scholarly journals Comprehensive Preoperative Pulmonary Rehabilitation Including Intensive Nutritional Support Reduces the Postoperative Morbidity Rate of Sarcopenia-Related Patients with Lung Cancer

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Hiroaki Harada ◽  
Miho Takahama ◽  
Junichi Nakao ◽  
Yoshinori Yamashita ◽  
Kiyomi Taniyama
Keyword(s):  
Lung Cancer ◽  
Body Weight ◽  
Pulmonary Rehabilitation ◽  
Nutritional Support ◽  
Postoperative Morbidity ◽  
Morbidity Rate ◽  
Team Approach ◽  
Weight Percentage ◽  
Group A ◽  
Related Group

Since surgical resection is the treatment of choice for localized lung cancer, it is important to develop an effective strategy to reduce the risk of postoperative complications caused by poor preoperative conditions. We prospectively implemented a comprehensive preoperative pulmonary rehabilitation (CHPPR) program that includes intensive nutritional support with branched-chain amino acids and herbal medicine supplementation concomitant with potential high-intensity physical therapy through an interdisciplinary team approach. This study aimed to evaluate whether CHPPR is beneficial for elderly, low body weight (percentage ideal body weight <90%) patients scheduled to undergo lung surgery. Between 2006 and 2015, 171 patients aged >70 years underwent standard lobectomy for lung cancers. Of these, 12 patients with a low body weight (sarcopenia-related, Group A) and 62 patients without a low body weight (sarcopenia-unrelated, Group B) underwent surgery after CHPPR. Twenty-four patients with a low body weight (sarcopenia-related, Group C) and 73 patients without a low body weight (sarcopenia-unrelated, Group D) refused CHPPR. The postoperative morbidity rates of patients in Groups A, B, C, and D were 17%, 16%, 63%, and 21%, respectively. Of the patients in the sarcopenia-related groups (Groups A and C), those who participated in the CHPPR program (Group A) had a significantly lower morbidity rate than those who did not participate in the CHPPR program (Group C) (P = 0.014). The CHPPR program is beneficial in reducing the postoperative morbidity rate of sarcopenia-related patients scheduled to undergo pulmonary resection.

scholarly journals Multidisciplinary Team-Based Approach for Comprehensive Preoperative Pulmonary Rehabilitation Including Intensive Nutritional Support for Lung Cancer Patients

PLoS ONE ◽  
2013 ◽  
Vol 8 (3) ◽  
pp. e59566 ◽  
Author(s):  
Hiroaki Harada ◽  
Yoshinori Yamashita ◽  
Keizo Misumi ◽  
Norifumi Tsubokawa ◽  
Junichi Nakao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Multidisciplinary Team ◽  
Pulmonary Rehabilitation ◽  
Nutritional Support ◽  
Lung Cancer Patients

scholarly journals Age Criteria As Operative Mortality Predictor After Modified Blalock-Taussig Shunt

2019 ◽  
Vol 40 (1) ◽  
Author(s):  
Muammar Riyandi ◽  
Oktavia Lilyasari ◽  
Dafsah Arifa Juzar ◽  
Budi Rahmat
Keyword(s):  
Body Weight ◽  
Mortality Rate ◽  
Postoperative Morbidity ◽  
Operative Mortality ◽  
Simple Procedure ◽  
Morbidity Rate ◽  
Mechanical Ventilator ◽  
Mortality And Morbidity ◽  
Mortality Predictors ◽  
Blalock Taussig Shunt

Background: Modified Blalock-Taussig shunt (MBTS) is considered as a simple procedure but has a considerable operative mortality rate. Patient’s characteristics who underwent MBTS in Indonesia is quite different than other country. There was no predictor of operative mortality has been identified in Indonesian.Objectives: To compare mortality rate based on age criteria and to identify mortality and morbidity predictors after MBTS procedure.Methods: A retrospectively cohort study was conducted on 400 patients who underwent MBTS at National cardiovascular center Harapan Kita (NCCHK) between January 2013 and december 2017.Results: There were 32,1% death at age ≤ 28 days, 19,9% at age 29-365 days, 3,6% at age 366-1825 days and 8% at age > 1825 days. Body weight < 3 kg, haematocrite level > 45% before procedure and activated partial thromboplastine time level (aPTT) < 60 seconds were operative mortality  predictors. Postoperative morbidity rate was 32,9%. Packed red cell  transfusion (PRC) more than 6 ml/kg, mechanical ventilator use before procedure, prostaglandin E1 use before procedure, aPTT level less than 60 seconds after procedure were identified as postoperative morbidity predictors.Conclusion: Operative mortality rate significantly different among age criteria but it was not proven as an operative mortality predictors. Body weight < 3 kg increase mortality rate and haematocrite level higher than 45% and aPTT level less than 60 seconds decrease mortality rate. Postoperative morbidity predictors were PRC transfusion more than 6ml/kg, mechanical ventilator use before procedure, prostaglandine E1 use and aPTT level less than 60 seconds.

Electron microscopic radioautographic studies on the incorporation of 3H proline in the glomerular basement membrane (GBM) in antistreptococcal-cell-membrane (SCM) injected mice

1984 ◽  
Vol 42 ◽  
pp. 188-189
Author(s):  
R.P. Nayyar ◽  
C.F. Lange ◽  
J. L. Borke
Keyword(s):  
Body Weight ◽  
Cell Membrane ◽  
Basement Membrane ◽  
Glomerular Basement Membrane ◽  
Mesangial Matrix ◽  
Electron Microscopic ◽  
Group A ◽  
Injection Protocol

Streptococcal cell membrane (SCM) antiserum injected mice show a significant thickening of glomerular basement membrane (GBM) and an increase in mesangial matrix within 4 to 24 hours of antiserum administration (1,2,3). This study was undertaken to evaluate the incorporation of 3H proline into glomerular cells and GBM under normal and anti-SCM induced conditions. Mice were administered, intraperitoneally, 0.1 ml of normal or anti-SCM serum followed by a 10 µC/g body weight injection of 3H proline. Details of the preparation of anti-SCM (Group A type 12 streptococcal pyogenes) and other sera and injection protocol have been described elsewhere (2). After 15 minutes of isotope injection a chase of cold proline was given and animal sacrificed at 20 minutes, 1,2,4,8,24 and 48 hours. One of the removed kidneys was processed for immunofluorescence, light and electron microscopic radioautographic studies; second kidney was used for GBM isolation and aminoacid analysis.

Effect of Opuntia dejecta (Salm-Dyck) flowers in liver of fructose-fed rats: Biochemicals, enzymatic and histological studies

2021 ◽  
pp. 096032712110134
Author(s):  
O Zouaoui ◽  
K Adouni ◽  
A Jelled ◽  
A Thouri ◽  
A Ben Chrifa ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Activity ◽  
Body Weight ◽  
Diabetes Type 2 ◽  
Male Rats ◽  
Control Group ◽  
Standard Drug ◽  
High Fructose ◽  
Group A ◽  
Histological Architecture

Phytochemical composition and antioxidant activity of flowers decoction at post-flowering stage (F3D) of Opuntia dejecta were determined. The obtained findings demonstrate that F3D has a marked antioxidant activity in all tested assays. Furthermore, the present study was designed to test the protective activity of F3D against induced Diabetes type 2 (DT2) in male rats. Those metabolic syndromes were induced by a high-fructose diet (HFD) (10% fructose solution) for a period of 20 weeks. F3D was administered orally (100 and 300 mg/kg body weight) daily for the last 4 weeks. Metformin (150 mg/kg body weight) was used as a standard drug and administrated orally for the last 4 weeks. The results showed a significant increase in blood glucose, triglycerides and hepatic markers (ALAT, ASAT and ALK-P) in HFD group. A significant increase in hepatic TBARS and a significant decrease in SOD, CAT and GPX were observed in fructose fed rats compared to control group. Administration of F3D showed a protective effect in biochemical and oxidative stress parameters measured in this study. Also, oral administration of F3D restored the histological architecture of rat liver in comparison with rats fed HFD. In conclusion, F3D attenuated hepatic oxidative stress in fructose-fed rats.

scholarly journals Pancreas-Preserving Total Duodenectomy: A Systematic Review

2021 ◽  
pp. 1-12
Author(s):  
Miguel Cantalejo-Díaz ◽  
José Manuel Ramia-Ángel ◽  
Ana Palomares-Cano ◽  
Mario Serradilla-Martín
Keyword(s):  
Systematic Review ◽  
Postoperative Morbidity ◽  
Operating Time ◽  
Pancreatic Head ◽  
Cochrane Library ◽  
Morbidity Rate ◽  
Intraoperative Bleeding ◽  
Risks And Benefits ◽  
Duodenal Lesions ◽  
The Mean

<b><i>Background:</i></b> The management of the pancreas in patients with duodenal trauma or duodenal tumors remains a controversial issue. Pancreas-preserving total duodenectomy (PPTD) requires a meticulous surgical technique. The most common indication is familial duodenal adenomatous polyposis (FAP). The aims of this study are to carry out a systematic review of the literature on the indications for PPTD and to highlight the risks and benefits compared with other more aggressive procedures. <b><i>Summary:</i></b> A systematic literature review was performed following PRISMA recommendations of studies published in PubMed, Embase, and Cochrane library until May 2019. Thirty articles describing 211 patients were chosen. The mean age was 48 years. The surgical indication in 75% of patients was FAP. The mean operating time was 329 min and mean intraoperative bleeding 412 mL. Postoperative morbidity rate was 49.7% (76% Clavien-Dindo &#x3c;IIIa), and mortality rate was 1.4%. The mean hospital stay was 22 days. Overall survival at 1–3–5 years was &#x3e;97.8%. <b><i>Key Messages:</i></b> PPTD is indicated for patients with benign and premalignant duodenal lesions without involvement of the pancreatic head. It is a feasible procedure offering an alternative to other more aggressive procedures in selected patients. Mortality is below 1.5%.

Evaluation of Dexmedetomidine Dosing in Obese Critically Ill Patients

2021 ◽  
pp. 089719002110215
Author(s):  
Sara A. Atyia ◽  
Keaton S. Smetana ◽  
Minh C. Tong ◽  
Molly J. Thompson ◽  
Kari M. Cape ◽  
...  
Keyword(s):  
Body Weight ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Statistical Difference ◽  
Ideal Body Weight ◽  
Weight Percentage ◽  
Before And After ◽  
Light Sedation ◽  
Icu Sedation ◽  
Dose Dependent

Background: Dexmedetomidine is a highly selective α2-adrenoreceptor agonist that produces dose-dependent sedation, anxiolysis, and analgesia without respiratory depression. Due to these ideal sedative properties, there has been increased interest in utilizing dexmedetomidine as a first-line sedative for critically ill patients requiring light sedation. Objective: To evaluate the ability to achieve goal intensive care unit (ICU) sedation before and after an institutional change of dosing from actual (ABW) to adjusted (AdjBW) body weight in obese patients on dexmedetomidine. Methods: This study included patients ≥ 18 years old, admitted to a surgical or medical ICU, required dexmedetomidine for at least 8 hours as a single continuous infusion sedative, and weighed ≥ 120% of ideal body weight. Percentage of RASS measurements within goal range (−1 to +1) during the first 48 hours after initiation of dexmedetomidine as the sole sedative agent or until discontinuation dosed on ABW compared to AdjBW was evaluated. Results: 100 patients were included in the ABW cohort and 100 in the AdjBW cohort. The median dosing weight was significantly higher in the ABW group (95.9 [78.9-119.5] vs 82.2 [72.1-89.8] kg; p = 0.001). There was no statistical difference in percent of RASS measurements in goal range (61.5% vs 69.6%, p = 0.267) in patients that received dexmedetomidine dosed based on ABW versus AdjBW. Conclusion: Dosing dexmedetomidine using AdjBW in obese critically ill patients for ongoing ICU sedation resulted in no statistical difference in the percent of RASS measurements within goal when compared to ABW dosing. Further studies are warranted.

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