Acceleration Of Rehabilitation Research Articles

Aplikasi Seedballs untuk Pertumbuhan Benih Nangka (Artocarpus heterophyllus), Bisbul (Diospyros blancoi), dan Merbau (Intsia bijuga)

The area of ​​critical land in Indonesia is increasing. Critical land rehabilitation has been carried out by one of the methods used is direct planting. However, direct planting has drawbacks, namely the seeds are very prone to be eaten by insects and birds, and the seeds are easily damaged due to environmental factors. One method that can be tested is the application of seedballs using adaptive plants, such as jackfruit (Artocarpus heterophyllus), bisbul (Diospyros blancoi), and merbau (Intsia bijuga). The purpose of this study was to formulate seedballs and their application for the growth of jackfruit (A. heterophyllus), bisbul (D. blancoi), and merbau (I. bijuga) plants. This study used a quantitative descriptive analysis method with 3 types of seedballs’ formulas. The results showed the fastest germination rate was produced by formula 1 (clay) on bisbul, formula 2 (clay: topsoil) on jackfruit, and formula 3 (clay: topsoil: husk charcoal: palm waste) on merbau. The highest seed germination capacities were formulas 1 and 3 for jackfruit species, formulas 2 and 3 for bisbul species, as well as formulas 1 and 2 for merbau species. Formula 3 is generally able to increase the height, diameter, and number of leaves of plants.
 Keywords: acceleration of rehabilitation, adaptive plant, oil palm waste

Безопіатна аналгоседація під час стентування коронарних артерій

The widespread usage of opioids / opiates in anesthetic practice has highlighted a number of related problems. Therefore, in recent years, the concept of opiate-free anesthesia has been gaining popularity among anesthesiologists around the world. In this context, we are interested in lidocaine as a component of this anesthesia. The attention of anesthesiologists to lidocaine during analgesia is due to its analgesic, anti-inflammatory and antihyperalgesic properties. The basis of the analgesic effect of the drug is that it blocks sodium channels and depolarizes nociceptive peripheral neurons, simultaneously inhibits NMDA receptors, reduces the number of cytokine complexes circulating in the plasma, and dissociates the Gq protein. In general, these properties lead to a decrease in opiate consumption, an acceleration of rehabilitation, a decrease in episodes of nausea and vomiting, a reduction in hospital stay, and even has certain neuroprotective properties. The purpose of our work was to establish the main aspects of non-opiate anesthesia usage that was based on lidocaine during coronary stenting. Material and methods. We studied 60 patients with coronary artery disease who underwent stenting of the coronary arteries in a planned manner. The main diagnosis was exertional angina FC II-III. In terms of the duration of the surgery, it was 38.54±19.3 minutes, and the number of stents was 1.3±0.7. The patients were evenly divided into two study groups, depending on the prescribed drug regimen. The first group included patients who were sedated by slow intravenous administration of diazepam and fentanyl. In the group of non-opiate anesthesia, a lidocaine solution was the main component of analgesia. At the stages before the start of the surgery, during the main stage, namely, the stent placement, and after the end of the surgery, the parameters of hemodynamics, saturation, gas and electrolyte composition of blood, the level of glycemia and cortisol were assessed. Results and discussion. The main complaint of patients in the control group was drowsiness, which was noted by 36.7% of patients. We attribute this feature to the use of diazepam. However, drowsiness was also noted in 33.3% of the experimental group after surgery. This fact can be explained by the use of significant doses of propofol, which were needed to maintain hemodynamics at the appropriate level. Episodes of nausea and vomiting may occur during surgery, especially when using opiates with a high probability. The phenomena of nausea were observed in 13.4% of the 1st group, and in the 2nd group it occurred in 3.3% of cases. According to the recommendations, we administered 4 mg of ondasetron solution after which the nausea disappeared. In the second group, complaints related to the local anesthetic effects of lidocaine came to the fore. 63.3% complained of "crawling ants" or numbness in the hand, the same sensations in the cheek and numbness of the tongue – 33.3%. After the operation, the feeling of numbness in the hand persisted in 16.7%. It should be noted that these sensations did not cause significant discomfort and did not interfere with anesthesia. Conclusion. In the course of the work, we came to the conclusion that the usage of lidocaine at a dose of 1 mg / kg of the patient's body weight is safe for coronary artery stenting operations and, at the same time, there are no negative effects inherent in opiate based anesthesia. At the same time, the local anesthetic effects after using lidocaine do not worsen the course of the postoperative period

FAST-TRACK HIP AND KNEE ARTHROPLASTY (LITERATURE REVIEW)

In the present paper the authors discuss the history of fast-track formation, its development and current status. Fast-track advantages in comparison to other rehabilitation options are analyzed. The focus is placed on methods of accelerated rehabilitation after total hip and knee arthroplasty in the leading European and American clinics. Fast-track protocols of surgical centers of Denmark and Hospital for special surgery in the US are described, factors that determine time of hospital stay after total hip and knee arthroplasty are considered, predictors of hospital stay and patients satisfaction after the surgery are examined. The paper reflects the results of the comparison of frequency of thromboembolic and other complications as well as readmission rate after traditional rehabilitation and after fast-track. The paper considers fast-track in bilateral total knee replacement. The authors conclude that further research on acceleration of rehabilitation and reduction of hospital stay after total hip and knee arthroplasty needs to be focused on the optimization of pain relief, especially after discharge, blood preservation techniques, supplementation of fluids loss and strengthening of muscles. Literature analysis demonstrated that the implementation of the Protocol for accelerated recovery after joint arthroplasty in Russia is at an insufficient level. Data of foreign multicenter studies during recent years indicate a high efficacy and safety of this technique in different groups of patients.

Clinical Strategies in Ischemic Heart Disease: New Concepts and Current Controversies

Responding to what they call an explosion of knowledge about ischemic heart disease, the editors of this book have brought together 79 recognized authorities to sort through jumbled heaps of fragmented information. In their preface, the editors point to the introduction of space-age ECG monitors in 1962, which have produced great piles of data, and draw attention to the dramatic spread of new diagnostic and therapeutic techniques throughout the nation as a result of national conferences promoted by the American College of Cardiology. This unprecedented spread of innovation into clinical medicine, they observe, has almost overwhelmed the requisite amount of learning for the professional who is eager to better detect and manage myocardial ischemia, infarction, and dyskinesis. Most recently, the editors continue, coronary bypass surgery has been accepted almost universally for relief of disabling angina, improvement in life-style, and acceleration of rehabilitation. But questions remain as to whether it improves