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Wyświetlanie 1-15 z 85
Tytuł:
Association of hand grip strength with psychological stress, exercise habits and body composition amongst medical students: a cross-sectional study
Autorzy:
Barre, Samira
Inyingi, Laura
Orrego Castellanos, Julianna
Patel, Agastya
Ruckemann-Dziurdzinska, Katarzyna A.
Bryl, Ewa D.
Witkowski, Jacek M.
Powiązania:
https://bibliotekanauki.pl/articles/33897312.pdf
Data publikacji:
2024-06-18
Wydawca:
Gdański Uniwersytet Medyczny
Tematy:
exercise
psychological stress
medical students
Hand grip strength
Opis:
Background The aim of this study was to assess the effectiveness of hand grip strength (HGS) test in identifying highly stressed individuals and to examine the effect of exercise and lifestyle on HGS and stress measures. Material and methods It is cross-sectional study. Students of the Medical University of Gdańsk, Poland were asked to fill out a questionnaire, undergo body composition analysis, perform HGS test and provide a saliva sample for cortisol measurement. Results Self-rated stress (SRS) was significantly higher in pre-clinical years (PCY) compared to clinical years (CY). HGS was significantly lower in PCY males than CY males. Participants who performed some form of exercise had significantly higher HGS compared with those who did not exercise. A positive correlation between HGS and BMI was noted. Students with low HGS were found to have lower levels of salivary cortisol (SC). However, there was no significant difference in SC levels between PCY and CY students. Conclusions HGS may be a reliable method of identifying stressed individuals and promoting healthy lifestyle behaviors. HGS testing is a safe, cheap and easy to perform method for a large number of participants while being time economical.
Źródło:
European Journal of Translational and Clinical Medicine; 2024, 7, 1; 33-46
2657-3148
2657-3156
Pojawia się w:
European Journal of Translational and Clinical Medicine
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Exploring barriers to vasectomy adoption among married men in Dadra and Nagar Haveli
Autorzy:
Patel, Ronak Dhirubhai
Dabhelker, Monika M.
Patel, Priya Mahendrabhai
Solanki, Preeti
Powiązania:
https://bibliotekanauki.pl/articles/36147545.pdf
Data publikacji:
2024-03-30
Wydawca:
Uniwersytet Rzeszowski. Wydawnictwo Uniwersytetu Rzeszowskiego
Tematy:
attitude
barriers
knowledge
married men
perception
vasectomy
Opis:
Introduction and aim. Vasectomy was introduced in India in 1992 and is the most effective, simple, and safe permanent method of contraception yet its use is very limited among the population. The study’s objectives were to assess the knowledge, attitude, and perception towards vasectomy and the barriers to adoption among married men in Dadra and Nagar Haveli. Material and methods. A cross-sectional hospital-based study was conducted on married male attendants of patients and data were collected on sociodemographic details, knowledge regarding vasectomy, their attitude and perceptions towards vasectomy, and their intention of using vasectomy in the future. Results. Out of 300 participants, 258 (86%) participants have heard of vasectomy as a contraceptive method, and only one participant has undergone vasectomy. The majority (285; 95%) of the participants agreed that family planning is also a responsibility of males while nearly two-third (185; 61.7%) of them were not willing to undergo vasectomy in the future. Procedure-related factors, post-procedure-related factors, social factors, availability of alternate contraceptive methods, and preference for tubectomy were the barriers to the adoption of vasectomy. Conclusion. There is a need to provide correct information and counseling about vasectomy and non-scalpel vasectomy to eligible couples to increase the acceptance of vasectomy as a safe, effective, and cheaper method of contraception.
Źródło:
European Journal of Clinical and Experimental Medicine; 2024, 22, 1; 45-51
2544-2406
2544-1361
Pojawia się w:
European Journal of Clinical and Experimental Medicine
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
A Study on the Influence of Reinforcement Volume on AA5083/(SiC-Gr) Hybrid Surface Composite Developed by Friction Stir Processing
Autorzy:
Bharti, Shalok
Ghetiya, Nilesh D.
Patel, Kaushik M.
Saxena, Kuldeep K.
Powiązania:
https://bibliotekanauki.pl/articles/27765096.pdf
Data publikacji:
2023
Wydawca:
Polska Akademia Nauk. Czasopisma i Monografie PAN
Tematy:
surface composites
multi-pass
Friction Stir Processing
reinforcement
hybrid composite
Opis:
In this study, a hybrid surface composite of AA5083/SiC-Gr was produced by Friction Stir Processing (FSP). Reinforcement material each in 50:50 proportion was filled in the base matrix using holes method. Three different hybrid reinforcement volumes of 301.6 mm3, 452.4 mm3, and 603.2 mm3 were prepared for surface composite. Optical and Scanning Electron Microscopy was used to check the quality of the prepared surface composite and homogeneous distribution of reinforcement was observed in the images. It was observed that due to better uniform distribution of reinforcement particles during 3 pass FSP, specimens with 301.6 mm3 reinforcement volume showed enhanced microhardness and wear properties in comparison with the other specimens.
Źródło:
Archives of Metallurgy and Materials; 2023, 68, 2; 625--629
1733-3490
Pojawia się w:
Archives of Metallurgy and Materials
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Formation, characterization, and analysis of curcumin nanoformulation for evaluating its in vitro cytotoxicity
Autorzy:
Parmar, Nilam
Mansuri, Abdulkhalik
Trivedi, Krupali
Ansari, Khairah
Kumar, Priyesh
Bagban, Mohammed Azim
Jhala, Devendrasinh
Patel, Alpesh
Chettiar, Shiva Shankaran
Powiązania:
https://bibliotekanauki.pl/articles/16706246.pdf
Data publikacji:
2023
Wydawca:
Polska Akademia Nauk. Czasopisma i Monografie PAN
Tematy:
anticancer
curcumin nanoformulation
D-α-tocopheryl polyethylene glycol 1000 succinate
solubility
stability
Opis:
Nanotechnology holds significance in all fields of research, and the formation and surface alterations of nanomaterials are particularly important in this discipline. Nanoformulations synthesized with bioactive plant components play a crucial role in the improvement of several therapeutics and diagnostics. In the present study, we reported the synthesis of a curcumin nanoformulation (CN) by using curcumin and D-α-tocopheryl polyethylene glycol 1000 succinate (TPGS). The synthesized CN was characterized using dynamic light scattering, UV-Visible spectrophotometry, Fourier-transform infrared spectroscopy, field-emission scanning electron microscopy, and X-ray diffraction. Furthermore, it was evaluated for solubility, drug loading, encapsulation efficiency, stability, in vitro release, and anticancer potentials. The role of TPGS in the synthesis of CN was validated. The synthesized CN exhibited a size of 6.2 ± 1.9 nm, needle-shaped morphology, a polydispersity index of 0.164, and zeta potential of -10.1 ± 3.21 mV, as determined by characterization techniques. Its water solubility was 2.5 × 104 times higher than that of pure curcumin. The encapsulation efficiency and curcumin loading efficiency of the synthesized CN were found to be 80 and 10%, respectively, with storage stability exceeding 30 days. Moreover, the synthesized CN demonstrated significant in vitro anticancer activity against the colorectal cancer cell line HCT-116, with an IC50 value of 12.74 ± 0.54 μM at 24 h.
Źródło:
BioTechnologia. Journal of Biotechnology Computational Biology and Bionanotechnology; 2023, 104, 3; 275-287
0860-7796
Pojawia się w:
BioTechnologia. Journal of Biotechnology Computational Biology and Bionanotechnology
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Influence of Rare Earth Sm Addition on Microstructure and Tensile Properties of Al-Si-Cu 319 Alloy
Autorzy:
Patel, D. N.
Sutaria, Mayur P.
Powiązania:
https://bibliotekanauki.pl/articles/27314115.pdf
Data publikacji:
2023
Wydawca:
Polska Akademia Nauk. Czasopisma i Monografie PAN
Tematy:
Al-Si-Cu alloy
addition
Samarium
SDAS
eutectic silicon
tensile properties
stop Al-Si-Cu
dodatki
Samar
krzem eutektyczny
właściwości wytrzymałościowe
Opis:
In the present investigation, the influence of addition of the rare earth element samarium (Sm) in different concentrations (0, 0.1, 0.3, 0.5, 0.7 and 0.9wt.%) on the microstructure and tensile properties of the Al-Si-Cu 319 alloy have been evaluated. Microstructural constituents such as SDAS of α-Al and characteristics of eutectic silicon particles were observed by optical microscopy. It was concluded from the findings that Sm addition reduces the size of secondary dendrite arm spacings (SDAS) and altered the morphology of the eutectic silicon particles from needle-like to lamellar and smaller segments. The tensile properties of the Al-Si-Cu 319 alloy improved with the concentration of Sm. It was found that the highest tensile properties were obtained at 0.7wt.% addition of Sm, i.e., 55.5% higher than unmodified 319 alloy. With the further addition of the Sm above 0.7wt.%, it does not improve the tensile properties of the alloy. This can be attributed to the precipitation of the brittle and needle like quaternary Sm-rich intermetallic compounds observed through Scanning electron microscopy.
Źródło:
Archives of Foundry Engineering; 2023, 23, 1; 25--33
1897-3310
2299-2944
Pojawia się w:
Archives of Foundry Engineering
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Effect of different wire materials on WEDM performance of Bio-compatible material
Autorzy:
Pandey, Gaurav Kumar
Patel, Praveen Bhai
Kumar, Abhishek
Niranjan, Ramendra Singh
Katiyar, Vikas
Chandra, A. K
Powiązania:
https://bibliotekanauki.pl/articles/23966616.pdf
Data publikacji:
2022
Wydawca:
Stowarzyszenie Menedżerów Jakości i Produkcji
Tematy:
WEDM
MRR
SR
Ti-6Al-4V
Opis:
The present experimental investigation aims to analyse the effect of various machining parameters, such as pulse peak current (Ion), pulse on time (Ton), pulse off time (Toff) and spark voltage (SV) on the surface roughness (SR) and material removal rate(MRR) by using continuous traveling of both wire electrode (i.e. brass wire and zinc-coated brass wire). The present work also analyses the effect of types of wires, such as brass wire and zinc-coated brass wire used during machining of Titanium alloy (Ti-6Al-4V) on Surface roughness (SR) and material removal rate (MRR). This work studies the correlation between various response parameter such SR and MRR by using same machining parameter by for both wires.
Źródło:
Production Engineering Archives; 2022, 28, 1; 50--55
2353-5156
2353-7779
Pojawia się w:
Production Engineering Archives
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Novel N,N’-bis(2,4-dimethoxybenzylidene)ethylenediamine PVC membrane electrode for the potentiometric iron selective sensor based on Schiff base ligand
Nowa elektroda membranowa z PVC i N,N’-bis(2,4-dimetoksybenzylideno)-etylenodiaminy jako potencjometryczny jonoselektywny czujnik żelaza oparty na ligandzie zasady Schiffa
Autorzy:
Kumar, Sachin
Sandhu, Susheel K.
Patel, Agnik K.
Parmar, Ketankumar H.
Powiązania:
https://bibliotekanauki.pl/articles/2120225.pdf
Data publikacji:
2022
Wydawca:
Sieć Badawcza Łukasiewicz - Instytut Chemii Przemysłowej
Tematy:
Fe3+ ions
ion-selective electrode
PVC membrane
potentiometry
Schiff base
jony Fe3+
elektrody jonoselektywne
membrana PVC
potencjometria
zasada Schiffa
Opis:
N,N’-bis(2,4-dimethoxybenzylidene)ethylenediamine was synthesized and used as a membrane carrier to create a novel poly(vinyl chloride) membrane potentiometric sensor that is selective especially for Fe3+ ions. The super-Nernstian slope of the projected sensor was 19.5 mV per decade over a concentration range of 7.3•10-8–1•10-1 M having detection limit at 7.3•10-8 M. The sensor displayed a linear potential response for the detection of Fe3+ ions in about 30 seconds, and it had a lifespan of no less than 9 weeks without lacking any potential divergence. The selected sensor showed high selectivity in water solutions in relation to Fe3+ ions, even in the presence of other metal cations in the pH range of 3.6–10.
Przedmiotem badań był potencjometryczny czujnik do selektywnego oznaczania jonów Fe3+ oparty na membranie wykonanej z poli(chlorku winylu) i N,N’-bis(2,4-dimetoksybenzylideno)etylenodiaminy. Nachylenie super-nernstowskie (ang. super-Nernstian slop) badanego czujnika wynosiło 9,5 mV na dekadę w zakresie stężeń 7,3•10-8–1•10-1 M z limitem detekcji 7.3•10-8 M. Czujnik wykazywał w obecności jonów Fe3+ liniową odpowiedź przez około 30 s, a jego czas życia bez rozbieżności potencjałów wynosił nie mniej niż 9 tygodni. Wybrany czujnik wykazywał w roztworach wodnych wysoką selektywność w stosunku do jonów Fe3+ nawet w obecności innych kationów metali w zakresie pH 3,6–10.
Źródło:
Polimery; 2022, 67, 5; 197--204
0032-2725
Pojawia się w:
Polimery
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Experimental Investigation and Optimization of Machining Parameters in Turning of Aluminum Alloy 075-T651
Autorzy:
Srivastava, Arpit
Verma, Mukesh Kumar
Niranjan, Ramendra Singh
Chandra, Abhishek
Patel, Praveen Bhai
Powiązania:
https://bibliotekanauki.pl/articles/26072641.pdf
Data publikacji:
2021
Wydawca:
Stowarzyszenie Menedżerów Jakości i Produkcji
Tematy:
metoda Taguchiego
siła posuwowa
siła skrawania
siła promieniowa
MRR
Taguchi method
feed force
cutting force
radial force
Opis:
Aluminum alloy 7075-T651 is a widely used material in the aviation, marine, and automobile sectors. The wide application marks the importance of this material’s research in the manufacturing field. This research focuses on optimizing input process parameters of the turning process in the machining of Aluminum 7075-T651 with a tungsten carbide insert. The input machining parameters are cutting speed, feed, and depth of cut for the output response parameters cutting force, feed force, radial force, material removal, and surface roughness of the workpiece. For optimization of process parameters, the Taguchi method, with standard L9 orthogonal array, is used. ANOVA is applied to obtain significant factors and optimal combinations of process parameters.
Źródło:
Production Engineering Archives; 2021, 27, 4; 296--305
2353-5156
2353-7779
Pojawia się w:
Production Engineering Archives
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Free Vibration Analysis of A357 Alloy Reinforced with Dual Particle Size Silicon Carbide Metal Matrix Composite Plates Using Finite Element Method
Autorzy:
Lakshmikanthan, A.
Mahesh, V.
Prabhu, R. T.
Patel, M. G. C.
Bontha, S.
Powiązania:
https://bibliotekanauki.pl/articles/1837831.pdf
Data publikacji:
2021
Wydawca:
Polska Akademia Nauk. Czytelnia Czasopism PAN
Tematy:
finite element method
shear deformation theory
FSDT
A357 alloy
Hamilton’s principle
A357/DPS-SiC
composites
metoda elementów skończonych
teoria odkształceń
stop A357
zasada Hamiltona
kompozyty
Opis:
In this work, the free vibration behaviour of A357 composite plate reinforced with dual particle size (DPS) (3 wt.% coarse + 3 wt.% fine, 4 wt.% coarse + 2 wt.% fine, and 2 wt.% coarse + 4 wt.% fine) SiC is evaluated using the finite element method. To this end, first-order shear deformation theory (FSDT) has been used. The equations of motion have been derived using Hamilton’s principle and the solution has been obtained through condensation technique. A thorough parametric study was conducted to understand the effect of reinforcement size and weight fraction, boundary conditions, aspect ratio and length-to-width ratio of plate geometry on natural frequencies of A357/DPS-SiC composite plates. Results reveal significant influence of all the above variables on natural frequency of the composite plates. In all the cases, A357 composite plate reinforced with 4 wt.% coarse and 2 wt.% fine SiC particles displayed the highest natural frequency owing to its higher elastic and rigidity modulus. Further, the natural frequencies increase with decrease in aspect ratio of the plate geometry. Natural frequency also decreases with increase in the number of free edges. Lastly, increasing the length-to-width ratio drastically improves the natural frequency of the plates.
Źródło:
Archives of Foundry Engineering; 2021, 21, 1; 101-112
1897-3310
2299-2944
Pojawia się w:
Archives of Foundry Engineering
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Geomorphic Control on Soil Erosion – a Case Study in the Subarnarekha Basin, India
Autorzy:
Kathwas, Amar Kumar
Patel, Nilanchal
Powiązania:
https://bibliotekanauki.pl/articles/2088182.pdf
Data publikacji:
2021
Wydawca:
Uniwersytet Marii Curie-Skłodowskiej. Wydawnictwo Uniwersytetu Marii Curie-Skłodowskiej
Tematy:
geomorphological feature
soil erosion
USLE
principal component analysis
Opis:
Geomorphology depicts the qualitative and quantitative characteristics of both terrain and landscape features combined with the processes responsible for its evolution. Soil erosion by water involves processes, which removes soil particles and organic matter from the upper sheet of the soil surface, and then transports the eroded material to distant location under the action of water. Very few studies have been conducted on the nature and dynamics of soil erosion in the different geomorphologic features. In the present investigation, an attempt has been made to assess the control of geomorphologic features on the soil loss. Universal Soil Loss Equation (USLE) was used to determine soil loss from the various geomorphological landforms. Principal component analysis (PCA) was implemented on the USLE parameters to determine the degree of association between the individual principal components and the USLE-derived soil loss. Results obtained from the investigation signify the influence of the various landforms on soil erosion. PC5 is found to be significantly correlated with the USLE-derived soil loss. The results ascertained significant association between the soil loss and geomorphological landforms, and therefore, suitable strategies can be implemented to alleviate soil loss in the individual landforms.
Źródło:
Polish Journal of Soil Science; 2021, 54, 1; 1-24
0079-2985
Pojawia się w:
Polish Journal of Soil Science
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Impact of industrial freight flows on the overall traffic in Surat city, India
Autorzy:
Dhonde, Bhavesh
Patel, Chetan
Powiązania:
https://bibliotekanauki.pl/articles/2091228.pdf
Data publikacji:
2021
Wydawca:
Politechnika Śląska. Wydawnictwo Politechniki Śląskiej
Tematy:
urban freight
textile
traffic
industry
transport miejski
tekstylia
ruch drogowy
przemysł
Opis:
Surat is one of the major textile manufacturing hubs in India, having 40% of the synthetic fabric produced in the country. The textile industry in the city has witnessed tremendous growth in the last decade, leading to many transportation-related changes within it. Textile manufacturing has different phases like weaving, processing, value addition and trading or distribution. These phases are located as clusters or pockets in different parts of the city. The scattered nature of the industry generates numerous freight trips. This study focuses on characterizing and estimating textile freight trips in the city. Establishment survey data was collected from production units located in various clusters. A multi-linear regression model for freight trips generated using the quantity of cloth produced was developed for the estimation of the total textile freight trips. Thus, this study will help the planner identify the strategic location of the textile and its allied industries as well as for freight infrastructure in the city. More so, it would help in understanding the impacts of textile freight movement on the city’s overall traffic.
Źródło:
Zeszyty Naukowe. Transport / Politechnika Śląska; 2021, 113; 45--59
0209-3324
2450-1549
Pojawia się w:
Zeszyty Naukowe. Transport / Politechnika Śląska
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Potential comparison of montmorillonite filled and unfilled epoxy methacrylate of bisphenol-C-glass/ jute/treated jute and hybrid composites
Autorzy:
Bhatt, Ritesh D.
Patel, Jignesh P.
Parsania, Parsotam H.
Powiązania:
https://bibliotekanauki.pl/articles/1193485.pdf
Data publikacji:
2021
Wydawca:
Przedsiębiorstwo Wydawnictw Naukowych Darwin / Scientific Publishing House DARWIN
Tematy:
Epoxy methacrylate
chemical resistance
composites
diffusivity
hydrolytic stability
mechanical and electrical properties
montmorillonite
Opis:
Montmorillonite filled and unfilled controls, jute/treated jute/glass/hybrid composites were prepared at room temperature for three h and under 5 MPa pressure. The composites were post cured at 150 °C for 30 min. A 40% styrene was used as a reactive diluent, and 1% methylethylketone peroxide, 1.5 % cobalt octoate, and 1.5% dimethylaniline were used as initiator and accelerator, and a promoter. Filled and unfilled composites showed good to excellent mechanical and electrical properties, excellent hydrolytic stability and chemical resistance against water acids, alkali, salt solutions; high water absorption tendency (7.9-20.5%), and longer equilibrium times (288-432h). In different environments at 30 °C observed water absorption trend is H2SO4 > HCl > NaOH > H2O > NaCl. Hybrid composites showed intermediate properties of their parent composites. MMT filled treated jute (46), and unfilled glass (48), and MMT filled glass (48) composites revealed Barcol hardness between the suggested range of 45-65 for scratch and wear resistance proof materials. The nature of the reinforcements, matrix, and filler; fiber treatment, environmental conditions, etc., had affected studied properties and water absorption behavior.
Źródło:
World Scientific News; 2021, 158; 227-246
2392-2192
Pojawia się w:
World Scientific News
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Bioremediation of melanoidin contamination in distillery effluent using Aspergillus brasiliensis
Autorzy:
Singh, T.A.
Singh, T.
Singh, R.
Pandey, P.K.
Gaur, R.
Jamal, F.
Patel, S.K.
Bansal, S.
Powiązania:
https://bibliotekanauki.pl/articles/2097092.pdf
Data publikacji:
2020
Wydawca:
Polska Akademia Nauk. Czytelnia Czasopism PAN
Tematy:
spent wash
effluent
melanoidin
bioremediation
decolorization
Opis:
The current investigation is the first report of utilization of Aspergillus brasiliensis for the decolorization of melanoidin in distillery effluent. The effluent generated from alcohol distilleries is one of the most complex wastewater with a high biological oxygen demand (BOD) and other organic, inorganic, and toxic constituents. The effluent contains melanoidin, a dark brown compound, which is difficult to remediate by using conventional technologies. The disposal of spent wash in the natural environment is hazardous and can deteriorate land and water resources. The decolorization of spent wash through physical and chemical methods remains unsuitable, and the only alternative to decolorize spent wash is biological treatment. In the current study, three fungal strains were isolated from the distillery waste and screened for their ability to decolorize melanoidin.The isolate RS2 exhibited maximum decolorization of 83% and was identified as Aspergillus brasiliensis. Its optimum growth temperature was 37EC, and the maximum efficiency was recorded after 120 h of incubation. Nutritional sources were investigated for the fungi showing the maximum decolorization of melanoidin, and starch and peptone were found to be the best carbon and nitrogen sources, respectively. At 1.5% starch concentration and 1.5% peptone concentration, the decolorization level attained was 87.45% and 88.74%, respectively. A. brasiliensis exhibited a high potential to decolorize melanoidin. The decolorization percentage was high, which makes this fungus a potential candidate for use at the industrial scale for the bioremediation of spent wash.
Źródło:
BioTechnologia. Journal of Biotechnology Computational Biology and Bionanotechnology; 2020, 101, 3; 205-213
0860-7796
Pojawia się w:
BioTechnologia. Journal of Biotechnology Computational Biology and Bionanotechnology
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Non-technical complications predict 30-day perioperative mortality in abdominal surgery. A propensity score matched analysis
Powikłania nietechniczne prognozują 30-dniową śmiertelność okołooperacyjną w chirurgii jamy brzusznej. Analiza dopasowania tendencji
Autorzy:
Vasavada, Bhavin B.
Patel, Hardik
Powiązania:
https://bibliotekanauki.pl/articles/1623542.pdf
Data publikacji:
2020
Wydawca:
Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
Tematy:
mortality
hepatobiliary surgery
surgical critical care
complication
śmiertelność
chirurgia wątrobowo-żółciowa
chirurgiczna opieka krytyczna
komplikacje
Opis:
Introduction: Surgical complications are a major cause of mortality and morbidity. Non-technical complications seem to be more dangerous than technique-related complications, however they are commonly neglected by surgeons. Aim: To study the relationship between non-technical complications and mortality after gastrointestinal and hepatobiliary surgery. Material and Methods: All gastrointestinal and hepatobiliary procedures performed over 3 years in one center were analysed. Non-technical postoperative complications were defined as perioperative complications related to patients’ physiological health or comorbidities, rather than surgical procedures or techniques. To avoid selection bias we conducted a 1:1 propensity score match analysis with non-technical complications as a dependent factor. The propensity scores were calculated using logistic regression. Preoperative confounding factors such as age, sex, American Society of Anesthesiologists (ASA) score and type of surgery were entered into our model as covariates. We used the nearest-neighbor protocol with a caliber of 0.2. The cases were not reusable after matching. The statistics were analyzed using SPSS version 23. Results: A total of 348 patients underwent gastrointestinal and HPB (Hepato Pancreatico Biliary) surgery in Hepatobiliary and Liver Transplant Department of Shalby Hospitals, India between April 2017 and March 2020. Twenty-four patients developed non-technical complications. ASA scores independently predicted non-technical complications (p=0.001, odds ratio 3.955, 95% C.I.: 1.774–8.813). After matching with 23 controls, non-technical complications were still significantly correlated with mortality (p<0.0001). Intraoperative factors did not predict non-technical complications. Surgery-related complications were not associated with mortality after matching. Conclusion: Non-technical complications are associated with a significant risk of mortality.
Wprowadzenie: Powikłania chirurgiczne są główną przyczyną śmiertelności i zachorowalności. Powikłania pozatechniczne wydają się być bardziej niebezpieczne niż powikłania techniczne, jednak chirurdzy często je zaniedbują. Celem pracy było zbadanie związku między powikłaniami niezwiązanymi z techniką chirurgiczną a śmiertelnością po rozległych zabiegach operacyjnych w obrębie przewodu pokarmowego, wątroby i dróg żółciowych. Materiał i metody: Przeprowadzono analizę danych wszystkich chorych leczonych w Hepatobiliary and Liver Transplant Department of Shalby Hospitals w Indiach w okresie 3 lat z powodu schorzeń przewodu pokarmowego, wątroby i dróg żółciowych. Powikłania nietechniczne zostały zdefiniowane jako wszystkie powikłania związane ze stanem ogólnym i chorobami współistniejącymi, niemające związku z samą techniką chirurgiczną. Aby zmniejszyć ryzyko błędu wynikającego z doboru chorych, przeprowadzono dodatkowo analizę porównawczą z odpowiednio dobraną pod kątem wszystkich innych cech grupą chorych, u których takie powikłania nie wystąpiły. W analizie wykorzystano regresję logistyczną. Przedoperacyjne czynniki, takie jak: wiek, płeć, wynik w skali Amerykańskiego Towarzystwa Anestezjologów (ASA) i rodzaj operacji, zostały wprowadzone do naszego modelu jako zmienne zaburzające. Użyto protokołu najbliższego sąsiada o kalibrze 0,2. Przypadki nie były wykorzystywane ponownie po dopasowaniu. Statystyki przeanalizowano za pomocą programu SPSS w wersji 23. Wyniki: Ogółem operowanych było 348 chorych w okresie od kwietnia 2017 r. do marca 2020 r. U 24 chorych rozwinęły się powikłania niechirurgiczne. Wystąpienie tych powikłań było związane z wyższym wynikiem oceny przedoperacyjnej w skali ASA (p=0,001, OR 3,955, 95% CI: 1,774–8,813). W analizie grup porównawczych stwierdzono wyższe ryzyko zgonu (p<0,0001) w grupie chorych z powikłaniami niechirurgicznymi. Powikłania techniczne związane z zabiegiem operacyjnym nie wpłynęły na zwiększenie ryzyka zgonu. Wniosek: Powikłania niechirurgiczne u chorych operowanych w obrębie przewodu pokarmowego, wątroby i dróg żółciowych wiążą się ze zwiększeniem ryzyka zgonu.
Źródło:
Państwo i Społeczeństwo; 2020, 4; 37-47
1643-8299
2451-0858
Pojawia się w:
Państwo i Społeczeństwo
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Open and laparoscopic approaches are associated with comparable 90-day morbidity and mortality following ERAS protocol.
Chirurgia klasyczna i laparoskopowa z zastosowaniem schematów ERAS wiąże się z podobnym ryzykiem powikłań i zgonów
Autorzy:
Vasavada, Bhavin B.
Patel, Hardik
Powiązania:
https://bibliotekanauki.pl/articles/527389.pdf
Data publikacji:
2020
Wydawca:
Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
Tematy:
enhanced recovery after surgery (ERAS)
laparoscopy
gastrointestinal surger
protokół kompleksowej opieki okołooperacyjnej dla poprawy wyników leczenia chirurgicznego (ERAS)
laparoskopia
chirurgia jamy brzusznej
Opis:
Introduction: The aim of this study is to compare 90-day mortality and morbidity between open and laparoscopic surgeries performed in one centre since the introduction of ERAS protocols. Material and Methods: All gastrointestinal surgeries performed between April 2016 and March 2019 at our institution after the introduction of ERAS protocols have been analysed for morbidity and mortality. The analysis was performed in a retrospective manner using data from our prospectively maintained database. Results: We performed 245 gastrointestinal and hepatobiliary surgeries between April 2016 and March 2019. The mean age of patients was 50.96 years. 135 were open surgeries and 110 were laparoscopic surgeries. The mean ASA score was 2.4, the mean operative time was 111 minutes and the mean CDC grade of surgery was 2.56. 40 were emergency surgeries and 205 were elective surgeries. Overall the 90-day mortality rate was 8.5% and the morbidity rate was around 9.79%. On univariate analysis morbidity was associated with a higher CDC grade of surgeries, a higher ASA grade, longer operating time, the use of more blood products, a longer hospital stay and open surgeries. HPB surgeries and luminal surgeries (non hpb gastrointestinal surgeries) were associated with 90-day post-operative morbidity. On multivariate analysis no factors independently predicted morbidity. On univariate analysis 90-day mortality was predicted by the grade of surgeries, a higher ASA grade, longer operative time, the use of more blood products, open surgeries and emergency surgeries. However on multivariate analysis only the use of more blood products was independently associated with mortality. Conclusion: The 90-day mortality and morbidity rates between open and laparoscopic surgeries after the introduction of ERAS protocol were similar.
Wprowadzenie: Celem pracy była ocena ryzyka powikłań i zgonów w ciągu 90 dni po zabiegach operacyjnych wykonywanych w jednym z ośrodków sposobem klasycznym i laparoskopowym z zastosowaniem schematu zdrowienia pooperacyjnego ERAS. Materiał i metody: Przeanalizowano wyniki leczenia wszystkich chorych operowanych w ośrodku w okresie od kwietnia 2016 r. do marca 2019 r., u których stosowano schemat ERAS. Analizę retrospektywną przeprowadzono na danych zbieranych w sposób prospektywny. Wyniki: Między kwietniem 2016 r. a marcem 2019 r. wykonano 245 zabiegów operacyjnych na przewodzie pokarmowym, wątrobie i drogach żółciowych. Średni wiek chorych wynosił 50,96 lat. Przeprowadzono 135 operacji sposobem klasycznym oraz 110 metodą laparoskopową. Średni wynik w skali ASA wynosił 2,4; średni czas trwania operacji to 111 minut, a średnia ciężkość operacji w skali CDC – 2,56. 40 zabiegów było wykonanych ze wskazań pilnych, a 205 planowych. Całkowity odsetek zgonów pooperacyjnych w okresie 90 dni wyniósł 8,5%, a powikłań 9,79%. W analizie jednoczynnikowej czynnikami wpływającymi na ryzyko powikłań były: wyższy wynik w skali CDC, wyższy wynik w skali ASA, dłuższy czas trwania operacji, większe zużycie produktów krwiopochodnych, dłuższy czas pobytu w szpitalu, klasyczny dostęp operacyjny, zabiegi w zakresie wątroby i dróg żółciowych. W analizie wieloczynnikowej nie stwierdzono czynników wpływających na zwiększenie ryzyka powikłań. W analizie jednoczynnikowej czynnikami wpływającymi na ryzyko zgonów w ciągu 90 dni były: wyższy wynik w skali CDC, wyższy wynik w skali ASA, dłuższy czas trwania operacji, większe zużycie produktów krwiopochodnych, klasyczny dostęp operacyjny i zabiegi ze wskazań pilnych. W analizie wieloczynnikowej jedynie zużycie preparatów krwiopochodnych wpływało na zwiększenie ryzyka zgonu. Wniosek: Ryzyko powikłań i zgonów w okresie 90 dni po zabiegach operacyjnych z dostępu klasycznego oraz laparoskopowego z zastosowaniem schematu ERAS było zbliżone.
Źródło:
Państwo i Społeczeństwo; 2020, 2; 39-50
1643-8299
2451-0858
Pojawia się w:
Państwo i Społeczeństwo
Dostawca treści:
Biblioteka Nauki
Artykuł
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