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1.
Clinical effect of total thyroidectomy combined with radioactive iodine in thyroid cancer treatment.
Yin, X, Li, Z, Zhang, Z, Song, L, Wang, X
Pakistan journal of pharmaceutical sciences. 2018;(4(Special)):1675-1678
Abstract
Aim of this research work is to observe and analyze the clinical effect of total thyroidectomy combined with radioactive iodine in thyroid cancer treatment. The 120 thyroid cancer patients treated in our hospital were enrolled as study subjects and assigned to study group (treated with total thyroidectomy and radioactive iodine) and reference group (treated with conventional total thyroidectomy). The overall treatment efficacy was compared between the two groups. Comparison of overall treatment efficacy of the two groups showed that the study group has superior results to the reference group (P<0.05). Comparison of incidence of recurrent laryngeal nerve injury in the two groups revealed no significant differences, P>0.05. However, in life quality assessment, the study group was significantly superior to the reference group in terms of physiological function, psychological function, social function, and overall life quality scores, P<0.05. Total thyroidectomy combined with radioactive iodine can well improve the overall treatment efficiency and enable patients to have higher quality of life at the same time.
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2.
Clinical observation of the efficacy of low-molecular-weight heparin calcium in prophylaxis of the deep venous thrombosis following the gynecological tumor surgery.
Wei, N, Qi, Y, Yang, H, Guo, L
Pakistan journal of pharmaceutical sciences. 2018;(6(Special)):2835-2839
Abstract
Present study is conducted to investigate the efficacy and safety of application of low-molecular-weight heparin calcium in the prophylaxis of deep venous thrombosis (DVT) following the laparoscopic surgery for gynecological tumors, so as to provide reference for the selection of anti-coagulant procedure in clinical practice. A total of 180 patients who underwent the laparoscopic surgery for the gynecological tumors in this hospital between January 2015 and December 2017 were enrolled in this study, and according to the anti-coagulant procedure, they were divided into two groups, i.e. the control group and the observation group, with 90 patients in each group. In the control group, 90 patients were free from the anti-coagulant agent or drugs affecting the coagulant functions, while those in the observation group received the subcutaneous injection of low-molecular-weight heparin calcium for consecutive 5 days. Then we compared the serological indicators, prothrombin time (PT), cross-section diameter of the lower limb, hemodynamic indicator and the incidence rate of complications. Following postoperative 5 days, the levels of fibrinogen and D-dimer in the observation group were (2.66±0.72) g/L and (0.61±0.17) μg/mL, significantly lower than those in the control group, and the differences had statistical significance (t=4.667, P=0.019; t=3.967, P= 0.029). At 3 d and 5 d after operation, PTs in the observation group were (13.74±3.92) s and (13.84±3.13) s, also superior to the control group (t=3.031, P=0.042; t=3.553, P =0.034). In the observation group, the cross-section diameter of lower limb and blood flow rate were (20.22±3.51) cm and (0.93±0.17) m/s, respectively, which were better than the control group, and the difference had statistical significance (t=4.412, P=0.021; t =4.724, P=0.019). In the observation group, the incidence rate of complications was only 3.33%, significantly lower than 10.00% in the control group (c2 =6.158, P=0.004). The application of the low-molecular-weight heparin calcium for anti-coagulation in the prophylaxis of the DVT following the laparoscopic surgery of gynecological tumor can better ameliorate the hemodynamics of patients, and prevent the formation of DVT.
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Evaluation of a Trial of a Desufflation Technique to Decrease the Rate of Postoperative Pneumoperitoneum after Percutaneous Endoscopic Gastrostomy.
Allen, AI, Vaughan, J, Cauthen, A, Long, E
The American surgeon. 2017;(9):e398-e399
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Characterization of Standard Urine Properties in Noncomplicated Orthotopic Ileal Neobladders: A Prospective Controlled Study.
El-Assmy, A, Mahmoud, O, Kamal, M, Soliman, W, Ashamallah, A, El-Wakeel, N, Abol-Enein, H
Urology. 2016;:80-84
Abstract
OBJECTIVE To characterize the standard physical, chemical, and microscopic characteristics of urine in patients with noncomplicated orthotopic ileal neobladders. MATERIALS AND METHODS This is a prospective study that included 100 male patients who underwent radical cystectomy and ileal neobladder between 1993 and 2013. All included patients were in a good health and having satisfactory function of the reservoirs with normal upper tract with a minimum 1-year postoperative follow-up. We excluded patients with oncological failure, those with diversion-related complications, those who were maintained on clean intermittent catheterization, or those who have symptoms of urinary tract infection. Patients with medical diseases that may affect urine properties (eg, diabetes mellitus) or receiving special medications (eg, diuretics, alkali therapy, or antibiotics) were also excluded. The patients were subjected to urine analysis, blood chemistry, pH, and blood gases; the results were compared to a control group of 40 normal male volunteers. RESULTS Urine analysis in diverted patients showed higher urine pH than in control group but it is still acidic. Pyuria, proteinuria, hematuria, and positive culture were significantly higher in diverted patients. The chemical analysis showed lower urinary calcium, phosphorus, and creatinine contents in diverted patients than in the control group. Serum creatinine was significantly higher in diverted patients, whereas blood pH and bicarbonate were lower, but these values are within normal. CONCLUSION Urine from uncomplicated orthotopic ileal reservoirs is acidic. Pyuria, proteinuria, minor degrees of microscopic hematuria, and positive nitrite reaction are normal findings. We also have normal findings for lower urinary calcium, phosphorus, and creatinine contents in patients.
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5.
[Clinical observation of early enteral nutrition support for post-laryngectomy patients].
Fu, W, Liu, J, Huang, Y, Li, W
Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery. 2015;(6):535-7
Abstract
OBJECTIVE To compare the postoperative nutritional status and the incidence of postoperative infection between post-laryngectomy patients with early eternal nutrition and those with normal liquid diet. METHOD The observational group were given eternal nutrition while the control group were given normal liquid diet. Nutrition indicators (total protein, albumin, globulin, prealbumin, hemoglobin, body weight) and immune parameters (lymphocyte count) were measured at preoperative day 3 and postoperative day 3, 7 and 10. The incidence of complications and postoperative hospitalization days were compared and analyzed. RESULT Compared with the control group, the total protein, albumin and globulin of observational group had no statistic significance at postoperative day 3, the total protein, albumin,globulin of observational group were higher (P<0. 05) at postoperative day 7 and 10: The body weight had no satisic significance at postoperative day 3 and 7, while observation group higher at postoperative day 10, while the hemoglobin of observational group had no statistic significance: The prealbumin and lymphocyte count had no statistic significance. The postoperative hospitalization days of the observational group was lower (P<0. 05) than the control group. CONCLUSION The early eternal nutrition for post-laryngectomy patients are conducive to improve of nutritional status and reduce the rate of post-operative complications.
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6.
Gum chewing enhances early recovery of bowel function following transperitoneal abdominal aortic surgery.
Takagi, K, Teshima, H, Arinaga, K, Yoshikawa, K, Hori, H, Kashikie, H, Nakamura, K
Surgery today. 2012;(8):759-64
Abstract
BACKGROUND AND PURPOSE Postoperative bowel dysfunction is still a major unsolved problem following transperitoneal abdominal aortic surgery. We conducted this study to establish if gum chewing during the postoperative period promotes recovery of bowel function following abdominal aortic surgery. METHODS The subjects were 44 patients who underwent elective abdominal aortic surgery. The patients were allocated to a control group (n = 21), who received standard postoperative care, or a "gum group" (n = 23), who received standard postoperative care and were also given gum to chew three times a day from postoperative day (POD) 0-5. RESULTS The patient characteristics, intraoperative, and postoperative care were equivalent in both groups. Flatus was passed on POD 1.49 in the gum group and on POD 2.35 in the control group (P = .0004) and the time to oral intake was 3.09 days in the gum group and 3.86 days in the control group (P = .023). The number of days to full mobilization in the hospital room was 3.35 versus 5.59 for the gum and control groups, respectively (P < .0001). CONCLUSIONS Gum chewing enhances early recovery of bowel function following transperitoneal abdominal aortic surgery. Moreover, it is a physiologically sound, safe, and an inexpensive part of the postoperative care.
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7.
Early postoperative complications in patients with Crohn's disease given and not given preoperative total parenteral nutrition.
Jacobson, S
Scandinavian journal of gastroenterology. 2012;(2):170-7
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Abstract
OBJECTIVE The effect of preoperative total parenteral nutrition (TPN) on the rate of early (within 30 days) postoperative complications in patients with moderate to severe Crohn's disease (CD) was examined. MATERIAL AND METHODS A series of 15 consecutive patients with CD (mean CD activity index score, 270) given preoperative TPN for 18-90 days (mean, 46 days) and undergoing bowel resection and primary anastomosis was compared with matching controls (105 patients) consecutively selected from all CD patients operated in Stockholm County during a preceding 20-year period without preoperative TPN. RESULTS During the preoperative TPN, all the patients studied displayed clinical remission of CD as reflected in improvement in their general well-being, relief of abdominal pain, and abatement of fever and diarrhea. There was no significant early postoperative complication in the TPN-treated group, whereas there were 29 patients with early postoperative complications in the control group, which means a significantly higher rate of postoperative complications when preoperative TPN was not provided. During the preoperative TPN, some crucial variables increased such as the body weight, the serum concentrations of albumin and triiodothyronine reflecting improved nutritional state, whereas the serum concentration of haptoglobin and the white cell count decreased reflecting decreased inflammatory activity. CONCLUSIONS This study shows that preoperative TPN for at least 18 days may be recommended to be given to patients with moderate to severe CD until clinical remission is achieved in order to minimize the risk of early postoperative complications.
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A multi-modal intervention in management of left ventricular assist device outpatients: dietary counselling, controlled exercise and psychosocial support.
Kugler, C, Malehsa, D, Schrader, E, Tegtbur, U, Guetzlaff, E, Haverich, A, Strueber, M
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2012;(6):1026-32
Abstract
OBJECTIVE Newer generation left ventricular assist devices (LVADs) are established for long-term support. The aim of this multi-modal intervention was to improve the body weight, exercise tolerance and psychosocial status in outpatients on long-term LVAD support. METHODS Seventy patients participated in this non-randomized intervention study [intervention group (IGr) n = 34; control group (CGr) n = 36] over 18 months (T1-T4); the baseline sample characteristics showed no differences between groups. Dietary counselling and weight management intervention was performed by a dietician based on a specific algorithm. Physical reconditioning followed a home ergometry protocol and was supplemented by psychosocial counselling. The outcomes were measured based on the body mass index (BMI), cardiopulmonary exercise testing and self-report [hospital anxiety and depression scale (HADS), SF-36]. RESULTS The intervention showed a strong positive effect on nutrition and weight management [95% confidence interval (CI): -0.71-0.69; effect size (ES): 0.907; P = 0.02)], resulting in the normal BMI (kg/m(2)) values in the IGr (T1: 24.0 ± 0.6; T4: 24.5 ± 1.1; P = 0.35) compared with a significant BMI increase in the CGr (T1: 23.8 ± 0.6; T4: 29.7 ± 0.8; P = 0.05). Significant differences appeared regarding exercise tolerance (VO(2)max/% predicted) in favour of IGr patients (IGr: 69 ± 2.9; CGr 62 ± 3.7; P = 0.04). This increase was reflected by patients' self-reporting based on the SF-36 physical component score (IGr: P = 0.04; CGr: P = 0.54). SF-36 psychosocial component scores showed no changes for both groups. However, CGr showed a tendency for increased anxiety scores relative to their counterparts (IGr: 4.95 ± 0.4; CGr: 6.6 ± 0.9; P = 0.03). CONCLUSIONS IGr patients showed a strong benefit from a multi-modal intervention, including dietary counselling, controlled exercise and psychosocial support. Dietary counselling holds potential to prevent obesity in this patient population.
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Optimal period for the prophylactic administration of neutrophil elastase inhibitor for patients with esophageal cancer undergoing esophagectomy.
Iwahashi, M, Nakamori, M, Nakamura, M, Ojima, T, Naka, T, Yamaue, H
World journal of surgery. 2011;(7):1573-9
Abstract
BACKGROUND The present study was designed to determine the optimal period for the prophylactic administration of the neutrophil elastase inhibitor, Sivelestat, in patients undergoing transthoracic esophagectomy. Sivelestat is reported to be effective in patients who undergo esophagectomy by providing an increased oxygenation ability and suppressing the serum inflammatory cytokines in the postoperative period. However, the optimal period for the prophylactic administration of Sivelestat remains to be elucidated. METHODS The 30 patients who underwent esophagectomy for thoracic esophageal cancer were enrolled in one of two groups. The initial 15 patients were assigned to group A and received intravenous infusion of Sivelestat sodium hydrate until postoperative day (POD) 2, and the subsequent 15 patients were assigned to group B and received Sivelestat until POD 5. Historical controls without Sivelestat administration were used. The postoperative courses and serum inflammatory cytokines were evaluated. RESULTS Sivelestat improved oxygenation in the postoperative period; however, there were no differences between the two groups in terms of duration of mechanical ventilation, intensive care unit stay, systemic inflammatory response syndrome, and postoperative change of oxygenation. In addition, there were no differences in the postoperative changes in the serum interleukin (IL)-6 and high mobility group box chromosomal protein 1. Although the serum IL-8 on POD 3 was lower in group B than in group A, the neutrophil elastase showed no difference between these groups. None of the patients in either group suffered respiratory complications. CONCLUSIONS The two-day administration of Sivelestat initiated immediately after intrathoracic manipulation was found to be sufficient for prophylactic use to prevent pulmonary complications by suppressing hypercytokinemia after esophagectomy.
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Local tissue water assessed by tissue dielectric constant: anatomical site and depth dependence in women prior to breast cancer treatment-related surgery.
Mayrovitz, HN, Davey, S, Shapiro, E
Clinical physiology and functional imaging. 2008;(5):337-42
Abstract
Assessing local tissue water using tissue dielectric constant (TDC) values is useful to evaluate oedema/lymphoedema features and their change. Knowledge of anatomical site and tissue depth dependence of TDC values could extend this method's utility. Our goal was to compare TDC values obtained at anatomically paired sites and to investigate their depth dependence. In 22 women (12 awaiting surgery for breast cancer and 10 cancer-free control subjects), four sites (mid-forearm, mid-biceps, axilla and lateral thorax) on both body sides were measured with a 2.5-mm sampling depth probe. Also, at forearm, four different probes with sampling depths of 0.5, 1.5, 2.5 and 5 mm were used. TDC values range between 1 for zero water to 78.5 for 100% water. Site comparisons showed TDC values (mean+/-SD) to be largest at axilla (36.4+/-8.9), least at biceps (21.6+/-3.5) and not different between forearm and thorax (24.3+/-4.0 versus 24.8+/-5.0). Group comparisons showed slightly greater values in patients at forearm and biceps (P<0.05) but no group difference at other sites. Dominant-non-dominant side comparisons showed no significant difference in paired-TDC values in either group at any site. Forearm TDC values decreased with increasing depth from 36.4+/-4.8 at 0.5 mm to a minimum of 21.4+/-3.9 at 5.0 mm, with a sharp decline between 1.5 and 2.5 mm. The composite findings suggest that TDC measurements have the necessary features for usefully assessing oedema/lymphoedema and its change on limbs and at body sites not routinely amenable to assessment by other techniques. The depth dependence feature provides additional flexibility to investigate oedematous or lymphoedematous conditions.