scholarly journals DETERMINING STRATEGIES FOR PSYCHOLOGICAL SUPPORT IN REHABILITATION OF PATIENTS WITH ESOPHAGEAL VARICES IN THE EARLY POSTOPERATIVE PERIOD

2021 ◽  
Vol 13 (4) ◽  
pp. 21-29
Author(s):  
Evgenii Vasilievich Semichev ◽  
Mariya Sergeevna Sevostyanova ◽  
Polina Andreevna Chernomurova
Keyword(s):  
Postoperative Period ◽  
Esophageal Varices ◽  
Disease Duration ◽  
Rank Correlation ◽  
Early Postoperative Period ◽  
Psychological Status ◽  
Hospital Treatment ◽  
Self Assessment ◽  
Cognitive Beliefs ◽  
The Impact

Background. Despite numerous data on the impossibility of effective rehabilitation of somatic patients without taking into account their psychological status, the psychological profile of patients with esophageal varices remains unexplored and not taken into account in the early postoperative period. Aim. The paper aims to identify the psychological features of patients with esophageal varices to determine promising strategies for increasing the effectiveness of the rehabilitation process in the early postoperative period. Materials and methods. The sample included 22 patients with a verified diagnosis of I 85.9 (ICD-10) and a disease duration of 1 year, who underwent in-hospital treatment in connection with the forthcoming endoscopic sclerosis. Structured clinical interviews and a detailed self-assessment test of disease significance, anxiety level, depression, awareness skills and a system of fundamental cognitive beliefs were conducted. Statistical processing was performed using the Spearman's rank correlation coefficient. Results. Both subclinical and clinical anxiety was diagnosed in 7 patients (31.81 %) each. No correlation was found between age, disease duration, the number of hospitalizations and the expression of anxiety and depressive symptoms. A high or very high effect of esophageal varices was revealed on the following spheres of social status – a limited feeling of strength and energy (90.9 %), career restrictions (81.8 %), material damage (77.2 %), limited pleasure (68.1 %). The relationship between self-assessment of disease significance (experiencing the impact of the disease on various spheres of life), awareness skills and the system of cognitive beliefs was reliably confirmed. Conclusion. Effective rehabilitation of patients with esophageal varices using the strategies of mindfulness-based cognitive therapy during the early postoperative period has been proven.

Laryngeal complaints and videolaryngoscopic laryngeal alterations in rheumatoid arthritis patients and its association with disease activity and duration

2019 ◽  
Vol 11 (5) ◽  
pp. 216-223
Author(s):  
Mohamed Baraka ◽  
Hossam ElDessouky ◽  
Alaa Abdel Azeez Labeeb ◽  
Eman Ezzat ◽  
Asmaa ElDessouky
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Duration ◽  
Systemic Disease ◽  
Vocal Folds ◽  
Moderate Activity ◽  
University Hospitals ◽  
Self Assessment ◽  
Perceptual Assessment ◽  
The Impact

Background: Rheumatoid arthritis (RA) is an autoimmune systemic disease with a wide clinical presentation. The laryngeal manifestations are often masked by the articular disability often experienced in the early and late stages of the disease. Objective: Association between different laryngeal complaints and videolaryngoscopic laryngeal alterations in patients with RA, and disease activity and duration. Patients and methods: A retrospective study was conducted on 79 patients with RA. All subjects were recruited from the out-patient clinic of physical medicine, rehabilitation, and rheumatology in Al-Menoufia University Hospitals during the period from March 2015 to March 2017. All patients were subjected to both phoniatric and rheumatological assessment. Results: Patients with phonasthenic symptoms and globus pharynges had significantly (p=0.01, 0.008 respectively) higher disease duration than patients without. No significant association found between rheumatoid arthritis duration and different videolaryngoscopic laryngeal alterations, patient’s self-assessment of the impact of laryngeal complaints on their lives, and auditory perceptual assessment (APA) of patient’s voice characters. As regards rheumatoid disease's activity no significant correlation has been established (p>0.05) with different laryngeal complaints except for patients in remission who had higher prevalence of intermittent dysphonia than patients with low activities. Rheumatoid disease's activity had no significant association with different laryngeal findings except those with moderate activity; they had significantly higher prevalence of vocal folds nodules than patients with high activity and patients in remission. Conclusion: A significant association between the disease's duration and presence of laryngeal complaints, dysphonia, and its persistence has been established. Also, patients with phonasthenic symptoms and globus pharynges had significantly higher disease duration than patients without. Rheumatoid diseases activity had significant association with different laryngeal complaints in patients with remission that had higher prevalence of intermittent dysphonia than patients with low activities. No significant association between the disease activity and different laryngeal findings that has been found except for patients with DAS-28>3.2, they had significantly higher prevalence of rheumatoid nodules.

scholarly journals Factors affecting the early postoperative period of cochlear implantation

2020 ◽  
Vol 19 (6) ◽  
pp. 57-63
Author(s):  
Yu. S. Preobrazhenskaya ◽  
◽  
M. V. Drozdova ◽  
S. B. Sugarova ◽  
D. D. Kalyapin ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Cochlear Implantation ◽  
Epstein Barr Virus ◽  
Molecular Genetic ◽  
Early Postoperative Period ◽  
Surgical Trauma ◽  
Herpesvirus Infection ◽  
Barr Virus ◽  
Epstein Barr ◽  
The Impact

Persistence of viral infections ((Epstein–Barr virus (EBV), cytomegalovirus (CMV)) contributes to the development of inflammatory pathology of the upper respiratory tract, as well as dystrophic processes in hepatocytes. The impact of this fact on the early postoperative period during cochlear implantation remains poorly understood. A clinical and audiological examination of 100 children with high-grade sensorineural hearing loss was performed. Within the framework of the work, a serological and molecular genetic examination of patients for herpesvirus infections (Epstein–Barr virus, cytomegalovirus) was performed. Two comparison groups are highlighted. The first group included 58 patients with detected latent infections. In the second group 42 patients did not have serological and molecular genetic markers of infection with herpesvirus infection. There is evidence in the literature that surgical trauma combined with general anesthesia can cause reactivation of persistent herpesvirus infection. In 4% (n = 4), markers of an active infectious process were detected. The analysis of the course of the postoperative period in children in two study groups after cochlear implantation was performed. In the hemostatic system, hypocoagulation disorders were found in a number of children. Persistent herpesvirus infection can be a trigger for the development of both inflammatory and non-inflammatory complications after surgical treatment.

scholarly journals The impact of desflurane and sevoflurane on the intraoperative and early postoperative period in liver transplantation

2021 ◽  
Vol 13 (4) ◽  
pp. 328-338
Author(s):  
S. V. Zhuravel ◽  
N. K. Kuznetsova ◽  
V. E. Aleksandrova ◽  
I. I. Goncharova
Keyword(s):  
Liver Transplantation ◽  
Reperfusion Injury ◽  
Postoperative Period ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Graft Function ◽  
Early Postoperative Period ◽  
Liver Graft ◽  
Inhalation Anesthetics ◽  
The Impact

Background. A pressing issue is the choice of an anesthetic agent for liver transplantation. The mechanism of the organprotective properties of desflurane and sevoflurane is not fully understood. It is important to understand the effects of desflurane and sevoflurane on the severity of ischemia-reperfusion injury of the liver graftAim. To study the effect of desflurane and sevoflurane on the intraoperative and early postoperative period in liver transplantation.Material and methods. The study included 47 patients with liver cirrhosis of various etiologies who underwent cadaveric liver transplantation between February and December 2020. The groups compared in the study included 24 patients who received desflurane and 23 patients who received sevoflurane.Results. There were no statistically significant differences in the effect of desflurane and sevoflurane on hemodynamic parameters, on the need for vasopressor drugs. Episodes of bradycardia and cardiac arrhythmias were significantly more frequent when using sevoflurane. Patients were extubated significantly faster after surgery in the desflurane group. In the early postoperative period, desflurane and sevoflurane did not adversely affect significantly the liver graft function and the degree of its ischemia-reperfusion injury. The groups appeared comparable in rates of using the renal replacement therapy, the incidence of the graft dysfunction development in the postoperative period, and the surgery outcomes.Conclusions. The use of modern inhalation anesthetics desflurane and sevoflurane to maintain anesthesia during liver transplantation does not adversely affect the course of the intraoperative and early postoperative period.

The impact of PET/CT imaging performed in the early postoperative period on the management of breast cancer patients

2013 ◽  
Vol 34 (6) ◽  
pp. 571-576 ◽  
Author(s):  
Feyza Sen ◽  
Ali T. Akpinar ◽  
Umit Ogur ◽  
Gani Duman ◽  
Feyzi Tamgac ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Ct Imaging ◽  
Breast Cancer Patients ◽  
Pet Ct ◽  
The Impact

Elevated IOP and Intentional Tube Occlusion

2013 ◽  
Author(s):  
Ronald L. Gross
Keyword(s):  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Postoperative Period ◽  
Glaucoma Surgery ◽  
Suture Technique ◽  
Early Postoperative Period ◽  
Polypropylene Suture ◽  
The Impact ◽  
Tube Shunt

Intrinsic to glaucoma surgery using a tube shunt is the management of early postoperative hypotony. This consideration is unavoidable in all cases when using a tube shunt without an intrinsic valve and must still be considered in tube shunts that contain a valve, as the valve may not function as anticipated. Unfortunately, in the attempt to avoid hypotony and its associated complications, we are faced with elevated intraocular pressure (IOP) and its associated difficulties. However, the attempt to control IOP is not the only consideration when anticipating intentional tube occlusion. Additional factors such as technical complexity of the procedure, predictability of IOP in the early postoperative period, potential to reverse occlusion either partially or completely, and the impact on the long-term function of the tube shunt must be considered. The desired endpoint when occluding a tube intentionally is the complete prevention of flow to the tube shunt reservoir. The standard ways to occlude the tube are an external encircling ligature or an internal occluding suture, otherwise known as an “obturator” or a “ripcord,” or some combination thereof. With the external suture technique, prior to placing the reservoir, a 7–0 or 8–0 polyglactin 910 (Vicryl™ , Ethicon, Inc., Somerville, New Jersey) suture is tightly tied around the tube approximately 4–6 mm from the reservoir (Figure 35.1). It is anticipated that this suture will dissolve in about one month, opening the tube. However, the timing of opening may be highly variable between individuals, and that variability may be problematic. Alternatively, a 9–0 polypropylene suture can be placed around the tip of an anterior chamber tube with release performed by laser lysis. To prevent the polypropylene suture from floating freely in the anterior chamber after release, a pass should be made through the wall of the tube during placement. Alternatively, with the “ripcord” technique, the end of a 3–0 polypropylene suture without the needle is threaded into the distal opening of the tube at the reservoir for a distance of 4–6 mm.

scholarly journals The Impact of Different Antiemetics on the Nausea in Early Postoperative Period after Laparoscopic Holecystectomy

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Goran Marijanovic ◽  
Ljubica Radunovic
Keyword(s):  
Postoperative Period ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Early Postoperative Period ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Preventive Strategies ◽  
Dexamethasone Treatment ◽  
Dexamethasone Group ◽  
The Impact

Abstract Postoperative nausea and vomiting (PONV) is a patient-important outcome; patients often rate PONV as worse than postoperative pain. This clinical study was aimed to asses the efficiency of standard aniemetics administration separately or in combination in prevention of PONV in patients who underwent to the same surgical procedure - laparoscopic cholecystectomy. Also, this article could provide a novel information about the best choice for prevention and treatment of PONV. This study included 87 patients divided into four groups according to the postoperative phramacological treatment: First group was control group without treatment, Second group was group of patients with ondasetron treatment in postoperative period, Third group was group of patients with ondasetron+dexamethasone treatment, and fourth group was group of patients with dexamethasone treatment in postoperative period for nausea. PONV was distributed in Ondansetron+Dexamethasone group in the lowest percent (4.5%), which means that this conbination of antiemetics was very effective. Than, Dexamethasone group was in relation with low incidence of PONV (14.3%), and after that were Ondansetron and Control groups. Also smokers and males has lower incidence of PONV, especially in combination with Ondansetron+Dexamethasone treatment. The incidence of PONV is lower in male smokers patients who were underwent to combination of two antiemetics, ondansetron and dexamethasone compared to monotherapy and female non-smokers. Preventive strategies for PONV must include risk stratification followed by prophylactic approach and also testing the newer antiemetics. Because of the high incidence of postoperative nausea and vomiting as a patient-important outcome, the preventive strategies should be considered as serious condition which requires multimodal approach.

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