ABSTRACT
Purpose@#The purpose of this study was to evaluate risk factors of pressure injuries in patients after neurosurgery. @*Methods@#A retrospective case-control study was conducted using 273 patients undergoing neurosurgery admitted to a general hospital from 2015 to 2021. Data were collected from September 1 to 30, 2021. The data were analyzed using the SPSS/WIN 26.0 program. @*Results@#Risk factors significantly influencing the occurrence of pressure injuries in the patients undergoing neurosurgery were hypertension (OR=3.12, p=.024), postoperative hypoalbuminemia (OR=0.30, p=.028), and prolonged operative duration (OR=1.00, p=.001). The regression model explained 86.0% of the variance of the outcome variable. @*Conclusion@#In order to prevent surgery-related pressure injuries in patients undergoing neurosurgery, thorough blood pressure management, avoidance of hypoalbuminemia, and preventive nursing intervention considering operative duration are required.
ABSTRACT
BACKGROUND AND OBJECTIVES: Ischemic injury is the most common and important cause of myocardial damage. Over past decades, a number of studies have identified a protective mechanism known as ischemic preconditioning, which can block or delay cell death from ischemic injury. Protein kinase C (PKC), especially theepsilonisoform has been proposed as a key factor in the signaling pathway of ischemic preconditioning. However, whether PKCepsilon expression in cardiomyocytes can offer such protection from acute ischemia has not been explored. MATERIALS AND METHODS: To demonstrate a direct effect of PKCepsilon expression, a lentiviral vector system was established. Using the lentiviral vector, PKCepsilon was introduced to neonatal rat ventricular myocytes (NRVM) cultured under ischemic conditions, and also to adult rat myocardium subject to left coronary artery ligation. RESULTS: Compared to control, PKCepsilon expression in cultured NRVM under ischemia resulted in preserved cell density and morphology, and a reduction in cell death (77.6+/-12.8% vs 58.1+/-7.2%, p<0.05). In adult rats, the infarcted area after coronary artery ligation was markedly reduced in myocardium injected with PKCepsilon vector compared to control (11.4+/-5.3% vs 20.5+/-11.3%, p<0.01). CONCLUSION: These results provide direct evidence that PKCepsilon is a central player in protection against cell death from acute ischemia.
Subject(s)
Adult , Animals , Humans , Rats , Cell Count , Cell Death , Coronary Vessels , Ischemia , Ischemic Preconditioning , Lentivirus , Ligation , Muscle Cells , Myocardium , Myocytes, Cardiac , Protein Kinase C , Protein Kinase C-epsilon , Protein KinasesABSTRACT
PURPOSE: To evaluate the efficacy of intravitreal injections of triamcinolone acetonide (TA) at the end of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: We analyzed 50 patients (52 eyes) who underwent PPV for treatment of PDR and received an intravitreal injection of 4 mg TA at the end of surgery. The study group (Group 1) was compared with a control group (Group 2, 46 patients, 51 eyes) (matched with the study group for preoperative parameters) who underwent PPV without intravitreal injection of TA. RESULTS: In Group 1, the grade of anterior chamber cells at postoperative days 1 and 7 was significantly lower than that of Group 2. There was slight mean IOP elevation in Group 1 at postoperative weeks 2, 3, 4, and 8, but it was not statistically significant. Forty-four eyes (84.6%) from Group 1 showed better visual acuity at the last follow-up than at the preoperative visit (Group 1). Thirty-two eyes (62.8%) from Group 2 showed better visual acuity at the last follow-up than at the preoperative visit. The degree of visual improvement was 0.75 logMAR in Group 1 and 0.59 logMAR in Group 2. Vitreous hemorrhage occurred in 9 eyes (17.3%) from Group 1 and in 19 eyes (37.3%) from Group 2. However, the differences in the occurrence of neovascularization in iris and neovascular glaucoma between two groups were not statistically significant. CONCLUSIONS: Intravitreal TA injection at the end of PPV seems to be effective in improving visual acuity and decreasing early postoperative inflammation and the frequency of vitreous hemorrhage.
Subject(s)
Humans , Anterior Chamber , Diabetic Retinopathy , Follow-Up Studies , Glaucoma, Neovascular , Inflammation , Intravitreal Injections , Iris , Triamcinolone Acetonide , Triamcinolone , Visual Acuity , Vitrectomy , Vitreous HemorrhageABSTRACT
PURPOSE: To evaluate the levels of vascular endothelial growth factor (VEGF) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and to find any correlation between clinical and fundus findings, grade of PDR, post-operative complications and surgical outcomes. METHODS: Using ELISA, the vitreous concentration of VEGF was measured in 74 patients with PDR who had undergone vitrectomy and in 13 control patients. RESULTS: The pre-operative levels of VEGFin the vitreous of the PDR patients was significantly increased compared with those of the control and with the post-operative levels. The pre-operative VEGF concentration in the vitreous of the PDR patients was correlated with the duration of diabetes and the severity of proteinuria, but not with the type of diabetes, level of HbA1c, hypertension and BUN/creatinine levels. The severity of PDR was also correlated with pre-operative VEGF levels, especially in NVD, NVE and NVI, but was not correlated with vitreous hemorrhage and fibrous proliferation elsewhere. There was negative correlation with the severity of retinal detachments. The vitreous levels of VEGF in PDR were significantly lower in those who had received previous laser photocoagulation than in those who did not. The VEGF levels were also significantly elevated in patients who developed NVI or NVG in the post-operative period. The changes of visual acuity after vitrectomy in the PDR patients were not correlated with vitreous levels of VEGF. CONCLUSIONS: These results show that VEGF is related to intraocular angiogenesis, progression of PDR and post-operative complications such as NVI or NVG, and that panretinal photocoagulation could prevent the progression of PDR.