Effects of Preoperative Oral Carbohydrate Loading on Neutrophil/Lymphocyte Ratio and Postoperative Complications following Colorectal Cancer Surgery: A Randomized Controlled Study.

INTRODUCTION: Preoperative carbohydrate oral (CHO) drinks attenuate the surgical stress response; however, the effects of CHO supplementation on the neutrophil-to-lymphocyte ratio (NLR) as an inflammatory and immunology-based predictor remain unclear. This study evaluated the effects of preoperative CHO loading on NLR values and complications following open colorectal surgery compared with a conventional fasting protocol. METHODS: Sixty eligible participants having planned for routine and open colorectal cancer surgery from May 2020 to January 2022 were prospectively and randomly allocated to either the control (fasting) group, whose members discontinued oral intake beginning the midnight before surgery, or the intervention (CHO) group, whose members consumed a CHO solution the night before surgery and 2 h prior to anaesthesia. NLR was assessed at 06:00 h before surgery (baseline) and at 06:00 h on postoperative days 1, 3, and 5. The incidence and severity of postoperative complications were assessed by Clavien-Dindo Classification up to postoperative day 30. All data were analysed using descriptive statistics. RESULTS: Postoperative NLR and delta NLR values were significantly higher in controls (p < 0.001; p < 0.001). Control group participants also demonstrated grade IV (n = 5; 16.7%, p < 0.01) and grade V (n = 1; 3.3%, p < 0.313) postoperative complications. There were no major postoperative complications in the CHO group. CONCLUSION: Preoperative CHO consumption reduced postoperative NLR values and the incidence and severity of postoperative complications following open colorectal surgery, compared with a preoperative fasting protocol. Preoperative carbohydrate loading may improve recovery following colorectal cancer surgery.

Influence of clonidine on the chemodynamic stability and stress response in the course of surgery on general anesthesia.

UNLABELLED: This work provides results of therapeutic efficacy testing and clonidine toleration in moderating of perioperative tachicardia and hypertension, as well as reducing the needs for anaestathic drugs, thus providing better patients' cardiovascular stability. MATERIAL AND METHODS: The study involved 60 patients, that were subdued to elective non-cardiosurgical operations in general anaesthesia. One half of the patients was administred the Clonidine, 0.2 microg/kg/min in solution, while the other half served as a control group. RESULTS: of the study it was evident that the Clonidine group had considerably less stress response, which was shown through variaton of cortisol levels during operation, glicemy levels and vital parameters. There was a statisticly significant difference (p < 0.001) in cortisol serum levels and glicemy beetwen these two groups. Complications during anesthesia were fewer in the Clonidine group, and the consumption of anesthetic drugs was also lower. CONCLUSION: Clonidine effects were favourable during anaesthesia.

Antimicrobial susceptibility of bacteria isolated from inpatients and outpatients urine samples.

Antibacterial resistance is generally regarded as a public health problem, not only in local terms, but also worldwide. The objective of this research work would be to analyze inpatient's and outpatient's antimicrobial resistance to a set of various agents. The patients have been medically treated in the region of Ze-do canton since 2005 until today. Total number of 164 patients was included in our research. Regarding the place of medical treatment, our patients were divided into two groups: a total number of 111 inpatients and a total number of 53 outpatients. 56 of them were males, rest females. Apart from the sex affiliation, the exeminees were divided into two groups, depending on the presence of the Foley's catheter (inpatients only). We were obliged to determine the antimicrobial sensitivity of the isolated bacteria to certain representatives of antimicrobials. During the conducted testing, it has been proved that the phenomenon of polymicrobic infection found while testing inpatients is in immediate correlation to the catheterization. The inpatients urine tract infections are duo to the most commonest agent--E. coli that is in terms of percentage 38.5%, followed closely by Proteus spp.--19.3%, Pseudomonas spp.--13.6%, Klebsiella pneumoniae, 12.5%, et cetera. The outpatients urine tract infections are due to the most common agent E. coli percentage is 81%, as well as to Klebsiella pneumoniae, 19.0%. During the testing of the antimicrobial sensitivity of the isolated bacteria, it has been determined that the urine tract infection agents (starting with E. coli and Klebsiella pneumoniae) isolated from the inpatients urine specimens are proved to have higher resistance to tested antimicrobials compared to the same agents isolated from the outpatient's urine specimens. The differences refferring to resistance rates are ranging from 0.2% (trimetoprim-sulphametoksazol) to 25.9% (cephazolin) for E. coli, since the difference refferring resistance to Klebsiella pneumoniae is more noticeable and ranging from 0.8% (amoxicillin- clavulonic acid) to 65.0% (gentamicin).

[Seroconversion makers of hepatitis in the dialysis center at the General Hospital in Tesanj (10 years' experience)]. / Serokonverzija markera hepatitisa u dijaliznom centru Opce bolnice u Tesnju (desetogodisnje iskustvo).

In the paper are stated the data of ten years observations of the occurrences of the seroconversion in the patients at the dyalized treatment in the dyalized center in Tesanj. The seropositiveness to B and C hepatitis was 16.5%, what is the usual percentage for the local population. The serconversion to the positive C hepatitis occurred in one patient, and that in the first year of the dialyzed treatment, what remains the possibility the dyalizis began in the period of the incubation. The separation of the seropositive apparati for the dyalisisi from the rest made the sufficient organizational measure by the dyalized center.