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1.
Int J Biol Macromol ; 272(Pt 2): 132941, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38848842

ABSTRACT

Research in creating 3D structures mirroring the extracellular matrix (ECM) with accurate environmental cues holds paramount significance in biological applications.Biomaterials that replicate ECM properties-mechanical, physicochemical, and biological-emerge as pivotal tools in mimicking ECM behavior.Incorporating synthetic and natural biomaterials is widely used to produce scaffolds suitable for the intended organs.Polycaprolactone (PCL), a synthetic biomaterial, boasts commendable mechanical properties, albeit with relatively modest biological attributes due to its hydrophobic nature.Chitosan (CTS) exhibits strong biological traits but lacks mechanical resilience for complex tissue regeneration.Notably, both PCL and CTS have demonstrated their application in tissue engineering for diverse types of tissues.Their combination across varying PCL:CTS ratios has increased the likelihood of fabricating scaffolds to address defects in sturdy and pliable tissues.This comprehensive analysis aspires to accentuate their distinct attributes within tissue engineering across different organs.The central focus resides in the role of PCL:CTS-based scaffolds, elucidating their contribution to the evolution of advanced functional 3D frameworks tailored for tissue engineering across diverse organs.Moreover, this discourse delves into the considerations pertinent to each organ.


Subject(s)
Biocompatible Materials , Chitosan , Polyesters , Tissue Engineering , Tissue Scaffolds , Chitosan/chemistry , Tissue Engineering/methods , Polyesters/chemistry , Tissue Scaffolds/chemistry , Humans , Biocompatible Materials/chemistry , Animals , Extracellular Matrix/chemistry
2.
Am J Clin Hypn ; 64(3): 248-262, 2022 Jan.
Article in English | MEDLINE | ID: mdl-35007479

ABSTRACT

The aim of the present study is to investigate the effectiveness of Cognitive Developmental Hypnotherapy (CDH) on Differentiation of Self, Meaning in Life and Marital Conflicts in married women. The method is quasi-experimental pretest and posttest with a control group. The statistical population of this study includes married women who came to FUM Counseling and Psychological Services Center to receive psychological services. The sample of this study included 40 married women who were selected by targeted sampling method and randomly assigned to two experimental and control groups. Participants in the pretest and posttest study answered the Differentiation of Self Inventory, the Marital Conflicts questionnaire by Sanaei, and the Meaning in Life questionnaire. The research data were analyzed using ANCOVA and MANCOVA with SPSS-21. The findings showed CDH led to an increase in Differentiation of Self and Meaning in life, and a reduction in Marital Conflicts in women. Accordingly, CDH through using techniques such as induction and empowerment of the Ego is effective in marital conflicts of married women. Therefore, using it as a means to improve the quality of married women's lives is recommended.


Subject(s)
Family Conflict , Hypnosis , Cognition , Female , Humans , Marriage , Surveys and Questionnaires
3.
Med J Islam Repub Iran ; 36: 170, 2022.
Article in English | MEDLINE | ID: mdl-37159756

ABSTRACT

Background: Lower respiratory tract infections, chronic obstructive pulmonary disease (COPD), tuberculosis, and lung cancer are among the leading 10 causes of death worldwide. The Board of Respiratory Diseases Research Network (RDRN), a sub-committee of the Iranian Non-Communicable Diseases Committee (INCDC) is particularly concerned that there should be a coordinated National strategy to address the burden caused by chronic respiratory diseases. Methods: Iranian Ministry of Health and Medical Education (MoHME) has decided to give promotion to the establishment of research networks and use them as the milestones for research management, particularly for the national health priorities. Results: National Service Framework (NSF), which was designed for Chronic Respiratory Diseases, is one of the main outcomes of the chronic respiratory diseases sub-committee of INCDC. The main seven strategies were represented by the Steering Committee in 2010 for a period of 10 years. Successful development and implementation of our goals provide the CRDs sub-committee of INCDC with the opportunity to develop a paradigm to prevent chronic respiratory diseases. Conclusion: A stronger national plan for controlling chronic respiratory diseases will ensure stronger advocacy to support respiratory health at national, sub-national, and regional levels.

4.
Anesth Pain Med ; 10(2): e100517, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32754433

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is one of the serious complications of cardiac surgery. It is worsened when accompanied by low cardiac output syndrome. OBJECTIVES: In this study, we compared kidney function based on the KDIGO criteria in isolated on-pump and off-pump coronary artery bypass graft (CABG) surgery. METHODS: In this cohort study, 52 patients with LCOS were enrolled after on-pump (28 patients) and off-pump (24 patients) CABG. In the first six hours after ICU entrance, blood samples were taken for serum creatinine based on routine. For determining AKI after surgery, we used the KDIGO criteria as a primary endpoint. Also, some clinical parameters were recorded before, during, and after surgery. The data were analyzed by SPSS software, version 24, using paired and independent t-test, ANOVA, and Pearson correlation test and non-parametric tests such as Mann-Whitney and Kruskal-Wallis tests at a significance level of P < 0.05. RESULTS: There was no significant difference in age (P = 0.3) and gender (P = 0.57) between the two groups. Among cardiac disease risk factors, only hypertension (P = 0.02) had a significant difference between the two groups, but AKI in patients with hypertension did not show a significant difference (P = 0.09). In paraclinical parameters, serum creatinine showed a significant difference before and after surgery in on-pump (P < 0.001) and off-pump (P = 0.007) groups. Also, this parameter had a significant difference at 6 h, 12 h, 24 h, and 48 h after surgery between the on-pump and on-pump groups. The AKI incidence showed a significant difference between the two groups (P < 0.001). CONCLUSIONS: The incidence of AKI was more in on-pump patients than in off-pump patients. Also, a significant difference was observed between their clinical parameters. Thus, to improve the patients' clinical outcomes and lower the health costs, we suggest that patients with a high risk of LCOS be followed up after CABG, especially on-pump CABG.

5.
J Cell Physiol ; 235(6): 5141-5145, 2020 06.
Article in English | MEDLINE | ID: mdl-31721206

ABSTRACT

There is a growing body of data reporting the association of genetic alterations in chromosome 9P21 with the risk of developing cancer. In the current study, we studied the association of a genetic variant in CDKN2A/B, rs1333049, with the risk of developing breast cancer. A total of 339 participants with and without breast cancer entered to the study. Genotyping was done by the TaqMan real-time polymerase chain reaction (RT-PCR) method and gene expression analysis was ran by RT-PCR. Our data showed that the minor allele homozygote in the total population was 10%, whereas for heterozygote was 38%. The dominant genetic model demonstrated that individuals with breast cancer had advanced TNM classification. Moreover, the logistic regression revealed that individuals who had CC/CG genotypes might have an enhanced risk of developing breast cancer when compared to the holders of GG genotype (e.g., OR = 2.8; 95% CI,1.4-5.4; p = .001), after regulated for confounders; age and body mass index. Furthermore, our analysis showed that the CDKN2A/B gene was downregulated in patients (p < .001). We showed a meaningful relationship of CDKN2A/B with the risk of breast cancer, cancer, showing the importance of studies in great sample size and several centers for studying the value of the marker as a risk classification in the management of patients with breast cancer.


Subject(s)
Breast Neoplasms/genetics , Cyclin-Dependent Kinase Inhibitor p15/genetics , Cyclin-Dependent Kinase Inhibitor p16/genetics , Genetic Predisposition to Disease , Adult , Aged , Alleles , Breast Neoplasms/epidemiology , Cyclin B/genetics , Female , Gene Expression Regulation, Neoplastic/genetics , Genotype , Humans , Middle Aged , Polymorphism, Single Nucleotide/genetics , Risk Factors
6.
Anesth Pain Med ; 9(4): e89277, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31754607

ABSTRACT

Anterior cruciate ligament (ACL) reconstruction is an extremely common surgery in sports medicine and orthopedic surgery. This surgery requires creating tunnels in bones (femur and tibia), which is often associated with severe pain and thus general or neuraxial anesthesia should be applied to mitigate pain and anxiety. This paper follows our previous case report of hypnoanesthesia in hand surgery, discussing the application of hypnosis as a non-pharmacologic intervention for controlling intraoperative and postoperative pain and anxiety, which can contribute to postoperative recovery of patients with ACL surgery. According to the results of this study, it seems better to teach hypnosis as a pain control protocol to anesthesia residents and pain service staff. Also, hypnosis can be considered an anxiety reduction strategy in perioperative phases and also useful for postoperative pain management.

7.
Mater Sci Eng C Mater Biol Appl ; 103: 109743, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31349530

ABSTRACT

Bacterial infection, wide inflammation, and osteoporosis are the most common factors in the failure of orthopedic implants. The present study aims to design an orthopedic implant based on Titania nanotubes (TiO2-NTs) which not only have a high biocompatibility but also are characterized by anti-bacterial property. In order to improve the osseointegration of the TiO2-NTs structures (110-120 nm in diameter, 40 µm in length), they were used to coat the Titania implant by electrochemical anodizing. Vancomycin, which is soluble in water, was loaded as a main clinical drug to control intensive infections caused by positive gram bacteria. For the first time, Silk Fibroin (SF) Nanofibers coating was used to control drug release by the implementation of electrospinning on the TiO2-NTs surface. In order to investigate the anti-bacterial activities, S. aureus bacterium culture test was used. The cell culture of MG63 was conducted for both coated and non-coated samples of TiO2-NTs. The results showed that the SF Nanofibers coating not only controls the drug being freely released from TiO2-NTs but also effects adhesion and development of osteoblast cells. In this regard, this coating inhibits biofilm formation and development, as well as bacteria colonization due to anti-bacterial drug release. Therefore, this system can be considered as a promising alternative for orthopedic implants, preventing bone infection, osteomyelitis, bone cancer treatment, and other orthopedic diseases.


Subject(s)
Anti-Bacterial Agents/pharmacokinetics , Fibroins/chemistry , Nanotubes/chemistry , Osteoblasts/drug effects , Titanium/chemistry , Anti-Bacterial Agents/administration & dosage , Cell Adhesion/drug effects , Cell Line , Cell Proliferation/drug effects , Coated Materials, Biocompatible/chemistry , Coated Materials, Biocompatible/pharmacokinetics , Drug Carriers/chemistry , Drug Carriers/pharmacokinetics , Drug Liberation , Humans , Microscopy, Atomic Force , Osteoblasts/cytology , Staphylococcus aureus/drug effects , Surface Properties , Vancomycin/administration & dosage , Vancomycin/pharmacokinetics
8.
Anesth Pain Med ; 8(3): e67859, 2018 Jun.
Article in English | MEDLINE | ID: mdl-30214883

ABSTRACT

BACKGROUND: Hypnosis is a psychological method used for treatment of different types of disorders and illnesses. This technique is also used in surgical interventions. Many studies proved the efficacy of hypnosis in medical treatment. However, the mechanism of hypnosis is unclear for scientists. To find out if the peripheral nervous system has a role in hypnotic anesthesia, we aimed to investigate the effect of hypnotic anesthesia on nerve conduction velocity (NCV). METHODS: In this study, healthy volunteers with high hypnotizability entered the study. First, The NCV test was performed in both hands of participants and then they all underwent hypnosis. Hypnotic anesthesia was induced in the right hand of all subjects followed by painful stimuli in their hand by vascular clasping. Then, the NCV test was repeated in both hands again. Data were analyzed by SPSS version16. RESULTS: The group study consisted of 13 (65%) women and 7 (35%) men with their age ranging between 14 to 52 years. According to the results, the mean values of sensory latency, and NCV changed from 3.225 ms and 54.355 m/s before hypnotic anesthesia to 3.32 ms and 55.3 m/s after hypnotic anesthesia in right hand, respectively. Results showed that there was a significant difference between data before and after hypnotic induction (P < 0.001). The covariance test also indicated a significant difference between the data obtained from both hands (P < 0.001). CONCLUSIONS: In contrast to our hypothesis, the NCV test showed an increase after the hypnotic anesthesia. However, increase in NCV did not lead to experience pain after the painful stimuli. It seems that central nervous system should be involved in this process.

9.
Electron Physician ; 9(10): 5578-5587, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29238500

ABSTRACT

BACKGROUND: Arrhythmia occurring during and after surgery is one of the major complications in open-heart surgery. Dexmedetomidine is an intravenous alpha-2 agonist and very specific short-acting drug to protect the various organs against ischemic injuries and blood reflow. However, the effect of dexmedetomidine for preventing intraoperative heart arrhythmias has not been recognized. OBJECTIVE: This study aimed to determine the effect of dexmedetomidine on the incidence rate of heart arrhythmias and anesthetic required in off-pump coronary artery bypass surgery. METHODS: This randomized clinical trial was conducted on patients who were candidates for off-pump coronary artery bypass referring to Imam Reza Hospital of Mashhad, Iran, from July 2016 through January 2017. The patients were randomly assigned to two groups of intervention (infusion of 0.5 mcg/kg/h dexmedetomidine together with induction followed by infusion of 0.5 mcg/kg/h by the end of the surgery) or control (saline infusion). Mean arterial pressure (MAP) and heart rate (HR) were measured before induction, during surgery operation and ICU admission. Data were analyzed by SPSS version 18 using Chi Square and independent-samples t-test. RESULTS: A total of 76 patients with a mean age of 59.8 ± 8.2 years (in two groups of 38) were studied. The two groups had no statistically significant difference in terms of background variables. The MAP and HR values before induction, during surgery and ICU admission were significantly higher in the control group than in the intervention group (p=0.001). Out of the studied arrhythmias, the values of PAC (55.2% vs. 15.7%), PVC (81.5% vs. 21.0%), AF (26.3% vs. 7.8%), VTAC (21.0% vs. 2.6%) were significantly lower in dexmedetomidine group (p=0.001). CONCLUSION: It seems that dexmedetomidine administration during induction and surgery can cause significant reduction in most of the common arrhythmias in off-pump coronary bypass surgery. The use of dexmedetomidine maintains MAP and HR at significantly lower values, and changes compared to the control group as well as reduces the need for anesthetic compounds. TRIAL REGISTRATION: The present study has been registered at the Iranian Registry of Clinical Trials (www.IRCT.IR) with a code of IRCT2016072413159N9 before starting the study. FOUNDING: This study was fully sponsored by the Research Deputy at Mashhad University of Medical Sciences, Iran (grant number 941413).

10.
Anesth Pain Med ; 7(2): e44628, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28824863

ABSTRACT

There are many acceptable approaches ranging from light to moderate intravenous sedation or analgesic drugs that are used to provide pain control in dilatation and curettage. We report the use of hypnosis as a nonpharmacologic approach to control pain in this manner.

11.
Anesth Pain Med ; 6(3): e35803, 2016 Jun.
Article in English | MEDLINE | ID: mdl-27642580

ABSTRACT

BACKGROUND: Central venous cannulation is a current and important procedure used in the operating room and intensive care unit. Some studies have shown that the application of ultrasound-guided cannulation can improve the success rate of surgery, save time, reduce the number of required needlesticks, and mitigate many complications compared to anatomical landmark-guided cannulation. OBJECTIVES: The aim of the present study was to draw a comparison between central venous cannulation of the internal jugular vein using ultrasound-guided and anatomical landmark-guided techniques. PATIENTS AND METHODS: A total of 321 patients scheduled for cardiac surgery in the surgical ward of a general hospital were randomly treated with central venous cannulation using either anatomical landmarks (150 patients) or ultrasound guidance (170 patients). The demographic data of patients, the success rate of cannulation, the execution time, and the number of attempts for successful cannulation as well as the complications were recorded and subjected to statistical analysis. RESULTS: The success rate of cannulation was 98.7% in the anatomical landmark-guided group and 99.4% in the ultrasound-guided group. The average operation times were 46.05 and 45.46 seconds in the anatomical landmark and ultrasound-guided groups, respectively. The two groups were not significantly different in terms of the success rates of treatment, the number of attempts, the time required for successful cannulation, or the prevalence of complications (P > 0.05) other than carotid artery puncture (P = 0.04). CONCLUSIONS: In our conditions, the use of an anatomical landmark-guided procedure was the preferred treatment method due to limited resources and a lack of adequate training.

12.
Int J Clin Exp Hypn ; 64(3): 365-72, 2016.
Article in English | MEDLINE | ID: mdl-27267679

ABSTRACT

Little attention has been paid to the effectiveness of hypnosis in improving the results of surgery in Iran. One hundred and twenty patients scheduled for laparoscopic cholecystectomy were randomly divided into either control (standard care) or experimental (hypnosis) groups. Prior to surgery and again after surgery, abdominal pain, nausea, and vomiting were assessed. The results suggest that hypnosis could effectively reduce pain after laparoscopic cholecystectomy and significantly reduce hospitalization time.


Subject(s)
Cholecystectomy, Laparoscopic , Hypnosis, Anesthetic , Pain, Postoperative/therapy , Adult , Cholecystectomy, Laparoscopic/methods , Female , Humans , Hypnosis, Anesthetic/methods , Length of Stay , Male , Middle Aged , Pain Management/methods
13.
Anesth Pain Med ; 5(5): e27695, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26587402

ABSTRACT

BACKGROUND: As pain and nausea is usually associated with endoscopy procedure, its management is important to alleviate patients' anxious in this regard. OBJECTIVES: The present study aimed to examine the effectiveness of conversational hypnosis in reducing anxiety and endoscopy-related complications as well as its role in increasing the satisfaction of patients exposed to endoscopic procedures. PATIENTS AND METHODS: The participants of upper GI endoscopy procedure were randomly assigned to an experiment group (with conversational hypnosis intervention, n = 93) and a control group (n = 47). The participants' hemodynamic indexes (HR, blood pressure, pulse oximetry), anxiety, satisfaction level, and complications resulted from the procedure were monitored and included in the self-administered questionnaire. RESULTS: The results indicated that the participants in experiment group had a significant reduction of anxiety in the posttest. The adverse side effects such as vomiting, nausea, and hiccups in the experimental group was less than the control group, though this difference was not significant (P = 0.54). CONCLUSIONS: The results suggested that conversational hypnosis technique could reduce anxiety as well as the sedation process in invasive procedures such as endoscopy.

14.
Case Rep Crit Care ; 2015: 513617, 2015.
Article in English | MEDLINE | ID: mdl-26435855

ABSTRACT

Nonsurgical bleeding after complex thoracic aortic procedures (such as aortic dissection and aortic aneurysm) is a great challenge for cardiac surgeons because of severe coagulopathy, exsanguinous bleeding, and inevitable death. Temporary mediastinal packing (with sponge) in such cases is the only life-saving technique with good result in most cases. Herein, we presented three cases with acute aortic dissection with intractable bleeding that was successfully managed with mediastinal packing.

15.
Indian J Surg ; 77(Suppl 2): 543-5, 2015 Dec.
Article in English | MEDLINE | ID: mdl-26730061

ABSTRACT

Surgery has dramatically improved survival of infants with esophageal atresia. However, early and late complications of these surgeries affect the future life of this population. A probable step toward minimizing such complications is through modifying the technique of surgery. We evaluated two groups of esophageal atresia undergoing surgery with two different techniques including preservation and ligation of the Azygos vein and compared early complications, duration of surgery, and hospital and neonatal intensive care unit (NICU) stay between them. A total number of 24 patients with mean age of 24 to 48 h, who were diagnosed with esophageal atresia, were included in the study. All cases were randomly allocated in two groups: group A (case group) in which patients underwent surgery with preservation of the Azygos vein and group B (control group) in which patients underwent the former surgical method with ligation of the Azygos vein. Incidence of early complications, duration of surgery, and NICU and hospital stay were compared between the two groups. None of the complications occurred in either group. Duration of surgery, NICU stay, and hospital stay were not statistically significant between the groups. Preserving the Azygos vein during esophageal atresia surgery is probably a good modification of the classic technique.

16.
Anesth Pain Med ; 4(4): e18545, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25337473

ABSTRACT

BACKGROUND: Cognitive disorder is a fluctuating cognitive destruction and a common problem for hospitalized patients, which leads to loss of consciousness. It is usually accompanied with increased mortality, prolonged hospital stay, and decreased rehabilitation. OBJECTIVES: The purpose of this study was to determine risk factors associated with cognitive disorder after open-heart surgery. PATIENTS AND METHODS: In total, 171 patients who had undergone off-pump open-heart surgery and lacked any history of psychiatric disorders were enrolled. Samples were selected according to a purposive sampling method. The Mini-Mental State Examination questionnaire was used for these patients to assess the incidence of cognitive disorder 24 hours after the operation in ICU and to compare creatinine level, ESR, extubation time and patients' age in the two groups, one with postoperative cognitive disorder and the other without it. Independent T-test was used to compare the two groups regarding any history of diseases such as diabetes, hypertension and hyperlipidemia, Chi square test was used. RESULTS: In total, 75% of patients had postoperative cognitive disorder. There was a significant association between the history of high blood pressure, C-reactive protein and preoperative creatinine levels in both cognitive disorder and control groups. CONCLUSIONS: Given the significant prevalence of postoperative cognitive disorder and significant associatio n between the history of high blood pressure, C-reactive protein and preoperative creatinine and cognitive disorder, detection of patient's clinical symptoms may improve diagnosis, treatment and prevention of this disorder.

17.
Iran J Psychiatry Behav Sci ; 8(2): 90-6, 2014.
Article in English | MEDLINE | ID: mdl-25053963

ABSTRACT

OBJECTIVE: The goal of this study was to evaluate preoperative anxiety and its predisposing factors in a group of adult patients who were candidate for any kind of heart surgery. METHODS: We evaluated preoperative anxiety in 300 patients undergoing heart surgery whose ages ranged between 18-65 years. Relationship of probable demographic factors like gender, educational level, marital status, number of children, family support, opium addiction, occupational status, and left ventricular ejection fraction (LVEF) with anxiety level of the patients were evaluated. To determine anxiety, the State-Trait Anxiety Inventory (STAI) was completed by the subjects. RESULTS: Descriptive anxiety levels showed that mean of state and trait anxiety of our studied patients were in moderate scaling. Correlation between state and trait anxiety was more prominent in females (r = 0.80) than in males (r = 0.70) (p < 0.001). Distribution of males and females was significantly different (p = 0.048). All the patients had significantly different underlying diseases (p = 0.018), opioid addiction (yes/no) was significantly different in all of the patients (p < 0.001), while family support (yes/no) was not significantly different in all of the patients (p = 0.453). There were significant differences between mean of preoperative anxiety at different LVEF values of any EF level (p < 0.001, F = 6.47); those who had LVEF of more than 50% had significantly lower mean anxiety scores. CONCLUSION: Preoperative psychiatric consultation should be focused more on women and patients with higher EF. Moreover, physical activity strength may be effective on reducing preoperative anxiety.

18.
Anesth Pain Med ; 4(1): e16049, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24660160

ABSTRACT

INTRODUCTION: Central venous catheter placement is a routine procedure for the management of critically ill patients; however, it is important to ensure its proper placement. A central venous catheter malposition may cause various complications, some of which can be fatal. CASE PRESENTATION: We report an unexpected malposition of a catheter in the left internal jugular vein, where it entered into the left internal mammary vein. CONCLUSIONS: We think one of the influential factors for leading a guidewire and catheter into a nominated vein may be the left sided bevel of the needle at the time of internal jugular vein needle and catheter insertion. We were required to continue going towards the subclavian vein and accidentally turned into the left internal mammary vein.

19.
Anesth Pain Med ; 4(4): e18514, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25632379

ABSTRACT

BACKGROUND: The relation between elevated blood lactate level and mortality and morbidity rates after coronary bypass surgery is a proven subject. One of the factors that seems to affect directly the blood lactate level is the storage duration of packed red blood cells. OBJECTIVES: This study aimed to evaluate the effect of storage duration of transfused blood on serum lactate during cardiac surgery and up to 24 hours after that in the ICU. PATIENTS AND METHODS: In a cross-sectional study, 228 patients referred to three hospitals of Mashhad University of Medical Sciences for open cardiac surgery, was enrolled using systematic random sampling method. Immediately after accessing arterial line, the first sample of arterial blood gas (ABG) was obtained. For evaluation of lactate levels, the next samples were obtained at the end of surgery and after 24 hours of staying ICU. RESULTS: Among 5 factors which affected lactate level during surgery, diabetes and higher ejection fraction (EF) reduced changes of the lactate level. On the other hand, the number of infused blood units, duration of on-pump time, and the mean storage duration of blood units were associated with elevated serum lactate during surgery. A significant relationship was found between blood storage duration and serum lactate levels 24 hours after surgery. CONCLUSIONS: Comparing the serum lactate level before operation and 24 hours after the operation showed that the number of received blood units had a significant effect on serum lactate. We found no significant effect for blood storage duration; however, the number of given blood units was more significant.

20.
Anesth Pain Med ; 4(4): e18280, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25599024

ABSTRACT

INTRODUCTION: Lung isolation is a common technique used in thoracic surgery to prevent spillage to unaffected lung and to provide a better view for the surgeon. CASE PRESENTATION: A 41-year-old woman with a history of pharyngo-laryngo-oesophagectomy (PLO) and tracheostomy was a candidate for thoracic duct ligation because of chylothorax. Since the patient had tracheostmy stomal stenosis, two cuffed tracheal tubes (internal diameter = 4.5 mm) were used; one tube was placed in the right bronchus and the other tube in the left one by fiberoptic laryngoscopy in 10 minutes. Right lung was collapsed during the surgery for 3.5 hours with a slight decrease in oxygenation (SpO2 = 91%-93%) and with no evident hemodynamic change. Potential trauma from a double-lumen tube and a bronchial blocker as well as inaccessibility to a univent tube prevented us to use these standard methods in this case. CONCLUSIONS: This report presents a new method for lung isolation in specific cases and in the absence of certain equipment.

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