Cc In Control Group Research Articles

Desmopressin effects on bleeding during functional endoscopic sinus surgery on patients with chronic rhinosinusitis

ObjectiveIn this study we aimed to determine whether Desmopressin (DDAVP) can alter bleeding and improves surgeon visual field and decrease operation time or lessen use of anesthesiology medication in a clinical trial study. MethodThis study is a randomized clinical trial using the permuted block randomization method. 44 patients were enrolled in study and divided into two equal intervention-control groups. The intervention group received maximum dose of 0/2 micrograms per kg of DDAVP. In the control group, 30 min before the surgery, 100 ml of normal saline will be injected. ResultsThe amount of bleeding was 517/17 cc in control group during surgery while it was 387/72 cc in group receiving DDAVP which is significantly lower. The satisfaction of surgeon regarding suitable visual field was 6/45 in control group while it was 3/77 in DDAVP receivers which is lower. ConclusionIt seems that intravenous DDAVP can reduce bleeding during surgery and offer an enhanced vision for surgeon during surgery but it has no potential efficacy on reduction of period of surgery and need for anesthesiology medication like remifentanil and isoflurane.

Effect of Local Tranexamic Acid on Hemostasis in Rhytidectomy.

Importance: Hematoma is the most common complication in rhytidectomy. Tranexamic acid (TXA) is an antifibrinolytic that may be a useful tool to reduce intraoperative bleeding and postoperative hematoma risk. Objective: To determine whether local TXA reduces intraoperative bleeding and postoperative drain output in rhytidectomy. Design, Setting, and Participants: Retrospective cohort study of patients undergoing deep plane rhytidectomy with platysmaplasty. Beginning January 1, 2019, we began adding 1 cc (100 mg) of TXA to every 10 cc of local anesthetic and tumescent solution. Patients were, therefore, separated into two cohorts: control and TXA. Primary outcomes include postoperative day 1 (POD1) drain output, days to drain removal, percentage drains removed POD1, and percentage POD1 drain output <25 cc. Secondary outcomes include minor hematoma, major hematoma, Nitro-bid use, intraoperative estimated blood loss (EBL), and thromboembolic events. Results: POD1 drain output reduced from 50.4 cc in control group versus 14.8 cc with TXA (p < 0.001). Average day of drain removal reduced from 1.8 days in control group versus 1.2 days with TXA (p = 0.001). Percentage of drains removed on POD1 was increased from 34.4% in control group to 77.3% with TXA (p < 0.001). Percentage of POD1 drain output <25 cc was increased from 21.9% in control group to 95.5% with TXA (p < 0.001). Intraoperative EBL <50 cc increased from 25% in control group to 75% with TXA (p < 0.001). No statistically significant difference was observed between control and TXA in rates of minor hematoma, major hematoma, Nitro-bid use, or thromboembolic events. Conclusions and Relevance: Local TXA used in rhytidectomy significantly reduces intraoperative blood loss, postoperative drain output, and time to drain removal. No significant difference was observed in postoperative complication rates.

Comparison of two different dosages of the tranexamic acid on reducing of bleeding during spinal fusion surgery

Background: One of the problems that influenced surgeon and anesthesiologist in strumental spinal fusion surgery (CD surgery) is the excessive bleeding during surgery. There are different ways for reducing bleeding during surgery such as the intravenous administration of tranexamic. In this study the effect of two doses of tranexamic acid for reducing of bleeding in spinal fusion surgery was evaluated. Methods: This clinical trial study was performed on 75 patients with class I and II ASA patients scheduled for strumental spinal fusion surgery under the same general anesthesia. The patient’s randomly divided into 3 groups. One group received single dose of tranexamic acid and another group received single dose of tranexamic acid plus maintenance dose of tranexamic acid that continued during surgery and the control group received normal saline as a placebo. The blood loss during surgery and until 24 hours later was documented. Bleeding score and surgeon satisfaction scores were recorded. Results: The amount of blood loss was reduced in both groups receiving the tranexamic acid (934 cc in control group, 664cc in single dose group and 758 cc in single dose plus maintenance dose group). But the difference was not statistically significant. (P value>0.05). Conclusion: The quality of surgery field, surgeon satisfaction scores and blood transfusion to patients in 3 groups was not significantly different.

135-P

Aim Anorexia nervosa (AN) is a complex disorder with many genetic factors implicated in disease onset and pathology. The cyp46 gene encodes the cholesterol 24-hydroxylase enzyme, which plays a key role in brain cholesterol turnover. A polymorphism in Intron2 in the CYP46 gene has recently been reported to be associated with the risk of poor cholesterol turnover. In the present study, we examined the possible association of CYP46 polymorphism and HLA DRB1 ∗ 03 with AN in Castilla y Leon (Spain) population. Methods 18 restrictive AN, ANR: 10 compulsive AN, ANC, and 98 controls were employed in this study. Classic SSP DR “Low resolution” kit of Dynal was employed in this study. A 285 bp polymerase chain reaction (PCR) product containing CYP46 was amplified using primers (for: 5′-TGA AAA CGA GTT TCC CGT CC-3′; rev: 5′-GTG TGA CCA GGT AAC AGT CA-3′). PCR was performed using 10 ng of genomic DNA in 20 mcl of reaction mixture. The PCR conditions was: 95° for 5 min, 1 cycle; 95° 30 seg, 53° 30s, 72° 30s 34 cycles, and 72° 10 min. PCR products were digested by Msp I restriction enzyme and revealed by agarose gels. CYP46 T allele corresponded to the uncut 285 bp fragment, CYP46 C allele was two fragments of 209 and 76 bp. Results The polymorphism distribution of CYP46 are 51,7% TT, 41,3% TC, 3,3 & CC in ANR; 56,6% TT, 40,0% TC, 6,9% CC in ANC and 42,8 TT, 46,9 TC 10,2 CC in control group. The DRB1 ∗ 03 distribution are 15.6% in AN and 14,6% in controls. Conclusions No significative differences are in the CYP46 and DRB1 ∗ 03 distributions inter patients groups and controls (The Chi-square test, p

Impact of Graft Hepatic Vein Inferior Vena Cava Reconstruction with Graft Venoplasty and Inferior Vena Cava Cavoplasty in Living Donor Adult Liver Transplantation Using a Left Lobe Graft

Hepatic venous reconstruction is critical in living donor adult liver transplantation (LDALT) because outflow obstruction in small for size graft may lead to graft dysfunction or loss. We describe the usefulness of venoplasties of the graft hepatic vein (HV) and graft HV-recipient inferior vena cava (IVC) reconstruction in LDALT using a left lobe graft. Sixty patients who underwent LDALT were studied. We divided the patients into following two groups: venoplasty group (n=30) and control group (n=30). For the patients with venoplasty group, venoplasty of the graft and recipient IVC cavoplasty was made to widen the orifice. Comparison examination of a background factors and postoperative bilirubin and the ascites was carried out. The mean graft volume standard liver volume ratio (GV/SLV) did not have the difference at 41.7% of venoplasty group, and 42.1% of control group (p=NS). The diameter of the hepatic vein in control and venoplasty group before and after venoplasty is 26.9+/-5.5, 28.2+/-2.9, and 34.1+/-3.9 mm, respectively. The diameter of the hepatic vein after venoplasty is larger than that of before venoplasty and of control (P<0.05). Mean total bilirubin level on postoperative day (POD) 7 is 13.8+/-9.3 mg/dl in control group and 7.0+/-3.3 mg/dl in venoplasty group (P<0.05). Mean amount of ascites on POD 7 and 14 are 1576+/-1113 and 1397+/-1661 cc in control group, and 736+/-416 and 550+/-385 cc in venoplasty group, respectively (P<0.05). Two-year survival rate is 75.2 % in control group and 86.6 % in venoplasty group (P<0.05). We conclude that in LDALT using left lobe graft, HV-IVC reconstruction with graft venoplasty and IVC cavoplasty is useful not only to prevent outflow block but also to improve graft function.

Clinical Characteristics of Contralateral Recurrent Lumbar Disc Herniation at the Same Level - A Retrospective Controlled Study -

‐ Abstract ‐ Study Design : A retrospective study of patients with contralateral recurrent lumbar disc herniation at the same level. Objectives : To analyze the risk factors of recurrence, clinical result and reoperative efficiency of contralateral recurrent lumbar disc herniation at the same level after primary discectomy compared with those after discectomy in primary lumbar disc herniation. Summary of Literature Review : There have been many studies on recurrent disc herniation, but little investigation of risk factors and clinical result of contralateral recurrent lumbar disc herniation at the same level. Materials and Methods : Ten cases who can investigate for 2 years among the patients who underwent reoperation for contralateral recurrent lumbar disc herniation at the same level after primary discectomy were selected as study group (groupⅠ) and thirty cases who underwent discectomy during the same study period were selected as control group (groupⅡ). Age, gender, etiology and symptom of disc herniation, clinical improvement rate and amount of remove disc were recorded. Overall patient satisfaction, pain severity, functional outcome and work status were evaluated. Risk factors of recurrence were analyzed. Results : Etiology was no different between both groups but showed the abrupt onset symptom in study group. Recurrence was more common in the case herniated posterolaterally and had severe degeneration change in lumbar disc before primary discectomy. The amount of bulging disc removed were average 1.5 cc in study group and 2.5 cc in control group. Recurrence was more in the cases removed smaller amount of bulging disc and remained the symptom of pain after primary discectomy. Clinical result show the same between both group after 2 years (p>0.05). C o n c l u s i o n s : Contralateral recurrent disc herniation at the same level mainly has abrupt symptom and more in the cases degenerated discs. Recurrence was more common in the cases removed smaller amount of bulging disc and remained the symptom after primary discectomy.