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1.
Nurs Open ; 8(3): 1157-1167, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482657

RESUMO

AIM: To investigate the effect of a supportive program on coping strategies and stress in women with breast cancer. DESIGN: A randomized, two-armed, controlled trial. METHODS: Sixty women were randomly allocated to intervention group (N = 30) and control group (N = 30). The interventions were held in six sessions, weekly from August 2018-March 2019 It was consisting of education regarding breast cancer; progressive muscle relaxation; stress management; emotional coping; and problem-solving strategies. RESULTS: At baseline, there was no difference between the two groups regarding the mean score of coping strategies and stress. Supportive program group participants experienced a significantly higher increase on their problem-oriented coping strategies score in comparison with the control group. At the same time, scores in emotion-oriented coping strategies and stress decreased significantly in the intervention group compared with the control group. Result of this study can be used to develop relevant interventions targeting coping strategies to reduce stress among women with breast cancer.


Assuntos
Neoplasias da Mama , Adaptação Psicológica , Treinamento Autógeno , Neoplasias da Mama/terapia , Feminino , Humanos , Resolução de Problemas , Estresse Psicológico
2.
Nurs Open ; 8(4): 1527-1537, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34102022

RESUMO

AIM: To investigate clinical trials affecting anxiety, stress and fear of childbirth in fathers. DESIGN: A systematic literature search was conducted based on Cochrane Collaboration statement recommendation and Preferred Reporting Items for Systematic reviews and Meta-Analyses checklist. METHODS: With assistance of Medical Subject Headings, keywords were employed to search for relevant trials. Articles published between November 2000-November 2019 were searched in five electronic databases including PubMed, Web of Science, Google Scholar, Scopus and Cochrane as well as Iranian databases. The risk of bias was assessed by Cochrane Risk of Bias Scale. RESULTS: A total of eight studies met the inclusion criteria. Interventions were classified into four categories including pre-natal education, music therapy, massage therapy and relaxation training. The results showed that there is no evidence of a best intervention, but it showed that non-pharmacological interventions can decrease anxiety, stress and fear of childbirth and increase the positive experience of childbirth in the expectant fathers.


Assuntos
Pai , Parto , Ansiedade/terapia , Medo , Feminino , Humanos , Irã (Geográfico) , Masculino , Gravidez
3.
Burns ; 46(8): 1942-1951, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32873443

RESUMO

BACKGROUND: Burn-specific pain anxiety and sleep disorders are common factors in burned patients that affect wound healing process, as well as the severity of burn pain. This study aimed to investigate the effect of foot reflexology massage on burn-specific pain anxiety and sleep condition of patients hospitalized in the burn ICU. METHOD: In this randomized controlled clinical trial, 52 patients were assigned by permuted block randomization 1:1 to the intervention (n=26) and control (n=26) groups. The intervention group received 20min of foot reflexology massage during 3 days on their third, fourth and fifth days of hospitalization and 15min before changing wound dressings. Patients in the control group merely received routine care. The Burn-Specific Pain Anxiety Scale (BSPAS) was completed for three consecutive days before and after changing wound dressings, and St. Mary's Hospital Sleep Questionnaire (SMHSQ) was filled out for four consecutive days before changing wound dressings for patients in both groups. The data were analyzed by IBM SPSS 16 software, Chicago, independent t, Chi-square, Friedman, Mann-Whitney and Wilcoxon tests. FINDINGS: We found no significant difference between pain-anxiety in the two groups before the intervention. The trend of different days in each groups were compared with Friedman test and showed that pain anxiety (p<0.001), sleep latency (p<0.001), duration of the last day's sleep (p<0.001) and satisfaction of the last night sleep (p<0.001) had a significant difference. In addition, Mann-Whitney test results showed that there were significant differences between the two groups at different times in terms of the above variables (p<0.05). The effect size was=0.82 for pain anxiety between group after the intervention. CONCLUSION: Based on the results, foot reflexology massage can effectively reduce pain anxiety levels and improve sleep quality and quantity of patients with burn injuries; therefore, this non- pharmacological therapeutic method is recommended to be used in the burn ICUs. (Clinical trial's registration code: IRCT20110906007494N27).

4.
Med J Islam Repub Iran ; 32: 20, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30159271

RESUMO

Background: The use of positive end-expiratory pressure (PEEP) can have an important role as one of the ways to prevent and treat atelectasis, but it seems that there is still no consensus about its beneficial level. The aim of this study was to determine the effect of different levels of PEEP on the incidence of atelectasis after heart surgery. Methods: This is a double-blind randomized controlled trial that was adopted from a research project recorded in the Iranian Registry of Clinical Trials. This paper is the result of a research project undertaken at Fatemeh Zahra Hospital (Mazandaran Heart Center) in 2015. 180 patients underwent open heart surgery were selected and were divided randomly into three groups: control, PEEP=8, and PEEP=10 (60 in each group). The patients in the two PEEP8 and PEEP10 intervention groups separately received 8 cm H2O and 10 cm H2O PEEP, respectively, 30 minutes after admission to the ICU for 4 hours and then received 5 cm H2O PEEP until extubation. Atelectasis was examined two hours after the extubation and on the third day after surgery. Results: The incidence rates of atelectasis two hours after extubation on the first day of surgery were 22 (36.7%), 20 (33.3%) and 10 (16.7%) patients in the control, PEEP8 and PEEP10 groups, respectively. The differences were statistically significant among the three groups (p=0.035). The incidence rates of atelectasis on the third day after surgery were 39 (65%), 36 (60%) and 21 (35%) patients in the control, PEEP8 and PEEP10 groups, respectively. The differences were also statistically significant among the three groups (p=0.003). Conclusion: The use of 10 cm H2O PEEP can lead to a reduction in the incidence of atelectasis, intubation time at the ICU and length of ICU and hospital stay. Given that this level of PEEP is effective, this method is recommended to be used in postoperative care of patients.

5.
Complement Ther Clin Pract ; 29: 53-57, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29122269

RESUMO

OBJECTIVE: This study was intended to examine the effect of selective soothing music on fistula puncture-related pain in hemodialysis patients. MATERIALS AND METHODS: This is a randomized clinical trial in which 114 participants were selected from two hemodialysis units by means of a non-random, convenience sampling method. The participants were then allocated in three groups of music (N = 38), headphone (N = 38), and control (N = 38). The fistula puncture-related pain was measured 1 min after venipuncture procedure in all three groups. The music group listened to their self-selected and preferred music 6 min before needle insertion into a fistula until the end of procedure. The headphone group wore a headphone alone without listening to music 6 min before needle insertion into a fistula until the end of procedure. The control group did not receive any intervention from the research team during needle insertion into a fistula. The pain intensity was measured immediately after the intervention in all three groups. RESULTS: This study showed a significant difference between the music and control groups, and the music and headphone groups in terms of the mean pain score after the intervention. However, the analysis did not indicate any significant difference between the headphone and control groups with regard to the mean pain score after the intervention. CONCLUSION: It is concluded that music can be used effectively for pain related to needle insertion into a fistula in hemodialysis patients. Future research should investigate the comparative effects of pharmacological and non-pharmacological interventions on fistula puncture-related pain.


Assuntos
Fístula , Musicoterapia , Música , Manejo da Dor/métodos , Dor/etiologia , Punções/efeitos adversos , Diálise Renal/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas , Medição da Dor
6.
PLoS Negl Trop Dis ; 11(8): e0005835, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28820882

RESUMO

Characteristics of mosquito larval habitats are important in determining whether they can survive and successfully complete their developmental stages. Therefore, data on the ecological factors affecting mosquito density and abundance especially the physicochemical properties of water of their breeding sites, can possibly be helpful in implementing larval management programs. Mosquito larvae were collected using a standard 350 ml dipper from fixed habitats including: artificial pool, river edge, creek and etc, in 30 villages of 16 counties from May-December 2014. Water samples were collected during larval collection and temperature (°C), acidity (pH), turbidity (NTU), electrical conductivity (µS/cm), alkalinity (mg/l CaCO3), total hardness (mg/l), nitrate (mg/l), chloride (mg/l), phosphate (mg/l) and sulphate (mg/l) were measured using standard methods. Spearman correlation coefficient, Kruskal-Wallis test of nonparametric analysis, Chi-square (χ2) analysis, regression analysis and C8 interspecific correlation coefficient were used for data analysis. A total of 7,566 mosquito larvae belonging to 15 species representing three genera were collected from fixed larval breeding places. Culex pipiens was the dominant species except in four villages where An. maculipennis s.l. and Cx. torrentium were predominant. There was a significant positive correlation between the density of Cx. pipiens and electrical conductivity, alkalinity, total hardness and chloride, whereas no significant negative correlation was observed between physicochemical factors and larval density. The highest interspecific association of up to 0.596 was observed between An. maculipennis s.l/An. pseudopictus followed by up to 0.435 between An. maculipennis s.l/An. hyrcanus and An. hyrcanus/An. pseudopictus. The correlations observed between physicochemical factors and larval density, can possibly confirm the effect of these parameters on the breeding activities of mosquitoes, and may be indicative of the presence of certain mosquito fauna in a given region.


Assuntos
Culicidae/classificação , Culicidae/crescimento & desenvolvimento , Ecossistema , Larva/crescimento & desenvolvimento , Temperatura , Água , Animais , Ecologia , Irã (Geográfico) , Análise de Regressão , Manejo de Espécimes
7.
Drug Res (Stuttg) ; 67(9): 527-533, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28499311

RESUMO

Type I diabetes mellitus (T1DM) patients are at risk of osteoporosis and fracture due to the osteoblast and osteoclast malfunction. Osteopontin (OPN) as the major non-collagenous bone matrix protein is produced by osteoblasts and osteoclasts and involve in bone resorption, formation and remodeling. To evaluate the serum levels of OPN, bone mineral density (BMD) and correlation in patients with T1DM this study was designed. In this case-control study, 87 children with T1DM and 87 age/sex-matched healthy subjects were enrolled. Blood samples were tested for OPN levels by ELISA. Dual energy X-ray absorptiometry was used to measure BMD. The mean levels of BMD in patients was significantly lower than control group (p<0.0001). There was no significant difference between patients and healthy subjects regarding the levels of OPN. However, in patients with high levels of OPN (mean+1.5 standard deviation) the BMD was significantly lower than other patients (p<0.0001). Totally there was a negative correlation between serum levels of OPN and BMD in patients with T1DM (p<0.016). These results indicated that the BMD in T1DM is less than healthy children and elevated level of OPN in patients could be associated with low BMD. A linear negative correlation between serum OPN and total BMD of T1DM patients compared to control group was noticed in this study indicating that the amount of serum OPN could be effective on BMD and a good predicting factor for osteoporosis in patients.


Assuntos
Densidade Óssea/fisiologia , Diabetes Mellitus Tipo 1/complicações , Osteopontina/sangue , Absorciometria de Fóton , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/sangue , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Masculino , Adulto Jovem
8.
Glob J Health Sci ; 7(7 Spec No): 97-105, 2015 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-26153209

RESUMO

INTRODUCTION: As the most common postoperative pulmonary complications after cardiac surgery, atelectasis is one of the most important and serious early postoperative complications and one of the most important causes of prolonged hospitalization, increased costs, and mortality rise. Therefore, the present study was aimed at specifying the frequency of atelectasis in patients following coronary artery bypass graft and its associated factors in Mazandaran Heart Center in 2013-2014. MATERIALS: The present investigation was a descriptive cross-sectional study in which sequential sampling was used. It was conducted on 375 patients whose coronary artery bypass graft had been performed by the same surgeon and anesthesiologist. For data collection, first the patients' demographic variables and the information of their surgery were retrieved through their profiles, direct observation, patient inquiry, and the collected data were recorded in the data collection forms. Then, atelectasis was measured before the surgery and on the first and second days after it by taking CXR whose results were checked by two radiologists who were not aware of the previous observations. Data were analyzed through t-test, Pearson test, and Chi-square test using SPSS 16.0. RESULTS: The results of the present study indicated that, 123 out of 375 patients (32.8%) were diagnosed with at least one type of tattletales during the first three days after the surgery. The mean age of the patients who were diagnosed with atelectasis was 62.9 and most of them were female. The results also showed that there was a significant relationship between postoperative frequency of atelectasis and the patients' pulmonary diseases and underlying diseases like diabetes and hyperlipidemia, smoking and alcohol use before the surgery, and transfusion of 4 units of packed red blood cells during the surgery (p<0.05). CONCLUSION: Atelectasis is the most common postoperative complication which emerges more in patients with pulmonary and underlying diseases than other patients.


Assuntos
Ponte de Artéria Coronária/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Atelectasia Pulmonar/epidemiologia , Idoso , Índice de Massa Corporal , Comorbidade , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos
9.
Med Arch ; 69(2): 72-6, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26005251

RESUMO

BACKGROUND AND AIM: As the most common postoperative pulmonary complication after cardiac surgery, atelectasis is one of the most important and serious early postoperative complications and one of the most important causes of prolonged hospitalization, increased costs, and mortality rise. Therefore, the present study was aimed at specifying the frequency of atelectasis in patients following coronary artery bypass graft and its associated factors in Mazandaran Heart Center in 2013-2014. MATERIALS AND METHODS: The present investigation was a descriptive cross-sectional study in which sequential sampling was used. It was conducted on 375 patients whose coronary artery bypass graft had been performed by the same surgeon and anesthesiologist. For data collection, first the patients' demographic variables and the information of their surgery were retrieved through their profiles, direct observation, patient inquiry, and the collected data were recorded in the data collection forms. Then, atelectasis was measured before the surgery and on the first and second days after it by taking CXR whose results were checked by two radiologists who were not aware of the previous observations. Data were analyzed through t-test, Pearson test, and Chi-square test using SPSS 16.0. RESULTS: The results of the present study indicated that, 123 out of 375 patients (32.8%) were diagnosed with at least one type of tattletales during the first three days after the surgery. The mean age of the patients who were diagnosed with atelectasis was 62.9±9 and most of them were female. The results also showed that there was a significant relationship between postoperative frequency of atelectasis and the patients' pulmonary diseases and underlying diseases like diabetes and hyperlipidemia, smoking and alcohol use before the surgery, and transfusion of 4 units of packed red blood cells during the surgery (p<0.05). CONCLUSION: Atelectasis is the most common postoperative complication which emerges more in patients with pulmonary and underlying diseases than other patients.


Assuntos
Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/mortalidade , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/mortalidade , Idoso , Isquemia Encefálica/complicações , Isquemia Encefálica/mortalidade , Feminino , Humanos , Hemorragias Intracranianas/complicações , Hemorragias Intracranianas/mortalidade , Masculino , Pessoa de Meia-Idade , Taxa de Sobrevida
10.
J Pediatr Adolesc Gynecol ; 25(3): 208-12, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22578482

RESUMO

PURPOSE: Polycystic syndrome (PCOS) is associated with multiple metabolic abnormalities. Studies in the adolescent population are still limited and the results have been much different. The aim of this study was to investigate the association between PCOS, overweight, and metabolic syndrome in adolescents. METHODS: 30 PCOS adolescents were randomly selected from a PCOS population with NIH 1990 criteria and 71 adolescents from the normal adolescents. Anthropometric, hormonal and metabolic parameters were evaluated in four sub-groups including obese and non-obese PCOS and obese and non-obese normal adolescents. RESULTS: The prevalence of overweight and metabolic syndrome in adolescents with PCOS was 52% and 33.3% respectively vs 22.4% (P = 0.005) and 11.26% in control (normal) adolescents (P = 0.0001). Among all subjects, including obese and non-obese adolescents with or without PCOS, the prevalence of insulin resistance, hypercholesterolemia, central obesity, and metabolic syndrome was higher in obese PCOS with 61.5%, 46.2%, 53.8%, and 69.2%, respectively. CONCLUSIONS: Obesity and IR are important risk factors for metabolic syndrome in PCOS. Considering the long-term health risks, it is necessary to identify metabolic disorders in adolescents with PCOS as early as possible.


Assuntos
Síndrome Metabólica/etiologia , Sobrepeso/etiologia , Síndrome do Ovário Policístico/complicações , Adolescente , Estudos de Casos e Controles , Feminino , Humanos , Hipercolesterolemia/etiologia , Resistência à Insulina , Síndrome Metabólica/epidemiologia , Obesidade/epidemiologia , Obesidade/etiologia , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco
11.
Arab J Nephrol Transplant ; 5(1): 19-24, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22283862

RESUMO

INTRODUCTION: Delayed Graft Function (DGF) is a common complication of renal transplants and the long-term relation between DGF and survival of patients and grafts is not well established. METHODS: This is a historical cohort study of transplanted patients in Taleghani Hospital of Shahid Beheshti University in Iran between 1994 and 2010. Patients who required dialysis during the first week after transplantation were considered to have DGF. The patients' conditions were updated to determine existing graft function, graft loss or patients' death at one year and five years post transplantation in relation to the presence or absence of DGF. RESULTS: DGF complicated 67/385 transplants (17.4%). Causes included acute tubular necrosis (58.2%), accelerated rejection (29.9%), transplant renal artery thrombosis (9%) and renal vein thrombosis (3%). More kidneys in the DGF group were procured from cadaveric donors (6% versus 0.9%, P = 0.02). At hospital discharge, patients with DGF had significantly higher mean creatinine level (4.4 ± 2.8 versus 2.0 ± 1.7; P = 0.001) compared to other patients. They also had more early acute rejection episodes and more late acute rejection episodes (34.3% versus 2% and 16.4% versus 3%, respectively; P = 0.0001) compared to other patients. The proportion of functioning grafts was significantly lower in the DGF group at 1-year (53.7% versus 95.3%, P = 0.0001) and 5-years (22.4% versus 61.6%, P = 0.001) compared to patients without DGF. CONCLUSION: The DGF group had a significantly higher acute rejection rate and an increased risk of graft loss at one and five years.


Assuntos
Função Retardada do Enxerto/mortalidade , Rejeição de Enxerto/mortalidade , Falência Renal Crônica/mortalidade , Transplante de Rim/mortalidade , Complicações Pós-Operatórias/mortalidade , Adulto , Cadáver , Estudos de Coortes , Feminino , Sobrevivência de Enxerto , Humanos , Falência Renal Crônica/cirurgia , Transplante de Rim/métodos , Doadores Vivos/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante Homólogo , Adulto Jovem
12.
Pediatr Neonatol ; 52(3): 161-4, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21703559

RESUMO

BACKGROUND: Renal disease may accidentally be discovered during urinalysis. This study was conducted to examine the usefulness of dipstick urinalysis screening in healthy neonates for the diagnosis of underlying renal disease and to study the magnitude of abnormal urinalysis in apparently healthy neonates. METHODS: In this descriptive study, voided urine samples were obtained from 400 apparently healthy neonates and tested using urine dipstick. The reaction of dipstick strip was read visually by a trained nurse. In cases with an abnormal urine analysis, a second screen test was performed within a week, and for those with persistent abnormalities, complete diagnostic tests were done. RESULTS: On the first urinalysis, 375 (94%) subjects were normal and 25 (6%) had abnormalities: 23 had proteinuria (5.75%), one was blood positive (0.25%), and one was both protein and blood positive (0.25%). Male neonates had a higher proportion of proteinuria than female neonates (p=0.038). In the second examination, proteinuria was found in five (1.25%) neonates, but the proportion of other abnormalities did not change. In follow-up investigations, ureteropelvic junction obstruction and vesicoureteral reflux were recognized in two infants who had blood-positive or combined blood- and protein-positive results on their first tests. CONCLUSION: The findings of this study show that dipstick test during neonatal period could be used for early diagnosis of renal diseases.


Assuntos
Triagem Neonatal/métodos , Urinálise , Feminino , Humanos , Recém-Nascido , Masculino , Proteinúria/diagnóstico , Refluxo Vesicoureteral/diagnóstico
13.
Turk J Gastroenterol ; 21(2): 119-24, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20872323

RESUMO

BACKGROUND/AIMS: Due to the lack of interest in using early oral feeding and the need for a trial study in this regard, this study aimed to compare the outcome of early oral feeding and traditional oral feeding in patients with upper gastrointestinal surgery. METHODS: Fifty-two patients who underwent upper gastrointestinal surgery were randomly assigned into two groups in a consecutive manner as either the early oral feeding group or traditional oral feeding group. Tolerance of oral feeding, ileus, nausea and vomiting, post-operative stay, and complications were recorded. RESULTS: Tolerance of oral feeding for the two groups was 24 (92.3%) in the early oral feeding group and 21 (91.3%) in the traditional oral feeding group (p=0.89). The post-operative hospital stays were 5.62 and 8.04 days in the early oral feeding and traditional oral feeding groups, respectively (p<0.0001). There were significant differences between the two groups in terms of the time of the first gas passing/defecation, the post-operative hospital stays, starting time of oral feeding, and satisfaction regarding early nasogastric tube removal. CONCLUSIONS: The results of this study show that early oral feeding is a safer and more cost-effective procedure in upper gastrointestinal surgery.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Ingestão de Alimentos , Cuidados Pós-Operatórios , Adolescente , Adulto , Idoso , Nutrição Enteral , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Adulto Jovem
14.
J Pak Med Assoc ; 60(9): 714-8, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21381574

RESUMO

OBJECTIVES: To explore the preferences of women; once at the time of delivery and then three months later, in using contraceptive methods during post partum period. METHODS: A sample of 575 women who gave birth during July 2007 and February 2008 in Vali-Asre teaching hospital of Zanjan, were recruited and interviewed once after delivery and then three month later. The interview questions included demographic characteristic and questions assessing the tendency of mothers to use the contraceptives they preferred at time of delivery and three months later. RESULTS: According to 537 (93.4%) of interviewed mothers, they intended using at least one contraceptive after getting discharged from the hospital. This figure dropped to 438 (76.1%) three months after delivery. Women who expressed the desire to use minipill after delivery were 169 (29.3%). However this value rose to 187 (32.2%) three months later. The difference was not statistically significant. There was significant relationship between type of contraceptives used and women's age, number of children, place of residence and level of education three months following delivery. CONCLUSION: Results suggest that health care must focus extensively on giving necessary information and consultation to pregnant women also their partners to help to improve selection of most favourite and safe method of contraception.


Assuntos
Comportamento Contraceptivo , Anticoncepção/estatística & dados numéricos , Dispositivos Anticoncepcionais Femininos/estatística & dados numéricos , Serviços de Planejamento Familiar/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Estudos de Coortes , Escolaridade , Feminino , Inquéritos Epidemiológicos , Hospitais de Ensino , Humanos , Irã (Geográfico) , Período Pós-Parto/psicologia , Gravidez , População Rural , População Urbana , Adulto Jovem
15.
Asian J Surg ; 32(4): 234-9, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19892627

RESUMO

OBJECTIVE: The aim of this clinical trial was to evaluate the effectiveness of using lyophilised porcine skin (Xenoderm) compared with 1% silver sulfadiazine (SSD) in partial-thickness burns with regard to wound infection, length of hospital stay, number of dressings and doses of analgesics used (oral and injection). METHODS: A total of 78 burns patients were included in this randomised study; their burns were caused by scalds or flames. They had second degree burns and had a burn area of 1060% of total body surface area (TBSA). Thirty-seven patients were treated with daily washing, followed by topical application of SSD dressing (the SSD group) and 39 with a biological dressing, i.e. Xenoderm (the Xenoderm group). The differences were evaluated using unpaired Student's t-test, Mann-Whitney U test and Chi-square test. RESULTS: There were no significant differences between the two groups with respect to age, gender, TBSA, cause of burn, and thickness of the burn or burn site. But there were significant differences regarding degree of wound infection, length of hospital stay, number of used dressings and given doses of analgesics. CONCLUSION: Xenoderm seems to be more effective than SSD dressing in terms of pain control, degree of wound infection, used wound dressings and length of hospital stay for partial-thickness burns. Prospective randomised studies are now necessary to compare possible reductions in the use of split thickness skin grafts and re-epithelialisation times.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Curativos Biológicos , Queimaduras/terapia , Sulfadiazina de Prata/administração & dosagem , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
16.
Asia Pac J Clin Nutr ; 18(2): 217-25, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19713181

RESUMO

The purpose of this study was to determine the anthropometric index that best predicts common cardiovascular risk factors. A total of 2768 individuals (1310 men and 1458 women) aged 21-75 years with full relevant data from the Zanjan Healthy Heart Study (a prospective study in Zanjan and Abhar, two main cities of Zanjan Province, Iran) were recruited. Common cardiovascular risk factors (TG, TC, HDL-c, LDL-c, fast blood sugar, blood pressure), anthropometric indices (BMI, WC, WHR, WHtR) were measured using standard process, and their correlated classification was evaluated by partial correlation and Receiver Operator Characteristic (ROC) curve analysis. Area under curve (AUC) of WHtR was the largest for most (6 of 7) of the common cardiovascular risk factors in both men and women; followed by WC (4 of the 7 including ties) in men, while AUCs of three anthropometric indices (WC, BMI, WHR) were the same with the largest for 1 of 7 risk factors in women. These results show that the high prevalence of lipid profiles, as cardiovascular risk factors, need special attention, intervention and appropriate treatment. Consistence with other reports, WHtR is a better discriminator of cardiovascular risk factors compared with the other three indices (BMI, WC, and WHR). We determined its optimal cut-off point of 0.5 for both genders. However, due to differences in reported cut-off values across different ethnic groups, future research and longitudinal data is needed before reaching an internationally accepted simple and appropriate measure that could be effectively used in the clinical and epidemiological fields.


Assuntos
Antropometria , Doenças Cardiovasculares/epidemiologia , Adulto , Idoso , Pressão Sanguínea , Estatura , Índice de Massa Corporal , Colesterol/sangue , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Caracteres Sexuais , Triglicerídeos/sangue , População Urbana , Circunferência da Cintura , Relação Cintura-Quadril
17.
J Pak Med Assoc ; 59(7): 452-5, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19579733

RESUMO

OBJECTIVE: To evaluate the outcome of undertaking out-patient laparoscopic cholecystectomy (OLC) and identifying its predictive failures. METHODS: One hundred and forty-nine consecutive patients with symptomatic cholelithiasis scheduled for preplanned elective laparoscopic cholecystectomy (LC) from August 2004 to December 2006 were included in the study. Patients with associated severe diseases, ASA class III and IV who would have required post operative surgical care, residents of remote areas and other surgical reasoning were entered in Inpatient's Laparoscopic Cholecystectomy (ILC) group (n = 57) and others were enrolled in OLC group (n = 87). Five patients converted to open surgery and thus were excluded from the study. All patients were recruited during the initial outpatient visit and the full preoperative details were explained to them. All of the related factors of OLC were recorded in every visit. Significant differences were evaluated using Chi-square and fisher exact test. RESULTS: Eighty seven patients (58.3%) were selected for outpatient group from which 69 patients (79.3%) successfully underwent outpatient LC. Eighteen (20.7%) patients (failure rate) were not discharged at all. Comparing successful and unsuccessful OLC, the mean age was 41.1 +/- 12.7 vs 51.3 +/- 16.1 years (P = 0.005), also the mean operation time was 33.7 +/- 13.3 vs 33.1 +/- 13.8 minutes and the ability for oral intake existed in 66 patients (95.7%) vs 15 patients (83.3%) (P = 0.1) respectively. Pain was the most common cause of failure of OLC. CONCLUSIONS: OLC is safe and feasible with low readmission. It achieves high levels of patient satisfaction and acceptance, when patients are carefully selected. A prospective study with a larger sample size should be warranted to verify whether OLC can be useful for high age and high ASA class patients.


Assuntos
Colecistectomia Laparoscópica , Pacientes Ambulatoriais , Colelitíase , Humanos , Cuidados Pós-Operatórios , Estudos Prospectivos
18.
Ulus Travma Acil Cerrahi Derg ; 15(2): 135-40, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19353315

RESUMO

BACKGROUND: For many years, burns were treated by daily saline-soaked dressings until the burns healed primarily. Today, wounds are closed via grafting techniques, or by using synthetic and biological dressings. Due to less experience and interest in the use of biological dressing in developing countries, the aim of this study was to compare the outcome of biological dressings versus 'conventional' treatment in patients with massive burns. METHODS: One hundred eighteen patients with total body surface area (TBSA) burns of 30% to 75%, by flame or scalds, were investigated from October 2002 to June 2006. The patients were divided into two groups. Those in the first group received conventional treatment (n=53) and those in the second group (n=65) received treatment with a biological dressing (Xenoderm). RESULTS: Mortality rates in the conventional group and biological group were 19 (35%) and 7 (10.8%), respectively (p=0.001). The mean hospital stay was 31.3 days vs 18.2 days and the number of dressings was 22.1 vs 9.9, respectively (p=0.0005). CONCLUSION: The results of this study indicate that a biological dressing (Xenoderm) gave a better outcome and lower mortality. However, a randomized clinical trial that compares the number of operations and decreasing need for split thickness skin grafts is warranted.


Assuntos
Curativos Biológicos/estatística & dados numéricos , Queimaduras/terapia , Transplante de Pele/métodos , Cicatrização/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
19.
J Coll Physicians Surg Pak ; 17(7): 406-9, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17686352

RESUMO

OBJECTIVE: To evaluate the role of Laparoscopic Cholecystectomy (LC) in Acute Cholecystitis (AC) and Chronic Cholecystitis (CC) in terms of hospital stay, operation time, reason and rate of conversion and complications. DESIGN: Quasi experimental. PLACE AND DURATION OF STUDY: Shafieeh Hospital, Zanjan University of Medical Sciences, Zanjan, Iran. The study was carried out prospectively between October 2003 and September 2006. PATIENTS AND METHODS: Fifty patients with Acute Cholecystitis (AC) were admitted to the emergency and performed LC in the first 72 hours following admission labelled as Acute Laparoscopic Cholecystectomy (ALC). One hundred and forty-one patients with AC were admitted for chronic LC, labelled as Chronic Laparoscopic Cholecystectomy (CLC). Patients were excluded with bilirubin greater than 3.5 mg/dl, alkaline phosphates greater than 250 (UL), age >90 years, choledocholithiasis and biliary pancreatitis. Data were collected prospectively which included patients' demographics, medical history, presentation, operative and postoperative time. For the comparison of groups, chi-square analysis, the Student 't' test and Mann-Whitney U test were used. P-value less than 0.05 were considered statistically significant. RESULTS: The median of hospital stay were 2 and 3 days in CLC and ALC respectively (P=0.0005). The median of post operative stay were 0.83 and 1 day in CLC and ALC respectively (P=0.0005). The mean of operation time were 39.9, 58.8 minutes in CLC and ALC respectively. Conversion occurred in 5 (3.6%) patients in CLC and in 7 (14%) patients in ALC groups. Major complications were observed in 5 patients (3.6%) in CLC and 2 patients (5.1%) in ALC. 63 (46.3%) patients in CLC, 11 (22%) patients in ALC were discharged less than 10 hours after surgery. CONCLUSION: This study showed that statistical differences exist in hospital stay, operation time, reason and rate of conversion in two groups, but no such difference in major complications. Laparoscopy appears to be safe and good approach for emergency cholecystectomy in patients with acute cholecystitis.

20.
Turk J Gastroenterol ; 18(2): 77-81, 2007 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17602354

RESUMO

BACKGROUND/AIMS: In developed countries, diagnosis of gastric cancer is performed in early stages through screening, and the five-year survival rate has risen to 86%. Although patients in developing countries have digestive symptoms for some time, they do not undergo early endoscopy. The patients refer to physicians in developed stages. This research was conducted to determine the median time of delay from the beginning of symptoms to surgery. METHODS: In this research, 63 patients suffering from gastric cancer were investigated during 2004-2005. A research questionnaire was completed from patient's admission to endoscopy until surgery through patient interview. Mann-Whitney statistical test and SPSS software were used for data analysis. RESULTS: Out of 63 patients, 48 (76.2%) were male and 43 (68.3%) were rural residents. The most common cancer area was cardia (31 patients) and the most common symptom was abdominal pain (28 patients). The results showed that the median total delay from the beginning of symptoms until surgery was 96 days. Median patient delay [from first symptom to presentation to general practitioner] was determined as 8 days, general practitioner delay (from the first referral to endoscopy) as 57 days, pathologist delay (from endoscopy to pathology confirmation) as 12 days, and surgeon delay (from pathology confirmation to surgery) as 7 days. Factors such as place of residence, education, income and gender had no significant effect on time of delay. CONCLUSIONS: Delays from referral to endoscopy performance and from performance of endoscopy to pathologic confirmation were higher than expected. A screening plan for timely referral of patients and performance of endoscopy seems essential. To reduce the time of delay, efforts such as physician education, cooperation between hospital units and pathologists and provision of necessary hospital equipment are highly recommended.


Assuntos
Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia , Dor Abdominal/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anorexia/etiologia , Transtornos de Deglutição/etiologia , Endoscopia Gastrointestinal , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Náusea/etiologia , Encaminhamento e Consulta , População Rural , Inquéritos e Questionários , Fatores de Tempo , População Urbana , Vômito/etiologia
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