RESUMO
Background@#Vitamin D concentrations are associated with sepsis, pneumonia, and mortality in critically ill patients. However, the role of vitamin D in critically injured patients with trauma remains unknown. This study investigated the effects of vitamin D concentrations on outcomes in critically injured patients with trauma. @*Methods@#A prospective observational study was conducted by randomly selecting 100 patients among those who visited our trauma center. The serum vitamin D concentration was measured upon arrival at the hospital, and the length of stay in a trauma intensive care unit after admission, duration of mechanical ventilation, number of days spent in the hospital, development of complications, and death were investigated. The association between the surveyed variables and vitamin D concentrations was investigated using regression analysis. @*Results@#Of the 100 patients, 69 were men and 31 were women with an average age of 51.7 years. The average intensive care unit stay length was 18.4 days, and 6 patients (5.9%) died. Univariate regression analysis showed that the factors affecting patient mortality were age (p = 0.02), volume of blood transfused within 24 hours of arrival (p = 0.009), systolic blood pressure measured upon hospital arrival (p = 0.01), and serum lactate concentration measured upon hospital arrival (p = 0.03). Multivariate regression analysis showed that the factors affecting patient mortality were age (p = 0.01), volume of blood transfusion (p = 0.04), and systolic blood pressure measured upon hospital arrival (p = 0.01). @*Conclusions@#There were no statistically significant effects of serum vitamin D concentrations in critically ill patients with trauma on death during hospitalization.
RESUMO
Purpose@#This study aims to evaluate the effect of different pneumoperitoneum pressures on postoperative pain, especially by subcategorizing the pressures into 3 groups during laparoscopic cholecystectomy (LC). @*Methods@#We conducted a prospective randomized, double-blinded study of 150 patients with benign and uncomplicated gallbladder disease. They were categorized into 3 groups. Each group (50 patients) underwent LC with different pneumoperitoneum methods: group VLP, very-low pressure (6–8 mmHg); group LP, low pressure (9–11 mmHg); and group SP, standard pressure (12–14 mmHg). The 3 groups were compared for pain intensity, duration, analgesic requirement, and complications. @*Results@#The characteristics of the patients were similar among all groups. Postoperative pain scores at each time point (1, 2, 4, 6, 12, 24, and 48 hours) were not significantly different among the 3 groups. Further, operation time, hospital stay, the number of analgesic consumption doses, and postoperative complications were not significantly different among the 3 groups. @*Conclusion@#This study demonstrates no difference in postoperative pain among various pneumoperitoneum pressures during LC. Therefore, routine use of lower-pressure pneumoperitoneum is not recommended unless in selected patients who require low-pressure pneumoperitoneum surgery.
RESUMO
Purpose@#This study aims to evaluate the effect of different pneumoperitoneum pressures on postoperative pain, especially by subcategorizing the pressures into 3 groups during laparoscopic cholecystectomy (LC). @*Methods@#We conducted a prospective randomized, double-blinded study of 150 patients with benign and uncomplicated gallbladder disease. They were categorized into 3 groups. Each group (50 patients) underwent LC with different pneumoperitoneum methods: group VLP, very-low pressure (6–8 mmHg); group LP, low pressure (9–11 mmHg); and group SP, standard pressure (12–14 mmHg). The 3 groups were compared for pain intensity, duration, analgesic requirement, and complications. @*Results@#The characteristics of the patients were similar among all groups. Postoperative pain scores at each time point (1, 2, 4, 6, 12, 24, and 48 hours) were not significantly different among the 3 groups. Further, operation time, hospital stay, the number of analgesic consumption doses, and postoperative complications were not significantly different among the 3 groups. @*Conclusion@#This study demonstrates no difference in postoperative pain among various pneumoperitoneum pressures during LC. Therefore, routine use of lower-pressure pneumoperitoneum is not recommended unless in selected patients who require low-pressure pneumoperitoneum surgery.
RESUMO
BACKGROUND: The aims of our study were to evaluate the success rate of irrigation and debridement with component retention (IDCR) for acutely infected total knee arthroplasty (TKA) (< 4 weeks of symptom duration) and to analyze the factors affecting prognosis of IDCR. METHODS: We retrospectively reviewed 28 knees treated by IDCR for acutely infected TKA from 2003 to 2012. We evaluated the success rate of IDCR. All variables were compared between the success and failure groups. Multivariable logistic regression analysis was also used to examine the relative contribution of these parameters to the success of IDCR. RESULTS: Seventeen knees (60.7%) were successfully treated. Between the success and failure groups, there were significant differences in the time from primary TKA to IDCR (p = 0.021), the preoperative erythrocyte sedimentation rate (ESR; p = 0.021), microorganism (p = 0.006), and polyethylene liner exchange (p = 0.017). Multivariable logistic regression analysis of parameters affecting the success of IDCR demonstrated that preoperative ESR (odds ratio [OR], 1.02; p = 0.041), microorganism (OR, 12.4; p = 0.006), and polyethylene liner exchange (OR, 0.07; p = 0.021) were significant parameters. CONCLUSIONS: The results show that 60.7% of the cases were successfully treated by IDCR for acutely infected TKA. The preoperative ESR, microorganism, and polyethylene liner exchange were factors that affected the success of IDCR in acutely infected TKA.