Study on the characteristics and some risk factors of transurethral prostatectomy syndrome

Background: Benign hyperplasia prostate is a common disease in older men (over 60 years old). Transurethral resection of benign hyperplasia prostate is a method of improving symptoms with the best results, though with a high rate of complications, in which the most serious complication is transurethral prostatectomy syndrome (TURPS). Objective: The study aimed to describe clinical and para-clinical characteristics of TURPS and to define some risk factors of TURPS. Subject and methods: A descriptive, prospective study was conducted in 200 patients, who underwent TURPS, ASA I-II at the Anesthetic Emergency Department, Viet Duc Hospital from April 2007 to October 2007. To describe TURPS by observing clinical signs and serum sodium. The risks of TURPS were considered as prostate weight, operation time and amounts of used irritants. Results: The incidence of the TURPS was 7% of all resections. Clinical signs of the TURPS were nausea, vomiting, headaches, confusion and disorientation. TURPS was associated with hypotension (42.9%), bradycardia (35.7%), increased CVP (21.4%). The sodium concentration fell below normal in certain patients (64.3%). The amount of 3% Sorbitol (> 20 liters) was an independent risk factor of TURPS, but not the prostate weight or the operation time. Conclusions: The main signs of TURPS included central nervous symptoms (100%), circulatory and respiratory disorders (42.9%, 21.4%, respectively) and hyponatremia (64.3%). Sorbitol 3% > 20 liters was an independent risk factor of TURPS.

Effects of simvastatin on coagulation parameters in dyslipidemia patients

Background: Statin and its derivate (simvastatin, autorvastatin, etc...) are used for dyslipidemia treatment and preventing thrombose. However, the mechanism of the antithrombotic action is still being studied. Objectives: (1) To study coagulation parameters in dyslipidemia. (2) To evaluate the effects of simvastatin on coagulation parameters in dyslipidemia patients. Subject and Method: A prospective study was carried out in a sample of 22 patients with primary hypercholesterolemia (type IIa), who were treated with simvastatin 20mg/d for 1 month. The lipid parameters (cholesterol, triglycerid, HDL, LDL) and coagulation parameters (PT, APTT, fibrinogen, factor II, V, VII, X, VIII, IX, XI) were compared between pre and post therapy, and to the control group (59 healthy people). Results: Most of coagulation parameter values (except factor VIII and X) of the pre treatment group were significantly change towards hypercoagulation (p<0.05%) when compared to the control group. After treatment, PT rate, APTT, APTT rate, fibrinogen, factor VII and IX were significantly changed towards coagulation when compared to pre treatment (p<0.05%). The plasma coagulation and lipid parameters of more than 50% of the hypercholesterolemia patients returned to normal values after treatment. Conclusions: Simvastatin therapy on dyslipidemia patients can reduce not only the level of serum lipid, but also coagulation, and proved its effectiveness in the prevention of thrombosis.

Platelet aggregation induced by ADP and collagen in dyslipidemia patients

Background: Dyslipidemia is an important risk factor of atherosclerosis. The endothelia can be injured by plaque that advantages for platelet adheadsion, aggregation and produces thrombosis. Objectives: (1) To evaluate the changes of platelet aggregation induced by ADP and collagen in hyperlipidemic patients; (2) To identify the relationship between platelet aggregation and various types of dyslipidemia. Subjects and methods: A descriptive cross sectional non-randomised control trial method was employed in this study. A total of 128 hyperlipidemic patients (in which 40 patients were type IIa, 36 were type lib, and 52 were type IV), and a control group of 88 people were measured the aggregation in platelet - rich plasma (PRP) induced by ADP and collagen. Results: There was no significant difference about the platelet counts in both intervention and control groups (p>0.05). ADP and collagen induced platelet aggregation increased significantly (p<0.01) in intervention group when compared to control group. A significant correlation was found between the plasma triglyceride concentration and platelet aggregation induced by ADP and collagen with r = 0,335 and 0,332 respectively, while that of cholesterol and ADP was 0,304. Conclusion: Platelet aggregation increased in hyperlipidemic patients and had a significant correlation with plasma triglyceride concentration. \r\n', u'\r\n', u'

Evaluate the content of ductus arteriosus by color doppler ultrasound in premature infants treated with ibuprofen

Background:The failure of medical treatment for closure of the ductus arteriosus in very premature is still high (41%). Objectives:This study aims to evaluate the response of ductus arteriosus by color doppler ultrasound in premature infants treated with ibuprofen. Subjects and method:A pilot study was conducted at neonatal intensive care patients on 8 prernatures. The mean birth weight was 825 g (640g - 1190g) and gestational average age of 27.4 weeks of amenorrhea with respiratory distress with ductus arteriosus significantly. The average size was 1.9\xb10.3mm. Intervention: Children received the first dose of Ibuprofen 10mg/kg/day at age from 35 to 54 hours of life, and then 5mg/kg/day after 2 doses. Results:The outcome measure of the size of the ductus arteriosus was performed before each dose of Ibuprofen and 6 hours and 12 hours after each dose. At least three different measures has been taken every echocardiographie. 4 ways of evolution kinetics of turnover: 1: ductus arteriosus ferrne rapidly for 12 early hours of 1st dose (2 patients). 2nd: ductus arteriosus after 3rd dose (3 patients). 3rd: ductus arteriosus quickly after first 12 hours of 1st dose and then reopened (1 patient). 4th: ductus arteriosus not ferrne (2 patients). The size of sales decreased significantly 6 hours and 12 hours after the 1st dose of the 1st prernatures cure in 7 (87%) whatever the final outcome (p<0.05). Conclusion:The different responses from one individual to another led us to consider a Echo guide personalized therapy. A further research should be carried out to find a protocol for better value.

Autologous bone marrow transfusion to treat the tibia diaphyseal nonunions

Background: Bone marrow stem cells with their plasticity can be used to replace and repair the other damaged organs and tissues, so they can also be used to obtain bone healing of nonunions. Objective: to evaluate the results of percutaneous autologous bone marrow grafting to treat the tibia diaphyseal nonunions. Subjects and methods: 12 patients with noninfected nonunion of the tibia were diagnosed and treated in Viet Duc Hospital. About 250mL of marrow was aspirated, then separated and concentrated by density gradient centrifugation. The final mononuclear cell mass containing stem cells and progenitors was washed in 30ml of 0.9% NaCL and then injected into the damaged sites. Patients were evaluated by clinical and X-rays examinations with at least 6 months follow-up. Results: None of the patients had post - op complications. Bone union was obtained in eleven of the twelve patients (91,7%) at an average of 15,3 weeks (range, 9 - 30 weeks), the bone marrow grafts used for these patients who had bone union contained a mean of 5,65 \xb1 3,74 x 106 (0,95 - 11,73 x 106) CD34(+) stem cells in total. Conclusions: Percutaneous autologous bone - marrow grafting is a minimally invasive alternative and a simple, effective, safe method for the treatment of the tibia diaphyseal nonunions with the comparative bone healing rate. \r\n', u'\r\n', u'

The effects of gamma iradiation with 25 gray on red cells in stored red cell concentrates

Background: Gamma irradiation has been often used for inactivating viable T lymphocytes in the blood product to prevent post-transfusion graft - vs - host disease (PT - GVHD) occurred in the recipients having immunodeficiency. But the irradiating method must be determined to minimize the reverse effects on other blood elements. Objectives: to evaluate the side effects of gamma irradiating with 25 Gy and in different ways on red cells in stored red cell concentrates. Subjects and methods: Each of 30 red cell concentrates was divided into 3 parts and treated in 3 different ways to create 3 groups of sample for studying. All the samples were stored 35 days at 4 - 6\xb0C and measured red cell osmotic fragility, hemoglobin (Hb) level in storage solution in days 1,7,14,21,28,35. Results: 1) Red cell osmotic fragility decreased and free Hb level increased with time in the samples of 3 groups. 2) Red cell osmotic fragility decreased strongly from the 28th day (p < 0.05) and free Hb level increased dramatically from the 14th day (p < 0.001) in the samples of group 2 compared to control group and group 3 with the same storage time, while there was no difference in these parameters in groups 1 and 3. Conclusion: 1) Gamma irradiation with 25 Gy affected the intact of red cells in red cell concentrates only when irradiated right after being produced and stored more than 14 days. 2) The quality of red cell would be unchanged if used immediately after irradiated. \r\n', u'\r\n', u'

Preliminary study on the effectiveness of oral ibuprofen in treating persistent Patent Ductus Arteriosus (PDA) for respiratory distress of premature neonates

Background: PDA is an especially common pathological condition in premature neonates because of the anatomical structural immaturity of the cardiovascular system. There are evidence for the effectiveness of ibuprofen for closing persistent ductus arteriosus, with few adverse effects. Objectives: To determine whether oral ibuprofen treatment is effective and safe in the closure of PDA in premature infants with respiratory distress syndrome. Subjects and methods: The prospective study was conducted on premature newborns with PDA who were presented at the Department of Neonatology, National Hospital of Pediatrics. Results: A total of 32 neonates were eligible for the study. Ductal closure was achieved in 22 newborns (68.6%), the ductus was persistent after 6 doses in 8 cases (25.1%), 2 newborns (6.3%) suffered from ductal reopening after closure (after 1 and 2 doses). PDA closure was achieved with 1 dose of ibuprofen in 7 cases, 2 doses in 9, 3 doses in 4 and more than 4 doses in 4 cases. The survival rate was 81.2% (26 out of 32). 6 patients (18.8%) died from severe respiratory distress and very low birth weight (2 cases), Klebsiella sepsis (4 cases). Mortality is higher in the closure failure group (p<0.05). Conclusions: Oral ibuprofen suspension can be considered as an effective and safe alternative for PDA closure in premature newborns. Larger comparative studies is required to confirm these results.