Clancygay8128
Maintenance of cell viability during cold storage is a key issue in organ transplantation. Selleck Fluorescein-5-isothiocyanate Methane (CH
) bioactivity has recently been recognized in ischemia/reperfusion conditions; we therefore hypothesized that cold storage in CH
-enriched preservation solution can provide an increased defense against organ dysfunction during experimental heart transplantation (HTX).
The hearts of donor Lewis rats were stored for 60 minutes in cold histidine-tryptophan-ketoglutarate (Custodiol [CS]) or CH
-saturated CS solution (CS-CH
) (n = 12 each). Standard heterotopic HTX was performed, and 60 minutes later, the left ventricular (LV) pressure-volume relationships LV systolic pressure (LVSP), systolic pressure increment (dP/dtmax), diastolic pressure decrement, and coronary blood flow (CBF) were measured. Tissue samples were taken to detect proinflammatory parameters, structural damage (by light microscopy), endoplasmic reticulum (ER) stress, and apoptosis markers (CCAAT/enhancer binding protein [C/EBP] homologouammation. Evidence shows that CH
reduced ER stress-linked proapoptotic signaling.
The addition of CH4 during 1 hour of cold storage improved early in vitro graft function and reduced mitochondrial dysfunction and activation of inflammation. Evidence shows that CH4 reduced ER stress-linked proapoptotic signaling.
Historically, patients bridged on extracorporeal membrane oxygenation (ECMO) to heart transplantation (HT) have very high post-transplant mortality. In the new heart transplant allocation system, ECMO-supported patients have the highest priority for HT. However, data are lacking on the outcomes of these critically ill patients. We compared the waitlist and post-transplant outcomes of ECMO-supported patients in the new and old allocation systems.
Adult patients supported by ECMO at the time of listing or transplantation who were registered in the United Network for Organ Sharing database between November 1, 2015 and September 30, 2019 were included. Clinical characteristics, outcomes in the waitlist, and post-transplant survival were compared between the old and new systems. Cox Proportional and subdistribution hazard regression models were used to evaluate the variables contributing to the post-transplant and waitlist outcomes RESULTS A total of 296 ECMO-supported patients were listed for HT. Of these, 191 were distributed to the old system, and 105 were distributed to the new system. Patients listed in the new system had a higher cumulative incidence of HT (p < 0.001) and lower incidence of death or removal (p = 0.001) from the transplant list than patients listed in the old system. The 6-month survival after transplantation was 74.6% and 90.6% for the old- and new-era patients, respectively (p = 0.002). Among ECMO-supported patients, being listed or transplanted on the new system was independently associated with improved outcomes in the waitlist and after transplantation.
With the implementation of the new heart transplant allocation system, ECMO-supported patients have a shorter waitlist time, improved frequency of HT, and improved short-term post-transplant survival.
With the implementation of the new heart transplant allocation system, ECMO-supported patients have a shorter waitlist time, improved frequency of HT, and improved short-term post-transplant survival.
To investigate the effect of lanolin on nipple pain and trauma in breastfeeding after application of a health education.
Randomized controlled clinical trial, with two arms, open, with 66 participants during prenatal care in the primary health care network in Goiania - Goias, Brazil. Participants were randomized (11) using computer generated numbers in both experimental group (EG) and control group (CG). The EG received lanolin and health education on breastfeeding at two different times with clinical demonstration using cloth didactic breast and illustrative album as the intervention, while the CG received standard health education. Health education was carried out by the same researchers in both groups. Measurement of pain, nipple trauma, and breastfeeding technique occurred on postpartum day eight. The analysis included descriptive statistics and inferential analysis by means chi-square or Fisher test, and Student's t-test, significance level set at 0.05.
A majority of the participants experienced no nipple trauma (59.1%) in both groups, and 60.6% of women experienced pain. In both groups, women showed favorable breastfeeding behaviors, except in the condition of the breasts. link2 There were no significant differences between groups in pain prevention (p=0.61), nipple lesions (p=0.21), and breastfeeding technique (p>0.05).
It is not clear whether the intervention, lanolin combined with health education, has a positive effect on the prevention of nipple pain and trauma. Further research is needed to elucidate this question. Registration number RBR-7tvhq8. Registry website http//www.ensaiosclinicos.gov.br/.
It is not clear whether the intervention, lanolin combined with health education, has a positive effect on the prevention of nipple pain and trauma. Further research is needed to elucidate this question. Registration number RBR-7tvhq8. Registry website http//www.ensaiosclinicos.gov.br/.
Lower urinary tract dysfunctions are frequent in patients with multiple sclerosis (MS). These disorders impair quality of life and can cause urological complications. In cases of urinary retention or incomplete bladder emptying, clean intermittent self-catheterization is the preferred option where possible.
To identify data concerning the use of intermittent self-catheterization by patients with MS.
A review was done using Medline/Pubmed with selection of articles in either English or French. The key words were «multiple sclerosis and intermittent catheterization, self-catheterization, neuro-urology/urinary guidelines, continent stoma, continent vesicostomy».
Studies were selected if they concerned either multiple sclerosis exclusively or with a majority of cases concerning MS.
Intermittent self-catheterization is recommended and commonly used in patients with MS. Studies are rare in this specific population. Questions still remain about indications and practicalities in this disease. Indications must be individually evaluated according to symptoms and complications. The use of self-catheterization can improve symptomatology or quality of life, however, global urinary management is necessary. Urinary infection is the most frequently reported side effect. The teaching of self-catheterization should take into account physical and cognitive impairment. Due to the developing nature of the pathology, indications and the patients' ability to carry out self-catheterization should be regularly assessed.
The search was limited to a single bibliographic source and studies are rare.
Further studies are necessary to increase knowledge of self-catheterization specificities in MS patients compared to other neurogenic patients.
Further studies are necessary to increase knowledge of self-catheterization specificities in MS patients compared to other neurogenic patients.Patient blood management (PBM) has been proposed as a standard of care in modern perioperative medicine. PBM-related interventions usually are implemented as bundles, but randomized controlled trials on the implementation of PBM as a bundle are missing. This special article focuses on the current evidence and controversies in the clinical practice of PBM and on emerging data related to specific PBM-related interventions in patients undergoing cardiac surgery. Strong evidence for many PBM-related interventions is limited because of missing studies or the poor quality of published findings and study endpoints. link3 Restrictive blood transfusion and timely interventions to maintain hemoglobin concentration and to reduce blood loss potentially might result in improved patient outcome, although the latter has yet to be proven.
Women undergoing elective caesarean deliveries are fasted for long periods prior to surgery and can become catabolic. The use of pre-operative carbohydrate drinks to optimise patients ahead of major surgery is now well established. However, evidence to support this in women undergoing elective caesarean delivery is limited.
We conducted a single-blind randomised control trial to study the effect of carbohydrate preloading on the presence of urinary ketones in mothers undergoing elective caesarean deliveries compared with standard care, fasting from midnight the night before surgery with free clear fluids until two hours prior to surgery.
Two-hundred-and-nine patients were allocated to either standard care (n=104) or pre-operative carbohydrate drinks (n=105) prior to elective caesarean section. Twenty-five were excluded from the analysis, leaving 184 (n=90; n=94). The incidence of urinary ketones immediately prior to surgery was lower in the carbohydrate group, 18.1% compared with 61.1% in the standard care group (P<0.001). Relative risk (95% CI) 3.33 (2.12 to 5.26), with a number needed-to-treat of three to prevent urinary ketosis in one woman. There were no major adverse events.
The results of this study support the introduction of carbohydrate drinks ahead of caesarean delivery to offset the effects of pre-operative fasting. However, the results may not be generalisable to all maternity units due to differences in fasting protocols.
The results of this study support the introduction of carbohydrate drinks ahead of caesarean delivery to offset the effects of pre-operative fasting. However, the results may not be generalisable to all maternity units due to differences in fasting protocols.
The aim of this study was to identify factors from the patient's perspective that influence quality of life and psychological stress after oral cancer, and to find out if these patients would opt for psycho-oncological assistance during further treatment.
Standardized interviews were conducted. All interviews were transcribed and reduced according to previously established rules. Next, the patients' statements were coded, put into one format, and summarized in categories. Each category was described individually so that a rule-based quantitative and qualitative evaluation of the patients' statements was then possible.
50 patients were interviewed. 40 of these patients indicated that their own personality and the social support received through friends and family were the most important predictors for quality of life and coping. Therefore, they suggested a focus on these aspects during psycho-oncological treatment. Nearly every patient stated that psycho-oncological assistance should be available for each of them.
The results of this study show that patients have clear ideas about the factors that influence their quality of life, and that play a role in coping with disease. Doctors and nursing staff should also understand these factors in order to support patients in the best possible way in the context of psychological first aid.
DRKS00006263.
DRKS00006263.
This study compared two transferring methods for virtually planned orthognathic surgery - the CAD/CAM intermediate splint and the customized surgical guide with fixation plates.
This was a prospective clinical study in which participants were consecutively recruited and underwent bimaxillary orthognathic surgery. They were divided into two groups based on the transferring method used. The pre- and postoperative CBCTs were aligned using voxel-based landmark-free registration, and the discrepancies for selected points were compared with the planned displacement of the virtually planned surgery. The maxilla and mandible were analyzed separately, and translation and rotation movements were considered.
A total of 16 patients, divided into two groups of eight patients each, were included in this study. The splintless group was significantly more accurate for the translation movement along the x-axes for points A (p=0.008; mean absolute error 0.527±0.387 for the splint group and 0.137±0.067 for the splintless group) and Ans (p=0.
