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  • 1
    Online Resource
    Online Resource
    Continuous fentanyl infusion reduces intra-abdominal pressure, postoperative pain and normalizes lungs’ mechanical changes in newborn with viscera-abdominal disproportion in early post-operative period
    Interdisciplinar Academy of Pain Medicine ; 2021
    In:  Pain medicine Vol. 6, No. 3 ( 2021-11-15), p. 18-23
    Details
    In: Pain medicine, Interdisciplinar Academy of Pain Medicine, Vol. 6, No. 3 ( 2021-11-15), p. 18-23
    Abstract: We aimed to study the influence of prolonged administration of fentanyl on postoperative pain, intra­ab­dominal pressure and mechanical lungs’ changes that may happen in neonates in early post­operative period. 30 newborns (in the period from January 2017 to May 2021) with gastroschisis were divided into two groups ac­cordingly to the method of analgesia (14 – morphine hydrochloride; 16 – prolonged infusion of fentanyl). Lungs’ mechanical characteristics, effectiveness of post­operative analgesia, abdominal wall relaxation was studied by monitoring of dynamic compliance (Cdyn), pressure and flow­volume loops, capnography. Apprising analgesia sta­tus, we measured hemodynamic, SаO2, blood level of cortizol, C­reactive protein (CRP), glucose, analyzed post­operative pain syndrome using visual analogue scales (VAS). Intra­abdominal pressure (IAP) was controlled by Cron. For statistic analysis we used Student’s t­test. In the group with morphine, thete was the increase of IAP by 11–12 cm H2O, being stable during some period of time, and also variable levels of pain according to VAS, the in­creasing of CRP from 0.8 ± 0.25 mg/dl by 5 mg/dl, cortisol by 674.4 nmol/l, and blood glucosae rate – 7.4 mmol/l. Periods with high traumatic effects and poor analgesia (morphine group) reasoned the increasing IAP, step by step dynamic compliance decreasing in 3.4 times, resistance increasing in 2.42 times and PIP rising till 22 cm H2O. Di­rect correlation between IAP increase and lungs’ mechanical changes took place. The study has demonstrated that prolonged administration of fentanyl prevented high increase of IAP, CRP, levels of glucose and cortizol and changes of VAS data, lungs’ mechanical characteristics.
    Type of Medium: Online Resource
    ISSN: 2519-2752 , 2414-3812
    URL: Article
    DOI: 10.31636/pmjua.v6i3.2
    Language: Unknown
    Publisher: Interdisciplinar Academy of Pain Medicine
    Publication Date: 2021
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  • 2
    Online Resource
    Online Resource
    BIOFILM FORMING ACTIVITY OF NON-FERMENTING GRAM-NEGATIVE BACTERIA
    ALUNA ; 2021
    In:  Wiadomości Lekarskie Vol. 74, No. 2 ( 2021-2), p. 252-256
    Details
    In: Wiadomości Lekarskie, ALUNA, Vol. 74, No. 2 ( 2021-2), p. 252-256
    Abstract: The aim: To study the influence of chemical, physical factors on the biofilm forming activity of P. aeruginosa, A. baumannii. Materials and methods: Biofilm forming activity of P. aeruginosa (10 isolates) and A. baumannii (10 isolates) was studied in nutrient media of different composition. There was used the method in 96-well crystalline violet staining plates with spectrophotometry (STAT FAX®4300, wavelength of 620 nm). Results: Results showed that in standard medium (trypto-soy broth), strains of P. aeruginosa (90%) and A. baumannii (60%) obtained high biofilm forming activity. A. baumannii formed biofilms even in sterile water. Biofilm forming activity of urease positive P. aeruginosa increased in the medium with 1.0% urea. Both Acinetbacteria and Pseudomonas intensively produced their biofilms in the presence of 5% serum or sub-bacteriostatic concentrations of levofloxacin in the media. High concentrations of sodium chloride inhibited their biofilm activity. Conclusions: Isolates of Acinetobacter and Pseudomonas obtain the protective biofilm-forming ability under such adverse environmental conditions as insufficient nutrients, high osmotic pressure, the presence of antibiotics but at high concentrations sodium chloride biofilm-formation is stimulated only in the first bacteria and suppressed in the second one.
    Type of Medium: Online Resource
    ISSN: 0043-5147
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.36740/WLek202102
    DOI: 10.36740/WiadLek
    DOI: 10.36740/WLek202102114
    Language: English
    Publisher: ALUNA
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Antibiotic resistance and rational outpatient antibiotic treatment of upper respiratory tract infections in children
    Interdisciplinar Academy of Pain Medicine ; 2023
    In:  Perioperaciina Medicina Vol. 5, No. 2 ( 2023-01-29), p. 4-12
    Details
    In: Perioperaciina Medicina, Interdisciplinar Academy of Pain Medicine, Vol. 5, No. 2 ( 2023-01-29), p. 4-12
    Abstract: On the eve of the season of respiratory infections, we would like to draw the attention of outpatient doctors to the fact that 80–90 percent of winter diseases affecting the nose, ears, throat and lungs are of viral origin. Improper and excessive consumption of antibiotics increases the risk of antibiotic resistance, and thus humanity enters the post-antibiotic era. The World Health Organization warns that the problems that antibiotic resistance could cause in the future can be compared to the spread of AIDS in the 1980s. The principles of rational use of antibiotics should always be based on the assumption that antibiotics are causal drugs, and their overuse very often leads to resistance, which negatively affects the entire population. Irrational antibiotic therapy can also lead to discomfort, worsening of acute and chronic pain. It is also important to know that in the post-antibiotic era, science has other options for fighting bacteria, such as vaccination, immunotherapy, and strengthening individual immunity. The correct attitude of doctors to the prevention of diseases and rational treatment with antibiotics can help reduce the resistance of bacterial strains, discomfort and pain.
    Type of Medium: Online Resource
    ISSN: 2617-2925 , 2616-339X
    URL: Article
    DOI: 10.31636/prmd.v5i2.1
    Language: Unknown
    Publisher: Interdisciplinar Academy of Pain Medicine
    Publication Date: 2023
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  • 4
    Online Resource
    Online Resource
    Perioperative hemodynamic protective assessment of adaptive support ventilation usage in pediatric surgical patients
    The Korean Society of Critical Care Medicine ; 2022
    In:  Acute and Critical Care Vol. 37, No. 4 ( 2022-11-30), p. 636-643
    Details
    In: Acute and Critical Care, The Korean Society of Critical Care Medicine, Vol. 37, No. 4 ( 2022-11-30), p. 636-643
    Abstract: Background: The aim of this study was to evaluate the hemodynamic protective effects of perioperative ventilation in pressure-controlled ventilation (PCV) and adaptive support ventilation (ASV) modes based on non-invasive hemodynamic monitoring indicators.Methods: The study included 32 patients who were scheduled for planned open abdominal surgery. Depending on the chosen ventilation strategy, patients were included in two groups of PCV mode ventilation (n=14) and ASV mode ventilation (n=18). The hemodynamic effects of the ventilation strategies were assessed by estimated continuous cardiac output (esCCO) and cardiac index (esCCI). Results: Preoperative cardiac output (CO) was 6.1±1.3 L/min in group 1 patients and 6.3±0.8 L/min in group 2 patients, and preoperative cardiac index (CI) was 3.9±0.4 mL/m2 in group 1 patients and 3.8±0.8 mL/m2 in group 2 patients. The ejection fraction (EF) in group 1 subjects was 55.4%±0.3%; this rate was 56.5%±0.5% in group 2 subjects. Group 1 patients experienced a 14.7% CO decrease to 5.2±0.7 L/min, a 17.9% CI decrease to 3.2±0.6 mL/m2, and a 12.8% mean arterial pressure decrease to 82.3±9.4 mm Hg 30 minutes after the start of surgery. One hour after the start of surgery, the CO mean values of group 2 patients were lower than baseline by 7.9% and differed from the dynamics of patients in group 1, in whom CO was lower than baseline by 13.1%. At the end of the operation, the CO values were lower than baseline by 11.5% and 6.3% in patients of groups 1 and 2, respectively. Our data showed that the changes in EF during and after surgery correlated with CO indicators determined by the esCCO.Conclusions: In our study, perioperative ventilation in ASV mode was more protective than PCV mode and was characterized by lower tidal volume (16.2%) and driving pressure (ΔP) (12.1%). Hemodynamically-controlled mechanical ventilation reduces the negative impact of cardiopulmonary interactions.
    Type of Medium: Online Resource
    ISSN: 2586-6052 , 2586-6060
    URL: Article
    DOI: 10.4266/acc.2022.00297
    Language: English
    Publisher: The Korean Society of Critical Care Medicine
    Publication Date: 2022
    detail.hit.zdb_id: 3003021-3
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  • 5
    Online Resource
    Online Resource
    PedSQL™ Family Impact Module as an Instrument foe Quality of Life Assessment (PedsQL™) in Children with Chronic Postsurgical Pain
    Scientific Foundation SPIROSKI ; 2023
    In:  Open Access Macedonian Journal of Medical Sciences Vol. 11, No. G ( 2023-02-05), p. 53-62
    Details
    In: Open Access Macedonian Journal of Medical Sciences, Scientific Foundation SPIROSKI, Vol. 11, No. G ( 2023-02-05), p. 53-62
    Abstract: BACKGROUND: The concept of quality of life (QoL) is today an integral part of the health-care system and clinical, medical, and social research. Untreated chronic pain in children increases the risk of developing mental disorders later in life. The pediatric QoL inventory 3.0 (PedsQL™) is one of the most valid and widely used tools for assessing pediatric QoL. AIM: The study was to assess QoL in children with chronic postsurgical pain 7 days, 3 months, and 6 months after surgery with different analgesic techniques by means of the PedsQL™ 3.0 Family Impact Module questionnaires. METHODS: Following the inclusion and exclusion criteria, a total of 80 children undergoing treatment at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council” were enrolled in the study. Among them, 60 children underwent anterior abdominal wall surgery with various types of anesthetic techniques. The patients were asked to fill in the questionnaires repeatedly 3 and 6 months after hospital discharge. RESULTS: QoL in patients with chronic pain syndrome reduced significantly (p 〈 0.001) on the scales of physical functioning, emotional functioning, social functioning, cognitive functioning, communication, worry, daily activities, family relationships, as well as pediatric QoL summary score, parent QoL summary score, and family functioning summary score 3 and 6 months after surgery with conventional analgesic techniques. CONCLUSIONS: Chronic pain syndrome reduces QoL in children aged 7–18 years after anterior abdominal wall surgery by reducing their physical, emotional, social, and cognitive functioning. The myofascial block in conjunction with general anesthesia accelerates patient’s recovery, relieves pain, and reduces emotional stress.
    Type of Medium: Online Resource
    ISSN: 1857-9655
    URL: Article
    DOI: 10.3889/oamjms.2023.11434
    Language: Unknown
    Publisher: Scientific Foundation SPIROSKI
    Publication Date: 2023
    detail.hit.zdb_id: 3032255-8
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  • 6
    Online Resource
    Online Resource
    EFFICACY OF COMBINATION OF TIOTROPIUM/OLODATEROL IN PATIENTS WITH COPD IN REAL CLINICAL PRACTICE
    ALUNA ; 2022
    In:  Wiadomości Lekarskie Vol. 75, No. 12 ( 2022-12), p. 2953-2957
    Details
    In: Wiadomości Lekarskie, ALUNA, Vol. 75, No. 12 ( 2022-12), p. 2953-2957
    Abstract: The aim: Show the efficacy of the Tiotropium / olodaterol combination in real clinical practice. Materials and methods: 100 patients with the diagnosis of COPD were included onto the study during the period of 2019-2020, an average age was 64.09±1.94 years, 66 were men (66 %) and 34 were women (34 %). There were 68 % of smokers with the average smoking experience of 24.44±4.84 pack-years. Average COPD duration was 9.35±2.42 years. There were 3 visits in the study – visit 1 (baseline), visit 2 (4-6 weeks) visit 3 (1 year). Source documentation was assessed at visit 1 and visit 3 for amount of exacerbations, antibiotic, glucocorticosteroid, methylxanthines use; mMRC and CAT were assessed at all visits. Results: Combined therapy with tiotropium/olodaterol improves clinical course of COPD, which is characterized by the significant decreased of the amount of exacerbations (2.63±0.29 to 1.63±0.21) and hospital admissions (1.2±0.2 tо 0.37±0.11). Improvement of symptoms and amount of exacerbation leads to much less use of antibiotics and glucocorticosteroids. A part of patients that used antibiotics decreased from 86±6.9 % to 67±9.3 %, amount of antibiotic courses from 1.37±0.17 tо 0.88±0.15, duration of treatment with antibiotics from 10.85±1.53 to 6.12±1.17 days. Part of the patients that used glucocorticosteroids decreased from 50±9.9 % tо 30±9.1 %, duration of treatment with antibiotics reduced from 3.97±1.06 tо 1.86±0.91 days. There also was a tendency towards a lesser used of methylxanthines. Combined therapy with tiotropium/olodaterol significantly decreased symptoms of COPD according to the mMRC (2.3±0.14 to 1.87±0.15) and САТ (23.28±1.71 to 15.77±1.58). Conclusions: Tiotropium/olodaterol combination showed its efficacy in real clinical practice. There was significant reduction in amount of exacerbation and antibiotic, gluco¬corticosteroid use during the study, which was also accompanied by the reduction is symptoms.
    Type of Medium: Online Resource
    ISSN: 0043-5147
    URL: Issue
    URL: Journal
    URL: Article
    DOI: 10.36740/WLek202212
    DOI: 10.36740/WiadLek
    DOI: 10.36740/WLek202212110
    Language: English
    Publisher: ALUNA
    Publication Date: 2022
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  • 7
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    Online Resource
    Adenocarcinoma in Meckel’s diverticulum: A rare case report
    Modestum Ltd ; 2024
    In:  Electronic Journal of General Medicine Vol. 21, No. 2 ( 2024-03-01), p. em572-
    Details
    In: Electronic Journal of General Medicine, Modestum Ltd, Vol. 21, No. 2 ( 2024-03-01), p. em572-
    Abstract: Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Its prevalence in the general population is 0.9-3.0%. Among the malignant neoplasms of MD, carcinoids and gastrointestinal stromal tumors are predominant. Adenocarcinomas account for less than 6.0% of all associated malignancies. We present a rare clinical case of a 67-year-old patient with gastric-type adenocarcinoma in MD, with metastatic foci in both lobes of the liver at diagnosis. This case demonstrates the diagnostic and therapeutic procedures that led to correct diagnosis and satisfactory treatment outcomes. This case emphasized the importance of using all the possibilities in the diagnosis and treatment and the necessity of cooperation with other experts in properly managing this disease. We also expressed an opinion about considering prophylactic resection of an intraoperatively discovered MD.
    Type of Medium: Online Resource
    ISSN: 2516-3507
    URL: Article
    DOI: 10.29333/ejgm/14199
    Language: Unknown
    Publisher: Modestum Ltd
    Publication Date: 2024
    detail.hit.zdb_id: 3143867-2
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  • 8
    Online Resource
    Online Resource
    Chronic pain in post-COVID syndrome
    AEPress, s.r.o. ; 2023
    In:  Bratislava Medical Journal Vol. 124, No. 02 ( 2023), p. 97-103
    Details
    In: Bratislava Medical Journal, AEPress, s.r.o., Vol. 124, No. 02 ( 2023), p. 97-103
    Type of Medium: Online Resource
    ISSN: 1336-0345
    URL: Article
    DOI: 10.4149/BLL_2023_014
    Language: Unknown
    Publisher: AEPress, s.r.o.
    Publication Date: 2023
    detail.hit.zdb_id: 2035032-6
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  • 9
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    Online Resource
    A 16-Year-Old Ukrainian Boy Shot at Close-Range to the Back of the Neck with a Handgun Who Required Surgical Removal of a 9×18-mm Bullet Shell from the Left Posterior Maxilla and Recovered Following Physical Therapy
    International Scientific Information, Inc. ; 2023
    In:  American Journal of Case Reports Vol. 24 ( 2023-02-13)
    Details
    In: American Journal of Case Reports, International Scientific Information, Inc., Vol. 24 ( 2023-02-13)
    Type of Medium: Online Resource
    ISSN: 1941-5923
    URL: Article
    DOI: 10.12659/AJCR.939413
    Language: English
    Publisher: International Scientific Information, Inc.
    Publication Date: 2023
    detail.hit.zdb_id: 2517183-5
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  • 10
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    Online Resource
    Treatment of purulent-inflammatory complications in a combat gunshot trauma
    Zaporizhia Medical Academy of Post-Graduate Education ; 2019
    In:  Modern medical technology , No. 2(41) ( 2019-08-20), p. 34-39
    Details
    In: Modern medical technology, Zaporizhia Medical Academy of Post-Graduate Education, , No. 2(41) ( 2019-08-20), p. 34-39
    Abstract: Purpose of the study. Justification of the effective treatment tactics of the wounded with the gunshot fractures of the long bones. Materials and methods. The examination and treatment of 123 wounded with gunshot fractures were performed. All wounded were divided into 3 groups according to clinical observation. For the first clinical group the traditional treatment of the combat fractures with osteometallosynthesis out of injury zone was done. In the second group, treatment was added with negative pressure therapy. In the third clinical group Wounded got a VAC-associated therapy with the proposed of counter-drainage of wounds with the flow-washing irrigation with antiseptic solutions Decasan + 3% hydrogen peroxide. A bacteriological study of the wounds` exudates was carried out, and the sensitivity of microorganisms to antibiotics was determined. Results. The assay of microbiological investigation of the wounds of patients, which got explosive and mineexplosive injuries, demonstrated a predominance gramnegative microflora in the wound microbiocenoses such as Acinetobacter spp. (53% of cases) and Pseudomonas spp. (15% of cases). Gram-positive cocci were isolated from 22,2% of cases. The analysis of the antibiotic sensitivity data of gram-negative nonfermentative rods showed a high level of resistance to most antibacterial. All strains of acinetobacteria and pseudomonads were susceptible to polymyxin B and colistin, but resistant to unprotected and protected aminopenicillins (amoxicillin/clavulanate, ampicillin/ sulbactam). Acceleration of regenerative processes in the wound under the influence of VAC-therapy (formation of healthy granulations, disappearance of edema) in patients with negative pressure suppression (II HS, III HS) led to a reduction of hospitalization period, which took in average 7,8 ± 1,2 days, that was 5,2 ± 0,8 days less than in a control group. In the third group of wounded, a mixture of Decasan and 3% hydrogen peroxide in the proportion of 3 : 1 was used for rinsing of wounds. On the third day tissue edema decreased in 94,45% of the wounded in that observation group, while in the second clinical group it was observed in 88,89% of patients. The duration of the hydration phase in the wound process was reduced to 5,7 days. The period of complete healing of the wounds was shorter for 2,5 days. The period of indoor stay of the wounded of this group in the hospital decreased from 14,97 to 10,8 days. Conclusions. Prevalence of gram-negative microorganisms in a gunshot wound and their high degree of resistance to antibiotics should be noticed when one takes a decision about empirical antibiotic therapy in the wounded. Observed clinical results of the proposed negative pressure therapy with counter-drainage of wounds by setting of flow-washing irrigation with a mixture of antiseptics Decasan and 3% hydrogen peroxide allow recommending this scheme for treatment of wounded with gunshot fractures of long bones.
    Type of Medium: Online Resource
    ISSN: 2072-9367
    URL: Article
    DOI: 10.34287/MMT.2(41).2019.35
    Language: Unknown
    Publisher: Zaporizhia Medical Academy of Post-Graduate Education
    Publication Date: 2019
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