Decompression Therapy Research Articles

Evaluating Racial Disparities in 30-day Outcomes for African Americans Following Colectomy for Volvulus.

Surgery is the definitive treatment for colonic volvulus despite initial decompression therapy. In general surgery, African Americans were found to have higher risks of mortality and morbidities. However, racial disparity in colectomy outcomes for volvulus among African Americans had not been explored. This study examined the 30-day outcomes for African Americans following colectomy for volvulus. The National Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2022 was used. Only patients with volvulus as the primary indication for colectomy were selected. A 1:1 propensity score matching was applied to African Americans and Caucasians to match sex, age, baseline characteristics, preoperative preparation, indication for surgery (if emergent), and operative approaches. Thirty-day postoperative outcomes were examined. There were 1027 and 7451 African Americans and Caucasians who underwent colectomy for volvulus, respectively. All African Americans were 1:1 propensity-score matched to their Caucasian counterparts. African Americans and Caucasians had a comparable mortality rate (7.21% vs 7.89%, P = 0.62). While African Americans had a higher risk of pulmonary complications (16.85% vs 13.53%, P = 0.04), other surgical complications were all comparable between African Americans and Caucasians. However, African Americans had a longer time from admission to operation (2.70 ± 3.99 vs 2.17 ± 3.36days, P < 0.01) and a longer length of stay (LOS; 12.81 ± 10.28 vs 10.50 ± 7.72days, P < 0.01). African Americans were found to have higher risks of pulmonary complications, delayed operation, and extended LOS. These disparities raise concerns and warrant further investigation into their underlying causes. Effective targeted interventions may be necessary to address these issues.

The effect of the Japanese Investigation Committee classification on hip joint survival after core decompression therapy in pre-collapsed avascular necrosis of the femoral head

Aim: This study aimed to determine the failure rate of pre-collapse avascular necrosis (AVN) of the femoral head treated with core decompression (CD) and risk factors affecting the progression of the disease in patients by using an easily applicable staging system. . Material and Methods: A total of 174 hips from 134 patients diagnosed with precollapse AVN and treated with CD were retrospectively examined. Each hip was classified using the Japanese Investigation Committee (JIC) classification. The endpoint for joint survival following treatment was defined as the occurrence of total hip arthroplasty (THA). The risk analysis on joint survival of various independent variables (treatment type, age, gender, etiology) and the frequency of THA 2 and 5 years after treatment was calculated. Results: The mean age of the patients was 44.0 ± 15.0 years, with the majority being male (71.8%). THA was performed in 28.7% of treated hips within two years and 40.2% within five years. The frequency of THA application within two years was 2% for type A, 8% for type B, 40% for type C1 and 50% for type C2. Age (p=0.033), type C1 (p=0.028) and type C2 (p

Comparison of the Effectiveness of Traditional Motorized Traction and Non-surgical Spinal Decompression Therapy Added to Conventional Physiotherapy for Treatment of Chronic Low Back Pain.

There are a limited number of studies comparing traditional motorized traction and non-surgical spinal decompression with other treatment options such as conventional motor traction in the treatment of low back pain caused by lumbar discopathy. This retrospective study aimed to compare the effectiveness of these treatments. The retrospective data of patients diagnosed with lumbar discopathy who underwent physical therapy in our clinic were reviewed. Demographic data, duration of their symptoms, physical examination findings, lumbosacral magnetic resonance imaging (MRI) reports, method and duration of treatment, and visual analog scale (VAS) and Oswestry Disability Index (ODI) results were recorded. A total of 160 patients met the inclusion criteria. Their mean age was 44.6±12.4 (range 21-65) years, 57.5% (n=92) were female, and 42.5% (n=68) were male. There were no differences between the conventional physiotherapy, motorized traction, and spinal decompression groups in terms of age, duration of symptoms, and the number of sessions (p>0.05). In all three groups, the mean scores of VAS and ODI were significantly decreased in the pre-and post-treatment comparisons (p<0.005). The rates of change in VAS and ODI were higher in the traction group and spinal decompression group compared to the conventional treatment (p<0.005). In patients with subacute and chronic lumbardiscopathies, motorized traction and spinal decompression treatments added to conventional treatment were found to be more effective than conventional treatment alone. The results of spinal decompression and conventional motorized traction treatments appear to be similar.

Laparoscopic management of small bowel obstruction secondary to a mesodiverticular band of a Meckel's diverticulum in an adult: A case report and literature review.

The mesodiverticular band (MDB) of a Meckel's diverticulum (MD) is a rare, yet notable etiology of small bowel obstruction (SBO) in adults. Due to the nonspecific symptoms and challenging diagnosis thereof, preoperative clinical suspicion and strategic management are crucial for achieving optimal outcomes. Therefore, we presented a case in which laparoscopic surgery was strategically performed to alleviate ileus, due to a preoperative diagnosis of SBO, suspected to be secondary to an MD with a concomitant MDB. A 32-year-old male patient presented with a half-day's duration of epigastric pain, abdominal distension, and tenderness, resulting in the working diagnosis of SBO. Initial non-contrast computed tomography (CT) revealed SBO without signs of strangulation, postulated to be caused by an MD and concomitant MDB, resulting in conservative management. The symptoms persisted, necessitating contrast-enhanced CT. However, the dilated bowel loop suggestive of an MD that had been observed on non-contrast CT could not be confirmed on contrast-enhanced CT. Decompression therapy using a long tube provided minimal relief, prompting laparoscopic surgery on the 5th day post-admission for diagnostic and therapeutic purposes. An MD resection effectively relieved the SBO. The histopathological analysis revealed a true diverticulum with ectopic pancreatic tissue, confirming the diagnosis of an MD. At the band site, vascular and neural structures were encased in a sheath, consistent with the remnants of the vitelline duct mesentery; and histopathologically diagnosed as an MDB. The postoperative course was uneventful, and the patient was discharged on the 9th day, postoperatively. Decompression therapy and strategic laparoscopic surgery based on the preoperative working diagnosis of SBO yielded favorable outcomes, highlighting the importance of the early clinical suspicion of an MD and a concomitant MDB, as the etiology of SBO. The imaging variability and rarity of an MD in adults emphasizes the need for a heightened awareness and an accurate diagnosis for optimal management. Early intervention should be deliberated for patients with suspected intestinal ischemia. However, this case accentuates the clinical implications of strategic planning and employing minimally invasive techniques in the management of an MD-related SBO in adults.

PLATELET RİCH PLASMA RESULTS IN THE TREATMENT OF FEMUR HEAD AVASCULAR NECROSIS

Purpose: It has been observed that the number of patients with hip avascular necrosis who applied to our clinic after Covid-19 and steroid treatment in Covid-19 treatment has increased. It is emphasized in the literature that core decompression therapy is effective in early stage femoral head avascular necrosis. Core It has been emphasized in many publications that the results of intraoperative platelet- rich plasma (PRP) application after decompression are effective. However, intraoperative The method of application of platelet- rich plasma (PRP) and its effectiveness in the post-Covid-19 period are not emphasized enough in the literature. The aim of this study is to evaluate the effect of local platelet-rich plasma (PRP) administered using the new technique after core decompression to patients diagnosed with avascular necrosis. Materials and methods: Local platelet- rich plasma (PRP) was applied to 15 hips diagnosed with femoral head avascular necrosis after core decompression with a new technique. Early results of the patients were evaluated with Ficat and Harris hip scores. Results: An improvement was detected in the early clinical and Magnetic resonance (MR) findings of a total of 15 hip avascular necrosis patients . Local treatment in patients with avascular necrosis with a medical history of Covid-19 The feasibility of PRP was demonstrated. Conclusion: This study shows the importance of the intraoperative application method of platelet- rich plasma (PRP) and that platelet- rich plasma (PRP) can also be applied to Covid-19 patients. But we believe long-term results are needed.

Effects of Decompression therapy in leg pain and straight leg rise in patient with lumbar radiculopathy due to disc protrusion

One among many disc problems is disc protrusion, which has more prevalence in outpatient department physical therapy management Centre globally. The purpose of this study was to compare the effect of lumbar spine decompression therapy and standard physical therapy treatment in patients with lumbar radiculopathy due to disc protrusion. The single-blind randomized control trial of 71 patients was conducted at Max Rehab &amp; Physical Therapy Centre Islamabad, Pakistan. After setting inclusion criteria all the patients were randomly allocated into treatment and control group. Both group received standard physical therapy treatment including, Moist Hot pack, Lumbar Mobilization, Stretching &amp; strengthening exercises. The only difference was that Decompression Group received additional Decompression therapy. The data included demographics and Numeric Pain Rating Scale score in supine lying position for the painful leg and Straight Leg Raise Range for the painful side. The values for leg pain for control group decreased from 6 to 3 and the value for straight leg raise increased from 15° to 49°. The values for leg pain for the Decompression Group decreased from 6 to 2 and the value for the straight leg raise increased from 10° to 48°, the p value for both the variables was &lt;.001 showing statistically significant difference between pre and post values in treating patients leg pain and straight leg raise range of motion. It is concluded that decompression therapy is more effective in managing lumbar radiculopathy.

Safety of Continuous Low-dose Aspirin Therapy for Lumbar Decompression Alone

Safety of Continuous Low-dose Aspirin Therapy for Lumbar Decompression Alone

Randomized controlled trial on the effects of mindfulness-based respiratory decompression therapy in claustrophobic patients undergoing MRI inspection

BackgroundClaustrophobia is a psychological disease. It is estimated to occur in 2.1–14.3% of all magnetic resonance imaging (MRI) examinations. Mindfulness decompression is an effective means to treat and reduce fear and anxiety. There is a rare report on the application of mindfulness-based stress reduction therapy in the magnetic resonance examinations of patients with claustrophobia to date.PurposeThe purpose of this study is to explore the intervention effect of mindfulness respiratory decompression therapy on the MRI inspection of patients with claustrophobia.MethodsA total of 86 patients with claustrophobia requiring MRI in our hospital from January 2018 to December 2020 were divided into two groups. The control group was given routine psychological nursing, and the observation group was given a mindfulness breathing technique on the basis of the control group. Before and after the intervention, we compared the intervention effect, satisfaction with nurses’ psychological intervention technique, severe autonomic nervous symptoms during the examination, self-rating anxiety scale (SAS) scores, and profile of mood states revised (POMS-R) scores.ResultsThe total effective rate of intervention in the observation group was 90.90%, which was significantly higher (χ2 = 6.857, p = 0.00004) than that in the control group (26.19%). Severe autonomic nervous symptoms in the observation group were significantly lower than those in the control group (p &amp;lt; 0.05). After the intervention, SAS scores and POMS-R scores in the observation group decreased with statistical significance (p &amp;lt; 0.05).ConclusionMindfulness respiratory decompression therapy can effectively help claustrophobic patients complete an MRI examination, which may be worthy of wide promotion and application in the clinic.

Perbandingan Terapi Injeksi Steroid dan Terapi Bedah Dekompresi Dengan Endoskopi Dalam Pengobatan Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition that causes pain, tingling and weakness in the hand due to compression of the median nerve in the wrist. Treatment of CTS is based on two main approaches, namely steroid injection therapy and endoscopic surgical decompression therapy. Steroid injection therapy provides greater temporary pain relief, but the benefits are not permanent. At the same time, surgical decompression treatment with endoscopy is a definitive treatment that is more effective in the long term and has a lower therapeutic failure rate than steroid injection treatment. This literature research explores various scientific studies and related literature that have been conducted in recent decades to understand the effectiveness and relative superiority of these two treatment methods. This review covers clinical aspects, such as the rate of pain recovery, recovery of hand function, as well as the impact on the patient's quality of life. The results of this literature review indicate that both treatment methods have their respective advantages and disadvantages. Steroid injection therapy can provide rapid and minimally invasive symptom relief, while endoscopic surgical decompression therapy tends to provide more lasting and complete improvement. Factors such as symptom severity, patient preference, and medical recommendations may influence the choice between these two methods.

Neurostimulation for Spinal Lesions: Enhancing Recovery and Axonal Regeneration.

Spinal neurostimulation is a promising approach for treating spinal lesions and has implications in various neurological disorders. It promotes axonal regeneration and neuronal plasticity to reestablish disrupted signal transduction pathways following spinal injuries or degeneration. This paper reviews the current technology and its differing utilities in various types of neurostimulation, including invasive and noninvasive methods. The paper also explores the efficacy of spinal compression and decompression therapy, with a primary focus on degenerative spinal disorders. Moreover, the potential of spinal neurostimulation in therapies for motor disorders, such as Parkinson's disease and demyelinating disorders, is discussed. Finally, the paper examines the changing guidelines of use for spinal neurostimulation following surgical tumor resection. The review suggests that spinal neurostimulation is a promising therapy for axonal regeneration in spinal lesions. This paper concludes that future research should focus on the long-term effects and safety of these existing technologies, optimizing the use of spinal neurostimulation to enhance recovery and exploring its potential for other neurological disorders.

A Prospective Clinical Evaluation of Adhesive Small Bowel Obstruction in Infants and Children

Background: Adhesive small bowel obstruction is a significant cause of postoperative morbidity in children. There are limited studies on the epidemiology and scope of conservative management for adhesive small bowel obstruction in children. The purpose of this study was to determine the presentation, risk factors, and management, including the role of Gastrografin, for adhesive small bowel obstruction in children. Methods: Between June 2015 and June 2020, 90 patients with an adhesive small bowel obstruction presented to our pediatric surgery department. Out of these, 10 patients underwent upfront surgery and were excluded, while the rest were put on conservative treatment. Patients who failed to improve after 24 hours of conservative management in the absence of signs of strangulation were administered Gastrografin. Patients were evaluated clinically and radiologically to determine the resolution of the obstruction. Results: The mean age was 9.04 ± 3.89 with sex a ratio of 2.6:1. Vomiting was the most symptom (90% cases), followed by pain abdomen (87.5%). Appendectomy (50%) and enterotomy for worm obstruction (17.5%) were the most common previous surgical procedures leading to acute small bowel obstruction. Recurrent obstruction was seen in 7.5% of the cases. Thirty eight (47.5%) patients were successfully managed conservatively by standard decompression therapy. Oral administration of Gastrografin successfully resolved the obstruction in 43% patients who failed standard decompression therapy, whereas 24 (30%) patients with persistent obstruction required laparotomy. Conclusion: Adhesive small bowel obstruction is a common surgical emergency in children. It can occur at any age and after laparotomy for any surgical condition; however, history of appendectomy is associated with high incidence of adhesion obstruction. Vomiting and abdominal pain are constant symptoms. Conservative management with standard decompressive therapy followed by using water-soluble contrast agents (Gastrografin) is a safe and effective approach in managing adhesion obstruction in selected children without signs of bowel ischemia.

Peritoneal dialysis-related peritonitis with encapsulated ascites due to Mycobacterium abscessus subsp. massilience and subsp. bolletii: a case series and literature review

BackgroundAs there is no established standard of care for non-tuberculous mycobacterium (NTM) peritoneal dialysis (PD)-related peritonitis, its treatments have to be case-dependent, which is often difficult. Additionally, several reported cases were accompanied by encapsulated ascites, adhesive ileus, and encapsulating peritoneal sclerosis, suggesting treatment difficulties. We report two cases of PD-related peritonitis with encapsulated ascites due to Mycobacterium abscessus subsp. massilience and subsp. bolletii. To the best of our knowledge, this is the first case series to report PD-related peritonitis caused by Mycobacterium abscessus subsp. bolletii.Case presentationThe first case is that of a 74-year-old male patient who started PD six years ago for end-stage renal failure due to diabetic nephropathy. In February 2021, he presented with signs of infection at the exit-site and swelling of the tunnel. Mycobacterium abscessus subsp. massilience was detected in the culture of the exit-site exudate; thus, he was diagnosed with tunnel infection (caused by NTM). Subsequently, fever, abdominal pain, and increased cell counts in the PD drainage fluid were observed, and he was judged to have NTM peritonitis. His general condition improved after PD catheter removal in addition to antimicrobial treatment and encapsulated ascites drainage. The second case is that of a 52-year-old man who commenced PD for end-stage renal failure due to nephrosclerosis 12 years ago. In May 2022, he was diagnosed with PD-related peritonitis based on signs of infection at the exit-site, encapsulated ascites on computed tomography, and a cloudy PD drainage fluid. Mycobacterium abscessus subsp. bolletii was detected in the culture of the exit-site exudate, which led to the diagnosis of NTM peritonitis. In addition to antimicrobial treatment, PD catheter removal and encapsulated ascites drainage were performed. The patient also had adhesive bowel obstruction due to peritonitis and required decompression therapy with the insertion of a gastric tube.ConclusionsPD catheter removal and encapsulated ascites drainage might have improved inflammation and treatment outcomes. Additionally, Mycobacterium abscessus might be prone to forming encapsulated cavities and/or intestinal adhesions; however, further accumulation of cases clarifying “subspecies” of Mycobacterium abscessus is necessary to confirm this hypothesis.

The treatment of different odontogenic cysts in children only using acrylic appliance-guided decompression: A long-term clinical study

Aim: Various odontogenic cysts may rarely occur in the jawbones during childhood, including radicular cysts, dentigerous cysts, and odontogenic keratocysts. Treatment for such cysts ranges from conservative approaches to radical surgical procedures. The present study evaluates the effect of the decompression alone method for treating various odontogenic cysts in children.Methods: A retrospective cohort study was performed that included pediatric patients who applied to the pedodontics clinic between 2014 and 2016. Data such as age, gender, anatomical location, reasons for admission, histopathological diagnosis and dimensions of the cysts, and associated teeth were recorded. All odontogenic cysts were treated using the decompression method with an acrylic obturator. All patients were evaluated clinically and radiologically one, three, six, and 12 months after the operation and annually thereafter.Results: As a result of the pathological examination, it was determined that 10 of the 16 odontogenic cysts were dentigerous cysts, 5 were radicular cysts and 1 was an odontogenic keratocyst. The patients consisted of 4 girls and 12 boys, with a mean age of 108.68±21.01 months. The average duration of the decompression was 7.3±1.41 months and the average follow-up was 9.6±2,56 years. In four patients, spontaneous eruption of the impacted permanent teeth was not observed; these were erupted using orthodontic treatment. In two cases of dentigerous cysts, the impacted teeth were extracted and the cyst was enucleated. In the remaining 14 cases, the permanent teeth erupted (spontaneous+orthodontic guided) successfully (87.5%), and the cysts healed completely after decompression treatment. Conclusion: To avoid developmental problems, conservative procedures should be preferred for the treatment of odontogenic cysts in children. Decompression therapy using an acrylic obturator is an effective treatment for odontogenic cysts in pediatric patients; this approach protects and maintains permanent teeth. However, new clinical studies with larger sample sizes are needed to support these results.

Effects of mindfulness decompression therapy on mental health and job burnout among nurses working in the frontline of the novel coronavirus pandemic: A retrospective study.

As the coronavirus disease 2019 (COVID-19) pandemic continues to spread worldwide, nucleic acid detection is a key step in controlling it. Psychological issues and job burnout of nurses working in nucleic acid sampling roles for long periods have become apparent. This study aimed to explore the effects of mindfulness decompression therapy on mental health and job burnout in front-line nurses working in nucleic acid sampling during the pandemic. Nucleic acid sampling frontline nurses who were positive for burnout on both the Symptom Checklist-90 (SCL-90) and the Maslach Burnout Inventory-General Scale (MBI-GS) were selected as the participants. Frontline nurses in the nucleic acid testing area who received routine psychological nursing intervention from June 2020 to April 2021 were used as the control group. Nurses who received both routine psychological nursing and mindfulness decompression therapy from May 2021 to December 2021 formed the "mindfulness" subject group. We compared the two groups' primary outcome measures of SCL-90 and MBI-GS scores. Before the intervention, there were no significant differences between the two groups in general data, SCL-90 scores, and MBI-GS scores. After the mindfulness decompression therapy, according to SCL-90 and MBI-GS scales, psychological distress and job burnout of nurses in the mindfulness group were significantly better than those in the control group. Mindfulness decompression therapy can effectively improve mental health and relieve job burnout in frontline nurses in nucleic acid sampling areas, which is worthy of clinical application. Randomized controlled trials are still needed, however, to fully confirm the effects of mindfulness decompression therapy.

Severe COVID-19-associated myocarditis with cardiogenic shock – management with assist devices – a case report & review

BackgroundPrimary viral myocarditis associated with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection is a rare diagnosis.Case presentationWe report the case of an unvaccinated, healthy patient with cardiogenic shock in the context of a COVID-19-associated myocarditis and therapy with simultaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and percutaneous left ventricular decompression therapy with an Impella. The aim of this review is to provide an overview of therapeutic options for patients with COVID-19-associated myocarditis.ConclusionsThe majority of patients required a combination of two assist devices to achieve sufficient cardiac output until recovery of left ventricular ejection fraction. Due to the rapid onset of this fulminant cardiogenic shock immediate invasive bridging therapy in a specialized center was lifesaving.

Portal Interventions in the Setting of Venous Thrombosis or Occlusion.

Portal vein thrombosis most commonly occurs as a complication of liver cirrhosis and can result in worsening symptoms of portal hypertension, which often can be challenging to treat with conventional decompression therapies. In addition, because complete portal vein thrombosis is associated with higher posttransplant morbidity and mortality, it is regarded as a relative contraindication to liver transplant. Often, the diagnosis of portal vein thrombosis is incidental; hence, imaging remains the mainstay for diagnosing this complication and is used to guide subsequent treatment. Although anticoagulation is the initial approach used to treat acute portal vein thrombosis, endovascular and/or surgical interventions may be necessary when there is concern for impending bowel ischemia. Treatment of chronic portal vein thrombosis is primarily aimed at alleviating the symptoms of portal hypertension and improving the chance of candidacy for liver transplant. Awareness of the portal venous anatomy to differentiate it from the periportal collaterals is key during recanalization of a chronically occluded portal vein. The authors provide an overview of the pathophysiology, acute and chronic imaging findings, and management of portal vein thrombosis, with a specific focus on endovascular management, as well as a summary of the current related literature. An invited commentary by Lopera and Yamaguchi is available online. ©RSNA, 2022.

Laboratory rats mesenteric vessel and intestine microcirculation intravital microscopy using original local abdominal decompression unit

Introduction. The local decompression therapy (including local abdominal decompression) is known to contribute to the intensity of capillary blood flow and improve the functional state of the microvasculature. We have proposed a development could be used for intravital investigation of changes in microcirculation directly under local negative pressure conditions.Purpose. Investigation of microcirculatory changes under the conditions of local negative pressure in the rat intestine and mesentery combined with pharmacological effects.Materials and methods. Unit for vital microscopy under local negative pressure was used for this work. The specific of the unit is the ability of continuous record the field of view of the microscope before, during and after the decompression session. In the experiment there were used Wistar rat males weighing 300–450 g, distributed into 5 groups of 5 animals. The animals were divided into groups depending on the pharmacological impact: atropine, pilocarpinum, drotaverine and chloropyramine and the control group.Results. It has been shown that dynamics of vascular constriction and dilatation after decompression session varies in response of certain agents suggested the involvement of certain receptor fields. The changing vessel number within the video recording frames by groups of animals was analyzed at different stages of exposure: before decompression, during decompression, within 1 minute after exposure, as well as in the interval from 1 to 5 minutes and from 5 to 19 minutes after exposure. In all groups vasoconstriction preceded decompression (i. e., reduced number of vessels in the frame), but in all of them vasodilation (increased number of vessels in the frame) occurred in the first minute after decompression. Interestingly, in the «drotaverine» group, the dynamics of changes was most pronounced: unlike other groups, vasoconstriction (0,24±0,177 %) continued during decompression, and expansion right after exposure was also highly expressed (1.034±0.997 %).Conclusion. hyperemic changes and the severity of prolongation of these changes was shown to be different depending on the type of pharmacological effect and could be recorded by the experimental unit developed by the authors.

Details of Targeted Temperature Management Methods for Patients Who Had Out-of-Hospital Cardiac Arrest Receiving Extracorporeal Cardiopulmonary Resuscitation: A Questionnaire Survey.

This study aimed to precisely describe the details of targeted temperature management (TTM) following extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA). A questionnaire to examine the TTM details following ECPR was distributed to 36 medical institutions that participated in the Study of Advanced life support for Ventricular fibrillation with Extracorporeal circulation in Japan (SAVE-J) II study. The survey was conducted using an anonymous questionnaire through the Internet and was distributed in January 2021 and collected in February 2021. Practical TTM methods (induction, maintenance, and rewarming duration) and monitoring and management methods, such as target levels, drugs, left ventricular decompression therapy, nutrition, and rehabilitation therapy, were recorded. We received responses from all 36 institutions. The target temperature was initiated at 34°C in 72.2% of institutions. In ∼90% of institutions, the maintenance duration was 24 hours, which was also the leading duration of rewarming 24 hours (38.9%), followed by 48 hours (30.6%). Electroencephalogram is routinely applied in only 13.9% of institutions. Prophylactic antibiotics were used in 58.6% of institutions. Enteral nutrition during TTM is consistently initiated in 27.8% of institutions and 33.3% of institutions initiated enteral nutrition for patients without catecholamine requirements. The 24-48 hours (55.6%) was the leading period of initiating early rehabilitation, followed by <24 hours. This survey described the details of the current practice for treating patients with OHCA by TTM following ECPR. Since various factors were undetermined in the TTM, randomized controlled trials will be necessary to resolve issues during TTM following ECPR.

Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial

BackgroundLumbar radiculopathy is an extensively common complaint reported by patients of low back pain (LBP), resulting in several impairments. A comparatively novel technique, non-surgical spinal decompression (NSD), is introduced, which uses a sensitive computerized feedback mechanism and decompresses the spinal nerve roots through segmental distraction. The objective of this study was to determine the effects of NSD therapy in addition to routine physical therapy on pain, lumbar range of motion (ROM), functional disability, back muscle endurance (BME), and quality of life (QOL) in patients with lumbar radiculopathy.MethodsA total of sixty patients with lumbar radiculopathy were randomly allocated into two groups, an experimental (n = 30) and a control (n = 30) group, through a computer-generated random number table. Baseline values were recorded before providing any treatment by using a visual analogue scale (VAS), Urdu version of Oswestry disability index (ODI-U), modified-modified Schober’s test (MMST), prone isometric chest raise test, and Short Form 36-Item Survey (SF-36) for measuring the pain at rest, functional disability, lumbar ROM, BME, and QOL, respectively. All patients received twelve treatment sessions over 4 weeks, and then all outcome measures were again recorded.ResultsBy using the ANCOVA test, a statistically significant (p < 0.05) between-group improvement was observed in VAS, ODI-U, BME, lumbar ROM, role physical (RP), and bodily pain (BP) domains of SF-36, which was in favour of NSD therapy group. The between-group difference was 1.07 ± 0.32 cm (p < .001) for VAS, 5.65 ± 1.48 points (p < .001) for ODI-U, 13.93 ± 5.85 s (p = 0.002) for BME, 2.62 ± 0.27 cm (p < .001) for lumbar flexion, 0.96 ± 0.28 (p < .001) for lumbar extension, 5.77 ± 2.39 (p = 0.019) for RP and 6.33 ± 2.52 (p = 0.016) for BP domain of SF-36. For these outcomes, a medium to large effect size (d = 0.61–2.47, 95% CI: 0.09–3.14) was observed.ConclusionIt was concluded that a combination of non-surgical spinal decompression therapy with routine physical therapy is more effective, statistically and clinically, than routine physical therapy alone in terms of improving pain, lumbar range of motion, back muscle endurance, functional disability, and physical role domain of quality of life, in patients with lumbar radiculopathy, following 4 weeks of treatment.Trial registrationWHO Iranian registry of clinical trials (IRCT20190717044238N1) Dated: 23.12.2019.

Efficacy and timing of gastrografin administration after ileus tube insertion in patients with adhesive small bowel obstruction

Background and study aimsGastrografin administration (GA) is performed for adhesive small bowel obstruction (ASBO) in cases when decompression therapy using an ileus tube fails to relieve the obstruction. This study evaluated the efficacy of GA and optimized its timing after ileus tube insertion. Patients and methodsIn this retrospective study, we evaluated data from patients with ASBO admitted between January 2014 and August 2018 and included patients who underwent ileus tube intubation and GA. The patients were classified as those treated with GA within 48 h after admission (early GA [EGA]) and those treated later with GA (delayed GA [DGA]). Propensity score matching was performed to compensate for differences between the groups. Short-term outcomes were compared between the two groups. ResultsWe included 67 and 80 patients in the EGA and DGA groups, respectively, and 55 pairs with similar background characteristics were matched. The rates of successful conservative management were 87.3% (48/55) in the EGA group, 96.4% (53/55) in the DGA group, and 91.8% (101/110) in the entire sample. The median period of ileus tube insertion in the DGA group was significantly lower than that in the EGA group, whereas other outcomes did not significantly differ between the groups. Aspiration pneumonia occurred in one patient in the EGA group. ConclusionsGA with an ileus tube achieved a high rate of successful conservative management. Follow-up using decompression with an ileus tube for at least 48 h after admission is recommended in patients with ASBO.