better body image than women after amputation - the mean score was 52 and 66, respectively (p = 0.01). With respect to Global Health Status/QoL and Physical Functioning, the quality of life of women in the early postoperative period was similar in women after breast amputation and those who underwent breast conserving surgery. Patients treated with breast conserving surgery had a better score for body image, while those who underwent amputation more often suffered from arm symptoms, such as pain, oedema, and problems with raising of the limb.

  15. Takotsubo Cardiomyopathy Occurring in the Postoperative Period.

    Science.gov (United States)

    Deniz, Süleyman; Bakal, Ömer; İnangil, Gökhan; Şen, Hüseyin; Özkan, Sezai

    2015-02-01

    Takotsubo cardiomyopathy simulates acute myocardial infarction, and it is characterised by reversible left ventricular failure. A case of Takotsubo cardiomyopathy diagnosed after emergency angiography performed in a patient with evidence of acute myocardial infarction in the postoperative period will be described in this report. Transurethral resection of a bladder tumour (TUR-BT) was performed in a 92-year-old male patient by the urology clinic. The patient was transferred to the post-anaesthesia care unit after the operation. An echocardiography was performed because of the sudden onset of dyspnoea, tachycardia (140-150 beats per minute, rhythm-atrial fibrillation) and ST-segment elevation on electrocardiography (ECG) at the first postoperative hour, and midapical dyskinesia was detected at the patient. An immediate angiography was performed due to suspicion of acute coronary syndrome. Patent coronary arteries and temporary aneurysmatic dilatation of the apex of the heart were revealed by angiography. As a result of these findings, the patient was diagnosed with Takotsubo cardiomyopathy by the cardiology service. The patient was discharged uneventfully following 10 days in the intensive care unit. Aneurysm of the apex of the left ventricle and normal anatomy of the coronary arteries in the angiography have diagnostic value for Takotsubo cardiomyopathy. Diuretics (furosemide) and beta-blockers (metoprolol) are commonly used for the treatment of Takotsubo cardiomyopathy. Even though Takotsubo cardiomyopathy is a rare and benign disease, it should be kept in mind in patients suspected for acute myocardial infarction in the postoperative period.

  16. The comparison of analgesic effects of various administration methods of diclofenac sodium, transdermal, oral and intramuscular, in early postoperative period in laparoscopic cholecystectomy operations.

    Science.gov (United States)

    Gulcin Ural, Sedef; Yener, Ozlem; Sahin, Hasan; Simsek, Tuncer; Aydinli, Bahar; Ozgok, Aysegul

    2014-01-01

    The aim of this study was to compare the efficacy of oral, intra muscular and transdermal diclofenac sodium for pain treatment in patients undergoing laparoscopic cholecystectomy, and their effect on postoperative opioid consumption. Following informed consent, 90 ASA I-II patients scheduled for laparoscopic cholecystectomy were randomized into three groups. Group PO got oral diclofenac sodium 1 hour before the operation, Group IM 75 mg diclofenac sodium intra muscular and Group TD diclofenac sodium patch 6 hours before the operation. Patients were not premedicated. Routine anaesthesia induction was used. After the operation in post anaesthesia care unit tramadol HCl infusion was delivered by intravenous patient controlled analgesia (iv PCA). Ramsey Sedation Score (RSS), Modified Aldrete's Score System(MASS) and Visual Analog Scale Pain Score (VAS) was used for postoperative evaluation. Postoperative opioid consumption was recorded. Demographic characteristics, intraoperative and postoperative hemodynamics of the patients were similar between groups. Postoperative VAS were lower at all time points in Group IM and Group TD than in Group PO. Lowest Postoperative RSS were in Group IM and the highest were in Group PO, and the difference between groups was significant. There was no significant difference in Postoperative MASS between groups. Postoperative tramadol consumption was statistically different between groups. Tramadol consumption in Group IM and Group TD was lower than Group PO. Postoperative nausea and vomiting was not observed. Local complications related to transdermal and intra muscular applications was not reported. In patients undergoing ambulatory laparoscopic cholecystectomy, a noninvasive application transdermal diclofenac sodium is as effective as intramuscular diclofenac sodium and can be preferred in postoperative pain treatment.

  17. Serum neutrophil gelatinase associated lipocalin during the early postoperative period predicts the recovery of graft function after kidney transplantation from donors after cardiac death.

    Science.gov (United States)

    Kusaka, Mamoru; Iwamatsu, Fumi; Kuroyanagi, Yoko; Nakaya, Miho; Ichino, Manabu; Marubashi, Shigeru; Nagano, Hiroaki; Shiroki, Ryoichi; Kurahashi, Hiroki; Hoshinaga, Kiyotaka

    2012-06-01

    Kidneys procured from donors after cardiac death hold great potential to expand the donor pool. However, they have not yet been fully used, in part due to the high incidence of delayed graft function. Although urine neutrophil gelatinase-associated lipocalin is a well-known early biomarker for renal injury after kidney transplantation, its usefulness is limited in cases with delayed graft function because of the unavailability of a urine sample. We evaluated serum neutrophil gelatinase-associated lipocalin as a potential biomarker to predict the functional recovery of kidneys transplanted from donors after cardiac death. Consecutive patients transplanted with a kidney from a living related (39), brain dead (1) or post-cardiac death (27) donor were retrospectively enrolled in the study. Serum samples were collected serially before and after kidney transplantation. Serum neutrophil gelatinase-associated lipocalin was measured using the ARCHITECT® assay. Average serum neutrophil gelatinase-associated lipocalin was markedly high during the pre transplantation period. It decreased rapidly after transplantation. The slope of the decrease correlated well with the recovery period. By analyzing ROC curves we determined cutoffs to predict immediate, slow or delayed graft function requiring hemodialysis for longer than 1 week with high sensitivity and specificity. These data suggest that serial monitoring of serum neutrophil gelatinase-associated lipocalin may allow us to predict graft recovery and the need for hemodialysis after kidney transplantation from a donor after cardiac death. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Corneal oedema after phacoemulsification in the early postoperative period: A qualitative comparative case-control study between diabetics and non-diabetics

    Directory of Open Access Journals (Sweden)

    Konstantinos T. Tsaousis

    2016-02-01

    Conclusions: The existence of diabetes mellitus type 2 appears to be a significant risk factor for the development of persistent corneal oedema. The results of our study led to the modification of the algorithm for postoperative follow-up of patients of this remote area of Greece.

  19. Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis

    Science.gov (United States)

    Sugaya, Hisashi; Kubota, Shigeki; Onishi, Mio; Kanamori, Akihiro; Sankai, Yoshiyuki; Yamazaki, Masashi

    2016-01-01

    The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

  20. A rare cause of pulmonary edema in the postoperative period

    Directory of Open Access Journals (Sweden)

    Kshitij Chatterjee

    2017-01-01

    Full Text Available With the increasing longevity of the population, the annual rates of hip arthroplasties performed have been steadily increasing over the past decade. Given the presence of medical comorbidities in the older patients, the peri-operative care of these individuals requires multi-specialty care, now more than ever. Hip arthroplasty is generally well tolerated, with early mortality after the procedure being <1%. Bone cement implantation syndrome (BCIS is an entity that is occasionally encountered during or after the surgery. It is characterized by hypoxemia, hypotension, cardiac arrhythmias, and cardiac arrest leading to death, in severe cases. We report a case of a middle-aged female who developed refractory hypotension and pulmonary edema while undergoing hemiarthroplasty for a pathological femoral neck fracture and experienced cardiac arrest in the immediate postoperative period. Critical care physicians must familiarize themselves with promptly diagnosing and managing BCIS.

  1. A Rare Cause of Pulmonary Edema in the Postoperative Period.

    Science.gov (United States)

    Chatterjee, Kshitij; Mittadodla, Penchala S; Colaco, Clinton; Jagana, Rajani

    2017-02-01

    With the increasing longevity of the population, the annual rates of hip arthroplasties performed have been steadily increasing over the past decade. Given the presence of medical comorbidities in the older patients, the peri-operative care of these individuals requires multi-specialty care, now more than ever. Hip arthroplasty is generally well tolerated, with early mortality after the procedure being <1%. Bone cement implantation syndrome (BCIS) is an entity that is occasionally encountered during or after the surgery. It is characterized by hypoxemia, hypotension, cardiac arrhythmias, and cardiac arrest leading to death, in severe cases. We report a case of a middle-aged female who developed refractory hypotension and pulmonary edema while undergoing hemiarthroplasty for a pathological femoral neck fracture and experienced cardiac arrest in the immediate postoperative period. Critical care physicians must familiarize themselves with promptly diagnosing and managing BCIS.

  2. Clinical Practice Guidelines for postoperative period of thoracic surgery.

    Directory of Open Access Journals (Sweden)

    Frank Carlos Alvarez Li

    2009-03-01

    Full Text Available Clinical Practice Guidelines for postoperative period of thoracic surgery. It is the period between the suture of the surgical wound and the total rehabilitation of the patient, which usually occurs in the Intensive Care Unit. This document includes a review and update of the main aspects such as classification, postoperative treatment, stressing the actions to face any complication. It includes assessment guidelines focused on the most important aspects to be accomplished.

  3. Delirium is associated with early postoperative cognitive dysfunction

    DEFF Research Database (Denmark)

    Rudolph, J.L.; Marcantonio, E.R.; Culley, D.J.

    2008-01-01

    The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects......). Postoperative cognitive dysfunction was defined as a composite Z-score > 2 across tests or at least two individual test Z-scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative...... cognitive dysfunction (adjusted risk ratio 1.6, 95% CI 1.1-2.1), but not long-term postoperative cognitive dysfunction (adjusted risk ratio 1.3, 95% CI 0.6-2.4). Delirium was associated with early postoperative cognitive dysfunction, but the relationship of delirium to long-term postoperative cognitive...

  4. Invasive hemodynamic monitoring in the postoperative period of cardiac surgery

    Directory of Open Access Journals (Sweden)

    Desanka Dragosavac

    1999-08-01

    Full Text Available OBJETIVE: To assess the hemodynamic profile of cardiac surgery patients with circulatory instability in the early postoperative period (POP. METHODS: Over a two-year period, 306 patients underwent cardiac surgery. Thirty had hemodynamic instability in the early POP and were monitored with the Swan-Ganz catheter. The following parameters were evaluated: cardiac index (CI, systemic and pulmonary vascular resistance, pulmonary shunt, central venous pressure (CVP, pulmonary capillary wedge pressure (PCWP, oxygen delivery and consumption, use of vasoactive drugs and of circulatory support. RESULTS: Twenty patients had low cardiac index (CI, and 10 had normal or high CI. Systemic vascular resistance was decreased in 11 patients. There was no correlation between oxygen delivery (DO2 and consumption (VO2, p=0.42, and no correlation between CVP and PCWP, p=0.065. Pulmonary vascular resistance was decreased in 15 patients and the pulmonary shunt was increased in 19. Two patients with CI < 2L/min/m² received circulatory support. CONCLUSION: Patients in the POP of cardiac surgery frequently have a mixed shock due to the systemic inflammatory response syndrome (SIRS. Therefore, invasive hemodynamic monitoring is useful in handling blood volume, choice of vasoactive drugs, and indication for circulatory support.

  5. Influence of different methods of nutritional support on infection rate during the early postoperative period of liver transplantation%肝移植术后早期不同营养方式对感染率的影响

    Institute of Scientific and Technical Information of China (English)

    罗文峰; 时军; 丁利民; 徐志丹; 李新长; 王永刚; 龙成美; 罗来邦

    2011-01-01

    目的:探讨肝移植术后早期不同营养方式对感染率的影响.方法:选择肝移植术后早期 (移植后1~7d)进行营养支持治疗的受者45例,随机分成3组,即肠外营养支持(PN)组、肠内营养 支持(EN)组、代谢调理(MI)组(肠内营养支持+谷氨酰胺及精氨酸静脉注射),每组15例.各组营 养支持均为等热量和等氮量.观察各组受者术后2周感染率的发生情况.结果 EN组和MI组术后 2周感染率显著低于PN组(P<0.05),EN组和MI组比较无统计学差异(P>0.05).结论 在肝移 植术后早期营养支持治疗中,肠内营养和代谢调理营养较之肠外营养更能有效地降低术后感染率.%Objective To investigate the influence of different methods of nutritional support on infection rate during the early postoperative period of liver transplantation ( LTx) . Methods Forty-five LTx recipients, who were to be given nutritional support in the early postoperative stage (1-7 days after operation ) , were randomly assigned into parental nutrition ( PN ) group, enteral nutrition ( EN ) group and metabolic intervention ( MI) group ( EN + glutamine + arginine) with 15 cases in each group. Each group of nutritional support received equal amounts of nitrogen and calories. The infection rate of each group in 2 weeks post-LTx was observed. Results The infection rate within 2 weeks post-LTx between the EN and MI group showed no difference, but both was significantly lower than that of the PN group ( P < 0. 05 ). Conclusions EN and MI supports are more effective than PN support in reducing the risk of infection during the early postoperative period of LTx.

  6. The surgery and early postoperative radicular pain in cases with multifocal lumbar disc herniation

    Science.gov (United States)

    Ulutaş, Murat; Çınar, Kadir; Seçer, Mehmet

    2017-01-01

    Abstract Persistence of postoperative radicular pain after surgery for multifocal disc herniation (MFDH) is a clinical problem. This study aims to evaluate the effects of a combined treatment approach compared with unilateral stabilization on early postoperative radicular pain in patients with MFDH. Age, sex, level of operation, clinical findings, and radicular pain visual analogue scale (VAS) scores before surgery in the early postoperative period and at 3 months after surgery were retrospectively reviewed for 20 cases of multifocal lumbar disc herniation. The combined approach (translaminar and far lateral) was used for 13 cases. Seven cases underwent transforaminal lumbar interbody fusion (TLIF) and unilateral transpedicular stabilization following total facetectomy. The mean age of the sample was 49.4 ± 10.1 years and the female-to-male ratio was 8:12. The mean VAS scores for radicular pain in cases treated with the combined approach were 8.2, 4.07, and 2.3 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean score for radicular pain improved by 50.4% in the early postoperative period and by 72% in the late postoperative period. The mean VAS scores for radicular pain in cases who underwent TLIF and unilateral stabilization after facetectomy were 8.4, 2.1, and 1.4 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean VAS score for radicular pain improved by 75% in the early postoperative period and by 83.3% in the late postoperative period. The combined approach is an effective alternative in cases with MFDH. TLIF and unilateral segmental stabilization provide substantial decompression and eliminate mechanical compression by conserving the height of the intervertebral foramen in the event that sufficient decompression is unable to obtain. We suggest that elimination of chemical mediators, particularly those causing pain in the dorsal ganglion, contributes to

  7. [The importance of communication during the postoperative recovery period].

    Science.gov (United States)

    Razera, Ana Paula Ribeiro; Braga, Eliana Mara

    2011-06-01

    The objective of this study was to learn about the importance of communication when the nursing team gives postoperative orientations to patients and/or relatives at a private institution, and learn their perception about those orientations. This cross-sectional, descriptive study was performed using a qualitative approach, having Interpersonal Communication and Content Analysis as the theoretical and methodological frameworks, respectively. Participants were 16 patients interviewed in the postoperative period. Results showed that the nursing team focused the orientations on the instrumental techniques of the professions and did not approach the individuals in a holistic manner. It was also observed that when the nurse stands away from the patient and/or does not provide appropriate information, it generates feelings of anxiety, fear, insecurity and a sensation of lack of care in the patients. On the other hand, when the nursing team is present and provides coherent information, patients reported high satisfaction and a feeling of being well cared for.

  8. [Early postoperative complications after scoliosis surgery].

    Science.gov (United States)

    Pérez-Caballero Macarrón, C; Burgos Flores, J; Martos Sánchez, I; Pérez Palomino, A; Vázquez Martínez, J L; Alvarez Rojas, E; Fernández Pineda, L; Vellibre Vargas, D

    2006-03-01

    Several medical complications can occur after scoliosis surgery in children and adolescents. New surgical techniques have allowed greater degrees of scoliosis correction but have also increased the possibility of postsurgical deficit due to their greater aggressivity. We analyzed the early postsurgical complications of scoliosis surgery in a pediatric intensive care unit over a 10-year period. Seventy-six surgical procedures were performed. Of these, no complications occurred in 55 (73%). Chest X-ray revealed pulmonary atelectasia in 8 patients (10%) and pleural effusion in 7 patients (9%). Symptoms and signs of infection related to surgery were observed in only 6 children (8%). The absence of severe medical complications may be related to new surgical techniques and an experienced team.

  9. [Comparative evaluation of efficacy of the upper part of the face endoscopic lifting in dynamics of postoperative period].

    Science.gov (United States)

    Kozynets', H P; Pinchuk, V D; Tkach, O S

    2014-05-01

    Comparative estimation of results for endoscopic lifting of the face upper part in dynamics of early and late postoperative period was adduced. In accordance to results of analysis, concerning the eyebrows height in a control terms, there was established, that through one year postoperatively the eyebrows have a tendency towards ptosis due to activity of the eyes circular muscles. Deterioration of the result achieved post-operatively is less prominent in patients after preliminary chemical denervation of mimic muscles. Chemical denervation of the eyes circular muscles, using injections of botulinic toxine type A before 2 weeks preoperatively secures a stable fixation of tissues in early postoperative period, what permits to escape loss of the result achieved, secures the results improvement in late postoperative period in 3.7 times.

  10. [Acute myocardial infarction in the postoperative period following pneumonectomy].

    Science.gov (United States)

    López Alvarez, S; Bonome González, C; Izquierdo Villarroya, B; Barbeito Vilariño, M J; Etxainz Alvarez, A; Alvarez Refojo, F

    2002-11-01

    A 72-year-old man, smoker, with insuline-dependent diabetes and dislipemia underwent left pneumonectomy. Several episodes of intraoperative hemodynamic instability associated with electrocardiographic ST segment alterations were attributed to surgical manipulation; ischemia was not suspected. Cardiorespiratory failure, related to extensive anterior infarction, developed a few minutes after admission to the postoperative intensive care unit (PICU). Cardiopulmonary resuscitation and mechanical ventilation were required. The patient responded to treatment with beta blockers, platelet antiaggregants and statins. Tube was removed a few hours later and the patient was discharged from the PICU on the fifth day. Pneumonectomy has a high rate of morbidity and mortality, with complications mainly arising in the lung and heart. Risk from anesthesia is considered to be great in this procedure, and for that reason it is essential to identify intraoperative myocardial ischemia so that it can be treated aggressively. In patients at high cardiovascular risk who undergo lung resection, intraoperative episodes of myocardial ischemia are associated with a high incidence of postoperative miocardial infarction. Therefore, careful postoperative monitoring is needed and measures should be taken to prevent angina. Early extubation should be avoided.

  11. Surgical treatment of partial atrioventricular septal defect: functional analysis of the mitral valve in the postoperative period

    Directory of Open Access Journals (Sweden)

    Josué Viana Castro Neto

    2002-11-01

    Full Text Available OBJECTIVE: To study mitral valve function in the postoperative period after correction of the partial form of atrioventricular septal defect. METHODS: Fifty patients underwent surgical correction of the partial form of atrioventricular septal defect. Their mean age was 11.8 years and 62% of the patients were males. Preoperative echocardiography showed moderate and severe mitral insufficiency in 44% of the patients. The mitral valve cleft was sutured in 45 (90% patients (group II - GII. Echocardiographies were performed in the early postoperative period, and 6 and 12 months after hospital discharge. RESULTS: The patients who had some type of arrhythmia in the postoperative period had ostium primum atrial septal defect of a larger size (2.74 x 2.08 cm. All 5 patients in group I (GI, who did not undergo closure of the cleft, had a competent mitral valve or mild mitral insufficiency in the preoperative period. One of these patients began to have moderate mitral insufficiency in the postoperative period. On the other hand, in GII, 88.8% and 82.2% of the patients had competent mitral valve or mild mitral insufficiency in the early and late postoperative periods, respectively. CONCLUSION: The mitral valve cleft was repaired in 90% of cases. Echocardiography revealed competent mitral valve or mild mitral insufficiency in 88.8% and 82.2% of GII patients in the early and late postoperative periods, respectively.

  12. Platelet activation in the postoperative period after lung transplantation

    Science.gov (United States)

    Sternberg, David I.; Shimbo, Daichi; Kawut, Steven M.; Sarkar, Joydeep; Hurlitz, Georg; D’Ovidio, Frank; Lederer, David J.; Wilt, Jessie S.; Arcasoy, Selim M.; Pinsky, David J.; D’Armiento, Jeanine M.; Sonett, Joshua R.

    2010-01-01

    Objective During lung transplantation, cells in the pulmonary parenchyma are subjected to ischemia, hypothermic storage, and reperfusion injury. Platelets, whose granular contents include adhesion receptors, chemokines, and coactivating substances that activate inflammatory and coagulant cascades, likely play a critical role in the lung allograft response to ischemia and reperfusion. The platelet response to the pulmonary allograft, however, has never been studied. Here we report significant platelet activation immediately after lung transplantation. Methods We performed a prospective cohort study comparing markers of platelet activation in patients undergoing lung transplantation and patients undergoing nontransplant thoracotomy. Plasma levels of soluble P-selectin, soluble CD40 ligand, and platelet–leukocyte conjugates were measured before surgery, after skin closure, and at 6 postoperative hours. Results Both soluble P-selectin and soluble CD40 ligand levels increased significantly after lung transplantation but not after thoracotomy. Additionally, platelet–monocyte conjugate fluorescence was significantly higher after lung transplantation than after thoracotomy alone. Conclusion These findings suggest that platelet activation is significantly increased after lung transplantation beyond that expected from the postoperative state. The increase in circulating platelet–monocyte conjugates suggests an important interaction between platelets and inflammatory cells. Further research should examine whether platelet activation affects early graft function after lung transplantation. PMID:18329493

  13. Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer.

    Science.gov (United States)

    Li, B; Liu, H Y; Guo, S H; Sun, P; Gong, F M; Jia, B Q

    2015-06-29

    The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

  14. Delirium: a cause for concern beyond the immediate postoperative period.

    Science.gov (United States)

    Martin, Billie-Jean; Buth, Karen J; Arora, Rakesh C; Baskett, Roger J F

    2012-04-01

    Delirium is a common neurologic complication after cardiac surgery, and may be associated with increased morbidity and mortality. Research has focused on potential causes of delirium, with little attention to its sequelae. Perioperative data were collected prospectively on all isolated cases of coronary artery bypass grafting (CABG) performed from 1995 to 2006 at a single center. The definition of delirium used in the study was that of the Society of Thoracic Surgeons. Characteristics of patients who became delirious postoperatively were compared with those of patients who did not. The outcomes of interest were long-term all-cause mortality, hospital admission for stroke, and in-hospital mortality, examined in all three cases through multivariate analysis. Of 8,474 patients who underwent CABG within the defined period, 496 (5.8%) developed postoperative delirium and 229 (2.7%) died while in the hospital. At baseline, patients who developed delirium were more likely to be older and to have a greater burden of comorbid illness. Delirium was an independent predictor of perioperative stroke (odds ratio [OR]; 1.96; 95% confidence interval [CI], 1.22 to 3.16), but was not associated with in-hospital mortality (OR, 0.81; 95%CI, 0.49 to 1.34). Delirious patients had a median postoperative hospital stay of 12 days (interquartile range [IQR], 8 to 21 days) versus 6 days (IQR, 5 to 8 days) for those who were nondelirious. Delirium was identified as an independent predictor of all-cause mortality (hazard ratio [HR], 1.52; 95%CI, 1.29 to 1.78) and hospitalization for stroke (HR, 1.54; 95%CI, 1.10 to 2.17). There was an association between delirium and adverse outcomes after CABG that persisted beyond the immediate perioperative period. Patients with delirium after CABG appear to have an increased long-term risk of death and stroke. The advancing age and rising rates of delirium in the CABG population make it necessary to address the prevention and management of delirium in this

  15. Early enteral nutrition therapy in congenital cardiac repair postoperatively: A randomized, controlled pilot study

    Science.gov (United States)

    Sahu, Manoj Kumar; Singal, Anuradha; Menon, Ramesh; Singh, Sarvesh Pal; Mohan, Alka; Manral, Mala; Singh, Divya; Devagouru, V.; Talwar, Sachin; Choudhary, Shiv Kumar

    2016-01-01

    Background and Objectives: Adequate nutritional supplementation in infants with cardiac malformations after surgical repair is a challenge. Critically ill infants in the early postoperative period are in a catabolic stress. The mismatch between estimated energy requirement (EER) and the intake in the postoperative period is multifactorial, predisposing them to complications such as immune deficiency, more infection, and growth failure. This study aimed to assess the feasibility and efficacy of enriched breast milk feed on postoperative recovery and growth of infants after open heart surgery. Methodology: Fifty infants surgery is feasible and recommended. In addition, enriching the EBM is helpful in achieving the maximum possible calorie intake in the postoperative period. EN therapy might help in providing adequate nutrition, and it decreases ventilation duration, infection rate, LOIS, LOHS, and mortality. PMID:27716696

  16. Early and late postoperative seizure outcome in 97 patients with supratentorial meningioma and preoperative seizures: a retrospective study.

    Science.gov (United States)

    Zheng, Zhe; Chen, Peng; Fu, Weiming; Zhu, Junming; Zhang, Hong; Shi, Jian; Zhang, Jianmin

    2013-08-01

    We identified factors associated with early and late postoperative seizure control in patients with supratentorial meningioma plus preoperative seizures. In this retrospective study, univariate analysis and multivariate logistic regression analysis compared 24 clinical variables according to the occurrence of early (≤1 week) or late (>1 week) postoperative seizures. Sixty-two of 97 patients (63.9 %) were seizure free for the entire postoperative follow-up period (29.5 ± 11.8 months), while 13 patients (13.4 %) still had frequent seizures at the end of follow-up. Fourteen of 97 patients (14.4 %) experienced early postoperative seizures, and emergence of new postoperative neurological deficits was the only significant risk factor (odds ratio = 7.377). Thirty-three patients (34.0 %) experienced late postoperative seizures at some time during follow-up, including 12 of 14 patients with early postoperative seizures. Associated risk factors for late postoperative seizures included tumor progression (odds ratio = 7.012) and new permanent postoperative neurological deficits (odds ratio = 4.327). Occurrence of postoperative seizures in patients with supratentorial meningioma and preoperative seizure was associated with new postoperative neurological deficits. Reduced cerebral or vascular injury during surgery may lead to fewer postoperative neurological deficits and better seizure outcome.

  17. NOSOCOMIAL INFECTIONS IN PATIENTS WITH UROLITHIASIS IN THE POSTOPERATIVE PERIOD

    Directory of Open Access Journals (Sweden)

    F. S. Sadulloev

    2015-01-01

    Full Text Available Abstract:Objective: To determine the most frequent causative agents of nosocomial infection in patients with urolithiasis in the postoperative period.Material and Methods. The study is based on the results of comprehensive studies conducted in 122 patients with nosocomial urinary tract infection, detected in 823 patients with urolithiasis treated by various methods. A cohort of 823 patients is isolated from 2688 patients treated without at admission signs of infections in the urinary tract for the period 2011–2014. All patients were treated at the Urological department of Avicenna Tajik State Medical University in the Republican Clinical Center of Urology. Main results. By the method of randomly selected 823 medical records of patients with urolithiasis various operations we carried out with 122 patients revealed cases of nosocomial infections. The diagnosis of nosocomial infections on the basis of established symptomatic urinary tract infection, asymptomatic bacteriuria or the presence of wound infection, use during the hospital stay for treatment of antibiotics, antiseptics, physiotherapy and other therapies. The incidence of nosocomial infections was studied in dependence with the severity of the underlying disease, the volume of surgical, invasive, endoscopic and other urological procedures, the timing and frequency of tests, the proportion of individual clinical manifestations in the overall structure of urinary tract infections, sex and age of patients.Conclusions. The leading microflora causing nosocomial infection in patients with urolithiasis in all treatments are gram-negative microorganisms, including prevailing E.coli (24,0%.

  18. Modification of early postoperative X-ray research after gastrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Sapounov, S.

    1982-10-01

    A modification of the early postoperative X-ray research after gastrectomy is described. The application of gastrografin happens through a nasogastric tube. By changing the position of its tip during the screening control, and excellent and precise represention of the anastomotic region will be achieved. We present a research of 35 patients.

  19. Orthostatic intolerance and the cardiovascular response to early postoperative mobilization

    DEFF Research Database (Denmark)

    Bundgaard-Nielsen, M; Jørgensen, Christoffer Calov; Jørgensen, T B

    2009-01-01

    BACKGROUND: A key element in enhanced postoperative recovery is early mobilization which, however, may be hindered by orthostatic intolerance, that is, an inability to sit or stand because of symptoms of cerebral hypoperfusion as intolerable dizziness, nausea and vomiting, feeling of heat...

  20. EARLY POSTOPERATIVE COMPLICATIONS IN ROUX-EN-Y GASTRIC BYPASS

    Science.gov (United States)

    STOLL, Aluisio; ROSIN, Leandro; DIAS, Mariana Fernandes; MARQUIOTTI, Bruna; GUGELMIN, Giovana; STOLL, Gabriela Fanezzi

    2016-01-01

    ABSTRACT Background: Roux-en-Y gastric bypass is one of the most common bariatric surgery and leads to considerable weight loss in the first months. Aim: To quantify the main early postoperative complications in patients submitted to the gastric bypass. Method: Observational retrospective cohort. Data of 1051 patients with class II obesity associated with comorbidities or class III obesity submitted to the gastric bypass with 30 days of follow-up starting from the date of the surgery. Results: The age average was 36 years with a predominance of females (81.1%). The mean preoperative body mass index was 43 kg/m². The major complication was fistula (2.3%), followed by intestinal obstruction (0.5%) and pulmonary embolism (0.5%). Death occurred in 0.6% of the cases. Conclusion: In the period of 30 days after surgery the overall complication rate was 3.8%; reoperation was necessary in 2.6% and death occurred in 0.6%. Fistula was the main complication and the leading cause of hospitalization in intensive care unit, reoperation and death. PMID:27683781

  1. Does testosterone prevent early postoperative complications after gastrointestinal surgery?

    Institute of Scientific and Technical Information of China (English)

    Birendra Kumar Sah; Ming-Min Chen; Yi-Bing Peng; Xiao-Jing Feng; Min Yan; Bing-Ya Liu; Qi-Shi Fan; Zheng-Gang Zhu

    2009-01-01

    AIM: To investigate the role of sex hormones in the early postoperative complications of gastrointestinal diseases.METHODS: A total of 65 patients who underwent operations for gastric and colorectal diseases (mainly malignant diseases) were included in the study.Peripheral venous blood samples were collected at different times for analysis of estradiol, testosterone and progesterone. The only study endpoint was analysis of postoperative complications.RESULTS: Patients of both sexes were uniform but postoperative complication rate was significantly higher in female patients ( P = 0.027). There was no significant association of estradiol and progesterone with postoperative complications. Testosterone levels in complicated patients were significantly lower than in uncomplicated patients ( P < 0.05). Area under the receiver operating characteristic curve showed that a lower value of testosterone was a predictor for higher complication rate ( P < 0.05), and a lower value of testosterone at later times after surgery was a better predictor of complications.CONCLUSION: Patients with low testosterone level were prone to higher postoperative complications, which was evident in both sexes. However, further studies are necessary to support this result.

  2. Early postoperative outcomes in lumpectomy versus simple mastectomy.

    Science.gov (United States)

    Chatterjee, Abhishek; Pyfer, Bryan; Czerniecki, Brian; Rosenkranz, Kari; Tchou, Julia; Fisher, Carla

    2015-09-01

    Relatively scarce outcomes research exists that compares early postoperative complications between breast conservation surgery (BCS) and simple mastectomy (SM). Such information would improve a surgeon's ability to provide informed consent when considering treatment options, especially for women with early stage breast cancer who have the option to receive either BCS or SM. The National Surgical Quality Improvement Program database from years 2009-2012 was analyzed. For each treatment group, we used Current Procedural Terminology codes specific to the treatment modality with sentinel lymph node biopsy as an inclusion criteria. We excluded patients who received axillary lymphadenectomies, bilateral disease or symmetry procedures, and additional breast reconstructive surgery. We compared each group with chi square and two-sample t-tests to look for preoperative comorbidity differences, then used unadjusted odds ratios to compare postoperative complication rates. Inclusion and exclusion criteria provided 6682 patients in the BCS group and 3339 patients in the SM group. Baseline comorbid condition characteristics showed no clinical differences between groups except for diabetes (8.5% in SM versus 6.5% in BCS). Statistical analysis between each treatment modality revealed that the SM group had significantly higher wound complications, bleeding, infections, and overall complications than the BCS group. Although both BCS and SM options have low early postoperative complication rates when treating early stage breast cancer, BCS has fewer complications with regard to bleeding, wound complications and infections. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. 术前与术后早期肠内营养对老年胃癌患者术后免疫功能及营养状态的影响%Effect of enteral nutrition during preoperative and early postoperative periods on immunologic function and postoperative nutritional status in old patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    鲁力; 谢敏; 魏少忠; 熊治国

    2014-01-01

    Objective:To investigate the effect of enteral nutrition support one week before surgery and postoperative periods on the postoperative immune function and nutritional status in old patients with gastric cancer. Methods:A retrospective analysis was con-ducted on 77 stomach cancer patients who were admitted and received surgical treatment in our hospital. Among the patients, 38 re-ceived enteral nutrition support one week before surgery and early period of postoperation, and were labeled as the experimental group. The remaining 39 patients did not receive enteral nutrition support one week before surgery and early period of postoperation, and were named as the control group. The levels of prealbumin, albumin, transferrin, CD4+T (%), CD8+T (%), and CD4+/CD8+cells were also an-alyzed before surgery and 1 d and 8 d after surgery. Results:No statistical differences in the gender, age, site of tumor, TNM staging, and differentiated degree were found between the two groups. All operations were successful and the patients recovered well after sur-gery. In the nutritional status, the levels of prealbumin, albumin, and transferrin in the patients of the two groups had no significant dif-ference (P>0.05). On the first day after the surgery, the levels of prealbumin, albumin, and transferrin were significantly low in both groups;the control group had lower levels than the experimental group (P0.05). On the first day after surgery, the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). Conclusion:Elderly patients with gastric cancer who receive appropriate enteral nutrition support one week before sur-gery would have better immune function and nutritional status after surgery than those who did not, and the recovery of old patients im-proved.%目的:探讨术前1周及术后早期应用肠内营养制剂对老年胃癌患者术后免疫功能及营养状

  4. SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION: EARLY POSTOPERATIVE COMPLICATIONS

    Directory of Open Access Journals (Sweden)

    M.Sh. Khubutia

    2014-01-01

    Full Text Available Aim: evaluation of the incidence of early postoperative complications after simultaneous pancreas-kidney transplantation.Materials and methods. The analysis of early postoperative complications after simultaneous pancreas-kidney transplantation is presented in the paper, the most rational diagnostic algorithms, non-surgical and surgical complications’ treatment; the outcomes of the SPKT are reported.Results. 15,6% of patients experienced surgical complications, 12,5% – immunological complications, 12,5% – infectious complications, 6,25% – complications of the immunosuppressive therapy. 1-year patient survival after SPKT was 91,4%; pancreas graft survival – 85,7%; kidney graft survival – 88,6%.Conclusion. The incidence of early postoperative complications after simultaneous pancreas-kidney transplantation remains signifi cant in spite of progressive improvement of simultaneous pancreas-kidney transplantation due to surgical technique improvement, introduction of new antibacterial and immunosuppressive agents. Data, we recovered, fully correspond to the data obtained from the global medical community.

  5. Laparoscopic retrieval of retained intraperitoneal drains in the immediate postoperative period.

    Science.gov (United States)

    Liao, Chih-Szu; Shieh, Min-Chieh

    2011-03-01

    Retained intraperitoneal Penrose drain secondary to fracture and adhesions in the immediate postoperative period happens on occasion. Most are unreported because of the fear of medico-legal problems. Previous management of such iatrogenic complications requires repeated laparotomy or wound exploration. Two patients who underwent appendectomy for ruptured appendicitis, with retained intraabdominal drains in the immediate postoperative period, managed eventually by laparoscopic retrieval are presented. Both patients had right low transverse incisions and intraabdominal drains exiting through a separate right lateral abdomen skin opening. Patient 1 had a stuck intraabdominal drain unable to be removed up to the second week. Patient 2's drain retracted intraperitoneally after its mobilization on the sixth post-op day. Both were managed by laparoscopy under general anesthesia with successful removal of both drains. Patient 1 underwent the procedure 3 weeks after the appendectomy, whereas Patient 2 had the procedure on her sixth post-op day. An additional new 1-cm wound in the periumbilical area was done for the introduction of pneumoperitoneum and 10-mm port for which the laparoscope was inserted. The second 5-mm port was inserted through the old drain site wound with peritoneal entry opening separate from the previous peritoneal defect viewed from laparoscope. Both drains had some marked adhesions from ingrowth of omentum to the side holes of the drain, causing it to get stuck in the pelvic cavity. This laparoscopic approach in the management of such iatrogenic complication, besides being cosmetically acceptable, contributes to early recovery and discharge of the patient, and helps to lessen the friction in the recently worsening doctor-patient relationship in Taiwan. Copyright © 2011. Published by Elsevier B.V.

  6. Minimally invasive colon resection is associated with a transient increase in plasma sVEGFR1 levels and a decrease in sVEGFR2 levels during the early postoperative period.

    Science.gov (United States)

    Shantha Kumara, H M C; Cabot, J C; Hoffman, A; Luchtefeld, M; Kalady, M F; Hyman, N; Feingold, D; Baxter, R; Whelan, R Larry

    2009-04-01

    Plasma vascular endothelial growth factor (VEGF) levels are elevated for 2-4 weeks after minimally invasive colorectal resection (MICR). VEGF induces wound and tumor angiogenesis by binding to endothelial cell (EC)-bound VEGF-receptor 1 (VEGFR1) and VEGFR2. Soluble receptors (sVEGFR1, sVEGFR2) sequester VEGF in the blood and decrease VEGF's proangiogenic effect. The importance of the MICR-related VEGF changes depends on the effect of surgical procedures on sVEGFR1 and sVEGFR2; this study assessed levels of these proteins after MICR for benign indications. Blood samples were taken (n=39) preoperatively (preop) and on postoperative days (POD) 1 and 3; in most cases a fourth sample was drawn between POD 7 and 30. sVEGFR1 and sVEGFR2 levels were measured via enzyme-linked immunosorbent assay (ELISA), which detects free and VEGF bound soluble receptor. Late samples were bundled into POD 7-13 and POD 14-30 time points. Results are reported as mean and standard deviation. The data was assessed with paired-samples t-test. Preop, mean plasma sVEGFR2 level (9,203.7+/-1,934.3 pg/ml) was significantly higher than the sVEGFR1 value (132.5+/-126.2 pg/ml). sVEGFR2 levels were significantly lower on POD 1 (6,957.8+/-1,947.7 pg/ml,) and POD 3 (7,085.6+/-2,000.2 pg/ml), whereas sVEGFR1 levels were significantly higher on POD 1 (220.0+/-132.8 pg/ml) and POD 3 (182.7+/-102.1 pg/ml) versus preop results. No differences were found on POD 7-13 or 14-30. sVEGFR2 values decreased and sVEGFR1 levels increased early after MICR; due to its much higher baseline, the sVEGFR2 changes dominate. The net result is less VEGF bound to soluble receptor and more free plasma VEGF.

  7. Obstructed surgical porto-systemic shunts in the early postoperative period: interventional therapy by angioplasty (PTA) and stent placement; Obstruktion chirurgischer portosystemischer Shunts in der fruehen postoperativen Phase: interventionelle Behandlung durch Angioplastie und Stentimplantation

    Energy Technology Data Exchange (ETDEWEB)

    Strunk, H.; Textor, J.; Koenig, R.; Wilhelm, K.; Schild, H. [Bonn Univ. (Germany). Radiologische Klinik; Wolff, M. [Bonn Univ. (Germany). Chirurgische Klinik und Poliklinik

    2001-05-01

    Recurrent variceal bleeding in patients treated with surgical porto-systemic shunting is most often due to shunt stenoses or occlusion. Radiological interventional procedures are a possible method of therapy and our experience herein is described in this report. Patients and Methods: from 1997 to 1999 54 patients with recurrent variceal bleeding were treated with a surgical porto-systemic shunt procedure. Of these early shunt occlusion occurred in 5 patients, which was treated with percutaneous transcatheter techniques. Results: in only one patient was PTA alone sufficient to reestablish shunt patency, in four patient stent placement was necessary in addition. In the follow-up period 1 patient died 26 month after intervention with (autopsy-proven) patent shunt, in one patient shunt reocclusion occurred after 11 months and in 3 patients the shunt is still patent. Conclusions: PTA, if necessary in combination with stent placement, is an attractive alternative method of therapy in case of an early surgical porto-systemic shunt occlusion. (orig.) [German] Rezidivblutungen nach chirurgischer portosystemischer Shuntanlage sind meistens durch eine Shuntstenose oder einen Shuntverschluss bedingt. Hier stellen interventionelle Eingriffe einen moeglichen therapeutischen Ansatz dar, ueber den im Folgenden berichtet werden soll. Patienten und Methode: zwischen 1997 und 1999 wurde bei insgesamt 54 Patienten wegen rezidivierender Blutungen ein operativer portosystemischer Shunt angelegt. Von diesen zeigten fuenf Patienten in der unmittelbaren postoperativen Periode einen Shuntverschluss, der radiologisch interventionell therapiert wurde. Ergebnisse: bei einem der fuenf Patienten genuegte zur Wiederherstellung des Flusses eine alleinige Ballondilatation (PTA), bei vier Patienten musste zusaetzlich eine Stentimplantation durchgefuehrt werden. In der weiteren Nachsorge ist ein Pat. nach 26 Wochen mit autoptisch offenem Shunt verstorben, bei 3 Pat. ist der Shunt offen, bei einem

  8. Early postoperative acetabular discontinuity after total hip arthroplasty.

    Science.gov (United States)

    Desai, Gaurav; Ries, Michael D

    2011-12-01

    Periprosthetic acetabular fracture is a rare complication after total hip arthroplasty (THA). However, we have treated 2 patients with acute postoperative acetabular discontinuity that occurred 2 and 3 weeks after primary THA. Both fractures were in elderly osteoporotic female patients with minimal trauma and may have developed from unrecognized intraoperative fractures. Pelvic stability was restored with acetabular revision using medial morselized bone grafting and a cemented reconstruction cage. This report demonstrates that early postoperative periprosthetic acetabular discontinuity after THA is a risk in elderly patients with severe osteoporosis and that salvage of acetabular fixation can be achieved with cemented cage reconstruction and medial morselized bone grafting. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. The PRAISE study: a prospective, multi-center, randomized, double blinded, placebo-controlled study for the evaluation of iloprost in the early postoperative period after liver transplantation (ISRCTN12622749).

    Science.gov (United States)

    Bärthel, Erik; Rauchfuss, Falk; Hoyer, Heike; Breternitz, Maria; Jandt, Karin; Settmacher, Utz

    2013-01-29

    Liver graft dysfunction can deteriorate to complete organ failure and increases perioperative morbidity and mortality after liver transplantation. Therapeutic strategies reducing the rate of graft dysfunction are of current clinical relevance. One approach is the systemic application of prostaglandins, which were demonstrated to be beneficial in reducing ischemia-reperfusion injury. Preliminary data indicate a positive effect of prostacyclin analogue iloprost on allograft viability after liver transplantation. The objective of the study is to evaluate the impact of iloprost in a multi-center trial. A prospective, double-blinded, randomized, placebo-controlled multicenter study in a total of 365 liver transplant recipients was designed to assess the effect of intravenous iloprost after liver transplantation. Primary endpoint will be the primary graft dysfunction characterized as presentation of one or more of the following criteria: ALAT or ASAT level>2000 IU/ml within the first 7 postoperative days, bilirubine  ≥ 10 mg/dl on postoperative day 7; INR ≥ 1.6 on postoperative day 7 or initial non-function. Secondary endpoints are parameters of post-transplant morbidity, like rates of infections, biliary complications, need of clotting factors or renal replacement therapy and the graft and patient survival. A well-established treatment concept to avoid graft dysfunction after liver transplantation does not exist at the moment. If the data of this research project confirm prior findings, iloprost would improve the general outcome after liver transplantation. German Clinical Trials Register: DRKS00003514. Current Controlled Trials Register: ISRCTN12622749.

  10. EFFECTIVENESS OF SCHEDULED AMBULATION ON EARLY POSTOPERATIVE OUTCOME AMONG PATIENTS WHO HAVE UNDERGONE ABDOMINAL HYSTERECTOMY

    Directory of Open Access Journals (Sweden)

    Rinku Girija

    2017-01-01

    Full Text Available BACKGROUND Abdominal hysterectomy is one of the most frequently performed surgical procedures in women. The non-ambulatory postoperative period is a high risk period for the development of various complications like wound infection, venous stasis, lower respiratory infection, secondary haemorrhage, deep vein thrombosis, pulmonary embolism, paralytic ileus etc. Prolonged surgery, delayed ambulation and not feeding the patient within 48 hours of surgery are often associated with post-operative morbidity and mortality. This study aims to assess the effectiveness of Scheduled Ambulation on early post-operative outcome among patients undergone abdominal hysterectomy by introduction of Scheduled Ambulation from second day of surgery. MATERIALS AND METHODS Method used is quantitative and quasi experimental post-test control method. Scheduled ambulation technique and pattern were taught pre operatively to 35 patients consecutively selected from general and post-operative ward who formed the experimental group. They were given scheduled ambulation from second to fifth post-operative days and results analysed. Another 35 patients taken as control were given the routine post-operative care. Data Analysis- was performed using SPSS version 17.0. Between group comparisons, quantitative variables analysed by Chisquare test p value >0, 05 considered significant. RESULTS The indication of hysterectomy was fibroid uterus in 80% of the control group and 88, 6% of the experimental group. 51.4% of the hysterectomies were encountered in the age group 40-49 years. There was a statistically significant reduction in the severity of pain, fatigue, postural hypotension and risk for developing Deep vein thrombosis in the experimental group on practicing Scheduled Ambulation from second to fifth post-operative days. CONCLUSION Scheduled ambulation helped the abdominal hysterectomy patients to recover from fatigue, pain, postural hypotension and risk for Deep vein thrombosis

  11. The PRAISE study: A prospective, multi-center, randomized, double blinded, placebo-controlled study for the evaluation of iloprost in the early postoperative period after liver transplantation (ISRCTN12622749

    Directory of Open Access Journals (Sweden)

    Bärthel Erik

    2013-01-01

    Full Text Available Abstract Background Liver graft dysfunction can deteriorate to complete organ failure and increases perioperative morbidity and mortality after liver transplantation. Therapeutic strategies reducing the rate of graft dysfunction are of current clinical relevance. One approach is the systemic application of prostaglandins, which were demonstrated to be beneficial in reducing ischemia-reperfusion injury. Preliminary data indicate a positive effect of prostacyclin analogue iloprost on allograft viability after liver transplantation. The objective of the study is to evaluate the impact of iloprost in a multi-center trial. Methods/Design A prospective, double-blinded, randomized, placebo-controlled multicenter study in a total of 365 liver transplant recipients was designed to assess the effect of intravenous iloprost after liver transplantation. Primary endpoint will be the primary graft dysfunction characterized as presentation of one or more of the following criteria: ALAT or ASAT level > 2000 IU/ml within the first 7 postoperative days, bilirubine ≥ 10 mg/dl on postoperative day 7; INR ≥ 1.6 on postoperative day 7 or initial non-function. Secondary endpoints are parameters of post-transplant morbidity, like rates of infections, biliary complications, need of clotting factors or renal replacement therapy and the graft and patient survival. Discussion A well-established treatment concept to avoid graft dysfunction after liver transplantation does not exist at the moment. If the data of this research project confirm prior findings, iloprost would improve the general outcome after liver transplantation. Trial Registration German Clinical Trials Register: DRKS00003514. Current Controlled Trials Register: ISRCTN12622749.

  12. Ventilatory pattern and associated episodic hypoxaemia in the late postoperative period in the general surgical ward

    DEFF Research Database (Denmark)

    Rosenberg, J; Rasmussen, G I; Wøjdemann, K R;

    1999-01-01

    Episodic oxygen desaturation is frequent in the late postoperative period and seems most pronounced on the second and third postoperative nights. However, the ventilatory pattern has not been described systematically during this period. We studied the ventilatory pattern and associated arterial...... oxygenation using the Edentrace II equipment (impedance pneumography and pulse oximetry) on the second and third postoperative nights in 28 patients undergoing major abdominal surgery. Ventilatory disturbances were common and included periods of hypopnoea, and obstructive, central and mixed apnoeas. Overall...... disturbances. Overall, 23% (0-100) of the hypopnoeas and 7% (0-100) of the apnoeas were associated with episodic hypoxaemia. In conclusion, ventilatory disturbances were common in the late postoperative period in the general surgical ward and often associated with episodes of oxygen desaturation....

  13. Intra-arterial pulmonary thrombolysis at the postoperative period of brain aneurysm clamping: case report.

    Science.gov (United States)

    Rojas, Salomón Soriano Ordinola; Veiga, Viviane Cordeiro; Carvalho, Júlio César de; Campodônico, Luis Enrique Amaya; Assis, Fabrizio Rodrigues; Shimizu, Sandra Patrícia; Morais, Elaine Aparecida; Buesio, Roberto; Marchesini, Andréia Maria; Junqueira, Ligia Maria Coscrato; Holanda, Carlos Vanderlei

    2008-09-01

    Pulmonary thromboembolism is a major cause of morbidity and mortality of patients undergoing neurosurgical procedures. The purpose of this study was to present a case of intra-arterial pulmonary thrombolysis in recent neurosurgery postoperative period. Male patient, undergoing neurosurgery, presented as a complication on the seventh day of postoperative massive pulmonary embolism with hemodynamic instability and intraarterial pulmonary thrombolysis with alteplase was indicated. Evolution was satisfactory without bleeding complications and patient was discharged. Pulmonary thromboembolism is a high morbidity and mortality condition at neurosurgical postoperative period and thrombolysis should be an alternative therapy in cases refractory to clinical treatment.

  14. Reoperation for early postoperative complications after gastric cancer surgery in a Chinese hospital

    Institute of Scientific and Technical Information of China (English)

    Birendra; Kumar; Sah

    2010-01-01

    AIM:To investigate the occurrence of postoperative complications of gastric cancer surgery,and analyze the potential causes of reoperation for early postoperative complications. METHODS:A total of 1639 patients who underwent radical or palliative gastrectomies for gastric cancer were included in the study.The study endpoint was the analysis of postoperative complications in inpatients. RESULTS:About 31%of patients had early postoperative complications,and complications of infection occurred most frequently....

  15. Postoperative intussusception in pediatric abdominal malignancies: early diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Maged M. Elshafiey; Gehad T. Meselhy; Amal Refaat; Alaa A. Younes

    2012-01-01

    Objective: The aim of this study was to review the incidence of postoperative intussusception (POI) in our patients with pediatric abdominal malignancies and the end result of management of these cases. Methods: From November2007 till the end of December 2011, a total of 538 patients with different abdominal malignancies were operated upon by laparotomies in our hospital. Reoperations were required in 12 patients for post operative intestinal obstruction developed in the 1st postoperative month. Review of the identified cases focused on patient's characteristics, the primary tumor type, the primary surgical procedure, clinical and imaging features of the intussusceptions, timing and findings at the 2nd laparotomy and the end result of subsequent interventions. Results: Early post operative intestinal obstruction (within 1 month) developed in 12 patients of whom 8 patients had POI. Five patients had adhesive intestinal obstruction (one patient developed POI then adhesive obstruction). The median duration between the primary surgery and the onset of intestinal obstruction symptoms was 5 days (range 4-12 days) in the POI group and 24 days (range 10-30 days) in the adhesion group. Abdominal CT was done in all cases and it could properly diagnose POI and detect its site in the POI group while in the adhesion group it showed evidence of complete obstruction. Plain radiograph failed to detect signs of intestinal obstruction in 3 cases (two in the POI group and one in the adhesion group). In POI group simple reduction was done in 7 cases while resection anastmosis was done in 1 case due to gangrene of the ileocecal region. Adhesiolysis was done in the 5 cases of intestinal adhesion group.Conclusion: Early POI in pediatric abdominal cancer is a rare complication; however it should be kept in mind with high index of suspicion. Early diagnosis and intervention is essential for successful management. Abdominal CT is very helpful as it can detect the level and possible cause of

  16. Repaired supraspinatus tendons in clinically improving patients: Early postoperative findings and interval changes on MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Eun; Park, Ji Seon; Ryu, Kyung Nam; Rhee, Yong Girl [Kyung Hee University Hospital, Seoul (Korea, Republic of); Yoon, So Hee; Park, So Young; Jin Wook [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of)

    2015-04-15

    To demonstrate and further determine the incidences of repaired supraspinatus tendons on early postoperative magnetic resonance imaging (MRI) findings in clinically improving patients and to evaluate interval changes on follow-up MRIs. Fifty patients, who showed symptomatic and functional improvements after supraspinatus tendon repair surgery and who underwent postoperative MRI twice with a time interval, were included. The first and the second postoperative MRIs were obtained a mean of 4.4 and 11.5 months after surgery, respectively. The signal intensity (SI) patterns of the repaired tendon on T2-weighted images from the first MRI were classified into three types of heterogeneous high SI with fluid-like bright high foci (type I), heterogeneous high SI without fluid-like bright high foci (type II), and heterogeneous or homogeneous low SI (type III). Interval changes in the SI pattern, tendon thickness, and rotator cuff interval thickness between the two postoperative MRIs were evaluated. The SI patterns on the first MRI were type I or II in 45 tendons (90%) and type III in five (10%). SI decreased significantly on the second MRI (p < 0.050). The mean thickness of repaired tendons and rotator cuff intervals also decreased significantly (p < 0.050). Repaired supraspinatus tendons exhibited high SI in 90% of clinically improving patients on MRI performed during the early postsurgical period. The increased SI and thickness of the repaired tendon decreased on the later MRI, suggesting a gradual healing process rather than a retear.

  17. [Noninvasive positive pressure ventilation in postoperative period of tracheal surgery].

    Science.gov (United States)

    De La Torre, C A; Hernández, F; Sanabria, P; Vázquez, J; Miguel, M; Luis, A L; Barrena, S; Aguilar, R; Ramírez, M; Hernández, S; Borches, D; Lassaletta, L; Tovar, J A

    2011-04-01

    Reconstructive surgery of the airway often means prolonged periods of intubation during the post-operatory period, increasing the needs for drugs and favoring the appearance of infectious complications. We present an original system of ventilatory support with non-invasive positive pressure ventilation (NIPPV) using in patients subjected to reconstructive surgery of the airway. A retrospective study in patients undergoing reconstructive procedures of the airway in the year 2009 was carried out. We exclude those treated endoscopically and those who had vascular rings. The positive pressure mechanism used in the Surgery Critical Care Unit was a design made by the unit based on the circuit devised by Mapleson that provides optimum levels of ventilation without need for connection to a respiratory. We analyze the results, postoperatory intubation time, time dependent on NIPPV and medical treatment received. A total of 7 patients (1 Female and 6 Males) with median age of 1.6 (0.1-7.5) years were included. The diagnoses were: 4 subglottic stenosis, 2 had tracheal stenosis and 1 subcarinal stenosis with involvement of both principal bronchioles. The techniques used were: laryngotracheoplasty with costal cartilage graft (4), tracheoplasty with costal cartilage (1) and sliding tracheoplasty (2) with bilateral bronchoplasty in one of them. The mean time of nasotracheal intubation was 3 days, and mean time of NIPPV was 2.3. No patient required reintubation and none had infectious complications. Ventilatory support by VPPNI allows effective extubation in these patients, it being possible to maintain a safe airway. Infectious complications, frequent in prolonged intubations, were not observed in any of the cases.

  18. Diagnostic value of abdominal free air detection on a plain chest radiograph in the early postoperative period: a prospective study in 648 consecutive patients who have undergone abdominal surgery.

    Science.gov (United States)

    Milone, Marco; Di Minno, Matteo Nicola Dario; Bifulco, Giuseppe; Maietta, Paola; Sosa Fernandez, Loredana Maria; Musella, Mario; Iaccarino, Vittorio; Buccelli, Claudio; Nappi, Carmine; Milone, Francesco

    2013-09-01

    To the best of our knowledge, this is the first study to evaluate the predictive value of free air (on a plain radiograph) for bowel perforation in a large prospective cohort of surgical patients. All consecutive patients undergoing abdominal surgery between January 2011 and June 2012 were screened for this study. We performed an upright chest radiograph on the second and third postoperative day. Thereafter, additional radiographic evaluations were performed every 2 days until the disappearance of abdominal free air. Of the 648 subjects enrolled in our study, free abdominal air was found in 65 subjects on the first radiographic evaluation (2 days after surgery), 51 on the second (3 days after surgery), three on the third (5 days after surgery), and none on the fourth (7 days after surgery). The presence of free abdominal air was associated with an increased risk of gastrointestinal perforation. The presence of free air was associated with a hazard ratio (HR) of 21.54 (95% CI 9.66-48.01, pSensitivity, specificity, positive predictive value, and negative predictive value were 70, 93, 33, and 98%, respectively, at 2 days after surgery, and similar results were confirmed at 3 days after surgery. We believe that the presence of free air at 3 days after surgery should not be considered a common finding. Here, we demonstrate that the detection of free air has a remarkable predictive value for gastrointestinal perforation, which has been overestimated in previous experience.

  19. Early and Periodic Screening, Diagnosis and Treatment

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 who...

  20. Difference between early versus delayed postoperative physical rehabilitation protocol following arthroscopic rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Samar M Fawzy

    2016-01-01

    Conclusion Significant improvement in pain, ROM, and function after arthroscopic rotator cuff repair was seen at 1 year postoperatively, regardless of early or delayed postoperative rehabilitation protocols. However, early motion increases pain scores and may increase the possibility of rotator cuff retear but with early regain of ROM. A delayed rehabilitation protocol with immobilization for 6 weeks would be better for tendon healing without risk for retear or joint stiffness and easily convalescence with less postoperative pain.

  1. Glucose balance and muscle glycogen during TPN in the early post-operative phase

    DEFF Research Database (Denmark)

    Henneberg, S; Stjernström, H; Essén-Gustavsson, B

    1985-01-01

    In order to study how muscle glycogen is influenced by different nutritional regimens in the early post-operative period we took muscle biopsies from 20 patients preoperatively and on the fourth post-operative day after abdominal aortic surgery. Ten patients received 93% of non-protein energy......-production) were performed and from these data glucose balance was calculated as the difference between glucose intake and glucose expenditure. Muscle biopsies were analysed for glycogen, adenosine triphosphate, glucose-6-phosphate, lactate and citrate. We found that it was possible to maintain muscle...... glycogen stores at pre-operative levels with a glucose-insulin regimen. With the fat regimen there was a 31% decrease in muscle glycogen and two patients had a negative glucose balance despite the fact that 150 g of glucose were given. Average glucose balance throughout the study correlated positively...

  2. Glucose balance and muscle glycogen during TPN in the early post-operative phase

    DEFF Research Database (Denmark)

    Henneberg, S; Stjernström, H; Essén-Gustavsson, B;

    1985-01-01

    In order to study how muscle glycogen is influenced by different nutritional regimens in the early post-operative period we took muscle biopsies from 20 patients preoperatively and on the fourth post-operative day after abdominal aortic surgery. Ten patients received 93% of non-protein energy...... as glucose, 7% as fat (Intralipid) and insulin was given to keep the blood glucose below 10 mmol/l. The remaining patients had 80% of non-protein energy as fat (Intralipid). Amino acids constituting 12 g of nitrogen daily were given to both groups. Daily measurements of gas exchange (oxygen uptake, CO2...... glycogen stores at pre-operative levels with a glucose-insulin regimen. With the fat regimen there was a 31% decrease in muscle glycogen and two patients had a negative glucose balance despite the fact that 150 g of glucose were given. Average glucose balance throughout the study correlated positively...

  3. Catatonia and jaw dislocation in the postoperative period with epidural morphine

    Directory of Open Access Journals (Sweden)

    Satyen Parida

    2011-01-01

    Full Text Available We report a case of temporomandibular joint dislocation occurring in the postoperative period in a patient, who developed catatonia following administration of a single dose of epidural morphine. The catatonic response to epidural morphine was delayed by several hours in the postoperative period, and might have resulted from intrathecal migration of the drug, through an initial dural puncture while locating the epidural space. The temporomandibular joint dislocation was diagnosed only after reversal of the effects of morphine with naloxone, when the patient complained of inability to fully close her mouth.

  4. Evaluation of fever in the immediate postoperative period in patients who underwent total joint arthroplasty.

    Science.gov (United States)

    Athanassious, Christian; Samad, Adil; Avery, Anthony; Cohen, Jason; Chalnick, David

    2011-12-01

    Forty percent to 50% of patients may experience an immediate postoperative fever. Research suggests that these are of aseptic cause due to inflammatory mediators. This is a retrospective analysis of fevers in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients from 2006 to 2008. Thirty-six percent of THA and 31% of TKA patients developed a fever, with most developing a maximum temperature on postoperative day (POD) 2. The maximum mean temperature between the THA and TKA group was not significantly different. Fevers in the immediate postoperative period are a normal variant in patients undergoing THA or TKA. Urinalysis, urine culture and sensitivity, and chest x-ray are not required during this period because most of these fevers stem from aseptic causes. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Decreased heart rate variability responses during early postoperative mobilization

    DEFF Research Database (Denmark)

    Jans, Øivind; Brinth, Louise; Kehlet, Henrik

    2015-01-01

    to postoperative autonomic dysfunction. Thus, based on a previous study on haemodynamic responses during mobilization before and after elective total hip arthroplasty (THA), we performed secondary analyses of heart rate variability (HRV) and aimed to identify possible abnormal postoperative autonomic responses...

  6. Early follow-up after endovascular aneurysm repair: is the first postoperative computed tomographic angiography scan necessary?

    Science.gov (United States)

    Oikonomou, Kyriakos; Ventin, Felipe C; Paraskevas, Kosmas I; Geisselsöder, Peter; Ritter, Wolfgang; Verhoeven, Eric L

    2012-04-01

    To examine whether initial postoperative computed tomographic angiography (CTA) is needed in all patients undergoing endovascular aneurysm repair (EVAR). A total of 105 consecutive patients underwent EVAR with standard infrarenal devices in our department between November 2009 and May 2011. Five patients were excluded due to severe renal insufficiency, leaving 100 (85 men; median age 73 years, range 46-91) eligible for prospective enrollment in a triple-modality early postoperative follow-up protocol [intraoperative completion angiography, postoperative duplex ultrasonography (DUS), and plain abdominal radiography). Findings were compared for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) against the first postoperative CTA results for the detection of endoleaks or other signs of EVAR failure. There were 10 inconclusive DUS examinations. In the remaining 90 patients, DUS had 75.0% sensitivity, 95.4% specificity, 85.7% PPV, and 91.5% NPV for the detection of endoleaks. The intraoperative angiogram, DUS, and abdominal radiograph combined resulted in 87.5% sensitivity and 95.4% specificity, with a 65.6% PPV and 94.8% NPV for the detection of endoleaks. In 2 patients who required a reintervention for endoleak in the early postoperative period, both endoleaks were correctly detected by the triple-modality early postoperative follow-up protocol. An early follow-up protocol consisting of an intraoperative completion angiogram, DUS, and abdominal radiograph shows a high sensitivity and NPV for the detection of endoleaks and should detect early migration or kinking of the stent-graft. An initial postoperative CTA is not necessary for most patients undergoing EVAR and should be reserved for those individuals in whom the aforementioned modalities are inconclusive or show signs of endoleak or other EVAR failure.

  7. 肝移植术后患者早期呼吸机脱机延迟的术前及术中危险因素%Pre-and intra-operative risk factors associated with delayed weaning from ventilator during early postoperative period in patients undergoing liver transplantation

    Institute of Scientific and Technical Information of China (English)

    张欢; 杨拔贤; 王天龙

    2010-01-01

    Objective To evaluate the pre- and intra-operative risk factors associated with delayed weaning from ventilator during the early postoperative period in patients undergoing liver transplantation.Methods Two hundred and twelve patients (152 male, 60 female) aged 22-69 yr undergoing liver transplantation from Sept 2004to Aug 2006 were enrolled in this study and were divided into 2 groups according to the time when the patients were weaned from ventilator: normal weaning group (Group A, the patients weaned from ventilator within 24 h after operation) and delayed weaning group (Group B, the patients weaned from ventilator more than 24 h after operation). Routine anesthesia wes performed. Blood and blood products were transfused according to the guidelines for blood transfusion to maintain the mean arterial pressure (MAP)≥60 mm Hg during operation. Sixteen preoperative variables (age>64 yr, gender, BMI ≥ 30kg/m2, PaO2<75 mm Hg,pleural effusion, a history of asthma, smoking, drinking alcohol, coronary artery disease, diabetes mellitus, encephalopathy>grade 3, spontaneous bacterial peritonitis, preoperative MELD score, serum albumin, ascites≥20 ml/kg and moderate hepatopulmonary hypertension) and 7 intraoperative variables (duration of operation, duration of anhepatic stage, transfusions of RBC,fresh frozen plasma (FFP), crystalloid and colloid, and urine output< 1 ml·kg-1·h-1) were recorded and compared between the two groups.Results There were significant differences in 9 preoperative variables (age > 64 yr, PaO2<75 mm Hg, pleural effusion,encephalopathy>grade 3, spontaneous bacterial peritonitis, preoperative MELD score, serum albumin, ascites≥20 ml/kg and moderate hepato-pulmonary hypertension) and 5 intraoperative variables (transfusions of RBC, FFP, crystalloid and colloid, and urine output<1 mi·kg-1·h-1) between the two groups (P<0.05 or 0.01). And logistic regression analysis showed that 5preoperative variables (age>64 yr, PaO2<75

  8. Left atrial volume index as a predictor for persistent left ventricular dysfunction after aortic valve surgery in patients with chronic aortic regurgitation: the role of early postoperative echocardiography.

    Science.gov (United States)

    Cho, In-Jeong; Chang, Hyuk-Jae; Hong, Geu-Ru; Heo, Ran; Sung, Ji Min; Lee, Sang-Eun; Chang, Byung-Chul; Shim, Chi Young; Ha, Jong-Won; Chung, Namsik

    2015-06-01

    This study aimed to explore whether echocardiographic measurements during the early postoperative period can predict persistent left ventricular systolic dysfunction (LVSD) after aortic valve surgery in patients with chronic aortic regurgitation (AR). We prospectively recruited 54 patients (59 ± 12 years) with isolated chronic severe AR who subsequently underwent aortic valve surgery. Standard transthoracic echocardiography was performed before the operation, during the early postoperative period (≤2 weeks), and then 1 year after the surgery. Twelve patients with preoperative LVSD demonstrated LVSD at early after the surgery. Of the 42 patients without LVSD at preoperative echocardiography, 15 patients (36%) developed early postoperative LVSD after surgical correction. All 27 patients without LVSD at early postoperative echocardiography maintained LV function at 1 year after surgery. In the other 27 patients with postoperative LVSD, 17 patients recovered from LVSD and 10 patients did not at 1 year after surgery. Multiple logistic analysis demonstrated that postoperative left atrial volume index (LAVI) was the only independent predictor for persistent LVSD at 1 year after surgery in patients with postoperative LVSD (OR 1.180, 95% CI, 1.003-1.390, P = 0.046). The optimal LAVI cutoff value (>34.9 mL/m(2) ) had a sensitivity of 80% and a specificity of 88% for the prediction of persistent LVSD. Prevalence of early postoperative LVSD was relatively high, even in the patients without LVSD at preoperative echocardiography. Postoperative LAVI could be useful to predict persistent LVSD after aortic valve surgery in patients with early postoperative LVSD. © 2014, Wiley Periodicals, Inc.

  9. Early postoperative dislocation of the anterior Maverick lumbar disc prosthesis: report of 2 cases.

    Science.gov (United States)

    Gragnaniello, Cristian; Seex, Kevin A; Eisermann, Lukas G; Claydon, Matthew H; Malham, Gregory M

    2013-08-01

    The authors report on 2 cases of anterior dislocation of the Maverick lumbar disc prosthesis, both occurring in the early postoperative period. These cases developed after experience with more than 50 uneventful cases and were therefore thought to be unrelated to the surgeon's learning curve. No similar complications have been previously reported. The anterior Maverick device has a ball-and-socket design made of cobalt-chromium-molybdenum metal plates covered with hydroxyapatite. The superior and inferior endplates have keels to resist translation forces. The patient in Case 1 was a 52-year-old man with severe L4-5 discogenic pain; and in Case 2, a 42-year-old woman with disabling L4-5 and L5-S1 discogenic back pain. Both patients were without medical comorbidities and were nonsmokers with no risk factors for osteoporosis. Both had undergone uneventful retroperitoneal approaches performed by a vascular access surgeon. Computed tomography studies on postoperative Day 2 confirmed excellent prosthesis placement. Initial recoveries were uneventful. Two weeks postoperatively, after stretching (extension or hyperextension) in bed at home, each patient suffered the sudden onset of severe abdominal pain with anterior dislocation of the Maverick prosthesis. The patients were returned to the operating room and underwent surgery performed by the same spinal and vascular surgeons. Removal of the Maverick prosthesis and anterior interbody fusion with a separate cage and plate were performed. Both patients had recovered well with good clinical and radiological recovery at the 6- and 12-month follow-ups. Possible causes of the anterior dislocation of the Maverick prosthesis include the following: 1) surgeon error: In both cases the keel cuts were neat, and early postoperative CT confirmed good placement of the prosthesis; 2) equipment problem: The keel cuts may have been too large because the cutters were worn, which led to an inadequate press fit of the implants; 3) prosthesis

  10. Dynamic thermal imaging control of an eye in postoperative period after cataract phacoemulsification

    Directory of Open Access Journals (Sweden)

    N.R. Lopatinskaya

    2010-06-01

    Full Text Available The research goal is to study the impact of various schemes of antibacterial therapy in the postoperative period in patients after cataract phacoemulsification with distant thermography. Under observation there were 68 patients with cortical initial cataract. All patients were subjected to cataract phacoemulsification. Patients were divided into 2 groups: 34 patients of the first group after the operation dropped into the operated eye medication «Oftaquiks» 1 drop 5 times a day for one day before surgery and for 5 days postoperatively. 34 patients from the second group as an antibacterial drug received medication "Cipromed" in a similar way. Inflammatory reaction in postoperative period in the first group was not evident. In the second group the presence of inflammatory reaction of various degrees was revealed. Period of its reduction was 6,3 ± 2 days. The temperature difference between the non-operated and operated eye in the 3d day in most cases was less than 1 day after surgery. In the first group of patients the average temperature difference in the 3d day after surgery was 0.35 ± 0.21 ° C, and in the second group of patients - 1.3±0.83°C. Advantages of dynamic thermal imaging method for monitoring the state of the eye, including the analysis of time dependencies of temperature in the process of natural load test, which allows to select the optimal drug correction of postoperative cataract pha-coemulsification were revealed

  11. Computed tomography findings of early abdominal postoperative complications

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: zisinrivka@clalit.org.il; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)

    2007-06-15

    Various surgical approaches are used for different abdominal pathological conditions. Postoperative complications occur not infrequently and vary according to the type of the surgery and the clinical context. Nowadays, multidetector computed tomography (MDCT) provides superb anatomic detail and diagnostic accuracy for various intraabdominal pathological processes, even if clinically unsuspected, and it thus has become an essential diagnostic tool for evaluating postoperative insults. Other advantages of abdominal MDCT include its accessibility and its speed, which allow scanning of uncooperative, marginally stable patients. Computed tomography (CT)-guided percutaneous (PC) drainage of postoperative collections is another advantage of CT. Therefore, although CT requires transportation of a critically ill, postoperative patient, it is recommended in any suspicious clinical setting because several conditions require prompt management and a correct diagnosis is crucial. In assessing a patient for suspected postoperative complications, several points should be taken into consideration, including the relevant clinical and laboratory data, the surgical findings, the type of the surgery, the time elapsed since surgery, and the operative technique (either open laparotomy of laparoscopic procedure). (author)

  12. Comparison of three devices for oxygen administration in the late postoperative period

    DEFF Research Database (Denmark)

    Stausholm, K; Rosenberg-Adamsen, S; Skriver, M;

    1995-01-01

    We have evaluated three different devices for oxygen administration in the surgical ward, the Hudson face mask (oxygen 3 litre min-1, air 12 litre min-1), the nasal prong (oxygen 3 litre min-1) and the binasal catheter (oxygen 3 litre min-1). We evaluated the three devices in random order......, but the highest degree of comfort was found with the binasal catheter. Use of the binasal catheter is recommended for oxygen administration in the late postoperative period....

  13. Relationship between postoperative erythromycin breath test and early morbidity in liver transplant recipients

    DEFF Research Database (Denmark)

    Schmidt, Lars E; Rasmussen, Allan; Kirkegaard, Preben;

    2003-01-01

    BACKGROUND: Interindividual variability in dosage requirements of the calcineurin inhibitor immunosuppressive agents cyclosporine and tacrolimus after liver transplantation may result from differences in the CYP3A activity of the liver graft. Early postoperative erythromycin breath test (ERMBT......) is an in vivo measure of graft CYP3A activity. This study evaluates the usefulness of an early postoperative ERMBT in predicting early morbidity in liver transplant recipients. METHODS: In 26 liver transplant recipients, ERMBT was performed within 2 hr after transplantation. Main end points were the occurrence...... with low postoperative ERMBT values (0.21%+/-0.15% 14C/hr vs. 1.09%+/-0.72% 14C/hr, P=0.002). CONCLUSION: An early postoperative ERMBT may be useful in predicting the development of cyclosporine and tacrolimus nephrotoxicity, severe graft dysfunction, or even graft loss in liver transplant recipients when...

  14. The immediate post-operative period following lung transplantation: mapping of nursing interventions

    Directory of Open Access Journals (Sweden)

    Rayssa Thompson Duarte

    2014-10-01

    Full Text Available OBJECTIVES: to investigate the principle nursing interventions/actions, prescribed in the immediate post-operative period for patients who receive lung transplantation, recorded in the medical records, and to map these using the Nursing Interventions Classification (NIC taxonomy.METHOD: retrospective documental research using 183 medical records of patients who received lung transplantation (2007/2012. The data of the patients' profile were grouped in accordance with the variables investigated, and submitted to descriptive analysis. The nursing interventions prescribed were analyzed using the method of cross-mapping with the related interventions in the NIC. Medical records which did not contain nursing prescriptions were excluded.RESULTS: the majority of the patients were male, with medical diagnoses of pulmonary fibrosis, and underwent lung transplantation from a deceased donor. A total of 26 most frequently-cited interventions/actions were found. The majority (91.6% were in the complex and basic physiological domains of the NIC. It was not possible to map two actions prescribed by the nurses.CONCLUSIONS: it was identified that the main prescriptions contained general care for the postoperative period of major surgery, rather than prescriptions individualized to the patient in the postoperative period following lung transplantation. Care measures related to pain were underestimated in the prescriptions. The mapping with the taxonomy can contribute to the elaboration of the care plan and to the use of computerized systems in this complex mode of therapy.

  15. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery

    Science.gov (United States)

    Costa, Altair da Silva; Bachichi, Thiago; Holanda, Caio; Rizzo, Luiz Augusto Lucas Martins De

    2016-01-01

    ABSTRACT Objective: To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. Methods: This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks. PMID:28117476

  16. Incidence of Diabetes Insipidus in Postoperative Period among the Patients Undergoing Pituitary Tumour Surgery.

    Science.gov (United States)

    Kadir, M L; Islam, M T; Hossain, M M; Sultana, S; Nasrin, R; Hossain, M M

    2017-07-01

    Post operative complications after pituitary tumour surgery vary according to procedure. There are several surgical procedures being done such as transcranial, transsphenoidal microsurgical and transsphenoidal endoscopic approaches. One of the commonest complications is diabetes insipidus (DI). Our main objective was to find out the incidence of diabetes insipidus in post operative period among patients undergoing surgical intervention for pituitary tumour in our institute. The presence of diabetes insipidus in the postoperative period was established by measuring serum Na+ concentration, hourly urine output and urinary specific gravity to find out the incidence of diabetes insipidus in postoperative period in relation to age, gender, tumour diameter, function of tumour (i.e., either hormone secreting or not) and operative procedure used for surgical resection of pituitary tumor. As it is the most common postoperative complication so, in this study we tried to find out how many of the patients develop diabetes insipidus in postoperative period following surgical resection of pituitary tumour. This cross sectional type of observational study was carried out in the department of Neurosurgery, BSMMU from May 2014 to October 2015 on 33 consecutive patients who underwent surgical intervention for pituitary tumour for the first time. Data was collected by using a data collection sheet. The incidence of diabetes insipidus was found 23.1% of patients in diabetes insipidus (p=0.073). Regarding tumour size 30.8% and 69.2% of patients developed diabetes insipidus having tumour diameter diabetes insipidus who was operated by transsphenoidal endoscopic approach, 23.1% and 7.7% of patients developed diabetes insipidus who underwent pituitary tumour resection through transsphenoidal microscopic approach and transcranial microscopic approach respectively (p=0.432). 17.6% of patients develop DI having functioning pituitary macroadenoma and 62.5% of patients develop DI having

  17. Clinical indicators of ineffective airway clearance for patients in the cardiac postoperative period.

    Science.gov (United States)

    de Sousa, Vanessa Emille Carvalho; de Oliveira Lopes, Marcos Venícios; de Araujo, Thelma Leite; Rolim, Isaura Letícia Tavares Palmeira; do Nascimento, Ranielly Vidal; Oliveira, Talita Ferreira

    2013-04-01

    The accuracy of an indicator determines the direct relationship between a defining characteristic and the presence or absence of a specific nursing diagnosis. To analyse the accuracy of the clinical indicators of ineffective airway clearance in patients during the postoperative period of cardiac surgery. A total of 98 patients recruited from a postoperative unit were included in the study. An analysis of sensitivity, specificity, predictive value, likelihood ratio, diagnostic odds ratio, accuracy, and area under the ROC curve was used to determine the accuracy of these clinical indicators. Four clinical indicators showed the highest levels of accuracy by statistical measure: dyspnoea, adventitious breath sounds, ineffective cough, and retained secretions. The indicators retained secretions and ineffective cough showed high diagnostic odds ratios (62.8 and 28.1, respectively). The results suggest that there are differences between the ineffective airway clearance indicators as accuracy measures.

  18. Does Kinesiology Taping Improve the Early Postoperative Outcomes in Anterior Cruciate Ligament Reconstruction? A Randomized Controlled Study.

    Science.gov (United States)

    Chan, Mark Ci-En; Wee, Justin Wen-Jie; Lim, Mui-Hong

    2017-05-01

    The efficacy of kinesiology taping in arthroscopic knee surgery has not been reported. The objective of this study is to investigate the efficacy of kinesiology taping in the early postoperative phase after anterior cruciate ligament reconstruction (ACLR). We hypothesized that kinesiology taping reduces knee pain and swelling and improves knee range of movement and functional outcome. Randomized controlled study. Primary Institutional Hospital. Sixty subjects who underwent an elective ACLR with or without concurrent meniscectomy were randomized into intervention (with kinesiology taping postsurgery) and control groups. Subjects from both groups received standardized postoperative physiotherapy. Subjects from the intervention group received additional kinesiology taping on the first and second weeks postsurgery, each application lasting 5 days. Pain visual analogue score (VAS), total range of motion (ROM) of the knee, Lysholm-Tegner scale, and mid patella circumferential girth were measured before the surgery and at the first, second, and sixth week postsurgery. Within each group, statistically significant differences were found in all study parameters in both groups. Comparison of the study parameters between both groups revealed no statistical significance at various time points except the reduction of pain in the taping group in the early postoperative phase (between the first and second week) (P kinesiology taping in arthroscopic knee surgery. Our study showed that kinesiology taping reduced pain in the early postoperative period after ACLR. There was no statistical significance in the reduction of swelling or improvement of knee score and total range of motion with kinesiology taping.

  19. Periprosthetic Infection following Primary Hip and Knee Arthroplasty: The Impact of Limiting the Postoperative Surveillance Period.

    Science.gov (United States)

    Roth, Virginia R; Mitchell, Robyn; Vachon, Julie; Alexandre, Stéphanie; Amaratunga, Kanchana; Smith, Stephanie; Vearncombe, Mary; Davis, Ian; Mertz, Dominik; Henderson, Elizabeth; John, Michael; Johnston, Lynn; Lemieux, Camille; Pelude, Linda; Gravel, Denise

    2017-02-01

    BACKGROUND Hip and knee arthroplasty infections are associated with considerable healthcare costs. The merits of reducing the postoperative surveillance period from 1 year to 90 days have been debated. OBJECTIVES To report the first pan-Canadian hip and knee periprosthetic joint infection (PJI) rates and to describe the implications of a shorter (90-day) postoperative surveillance period. METHODS Prospective surveillance for infection following hip and knee arthroplasty was conducted by hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) using standard surveillance definitions. RESULTS Overall hip and knee PJI rates were 1.64 and 1.52 per 100 procedures, respectively. Deep incisional and organ-space hip and knee PJI rates were 0.96 and 0.71, respectively. In total, 93% of hip PJIs and 92% of knee PJIs were identified within 90 days, with a median time to detection of 21 days. However, 11%-16% of deep incisional and organ-space infections were not detected within 90 days. This rate was reduced to 3%-4% at 180 days post procedure. Anaerobic and polymicrobial infections had the shortest median time from procedure to detection (17 and 18 days, respectively) compared with infections due to other microorganisms, including Staphylococcus aureus. CONCLUSIONS PJI rates were similar to those reported elsewhere, although differences in national surveillance systems limit direct comparisons. Our results suggest that a postoperative surveillance period of 90 days will detect the majority of PJIs; however, up to 16% of deep incisional and organ-space infections may be missed. Extending the surveillance period to 180 days could allow for a better estimate of disease burden. Infect Control Hosp Epidemiol 2017;38:147-153.

  20. [Anesthetic service and the postoperative period in pregnant women with gestosis].

    Science.gov (United States)

    Shepetovskaia, N L; Pivovarova, G M; Volodin, A V; Tolmachev, G N

    2007-01-01

    The paper analyzes the results of using in the anesthetic maintenance of pregnant females with gestosis the algorithm of preventing possible impairments in the development of the general adaptation syndrome in response to pregnancy and surgical labor. Calcium antagonists (eliminating dysfunction of secondary calcium messenger), ketonal, and tranexamic acid (which inhibiting a number of pain and inflammation mediators), and hydroxyethyl starch-130/04 solution (regenerating the endothelium) were administered to prevent the clinical manifestations of the intraabdominal compartment syndrome, ischemia-pefusion, and the second wave of the systemic inflammatory response syndrome in response to surgery. The differential use of the above agents at all stages of anesthetic maintenance in pregnant women with gestosis promoted the postoperative preservation of the most efficient eukinetic hemodynamics and physiological sympathicotonia and the elimination of water metabolic disturbances more early than in the control puerperas. A more physiological postoperative course in the study group puerperas called for much less pharmacotherapy, which created more favorable conditions for postoperative maternal-neonatal contact (feeding, etc.).

  1. Preoperative factors as a predictor for early postoperative outcomes after repair of congenital transposition of the great arteries.

    Science.gov (United States)

    Kim, Jung-Won; Gwak, Mijeung; Shin, Won-Jung; Kim, Hyun-Jung; Yu, Jeong Jin; Park, Pyung-Hwan

    2015-03-01

    Transposition of the great arteries (TGA) requires early surgical repair during the neonatal period. Several preoperative factors have been identified for the postoperative poor outcome after arterial switch operation (ASO). However, the data remain uncertain an association. Therefore, we investigated the preoperative factors which affect the early postoperative outcomes. Between March 2005 and May 2012, a retrospective study was performed which included 126 infants with an ASO for TGA. Preoperative data included the vasoactive inotropic score (VIS) and baseline hemodynamics. Early postoperative outcomes included the duration of mechanical ventilation, the length of stay in the intensive care unit and hospital, and early mortality. Multivariate linear regression and receiver operating characteristics analysis were performed. The duration of mechanical ventilation was significantly correlated with the preoperative mechanical ventilator support and VIS, and CPB time. On multivariate linear regression analysis, a higher preoperative VIS, preoperative B-type natriuretic peptide (BNP) level, and the CPB time were identified as independent risk factors for delayed mechanical ventilation. Preoperative VIS (OR 1.154, 95 % CI 1.024-1.300) and the CPB time (OR 1.034, 95 % CI 1.009-1.060) were independent parameters predicting early mortality. A preoperative VIS of 12.5 had the best combined sensitivity (83.3 %) and specificity (85.3 %) and an AUC of 0.852 (95 % CI 0.642-1.061) predicted early mortality. Our results suggest that preoperative VIS and BNP can predict the need for prolonged postoperative mechanical ventilation. Moreover, preoperative VIS may be used as a simple and feasible indicator for predicting early mortality.

  2. Avaliação da qualidade de vida em pacientes submetidos à ressecção colorretal por via laparoscópica ou aberta em período pós-operatório inicial Evaluation of quality of life in patients underwent laparoscopic or open colorectal resection in the early postoperative period

    Directory of Open Access Journals (Sweden)

    Teon Augusto Noronha de Oliveira

    2010-03-01

    laparoscópica apresentaram melhor qualidade de vida ao final do primeiro mês de pós-operatório, quando comparados com os pacientes submetidos à cirurgia aberta.INTRODUCTION: Several studies, including meta-analysis, have demonstrated the safety, effectiveness and oncologic equivalence of laparoscopic resections when compared to open procedures leading minimally invasive colorectal surgery to be adopted in crescent number of services around the world. This study aims to evaluate the quality of life of patients underwent laparoscopic and open colorectal resections in the early postoperative period. METHODS: this is a prospective study which evaluated 42 patients underwent laparoscopic and open colorectal resection between May to November 2008 followed up until 60th postoperative day. Questionnaires of quality of life were applied in 3th, 7th and 30th postoperative days. Statistical analysis consisted of descriptive analysis of global healthy status scores, functional scores and symptoms of EORTC/QLQ 30. Shapiro-Wilk, Mann-Whitney e t de Student statistical tests were used to check the data, with level of significance in 0.05. RESULTS: Most of patients were females (57.1% with mean age of 61.5 years. It was observed significant difference of "global health status" score on the 30th postoperative between groups, with values of 75.0 and 58.3 for patients underwent laparoscopic and open procedures respectively (p = 0.005. There were no differences in terms of physical function and others as, accomplishment, emotional, cognitive and social functions. In relation to symptoms (fatigue, nausea, pain, dyspnea, insomnia, loss of appetite and constipation and financial difficulties, there were also no differences between groups. CONCLUSION: Our results have demonstrated that patients underwent laparoscopic colorectal resections have better quality of life at the end of first postoperative month when compared to patients underwent to open colorectal resections.

  3. Colchicine to Reduce Atrial Fibrillation in the Postoperative Period of Myocardial Revascularization

    Science.gov (United States)

    Zarpelon, Camila Stuchi; Netto, Miguel Chomiski; Jorge, José Carlos Moura; Fabris, Cátia Carolina; Desengrini, Dieli; Jardim, Mariana da Silva; da Silva, Diego Guedes

    2016-01-01

    Background The high prevalence of atrial fibrillation (AF) in the postoperative period of myocardial revascularization surgery increases morbidity and mortality. Objective To assess the efficacy of colchicine to prevent AF in the postoperative period of myocardial revascularization surgery, the impact of AF on hospital length of stay and death, and to identify its risk factors. Methods Between May 2012 and November 2013, 140 patients submitted to myocardial revascularization surgery were randomized, 69 to the control group and 71 to the colchicine group. Colchicine was used at the dose of 1 mg orally, twice daily, preoperatively, and of 0.5 mg, twice daily, until hospital discharge. A single dose of 1 mg was administered to those admitted 12 hours or less before surgery. Results The primary endpoint was AF rate in the postoperative period of myocardial revascularization surgery. Colchicine group patients showed no reduction in AF incidence as compared to control group patients (7.04% versus 13.04%, respectively; p = 0.271). There was no statistically significant difference between the groups regarding death from any cause rate (5.6% versus 10.1%; p = 0,363) and hospital length of stay (14.5 ± 11.5 versus 13.3 ± 9.4 days; p = 0.490). However, colchicine group patients had a higher infection rate (26.8% versus 8.7%; p = 0.007). Conclusion The use of colchicine to prevent AF after myocardial revascularization surgery was not effective in the present study. Brazilian Registry of Clinical Trials number RBR-556dhr. PMID:27223641

  4. [Quality of life measurement in the postoperative period in general and gastrointestinal surgery].

    Science.gov (United States)

    Balongo García, Rafael; Espinosa Guzmán, Eduardo; Naranjo Rodríguez, Pedro; Tejada Gómez, Antonio; Rodríguez Pérez, Margarita; Abreu Sánchez, Ana

    2010-09-01

    Health related quality of life measurement (HRQL) is widely accepted as an appropriate outcome of surgical care for assessing effectiveness and for risk adjusted outcomes. Nevertheless its use in the immediate postoperative period has show limitations. The aim of this study is to prove that is possible, with a specific new tool, to assess the HRQL during this period. The study is designed to create a specific close questionnaire related to the patient's condition after surgery, structured in domains, with the subsequent use of: literature searches, patient interviews (n=30), and a Delphi survey with health care providers. Finally the tool was validated using a pre-test (n=36) and a prospective observational cohort trial (n=250), to assess the discriminant validity for different cohorts of patients, reliability, responsiveness, and convergent validity, and to compare with the widely used generic tool, Short Form 36 (SF-36). The questionnaire was shown to have good sensitivity to change (single index and domains score), as well as good sensitivity to distinguish cohorts of patients, a high internal consistency (Cronbach's alpha 0.88), absence of redundancy between domains (Spearman's rho range, 0.29-0.84), and good convergent validity with patient opinion. The SF-36 questionnaire showed poor discriminant validity, and lack of convergent validity with patient opinion. These results support that the created questionnaire is appropriate to assess HRQL in the immediate postoperative period; and was more specific than SF-36. Copyright © 2010 AEC. Published by Elsevier Espana. All rights reserved.

  5. [The relationship between the effectiveness and specific features of the early postoperative rehabilitation of the patients presenting with cholelithiasis].

    Science.gov (United States)

    Poddubnaya, O A; Marsheva, S I

    2015-01-01

    The objective of the early postoperative rehabilitation of the patients presenting with cholelithiasis is to prevent the further progression of the disease and reduce the risk of development of post-cholecystectomy disorders. The combined treatment including the use of low-mineralized mineral waters, magnetic, laser, and EHF-therapy makes it possible to significantly improve the parameters of interest due to the marked improve mentor normalization of the clinical and laboratory characteristics, the increase of adaptive capabilities, and the correction of the psycho-emotional and vegetative status of the patients. Taken together, the peculiarities of the combined rehabilitative treatment of the patients with cholelithiasis during the early postoperative period account for its high clinical effectiveness amounting to 94.7%. The results of the study give reason to recommend the application of the proposed technology for the rehabilitative treatment of the patients presenting with cholelithiasis.

  6. The effect of patient-selected music on early postoperative pain, anxiety, and hemodynamic profile in cesarean section surgery.

    Science.gov (United States)

    Ebneshahidi, Amin; Mohseni, Masood

    2008-09-01

    After cesarean section surgery, routine pharmacologic methods of analgesia--opioids and benzodiazepines--may impair the immediate close contact of mother and neonate for their sedative and emetic effects. The aim of this study was to explore the effect of patient-selected music on postoperative pain, anxiety, opioid requirement, and hemodynamic profile. A total of 80 patients, American Society of Anesthesiologists (ASA) physical status I-II, scheduled to undergo general anesthesia and elective cesarean section surgery were enrolled. Patients were randomly allocated to receive 30 minutes of music or silence via headphones postoperatively. Pain and anxiety were measured with a visual analogue scale. Total postoperative morphine requirement as well as blood pressure and heart rate were recorded after the intervention period. Pain score and postoperative cumulative opioid consumption were significantly lower among patients in the music group (p 0.05). Postoperative use of patient-selected music in cesarean section surgery would alleviate the pain and reduce the need for other analgesics, thus improving the recovery and early contact of mothers with their children.

  7. BASE DEFICIT IN IMMEDIATE POSTOPERATIVE PERIOD OF OPEN HEART SURGERY AND OUTCOME OF PATIENTS

    Directory of Open Access Journals (Sweden)

    F. Sabzi

    2007-07-01

    Full Text Available "nBase deficit is a non-respiratory indicator of acid base status. Aim of this study is to assess relationship between the base deficit value in immediate post operative period of CABG and valvular heart disease with cardiopulmonary and in hospital outcome of patient. A total of 136 consecutive with CABG and valvular heart disease scheduled in study. 20 variables were determined during the pre-intra-and postoperative period. Statistical univariate analysis was performed differentiating patients whose initial base deficit after weaning from cardiopulmonary bypass was -8 meq and these whose base deficit was equal or more than -8 meq. Secondly a logistic regression model was performed on the variables shown to have a statistically significant difference in univariate analysis with determination of the odd ratio. 3 variables had a statistically significant difference in univariate analysis and 2 of them high lighted by the linear logistic model. The value of base deficit measured during the immediate postoperative open-heart surgery is correlated with volume of fresh frozen plasma and blood transfusion after open heart surgery and using of intra aortic balloon pump after surgery.

  8. Quality of Life of related liver donors in the late postoperative period

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2017-01-01

    Full Text Available Introduction. Quality of life (QoL is a new promising area of clinical medicine that provides the opportunity to assess the state of health of the patient and to have a notion of the surgery effects based on the parameters which are lying at the intersection of scientific approach of the surgeons and subjective point of view of the patient.Materials and methods. The study included 52 living-related liver fragment donors operated between 2009 and 2014. Donors were surveyed after 2–5 years from the surgery. Comparison group was formed by healthy volunteers, students of the Medical University. The Russian version of the non-specific SF-36 questionnaire was used to assess QoL.Results. Donors in the postoperative period have demonstrated a high level of physical parameter (57.65 ± 3.8. Parameter of psychological health in the postoperative period was (52.01 ± 5.2. These figures are comparable with the results in the comparison group (p > 0.05. All donors have returned to normal life.Conclusions. Overall results of this study were similar to those of the foreign colleagues which confirm the high safety of liver resection surgery and the efficacy of SF-36 questionnaire in the assessment of quality of life of the living-related liver fragment donors.

  9. Dexmedetomidine improves early postoperative cognitive dysfunction in aged mice.

    Science.gov (United States)

    Qian, Xiao-Lan; Zhang, Wei; Liu, Ming-Zheng; Zhou, Yu-Bing; Zhang, Jing-Min; Han, Li; Peng, You-Mei; Jiang, Jin-hua; Wang, Qing-Duan

    2015-01-05

    Postoperative cognitive dysfunction (POCD) is a frequent complication following major surgery in the elderly. However, the exact pathogenic mechanisms are still unknown. Dexmedetomidine, a selective alpha 2 adrenal receptor agonist, was revealed anesthesia and brain protective role. The present study aimed to examine whether dexmedetomdine protects against POCD induced by major surgical trauma under general anesthesia in aged mice. In the present study, cognitive function was assessed by Y-maze. Proinflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor (TNF-α), apoptosis-related factor caspase-3 and Bax were detected by real-time PCR, Western blot or immunohistochemistry. The results showed that anesthesia alone caused weak cognitive dysfunction on the first day after general anesthesia. Cognitive function in mice with splenectomy under general anesthesia was significantly exacerbated at the first and third days after surgery, and was significantly improved by dexmedetomidine administration. Splenectomy increased the expression of IL-1β, TNF-α, Bax and caspase-3 in hippocampus. These changes were significantly inversed by dexmedetomidine. These results suggest that hippocampal inflammatory response and neuronal apoptosis may contribute to POCD, and selective alpha 2 adrenal receptor excitation play a protective role.

  10. Outcomes Associated with Early Postoperative Noninvasive Ventilation in Bariatric Surgical Patients with Sleep Apnea

    Science.gov (United States)

    Stefan, Mihaela S.; Hill, Nicholas S.; Raghunathan, Karthik; Liu, Xiaoxia; Pekow, Penelope S.; Memtsoudis, Stavros G.; Ramachandran, Satya Krishna; Lindenauer, Peter K.

    2016-01-01

    Study Objectives: To examine the relationship of early initiation of noninvasive ventilation (NIV) with postoperative outcomes in patients with obstructive sleep apnea (OSA) undergoing bariatric surgery. Methods: We included 5,266 patients with OSA undergoing bariatric surgeries at 161 hospitals in the United States. We defined early postoperative NIV as NIV used on the day of or the day after surgery; this could include prophylactic NIV or NIV used for early signs of respiratory deterioration. We developed a hierarchical model to identify factors associated with early use of NIV. Then, in a propensity matched cohort, we assessed the association between NIV use and outcomes. Results: Overall, 996 patients (18.9%) were treated with early postoperative NIV. Predictors of NIV initiation were: male sex (odds ratio: 1.34, 95% confidence interval 1.14–1.59), older age, chronic obstructive pulmonary disease (COPD; odds ratio 1.39, confidence interval: 1.17–1.64), gastric bypass surgery, short-acting narcotics intravenous on the day of surgery and admission to a hospital with high rate of OSA diagnosis. In a propensity matched analysis, we found no significant association between early initiation of NIV and receipt of invasive mechanical ventilation (IMV) (early NIV 4.5% vs. no NIV 3.8% p = 0.46), cardiovascular complications or mortality. Results were consistent in several sensitivity analyses. Conclusions: In this large observational study of patients with OSA undergoing bariatric surgery, early postoperative NIV use was not associated with better outcomes including less intubation and mortality. Properly designed controlled trials will be necessary to provide more definitive answers to this important clinical question. Citation: Stefan MS, Hill NS, Raghunathan K, Liu X, Pekow PS, Memtsoudis SG, Ramachandran SK, Lindenauer PK. Outcomes associated with early postoperative noninvasive ventilation in bariatric surgical patients with sleep apnea. J Clin Sleep Med 2016

  11. Intra-operative remifentanil might influence pain levels in the immediate post-operative period after major abdominal surgery

    DEFF Research Database (Denmark)

    Hansen, E G; Duedahl, T H; Rømsing, J;

    2005-01-01

    Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...... any impact on post-operative pain and opioid consumption after major abdominal surgery.......Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...

  12. Echocardiography and passive leg raising in the postoperative period: A prospective observational study.

    Science.gov (United States)

    El Hadouti, Yasser; Valencia, Lucía; Becerra, Angel; Rodríguez-Pérez, Aurelio; Vincent, Jean L

    2017-07-15

    Signs of hypovolaemia are frequent in the postoperative period, but not all patients need or respond to fluid administration. An increase in cardiac output (CO) after passive leg raising (PLR) has been demonstrated to be useful as a volume response predictor in non-surgical, spontaneously breathing patients. The objective of this study was to evaluate the accuracy of transthoracic echocardiography after PLR to predict fluid responsiveness in post-surgical patients. A prospective observational study. A tertiary hospital between January and July 2015. Fifty-one spontaneously breathing postoperative patients with suspected hypovolaemia (arterial hypotension, oliguria, tachycardia or delayed capillary refill) were considered for the study. Demographic and personal data were collected, as well as heart rate variations, mean arterial pressure during PLR and after administering 500 ml of Ringer's lactate solution. CO was measured by transthoracic echocardiography. The primary outcome was measurement of CO before and after PLR and Ringer's lactate administration. Forty-one patients were included in the study (six patients were excluded because of a poor echocardiographic window and four because of misalignment of the Doppler and outflow tract of the left ventricle). Twenty-two patients (54%) were considered responders to fluid therapy, with an increase of stroke volume greater than or equal to 15% after 500 ml lactated Ringer's infusion. The highest area under the curve was found for an increase in CO (0.91 ± 0.05; 95% confidence interval 0.78 to 0.97). An increase in CO greater than 11% after the PLR manoeuvre predicts a volume response with 68% sensitivity and 100% specificity. This is the first study showing that measurement of CO after PLR can predict volume response in spontaneously breathing postoperative patients.

  13. Value of clinical and laboratory inflammation factors in the postoperative period after laparoscopic urogynecological surgery.

    Science.gov (United States)

    Noé, Günter-Karl; Anapolski, Michael; Soltész, Stefan; Spüntrup, Carolin; Mettler, Liselotte; Schollmeyer, Thoralf; Alkatout, Ibrahim

    2015-01-01

    Leukocytes and C-reactive protein (CRP) levels are often used to detect infections. The aim of this study was to evaluate the diagnostic and screening validity of leukocytes and CRP levels as well as body temperature >38° C to predict infections after laparoscopic sacrocolpopexy. The study included 287 patients suffering from genital prolapse higher than POP-Q I. In addition to the sacrocolpopexy, a laparoscopic supracervical hysterectomy was performed in cases of preexisting uterus (n = 171). Leukocytes and CRP levels were analyzed preoperatively and 4 days after surgery. Early and late onset of infections was documented. Urinary tract infection was identified as the most frequent early postoperative complication (11.4%). Early wound infections were found in 2.8% of the patients (8/287). Late onset of infections was found in 1% of patients (3/287). Areas under ROC curves were low for both leukocytes (0.52, 95% CI: 0.37-0.66) and CRP levels (0.60, 95% CI: 0.44-0.77). Our findings question the benefit of routine determination of leukocytes and CRP levels 4 days after surgery. The sensitivity and specificity of leukocytes and CRP levels are probably more significant after normalization of the initial tissue response (days 8-10). © 2014 S. Karger AG, Basel.

  14. 肝移植术后患者早期呼吸机脱机延迟的术前及术中危险因素%Pre-and intraoperative risk factors associated with delayed weaning from ventilator during the early postoperative period in patients undergoing liver transplantation

    Institute of Scientific and Technical Information of China (English)

    张欢; 杨拔贤; 王天龙; 朱凤雪; 栗光明; 朱继业

    2008-01-01

    目的 分析肝移植术后患者早期呼吸机脱机延迟的术前及术中危险因素.方法 2004年9月至2006年8月212例肝移植术患者,其中男性152例,女性60例,年龄22~69岁.术中常规麻醉管理,按输血原则输入血制品,并维持平均动脉压不低于60 mm Hg.记录16个术前变量和7个术中变量.术后24 h按第1次拔除气管导管时间分为正常脱机组和脱机延迟组.结果 两组间9个术前变量[分别为年龄>64岁、PaO2<75 mm Hg、胸膜渗出、Ⅲ级以上肝性脑病、合并自发性细菌性腹膜炎、晚期肝病模型(MELD)评分、血清白蛋白、腹水≥20 ml/kg和中度门肺高压]及5个术中变量[RBC输入量、新鲜冰冻血浆输入量、晶体液输入量、胶体液输入量和尿量<1 ml·kg-1·h-1]差异有统计学意义(P<0.05或0.01).logistic回归分析显示,5个术前变量(年龄>64岁、PaO2<75 mm Hg、Ⅲ级以上肝性脑病、MELD评分和中度门肺高压)及2个术中变量(RBC输入量和尿量<1 ml·kg-1·h-1)与术后脱机延迟存在相关性(P<0.05或0.01).结论 5个术前变量(年龄>64岁、术前PaO2<75 mm Hg、Ⅲ级以上肝性脑病、MELD评分和中度门肺高压)及2个术中变量(RBC输入量和尿量<1 ml·kg-1·h-1)是肝移植术后患者早期脱机延迟的危险因素.%Objective To evaluate the pre-and intraoperative risk factors associated with delayed weaning from ventilator during the early postoperative period in patients undergoing liver transplantation.Methods Two hundred and twelve patients(152 male,60 female)aged 22-69 yr undergoing liver transplantation from Sept.2004 to Aug.2006 were enrolled in this study and were divided into 2 groups according to the time when the patients were weaned from ventilator:A normal weaning group(the patients were weaned from ventilator ≤24 h after operation)and B delayed weaning group(>24 h after operation).Routine anesthesia performed.Blood and blood products were transfused

  15. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

    Directory of Open Access Journals (Sweden)

    Poissonnet Gilles

    2007-04-01

    Full Text Available Abstract Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure.

  16. Patients with ovarian cancer have elevated (51)Cr-EDTA plasma clearance early post-operatively

    DEFF Research Database (Denmark)

    Nielsen, S S; Havsteen, H; Petersen, L K;

    2002-01-01

    Plasma clearance of (51)Cr-EDTA (Clp(EDTA)) is widely used to determine glomerular filtration rate prior to carboplatin based chemotherapy. We have observed that many patients with ovarian cancer have elevated Clp in the early post-operative phase compared to later phases. The purpose of this stu...

  17. Impact of mild renal impairment on early postoperative mortality after open cardiac surgery

    Directory of Open Access Journals (Sweden)

    Ghani A

    2010-01-01

    Full Text Available Preoperative severe renal impairment is included in the risk scores to predict out-come after open cardiac surgery. The purpose of this study was to assess the impact of pre-operative mild renal impairment on the early postoperative mortality after open heart surgery. Data of all cases of open cardiac surgery performed from January 2005 to June 2006 were collec-ted. Cases with preoperative creatinine clearance below 60 mL/min were excluded from the study. Data were retrospectively analyzed to find the impact of renal impairment on short-term outcome. Of the 500 cases studied, 47 had preoperative creatinine clearance between 89-60 mL/min. The overall mortality in the study cases was 6.8%. The mortality was 28.7% in those who developed postoperative ARF, 33.3% in those who required dialysis and 40.8% in those with preoperative mild renal impairment. Binary logistic regression analysis showed that female gender (P = 0.01, preoperative mild renal impairment (P = 0.007 as well as occurrence of multi organ failure (P < 0.001 were the only independent variables determining the early postoperative mortality after cardiac surgeries. Among them, preoperative mild renal impairment was the most significant and the best predictor for early postoperative mortality after cardiac surgery. Our study suggests that renal impairment remains a strong predictor of early mortality even after adjustment for several confounders.

  18. Postoperative medical complications are the main cause of early death after emergency surgery for colonic cancer

    DEFF Research Database (Denmark)

    Iversen, L.H.; Bulow, S.; Christensen, Ib Jarle

    2008-01-01

    . The strongest risk factor for early death was postoperative medical complications (cardiopulmonary, renal, thromboembolic and infectious), with an odds ratio of 11.7 (95 percent confidence interval 8.8 to 15.5). Such complications occurred in 24.4 per cent of patients, of whom 57.8 per cent died. Other...

  19. Effect of unrestricted bottle-feeding on early postoperative course after cleft palate repair.

    Science.gov (United States)

    Kim, Eun Key; Lee, Taik Jong; Chae, Soo Wook

    2009-09-01

    Although bottle-feeding after cheiloplasty is widely accepted, postoperative feeding regimen after palatoplasty is still controversial. The aim of this prospective randomized study was to evaluate the effect of bottle-feeding on early postoperative course after palatoplasty in a relatively homogeneous group of patients. Eighty-two consecutive patients with nonsyndromic cleft palate undergoing 2-flap palatoplasty by a single surgeon were randomized to feeding from a bottle with the usual nipple (G1, N = 42) or to feeding with a spoon, cup, or syringe (G2, N = 40). Complication rates, postoperative sedative use, oral intake for the first 6 days, and relative weight gain at 1 and 2 months were compared. There were no significant complications such as bleeding or respiratory problem. The overall complication rate including wound dehiscence and oronasal fistula was similar in G1 and G2 (11.9% versus 12.5%, P = 1.000) as was postoperative sedative use and mean daily oral intake for the first 5 days. Mean intake on the sixth day was significantly higher in G1. There were no significant between-group differences in relative weight gain after 1 and 2 months. In conclusion, bottle-feeding had no adverse effect on the early postoperative course after palatoplasty including complication rate, oral intake, and weight gain. These findings suggest that an unrestricted feeding regimen is appropriate immediately after palatoplasty.

  20. Reliable? The Value of Early Postoperative Magnetic Resonance Imaging after Cerebral Cavernous Malformation Surgery.

    Science.gov (United States)

    Chen, Bixia; Göricke, Sophia; Wrede, Karsten; Jabbarli, Ramazan; Wälchli, Thomas; Jägersberg, Max; Sure, Ulrich; Dammann, Philipp

    2017-07-01

    Cerebral cavernous malformations (CCM) can cause intracerebral hemorrhage. The lesions themselves are frequently associated with perifocal hemosiderin deposits caused by repetitive microhemorrhages. Main indications for a surgical treatment are recurrent symptomatic hemorrhages or cavernoma-related epilepsy. After surgical resection, follow-up magnetic resonance imaging (MRI) is usually performed to confirm 1) the complete resection of the CCM and, especially in cases of cavernoma-related epilepsy, 2) the complete resection of the hemosiderin deposits. This prospective study evaluates the value of early postoperative MRI (within 72 hours) regarding the detection of CCM or hemosiderin remnants compared with a standard 3-6 months postoperative MRI control in 61 CCM cases. Sensitivity of early postoperative MRI for CCM remnant detection was 66.67% (95% confidence interval [CI], 9.43%-99.16%), specificity was 76.74% (95% CI, 61.37%-88.24%), positive predictive value was 16.67% (95% CI, 2.09%-48.41%), and negative predictive value was 97.06% (95% CI, 84.67%-99.93%). Because of the high number of patients who could not be evaluated because of imaging artifacts, sensitivity and specificity analysis was not performed for early postoperative MRI using T2*/susceptibility-weighted imaging to assess hemosiderin remnants. Sensitivity of early postoperative MRI for hemosiderin remnant detection using T2-weighted sequences was 85.71% (95% CI, 63.66%-96.95%), specificity was 66.67% (95% CI, 44.68%-84.37%), positive predictive value was 69.23% (95% CI, 55.45%-80.27%), and negative predictive value was 84.21% (95% CI, 64.31%-94.04%). Our data suggest that early postoperative MRI after CCM surgery is often hampered by imaging artifacts creating false-positive results and therefore ineligible for a resection control. However, reliability of a negative result on early postoperative T2-weighted MRI is relatively high regarding both CCM and hemosiderin remnants. Copyright © 2017

  1. THE PHENOTYPE AND METABOLISM RELATIONSHIP OF BLOOD NEUTROPHILS IN PATIENTS WITH WIDESPREAD PURULENT PERITONITIS IN THE POSTOPERATIVE PERIOD DYNAMICS

    Directory of Open Access Journals (Sweden)

    A. A. Savchenko

    2017-01-01

    Full Text Available The aim of the study was to examine the relationship of the phenotype and metabolism of neutrophils in patients with widespread purulent peritonitis (WPP in the dynamics of the postoperative period. The study involved 27 patients with acute surgical diseases and injuries of abdominal organs complicated by WPP. Blood sampling was performed prior to surgery (pre-operative period and at 7, 14 and 24 day post-operative period. As controls 67 respect healthy people were examined. Research blood neutrophilic granulocytes phenotype was performed by f low cytometry using a direct immunof luorescence whole peripheral blood. The levels of surface receptor expression was assessed by the mean f luorescence intensity. The NADand NADP-dependent dehydrogenases activity in the blood neutrophils studied using bioluminescence method. It was found that in patients with WPP in the preoperative period in the peripheral blood increased content of CD62L+-, HLA-DR+and CD64+-neutrophils. High levels of CD62L+-cells stored within 24 postoperative days, whereas the amount of HLA-DR+and CD64+-neutrophils on 24 postoperative day is reduced to the level of controls. The dynamics of changes in the content of CD64+-cells in the peripheral blood of patients with WPP corresponds to the expression level of CD64-receptor on the membrane of neutrophilic granulocytes. The metabolism of blood neutrophils in patients with WPP in the preand postoperative period is characterized by high intensity of the substrate stream on the citric acid cycle, low activity of NADP-dependent glutamate dehydrogenase and aerobic reaction of lactate dehydrogenase. In the preoperative period and within 14 days of the postoperative period in neutrophil granulocytes of the patients revealed high activity of anaerobic lactate dehydrogenase reaction characterized by increased activity of anaerobic glycolysis. In the late postoperative period the intensity of anaerobic energy in the neutrophils of patients with

  2. Manual vibrocompression and nasotracheal suctioning in post-operative period of infants with heart deffects

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    Maíra Seabra de Assumpção

    2013-12-01

    Full Text Available OBJECTIVE: To evaluate the impact of manual vibrocompression and nasotracheal suctioning on heart (hr and respiratory (rr rates, peripheral oxygen saturation (SpO2, pain and respiratory distress in infants in the postoperative period of a cardiac surgery. METHODS: Randomized controlled trial, in which the assessments were performed by the same physiotherapist in two moments: before and after the procedure. The infants were randomly divided into two groups: Intervention (IG, with manual chest vibrocompression, nasotracheal suctioning and resting; and Control CG, with 30 minutes of rest. Cardiorespiratory data (SpO2; hr; rr were monitored and the following scales were used: Neonatal Infant Pain Scale (NIPS, for pain evaluation, and Bulletin of Silverman-Andersen (BSA, for respiratory distress assessment. The data were verified by analysis of variance (ANOVA for repeated measures, being significant p<0.05. RESULTS: 20 infants with heart disease, ten in each group (seven acyanotic and three cyanotic were enrolled, with ages ranging from zero to 12 months. In the analysis of the interaction between group and time, there was a significant difference in the variation of SpO2 (p=0.016, without changes in the other variables. Considering the main effect on time, only rr showed a significant difference (p=0.001. As for the group main effect, there were no statistical differences (SpO2 - p=0.77, hr - p=0.14, rr - p=0.17, NIPS - p=0.49 and BSA - p=0.51 . CONCLUSIONS: The manual vibrocompression and the nasotracheal suctioning applied to infants in postoperative of cardiac surgery did not altered SpO2 and rr, and did not trigger pain and respiratory distress. [Brazilian Registry of Clinical Trials (ReBEC: REQ: 1467].

  3. Early postoperative cognitive dysfunction and postoperative delirium after anaesthesia with various hypnotics: study protocol for a randomised controlled trial - The PINOCCHIO trial

    Directory of Open Access Journals (Sweden)

    Spinelli Allison

    2011-07-01

    Full Text Available Abstract Background Postoperative delirium can result in increased postoperative morbidity and mortality, major demand for postoperative care and higher hospital costs. Hypnotics serve to induce and maintain anaesthesia and to abolish patients' consciousness. Their persisting clinical action can delay postoperative cognitive recovery and favour postoperative delirium. Some evidence suggests that these unwanted effects vary according to each hypnotic's specific pharmacodynamic and pharmacokinetic characteristics and its interaction with the individual patient. We designed this study to evaluate postoperative delirium rate after general anaesthesia with various hypnotics in patients undergoing surgical procedures other than cardiac or brain surgery. We also aimed to test whether delayed postoperative cognitive recovery increases the risk of postoperative delirium. Methods/Design After local ethics committee approval, enrolled patients will be randomly assigned to one of three treatment groups. In all patients anaesthesia will be induced with propofol and fentanyl, and maintained with the anaesthetics desflurane, or sevoflurane, or propofol and the analgesic opioid fentanyl. The onset of postoperative delirium will be monitored with the Nursing Delirium Scale every three hours up to 72 hours post anaesthesia. Cognitive function will be evaluated with two cognitive test batteries (the Short Memory Orientation Memory Concentration Test and the Rancho Los Amigos Scale preoperatively, at baseline, and postoperatively at 20, 40 and 60 min after extubation. Statistical analysis will investigate differences in the hypnotics used to maintain anaesthesia and the odds ratios for postoperative delirium, the relation of early postoperative cognitive recovery and postoperative delirium rate. A subgroup analysis will be used to categorize patients according to demographic variables relevant to the risk of postoperative delirium (age, sex, body weight and to the

  4. Acute pancreatitis in early postpartum period: A case report

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    Arun Sharma

    2013-01-01

    Full Text Available Acute pancreatitis (AP during peripartum is a rare life-threatening condition which poses as a real challenge for clinician to diagnose it early. Here, we present a case of severe AP occurring in early postpartum period.

  5. Postoperative anemia and early functional outcomes after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, Øivind; Bandholm, Thomas Quaade; Kurbegovic, Sorel

    2016-01-01

    BACKGROUND: Postoperative anemia is prevalent in fast-track hip arthroplasty (THA) where patients are mobilized and discharged early, but whether anemia impairs functional recovery after discharge has not been adequately evaluated previously. This study aimed to evaluate whether postoperative...... anemia influenced recovery of mobility and quality of life (Qol) during the first 2 weeks after discharge from THA. STUDY DESIGN AND METHODS: This was a prospective observational study in 122 THA patients more than 65 years of age. Mobility and Qol were assessed pre- and postoperatively by the 6-minute...... walk test (6MWT; primary outcome), the timed up-and-go test, and the FACT-anemia subscale. Twenty-four-hour mobility at home was assessed by activity monitoring on Days 1 to 6 after discharge. Hemoglobin (Hb) at discharge (HbD) and the Hb decrease from preoperatively (ΔHb) were compared to mobility...

  6. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery.

    Science.gov (United States)

    Costa, Altair da Silva; Bachichi, Thiago; Holanda, Caio; Rizzo, Luiz Augusto Lucas Martins De

    2016-01-01

    To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks. Relatar a experiência inicial com um sistema de drenagem digital no pós-operatório de cirurgia torácica pediátrica. Estudo observacional e prospectivo envolvendo pacientes consecutivos do ambulatório de cirurgia torácica pediátrica da instituição, com idade até 14 anos, e com indicação de ressecção pulmonar (lobectomia e/ou segmentectomia através de toracotomia poupadora muscular). Os parâmetros avaliados foram perda aérea (quantificada com o sistema digital), biossegurança, tempo de drenagem, tempo de internação e complicações. O sistema digital foi utilizado em 11 crianças, com média de idade de 5,9 ± 3,3 anos. A média do tempo de internação foi de 4,9 ± 2,6 dias, a de tempo de drenagem foi de 2,5 ± 0,7 dias, e a de volume de drenagem foi de 270,4 ± 166,7 ml. A média da perda aérea máxima foi de 92,78 ± 95,83 ml

  7. Continuous irrigation and drainage for early postoperative deep wound infection after posterior instrumented spinal fusion.

    Science.gov (United States)

    Lian, Xiao-Feng; Xu, Jian-Guang; Zeng, Bing-Fang; Liu, Xiao-Kang; Li, Hao; Qiu, Man-le; Yang, Er-Zhu

    2014-12-01

    A retrospective study of clinical cases. To evaluate the efficacy of continuous irrigation and drainage for early postoperative deep wound infection after posterior instrumented spinal fusion. Aggressive debridement and irrigation has been recommended to treat postoperative wound infections after instrumented spinal fusion. However, this method of management, indicating repeating visits to the operating room until the wound is clean enough for closure, often results in prolonged hospitalization, increased cost, and sometimes compromise of the desired outcome. We hypothesize that repeat visits to the operating room for debridements can be avoided by aggressive debridements and primary closure with continuous irrigation and drainage for postoperative wound infections. From 2004 to 2009, 23 patients with early postoperative deep wound infections after spinal fusion with instrumentation were surgically treated with thorough debridement and primary closure with continuous irrigation and drainage. All patients were followed up for 30.6 months (range, 24-54 mo). The mean duration of irrigation was 12.0 days (range, 7-16 d). In 21 patients (91.3%), the wound healed after continuous irrigation. The removal of the instrumentation or cages was not required in any case. Spinal fusion was achieved in all cases, except 1, where the patient developed a pseudoarthrosis at the L4-L5 level after L4-S1 fusion. The mean ODI for these 23 patients improved significantly from 53.4±18.7 preoperatively to 18.3±11.2 at the final follow-up visit (Pirrigation and drainage is an effective and safe method for the treatment of early postoperative deep wound infection after posterior instrumented spinal fusion.

  8. A Comparison of Postoperative Early Enteral Nutrition with Delayed Enteral Nutrition in Patients with Esophageal Cancer

    Directory of Open Access Journals (Sweden)

    Gongchao Wang

    2015-06-01

    Full Text Available We examined esophageal cancer patients who received enteral nutrition (EN to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3 based on whether they received EN within 48 h, 48 h–72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH, days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019. Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients.

  9. Differentiated method of physiotherapy for patients with congenital hip dislocation in postoperative rehabilitation period

    Directory of Open Access Journals (Sweden)

    Pozdniakova О.N.

    2011-06-01

    Full Text Available The aim of the research was to develop a new rehabilitation method for patients with congenital dislocation of hip in the late postoperative period. It is based on anatomical, physiological, pathogenetic, functional and ontogenetic foundations and prevents coxarthrosis development and progress. Materials. The data from examination and treatment of 71 patients are presented. The main group consisted of 48 children and the comparison group consisted of 23 children. Methods. Data processing was made by «Statistica 6,0» programme. Normalcy of distribution was estimated by the Shapiro-Wilktest. Hypothesis proof of two means equality was provided by the Wilcoxon signed-ranktest. Correlation analysis was made by definition of the Pearson correlation coefficient and the Spearman»s rank correlation coefficient. Rate difference was considered as a reliable rate if p<0,05. Results. According to the results, a proper short-term gait stereotype formation has been attained as opposed to the routine rehabilitation methods. Conclusion. Due to advantages of the new method, therapy efficiency is extended and reoperation risks are decreased

  10. Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay.

    Science.gov (United States)

    Souza Possa, S; Braga Amador, C; Meira Costa, A; Takahama Sakamoto, E; Seiko Kondo, C; Maida Vasconcellos, A L; Moran de Brito, C M; Pereira Yamaguti, W

    2014-01-01

    The aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period. A "before and after" study design with historical control was used. The "before" period included consecutive patients who underwent UAS before guideline implementation (intervention). The "after" period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization). There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2±4.1 days) compared to patients in the pre-intervention period (12.1±8.3 days) (p<0.05). The implementation of a physical therapy guideline for patients undergoing UAS resulted in reduced incidence of atelectasis and reduction in length of hospital stay in the postoperative period. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  11. Manual lymphatic drainage and therapeutic ultrasound in liposuction and lipoabdominoplasty post-operative period

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    Igor F. B. Masson

    2014-01-01

    Full Text Available Background: Physiotherapy in the plastic surgery post-operative (PO is essential to provide means for an adequate and fast recovery as it restores function through the use of physiotherapeutic procedures. Aim: The aim of the following study is to verify the effects of the association between the manual lymphatic drainage and the therapeutic ultrasound on pain, oedema and the tissue fibrosis in liposuction and lipoabdominoplasty PO. Design: This is a clinical trial prospective. Materials and Methods: Eighteen women aged between 18 and 60 years participated in this study, in the late PO period following lipoabdominoplasty or liposuction in the abdomen, flanks and lower trunk, which showed tissue fibrosis of the flanks and abdomen regions. They were divided into two groups: Liposuction group and lipoabdominoplasty group. A total of twelve sessions of therapeutic ultrasound followed by the manual lymphatic drainage were performed. The patients were assessed with regard to pain, oedema and tissue fibrosis in different moments: Initial assessment, during assessment and final assessment through the application of the protocol of evaluation of cysts fibrosis levels. Statistical Analysis: The test of equality for two proportions and the confidence interval test for mean to evaluate the distribution of variables. The significance level adopted for statistical tests was 5% (P < 0.05. Results: There was a statistically significant reduction of pain, swelling and tissue fibrosis in both groups. Conclusion: the association between manual lymphatic drainage and the therapeutic ultrasound reduced the swelling and the tissue fibrosis and made pain disappear in liposuction and lipoabdominoplasty PO period.

  12. MODERN PHYSICAL THERAPY IN THE EARLY POSTOPERATIVE REHABILITATION OF PATIENTS WITH CHOLELITHIASIS

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    O. A. Poddubnaya

    2013-01-01

    Full Text Available Early postoperative rehabilitation of patients with cholelithiasis is aimed at improving the function of bile secretion, adaptability and normalization of psycho-vegetative state body, which in the aggregate prevents progression of the disease and reduces the risk of postcholecystectomy violations. Use in rehabilitation activities fresh mineral water, magnetic-laser and EHF-therapy allows to receive significant improvement of the studied parameters in a significant improvement and normalization of clinical and laboratory indicators, increase adaptive capacity and normalization of psychoemotional and vegetative status of the organism. It is provides immediate high efficiency of the activities (94.7% of early postoperative rehabilitation of patients with cholelithiasis, which reduces the risk of the development of postcholecystectomy violations and prevents progression of the disease.

  13. Randomized Clinical Trial for Early Postoperative Complications of Ex-PRESS Implantation versus Trabeculectomy: Complications Postoperatively of Ex-PRESS versus Trabeculectomy Study (CPETS).

    Science.gov (United States)

    Arimura, Shogo; Takihara, Yuji; Miyake, Seiji; Iwasaki, Kentaro; Gozawa, Makoto; Matsumura, Takehiro; Tomomatsu, Takeshi; Takamura, Yoshihiro; Inatani, Masaru

    2016-05-17

    We compared early postoperative complications between trabeculectomy and Ex-PRESS implantation. Enrolled patients with 39 primary open-angle or 25 exfoliative glaucoma were randomly assigned to receive trabeculectomy (trabeculectomy group) or Ex-PRESS implantation (Ex-PRESS group). Primary outcomes were early postoperative complications, including postoperative anterior chamber inflammation, frequencies of hyphema, flat anterior chamber, choroidal detachment, hypotonic maculopathy, and the change of visual acuity. The postoperative flare values in trabeculectomy group were higher than those in the Ex-PRESS group (overall, P = 0.004; and 10 days, P = 0.02). Hyphema occurred significantly more frequently in the trabeculectomy group (P = 0.0025). There were no significant differences of the other primary outcomes between the two groups. Additionally, duration of anterior chamber opening was significantly shorter in the Ex-PRESS group (P = 0.0002) and the eyes that had iris contact with Ex-PRESS tube had significantly shallower anterior chambers than did the eyes without the iris contact (P = 0.013). The Ex-PRESS implantation prevented early postoperative inflammation and hyphema in the anterior chamber and shortened the duration of anterior chamber opening. Iris contact with the Ex-PRESS tube occurred more frequently in eyes with open-angle glaucoma and shallow anterior chambers.

  14. Intra-operative remifentanil might influence pain levels in the immediate postoperative period after major abdominal surgery

    DEFF Research Database (Denmark)

    Hansen, EG; Duedahl, Tina H; Rømsing, Janne

    2005-01-01

    Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...

  15. DYNAMICS OF WOUND HEALING AFTER SURGICAL INTERFERENCE ON PERIODONTAL TISSUES BY USING TRANSCRANIAL STIMULATION IN POSTOPERATIVE PERIOD

    OpenAIRE

    Kondrateva, A.

    2011-01-01

    Results of morphological research of marginal gingival tissues before surgical treatment and in process of wound healing in patients with traditional postoperative period and application of transcranial stimulation are presented. It is shown that transcranial stimulation accelerates wound healing and is an effective method of non-drug treatment of periodontal patients after surgery.

  16. Endoscopic Plantar Fasciotomy Improves Early Postoperative Results: A Retrospective Comparison of Outcomes After Endoscopic Versus Open Plantar Fasciotomy.

    Science.gov (United States)

    Chou, Andrew Chia Chen; Ng, Sean Yung Chuan; Koo, Kevin Oon Thien

    2016-01-01

    Plantar fasciotomy is offered to patients with recalcitrant plantar fasciitis. Few studies have characterized the functional outcomes over time for the endoscopic approach compared with the open approach. We hypothesized that patients undergoing endoscopic surgery will have better postoperative functional outcomes early in the postoperative period but equivalent long-term outcomes compared with patients undergoing open surgery. We analyzed the prospectively collected data of all patients undergoing plantar fasciotomy at our institution from December 2007 to August 2014. A total of 42 feet of 38 patients were included in the analysis. The clinical data were collected preoperatively and at 3 and 6 months and 1 year. The functional outcomes analyzed included the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale, the Medical Outcomes Study, Short-Form, 36-item Health Survey, and patient satisfaction and expectations. Patients undergoing endoscopic surgery had significantly greater American Orthopaedic Foot and Ankle Society Ankle-Hindfoot and SF-36 Health Survey scores and lower pain scores at the 3-month period. They were also significantly more likely to be satisfied with and have had their expectations met by surgery. Compared with the open approach, the patients who had undergone endoscopic plantar fasciotomy experienced significantly greater improvements in the subjective and objective functional outcomes, with less pain and greater satisfaction, and had had their expectations met earlier in the recovery period, with equivalent long-term outcomes, compared with the patients who had undergone open plantar fasciotomy.

  17. Postoperative handover

    DEFF Research Database (Denmark)

    Møller, Thea P; Madsen, Marlene D; Fuhrmann, Lone

    2013-01-01

    Current research has identified numerous safety risks related to patient handovers including postoperative handovers. During the postoperative handover and the recovery period, the patient is at risk of potential complications of surgery or anaesthesia. Furthermore, patients are subject to a down......Current research has identified numerous safety risks related to patient handovers including postoperative handovers. During the postoperative handover and the recovery period, the patient is at risk of potential complications of surgery or anaesthesia. Furthermore, patients are subject...

  18. High incidence and spontaneous resolution of mastoid effusion after craniotomy on early postoperative magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, T.; Saito, N.; Takahashi, A.; Fujimaki, H.; Tosaka, M.; Sasaki, T. [Department of Neurosurgery, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Gunma (Japan); Sato, N. [Department of Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Gunma (Japan)

    2003-07-01

    Mastoid effusion is a poorly understood complication after craniotomy. The incidence and severity of postoperative mastoid effusion were retrospectively examined on postoperative magnetic resonance (MR) images to assess any association with craniotomy procedures, time course, and neuro-otological complications. We evaluated the early postoperative MR images (within 4 days of craniotomy) and medical records of 74 patients who underwent 77 operations for the treatment of various intracranial diseases from January 2000 to December 2001. Mastoid effusion was classified into four grades: none, partial, moderate, and severe diffuse effusion in the mastoid air cells. Thirty-three follow-up MR images from 26 patients were also reviewed. Postoperative mastoid effusion occurred ipsilateral to the craniotomy site in 62 cases and contralateral in 56 cases. Mastoid effusion was significantly more severe ipsilateral than contralateral to craniotomy with exposure of the mastoid air cells (P<0.0001). There was no significant difference in severity between the contralateral and ipsilateral sides after craniotomy without mastoid air cell opening (P=0.437). Mastoid effusion following craniotomy without exposure of mastoid air cells resolved within 3 months. However, otitis media with effusion developed in six patients with severe mastoid effusion ipsilateral to craniotomy with exposure of the mastoid air cells. Mastoid effusion frequently developed on both sides. Any grade of mastoid effusion on the ipsilateral side to craniotomy without exposure of mastoid air cells, or on the contralateral side, was asymptomatic or had a benign course, and disappeared within 3 months. (orig.)

  19. Effect of early nutrition support on postoperative rehabilitation in patients with oral cancer

    Institute of Scientific and Technical Information of China (English)

    Xing-An Zhang; Xiao-Yao Tan; Lan-Fang Zhang; Hua-Dong Wang; Xin-Sheng Han; Hua-Wei Ming

    2016-01-01

    Objective:To explore the effect of early nutrition support on the postoperative nutrition metabolism and rehabilitation in patients with oral cancer.Methods:A total of 80 patients with oral cancer who were admitted in our hospital from January, 2013 to January, 2015 were included in the study, and divided into the observation group (early nutrition support) and control group (routine treatments) with 40 cases in each group. The postoperative basic nutrition requirement amount in the observation group was calculated according to Harris-Nenedict formula. The appropriate pharmaceutics and nutritional pathway were selected. The patients in the control group were given routine diets after operation. The levels of ALB, PAB, TRF, TCL, IgM, IgG, and IgA before and after operation in the two groups were compared. The body mass and wound healing in the two groups were recorded and compared.Results:The body mass and serum TRF level after operation in the observation group were slightly reduced, but were not significantly different from those before operation (P>0.05). The serum ALB, PAB, and TLC levels after operation in the observation group were significantly reduced when compared with before operation (P0.05), but the above indicators were significantly elevated after operation (P<0.05). The peripheral blood IgM, IgG, and IgA levels 1 week after operation in the observation group were significantly higher than those in the control group (P<0.05). The stage I healing rate of the surgical wound in the observation group was significantly higher than that in the control group (P<0.05). Conclusions: The early nutrition support can effectively enhance the postoperative nutrition status and immunological function in patients with oral cancer, and is beneficial for the postoperative rehabilitation.

  20. Effectiveness criteria of early rehabilitative treatment of patients with postoperative upper plexopathy

    Directory of Open Access Journals (Sweden)

    Tosheva M.l.

    2017-03-01

    Full Text Available The damage of the peripheral nervous system often acts as a complication of extensive surgical interventions on the removal of malignant breast tumors. The research goal is to evaluate the criteria for the effectiveness of early rehabilitation treatment of postoperative upper plexopathies. Material and Methods. The analyzed results of complex diagnosis and treatment of 162 women undergoing radical mastectomy for breast cancer, aged 33 to 79 years were presented. The examination included neurological examination, analysis of the psychological state using the HADS scales, Janet Taylor and HDRS, holding electroneuromyography Results. 98.76% of cases of patients after radical mastectomy for malignant breast tumors were diagnosed with unilateral shoulder complex. At 1.24% it established a bilateral lesion of the brachial plexus. The presence of pain is not a leading complaint in all cases. Among patients with classical mastectomy performed significantly prevailed damage of the intercostal nerves III and IV. In post-operative patients with the retrofit radical mastectomy neuro- and plexopathy were often diagnosed. Consent to one-stage reconstructive surgery is directly correlated with the level of education and marital status. Indicators of depression and anxiety were lower after reconstructive plastic surgery. Conclusion. The criteria for the effectiveness of early rehabilitation treatment of postoperative upper plexopathies were obtained. The decisions on the nature and scope of reconstructive and plastic surgery were established to be in conjunction with the social components of life of patients.

  1. EARLY POST-OPERATIVE WOUND INFECTION IN ORTHOPAEDIC IMPLANT SURGERY AND ITS COMPLICATION

    Directory of Open Access Journals (Sweden)

    Rajesh

    2013-03-01

    Full Text Available ABSTRACT: INTRODUCTION: Bone infections after implant surgery leading to non union and implant failure is one of the most challenging Ortho paedic complications. This study is done to find out relation of type of pathogens causing postope rative infection with that of fracture nonunion, chronic osteomylities and implant failure. METHODOLOGY: This is a retrograde study of 20 cases, in which post operative wound infe ction occurred after implant surgery from 2009 to 2012. Results: Out of 20 postoperative infect ed cases, 12 were infected by S ’ \\aureus, 2 by pseudomonas and 1 from E-coli. 5 cases had their culture sterile. Out of 12 cases infected by S. aureus 7 developed infected non union in which 4 had serious infection also leading to chronic osteomylities.5 cases of S aureus infection got cured after implant removal following union. CONCLUSION: Most of the postoperative wound infections are cause d by S. aureus. 2-.S. aureus is the commonest organism isolated from infe cted non-union. Majority have early onset of infection. 3-Early culture positive infection (w ithin seven days after surgery have poor out come.4- In our setup S Aurous strain is sensitive t o linezolid, clindamycin and vancomycin. 5- The use of ceftriaxone for preoperative surgical pro phylaxis in orthopaedic implant surgery is questionable.6- The ideal strategy for S. aureus in fected implant is lacking. By surgical debridement, culture sensitivity specific antibiotic for 6 to 8 week and retention of implant, union were not achieved in majority of cases. 7-New approach is required for prevention and management of postoperative S. aureus infected implan t

  2. Intraoperative ICG plasma disappearance rate helps to predict absence of early postoperative complications after orthotopic liver transplantation

    NARCIS (Netherlands)

    Vos, J. J.; Scheeren, T. W. L.; Lukes, D. J.; de Boer, M. T.; Hendriks, H. G. D.; Wietasch, J. K. G.

    2013-01-01

    Early postoperative complications after orthotopic liver transplantation (OLT) are a common problem in intensive care medicine. Adequate assessment of initial graft function remains difficult, however, plasma disaperance rate of indocyanine green (PDRICG) may have an additional diagnostic and

  3. Life Structure of Early Adulthood Period in Levinson's Theory

    Directory of Open Access Journals (Sweden)

    Yahya Aktu

    2016-06-01

    Full Text Available Early adulthood is one of the important defining periods considered within life-long development in the relevant literature. Early adulthood period consists of psychologically the most satisfying as well as turbulent years of ones life. Universality of theories explaining early adulthood has long been discussed. One of these theories is the Levinsons theory of individual life structure that emphasis on early adult years. In this study life structures of individuals in the early adulthood period was examined in terms of structure-building and structure-changing development tasks, regarding Levinsons theory of individual life structure. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 162-177

  4. Periodic Early Childhood Hearing Screening: The EHDI Perspective

    Science.gov (United States)

    Hoffman, Jeff; Houston, K. Todd; Munoz, Karen F.; Bradham, Tamala S.

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Concerning periodic early childhood hearing screening, 47 coordinators listed 241 items and themes were identified within each SWOT…

  5. Periodic Early Childhood Hearing Screening: The EHDI Perspective

    Science.gov (United States)

    Hoffman, Jeff; Houston, K. Todd; Munoz, Karen F.; Bradham, Tamala S.

    2011-01-01

    State coordinators of early hearing detection and intervention (EHDI) programs completed a strengths, weaknesses, opportunities, and threats, or SWOT, analysis that examined 12 areas within state EHDI programs. Concerning periodic early childhood hearing screening, 47 coordinators listed 241 items and themes were identified within each SWOT…

  6. Analysis of obese patients' medical conditions in the pre and postoperative periods of bariatric surgery.

    Science.gov (United States)

    Rêgo, Anderson DA Silva; Zulin, Aline; Scolari, Sandro; Marcon, Sônia Silva; Radovanovic, Cremilde Aparecida Trindade

    2017-01-01

    to compare the clinical conditions of obese patients in the pre and postoperative period of bariatric surgery. we carried out a descriptive, retrospective, quantitative study by consulting the charts of 134 patients who underwent bariatric surgery in the period from 2009 to 2014. We collected the data between September and November 2015. We performed a descriptive statistical analysis and comparative analysis of anthropometric, metabolic, biochemical and clinical variables, considering six months before and after surgery. the majority of the patients were female (91.8%), with a higher prevalence (35%) in the age group 18-29 years old, complete high-school education (65.6%) and grade III obesity (60.4%). Six months after surgery, weight and lipid profile reduction were significant in both genders, but the impact on biochemical, anthropometric, metabolic and clinical parameters was significant only in female subjects, with a reduction in morbidities associated with obesity, such as arterial hypertension, diabetes mellitus, dyslipidemia and metabolic syndrome and in the use of drugs to control them. bariatric surgery was effective in weight loss, with improvements in anthropometric, metabolic and biochemical parameters and in the reduction of morbidities associated with obesity. comparar as condições clínicas de pacientes obesos em período pré e pós-operatório de cirurgia bariátrica. estudo descritivo, retrospectivo, de abordagem quantitativa, por meio de consulta ao prontuário de 134 pacientes submetidos à cirurgia bariátrica no período de 2009 a 2014. Os dados foram coletados entre os meses de setembro e novembro de 2015. Foi realizada análise estatística descritiva e comparativa das variáveis antropométricas, metabólicas, bioquímicas e clínicas, considerando seis meses antes e após a cirurgia. a maioria dos pacientes era do sexo feminino (91,8%), com maior prevalência (35%) na faixa etária de 18 aos 29 anos, com ensino médio completo (65

  7. Pain locations in the postoperative period after cardiac surgery: Chronology of pain and response to treatment.

    Science.gov (United States)

    Roca, J; Valero, R; Gomar, C

    Postoperative pain after cardiac surgery (CS) can be generated at several foci besides the sternotomy. Prospective descriptive longitudinal study on the chronological evolution of pain in 11 sites after CS including consecutive patients submitted to elective CS through sternotomy. The primary endpoints were to establish the main origins of pain, and to describe its chronological evolution during the first postoperative week. Secondary endpoints were to describe pain characteristics in the sternotomy area and to correlate pain intensity with other variables. Numerical Pain Rating Scale from 0 to 10 at rest and at movement on postoperative days 1, 2, 4 and 6. Numerical Pain Rating Scale>3 was considered moderate pain. Statistical analysis consisted in Mann-Whitney U-test, a Chi-squared, a Fisher exact text and Pearson's correlations. Forty-seven patients were enrolled. In 4 of 11 locations pain was reported as Numerical Pain Rating Scale>3 (sternotomy, oropharynx, saphenectomy and musculoskeletal pain in the back and shoulders). Maximum intensity of pain on postoperative days 1 and 2 was reported in the sternotomy area, while on postoperative days 4 and 6 it was reported at the saphenectomy. Pain at rest and at movement differed considerably in the sternotomy, saphenectomy and oropharynx. Pain at back and shoulders and at central venous catheter entry were not influenced by movement. Pain in the sternotomy was mainly described as oppressive. Patients with arthrosis and younger patients presented higher intensity of pain (P=.004; P=.049, respectively). Four locations were identified as the main sources of pain after CS: sternotomy, oropharynx, saphenectomy, and back and shoulders. Pain in different focuses presented differences in chronologic evolution and was differently influenced by movement. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. [Postoperative hypothyroidism].

    Science.gov (United States)

    Olifirova, O S; Trynov, N N

    2015-01-01

    There is a number of factors such as the thyroidectomy and limiting subtotal thyroid resection against the background of euthyroidism and initial hypothyroidism (in any extent of operation) which leads to the prediction of early postoperative hypothyroidism origin during 10 days of the postoperative peri- od. The early postoperative hypothyroidism is accompanied by activation processes of lipid peroxide oxidation and at the same time by reduction of antioxidant protection.

  9. Acute Pancreatitis with Splenic Infarction as Early Postoperative Complication following Laparoscopic Sleeve Gastrectomy

    Directory of Open Access Journals (Sweden)

    Aleksandr Kalabin

    2017-01-01

    Full Text Available Obesity is becoming a global health burden along with its comorbidities. It imposes tremendous financial burden and health costs worldwide. Surgery has emerged as the definitive treatment option for morbidly obese patients with comorbidities. Laparoscopic sleeve gastrectomy is performed now more than ever making it imperative for physicians and surgeons to recognize both the common and the uncommon risks and complications associated with it. In this report we describe a rare early life-threatening postoperative complication following laparoscopic sleeve gastrectomy. From our extensive review of literature, there is no existing report of acute pancreatitis with splenic infarction postsleeve gastrectomy to this date.

  10. [The early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress].

    Science.gov (United States)

    Poddubnaia, O A; Marsheva, S I

    2013-01-01

    Early postoperative rehabilitation of the patients presenting with cholelithiasis and experiencing psychoemotional stress is designed to restore the function of bile secretion, enhance their adaptive capabilities, and normalize the psychovegetative status for the purpose of preventing further progress of the disease and reducing the risk of the development of post-cholecystectomy syndrome. The inclusion of drinking mineral water, magnetic laser therapy, and UHF therapy in the combined rehabilitative treatment of such patients results in the appreciable enhancement of all functional abilities of the body manifest as the significant improvement and normalization of clinical and laboratory characteristics (elimination of clinical symptoms of the disease, improvement of general and biochemycal parameters of peripheral blood). Simultaneously, the adaptive capabilities and the psychovegetative status of the patients improved as apparent from the increased lymphocyte count, normalization of the Kerdo and Hildebrandt indices and indices of stress level, decreased psychoemotional stress, enhancement of physical functioning characteristics. Taken together, these changes account for the high effectiveness of the above procedures of early postoperative rehabilitation of the patients presenting with cholelithiasisand experiencing psychoemotional stress (94.7%).

  11. The Effects of Early Post-Operative Soluble Dietary Fiber Enteral Nutrition for Colon Cancer

    Directory of Open Access Journals (Sweden)

    Rui Xu

    2016-09-01

    Full Text Available We examined colon cancer patients who received soluble dietary fiber enteral nutrition (SDFEN to evaluate the feasibility and potential benefit of early SDFEN compared to EN. Sixty patients who were confirmed as having colon cancer with histologically and accepted radical resection of colon cancer were randomized into an SDFEN group and an EN group. The postoperative complications, length of hospital stay (LOH, days for first fecal passage, and the difference in nutritional status, immune function and inflammatory reaction between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test and the chi square test. Statistical significance was defined as p < 0.05. After the nutrition support, differences in the levels of albumin, prealbumin and transferrin in each group were not statistically significant (p > 0.05; the levels of CD4+, IgA and IgM in the SDFEN group were higher than that of the EN group at seven days (p < 0.05; the levels of TNF-α and IL-6 in the SDFEN group were lower than that of the EN group at seven days (p < 0.05; and patients in the SDFEN group had a significantly shorter first flatus time than the EN group (p < 0.05. Early post-operative SDFEN used in colon cancer patients was feasible and beneficial in immune function and reducing inflammatory reaction, gastrointestinal function and speeding up the recovery.

  12. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

    OpenAIRE

    2015-01-01

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal ...

  13. Validation of pulse oximetry for monitoring of hypoxaemic episodes in the late postoperative period

    DEFF Research Database (Denmark)

    Stausholm, K; Rosenberg-Adamsen, S; Edvardsen, L;

    1997-01-01

    We monitored 12 patients undergoing major abdominal surgery using a pulse oximeter (Nellcor N-200) and a transcutaneous oxygen tension monitor (TINA, Radiometer A/S) on the second or third night after operation. Of the shortest hypoxaemic episodes measured with the pulse oximeter (... duration), 78% also occurred in the transcutaneous oxygen tension measurement. Episodes of longer duration (> or = 1 min duration on the pulse oximeter) were, in 95% of cases, reflected in the transcutaneous oxygen tension measurement also. Thus postoperative episodic desaturations lasting > or = 1 min...

  14. Do the different types of renal surgery impact the quality of life in the postoperative period?

    DEFF Research Database (Denmark)

    Azawi, Nessn H.; Tesfalem, H; Dahl, C

    2015-01-01

    PURPOSE: Because more than 70 % of patients with localized tumors experience 10 years of cancer-specific survival, their quality of life (QoL) after surgery is important. The aim of this study was to explore the impact of the type of surgery (partial vs. total nephrectomy) and the postoperative...... outcome on the QoL of patients with renal cancer. METHODS: A total of 205 patients underwent partial or total nephrectomy at the Department of Urology, Roskilde Hospital, between February 2008 and June 2013 and survived until the time of the survey. The European Organization for Research and Treatment...

  15. Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-xin; GUO Sheng-jie; LIU Qing; TANG Jing; LI Yu-jun

    2009-01-01

    Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.

  16. Early postoperative fluoroquinolone use is associated with an increased revision rate after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Cancienne, Jourdan M; Brockmeier, Stephen F; Rodeo, Scott A; Young, Chris; Werner, Brian C

    2017-07-01

    To evaluate the association of postoperative fluoroquinolone use following arthroscopic primary rotator cuff repair with failure requiring revision rotator cuff repair. An insurance database was queried for patients undergoing rotator cuff repair from 2007 to 2015. These patients were divided into three groups: (1) patients prescribed fluoroquinolones within 6 months postoperatively (divided into 0-2, 2-4, and 4-6 months), (2) a matched negative control cohort of patients not prescribed fluoroquinolones, and (3) a matched positive control cohort of patients prescribed fluoroquinolones between 6 and 18 months following rotator cuff repair. Rates of failure requiring revision rotator cuff repair were compared within 2 years. A total of 1292 patients were prescribed fluoroquinolones within 6 months after rotator cuff repair, including 442 within 2 months, 433 within 2 to 4 months, and 417 within 4 to 6 months, and were compared to 5225 matched negative controls and 1597 matched positive controls. The rate of revision rotator cuff repair was significantly higher in patients prescribed fluoroquinolones within 2 months (6.1 %) compared to matched negative (2.2 %, P = 0.0009) and positive controls (2.4 %, P = 0.0026). There were no significant differences in the rate of revision rotator cuff repair when fluoroquinolones were prescribed >2 months after rotator cuff repair. Early use of fluoroquinolones following rotator cuff repair was independently associated with significantly increased rates of failure requiring revision rotator cuff repair. This is the first clinical study examining the association of postoperative fluoroquinolone use with failure following arthroscopic rotator cuff repair. III.

  17. [High thoracic epidural analgesia in the postoperative period after correction of congenital heart defects in children].

    Science.gov (United States)

    Slin'ko, S K

    1999-01-01

    The effects and side effects of thoracic epidural analgesia on the respiratory response, awakening time, and cooperation with nurses were studied. Forty children received epidural analgesia after open-heart surgery. Lidocaine was injected in a dose of 1.5-2 mg/kg every 1.5-2 h. Controls (16 pts) received intravenous fentanyl + diazepam analgesia. Respiratory response and awakening were significantly earlier (p < 0.001) in the epidural group. Cooperation with nurses was much better in this group, too. No side effects were observed in the epidural group. Therefore, thoracic epidural analgesia is a safe and effective method of postoperative analgesia for children subjected to open-heart surgery.

  18. Early post-operative relief of pain and shivering using diclofenac suppository versus intravenous pethidine in spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Ali Janpour Ebrahim

    2014-01-01

    Full Text Available Background: Pain and shivering are two challenging components in the post operative period. Many drugs were used for prevention and treatment of them. The aim of this study was to compare the effects of prophylactic prescription of diclofenac suppository versus intravenous (IV pethidine in spinal anesthesia. Materials and Methods: We conducted a multi central, prospective, double-blind, randomized clinical trial on a total of 180 patients who were scheduled for surgery under spinal anesthesia including 60 patients in three groups. Patients were randomly allocated to receive 100 mg sodium diclofenac suppository or 30 mg IV pethidine or placebo. Categorical and continuous variables were analyzed by Chi-square test, t-test, Mann-Whitney and ANOVA or Kruskal-Wallis tests. Results: There was no statistical difference with regard to patient characteristics and hemodynamic indices among the three groups. Nine (15%, 10 (16.65% and 24 (40% of patients in diclofenac, pethidine and control groups reported pain and 2, 2, 7 patients received treatment due to it, respectively (P = 0.01. Prevalence of shivering in pethidine group and diclofenac group was the same and both of them were different from the control group (P < 0.001. Pruritus was repetitive in the pethidine group and was statistically significant (P = 0.036 but, post-operative nausea and vomiting was not significantly different among groups. Conclusion: A single dose of sodium diclofenac suppository can provide satisfactory analgesia immediately after surgery and decrease shivering without remarkable complications. This investigation highlights the role of pre-operative administration of a single dose of rectal diclofenac as a sole analgesic for early post-operative period.

  19. Accuracy of transcutaneous laryngeal ultrasound for detecting vocal cord paralysis in the immediate postoperative period after total thyroidectomy.

    Science.gov (United States)

    de Miguel, Marcos; Peláez, Eva M; Caubet, Enric; González, Óscar; Velasco, Mercedes; Rigual, Lidia

    2017-06-14

    Transcutaneous laryngeal ultrasound (TLUS) has emerged as a promising imaging tool for vocal cord examination in patients undergoing thyroid surgery. The focus of this prospective, double-blind study was to assess the accuracy of TLUS in the diagnosis of vocal cord paralysis in the immediate postoperative period following total thyroidectomy. The study included 93 patients undergoing total thyroidectomy and assessed by videostrobolaryngoscopy (VSL) and TLUS. VSL was carried out the day before surgery and was repeated at 4 days postoperatively. TLUS was performed before surgery in the preanesthesia holding area and at completion of the procedure in the postanesthesia care unit. The preoperative and postoperative TLUS results were correlated with those of VSL. The statistical analysis included the sensitivity, specificity, positive predictive value, and negative predictive value (with 95% CI) of TLUS for detecting vocal cord paralysis. The visualization rate associated with TLUS was 93%. The total vocal cord paralysis rate was 16.1%. The performance of TLUS for diagnosing this condition was as follows: sensitivity, 93.3% (95% CI, 77.3%-100%); specificity 96.1% (95% CI, 91.2%-100%); positive predictive value, 82.3% (95% CI, 61.2%-100%); negative predictive value, 98.6% (95%CI, 95.4%-100%). TLUS may be a suitable technique for detecting vocal cord paralysis shortly after total thyroidectomy.

  20. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

    Science.gov (United States)

    Subhas, Gokulakkrishna; Gupta, Anupam; Sabir, Mubashir; Mittal, Vijay K

    2015-01-01

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on post-operative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement. PMID:26649158

  1. Gastric remnant twist in the immediate post-operative period following laparoscopic sleeve gastrectomy

    Institute of Scientific and Technical Information of China (English)

    Gokulakkrishna; Subhas; Anupam; Gupta; Mubashir; Sabir; Vijay; K; Mittal

    2015-01-01

    Twist of stomach remnant post sleeve gastrectomy is a rare entity and difficult to diagnose pre-operatively. We are reporting a case of gastric volvulus post laparoscopic sleeve gastrectomy, which was managed conservatively. A 38-year-old lady with a body mass index of 54 underwent laparoscopic sleeve gastrectomy. Sleeve gastrectomy was performed over a 32 French bougie using Endo-GIA tri-stapler. On post-operative day 1, patient had nausea and non-bilious vomiting. An upper gastrointestinal gastrografin study on postoperative days 1 and 2 revealed collection of contrast in the fundic area of stomach with poor flow distally, and she vomited gastrograffin immediately post procedure. With the suspicion of a stricture in the mid stomach as the cause, the patient was taken back for a exploratory laparoscopy and intra-operative endoscopy. We found a twist in the gastric tube which was too tight for the endoscope to pass through. This was managed conservatively with a long stent to keep the gastric tube straight and patent. The stent was discontinued in 7 d and the patient did well. In laparoscopic sleeve gastrectomy the stomach is converted into a tube and is devoid of its supports. If the staples fired are not aligned appropriately, it can predispose this stomach tube to undergo torsion along its long axis. Such a twist can be avoided by properly aligning the staples and by placing tacking sutures to the omentum and new stomach tube. This twist is a functional obstruction rather than a stricture; thus, it can be managed by endoscopy and stent placement.

  2. Early individualised manipulative rehabilitation following lumbar open laser microdiscectomy improves early post-operative functional disability: A randomized, controlled pilot study.

    Science.gov (United States)

    Kim, Byungho J; Ahn, Junghoon; Cho, Heecheol; Kim, Dongyun; Kim, Taeyeong; Yoon, Bumchul

    2016-01-01

    Lumbar open laser microdiscectomy has been shown to be an effective intervention and safe approach for lumbar disc prolapse. However early post-operative physical disability affecting daily activities have been sporadically reported. To evaluate the feasibility of using early individualised manipulative rehabilitation to improve early post-operative functional disability following lumbar discectomy. Randomised controlled pilot trial. Setting at a major metropolitan spine surgery hospital. Twenty-one patients aged 25-69 years who underwent lumbar microdiscectomy were randomised to either the manipulative rehabilitation treatment group or the active control group. Rehabilitation was initiated 2-3 weeks after surgery, twice a week for 4 weeks. Each session was for 30 minutes. Primary outcomes were the Roland-Morris disability questionnaire and the visual analogue pain scale. Outcome measures were assessed at baseline and post-intervention. Early post-operative physical disability was improved with a 55% reduction by early individualised manipulative rehabilitation, compared to that of control care with a 5% increase. Early post-operative residual leg pain decreased with rehabilitation (55%) and control care (9%). This pilot study supports the feasibility of a future definitive randomised control trial and indicates this type of rehabilitation may be an important option for post-operative management after spinal surgery.

  3. Early ambulation and prevention of post-operative thrombo-embolic risk.

    Science.gov (United States)

    Talec, P; Gaujoux, S; Samama, C M

    2016-12-01

    The prevention of post-operative risk of venous thrombo-embolism (VTE) is of fundamental importance, but preventive methods have progressed with the introduction of direct oral anticoagulants (DOAC), the development of ambulatory surgery and enhanced recovery programs (ERP) after surgery. Surgery is, inherently a trigger for venous thrombo-embolic disease, as is prolonged immobilization. However, the risk of VTE is very low following ambulatory surgery, especially in this selected population. ERP, consists of a set of measures to optimize the patient's peri-operative management while reducing length of stay, costs and morbidity and mortality; one measure is the encouragement of early ambulation. This will undoubtedly have an impact on the incidence of VTE and lessen the need for prolonged thrombo-prophylaxis.

  4. PATIENT’S TOLERANCE OF PHYSICAL EFFORT AFTER MITRAL VALVE REPLACEMENT IN DURABLE POST-OPERATIVE PERIODS

    Directory of Open Access Journals (Sweden)

    S.I. Kitavina

    2008-06-01

    Full Text Available It is reasonable for the replacement findings of the mitral valve in case of durable post-operative periods, to evaluate patient’s tolerance of physical effort, which results, firstofall, in the condition of the cardio-vascular system. Taking into consideration the seriousness of patients' condition of understudy, data about physical tolerance maybe received with the help of dosed physical effort. A group of factors, also choice of mitral valve replacement method, influences on degree of patients' physical effort. The more preferable method of correction of mitral valve disease in case of prosthesis is a preservation of subvalvular structures of mitral valve.

  5. Differentially expressed proteins on postoperative 3 days healing in rabbit Achilles tendon rupture model after early kinesitherapy

    Institute of Scientific and Technical Information of China (English)

    Ainuer Jialili; Haxiaobieke Kasimu; Jiasharete Jielile; Shajidan Abudoureyimu; Gulnur Sabirhazi; Darebai Redati; Bai Jingping; Bin Liang; Sailike Duisabai; Jiangaguli Aishan

    2011-01-01

    Objectives: Surgical repair of Achilles tendon (AT) rupture should immediately be followed by active tendon mobilization. The optimal time as to when the mobilization should begin is important yet controversial.Early kinesitherapy leads to reduced rehabilitation period.However, an insight into the detailed mechanism of this process has not been gained. Proteomic technique can be used to separate and purify the proteins by differential expression profile which is related to the function of different proteins, but research in the area ofproteomic analysis of AT 3 days after repair has not been studied so far.Methods: Forty-seven New Zealand white rabbits were randomized into 3 groups. Group A (immobilization group,n=16) received postoperative cast immobilization; Group B (early motion group, n= 16) received early active motion treatments immediately following the repair of AT rupture from tenotomy. Another 15 rabbits served as control group (Group C). The AT samples were prepared 3 days following the microsurgery. The proteins were separated employing twodimensional polyacrylamide gel electrophoresis (2D-PAGE).PDQuest software version 8.0 was used to identify differentially expressed proteins, followed by peptide mass fingerprint (PMF) and tandem mass spectrum analysis, using the National Center for Biotechnology Information (NCBI) protein database retrieval and then for bioinformatics analysis.Results: Amean of 446.33,436.33 and 462.67 protein spots on Achilles tendon samples of 13 rabbits in Group A,14 rabbits in Group B and 13 rabbits in Group C were successfully detected in the 2D-PAGE. There were 40, 36 and 79unique proteins in Groups A, B and C respectively. Some differentially expressed proteins were enzyme with the gel,matrix-assisted laser-desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We successfully identified 9 and 11 different proteins in Groups A and B,such as GAPDH, phosphoglycerate kinase 1, pro-alpha-1type 1 collagen

  6. The oldest articulated chondrichthyan from the Early Devonian period.

    Science.gov (United States)

    Miller, Randall F; Cloutier, Richard; Turner, Susan

    2003-10-01

    Chondrichthyans (including living sharks, skates, rays and chimaeras) have a fossil record of scales and dermal denticles perhaps dating back to the Late Ordovician period, about 455 million years ago. Their fossil tooth record extends to the earliest Devonian period, almost 418 million years ago, whereas the oldest known articulated shark remains date from the Early Devonian period, about 394 million years ago. Here we report the discovery of an articulated shark that is almost 409 million years old from the Early Devonian (early Emsian) period of New Brunswick, Canada. The specimen, identified as Doliodus problematicus (Woodward), sheds light on the earliest chondrichthyans and their interrelationships with basal jawed vertebrates. This species has been truly problematic. Previously known only from isolated teeth, it has been identified as an acanthodian and a chondrichthyan. This specimen is the oldest shark showing the tooth families in situ, and preserves one of the oldest chondrichthyan braincases. More notably, it shows the presence of paired pectoral fin-spines, previously unknown in cartilaginous fishes.

  7. [Sudden motor and sensorial loss due to retroperitoneal hematoma during postoperative periods: a case report].

    Science.gov (United States)

    Şen, Pelin; Gültekin, Havva Gül; Caymaz, İsmail; Özel, Ömer; Türköz, Ayda

    A 68 year-old male patient was hospitalized for radical prostatectomy. He had no abnormal medical history including neurological deficit before the operation. Prior to general anesthesia, an epidural catheter was inserted in the L3-4 interspace for intraoperative and postoperative analgesia. After surgery for nine hours, he developed confusion and flaccid paralysis of bilateral lower extremities occurred. No pathology was detected from cranial computed tomography and diffusion magnetic resonance imaging no pathology was detected. His thoracic/lumbar magnetic resonance imaging. Intraabdominal pressure was shown to be 25mmHg, and abdominal ultrasonography revealed progression in the inflammation/edema/hematoma in the perirenal region. The Bromage score was back to 1 in the right foot on the 24th hour and in the left foot on the 26th hour. Paraplegia developed in patients after epidural infusion might be caused by potentiated local anesthetic effect due to retroperitoneal hematoma and/or elevated intra-abdominal pressure. Copyright © 2016 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  8. Gardens, knowledge and the sciences in the early modern period

    CERN Document Server

    Remmert, Volker; Wolschke-Bulmahn, Joachim

    2016-01-01

    This volume focuses on the outstanding contributions made by botany and the mathematical sciences to the genesis and development of early modern garden art and garden culture. The many facets of the mathematical sciences and botany point to the increasingly “scientific” approach that was being adopted in and applied to garden art and garden culture in the early modern period. This development was deeply embedded in the philosophical, religious, political, cultural and social contexts, running parallel to the beginning of processes of scientization so characteristic for modern European history. This volume strikingly shows how these various developments are intertwined in gardens for various purposes.

  9. Increased risk of intraoperative and early postoperative periprosthetic femoral fracture with uncemented stems

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C.; Solgaard, Søren

    2017-01-01

    fractures ≤ 90 days postoperatively was 2.1% (n = 150). 70 fractures were detected intraoperatively (46 required osteosynthesis). 51 postoperatively detected fractures occurred without trauma (42 of which were reoperated) and 29 were postoperative fall-related fractures (27 of which were reoperated). 134...

  10. The influence of informal caregivers on the rehabilitation of the elderly in the postoperative period of proximal femoral fracture.

    Science.gov (United States)

    Rocha, Suelen Alves; Avila, Marla Andréia Garcia de; Bocchi, Silvia Cristina Mangini

    2016-03-01

    Objective To analyze the influence of informal caregivers on the functional independence of older adults in the postoperative period of proximal femoral fracture due to falls. Method It is an integrative review of a corpus for analysis that gathered 23 articles, between 2002 and 2012, from databases "Literatura Latino-Americana e do Caribe em Ciências da Saúde" (Latin-American and Caribbean Health Sciences Literature in Health Sciences), Cumulative Index to Nursing and Allied Health Literature, US National Library of Medicine and Scopus. Results There was a predominance of studies by Chinese authors and nurses. The analysis of the studies evidenced that falls followed by fractures lead to dependence of older adults and, consequently, an overload to caregivers. Moreover, older adults and caregivers showed a need for support in the rehabilitation process. Conclusions Informal caregivers still need to be included in care planning and to be qualified for such care by health professionals, since they positively influence functional independence in the postoperative period.

  11. Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

    Energy Technology Data Exchange (ETDEWEB)

    Kim Ju Ree; Lee, Sang Hoon [Cheil General Hospital and Women' s Healthcare Center, Kwandong University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the fi nal Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

  12. Administration of Mycobacterium phlei cell wall-nucleic acid complex in the immediate postoperative period for the treatment of non-muscle-invasive bladder cancer

    Science.gov (United States)

    Morales, Álvaro

    2016-01-01

    Introduction: This review sought to investigate the safety of intravesical administration of Mycobacterium phlei cell wall-nucleic acid (MCNA) in the immediate postoperative period after biopsy/resection for non-muscle-invasive bladder cancer (NMIBC). Methods: Patients with NMIBC who failed bacillus Calmette-Guérin (BCG) therapy and at high risk of recurrence and progression participated in this study. Treatment involved an induction phase of six weeks and maintenance of three weekly instillations every six months for two years. Biopsies were mandatory at six months and resections/biopsies as indicated. Of the 129 patients enrolled, 18 (14%) received one or more instillations of MCNA within 24 hours of an endoscopic procedure for a total of 32 instillations. Results: Fourteen patients (78%) received MCNA in the immediate postoperative period. Two (11%) received treatment the day after surgery, but a second treatment immediately after a transurethral resection of the bladder tumour (TURBT). The remaining two patients received an instillation each the day after surgery. Adverse events (AEs) occurred in 31.3% of those treated immediately after the procedure; they were mild, limited to the lower urinary tract, and not drug-related. Only one patient experienced systemic symptoms of moderate severity. None of the AEs resulted in postponement of treatment. There were no AEs among those receiving MCNA the day after surgery. Conclusions: The dual mechanism of action of MCNA suggests that early treatment would take advantage of its chemotherapeutic (pro-apoptotic) activity. Concerns about early administration due to the presence of live bacteria are circumvented with this sterile preparation. These preliminary results warrant further investigation to confirm the safety of perioperative administration of MCNA. PMID:27800054

  13. Influence of yoga on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Rao Raghavendra

    2008-01-01

    Full Text Available Context : Pre- and postoperative distress in breast cancer patients can cause complications and delay recovery from surgery. Objective : The aim of our study was to evaluate the effects of yoga intervention on postoperative outcomes and wound healing in early operable breast cancer patients undergoing surgery. Methods : Ninety-eight recently diagnosed stage II and III breast cancer patients were recruited in a randomized controlled trial comparing the effects of a yoga program with supportive therapy and exercise rehabilitation on postoperative outcomes and wound healing following surgery. Subjects were assessed at the baseline prior to surgery and four weeks later. Sociodemographic, clinical and investigative notes were ascertained in the beginning of the study. Blood samples were collected for estimation of plasma cytokines-soluble Interleukin (IL-2 receptor (IL-2R, tumor necrosis factor (TNF-alpha and interferon (IFN-gamma. Postoperative outcomes such as the duration of hospital stay and drain retention, time of suture removal and postoperative complications were ascertained. We used independent samples t test and nonparametric Mann Whitney U tests to compare groups for postoperative outcomes and plasma cytokines. Regression analysis was done to determine predictors for postoperative outcomes. Results : Sixty-nine patients contributed data to the current analysis (yoga: n = 33, control: n = 36. The results suggest a significant decrease in the duration of hospital stay ( P = 0.003, days of drain retention ( P = 0.001 and days for suture removal ( P = 0.03 in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels following surgery in the yoga group ( P < 0.001, as compared to the controls. Regression analysis on postoperative outcomes showed that the yoga intervention affected the duration of drain retention and hospital stay as well as TNF alpha levels. Conclusion : The results suggest

  14. Procalcitonin, interleukin 6 and systemic inflammatory response syndrome (SIRS): early markers of postoperative sepsis after major surgery.

    Science.gov (United States)

    Mokart, D; Merlin, M; Sannini, A; Brun, J P; Delpero, J R; Houvenaeghel, G; Moutardier, V; Blache, J L

    2005-06-01

    Patients who undergo major surgery for cancer are at high risk of postoperative sepsis. Early markers of septic complications would be useful for diagnosis and therapeutic management in patients with postoperative sepsis. The aim of this study was to investigate the association between early (first postoperative day) changes in interleukin 6 (IL-6), procalcitonin (PCT) and C-reactive protein (CRP) serum concentrations and the occurrence of subsequent septic complications after major surgery. Serial blood samples were collected from 50 consecutive patients for determination of IL-6, PCT and CRP serum levels. Blood samples were obtained on the morning of surgery and on the morning of the first postoperative day. Sixteen patients developed septic complications during the first five postoperative days (group 1), and 34 patients developed no septic complications (group 2). On day 1, PCT and IL-6 levels were significantly higher in group 1 (P-values of 0.003 and 0.006, respectively) but CRP levels were similar. An IL-6 cut-off point set at 310 pg ml(-1) yielded a sensitivity of 90% and a specificity of 58% to differentiate group 1 patients from group 2 patients. When associated with the occurrence of SIRS on day 1 these values reached 100% and 79%, respectively. A PCT cut-off point set at 1.1 ng ml(-1) yielded a sensitivity of 81% and a specificity of 72%. When associated with the occurrence of SIRS on day 1, these values reached 100% and 86%, respectively. PCT and IL-6 appear to be early markers of subsequent postoperative sepsis in patients undergoing major surgery for cancer. These findings could allow identification of postoperative septic complications.

  15. Influence of early postoperative complication on the operative results in elderly intertrochanteric fractured patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective:Early complications were analyzed in those with Evans Ⅲ type of intertrochanteric fracture treated with operation or nonoperative approaches. Methods:59 cases with Evans Ⅲ type of intertrochanteric fracture between June, 1999 to July, 2006 were admitted in our department. 38 patients were complicated with cardiovascular diseases, such as hypertension and arrhythmia. All the cases were operated. Results:58 cases were operated successfully. One died of pulmonary interstitial fibrosis. Grade data of different age brackets indicated that early infective complications had apparent differences between the operation and the control group. Compared with the control group, the operation group had benefits such as fewer complications, especially the infective complications, and incidence of lower extremities venous thrombosis, and the results showed notable differences. Conclusion:In elderly patients with Evans Ⅲ type of intertrochanteric fracture, the incidence of pulmonary infection was the highest. Venous thrombosis in lower extremities was the most serious complication. So it will be helpful to perform the quadriceps femories function exercise. The postoperative effect is also related with the operation approach.

  16. STUDY ON EARLY PHYSICAL THERAPY IN POSTOPERATIVE INTERVENTION ON CHILDREN WITH MYELOMENINGOCELE

    Directory of Open Access Journals (Sweden)

    Necula Dana

    2015-10-01

    Full Text Available Objectives targeted in early intervention thru physical therapy postoperative, to recover the functional for the neuro-musculo-arthropod kinetic system and prevent bone deformities and dysfunctions of micturition and defecation sequlae. Materials and methods The study included 12 children aged 0-5 years, 7 boys and 5 girls that followed at least 12 months of recovery. The group included children with hydrocephalus associated with myelomeningocele and equinus foot lime, lime myelomeningocele and equinus foot (with varying degrees of paraplegia mono or bilateral and children with myelomeningocele and only urinary dysfunction and lower limb hypotonia. Results and discussion: Initial tests showed the presence of lumbar neurological paraplegia disorders with symptoms as urination and defecation dysfunction, impaired neuromotor development as a result of hydrocephalus, mono or bilateral foot equine deviated lime and dysplasia of the hip joint. Conclusions: Early physiotherapy intervention after complex neurosurgical intervention has an important role in regaining muscle tone, joint mobility and muscle strength in the lower body, improving and regaining alignment vault planting. Also we mention prophylaxis of the urinating device and prevention of deficiencies in postural alignment of the spine and pelvis.

  17. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer

    DEFF Research Database (Denmark)

    Bendixen, Morten; Jørgensen, Ole Dan; Kronborg, Christian

    2016-01-01

    (1:1) to lobectomy via four-port VATS or anterolateral thoracotomy. After surgery, we applied identical surgical dressings to ensure masking of patients and staff. Postoperative pain was measured with a numeric rating scale (NRS) six times per day during hospital stay and once at 2, 4, 8, 12, 26...... died during the follow-up period (three in the VATS group and six in the thoracotomy group). INTERPRETATION: VATS is associated with less postoperative pain and better quality of life than is anterolateral thoracotomy for the first year after surgery, suggesting that VATS should be the preferred......BACKGROUND: Video-assisted thoracoscopic surgery (VATS) is used increasingly as an alternative to thoracotomy for lobectomy in the treatment of early-stage non-small-cell lung cancer, but remains controversial and worldwide adoption rates are low. Non-randomised studies have suggested that VATS...

  18. Which frailty measure is a good predictor of early post-operative complications in elderly hip fracture patients?

    Science.gov (United States)

    Kua, Joanne; Ramason, Rani; Rajamoney, Ganesan; Chong, Mei Sian

    2016-05-01

    Current pre-operative assessment using, e.g., American Society of Anaesthesiologists score does not accurately predict post-operative outcomes following hip fracture. The multidimensional aspect of frailty syndrome makes it a better predictor of post-operative outcomes in hip fracture patients. We aim to discover which frailty measure is more suitable for prediction of early post-operative outcomes in hip fracture patients. Hundred consecutive hip fracture patients seen by the orthogeriatric service were included. We collected baseline demographic, functional and comorbidity data. In addition to ASA, a single blinded rater measured frailty using two scales (i) modified fried criteria (MFC) and (ii) reported edmonton frail scale (REFS). The MFC adopted a surrogate gait speed measure with two questions: (i) Climbing one flight of stairs and (ii) Ability to walk 1 km in the last 2 weeks. Immediate post-operative complications during the inpatient stay were taken as the primary outcome measure. Subjects had mean age of 79.1 ± 9.6 years. Sixty six percent were female and 87 % of Chinese ethnicity. Eighty two percent had surgery, of which 37.8 % (n = 31) had post-operative complications. Frailty, measured by MFC (OR 4.46, p = 0.04) and REFS (OR 6.76, p = 0.01) were the only significant predictors of post-operative complications on univariate analyses. In the hierarchical logistic regression model, only REFS (OR 3.42, p = 0.04) predicted early post-operative complications. At 6 months follow-up, REFS significantly predicted [basic activities of daily living (BADL)] function on the multivariable logistic regression models. (BADL, OR 6.19, p = 0.01). Frailty, measured by the REFS is a good predictor of early post-operative outcomes in our pilot study of older adults undergoing hip surgery. It is also able to predict 6 months BADL function. We intend to review its role in longer-term post-operative outcomes and validate its potential role in pre

  19. Early Postoperative Nociceptive Threshold and Production of Brain-Derived Neurotrophic Factor Induced by Plantar Incision Are Not Influenced with Minocycline in a Rat: Role of Spinal Microglia

    Directory of Open Access Journals (Sweden)

    Eiji Masaki

    2016-03-01

    Full Text Available Background: Brain-derived neurotrophic factor (BDNF from spinal microglia is crucial for aberrant nociceptive signaling in several pathological pain conditions, including postoperative pain. We assess the contribution of spinal microglial activation and associated BDNF overexpression to the early post-incisional nociceptive threshold. Methods: Male Sprague-Dawley rats were implanted with an intrathecal catheter. A postoperative pain model was established by plantar incision. Thermal and mechanical nociceptive responses were assessed by infrared radiant heat and von Frey filaments before and after plantar incision. Rats were injected intrathecally the microglial activation inhibitor minocycline before incision, 24 h after incision, or both. Other groups were subjected to the same treatments and the L4-L5 spinal cord segment removed for immunohistochemical analysis of microglia activation and BNDF expression. Results: Plantar incision reduced both thermal latency and mechanical threshold, indicating thermal hypersensitivity and mechanical allodynia. Minocycline temporally reduced thermal withdrawal latency but had no effect on mechanical withdrawal threshold, spinal microglial activity, or dorsal horn BDNF overexpression during the early post-incision period. Conclusion: These results suggest that spinal microglia does not contribute substantially to post-incisional nociceptive threshold. The BDNF overexpression response that may contribute to postoperative hyperalgesia and allodynia is likely derived from other sources.

  20. Complications after emergency laparotomy beyond the immediate postoperative period - a retrospective, observational cohort study of 1139 patients

    DEFF Research Database (Denmark)

    Toft Tengberg, Line; Cihoric, M; Foss, N B;

    2016-01-01

    %) deaths occurred between 72 h and 30 days after surgery; all of these patients had complications, indicating that there is a prolonged period with a high frequency of complications and mortality after emergency laparotomy. We conclude that peri-operative, enhanced recovery care bundles for preventing......Mortality and morbidity occur commonly following emergency laparotomy, and incur a considerable clinical and financial healthcare burden. Limited data have been published describing the postoperative course and temporal pattern of complications after emergency laparotomy. We undertook...... a retrospective, observational, multicentre study of complications in 1139 patients after emergency laparotomy. A major complication occurred in 537/1139 (47%) of all patients within 30 days of surgery. Unadjusted 30-day mortality was 20.2% and 1-year mortality was 34%. One hundred and thirty-seven of 230 (60...

  1. The postoperative stomach

    Energy Technology Data Exchange (ETDEWEB)

    Woodfield, Courtney A. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Levine, Marc S. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States)]. E-mail: marc.levine@uphs.upenn.edu

    2005-03-01

    Gastric surgery may be performed for the treatment of a variety of benign and malignant diseases of the upper gastrointestinal tract, including peptic ulcers and gastric carcinoma. Radiographic studies with water-soluble contrast agents often are obtained to rule out leaks, obstruction, or other acute complications during the early postoperative period. Barium studies may also be obtained to evaluate for anastomotic strictures or ulcers, bile reflux gastritis, recurrent tumor, or other chronic complications during the late postoperative period. Cross-sectional imaging studies such as CT are also helpful for detecting abscesses or other postoperative collections, recurrent or metastatic tumor, or less common complications such as afferent loop syndrome or gastrojejunal intussusception. It is important for radiologists to be familiar not only with the radiographic findings associated with these various abnormalities but also with the normal appearances of the postoperative stomach on radiographic examinations, so that such appearances are not mistaken for pseudoleaks or other postoperative complications. The purpose of this article is to describe the normal postsurgical anatomy after the most commonly performed operations (including partial gastrectomy, esophagogastrectomy and gastric pull-through, and total gastrectomy and esophagojejunostomy) and to review the acute and chronic complications, normal postoperative findings, and major abnormalities detected on radiographic examinations in these patients.

  2. Early post-operative results of percutaneous needle fasciotomy in 451 patients with Dupuytren disease.

    Science.gov (United States)

    Molenkamp, Sanne; Schouten, Tanneke A M; Broekstra, Dieuwke C; Werker, Paul M N; Moolenburgh, J Daniel

    2017-02-13

    Percutaneous needle fasciotomy (PNF) is a minimally invasive treatment modality for Dupuytren disease (DD). In this study we analyzed the efficacy and complication-rate of PNF using a statistical method that takes the multi-level structure of data, regarding multiple measurements from the same patients, into account. The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy (PNF) were analyzed retrospectively. We described the early postoperative results of PNF and we applied linear mixed models to compare mean correction of PED between joints and efficacy of primary versus secondary PNF. Mean preoperative PED's at the metacarpophalangeal (MCP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints were 37˚, 40˚ and 31˚ respectively. Mean preoperative TPED was 54˚. Results were excellent, with a mean TPED correction of 85%. PNF was most effective for MCP-joints and less effective for PIP and DIP-joints. Secondary PNF was as effective as primary PNF. Complications were rare and mostly minor. The results of this study confirm that PNF is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure.

  3. Early Postoperative Results of Percutaneous Needle Fasciotomy in 451 Patients with Dupuytren Disease.

    Science.gov (United States)

    Molenkamp, Sanne; Schouten, Tanneke A M; Broekstra, Dieuwke C; Werker, Paul M N; Moolenburgh, J Daniel

    2017-06-01

    Percutaneous needle fasciotomy is a minimally invasive treatment modality for Dupuytren disease. In this study, the authors analyzed the efficacy and complication rate of percutaneous needle fasciotomy using a statistical method that takes the multilevel structure of data, regarding multiple measurements from the same patient, into account. The data of 470 treated rays from 451 patients with Dupuytren disease that underwent percutaneous needle fasciotomy were analyzed retrospectively. The authors described the early postoperative results of percutaneous needle fasciotomy and applied linear mixed models to compare mean correction of passive extension deficit between joints and efficacy of primary versus secondary percutaneous needle fasciotomy. Mean preoperative passive extension deficits at the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints were 37, 40, and 31 degrees, respectively. Mean preoperative total passive extension deficit was 54 degrees. Results were excellent, with a mean total passive extension deficit correction of 85 percent. Percutaneous needle fasciotomy was most effective for metacarpophalangeal joints and less effective for proximal interphalangeal and distal interphalangeal joints. Secondary percutaneous needle fasciotomy was as effective as primary percutaneous needle fasciotomy. Complications were rare and mostly minor. The results of this study confirm that percutaneous needle fasciotomy is an effective and safe treatment modality for patients with mild to moderate disease who prefer a minimally invasive procedure. Therapeutic, IV.

  4. Parathyroid hormone levels 1 hour after thyroidectomy: an early predictor of postoperative hypocalcemia.

    Science.gov (United States)

    AlQahtani, Awad; Parsyan, Armen; Payne, Richard; Tabah, Roger

    2014-08-01

    Parathyroid dysfunction leading to symptomatic hypocalcemia is not uncommon following a total or completion thyroidectomy and is often associated with significant patient morbidity and a prolonged hospital stay. A simple, reliable indicator to identify patients at risk would permit earlier pharmacologic prophylaxis to avoid these adverse outcomes. We examined the role of intact parathormone (PTH) levels 1 hour after surgery as a predictor of post-thyroidectomy hypocalcemia. We prospectively reviewed the cases of consecutive patients undergoing total or completion thyroidectomy. Ionized calcium (Ca(2+)) and intact PTH levels were measured preoperatively and at 1-, 6- and 24-hour intervals postoperatively. The specificity, sensitivity, negative and positive predictive values of the 1-hour PTH serum levels (PTH-1) in predicting 24-hour post-thyroidectomy hypocalcemia and eucalcemia were determined. We reviewed the cases of 149 patients. Biochemical hypocalcaemia (Ca(2+) sensitivity, specificity, positive and negative predictive values of a low PTH-1 were 89%, 100%, 97% and 100%, respectively. We found that PTH-1 levels were predictive of symptomatic hypocalcemia 24 hours after thyroidectomy. Routine use of this assay should be considered, as it could prompt the early administration of calcitriol in patients at risk of hypocalcemia and allow for the safe and timely discharge of patients expected to remain eucalcemic.

  5. [Experience with treatment of chronic polypoid rhinosinusitis using low doses of clarithromycin in the postoperative period].

    Science.gov (United States)

    Piskunov, G Z; Bobacheva, T Iu

    2012-01-01

    A total of 37 patients at the age from 25 to 65 years presenting with chronic polipoid rhinosinusitis (CPRS) were available for the observation. They were allocated to two groups based on the results of endoscopic polyposinusotomy. The patients in group 1 (n=18) were instructed at discharge from the clinic to take 250 mg of clarithromycin daily for 3 months in combination with the local application of a topical corticosteroid. The patients in group 2 (n=19) were prescribed topical corticosteroids alone. It was shown that clarithromycin at low doses caused significant stabilization of CPRS remission and prevented the development of relapses in the majority of the patients (66%). Therapy of CPRS with low doses of clarithromycin was associated with a significant decrease of the frequency of acute retroviral infections (ARVI). The intake of clarithromycin had no effect on the development and/or aggravation of intestinal dysbacteriosis nor did it provoke deviation of blood biochemical characteristics from the normal values both at the onset of therapy and after a follow-up period of 3 months.

  6. Early Toxicity in Patients Treated With Postoperative Proton Therapy for Locally Advanced Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cuaron, John J. [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Chon, Brian; Tsai, Henry; Goenka, Anuj; DeBlois, David [Procure Proton Therapy Center, Somerset, New Jersey (United States); Ho, Alice; Powell, Simon [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Hug, Eugen [Procure Proton Therapy Center, Somerset, New Jersey (United States); Cahlon, Oren, E-mail: cahlono@mskcc.org [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Procure Proton Therapy Center, Somerset, New Jersey (United States)

    2015-06-01

    Purpose: To report dosimetry and early toxicity data in breast cancer patients treated with postoperative proton radiation therapy. Methods and Materials: From March 2013 to April 2014, 30 patients with nonmetastatic breast cancer and no history of prior radiation were treated with proton therapy at a single proton center. Patient characteristics and dosimetry were obtained through chart review. Patients were seen weekly while on treatment, at 1 month after radiation therapy completion, and at 3- to 6-month intervals thereafter. Toxicity was scored using Common Terminology Criteria for Adverse Events version 4.0. Frequencies of toxicities were tabulated. Results: Median dose delivered was 50.4 Gy (relative biological equivalent [RBE]) in 5 weeks. Target volumes included the breast/chest wall and regional lymph nodes including the internal mammary lymph nodes (in 93%). No patients required a treatment break. Among patients with >3 months of follow-up (n=28), grade 2 dermatitis occurred in 20 patients (71.4%), with 8 (28.6%) experiencing moist desquamation. Grade 2 esophagitis occurred in 8 patients (28.6%). Grade 3 reconstructive complications occurred in 1 patient. The median planning target volume V95 was 96.43% (range, 79.39%-99.60%). The median mean heart dose was 0.88 Gy (RBE) [range, 0.01-3.20 Gy (RBE)] for all patients, and 1.00 Gy (RBE) among patients with left-sided tumors. The median V20 of the ipsilateral lung was 16.50% (range, 6.1%-30.3%). The median contralateral lung V5 was 0.34% (range, 0%-5.30%). The median maximal point dose to the esophagus was 45.65 Gy (RBE) [range, 0-65.4 Gy (RBE)]. The median contralateral breast mean dose was 0.29 Gy (RBE) [range, 0.03-3.50 Gy (RBE)]. Conclusions: Postoperative proton therapy is well tolerated, with acceptable rates of skin toxicity. Proton therapy favorably spares normal tissue without compromising target coverage. Further follow-up is necessary to assess for clinical outcomes and cardiopulmonary

  7. Early postoperative 18F-FDG PET/CT in high-risk stage III colorectal cancer.

    Science.gov (United States)

    Wasserberg, Nir; Purim, Ofer; Bard, Vyacheslav; Kundel, Yulia; Gordon, Noa; Groshar, David; Goldberg, Natalia; Kashtan, Hanoch; Sulkes, Aaron; Brenner, Baruch

    2015-04-01

    PET/CT may contribute to staging modification in different phases of colorectal cancer (CRC) management. However, it is not routinely indicated for stage III CRC. This study sought to determine the role of early postoperative PET/CT in patients with high-risk stage III CRC. The tumor registry of a tertiary medical center was searched (2004-2011) for all patients with stage III CRC who underwent early postoperative PET/CT because of the presence of high-risk factors for systemic disease. Demographic and clinicopathological characteristics were compared between patients found/not found to have metastatic disease. The cohort included 91 patients with a median age of 67 years (range, 29-90 years). Pathological FDG uptake was observed in 38 (41%). Of these, 14 (15% of the whole cohort) were upstaged with alteration of their treatment protocol, 10 (11%) had local postoperative changes, and 14 (15%) had false-positive findings. The sensitivity and specificity of PET/CT for detecting metastatic disease were 100% and 69%, respectively. Elevated postoperative carcinoembryonic antigen and CA-19.9 levels correlated with a positive PET/CT (P = 0.05 and P = 0.03, respectively). The median follow-up time was 34 months (range, 4-85 months). The estimated 5-year survival rate was significantly higher in patients with a negative than a positive scan (70% vs 42%, P postoperative PET/CT may influence staging and treatment in 15% of selected patients with high-risk stage III CRC. Postoperative levels of carcinoembryonic antigen and CA-19.9 may serve as indications for PET/CT scanning in this setting. Prospective validation is warranted.

  8. The Results and Prognostic Factors of Postoperative Radiation Therapy in the Early Stages of Endometrial Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2008-09-15

    To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial

  9. Postoperative nutritional effects of early enteral feeding compared with total parental nutrition in pancreaticoduodectomy patients: a prosepective, randomized study.

    Science.gov (United States)

    Park, Joon Seong; Chung, Hye-Kyung; Hwang, Ho Kyoung; Kim, Jae Keun; Yoon, Dong Sup

    2012-03-01

    The benefits of early enteral feeding (EEN) have been demonstrated in gastrointestinal surgery. But, the impact of EEN has not been elucidated yet. We assessed the postoperative nutritional status of patients who had undergone pancreaticoduodenectomy (PD) according to the postoperative nutritional method and compared the clinical outcomes of two methods. A prospective randomized trial was undertaken following PD. Patients were randomly divided into two groups; the EEN group received the postoperative enteral feed and the control group received the postoperative total parenteral nutrition (TPN) management. Thirty-eight patients were included in our analyses. The first day of bowel movement and time to take a normal soft diet was significantly shorter in EEN group than in TPN group. Prealbumin and transferrin were significantly reduced on post-operative day (POD) 7 and were slowly recovered until POD 90 in the TPN group than in the EEN group. EEN group rapidly recovered weight after POD 21 whereas it was gradually decreased in TPN group until POD 90. EEN after PD is associated with preservation of weight compared with TPN and impact on recovery of digestive function after PD.

  10. Determining plasma morphine levels using GC-MS after solid phase extraction to monitor drug levels in the postoperative period

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    Veronica Santos

    2008-01-01

    Full Text Available OBJECTIVE: To implement a selective and sensitive analytical method to quantify morphine in small volumes of plasma by gas-liquid chromatography-mass spectrometry (GC-MS, aimed at post-operatively monitoring the drug. METHOD: A gas-liquid chromatographic method with mass detection has been developed to determine morphine concentration in plasma after solid phase extraction. Morphine-d3 was used as an internal standard. Only 0.5 mL of plasma is required for the drug solid-phase extraction in the Bond Elut-Certify®, followed by the quantification of morphine derivative by GC-MS using a linear temperature program, a capillary fused silica column, and helium as the carrier and make-up gas. The method was applied to determine morphine content in plasma samples of four patients during the postoperative period of cardiac surgery. Patient-controlled analgesia with morphine was performed by a venous catheter, and a series of venous blood samples were collected. After the oro-After the orotracheal extubation, morphine plasma levels were monitored for up to 36 hours. RESULTS: The run time was 16 minutes because morphine and the internal standard were eluted after 8.8 minutes. The GC-MS method had 0.5 -1000 ng/mL linearity range (r²=0.9995, 0.1 ng/mL limit of detection, intraday and interday precision equivalent to 1.9% and 6.8%, and 0.1% and 0.8% systematic error (intraday and interday, respectively. The analytical method showed optimal absolute (98% and relative (100.7% recoveries. Morphine dose requirements and plasma levels are discussed. CONCLUSION: The analytical gas-liquid chromatography-mass spectrometry method is selective and adequate for morphine measurements in plasma for applications in clinical studies.

  11. Determining plasma morphine levels using GC-MS after solid phase extraction to monitor drug levels in the postoperative period.

    Science.gov (United States)

    Santos, Veronica; López, Karin Jannet Vera; Santos, Luciana Moraes; Yonamine, Mauricio; Carmona, Maria José Carvalho; Santos, Silvia Regina Cavani Jorge

    2008-06-01

    To implement a selective and sensitive analytical method to quantify morphine in small volumes of plasma by gas-liquid chromatography-mass spectrometry (GC-MS), aimed at post-operatively monitoring the drug. A gas-liquid chromatographic method with mass detection has been developed to determine morphine concentration in plasma after solid phase extraction. Morphine-d3 was used as an internal standard. Only 0.5 mL of plasma is required for the drug solid-phase extraction in the Bond Elut-Certify, followed by the quantification of morphine derivative by GC-MS using a linear temperature program, a capillary fused silica column, and helium as the carrier and make-up gas. The method was applied to determine morphine content in plasma samples of four patients during the postoperative period of cardiac surgery. Patient-controlled analgesia with morphine was performed by a venous catheter, and a series of venous blood samples were collected. After the oro-After the orotracheal extubation, morphine plasma levels were monitored for up to 36 hours. The run time was 16 minutes because morphine and the internal standard were eluted after 8.8 minutes. The GC-MS method had 0.5 -1000 ng/mL linearity range (r(2)=0.9995), 0.1 ng/mL limit of detection, intraday and interday precision equivalent to 1.9% and 6.8%, and 0.1% and 0.8% systematic error (intraday and interday, respectively). The analytical method showed optimal absolute (98%) and relative (100.7%) recoveries. Morphine dose requirements and plasma levels are discussed. The analytical gas-liquid chromatography-mass spectrometry method is selective and adequate for morphine measurements in plasma for applications in clinical studies.

  12. Comparison of two maintenance electrolyte solutions in children in the postoperative appendectomy period: a randomized, controlled trial

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    Maria Clara da Silva Valadão

    2015-10-01

    Full Text Available ABSTRACT OBJECTIVE: To compare two electrolyte maintenance solutions in the postoperative period in children undergoing appendectomy, in relation to the occurrence of hyponatremia and water retention. METHODS: A randomized clinical study involving 50 pediatric patients undergoing appendectomy, who were randomized to receive 2,000 mL/m2/day of isotonic (Na 150 mEq/L or 0.9% NaCl or hypotonic (Na 30 mEq/L NaCl or 0.18% solution. Electrolytes, glucose, urea, and creatinine were measured at baseline, 24 h, and 48 h after surgery. Volume infused, diuresis, weight, and water balance were analyzed. RESULTS: Twenty-four patients had initial hyponatremia; in this group, 13 received hypotonic solution. Seventeen patients remained hyponatremic 48 h after surgery, of whom ten had received hypotonic solution. In both groups, sodium levels increased at 24 h (137.4 ± 2.2 and 137.0 ± 2.7 mmol/L, with no significant difference between them (p = 0.593. Sodium levels 48 h after surgery were 136.6 ± 2.7 and 136.2 ± 2.3 mmol/L in isotonic and hypotonic groups, respectively, with no significant difference. The infused volume and urine output did not differ between groups during the study. The water balance was higher in the period before surgery in patients who received hypotonic solution (p = 0.021. CONCLUSIONS: In the post-appendectomy period, the use of hypotonic solution (30 mEq/L, 0.18% did not increase the risk of hyponatremia when compared to isotonic saline. The use of isotonic solution (150 mEq/L, 0.9% did not favor hypernatremia in these patients. Children who received hypotonic solution showed higher cumulative fluid balance in the preoperative period.

  13. Postoperative interleukin-6 level and early detection of complications after elective major abdominal surgery

    NARCIS (Netherlands)

    Rettig, Thijs C. D.; Verwijmeren, Lisa; Dijkstra, Ineke M.; Boerma, Djamila; Van De Garde, Ewoudt M. W.; Noordzij, Peter G.

    2016-01-01

    Objective: To assess the association of systemic inflammation and outcome after major abdominal surgery. Background: Major abdominal surgery carries a high postoperative morbidity and mortality rate. Studies suggest that inflammation is associated with unfavorable outcome. Methods: Levels of

  14. Intraoperative and early postoperative flap-related complications of laser in situ keratomileusis using two types of Moria microkeratomes.

    Science.gov (United States)

    Karabela, Yunus; Muftuoglu, Orkun; Gulkilik, Ibrahim Gokhan; Kocabora, Mehmet Selim; Ozsutcu, Mustafa

    2014-10-01

    The purpose of this study is to describe the incidence, management, and visual outcomes of intraoperative and early postoperative flap-related complications of laser in situ keratomileusis (LASIK) surgery using two types of Moria M2 microkeratomes. This retrospective analysis was performed on 806 primary LASIK cases. The intraoperative and early postoperative flap-related complications were identified and categorized according to type of Moria microkeratome. There were 52 intraoperative and early postoperative complications--one case of partial flap (0.124 %), one case of free flap (0.124 %), one case of small flap (0.124 %), 13 cases of epithelial defect (1.61 %), 12 cases of flap striae (1.49 %), 10 cases of diffuse lamellar keratitis (1.24 %), 10 cases of interface debris (1.24 %), three cases of epithelial ingrowth (0.37 %), and one case of microbial infection (0.124 %). The overall incidence of flap complications was 6.45 %. There were 27 right eye (6.73 %) and 25 left eye (6.17 %) complications. The incidence of complications with the Moria automated metallic head 130 microkeratome was 4.22 % and with the Moria single-use head 90 microkeratome was 2.23 %. We observed one culture-negative interface abscess which was cured with surgical cleaning and intensive medical treatment. The most common complication encountered was epithelial defects, followed by flap striae. Our study showed that LASIK with a microkeratome has a relatively low incidence of intraoperative and early postoperative flap complications. The authors have no financial interest in any of the issues contained in this article and have no proprietary interest in the development of marketing of or materials used in this study.

  15. Origin of Qipao Fashion in Early Republic Period

    Institute of Scientific and Technical Information of China (English)

    卞向阳

    2003-01-01

    The goal of this research is to analyze and discuss the origin of Qipao as women's fashionable wear in the early Republic Period (1911-1949).The origin of Qipao fashion will be discussed in three aspects:1) discussion of the original time,place and consumer group of Qipao fashion;2) analysis of initial style and wear combination of Qipao,3) deduction of the origin of the name Qipao.Besides,the analysis will also be given about Qipao's aesthetic characters,its production,consumption guarantee as well as its social backgrounds.The research will be made on the basis of the principles and methods of history,social psychology of clothing and design,and will use many materials especially historical writings and publications to give a more detailed discussion. Here are some tentative conclusions. Firstly, Qipao as a kind of one-piece dress was not inherited directly from the robe of Banner Style. It was a new fashion in the 1920s, which combined the elements of long vest called Qipao Majia, Wenming Xin Zhuang and the Western dress. Secondly, the Shanghai female students were the pioneering group wearing Qipao in 1925. Thirdly, the gradual acceptance of Qipao was mainly due to its aesthetic characters, production, consumption as well as social backgrounds at that time. And it was the kind of daily wear of many Chinese women after 1927. Fourthly, since Qipao represents the special clothing which integrated Chinese traditional style and the Western fashion in the early Republic Period, Qipao is advised to be taken as a special term to take the place of the previous ones like Mandarin Dress, Chipau and Cheongsam and so on.

  16. Early rehabilitation after surgery program versus conventional care during perioperative period in patients undergoing laparoscopic assisted total gastrectomy

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Objective: To evaluate the safety and efficacy of early rehabilitation after surgery program (ERAS in patients undergoing laparoscopic assisted total gastrectomy. Materials And Methods: This is a study where 47 patients who are undergoing lap assisted total gastrectomy are selected. Twenty-two (n = 22 patients received enhanced recovery programme (ERAS management and rest twenty-five (n = 25 conventional management during the perioperative period. The length of postoperative hospital stay, time to passage of first flatus, intraoperative and postoperative complications, readmission rate and 30 day mortality is compared. Serum levels of C-reactive protein pre-operatively and also on post-op day 1 and 3 are compared. Results: Postoperative hospital stay is shorter in ERAS group (78 ± 26 h when compared to conventional group (140 ± 28 h. ERAS group passed flatus earlier than conventional group (37 ± 9 h vs. 74 ± 16 h. There is no significant difference in complications between the two groups. Serum levels of CRP are significantly low in ERAS group in comparison to conventional group. [d1 (52.40 ± 10.43 g/L vs. (73.07 ± 19.32 g/L, d3 (126.10 ± 18.62 g/L vs. (160.72 ± 26.18 g/L]. Conclusion: ERAS in lap-assisted total gastrectomy is safe, feasible and efficient and it can ameliorate post-operative stress and accelerate postoperative rehabilitation in patients with gastric cancer. Short term follow up results are encouraging but we need long term studies to know its long term benefits.

  17. BOOK AND EARLY PERIOD FORMS – PLATE AND DESIGN RELATION

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    Mesude Hülya (ŞANES DOĞRU

    2015-04-01

    Full Text Available The Koran, main book of the Islam civilization takes place in base of various art forms. The book elements such as superscription, interior face of binder, title, epilogue, heading of sura (section of the Koran applied during the centuries by the ornamentation are available in all scientific, historical and literary artworks. These forms of the ornamentation within the book as well as periods and changed styles had also continued their improvement. The ornamentation and the script in its center had met in the books firstly and this togetherness had demonstrated a full compliance at the classic period. Presentation wish of the script and the ornamentation getting out of the book pages and targeting more independent and more persons was also a precipitating of improvement in the script and the ornamentation. The cuts and murakka which could be accepted as early period forms other than books had enabled to presentation of the calligraphy and the illumination as a plate with their ornamentation concepts resembling books but becoming free. The tughras and illuminated edicts which were the basis of the Turkish-Islam plate concept are considered. At ornamentation of the tughras, it is possible to see the ornamentation in the certificate which sent by the Sultan was thought for a nice presentation of an entire artwork. While the style difference which is in view at any time are evaluated in any way, big change in the forms and presentation style must not be overlooked. If it is possible to see a plate as the interior decoration of the architecture or a space, of course we must also count inscriptions and ornamentations among basic concepts which constitute such style. While some forms such as hilye’s, mosque scripts were starting the plate tradition, improvement of the apparent scripts and aesthetic caught by the calligraphers at this field had encountered to the periods when the Turkish ornamentation had under the influence of the west. The master

  18. Early versus delayed postoperative oral hydration after general anesthesia: a prospective randomized trial

    Science.gov (United States)

    Yin, Xiaorong; Ye, Ling; Zhao, Liang; Li, Lisha; Song, Jinping

    2014-01-01

    The purpose of our study was to determine the safety and tolerability of early oral hydration (EOH) compared with delayed oral hydration (DOH) after general anesthesia. One thousand anesthesiology (ASA) I to III adult patients undergoing non-gastrointestinal surgery with general anesthesia were randomized assigned into two groups: DOH (n=500, patients were given water 4 h after general anesthesia), EOH (n=500, patients were given 0.5 ml/kg water once recovered from general anesthesia.) in the postanesthesia care unit (PACU). Patients were evaluated for nausea, vomiting, drink desire, thirsty scale, oropharyngeal discomfort scale, and satisfaction scale. Statistical analysis was performed with Student’s t and Chi-Square tests. Complete data were available for 983 patients (EOH=488, DOH=495). Twenty minutes after receiving water the incidence of vomiting in EOH group was very low. And there was no significant difference between the two groups at the same time point (p > 0.05). Compared with DOH group, after receiving water there was a significant decrease of patients’ thirsty scales (p < 0.0001) and oropharyngeal discomfort scales (p < 0.0001) in EOH group. Significantly more patients’ satisfaction were reported in EOH group (p < 0.001). No serious adverse effects were reported during the study period. For patients undergoing non-gastrointestinal surgery, early oral hydration after recovery from general anesthesia was safe, with lower thirsty scale and oropharyngeal discomfort scales, and higher satisfaction. PMID:25419388

  19. Respiratory-Kinesiological Rehabilitation in the Early Periods after Cardiosurgical Interventions

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    G. P. Plotnikov

    2009-01-01

    Full Text Available Objective: to substantiate an algorithm for early respiratory-kinesiological rehabilitation used in the multimodality treatment of cardiosurgical patients developing multiple organ dysfunction syndrome (MODS. Subjects and methods. A randomized study was performed in 90 cardiosurgical patients with postoperatively evolving MOD, who were mechanically ventilated. In addition to conventional intensive therapy, these patients received an original complex of early respiratory-kinesiological rehabilitation. Results and Conclusion. The study has demonstrated the impact of respiratory and kinesiological rehabilitation on the course of a postoperative period: normalization of autonomic status-evaluating tests (from Д13±1.7 to Д7.5±4.9, endurance coefficient (21.8±9.9 to 16.5±7.2 in the study group versus 20.5±10.2 to 18.3±6.5 in the control group, adaptation potential (from the poor values 3.3±2.7 to the tension ones 2.9±2.2 scores since day 2; this trend was observed in the control group since postoperative day 5; improvement of gas transport parameters during exercises and within at least 6 hours after this, without changing artificial ventilation (AV modes (improvement of the values of DO2I (by 12.3±4.5% of the baseline value, VO2I (by 8.8±5.3% of the baseline value, O2ER (by 16.5±8.5% of the baseline value; accelerated switching to assisted ventilation modes (78.6±18.3 hours (the start of assisted AV modes in the study group versus 92.1±22.7 hours in the control one; a shorter length of stay in an intensive care unit (9.55±4.3 versus 14.2±5.5 days. The positive result from a primary pharmacoeconomic analysis for surviving patients is shown. Key words: rehabilitation, multiple organ dysfunction, cardiac surgery.

  20. Incidence of inferior vena cava thrombosis detected by transthoracic echocardiography in the immediate postoperative period after adult cardiac and general surgery.

    Science.gov (United States)

    Saranteas, T; Kostopanagiotou, G; Tzoufi, M; Drachtidi, K; Knox, G M; Panou, F

    2013-11-01

    Venous thromboembolism is an important complication after general and cardiac surgery. Using transthoracic echocardiography, this study assessed the incidence of inferior vena cava (IVC) thrombosis among a total of 395 and 289 cardiac surgical and major surgical patients in the immediate postoperative period after cardiac and major surgery, respectively. All transthoracic echocardiography was performed by a specialist intensivist within 24 hours after surgery with special emphasis on using the subcostal view in the supine position to visualise the IVC. Of the 395 cardiac surgical patients studied, the IVC was successfully visualised using the subcostal view in 315 patients (79.8%) and eight of these patients (2.5%) had a partially obstructive thrombosis in the IVC. In 250 out of 289 (85%) general surgical patients, the IVC was also clearly visualised, but only one patient (0.4%) had an IVC thrombosis (2.5 vs 0.4%, P cardiac and major surgery. IVC thrombosis appeared to be more common after adult cardiac surgery than general surgery. A large prospective cohort study is needed to define the risk factors for IVC thrombus and whether early thromboprophylaxis can reduce the incidence of IVC thrombus after adult cardiac surgery.

  1. Respiratory complications in the early post-operative period following elective craniotomies

    OpenAIRE

    Bharati, Sachidanand J; Mihir P Pandia; Rath, Girija P.; Parmod K Bithal; Dash, Hari H

    2015-01-01

    Background and Aims: Respiratory complications are of major concern after intracranial procedures. The objective of the study was to assess the incidence of respiratory complications in the initial 72 hours after elective craniotomies and to identify the associated risk factors. Materials and Methods: Patients undergoing elective craniotomies were studied prospectively. Information pertinent to history, physical examinations, investigation reports, perioperative events and outcome at discharg...

  2. [Methods of the use of ketorolac tromethamine in patients during the early postoperative period].

    Science.gov (United States)

    Lebedeva, R N; Maiachkin, R B; Nikoda, V V; Rusina, O V; Broun, N K; Molochnikov, I O

    1997-01-01

    Analgesia with nonsteroid antiinflammatory drugs (NSAID) becomes a pressing problem today. One such drug is ketorolak tromethamine (KT), characterized by expressed analgesic activity comparable with that of opioid analgesics morphine or promedol. Our purpose was to assess KT efficacy in analgesia performed by different methods, including analgesia controlled by the patient (ACP) after surgery. In medium severe and strong pain KT was used in group I (n = 60) "as needed" in a dose of 30 mg up to 3-4 times a day, in group 2 (n = 12) by the ACP method, in group 3 (n = 16) KT was incessantly infused in a daily dose of up to 120 mg, and in group 4 (n = 11) KT was injected 3-4 times a day in a dose of 30 mg in combination with morphine ACP. The results indicate a high efficacy of KT: 83% after a single injection. Combined use of KT and promedol decreased the dose by 40-50%. Side effects were observed in 15% of patients: most often it was a sense of fever and sweating (in 4% of patients), nausea and vomiting (in 2%), insomnia (in 2%). ACP and planned injections in a daily dose of 90-120 mg is the optimal method of analgesia in patients after extensive surgical interventions.

  3. Predictors of cardiac arrhythmias in the postoperative period by echocardiography, tissue Doppler and speckle tracking in patients with congenital heart diseases

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    Averina I.I.

    2015-09-01

    Conclusion. The indicators with predictive value for the arrhythmia in the postoperative period reflect the universal process of remodeling with the development of diastolic and systolic dysfunction, damage of longitudinal and circular functions of LV, longitudinal function of left atrium and the mitral valve function.

  4. Oral clonidine: a simple yet effective and safe premedicant for hemodynamic stability during laparoscopic surgery and a calm post-operative period

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    Ketaki Marodkar

    2016-04-01

    Conclusions: Oral clonidine in the present dose is able to maintain stable intra-operative haemodynamics and achieve a calm post-operative period during laparoscopic surgeries in ASA I/II patients. [Int J Basic Clin Pharmacol 2016; 5(2.000: 293-299

  5. [The clinical estimation of ketoprofen lysine salt effect on the intensitivity of acute pain syndrome in the oral cavity during surgical procedures and postoperative period].

    Science.gov (United States)

    Durnovo, E A; Shashurina, S V; Bespalova, N A; Khomutinnikova, N E; Gliavina, I A; Marochkina, M S; Iartseva, A V

    2013-01-01

    Is studying and control of the clinical efficacy and safety of ketoprofen lysine salt (КLS) (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in the form of sachets and solutions for application in postoperative period after dental surgeries procedures. The comparison of the analgetic effect of systemic and local forms of the "Oki" drug, depending on the type and extent of surgery procedures. Was carried out surgical treatment and patients examination in the postoperative period. Surgical procedures included: vestibulolasty, vestibulolasty with apically-displaced flap, vestibulolasty with apically-displaced flap and a free palatal mucogingival graft, removal impacted and dystopic teeth, periodontal surgery. The research was conducted in the Surgical stomatology and Maxillofacial surgery Department (stomatological policlinic of the Nizhny Novgorod State Medical Academy). Was noted rapid advanced of anesthesia when using sachets and solutions of the ketoprofen lysine salt (the commercial name is "Oki" manufacturer by Dompe CPA, Italy) in postoperative period after dental surgical procedures. Was noted a more advanced of analgetic effect in the application therapy by DCI solution when open surgical wound presented. Analgetic effect was observed after 20-30 min and was maintained in the postoperative period to an average of 8 hours. Local application sachets and solution of the ketoprofen lysine salt (KLS ), in our opinion, is the most appropriate and is highly effective when open surgical wound presented. Ketoprofen lysine salt (KLS) has a neutral pH and does not irritate the gastrointestinal tract, that determines the safety of its used.

  6. Postoperative interleukin-6 level and early detection of complications after elective major abdominal surgery

    NARCIS (Netherlands)

    Rettig, Thijs C. D.; Verwijmeren, Lisa; Dijkstra, Ineke M.; Boerma, Djamila; Van De Garde, Ewoudt M. W.; Noordzij, Peter G.

    2016-01-01

    Objective: To assess the association of systemic inflammation and outcome after major abdominal surgery. Background: Major abdominal surgery carries a high postoperative morbidity and mortality rate. Studies suggest that inflammation is associated with unfavorable outcome. Methods: Levels of C-react

  7. Postoperative interleukin-6 level and early detection of complications after elective major abdominal surgery

    NARCIS (Netherlands)

    Rettig, Thijs C. D.; Verwijmeren, Lisa; Dijkstra, Ineke M.; Boerma, Djamila; Van De Garde, Ewoudt M. W.|info:eu-repo/dai/nl/304841528; Noordzij, Peter G.

    2016-01-01

    Objective: To assess the association of systemic inflammation and outcome after major abdominal surgery. Background: Major abdominal surgery carries a high postoperative morbidity and mortality rate. Studies suggest that inflammation is associated with unfavorable outcome. Methods: Levels of C-react

  8. May Renal Resistive Index Be an Early Predictive Tool of Postoperative Complications in Major Surgery? Preliminary Results

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    Enrico Giustiniano

    2014-01-01

    Full Text Available Background. Patients who undergo high-risk surgery represent a large amount of post-operative ICU-admissions. These patients are at high risk of experiencing postoperative complications. Renal Resistive Index was found to be related with renal dysfunction, hypertension, and posttraumatic hemorrhagic shock, probably due to vasoconstriction. We explored whether Renal Resistive Index (RRI, measured after awakening from general anesthesia, could have any relationship with postoperative complications. Methods. In our observational, stratified dual-center trial, we enrolled patients who underwent general anesthesia for high-risk major surgery. After awakening in recovery room (or during awakening period in subjects submitted to cardiac surgery we measured RRI by echo-color-Doppler method. Primary endpoint was the association of altered RRI (>0.70 and outcome during the first postoperative week. Results. 205 patients were enrolled: 60 (29.3% showed RRI > 0.70. The total rate of adverse event was 27 (18.6% in RRI ≤ 0.7 group and 19 (31.7% in RRI > 0.7 group (P=0.042. Significant correlation between RRI > 0.70 and complications resulted in pneumonia (P=0.016, septic shock (P=0.003, and acute renal failure (P=0.001 subgroups. Patients with RRI > 0.7 showed longer ICU stay (P=0.001 and lasting of mechanical ventilation (P=0.004. These results were confirmed in cardiothoracic surgery subgroup. RRI > 0.7 duplicates triplicates the risk of complications, both in general (OR 2.03 93 95% CI 1.02–4.02, P=0.044 and in cardiothoracic (OR 2.62 95% CI 1.11–6.16, P=0.027 population. Furthermore, we found RRI > 0.70 was associated with a triplicate risk of postoperative septic shock (OR 3.04, CI 95% 1.5–7.01; P=0.002.

  9. Postoperative pyrexia after arthroplasty - when to panic ?

    OpenAIRE

    Agarwala Sanjay; Jain Deepak; Bhagwat Abhijit

    2005-01-01

    Background: Success of arthroplasty is contingent on a clear understanding of the potential complications. Today with improved methods of sepsis control, incidence of joint sepsis has dropped to less than 2%. Despite this fever is still common in the early post-operative period. Methods: We reviewed 184 consecutive hip and knee replacement surgeries for incidence and clinical significance of post-operative fever. The cases were followed up for a period of over 3 to 5 years. Temperat...

  10. [Combined cataract-glaucoma surgery with deep sclerectomy. An alternative to gonio-trephination in the intra- and early postoperative phases].

    Science.gov (United States)

    Mohr, A; Rais, M; Eckardt, C

    2001-03-01

    We examined the value of deep sclerectomy combined with phacoemulsification as a surgical technique in the peri- and postoperative phases. Deep sclerectomy with phacoemulsification was carried out in 18 patients. Mean postoperative follow-up was 7.5 weeks. Deep sclerectomy was more difficult to perform than goniotrephination. We observed neither fibrin reaction nor hypotonic dysregulation (intraocular pressure, IOP, < 8 mmHg). Five patients required additional pressure-lowering drugs during postoperative IOP regulation. We consider the low inflammatory response in the early postoperative phase to outweigh the greater surgical difficulty and prolonged surgery time. Further studies must verify whether higher IOP during the early postoperative phase is sufficient for good long-term IOP regulation.

  11. Early period of fracture healing in ovariectomized rats

    Institute of Scientific and Technical Information of China (English)

    徐少文; 喻任; 赵光锋; 王建卫

    2003-01-01

    Objective: To evaluate the effect of osteoporosis on fracture healing through observing the histomorphological changes, bone mineral density of callus and expression and distribution of transforming growth factor beta 1 (TGF-β1),basic fibroblast growth factor (bFGF) and bone morphogenetic protein-2 (BMP-2) in ovariectomized rats.Methods: Sixty female Sprague-Dawley rats (aged 12 weeks and weighing 235 g on average) were randomly divided into an ovariectomized (OVX) group (n=30) and a sham-operated (SO) group (n=30). Ovariectomy was performed in the OVX rats and same incision was made in the SO rats. Three months later, fracture of femoral shaft was made on all the rats. Then they were killed at different time points. Callus formation was observed with histological and immunohistochemical methods.Results: A reduction in callus and bone mineral density in the healing femur and a decrease of osteoblasts expressing TGF-β1 near the bone trabecula were observed in the OVX rats 3-4 weeks after fracture. Histomorphological analysis revealed a higher content of soft callus in the OVX rats than that in the SO rats. Immunohistochemistry results showed that no remarkable difference in expression and distribution of BMP-2 and bFGF between the OVX and SO groups was found.Conclusions: Osteoporosis influences the quantity and quality of callus during the early period of fracture healing. The effect of osteoporosis on fracture healing has no relationship with the expression of BMP-2 or bFGF. The decreased expression of TGF-β1 in osteoblasts may cause a decrease in quality of facture healing after osteoporosis.

  12. Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients.

    Science.gov (United States)

    Almonacid, Clara Inés Flórez; Ramos, Alfredo Jurado; Rodríguez-Borrego, María-Aurora

    2016-06-14

    estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it. estimar a prevalência de ansiedade do paciente laringectomizado no pré-operatório e pós-operatório e sua relação com o nível de autocuidado. pesquisa observacional de 40 pacientes com câncer da laringe estágio IV. Foram realizadas 3 observações: no pré-operatório, a 7 e 14 dias pós-operatório, no período de junho de 2010 a dezembro de 2012. Dois níveis de autocuidado foram definidos: autossuficientes e precisar ajuda para as atividades da vida diária e relacionadas ao tratamento. Para avaliar a ansiedade, foi utilizada a escala de ansiedade hospitalar de Zigmond (1983). no pré-operatório e pós-operatório, os pacientes apresentaram níveis elevados de ansiedade. Com relação ao autocuidado, os pacientes autossuficientes apresentaram na média níveis inferiores de ansiedades que os pacientes que precisavam de ajuda para realizar as atividades da vida diária y as derivadas da cirurgia, sem chegar a ser

  13. ANAESTHESIA, POSTOPERATIVE ANALGESIA AND EARLY REHABILITATION FOR UPPER EXTREMITY BONE AND MAJOR JOINTS SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Kurnosov

    2011-01-01

    Full Text Available A new method was developed to perform prolonged brachial plexus block with almost 100% effectiveness. It was also shown in 44 patients to be 33 % safer for local complications and 11,3 % safer for general complications than common used supraclavicular Winnie block (42 patients in control group, received opiates and NSAID for post-operative analgesia. This new method of analgesia allows effective rehabilitation after elbow arthroplasty to be started on the first day after the surgery.

  14. [VIABILITY OF MYOCAROIUM AS RISK FACTOR FOR MORTALITY IN EARLY AND LATE PERIOD AFTER BYPASS SURGERY OF CORONARY ARTERIES IN PATIENTS WITH CORONARY HEART DISEASE AND SEVERE LEFT VENTRICULAR DYSFUNCTION].

    Science.gov (United States)

    Todurov, B M; Zelenchuk, V; Kuzmich, I M; Ivanyuk, N B; Nikolaichuk, M V

    2015-06-01

    In coronary heart disease and low ejection fraction of the left ventricle (LV) in patients after coronary artery bypass surgery tend mortality and complication rate higher than preserved LV systolic function. Significant preoperative predictors of early mortality and remote in these patients, and the incidence of complications in the early postoperative period were reveald.

  15. Postoperative early hemolytic anemia due to inverted teflon felt strip after emergency repair for type A dissection.

    Science.gov (United States)

    Hata, M; Yoshitake, I; Wakui, S; Unosawa, S; Hata, H; Shiono, M

    2012-10-01

    A 39-year-old man underwent emergency surgery for type A acute aortic dissection complicated by paraplegia. However, hemolytic anemia increased significantly due to severe stenosis of the proximal anastomosis one month after surgery. He finally underwent a redo procedure 4 months after the initial operation whereupon it was verified that half of the inner felt strip used for proximal stump fixation had turned up and was protruding into the inner lumen. We report here on a rare case of survival of postoperative early hemolytic anemia due to severe graft stenosis caused by an inverted inner Teflon felt strip without any extra vascular compression.

  16. Video-assisted thoracic surgery reduces early postoperative stress. A single-institutional prospective randomized study

    Science.gov (United States)

    Asteriou, Christos; Lazopoulos, Achilleas; Rallis, Thomas; Gogakos, Apostolos S; Paliouras, Dimitrios; Tsakiridis, Kosmas; Zissimopoulos, Athanasios; Tsavlis, Drosos; Porpodis, Konstantinos; Hohenforst-Schmidt, Wolfgang; Kioumis, Ioannis; Organtzis, John; Zarogoulidis, Konstantinos; Zarogoulidis, Paul; Barbetakis, Nikolaos

    2016-01-01

    Background Video-assisted thoracic surgery (VATS) has been shown to effectively reduce postoperative pain, enhance mobilization of the patients, shorten in-hospital length of stay, and minimize postoperative morbidity rates. The aim of this prospective study is to evaluate neuroendocrine and respiratory parameters as stress markers in cancer patients who underwent lung wedge resections, using both mini muscle-sparing thoracotomy and VATS approach. Methods The patients were randomly allocated into two groups: Group A (n=30) involved patients who were operated on using the VATS approach, while in group B (n=30), the mini muscle-sparing thoracotomy approach was used. Neuroendocrine and biological variables assessed included blood glucose levels, C-reactive protein (CRP) levels, cortisol, epinephrine, and adrenocorticotropic hormone (ACTH) levels. Arterial oxygen (PaO2) and carbon dioxide (PaCO2) partial pressure were also evaluated. All parameters were measured at the following time points: 24 hours preoperatively (T1), 4 hours (T2), 24 hours (T3), 48 hours (T4), and 72 hours (T5), after the procedure. Results PaO2 levels were significantly higher 4 and 24 hours postoperatively in group A vs group B, respectively (T2: 94.3 vs 77.9 mmHg, P=0.015, T3: 96.4 vs 88.7 mmHg, P=0.034). Blood glucose (T2: 148 vs 163 mg/dL, P=0.045, T3: 133 vs 159 mg/dL, P=0.009) and CRP values (T2: 1.6 vs 2.5 mg/dL, P=0.024, T3: 1.5 vs 2.1 mg/dL, P=0.044) were found increased in both groups 4 and 24 hours after the procedure. However, their levels were significantly lower in the VATS group of patients. ACTH and cortisol values were elevated immediately after the operation and became normal after 48 hours in both groups, without significant difference. Postoperative epinephrine levels measured in group A vs group B, respectively, (T2: 78.9 vs 115.6 ng/L, P=0.007, T3: 83.4 vs 122.5 ng/L, P=0.012, T4: 67.4 vs 102.6 ng/L, P=0.021). The levels were significantly higher in group B. Conclusion This

  17. Telemedicine with mobile devices and augmented reality for early postoperative care.

    Science.gov (United States)

    Ponce, Brent A; Brabston, Eugene W; Shin Zu; Watson, Shawna L; Baker, Dustin; Winn, Dennis; Guthrie, Barton L; Shenai, Mahesh B

    2016-08-01

    Advanced features are being added to telemedicine paradigms to enhance usability and usefulness. Virtual Interactive Presence (VIP) is a technology that allows a surgeon and patient to interact in a "merged reality" space, to facilitate both verbal, visual, and manual interaction. In this clinical study, a mobile VIP iOS application was introduced into routine post-operative orthopedic and neurosurgical care. Survey responses endorse the usefulness of this tool, as it relates to The virtual interaction provides needed virtual follow-up in instances where in-person follow-up may be limited, and enhances the subjective patient experience.

  18. Effect of glutamine on change in early postoperative intestinal permeability and its relation to systemic inflammatory response

    Institute of Scientific and Technical Information of China (English)

    Zhu-Fu Quan; Chong Yang; Ning Li; Jie-Shou Li

    2004-01-01

    AIM: To study the effects of glutamine (Gln) on the change of intestinal permeability and its relationship to systemic inflammatory response in early abdominal postoperative patients.METHODS: A prospective, randomized, double-blind and controlled trial was taken. Twenty patients undergoing abdominal surgery were randomized into Gln group (oral administration of glutamine, 30 g/d, for 7 d, n=10) and placebo group (oral administration of placebo, 30 g/d, for 7 d, n=10). Temperatures and heart rates of all patients were daily recorded. White blood cell counts(WBC) and biochemical variables were measured before operation and 4 and 7 d after drug administration. Serum concentrations of glutamine, endotoxin, diamine oxidase and malondialdehyde and urine lactulose/mannito (L/M) ratio were measured before and 7 d after drug administration.RESULTS: The patients in the 2 groups were comparable prior to drug administration. Serum Gln concentration was significantly decreased in the placebo group and increased in the Gln group 7 d after drug administration. Urine L/M ratio was significantly increased in the placebo group and decreased in the Gln group. The serum concentration of endotoxin, diamine oxidase and malondialdehyde was significantly decreased in the Gln group compared with those in the placebo group. Temperatures, heart rates and WBC counts were significantly lower in the Gln group than those in the placebo group.CONCLUSION: Gut is one of the sources of systemic inflammatory response in abdominal postoperative patients and glutamine can decrease intestinal permeability, maintain intestinal barrier and attenuate systemic inflammatory response in early postoperative patients.

  19. Uncorrected visual acuity in the immediate postoperative period following uncomplicated cataract surgery: bimanual microincision cataract surgery versus standard coaxial phacoemulsification.

    LENUS (Irish Health Repository)

    Saeed, Ayman

    2012-02-01

    AIM: We compared bimanual microincision cataract surgery (MICS) and standard coaxial phacoemulsification (CAP) in terms of uncorrected visual acuity (UCVA) recorded 1 h and 2 weeks postoperatively. METHODS: This was a prospective, nonrandomised comparative study. All MICS procedures were performed by one surgeon (MGM), and all CAP procedures were performed by another surgeon (SB). Eyes with visually consequential ocular morbidity were excluded. The primary outcome measure was UCVA recorded 1 h postoperatively. RESULTS: One hundred eyes underwent MICS and CAP (50 eyes in each group). The treatment groups did not differ significantly in terms of preoperative mean best corrected visual acuity (6\\/24 +\\/- 4.3 lines and 6\\/20 +\\/- 4.4 lines in the MICS and the CAP groups, respectively; P = 0.65). Also, there was no significant difference in terms of postoperative UCVA at 1 h or at 2 weeks (mean +\\/- standard deviation UCVA 1 h postoperatively: MICS: 6\\/36 +\\/- 5.7 lines; CAP: 6\\/30 +\\/- 4.7 lines; P = 0.80; UCVA 2 weeks postoperatively: MICS: 6\\/10 +\\/- 1.9 lines; CAP: 6\\/10 +\\/- 2.2 lines; P = 0.90). However, nine eyes (18%) and one eye (2%) achieved a UCVA of C6\\/12 at 1 h following MICS and CAP, respectively, and this difference was statistically significant (P = 0.02). CONCLUSION: Mean UCVA at 1 h and at 2 weeks following cataract surgery was not significantly different between eyes undergoing MICS and CAP. However, a greater proportion of patients achieved a UCVA of C6\\/12 following MICS when compared with CAP.

  20. Implementation of a novel postoperative monitoring system using automated Modified Early Warning Scores (MEWS) incorporating end-tidal capnography.

    Science.gov (United States)

    Blankush, Joseph M; Freeman, Robbie; McIlvaine, Joy; Tran, Trung; Nassani, Stephen; Leitman, I Michael

    2016-10-20

    Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload. This study investigates whether the implementation of automated devices that utilize ongoing vital signs monitoring and MEWS calculations, inclusive of a score for end-tidal CO2 (EtCO2), can be feasibly implemented on the general care hospital floor and effectively identify derangements in a post-operative patient's condition while limiting the amount of false alarms that would serve to increase provider workload. From July to November 2014, post-operative patients meeting the inclusion criteria (BMI > 30 kg/m(2), history of obstructive sleep apnea, or the use of patient-controlled analgesia (PCA) or epidural narcotics) were monitored using automated devices that record minute-by-minute VS included in classic MEWS calculations as well as EtCO2. Automated messages via pagers were sent to providers for instances when the device measured elevated MEWS, abnormal EtCO2, and oxygen desaturations below 85 %. Data, including alarm and message details from the first 133 patients, were recorded and analyzed. Overall, 3.3 alarms and pages sounded per hour of monitoring. Device-only alarms sounded 2.7 times per hour-21 % were technical alarms. The remaining device-only alarms for concerning VS sounded 2.0/h, 70 % for falsely recorded VS. Pages for abnormal EtCO2 sounded 0.4/h (82 % false recordings) while pages for low blood oxygen saturation sounded 0.1/h (55 % false alarms). 143 times (0.1 pages/h) the devices calculated a MEWS

  1. A study of partial pressure of arterial carbon dioxide and end-tidal carbon dioxide correlation in intraoperative and postoperative period in neurosurgical patients

    Science.gov (United States)

    Gaur, Pallavi; Harde, Minal; Gujjar, Pinakin; Deosarkar, Devanand; Bhadade, Rakesh

    2017-01-01

    Background and Aim: Monitoring carbon dioxide (CO2) is of utmost importance in neurosurgical patients. It is measured by partial pressure of arterial CO2 (PaCO2) and end-tidal CO2 (ETCO2). We aimed to study the correlation between PaCO2 and ETCO2 in neurosurgical patients in the intraoperative and postoperative period on mechanical ventilation in Postanesthesia Care Unit (PACU). Methodology: This was prospective observational study done at tertiary care teaching public hospital over a period of 1 year. We studied 30 patients undergoing elective craniotomy intraoperatively and in the postoperative period on mechanical ventilation for 24 h. Serial measurement of ETCO2 and PaCO2 at baseline, hourly intraoperatively and every 6 hourly in the PACU were studied. Data analysis was done using SPSS software version 20. Results: The mean PaCO2–ETCO2 gradient intraoperatively over 4 h is 3.331 ± 2.856 and postoperatively over 24 h is 2.779 ± 2.932 and lies in 95% confidence interval. There was statistically significant correlation between PaCO2 and ETCO2 intraoperatively baseline, 1 h, 2 h, 3 h, and 4 h with Pearson's correlation coefficients of 0.799, 0.522, 0582, 0.439, and 0.547, respectively (P < 0.05). In PACU at baseline, 6 h, 12 h, 18 h, and 24 h Pearson's correlation coefficients were. 534, −0.032, 0.522, 0.242, 0.592, and 0.547, respectively, which are highly significant at three instances (P < 0.01). Conclusion: ETCO2 correlates PaCO2 with acceptable accuracy in neurosurgical patients in the intraoperative and postoperative period on mechanical ventilation in Intensive Care Unit. Thus, continuous and noninvasive ETCO2 can be used as a reliable guide to estimate arterial PCO2 during neurosurgical procedures and in PACU. PMID:28761526

  2. Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults

    Science.gov (United States)

    2014-01-01

    Introduction Altered peripheral perfusion is strongly associated with poor outcome in critically ill patients. We wanted to determine whether repeated assessments of peripheral perfusion during the days following surgery could help to early identify patients that are more likely to develop postoperative complications. Methods Haemodynamic measurements and peripheral perfusion parameters were collected one day prior to surgery, directly after surgery (D0) and on the first (D1), second (D2) and third (D3) postoperative days. Peripheral perfusion assessment consisted of capillary refill time (CRT), peripheral perfusion index (PPI) and forearm-to-fingertip skin temperature gradient (Tskin-diff). Generalized linear mixed models were used to predict severe complications within ten days after surgery based on Clavien-Dindo classification. Results We prospectively followed 137 consecutive patients, from among whom 111 were included in the analysis. Severe complications were observed in 19 patients (17.0%). Postoperatively, peripheral perfusion parameters were significantly altered in patients who subsequently developed severe complications compared to those who did not, and these parameters persisted over time. CRT was altered at D0, and PPI and Tskin-diff were altered on D1 and D2, respectively. Among the different peripheral perfusion parameters, the diagnostic accuracy in predicting severe postoperative complications was highest for CRT on D2 (area under the receiver operating characteristic curve = 0.91 (95% confidence interval (CI) = 0.83 to 0.92)) with a sensitivity of 0.79 (95% CI = 0.54 to 0.94) and a specificity of 0.93 (95% CI = 0.86 to 0.97). Generalized mixed-model analysis demonstrated that abnormal peripheral perfusion on D2 and D3 was an independent predictor of severe postoperative complications (D2 odds ratio (OR) = 8.4, 95% CI = 2.7 to 25.9; D2 OR = 6.4, 95% CI = 2.1 to 19.6). Conclusions In a group of patients assessed following major abdominal surgery

  3. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    Energy Technology Data Exchange (ETDEWEB)

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M. [Department of Radiology, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy); Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E. [Department of Surgery, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy)

    2000-07-01

    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  4. 78 FR 22918 - Early Career Doctorates Survey; Extension of Public Comment Period; Correction

    Science.gov (United States)

    2013-04-17

    ... From the Federal Register Online via the Government Publishing Office NATIONAL SCIENCE FOUNDATION Early Career Doctorates Survey; Extension of Public Comment Period; Correction AGENCY: National Science... the Early Career Doctorates Survey. The document contained an incorrect date. FOR FURTHER...

  5. Post-operative levamisole may compromise early healing of experimental intestinal anastomoses.

    Science.gov (United States)

    de Waard, J. W.; Wobbes, T.; de Man, B. M.; van der Linden, C. J.; Hendriks, T.

    1995-01-01

    There exists growing interest in immediate post-operative local adjuvant therapy after resection of intestinal malignancies. It is therefore necessary to assess it potential effect on the healing of intestinal anastomoses. Five groups (n = 20) of rats underwent resection and anastomosis of both ileum and colon: a control group and four experimental groups receiving intraperitoneal 5-fluorouracil (5-FU), 5-FU plus leucovorin, 5-FU plus levamisole or levamisole alone, on the day of surgery and the next 2 days. Animals were killed 3 or 7 days after operation. Another three groups (n = 6) of animals were used to compare anastomotic collagen synthetic capacity in control rats or rats receiving 5-FU or 5-FU plus levamisole. On the third post-operative day, the average anastomotic bursting pressure in the 5-FU/levamisole group was reduced by 36% as compared with the control group, both in ileum (P = 0.02) and in colon (P = 0.01). Values in the other groups were similar to those in the control group. Anastomotic breaking strength was significantly (P < 0.025) lowered in the ileum from the levamisole group at both days 3 and 7. Anastomotic collagen synthetic capacity was strongly reduced in the 5-FU and 5-FU/levamisole groups. However, there was no significant difference between the control group and the four experimental groups with regard to anastomotic hydroxyproline concentration and content, either 3 or 7 days after operation. Thus, limited use of levamisole, alone or in combination with intraperitoneal 5-FU, may compromise intestinal healing. PMID:7640232

  6. Postoperative Interleukin-6 Level and Early Detection of Complications After Elective Major Abdominal Surgery.

    Science.gov (United States)

    Rettig, Thijs C D; Verwijmeren, Lisa; Dijkstra, Ineke M; Boerma, Djamila; van de Garde, Ewoudt M W; Noordzij, Peter G

    2016-06-01

    To assess the association of systemic inflammation and outcome after major abdominal surgery. Major abdominal surgery carries a high postoperative morbidity and mortality rate. Studies suggest that inflammation is associated with unfavorable outcome. Levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α and the systemic inflammatory response syndrome (SIRS) were assessed in 137 patients undergoing major abdominal surgery. Blood samples were drawn on days 0, 1, 3, and 7, and SIRS was scored during 48 hours after surgery. Primary outcome was a composite of mortality, pneumonia, sepsis, anastomotic dehiscence, wound infection, noncardiac respiratory failure, atrial fibrillation, congestive heart failure, myocardial infarction, and reoperation within 30 days of surgery. An IL-6 level more than 432 pg/mL on day 1 was associated with an increased risk of complications (adjusted odds ratio: 3.3; 95% confidence interval [CI]: 1.3-8.5) and a longer median length of hospital stay (7 vs 12 days, P < 0.001). As a single test, an IL-6 cut-off level of 432 pg/mL on day 1 yielded a specificity of 70% and a sensitivity of 64% for the prediction of complications (area under the curve: 0.67; 95% CI: 0.56-0.77). Levels of CRP started to discriminate from day 3 onward with a specificity of 87% and a sensitivity of 58% for a cut-off level of 203 mg/L (AUC: 0.73; 95% CI: 0.63-0.83). A high IL-6 level on day 1 is associated with postoperative complications. Levels of IL-6 help distinguish between patients at low and high risk for complications before changes in levels of CRP.

  7. Pre-operative and early post-operative factors associated with surgical site infection after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Oller, Inmaculada; Llavero, Carolina; Arroyo, Antonio; Muñoz, Jose Luis; Calero, Alicia; Diez, María; Zubiaga, Lorea; Calpena, Rafael

    2013-08-01

    Surgical procedures on obese patients are expected to have a high incidence of surgical site infection (SSI). The identification of pre-operative or early post-operative risk factors for SSI may help the surgeon to identify subjects in risk and adequately optimize their status. We conducted a study of the association of comorbidities and pre- and post-operative analytical variables with SSI following laparoscopic sleeve gastrectomy for the treatment of morbid obesity. We performed a prospective study of all morbidly obese patients undergoing laparoscopic sleeve gastrectomy as a bariatric procedure between 2007 and 2011. An association of clinical and analytical variables with SSI was investigated. The study included 40 patients with a mean pre-operative body mass index (BMI) of 51.2±7.9 kg/m(2). Surgical site infections appeared in three patients (7.5%), of whom two had an intra-abdominal abscess located in the left hypochondrium and the third had a superficial incisional SSI. Pre-operatively, a BMI >45 kg/m(2) (OR 8.7; p=0.008), restrictive disorders identified by pulmonary function tests (OR 10.0; p=0.012), a serum total protein concentration 30 mcg/dL (OR 13.0; p=0.003), and a mean corpuscular volume (MCV) 128 mg/dL (OR 4.7; p=0.012) and hemoglobin <11g/dL (OR 7.5; p=0.002) were associated with SSI. The study supports the role of restrictive lung disorders and the values specified above for preoperative BMI, serum total protein and cortisol concentrations, and MCV, and of post-operative anemia and hyperglycemia as risk factors for SSI. In these situations, the surgeon must be aware of and seek to control these risk factors.

  8. The OPERA trial - comparison of early nasal high flow oxygen therapy with standard care for prevention of postoperative hypoxemia after abdominal surgery: study protocol for a multicenter randomized controlled trial.

    Science.gov (United States)

    Futier, Emmanuel; Paugam-Burtz, Catherine; Constantin, Jean-Michel; Pereira, Bruno; Jaber, Samir

    2013-10-18

    Respiratory support following postoperative extubation is of major importance to prevent hypoxemia and subsequent respiratory failure and reintubation. High-flow nasal cannula oxygen (HFNC) delivers a flow-dependent positive airway pressure and improves oxygenation by increasing end-expiratory lung volume. Whether application of HFNC may have therapeutic advantages over conventional oxygen therapy for respiratory support in the early postextubation surgical period remains to be established. The Optiflow for prevention of post-extubation hypoxemia after abdominal surgery (OPERA) trial is an investigator-initiated multicenter randomized controlled two-arm trial with assessor-blinded outcome assessment, randomizing 220 patients with intermediate to high risk of pulmonary complications after abdominal surgery to receive HFNC or conventional oxygen therapy following extubation, stratified by the presence of epidural analgesia and center. The primary outcome measure is the percentage of patients with postoperative hypoxemia one hour after tracheal extubation. Secondary outcome measures are postoperative pulmonary complications, need for noninvasive ventilation and intubation for respiratory failure. The OPERA trial is the first randomized controlled study powered to investigate whether early application of HFNC following extubation after abdominal surgery prevents against postoperative hypoxemia and pulmonary complications. ClinicalTrials.gov Identifier: NCT01887015.

  9. Impact of general versus epidural anesthesia on early post-operative cognitive dysfunction following hip and knee surgery

    Directory of Open Access Journals (Sweden)

    Mandal Sripurna

    2011-01-01

    Full Text Available Background : Post-operative cognitive dysfunction is the subtle cerebral complication temporally seen following surgery. The aim of this study was to compare the influence of either general anesthesia (GA or epidural anesthesia (EA on the early post-operative neurocognitive outcome in elderly (>59 years subjects undergoing hip and knee surgery. Methods : A total of 60 patients were recruited in a prospective, randomized, parallel-group study, comparable by age and sex. They were enrolled and randomized to receive either EA (n = 30 or GA (n = 30. All of them were screened using the Mini Mental State Examination (MMSE, with components of the Kolkata Cognitive Screening Battery. The operated patients were re-evaluated 1 week after surgery using the same scale. The data collected were analyzed to assess statistical significance. Results : We observed no statistical difference in cognitive behavior in either group pre-operatively, which were comparable with respect to age, sex and type of surgery. Grossly, a significant difference was seen between the two groups with respect to the perioperative changes in verbal fluency for categories and MMSE scores. However, these differences were not significant after the application of the Bonferroni correction for multiple analyses, except the significant differences observed only in the MMSE scores. Conclusions : We observed a difference in cognitive outcome with GA compared with EA. Certain aspects of the cognition were affected to a greater extent in this group of patients undergoing hip and knee surgery.

  10. Early global warming in the period 1850 to 1920

    Science.gov (United States)

    Venema, Victor; Lindau, Ralf; Brandsma, Theo; Auchmann, Renate; Esper, Jan; Haustein, Karsten

    2016-04-01

    The current global temperature datasets show no warming in the land surface temperature and the sea surface temperature for the period between 1850 and 1920. However, several lines of evidence suggest that the Earth's surface was warming during this period. Every line of evidence by itself is currently not compelling, but the consilience of evidence at least makes a good case for further research. This period is characterized by the introduction of Stevenson screens, which reduce radiation errors more than the monitoring methods used before. As a consequence, Stevenson screens typically observe cooler temperatures than earlier observations. Recent analyses of parallel measurements suggest that this cooling bias is larger than previously thought. Physical reasoning suggests this bias to be largest in sub-tropical and tropic regions; this pattern is also found in the limited number of parallel measurements available. We are missing information from continental climates. The Global Historical Climate Network (GHCNv3) does not change the trend between 1870 and 1920 and adjust 0.1°C between 1850 and 1970. This small adjustment seems to be less than needed for this transition compared to the size of this jump estimated from the limited evidence we have from parallel measurements Further evidence for warming during this period can be found in lake and river freeze and breakup times, which show a clear shortening of the freezing period between 1850 and 1920. Most of the glaciers for which we have data from this period show reductions in their lengths, which signals clear warming. Also temperature reconstructions from proxies show warming. The CMIP model ensemble shows 0.2°C warming in the global mean temperature. We will be looking at well-homogenized national datasets and compare them to the national averages from the global collections. For this period we have up to now 3 such comparisons (Austria, Italy and Spain), these have too much scatter relative to the BEST

  11. Correlates of satisfaction with pain treatment in the acute postoperative period: results from the international PAIN OUT registry.

    Science.gov (United States)

    Schwenkglenks, Matthias; Gerbershagen, Hans J; Taylor, Rod S; Pogatzki-Zahn, Esther; Komann, Marcus; Rothaug, Judith; Volk, Thomas; Yahiaoui-Doktor, Maryam; Zaslansky, Ruth; Brill, Silviu; Ullrich, Kristin; Gordon, Debra B; Meissner, Winfried

    2014-07-01

    Patient ratings of satisfaction with their postoperative pain treatment tend to be high even in those with substantial pain. Determinants are poorly understood and have not previously been studied in large-scale, international datasets. PAIN OUT, a European Union-funded acute pain registry and research project, collects patient-reported outcome data on postoperative day 1 using the self-reported International Pain Outcome Questionnaire (IPO), and patient, clinical, and treatment characteristics. We investigated correlates of satisfaction and consistency of effects across centres and countries using multilevel regression modelling. Our sample comprised 16,868 patients (median age 55 years; 55% female) from 42 centres in 11 European countries plus Israel, USA, and Malaysia, who underwent a wide range of surgical procedures, for example, joint, limb, and digestive tract surgeries. Median satisfaction was 9 (interquartile range 7-10) on a 0-10 scale. Three IPO items showed strong associations and explained 35% of the variability present in the satisfaction variable: more pain relief received, higher allowed participation in pain treatment decisions, and no desire to have received more pain treatment. Patient factors and additional IPO items reflecting pain experience (eg, worst pain intensity), pain-related impairment, and information on pain treatment added little explanatory value, partially due to covariate correlations. Effects were highly consistent across centres and countries. We conclude that satisfaction with postoperative pain treatment is associated with the patients' actual pain experience, but more strongly with impressions of improvement and appropriateness of care. To the degree they desire, patients should be provided with information and involved in pain treatment decisions.

  12. Low Incidence of Early Postoperative Cerebral Edema After Coronary Artery Bypass Grafting

    NARCIS (Netherlands)

    Ottens, Thomas H.; Hendrikse, J; Slooter, Arjen J. C.; van Herwerden, LA; Dieleman, Stefan; van Dijk, Diederik

    2015-01-01

    Objective: Using magnetic resonance imaging, the authors studied the influence of a single high dose of intraoperative dexamethasone on the severity of cerebral edema that can occur early after coronary artery bypass grafting (CABG). It was hypothesized that high-dose intraoperative dexamethasone re

  13. Risk factors for early post-operative neurological deterioration in dogs undergoing a cervical dorsal laminectomy or hemilaminectomy: 100 cases (2002-2014).

    Science.gov (United States)

    Taylor-Brown, F E; Cardy, T J A; Liebel, F X; Garosi, L; Kenny, P J; Volk, H A; De Decker, S

    2015-12-01

    Early post-operative neurological deterioration is a well-known complication following dorsal cervical laminectomies and hemilaminectomies in dogs. This study aimed to evaluate potential risk factors for early post-operative neurological deterioration following these surgical procedures. Medical records of 100 dogs that had undergone a cervical dorsal laminectomy or hemilaminectomy between 2002 and 2014 were assessed retrospectively. Assessed variables included signalment, bodyweight, duration of clinical signs, neurological status before surgery, diagnosis, surgical site, type and extent of surgery and duration of procedure. Outcome measures were neurological status immediately following surgery and duration of hospitalisation. Univariate statistical analysis was performed to identify variables to be included in a multivariate model. Diagnoses included osseous associated cervical spondylomyelopathy (OACSM; n = 41), acute intervertebral disk extrusion (IVDE; 31), meningioma (11), spinal arachnoid diverticulum (10) and vertebral arch anomalies (7). Overall 54% (95% CI 45.25-64.75) of dogs were neurologically worse 48 h post-operatively. Multivariate statistical analysis identified four factors significantly related to early post-operative neurological outcome. Diagnoses of OACSM or meningioma were considered the strongest variables to predict early post-operative neurological deterioration, followed by higher (more severely affected) neurological grade before surgery and longer surgery time. This information can aid in the management of expectations of clinical staff and owners with dogs undergoing these surgical procedures.

  14. Forensic DNA expertise of incest in early period of pregnancy.

    Science.gov (United States)

    Jakovski, Zlatko; Jankova, Renata; Nikolova, Ksenija; Spasevska, Liljana; Jovanovic, Rubens; Janeska, Biljana

    2011-01-01

    Proving incest from tissue obtained by abortion early in pregnancy can be a challenge. Problems include the small quantity of embryonic tissue in the products of conception, and the mixing of DNA from mother and embryo. In many cases, this amorphous material cannot be grossly segregated into maternal and fetal components. Thus, morphological discrimination requires microscopy to select relevant tissue particles from which DNA can be typed. This combination of methods is reliable and efficient. In this article, we present two cases of incest discovered by examination of products of conception.

  15. Early-type Eclipsing Binaries at Intermediate Orbital Periods

    CERN Document Server

    Moe, Maxwell

    2015-01-01

    We analyze 221 eclipsing binaries (EBs) in the Large Magellanic Cloud with B-type main-sequence (MS) primaries ($M_1$ $\\approx$ 4 - 14 M$_{\\odot}$) and orbital periods $P$ = 20 - 50 days that were photometrically monitored by the Optical Gravitational Lensing Experiment. We utilize our three-stage automated pipeline to (1) classify all 221 EBs, (2) fit physical models to the light curves of 130 detached well-defined EBs from which unique parameters can be determined, and (3) recover the intrinsic binary statistics by correcting for selection effects. We uncover two statistically significant trends with age. First, younger EBs tend to reside in dustier environments with larger photometric extinctions, an empirical relation that can be implemented when modeling stellar populations. Second, younger EBs generally have large eccentricities. This demonstrates that massive binaries at moderate orbital periods are born with a Maxwellian "thermal" orbital velocity distribution, which indicates they formed via dynamica...

  16. Effects of various operations on the electrical activity of the human stomach recorded during the postoperative recovery period.

    Science.gov (United States)

    Aldrete, J S; Shepard, R B; Halpern, N B; Jimenez, H; Piantadosi, S

    1982-01-01

    This study attempts to characterize any changes occurring in the human gastric control electrical rhythm (CER), following a variety of gastric surgical procedures. Pairs of electrodes were implanted in selected specific sites on the stomachs of 57 patients undergoing either antrectomy and vagotomy, proximal gastric vagotomy (PGV), vagotomy and drainage, gastric resection without vagotomy, or fundoplication. Five patients undergoing nongastric operations served as controls. After operation recordings were obtained with differential preamplifiers, an oscilloscope, and a dual-channel tape recorder. An electrical signal compatible with a CER was found almost always in the distal body or antrum, regardless of whether vagotomy was performed. In contrast, a CER was found only occasionally in the fundus, and was never found following PGV. Although there was a difference in the frequency of occurrence of fundic CER in patients with and without vagotomy, it was not statistically significant (p = 0.0668). Patients with prolonged postoperative convalescence because of gastric atony were compared with patients with normal postoperative courses regarding the presence or absence of CER in the gastric antrum or fundus. A statistically significant relationship between abnormal gastric motility and absence of CER was not established. Images Fig. 1. PMID:7073363

  17. Prospective evaluation of early postoperative male and female sexual function after radical prostatectomy with erectile nerves preservation.

    Science.gov (United States)

    Tran, S-N; Wirth, G J; Mayor, G; Rollini, C; Bianchi-Demicheli, F; Iselin, C E

    2015-01-01

    protective effect on both the patient's and his partner's sexual function with a significant effect of bilateral over unilateral neurovascular bundle preservation. Furthermore, we found that conjugal complicity remains stable throughout the first semestrial postoperative period despite the decrease in sexual function.

  18. STRATEGIES OF PROPHYLAXIS AND MANAGEMENT OF POSTOPERATIVE ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    Dembele, A.

    2016-07-01

    Full Text Available This article analyses different strategies of prophylaxis and management of postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting (CABG at different periods after acute myocardial infarction (AMI. It examines the efficacy of early administration of beta-adrenergic blocking agents (metoprolol and amiodarone (in prophylactic doses in the diminution of the risk of postoperative atrial fibrillation in different groups of patients. The article also discerns the effectiveness of digoxin in the management of episodes of postoperative atrial fibrillation.

  19. Acute Pancreatitis with Splenic Infarction as Early Postoperative Complication following Laparoscopic Sleeve Gastrectomy

    OpenAIRE

    Aleksandr Kalabin; Mani, Vishnu R.; Ankita Mishra; Hector Depaz; Leaque Ahmed

    2017-01-01

    Obesity is becoming a global health burden along with its comorbidities. It imposes tremendous financial burden and health costs worldwide. Surgery has emerged as the definitive treatment option for morbidly obese patients with comorbidities. Laparoscopic sleeve gastrectomy is performed now more than ever making it imperative for physicians and surgeons to recognize both the common and the uncommon risks and complications associated with it. In this report we describe a rare early life-threat...

  20. The early period of the calculus of variations

    CERN Document Server

    Freguglia, Paolo

    2016-01-01

    This monograph explores the early development of the calculus of variations in continental Europe during the Eighteenth Century by illustrating the mathematics of its founders. Closely following the original papers and correspondences of Euler, Lagrange, the Bernoullis, and others, the reader is immersed in the challenge of theory building. We see what the founders were doing, the difficulties they faced, the mistakes they made, and their triumphs. The authors guide the reader through these works with instructive commentaries and complements to the original proofs, as well as offering a modern perspective where useful. The authors begin in 1697 with Johann Bernoulli’s work on the brachystochrone problem and the events leading up to it, marking the dawn of the calculus of variations. From there, they cover key advances in the theory up to the development of Lagrange’s δ-calculus, including: • The isoperimetrical problems • Shortest lines and geodesics • Euler’s Methodus Inveniendi and the two Addi...

  1. Convulsions in early post-partum period, a diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Anil H. Inamdar

    2013-04-01

    Full Text Available Neurocysticercosis is the most common helminthic (tapeworm infection of the brain worldwide. It presents as hydrocephalus and acute onset seizures. A 28-year-old para 3 live 3 [P3L3], post-partum [day 7], resident of Arvi, presented in casualty during emergency hours with headache and fever since 7 days. She presented with h/o convulsions 2 episodes, one on day 5 and one on day 7 of her full term vaginal home delivery. She presented to the Emergency Department on day 7 with generalised tonic-clonic seizures preceded by nausea and headache. All her blood investigations were within normal limits except an extremely surprising finding on CT scan. 40% of patients having postpartum convulsions do not experience preeclampsia, clinical awareness is essential for early treatment and care. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 231-233

  2. Clinical outcome of exercise therapy and early post-operative rehabilitation for treatment of neglected Achilles tendon rupture: a randomized study.

    Science.gov (United States)

    Jielile, Jiasharete; Badalihan, Ayinazi; Qianman, Bayixiati; Satewalede, Tuerde; Wuerliebieke, Jianati; Kelamu, Mailamuguli; Jialihasi, Ayidaer

    2016-07-01

    Treatment of neglected Achilles tendon rupture is very challenging. This randomized study aimed to compare the clinical outcome of early post-operative rehabilitation (EPR) with post-operative cast immobilization (PCI). Fifty-seven patients with neglected Achilles tendon rupture were randomized to receive EPR (n = 26) or PCI (n = 31) management following surgery. Clinical outcome was monitored by follow-up at weeks 8, 12, 18 and 26 and year 2. The significance of intergroup differences from the Leppilahti scoring system (LSS), ultrasonography, multislice spiral computerized tomography (MSCT) and electromyography was assessed. Ultrasonography and MSCT revealed no occurrence of tendon elongation or adhesion. Four patients could perform sustained single-leg heel-raise exercise for 60 s at post-operative day 40. The PCI group also showed increased post-operative LSS score, but recovery was slower. Post-operative complications, such as ankle joint ankylosis and osteoporosis, only occurred in the PCI group. Compared with cast immobilization, early post-operative rehabilitation results in better clinical outcome and faster overall tendon regeneration of neglected Achilles tendon rupture. II.

  3. Outcome of a one-stage tensile stress surgical technique and early postoperative rehabilitation in the treatment of neglected achilles tendon rupture.

    Science.gov (United States)

    Badalihan, Ayinazi; Aihemaiti, Amina; Shawutali, Nuerai; Jielile, Jiasharete; Jialihasi, Ayidaer; Tangkejie, Wulanbai; Nuerdoula, Yeermike; Satewalede, Turde; Hunapiya, Beisen; Niyazebieke, Hadelebieke; Hezibieke, Hayilat; Zhao, Qin; Bahetijiang, Ahezhuoli; Kelamu, Mailamuguli; Qianman, Bayixiati

    2015-01-01

    The present study evaluated the effect of single-stage internal traction combined with early postoperative active rehabilitation and the yurt bone suture method, a new surgical technique, on the clinical outcomes after surgical repair of Achilles tendon. A total of 51 patients with neglected Achilles tendon rupture who underwent the yurt bone suture treatment also participated in an accelerated postoperative rehabilitation program. The clinical outcome was evaluated for 18 weeks using the Leppilahti scoring system, bilateral ultrasound examination, and computed tomography examination. The ultrasound and computed tomography examinations revealed that Achilles tendon elongation and adhesion occurred in none of the patients. All the patients could perform the single leg heel raise exercise for a mean of 30 ± 7.6 seconds at 12 weeks postoperatively. In addition, the patients could participate in sport exercises and heavy physical activities by around 13 weeks postoperatively. The mean Leppilahti score was 85.8 ± 3.7 at 8 weeks postoperatively, and it had increased to 96.1 ± 3.2 and 100.0 ± 0.0 at 12 and 18 weeks, respectively, after the operation. The 1-stage internal traction technique, combined with early postoperative active rehabilitation and the yurt bone surgical technique, resulted in good clinical outcomes for the treatment of neglected Achilles tendon rupture. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Effects of tolvaptan in the early postoperative stage after heart valve surgery: results of the STAR (Study of Tolvaptan for fluid retention AfteR valve surgery) trial.

    Science.gov (United States)

    Nishi, Hiroyuki; Toda, Koichi; Miyagawa, Shigeru; Yoshikawa, Yasushi; Fukushima, Satsuki; Kawamura, Masashi; Yoshioka, Daisuke; Saito, Tetsuya; Ueno, Takayoshi; Kuratani, Toru; Sawa, Yoshiki

    2015-12-01

    The purpose of this study was to assess the efficacy of tolvaptan, a vasopressin V2 receptor antagonist, for the management of postoperative surgical fluid retention after heart valve surgery. This was a prospective observational study of 64 patients with heart valve disease who underwent valve surgery between 2013 and 2014. Those in the tolvaptan group received tolvaptan in addition to conventional diuretic therapy. The results were compared to the results of 55 patients who underwent heart valve surgery between 2007 and 2010 and received conventional postoperative diuretics alone. The time to return to the preoperative BW was significantly shorter in the patients who received tolvaptan (6.1 ± 3.8 vs. 8.7 ± 6.7 days, p fluid retention during the early postoperative stage in cardiac surgery patients, without increased renal failure or abnormal electrolyte levels. This new type of diuretic therapy may be a suitable option for postoperative fluid management in patients undergoing cardiac surgery.

  5. Prevalence of and risk factors for postoperative pulmonary complications after lung cancer surgery in patients with early-stage COPD

    Directory of Open Access Journals (Sweden)

    Kim ES

    2016-06-01

    Full Text Available Eun Sun Kim,1 Young Tae Kim,2 Chang Hyun Kang,2 In Kyu Park,2 Won Bae,1 Sun Mi Choi,1 Jinwoo Lee,1 Young Sik Park,1 Chang-Hoon Lee,1 Sang-Min Lee,1 Jae-Joon Yim,1 Young Whan Kim,1 Sung Koo Han,1 Chul-Gyu Yoo1 1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, 2Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea Purpose: This study aimed to investigate whether the prevalence of postoperative pulmonary complications (PPCs in patients with non-small-cell lung cancer (NSCLC is even higher in the early stages of COPD than in such patients with normal lung function and to verify the usefulness of symptom- or quality of life (QoL-based scores in predicting risk for PPCs.Patients and methods: Patients undergoing pulmonary resection for NSCLC between July 2012 and October 2014 were prospectively enrolled. Preoperative measurements of lung function, dyspnea, and QoL, operative characteristics, PPCs, duration of postoperative hospitalization, and in-hospital mortality were assessed.Results: Among 351 consecutive patients with NSCLC, 343 patients with forced expiratory volume in 1 second (FEV1 ≥70% of predicted value were enrolled. At least one PPC occurred in 57 (16.6% patients. Prevalence of PPC was higher in patients with COPD (30.1% than in those with normal spirometry (10.0%; P<0.001. However, in patients with COPD, the prevalence of PPC was not different in patients with FEV1 ≥70% compared to those with FEV1 <70% and between group A (low risk and less symptoms and group B (low risk and more symptoms patients with COPD, based on the new Global initiative for chronic Obstructive Lung Disease 2011 guidelines. In patients with COPD, body mass index (odds ratio [OR]: 0.80, P=0.007, carbon monoxide diffusing capacity of the lung (DLCO, % predicted value (OR: 0.97, P=0.024, and operation time (OR: 1.01, P=0.003, but not COPD assessment test or St

  6. Early postoperative mortality following cholecystectomy in the entire female population of Denmark, 1977-1981

    DEFF Research Database (Denmark)

    Bredesen, J; Jørgensen, T; Andersen, T F

    1992-01-01

    of the patient's residential area was not associated with mortality. As regards early mortality, it is concluded that simple elective cholecystectomy is a safe procedure before the age of 50 to 60 years. Acute admissions and more than one diagnosis at discharge were associated with an increased mortality......This paper assesses the risk of dying within 30 days of admission among 13,854 women who had a cholecystectomy performed as the principal operation from 1977 to 1981. The overall crude mortality rate was 1.2%. Women who had a simple elective cholecystectomy performed had a mortality rate similar...... to women who had a simple hysterectomy. The mortality was significantly higher than in the general female population (p less than 0.05). Increased age, acute admission, admissions to hospital within 3 months prior to the index admission, the number of discharge diagnoses, and the geographical region were...

  7. Intraoperative and early postoperative complications using the buccal fat pad during cleft palate surgery in East Indonesia

    Directory of Open Access Journals (Sweden)

    Eveline Vere Konijnendijk

    2016-06-01

    Full Text Available Six baby’s with cleft are born in Indonesia every hour. There is no standardized treatment of cleft in East Indonesia. Closure is an important aspect during cleft lip and palate surgery. Various techniques have been advocated to gain tissue for closure of cleft area. Mostly these techniques may only provide a small amount of additional length. For lager defects they may be use the local flaps or the buccal fat pad flap. The aim of this study is gain more information about intraoperative and early postoperative complications using the buccal fat pat during cleft palate surgery in East Indonesia. The mouth can be divided in six parts therefor the LAHSAL index will be used. This LAHSAL system is a diagrammatic classification of cleft lip and palate. The LAHSAL system is being used for this study as this system classifies the cleft primarily on location and also on the cleft being complete or incomplete, which can be significant for the research. After diagnosis and classification, the following patient data was obtained: patient age, weight, gender, type of surgery (primary or following, i.e. when the surgery is a correction of a previous treatment, if a bone graft is needed for closure, history of maxillofacial surgery or orthodontics, operation technique, operation duration, type of an aesthesia (local or general, radiographical records and light photos. These data were collected during the pre-operative consultation, about 24 hours before surgery. It was the policy of the team to admit and see all patients one day prior to surgery for counselling, postoperative instructions and evaluating the patient's facial defect.

  8. An Early Holocene Eruptive Period at Mount Rainier, Washington

    Science.gov (United States)

    Byman, J.; Vallance, J. W.

    2001-12-01

    Tephrochronologic studies indicate that the Cowlitz Park eruptive period at Mount Rainier began about 7500 years ago and continued intermittently until about 6800 years ago. Stratigraphic evidence suggests that Cowlitz Park time comprises four distinct eruptive episodes, each of which occurred during a relatively brief interval. The eruptions produced subplinian falls, several small ash falls, pyroclastic flows, and lahars, the largest of which swept down the White River valley to Puget Sound lowland. Tephra layers are of two types: vesicle rich (chiefly pumice lapilli, scoria, and ash) and vesicle poor (chiefly fine-grained glass and lithic fragments). Pumice and glass shards in vesicle-rich deposits are microlite-poor and derive from larger explosive eruptions. Glass shards in vesicle-poor ashes have variable microlite contents and derive from smaller explosions, or from ash clouds that billow up from block-and-ash pyroclastic flows. Although the Pleistocene record indicates considerable effusive activity at Mount Rainier, no record remains of lavas that might have erupted during Cowlitz Park time. The oldest eruption, ca 7500 cal yr BP, produced vesicular tephra "A," distributed to the east, with a volume of 5 x 106 m3. Layer A is pumiceous, but fine-grained, glassy layers, suggestive of ash-clouds derived from pyroclastic flows, bracket it stratigraphically. About 7300 cal yr BP, within a short interval of time, a more complex eruptive episode occurred that produced a subplinian fall, at least 3 minor ash layers and an avalanche of hydrothermally altered rock on the south flank of the volcano that generated a lahar. The subplinian layer, "L," was among the most voluminous in the Holocene 30 x 106 m3 at Mount Rainier. This tephra occurs to the southeast and chiefly contains pumice along with subordinate, juvenile, lithic clasts. Related fine-to-coarse-grained ash layers derive from small explosions that occurred shortly before and after the eruption of layer L

  9. Effect of Target Controlled Infusion of Remifentanil Combined with Sufentanil on Stress Reaction and Postoperative Pain of Elderly Patients in Perioperative Period

    Institute of Scientific and Technical Information of China (English)

    Naser Babaee; Ali Jahangiri Alavi

    2016-01-01

    Objective:To explore the effect of target controlled infusion (TCI) of remifentanil combined with sufentanil on the stress reaction and postoperative pain of elderly patients in perioperative period. Methods: Ninety-four patients receiving general anesthesia who underwent upper abdominal operation selectively were collected and randomly assigned into observation group (n=47) and control group (n=47). The patients in control group were given remifentanil 5 ng/mL for anesthesia induction and 4 ng/mL for anesthesia maintenance. Patient-controlled intravenous analgesia (PCIA) was conducted at the time of suture. The patients in observation group were given remifentanil and sufentanil 2 ng/mL for anesthesia induction and maintenance. PCIA was performed at the time of suture. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) of patients in two groups were compared respectively before anesthesia (T1), before intubation (T2), 1 min after intubation (T3), 1 min after laparotomy (T4) and 1 min after extubation (T5). The violent fluctuation times of intraoperative hemodynamics were closely observed. The levels of serum cortisol and glucose before operation, during operation, 12 h and 24 h after operation, visual analogue scale (VAS) scores and doses of analgesics at different postoperative time points were also recorded. Results: Both SBP and DBP at different time points as well as HR at T3 and T4 were signiifcantly lower in observation group than in control group, and the difference was shown statistically significance (P Conclusion: For elderly patients in perioperative period, TCI of remifentanil combined with sufentanil can effectively attenuate the increase of blood pressure and HR, maintain the lfuctuation times of hemodynamics and depth of anesthesia, and decrease the stress reaction and postoperative doses of analgesics.

  10. Distinctive Hemodynamics in the Immediate Postoperative Period of Patients with a Longer Cardiac Intensive Care Stay Post-Tetralogy of Fallot Repair.

    Science.gov (United States)

    Beg, Kisha A; Haq, Anwarul; Amanullah, Muneer; Laique, Sobia N; Sadqani, Saleem; Aslam, Nadeem; Rehmat, Amina Wali; Hasan, Babar S

    2015-01-01

    After complete surgical repair the majority of tetralogy of Fallot (ToF), patients stay ≤2 days in the Cardiac Intensive Care Unit (CICU) while some may stay longer. We undertook this study to investigate the factors associated with shorter vs. longer length of stay in the CICU to help manage resources effectively. Patients who underwent ToF repair at Aga Khan University, Pakistan, between July 2006 and December 2011 were studied in a case-control design. Clinical parameters were compared between short stay group (SSG) (≤2 days) and long stay group (LSG) (>2 days). Odds ratios were calculated, and regression was performed. Ninety-eight patients (LSG 65, SSG 33) were included. Patients with lower preoperative saturation were 2.67 times more likely to be in the LSG group (P = .02). At 4 hours postoperatively, patients with a higher inotropic score (odds ratio [OR] = 3.03, confidence interval [CI] = 1.19-7.7, P = .02), higher central venous pressure (OR = 3.04, CI = 1.27-7.32, P = .013), and significant tachycardia at 4 hours (OR = 3.5, CI = 1.19-10.3. P = .02) were at risk for having a prolonged CICU stay. On multivariate analysis, significant postoperative tachycardia at 4 hours (z-score ≥3) was highly specific (sensitivity = 38.5%, specificity = 84.9%) for predicting the chances of being in the LSG. Other predictors included preop O(2) saturation ≤82.5% (sensitivity = 61.1%, specificity = 63.0%) and CVP ≥10 mm Hg at 4 hours (sensitivity = 55.4%, specificity = 71.9%). Patients who end up staying longer in the CICU have features that are distinctive in the immediate postoperative period, and this can help clinicians in identifying patients who may need more support. © 2015 Wiley Periodicals, Inc.

  11. Food quality in the late postoperative period of bariatric surgery: an evaluation using the bariatric food pyramid.

    Science.gov (United States)

    Soares, Fernando Lucas; Bissoni de Sousa, Larissa; Corradi-Perini, Carla; Ramos da Cruz, Magda Rosa; Nunes, Mario Gilberto Jesus; Branco-Filho, Alcides José

    2014-09-01

    Bariatric surgery is an effective intervention in the treatment of obesity, but lifestyle and diet should be monitored after this procedure to ensure success. The Bariatric Food Pyramid was created basing on long-term nutritional care that proposes a standard of healthy living and eating habits considering gastric capacity and specific nutritional needs. The purpose of the current study is to evaluate the life habits and diet quality of patients who have undergone bariatric surgery (who have been recovering for at least 6 months) based on the specific food pyramid. Retrospective data analysis was performed using medical records of patients who had been followed for at least 6 months after bariatric surgery. The following data were collected from patient records: age, gender, education level (years), BMI (preoperative and postoperative), percentage of excess weight loss (EWL) relative to the time of surgery, frequency of physical activity, use of nutritional supplements, usual dietary intake history, and fluid intake. Results were analyzed using descriptive statistics. We evaluated 172 patient records. In this study, there was a low prevalence of physical activity, use of vitamin-mineral supplements, and water intake. There also was low consumption of protein, fruit, vegetables, and vegetable oils. In addition, intake of carbohydrates, sugars, and fats were higher than the recommendations established by the pyramid. The results indicate that patients who have undergone bariatric surgery have an inadequate diet according to food evaluation with the specific pyramid. In the long term, this may lead to weight gain and vitamin and mineral deficiencies.

  12. [Comparative assessment of ct-bypass angiography and invasive coronary angiography in patients after coronary bypass surgery in the late postoperative period].

    Science.gov (United States)

    Men'kov, I A; Trufanov, G E; Zhelezniak, I S; Rud', S D; Kniazev, E A

    2013-10-01

    The aim of the study was to evaluate the diagnostic accuracy of ct-bypass angiography in the evaluation of significant stenosis and occlusion of grafts, recipient and nongrafted vessels in patients after coronary bypass surgery in the late postoperative period. Ct-bypass angiography was performed on 64-slice ct scanner with a slice thickness of 0.5 mm and a gantry rotation time of 0.4 s. All results were compared with quantitative invasive coronary angiography. 43 patients with 113 grafts were included in the study. Sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy for the evaluation of significant stenosis were 94%, 95%, 88%, 98%, 95%, respectively. Diagnostic accuracy for the evaluation of significant stenosis in the recipient and nongrafted vessels were 91% and 90%, respectively. The diagnostic accuracy for the evaluation graft occlusion, recipient and nongrafted vessels was 100%, 100% and 98%, respectively. Ct-bypass angiography allows accurate non-invasive assessment of significant stenosis and occlusion of coronary bypass grafts and native coronary arteries in patients after coronary bypass surgery in the late postoperative period.

  13. Eyelid hygiene as a tool for prevention and treatment of complications due to ocular surface diseases in early post-LASIK period

    Directory of Open Access Journals (Sweden)

    V. V. Kurenkov

    2014-07-01

    Full Text Available Purpose: to analyze the effect of eyelid hygiene and therapy on early post-op period following excimer laser refractive surgery.Methods: 144 patients (288 eyes aged 18-57 yrs who underwent excimer laser vision correction (LASIK were followed. All patients were divided into two groups depending on therapy. In treatment group (70 patients/140 eyes, eyelid hygiene was prescribed 7 days before and 7 days again following refractive surgery for 1 or 2 months. In control group (74 patients/148 eyes, no eyelid hygiene was prescribed.Results: Complex method of eyelid hygiene and therapy was developed that consisted in eyelid margins self-massage using Blepharogel 1 or Blepharogel 2 and warm compresses using Blepharopads impregnated with Blepharolotion. When using in combina- tion with antibacterial and tear replacement therapy, this method provides significant decrease in infectious complications rate and effective recovery of tear production in early post-op period following excimer laser surgery. these observations are confirmed by the dynamics of clinical, functional and subjective parameters.Conclusion: 7-days eyelid hygiene and therapy course that is prescribed immediately before and following laser vision correctionprovides multi-factorial effect, i.e., reduces post-op inflammatory complications rate and increases tear film stability.

  14. Eyelid hygiene as a tool for prevention and treatment of complications due to ocular surface diseases in early post-LASIK period

    Directory of Open Access Journals (Sweden)

    V. V. Kurenkov

    2012-01-01

    Full Text Available Purpose: to analyze the effect of eyelid hygiene and therapy on early post-op period following excimer laser refractive surgery.Methods: 144 patients (288 eyes aged 18-57 yrs who underwent excimer laser vision correction (LASIK were followed. All patients were divided into two groups depending on therapy. In treatment group (70 patients/140 eyes, eyelid hygiene was prescribed 7 days before and 7 days again following refractive surgery for 1 or 2 months. In control group (74 patients/148 eyes, no eyelid hygiene was prescribed.Results: Complex method of eyelid hygiene and therapy was developed that consisted in eyelid margins self-massage using Blepharogel 1 or Blepharogel 2 and warm compresses using Blepharopads impregnated with Blepharolotion. When using in combina- tion with antibacterial and tear replacement therapy, this method provides significant decrease in infectious complications rate and effective recovery of tear production in early post-op period following excimer laser surgery. these observations are confirmed by the dynamics of clinical, functional and subjective parameters.Conclusion: 7-days eyelid hygiene and therapy course that is prescribed immediately before and following laser vision correctionprovides multi-factorial effect, i.e., reduces post-op inflammatory complications rate and increases tear film stability.

  15. Postoperative spine; Postoperative Wirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Schlaeger, R. [Universitaetsspital Basel, Neurologische Klinik und Poliklinik, Basel (Switzerland); Lieb, J.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Shariat, K. [Neurochirurgie Koeln-Merheim, Koeln (Germany); Ahlhelm, F.J. [Kantonsspital Baden AG, Abteilung Neuroradiologie, Institut fuer Radiologie, Baden (Switzerland)

    2014-11-15

    Approximately 15-30 % of surgical procedures involving the lumbar spine are associated with complications that require further diagnostic work-up. The choice of imaging modality for postoperative complications depends on the extent, pattern and temporal evolution of the postoperative neurological signs and symptoms as well as on the preoperative clinical status, the surgical procedure itself and the underlying pathology. The interpretation of imaging findings, in particular the distinction between postoperative complications and normally expected nonspecific postoperative imaging alterations can be challenging and requires the integration of clinical neurological information and the results of laboratory tests. The combination of different imaging techniques might help in cases of equivocal imaging results. (orig.) [German] Etwa 15-30 % der operativen Eingriffe im Bereich der lumbalen Wirbelsaeule verlaufen nicht komplikationsfrei und erfordern weiterfuehrende Abklaerungen. Die Auswahl des bildgebenden Verfahrens im Rahmen postoperativer Komplikationen haengt dabei wesentlich von der zeitlichen Entwicklung, dem Ausmass und Verteilungsmuster der neuaufgetretenen klinisch-neurologischen bzw. orthopaedischen Symptome sowie von den Ausfaellen vor dem Eingriff, der zugrundeliegenden Pathologie und der Lokalisation und Art des Eingriffs ab. Die Interpretation der bildgebenden Befunde, insbesondere die Abgrenzung postoperativer Komplikationen von natuerlicherweise zu erwartenden postoperativen Veraenderungen kann dabei eine Herausforderung darstellen. Bei unklaren Befunden kann ergaenzend zur eingehend klinisch-neurologischen und laborchemischen Bestandsaufnahme auch der kombinierte Einsatz mehrerer bildgebender Modalitaeten diagnostisch weiterhelfen. (orig.)

  16. Effect of Target Controlled Infusion of Remifentanil Combined with Sufentanil on Stress Reaction and Postoperative Pain of Elderly Patients in Perioperative Period

    Directory of Open Access Journals (Sweden)

    Naser Babaee

    2016-06-01

    Full Text Available Objective: To explore the effect of target controlled infusion (TCI of remifentanil combined with sufentanil on the stress reaction and postoperative pain of elderly patients in perioperative period.Methods: Ninety-four patients receiving general anesthesia who underwent upper abdominal operation selectively were collected and randomly assigned into observation group (n=47 and control group (n=47. The patients in control group were given remifentanil 5 ng/mL for anesthesia induction and 4 ng/mL for anesthesia maintenance. Patient-controlled intravenous analgesia (PCIA was conducted at the time of suture. The patients in observation group were given remifentanil and sufentanil 2 ng/mL for anesthesia induction and maintenance. PCIA was performed at the time of suture. Systolic blood pressure (SBP, diastolic blood pressure (DBP and heart rate (HR of patients in two groups were compared respectively before anesthesia (T1, before intubation (T2, 1 min after intubation (T3, 1 min after laparotomy (T4 and 1 min after extubation (T5. The violent fluctuation times of intraoperative hemodynamics were closely observed. The levels of serum cortisol and glucose before operation, during operation, 12 h and 24 h after operation, visual analogue scale (VAS scores and doses of analgesics at different postoperative time points were also recorded.Results: Both SBP and DBP at different time points as well as HR at T3 and T4 were significantly lower in observation group than in control group, and the difference was shown statistically significance (P<0.05 or P<0.01. The violent fluctuation times of intraoperative hemodynamics were (2.7±1.2 in observation group and (3.9±1.7 in control group, and the difference was shown statistically significance (t=3.954, P<0.001. The levels of serum cortisol and glucose, VAS scores and doses of analgesics were all significantly lower in observation group than in control group at different postoperative time points, and there was

  17. MARSSIM Landform Evolution Model: Hydrologic Constraints on the Noachian Early Dry Period

    Science.gov (United States)

    Boatwright, B. D.; Head, J. W.

    2017-10-01

    We propose to test several hydrologic parameters to constrain the nature of highland degradation on Noachian Mars. This early dry period is less well characterized than the terminal epoch of valley network formation.

  18. Early post-operative magnetic resonance imaging in glioblastoma: correlation among radiological findings and overall survival in 60 patients

    Energy Technology Data Exchange (ETDEWEB)

    Majos, Carles [IDI Centre Bellvitge, HU de Bellvitge, Department of Radiology, Barcelona (Spain); Centro de Investigacion en Red en Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain); Hospital Duran i Reynals, IDI Centre Bellvitge, Barcelona (Spain); Cos, Monica; Castaner, Sara [IDI Centre Bellvitge, HU de Bellvitge, Department of Radiology, Barcelona (Spain); Gil, Miguel [ICO l' Hospitalet, HU de Bellvitge, Department of Medical Onclogy, Barcelona (Spain); Plans, Gerard [HU de Bellvitge, Department of Neurosurgery, Barcelona (Spain); Lucas, Anna [ICO l' Hospitalet, HU de Bellvitge, Department of Radiotherapy Oncology, Barcelona (Spain); Bruna, Jordi [HU de Bellvitge, Department of Neurology, Barcelona (Spain); Aguilera, Carles [IDI Centre Bellvitge, HU de Bellvitge, Department of Radiology, Barcelona (Spain); Centro de Investigacion en Red en Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain)

    2016-04-15

    To evaluate early post-operative magnetic resonance (EPMR) as a prognostic tool after resection of glioblastoma. Sixty EPMR examinations were evaluated for perioperative infarct, tumour growth between diagnosis and EPMR, contrast enhancement pattern, and extent of resection (EOR). The EOR was approached with the subjective evaluation of radiologists and by quantifying volumes. These parameters were tested as predictors of survival using the Kaplan-Meier method. Contrast enhancement was found in 59 patients (59/60; 98 %). Showing a thin-linear pattern of enhancement was the most favourable finding. Patients with this pattern survived longer than patients with thick-linear (median overall survival (OS) thin-linear=609 days; thick-linear=432 days; P =.023) or nodular (median OS = 318 days; P =.001) enhancements. The subjective evaluation of the EOR performed better than its quantification. Patients survived longer when resection was total (median OS total resection=609 days; subtotal=371 days; P =.001). When resection was subtotal, patients survived longer if it was superior to 95 % (median OS resection superior to 95 %=559 days; inferior to 95 %=256 days; P =.034). EPMR provides valuable prognostic information after surgical resection of glioblastomas. A thin-linear pattern of contrast enhancement is the most favourable finding. Further prognostic stratification may be obtained by assessing the EOR. (orig.)

  19. Effect of pre-fracture mobility on the early post-operative functional outcome in elderly patients with a hip fracture

    Directory of Open Access Journals (Sweden)

    S. Adam

    2013-12-01

    Full Text Available Background: Hip fractures are among the most commoncauses of disability and hospitalisation in the elderly. There are no studies inSouth Africa that determine the effect of pre-fracture functional mobility onearly post-operative functional outcome in elderly patients with a hip fracture.Aim: The aim of this study was to determine the effect of pre-fracture functionalmobility on early post-operative functional outcome in elderly patients with ahip fracture.Methodology: A prospective pre-test post-test observational study designwas done. Assessments were conducted pre-operatively, at discharge and sixweeks post discharge at two public hospitals in Johannesburg, South Africa. Thepre-fracture functional mobility of the participants was determined using theNew Mobility Score (NMS pre-operatively. At discharge and at six weeks post discharge the participants post-operative functionallevel was assessed using the Elderly Mobility Scale (EMS and the Lower Extremity Functional Scale (LEFS.Results: More than two thirds of participants were independently mobile prior to the fracture. Pre-fracture functional mobilityis a strong determinant of early post operative functional outcome in elderly patients with a hip fracture(β = 1.39, p = 0.0001.Conclusion: Independent pre-fracture mobility predicts better early post-operative functional outcomes in the elderly.

  20. Individualized Prediction of Overall Survival After Postoperative Radiation Therapy in Patients With Early-Stage Cervical Cancer: A Korean Radiation Oncology Group Study (KROG 13-03)

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyun Jin [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Han, Seungbong [Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Kim, Young Seok, E-mail: ysk@amc.seoul.kr [Department of Radiation Oncology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Nam, Joo-Hyun [Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of); Kim, Hak Jae [Department of Radiation Oncology, Seoul National University Hospital, Seoul (Korea, Republic of); Kim, Jae Weon [Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul (Korea, Republic of); Park, Won [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Byoung-Gie [Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Jin Hee [Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Cha, Soon Do [Department of Obstetrics and Gynecology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Kim, Juree [Department of Radiation Oncology, Cheil General Hospital and Women' s Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Lee, Ki-Heon [Department of Obstetrics and Gynecology, Cheil General Hospital and Women' s Healthcare Center, Kwandong University, College of Medicine, Seoul (Korea, Republic of); Yoon, Mee Sun [Department of Radiation Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do (Korea, Republic of); and others

    2013-11-15

    Purpose: A nomogram is a predictive statistical model that generates the continuous probability of a clinical event such as death or recurrence. The aim of the study was to construct a nomogram to predict 5-year overall survival after postoperative radiation therapy for stage IB to IIA cervical cancer. Methods and Materials: The clinical data from 1702 patients with early-stage cervical cancer, treated at 10 participating hospitals from 1990 to 2011, were reviewed to develop a prediction nomogram based on the Cox proportional hazards model. Demographic, clinical, and pathologic variables were included and analyzed to formulate the nomogram. The discrimination and calibration power of the model was measured using a concordance index (c-index) and calibration curve. Results: The median follow-up period for surviving patients was 75.6 months, and the 5-year overall survival probability was 87.1%. The final model was constructed using the following variables: age, number of positive pelvic lymph nodes, parametrial invasion, lymphovascular invasion, and the use of concurrent chemotherapy. The nomogram predicted the 5-year overall survival with a c-index of 0.69, which was superior to the predictive power of the International Federation of Gynecology and Obstetrics (FIGO) staging system (c-index of 0.54). Conclusions: A survival-predicting nomogram that offers an accurate level of prediction and discrimination was developed based on a large multi-center study. The model may be more useful than the FIGO staging system for counseling individual patients regarding prognosis.

  1. Postoperative versus definitive chemoradiation in early-stage anal cancer. Results of a matched-pair analysis

    Energy Technology Data Exchange (ETDEWEB)

    Berger, B.; Menzel, M.; Bamberg, M.; Weinmann, M. [Tuebingen Univ. (Germany). Dept. of Radiation Oncology; Breucha, G. [Kreiskrankenhaus Hechingen, Tuebingen Univ. (Germany). Dept. of Surgery

    2012-07-15

    Background and purpose: The goal of the present study was to comparatively assess the results of definitive chemoradiation (CRT) with or without previous macroscopically complete resection in patients with early-stage node-negative (T1-2 N0) anal carcinoma. Patients and methods: A total of 20 patients with T1-2 N0 anal carcinoma who received radiotherapy (RT) with or without chemotherapy following incidental R0/1 tumor resection (S/CRT group) were selected. These were matched to 20 comparable patients who underwent definitive chemoradiation without previous surgery (CRT group). Major objectives of this analysis were treatment outcomes in terms of locoregional tumor control (LRC), overall survival (OS), colostomy-free survival, and toxicity. Results: Patients treated postoperatively received significantly lower RT doses (median 54.0 Gy vs. 59.7 Gy; p < 0.001) and less frequently concomitant chemotherapy than those treated definitely. The 5-year LRC and 5-year OS rates were 97.5% and 90.0%, respectively, without significant differences between the S/CRT and the CRT groups. The distribution of acute and late toxicities was comparable, and the 5-year colostomy-free survival was 95% in both groups. Conclusion: This matched-pair comparison of incidental R0/1 resection plus dose-reduced CRT with standard definitive CRT of early-stage anal cancer shows similar treatment results. Thus, dose-reduced RT with or without chemotherapy may be considered in R0/1 resected patients with T1-2 N0 anal carcinoma. (orig.)

  2. Evaluation of Craniofacial Morphology of Children with Dental Fluorosis in Early Permanent Dentition Period

    OpenAIRE

    Dogan, Alev Aksoy; Bolpaca, Pinar

    2009-01-01

    Objectives High intake of fluoride (>1.5 mg/L) for a prolonged period may lead to skeletal fluorosis as well as dental fluorosis. The aim of this study was to compare the craniofacial characteristics of children with dental fluorosis in early permanent dentition period to those without fluorosis. Methods Two hundred and sixteen children in early permanent dentition (girls:121, boys:95) were included in the study. Study group was composed of 124 children with dental fluorosis who was born and ...

  3. 78 FR 21979 - Early Career Doctorates Survey; Extension of Public Comment Period

    Science.gov (United States)

    2013-04-12

    ... From the Federal Register Online via the Government Publishing Office NATIONAL SCIENCE FOUNDATION Early Career Doctorates Survey; Extension of Public Comment Period AGENCY: National Science Foundation... published a notice on April 9, 2013, at 78 FR 21162, seeking comments on establishing the Early...

  4. Combined spinal/general anesthesia with postoperative femoral nerve block for total knee replacement in a patient with familial hyperkalemic periodic paralysis: a case report.

    Science.gov (United States)

    Barker, Maria C

    2010-06-01

    Familial hyperkalemic periodic paralysis (HYPP) is a rare genetic disorder in which the sodium channels in skeletal muscle cells have altered structure and function. Small elevations in serum potassium lead to inactivation of sodium channels, causing episodic weakness or paralysis. Exposure to cold, anesthesia, fasting, emotional stress, potassium ingestion, and rest after exercise can stimulate an attack. This case report describes a 65-year-old man with HYPP who was admitted for a right total knee arthroplasty. He had a history of arteriosclerotic heart disease and stenting 8 years earlier, previous inferior wall myocardial infarction with ejection fraction of 65%, anxiety, degenerative joint disease, well-controlled type 2 diabetes mellitus, and a body mass index of 53.3 kg/m2. A combined spinal/general anesthetic with a femoral nerve block for postoperative pain control was chosen. Careful attention was given to monitoring and maintenance of core temperature, use of insulin and glucose to maintain normokalemia, and carbohydrate loading the night before surgery. The patient recovered from the anesthetic without complication and had pain relief for approximately 22 hours postoperatively because of the femoral nerve block. The patient was without weakness or paralysis related to HYPP in the postanesthesia care unit or throughout his hospitalization.

  5. Do mature forest birds prefer early-successional habitat during the post-fledging period?

    Science.gov (United States)

    Carlin C. Chandler; David I. King; Richard B. Chandler

    2012-01-01

    Recent studies have highlighted the importance of the post-fledging period to bird populations, suggesting that the importance of this portion of the life cycle is equal to or greater than the nesting period. Nevertheless, few studies have compared abundance of forest nesting species between mature forest and early-successional habitats while controlling for...

  6. The associations between severity of early postoperative pain, chronic postsurgical pain and plasma concentration of stable nitric oxide products after breast surgery.

    LENUS (Irish Health Repository)

    Iohom, Gabriella

    2012-02-03

    In this study, we compared the effects of two analgesic regimens on perioperative nitric oxide index (NOx) and the likelihood of subsequent development of chronic postsurgical pain (CPSP) after breast surgery and sought to determine the association among early postoperative pain, NOx, and the likelihood of subsequent development of CPSP. Twenty-nine consecutive ASA I or II patients undergoing breast surgery with axillary clearance were randomly allocated to one of two groups. Patients in group S (n = 15) received a standard intraoperative and postoperative analgesic regimen (morphine sulfate, diclofenac, dextropropoxyphene hydrochloride + acetaminophen prn). Patients in group N (n = 14) received a continuous paravertebral block (for 48 h) and acetaminophen and parecoxib (followed by celecoxib up to 5 days). Visual analog scale pain scores at rest and on arm movement were recorded regularly until the fifth postoperative day. A telephone interview was conducted 10 wk postoperatively. The McGill Pain Questionnaire was used to characterize pain. NOx was estimated preoperatively, at the end of surgery, 30 min and 2, 4, 12, 24, 48 h postoperatively. Twelve (80%) patients in group S and no patient in group N developed CPSP (P = 0.009). Compared with patients with a pain rating index > or =1 (n = 18) 10 wk postoperatively, patients with a pain rating index = 0 (n = 11) had lesser visual analog scale pain scores on movement at each postoperative time point from 30 min until 96 h postoperatively (P < 0.005) and at rest 30 min (0.6 +\\/- 1.5 versus 30.2 +\\/- 26.8; P = 0.004), 4 h (2.3 +\\/- 7.5 versus 19.0 +\\/- 25.8; P = 0.013), 8 h (4.4 +\\/- 10.2 versus 21.4 +\\/- 27.0; P = 0.03) and 12 h (0.7 +\\/- 1.2 versus 15.4 +\\/- 27.0; P = 0.035) postoperatively. NOx values were greater in group N compared with group S 48 h postoperatively (40.6 +\\/- 20.1 versus 26.4 +\\/- 13.5; P = 0.04).

  7. Postoperative delirium and myocardial infarction in elderly patients with hip fractures: the role of postoperative anemia

    Directory of Open Access Journals (Sweden)

    V. V. Kuz’Min

    2015-01-01

    Full Text Available Objective. To assess the impact of anemia on the incidence of myocardial infarction and delirium in the early postoperative period in patients with hip fractures who underwent total hip replacement. Materials and methods. A retrospective study of 303 patients with hip fractures who underwent total hip replacement was performed. Patients were divided into two groups according to the level of hemoglobin (Hb on the 2nd postoperative day: Group 1 (n = 116 with Hb levels above 100 g/L and Group 2 (n = 187 with Hb levels below 100 g/L. Results and conclusion. Transfusion in Group 1 was performed more often intraoperatively or in the early postoperative hours (67 vs. 35 patients; p <0.001. Hb levels on the 2nd day were significantly higher in Group 1 (108 [104; 117] vs. 87 [80; 92] g/L; p <0.001. Moderate and severe anemia in the early postoperative period was noted in 53.5% and 4.3% of the patients of Group 2, respectively. The incidence of myocardial infarction and delirium was higher in Group 2 than in Group 1 (6.4% vs. 0%; p = 0,013 and 7.5% vs 0.8%; p = 0.021, respectively. The study has shown that moderate and severe anemia in the early postoperative period is associated with an increase in the incidence of myocardial infarction and delirium.

  8. Postoperative early ultrasensitive prostate-specific antigen identifies patients at risk for biochemical recurrence in margin positive prostate cancers: a single-center study.

    Science.gov (United States)

    Hatano, Koji; Okusa, Takuya; Ishizuya, Yu; Nakai, Yasutomo; Nakayama, Masashi; Kakimoto, Ken-Ichi; Nishimura, Kazuo

    2017-01-01

    To identify predictors for biochemical recurrence among patients with positive surgical margins (RM1) after radical prostatectomy and to examine the effect of ultrasensitive prostate-specific antigen measured early after prostatectomy on biochemical recurrence. We identified 705 patients with prostate cancer who were treated with radical prostatectomy without preoperative hormonal therapy at our institution between 2000 and 2014. The patients with RM1 who had a postoperative prostate-specific antigen 0.02 ng/ml was the significant risk factor for biochemical recurrence (hazard ratio 13.10). Meanwhile, the patients with postoperative early ultrasensitive prostate-specific antigen <0.01 ng/ml had a significantly lower risk for biochemical recurrence (hazard ratio 0.12). Area under the curve for the postoperative early ultrasensitive prostate-specific antigen value to predict biochemical recurrence was 0.789. The ultrasensitive prostate-specific antigen value measured early after prostatectomy was the potent predictor of biochemical recurrence among the patients with RM1. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Colonic resection with early discharge after combined subarachnoid-epidural analgesia, preoperative glucocorticoids, and early postoperative mobilization and feeding in a pulmonary high-risk patient

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Rosenberg, J

    1994-01-01

    BACKGROUND AND OBJECTIVES. A pulmonary high-risk patient undergoing right hemicolectomy for cancer was treated with a combination of intense afferent neural block with subarachnoid-epidural local anesthetics followed by continuous epidural analgesia, preoperative high-dose glucocorticoids......) with unchanged pulmonary function. Nocturnal episodic oxygen desaturation, hyperthermia, and postoperative fatigue were prevented. Defecation occurred on the first postoperative day and oral caloric intake was normal after 24 hours with no postoperative weight loss. Self care was normalized on the third...

  10. Postoperative pain

    DEFF Research Database (Denmark)

    Kehlet, H; Dahl, J B

    1993-01-01

    also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

  11. Anthropometric evaluation and micronutrients intake in patients submitted to laparoscopic Roux-en-Y gastric bypass with a postoperative period of ≥ 1 year.

    Science.gov (United States)

    Mercachita, Tânia; Santos, Zélia; Limão, Jorge; Carolino, Elisabete; Mendes, Lino

    2014-01-01

    Bariatric surgery is indicated as the most effective treatment for morbid obesity; the Roux-en-Y gastric bypass (RYGB) is considered the procedure of choice. However, nutritional deficiency may occur in the postoperative period as a result of reduced gastric capacity and change in nutrients absorption in the gastrointestinal tract. The prescription of vitamin and mineral supplementation is a common practice after RYGB; however, it may not be sufficient to prevent micronutrient deficiencies. The aim of this study was to quantify the micronutrient intake in patients undergoing RYGB and verify if the intake of supplementation would be enough to prevent nutritional deficiencies. The study was conducted on 60 patients submitted to RYGB. Anthropometric, analytical, and nutritional intake data were assessed preoperatively and 1 and 2 years postoperatively. The dietary intake was assessed using 24-h food recall; the values of micronutrients evaluated (vitamin B12, folic acid, iron, and calcium) were compared to the dietary reference intakes (DRI). There were significant differences (p < 0.05) between excess weight loss at the first and second year (69.9 ± 15.3 vs 9.6 ± 62.9 %). In the first and second year after surgery, 93.3 and 94.1 % of the patients, respectively, took the supplements as prescribed. Micronutrient deficiencies were detected in the three evaluation periods. At the first year, there was a significant reduction (p < 0.05) of B12, folic acid, and iron intake. Despite taking vitamin and mineral supplementation, micronutrient deficiencies are common after RYGB. In the second year after surgery, micronutrient intake remains below the DRI.

  12. Split liver transplantation using extended right grafts: the natural history of segment 4 and its impact on early postoperative outcomes.

    Science.gov (United States)

    Sepulveda, Ailton; Scatton, Olivier; Tranchart, Hadrien; Gouya, Hervé; Perdigao, Fabiano; Stenard, Fabien; Bernard, Denis; Conti, Filomena; Calmus, Yvon; Soubrane, Olivier

    2012-04-01

    Split liver transplantation (SLT) using extended right grafts is associated with complications related to ischemia of hepatic segment 4 (S4), and these complications are associated with poor outcomes. We retrospectively analyzed 36 SLT recipients so that we could assess the association of radiological, biological, and clinical features with S4 ischemia. The overall survival rates were 84.2%, 84.2%, and 77.7% at 1, 3, and 5 years, respectively. The recipients were mostly male (24/36 or 67%) and had a median age of 52 years (range = 13-63 years), a median body mass index of 22.9 kg/m(2) (range = 17.3-29.8 kg/m(2) ), and a median graft-to-recipient weight ratio of 1.3% (range = 0.9%-1.9%). S4-related complications were diagnosed in 22% of the patients (8/36) with a median delay of 22 days (range = 10-30 days). Secondary arterial complications were seen in 3 of these patients and led to significantly decreased graft survival in comparison with the graft survival of patients without complications (50.0% versus 85.6%, P = 0.017). Patients developing S4-related complications had significantly elevated aspartate aminotransferase (AST) levels (>1000 IU/L) on postoperative day (POD) 1 and elevated gamma-glutamyl transpeptidase (GGT) levels (>300 IU/L) on PODs 7 and 10 (P graft survival, and the development of these complications can be anticipated by the early identification of a specific biological profile and a routine radiological examination.

  13. Clinical analysis of early postoperative hypoxemia%外科手术后早期低氧血症的临床分析

    Institute of Scientific and Technical Information of China (English)

    何征宇; 皋源; 王祥瑞

    2009-01-01

    目的 探讨术后早期的低氧血症发生的高危因素,预防术后早期低氧血症的发生.方法 将2005年7月至2007年6月进入上海交通大学医学院附属仁济医院外科监护室于手术后24 h内发生低氧血症的患者作为病例组,按1:2比例随机抽取同时期进入外科监护室未发生低氧血症的手术患者作为对照组.分析病例组患者的手术类型以及引起术后早期低氧血症的直接原因.筛选出高危因素后在两组间进行单因素分析和Logistic多元回归分析.结果 病例组患者以接受胸部手术(33.78%)和上腹部手术(24.32%)为主.术后早期引起低氧血症的直接原因包括:肺部原发病加重(17.57%)、胸部手术并发症(24.32%)、围手术期处理不当(21.62%)、其他基础疾病(18.92%)等.单因素分析发现:大量吸烟史、术前合并肺部原发病、危重患者、合并胸部手术并发症、大量输液以及呼吸支持不足等因素与术后低氧血症密切相关.多因素分析结果表明,术前合并肺部原发病、危重患者、合并胸部手术并发症以及呼吸支持不足的患者术后低氧血症发生的风险显著增加(P<0.05).结论 术后早期低氧血症与大量吸烟、肺部及其他系统危重疾病、胸部手术并发症、输液过多以及呼吸支持不足等因素密切相关,必须采取相应措施防止术后早期低氧血症的发生.%Objective To study high risk factors of early postoperative hypoxemia and its prevention. Methods Patients admitted to SICU suffering from postoperative hypoxemia in 24 h during recent 2 years were taken as case group. Those who did not suffering from postoperative hypoxemia during the same period drawn by proportion of 1:2 randomly were taken as control group. The surgical operation categories and directive cause of hypoxemia were analyzed in case group. Then the high risk factors were deduced and were investig ated with single factor analysis and Logistie multiple

  14. Concept Analysis of Burden in Caregivers of Stroke Survivors During the Early Poststroke Period.

    Science.gov (United States)

    Byun, Eeeseung; Evans, Lois K

    2015-10-01

    It is important to understand burden in caregivers of stroke survivors during the early poststroke period if we are to prevent or decrease the longer-term experience of caregiver burden and its consequences. This article reports a concept analysis of burden in caregivers of stroke survivors during the early poststroke period. A literature review using MEDLINE, PubMed, CINAHL, PsycINFO, and ISI Web of Knowledge databases (1960-2014) identified 32 relevant articles published from 1993 to 2013. Rodgers's evolutionary method of concept analysis was used. Three attributes--objective and subjective aspects, time spent caring for the stroke survivor, and uncertainty about the future for the stroke survivor and caregiver--were identified. Multiple definitions of caregiver burden have been used. In the early poststroke period, burden appears closely interconnected with other factors, some of which may be modifiable. © The Author(s) 2014.

  15. The correlation between variation of visual acuity and the anterior chamber depth in the early period after phacoemulsification

    Directory of Open Access Journals (Sweden)

    Kai-jian CHEN

    2011-04-01

    Full Text Available Objective To investigate the correlation between the visual acuity variation and the anterior chamber depth in the early period after phacoemulsification.Methods Thirty-six eyes of 32 patients with age-related cataract underwent 3.2mm clear corneal incision phacoemulsification and intraocular lens(IOL implantation.The visual acuity was examined and horizontal curvature(K1,vertical curvature(K2,corneal astigmatism,and anterior chamber depth were measured with IOL-master preoperatively and also on 1,3,7 and 15 postoperative days.The changes in parameters were compared,and the correlations among visual acuity,corneal astigmatism and anterior chamber depth were analyzed.Results Before operation and 1d,3d,7d and 15d after operation,the corneal astigmatism was-0.87±0.40D,-1.92±1.38D,-1.69±1.13D,-1.45±0.79D and-1.36±0.74D;the anterior chamber depth was 3.08±0.35mm,4.04±0.38mm,4.28±0.29mm,4.22±0.17mm and 4.22±0.16mm;the visual acuity was 0.18±0.10,0.44±0.14,0.59±0.12,0.61±0.11 and 0.62±0.14.Significant difference was found between pre-operative and postoperative visual acuity,corneal astigmatism and anterior chamber depth,and it was also found in corneal astigmatism between 1d and 15d post operation(P < 0.05,as well as in anterior chamber depth and visual acuity between 1d and 3d post operation(P < 0.05.A positive correlation was found between visual acuity and corneal astigmatism on 1d(r=0.42,P < 0.05,3d(r=0.35,P < 0.05 and 7d(r=0.35,P < 0.05 post operation;and a negative correlation was found between visual acuity and anterior chamber depth on 3d(r=-0.29,P < 0.05,7d(r=-0.43,P < 0.01 and 15d(r=-0.37,P < 0.05 post operation.Conclusion Both the corneal astigmatism and the anterior chamber depth are correlated with the visual acuity variation in the early period after phacoemulsification.

  16. Low cardiac output syndrome in the postoperative period of cardiac surgery. Profile, differences in clinical course and prognosis. The ESBAGA study.

    Science.gov (United States)

    Pérez Vela, J L; Jiménez Rivera, J J; Alcalá Llorente, M Á; González de Marcos, B; Torrado, H; García Laborda, C; Fernández Zamora, M D; González Fernández, F J; Martín Benítez, J C

    2017-07-20

    An analysis is made of the clinical profile, evolution and differences in morbidity and mortality of low cardiac output syndrome (LCOS) in the postoperative period of cardiac surgery, according to the 3 diagnostic subgroups defined by the SEMICYUC Consensus 2012. A multicenter, prospective cohort study was carried out. ICUs of Spanish hospitals with cardiac surgery. A consecutive sample of 2,070 cardiac surgery patients was included, with the analysis of 137 patients with LCOS. No intervention was carried out. The mean patient age was 68.3±9.3 years (65.2% males), with a EuroSCORE II of 9.99±13. NYHA functional class III-IV (52.9%), left ventricular ejection fraction<35% (33.6%), AMI (31.9%), severe PHT (21.7%), critical preoperative condition (18.8%), prior cardiac surgery (18.1%), PTCA/stent placement (16.7%). According to subgroups, 46 patients fulfilled hemodynamic criteria of LCOS (group A), 50 clinical criteria (group B), and the rest (n=41) presented cardiogenic shock (group C). Significant differences were observed over the evolutive course between the subgroups in terms of time subjected to mechanical ventilation (114.4, 135.4 and 180.3min in groups A, B and C, respectively; P<.001), renal replacement requirements (11.4, 14.6 and 36.6%; P=.007), multiorgan failure (16.7, 13 and 47.5%), and mortality (13.6, 12.5 and 35.9%; P=.01). The mean maximum lactate concentration was higher in cardiogenic shock patients (P=.002). The clinical evolution of these patients leads to high morbidity and mortality. We found differences between the subgroups in terms of the postoperative clinical course and mortality. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  17. [ACUTE KIDNEY INJURY IN PATIENTS WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME IN THE EARLY PERIOD AFTER CARDIAC SURGERY].

    Science.gov (United States)

    Eremenko, A A; Minbolatova, N M

    2015-01-01

    Acute kidney injury can greatly increase the severity of multiple organ dysfunction syndrome (MODS) and impair patient outcomes. To study the clinical significance of acute kidney injury in patients with MODS in early postoperative period after cardiac surgety and its influence, on the severity of the patient condition and outcomes. The study involved 117 patients aged 57.2 ± 1.2 years. The Group 1, control, included 74 patients with uncomplicated postoperative period; the Group 2--43 patients with MODS, who were divided into the survivors (33 patients, group 2a) and deaths (10 patients, group 2b). In Group 2. thefollowingparaineters were higher--the volume of blood loss by 1.5 times (p = 0,001), the duration of the cardiopulmonary bypass 1.7 times (p 0.001), and aortic clamping 1.6 times (p = 0,001). Group 2a and 2b on these indicators did not differ Average scale Group 2b was 1,3-fold higher than in survivors (p = 0,001). Patients differ in the severity of the central nervous system disorders (the average score of Glasgow Coma Scale survivors was 1.3 times higher P = 0,001) and severity of acute kidney injury On a RIFLE scale patients of group 2a normal data was observed in 12%, the stage of risk in 61%, and damage in 27%. In 50% of the dead was a stage of disease (p = 0.04), the rest--damage. In the dynamics of the group 2b impaired renal and hepatic functions have progressed. By day 3 ASTwas on average 2-fold higher (p = 0.01), ALT (1.9 fold, p = 0,001), alkaline phosphatase 1.5 times (p = 0.001), while the total blood protein below 1.3 times (p = 0.00 1), than in group 2a. Creatinine in patients of Group 2b was 1.4 tunes higher (p = 0,036), urea 1.6 (p = 0.026), u-NGAL 7 times higher (p = 0.001), than in group 2a. Long cardiopulmonary bypass, clamping of the aorta and a large amount of perioperative the risk of MODS in the early postoperative period, but do not affect the outcome. On the background of the dzvelopment of MODS an average score on MODS-2 scale

  18. Early diagnosis of postoperative pneumonia following upper abdominal surgery. A study in patients without cardiopulmonary disorder at operation

    DEFF Research Database (Denmark)

    Ejlertsen, Tove; Nielsen, P H; Jepsen, S

    1989-01-01

    In 130 patients with no cardiac or pulmonary disease at the time of elective upper abdominal surgery, chest radiography was performed 2 and 4 days postoperatively. The sputum was examined and the patients were monitored with measurement of body temperature, arterial oxygen tension and white blood...... counts. Pneumonic infiltrates appeared in 8.4% of the patients and atelectasis in 68.5%. Most of the patients had elevated body temperature, raised white blood count and reduced arterial oxygen tension postoperatively. None of these commonly employed clinical or laboratory findings, singly...

  19. Local analgesic effect of tramadol is not mediated by opioid receptors in early postoperative pain in rats

    Directory of Open Access Journals (Sweden)

    Angela Maria Sousa

    2015-06-01

    Full Text Available BACKGROUND AND OBJECTIVES: Tramadol is known as a central acting analgesic drug, used for the treatment of moderate to severe pain. Local analgesic effect has been demonstrated, in part due to local anesthetic-like effect, but other mechanisms remain unclear. The role of peripheral opioid receptors in the local analgesic effect is not known. In this study, we examined role of peripheral opioid receptors in the local analgesic effect of tramadol in the plantar incision model. METHODS: Young male Wistar rats were divided into seven groups: control, intraplantar tramadol, intravenous tramadol, intravenous naloxone-intraplantar tramadol, intraplantar naloxone-intraplantar tramadol, intravenous naloxone-intravenous tramadol, and intravenous naloxone. After receiving the assigned drugs (tramadol 5 mg, naloxone 200 µg or 0.9% NaCl, rats were submitted to plantar incision, and withdrawal thresholds after mechanical stimuli with von Frey filaments were assessed at baseline, 10, 15, 30, 45 and 60 min after incision. RESULTS: Plantar incision led to marked mechanical hyperalgesia during the whole period of observation in the control group, no mechanical hyperalgesia were observed in intraplantar tramadol group, intraplantar naloxone-intraplantar tramadol group and intravenous naloxone-intraplantar tramadol. In the intravenous tramadol group a late increase in withdrawal thresholds (after 45 min was observed, the intravenous naloxone-intravenous tramadol group and intravenous naloxone remained hyperalgesic during the whole period. CONCLUSIONS: Tramadol presented an early local analgesic effect decreasing mechanical hyperalgesia induced by plantar incision. This analgesic effect was not mediated by peripheral opioid receptors.

  20. Parents' Views on the Use of Technology in the Early Childhood Period

    Science.gov (United States)

    Ekici, Fatma Yasar

    2016-01-01

    The main aim of this research is to examine parents' views on technology use in the early childhood period. Survey method was used in this research. The research population consists of the parents, whose children go to the pre-school education institutions in Istanbul province. The research sample consists of 477 parents chosen by the random…

  1. COMPARISON OF GESTATIONAL AGE AT DELIVERY BASED ON LAST MENSTRUAL PERIOD AND EARLY ULTRASOUND

    Science.gov (United States)

    Reported date of last menstrual period (LMP) is commonly used to estimate gestational age but may be unreliable if recall is inaccurate or time between menstruation and ovulation differs from the presumed 15-day interval. Early ultrasound is generally a more accurate method than ...

  2. Effects of three-dimensional navigation on intraoperative management and early postoperative outcome after open reduction and internal fixation of displaced acetabular fractures

    DEFF Research Database (Denmark)

    Oberst, Michael; Hauschild, Oliver; Konstantinidis, Lukas;

    2012-01-01

    BACKGROUND: This study was conducted to evaluate whether intraoperative procedure and/or early postoperative results after open reduction and internal fixation (ORIF) of displaced acetabulum fractures are influenced by the use of a three-dimensional (3D) image intensifier in combination with a na....... In addition, the complication rate in the navigated group was significantly lower. CONCLUSION: We support the use of navigation systems and a 3D image intensifier as helpful tools during ORIF of displaced acetabular fractures. LEVEL OF EVIDENCE: Therapeutic study, level III....... acetabular fractures led to a significant increase in skin-to-skin time. Postoperative radiolographic analysis revealed an improvement in the quality of fracture reduction in the 3D navigation group. Navigation in combination with the 3D images of the ISO-C 3D limited the need for extended approaches...

  3. The effect of preoperative renal dysfunction with or without dialysis on early postoperative outcome following cardiac surgery.

    LENUS (Irish Health Repository)

    Al-Sarraf, Nael

    2011-01-01

    Although previous studies have shown increased mortality in renal dysfunction patients undergoing cardiac surgery, there is lack of data on the pattern of postoperative complications that occur in such patients and their distribution among dialysis and non-dialysis dependent renal dysfunction.

  4. Early post-operative pulmonary function tests after mitral valve replacement: Minimally invasive versus conventional approach. Which is better?

    Directory of Open Access Journals (Sweden)

    Magdy Gomaa

    2016-12-01

    Conclusion: Minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. There was a highly significant difference denoting better post operative pulmonary function of the minimally invasive approach.

  5. The cognitive function changes of patients accepted carotid artery stenting in postoperative different period%颈动脉支架置入患者术后不同时期的认知功能变化

    Institute of Scientific and Technical Information of China (English)

    王雁; 孙涛

    2011-01-01

    目的 探讨颈动脉支架置入(CAS)患者术后不同时期的认知功能变化及其可能机制.方法 选取76例接受CAS的颈动脉狭窄患者(病例组)和63例接受冠脉支架置入术的冠心病患者(对照组)作为研究对象,所有患者术前行DSA检查,分别在支架置入术前及术后3 d、10个月,应用蒙特利尔认知评估量表对患者进行认知评估.结果 病例组术后3 d与术前比较,MoCA总分、交替连线试验,复制立方体、画钟、注意力、延迟回忆测评得分降低,具有显著性差异;术后10个月与术前比较,注意力、延迟回忆测评得分升高,差异具有显著性;术后3 d与术后10个月比较,MoCA总分、交替连线试验、复制立方体、画钟、注意力、延迟回忆测评得分的差异均有显著性.病例组与对照组比较,术前、术后3 d的注意力、延迟回忆测评得分差异有显著性.结论 颈动脉狭窄置入术可最终改善注意力和延迟回忆功能.术后早期可出现暂时的、可逆的认知功能恶化,但认知功能在远期多会改善.%Objective To investigate the changes of cognitive function in different period after carotid artery stenting and explore the related mechanism of cognitive changes. Methods 76 carotid stenosis patients were treated with carotid artery stenting and 63 patients were given coronary artery stenting ( control group) as subjects. All patients were accepted DSA, and respectively were tested with montreal cognitire assessment at preoperative and third day, tenth month after stenting. Results Compared postoperative third day with preoperative cognitive function, cognitive test scores including MoCA total score, Trial Making B task, three-dimensional cube copy, clock-drawing task, attention, and delayed recall had significantly declined. Compared postoperative tenth month with preoperative, cognitive test scores including attention, and delayed recall were significantly improved. Compared postoperative

  6. Comparison of surgical time and IOP spikes with two ophthalmic viscosurgical devices following Visian STAAR (ICL, V4c model insertion in the immediate postoperative period

    Directory of Open Access Journals (Sweden)

    Ganesh S

    2016-01-01

    Full Text Available Sri Ganesh, Sheetal BrarDepartment of Phaco and Refractive Surgeries, Nethradhama Superspeciality Eye Hospital, Bangalore, IndiaPurpose: To compare the effect of two ocular viscosurgical devices (OVDs on intraocular pressure (IOP and surgical time in immediate postoperative period after bilateral implantable collamer lens (using the V4c model implantation.Methods: A total of 20 eligible patients were randomized to receive 2% hydroxypropylmethylcellulose (HPMC in one eye and 1% hyaluronic acid in fellow eye. Time taken for complete removal of OVD and total surgical time were recorded. At the end of surgery, IOP was adjusted between 15 and 20 mmHg in both the eyes.Results: Mean time for complete OVD evacuation and total surgical time were significantly higher in the HPMC group (P=0.00. Four eyes in the HPMC group had IOP spike, requiring treatment. IOP values with noncontact tonometry at 1, 2, 4, 24, and 48 hours were not statistically significant (P>0.05 for both the groups.Conclusion: The study concluded that 1% hyaluronic acid significantly reduces total surgical time, and incidence of acute spikes may be lower compared to 2% HPMC when used for implantable collamer lens (V4c model.Keywords: OVD, hyaluronic acid, ICL, V4c, IOP spikes

  7. Comparison of surgical time and IOP spikes with two ophthalmic viscosurgical devices following Visian STAAR (ICL, V4c model) insertion in the immediate postoperative period

    Science.gov (United States)

    Ganesh, Sri; Brar, Sheetal

    2016-01-01

    Purpose To compare the effect of two ocular viscosurgical devices (OVDs) on intraocular pressure (IOP) and surgical time in immediate postoperative period after bilateral implantable collamer lens (using the V4c model) implantation. Methods A total of 20 eligible patients were randomized to receive 2% hydroxypropylmethylcellulose (HPMC) in one eye and 1% hyaluronic acid in fellow eye. Time taken for complete removal of OVD and total surgical time were recorded. At the end of surgery, IOP was adjusted between 15 and 20 mmHg in both the eyes. Results Mean time for complete OVD evacuation and total surgical time were significantly higher in the HPMC group (P=0.00). Four eyes in the HPMC group had IOP spike, requiring treatment. IOP values with noncontact tonometry at 1, 2, 4, 24, and 48 hours were not statistically significant (P>0.05) for both the groups. Conclusion The study concluded that 1% hyaluronic acid significantly reduces total surgical time, and incidence of acute spikes may be lower compared to 2% HPMC when used for implantable collamer lens (V4c model). PMID:26869754

  8. Does the Length of Fielding Period Matter? Examining Response Scores of Early Versus Late Responders

    Directory of Open Access Journals (Sweden)

    Sigman Richard

    2014-12-01

    Full Text Available This article discusses the potential effects of a shortened fielding period on an employee survey’s item and index scores and respondent demographics. Using data from the U.S. Office of Personnel Management’s 2011 Federal Employee Viewpoint Survey, we investigate whether early responding employees differ from later responding employees. Specifically, we examine differences in item and index scores related to employee engagement and global satisfaction. Our findings show that early responders tend to be less positive, even after adjusting their weights for nonresponse. Agencies vary in their prevalence of late responders, and score differences become magnified as this proportion increases. We also examine the extent to which early versus late responders differ on demographic characteristics such as grade level, supervisory status, gender, tenure with agency, and intention to leave, noting that nonminorities and females are the two demographic characteristics most associated with responding early.

  9. Local analgesic effect of tramadol is not mediated by opioid receptors in early postoperative pain in rats.

    Science.gov (United States)

    Sousa, Angela Maria; Ashmawi, Hazem Adel

    2015-01-01

    Tramadol is known as a central acting analgesic drug, used for the treatment of moderate to severe pain. Local analgesic effect has been demonstrated, in part due to local anesthetic-like effect, but other mechanisms remain unclear. The role of peripheral opioid receptors in the local analgesic effect is not known. In this study, we examined role of peripheral opioid receptors in the local analgesic effect of tramadol in the plantar incision model. Young male Wistar rats were divided into seven groups: control, intraplantar tramadol, intravenous tramadol, intravenous naloxone-intraplantar tramadol, intraplantar naloxone-intraplantar tramadol, intravenous naloxone-intravenous tramadol, and intravenous naloxone. After receiving the assigned drugs (tramadol 5mg, naloxone 200 μg or 0.9% NaCl), rats were submitted to plantar incision, and withdrawal thresholds after mechanical stimuli with von Frey filaments were assessed at baseline, 10, 15, 30, 45 and 60 min after incision. Plantar incision led to marked mechanical hyperalgesia during the whole period of observation in the control group, no mechanical hyperalgesia were observed in intraplantar tramadol group, intraplantar naloxone-intraplantar tramadol group and intravenous naloxone-intraplantar tramadol. In the intravenous tramadol group a late increase in withdrawal thresholds (after 45 min) was observed, the intravenous naloxone-intravenous tramadol group and intravenous naloxone remained hyperalgesic during the whole period. Tramadol presented an early local analgesic effect decreasing mechanical hyperalgesia induced by plantar incision. This analgesic effect was not mediated by peripheral opioid receptors. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  10. Changes in food processing and occlusal dental wear during the early agricultural period in northwest Mexico.

    Science.gov (United States)

    Watson, James T

    2008-01-01

    Crown dimensions and occlusal surface wear rate and wear plane were evaluated using paired first and second mandibular molars from a sample of 84 Early Agricultural period (1600 B.C.-A.D. 200) skeletons from northwest Mexico. Although this period represents a major shift in subsistence strategies in the Sonoran Desert, from food-foraging to agriculture, archaeological and dental pathology studies have identified this period as one of relative dietary stability. It was therefore predicted that very little variation in occlusal wear would have occurred between the early phase (San Pedro: 1600-800 B.C.) and late phase (Cienega: 800 B.C.-A.D. 200). Comparison of crown diameters identified some phenotypic differences between sexes but not between archaeological phases. Molar occlusal surfaces were then divided into four quadrants, and wear scores recorded for each quadrant. Principle axis analysis was performed between total wear scores of paired, adjacent first and second mandibular molars to assess rate and occlusal wear plane over time. The analysis demonstrated that both wear rate and wear plane increased from the early to the late phase of the Early Agricultural period. These results indicate that although diet may have indeed remained stable during this period in the Sonoran Desert increases in the rate of wear and wear plane may reflect changes in food-processing techniques. It is suggested that more intensive processing of agricultural products during the Cienega phase simultaneously softened the diet to create more tooth-contact wear and introduced more grit to cause faster and more angled wear on the molar occlusal surfaces.

  11. [Characteristics of postoperative peritonitis].

    Science.gov (United States)

    Lock, J F; Eckmann, C; Germer, C-T

    2016-01-01

    Postoperative peritonitis is still a life-threatening complication after abdominal surgery and approximately 10,000 patients annually develop postoperative peritonitis in Germany. Early recognition and diagnosis before the onset of sepsis has remained a clinical challenge as no single specific screening test is available. The aim of therapy is a rapid and effective control of the source of infection and antimicrobial therapy. After diagnosis of diffuse postoperative peritonitis surgical revision is usually inevitable after intestinal interventions. Peritonitis after liver, biliary or pancreatic surgery is managed as a rule by means of differentiated therapy approaches depending on the severity.

  12. Stairs climbing test with pulse oximetry as predictor of early postoperative complications in functionally impaired patients with lung cancer and elective lung surgery: prospective trial of consecutive series of patients.

    Science.gov (United States)

    Nikolić, Igor; Majerić-Kogler, Visnja; Plavec, Davor; Maloca, Ivana; Slobodnjak, Zoran

    2008-02-01

    To test the predictive value of stairs climbing test for the development of postoperative complications in lung cancer patients with forced expiratory volume in one second (FEV1)stairs climbing with pulse oximetry before the operation with the number of steps climbed and the time to complete the test recorded. Oxygen saturation and pulse rate were measured every 20 steps. Data on postoperative complications including oxygen use, prolonged mechanical ventilation, and early postoperative mortality were collected. Eighty-seven of 101 patients (86%) had at least one postoperative complication. The type of surgery was significantly associated with postoperative complications (25.5% patients with lobectomy had no early postoperative complications), while age, gender, smoking status, postoperative oxygenation, and artificial ventilation were not. There were more postoperative complications in more extensive and serious types of surgery (Pstairs climbing test produced a significant decrease in oxygen saturation (-1%) and increase in pulse rate (by 10/min) for every 20 steps climbed. The stairs climbing test was predictive for postoperative complications only in lobectomy group, with the best predictive parameter being the quotient of oxygen saturation after 40 steps and test duration (positive likelihood ratio [LR], 2.4; 95% confidence interval [CI], 1.71-3.38; negative LR, 0.53; 95% CI, 0.38-0.76). In patients with other types of surgery the only significant predictive parameter for incident severe postoperative complications was the number of days on artificial ventilation (P=0.006). Stairs climbing test should be done in routine clinical practice as a standard test for risk assessment and prediction of the development of postoperative complications in lung cancer patients selected for elective surgery (lobectomy). Comparative to spirometry, it detects serious disorders in oxygen transport that are a baseline for a later development of cardiopulmonary postoperative

  13. The Global Trade of Textiles and Clothing in the Early Modern Period: Exchange, Meaning and Materialities

    Directory of Open Access Journals (Sweden)

    Karolina Hutkova

    2015-03-01

    Full Text Available The two-day workshop at the University of Warwick brought together early career researchers studying various aspects of textile history – production, consumption, trade, fashion, and design – with the aim of drawing broader conclusions about the role of textiles and clothing in the development of societies, cultures and economies. The methodological and geographical breadth of the presented research holds a promise that in the near future we will be presented with a much more global picture of textile production, consumption and trade in the early modern period.

  14. Late Archaic–Early Formative period microbotanical evidence for potato at Jiskairumoko in the Titicaca Basin of southern Peru

    National Research Council Canada - National Science Library

    Rumold, Claudia Ursula; Aldenderfer, Mark S

    2016-01-01

    ...) within its botanical locus of origin in the high south-central Andes. The data derive from Jiskairumoko, an early village site in the western Titicaca Basin dating to the Late Archaic to Early Formative periods...

  15. [Aspartate kinase complex of Anabaena variabilis during the early period of development of cyanophage A-1].

    Science.gov (United States)

    Koltukova, N V; Kadyrova, G Kh; Lysenko, T G; Mendzhul, M I

    1994-01-01

    Aspartate kinase activity in cells of A. variabilis has been studied in the dynamics of development of virus infection. An early period of reproduction of cyanophage A-1 has been determined to be conjugated with the increase of biosynthesis of amino acids from aspartate family. Five isoenzymes of aspartate kinase were isolated and purified from A. variabilis cells during early development period of cyanophage A-1. Physicochemical properties and influence of amino acids of aspartate family on the activity of homogeneous isoenzymes have been studied. Retroinhibition effect was not observed in infected cyanobacteria cells, which probably enables one to increase 2-7 times the concentration of amino acids in a cell. Such an increase of the amino acids pool is apparently necessary for realization of viral genome strategy.

  16. [State of immunity to diphtheria and tetanus in women in early postpartum period].

    Science.gov (United States)

    Savis'ko, A A; Kostinov, M P; Kharseeva, G G; Labushkina, A V; Alutina, É L

    2011-01-01

    Study of anti-diphtheria and anti-tetanus immunity in women in early postpartum period depending on age. Women in early postpartum period (n =139) with unknown vaccine anamnesis aged 17 to 44 years and under the supervision of Rostov-on-Don maternity hospital No. 2 were examined for the evaluation of the anti-diphtheria and anti-tetanus immunity state. All the women had high level of protection form these infections. The level of anti-tetanus immunity intensity in the examined was higher than anti-diphtheria. Monitoring of anti-diphtheria and anti-tetanus immunity in women of childbearing age is necessary to resolve the issue of vaccine administration in this group. High level of maternal immunity intensity will allow to form a sufficient protection from infectious agents in neonates.

  17. Heart Rate Variability Biofeedback Intervention for Reduction of Psychological Stress During the Early Postpartum Period

    OpenAIRE

    Kudo, Naoko; Shinohara, Hitomi; KODAMA, Hideya

    2014-01-01

    This study examined the effectiveness of heart rate variability (HRV) biofeedback intervention for reduction of psychological stress in women in the early postpartum period. On postpartum day 4, 55 healthy subjects received a brief explanation about HRV biofeedback using a portable device. Among them, 25 mothers who agreed to implement HRV biofeedback at home were grouped as the biofeedback group, and other 30 mothers were grouped as the control group. At 1 month postpartum, there was a signi...

  18. Ruptured Sinus of Valsalva Aneurysm and Coarctation of Aorta in a Woman at Early Postpartum Period

    Directory of Open Access Journals (Sweden)

    Erol Sener

    2014-01-01

    Full Text Available Coarctation of aorta and sinus of Valsalva aneurysm are frequently missed congenital cardiac defects that their diagnosis might be delayed. To our knowledge, coincidence of these cardiac defects is unusual and has not been reported in the literature before. Here, we present a patient with coarctation of aorta and ruptured noncoronary sinus of Valsalva aneurysm leading to aorto-right atrial fistula in the early postpartum period and our management of this unusual case.

  19. Weekly milk producation trends in early lactation period of Nagpuri buffalo

    Directory of Open Access Journals (Sweden)

    M.G.Sahare

    Full Text Available Nagpuri breed of buffalo is recognized breed, mostly found in Central India particularly in Vidharbha region of Maharashtra.The early milk production record were collected for each buffalo from 1st week of lactation to 15th week of lactation .The weekly milk production of Nagpuri buffalo was found to be 35.19 ± 0.3 kg with a range 16.22 ±0.77 to 41.5 ± 0.28 kg .The overall variability found in early milk production was 12.16% .The variation in production in early lactation period between the animal up to the 15th week of lactation where non-significant. [Vet World 2009; 2(7.000: 278-279

  20. [Postoperative biliary peritonitis].

    Science.gov (United States)

    Kurbonov, K M; Daminova, N M; Mukhiddinov, N D

    2008-01-01

    An analysis of results of surgical treatment of 91 patients with postoperative biliary peritonitis has shown that frequency of postoperative biliary peritonitis depended on the volume and character of operative interventions, as well as on technical errors made at the preoperative period and during operation. The presence of latent hepatic insufficiency made for the development of polyorganic insufficiency, had negative influence on the course of the disease and might be one of the causes of high postoperative lethality (up to 23.1%) in this category of patients.

  1. A COMPARATIVE ANALYSIS BETWEEN THE RECOVERY RESULTS OF PATIENTS WITH HIP JOINT REPLACEMENT IN THE PERIOD OF EARLY REHABILITATION AT HOME (13-45 DAYS AFTER SURGERY

    Directory of Open Access Journals (Sweden)

    Maya St. Krastanova

    2016-04-01

    Full Text Available Rehabilitation of the patients with Hip Joint Arthroplasthy is an indispensable part of the functional recovery. The purpose of this report is to track and measure the results of an applied complex rehabilitation program during the early post-surgery period in home setting (13-45 days after surgery and to make a comparative analysis between the recovery results of patients who conducted a comprehensive rehabilitation treatment, and a control group of patients who conducted only early physical therapy and occupational therapy in the hospitalization in the Department of Orthopedics and Traumatology. Methods and materials: 152 patients (107 female and 45 male aged between 22 and 84 with Hip Joint Arthroplasthy due to osteoarthritis or femoral neck fracture participated in the study, divided into two groups, according to postoperative behavior. The rehabilitation program consists of: kinesitherapy (positional therapy, isometric exercises, movement of the artificial hip joint within the allowed volumes, exercises for upper limbs and the healthy lower limb and ergotherapy (ergonomic home environment adjusted to performing the daily activities of life. Patients in the second control group have conducted kinesitherapy and occupational therapy only in the early postoperative period in orthopedic clinic. Results: Locomotion test and DAL test measurements were taken and the results for each patient were stored in a special patient file. Conclusion: Ensuring an ergonomic home environment and independent practice of kinesitherapeutic and ergotherapeutic stimulate the recovery of the patients’ self-reliance significantly improve the psycho-emotional balance and self-respect, and serves as an important basis for the latter stages of rehabilitation.

  2. Postoperative Delirium

    Science.gov (United States)

    Marcantonio, Edward R.

    2013-01-01

    Delirium (acute confusion) complicates 15% to 50% of major operations in older adults and is associated with other major postoperative complications, prolonged length of stay, poor functional recovery, institutionalization, dementia, and death. Importantly, delirium may be predictable and preventable through proactive intervention. Yet clinicians fail to recognize and address postoperative delirium in up to 80% of cases. Using the case of Ms R, a 76-year-old woman who developed delirium first after colectomy with complications and again after routine surgery, the diagnosis, prevention, and treatment of delirium in the postoperative setting is reviewed. The risk of postoperative delirium can be quantified by the sum of predisposing and precipitating factors. Successful strategies for prevention and treatment of delirium include proactive multifactorial intervention targeted to reversible risk factors, limiting use of sedating medications (especially benzodiazepines), effective management of postoperative pain, and, perhaps, judicious use of antipsychotics. PMID:22669559

  3. Robotic versus Endoscopic Thyroidectomy for Thyroid Cancers: A Multi-Institutional Analysis of Early Postoperative Outcomes and Surgical Learning Curves

    Directory of Open Access Journals (Sweden)

    Jandee Lee

    2012-01-01

    Full Text Available Robotic thyroidectomy is an emerging technique with postoperative outcomes that are at least comparable to those of conventional endoscopic thyroidectomy, with some end-points appearing superior. Our multicenter series represents the largest comparison of robotic and endoscopic thyroidectomy to date, with results suggesting a comparable robot technology we used that could overcome some of the technical limitations associated with conventional endoscopic procedures, with reduced operation times and increased lymph node retrieval. Moreover, we found that the learning curve for robotic thyroidectomy was shorter than that for endoscopic thyroidectomy.

  4. Postoperative pyrexia after arthroplasty - when to panic ?

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    Agarwala Sanjay

    2005-01-01

    Full Text Available Background: Success of arthroplasty is contingent on a clear understanding of the potential complications. Today with improved methods of sepsis control, incidence of joint sepsis has dropped to less than 2%. Despite this fever is still common in the early post-operative period. Methods: We reviewed 184 consecutive hip and knee replacement surgeries for incidence and clinical significance of post-operative fever. The cases were followed up for a period of over 3 to 5 years. Temperature charts up to 6 th postoperative day and all investigations were reviewed to determine the cause of fever. Results: Post operative fever was recorded after 82 procedures (44.6%. The average maximum temperature occurred on post-operative day 1 (98.9 o F. Only 2 TKR got infected. Incidence of fever was higher in TKR as compared to THR. Conclusion: Post-operative fever is common and probably inflammatory. It is not an important predictive factor of joint infection. Work up for joint infection is not indicated unless other corroborative features are present. Aspiration of painful joint is a highly accurate for identifying an infection.

  5. Early functional postoperative therapy of distal radius fracture with a dynamic orthosis: results of a prospective randomized cross-over comparative study.

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    Fabian M Stuby

    Full Text Available This study was conducted according to GCP criteria as a prospective randomized cross-over study. The primary goal of the study was to determine clinical findings and patient satisfaction with postoperative treatment. 29 patients with a distal radius fracture that was surgically stabilized from volar and who met the inclusion criteria were enrolled over a 12-month period. Each patient randomly received either a dorsal plaster splint or a vacuum-fit flexible but blocked orthosis applied postoperatively in the operating theatre to achieve postoperative immobilization. After one week all patients were crossed over to the complementary device maintaining the immobilization until end of week 2. After week 2 both groups were allowed to exercise wrist mobility with a physiotherapist, in the orthosis group the device was deblocked, thus allowing limited wrist mobility. After week 4 the devices were removed in both groups. Follow-up exams were performed after postoperative weeks 1, 2, 4 and 12.Results were determined after week 1 and 2 using SF 36 and a personally compiled questionnaire; after weeks 4 and 12 with a clinical check-up, calculation of ROM and the DASH Score. Comparison of the two groups showed a significant difference in ROM for volar flexion after 4 weeks, but no significant differences in DASH Score, duration of disability or x-ray findings. With regard to satisfaction with comfort and hygiene, patients were significantly more satisfied with the dynamic orthosis, and 23 of the 29 patients would prefer the flexible vacuum orthosis in future.German Clinical Trials Register (DRKS DRKS00006097.

  6. Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer.

    Science.gov (United States)

    Yu, Guiping; Chen, Guoqiang; Huang, Bin; Shao, Wenlong; Zeng, Guangqiao

    2013-06-01

    To explore the effect of early enteral nutrition (EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer or cardiac cancer. A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study. They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4 and 7 after surgery. The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme-linked immunosorbent assay (ELISA). After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than those in the PN group (Pcancer or cardiac cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier (by reducing plasma endoxins), and enhance the immune function.

  7. Spatial patterns of substantial climate impact from anthropogenic aerosols in the early instrumental period

    Science.gov (United States)

    Undorf, Sabine; Bollasina, Massimo; Hegerl, Gabriele

    2016-04-01

    While many aspects of climate variation in the early instrumental period (1860-1950) are still unexplained, for instance the early twentieth-century warming from the 1910s to the 1940s, the role of anthropogenic aerosols in this period has been overlooked. Yet, the period is also an interesting case study to isolate aerosol impacts since it is characterised by the increase of North American and especially European aerosol emissions concurrently with negligible Asian emissions and relatively low carbon dioxide concentrations. We thus analyse the spatial and temporal patterns of aerosol impact for this period in available observations (NOAA 20th-century reanalysis, etc.) and historical single-forcing and all-forcing experiments with state-of-the-art CMIP5 models. We make use of coupled empirical orthogonal functions (EOFs) applied to surface temperature -the most reliable variable in observations- and different aerosol indicating variables such as aerosol optical depth and short-wave downward radiation, some of which include aerosol indirect effects. The principal components of the most important EOFs are then regressed onto sea level pressure, winds, and other variables to identify associated circulation patterns. A decomposition into multi-decadal and longer time scales is performed by filtering the data prior to the analysis. Our analysis reveals both statistically significant local and non-local aerosol impact and identifies circulation states associated with the temperature response. The results are consistent across different aerosol variables, and show a strong non-local response as well as specific differences between time scales. We find a distinctive circulation pattern which strongly resembles observations and might explain the observed early twentieth century warming in the Arctic.

  8. Mode of Birth Influences Preterm Infant Intestinal Colonization With Bacteroides Over the Early Neonatal Period.

    Science.gov (United States)

    Gregory, Katherine E; LaPlante, Rose D; Shan, Gururaj; Kumar, Deepak Vijaya; Gregas, Matt

    2015-12-01

    Intestinal colonization during infancy is important to short- and long-term health outcomes. Bacteroides, an early member of the intestinal microbiome, is necessary for breaking down complex molecules within the intestine and function to assist the body's immune system in fighting against potentially harmful pathogens. Little is known about the colonization pattern of Bacteroides in preterm infants during the early neonatal period. This study measured Bacteroides colonization during the early neonatal period in a population of preterm infants, based on clinical factors including mode of birth, antibiotics, and nutrition. Bacterial DNA was isolated from 144 fecal samples from 29 preterm infants and analyzed using quantitative real-time polymerase chain reaction. Analyses included liner mixed models to determine which clinical factors affect Bacteroides colonization of the infant gut. We found that infants born via vaginal canal had a higher rate of increase in Bacteroides than infants born via cesarean section (P Bacteroides colonization. These findings highlight the significant influence of mode of birth on Bacteroides colonization. While mode of birth is not always modifiable, these study findings may help develop interventions for preterm infants born via cesarean section aimed at overcoming delayed Bacteroides colonization. Greater study of the intestinal microbiome and the clinical factors relevant to the preterm infant is needed so that interventions may be developed and tested, resulting in optimal microbial and immune health.

  9. 采用斑点追踪食道超声观察经冠状动脉灌注舒芬太尼对2型糖尿病患者非体外循环冠脉旁路移植术后早期左心室功能失调的影响%Effect on the left ventricular dysfunction in the early postoperative period following off-pump coronary artery bypass grafting of type 2 diabetes mellitus underlying sufentanil coronary perfusion against ischemia-reperfusion injury by speckle tracking transesophageal echocardiography

    Institute of Scientific and Technical Information of China (English)

    鲁显福; 刘训芹; 顾尔伟

    2012-01-01

    背景 采用经斑点追踪食道超声(speckle tracking transesophageal echocardiography,STTE)记录左心室长轴平均收缩峰值应变(averaged global longitudinal peak systolic strain,aGLPS)值、观察舒芬太尼后处理对2型糖尿病-心血管病共病患者与单纯心血管病患者行非体外循环冠脉旁路移植(off-pump coronary artery bypass grafting,OPCABG)术后早期左心室功能失调的影响.方法 择期单纯心血管病患者(CVD组)与2型糖尿病-心血管疾病共病患者(T2DM-CVD组)各20例,择期施行OPCABG手术,术中经冠脉内灌注舒芬太尼(0.2 μg/kg)行缺血心肌后处理(Suf-PostC);经二维食道超声采集STTE/aGLPS,采用FloTrac/Vigileo及Philips M6多功能监测仪行心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、心脏指数(CI)、每搏量(SV)、左心室射血分数(LVEF).观察并测算给药后各时间点aGLPS(T0,Suf-PoC0 min;T1,Suf-PoC30 min;T2,Suf-PoC2 h;T3,SufPoC4 h;T4,Suf-PoC6 h).结果 两组患者术前除血糖外一般情况均无统计学差异;但在Suf-PoC2 h以后(冠脉全部复通后,T2-T4期),两组患者LVEF值均较术前明显改善(P<0.05);T2DM-CVD组[aGLPST0:(-13.4±2.2)%,aGLPST1:(-17.0±2.4)%,aGLPST2:( -17.3±3.1)%,aGLPST3:(-14.6±2.6)%,aGLPST4:( -14.7±1.7)%],CVD组[aGLPST0:(-13.1±2.4)%,aGLPST1:(-16.4±3.1)%,aGLPST2:( -19.6±3.4)%,aGLPST3:( -20.3±2.6)%,aGLPST4:(-20.4±1.9)%],两组患者aGLPS值在(T2~T4)期行同一时间点下的各组绝对数值比较差异有统计学意义(P<0.05). 结论 采用STTE记录aGLPS能够定量监测OPCABG患者术中左心室收缩功能;2型糖尿病削弱舒芬太尼后处理对于心肌缺血/再灌注损伤所起保护效应的临床研究仍需进一步积累资料.%Objective To assess sufentanil postconditioning against ischemia-reperfusion injury whether left ventricular systolic deformation in the early postoperative period could be estimated by speckle tracking transesophageal

  10. [An unexpected stage of alkalosis in the dynamics of the early posthemorrhagic period].

    Science.gov (United States)

    Beliaev, A V

    2000-01-01

    A study was made on acid-base metabolism in early posthemorrhagic period as exemplified by examination of patients presenting with gastrointestinal hemorrhage. It has been ascertained that hemorrhage is accompanied by a mixed variant of the acid-base state (ABS) deviation, namely metabolic lactate-acidosis and respiratory alkalosis. In the time-related course of posthemorrhagic period such deviations persist in patients with lethal outcome; with the disease running a favourable course the above deviations are found to return to normal quite soon. The development of complications leads to staging in ABC, its stages being as follows: stage I--the initial stage, stage II--persisting metabolic acidosis and respiratory alkalosis, stage III--alkalosis, stage IV--normalization, with stage III of ABS being encouraged by hypocapnia caused by function disorders of the lungs in early posthemorrhagic period, normalization of cell metabolism, increase in the rate of urination as a reflection of the third earlier identified stage of water metabolism, with the H+ excretion in the urine at the previous level. The identified ABS stage III threatens coming trouble, being accompanied by metabolic deviations together with a risk of function disorder of the myocardium.

  11. Reappraisal of twinning: epidemiology and outcome in the early neonatal period

    Science.gov (United States)

    Gupta, Priyanka; Faridi, Mohammad Moonis Akbar; Goel, Neerja; Zaidi, Zeashan

    2014-01-01

    INTRODUCTION The present study aimed to determine the epidemiology, maternal complications and adverse neonatal outcomes associated with twin births at a tertiary care hospital in India. METHODS A prospective observational study was conducted on all successively born twin pairs (≥ 23 weeks of gestation) and their mothers from January to September 2005. Main outcome measures included maternal medical/obstetric complications, labour characteristics and the morbidities/mortality observed during the early neonatal period. RESULTS The twinning rate was 1 in 54 deliveries. Around 10% of mothers had a predisposition for twinning in the form of familial tendency or consumption of clomiphene. Anaemia (85%) was the most common maternal complication, followed by gestational hypertension (17%). Nearly one-third of births were delivered via Caesarean section. Prematurity (61%) was the most common neonatal complication followed by early-onset neonatal sepsis (21%). The risk of early neonatal death was 27%. Shorter gestation and low birth weight were significantly associated with adverse neonatal outcome (p delivery time interval, gender and intra-pair birth weight discordance did not affect neonatal morbidity or mortality (p ≥ 0.05). CONCLUSION The rates of maternal complications and early neonatal morbidities/mortality were quite high in twin gestations. Except for the prematurity and low birth weight, none of the other factors, including inter-twin delivery time interval of more than 15 mins, were found to affect neonatal outcome. PMID:25017406

  12. Early Postoperative Obstruction of Small Bowel in Children%小儿术后早期小肠梗阻

    Institute of Scientific and Technical Information of China (English)

    伍连康; 张丽瑜; 蔡民宇

    1992-01-01

    报道腹腔内手术3041例(不包括新生儿)在术后1个月内因肠梗阻再手术者39例(1.28%).术中发现粘连性肠梗阻22例,肠套叠及肠扭转各5例,绞窄内疝3例,盲攀综合征2例,拖出结肠系膜过紧压迫十二指肠空肠交界处1例,功能性肠梗阻2例.本组治愈36例(92.30%),死亡3例(7.70%).对诊断标准,发病情况,诊断和治疗进行了讨论.%3041 laparotmies were performed on infants and children(excluding neonates)between January 1980 and December 1990.39 were complicated by a postoperative small bowel obstruction(SBO), and a secondary laparotorny performed within the first month after the primary operation. 22(56.41%)cases were due to intraperitoneal adhesions(including a strangulated internal hernia), 5 postoperative intussusception and 5 volvulus respectively, 2 internal hernins into mesenterie defect after abdominoperineal resection for Hirschsprung's disease end anorectal malformation. The other two cases caused by blind loop syndrome, and another one by mesenterie comprossion at duodenoiejunal region after rectal pull-through procedure. Functional SBO was found in two. The all round mortality was 7.7%(3 cases).

  13. Early postoperative oral feeding impacts positively in patients undergoing colonic resection: results of a pilot study La alimentación oral precoz posoperatoria tiene un impacto positivo en pacientes sometidos a resección colónica: resultados de un estudio piloto

    OpenAIRE

    M. Lobato Dias Consoli; L. Maciel Fonseca; R. Gomes da Silva; M.ª I. Toulson Davisson Correia

    2010-01-01

    Background and aims: Early oral feeding after colorectal resections is one of the many factors that contributes to enhance recovery after surgery, mainly impacting on postoperative ileus. The aim of this study was to evaluate the impact of early postoperative oral feeding in patients undergoing elective colorectal resection. Methods: Patients were randomly assigned to either a conventional postoperative dietary regimen or a free diet on the first postoperative day. Results: Altogether 29 pati...

  14. The Conservation of Early Post-Medieval Period Coins Found in Estonia

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    Aive Viljus

    2013-02-01

    Full Text Available This article deals with archaeological find material with a low silver content and the problems of conserving such material. The aim of the research was to find the most suitable method for the conservation of poorly preserved early post-medieval period coins with varying composition. For this, first, the composition of both the metal and the corrosion products of the archaeological coins were analysed, after which comparative experiments of different cleaning methods were carried out in order to find out the least harmful and most efficient method. A test was also performed to determine the necessity and efficiency of stabilizing the surface of the coins after cleaning.

  15. Perioperative pentoxifylline therapy attenuates early postoperative neuro-cognitive decline in patients undergoing coronary artery bypass grafting surgery using cardiopulmonary bypass

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    Sambhunath Das

    2015-01-01

    Full Text Available Background: Postoperative cognitive decline (POCD after coronary artery bypass grafting (CABG is a common problem. Studies show that pentoxifylline administration reduces inflammation induced by cardiopulmonary bypass and brain injury after ischaemia. Hence the perioperative use of pentoxifylline in attenuating POCD was evaluated in the study. Materials and Methods: Eighty patients were divided randomly into two groups from 106 patients scheduled for CABG surgery. The study group was administered pentoxifylline 400 mg twice daily orally from day of admission to 7th day after surgery, whereas the control group patients received placebo. Neurocognitive assessment was assessed by an independent clinical psychologist one day after admission to hospital and again on 7th postoperative day. The data was analyzed and a P < 0.05 was considered significant results. Results: Pentoxifylline-treated group showed no statistically significant difference in animal naming test scores (10.3 ± 2.2 versus 9.4 ± 2.5, P = 0.07, digit symbol substitution test (26.1 ± 7.47 vs 22.2 ± 6.07, P = 0.09 and 8 subtests of Post Graduate Institute-memory scale. The control group had significant POCD as detected by animal naming test (10.5 ± 3.7 versus 8.6 ± 3.9, P = 0.008, digit symbol substitution test (20.2 ± 8.2 versus 14.7 ± 8.9, P = 0.008 and five subtests of memory scale (P = 0.01, 0.04, 0.003, 0.005 and 0.02. The incidence of POCD was 50% in placebo-treated group compared to 22.5% in pentoxifylline group. Conclusions: The perioperative use of pentoxifylline attenuates the early postoperative neurocognitive decline after CABG using cardiopulmonary bypass.

  16. 腹部手术后早期小肠内疝的诊治%The diagnosis and treatment of early postoperative internal hernia

    Institute of Scientific and Technical Information of China (English)

    王颢; 单永琪; 廖秀军; 孟荣贵; 傅传刚; 于恩达; 张卫; 刘连杰

    2008-01-01

    Objective To investigate the clinical manifestations of early postoperative internal hernia. Methods Patients who were diagnosed with early postoperative small bowel obstruction(EPSBO)within 30 days after operation and underwent laparotomy between 1994 and 2006 were included for study.Clinical and radiological findings were analyzed. Results Totally 38 EPSBO patients were identined.among those,9 patients(23.7%)had an internal hera ag the cause of the howel obstruction.Other causes included intestinal adhesions in 27 patients(71.1%),gallstone ileus in 1 patient(2.6%)and stoma obstruction in 1 patient(2.6%).In the internal hernia group,6 cases were male and 3 cases were female witIl a mean age of 53.6 years.The mean time from the primary operation to symptom development was 7.8 d(range,2~17 d)and the mean time of conservative treatment Was 3.4 d(range,1~8 d).The main clinical features included:complete mechanical obstruction with symptoms rapidly progressing and early bowel strangulation.Specific radiologic abnormalities misht be identified,especially by contrast-enhanced CT.In this series,intestinal strangulation was found in 6 patients with bowel necrosis in 4 eases,necessitating howel resection in 5 patients.Wound infection developed in one cage and there was no perioperative death.Conclusion Internal hernia can occur early postoperatively and it bears a high risk of strangulation and bowel necrosis.Prompt operative intervention should be carried out in highly suspicious patients in order to avoid complications and achieve good outcome.%目的 研究术后早期小肠内疝的临床特点. 方法回顾性研究1994-2006年38例腹部手术后早期小肠梗阻(early postoperative small bowel obstruction,EPSBO)患者的临床资料.结果 手术治疗术后早期小肠梗阻(发生于术后30 d内)的38例中各种原因所致小肠内疝占9例(23.7%).男6例,女3例,平均年龄53.6岁(32~72岁).术后出现症状的平均时间为7.8 d(2~17 d),平

  17. Pronoia in the Military Organization of the Byzantine Empire at Early Palaeologian Period (Part 2

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    Zolotovskiy Vladimir A.

    2016-06-01

    Full Text Available In the present study the author disclosed the role of pronoia in the military organization of the Byzantine Empire at early Palaeologian period. The concrete cases of the award allow recognizing the proniarety as the Byzantine military institution dealing exclusively with the military leadership. The grant of pronoia was a replacement for traditional rewards of military commanders of noble origin. However, in some cases it was identified that compulsory military service was a function of power which was granted to the proniares in addition to the tax quota. Holders of pronoia were not only the Romans military commanders but also the mercenaries. Such awards could reduce the costs of imperial treasury for direct payments. In the case of proniares-Byzantines, depending on posotis, we can talk about the conferring upon pronoia the representatives of various levels of the military leadership. The pronoias granted as a reward or the compensation for losses incurred as a result of the performance of official engagements, could be transferred to the commanders of low levels which were recruited from among stratiotes (obviously, dekarhes. Definition of the role of pronoia in military practice of the early palaeologian period which would be possible in the identification of the proportion of pronoiares and strateia contingents and the correlation of victories and defeats, won by them, is impossible in practice.

  18. The patterns of peripheral plasma renin concentration in the early post-renal-transplant period.

    Science.gov (United States)

    Kornerup, H J

    1979-01-01

    Serial determinations of peripheral plasma renin concentration (PRC) were performed in 11 kidney transplant recipients during the early post-transplant period. In 5 recipients with late onset of graft function, PRC values were increased during the anuric phase and, subsequently, PRC values declined in every during restoration of graft function. In 4 recipients with an acute renal allograft reaction, PRC values were increased at the onset of the allograft reaction in 3 with hypertension whereas PRC values were normal in one normotensive recipient. Subsequently, PRC normalized in the hypertensives coincident with increasing body weights. In 2 recipients with an uncomplicated course and with a normal graft function immediately after transplantation and throughout the study period, PRC values were constantly normal. The results indicate that acute anuria in the early phase after kidney transplantation is associated with an increased release of renin. The results also suggest that an increased activity of the renin-angiotensin system may be counterbalanced by sodium and fluid retention in hypertension following an acute renal allograft reaction.

  19. The role of natural killer cells in the early period of infection in murine cutaneous leishmaniasis

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    M.D. Laurenti

    1999-03-01

    Full Text Available In order to study the role of natural killer (NK cells during the early period of Leishmania infection, BALB/c mice were selectively and permanently depleted of NK cells by injection with 90Sr and subsequently infected with Leishmania (Leishmania amazonensis (HSJD-1 strain. 90Sr is known to selectively deplete NK cells, leaving an intact T- and B-cell compartment and preserving the ability to produce both interferon alpha and IL-2. This method of depletion has advantages when compared with depletion using anti-NK cell monoclonal antibodies because the effect is permanent and neither activates complement nor provokes massive cell death. In the present study, after one month of treatment with 90Sr, the depletion of NK cells was shown by a more than ten-fold reduction in the cytotoxic activity of these cells: 2 x 106 spleen cells from NK-depleted animals were required to reach the same specific lysis of target cells effected by 0.15 x 106 spleen cells from normal control animals. The histopathology of the skin lesion at 7 days after Leishmania infection showed more parasites in the NK cell-depleted group. This observation further strengthens a direct role of NK cells during the early period of Leishmania infection.

  20. [Nutritive provision of children during intensive therapy in the early post-aggressive period].

    Science.gov (United States)

    Uglitskikh, A K

    2007-01-01

    The purpose of the study conducted at the intensive care units (ICI) of a Tushino children's city hospital (CCH), Moscow, in 2000-2005, was to enhance the efficiency of treatment in children with brain injuries, severe pneumonias, or appendicitis-induced peritonitis in the early postaggression period, by optimizing their feeding. Examination of 224 patients aged 1 month to 15 years, treated at the ICI of the Tushino CCH for brain injuries, severe pneumonias, or appendicitis-induced peritonitis in 2000-2005, indicated that mixed (parenteral and enteral) feeding was more effective in children in the early postaggression period than enteral feeding. Consideration of the size of protein losses and the amount of dietary protein and energy and estimation of nitrogen balance revealed that, by increasing the amount of dietary protein and energy, lowering protein losses, and thus producing positive changes in nitrogen balance, higher blood glucose decrease rates, and in a number of anthropometric and somatometric indices, mixed (parenteral and enteral) feeding is an effective method of nutritive provision in children at an intensive care unit.

  1. Greek-Romanian Symbiotic Patterns in the Early Modern Period: History,Mentalities, Institutions - I

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    Nikos Panou

    2007-01-01

    Full Text Available The patriarchal decree validating the establishment of the Wallachian archdiocese in 1359; a series of documents pertaining to the early history of the Koutloumousiou monastery on Mount Athos; the surviving redactions of Patriarch Niphon II's lost vita; the proceedings of the interrogation of a Greek priest arrested by the Polish authorities on charges of conspiracy and espionage; and an emphatically digressive section in Matthew of Myra's verse chronicle known as History of Wallachia. This article, of which the first part is presently published, offers a discussion of these textual materials - which span four crucial centuries of Balkan history and represent an intriguing variety of discursive practices and traditions. It aims to contribute to a deeper understanding of the intricate mechanisms that generated a climate of toleration, mobility and inter-ethnic contact in the Ottoman Balkans, enabling a symbiotic relationship between Greeks and Romanians, which found its vital space in the semi-autonomous and strategically located Danubian principalities, and endured throughout the early modern period despite having been severely undermined by opposing tendencies and conflicting interests. The two sections at hand focus on the Bishop of Myra's pivotal text, as well as on written records related to the early, and yet formative, contacts between the nascent Romanian states and the late Byzantine Empire; in the two remaining sections, which will appear in the next volume of The Historical Review, this endeavour will be brought to a conclusion by means of a (necessarily selective presentation of evidence dating from the period after the fall of Constantinople and up to the beginning of the seventeenth century.

  2. Greek-Romanian Symbiotic Patterns in the Early Modern Period: History,Mentalities, Institutions - I

    Directory of Open Access Journals (Sweden)

    Nikos Panou

    2007-01-01

    Full Text Available The patriarchal decree validating the establishment of the Wallachian archdiocese in 1359; a series of documents pertaining to the early history of the Koutloumousiou monastery on Mount Athos; the surviving redactions of Patriarch Niphon II's lost vita; the proceedings of the interrogation of a Greek priest arrested by the Polish authorities on charges of conspiracy and espionage; and an emphatically digressive section in Matthew of Myra's verse chronicle known as History of Wallachia. This article, of which the first part is presently published, offers a discussion of these textual materials - which span four crucial centuries of Balkan history and represent an intriguing variety of discursive practices and traditions. It aims to contribute to a deeper understanding of the intricate mechanisms that generated a climate of toleration, mobility and inter-ethnic contact in the Ottoman Balkans, enabling a symbiotic relationship between Greeks and Romanians, which found its vital space in the semi-autonomous and strategically located Danubian principalities, and endured throughout the early modern period despite having been severely undermined by opposing tendencies and conflicting interests. The two sections at hand focus on the Bishop of Myra's pivotal text, as well as on written records related to the early, and yet formative, contacts between the nascent Romanian states and the late Byzantine Empire; in the two remaining sections, which will appear in the next volume of The Historical Review, this endeavour will be brought to a conclusion by means of a (necessarily selective presentation of evidence dating from the period after the fall of Constantinople and up to the beginning of the seventeenth century.

  3. Journal “Topics in Early Childhood Special Education”: assessment of the periodical and articles

    Directory of Open Access Journals (Sweden)

    Paulo Celso Pereira

    2008-12-01

    Full Text Available Journals have the purpose of dissemination and communication of scientific knowledge. As a vehicle to the dissemination of scientific productions, it is necessary the periodical assessment to evaluate the quality of research: accuracy, reliability and seriousness. The objective of this study is to assess the journal Topics in Early Childhood Special Education, considering for the analysis the whole journal and the formal and the contents aspects of all articles. The analysis revealed that the periodical satisfactorily fulfills the normalization criterion, the authors’ instruction criterion and the articles assessment criterion. However, it was identified the need for major accuracy in the bibliographic legend that should appear on all pages of articles. Regarding the analysis of the articles it was observed the lack of keywords and a wide variety of information in the abstracts, which they were sometimes not related to the key aspects of the research. All authors and institutions are from United States of America and the type of study most published it was the research report. The participants’ characterization indicated that the journal broachs different types of special needs, but there is more studies about autism. The study data confirm the journal purpose that is providing relevant and current information on all aspects of early education for children with special needs, including their families. It was pointed the need for more articles from other countries beyond the North American continent, including the participation of researcher from other countries. Additionally, the model used for the journal assessment showed to be effective in providing data quality, reliability and accuracy of the whole periodical and the studies that it was published in the journal.

  4. Low-level lead exposure in the prenatal and early preschool periods: Language development

    Energy Technology Data Exchange (ETDEWEB)

    Ernhart, C.B.; Greene, T. (Case Western Reserve Univ., Cleveland, OH (USA))

    1990-11-01

    Inconsistent results continue to be reported from studies linking low-level lead exposure and child development. This inconsistency is seen for both prenatal exposure and exposure in the preschool years. The primary outcome measures in most reports are indices of cognitive development, including IQ. Verbal skills may be particularly vulnerable to toxic insult. The fact that 2 y of age is both a time of peak exposure and also a time of rapid language development suggests that this may be a critical period for such an effect. The later prenatal and early infancy period, at which time the nervous system is developing rapidly, may also be critical exposure period. We examined the relationship of maternal and cord blood lead (PbB) at birth and venous PbB at 6 mo, 2 y, and 3 y with language measures at 1, 2, and 3 y of age. The sample consisted of disadvantaged urban children. Multivariate analyses revealed no statistically significant relationship of either prenatal PbB or early preschool PbB with language measures after control of cofactors. Supplementary partial correlations revealed a marginal relationship of cord PbB and mean length of utterance (MLU), which describes a child's ability to form meaningful word combinations. Because this analysis was one of a large number of analyses with both positive and negative regression coefficients, the possibility that this was a chance effect was considered. If there is an effect of low-level lead exposure on language development, that effect is not robust.

  5. Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: A prospective observational study in adults

    NARCIS (Netherlands)

    M.E. van Genderen (Michel); J. Paauwe (Jaap); J. de Jonge (Jeroen); R.J.P. van der Valk (Ralf); A.A.P. Lima (Alexandre ); J. Bakker (Jan); J. van Bommel (Jasper)

    2014-01-01

    textabstractIntroduction: Altered peripheral perfusion is strongly associated with poor outcome in critically ill patients. We wanted to determine whether repeated assessments of peripheral perfusion during the days following surgery could help to early identify patients that are more likely to

  6. Difficulties with assessment and management of an infant’s distress in the postoperative period: Optimising opportunities for interdisciplinary information-sharing

    Directory of Open Access Journals (Sweden)

    Carlye Weiner

    2016-12-01

    Full Text Available Objectives: The importance of accurate paediatric patient assessment is well established but under-utilised in managing postoperative medication regimens. Methods: Data for this case report were collected through observations of clinical practice, conduct of interviews, and retrieval of information from the medical record. This case report involving a hospitalised 1-year-old boy demonstrates the difficulties associated with assessing and managing postoperative distress, including pain and other clinical conditions related to the surgical procedure. Results: Postoperatively, there were difficulties in managing pain and an episode of over-sedation, occasioning opiate reversal with naloxone. In addition, he had decreasing oxygen saturation and increased work of breathing. X-ray showed changes consistent with either atelectasis or aspiration, and he was commenced on antibiotics. The patient experienced respiratory distress and required intervention from the medical emergency team. Conclusion: This case demonstrated the importance of comprehensive assessment and careful consideration of alternative causes of an infant’s distress using the results of assessment tools to aid decision-making. Communication moderates effective patient care, and more favourable outcomes could be achieved by optimising interdisciplinary information-sharing.

  7. Effect of early enteral nutrition on postoperative nutritional status and immune function in elderly patients with esophageal cancer or cardiac cancer

    Institute of Scientific and Technical Information of China (English)

    Guiping Yu; Guoqiang Chen; Bin Huang; Wenlong Shao; Guangqiao Zeng

    2013-01-01

    Objective:To explore the effect of early enteral nutrition (EN) on postoperative nutritional status,intestinal permeability,and immune function in elderly patients with esophageal cancer or cardiac cancer.Methods:A total of 96 patients with esophageal cancer or cardiac cancer who underwent surgical treatment in our hospital from June 2007 to December 2010 were enrolled in this study.They were divided into EN group (n=50) and parenteral nutrition (PN) group (n=46) based on the nutrition support modes.The body weight,time to first flatus/defecation,average hospital stay,complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed.Peripheral blood samples were collected on the days 1,4 and 7 after surgery.The plasma diamine oxidase (DAO) activity and D-lactate level were determined to assess the intestinal permeability.The plasma endotoxin levels were determined using dynamic turbidimetric assay to assess the protective effect of EN on intestinal mucosal barrier.The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzymelinked immunosorbent assay (ELISA).Results:After the surgery,the time to first flatus/defecation,average hospital stay,and complications were significandy less in the EN group than those in the PN group (P<0.05),whereas the EN group had significantly higher albumin levels than the PN group (P<0.05).On the 7th postoperative day,the DAO activity,D-lactate level and endotoxin contents were significantly lower in the EN group than those in the PN group (all P<0.05).In addition,the EN group had significantly higher IgA,IgG,IgM,and CD4 levels than the PN group (P<0.05) but significantly lower IL-2,IL-6,and TNF-α levels (P<0.05).Conclusions:In elderly patients with esophageal cancer or cardiac cancer,early EN after surgery can effectively improve the nutritional status,protect intestinal mucosal barrier (by reducing plasma endoxins),and enhance the

  8. Mast cells facilitate local VEGF release as an early event in the pathogenesis of postoperative peritoneal adhesions.

    LENUS (Irish Health Repository)

    Cahill, Ronan A

    2012-02-03

    BACKGROUND: Peritoneal injury sustained at laparotomy may evoke local inflammatory responses that result in adhesion formation. Peritoneal mast cells are likely to initiate this process, whereas vascular permeability\\/endothelial growth factor (VEGF) may facilitate the degree to which subsequent adhesion formation occurs. METHODS: Mast cell deficient mice (WBB6F1-\\/-), along with their mast cell sufficient counterparts (WBB6F1+\\/+), underwent a standardized adhesion-inducing operation (AIS) with subsequent sacrifice and adhesion assessment 14 days later in a blinded fashion. Additional CD-1 and WBB6F1+\\/+, and WBB6F1-\\/- mice were killed 2, 6, 12, and 24 hours after operation for measurement of VEGF by ELISA in systemic serum and peritoneal lavage fluid. Two further groups of CD-1 mice underwent AIS and received either a single perioperative dose of anti-VEGF monoclonal antibody (10 mug\\/mouse) or a similar volume of IgG isotypic antibody and adhesion formation 2 weeks later was evaluated. RESULTS: WBB6F1-\\/- mice had less adhesions then did their WBB6F1+\\/+ counterparts (median [interquartile range] adhesion score 3[3-3] vs 1.5[1-2] respectively; P < .003). Local VEGF release peaked 6 hours after AIS in both WBB6F1+\\/+ and CD-1 mice whereas levels remained at baseline in WBB6F1-\\/- mice. CD-1 mice treated with a single dose of anti-VEGF therapy during operation had less adhesions than controls (2[1.25-2] vs 3[2.25-3], P = .0002). CONCLUSIONS: Mast cells and VEGF are central to the formation of postoperative intra-abdominal adhesions with mast cells being responsible, either directly or indirectly, for VEGF release into the peritoneal cavity after operation. In tandem with the recent clinical success of anti-VEGF monoclonal antibodies in oncologic practice, our observations suggest an intriguing avenue for research and development of anti-adhesion strategy.

  9. Effect of Early Use of Covered Self-Expandable Endoscopic Stent on the Treatment of Postoperative Stapler Line Leaks.

    Science.gov (United States)

    Quezada, Nicolás; Maiz, Cristóbal; Daroch, David; Funke, Ricardo; Sharp, Allan; Boza, Camilo; Pimentel, Fernando

    2015-10-01

    Postoperative leaks are a dreaded complication after bariatric surgery (BS). Its treatment is based on nutritional support and sepsis control by antibiotics, collections drainage and/or prosthesis, and/or surgery. The aim of this study is to report our experience with coated self-expandable endoscopic stents (SEES) for leaks treatment. This study was performed in a University Hospital, (censored). We performed a retrospective analysis of our BS database from January 2007 to December 2013. All patients with leak after BS treated with SEES were included. We identified 29 patients; 17 (59%) were women, with median age of 37 (19-65) years, and preoperative body mass index of 40 (28.7-56-6) kg/m(2). Nineteen (65.5%) patients had a sleeve gastrectomy and 10 (34.5%) a Roux-en-Y gastric bypass. All patients had a leak in the stapler line. Median time from surgery to leak diagnosis was 7 (1-51) days, and SEES were installed 8 (0-104) days after diagnosis. Twenty-one (72%) patients also had abdominal exploration. Median length of SEES use was 60 (1-299) days. Patients who had SEES as primary treatment (with or without simultaneous reoperation) had a shorter leak closure time (50 [6-112] vs 109 [60-352] days; p = 0.008). Twenty-eight (96.5%) patients successfully achieved leak closure with SEES. There were 16 migrations in 10 (34%) patients, 1 (3%) stent fracture, 1 opening of the blind end of alimentary limb (3%), and 5 patients (17%) required a second stent due to leak persistence. SEES is a feasible, safe, and effective management of post BS leaks, although patients may also require prosthesis revision and abdominal exploration. Primary SEES placement is associated with a shorter leak resolution time.

  10. Developmental changes in hepatic glucose metabolism in a newborn piglet model: A comparative analysis for suckling period and early weaning period.

    Science.gov (United States)

    Xie, Chunyan; Wang, Qinhua; Wang, Jing; Tan, Bie; Fan, Zhiyong; Deng, Ze-yuan; Wu, Xin; Yin, Yulong

    2016-02-19

    The liver glucose metabolism, supplying sufficient energy for glucose-dependent tissues, is important in suckling or weaned animals, although there are few studies with piglet model. To better understand the development of glucose metabolism in the piglets during suckling period and early weaning period, we determined the hepatic glycogen content, and investigated the relative protein expression of key enzymes of glucogenesis (GNG) and mRNA levels of some glucose metabolism-related genes. During suckling period, the protein level of G6Pase in the liver of suckling piglets progressively declined with day of age compared with that of newborn piglets (at 1 day of age), whereas the PEPCK level stabilized until day 21 of age, indicating that hepatic GNG capacity gradually weakened in suckling piglets. The synthesis of hepatic glycogen, which was consistent with the fluctuation of glycolytic key genes PFKL and PKLR that gradually decreased after birth and was more or less steady during latter suckling period, although both the mRNA levels of GCK and key glucose transporter GLUT2 presented uptrend in suckling piglets. However, early weaning significantly suppressed the hepatic GNG in the weaned piglets, especially at d 3-5 of weaning period, then gradually recovered at d 7 of weaning period. Meanwhile, PFKL, PKLR and GLUT2 showed the similar trend during weaning period. On the contrast, the hepatic glycogen reached the maximum value when the G6Pase and PEPCK protein expression were at the lowest level, although the GCK level maintained increasing through 7 days of weaning period. Altogether, our study provides evidence that hepatic GNG and glycolysis in newborn piglets were more active than other days during suckling period, and early weaning could significantly suppressed glucose metabolism in liver, but this inhibition would progressively recover at day 7 after weaning.

  11. Examination of the eye as a means to determine the early postmortem period: a review of the literature.

    Science.gov (United States)

    Jaafar, S; Nokes, L D

    1994-02-01

    Reported are various techniques to determine the early postmortem period by examining the eye. These include corneal opacity, retinal vessel segmentation, pupil reaction, retinal changes and intraocular pressure. All are subjective, requiring experience to implement the techniques.

  12. Sword of the early sarmatian period from the Ik-Zay interfluve

    Directory of Open Access Journals (Sweden)

    Izmaylov Iskander L

    2015-06-01

    Full Text Available A sword discovered in 2001 as a stray find in the area of Chaply village (Aznakayevsky District of the Tatarstan Republic is analyzed in the article. The sword is kept at Aznakayevsky Local History Museum. The shape of its guard and blade allowed the author to suggest its Sarmatian origin. Similar artifacts of Sarmatian culture suggest dating the sword by the late 4th - late 3rd cc. A.D., i.e. by the Prohorovo (Early Sarmatian period. This find is unique for the entire South-Eastern Tatarstan and was discovered far to the north of the main distribution area of the Sarmatian artifacts. It provides grounds for inclusion of this territory into the Prohorovo cultural area and should promote a more thorough study of artifacts at interfluves of minor rivers – the Kama tributaries – in order to identify and research barrows.

  13. A Case Report on Juvenile Neuromyelitis Optica: Early Onset, Long Remission Period, and Atypical Treatment Response.

    Science.gov (United States)

    Elpers, Christiane; Gross, Catharina C; Fiedler, Barbara; Meuth, Sven G; Kurlemann, Gerhard

    2015-08-01

    Neuromyelitis optica (NMO) is a severe inflammatory demyelinating disease of the central nervous system and preferentially targets the optic nerves and spinal cord. NMO is rare in children and clinical course of the disease is highly variable as described in studies. Here, we present a case report of a young girl presenting with a rare course of pediatric NMO with an early disease onset at the age of 12 years, a relapse free interval of 4 years, evidence of NMO immunoglobulin G (IgG) and an unusual response against immunosuppressive therapy. The aim of this report is to highlight the potentially long remission period between relapses complicating proper diagnosis despite well defined diagnostic criteria. In addition, we want to encourage the use of rituximab in pediatric NMO, although larger cohorts are warranted to establish B cell depleting therapies in juvenile NMO.

  14. Biological and spatial structure of an early classic period cemetery at Charco Redondo, Oaxaca.

    Science.gov (United States)

    Paul, Kathleen S; Stojanowski, Christopher M; Butler, Michelle M

    2013-10-01

    This article presents an analysis of biological and spatial patterning of an Early Classic (A.D. 250-500) Chatino cemetery at the archaeological site of Charco Redondo, located in the lower Río Verde Valley, Oaxaca, Mexico. The Early Classic was a time of political instability positioned between two phases of state-level centralization within the coastal valley. The communal cemetery at Charco Redondo adds significantly to the inventory of excavated graves from this time period and provides novel data on mortuary practices during a critical phase in the development of state level polities in the region. Cluster analysis of mortuary data is combined with intracemetery biodistance approaches to reconstruct how the Charco Redondo cemetery was organized with respect to biological relationships. Cluster analysis of mortuary data identified three groupings of burials. Multidimensional scaling of Euclidean distances and Gower coefficients based on 45 odontometric and 13 dental morphological variables suggests a strong relationship between grave characteristics and locations and phenotypic variation. In other words, the cemetery at Charco Redondo appears biologically kin-structured. The communal nature of the cemetery conflicts with the assumed "household" burial model for this time period. We propose the observed combination of features represents a transitional practice in which aspects of community, kin, and individual identity were signaled simultaneously within the funerary environment during a time of political transition in the Valley. This article highlights the utility of intracemetery biodistance analyses for examining dimensions of kinship, "house," and community throughout Mesoamerica where overarching models often mask regional variability.

  15. QTLs Analysis of Cold Tolerance During Early Growth Period for Rice

    Institute of Scientific and Technical Information of China (English)

    HE Xiu-ying; HAN Long-zhi; XU Shi-ping; QIAO Yong-li; LIAO Yao-ping; CAO Gui-lan; MAO Xing-xue; ZHANG Yuan-yuan; WENG Ke-nan; AN Yong-ping; CHEN Zhao-ming; YE Jong-doo; CHEN Yue-han; KOH Hee-jong; XIAO Wan-sheng

    2004-01-01

    The quantitative trait loci (QTLs) for cold tolerance during early growth period were identified using a F2:3 population microsatellite markers. The cold tolerance at the seedling and tillering stages, and the growth ability of seedling under low temperature conditions were evaluated. All of the traits associated with cold tolerance at early growth stages appeared a continuous distribution near to normal in F3 lines, these were inherited as quantitative traits controlled by polygenes. Three QTLs on chromosomes 1, 5 and 9, which associated with cold tolerance at the seedling stage were detected. Among them, qCTS1accounted for 15.5% of observed phenotypic variation; Five QTLs on chromosomes 2, 3, 7, 9 and 11, associated with cold tolerance at the tillering stage were found, which explained lower percentage of observed phenotypic variation; Four QTLs on chromosomes 1,2, 11 and 12, which associated with the growth ability of seedling under low temperature conditions were found, among them,qGAS2 and qGAS12 explained 26.6 and 42.9% of observed phenotypic variation, respectively, which were major genes.

  16. Changes in coagulation and fibrinolysis in the postoperative period immediately after kidney transplantation in patients receiving OKT3 or cyclosporine A as induction therapy.

    Science.gov (United States)

    Deira, J; Alberca, I; Lerma, J L; Martín, B; Tabernero, J M

    1998-10-01

    Different immunosuppressive agents, in particular OKT3, have been implicated as causative factors in the risk for renal thrombosis in the period immediately after kidney transplantation. Also, in different types of vascular surgery, a state similar to hypercoagulation has been reported. To assess the extent to which OKT3, cyclosporine A (CsA), and surgery itself affect coagulation and fibrinolysis, a study was conducted of 20 patients divided into two groups: group A, 10 patients received OKT3 (first dose during the induction of anesthesia); and group B, 10 patients received CsA (first dose at least 2 hours before transplantation). Basal determinations and determinations at 2, 4, and 24 hours after the induction of anesthesia were made. No differences were found between the groups with respect to the clinical and usual coagulation parameters. The following were studied in both groups: (1) markers of coagulation activity (prekallikrein [PKK] levels and formation of thrombin-antithrombin complexes [TATc]), (2) inhibitors and suppressors of hemostasis (antithrombin III [AT-III] and protein C [PC] activity), (3) markers of fibrinolysis activation (levels of plasminogen [PLG] and of alpha2-antiplasmin [alpha2-APL]), and (4) markers of endothelial damage (tissue plasminogen activator [TPA] and thrombomodulin [TMD]). In both groups, an important formation of TATc was observed early, together with a decrease in PKK levels and consumption of both AT-III and PC, which reached their lowest levels at 24 hours. This points to an activation of coagulation through the intrinsic route and a secondary consumption of hemostasis inhibitors, both possibly caused by surgery. A consumption of PLG and alpha2-APL was also observed, reflecting stimulation of the fibrinolytic system and a physiological response to the activation of coagulation. A greater release of endothelial TPA was only observed in the patients receiving OKT3 (P < 0.0001), possibly signaling endothelial activation. It is

  17. Oxygen therapy reduces postoperative tachycardia

    DEFF Research Database (Denmark)

    Stausholm, K; Kehlet, H; Rosenberg, J

    1995-01-01

    Concomitant hypoxaemia and tachycardia in the postoperative period is unfavourable for the myocardium. Since hypoxaemia per se may be involved in the pathogenesis of postoperative tachycardia, we have studied the effect of oxygen therapy on tachycardia in 12 patients randomly allocated to blinded...

  18. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF): incremental validity in predicting early postoperative outcomes in spine surgery candidates.

    Science.gov (United States)

    Marek, Ryan J; Block, Andrew R; Ben-Porath, Yossef S

    2015-03-01

    A substantial proportion of individuals who undergo surgical procedures to relieve spine pain continue to report significant pain and dysfunction after recovery. Psychopathology and patient expectations have been linked to poor results, leading to an increasing reliance on presurgical psychological screening (PPS) as part of the surgical diagnostic process. The original Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and the MMPI-2 (Butcher, Graham, Ben-Porath, Tellegen, & Dahlstrom, 2001) were among the measures most commonly used in PPS evaluations and research. This study focuses on the newest version of the test, the MMPI-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011; Tellegen & Ben-Porath, 2008/2011) as a predictor of outcomes for spine surgery candidates. Using a sample of 172 men and 210 women who underwent a PPS, we examined the ability of MMPI-2-RF scale scores to predict early surgical outcomes independent of other presurgical risk factors identified by other means, as well as patients' presurgical expectations. MMPI-2-RF results accounted for up to 11% of additional variance in measures of early postoperative functioning. MMPI-2-RF scales that assess for emotional/internalizing problems, specifically Demoralization, measures of somatoform dysfunction, and interpersonal problems contributed most to the prediction of diminished outcome. 2015 APA, all rights reserved

  19. Subarachnoid sufentanil for early postoperative pain management in orthopedic patients: a placebo-controlled, double-blind study using spinal microcatheters.

    Science.gov (United States)

    Standl, T G; Horn, E; Luckmann, M; Burmeister, M; Wilhelm, S; Schulte am Esch, J

    2001-02-01

    Continuous spinal anesthesia is frequently used for intraoperative anesthesia but rarely for postoperative pain management. Because even small doses of local anesthetics can be associated with motor deficits, subarachnoid opioid injection may be an alternative. Eighty patients randomly received a subarachnoid injection of 10 microg sufentanil, 5 mg bupivacaine, 2.5 microg sufentanil plus 2.5 mg bupivacaine, or saline through 28-gauge spinal microcatheters for early postoperative pain relief after major lower-limb surgery (n = 20 in each group). Hemodynamic and respiratory parameters, pain scores, and motor function were monitored, and sufentanil concentrations in plasma and cerebrospinal fluid were measured. Ten additional patients received up to three repetitive injections of 10 microg sufentanil over 24 h. All drugs provided excellent pain relief within 15 min after injection, lasting 128 +/- 61 min with sufentanil, 146 +/- 74 min with bupivacaine, and 167 +/- 78 min with the mixture. Patients receiving bupivacaine showed the highest cephalad extension of sensory block (median, T6) and the most intense motor block, whereas patients given only sufentanil had no motor deficit. The duration of analgesia was shorter after subsequent sufentanil injection (100-115 min) than after the first injection (198 +/- 70 min). Six of 50 patients with sufentanil experienced a short episode of respiratory depression within 30 min after the first injection. Cerebrospinal fluid concentrations of sufentanil peaked at 5 min after injection (183 +/- 167 ng/ml) but were at the level of detection in the plasma. Sufentanil injected through microspinal catheters provided profound pain relief without impairing motor function when compared with bupivacaine. However, close monitoring remains mandatory in this setting.

  20. Postoperative astigmatism.

    Science.gov (United States)

    Swinger, C A

    1987-01-01

    With the numerous significant advances in surgical methodology--e.g., microinstrumentation, the operating microscope, the surgical keratometer, and intraocular lenses--that have been developed over the past two decades, both surgeons and patients have become increasingly aware of the final optic result of any surgical intervention. This is especially so since the development of refractive surgery, where good uncorrected vision is frequently the final arbiter of success. We have progressed to the stage where the optic manipulation of the cornea, whether intentional or otherwise, can be understood in terms of a number of variables. These include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations. Where these have failed and postoperative astigmatism still occurs, a number of surgical procedures are available to reduce the astigmatic error to an acceptable level.

  1. Postoperative spinal column; Postoperative Wirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Kaefer, W. [Westpfalzklinikum GmbH, Standort II, Abteilung fuer Wirbelsaeulenchirurgie, Kusel (Germany); Heumueller, I. [Westpfalzklinikum GmbH, Standort II, Institut fuer Radiologie II, Kusel (Germany); Harsch, N.; Kraus, C.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2016-08-15

    As a rule, postoperative imaging is carried out after spinal interventions to document the exact position of the implant material. Imaging is absolutely necessary when new clinical symptoms occur postoperatively. In this case a rebleeding or an incorrect implant position abutting a root or the spinal cord must be proven. In addition to these immediately occurring postoperative clinical symptoms, there are a number of complications that can occur several days, weeks or even months later. These include the failed back surgery syndrome, implant loosening or breakage of the material and relapse of a disc herniation and spondylodiscitis. In addition to knowledge of the original clinical symptoms, it is also important to know the operation details, such as the access route and the material used. In almost all postoperative cases, imaging with contrast medium administration and corresponding correction of artefacts by the implant material, such as the dual energy technique, correction algorithms and the use of special magnetic resonance (MR) sequences are necessary. In order to correctly assess the postoperative imaging, knowledge of the surgical procedure and the previous clinical symptoms are mandatory besides special computed tomography (CT) techniques and MR sequences. (orig.) [German] In der Regel erfolgt bei spinalen Eingriffen eine postoperative Bildgebung, um die exakte Lage des Implantatmaterials zu dokumentieren. Unbedingt notwendig ist die Bildgebung, wenn postoperativ neue klinische Symptome aufgetreten sind. Hier muessen eine Nachblutung bzw. inkorrekte, eine Wurzel oder das Myelon tangierende Implantatlage nachgewiesen werden. Neben diesen direkt postoperativ auftretenden klinischen Symptomen gibt es eine Reihe von Komplikationen, die erst nach mehreren Tagen, Wochen oder sogar nach Monaten auftreten koennen. Hierzu zaehlen das Failed-back-surgery-Syndrom, die Implantatlockerung oder -bruch, aber auch ein Rezidivvorfall und die Spondylodiszitis. Neben der

  2. The alcohol-sensitive period during early octavolateral organ development in zebrafish (Danio rerio).

    Science.gov (United States)

    Zamora, Lilliann Y; Miguel, Kayla C; Lu, Zhongmin

    2017-01-20

    Fetal alcohol exposure can cause Fetal Alcohol Spectrum Disorders (FASD), completely preventable developmental disabilities characterized by permanent birth defects. However, specific gestational timing when developing organs are most sensitive to alcohol exposure is unclear. In this study, we examined the temporal effects of embryonic alcohol exposure on octavolateral organs in zebrafish (Danio rerio), including inner ears and lateral line neuromasts that function in hearing, balance, and hydrodynamic detection, respectively. To determine an alcohol-sensitive period in the first 24 hours post fertilization (hpf), Et(krt4:EGFP)(sqet4) zebrafish that express green fluorescent protein in sensory hair cells were treated in 2% alcohol for 2, 3, and 5-hours. Octavolateral organs of control and alcohol-exposed larvae were examined at 3, 5, and 7 days post fertilization (dpf). Using confocal and light microscopy, we found that alcohol-exposed larvae had significantly smaller otic vesicles and saccular otoliths than control larvae at 3 dpf. Only alcohol-exposed larvae from 12-17 hpf had smaller otic vesicles at 5 dpf, smaller saccular otoliths at 7 dpf and fewer saccular hair cells, neuromasts and hair cells per neuromast at 3 dpf. In addition, auditory function was assessed by microphonic potential recordings from inner ear hair cells in response to 200-Hz stimulation. Hearing sensitivity was reduced for alcohol-exposed larvae from 7-12 and 12-17 hpf. Our results show that 12-17 hpf is an alcohol-sensitive time window when morphology and function of zebrafish octavolateral organs are most vulnerable to alcohol exposure. This study implies that embryonic alcohol exposure timing during early development can influence severity of hearing deficits. © 2017 Wiley Periodicals, Inc.

  3. Postoperative Ileus in the Elderly

    Directory of Open Access Journals (Sweden)

    Chih-Peng Tu

    2014-03-01

    Full Text Available Postoperative ileus is among the most common complications after surgery. Aging is associated with an increased colonic transit time, and anesthetic disturbance to colonic motility is often aggravated in the elderly. Postoperative ileus increases morbidity, prolongs the length of hospital stay, and constitutes a significant economic burden on the healthcare system. Multimodal enhanced recovery protocols, or fast-track surgeries, have been developed to improve postoperative recovery. Patient education, avoidance of perioperative fluid overload, selective use of nasogastric decompression, early ambulation, adopting a minimally invasive approach, early initiation of clear fluids, and gum chewing are all possible measures to reduce postoperative ileus. Thoracic epidural anesthesia is a well-established technique to hasten recovery, whereas insufficient data are available to ascertain the safety and efficacy of opioid-sparing analgesia in the elderly. The evidence is clear that traditional prokinetic medications are not helpful in the treatment or prevention of postoperative ileus. Early results suggest that alvimopan is a promising agent to reverse opioid-induced ileus. Since postoperative ileus is a multifactorial condition, a concerted effort is therefore necessary to prevent or decrease the duration of postoperative ileus using multimodal strategies.

  4. A magnificent circumcision carnival in the early 18th century Ottoman period.

    Science.gov (United States)

    Verit, Ayhan; Cengiz, Mustafa; Yeni, Ercan; Unal, Dogan

    2005-01-01

    Circumcision has always been regarded as both an important social event and a milestone of a young man's life in Turkish culture, especially in the Ottoman period. Herein we study an exceptional circumcision festivity which lasted 15 days in the early autumn of the year 1720, for the 4 princes of Sultan III Ahmed, some sons of two high-ranking Ottoman officials and thousands of male children of poor citizens of Istanbul as representing the beneficent of the Sultan. All the organizations of the Empire participated in this huge event, including many shows and a feast, and the preparations were initiated months before. Traditionally, this kind of important social event of Ottoman culture had been described in a literary manner, and Surname-i Vehbi was the special name for the book of this circumcision festivity with 137 colored paintings and a total of 175 pages. The original of this work, which is in the library of Topkapi Palace Museum in Istanbul, was written by Vehbi and illustrated by Levni. The importance of this antique book is that it is the last important example of the illustrated festivity books of Ottoman literature.

  5. Heart rate variability biofeedback intervention for reduction of psychological stress during the early postpartum period.

    Science.gov (United States)

    Kudo, Naoko; Shinohara, Hitomi; Kodama, Hideya

    2014-12-01

    This study examined the effectiveness of heart rate variability (HRV) biofeedback intervention for reduction of psychological stress in women in the early postpartum period. On postpartum day 4, 55 healthy subjects received a brief explanation about HRV biofeedback using a portable device. Among them, 25 mothers who agreed to implement HRV biofeedback at home were grouped as the biofeedback group, and other 30 mothers were grouped as the control group. At 1 month postpartum, there was a significant decrease in total Edinburgh Postnatal Depression Scale score (P biofeedback group; this change was brought about mainly by decreases in items related to anxiety or difficulty sleeping. There was also a significant increase in standard deviation of the normal heartbeat interval (P biofeedback group after adjusting for potential covariates. In conclusion, postpartum women who implemented HRV biofeedback after delivery were relatively free from anxiety and complained less of difficulties sleeping at 1 month postpartum. Although the positive effects of HRV biofeedback may be partly attributable to intervention effects, due to its clinical outcome, HRV biofeedback appears to be recommendable for many postpartum women as a feasible health-promoting measure after childbirth.

  6. Cemetery of the late Tumulus – early Urnfield period at Balatonfűzfő, Hungary

    Directory of Open Access Journals (Sweden)

    Gábor Ilon

    2016-02-01

    Full Text Available On the outskirts of Balatonfűzfő, an excavation was carried out by Sylvia K. Palágyi between 1991–1994 as a continuation of the excavation in 1966 that preceded the construction of the so-called Delta junction of roads no. 71–72. In 1992–1993, during the excavation of a Roman Age pottery workshop five graves of a late Tumulus – early Urnfield period (Br D2–Ha A1 cemetery came to light. Each cremation grave (with the cremated remains either scattered in the pit or put in an urn was characterised by a certain burial rite. The richest grave (no. 6 was that of an adult male, buried with his weapons, among them a uniquely decorated knife with a grip terminating in a bird's head. Graves no. 2 and no. 4 contained female burials with jewellery, while grave no. 1 belonged to a child, and included jewellery as well as several ceramic vessels.

  7. Illustrations of neurosurgical techniques in early period of Ottoman Empire by Serefeddin Sabuncuoğlu.

    Science.gov (United States)

    Turgut, M

    2007-10-01

    Serefeddin Sabuncuoğlu (A.D. 1385-1468) was the author of the first illustrated surgery atlas Cerrahiyyetü'l Haniyye (Imperial Surgery), which was written in Turkish in 1465. The purpose of this report is to present his unique contribution to modern neurological surgery. Cerrahiyyetü'l Haniyye consists of 412 pages in three chapters, in which there are a total of 191 sections dealing with a variety of surgical specialties, including neurosurgery. In each section of the book, a sentence written in rhyme and meter gives the diagnosis, classification and surgical technique in detail. Serefeddin Sabuncuoğlu describes medical and surgical management of neurological diseases such as spinal trauma, epilepsy, migraine, facial palsy, hemiplegia, low back pain, cranial fracture, hydrocephalus and abscesses of the head in his textbook. Serefeddin Sabuncuoğlu was a great surgeon in Turkish medical history and the sections on neurological diseases in Cerrahiyyetü'l Haniyye are of great importance in neurosurgery. Today, he is justified as a pioneer of surgery, an investigator and a medical illustrator in the early period of Ottoman Empire. His atlas is a modification of original contributions from earlier treatises.

  8. Seafaring Archaeology of the East Coast of India and Southeast Asia during the Early Historical Period

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    Sila Tripati

    2017-07-01

    Full Text Available The concept of trade in ancient India was quite different from modern times. In olden day’s mariners, artisans, traders, Buddhist monks and religious leaders used to set sail together and this trend continued till the advent of modern shipping. The representation of art on the walls of the caves, stupas and temples enlighten us regarding their joint ventures, experiences and problems faced during the sea voyages. The finding of varieties of pottery, punch marked and Roman coins, Brahmi and Kharoshti inscriptions along the ports, trade centres and Buddhist settlements suggest the role played by them in maritime trade during the early historical period and later. Mariners of India were aware of the monsoon wind and currents for more than two thousand years if not earlier. Furthermore, the study shows that the maritime contact with Southeast Asian countries was seasonal and no changes of Southwest and Northeast monsoon have been noticed since then. This paper details the types of pottery, beads, cargo found at ports, trade routes and Buddhist settlements along the east coast of India and the role of monsoons in maritime trade. The impact of Buddhism on trade and society of the region are also discussed.

  9. Trajectories of fathers' psychological distress across the early parenting period: Implications for parenting.

    Science.gov (United States)

    Giallo, Rebecca; Cooklin, Amanda; Brown, Stephanie; Christensen, Daniel; Kingston, Dawn; Liu, Cindy H; Wade, Catherine; Nicholson, Jan M

    2015-10-01

    Fathers' parenting behavior is a likely key mechanism underlying the consistent associations between paternal mental health difficulties and poor emotional-behavioral outcomes for children. This study investigates the association between fathers' mental health trajectories and key parenting behaviors (warmth, hostility, consistency) spanning the first 8-9 years postpartum. Secondary analyses of 5 waves of data from 2,662 fathers participating in the Longitudinal Study of Australian Children were conducted. Latent growth class analysis was used to identify distinct trajectories of fathers' distress (Kessler-6; Kessler et al., 2003), and latent growth models estimated parenting warmth, hostility, and consistency. Multiple group analyses were conducted to describe and compare the course of parenting behaviors for fathers assigned to the distress trajectories identified. Two distinct classes of fathers were identified based on the trajectories of distress: minimal distress (92%) and persistent and increasing distress (8%). The latter group reported significantly lower parenting warmth when their children were 8-9 years and lower consistency and higher hostility across all study intervals. The postnatal and early parenting period is a critical time for the development of parenting behaviors that are important for children's development. Engagement and support for fathers around well-being and parenting is vital for promoting optimal family and child developmental outcomes.

  10. Induction of ovarian activity in Bulgarian Murrah buffaloes by hormonal treatment in the early postpartum period

    Institute of Scientific and Technical Information of China (English)

    Stanimir A Yotov; Anatoli S Atanasov; Yordanka Y Ilieva

    2013-01-01

    Objective: To determine the possibilities for induction of ovarian activity in Bulgarian Murrah buffaloes by hormonal treatment in the early postpartum period. Methods: Twenty six clinically healthy animals, weighing 480-520 kg, 3-5 years of age, with normal parturition, without clinical signs of endometritis during the entire experimental period were divided into 2 groups: control (n=10) and experimental (n=16). Primiparous and multiparous buffaloes were proportionally allotted into both groups. By 5, 21, and 28 postpartum days, control animals were intramuscularly treated with 2 mL physiological saline, whereas experimental buffaloes received 500 mg PGF2αby the 5th postpartum day, 100 μg GnRH by the 21st postpartum day and a second prostaglandin dose 7 days later. All buffaloes were submitted to transrectal ultrasound examination on days 5, 21 and 28 after calving. Evaluation of ovarian activity was made on the basis of follicle type and detection of a newly formed corpus luteum. The percentage of animals with small, medium or dominant follicle and corpus luteum after either spontaneous or induced ovulation was determined. Insemination management included introduction of two proven fertile bulls into the herd at the start of the treatment. Pregnancy ultrasound checks were performed on postpartum days 58, 68, 120 and 150. The proportion of buffaloes with clinical signs of spontaneous or induced oestrus until the 35th postpartum day, pregnancy rates by the 35th and 90th postpartum days and service periods 90 days were registered. Results: On the 5th day after calving, small follicles were predominating in the ovaries of buffaloes from both groups. Similar findings were established on the 21st day in the control group, whereas the share of experimental buffaloes with small follicles was significantly (P<0.01) lower. By the 21st day, there were no medium follicles in untreated animals, while in hormonally treated ones they were found out in 25% of cases. The

  11. Early detection and treatment of myocardial ischaemia after operation using continual ambulatory arterial pressure monitoring and ECG ST segment analysis.

    Science.gov (United States)

    Edwards, N D; Troy, G; Yeo, W; Jackson, P; Reilly, C S

    1995-10-01

    We report a case in which the use of continual ambulatory arterial pressure monitoring and ECG ST-segment analysis allowed early detection and treatment of myocardial ischaemia in the postoperative period. We believe that this case illustrates the potential value of ambulatory monitoring in the early postoperative period in high-risk patients.

  12. Laparoscopic versus Open Liver Resection: Differences in Intraoperative and Early Postoperative Outcome among Cirrhotic Patients with Hepatocellular Carcinoma—A Retrospective Observational Study

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    Antonio Siniscalchi

    2014-01-01

    Full Text Available Introduction. Laparoscopic liver resection is considered risky in cirrhotic patients, even if minor surgical trauma of laparoscopy could be useful to prevent deterioration of a compromised liver function. This study aimed to identify the differences in terms of perioperative complications and early outcome in cirrhotic patients undergoing minor hepatic resection for hepatocellular carcinoma with open or laparoscopic technique. Methods. In this retrospective study, 156 cirrhotic patients undergoing liver resection for hepatocellular carcinoma were divided into two groups according to type of surgical approach: laparoscopy (LS group: 23 patients or laparotomy (LT group: 133 patients. Perioperative data, mortality, and length of hospital stay were recorded. Results. Groups were matched for type of resection, median number of nodules, and median diameter of largest lesions. Groups were also homogeneous for preoperative liver and renal function tests. Intraoperative haemoglobin decrease and transfusions of red blood cells and fresh frozen plasma were significantly lower in LS group. MELD score lasted stable after laparoscopic resection, while it increased in laparotomic group. Postoperative liver and renal failure and mortality were all lower in LS group. Conclusions. Lower morbidity and mortality, maintenance of liver function, and shorter hospital stay suggest the safety and benefit of laparoscopic approach.

  13. 活体供者供肝术后早期并发症分析%The early postoperative complications in living liver transplantation donors

    Institute of Scientific and Technical Information of China (English)

    米凯; 李川; 文天夫; 严律南; 李波; 王文涛; 徐明清; 杨家印; 魏永刚

    2012-01-01

    Objective To investigate the incidence of early postoperative complications in living donor liver transplantation.Methods Postoperative data of 170 living liver donors were retrospectively collected from January 2002 to August 2009 and the collected data were divided into two groups according to the type of donors (right-lobe graft,R group and left lobe graft,L group). Early postoperative complications were analyzed using Clavien classification system.Results The difference between two groups was no statistically significant in donor's age,body mass index,operation time and other characters (P>0.05).R group had a bigger actual cut weight of donor liver (P<0.05),smaller residual liver weight (P<0.05) which also smaller than standard liver weight (P<0.05),and a longer hospital stay (P<0.05) than L group.During hospitalization,62 complications occurred in 55 cases with the total complication rate being 32.35% (55/170). In detail,the incidence of complications was 34.39% (54/157) in R group,and 7.69% (1/13) in L group (chi-square value =2.787,P>0.05).Among these 62 complications,there were 39 times of Ⅰ grade,5 times of Ⅱ grade,16 times of Ⅲ grade,2 times of Ⅳ a grade. All the complications were cured by active treatment and all donors survived well.Conclusion Although the security of living donor liver transplantation is better,the risk of serious complications must be faced.We must strictly select and assess the donor before the operation,very carefully carry out surgical operation,and pay more attention to postoperative management in order to avoid postoperative complications of donors.%目的 探讨活体肝移植供者术后早期并发症的发生情况.方法 对2002年1月至2009年8月间170例活体肝移植供者的临床资料进行回顾性分析,依据供肝类型分为右半供肝组和左半供肝组,采用Clavien分类系统对术后早期发生的并发症进行分析.结果 两组间供者年龄、身高体重指数、手

  14. Periodic anoxic shelf in the Early-Middle Ordovician transition: ichnosedimentologic evidence from west-central Utah, USA

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Ichnosedimentologic evidence of periodic anoxic shelf in the Early-Middle Ordovician transition includes lower ichnodiversity, shallower bioturbation and burrowing depth (<4 cm ), rare domichnia, tiny Chondrites occupying shallower or shallowest tiering, widely distributed nodules of limonite pseudomorphs after pyrite, occurrence of trace fossils being closely associated with the storm event layers, and stratigraphic successions with orbital cyclostratigraphic architecture. It is suggested that lower atmospheric oxygen level during the Early Paleozoic, the Ordovician radiation, dramatic transgression and warmer temperatures would result in the periodic anoxia in the Early-Middle Ordovician transition. This episode began at the later Early Ordovician and lasted about 3.4 Ma on the basis of orbital cyclostratigraphy.

  15. Trombólise intra-arterial pulmonar no pós-operatório de clipagem de aneurisma cerebral: relato de caso Intra-arterial pulmonary thrombolysis at the postoperative period of brain aneurysm clamping: case report

    Directory of Open Access Journals (Sweden)

    Salomón Soriano Ordinola Rojas

    2008-09-01

    Full Text Available O tromboembolismo pulmonar (TEP é uma importante causa de morbimortalidade nos pacientes submetidos a procedimentos neurocirúrgicos. O objetivo deste estudo foi apresentar um caso de trombólise intra-arterial pulmonar em pós-operatório recente de neurocirurgia. Paciente do sexo masculino, sendo submetido a clipagem de aneurisma de artéria comunicante anterior, apresentou como complicação no sétimo dia de pós-operatório, tromboembolismo pulmonar maciço, apresentando instabilidade hemodinâmica, sendo optado pela trombólise intra-arterial pulmonar com alteplase. Apresentou evolução satisfatória, sem complicações hemorrágicas, recebendo alta hospitalar. O tromboembolismo pulmonar é uma condição com alta morbi-mortalidade no pós-operatório de neurocirurgia, devendo ser a trombólise ser uma alternativa terapêutica nos casos refratários ao tratamento clínico.Pulmonary thromboembolism is a major cause of morbidity and mortality of patients undergoing neurosurgical procedures. The purpose of this study was to present a case of intra-arterial pulmonary thrombolysis in recent neurosurgery postoperative period. Male patient, undergoing neurosurgery, presented as a complication on the seventh day of postoperative massive pulmonary embolism with hemodynamic instability and intraarterial pulmonary thrombolysis with alteplase was indicated. Evolution was satisfactory without bleeding complications and patient was discharged. Pulmonary thromboembolism is a high morbidity and mortality condition at neurosurgical postoperative period and thrombolysis should be an alternative therapy in cases refractory to clinical treatment.

  16. Fetal Nerve Cell Transplantation in Early Post-Resuscitation Period in Rats

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    Damira Tazhibayeva

    2015-02-01

    was less than in the control group. Moreover, cell therapy improved the reflexes in the experimental animals. Conclusions. The study revealed the positive neuroprotective effect of the fetal nerve cells on the recovery in the early post-resuscitation period. This was confirmed by the normalization of enzymatic reactions, improvement reflective activity, and increase in the survival rate of the resuscitated animals in the group treated with fetal nerve cell transplantation. These findings warrant future research on the mechanisms associated with reflex improvement. 

  17. Recrutamento alveolar em pacientes no pós-operatório imediato de cirurgia cardíaca Alveolar recruitment in patients in the immediate postoperative period of cardiac surgery

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    Cauê Padovani

    2011-03-01

    Full Text Available Complicações pulmonares no pós-operatório de cirurgia cardíaca são frequentes, destacando-se a atelectasia e a hipoxemia. As manobras de recrutamento alveolar contribuem significativamente para a prevenção e o tratamento destas complicações. Desta forma, este estudo buscou agrupar e atualizar os conhecimentos relacionados à utilização das manobras de recrutamento alveolar no pós-operatório imediato de cirurgia cardíaca. Observou-se a eficácia do recrutamento alveolar por meio de diferentes técnicas específicas e a necessidade do desenvolvimento de novas pesquisas.Lung complications during postoperative period of cardiac surgery are frequently, highlighting atelectasis and hypoxemia. Alveolar recruitment maneuvers have an important role in the prevention and treatment of these complications. Thus, this study reviewed and updated the alveolar recruitment maneuvers performance in the immediate postoperative period of cardiac surgery. We noted the efficacy of alveolar recruitment through different specific techniques and the need for development of new studies.

  18. Clinical Practice Guidelines for postoperative period of thoracic surgery. Guía de práctica clínica para el posoperatorio de cirugia de tórax

    Directory of Open Access Journals (Sweden)

    Félix Molina Díaz

    2009-03-01

    Full Text Available Clinical Practice Guidelines for postoperative period of thoracic surgery. It is the period between the suture of the surgical wound and the total rehabilitation of the patient, which usually occurs in the Intensive Care Unit. This document includes a review and update of the main aspects such as classification, postoperative treatment, stressing the actions to face any complication. It includes assessment guidelines focused on the most important aspects to be accomplished.Guía de práctica clínica para el posoperatorio de cirugía de tórax. Período de tiempo que transcurre desde que el cirujano cierra la herida quirúrgica en el quirófano, hasta el momento en que el paciente se restablece de su operación, lo cual comúnmente ocurre en Cuidados Intensivos. El documento revisa y actualiza aspectos fundamentales como clasificación y tratamiento posoperatorio, con énfasis en la conducta ante sus complicaciones. Concluye con su guía de evaluación, enfocada en los aspectos más importantes a cumplir.

  19. Postoperative incentive spirometry use.

    Science.gov (United States)

    Hassanzadeh, Hamid; Jain, Amit; Tan, Eric W; Stein, Benjamin E; Van Hoy, Megan L; Stewart, Nadine N; Lemma, Mesfin A

    2012-06-01

    The authors hypothesized that the use of incentive spirometry by orthopedic patients is less than the recommended level and is affected by patient-related factors and type of surgery. To determine its postoperative use, the authors prospectively surveyed all patients in their institution's general orthopedic ward who had undergone elective spine surgery or total knee or hip arthroplasty during a consecutive 3-month period in 2010, excluding patients with postoperative delirium or requiring a monitored bed. All 182 patients (74 men, 108 women; average age, 64.5 years; range, 32-88 years; spine group, n=55; arthroplasty group, n=127), per protocol, received preoperative spirometry education by a licensed respiratory therapist (recommended use, 10 times hourly) and reinforcement education by nurses. Patients were asked twice daily (morning and evening) regarding their spirometry use during the previous 1-hour period by a registered nurse on postoperative days 1 through 3. All data were collected by the same 2 nurses using the same standardized questionnaire. Spirometry use was correlated with surgery type, postoperative day/time, and patient's age and sex. Student's t test, Spearman test, and one-way analysis of variance were used to compare differences (PSpirometry use averaged 4.1 times per hour (range, 0-10 times). No statistical correlations were found between spirometry use and age. Sex did not influence spirometry use. The arthroplasty group reported significantly higher use than did the spine group: 4.3 and 3.5 times per hour, respectively. Mean use increased significantly between postoperative days 1, 2, and 3.

  20. NEWBORNS OF HIGH RISK GROUPS AND ELECTROPHYSIOLOGICAL CARDIAC ACTIVITY DURING THE PERIOD OF EARLY ADAPTATION

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    T. S. Tumaeva

    2014-01-01

    Full Text Available Aim: to study characteristics of electrophysiological cardiac activity in children of risk groups and to assess possibilities of Holter-electrocardiography (H-ECG in revealing of cardiac dysfunction during the period of early adaptation. Patients and methods: 250 newborns were examined. The main group consisted of 200 children with cerebral ischemia (CI. This group was divided into 2 subgroups: 100 full-term and 100 premature (at various gestation age infants. Control group contained 50 children born at 38–40th weeks of gestation with physiological course of pregnancy and delivery, APGAR score of 8–9 points. Complex examination included H-ECG according the standard technic with evaluation of the hearth rate (HR during sleep and wakefulness; HRmin, HRmax; arrhythmias, conductivity disorders, duration of the intervals; rhythm variability. Results: according to the ECG children with CI, especially premature ones, and children delivered via Cesarean section more often had ST-T disturbances, arrhythmias (sinus tachycardia, less often — sinus bradycardia and conductivity disorders, Q-Tc prolongation. H-EGC revealed decrease of sleep HR, HRmin and HRmax in children with CI especially in delivered via Cesarean section. The most common arrhythmia was supraventricular extrasystole.  Pauses in rhythms and variability were the highest in premature children delivered via Cesarean section. Conclusions: hypoxia/ischemia is a trigger for development of cardiovascular dysfuncion in newborns. Premature and children delivered via Cesarean section form a group of high risk. H-ECG widens possibilities of revealing of symptoms of cardiac dysfunction (disturbances at the basal level of functioning, of adaptation resources of the sinus node, electric instability of the myocardium and heart rate variability in children of risk group for development of cardiovascular disorders. 

  1. Early experience with racial discrimination and conduct disorder as predictors of subsequent drug use: a critical period hypothesis.

    Science.gov (United States)

    Gibbons, Frederick X; Yeh, Hsiu-Chen; Gerrard, Meg; Cleveland, Michael J; Cutrona, Carolyn; Simons, Ronald L; Brody, Gene H

    2007-04-01

    A critical period hypothesis linking early experiences with both racial discrimination and conduct disorder (CD) with subsequent drug use was examined in a panel of 889 African American adolescents (age 10.5 at time 1) and their parents. Analyses indicated that these early experiences did predict use by the adolescents at time 3 (T3)-5 years later. These relations were both direct and indirect, being mediated by an increase in affiliation with friends who were using drugs. The relations existed controlling for parents' reports of their use, discrimination experiences, and their socioeconomic status (SES). The impact of these early experiences on African American families is discussed.

  2. Quantitation of nasal development in the early prenatal period using geometric morphometrics and MRI: a new insight into the critical period of Binder phenotype.

    Science.gov (United States)

    Katsube, Motoki; Yamada, Shigehito; Miyazaki, Reina; Yamaguchi, Yutaka; Makishima, Haruyuki; Takakuwa, Tetsuya; Yamamoto, Akira; Fujii, Yosuke; Morimoto, Naoki; Ito, Tsuyoshi; Imai, Hirohiko; Suzuki, Shigehiko

    2017-09-01

    Disturbance of the development of the nasal septum in the early prenatal period causes congenital facial anomalies characterized by a flat nose and defects of the anterior nasal spine (ANS), such as Binder phenotype. The present research aimed to assess the development of the nasal septum and the ANS with growth in the early prenatal period. Magnetic resonance images were obtained from 56 specimens. Mid-sagittal images were analyzed by using geometric morphometrics for the development of the nasal septum, and angle analysis was performed for the development of the ANS. Additionally, we calculated and visualized the ontogenetic allometry of the nasal septum. Our results showed that the nasal septum changed shape in the anteroposterior direction in smaller specimens, while it maintained an almost isometric shape in larger specimens. Furthermore, mathematical evidence revealed that the maturation periods of the shapes of the ANS and the nasal septum were around 12 and 14 weeks of gestation, respectively. The anteroposterior development of the nasal septum is specific until 14 weeks of gestation, and it is important for nasal protrusion and the development of the ANS. Therefore, the disturbance of such development could induce low nasal deformity, including Binder phenotype. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

  3. Prevention of postoperative ileus

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2002-01-01

    Postoperative ileus (PI) is a major contributor to postoperative morbidity and prolonged convalescence after major surgical procedures. The pathophysiology of PI is multifactorial, including activation of the stress response to surgery, with inhibitory sympathetic visceral reflexes and inflammatory...... mediators. We update evidence on the advances in the prevention and treatment on PI. As single interventions, continuous thoracic epidural analgesia with local anesthetics and minimally invasive surgery are the most efficient interventions in the reduction of PI. The effects of pharmacological agents have...... generally been disappointing with the exception of cisapride and the introduction of the new selective peripherally acting m-opioid antagonists. Presently, introduction of a multi-modal rehabilitation programme (including continuous epidural analgesia with local anesthetics, early oral feeding and enforced...

  4. The rise of the managerial state in Indonesia : institutional transition during the early independence period. 1950-1965

    NARCIS (Netherlands)

    Fakih, Farabi

    2014-01-01

    The dissertation analyzes the production of a new elite group in Indonesia, the managers, during the early independence period. Indonesia faced lack of expertise and a government incapable of managing a national plan. The expansion of the managerial class was the result of the lack of leadership of

  5. Investigations Into Early Magnitude Estimation From Predominant Period, Using Synthetic Rupture Models

    Science.gov (United States)

    Hildyard, M.; Rietbrock, A.

    2007-12-01

    Considerable interest has been shown in a method for estimating predominant period in the time domain (TpMax), first proposed by Nakamura (1988) and currently being developed for other early warning systems (e.g. Lockman and Allen, BSSA, 2005). Issues still exist as to the causes of the scatter evident in empirical work, and how effective the method is for characterising large events whose time to rupture is longer than the few seconds desired to estimate the magnitude. Our work on applying this method to an aftershock dataset motivated us to investigate the method through the use of synthetic rupture models. The rupture model we use prescribes a stress-drop with a prescribed rise-time over a small patch of the fault surface. This stress-drop is propagated to other patches of the fault according to a prescribed rupture rate. The same finite difference model geometry and fault patch size was then used to model events ranging from magnitude 3.7 to 7.2. Moment Magnitude was calculated directly by integrating the resultant slip on the fault, and TpMax was calculated from seismograms recorded on surface 50 km from the centre of the fault. The initial modelling used a homogenous stress drop, rise-time, and rupture rate. A dataset of 165 events, showed a significant increasing relationship between the TpMax calculation and magnitude. Isolating similar events initiating at the same point on the fault, gave a near straight-line trend. Scatter in the relationship is shown to result from variations in the position, initiation point, stress drop, rise time, and rupture velocity. Low frequency filtering was found to significantly affect the TpMax calculations and trends. Without filtering, the relationship saturated from just after magnitude 6, as the time to rupture becomes longer than the window used to calculate TpMax. However, low frequency filtering actually reduces the time to reach a maximum in the calculation, and this can cause the increasing trend to continue into

  6. Optimization of post-operative early enteral nutrition with sequential therapy%"序贯疗法"优化手术后早期肠内营养

    Institute of Scientific and Technical Information of China (English)

    于健春

    2011-01-01

    肠内营养较肠外营养更符合生理,具有保护肠屏障功能、肝功能和免疫功能,促进胃肠道功能及蛋白质合成,降低应激反应及胰岛素抵抗,降低感染并发症和医疗费用等重要作用和优势.肠内营养实施的关键是对肠内营养适应证、并发症和禁忌证的认识,以及对肠内营养制剂、置管途径及器械装置配套的合理选择.为增加手术后肠内营养耐受性,降低并发症,提高营养支持治疗效果,提出了肠内营养临床应用新方法.手术后早期肠内营养"序贯疗法".%Compared with parenteral nutrition (PN) , enteral nutrition (EN) is more favorable in maintaining physiological status, protecting intestinal barrier function, liver function, immune function, and gastrointestinal function, promoting protein synthesis, reducing the stress response and insulin resistance, reducing infectious complications, and lowering healthcare costs. Successful implementation of EN depends on the good knowledge of indications, complications, and contraindications and on the proper choice of EN preparations, tube placement route, and equipment In this article, with an attempt to increase the tolerance of EN after surgery, reduce complications , and improve the therapeutic effect of nutritional support, we propose a new method of clinical application-optimization of post-operative early enteral nutrition with sequential therapy.

  7. Polymicrobial Infections in the Early Period of Kidney Transplantation in a Case with Wegener's Granulomatosis

    Directory of Open Access Journals (Sweden)

    Funda COŞKUN

    2011-01-01

    Full Text Available Wegener's granulomatosis (WG is a disorder that causes necrotizing granulomatosis vasculitis particularly of the upper respiratory tract, lung and kidney. A 43-year-old male who had been treated with hemodialysis because of renal insufficiency due to WG underwent live donor renal transplantation. Pulmonary infiltrates were detected on the postoperative 4th day and antibiotic therapy was started with a diagnosis of sepsis and pulmonary infection. Dialysis treatment was also started due to the degradation of renal function for the patient who was intubated during follow-up. Non-invasive mechanical ventilation (BiPAP treatment was started after extubation. The graft and respiratory function improved during clinical follow-up. Resistant hospital infections, causing respiratory failure and systemic complications, were facilitated by a long history of hospitalization before transplantation, the presence of WG and immunosupression and were successfully treated with a multidisciplinary approach.a

  8. Postoperative hyperkalemia.

    Science.gov (United States)

    Ayach, Taha; Nappo, Robert W; Paugh-Miller, Jennifer L; Ross, Edward A

    2015-03-01

    Hyperkalemia occurs frequently in hospitalized patients and is of particular concern for those who have undergone surgery, with postoperative care provided by clinicians of many disciplines. This review describes the normal physiology and how multiple perioperative factors can disrupt potassium homeostasis and lead to severe elevations in plasma potassium concentration. The pathophysiologic basis of diverse causes of hyperkalemia was used to broadly classify etiologies into those with altered potassium distribution (e.g. increased potassium release from cells or other transcellular shifts), reduced urinary excretion (e.g. reduced sodium delivery, volume depletion, and hypoaldosteronism), or an exogenous potassium load (e.g. blood transfusions). Surgical conditions of particular concern involve: rhabdomyolysis from malpositioning, trauma or medications; bariatric surgery; vascular procedures with tissue ischemia; acidosis; hypovolemia; and volume or blood product resuscitation. Certain acute conditions and chronic co-morbidities present particular risk. These include chronic kidney disease, diabetes mellitus, many outpatient preoperative medications (e.g. beta blockers, salt substitutes), and inpatient agents (e.g. succinylcholine, hyperosmolar volume expanders). Clinicians need to be aware of these pathophysiologic mechanisms for developing perioperative hyperkalemia as many of the risks can be minimized or avoided.

  9. Unilateral lesion of dorsal hippocampus in adult rats impairs contralateral long-term potentiation in vivo and spatial memory in the early postoperative phase.

    Science.gov (United States)

    Li, Hongjie; Wu, Xiaoyan; Bai, Yanrui; Huang, Yan; He, Wenting; Dong, Zhifang

    2012-05-01

    It is well documented that bilateral hippocampal lesions or unilateral hippocampal lesion at birth causes impairment of contralateral LTP and long-term memory. However, effects of unilateral hippocampal lesion in adults on contralateral in vivo LTP and memory are not clear. We here examined the influence of unilateral electrolytic dorsal hippocampal lesion in adult rats on contralateral LTP in vivo and spatial memory during different postoperative phases. We found that acute unilateral hippocampal lesion had no effect on contralateral LTP. However, contralateral LTP was impaired at 1 week after lesion, and was restored to the control level at postoperative week 4. Similarly, spatial memory was also impaired at postoperative week 1, and was restored at postoperative week 4. In addition, the rats at postoperative week 1 showed stronger spatial exploratory behavior in a novel open-field environment. The sham operation had no effects on contralateral LTP, spatial memory and exploration at either postoperative week 1 or week 4. These results suggest that unilateral dorsal hippocampal lesion in adult rats causes transient contralateral LTP impairment and spatial memory deficit. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Early efforts in modeling the incubation period of infectious diseases with an acute course of illness

    Directory of Open Access Journals (Sweden)

    Nishiura Hiroshi

    2007-05-01

    Full Text Available Abstract The incubation period of infectious diseases, the time from infection with a microorganism to onset of disease, is directly relevant to prevention and control. Since explicit models of the incubation period enhance our understanding of the spread of disease, previous classic studies were revisited, focusing on the modeling methods employed and paying particular attention to relatively unknown historical efforts. The earliest study on the incubation period of pandemic influenza was published in 1919, providing estimates of the incubation period of Spanish flu using the daily incidence on ships departing from several ports in Australia. Although the study explicitly dealt with an unknown time of exposure, the assumed periods of exposure, which had an equal probability of infection, were too long, and thus, likely resulted in slight underestimates of the incubation period. After the suggestion that the incubation period follows lognormal distribution, Japanese epidemiologists extended this assumption to estimates of the time of exposure during a point source outbreak. Although the reason why the incubation period of acute infectious diseases tends to reveal a right-skewed distribution has been explored several times, the validity of the lognormal assumption is yet to be fully clarified. At present, various different distributions are assumed, and the lack of validity in assuming lognormal distribution is particularly apparent in the case of slowly progressing diseases. The present paper indicates that (1 analysis using well-defined short periods of exposure with appropriate statistical methods is critical when the exact time of exposure is unknown, and (2 when assuming a specific distribution for the incubation period, comparisons using different distributions are needed in addition to estimations using different datasets, analyses of the determinants of incubation period, and an understanding of the underlying disease mechanisms.

  11. Pedoarchaeology of Early Agricultural Period Irrigation Systems in the Tucson Basin of the American Southwest

    Science.gov (United States)

    Homburg, Jeffrey; Nials, Fred

    2017-04-01

    Pedoarchaeological studies were conducted at the Las Capas and Sunset Road sites in the Tucson Basin of Arizona in order to document and evaluate soil productivity and hydraulic soil properties of ancient agricultural irrigation systems. These ancient irrigated fields are on the margin of the Santa Cruz River floodplain, between two alluvial fans where high water tables and stable to aggrading geomorphic conditions facilitated diverting water from drainages and directing it to fields by gravity-fed canal irrigation. Archaeological investigations at these sites recently provided opportunities for documenting the configuration and evolution of the oldest irrigation systems yet identified in the United States, the earliest dating to more than three millennia in age. This research is significant archaeologically because of: (1) the antiquity ( 575-1225 B.C.) of the Early Agricultural period irrigation systems at these sites, (2) the fact that irrigation systems dated to different times are separated stratigraphically within the sites, and (3) the fact that extensive, well-preserved gridded irrigation features were identified using mechanical stripping, with nearly 100 ancient footprints preserved on a buried agricultural surface at Sunset Road. The stratigraphic separation of buried surfaces that were irrigated and the abundant cultivated irrigation plots facilitated soil sampling so that field, border, and uncultivated control samples could be compared in order to measure the anthropogenic effects of agriculture on soil quality in the irragric soils. Long-term indicators of agricultural soil quality such as organic carbon, nutrient content, and hydraulic soil water properties such as available water capacity and saturated hydraulic conductivity, indicate that soil changes were generally favorable for agricultural production and that these ancient irrigation systems were sustainable. Canals regularly supplied water to the fields, but they also supplied nutrient

  12. Torsional oscillations and observed rotational period variations in early-type stars

    CERN Document Server

    Krticka, J; Henry, G W; Kurfurst, P; Karlicky, M

    2016-01-01

    Some chemically peculiar stars in the upper main sequence show rotational period variations of unknown origin. We propose these variations are a consequence of the propagation of internal waves in magnetic rotating stars that lead to the torsional oscillations of the star. We simulate the magnetohydrodynamic waves and calculate resonant frequencies for two stars that show rotational variations: CU Vir and HD 37776. We provide updated analyses of rotational period variations in these stars and compare our results with numerical models. For CU Vir, the length of the observed rotational-period cycle, $\\mathit\\Pi=67.6(5)$ yr, can be well reproduced by the models, which predict a cycle length of 51 yr. However, for HD 37776, the observed lower limit of the cycle length, $\\mathit\\Pi\\geq100$ yr, is significantly longer than the numerical models predict. We conclude that torsional oscillations provide a reasonable explanation at least for the observed period variations in CU Vir.

  13. On the new late B- and early A-type periodic variable stars

    CERN Document Server

    Mowlavi, Nami; Barblan, Fabio; Eyer, Laurent

    2013-01-01

    We summarize the properties of the new periodic, small amplitude, variable stars recently discovered in the open cluster NGC 3766. They are located in the region of the Hertzsprung-Russell diagram between \\delta\\ Sct and slowly pulsating B stars, a region where no sustained pulsation is predicted by standard models. The origin of their periodic variability is currently unknown. We also discuss how the Gaia mission, to be launched at the end of 2013, can contribute to our knowledge of those stars.

  14. [Early risk factors of eating disorders--do events of prenatal and perinatal periods bear significance?].

    Science.gov (United States)

    Raevuori, Anu; Niemelä, Solja; Keski-Rahkonen, Anna; Sourander, Andre

    2009-01-01

    Evidence of the relation of complications occurring in the pregnancy, delivery and neonatal periods to the risk of contracting a subsequent eating disorder has been obtained during recent years. Factors associated with parturition and neonatal period seem to predict both anorexia and bulimia, whereas disorders during pregnancy are more clearly associated with the descendant's anorexia. This difference may play an important role in the pathogenesis of the disorders.

  15. Individuals' Life Structures in the Early Adulthood Period Based on Levinson's Theory

    Science.gov (United States)

    Aktu, Yahya; Ilhan, Tahsin

    2017-01-01

    Early adulthood is one of the important milestones considered within lifelong development in the relevant literature. Adulthood is examined through various theories; however, universality of many of these is still being discussed. One of these theories is Levinson's theory of life structure. Thus, the current research aims to examine the extent to…

  16. Two critical periods in early visual cortex during figure-ground segregation

    NARCIS (Netherlands)

    Wokke, M.E.; Sligte, I.G.; Scholte, H.S.; Lamme, V.A.F.

    2012-01-01

    .The ability to distinguish a figure from its background is crucial for visual perception. To date, it remains unresolved where and how in the visual system different stages of figure-ground segregation emerge. Neural correlates of figure border detection have consistently been found in early visual

  17. The postanesthetic period. Complications.

    Science.gov (United States)

    Malamed, S F

    1987-01-01

    Postanesthetic complications can occur even in the best of circumstances. Proper preparation of the staff, aggressive monitoring of the recovering patient, and early recognition and management of the complications are essential if the outcome is to be successful. In reviewing postanesthetic complications, two factors are present in the overwhelming majority of situations--hypoxia and hypercarbia--often the direct result of inadequate monitoring during the postanesthetic period. The anesthetic procedure is not over once the anesthetic agents are discontinued. The skillful anesthetist is aware of the possibilities of postoperative complications and prevents problems by employing enhanced monitoring techniques during the recovery phase.

  18. Early postoperative active mobilisation versus immobilisation following tibialis posterior tendon transfer for foot-drop correction in patients with Hansen's disease.

    Science.gov (United States)

    Rath, Santosh; Schreuders, Ton A R; Selles, Ruud W

    2010-03-01

    After tibialis posterior tendon transfer surgery for foot-drop correction, the foot is traditionally immobilised for several weeks. To test the feasibility of early mobilisation after this procedure in patients with Hansen's disease, 21 consecutive patients received active mobilisation of the transfer starting on the 5th postoperative day. Transfer insertion strength was enhanced by Pulvertaft weave. The results were compared with a historical cohort of 21 patients receiving 4 weeks of immobilisation. The primary outcomes were active dorsiflexion, active plantar flexion and total active motion at the ankle, tendon-insertion pullout and time until discharge from rehabilitation with independent walking without aid. Assessments at discharge from rehabilitation and the last clinical follow-up at more than 1 year were compared between both groups. The Student's t-test was used to compare data between the groups, and 95% confidence interval of the difference between groups was determined. A p-value of 0.05 was considered statistically significant. The average follow-up was 22 months for both groups. There was no incidence of insertion pullout of the tendon transfer in either group. In addition, there was no difference in active dorsiflexion angle between the groups at discharge (mean difference: 2.2 degrees, p=0.22) and final assessment (mean difference: 2.3 degrees, p=0.42). The plantar flexion angles were similar in both groups at discharge (mean difference: 0.5 degrees, p=0.86) and final assessment (mean difference: 0.5 degrees, p=0.57). In addition, there was no difference in total active motion between the groups at discharge (mean difference: 2 degrees, p=0.54) and final assessment (mean difference: 1 degrees, p=0.49). The patients were discharged from rehabilitation with independent walking at 44.04+/-7.9 days after surgery in the mobilisation group compared to 57.07+/-2.3 days in the immobilisation group. This indicates a significant difference in morbidity (mean

  19. Impact of post-operative radiation on coronary arteries in patients of early breast cancer: A pilot dosimetric study from a tertiary cancer care center from India

    Directory of Open Access Journals (Sweden)

    S Roy

    2015-01-01

    Full Text Available Background: The significant impact of postoperative radiotherapy (PORT on cardiac morbidity in patients of early breast cancer (EBC undergoing breast-conserving surgery has been shown in different studies. The present study was conducted to assess the impact of surgery and the side of involvement on radiation dose to left anterior descending artery (LAD and Left circumflex coronary artery (LCx. Materials And Methods: Totally, 58 patients of EBC were randomly chosen for this dosimetric study and planned with tangential field technique without intensity modulation (IM. Heart, LAD, and LCx (n = 55 were contoured. Dose volume histograms were analyzed to determine the Dmax (maximum dose and Dmean (mean dose of LAD and LCx. Student's t-test was used for comparative analysis of the means. Results: The mean Dmax of LAD for left (L EBC was 3.17 Gray (Gy while for right (R EBC it was 0.86 Gy (P = 0.007; 95% C.I, 1.14–3.48. The mean Dmean of LAD for L-EBC and R-EBC were 1.97 Gy and 0.79 Gy, respectively (P = 0.029; 95% C.I, 0.77–1.60. The mean-Dmax of LCx for patients with L-EBC (2.9 Gy; range: 1.2–4.35 Gy was statistically higher than that for R-EBC (1.3 Gy; range: 0.7–3.2 Gy (P = 0.045. The mean-Dmean of LCx for L-EBC (2.1 Gy; range: 0.6–3.6 Gy was also significantly higher than that of L-EBC (0.9 Gy; range: 0.7–2.1 Gy (P = 0.03. There was no significant impact of the pattern of surgery on LAD dose, but significance was noted for LCx dose parameters (P = 0.04 and 0.08 for m-Dmax and m-Dmean of LCx. Conclusion: This pilot dosimetric study confirms the assumption that patients with left-sided EBC are at higher risk of developing long-term cardiac morbidity when treated with PORT due to increased dose to LAD.

  20. Peroxide effects of iodide excess on mitochondria in Fischer rat thyroid cell line in the early period

    Institute of Scientific and Technical Information of China (English)

    李敏

    2014-01-01

    Objective To investigate the peroxide effects of iodide excess on mitochondria in Fischer rat thyroid cell line(FRTL)in the early period.Methods After treatment with 0.0 mmol/L(control group)or 0.1 mmol/L potassium iodide(KI)for 2,4 and 24 h,respectively,changes of mitochondrial superoxide formation were assayed by flow cytometry and fluorescence microscopy using mitochondria-targeted hydroethidine(Mito SOX).

  1. Impact of oxidative stress on early postoperative knee function and muscle injury biochemical markers: Is it possible to create an ischemic preconditioning effect in sequential ischemic surgical procedures?

    Science.gov (United States)

    Aktaş, Erdem; Atay, Çiğdem; Deveci, Mehmet Ali; Arıkan, Murat; Toğral, Güray; Yıldırım, Ahmet

    2015-01-01

    Simultaneous bilateral total knee arthroplasty (TKA) with prolonged tourniquet time has the potential to trigger ischemia-reperfusion injury, which can adversely affect knee function. Studies suggest that the magnitude of injury is less if it occurs following an ischemic event which takes place in another part of the body, known as ischemic preconditioning (IPC). The purpose of this study was to investigate the impact of oxidative stress on muscle injury and knee function and to elucidate if potential IPC effect can attenuate ischemia-reperfusion injury metabolites and prevent poor functional outcomes in single-stage bilateral TKA. Thirty patients who underwent single-stage bilateral TKA under tourniquet were enrolled in the study. All procedures were initiated from the right limb. Upon completion of the procedure, the left tourniquet was inflated 20 minutes after the first tourniquet was deflated. The tourniquet time was noted. Pre- and postoperative levels of malondialdehyde (MDH), creatine kinase (CK), and lactate dehydrogenase (LDH) were evaluated. Knee function was assessed postoperatively at 1 month using WOMAC score. Postoperative levels of MDH, CK, and LDH were significantly increased in both extremities compared to preoperative levels. Serum MDH, CK, and LDH levels were not found to be correlated with tourniquet time for either extremity. Compared to the left extremity, the right extremity revealed increased postoperative oxidative stress, which was indicated by elevated serum MDH, CK, and LDH levels. Although tourniquet time and postoperative serum MDH, CK, and LDH levels were not found to be correlated with WOMAC index in either knee, the average change in WOMAC score at 1 month postoperatively was found to be higher in the left knee compared to the right. The biochemical and functional outcomes can be attributed to potential IPC effect. During bilateral TKA, a 20-minute interval between tourniquets can create IPC effect and attenuate the magnitude of

  2. Early action to reduce greenhouse gas emissions before the commitment period of the Kyoto protocol: advantages and disadvantages.

    Science.gov (United States)

    Michaelowa, A; Rolfe, C

    2001-09-01

    Current "business as usual" projections suggest greenhouse gas emissions from industrialized nations will grow substantially over the next decade. However, if it comes into force, the Kyoto Protocol will require industrialized nations to reduce emissions to an average of 5% below 1990 levels in the 2008-2012 period. Taking early action to close this gap has a number of advantages. It reduces the risks of passing thresholds that trigger climate change "surprises." Early action also increases future generations' ability to choose greater levels of climate protection, and it leads to faster reductions of other pollutants. From an economic sense, early action is important because it allows shifts to less carbon-intensive technologies during the course of normal capital stock turnover. Moreover, many options for emission reduction have negative costs, and thus are economically worthwhile, because of paybacks in energy costs, healthcare costs, and other benefits. Finally, early emission reductions enhance the probability of successful ratification and lower the risk of noncompliance with the protocol. We discuss policy approaches for the period prior to 2008. Disadvantages of the current proposals for Credit for Early Action are the possibility of adverse selection due to problematic baseline calculation methods as well as the distributionary impacts of allocating a part of the emissions budget already before 2008. One simple policy without drawbacks is the so-called baseline protection, which removes the disincentive to early action due to the expectation that businesses may, in the future, receive emission rights in proportion to past emissions. It is particularly important to adopt policies that shift investment in long-lived capital stock towards less carbon-intensive technologies and to encourage innovation and technology development that will reduce future compliance costs.

  3. Progress in studies of the climate of humid period and the impacts of changing precession in early-mid Holocene

    Institute of Scientific and Technical Information of China (English)

    Jianbin Huang; Shaowu Wang; Xinyu Wen; Bao Yang

    2008-01-01

    Studies on the climate of humid period and the impacts of changing precession in the early-mid Holocene are reviewed in this paper.High-resolution proxy data indicated that the African Humid Period,strong summer monsoon from the Arabian Sea to South Asia,northward migration of ITCZ (Intertropical Convergence Zone) over the northern South America,and the humid period of China appeared in 10.5-5.5 kaBP,10.0-6.0 kaBP,10.5-5.4 kaBP,and 11.0-8.0 kaBP,respectively.Modeling studies proved that summer inso-lation over the Northern Hemisphere increased following the changes of precession in the early Holocene,which increased the land-sea temperature contrasts,intensified the summer monsoon circulation in the Northern Hemisphere,and finally induced a humid climate over the area under the influence of summer monsoon.However,modeling results underestimated the increase of precipitation and the degree of northward extension of monsoon rain belt compared with palaeo-environmental data.These discrepancies between the modeling results and the palaeo-environmental data may be associated with the changes of North Atlantic circulation,sea ice and veg-etation covers.Moreover,climate of the humid period was not stable,in which several droughts were inlaid on centennial scale.In this review,perspectives for further studies of the climate change of the humid period in the early-mid Holocene are also proposed.

  4. Critical evaluation of pulmonary contusion in the early post-traumatic period: risk of assisted ventilation.

    Science.gov (United States)

    Hamrick, Miller C; Duhn, Ryan D; Ochsner, M Gage

    2009-11-01

    This study attempts to accurately quantify pulmonary contusion and predict those patients most likely to require assisted ventilation early in their hospital course. Patients admitted to a Level I trauma center were evaluated for pulmonary contusion by helical CT scan. Scans were reviewed by a single radiologist who attempted to accurately quantify contusion as a percentage of total lung volume. These patients were then followed for 48 hours in an attempt to use CT measurements of contusion to predict those that would require assisted ventilation early in their hospital course. After using numerous exclusion criteria, 152 patients were included in the study. Of these, 31 patients (20%) required assisted ventilation within 48 hours of hospital admission. Twenty per cent pulmonary contusion proved to be a highly predictive variable leading to need for assisted ventilation. Of patients sustaining contusion, only 7 of 92 (8%) required assisted ventilation versus 24 of 60 (40%) sustaining >20 per cent contusion. Pulmonary contusion is a significant injury especially when contusion volume exceeds 20 per cent of total lung volume. With accurate measurement of contusion, we can identify those patients at high risk of requiring assisted ventilation early in their hospital course.

  5. Obesity prevention and health promotion during early periods of growth and development

    Institute of Scientific and Technical Information of China (English)

    钱名佳

    2007-01-01

    @@ Introduction Current problems of health-related fitness promotion in children and adolescents: economic, social, cultural and other environmental factors. A relationship between the environment and the child, beginning during the gestation period that influences both positive and negative,health outcomes later in life.

  6. Cyclooxygenase-2 contributes to elevated renin in the early postnatal period in rats

    DEFF Research Database (Denmark)

    Stubbe, Jane; Jensen, Boye L; Bachmann, Sebastian;

    2003-01-01

    We asked whether cyclooxygenase (COX) activity controls the renin-angiotensin system in the postnatal period. During kidney development, renin peaked at postnatal days 0-1 at the mRNA, tissue protein [renal renin concentration (RRC)], and plasma renin concentration (PRC) levels and was widely...

  7. Interceptive orthopedics for the correction of maxillary transverse and sagittal deficiency in the early mixed dentition period

    Directory of Open Access Journals (Sweden)

    Ashok Kumar Talapaneni

    2011-01-01

    Full Text Available Dentofacial Orthopedics directed to a hypoplastic maxilla in the prepubertal period redirects growth of the maxilla in the vertical, transverse and sagittal planes of space. The orthopedic correction of maxillary hypoplasia in the early mixed dentition period thus intercepts the establishment of permanent structural asymmetry in the mandible and helps in the achievement of optimal dentofacial esthetics. This paper presents the growth redirection in a hypoplastic maxilla of an 8-year-old girl with simultaneous rapid maxillary expansion and protraction headgear therapy for a period of 11 months which corrected the posterior unilateral cross-bite, the positional asymmetry of the mandible and established an orthognathic profile in the individual.

  8. Pulmonary influences on early post-operative recovery in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: a retrospective study

    Directory of Open Access Journals (Sweden)

    Arakelian Erebouni

    2012-11-01

    Full Text Available Abstract Background The combination of cytoreductive surgery (CRS and hyperthermic intraperitoneal chemotherapy (HIPEC is a curative treatment option for peritoneal carcinomatosis (PC. There have been few studies on the pulmonary adverse events (AEs affecting patient recovery after this treatment, thus this study investigated these factors. Methods Between January 2005 and December 2006, clinical data on all pulmonary AEs and the recovery progress were reviewed for 76 patients with after CRS and HIPEC. Patients with pulmonary interventions (thoracocenthesis and chest tubes were compared with the non-intervention patients. Two senior radiologists, blinded to the post-operative clinical course, separately graded the occurrence of pulmonary AEs. Results Of the 76 patients, 6 had needed thoracocentesis and another 6 needed chest tubes. There were no differences in post-operative recovery between the intervention and non-intervention groups. The total number of days on mechanical ventilation, the length of stay in the intensive care unit, total length of hospital stay, tumor burden, and an American Society of Anesthesiologists (ASA grade of greater than 2 were correlated with the occurrence of atelectasis and pleural effusion. Extensive atelectasis (grade 3 or higher was seen in six patients, major pleural effusion (grade 3 in seven patients, and signs of heart failure (grade 1–2 in nine patients. Conclusions Clinical and radiological post-operative pulmonary AEs are common after CRS and HIPEC. However, most of the pulmonary AEs did not affect post-operative recovery.

  9. Periodically correlated random processes: Application in early diagnostics of mechanical systems

    Science.gov (United States)

    Javorskyj, I.; Kravets, I.; Matsko, I.; Yuzefovych, R.

    2017-01-01

    The covariance and spectral characteristics of periodically correlated random processes (PCRP) are used to describe the state of rotary mechanical systems and in their fault detection. The methods for estimation of mean function, covariance function, instantaneous spectral density and their Fourier coefficients for a given class of non-stationary random processes on the basis of experimental data, namely: the synchronous averaging, component, least squares method and linear filtration methods are considered. The first and second order periodicity detection methods are used for vibration signals analysis. A method for mechanical system fault identification and classification based on a harmonic series representation is developed. Examples of fault detection in rolling/sliding bearings and gearboxes are given.

  10. Congenital Cataract:Progress in Surgical Treatment and Postoperative Recovery of Visual Function

    Institute of Scientific and Technical Information of China (English)

    Mingyue Wang; Wei Xiao

    2015-01-01

    Congenital cataract is a common cause of childhood low vi-sion or blindness worldwide..Early surgery should be per-formed in sensitive vision development period to avoid vision deprivation in cases of strabismus and nystagmus develop-ment. Postoperative recovery of visual function is of great sig-nificance for these patients and should include proper postop-erative aphakia correction by the application of a contact lens and secondary implantation of an intraocular lens (IOL). Pa-tients should receive amblyopic training after surgery to im-prove their postoperative visual acuity..Although recent ad-vances in surgery techniques and materials have brought better postoperative visual acuity and less complications , a few post-operative complications can still hamper vision condition and vision development,.including posterior capsule opacification and secondary glaucoma. Surgery in early infancy are risk fac-tors for these two complications..Life-long follow-up is essen-tial for these patients..Further study will continue to address the surgery timing issue and methods that prevent postopera-tive complications.

  11. Distribution features of the rats’ major salivary glands cells glycoproteins during early postnatal period after antenatal antigen action

    Directory of Open Access Journals (Sweden)

    Syrtsov V.K.

    2014-06-01

    Full Text Available Background. Nowadays, in the diseases’ structure, according to literature data, one of the leading place take pathological condition connecting with the salivary glands’ inflammatory and dystrophic disorders. The problem of etiology and pathogenic not enough studied and demanded intent attention of researchers. Objective. The purpose was to determine the features of glycoproteins’ distribution in the structures of rats’ major salivary glands in early postnatal period after intrauterine antigen action. Methods. The object of the research was 224 salivary glands of white laboratory rats. Due to impossible quality materials’ taking in the early periods of postnatal life parotid and sublingual salivary glands, the investigation done at the gl. submaxillaris. The histochemical exposure and differentiation of carbohydrate compounds conducted by means of PAS-staining technic. For fermentative control used diastase. The results of histochemical exposure of glycoproteins stain were done by semi-quantitative. Results. In newborn animals receiving antigen in the antenatal period, in the cells’ cytoplasm indicate the accumulation’ increase of PAS-positive compounds retained until the 14th and offset at the 45th day of postnatal life. The detected changes in the major salivary glands cells’ are the basis for the development of inflammatory and dystrophic processes and can lead to the functional violations formation’ hereinafter. Conclusion. Our findings indicate that at the background of intrauterine antigen action, the glycoproteins’ accumulation intensity in parenchymal and stromal cells’ cytoplasm of the major salivary glands is decrease, but glycogen content is increase compared with intact animals group. Furthermore, we detected cells’ secretory activity reduction from 1st to 14th day of postnatal life with increase glycogen’ accumulation in the cells’ cytoplasm. That revealed changes offset at the 45th day after birth in all

  12. Early optical observations of GRBs by the TAROT telescopes: period 2001-2008

    CERN Document Server

    Klotz, A; Atteia, J L; Gendre, B

    2009-01-01

    The TAROT telescopes (Telescopes a Action Rapide pour les Objets Transitoires) are two robotic observatories designed to observe the prompt optical emission counterpart and the early afterglow of gamma ray bursts (GRBs). We present data acquired between 2001 and 2008 and discuss the properties of the optical emission of GRBs, noting various interesting results. The optical emission observed during the prompt GRB phase is rarely very bright: we estimate that 5% to 20% of GRBs exhibit a bright optical flash (R<14) during the prompt gamma-ray emission, and that more than 50% of the GRBs have an optical emission fainter than R=15.5 when the gamma-ray emission is active. We study the apparent optical brightness distribution of GRBs at 1000 s showing that our observations confirm the distribution derived by other groups. The combination of these results with those obtained by other rapid slewing telescopes allows us to better characterize the early optical emission of GRBs and to emphasize the importance of very...

  13. Sensory Deprivation during Early Postnatal Period Alters the Density of Interneurons in the Mouse Prefrontal Cortex

    Directory of Open Access Journals (Sweden)

    Hiroshi Ueno

    2015-01-01

    Full Text Available Early loss of one sensory system can cause improved function of other sensory systems. However, both the time course and neuronal mechanism of cross-modal plasticity remain elusive. Recent study using functional MRI in humans suggests a role of the prefrontal cortex (PFC in cross-modal plasticity. Since this phenomenon is assumed to be associated with altered GABAergic inhibition in the PFC, we have tested the hypothesis that early postnatal sensory deprivation causes the changes of inhibitory neuronal circuit in different regions of the PFC of the mice. We determined the effects of sensory deprivation from birth to postnatal day 28 (P28 or P58 on the density of parvalbumin (PV, calbindin (CB, and calretinin (CR neurons in the prelimbic, infralimbic, and dorsal anterior cingulate cortices. The density of PV and CB neurons was significantly increased in layer 5/6 (L5/6. Moreover, the density of CR neurons was higher in L2/3 in sensory deprived mice compared to intact mice. These changes were more prominent at P56 than at P28. These results suggest that long-term sensory deprivation causes the changes of intracortical inhibitory networks in the PFC and the changes of inhibitory networks in the PFC may contribute to cross-modal plasticity.

  14. Early Period Results and Clinical Characteristics of Upper Gastrointestinal Endoscopy in Sivrihisar State Hospital

    Directory of Open Access Journals (Sweden)

    Ozgur Turk

    2014-12-01

    Full Text Available Aim: Our aim was to identify the characteristics of the patient that performed upper gastrointestinal endoscopy in a new established endoscopy unit of a state hospital. We want to present the spectrum of gastrointestinal diseases in our hospitals region. Material and Method: We analyzed patients upper endoscopy results according to age, sex, complaints, clinical characteristics, type of anesthesia, and the necessity of biopsy. We reviewed 256 patients data between 2013 December-2014 July. All endoscopies were performed by same surgeon. Results: The highest complaint was epigastric pain (n=112, 43, 8%. Other complaints were followed as dyspepsia (n=84, 32.8%, heartburn (n=42, 16.4%, nausea (n=4, 1.6%, vomiting (n=2, 0.8%, dysphagia (n=6, 2.3%. We determined 218 gastritis (85.2%, 64 hiatal hernia (25%, 120 esophagitis (46.9%, 76 duodenitis (29.7%, 4 gastric ulcer (1.6%, 18 duodenal ulcers (7%, 20 bile reflux (7.8%, 26 Gastro esophageal reflux disease (GERD in patients (10.2%. 10 patients reported as normal (3.9%. Biopsy was performed in 186 of the patients. Discussion: Endoscopy can become an early diagnostic examination by increasing the availability of endoscopy. Also alarm symptoms should not be ignored and endoscopy should perform immediately in symptomatic patients. As an early result of upper gastrointestinal endoscopies that performed in this study; gastritis, esophagitis, duodenitis and hiatal hernia are common gastrointestinal diseases in our region.

  15. Sensory Deprivation during Early Postnatal Period Alters the Density of Interneurons in the Mouse Prefrontal Cortex.

    Science.gov (United States)

    Ueno, Hiroshi; Suemitsu, Shunsuke; Matsumoto, Yosuke; Okamoto, Motoi

    2015-01-01

    Early loss of one sensory system can cause improved function of other sensory systems. However, both the time course and neuronal mechanism of cross-modal plasticity remain elusive. Recent study using functional MRI in humans suggests a role of the prefrontal cortex (PFC) in cross-modal plasticity. Since this phenomenon is assumed to be associated with altered GABAergic inhibition in the PFC, we have tested the hypothesis that early postnatal sensory deprivation causes the changes of inhibitory neuronal circuit in different regions of the PFC of the mice. We determined the effects of sensory deprivation from birth to postnatal day 28 (P28) or P58 on the density of parvalbumin (PV), calbindin (CB), and calretinin (CR) neurons in the prelimbic, infralimbic, and dorsal anterior cingulate cortices. The density of PV and CB neurons was significantly increased in layer 5/6 (L5/6). Moreover, the density of CR neurons was higher in L2/3 in sensory deprived mice compared to intact mice. These changes were more prominent at P56 than at P28. These results suggest that long-term sensory deprivation causes the changes of intracortical inhibitory networks in the PFC and the changes of inhibitory networks in the PFC may contribute to cross-modal plasticity.

  16. Epidural Analgesia in the Postoperative Period

    Science.gov (United States)

    2001-10-01

    epidurally. They are opiods and local anesthetics. The pharmacokinetics and pharmacodynamics of each class are different, and they may act...overall pharmacodynamics of the drug. Epidural Opioids Brown (2000) states that opioids are one class of drug that may be used for epidural analgesia...morphine with lidocaine or bupivacaine with the effects of these medications when administered alone in mice. They used various tests to measure

  17. Cerebral salt wasting in a postoperative period.

    Science.gov (United States)

    Janus, Dominika; Wojcik, Malgorzata; Dolezal-Oltarzewska, Katarzyna; Kalicka-Kasperczyk, Anna; Poplawska, Karolina; Starzyk, Jerzy B

    2014-01-01

    Cerebral salt wasting syndrome (CSW-cerebral salt wasting) was first described in 1950 by Peters. This syndrome can occur in patients who have sustained damage to the central nervous system (e.g. patients with subarachnoid bleeding, bacterial meningitis or after neurosurgery). Patients present with excessive natriuresis and hyponatremic dehydration. Differentiating this syndrome with the syndrome of inappropriate antidiuretic hormone secretion (SIADH-syndrome of inappropriate antidiuretic hormone secretion), which may occur in the same group of patients, is necessary in order to administer the correct treatment which consists of fluid restriction and sodium replacement in SIADH and fluid and sodium replacement as well as occasional mineralocorticoid therapy in CSW.

  18. Nursing observation early postoperative gastrointestinal surgery in elderly patients with jejunal enteral nutrition infusion%胃肠外科老人术后早期空肠输注肠内营养护理

    Institute of Scientific and Technical Information of China (English)

    罗美珍

    2015-01-01

    目的: 对应用综合护理干预模式对接受胃肠外科手术治疗的老年患者在术后早期空肠输注肠内营养支持过程中实施护理的临床效果进行研究.方法:选择接受胃肠外科手术治疗的老年患者86例,随机分为对照组和观察组,每组43例,在术后均实施早期空肠输注肠内营养支持.采用综合护理干预模式对观察组患者在营养支持期间实施护理;采用常规护理模式对对照组患者在营养支持期间实施护理.结果:观察组患者对术后营养支持期间的护理服务满意度明显高于对照组;术后营养支持计划实施时间和住院时间明显短于对照组.结论:应用综合护理干预模式对接受胃肠外科手术治疗的老年患者在术后早期空肠输注肠内营养支持过程中实施护理的临床效果非常明显.%Objective:The clinical effect of comprehensive nursing intervention model for application acceptance of gastrointestinal surgical treatment of elderly patients in the early postoperative jejunal enteral nutrition infusion during the implementation of nursing research. Methods:In our hospital receiving treatment in elderly gastrointestinal surgery 86 patients were randomly divided into control group and observation group, 43 cases on average each group, in implementation of early postoperative jejunal infusion of enteral nutrition. Integrated nursing intervention model to observe patients during nutritional support of nursing; conventional nursing model for the control group of patients nutritional support during the implementation of care. Results:The patient satisfaction with care during the postoperative nutritional support significantly higher; postoperative nutritional support program implementation time and total time in hospital receiving treatment was significantly shorter than the control group. Conclusion:Comprehensive nursing intervention model for accepting gastrointestinal surgery in elderly patients in the early

  19. The Poor and the Patient : Protestant Geneva in the Early Modern Period

    Directory of Open Access Journals (Sweden)

    Rieder, Philip

    2006-11-01

    Full Text Available Exploring the medical marketplace in early modern Geneva reveals an active town with a high density of both regular and irregular healers. The aim of this article is to assess just how ordinary and poor people used these services and to what extent medical commodities were available to the destitute. Using both court records, private and public sources, this article explores traces of practices highlighting the flexibility with which practitioners were admitted, the high tolerance to irregular practices and the continuity of the recourse to supernatural and catholic healing traditions by Protestants living within the city walls. Data on self-help and medical support offered by family, friends and neighbours is discussed, suggesting the importance of informal medical services in everyday life. Examples demonstrate that to some extent the poor managed to elect strategies and to control therapies, whereas expensive treatment was regularly offered by charities interested in getting the ill back to work.

  20. EVOLUTION OF STATE SECURITY SYSTEM OF THE WESTERN URALS IN REVOLUTIONARY PERIOD (1917 – EARLY 1918

    Directory of Open Access Journals (Sweden)

    E. A. KOBELEVA

    2016-01-01

    Full Text Available This article focuses on problems, related to changes that took place in 1917 – the most significant period in Russian history. During that year 3 government alternation took place: autocracy crashed and was replaced by the bourgeoisie. Provisional government collapsed and ceded power to Soviet system. It had a major impact on state security issues. Old state security institutions were dismantled; its employees suffered persecution not only in the capital cities but also in the regions, which include the Western Urals. Agencies for combating counter-revolution were established spontaneously during that period. This tendency became stronger due to the weakening of the Provisional government and lack of possibilities to influence regional political processes. In opinion of Soviet historians, the organizing processes of extraordinary commissions bore no relation with imperial-era commissions as its functions, authorities and operating methods varied dramatically. The novelty of the article resides in examining the transformation process of state security institutions in the Western Urals taken together as a composite whole during 1917 and start of 1918 opposite to the Soviet historiography.

  1. MULTIDETECTOR COMPUTED TOMOGRAPHY IN POSTOPERATIVE ASSESSMENT OF CAROTID ARTERIES

    Directory of Open Access Journals (Sweden)

    M. V. Jr Vishnyakova

    2015-01-01

    Full Text Available Rationale: Carotid endarteractomy is a surgical intervention that is performed for prevention of cerebrovascular accidents, up to 80% of them being of ischemic origin, in the presence of a marked stenosis and occlusion of carotid arteries. A detailed description of specifics of postoperative changes in carotid arteries depending on the type of surgical intervention has not been published.Aim: To evaluate internal carotid arteries in the early postoperative period by means of multidetector computed tomography (MDCT and to match the changes detected with the type of surgical intervention.Materials and methods: In 2014, 23 patients with atherosclerotic stenoses of internal carotid arteries were assessed in the Department of Roentgenology of MONIKI. As a part of preoperative work-up, the patients underwent ultrasound examination (USE of the neck vasculature and MDCT with bolus contrast enhancement. Postoperative monitoring also included USE and MDCT. The data obtained were matched against the type of surgical intervention.Results: After the eversion procedure (15 patients, there were 14 cases of expected (normal postoperative changes and 1 case of changes that required a follow-up. After an open (classic carotid endarterectomy (3 patients there was 1 case of expected postoperative changes and 2 cases requiring a follow-up. Among 5 patients who underwent a resection of internal carotid artery and its prosthetic replacement, 2 patients had expected changes, 2 patients had changes that required a follow-up and 1 patient had a complication after surgery.Conclusion: The postoperative use of MDCT for assessment of reconstructed arteries allows for identification of various types of postoperative changes, for detection of symptoms of severe complications and borderline conditions that require subsequent targeted diagnostics and monitoring. 

  2. The Preboreal-like Asian monsoon climate in the early last interglacial period recorded from the Dark Cave, Southwest China

    Science.gov (United States)

    Jiang, Xiuyang; He, Yaoqi; Wang, Xiaoyan; Sun, Xiaoshuang; Hong, Hui; Liu, Juan; Yu, Tsai-Luen; Li, Zhizhong; Shen, Chuan-Chou

    2017-08-01

    Transitions of glacial-interglacial cycles are critical periods for Quaternary climate shifts. Here, we present new, decadal resolution Asian summer monsoon (ASM) record from three stalagmites obtained from the Dark Cave in southwestern China over 130-114 thousand years ago (ka, before CE 1950). Chronology was anchored by 28 230Th dates with typical uncertainties of ±0.3-1.0 kyr, allowing an assessment of timing and transition of climate changes during the onset and end of the last interglacial. An agreement between this new and previous stalagmite δ18O records supports that summer insolation predominates orbital-scale ASM evolution. A 2-3 kyr-long gradually increasing ASM period, analogous to the classical Preboreal episode in the early Holocene, follows the termination of a weak monsoon interval at 129.0 ± 0.8 ka. This finding suggests a strong influence of high-latitude ice-sheet dynamics on Asian monsoonal conditions during the early interglacial period. An abrupt end of the marine isotope stage 5e at 118.8 ± 0.6 ka was probably caused by the internal climate system threshold effects.

  3. The effect of early musical training on adult motor performance: evidence for a sensitive period in motor learning.

    Science.gov (United States)

    Watanabe, Donald; Savion-Lemieux, Tal; Penhune, Virginia B

    2007-01-01

    Developmental changes in the human brain coincide with and underlie changes in a wide range of motor and cognitive abilities. Neuroimaging studies have shown that musical training can result in structural and functional plasticity in the brains of musicians, and that this plasticity is greater for those who begin training early in life. However, previous studies have not controlled for differences between early-trained (ET) and late-trained (LT) musicians in the total number of years of musical training and experience. In the present experiment, we tested musicians who began training before and after the age of 7 on learning of a timed motor sequence task. The groups were matched for years of musical experience, years of formal training and hours of current practice. Results showed that ET musicians performed better than LT musicians, and that this performance advantage persisted after 5 days of practice. Performance differences were greatest for a measure of response synchronization, suggesting that early training has its greatest effect on neural systems involved in sensorimotor integration and timing. These findings support the idea that there may be a sensitive period in childhood where enriched motor training through musical practice results in long-lasting benefits for performance later in life. These results are also consistent with the results of studies showing structural changes in motor-related regions of the brain in musicians that are specifically related to training early in life.

  4. The Bodyguard of the Caliphs During the Umayyad and the Early Abbasid Periods

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    Perlman, Yaara

    2015-12-01

    Full Text Available During early Islam, the ḥaras was a government unit that was responsible for the personal security of the caliph. Since the reign of the first Umayyad Caliph, Mu‘āwiya b. Abī Sufyān, the ḥaras, headed by a ḥaras chief, protected all caliphs. This paper will attempt to describe the functions of the ḥaras during the Umayyad and the early Abbasid caliphates by delineating the characteristics of the ḥaras chiefs under the different caliphs. As with other institutions during early Islam, accounts that refer to the ḥaras offer information about the men who headed it rather than about the institution itself, making it necessary to employ the method of prosopography in order to arrive at an adequate description of the institution. The majority of the ḥaras chiefs appear to have been mawālī, often entrusted with administrative offices in addition to heading the ḥaras. It seems that the ḥaras chiefs were responsible not only for protecting the caliphs, but also for carrying out executions. The establishment of the ḥaras, the qualifications of the ḥaras chiefs and the weapons used by members of this body are also discussed. This significant institution has not yet received due attention in the literature. I hope to provide a useful outline and to open up a space for further research.Durante los principios del Islam el ḥaras fue una unidad del gobierno, responsable de la seguridad personal de los califas. Desde el reinado del primer califa omeya Mu‘āwiya b. Abī Sufyān, el ḥaras que estaba bajo las ordenes de su jefe, custodió a todos los califas. El propósito de este artículo es describir el papel del ḥaras durante el periodo del Califato Omeya y el principio del Califato Abbasí y describir las características de los jefes del ḥaras bajo los diferentes califas. Al igual que con otras instituciones durante el comienzo del Islam, la información relacionada con el ḥaras se basa en la vida y obra de los hombres

  5. Early enrichment effects on brain development in hatchery-reared Atlantic salmon (Salmo salar): no evidence for a critical period

    DEFF Research Database (Denmark)

    Näslund, Joacim; Aarestrup, Kim; Thomassen, Søren T.;

    2012-01-01

    In hatcheries, fish are normally reared in barren environments, which have been reported to affect their phenotypic development compared with wild conspecifics. In this study, Atlantic salmon (Salmo salar) alevins were reared in conventional barren hatchery trays or in either of two types...... of structurally enriched trays. We show that increased structural complexity during early rearing increased brain size in all investigated brain substructures. However, these effects disappeared over time after transfer to barren tanks for external feeding. Parallel to the hatchery study, a group of salmon parr...... was released into nature and recaptured at smoltification. These stream-reared smolts developed smaller brains than the hatchery reared smolts, irrespective of initial enrichment treatment. These novel findings do not support the hypothesis that there is a critical early period determining the brain growth...

  6. Congenital cataract surgery during the early enlightenment period and the Stepkins oculists.

    Science.gov (United States)

    Leffler, Christopher T; Schwartz, Stephen G; Davenport, Byrd

    2014-07-01

    From antiquity through the Renaissance, congenital blindness was generally regarded as incurable, as noted in both medical and lay publications. The earliest reference to congenital cataract surgery that we identified, reported in 1663, referred to an 18-year-old female treated by English oculist John Stepkins (d. 1652). An examination of the literature related to the Stepkins family reveals the presence of male and female oculists during that period, including his daughter, Lady Theodosia Ivy. Eye waters attributed to Stepkins contained tutty (an oxide of zinc), roses, sugar candy, and other ingredients. Interestingly, John Thomas Woolhouse, the author of the next identified report of congenital cataract surgery in 1706, stated that he was related to Stepkins. Woolhouse reported by 1721 that he had performed 36 congenital cataract surgeries, with the youngest patient being 18 months of age.

  7. An early explanation of the periodic table: Lars Vegard and X-ray spectroscopy

    CERN Document Server

    Kragh, Helge

    2011-01-01

    The Norwegian physicist Lars Vegard may have been the first to propose electron configurations for all the chemical elements, from hydrogen to uranium, on the basis of quantum atomic theory. This he did in papers of 1918-1919 in which he argued that the principal quantum number corresponded to the shells in Bohr's picture of atomic structure. Vegard's theory of the periodic system, based on the methods of theoretical X-ray spectroscopy in particular, was a significant advance but exerted little influence on the further development. It presupposed atoms made up of planar electron rings, and with the abandonment of the ring atom about 1920 this and similar models lost their credibility.

  8. Influence of Early Enteral Nutrition on the Intestinal Function Recovery of Postoperative Gastric Cancer%早期肠内营养对胃癌术后肠功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    黄俊勇

    2013-01-01

    Objective:To investigate the effects of early enteral nutrition on intestinal function recovery of patients with postoperative gastric cancer. Methods:80 patients were divided into observation group and control group according to the postoperative trophic modes, observation group adopted early enteral nutrition, while the control group received parenteral nutrition, to compare the influence of intestinal function recovery with two kinds of trophic modes. Results:Recovery time of intestinal function, protein level and body weight of observation group were all superior to those of con-trol group (P<0.05). Conclusion:Early enteral nutrition on patients with postoperative gastric cancer is safe and effective, which can shorten recov-ery time of intestinal function, improve the nutritional status and enhance patients' immunity.%  目的:探讨早期肠内营养对胃癌术后患者肠功能恢复的影响。方法:将80例患者根据术后营养方式分为观察组及对照组,观察组采用早期肠内营养,对照组行肠外营养,比较两种营养方式对患者肠功能恢复的影响。结果:观察组患者肠功能恢复时间、蛋白水平及体重均优于对照组(P<0.05)。结论:胃癌术后患者行早期肠内营养安全有效,能缩短患者肠功能恢复时间,改善营养状况,提高机体免疫力。

  9. Semantic Wavelet-Induced Frequency-Tagging (SWIFT) Periodically Activates Category Selective Areas While Steadily Activating Early Visual Areas.

    Science.gov (United States)

    Koenig-Robert, Roger; VanRullen, Rufin; Tsuchiya, Naotsugu

    2015-01-01

    Primate visual systems process natural images in a hierarchical manner: at the early stage, neurons are tuned to local image features, while neurons in high-level areas are tuned to abstract object categories. Standard models of visual processing assume that the transition of tuning from image features to object categories emerges gradually along the visual hierarchy. Direct tests of such models remain difficult due to confounding alteration in low-level image properties when contrasting distinct object categories. When such contrast is performed in a classic functional localizer method, the desired activation in high-level visual areas is typically accompanied with activation in early visual areas. Here we used a novel image-modulation method called SWIFT (semantic wavelet-induced frequency-tagging), a variant of frequency-tagging techniques. Natural images modulated by SWIFT reveal object semantics periodically while keeping low-level properties constant. Using functional magnetic resonance imaging (fMRI), we indeed found that faces and scenes modulated with SWIFT periodically activated the prototypical category-selective areas while they elicited sustained and constant responses in early visual areas. SWIFT and the localizer were selective and specific to a similar extent in activating category-selective areas. Only SWIFT progressively activated the visual pathway from low- to high-level areas, consistent with predictions from standard hierarchical models. We confirmed these results with criterion-free methods, generalizing the validity of our approach and show that it is possible to dissociate neural activation in early and category-selective areas. Our results provide direct evidence for the hierarchical nature of the representation of visual objects along the visual stream and open up future applications of frequency-tagging methods in fMRI.

  10. Vojta and Bobath combined treatment for high risk infants with brain damage at early period

    Institute of Scientific and Technical Information of China (English)

    Chunyan Wu; Xiaohui Peng; Xuesong Li; Qingling Niu; Hong Guo; Huitao Huang

    2007-01-01

    BACKGROUND: In the process of early screening and interventions to high risk infants with brain damage,the occasion and choosing methods of interventions and the combined application of different interventions are still at the exploratory phase.OBJECTIVE: To observe the efficacy of early intervention using Vojta and Bobath combined treatment in high risk infants with brain damage, and investigate the effect of early rehabilitation on the prognosis.DESIGN: A randomized controlled comparative observation.SETTING: Daqing Oil Field General Hospital of Heilongjiang Province.PARTICIPANTS: Eighty-four high risk infants younger than 1 year were selected from the Department of Pediatrics, Daqing Oil Field General Hospital of Heilongjiang Province from October 2005 to October 2006,including 52 boys (62%) and 32 girls (38%). The treatment started at the age of 0 - 3 months in 11 cases (13%), 4 - 6 months in 28 cases (33%), 7 - 9 months in 35 cases (42%), and 10 - 12 months in 10 cases (12%). Infants with at least two of the followings were enrolled, including 7 Vojta abnormal postural reflexes,slow or disorder of motor development, increase of muscular tension, postural abnormality, primary reflection residual and CT/MRI abnormalities. Informed consents were obtained from their guardians. The 84 infants were randomly divided into treatment group (n =42) and control group (n =42).METHODS: All the children were intravenously injected with cerebroprotein hydrolysate injection or cattle encephalon glycoside and ignotin injection, 10 times as a course for 2 - 5 courses; Besides, the infants in the treatment group also received early rehabilitative training of Vojta and Bobath combined treatment, once a day, 40 minutes per time, 5 times a week followed by a 2-day rest, 1 month as a course, and totally 2 - 5 courses. The Vojta method was to facilitate the automatic regulation by reflexlocomotion. Bobath method was to inhibit abnormal posture but facilitate the normal one, thus it is

  11. 术后早期康复训练对高龄髋关节置换患者功能恢复的影响%Evaluation of an early postoperative rehabilitation program for elderly hip replacement patients

    Institute of Scientific and Technical Information of China (English)

    齐向北; 张英泽; 潘进社; 王志红; 马利杰; 王建朝; 王琳

    2009-01-01

    目的 探讨术后早期康复训练对高龄髋关节置换患者功能恢复的影响.方法 共选取95例髋关节置换息者,根据患者年龄将其划分为高龄组(年龄≥80岁)及非高龄组(年龄<80岁).于手术前发给每位患者一本康复指导手册,主要向患者介绍手术前后康复训练要点.在康复医师指导下.2组患者于手术前后参照该手册进行早期康复训练.本研究于术前及术后6个月时分别采用WOMAC量表和SF-36量表对患者髋关节功能及全身健康状况进行评定.结果 2组患者在治疗过程中无一例发生栓塞性并发症.通过比较WOMAC评分结果发现,2组患者髋关节疼痛、功能、僵硬情况均较治疗前明显改善(均P<0.05),除高龄组患者术后6个月时髋关节僵硬评分显著优于非高龄组外(P<0.05),其它各项指标组间差异均无统计学意义(P>0.05);比较SF-36评分结果发现,2组患者健康状况均较治疗前明显改善(均P<0.05),除情感职能、精神状态评分2组间差异有统计学意义外(P<0.05),其余各项指标组间差异均无统计学意义(P>0.05).结论 术后早期康复训练对高龄及非高龄髋关节置换患者疗效相当,均能显著促进患者术后髋关节功能恢复.%Objective To evaluate the effect of early poatoperative rehabilitation on functional recovery of elderly patients post hip replacement. Methods Ninety-five patiens who had received primary hip replacement were included in this study. They were divided into and elderly group (age≥80 years) and a non-elderly group (<80 years). Before the operation each patient was given a guidebook describing the rehabilitation program during the hospitalizaation period pre-operation and post-operation. Guided by a therapist, the patients' rehabilitation training was carried out in accordance with the guidebook. Patients were evaluated immediately prior to surgery and 6 months postoperation. Hip function and health

  12. Fibrilación auricular en el postoperatorio de cirugía cardíaca: Prevalencia y tiempo de internación Atrial fibrillation in postoperative cardiac surgery: Prevalence and hospitalized period

    Directory of Open Access Journals (Sweden)

    Alejandro E. Contreras

    2010-08-01

    Full Text Available La fibrilación auricular es el trastorno del ritmo más frecuente luego de la cirugía cardíaca. En estudios previos se ha asociado a prolongación de la internación, aumento en los costos e incremento en la mortalidad. El objetivo de este estudio fue conocer la prevalencia de fibrilación auricular en el postoperatorio de cirugía cardíaca y determinar el efecto en el tiempo de estadía hospitalaria. Se analizaron retrospectivamente las historias clínicas de pacientes sometidos a cirugía cardíaca consecutivamente (de revascularización miocárdica, valvulares o ambas entre enero 2006 y noviembre 2008. El punto final evaluado en el postoperatorio fue la presencia de fibrilación auricular. Se dividió a la muestra en dos grupos según tuvieran o no fibrilación auricular, y se compararon las variables clínicas y el tiempo de estadía hospitalaria. Ciento setenta y dos pacientes fueron operados en este período. Se excluyeron del análisis siete pacientes por falta de datos. La edad media fue 64.2 ± 9.5 años, con predominio del sexo masculino. La fibrilación auricular fue la complicación más frecuente (23.6%. El tiempo promedio de internación fue 6.7 ± 4.6 días. No hubo diferencias relevantes al comparar la estadía hospitalaria entre los grupos con o sin fibrilación auricular, 7.5 ± 4.1 días vs. 6.5 ± 4.7 días respectivamente, p = 0.21. La presencia de fibrilación auricular no prolongó la hospitalización. Probablemente una estrategia de prevención indiscriminada no sería costo-efectiva.Atrial fibrillation is the most common heart rhythm disorder after cardiac surgery. In previous studies it has been associated with prolonged hospitalization, increased costs and mortality. This study aimed to determine the prevalence of postoperative atrial fibrillation in cardiac surgery and its impact on the hospitalization period. Medical records of consecutive patients undergoing cardiac surgery (coronary artery bypass graft

  13. Postoperative acute kidney injury in living donor liver transplantation recipients.

    Science.gov (United States)

    Atalan, Hakan K; Gucyetmez, Bulent; Aslan, Serdar; Yazar, Serafettin; Polat, Kamil Y

    2017-09-05

    There are many risk factors for postoperative acute kidney injury in liver transplantation. The aim of this study is to investigate the risk factors for postoperative acute kidney injury in living donor liver transplantation recipients. 220 living donor liver transplantation recipients were retrospectively evaluated in the study. According to the Kidney Disease Improving Global Outcomes Guidelines, acute kidney injury in postoperative day 7 was investigated for all patients. The patient's demographic data, preoperative and intraoperative parameters, and outcomes were recorded. Acute kidney injury was found in 27 (12.3%) recipients. In recipients with acute kidney injury, female population, model for end-stage liver disease score, norepinephrine requirement, duration of mean arterial pressure less than 60 mmHg, the usage of gelatin and erythrocyte suspension and blood loss were significantly higher than recipients with nonacute kidney injury (for all p5 mL kg-1 and duration of MAP less than 60 mmHg ≥5.5 minutes respectively (for all p<0.05). In living donor liver transplantation recipients, serum tacrolimus levels, intraoperative blood loss, hypotension period and the usage of gelatin may be risk factors for acute kidney injury in the early postoperative period.

  14. Neurobehavioral manifestation in early period of Alzheimer Disease and Vascular Dementia

    Directory of Open Access Journals (Sweden)

    Bidzan, Mariola

    2014-04-01

    Full Text Available Introduction: AD and VD are preceded by a preclinical stage. Small but tangible cognitive impairments sometimes occur many years before the onset and diagnosis of dementia. The ongoing degenerative process can be conductive to behavioural and psychological symptoms. Aim: The aim of the study was to investigate the rates of neurobehavioral symptoms in the preclinical stages of AD and VD. Methods: Two hundred and ninety one residents of nursery homes were included in the study. Participants of the study did not display symptoms of dementia in accordance with DSM IV criteria and obtained at least 24 points on the MMSE scale and were on the first or second level of the Global Deterioration Scale. Participants were screened for behavioural and psychological symptoms with the NPI – NH scale, while their cognitive functioning was evaluated by means of the ADAS-cog. Participants of the study were evaluated with the MMSE scale annually. Participants who obtained less than 24 points on the MMSE scale were evaluated by a senior psychiatrist. Diagnosis of dementia was done on the basis of DSM criteria. Alzheimer’s Disease was diagnosed on the basis of NINCDS-ADRDA criteria and vascular dementia on the NINDS-AIREN criteria. The study was carried out over a period of seven consecutive years. Results: A hundred and fifty people were included in the final analysis – in 111 of them were found not to be afflicted with dementia, 25 were found to have AD and in 14 VD was diagnosed. The control group differed from the AD and VD group with respect to the initial level of cognitive impairment (ADAS-cog and the intensity of behavioural and psychological symptoms (NPI –NH scale. Particular items of the NPI –NH scale differentiated the two groups to a different degree. In people with AD the greatest differences were observed with respect to agitation/aggression, mood swings, irritability/emotional liability and the rates of anxiety. People with VD, similarly to

  15. Development and morphogenesis of human wrist joint during embryonic and early fetal period.

    Science.gov (United States)

    Hita-Contreras, Fidel; Martínez-Amat, Antonio; Ortiz, Raúl; Caba, Octavio; Alvarez, Pablo; Prados, José C; Lomas-Vega, Rafael; Aránega, Antonia; Sánchez-Montesinos, Indalecio; Mérida-Velasco, Juan A

    2012-06-01

    The development of the human wrist joint has been studied widely, with the main focus on carpal chondrogenesis, ligaments and triangular fibrocartilage. However, there are some discrepancies concerning the origin and morphogenetic time-table of these structures, including nerves, muscles and vascular elements. For this study we used serial sections of 57 human embryonic (n = 30) and fetal (n = 27) specimens from O'Rahilly stages 17-23 and 9-14 weeks, respectively. The following phases in carpal morphogenesis have been established: undifferentiated mesenchyme (stage 17), condensated mesenchyme (stages 18 and 19), pre-chondrogenic (stages 19 and 20) and chondrogenic (stages 21 and over). Carpal chondrification and osteogenic processes are similar, starting with capitate and hamate (stage 19) and ending with pisiform (stage 22). In week 14, a vascular bud penetrates into the lunate cartilaginous mold, early sign of the osteogenic process that will be completed after birth. In stage 18, median, ulnar and radial nerves and thenar eminence appear in the hand plate. In stage 21, there are indications of the interosseous muscles, and in stage 22 flexor digitorum superficialis, flexor digitorum profundus and lumbrical muscles, transverse carpal ligament and collateral ligaments emerge. In stage 23, the articular disc, radiocarpal and ulnocarpal ligaments and deep palmar arterial arch become visible. Radiate carpal and interosseous ligaments appear in week 9, and in week 10, dorsal radiocarpal ligament and articular capsule are evident. Finally, synovial membrane is observed in week 13. We have performed a complete analysis of the morphogenesis of the structures of the human wrist joint. Our results present new data on nervous and arterial elements and provide the basis for further investigations on anatomical pathology, comparative morphology and evolutionary anthropology. © 2012 The Authors. Journal of Anatomy © 2012 Anatomical Society.

  16. Effect of the Nerve Growth Factor Mimetic GK-2 on Brain Structural and Functional State in the Early Postresuscitation Period

    Directory of Open Access Journals (Sweden)

    M. Sh. Avrushchenko

    2012-01-01

    Full Text Available Objective: to evaluate the efficacy of the nerve growth factor mimetic GK-2 used to improve the structural and functional state of the brain in the early postresuscitation period. Material and methods. Cardiac arrest was induced in mature male albino rats for 12 minutes, followed by resuscitation. The neurological state of the resuscitated animals was assessed by a scoring scale. On postresuscitation day 7, the density and composition of neuronal populations of Purkinje cells in the lateral cerebellar region and pyramidal neurons in the hippocampal CA1 sector were determined by a differential morphometric analysis. The results were statistically processed using the ANOVA method. Results. The use of GK-2 was found to accelerate neurological recovery in the resuscitated animals. On day 7 after 12-minute cardiac arrest, the resuscitated animals showed neuronal dystrophic changes and death in the neuronal populations highly susceptible to ischemia. It was shown that the systemic administration of the nerve growth factor mimetic GK-2 contributed to a reduction in the magnitude and depth of postresuscitation changes in the cerebellar Purkinje cells and prevented dystrophic changes in the pyramidal cells of the hippocampal CA1 sector. The findings suggest that GK-2 has a neuroprotective effect in the recovery period after total body ischemia. Conclusion. The results of this study indicate the efficiency of the systemic administration of the nerve growth factor mimetic GK-2 in improving the brain structural and functional state in the early postresuscitation period. This determines perspectives for the use of GK-2 to prevent and correct posthypoxic encephalopathies. Key words: the nerve growth factor mimetic GK-2, postresuscitation period, neuronal dystrophic changes and death, neurological status.

  17. Anatomical and histological researches on rootstock and scion compatibility in early period after grafting in avocado

    Directory of Open Access Journals (Sweden)

    Süleyman BAYRAM

    2014-12-01

    Full Text Available Avocado seedling rootstocks are used entirely due to easier and cheaper production in conditions of our country. However, a study on compatibility of scion and rootstock of varieties used as seedling rootstock, have not been produced in our country yet. Thus, seedlings of the 'Bacon', 'Fuerte', 'Hass' and 'Zutano' varieties produced as commercial varieties along with 'Topa Topa' and 'Mexicola' varieties used as a source of seedling rootstocks were studied under greenhouse conditions between the years 2009-2011. Determination of the scion and rootstock compatibility was purposed in the graft sections during certain periods after grafting of 'Hass' variety with these seedlings. As a result; graft union formations in samples of all combinations successfully realized in the anatomical and histological studies after 30 and 90 days from grafting and a negative finding regarding to incompatibility were not met. However, more studies should be made for determination of incompatibility that may arise in between rootstocks and scions in the later years.

  18. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  19. Einstein@Home search for periodic gravitational waves in early S5 LIGO data

    Science.gov (United States)

    Abbott, B. P.; Abbott, R.; Adhikari, R.; Ajith, P.; Allen, B.; Allen, G.; Amin, R. S.; Anderson, S. B.; Anderson, W. G.; Arain, M. A.; Araya, M.; Armandula, H.; Armor, P.; Aso, Y.; Aston, S.; Aufmuth, P.; Aulbert, C.; Babak, S.; Baker, P.; Ballmer, S.; Barker, C.; Barker, D.; Barr, B.; Barriga, P.; Barsotti, L.; Barton, M. A.; Bartos, I.; Bassiri, R.; Bastarrika, M.; Behnke, B.; Benacquista, M.; Betzwieser, J.; Beyersdorf, P. T.; Bilenko, I. A.; Billingsley, G.; Biswas, R.; Black, E.; Blackburn, J. K.; Blackburn, L.; Blair, D.; Bland, B.; Bodiya, T. P.; Bogue, L.; Bork, R.; Boschi, V.; Bose, S.; Brady, P. R.; Braginsky, V. B.; Brau, J. E.; Bridges, D. O.; Brinkmann, M.; Brooks, A. F.; Brown, D. A.; Brummit, A.; Brunet, G.; Bullington, A.; Buonanno, A.; Burmeister, O.; Byer, R. L.; Cadonati, L.; Camp, J. B.; Cannizzo, J.; Cannon, K. C.; Cao, J.; Cardenas, L.; Caride, S.; Castaldi, G.; Caudill, S.; Cavaglià, M.; Cepeda, C.; Chalermsongsak, T.; Chalkley, E.; Charlton, P.; Chatterji, S.; Chelkowski, S.; Chen, Y.; Christensen, N.; Chung, C. T. Y.; Clark, D.; Clark, J.; Clayton, J. H.; Cokelaer, T.; Colacino, C. N.; Conte, R.; Cook, D.; Corbitt, T. R. C.; Cornish, N.; Coward, D.; Coyne, D. C.; Creighton, J. D. E.; Creighton, T. D.; Cruise, A. M.; Culter, R. M.; Cumming, A.; Cunningham, L.; Danilishin, S. L.; Danzmann, K.; Daudert, B.; Davies, G.; Daw, E. J.; Debra, D.; Degallaix, J.; Dergachev, V.; Desai, S.; Desalvo, R.; Dhurandhar, S.; Díaz, M.; Dietz, A.; Donovan, F.; Dooley, K. L.; Doomes, E. E.; Drever, R. W. P.; Dueck, J.; Duke, I.; Dumas, J.-C.; Dwyer, J. G.; Echols, C.; Edgar, M.; Effler, A.; Ehrens, P.; Ely, G.; Espinoza, E.; Etzel, T.; Evans, M.; Evans, T.; Fairhurst, S.; Faltas, Y.; Fan, Y.; Fazi, D.; Fehrmann, H.; Finn, L. S.; Flasch, K.; Foley, S.; Forrest, C.; Fotopoulos, N.; Franzen, A.; Frede, M.; Frei, M.; Frei, Z.; Freise, A.; Frey, R.; Fricke, T.; Fritschel, P.; Frolov, V. V.; Fyffe, M.; Galdi, V.; Garofoli, J. A.; Gholami, I.; Giaime, J. A.; Giampanis, S.; Giardina, K. D.; Goda, K.; Goetz, E.; Goggin, L. M.; González, G.; Gorodetsky, M. L.; Goßler, S.; Gouaty, R.; Grant, A.; Gras, S.; Gray, C.; Gray, M.; Greenhalgh, R. J. S.; Gretarsson, A. M.; Grimaldi, F.; Grosso, R.; Grote, H.; Grunewald, S.; Guenther, M.; Gustafson, E. K.; Gustafson, R.; Hage, B.; Hallam, J. M.; Hammer, D.; Hammond, G. D.; Hanna, C.; Hanson, J.; Harms, J.; Harry, G. M.; Harry, I. W.; Harstad, E. D.; Haughian, K.; Hayama, K.; Heefner, J.; Heng, I. S.; Heptonstall, A.; Hewitson, M.; Hild, S.; Hirose, E.; Hoak, D.; Hodge, K. A.; Holt, K.; Hosken, D. J.; Hough, J.; Hoyland, D.; Hughey, B.; Huttner, S. H.; Ingram, D. R.; Isogai, T.; Ito, M.; Ivanov, A.; Johnson, B.; Johnson, W. W.; Jones, D. I.; Jones, G.; Jones, R.; Ju, L.; Kalmus, P.; Kalogera, V.; Kandhasamy, S.; Kanner, J.; Kasprzyk, D.; Katsavounidis, E.; Kawabe, K.; Kawamura, S.; Kawazoe, F.; Kells, W.; Keppel, D. G.; Khalaidovski, A.; Khalili, F. Y.; Khan, R.; Khazanov, E.; King, P.; Kissel, J. S.; Klimenko, S.; Kokeyama, K.; Kondrashov, V.; Kopparapu, R.; Koranda, S.; Kozak, D.; Krishnan, B.; Kumar, R.; Kwee, P.; Lam, P. K.; Landry, M.; Lantz, B.; Lazzarini, A.; Lei, H.; Lei, M.; Leindecker, N.; Leonor, I.; Li, C.; Lin, H.; Lindquist, P. E.; Littenberg, T. B.; Lockerbie, N. A.; Lodhia, D.; Longo, M.; Lormand, M.; Lu, P.; Lubiński, M.; Lucianetti, A.; Lück, H.; Machenschalk, B.; Macinnis, M.; Mageswaran, M.; Mailand, K.; Mandel, I.; Mandic, V.; Márka, S.; Márka, Z.; Markosyan, A.; Markowitz, J.; Maros, E.; Martin, I. W.; Martin, R. M.; Marx, J. N.; Mason, K.; Matichard, F.; Matone, L.; Matzner, R. A.; Mavalvala, N.; McCarthy, R.; McClelland, D. E.; McGuire, S. C.; McHugh, M.; McIntyre, G.; McKechan, D. J. A.; McKenzie, K.; Mehmet, M.; Melatos, A.; Melissinos, A. C.; Menéndez, D. F.; Mendell, G.; Mercer, R. A.; Meshkov, S.; Messenger, C.; Meyer, M. S.; Miller, J.; Minelli, J.; Mino, Y.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Miyakawa, O.; Moe, B.; Mohanty, S. D.; Mohapatra, S. R. P.; Moreno, G.; Morioka, T.; Mors, K.; Mossavi, K.; Mowlowry, C.; Mueller, G.; Müller-Ebhardt, H.; Muhammad, D.; Mukherjee, S.; Mukhopadhyay, H.; Mullavey, A.; Munch, J.; Murray, P. G.; Myers, E.; Myers, J.; Nash, T.; Nelson, J.; Newton, G.; Nishizawa, A.; Numata, K.; O'Dell, J.; O'Reilly, B.; O'Shaughnessy, R.; Ochsner, E.; Ogin, G. H.; Ottaway, D. J.; Ottens, R. S.; Overmier, H.; Owen, B. J.; Pan, Y.; Pankow, C.; Papa, M. A.; Parameshwaraiah, V.; Patel, P.; Pedraza, M.; Penn, S.; Perreca, A.; Pierro, V.; Pinto, I. M.; Pitkin, M.; Pletsch, H. J.; Plissi, M. V.; Postiglione, F.; Principe, M.; Prix, R.; Prokhorov, L.; Punken, O.; Quetschke, V.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raics, Z.; Rainer, N.; Rakhmanov, M.; Raymond, V.; Reed, C. M.; Reed, T.; Rehbein, H.

    2009-08-01

    This paper reports on an all-sky search for periodic gravitational waves from sources such as deformed isolated rapidly spinning neutron stars. The analysis uses 840 hours of data from 66 days of the fifth LIGO science run (S5). The data were searched for quasimonochromatic waves with frequencies f in the range from 50 to 1500 Hz, with a linear frequency drift f˙ (measured at the solar system barycenter) in the range -f/τ

  20. Einstein@Home search for periodic gravitational waves in early S5 LIGO data

    CERN Document Server

    2009-01-01

    This paper reports on an all-sky search for periodic gravitational waves from sources such as deformed isolated rapidly-spinning neutron stars. The analysis uses 840 hours of data from 66 days of the fifth LIGO science run (S5). The data was searched for quasi-monochromatic waves with frequencies f in the range from 50 Hz to 1500 Hz, with a linear frequency drift \\dot{f} (measured at the solar system barycenter) in the range -f/\\tau < \\dot{f} < 0.1 f/\\tau, for a minimum spin-down age \\tau of 1000 years for signals below 400 Hz and 8000 years above 400 Hz. The main computational work of the search was distributed over approximately 100000 computers volunteered by the general public. This large computing power allowed the use of a relatively long coherent integration time of 30 hours while searching a large parameter space. This search extends Einstein@Home's previous search in LIGO S4 data to about three times better sensitivity. No statistically significant signals were found. In the 125 Hz to 225 Hz ba...

  1. Sexual behavior of Pecari tajacu (Cetartiodactyla: Tayassuidae) during periovulatory and early gestation periods.

    Science.gov (United States)

    da Silva, Suleima do Socorro Bastos; Le Pendu, Yvonnick; Ohashi, Otavio Mitio; Oba, Eunice; de Albuquerque, Natália Inagaki; Garcia, Alexandre Rossetto; Mayor, Pedro; de Araujo Guimarães, Diva Anelie

    2016-10-01

    The goal of this study was to describe the sexual behavior in female and male collared peccary. Twenty females and twelve males were monitored in familiar and non-familiar units for two 60 days periods. During both phases, we recorded 2747 sexual interactions initiated by 20 different females toward males and 4461 sexual interactions initiated by 12 males toward females. The frequency of sexual interactions initiated per female significantly increased from proestrus to estrus, and they were significantly more frequently courted. Females initiated olfactory inspections 15.42 times more and were mounted 22.6 times more during estrus than during proestrus. Nulliparous and primiparous females copulated only when exposed to non-parental males. After estrus, the frequency of sexual interactions received by females sharply decreased. One mating event was recorded during the first gestation week and 31 mountings were observed after the second week. In conclusion, the behavioral monitoring is a useful procedure for the recognition of estrus. Our results suggest that ovulation may be associated with the end of the estrus, which will support future work in assisted reproduction in this species. To promote good handling practices, females of reproductive age should be removed from their family unit of origin.

  2. Western esotericism and the history of European science and medicine in the early modern period

    Directory of Open Access Journals (Sweden)

    Jole Shackelford

    2008-01-01

    Full Text Available The history of science and the history of medicine were, from their beginnings as subjects in the Enlightenment and post-Enlightenment periods, hostile to esoteric ideas and practices and generally excluded them from the scope of academic study. Esoteric belief systems by definition prioritize inner knowledge, knowledge that is not attainable or transferable by the standard practices of public pedagogy, but rather is acquired by direct apprehension or by internal illumination. I call these ‘belief systems’, because people who defend esoteric knowledge do so within a worldview, a physics and metaphysics that explains and makes sense of their hopes and experiences. Such belief systems can therefore be compared with other worldviews—cosmologies in the most general sense of the term—and points of tangency, or even zones of interpenetration, can be examined. It is just such points of confrontation and zones of commonality between the occult and manifest sciences which are of particular interest to historians of science, because it is here that the disciplinary boundaries of modern science are being negotiated.

  3. The Specific Features of an Early Period after Minimally Invasive Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    V. A. Shmyrev

    2014-01-01

    Full Text Available Objective: to comparatively evaluate the perioperative clinical period in patients operated on via miniinvasive access and median sternotomy.Subjects and methods. A retrospective analysis included all patients who had undergone correction of mitral valve defect with or without tricuspid valve correction and atrial ablation. 121 and 112 patients were operated on through miniinvasive access (a study group and median sternothomy (a control group, respectively.Results. The duration (median [25; 75 percentiles] of aortic occlusion in the study group (89 [71; 120] min was significantly longer than that in the control group (65 [52; 84] min; р<0.01. Acute heart failure complicated the clinical course in 28 (23.1% and 15 (13.4% cases in the study and control groups, respectively; р=0.06. In the miniinvasiveaccess group, two deaths were caused by intraoperative aortic dissection. There was no significant difference in the length of stay in the intensive care unit and in that of hospitalization between the groups.Conclusion. The findings are generally correlated with the world data obtained while implementing the procedure. The frequency and pattern of complications due to miniinvasive correction of mitral valve defect require additional financial expenditures and human resources. It is necessary to analyze the longterm results of treatment for the reasonable evaluation of the efficiency and expediency of using this procedure.

  4. Predicting and preventing postoperative decline in older cardiac surgery patients

    NARCIS (Netherlands)

    Ettema, R.G.A.

    2014-01-01

    Introduction: Delirium, depression, pressure ulcers and infection are frequently occurring postoperative complications in older cardiac surgery patients. Prevention of postoperative complications in cardiac surgery is mainly focused on the period of the hospital admission itself. There is however a

  5. Determinants of HIV-induced brain changes in three different periods of the early clinical course: A data mining analysis

    Directory of Open Access Journals (Sweden)

    Bokai Cao

    2015-01-01

    Full Text Available To inform an understanding of brain status in HIV infection, quantitative imaging measurements were derived at structural, microstructural and macromolecular levels in three different periods of early infection and then analyzed simultaneously at each stage using data mining. Support vector machine recursive feature elimination was then used for simultaneous analysis of subject characteristics, clinical and behavioral variables, and immunologic measures in plasma and CSF to rank features associated with the most discriminating brain alterations in each period. The results indicate alterations beginning in initial infection and in all periods studied. The severity of immunosuppression in the initial virus host interaction was the most highly ranked determinant of earliest brain alterations. These results shed light on the initial brain changes induced by a neurotropic virus and their subsequent evolution. The pattern of ongoing alterations occurring during and beyond the period in which virus is suppressed in the systemic circulation supports the brain as a viral reservoir that may preclude eradication in the host. Data mining capabilities that can address high dimensionality and simultaneous analysis of disparate information sources have considerable utility for identifying mechanisms underlying onset of neurological injury and for informing new therapeutic targets.

  6. Determinants of HIV-induced brain changes in three different periods of the early clinical course: A data mining analysis.

    Science.gov (United States)

    Cao, Bokai; Kong, Xiangnan; Kettering, Casey; Yu, Philip; Ragin, Ann

    2015-01-01

    To inform an understanding of brain status in HIV infection, quantitative imaging measurements were derived at structural, microstructural and macromolecular levels in three different periods of early infection and then analyzed simultaneously at each stage using data mining. Support vector machine recursive feature elimination was then used for simultaneous analysis of subject characteristics, clinical and behavioral variables, and immunologic measures in plasma and CSF to rank features associated with the most discriminating brain alterations in each period. The results indicate alterations beginning in initial infection and in all periods studied. The severity of immunosuppression in the initial virus host interaction was the most highly ranked determinant of earliest brain alterations. These results shed light on the initial brain changes induced by a neurotropic virus and their subsequent evolution. The pattern of ongoing alterations occurring during and beyond the period in which virus is suppressed in the systemic circulation supports the brain as a viral reservoir that may preclude eradication in the host. Data mining capabilities that can address high dimensionality and simultaneous analysis of disparate information sources have considerable utility for identifying mechanisms underlying onset of neurological injury and for informing new therapeutic targets.

  7. Role of intercostal nerve block in reducing postoperative pain following video-assisted thoracoscopy: A randomized controlled trial.

    Science.gov (United States)

    Ahmed, Zulfiqar; Samad, Khalid; Ullah, Hameed

    2017-01-01

    The main advantages of video assisted thoracoscopic surgery (VATS) include less post-operative pain, rapid recovery, less postoperative complications, shorter hospital stay and early discharge. Although pain intensity is less as compared to conventional thoracotomy but still patients experience upto moderate pain postoperatively. The objective of this study was to assess the efficacy and morphine sparing effect of intercostal nerve block in alleviating immediate post-operative pain in patients undergoing VATS. Sixty ASA I-III patients, aged between 16 to 60 years, undergoing mediastinal lymph node biopsy through VATS under general anaesthesia were randomly divided into two groups. The intercostal nerve block (ICNB group) received the block along with patient control intravenous analgesia (PCIA) with morphine, while control group received only PCIA with morphine for post-operative analgesia. Patients were followed for twenty four hours post operatively for intervention of post-operative pain in the recovery room and ward. The pain was assessed using visual analogue scale (VAS) at 1, 6, 12 and 24 hours. There was a significant decrease in pain score and morphine consumption in ICNB group as compared to control group in first 6 hours postoperatively. There was no significant difference in pain scores and morphine consumption between the two groups after 6 hours. Patients receiving intercostal nerve block have better pain control and less morphine consumption as compared to those patients who did not receive intercostal nerve block in early (6 hours) post-operative period.

  8. Effects of dry period length and dietary energy source on metabolic status and hepatic gene expression of dairy cows in early lactation

    NARCIS (Netherlands)

    Chen, J.C.; Gross, J.J.; Dorland, van H.A.; Remmelink, G.J.; Bruckmaier, R.M.; Kemp, B.; Knegsel, van A.T.M.

    2015-01-01

    In a prior study, we observed that cows with a 0-d dry period had greater energy balance and lower milk production compared with cows with a 30- or 60-d dry period in early lactation. The objective of the current study was to evaluate the influence of dry period length on metabolic status and hepati

  9. High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty

    DEFF Research Database (Denmark)

    Calatayud, Joaquin; Casaña, Jose; Ezzatvar, Yasmin;

    2017-01-01

    -four subjects (7 men, 37 women) scheduled for unilateral TKA for osteoarthritis (OA) during 2014 participated in this randomized controlled trial. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Physical Functioning Scale of the Short Form-36 questionnaire (SF-36), a 10-cm visual...... analogue scale (VAS), isometric knee flexion, isometric knee extension, isometric hip abduction, active knee range of motion and functional tasks (Timed Up and Go test and Stair ascent-descent test) were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3...

  10. Dry period and parturient predictors of early lactation hyperketonemia in dairy cattle.

    Science.gov (United States)

    McArt, J A A; Nydam, D V; Oetzel, G R

    2013-01-01

    The purpose was to determine important dry and calving period predictors of (1) a cow developing hyperketonemia at any time between 3 and 16 d in milk (DIM) and (2) a cow having hyperketonemia at her first β-hydroxybutyrate (BHBA) test after calving (between 3 and 5 DIM). Cows from 4 freestall dairy herds [2 in New York (NY) and 2 in Wisconsin] were enrolled at 266 d carried calf. Precalving data included body condition score, locomotion score, and blood nonesterified fatty acids (NEFA) concentration; calving-associated data included previous days carried calf, calving ease, calf sex, twins, stillbirth, and parity. Cows were each tested 6 times for hyperketonemia from 3 to 16 DIM on Mondays, Wednesdays, and Fridays using the Precision Xtra meter (Abbott Laboratories, Abbott Park, IL). Hyperketonemia was defined as a blood BHBA concentration of ≥1.2 mmol/L. Multivariable fixed-effects Poisson regression models were developed to predict the probability of a cow developing hyperketonemia between either 3 and 16 DIM or at her first BHBA test. As only the NY herds had precalving NEFA data, each prediction model was developed twice: once with data from all 4 herds (n=1,672) and once with data from only the NY herds (n=544). For the models with data from all 4 herds, increased body condition score group and an interaction between advanced parity and herd were important predictors of hyperketonemia development at any time from 3 to 16 DIM; calf sex (male), herd, and an advanced parity by increased body condition score group interaction were important predictors of hyperketonemia development between 3 and 5 DIM. The 4-herd models had a 64 and 78% predictive concordance for hyperketonemia between 3 and 16 DIM and at first BHBA test, respectively. For the models with data from the NY herds only, increased NEFA, calf sex (male), advanced parity, and herd were found to be important predictors of hyperketonemia development at any time from 3 to 16 DIM; increased NEFA, calf

  11. First look at a major transition period in the early Universe

    Science.gov (United States)

    1997-08-01

    In recent years astronomers have successfully `looked back' towards this period, but the new observations of HE 2347-4342 have now homed in on an important transitionary epoch during the evolution of the young Universe. Searching for clear views towards bright quasars As has been the case for many other important scientific achievements, this observational breakthrough was preceded by a long and tedious period of careful preparatory work. It began in 1989, when Dieter Reimers and his collaborators from the University of Hamburg (Germany) initiated a spectral survey of the entire southern sky with the 1-metre ESO Schmidt Telescope at La Silla. The aim was to find bright quasars, a rare class of remote galaxies with unusually bright and energetic centres. They would then be studied in greater detail with other, larger telescopes. For this programme, a large objective prism is placed in front of the telescope, allowing the simultaneous recording on a large photographic plate of spectra of about 40,000 celestial objects in a 5o x 5o sky field. The plates are sent to Hamburg where they are scanned (digitized) in a microphotometer and automatically searched for spectra of quasars. Until now, more than 400 plates have been obtained. One of the main goals of this vast programme is to find bright and distant quasars, in particular those whose light reaches us along relatively unobstructed paths. Or, in other words, those intrinsically bright and remote quasars which are located in directions where the Universe is unusually transparent for ultraviolet light. With a 'clear view' thus ensured, it would subsequently be possible to study such far-away objects and the intergalactic gas out there in unprecedented detail with large telescopes. The greater the distance, the longer has the light been underway, the longer is the 'look-back' time and the earlier is the epoch about which we then obtain new information. Discovery of a unique quasar Altogether, more than 650 bright

  12. Impact of Clipping versus Coiling on Postoperative Hemodynamics and Pulmonary Edema after Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Nobutaka Horie

    2014-01-01

    Full Text Available Volume management is critical for assessment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH. This multicenter prospective cohort study compared the impact of surgical clipping versus endovascular coiling on postoperative hemodynamics and pulmonary edema in patients with SAH. Hemodynamic parameters were measured for 14 days using a transpulmonary thermodilution system. The study included 202 patients, including 160 who underwent clipping and 42 who underwent coiling. There were no differences in global ejection fraction (GEF, cardiac index, systemic vascular resistance index, or global end-diastolic volume index between the clipping and coiling groups in the early period. However, extravascular lung water index (EVLWI and pulmonary vascular permeability index (PVPI were significantly higher in the clipping group in the vasospasm period. Postoperative C-reactive protein (CRP level was higher in the clipping group and was significantly correlated with postoperative brain natriuretic peptide level. Multivariate analysis found that PVPI and GEF were independently associated with high EVLWI in the early period, suggesting cardiogenic edema, and that CRP and PVPI, but not GEF, were independently associated with high EVLWI in the vasospasm period, suggesting noncardiogenic edema. In conclusion, clipping affects postoperative CRP level and may thereby increase noncardiogenic pulmonary edema in the vasospasm period. His trial is registered with University Hospital Medical Information Network UMIN000003794.

  13. Influence of enteral nutrition during the preoperative and postoperative periods on postoperative nutritional status and immunologic function in patients with gastric cancer%术前和术后肠内营养对胃癌患者术后营养状况及免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    王宏星; 夏艳; 邵少英

    2011-01-01

    目的 研究术前一周开始肠内营养(enteral nutrition,EN)支持对胃癌患者术后营养状况、免疫功能及炎性反应的影响.方法 将126例胃癌患者随机分为术前一周开始EN组(研究组)和术后早期EN组(对照组),分别按不同治疗方案进行营养支持至手术后第9天.所有患者均于术前、术后第1、10天测量体重、皮褶厚度、上臂围、血白细胞计数(WBC)、白蛋白(ALB)、前白蛋白(PA),C反应蛋白(C-reactive protein,CRP)、体液免疫(IgA、IgG)、T细胞亚群(CD4、CD8、CD4/CD8)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等.结果 术后第10天研究组前白蛋白和IgG水平高于对照组,IL-6低于对照组.结论 对胃癌患者术前进行合适的EN支持,能更好地改善患者术后的营养状况、免疫功能并减轻患者机体炎性反应,更有利于促进患者恢复.%Objective To study the effect of enteral nutrition (EN) support starting one week before operation on the postoperative nutritional status, immune function and inflammatory reaction of gastric cancer patients.Methods A total of 126 patients with gastric cancer were randomized to receive either preoperative enteral nutrition (study group) or an early postoperative enteral nutrition (control group).The two groups received the enteral nutrition for nine days after the operation.The weight, thickness of rhicnosis, upper-arm circumference, white blood cell (WBC) count, albumin (ALB), prealbumin ( PA), C-reactive protein ( CRP),humoral immune (IgG, IgA), T lymphocyte subsets (CD4, CD8 and CD4/CD8), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) were detected before and on the first and tenth day after surgery.Results On the tenth day, prealbumin and IgG levels were significantly higher and IL-6 was significantly lower in the study group than in the control group.Conclusion Preoperative EN support in gastric cancer patients can improve the patients' postoperative nutritional status

  14. Motives for early retirement of self-employed GPs in the Netherlands: a comparison of two time periods

    Directory of Open Access Journals (Sweden)

    Van Greuningen Malou

    2012-12-01

    Full Text Available Abstract Background The high cost of training and the relatively long period of training for physicians make it beneficial to stimulate physicians to retire later. Therefore, a better understanding of the link between the factors influencing the decision to retire and actual turnover would benefit policies designed to encourage later retirement. This study focuses on actual GP turnover and the determining factors for this in the Netherlands. The period 2003–2007 saw fewer GPs retiring from general practice than the period 1998–2002. In addition, GPs’ retirement age was higher in 2003–2007. For these two periods, we analysed work perception, objective workload and reasons for leaving, and related these with the probability that GPs would leave general practice at an early age. Methods In 2003, a first retrospective survey was sent to 520 self-employed GPs who had retired between 1998 and 2002. In 2008, the same survey was sent to 405 GPs who had retired between 2003 and 2007. The response rates were 60% and 54%, respectively. Analyses were done to compare work perception, objective workload, external factors and personal reasons for retiring. Results For both male and female GPs, work perception was different in the periods under scrutiny: both groups reported greater job satisfaction and a lower degree of emotional exhaustion in the later period, although there was no notable difference in subjective workload. The objective workload was lower in the second period. Moreover, most external factors and personal reasons that may contribute to the decision to retire were reported as less important in the second period. There was a stronger decrease in the probability that female GPs leave general practice within one year than for male GPs. This underscores the gender differences and the need for disaggregated data collection. Conclusions The results of this study suggest that the decrease in the probability of GPs leaving general practice

  15. Clinical observation of early enteral nutrition in postoperative gastric cancer patients%早期肠内营养在胃癌术后应用的疗效观察

    Institute of Scientific and Technical Information of China (English)

    罗嘉; 吴飞跃

    2011-01-01

    目的 观察胃癌术后患者早期肠内营养支持的近期疗效.方法 将 117 例患者随机分为肠内营养组与肠外营养组,于术后 24h 开始分别给予肠内与肠外营养,比较两组患者术后营养状况、免疫水平和临床恢复情况的差异.结果 在供能基本相同的情况下,肠内营养组在术后短期内免疫水平和临床恢复及住院时间方面都优于肠外营养组(均P<0.05).结论 术后早期肠内营养能够有效改善胃癌术后患者的免疫功能,加快胃肠道功能的恢复.%Objective To observe the effect of early enteral nutrition in postoperative gastric cancer patients.Methods There were 117 cases of postoperative gastic cancer patients who were divided randomly into enteral nutrition group ( EN ) or parenteral nutrition group ( PN ). Nutrition support was started 24 hours after the operation. Nutritional condition, immunological level and variables of clinical recovery were measured and compared after the operation. Results EN group showed better immunological level and clinical recovery than the PN group ( P < 0. 05 ); and the hostal stay of EN group was also shorter than that of PN group (P <0.05 ). Conclusions Early enteral nutrition in postoperative gastric cancer patients can improve the patients immunological level and enhance the restoration of gastrointestinal function.

  16. Establishing the volatile profile of pig carcasses as analogues for human decomposition during the early postmortem period

    Directory of Open Access Journals (Sweden)

    P. Armstrong

    2016-02-01

    Full Text Available Following a mass disaster, it is important that victims are rapidly located as the chances of survival decrease greatly after approximately 48 h. Urban search and rescue (USAR teams may use a range of tools to assist their efforts but detector dogs still remain one of the most effective search tools to locate victims of mass disasters. USAR teams can choose to deploy human scent dogs (trained to locate living victims or human remains detection (HRD dogs (trained to locate deceased victims. However, little is known about the variation between live human scent and postmortem human remains scent and the timeframe during which one type of scent transitions to the other. The aim of the current study was to measure the change in the scent profile of human decomposition analogues during the first 72 h postmortem by measuring the volatile organic compounds (VOCs that comprise the odour. Three pig carcasses (Sus scrofa domesticus L. were placed on a soil surface and allowed to decompose under natural conditions. Decomposition odour was sampled frequently up to 75 h postmortem and analysed using comprehensive two-dimensional gas chromatography – time-of-flight mass spectrometry (GC×GC-TOFMS. A total of 105 postmortem VOCs were identified during the early postmortem period. The VOC profile during the early postmortem period was highly dynamic, changing both hourly and daily. A transition period was observed after 43 h postmortem, where the VOC profile appeared to shift from a distinct antemortem odour to a more generalised postmortem odour. These findings are important in informing USAR teams and their use of detector dogs for disaster victim recovery.

  17. Is the Predictability of New-Onset Postpartum Depression Better During Pregnancy or in the Early Postpartum Period? A Prospective Study in Croatian Women.

    Science.gov (United States)

    Nakić Radoš, Sandra; Herman, Radoslav; Tadinac, Meri

    2016-01-01

    The researchers' aim was to examine whether it was better to predict new-onset postpartum depression (PPD) during pregnancy or immediately after childbirth. A prospective study conducted in Croatia followed women (N = 272) from the third trimester of pregnancy through the early postpartum period (within the first 3 postpartum days), to 6 weeks postpartum. Questionnaires on depression, anxiety, stress, coping, self-esteem, and social support were administered. Through regression analyses we showed that PPD symptoms could be equally predicted by variables from pregnancy (30.3%) and the early postpartum period (34.0%), with a small advantage of PPD prediction in the early postpartum period.

  18. Research Progress of Early Breast Cancer's Conserving Surgery and Postoperative Treatment%早期乳腺癌保乳术及术后治疗的研究进展

    Institute of Scientific and Technical Information of China (English)

    黎艳萍

    2013-01-01

    The treatment of early breast cancer has been developed from the traditional radical surgery to the breast-conserving surgery combined with postoperative radiotherapy. The treatments after breast-conserving surgery include radiotherapy, chemotherapy, endocrine therapy and comprehensive treatment. The postoprative radiotherapy has significant value to the prognosis. The techniques of radiotherapy after surgery commonly used now include tissue implantation,three-dimensional conformal radiotherapy,brachytherapy and intraoperative radiatiotherapy. Study on the early breast-conserving surgery and postoperative treatment can positively improve the clinical diagnosis and treatment level.%早期乳腺癌治疗手段已经由传统的根治手术发展到现在的保乳术结合术后治疗.保乳术后的四种治疗方式分别是放疗、化疗、内分泌治疗及综合治疗.保乳术后进行放射治疗对预后具有重要意义,目前常用的部分照射技术手段有组织插植,三维适形体外照射,腔内照射,术中放射治疗.研究分析早期乳腺癌保乳术及术后治疗的现状可积极合理地提高临床诊疗水平.

  19. Analysis of the Effect of Early Enteral Nutrition on Postoperative Patients With Gastric Cancer%早期肠内营养对胃癌术后患者影响分析

    Institute of Scientific and Technical Information of China (English)

    于洪玥

    2015-01-01

    Objective To investigate the effect of early enteral nutrition in patients after radical gastric cancer.Methods 90 patients in our hospital with gastric cancer surgery were devided 50 patients into observation group, and 40 patients in the control group.Compared in patients with bowel function recovery time and postoperative nutritional status. Results The postoperative intestinal function recovery time was significantly shorter than the control group, the nutritional situation was significantly better than the control group.ConclusionsEarly enteral nutrition is conducive to the prognosis of gastric cancer patients .%目的:探讨早期肠内营养对胃癌根治术后患者的影响。方法选取我院收治并行根治术的胃癌患者90例,观察组40例,对照组50例,比较两组患者肠功能恢复时间及术后营养状况。结果观察组术后肠功能恢复时间比对照组短,营养状况优于对照组。结论早期肠内营养有利于胃癌根治术后患者的预后。

  20. LONG-ORBITAL-PERIOD PREPOLARS CONTAINING EARLY K-TYPE DONOR STARS. BOTTLENECK ACCRETION MECHANISM IN ACTION

    Energy Technology Data Exchange (ETDEWEB)

    Tovmassian, G.; González–Buitrago, D.; Zharikov, S. [Instituto de Astronomía, Universidad Nacional Autónoma de México, Apartado Postal 877, Ensenada, Baja California, 22800 México (Mexico); Reichart, D. E.; Haislip, J. B.; Ivarsen, K. M.; LaCluyze, A. P.; Moore, J. P. [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Campus Box 3255, Chapel Hill, NC 27599 (United States); Miroshnichenko, A. S., E-mail: gag@astro.unam.mx, E-mail: dgonzalez@astro.unam.mx, E-mail: zhar@astro.unam.mx [Department of Physics and Astronomy, University of North Carolina at Greensboro, Greensboro, NC 27402-6170 (United States)

    2016-03-01

    We studied two objects identified as cataclysmic variables (CVs) with periods exceeding the natural boundary for Roche-lobe-filling zero-age main sequence (ZAMS) secondary stars. We present observational results for V1082 Sgr with a 20.82 hr orbital period, an object that shows a low luminosity state when its flux is totally dominated by a chromospherically active K star with no signs of ongoing accretion. Frequent accretion shutoffs, together with characteristics of emission lines in a high state, indicate that this binary system is probably detached, and the accretion of matter on the magnetic white dwarf takes place through stellar wind from the active donor star via coupled magnetic fields. Its observational characteristics are surprisingly similar to V479 And, a 14.5 hr binary system. They both have early K-type stars as donor stars. We argue that, similar to the shorter-period prepolars containing M dwarfs, these are detached binaries with strong magnetic components. Their magnetic fields are coupled, allowing enhanced stellar wind from the K star to be captured and channeled through the bottleneck connecting the two stars onto the white dwarf’s magnetic pole, mimicking a magnetic CV. Hence, they become interactive binaries before they reach contact. This will help to explain an unexpected lack of systems possessing white dwarfs with strong magnetic fields among detached white+red dwarf systems.

  1. Long orbital period pre-polars containing an early K-type donor stars. Bottleneck accretion mechanism in action

    CERN Document Server

    Tovmassian, G; Zharikov, S; Reichart, D E; Haislip, J B; Ivarsen, K M; LaCluyze, A P; Moore, J P; Miroshnichenko, A S

    2016-01-01

    We studied two objects identified as a Cataclysmic Variables (CVs) with periods exceeding the natural boundary for Roche lobe filling ZAMS secondary stars. We present observational results for V1082 Sgr with 20.82 h orbital period, an object that shows low luminosity state, when its flux is totally dominated by a chromospherically active K- star with no signs of ongoing accretion. Frequent accretion shut-offs, together with characteristics of emission lines in a high state, indicate that this binary system is probably detached and the accretion of matter on the magnetic white dwarf takes place through stellar wind from the active donor star via coupled magnetic fields. Its observational characteristics are surprisingly similar to V479 And, a 14.5 h binary system. They both have early K-type stars as a donor star. We argue, that similar to the shorter period pre-polars containing M-dwarfs, these are detached binaries with strong magnetic components. Their magnetic fields are coupled, allowing enhanced stellar ...

  2. Early doors (Edo) mutant mouse reveals the importance of period 2 (PER2) PAS domain structure for circadian pacemaking.

    Science.gov (United States)

    Militi, Stefania; Maywood, Elizabeth S; Sandate, Colby R; Chesham, Johanna E; Barnard, Alun R; Parsons, Michael J; Vibert, Jennifer L; Joynson, Greg M; Partch, Carrie L; Hastings, Michael H; Nolan, Patrick M

    2016-03-08

    The suprachiasmatic nucleus (SCN) defines 24 h of time via a transcriptional/posttranslational feedback loop in which transactivation of Per (period) and Cry (cryptochrome) genes by BMAL1-CLOCK complexes is suppressed by PER-CRY complexes. The molecular/structural basis of how circadian protein complexes function is poorly understood. We describe a novel N-ethyl-N-nitrosourea (ENU)-induced mutation, early doors (Edo), in the PER-ARNT-SIM (PAS) domain dimerization region of period 2 (PER2) (I324N) that accelerates the circadian clock of Per2(Edo/Edo) mice by 1.5 h. Structural and biophysical analyses revealed that Edo alters the packing of the highly conserved interdomain linker of the PER2 PAS core such that, although PER2(Edo) complexes with clock proteins, its vulnerability to degradation mediated by casein kinase 1ε (CSNK1E) is increased. The functional relevance of this mutation is revealed by the ultrashort (Edo/Edo); Csnk1e(Tau/Tau) mice and the SCN. These periods are unprecedented in mice. Thus, Per2(Edo) reveals a direct causal link between the molecular structure of the PER2 PAS core and the pace of SCN circadian timekeeping.

  3. Prevention of postoperative ileus

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2002-01-01

    Postoperative ileus (PI) is a major contributor to postoperative morbidity and prolonged convalescence after major surgical procedures. The pathophysiology of PI is multifactorial, including activation of the stress response to surgery, with inhibitory sympathetic visceral reflexes and inflammato...

  4. Control study of early and late post-operative functional exercise in Arnold-Chiari malformation patients%Arnold-Chiari畸形患者术后早期与晚期功能锻炼的对照研究

    Institute of Scientific and Technical Information of China (English)

    殷淑珍; 梁艳

    2009-01-01

    目的 探讨Arnold-Chiari畸形患者术后早期或晚期功能锻炼对术后症状缓解和并发症发生的影响.方法 按术后是否早期下床活动,将74例Arnold-Chiari畸形患者分为早期活动组41例和晚期活动组33例.观察两组术后自觉症状、客观体征和护理指标.结果 2组间疼痛缓解、肌力改善、温度觉改善、肢体麻木缓解、压疮、头晕、泌尿系感染等差异有统计学意义,早期活动组优于晚期活动组.结论 Arnold-Chiari畸形患者术后早期进行功能锻炼,对缓解术后症状、减少患者并发症的发生有积极的影响.%Objective To study influence of early and late functional exercise on post-operative symptomatic relief and complication in Arnold-Chiari malformation patients. Methods A total of 74 Arnold-Chiari malformation patients were divided into two groups: early functional exercise(n=41) and late functional exercise(n=33). The result of the two groups were compared. Results Age and sex of the two groups had no significant difference. Pain relief, muscle force improvement, thermesthesia improvement, numbness relief and decubitus in the two groups had significantly different. Symptoms of patients who did early functional exercise relieved better. Conclusions Early post-operative functional exercise had beneficial effect on symptom relief and complication prevention in Arnold-Chiari malformation patients.

  5. Postoperative circadian disturbances

    DEFF Research Database (Denmark)

    Gögenur, Ismail

    2010-01-01

    in patients with lower than median pain levels for a three days period after laparoscopic cholecystectomy. In the series of studies included in this thesis we have systematically shown that circadian disturbances are found in the secretion of hormones, the sleep-wake cycle, core body temperature rhythm......An increasing number of studies have shown that circadian variation in the excretion of hormones, the sleep wake circle, the core body temperature rhythm, the tone of the autonomic nervous system and the activity rhythm are important both in health and in disease processes. An increasing attention...... has also been directed towards the circadian variation in endogenous rhythms in relation to surgery. The attention has been directed to the question whether the circadian variation in endogenous rhythms can affect postoperative recovery, morbidity and mortality. Based on the lack of studies where...

  6. 腹部术后早期肠梗阻再手术治疗21例分析%Reasons for Reoperation in 21 Cases of Early Postoperative Intestinal Obstruction

    Institute of Scientific and Technical Information of China (English)

    汪雷; 刘弋

    2011-01-01

    目的 探讨腹部术后早期肠梗阻的因为,总结再手术的经验.方法 回顾分析2005年1月2010年6月21例腹部术后早期肠梗阻再手术患者的临床资料.结果 21例术后早期肠梗阻出现时间为术后4~11 d,经再手术明确梗阻因为,术中证实粘连性肠梗阻12例,漏诊消化系统肿瘤3例,漏诊直肠癌1例,陈旧性粘连带致肠管卡压2例,遗漏多发肠石1例,合并急性阑尾炎、阑尾周围脓肿合并肠粘连梗阻2例,合并肠套叠1例.1例粘连性肠梗阻为术后17 d再次手术,由于无法找到明确的梗阻点,故行梗阻远近两端侧侧吻合术,术后25 d梗阻解除;其余20例经再手术后3~5d梗阻均解除,无手术死亡病例.结论 腹部术后早期肠梗阻多见为肠粘连.充分的术前准备,规范的手术操作,严密的术后观察,可减少粘连性肠梗阻的几率.选择适宜的手术方式,精确细致的手术操作是再手术成功的关键.%Objective To analyze the reasons for reoperation for early postoperative intestinal small obstruction, and summarize the experience of reoperation and treatment.Methods The reasons for reoperation in 21 patients with early postoperative intestinal small obstruction treated in our hospital from Jan 2005 to June 2010 were retrospectively analyzed.Results The 21 cases of early intestinal obstruction were occurred from 4 to 11 days after operation.By re-operating these 21 patients, the reasons for early postoperative intestinal small obstruction were clear.12 of 21 cases were adhesive intestinal obstruction,3 of 21 cases with digestive system cancer were missed diagnosed, 1 case with rectum cancer was missed diagnosed, 1 case with multiple intestinal stones was missed.And 2 cases with old intestinal adhesions and compression were diagnosed, 2 cases with acute appendicitis, the appendix abscess combined adhesive intestinal obstruction was diagnosed, and 1 case with intussusception was diagnosed.1 of 21 cases with adhesive

  7. When is a postoperative seizure equivalent to "epilepsy recurrence" after epilepsy surgery?

    Science.gov (United States)

    Jehi, Lara; Sarkis, Rani; Bingaman, William; Kotagal, Prakash; Najm, Imad

    2010-06-01

    Up to one-half of epilepsy surgery patients will have at least one seizure after surgery. We aim to characterize the prognosis following a first postoperative seizure, and provide criteria allowing early identification of recurrent refractory epilepsy. Analyzing 915 epilepsy surgery patients operated on between 1990 and 2007, we studied 276 who had >or=1 seizure beyond the immediate postoperative period. The probability of subsequent seizures was calculated using survival analysis. Patients were divided into seizure-free (no seizures for >or=1 year) and refractory (persistent seizures) and analyzed using multivariate regression analysis. After a first seizure, 50% had a recurrence within 1 month and 77% within a year before the risk slowed down to additional 2-3% increments every two subsequent years. After a second seizure, 50% had a recurrence within 2 weeks, 78% within 2 months, and 83% within 6 months. Having both the first and second seizures within six postoperative months [odds ratio (OR) 4.04; 95% confidence interval (CI) 2.05-8.40; p = 0.0001], an unprovoked initial recurrence (OR 3.92; 95% CI 2.13-7.30; p epilepsy and recurrent seizures developed refractoriness. Seizures will recur in most patients who present with their first postoperative event, with one-third eventually regaining seizure-freedom. Etiology and early and unprovoked postoperative seizures with epileptiform activity on EEG at six postoperative months may predict recurrent medical refractoriness.

  8. Post-operative pain relief in children following caudal bupivacaine and buprenorphine--a comparative study.

    Directory of Open Access Journals (Sweden)

    Anilkumar T

    1994-04-01

    Full Text Available Eighty-five paediatric patients (age range: 6 mths-12yrs undergoing lower abdominal surgery were studied for post-operative pain relief following either caudal bupivacaine (GpI: n = 43 or buprenorphine (GpII: n = 42. Bupivacaine was administered as 0.5ml/kg body weight of 0.25% solution and buprenorphine as 4 micrograms/ml and volume of 0.5 ml/Kg body weight in normal saline. Post-operatively pain was graded on a 4-point scale and behaviour on a 5-point scale. Any post-operative complications and need for additional analgesia were also noted. Bupivacaine provided good pain relief in the early post-operative hours but buprenorphine provided pain relief lasting for 24 hrs or more post-operatively. Post-operative behaviour of 10 patients receiving buprenorphine was graded as cheerful as compared to 2 from bupivacaine group. Till the end of observation period (i.e. 8 hr post-operatively, majority of patients receiving buprenorphine remained cheerful.

  9. EVALUATION OF POST-OPERATIVE SENSITIVITY AND ...

    African Journals Online (AJOL)

    Prof

    composites in wear resistance and achievement of good proximal contour ... change in result was recorded for post-operative sensitivity at the end of the evaluation period. 100% was recorded ..... Overcoming challenges with resin in class II ...

  10. Effects of brief daily periods of unrestricted vision during early monocular form deprivation on development of visual area 2.

    Science.gov (United States)

    Zhang, Bin; Tao, Xiaofeng; Wensveen, Janice M; Harwerth, Ronald S; Smith, Earl L; Chino, Yuzo M

    2011-09-14

    Providing brief daily periods of unrestricted vision during early monocular form deprivation reduces the depth of amblyopia. To gain insights into the neural basis of the beneficial effects of this treatment, the binocular and monocular response properties of neurons were quantitatively analyzed in visual area 2 (V2) of form-deprived macaque monkeys. Beginning at 3 weeks of age, infant monkeys were deprived of clear vision in one eye for 12 hours every day until 21 weeks of age. They received daily periods of unrestricted vision for 0, 1, 2, or 4 hours during the form-deprivation period. After behavioral testing to measure the depth of the resulting amblyopia, microelectrode-recording experiments were conducted in V2. The ocular dominance imbalance away from the affected eye was reduced in the experimental monkeys and was generally proportional to the reduction in the depth of amblyopia in individual monkeys. There were no interocular differences in the spatial properties of V2 neurons in any subject group. However, the binocular disparity sensitivity of V2 neurons was significantly higher and binocular suppression was lower in monkeys that had unrestricted vision. The decrease in ocular dominance imbalance in V2 was the neuronal change most closely associated with the observed reduction in the depth of amblyopia. The results suggest that the degree to which extrastriate neurons can maintain functional connections with the deprived eye (i.e., reducing undersampling for the affected eye) is the most significant factor associated with the beneficial effects of brief periods of unrestricted vision.

  11. Duty periods with early start times restrict the amount of sleep obtained by short-haul airline pilots.

    Science.gov (United States)

    Roach, Gregory D; Sargent, Charli; Darwent, David; Dawson, Drew

    2012-03-01

    Most of the research related to human fatigue in the aviation industry has focussed on long-haul pilots, but short-haul pilots also experience elevated levels of fatigue. The aim of this study was to examine the impact of early start times on the amount of sleep obtained prior to duty and on fatigue levels at the start of duty. Seventy short-haul pilots collected data regarding their duty schedule and sleep/wake behaviour for at least two weeks. Data were collected using self-report duty/sleep diaries and wrist activity monitors. Mixed-effects regression analyses were used to examine the effects of duty start time (04:00-10:00 h) on (i) the total amount of sleep obtained in the 12h prior to the start of duty and (ii) self-rated fatigue level at the start of duty. Both analyses indicated significant main effects of duty start time. In particular, the amount of sleep obtained in the 12h prior to duty was lowest for duty periods that commenced between 04:00 and 05:00 h (i.e. 5.4h), and greatest for duty periods that commenced between 09:00 and 10:00 h (i.e. 6.6h). These data indicate that approximately 15 min of sleep is lost for every hour that the start of duty is advanced prior to 09:00 h. In addition, self-rated fatigue at the start of duty was highest for duty periods that commenced between 04:00 and 05:00 h, and lowest for duty periods that commenced between 09:00 and 10:00 h. Airlines should implement a fatigue risk management system (FRMS) for short-haul pilots required to work early-morning shifts. One component of the FRMS should be focussed on the production of 'fatigue-friendly' rosters. A second component of the FRMS should be focussed on training pilots to optimise sleep opportunities, to identify circumstances where the likelihood of fatigue is elevated, and to manage the risks associated with fatigue-related impairment.

  12. Record review to explore the adequacy of post-operative vital signs monitoring using a local modified early warning score (mews chart to evaluate outcomes.

    Directory of Open Access Journals (Sweden)

    Una Kyriacos

    Full Text Available OBJECTIVES: 1 To explore the adequacy of: vital signs' recordings (respiratory and heart rate, oxygen saturation, systolic blood pressure (BP, temperature, level of consciousness and urine output in the first 8 post-operative hours; responses to clinical deterioration. 2 To identify factors associated with death on the ward between transfer from the theatre recovery suite and the seventh day after operation. DESIGN: Retrospective review of records of 11 patients who died plus four controls for each case. PARTICIPANTS: We reviewed clinical records of 55 patients who met inclusion criteria (general anaesthetic, age >13, complete records from six surgical wards in a teaching hospital between 1 May and 31 July 2009. METHODS: In the absence of guidelines for routine post-operative vital signs' monitoring, nurses' standard practice graphical plots of recordings were recoded into MEWS formats (0 = normal, 1-3 upper or lower limit and their responses to clinical deterioration were interpreted using MEWS reporting algorithms. RESULTS: No patients' records contained recordings for all seven parameters displayed on the MEWS. There was no evidence of response to: 22/36 (61.1% abnormal vital signs for patients who died that would have triggered an escalated MEWS reporting algorithm; 81/87 (93.1% for controls. Death was associated with age, ≥61 years (OR 14.2, 3.0-68.0; ≥2 pre-existing co-morbidities (OR 75.3, 3.7-1527.4; high/low systolic BP on admission (OR 7.2, 1.5-34.2; tachycardia (≥111-129 bpm (OR 6.6, 1.4-30.0 and low systolic BP (≤81-100 mmHg, as defined by the MEWS (OR 8.0, 1.9-33.1. CONCLUSIONS: Guidelines for post-operative vital signs' monitoring and reporting need to be established. The MEWS provides a useful scoring system for interpreting clinical deterioration and guiding intervention. Exploration of the ability of the Cape Town MEWS chart plus reporting algorithm to expedite recognition of signs of clinical and physiological

  13. The Effect of Early Nursing Intervention on Postoperative abdominal Distension in Puerperas with Caesarean Section%剖腹产术后腹胀因素分析及护理

    Institute of Scientific and Technical Information of China (English)

    杨红

    2012-01-01

    Objective:To investigate the effect of early nursing intervention on postoperative abdominal distension in puerperas with caesarean section.Methods:214 cases of caesarean mothers from Jun. 2010 to Jun. 2011were selected and randomly divided into observation group(n=107) and control group (n=107). The control group was received usual care , analgesia and normal eating after anal discharge. The observation group was given earl nursing intervention, including diet guidance, abdominal massage to help patients turn over in bed and early mobilization guidance,etc..The anal exhaust time, incidences of abdominal distension and postoperative complications were observed and compared.Results:The anal exhaust time of the observation group was significantly shorter than that of the control group(P<0.05) and the incidences of abdominal distension and postoperative complications were significantly lower than those of the control group(P<0.05).Conclusion:Scientific nursing intervention after caesarean section can reduce abdominal distension and the incidence of postoperative complications in puerperas%目的:探讨及早护理干预对剖腹产术后产妇腹胀的影响.方法:选择2010年6月~2011年6月在我院住院剖腹产术后腹胀产妇214例,随机分为观察组(n=107)和对照组(n=107),对照组剖腹产术后进行常规护理、止痛,肛门排气后正常进食,观察组在常规护理基础上给予术前、术后早期护理干预,包括饮食、止痛、腹部按摩、早期活动指导等,对比观察两组产妇的肛门排气时间、腹胀发生率及术后并发症.结果:观察组的肛门排气时间明显少于对照组,腹胀、术后并发症发生率明显低于对照组,差异均有统计学意义(P<0.05).结论:剖腹产术后科学的护理干预能有效减少腹胀及术后并发症.

  14. Effect of Magnesium on Nitric Oxide Synthase of Neurons in Cortex during Early Period of Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    SUN Xiu; MEI Yuanwu; TONG E'tang

    2000-01-01

    To investigate the effect of magnesium on nitric oxide synthase (NOS) of neurons in cortex during early cerebral ischemic period, a rat model of middle cerebral artery occlusion (MCAO) was established. The results showed that the NOS activity of neurons in cortex was increased significantly at 15 min after MCAO, reached its peak at 30 min after MCAO and returned to normal levels at 60 min after MCAO. The NOS activity of neurons in the magnesium-treated group was decreased significantly as compared with that in the ischemic group at 15 min and 30min after MCAO respectively. The results suggested that magnesium could inhibit the elevated NOS activity of neurons in cortex induced by cerebral ischemia.

  15. Using CT perfusion during the early baseline period in aneurysmal subarachnoid hemorrhage to assess for development of vasospasm

    Energy Technology Data Exchange (ETDEWEB)

    Sanelli, Pina C. [New York-Presbyterian Hospital/Weill Cornell Medical College, Department of Radiology, New York, NY (United States); New York-Presbyterian Hospital/Weill Cornell Medical College, Department of Public Health, New York, NY (United States); Jou, Austin; Reichman, Melissa; Greenberg, Edward; Cayci, Zuzan [New York-Presbyterian Hospital/Weill Cornell Medical College, Department of Radiology, New York, NY (United States); Gold, Rachel [New York College of Osteopathic Medicine, 1 Northern Boulevard, P.O. Box 8000, Old Westbury, NY (United States); John, Majnu [New York-Presbyterian Hospital/Weill Cornell Medical College, Department of Public Health, New York, NY (United States); Ugorec, Igor [Atlantic Neurosurgical Specialists, Department of Neurology, Morristown, NJ (United States); Rosengart, Axel [New York-Presbyterian Hospital/Weill Cornell Medical College, Department of Neurology, New York, NY (United States)

    2011-06-15

    The aim of this study is to evaluate computed tomography perfusion (CTP) during admission baseline period (days 0-3) in aneurysmal subarachnoid hemorrhage (A-SAH) for development of vasospasm. Retrospective analysis was performed on A-SAH patients from Dec 2004 to Feb 2007 with CTP on days 0-3. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were analyzed for qualitative perfusion deficits. Quantitative analysis was performed using region-of-interest placement to obtain mean CTP values. Development of vasospasm was determined by a multistage hierarchical reference standard incorporating both imaging and clinical criteria. Student's t test and threshold analysis were performed. Seventy-five patients were included, 37% (28/75) were classified as vasospasm. Mean CTP values in vasospasm compared to no vasospasm groups were: CBF 31.90 ml/100 g/min vs. 39.88 ml/100 g/min (P < 0.05), MTT 7.12 s vs. 5.03 s (P < 0.01), and CBV 1.86 ml/100 g vs. 2.02 ml/100 g (P = 0.058). Fifteen patients had qualitative perfusion deficits with 73% (11/15) developed vasospasm. Optimal threshold for CBF is 24-25 mL/100 g/min with 91% specificity and 50% sensitivity, MTT is 5.5 s with 70% specificity and 61% sensitivity and CBV is 1.7 mL/100 g with 89% specificity and 36% sensitivity. These initial results support our hypothesis that A-SAH patients who develop vasospasm may demonstrate early alterations in cerebral perfusion, with statistically significant CBF reduction and MTT prolongation. Overall, CTP has high specificity for development of vasospasm. Future clinical implications include using CTP during the baseline period for early identification of A-SAH patients at high risk for vasospasm to prompt robust preventative measures and treatment. (orig.)

  16. Analysis of acylcarnitine profiles in umbilical cord blood and during the early neonatal period by electrospray ionization tandem mass spectrometry

    Science.gov (United States)

    Vieira Neto, E.; Fonseca, A.A.; Almeida, R.F.; Figueiredo, M.P.; Porto, M.A.S.; Ribeiro, M.G.

    2012-01-01

    Acylcarnitine profiling by electrospray ionization tandem mass spectrometry (ESI-MS/MS) is a potent tool for the diagnosis and screening of fatty acid oxidation and organic acid disorders. Few studies have analyzed free carnitine and acylcarnitines in dried blood spots (DBS) of umbilical cord blood (CB) and the postnatal changes in the concentrations of these analytes. We have investigated these metabolites in healthy exclusively breastfed neonates and examined possible effects of birth weight and gestational age. DBS of CB were collected from 162 adequate for gestational age neonates. Paired DBS of heel-prick blood were collected 4-8 days after birth from 106 of these neonates, the majority exclusively breastfed. Methanol extracts of DBS with deuterium-labeled internal standards were derivatized before analysis by ESI-MS/MS. Most of the analytes were measured using a full-scan method. The levels of the major long-chain acylcarnitines, palmitoylcarnitine, stearoylcarnitine, and oleoylcarnitine, increased by 27, 12, and 109%, respectively, in the first week of life. Free carnitine and acetylcarnitine had a modest increase: 8 and 11%, respectively. Propionylcarnitine presented a different behavior, decreasing 9% during the period. The correlations between birth weight or gestational age and the concentrations of the analytes in DBS were weak (r ≤ 0.20) or nonsignificant. Adaptation to breast milk as the sole source of nutrients can explain the increase of these metabolites along the early neonatal period. Acylcarnitine profiling in CB should have a role in the early detection of metabolic disorders in high-risk neonates. PMID:22488223

  17. Analysis of acylcarnitine profiles in umbilical cord blood and during the early neonatal period by electrospray ionization tandem mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Vieira Neto, E. [Serviço de Genética Médica, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil); Laboratório Diagnósticos Laboratoriais Especializados, Rio de Janeiro, RJ (Brazil); Fonseca, A.A.; Almeida, R.F. [Laboratório Diagnósticos Laboratoriais Especializados, Rio de Janeiro, RJ (Brazil); Figueiredo, M.P.; Porto, M.A.S. [Maternidade Escola, Rio de Janeiro, RJ (Brazil); Ribeiro, M.G. [Serviço de Genética Médica, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ (Brazil)

    2012-04-13

    Acylcarnitine profiling by electrospray ionization tandem mass spectrometry (ESI-MS/MS) is a potent tool for the diagnosis and screening of fatty acid oxidation and organic acid disorders. Few studies have analyzed free carnitine and acylcarnitines in dried blood spots (DBS) of umbilical cord blood (CB) and the postnatal changes in the concentrations of these analytes. We have investigated these metabolites in healthy exclusively breastfed neonates and examined possible effects of birth weight and gestational age. DBS of CB were collected from 162 adequate for gestational age neonates. Paired DBS of heel-prick blood were collected 4-8 days after birth from 106 of these neonates, the majority exclusively breastfed. Methanol extracts of DBS with deuterium-labeled internal standards were derivatized before analysis by ESI-MS/MS. Most of the analytes were measured using a full-scan method. The levels of the major long-chain acylcarnitines, palmitoylcarnitine, stearoylcarnitine, and oleoylcarnitine, increased by 27, 12, and 109%, respectively, in the first week of life. Free carnitine and acetylcarnitine had a modest increase: 8 and 11%, respectively. Propionylcarnitine presented a different behavior, decreasing 9% during the period. The correlations between birth weight or gestational age and the concentrations of the analytes in DBS were weak (r ≤ 0.20) or nonsignificant. Adaptation to breast milk as the sole source of nutrients can explain the increase of these metabolites along the early neonatal period. Acylcarnitine profiling in CB should have a role in the early detection of metabolic disorders in high-risk neonates.

  18. Analysis of acylcarnitine profiles in umbilical cord blood and during the early neonatal period by electrospray ionization tandem mass spectrometry

    Directory of Open Access Journals (Sweden)

    E. Vieira Neto

    2012-06-01

    Full Text Available Acylcarnitine profiling by electrospray ionization tandem mass spectrometry (ESI-MS/MS is a potent tool for the diagnosis and screening of fatty acid oxidation and organic acid disorders. Few studies have analyzed free carnitine and acylcarnitines in dried blood spots (DBS of umbilical cord blood (CB and the postnatal changes in the concentrations of these analytes. We have investigated these metabolites in healthy exclusively breastfed neonates and examined possible effects of birth weight and gestational age. DBS of CB were collected from 162 adequate for gestational age neonates. Paired DBS of heel-prick blood were collected 4-8 days after birth from 106 of these neonates, the majority exclusively breastfed. Methanol extracts of DBS with deuterium-labeled internal standards were derivatized before analysis by ESI-MS/MS. Most of the analytes were measured using a full-scan method. The levels of the major long-chain acylcarnitines, palmitoylcarnitine, stearoylcarnitine, and oleoylcarnitine, increased by 27, 12, and 109%, respectively, in the first week of life. Free carnitine and acetylcarnitine had a modest increase: 8 and 11%, respectively. Propionylcarnitine presented a different behavior, decreasing 9% during the period. The correlations between birth weight or gestational age and the concentrations of the analytes in DBS were weak (r £ 0.20 or nonsignificant. Adaptation to breast milk as the sole source of nutrients can explain the increase of these metabolites along the early neonatal period. Acylcarnitine profiling in CB should have a role in the early detection of metabolic disorders in high-risk neonates.

  19. Determinants of resumption of vaginal intercourse in puerperium period in Ogbomoso: consideration for early use of contraceptives

    Directory of Open Access Journals (Sweden)

    Kola M. Owonikoko

    2014-08-01

    Full Text Available Background: Early postpartum period for mothers is characterized with high demand for neonatal care, adjusting to sudden withdrawal of hormones of pregnancy and dealing with sexual desires of the husband. The study aimed at determines the timing, factors influencing postpartum resumption of vaginal intercourse and the contraceptive usage. Methods: Women in puerperium were interviewed with structured questionnaire on their socio-demographic status, obstetric history, sexual activities, contraception usage and reason for sexual abstinence. Results: About 40% (143 of participants had resumed vaginal intercourse within puerperium with mean resumption period of 3.2 +/- 1.8 weeks. Only 12% (48 of them used modern contraceptive. Educational status (P <0.001; occupation (P <0.001; educational status of the husband (P <0.001; occupation of the husband (P <0.001; parity (P <0.05; husband's income (P <0.05 and use of modern contraception (P <0.001 showed significant statistical difference between the women who had resumed vaginal sexual intercourse and those who have not. Logistic regression showed that educational status of the participants (OR = 0.48, CI = 0.246-0.938; P = 0.032 and parity (OR = 0.34, CI = 0.196-0.591; P = 0.001 were the most significant factors associated with early resumption of vaginal intercourse. One hundred and eighty-five (72% of women who were yet to resume coitus, did so because of fear of pregnancy. Conclusions: Significant number of women resumed vaginal intercourse during the puerperium despite low contraception usage. There is need to initiate a contraception method before discharge home following delivery. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1061-1066

  20. Postoperative magnetic resonance imaging characterization of slings for female stress urinary incontinence.

    LENUS (Irish Health Repository)

    Giri, Subhasis K

    2012-01-31

    PURPOSE: The aim was to characterize different types of slings such as autologous rectus fascia (ARF), porcine dermis (PD) and tension-free vaginal tape (TVT) in the early postoperative period with regard to its visibility and location by using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Between October 2003 and June 2007, total of 60 patients underwent MRI after a sling procedure. Thirty-six patients had ARF slings. Twelve patients had a PD sling and 12 had a TVT. All patients had pelvic MRI 6-8 hr postoperatively. Six patients in the ARF sling group had both preoperative and postoperative images at 6 hr and 3 months. MRI images were analyzed with regard to visibility and location. All data were collected prospectively. RESULTS: ARF slings were clearly visible in both T1W and T2W images. ARF appeared as low signal intensity area with surrounding high signal intensity due to fat attached to the rectus fascia in the MRI images obtained 6 hr after the procedure. Although the fatty component of the sling was diminished but was still visible on MRI scan 3 months postoperatively. On the other hand PD and TVT sling materials were not visible by MRI. Most of the ARF slings were located just below the bladder neck. CONCLUSIONS: The ARF sling is easily identifiable on MRI in the early postoperative period primarily because of the fat attached to the autologous rectus fascia. However, depiction of the PD and TVT slings in the early postoperative period is very poor.

  1. Influence of early enteral nutrition on nutritional status, immunity and body composition in postoperative elderly gastric cancer patients%早期肠内营养对老年胃癌术后患者营养免疫及人体成分的影响

    Institute of Scientific and Technical Information of China (English)

    王凤; 王庆华; 陈强谱

    2011-01-01

    目的 探讨早期肠内营养(EEN)对老年胃癌患者术后营养、免疫和人体成分的影响.方法 将360例老年胃癌患者分为EEN组和肠外营养(PN)组各180例.EEN组术后20~24 h开始行EEN;PN组术后1d经周围静脉或中心静脉开始PN.术前、术后1d、7d检测营养指标、免疫和人体成分指标测量.结果 两组患者术后营养、免疫指标及人体成分指标值均有降低,但EEN组术后下降程度显著小于PN组(均P<0.05),并发症发生率低于PN组.结论 老年胃癌患者术后EEN支持能有效改善营养状况、免疫功能和人体成分的变化,减少术后并发症的发生,有利于促进患者康复.%Objective To study the effect of early enteral nutrition on nutritional status, immunity and body composition in elderly patients with gastric cancer after operations. Methods A total of 360 patients with gastric cancer after operation were equally randomized into two groups receiving either parenteral nutrition (PN group) on the first postoperative day or early enteral nutrition (EN group) in 20-hour to 24-hour postoperative period. The parameters of nutritional status, immunity and body composition were measured before operation and on the first and seventh postoperative days. Results The values of parameters of nutritional status, immunity and body composition decreased after operation in both groups, with the fluctuations of parameters in the EN group being smaller than the PN group (P<0. 05 for all). The incidence of complications in the EN group was lower than the PN group. Conclusion Early enteral nutrition can improve nutritional status, immune function and body composition in elderly patients with gastric cancer after operations, reduce complications, and promote patients recovery.

  2. Early Prognostic Factors for the Progress of Preeclampsia – Our Experience in the Period 2010-2011

    Directory of Open Access Journals (Sweden)

    Mariya Angelova Angelova

    2016-08-01

    Full Text Available AIM: To determine the prognostic value of the low Pregnancy-associated plasma protein A (PAPP-A levels in the early stages of pregnancy (11–13 weeks GA independently and i