scholarly journals Evaluation of Dynamic / Thiol Disulfide Balance and İschemia Modified Albumin in Children with Trauma

2021 ◽  
Author(s):  
CAN OZTORUN ◽  
HAYAL DORUK ◽  
DOĞUŞ GÜNEY ◽  
ÜLFET NİHAL İRDEM KÖSE ◽  
TUĞBA ÖRNEK DEMİR ◽  
...  
Keyword(s):  
Blunt Trauma ◽  
Multiple Trauma ◽  
Ischemia Reperfusion ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Healthy Children ◽  
Surgical Intensive Care ◽  
Ischemia Modified Albumin ◽  
Total Thiol ◽  
Trauma Group

Introduction: Trauma is the most common cause of death in childhood. Tissue damage, ischemia-reperfusion injury and inflammatory response are mainly responsible for increasing serbest oxiygen radicals. In this study, we aimed to investigate the use of thiol-disulfide and ischemia-modified albumin levels as a diagnostic laboratory parameter in trauma children. Method: Of 202 children, 101 of them were hospitalized in pediatric surgical intensive care unit with trauma and 101 of others were healthy children. Levels of native thiol (-SH), total thiol (SH + SS), dynamic disulfide (SS), dynamic disulfide (SS) / total thiol (SH + SS), albumin and ischemic modified albumin (IMA) were measured from the sera of patients and healthy volunteers. For statistical analyses, SPSS 17.0 was used. Mann-Whitney U and paired correlation test were used where appropriate. p <0.05 was considered significant. Results: The mean age of the patients in the trauma group (Boys: 61 Girls: 40) was 7,88 years and the control group was 8,00 years. In trauma group, 86 of children were exposed to blunt trauma, 15 of children had penetrating trauma and 54 patients had multiple trauma. Surgical procedures were performed in 17 patients. In the trauma group, native thiol, total thiol, dynamic disulfide / total thiol, albumin and IMA levels were significantly lower than that of control (p <0.001) and their dynamic disulfide (p = 0.001) was higher compared to the control. There was no difference thiol-disulfide parametres in trauma groups sub-division as surgery(n=17) vs. follow-up(n=84) groups or multiple trauma(n=54) vs. isolated organ trauma(n=47) groups, or penetrating(n=15) or blunt trauma(n=86) groups. Conclusion: Thiol-disulfide balance and IMA levels show changes in favor of oxidative stress in children with trauma, however, it cannot be used as a laboratory marker that helps to show the system and organ affected by the trauma and to decide the surgical intervention.

scholarly journals Dynamic thiol-disulphide homeostasis in the etiopathogenesis of obstructive jaundice

2021 ◽  
Author(s):  
Fadime Gullu Haydar ◽  
Yavuz Otal ◽  
GAMZE AVCIOĞLU ◽  
Alp Şener ◽  
Selda Kidak Ozkaya ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Total Bilirubin ◽  
Significant Negative Correlation ◽  
Control Group ◽  
Ischemia Modified Albumin ◽  
Total Thiol ◽  
Admission Data ◽  
Novel Method ◽  
Time Of Admission ◽  
Stress Biomarker

ABSTRACT Background:Metabolic changes seen after obstructive jaundice increase the load of oxidative stress.The thiol-disulphide homeostasis (TDB) has a vital importance as oxidatice stress biomarker. Aim: The aim of present study is to investigate the dynamic thiol-disulphide homeostasis in patients diagnosed with obstructive jaundice and to compare the dynamic thiol-disulphide homeostasis with ischemia modified albumin. Study design: A total of 146 participants who were admitted to emergency department and who consisted of 69 patients and 77 healthy volunteers, were included in the study. Detailed blood samples were obtained from the patients at the time of admission. Methods: Thiol / disulphide levels were examined using a novel method developed by Erel and Neselioglu on the patients diagnosed with obstructive jaundice during the admission. Data were evaluated in computer system. Results: The levels of total thiol (p =0.025) and native thiol (p =0.023) were statistically significantly lower in the patient with obstructive jaundice than in the control group. It was observed that there was a significant negative correlation between the native thiol levels and the ALP (r =-0.262, p<0.01), urea (r =-0.313, p<0.01), total bilirubin (r =-0.388, p<0.01), direct bilirubin (r =-0.351, p<0.01) levels. At the same time, the level of disulphide (p = 0.235) was lower in the patient group than in the control group but not statistically significant. It was found that the ischemia modified albumin (IMA) values were lower in the control group than the obstructive jaundice group (p = 0.03). Conclusion: Total thiol, native thiol and IMA levels decrease in obstructive jaundice pathogenesis.

Limited Impact of Sustained Simple Feedback Based on Soap and Paper Towel Consumption on the Frequency of Hand Washing in an Adult Intensive Care Unit

2002 ◽  
Vol 23 (3) ◽  
pp. 120-126 ◽  
Author(s):  
Marvin J. Bittner ◽  
Eugene C. Rich ◽  
Paul D. Turner ◽  
William H. Arnold
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Trial ◽  
Hand Washing ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care ◽  
Adult Intensive Care Unit ◽  
Paper Towel

Objective:To determine whether hand washing would increase with sustained feedback based on measurements of soap and paper towel consumption.Design:Prospective trial with a nonequivalent control group.Setting:Open multibed rooms in the Omaha Veterans Affairs Medical Center's Surgical Intensive Care Unit (SICU) and Medical Intensive Care Unit (MICU).Subjects:Unit staff.Intervention:Every weekday from May 26 through December 8,1998, we recorded daytime soap and paper towel consumption, nurse staffing, and occupied beds in the SICU (intervention unit) and the MICU (control unit) and used these data to calculate estimated hand washing episodes (EHWEs), EHWEs per occupied bed per hour, and patient-to-nurse ratios. In addition, from May 26 through June 26 (baseline period) and from November 2 through December 8 (follow-up period), live observers stationed daily for random 4-hour intervals in the MICU and the SICU counted actual hand washing episodes (CHWEs). The intervention consisted of posting in the SICU, but not in the MICU, a graph showing the weekly EHWEs per occupied bed per hour for the preceding 5 weeks.Results:Directly counted hand washing fell in the SICU from a baseline of 2.68 ± 0.72 (mean ± standard deviation) episodes per occupied bed per hour to 1.92 ± 1.35 in the follow-up period. In the MICU, episodes fell from 2.58 ± 0.95 (baseline) to 1.74 ± 0.69. In the MICU, the withdrawal of live observers was associated with a decrease in estimated episodes from 1.36 ± 0.49 at baseline to 1.01 ± 0.36, with a return to 1.16 ± 0.50 when the observers returned. In the SICU, a similar decrease did not persist throughout a period of feedback. Estimated hand washing correlated negatively with the patient-to-nurse ratio (r= -0.35 for the MICU,r= -0.46 for the SICU).Conclusions:Sustained feedback on hand washing failed to produce a sustained improvement. Live observers were associated with increased hand washing, even when they did not offer feedback. Hand washing decreased when the patient-to-nurse ratio increased.

scholarly journals Catheter-associated urinary tract infection in a surgical intensive care unit

2015 ◽  
Vol 72 (10) ◽  
pp. 883-888 ◽  
Author(s):  
Jovan Mladenovic ◽  
Milic Veljovic ◽  
Ivo Udovicic ◽  
Srdjan Lazic ◽  
Zeljko Jadranin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nosocomial Infections ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care

Background/Aim. Because patients in intensive care units usually have an urinary catheter, the risk of urinary tract infection for these patients is higher than in other patients. The aim of this study was to identify risk factors and causative microrganisms in patients with catheter-associated urinary tract infection (CAUTI) in the Surgical Intensive Care Unit (SICU) during a 6-year period. Methods. All data were collected during prospective surveillance conducted from 2006 to 2011 in the SICU, Military Medical Academy, Belgrade, Serbia. This case control study was performed in patients with nosocomial infections recorded during surveillance. The cases with CAUTIs were identified using the definition of the Center for Disease Control and Prevention. The control group consisted of patients with other nosocomial infections who did not fulfill criteria for CAUTIs according to case definition. Results. We surveyed 1,369 patients representing 13,761 patient days. There were a total of 226 patients with nosocomial infections in the SICU. Of these patients, 64 had CAUTIs as defined in this study, and 162 met the criteria for the control group. Multivariate logistic regression analysis identified two risk factors independently associated to CAUTIs: the duration of having an indwelling catheter (OR = 1.014; 95% CI 1.005-1.024; p = 0.003) and female gender (OR = 2.377; 95%CI 1.278-4.421; p = 0.006). Overall 71 pathogens were isolated from the urine culture of 64 patients with CAUTIs. Candida spp. (28.2%), Pseudomonas aeruginosa (18.3%) and Klebsiella spp. (15.5%) were the most frequently isolated microorganisms. Conclusions. The risk factors and causative microrganisms considering CAUTIs in the SICU must be considered in of planning CAUTIs prevention in this setting.

Protective Effects of Astaxanthin on Nephrotoxicity in Rats with Induced Renovascular Occlusion

2020 ◽  
Vol 23 ◽  
Author(s):  
Erkan Arslan ◽  
Hakan Turk ◽  
Murat Caglayan ◽  
Tugba Taskin Turkmenoglu ◽  
Ataman Gonel ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Olive Oil ◽  
Caspase 3 ◽  
Ischemia Reperfusion ◽  
Renal Ischemia ◽  
Control Group ◽  
Tubular Damage ◽  
Total Thiol ◽  
Tnf Α ◽  
Anti Inflammatory

Background: Various effects of Astaxanthin was shown in the studies including its antioxidant, anti-inflammatory, anti-tumor and immunregulator effects. Objective: The aim of this study was to evaluate the beneficial effects of Astaxanthin on renovascular occlusion induced renal injury and to investigate the possible mechanisms. Methods: The rats were randomly assigned into three groups as follows: Group 1: control group (n=12), Group 2: renal ischemiareperfusion injury group (n=12), Group 3: renal ischemia-reperfusion + asthaxantine treated group (n=12). The control group and the renal ischemia-reperfusion group were given 2cc/kg/g olive oil for 7 days before establishing ischemia to renal tissue. Astaxanthin dissolved in olive oil was given orally to the renal ischemia+astaxanthin group for 7 days before inducing renal ischemia. Caspase-(3, 8, 9), GSH, SOD, Total Thiol, TNF-α, IL-6, 8-OHdG were performed for each group. Results: Renal IRI was verified by analysing the pathological changes of renal tissues and the renal functions after renal reperfusion. Much less renal tubular damage was determined the IRI+ASX group in comparison to the IRI group. Caspase-8, -9 and -3 immunoreactivity was observed to be minimal in the control group. Apoptosis was observed to be significantly reduced in the IRI + ASX group with respect to IRI group and close to the level of the control group (p <0.05). Caspase-3 levels of tissue samples were significantly increased in IRI group compared to other groups, but significantly lower in IRI+ASX group with respect to the IRI group (p<0.05). The TOS and OSI levels, indicating increased oxidative stress, were significantly lower in the IRI+ASX group with respect to the IRI group (p <0.001), but still higher than the control group (p <0.001). In addition to GSH, SOD and Total Thiol levels, TAS levels were also significantly higher in IRI + ASX group in comparison to the IRI group (p <0.05). TNF-α, IL-6, lipid hydroperoxide, AOPP and 8-OHdG levels were lower in the IRI+ASX group than the IRI group (p <0.001). MPO, IL-6, TNF-α levels, representing the parameters indicating neutrophil infiltration and inflammation of the renal tissues, significantly increased in IRI group with respect to the other groups (p <0.005). Conclusion: When all the data obtained in our study were evaluated, ASX was determined to prevent renal damage due to renovascular occlusion to a great extent, through complex mechanisms involving antioxidant, anti-inflammatory and antiapopitotic effects. Biochemical, histological and oxidative stress parameters were improved due to ASX.

Thiol-disulfide homeostasis and ischemia-modified albumin levels as indicators of oxidative stress in welders’ lung disease

2019 ◽  
Vol 38 (11) ◽  
pp. 1227-1234 ◽  
Author(s):  
M Karataş ◽  
TN Öziş ◽  
M Büyükşekerci ◽  
M Gündüzöz ◽  
OG Özakıncı ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Lung Disease ◽  
Control Group ◽  
Welding Fumes ◽  
Ischemia Modified Albumin ◽  
Total Thiol ◽  
Test Parameters ◽  
Function Test ◽  
And Control ◽  
Mixed Exposure

Welders’ lung disease refers to mixed exposure to different kinds of metals and chemicals from welding fumes, which affect all parts of the respiratory tract including airways and parenchyma together. This study aimed to investigate the oxidative status in patients with welders’ lung (PWL) by means of thiol-disulfide homeostasis and ischemia-modified albumin (IMA) levels. The male welder workers diagnosed with welders’ lung disease and healthy individuals were recruited in the study. Plasma levels of disulfide, disulfide/native thiol ratio, disulfide/total thiol ratio, IMA, and catalase (CAT) were determined. Pulmonary function test parameters of both groups were compared. The thiol-disulfide homeostasis parameters of PWL and control group were as follows: disulfide (20.5 ± 6.3 vs. 16.2 ± 3.9 μmol L−1, p < 0.001), disulfide/native thiol (4.36 (1.59) vs. 4.0 (1.64), p = 0.024), and disulfide/total thiol (4.01 (1.34) vs. 3.71 (1.41), p = 0.024). IMA levels in PWL were significantly higher than the control group (1.37 (0.27) mg dL−1 vs. 0.49 (0.61) mg dL−1, p < 0.001), whereas CAT activities were significantly higher in the control group (106.6 (54.5) kU L−1 vs. 78.3 (67.8) kU L−1, p = 0.003). The findings of the present study revealed that oxidative stress plays a key role in the pathogenesis of welders’ lung disease. Plasma thiol-disulfide homeostasis and IMA levels might be indicators of oxidative stress in PWL.

Feasibility of a Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel

2017 ◽  
Vol 26 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Beth A. Steinberg ◽  
Maryanna Klatt ◽  
Anne-Marie Duchemin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Work Engagement ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Negative Effects ◽  
Surgical Intensive Care ◽  
Utrecht Work Engagement Scale

Background Surgical intensive care unit personnel are exposed to catastrophic situations as they care for seriously injured or ill patients. Few interventions have been developed to reduce the negative effects of work stress in this environment. Objective This pilot study evaluated the feasibility of a workplace intervention for increasing resilience to stress. The intervention was implemented within the unique constraints characteristic of surgical intensive care units. Methods Participants were randomly assigned to an intervention or control group. The mindfulness-based intervention included meditation, mild yoga movement, and music and was conducted in a group format 1 hour a week for 8 weeks in a surgical intensive care unit during work hours. Assessments were performed 1 week before and 1 week after the intervention. Results The intervention was well received, with a 97% overall retention rate and 100% retention in the intervention group. Work satisfaction, measured with the Utrecht Work Engagement Scale, increased significantly in the intervention group with no change in the control group. Negative correlations were found between the vigor subscale scores of the Utrecht Work Engagement Scale and scores for emotional exhaustion on the Maslach Burnout Inventory and scores for burnout on the Professional Quality of Life scale. Participants rated recognizing their stress response as a main benefit of the intervention. Conclusion Workplace group interventions aimed at decreasing the negative effects of stress can be applied within hospital intensive care units. Despite many constraints, attendance at weekly sessions was high. Institutional support was critical for implementation of this program.

scholarly journals Using simulation and inter-professional education to teach infection prevention during resuscitation

2021 ◽  
Vol 6 (1) ◽  
pp. 93-108
Author(s):  
Kah Wei Tan ◽  
Hwee Kuan Ong ◽  
Un Sam Mok
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Professional Education ◽  
Infection Prevention ◽  
Teaching Method ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care

Introduction: During resuscitations, healthcare professionals (HCPs) find balancing the need for timely resuscitation and adherence to infection prevention (IP) measures difficult. This study explored the effects of an innovative teaching method, using in-situ simulation and inter-professional education to enhance compliance to IP through better inter-professional collaboration. Methods: The study was conducted in the Surgical Intensive Care Unit (SICU) in a 1200-beds teaching hospital. HCPs working in the SICU were conveniently allocated to the intervention or control group based on their work roster. The intervention group attended an in-situ simulated scenario on managing cardiac arrest in an infectious patient. The control group completed the standard institution-wide infection control eLearning module. Outcomes measured were: (a) attitudes towards inter-professional teamwork [TeamSTEPPS Teamwork Attitudes Questionnaire (TAQ)], (b) infection prevention knowledge test, (c) self-evaluated confidence in dealing with infectious patients and (d) intensive care unit (ICU) audits on infection prevention compliance during actual resuscitations. Results: 40 HCPs were recruited. 29 responded (71%) to the pre- and post-workshop questionnaires. There were no significant differences in the TeamSTEPPS TAQ and infection prevention knowledge score between the groups. However, ICU audits demonstrated a 60% improvement in IP compliance for endotracheal tube insertion and 50% improvement in parenteral medication administration. This may be attributed to the debriefing session where IP staff shared useful tips on compliance to IP measures during resuscitation and identified threats that could deter IP compliance in SICU. Conclusion: Learning infection prevention through simulated inter-professional education (IPE) workshops may lead to increased IP compliance in clinical settings.

Selective Serotonin Reuptake Inhibitor Therapy Reduces Time to Emergence and Arousal from TBI-induced Prolonged Coma: A Pilot Study

2020 ◽  
Author(s):  
Omar Danner K
Keyword(s):  
Minimally Conscious State ◽  
The United States ◽  
Selective Serotonin ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Glascow Coma Scale ◽  
Severe Tbi ◽  
Prolonged Coma

Objective: Traumatic Brain Injury (TBI) continues to be a significant cause of death and disability in the United States and is commonly due to sudden, forceful impacts to the head. This may lead to disruption of neurological and neurochemical functioning of the brain, resulting in coma (Glascow Coma Scale score (GCS) ≤ 8). The objective of this study is to evaluate the potential effect of Selective Serotonin Re-uptake Inhibitors(SSRI), sertraline, on improvement in the level of consciousness and motor function in patients with prolonged, refractory coma after severe TBI. It has been theorized that the administration of SSRIs may shorten the time to emergence from comain trauma victims presenting with low GCS scores. Methods: The data from 14 trauma patients with severe TBI and Refractorycoma (RC) as defined by a GCS score <8 (coma) for >6 days admitted to the surgical intensive care unit (SICU) at a busy urban level 1 trauma center was retrospectively collected and screened. The patients were started on sertraline between 7 to 21 days after sustaining TBI-induced coma, principally based on attending judgment and preference, and were compared to a control group of similar TBI-induced prolonged coma patients admitted to the ICU during the study period who did not receive SSRI therapy. Results: In the study, 100% of the SSRI group became aroused to a GCS >8 and 66.7% (6/9) emerged to a minimally conscious state or regained consciousness based on a GCS scores >9 or 9T over a period of 11.9 days after initiation of therapy whereas 60% of control patients (3/5) emerged from coma. Conclusion: SSRI therapy using Sertraline may be associated with shorter time to emergence and improved reactiveness in patients with prolonged refractory coma states post-TBI.

Effectiveness of Surveillance of Central Catheter-Related Bloodstream Infection in an ICU in Korea

2001 ◽  
Vol 22 (7) ◽  
pp. 433-436 ◽  
Author(s):  
Sunmi Yoo ◽  
Mina Ha ◽  
Daeok Choi ◽  
Hyunjoo Pai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Intervention Period ◽  
Active Infection ◽  
Surgical Intensive Care ◽  
And Control

AbstractObjective:To determine whether surveillance and infection control interventions decrease the incidence of catheter-related (CR) bloodstream infections (BSIs) in Korea.Setting:A medical-surgical intensive care unit (ICU) of a university hospital in Korea.Design:The CR infection rate of the intervention period was compared to that of historical controls for a 4-month period.Patients:All patients with a central venous catheter in the intensive care unit (ICU) from October 1998 to January 1999.Methods:Active infection control programs were initiated during the intervention period. Data collected included patient characteristics, risk factors of CR infection, and the microbiology laboratory results. Laboratory-proven CR infection rates were compared between the intervention group and control group.Results:304 catheters were inserted into 248 patients. The intervention group and the control group showed similar characteristics, but more patients in the intervention group received steroid therapy, and subclavian insertion was more common in the intervention group. CR BSI occurred in 1.3 per 1,000 catheter-days in the intervention group and 4.2 in the control group (binomial test, P=.14). CR infections were associated with the duration of ICU admission by multivariate logistic regression.Conclusions:The data suggested that an active infection surveillance and control program could reduce the rate of CR BSI in an ICU.

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