ABSTRACT
BACKGROUND: The main defence against bacterial infection is oxidative killing by neutrophils, which requires molecular oxygen in wounded tissues. High inspired-oxygen fractions increase tissue oxygenation. But, whether improving tissue oxygenation actually reduces surgical-site infection (SSI) remains controversial. We therefore tested the primary hypothesis that supplemental oxygen (80% vs 30%) reduces the risk of a 30-day composite of deep tissue or organ-space SSI, healing-related wound complications, and mortality. METHODS: In an isolated suite of operating rooms, the inspired-oxygen concentration was alternated between 30% and 80% at 2-week intervals for 39 months. The analysis was restricted to patients who had major intestinal surgery lasting at least 2 h. Qualifying operations (5749) were analysed, including 2843 (49%) colorectal resections, 1866 (32%) lower gastrointestinal therapeutic procedures, 373 (6%) small-bowel resections, and 667 (13%) other colorectal procedures. RESULTS: The 80% and 30% oxygen groups were well balanced on all of the demographic, baseline, and procedural variables. The oxygen intervention had no effect on the composite primary outcome or any of its components. The overall observed incidence of the composite outcome was 10.8% (314/2896) in the 80% oxygen group and 11.0% (314/2853) in the 30% group. The estimated relative risk was 0.99 (95% CI: 0.85, 1.14) for 80% vs 30%, P=0.85. CONCLUSIONS: Supplemental oxygen does not prevent major infection and healing-related complications after major intestinal surgery. CLINICAL TRIAL REGISTRATION: NCT01777568.
Subject(s)
Oxygen/therapeutic use , Surgical Wound Infection/drug therapy , Adult , Aged , Colorectal Surgery , Digestive System Surgical Procedures , Female , Humans , Incidence , Intestine, Large/surgery , Intestines/surgery , Male , Middle Aged , Negative Results , Oxygen Consumption , Perioperative Care , Risk Assessment , Surgical Wound Infection/mortality , Surgical Wound Infection/prevention & control , Wound HealingABSTRACT
Regularities of changes in the content of (137)Cs in green fodder during the remote period after the CNPP accident depending on application of agro-technical and agrochemical activities are analyzed. It is revealed that the use of mineral fertilizers reduces receipt of (137)Cs from the soil to forage and further to a food chain. It is also established that agrochemical activities are more effective than agro-technical ones.
Subject(s)
Chernobyl Nuclear Accident , Food Contamination, Radioactive/prevention & control , Radiation Monitoring , Soil Pollutants, Radioactive/radiation effects , Animal Feed/radiation effects , Animals , Cattle , Cesium Radioisotopes/isolation & purification , Cesium Radioisotopes/toxicity , Humans , Meat/radiation effects , Milk/radiation effects , Republic of Belarus , Russia , Soil Pollutants, Radioactive/chemistry , UkraineABSTRACT
Implementation of field experiments took place in two sites located in the Bragin district of the Gomel region, Belarus, i.e. a field in the evacuation zone and a private plot of land in a residential area of thedistrict. The objective of the research was to study the levels of radioactive contamination of air due to the dust raised up during crop harvesting operations. Comparative dose assessment was done to assess external exposure and committed effective doses of internal exposure due to inhalation of (241)Am, (238,239+240)Pu, (137)Cs and (90)Sr by agricultural workers involved in dust-generating harvesting operations. According to the results, the dominant contributors (93-97%) to internal exposure of agricultural workers both on a private plot of land and in the area of evacuation, were the transuranic elements (241)Am and (238,239,240)Pu. In the context of the total doses received by the harvest-workers, the dominant contribution belonged to external exposure which was 2-3 orders of magnitude higher than the levels of internal exposure due to inhalation of radionuclides.
