Articles de revues : « Operative parameters »

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Kerekes, Attila, et András Zöld. « Consideration of Operative Temperature in Design and Operation ». Applied Mechanics and Materials 861 (décembre 2016) : 438–45. http://dx.doi.org/10.4028/www.scientific.net/amm.861.438.

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In order to provide appropriate thermal conditions current national regulations prescribe operative temperature as the base of design and operation. In simplified calculation procedure prescribed operative temperature can be provided using a corrected air temperature. Interrelation of operative and indoor air temperature has been investigated in function of overall heat loss coefficient and glazed ratio. Based on regression analysis necessary corrections in function of the above parameters are investigated, the consequences of neglected Mean Radiant Temperature are analysed. Operative temperature represents a control problem, too: disregarding the sensor itself its position in the room, the uneven distribution of radiant field in one room and in the rooms of a flat requires compromises. The possible solutions, their pros and cons are presented.

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Chaitanya, Burra Viswa, Tridip Dutta Baruah, Alok Mohanty et Ajay Gujar. « Pre-Operative Parameters for Predicting Difficult Laparoscopic Cholecystectomy ». International Journal of Contemporary Surgery 6, n^o 2 (2018) : 49. http://dx.doi.org/10.5958/2321-1024.2018.00033.8.

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Bergan, T. « Introduction : Parameters for Prevention of Post-Operative Infections ». Journal of Chemotherapy 13, sup4 (janvier 2001) : 5. http://dx.doi.org/10.1179/joc.2001.13.supplement-2.5.

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Maharjan, Leison, Aditya Singhal et Rajendra P. S. Guragain. « Effectiveness of Audit and Feedback in Improving the Quality of Operative Notes - A Retrospective Observational Study ». Journal of Institute of Medicine Nepal 41, n^o 1 (30 avril 2019) : 75–78. http://dx.doi.org/10.3126/jiom.v41i1.28604.

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Introduction: Surgeons must maintain detailed and accurate operative notes as it is important not only for safe patient care but also for research, audit and medicolegal purposes. But literature has shown that many operative notes are incomplete and illegible. Audit and feedback is a useful strategy to improve such practices which our department has been following. Our aim is to study its effectiveness by comparing the quality of operative notes of 2016 with that of 2014. Methods: Total 96 operative notes, 48 each of the year 2014 and 2016 were studied under 22 parameters including 18 suggested by “Good Surgical Practice” guideline. Each operative notes was analyzed by a single observer for completeness. Parameters of the operative notes of two different years were compared and given the status of either improved, deteriorated or unchanged. Results: Only parameters related to patient identification, date, surgeon’s fullname, postoperative plan were complete in both the years. In comparison to earlier year, in 2016 improvement was seen in parameters such as postoperative diagnosis, details of tissue removed, authors details, closure details, operation time and operative difficulties/ complications and deterioration was seen in hospital number, preoperative diagnosis, procedure, fullname of anesthetist, fullname of scrub nurse, operative findings and signature of the surgeon. Conclusion: Improvement in the quality of the operative notes was not adequate with audit and feedback strategy alone. Hence to increase the effectiveness, other methods such as computerized operative notes and aide-memoire should also be introduced.

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Leo Samuel, D. G., S. M. Shiva Nagendra et M. P. Maiya. « An analysis of operating parameters in the cooling tower-based thermally activated building system ». Indoor and Built Environment 27, n^o 9 (10 mai 2017) : 1175–86. http://dx.doi.org/10.1177/1420326x17704276.

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Thermally activated building system is not only energy efficient but also provides better thermal comfort compared to the conventional cooling systems. In this paper, COMSOL Multiphysics, a computational fluid dynamics tool, is used to simulate the performance of a cooling tower coupled with thermally activated building system for the hot and dry summer climatic conditions of New Delhi. The effects of three operating parameters, namely, temperature and inlet velocity of water and the number of cooling surfaces (area), on the performance of the system have been investigated. The results indicate that increasing the water inlet temperature from wet bulb temperature (WBT) to WBT + 6℃ would increase the operative temperature of the indoor space, a thermal comfort index, by 2℃. The increase in water inlet velocity from 0.2 to 1 m/s would decrease the diurnal average of operative temperature by 1.4℃. If only the roof was cooled, the diurnal average of operative temperature was 36.7℃. The diurnal average of operative temperature was reduced by 5.7℃ if all the building fabrics were cooled. In this case, with pipes connected in series from the floor first to walls and then to roof resulted in 2.9℃ lower operative temperature compared to that in the reverse sequence. Hence, the sequence in which the fabrics are cooled would have an appreciable influence on the performance of thermally activated building system.

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Niitsu, Yorikazu, Kaoru Ishida, Keiko Kimura, Kazumi Okamoto, Koji Murakami, Masanori Terashima, Nobuhiro Sato et al. « Changes of Immunological Parameters after Esophageal Cancer Operation According to Post-operative Adjuvant Therapy. » Japanese Journal of Gastroenterological Surgery 25, n^o 8 (1992) : 2069–75. http://dx.doi.org/10.5833/jjgs.25.2069.

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S., Anuja B., Elsa Sanatombi Devi, Leena Sequira, Lavanya Rao et Vijaya Pai H. « EFFECTIVENESS OF INTRA OPERATIVE HAND HOLDING ON ANXIETY AND PHYSIOLOGICAL PARAMETERS AMONG PATIENTS UNDERGOING CATARACT SURGERY ». Journal of Health and Allied Sciences NU 04, n^o 02 (juin 2014) : 027–33. http://dx.doi.org/10.1055/s-0040-1703760.

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Abstract: Introduction: Patients who are undergoing cataract surgery under local anaesthesia may be more stressed than those having general anaesthesia as they are awake during the surgical procedure. Therefore, psychological comfort in the preoperative phase and compliance during operation are very important for postoperative prognosis. This study explored the pre operative anxiety level of patients undergoing cataract surgery and the effectiveness of intra operative hand holding on anxiety and its related physiological parameters. Methods: A quasi experimental pre-test post-test control group design was used to collect data from a purposive sample of 54 patients who were underwent cataract surgery at Kasturba Hospital, Manipal. Results: Most of the patients in the experimental group perceived intra operative hand holding as a measure to reduce their anxiety even though there was no significant statistical difference in the immediate post operative anxiety score between the groups. It was also found that hand holding was effective in reducing blood pressure and heart rate except the respiratory rate of patients undergoing cataract surgery. Conclusion: The following conclusions were drawn on the basis of the findings of the present study that is, Intra operative hand holding was effective in reducing the physiological parameters such as heart rate, systolic blood pressure and diastolic blood pressure. Also most of the patients perceived intra operative hand holding as beneficial in relieving anxiety.

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Thavagnanam, Surendran, Saou Y. Cheong, Karuthan Chinna, Anna M. Nathan et Jessie A. de Bruyne. « Pre-operative parameters do not reliably identify post-operative respiratory risk in children undergoing adenotonsillectomy ». Journal of Paediatrics and Child Health 54, n^o 5 (23 novembre 2017) : 530–34. http://dx.doi.org/10.1111/jpc.13789.

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Gritsuk, Igor, Volodymyr Volkov, Eugene Ukrainskyi, Nikita Volodarets, Volodymyr Kuzhel, Tetiana Volkova et Victoria Ryzhova. « Operative ensuring information system of the standardization of vehicle operation indicators ». Journal of Mechanical Engineering and Transport 16, n^o 2 (17 janvier 2023) : 16–22. http://dx.doi.org/10.31649/2413-4503-2022-16-2-16-22.

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The formation of the method of ensuring the rationing of indicators and management of fuel economy of the vehicle in variable operating conditions by means of operational control on the basis of intelligent transport systems is shown. A systematic approach was used as the methodological basis of the research to solve the tasks set in the work. The general technique of carrying out of scientific research of rationing and fuel economy of the freight vehicle of category N3 in variable conditions of operation by means of operative control on the basis of intelligent transport systems is developed. The target function of the study is a combination of objective and subjective factors of vehicle operation, which ensure minimal fuel consumption. At the same time the minimum task is solved, namely: rationing of operational indicators, fuel economy of the vehicle in the conditions of operation tends to reach the maximum, despite the fact that fuel consumption tends to reach the minimum values. The general approach to the formation of the method of ensuring the fuel economy of the vehicle in variable operating conditions by means of operational control based on intelligent transport systems is formulated. The processes of solving the tasks are based on the implementation of systemic interaction of three interrelated components: process, information and analytical. It is shown that the peculiarity of the method is that it involves the joint use of all available methods and means of obtaining information about the processes of operation of the vehicle, fuel consumption, parameters of technical condition and speed, and so on. Thus, the process of forming a method to ensure the rationing of performance and fuel economy of the vehicle in variable operating conditions by means of operational control on the basis of intelligent transport systems involves clarifying information on fuel consumption, actual technical condition, methods and means of implementation. The article shows that this task on the basis of information about fuel consumption parameters and technical condition can be expressed as a complex function in the implementation of relevant tasks. In the work, a method of determining and calculating the fuel consumption of vehicles in operating conditions was developed specifically for the purpose of researching and justifying the regulation and parameters of fuel economy, the peculiarity of the method is that it involves the joint use of all available methods and means of obtaining information about operational processes vehicles, namely fuel consumption, parameters of the technical condition and speed of the vehicle.

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Markmann, James F., Joseph W. Markmann, Niraj M. Desai, Angeles Baquerizo, Jennifer Singer, Hasan Yersiz, Curtis Holt, Rafik M. Ghobrial, Douglas G. Farmer et Ronald W. Busuttil. « Operative parameters that predict the outcomes of hepatic transplantation ». Journal of the American College of Surgeons 196, n^o 4 (avril 2003) : 566–72. http://dx.doi.org/10.1016/s1072-7515(02)01907-5.

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Herrero, C., P. Prádanos, J. I. Calvo, F. Tejerina et A. Hernández. « Flux Decline in Protein Microfiltration : Influence of Operative Parameters ». Journal of Colloid and Interface Science 187, n^o 2 (mars 1997) : 344–51. http://dx.doi.org/10.1006/jcis.1996.4662.

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Karson, Tarn, Lee Qun-Jid et Wong Yiu-Chung. « Unicompartmental knee replacement - An Underrated Alternative of Total Knee Replacement : A Matched Comparative Study Analysing Their Benefits and Risks in Local Population ». Journal of Orthopaedics, Trauma and Rehabilitation 25, n^o 1 (1 juin 2018) : 58–61. http://dx.doi.org/10.1016/j.jotr.2017.07.001.

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Introduction The demand of knee arthroplasty is increasing worldwide with aging population. Even though unicompartmental knee replacement is associated with fewer complications namely stroke, myocardial infarction, thrombo-embolism, blood transfusion and mortality, it merely comprises 3–8% of knee arthroplasties. The aim of the study is to establish the role of unicompartmental knee replacement by evaluating the benefits and risks of unicompartmental knee replacement versus total knee replacement in Hong Kong population. Methods All unicompartmental knee replacement performed in our institute from 2011 to 2014 were reviewed. Comparative analyses were performed on pre-operative, operative and post-operative parameters. Primary total knee replacement performed in the same period was chosen as control group with 1:1 matching for age, sex, BMI and pre-operative range of motion. Results There were 46 unicompartmental knee replacement. It comprises 3.3% of all knee arthroplasties in our institute. The mean follow-up time was 12.8 months (4–38 months). There was no significant difference in all pre-operative parameters except WOMAC score. All operative parameters favored unicompartmental knee replacement significantly (operation time 76 vs 91 minutes; wound size 7.5 vs 12.4 cm; haemoglobin drop 0.75 vs 2.46g/dl, p < 0.05). Early post-operative parameters also favored unicompartmental knee replacement (Deep vein thrombosis rate 4.3 vs 23.9%; length of stay 5.4 vs 7.0 days, p < 0.05). There was no infection or mortality in both groups. Conclusion Because of less operative risk and faster rehabilitation, this study suggested that unicompartmental knee replacement is more cost effective and might be a better choice for patients with unicompartmental arthritis in local population.

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Rahman, Sharah, Jalal Ahmed, Anisur Rahman, Ishtiaque Anwar, Tarzia Asma Zafrullah, Sharifa Zahan Mitu, Mahziba Rahman Chowdhury et Syeed Mehbub Ul Kadir. « IOP change after phacoemulsification with PCIOL implantation and its association with ocular biometric parameters ». Indian Journal of Clinical and Experimental Ophthalmology 7, n^o 3 (15 septembre 2021) : 466–70. http://dx.doi.org/10.18231/j.ijceo.2021.093.

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: To assess the impact on intraocular pressure (IOP) after Phacoemulsification (PE) with Posterior Chamber Intraocular Lens (PCIOL) implantation and its relation with ocular biometric parameters. The study was a prospective observational study included 524 eyes with normal IOP (11-21 mmHg) who underwent uneventful Phacoemulsification with PCIOL Implantation surgery for age-related cataract. IOP, Central Corneal Thickness (CCT), Anterior Chamber Depth (ACD), Axial Length (AL) were measured pre-operatively and one month post-operatively by Goldman Applanation Tonometer, Corneal Pachymeter and Optical Coherence Biometer, respectively. The post-operative IOP change and its relation with preoperative biometric parameters were determined.: The mean pre-operative and post-operative IOP was 13.44±1.98 & 11.54±1.66mmHg, respectively, with an average IOP reduction after one month of 1.90±0.61mmHg. The mean pre-operative and post-operative ACD was 3.27±0.24 and 3.66±0.27 mm, respectively, with an average increase of 0.39 ±0.3 mm. Paired t-test showed post-operative IOP reduction was significantly associated with preoperative IOP (p<0.001) and ACD (p<0.001). But CCT and AL were not significantly associated. The linear regression analysis confirmed the proportional reduction of post-operative IOP, r 0.921. So 92.1% of the preoperative IOP is proportional to post-operative IOP reduction. The graphical representation shows more the pre-operative IOP, more the post-operative IOP reduction.: IOP is significantly reduced, and ACD increased after PE with PCIOL implantation surgery and is associated with post-operative IOP reduction. The post-operative IOP reduction is proportional to pre-operative IOP, and more the preoperative IOP, more the post-operative IOP reduction.

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KACZMARCZYK, Jan, Joanna FERDYN-GRYGIEREK et Andrzej BARANOWSKI. « THE IMPACT OF BUILDING PARAMETERS AND WAY OF OPERATION ON THE OPERATIVE TEMPERATURE IN ROOMS ». Architecture, Civil Engineering, Environment 11, n^o 2 (2018) : 107–14. http://dx.doi.org/10.21307/acee-2018-028.

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Gadappa, Shrinivas N., Pratibha V. Dixit, Deepika Sharma et Yogita Gavit. « Clinical study of Misgav Ladach technique of caesarean section ». International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, n^o 12 (23 novembre 2017) : 5532. http://dx.doi.org/10.18203/2320-1770.ijrcog20175275.

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Background: In the last decades caesarean section rates increased in many countries becoming the most performed intraperitoneal surgical procedure. The operative technique performed is made chiefly on the basis of the individual experience and preference of operators, the characteristics of patients, timing and urgency of intervention. Present study was undertaken to assess the benefits of the Misgav Ladach caesarean section technique in tertiary care hospital and evaluate the operative parameters like efficacy, safety, duration of surgery, blood loss, need for suture material, post-operative morbidity.Methods: Prospective surgical interventional study conducted in department of obstetrics and gynecology in tertiary care institute.Results: The duration of surgery, blood loss and post-operative complications were significantly less in the Misgav Ladach technique of LSCS.Conclusions: The choice of the Caesarean section technique is strictly linked to the individual experience and confidence of the surgical team. Misgav-Ladach technique proved to be associated to less complications, moreover, since its shorter operating time; it is to prefer in all that cases a prompt operation is required.

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Jeong, Dajeong, Seon Young Kim, Ja-Yoon Gu et Hyun Kyung Kim. « Assessment of Rotational Thromboelastometry and Thrombin Generation Assay to Identify Risk of High Blood Loss and Re-Operation After Cardiac Surgery ». Clinical and Applied Thrombosis/Hemostasis 28 (janvier 2022) : 107602962211233. http://dx.doi.org/10.1177/10760296221123310.

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Introduction: We aimed to investigate parameters for prediction of post-operative blood loss and re-operation in patients who underwent cardiopulmonary bypass. Methods: Thrombin generation assay, activated partial thromboplastin time, activated clotting time and rotational thromboelastometry (ROTEM) tests were performed at 4 time points in 65 patients: before skin incision (T1), after heparin injection (T2), after protamine reversal (T3) and before skin closure (T4). Results: Pre-operative endogenous thrombin potential (ETP) and peak thrombin levels were significantly lower in patients with high post-operative blood loss (≥ 800 mL) within 24 h than in those with low blood loss (< 800 mL). Clotting time (CT), maximal clotting firmness, clotting firmness time and alpha angle values of ROTEM measured at T2, T3 or T4 were significant predictors for high post-operative blood loss. An increase in CT-EXTEM over 4 time points was significant in patients who had a re-operation within 48 h compared to their counterparts. Conclusions: This study indicates that pre-operative ETP could predict high post-operative blood loss and that intra-operative ROTEM also helps to stratify risks of high post-operative blood loss and re-operation.

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Bellido-Esteban, Alberto, Pablo Ruisoto, José Francisco Tornero-Aguilera et Vicente Javier Clemente-Suárez. « Modification in Psychophysiological Stress Parameters of Soldiers after an Integral Operative Training Prior to a Real Mission ». Sustainability 14, n^o 5 (27 février 2022) : 2792. http://dx.doi.org/10.3390/su14052792.

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(1) Background. Military personel could be defined as “Tactical Athletes”. However, experimental evidence about the effects of new HIIT trainings in comparison with traditional training schedules is lacking. The aim of this study was to experimentally analyze the modifications on psycho-physiological and performance response of soldiers after completing experimental integral operative training. (2) Methods. A total of 43 male subjects of a special unit force of the Spanish armed forces were randomly selected and assigned into the experimental and control groups assessed after training and after deploying in a real operation area. The experimental group underwent an integral operative pre-mission 6-week training (IOT), and the control group, the 6-week traditional training. (3) Results. HIIT-based integral operative training significantly improved combat performance (melee combat score) and the psychophysiological stress response, as measured by heart rate variability indexes. (4) Conclusion. This study provides experimental evidence supporting a new integral operative effective for improved autonomic regulation, reduced perceived stress, melee and close-quarter combat techniques, in addition to aerobic and anaerobic performance and lower body strength in comparison with the traditional training.

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Castro Rodríguez, David Javier, Omar Gutiérrez Benítez, Enmanuel Casals Pérez, Micaela Demichela, Alberto Godio et Fulvia Chiampo. « Bioremediation of Hydrocarbon-Polluted Soil : Evaluation of Different Operative Parameters ». Applied Sciences 12, n^o 4 (15 février 2022) : 2012. http://dx.doi.org/10.3390/app12042012.

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The bioremediation of soils polluted with hydrocarbons demonstrated to be a simple and cheap technique, even if it needs a long time. The current paper shows the application of statistical analysis, based on two factors involved in the biological process at several levels. We focus on the Design of Experiments (DOE) to determine the number and kind of experimental runs, whereas the use of the categorical factors has not been widely exploited up to now. This method is especially useful to analyze factors with levels constituted by categories and define the interaction effects. Particularly, we focused on the statistical analysis of (1) experimental runs carried out at laboratory scale (test M, in microcosm), on soil polluted with diesel oil, and (2) bench scale runs (test B, in biopile), on refinery oil sludge mixed with industrial or agricultural biodegradable wastes. Finally, the main purpose was to identify the factor’s significance in both the tests and their potential interactions, by applying the analysis of variance (ANOVA). The results demonstrate the robustness of the statistical method and its quality, especially when at least one of the factors cannot be defined with a numerical value.

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Puyda, Volodymyr. « Special processor for operative control of parameters in real time ». Computer systems and network 1, n^o 905 (26 février 2018) : 111–17. http://dx.doi.org/10.23939/csn2018.905.111.

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Petrechenko, O. A. « Operative method of determination of parameters of maneuver of divergence ». Science and Education a New Dimension VI(186), n^o 22 (20 décembre 2018) : 68–71. http://dx.doi.org/10.31174/send-nt2018-186vi22-18.

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Tambascia, Rafael Andrade, Rodrigo Antunes Vasconcelos, Wilson Mello, Paulo Portes Teixeira et Debora Bevilaqua Grossi. « Pre-operative Functional Parameters of Patients Undergoing Total Knee Arthroplasty ». Physiotherapy Research International 21, n^o 2 (27 février 2015) : 77–83. http://dx.doi.org/10.1002/pri.1622.

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Chhetri, Raj Kumar, Suman Baral et Neeraj Thapa. « Prediction of Infectious Complications after Percutaneous Nephrolithotomy ». Journal of Society of Surgeons of Nepal 21, n^o 2 (31 décembre 2018) : 12–18. http://dx.doi.org/10.3126/jssn.v21i2.24355.

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Introduction: Post-operative infection is one of the most common and potentially life-threatening complications following percutaneous nephrolithotomy, ranging from Systemic inflammatory response syndrome (SIRS) to severe sepsis. It is reported to be the most common peri-operative cause of death. Despite taking utmost precautions, we come across major complications such as haemorrhage and urosepsis after percutaneous nephrolithotomy. This study aims to find the risk factors for infectious complications after percutaneous nephrolithotomy. Methods: This was an observational, cross-sectional, analytical study carried out in the Department of Surgery of Lumbini Medical College and Teaching Hospital over a period of six months. Pre- operative and intra-operative parameters of ninety-seven patients who underwent percutaneous nephrolithotomy were analysed to see the association between perioperative and intraoperative factors in development of post-operative infectious complications. Results: Post-operatively, SIRS was observed in 28.9% of the patients and 6.2% developed post operative sepsis. Stone burden, types of stone, abnormal urinalysis and mean operative time were associated with post-operative SIRS while stone burden, abnormal urinalysis, positive urine culture and operation time were statistically associated with post-operative sepsis. In univariate analysis only mean operation time and mean stone burden were statistically associated in development of post operative SIRS and sepsis. Conclusion: In the present study mean operation time and mean stone burden were found to be the predictive factors for post-operative infectious complications after percutaneous nephrolithotomy.

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Joshi, Mukund Raj, Tanka Prasad Bohara, Shail Rupakheti, Anuj Parajuli, Dipendra Kumar Shrestha, Dimindra Karki et Uttam Laudari. « Pre-operative Prediction of Difficult Laparoscopic Cholecystectomy ». Journal of Nepal Medical Association 53, n^o 200 (31 décembre 2015) : 221–26. http://dx.doi.org/10.31729/jnma.2734.

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Introduction: Laparoscopic cholecystectomy is one of the most common operation performed. Though LC have become safer and easier at times it can be difficult. Difficult cases can result in prolonged operative time, bleeding, bile spillage, conversion to open technique and bile duct injury resulting in unplanned prolonged hospital stay, increase in estimated cost to the patients and for the surgeon it leads to increased stress during operation and time pressure to complete the operative list. . Identification of difficult cases has potential advantages for surgeons, patients and their relatives. We aim to develop and validate a scoring system to predict difficult LC preoperatively. Methods: Prospective study. History, physical examination, abdominal ultrasound and biochemical parameters were included to develop a scoring system. Hundred patients undergoing LC were included and preoperative scores were calculated preoperatively to predict difficult LC which was compared with operative assessment. Results: Sensitivity and specificity of the preoperative scoring for difficult case was 53.8 % and 89.2 % respectively with PPV of 63.64 % and NPV of 84.62%. Only three parameters (history of acute cholecystitis, gall bladder wall thickness and contracted gall bladder) were statistically significant to predict difficult LC individually. Area under ROC curve was 0.779 (95 % CI, 0.657-0.883). Conclusions: Preoperative scoring system can be used to predict difficult LC. Surgeons can plan operation based on predicted difficulty. Patients and relatives can be counselled preoperatively for the possibility of difficult operation, prolonged hospital stay and increased cost in predicted difficult case. Keywords: difficult cholecystectomy; laparoscopic cholecystectomy; symptomatic cholelithiasis.

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Cho, Young Jae, In Seok Park, Jungbin Kim, Hyun Jin Cho, Geum Hee Gwak, Keun Ho Yang, Byung Noe Bae et Ki Hwan Kim. « Factors Predicting the Need for Early Surgical Intervention for Small Bowel Obstruction ». Annals of Coloproctology 36, n^o 4 (31 août 2020) : 223–28. http://dx.doi.org/10.3393/ac.2019.09.30.

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Purpose: Small bowel obstruction (SBO) is a common disease that requires hospitalization. The most common cause of SBO is postoperative adhesion. Delayed timing of operations in patients who need surgical intervention results in mortality or morbidity. A number of studies on SBO have established criteria for emergency surgery. However, few objective clinical parameters are available for screening patients who need a delayed operation. Therefore, we analyzed factors that affect the clinical course of SBO to select appropriate therapeutic plans for reducing the risk of complications in these patients.Methods: We investigated the clinical characteristics of patients admitted to the surgery department of our hospital between January 1, 2015, and December 31, 2016, who were diagnosed with SBO. Patients were divided into an operative treatment group (n = 12) and a conservative treatment group (n = 96). We compared clinical characteristics between the 2 groups.Results: The operative treatment group underwent more operations before SBO than the conservative treatment group (P = 0.007). Initial leukocyte counts (P = 0.004) and C-reactive protein (CRP) levels (P = 0.028) were elevated in the operative group. Body mass index (BMI) was lower in the operative group (P = 0.013).Conclusion: The number of operations before SBO, leukocyte counts, CRP levels, and BMI were useful parameters for selecting patients who needed an urgent operation for SBO.

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Jacob, Anna, Andrea Plaikner, Achim Schneider, Giovanni Favero, Roberto Tozzi, Peter Mallmann, Christian Domröse et al. « Comparison of surgical and pathological parameters after laparoscopic transperitoneal pelvic/para-aortic lymphadenectomies ». International Journal of Gynecologic Cancer 30, n^o 11 (9 octobre 2020) : 1798–802. http://dx.doi.org/10.1136/ijgc-2020-001677.

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ObjectiveLymphadenectomy is an integral part of surgical staging and treatment for patients with gynecologic malignancies. Since its introduction, laparoscopic lymphadenectomy has proved feasible, safe, and oncologically adequate compared with open surgery while morbidity is lower and hospital stay considerably shorter. The aim of this study was to examine if surgical outcomes may be improved after the initial learning curve is complete.MethodsAn analysis of 2535 laparoscopic pelvic and/or para-aortic lymphadenectomies was performed between July 1994 and March 2018 by one team of gynecologic oncology surgeons but with the consistent supervision of a consultant surgeon. Data were collected prospectively evaluating operative time, intra-operative and post-operative complications, number of lymph nodes, and body mass index (BMI). Previously published data of 650 patients treated after introduction of the method (period 1, 1994–2003) were compared with the latter 524 patients (period 2, 2014–2018).ResultsThe median age of the 2535 patients was 43 years (IQR 34–57). The most common indication for pelvic and/or para-aortic lymphadenectomy was cervical cancer (n=1893). Operative time for para-aortic lymph node dissection was shorter in period 2 (68 vs 100 min, p<0.001). The number of harvested lymph nodes was increased for pelvic (19.2 (range 2–52) vs 21.9 (range 4–87)) and para-aortic lymphadenectomy (10.8 (range 1–52) vs 14.4 (range 4–64)), p<0.001. BMI did not have a significant influence on node count or operative time, with BMI ranging from 14.6 to 54.1 kg/m2. In contrast to period 1 (n=18, 2.9%), there were no intra-operative complications in period 2 (n=0, 0.0%, p<0.001) whereas post-operative complications were similar (n=35 (5.8%) in period 1; n=38 (7.6%) in period 2; p=0.32).ConclusionIn this large cohort of patients who underwent laparoscopic transperitoneal lymphadenectomy, lymph node count and peri-operative complications improved after the initial learning curve.

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Paulraj, Pratheep Samraj Rajendran, Kiran Kailas Chirayil, Renuka Jayakumar Bellasindhi, Punitha Thetraravu Oli, Mohith Mathew et Anish Jomy. « Comparison of the surgical and post-operative outcomes between single incision laparoscopic appendicectomy (cross triangulation method) with normal conventional laparoscopic appendicectomy ». International Surgery Journal 8, n^o 7 (28 juin 2021) : 1982. http://dx.doi.org/10.18203/2349-2902.isj20212341.

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Background: The usual multiport conventional laparoscopic surgeries (appendicectomy) are now being replaced by single incision laparoscopic surgeries (appendicectomy).In our study various aspects of SILS in comparison with the multiport conventional laparoscopic appendicectomy such as incision site pain, duration of surgery, morbidity and instruments used are discussed, duration of surgery, morbidity and instruments used are discussed.Methods: A single blinded randomized control trial was done on patients presenting with acute appendicitis. Pain numerical scale, use of analgesics, time to return to routine activities, hospital re-admission, complication like port site infection, hernia, intra operative complications rates, conversion rates and duration of surgery were evaluated. Various statistics of pain and other parameters are studied and evaluated. The mean operation time, mean recovery time, post-operative pain were statistically analysed using unpaired t-test. Results: Mean operating time was 44.16 minutes for SILS and 26.88 minutes for laparoscopic appendicectomy. The mean operative pain in scale of 1 to 4 was 1.40 and 0.40 for SILS and for laparoscopic appendicenctomy respectively making SILS more pain free and comfortable for the patient. The mean post-operative recovery time was 3.12 days for SILS and 7.88 days for laparoscopic appendicenctomy giving SILS patients more rapid recovery and resumption of work. Conclusions: SILS offers better cosmetic outcome, lesser post-operative pain and shorter duration of hospital stay compared to classical 3 port conventional laparoscopic surgery but at the expense of time. Operative difficulties along with time constraint need to be overcome by the surgeon.

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Pateriya, Anurag, Mathura Prasad Agrawal et Surendra Kumar Samar. « Open versus laparoscopic cholecystectomy : a comparative study on patient parameters ». International Surgery Journal 8, n^o 6 (28 mai 2021) : 1767. http://dx.doi.org/10.18203/2349-2902.isj20212269.

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Background: The advent of laparoscopic surgeries have heralded a giant leap for minimally invasive surgeries and are now being used as a primary modality due to its various benefits. The use of laparoscopic surgeries has been limited only by patient related factors and in certain scenarios by lack of infrastructure availability. The present study aimed to provide a comparative review of the traditional and minimally invasive modalities.Methods: The study employed a comparative prospective randomized study model with 100 subjects divided in two groups based on modality employed. The operative and post-operative parameters were noted and presented.Results: The study displayed that the advent of post-operative complications as well as hospital stay duration was higher in traditional laparoscopic cholecystectomy cases.Conclusions: The study reiterated the long known fact that laparoscopic surgeries in gall stones is favorable from the patient perspective but is riddled with unavailability due to financial and infrastructure based concerns.

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Wallner, Juergen, Michael Schwaiger, Sarah-Jayne Edmondson, Irene Mischak, Jan Egger, Matthias Feichtinger, Wolfgang Zemann et Mauro Pau. « Effects of Pre-Operative Risk Factors on Intensive Care Unit Length of Stay (ICU-LOS) in Major Oral and Maxillofacial Cancer Surgery ». Cancers 13, n^o 16 (4 août 2021) : 3937. http://dx.doi.org/10.3390/cancers13163937.

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Objective: This study aimed to investigate the effect of certain pre-operative parameters directly on the post-operative intensive care unit (ICU)-length of stay (LOS), in order to identify at-risk patients that are expected to need prolonged intensive care management post-operatively. Material and Methods: Retrospectively, patients managed in an ICU after undergoing major oral and maxillofacial surgery were analyzed. Inclusion criteria entailed: age 18–90 years, major primary oral cancer surgery including tumor resection, neck dissection and microvascular free flap reconstruction, minimum operation time of 8 h. Exclusion criteria were: benign/borderline tumors, primary radiation, other defect reconstruction than microvascular, treatment at other centers. Separate parameters used within the clinical routine were set in correlation with ICU-LOS, by applying single testing calculations (t-tests, variance analysis, correlation coefficients, effect sizes) and a valid univariate linear regression model. The primary outcome of interest was ICU-LOS. Results: This study included a homogenous cohort of 122 patients. Mean surgery time was 11.4 (±2.2) h, mean ICU-LOS was 3.6 (±2.6) days. Patients with pre-operative renal dysfunction (p < 0.001), peripheral vascular disease-PVD (p = 0.01), increasing heart failure-NYHA stage categories (p = 0.009) and higher-grade categories of post-operative complications (p = 0.023) were identified as at-risk patients for a significantly prolonged post-operative ICU-LOS. Conclusions: At-risk patients are prone to need a significantly longer ICU-LOS than others. These patients are those with pre-operative severe renal dysfunction, PVD and/or high NYHA stage categories. Confounding parameters that contribute to a prolonged ICU-LOS in combination with other variables were identified as higher age, prolonged operative time, chronic obstructive pulmonary disease, and intra-operatively transfused blood.

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Kalchofner Guerrero, Karin S., Iris M. Reichler, Andrea Schwarz, Rahel S. Jud, Michael Hässig et Regula Bettschart-Wolfensberger. « Alfaxalone or ketamine-medetomidine in cats undergoing ovariohysterectomy : a comparison of intra-operative parameters and post-operative pain ». Veterinary Anaesthesia and Analgesia 41, n^o 6 (novembre 2014) : 644–53. http://dx.doi.org/10.1111/vaa.12157.

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Rao, N., R. Ramachandran, P. Singh, N. Tandon et R. Kumar. « 719 Can peri-operative parameters predict the need for post-operative inotropic support following surgical resection of pheochromocytomas ? » European Urology Supplements 14, n^o 2 (avril 2015) : e719. http://dx.doi.org/10.1016/s1569-9056(15)60711-4.

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Balzarotti, Riccardo, Cinzia Cristiani et Lorraine F. Francis. « Spin coating deposition on complex geometry substrates : Influence of operative parameters ». Surface and Coatings Technology 330 (décembre 2017) : 1–9. http://dx.doi.org/10.1016/j.surfcoat.2017.09.077.

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Revel, P., J. M. Dassonville, B. Binje et P. Erny. « PROGNOSIS VALUE OF PRE OPERATIVE BIOLOGICAL PARAMETERS BEFORE ORTHOTOPIC LIVER TRANSPLANTATION ». Transplantation 67, n^o 9 (mai 1999) : S639. http://dx.doi.org/10.1097/00007890-199905150-00409.

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Horiot, J. C., et J. F. Bosset. « Pre-operative radiotherapy for rectal cancer : What benefit ? Which technical parameters ? » European Journal of Cancer 30, n^o 11 (janvier 1994) : 1597–99. http://dx.doi.org/10.1016/0959-8049(94)00335-3.

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SEBASTIO, N., M. SIMONAZZI, E. FERRI, S. MELI, P. SALSI et P. CORTELLINI. « Profile of the urethral transmission pressure in patients undergoing tension-free vaginal tape (T.V.T.) ». Urogynaecologia 14, n^o 1 (1 juillet 2010) : 25. http://dx.doi.org/10.4081/uij.2000.25.

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The aim of the paper is to compare the pre-operative and postoperative urodynamic parameters of women with stress incontinence undergoing a TVT (Tension-free Vaginal Tape) operation in order to evaluate the functional dynamics of the operation. Twenty-two patients (mean age 56.3 years, range 30-69 years) underwent the TVT operation for the correction of stress urinary incontinence. Cervical urethral hypermobility was present in all the patients and only the TVT operation and no other surgical procedure was performed. The main urodynamic modification was the improved transmission pressure to the urethra (CTU%) at the post-operative check up, although the maximum urethral closure pressure (MUCP), the functional length (FL) and the maximum flow (Qmax) remained unchanged.

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Lu, Shao-Jung, Shyue-Yih Chang et Guang-Ming Shiao. « Comparison between short-term and long-term post-operative evaluation of sleep apnoea after uvulopalatopharyngoplasty ». Journal of Laryngology & ; Otology 109, n^o 4 (avril 1995) : 308–12. http://dx.doi.org/10.1017/s0022215100129998.

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AbstractFor a long time uvulopalatopharyngoplasty (UPPP) has been used to treat the obstructive sleep apnoea syndrome (OSAS). The diverse surgical effects, the inadequate understanding of operation effect consistency, the possibility of disease progression, and the few reported papers for long-term evaluation after UPPP aroused our interest in designing this study. Fifteen OSAS patients who had undergone UPPP with pre-operative, initial post-operative and long-term post-operative polysomnographic studies were included in this study. Long-term post-operative polysomnography was undertaken more than five years after surgery. The polysomnographic evaluations included respiratory disturbance index (RD I), duration of saturation SaO2 <85 per cent (DOS), and the lowest O2 saturation (LOS). Amongst them, 10 patients with initial post-operative RDI reduction > 50 per cent were considered responders. In these responders, the long-term follow-up results of all three parameters showed improvement compared to the preoperative data. In a comparison between the initial and long-term post-operative sleep study results, LOS and DOS showed no significant difference. However, the long-term post-operative RDI result became significantly worse. More than 80 per cent of all cases had subjective symptomatic improvement in the long-term post-operative evaluation. The subjective improvement after operation is not adequately correlated to the polysomnographic result. We suggest that long-term follow-up for patients after UPPP is necessary.

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Khudiakov, Igor, Igor Gritsuk, Valentina Chernenko, Yriy Gritsuk, Dmytro Pohorletskyi, Tamara Makarova et Viktor Manzhelei. « Features of modeling and construction of the information system of remote monitoring of the technical condition of vehicles ». Journal of Mechanical Engineering and Transport 14, n^o 2 (janvier 2022) : 140–48. http://dx.doi.org/10.31649/2413-4503-2021-14-2-140-148.

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The article presents the features of construction and modeling of the system of operational remote monitoring of the technical condition of the truck in operation, and ensuring the interaction of monitoring data of the technical condition of the vehicle, trailer, mode of operation and rest of the driver and physical condition of the driver. The peculiarity of the vehicle monitoring information system equipped with the means of registration, mode of work and rest of the driver and physical condition of the driver is that it considers the features of remote inspection of the mode of work and rest of the driver and physical condition of the driver in the modern information and communication complex. means. The on-board intelligent diagnostic complex allows to measure in the conditions of operation a large number of parameters of the vehicle with the internal combustion engine and to carry out their registration on the remote computer with use of possibilities of the claimed method. As a result of forming a model of information system for monitoring the technical condition of the vehicle, it is possible to simultaneously monitor the parameters of the vehicle, provide remote inspection of driver's work and rest, physical condition of the driver, environmental performance of the vehicle, speeding. The process of formation and analysis of information structures of information-analytical system of operative control of technical condition of vehicle in operating conditions (Systems of Operative Control of a Technical Condition of the Vehicle in Operating Conditions) is considered. The effectiveness of the remote monitoring information system is enhanced by the possibility of prompt adjustment of the level of negative impact of motor vehicles on the environment and road infrastructure.

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Mirkheshti, A., Moghaddam M. Jabbary, Niaki A. Saadat, M. S. Kalantar, S. S. Razavi et M. Mirzaei. « Comparison between intra operative hemodynamic parameters and post operative analgesia of gabapentin and tizanidine in patients by tibial fractures ». European Journal of Anaesthesiology 28 (juin 2011) : 196–97. http://dx.doi.org/10.1097/00003643-201106001-00634.

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Mladenov, G., V. Spivak, E. Koleva, A. Bogdan et S. Zelensky. « Micro-and nanostructures in modern memory devices ». Electronics and Communications 16, n^o 2 (28 mars 2011) : 5–8. http://dx.doi.org/10.20535/2312-1807.2011.16.2.267720.

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Electronic storage devices are an important part of modern information and communication systems, defining the parameters and possibilities of the whole system. In this paper it is shown the operating principle and parameters of dynamic random-access storage media, working as operative memory in computer systems as well as the flash-memories, wide and successive used as input and output of data and to keep it out of information systems.

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Milonas, Daimantas. « Significance of operative parameters on outcomes after transurethral resection of the prostate ». Medicina 46, n^o 1 (9 janvier 2010) : 24. http://dx.doi.org/10.3390/medicina46010004.

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Objective. The aim of this prospective study was to establish the influence of operative parameters on outcomes after transurethral resection of the prostate. Materials and methods. In this prospective case series study, 89 patients underwent transurethral resection of the prostate. The standardized protocol was used to investigate the impact of operative parameters (resected tissue weight, residual prostate weight, and residual prostatic weight ratio [total prostate volume – resected tissue weight / total prostate volume]) on outcomes after six months following transurethral resection of the prostate. The evaluation of treatment efficacy was done using the criteria of the Second International Consultation on Benign Prostatic Hyperplasia. All postoperative results were categorized as excellent, good, fair, or none. Treatment was considered effective when the postoperative results were excellent and good, and ineffective when results were fair and none. Results. Treatment was effective for 85.4% and ineffective for 14.6% of the patients. The univariate analysis of operative parameters detected the residual prostatic weight ratio (cutoff value, 0.71; P<0.001; sensitivity, 0.62; specificity, 0.96; OR, 39.47) as the strongest independent predictor of ineffective outcome. Logistic regression analysis revealed two important parameters of unfavorable outcomes: residual prostatic weight ratio (cutoff value, 0.71; P<0.001; OR, 62.16) and residual prostate weight (cutoff value, 26.6 mL; P=0.013; OR, 9.98). When the values of both these parameters were lower than their cutoff values, the probability of an ineffective outcome was reduced to 3%; however, when they were higher, the probability of an unfavorable outcome was increased to 95%. Conclusions. Residual prostatic weight ratio and residual prostatic weight are significant operative parameters for the prediction of outcomes after transurethral resection of the prostate.

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Ganesan, Prabu, Kumari Jayaram Manjini et Sai Chandran Bathala Vedagiri. « Effect of Music on Pain, Anxiety and Physiological Parameters among Postoperative Sternotomy Patients : A Randomized Controlled Trial ». Journal of Caring Sciences 11, n^o 3 (20 juillet 2022) : 139–47. http://dx.doi.org/10.34172/jcs.2022.18.

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Introduction: Music is a non-invasive, inexpensive and non-pharmacological nursing intervention that has no side effects and can be effective when provided alongside the routine care in cardiothoracic and vascular surgery (CTVS) ward and intensive care unit (ICU). The objective of the study was to assess the effect of music on pain, anxiety and physiological parameters among the post-operative sternotomy patients from CTVS ward and ICU in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Methods: A randomized controlled trial research design was used to conduct the study among 70 post-operative sternotomy patients. The pain score, and anxiety level were recorded using Numerical Pain Rating Scale (NPRS) and post-operative anxiety scale, with the physiological parameters recorded for both groups before the music intervention, after the first post-operative day, and after the intervention on seventh post-operative day. Data were analyzed by SPSS software version 23. Results: There was a marked reduction in the mean score of pain, anxiety, systolic and diastolic blood pressure (SBP & DBP), heart rate and respiratory rate in the study group as compared to the control group. There was a significant difference between the mean score of pain, anxiety, SBP, DBP, heart rate, respiratory rate and oxygen saturation in both groups after the intervention. Conclusion: Music was found to be effective on pain, anxiety, diastolic blood pressure, heart rate and oxygen saturation among post-operative sternotomy patients. Thus, it is essential to include music as a tool in post-operative care.

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Vaivode, Ieva, Dace Baltina, Vilnis Lietuvietis, Maris Jakubovskis, Renars Erts, Ludmila Engele, Maris Sperga, Zane Vitenberga et Simona Donina. « Clinical Relevance of Haematologic Parameters in Predicting the Malignant Potential of Suspicious Renal Masses ». Acta Chirurgica Latviensis 15, n^o 1 (1 avril 2015) : 12–17. http://dx.doi.org/10.1515/chilat-2016-0003.

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Summary Introduction. The expanded use of imaging technology has led to improvements in the early diagnosis of kidney cancer. However, providing correct diagnoses regarding the malignant potential of small renal lesions remains problematic for clinicians. In addition to imaging, pre-operative investigations usually include a complete blood count and biochemistry tests. Aim of the study. To evaluate whether the pre-operative blood cell count, cell ratios, C-reactive protein (CRP) levels, and erythrocyte sedimentation rate (ESR) can be helpful in predicting the malignancy of visually suspicious renal masses prior to surgery. Material and methods. Data on pre-operative blood tests were retrospectively collected from 84 cases of stage I renal cell carcinoma (RCC) and 55 benign lesions from patients hospitalized after a radiological finding of renal cancer and following nephrectomy. The predictive ability of various blood tests for malignant potential was analysed using the following statistical methods: the Mann- Whitney U test, receiver operating characteristic (ROC) curves and binary logistic regression. Results. The mean CRP levels, monocyte (Mo) counts, platelet (PLT) counts and monocyte/lymphocyte ratios (MLRs) varied significantly between the patients with stage I RCC and patients that had benign renal lesions with a small effect size. Among these tests, the highest AUCs were displayed by CRP [0.704, 95% confidence interval: 0.567 - 0.807] and MLR [0.736, 0.612 - 0.861]. Based on the ROC curves, optimal cut-off values of 0.26 for MLR and 1.75 mg/L for CRO were selected. A binary logistic regression was used to determine if the combination of CRP and MLR could be used to predict whether patients with renal lesions had cancer resulting in increase of area under the curve (AUC) to 0.798 [0.690 -0.905]. Conclusions. In cases of diagnostic difficulties observing small renal lesions radiologically, the combination of elevated CRP levels and MLRs above 0.26 may help to confirm the presence of renal cancer.

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Hunt, Beverley J., S. Moganansundram, S. M. Tibby, F. Holton, A. Durward, D. Anderson, C. Austin et I. Murdoch. « Use of Thromboelastography to Assess Haemostatic Changes during Paediatric Cardiac Surgery and to Predict Post-Operative Bleeding. » Blood 104, n^o 11 (16 novembre 2004) : 1038. http://dx.doi.org/10.1182/blood.v104.11.1038.1038.

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Abstract The management of post-operative bleeding in paediatric cardiac surgery is difficult because the underlying haemostatic changes have been poorly studied. The thromboelastogram (TEG) provides a real-time, functional measure of haemostasis, quantifying clot formation, strength and lysis. We investigated the use of serial intra-operative TEG to assess perioperative haemostatic changes and as an adjunct to demographic and laboratory variables for the prediction of bleeding following cardiopulmonary bypass (CPB) surgery. Ethical committee approval was obtained to study fifty-one children, median (interquartile) age 6.8 months (0.5 to 10.5) prospectively through CPB and for the first 24 hours after intensive care unit admission. Significant post-operative blood loss was defined as more than 10ml/kg in the first four post-operative hours. TEG readings and traditional coagulation parameters were measured throughout CPB. Forward stepwise logistic regression analysis was used to predict bleeding. The incidence of bleeding was 37% (19/51), with a mean 4-hour blood loss of 24 ml/kg. Both groups showed abnormalities in all TEG parameters (apart from lysis) at the end of CPB, which were more marked among those who bled (all p<0.05). Hyperfibrinolysis was not seen. Addition of heparinase to the TEG samples taken after protamine administration demonstrated a small but consistent heparin effect for all TEG parameters only among patients who bled, however this group exhibited comparable protamine:heparin ratios to those who did not (p = 0.22). Significant multivariate predictors of bleeding included fibrinogen level at induction of anaesthesia; occurrence of circulatory arrest; and two TEG parameters taken at the end of CPB: “k” (the time to maximal clot formation) and “angle” (the rate of clot formation). The final model predicted bleeding well, producing an area under the receiver operating characteristic curve of 0.855 (95% CI 0.750 to 0.960). In summary, the aetiology of bleeding after paediatric cardiac surgery appears to be due to inadequate clot formation rather than fibrinolysis. TEG readings taken at the end of CPB, in conjunction with laboratory and demographic variables may provide a useful predictor of post-operative bleeding.

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Dereli, Y., E. Ege, S. Kurban, C. Narin, A. Sarigül et M. Yeniterzi. « Pre-Operative Atorvastatin Therapy to Decrease the Systemic Inflammatory Response after Coronary Artery Bypass Grafting ». Journal of International Medical Research 36, n^o 6 (décembre 2008) : 1248–54. http://dx.doi.org/10.1177/147323000803600611.

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The effect of pre-operative atorvastatin on systemic inflammatory response syndrome (SIRS), often seen after coronary artery bypass grafting (CABG) was evaluated in 40 patients undergoing elective CABG. Patients were divided into two groups: group I (pre-operative LDL cholesterol ≤ 100 mg/dl; n = 20) received 20 mg/day atorvastatin for at least 15 days pre-operatively; group II (pre-operative LDL cholesterol < 100 mg/dl; n = 20) did not receive antihyperlipidaemic agents. All patients underwent CABG with cardiopulmonary bypass. Blood samples were taken pre-operatively and 24 h post-operatively. There were no significant differences between the two groups in terms of demographic, pre-operative or operative parameters. At 24 h post-operatively, median high-sensitivity C-reactive protein and mean interleukin-6 levels were significantly lower in group I compared with group II. There were no other significant differences in postoperative parameters between the two groups, except for duration of stay in the intensive care unit, which was shorter in group I patients. In conclusion, pre-operative atorvastatin treatment in patients undergoing elective CABG decreased inflammation parameters and could be effective in preventing SIRS.

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Jamal, Ahmed, Usman Javed Iqbal, Aroosa Amjad, Rabia Javed Iqbal et Abrar Hussain, Hassan Abbas Abdullah. « Assessment of Neurocognitive Effect in Patients Undergoing Cardiopulmonary Bypass : A Prospective Longitudinal Study ». Pakistan Journal of Medical & ; Health Sciences 16, n^o 10 (30 octobre 2022) : 238–40. http://dx.doi.org/10.53350/pjmhs221610238.

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Objective: To assess neurocognitive effects in patients who underwent cardiopulmonary bypass. Study Design & Setting: Using non probability purposive sampling, a prospective study design was used to collect the data from in tertiary care hospitals with 60 beds in ICU. Methodology: Patients who underwent CPB having no history of psychological and mental illness was recruited for the said study. We used a short test of global mental status to measure cognitive performance called the “Mini-Mental State Examination (MMSE)”.Wilcoxon test was used to analyze the pre- and post-operative changes over MMSE. The Folstein test, often known as the mini-mental state examination (MMSE), is a 30-point survey that has been widely used in clinical and research contexts to evaluate cognitive impairment. Different parameters; temporal, spatial, alternate, recognition, and recall were evaluated. P-value ≤0.05 was considered as significant. Results: In this study, a significant fall in spatial, temporal, short term recall, long term recall, object recognition, alternate, reading, writing, read and act, and drawing in post-operative MMSE scores was observed as compared to pre-operative. However, there was no significant change in command so there is little or no effect on command parameters in pre-operative and post-operative cardiopulmonary bypass patients. There was a significant difference between pre-operation and post-operation total scores i.e., a fall in the ‘total’ score of neurocognition occurred after cardiopulmonary bypass. Practical implication Study finding may be used for practical implications in managing neurocognitive outcome in patients undergoing cardiopulomonary bypass. Conclusion: This research concludes that neurocognition is affected in patients who underwent CPB, with CPB itself a bigger risk factor in causing postoperative neurocognitive dysfunction. Keywords: Cardiopulmonary bypass, Mental health, Neurocoagnitive impairment, POCD

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Beyer, F., F. Geier, J. Bredow, J. Oppermann, P. Eysel et R. Sobottke. « Influence of spinopelvic parameters on non-operative treatment of lumbar spinal stenosis ». Technology and Health Care 23, n^o 6 (27 octobre 2015) : 871–79. http://dx.doi.org/10.3233/thc-151032.

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Bogatu, Laura, Simona Turco, Massimo Mischi, Lars Schmitt, Pierre Woerlee, Rick Bezemer, Arthur R. Bouwman, Erik H. H. M. Korsten et Jens Muehlsteff. « New Hemodynamic Parameters in Peri-Operative and Critical Care—Challenges in Translation ». Sensors 23, n^o 4 (16 février 2023) : 2226. http://dx.doi.org/10.3390/s23042226.

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Hemodynamic monitoring technologies are evolving continuously—a large number of bedside monitoring options are becoming available in the clinic. Methods such as echocardiography, electrical bioimpedance, and calibrated/uncalibrated analysis of pulse contours are becoming increasingly common. This is leading to a decline in the use of highly invasive monitoring and allowing for safer, more accurate, and continuous measurements. The new devices mainly aim to monitor the well-known hemodynamic variables (e.g., novel pulse contour, bioreactance methods are aimed at measuring widely-used variables such as blood pressure, cardiac output). Even though hemodynamic monitoring is now safer and more accurate, a number of issues remain due to the limited amount of information available for diagnosis and treatment. Extensive work is being carried out in order to allow for more hemodynamic parameters to be measured in the clinic. In this review, we identify and discuss the main sensing strategies aimed at obtaining a more complete picture of the hemodynamic status of a patient, namely: (i) measurement of the circulatory system response to a defined stimulus; (ii) measurement of the microcirculation; (iii) technologies for assessing dynamic vascular mechanisms; and (iv) machine learning methods. By analyzing these four main research strategies, we aim to convey the key aspects, challenges, and clinical value of measuring novel hemodynamic parameters in critical care.

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Cooper, Savannah, Benjamin Johnson, Tyler Youngman, Philip Wilson, Daniel Sucato, David Podeszwa, Henry Ellis et Philip Serbin. « Paper 22 : PREDICTORS OF RE-OPERATION IN ADOLESENTS UNDERGOING HIP PRESERVATION SURGERY FOR FEMOROACETABULAR IMPINGEMENT ». Orthopaedic Journal of Sports Medicine 10, n^o 7_suppl5 (1 juillet 2022) : 2325967121S0058. http://dx.doi.org/10.1177/2325967121s00586.

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Objectives: Femoroacetabular Impingement(FAI) is a condition caused by repetitive motion of abnormal hip osseous anatomy that contributes to labral and chondral injury. An understanding of radiographic parameters associated with successful primary surgery has not been well established. The primary objective was to determine pre-operative radiographic parameters that predict reoperation for FAI and, secondarily, correlate radiographic measures and outcomes in these patients. Methods: A prospectively-collected institutional registry of adolescent patients (age <19 y.o.) who underwent surgery for FAI (arthroscopic/open) was reviewed. Standing AP pelvis X-rays were analyzed for alpha, lateral center edge(LCEA), Tönnis, and Sharp’s angles, and femoro-epiphyseal acetabular(FEAR) index. Patient-reported outcomes(PROs) [modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score(HOOS)] were analyzed. Mann-Whitney-U test was used to compare the radiographic measures of re-operation to non-reoperation patients and those who achieved MCID to those who did not. Radiographic indication of risk for re-operation was evaluated with receiver operating characteristic(ROC) analysis. Spearman’s correlation was calculated between radiographic measurements and PROs at 2-years post-op. Results: Eighty-seven patients underwent primary surgery (56 surgical dislocations vs 31 scopes) for FAI. The average age at time of primary operation was 16.27 years(73.6%Female). 10 underwent re-operation (11.5%) at an average of 20.6 months from primary surgery. No differences were found in demographics, activity, surgery type, labral disease, or alpha angle for re-operation vs. non-reoperation. The LCEA, FEAR Index, Sharps, and Tönnis angle were significantly different (p<0.05) (Table 1). ROC analysis indicated that LCEA<21 and FEAR index>-8.8 were predictors for increased risk of reoperation. Patients with LCEA<21°, 46% underwent a reoperation compared to those with LCEA>21° (6%). Patients with FEAR index<-8.8, 32% underwent a reoperation compared to patients>-8.8 (5%). Patients who achieved MCID (61.9%) had lower BMI, worse pre-operative PROs, and better post-operative PROs at 2-years. Alpha, Tönnis, and Sharp’s angles were positively correlated with 2+ year PROs, while LCEA was negatively correlated(p<0.05). Conclusions: In patients undergoing treatment for FAI, a reoperation was associated with radiographic signs of hip dysplasia, indicating that patients with a shallower acetabulum are at risk for a repeat operation. Surgeons can utilize these parameters to help in surgical decision making, better predict outcomes and to counsel patients the need for potential subsequent surgery. UPLOAD- https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/10177e80-b6a8-458e-b216-840ad950f2a6/1/Tables.docx

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Serbin, Philip A., Savannah Cooper, Benjamin L. Johnson, Tyler R. Youngman, Philip L. Wilson, Dan Sucato, David Podeszwa et Henry B. Ellis. « Predictors of Re-Operation in Adolesents Undergoing Hip Preservation Surgery for Femoroacetabular Impingement ». Orthopaedic Journal of Sports Medicine 10, n^o 5_suppl2 (1 mai 2022) : 2325967121S0045. http://dx.doi.org/10.1177/2325967121s00451.

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Background: Femoroacetabular Impingement(FAI) is a condition caused by repetitive motion of abnormal hip osseous anatomy that contributes to labral and chondral injury. An understanding of radiographic parameters associated with successful primary surgery has not been well established. Hypothesis/Purpose: The primary objective was to determine pre-operative radiographic parameters that predict reoperation for FAI and, secondarily, correlate radiographic measures and outcomes in these patients. Methods: A prospectively-collected institutional registry of adolescent patients (age <19 y.o.) who underwent surgery for FAI (arthroscopic/open) was reviewed. Standing AP pelvis X-rays were analyzed for alpha, lateral center edge(LCEA), Tönnis, and Sharp’s angles, and femoro-epiphyseal acetabular(FEAR) index. Patient-reported outcomes(PROs) [modified Harris Hip Score (mHHS), Hip Disability and Osteoarthritis Outcome Score(HOOS)] were analyzed. Mann-Whitney-U test was used to compare the radiographic measures of re-operation to non-reoperation patients and those who achieved MCID to those who did not. Radiographic indication of risk for re-operation was evaluated with receiver operating characteristic(ROC) analysis. Spearman’s correlation was calculated between radiographic measurements and PROs at 2-years post-op. Results: Eighty-seven patients underwent primary surgery (56 surgical dislocations vs 31 scopes) for FAI. The average age at time of primary operation was 16.27 years(73.6%Female). 10 underwent re-operation (11.5%) at an average of 20.6 months from primary surgery. No differences were found in demographics, activity, surgery type, labral disease, or alpha angle for re-operation vs. non-reoperation. The LCEA, FEAR Index, Sharps, and Tönnis angle were significantly different (p<0.05) (Table 1). ROC analysis indicated that LCEA<21 and FEAR index>-8.8 were predictors for increased risk of reoperation. Patients with LCEA<21°, 46% underwent a reoperation compared to those with LCEA>21° (6%). Patients with FEAR index<-8.8, 32% underwent a reoperation compared to patients>-8.8 (5%). Patients who achieved MCID (61.9%) had lower BMI, worse pre-operative PROs, and better post-operative PROs at 2-years. Alpha, Tönnis, and Sharp’s angles were positively correlated with 2+ year PROs, while LCEA was negatively correlated(p<0.05). Conclusion: In patients undergoing treatment for FAI, a reoperation was associated with radiographic signs of hip dysplasia, indicating that patients with a shallower acetabulum are at risk for a repeat operation. Surgeons can utilize these parameters to help in surgical decision making, better predict outcomes and to counsel patients the need for potential subsequent surgery. [Table: see text]

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Wilson, MSJ, P. Maniam, A. Ibrahim, N. Makaram, SR Knight et P. Patil. « Polymeric clips are a quicker and cheaper alternative to endoscopic ligatures for securing the appendiceal stump during laparoscopic appendicectomy ». Annals of The Royal College of Surgeons of England 100, n^o 6 (juillet 2018) : 454–58. http://dx.doi.org/10.1308/rcsann.2018.0036.

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Introduction The use of polymeric clips in securing the appendiceal stump has been increasingly reported as a viable alternative to current methods in emergency laparoscopic appendicectomy. We evaluated the operative outcomes following the use of polymeric clips versus endoscopic ligatures. The primary endpoint was operative time, with secondary outcomes including complications, inpatient stay, and cost analysis. Materials and methods Operative records were retrospectively analysed to identify patients undergoing laparoscopic appendicectomy between January 2014 and June 2015. Data collected included age, gender, body mass index, duration of surgery, length of hospital stay, antibiotic use, preoperative haematological and biochemical parameters, 30-day readmission rate and complications. Results A total of 125 patients were included within the study, with 78 within the endoloop group and 47 in the polymeric clip group. There were no differences in age, gender, body mass index, hospital stay, antibiotic use, 30-day readmission rates or postoperative complications. Operative time was significantly reduced in the polymeric clip group (59 vs. 68 minutes, P = 0.00751). The use of polymeric clips cost £21 compared with £49 for endoloops per operation, which rose to £70 if both clips and endoloops were used during the procedure. Discussion Polymeric clips are a safe, viable and economical method for securing the appendiceal stump during laparoscopic appendicectomy. The clinical significance of nine minutes of reduced operating time in the polymeric clip cohort warrants further study with an adequately powered randomised controlled trial.

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Ahn, Jungtae, Tae Yong Kim, Tae Wook Kim et Bi O. Jeong. « Learning Curve for Open Reduction and Internal Fixation of Displaced Intra-Articular Calcaneal Fracture by Extensile Lateral Approach Using the Cumulative Summation Control Chart ». Foot & ; Ankle Orthopaedics 4, n^o 4 (1 octobre 2019) : 2473011419S0008. http://dx.doi.org/10.1177/2473011419s00087.

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Category: Trauma Introduction/Purpose: Open reduction and internal fixation (ORIF) of displaced intra-articular calcaneal fracture (DIACF) by extensile lateral approach is widely used but is technically challenging. In this study, the learning curve for ORIF of DIACF by extensile lateral approach was investigated. Methods: Between March 2014 and July 2018, 45 cases consisting of 40 patients underwent operative treatment for DIACF by the extensile lateral approach performed in all instances by a single surgeon. A moving average and cumulative summation control chart (CUSUM) were used for learning curve analyses. Operative failure was defined when at least one of the following parameters were unsatisfactory: reduction of Gissane angle and Böhler angle, posterior facet congruency, calcaneal width, subfibular impingement, axial alignment, or calcaneocuboid joint congruency. Results: The mean operating time was 117.4 min. Regarding the quality of reduction, the mean preoperative sum of the 7 parameters was 5.1 and improved to 0.6 postoperatively. The CUSUM for operative success peaked in the 20th case. The CUSUM and moving average graphics of operating time peaked at the 9th case and registered nadirs at the 34th case, with slight ascent and decent. The operating time for twenty cases in phase 1 (1–20) and for twenty-five cases in phase 2 (21–45) of the learning curve did not differ significantly. There was no statistical difference in the severity of fracture pattern. By comparison, significant differences in phase 2 patients showed a better postoperative reduction quality. Conclusion: As indicated by multidimensional statistical analyses, primary technical competence in improving the reduction quality of DIACF was achieved after the initial learning period with 20 cases. After the learning curve for ORIF of DIACF, a better reduction quality in the sum of reduction parameters was observed.

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