Medicina
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Randomized Controlled Trial Comparative Study
Comparison of Renal Tubular Damage with Kidney Injury Molecule-1 in Open and Laparoscopic Colorectal Cancer Surgery.
Background and Objectives: Colorectal cancer is the third most common type of cancer in men and women. With advancements in technology, minimally invasive treatment options have become increasingly prominent in colorectal cancer surgery. This study aimed to compare the increased intra-abdominal pressure in laparoscopic colon and rectal surgery with open procedures using kidney injury molecule-1 (KIM-1) secreted from renal tubules. ⋯ Results: The urinary KIM-1/Cr levels increased at the 4th postoperative hour after the open and laparoscopic procedures. On postoperative day 14, the urinary KIM-1/Cr levels were lower than those in the preoperative period in all groups, except the LAR group. Conclusions: Our study shown that the average pressure in laparoscopic colon and rectal surgery did not have a long-term impact on kidney injury in comparison to open colon and rectal surgery.
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Randomized Controlled Trial
The Role of Omega-3 Polyunsaturated Fatty Acids in Patients with Metabolic Syndrome and Endothelial Dysfunction.
Background and Objectives: Metabolic syndrome (MS) represents several diseases encompassing a heterogeneous group of biochemical and physiological abnormalities characterized by structural and functional alterations in the myocardium, including the endothelium of the coronary arteries. MS also affects a substantial portion of the global population. Understanding the risk factors, the development and treatment associated with MS are of paramount importance for early identification, treatment and prevention. ⋯ The augmentation index changed from 14.66 ± 19.55 to 9.21 ± 15.64 after the treatment (p = 0.003) with n-3 PUFA. The results also revealed a statistically significant decrease in apolipoprotein B (0.94 ± 0.36 vs. 1.13 ± 0.35, p = 0.001) and homocysteine (19.31 ± 5.29 vs. 13.78 ± 3.05, p = 0.001) and an increase in glutathione peroxidase plasma levels (41.65 ± 8.90 vs. 45.20 ± 8.01), p = 0.001. Conclusions: The results of this prospective study showed a significant improvement in EF in subjects with MS treated with n-3 PUFAs in a dose of 2.4 g daily.
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Randomized Controlled Trial
Multistrategic Approaches in the Treatment of Acute Migraine During Pregnancy: The Effectiveness of Physiotherapy, Exercise, and Relaxation Techniques.
Background and Objectives: Migraine is a common neurological condition that significantly impacts quality of life, especially in women during their reproductive years. Pregnancy poses unique challenges for migraine management due to hormonal changes and the limited use of pharmacological treatments. Non-pharmacological interventions, such as physiotherapy, exercise, and relaxation techniques, offer promising alternatives for managing migraines during this critical period. ⋯ Conclusions: Physiotherapy, structured exercise, and relaxation techniques are effective, safe, and non-invasive interventions for managing acute migraines during pregnancy. These findings provide evidence-based alternatives to pharmacological treatments, highlighting the importance of holistic approaches to migraine management during pregnancy. Further research is needed to confirm long-term efficacy and explore combined interventions.
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Randomized Controlled Trial
Effects of a Serratus Anterior Plane Block After Video-Assisted Lung Wedge Resection: A Single-Center, Prospective, and Randomized Controlled Trial.
Background and Objectives: Video-assisted thoracoscopic surgery (VATS) is associated with less postoperative pain than traditional open thoracotomy. However, trocar and chest tube placement may damage the intercostal nerves, causing significant discomfort. An ultrasound-guided serratus anterior plane block (SAPB) is a promising mode of pain management; this reduces the need for opioids and the associated side-effects. ⋯ No significant between-group differences were observed in postoperative complications, including nausea and vomiting. Conclusions: SAPB effectively reduced opioid consumption after VATS lung wedge resection. SABP may serve as a valuable component of multimodal pain management.
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Randomized Controlled Trial
Management of Ventilator-Associated Pneumonia Caused by Pseudomonas and Acinetobacter Organisms in a Pediatric Center: A Randomized Controlled Study.
A dangerous infection contracted in hospitals, ventilator-associated pneumonia is frequently caused by bacteria that are resistant to several drugs. It is one of the main reasons why patients in intensive care units become ill or die. This research aimed to determine the most effective empirical therapy of antibiotics for better ventilator-associated pneumonia control and to improve patient outcomes by using the minimal inhibitory concentration method and the Ameri-Ziaei double antibiotic synergism test and by observing the clinical responses to both single and combination therapies. ⋯ The combination therapy that showed the greatest improvement was a mix of aminoglycosides, quinolones, and β-lactams. A combination of aminoglycosides and dual β-lactams came next. Although the optimal duration of antibiotic treatment for ventilator-associated pneumonia is still unknown, treatments longer than seven days are usually required to eradicate MDR P. aeruginosa or A. baumannii completely.