RESUMEN
A retrospective study on safety of prophylactic use of Enoxaparin in rejuvenating face lift procedures. The prophylactic use of Enoxaparin was not found to be associated with increased perioperative bleeding or higher incidence of postoperative hematomas requiring reoperation.
Asunto(s)
Enoxaparina , Ritidoplastia , Tromboembolia Venosa , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Pérdida de Sangre Quirúrgica/prevención & control , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Relación Dosis-Respuesta a Droga , Enoxaparina/administración & dosificación , Enoxaparina/efectos adversos , Femenino , Humanos , Inyecciones Subcutáneas , Masculino , Persona de Mediana Edad , Hemorragia Posoperatoria/inducido químicamente , Hemorragia Posoperatoria/epidemiología , Hemorragia Posoperatoria/prevención & control , Cuidados Preoperatorios/métodos , Estudios Retrospectivos , Ritidoplastia/efectos adversos , Ritidoplastia/métodos , Federación de Rusia , Resultado del Tratamiento , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & controlRESUMEN
A prospective controlled study was carried out in a total of thirty-four patients presenting with atherosclerotic gangrene ofthe lower extremities. Surgery was preceded by studying haemostasiograms, biochemical parameters and indices of the functional system of detoxication, level of acute-phase proteins, cytokines, stress enzymes. It was determined that irreversibility of tissue damage in atherosclerotic gangrene of the lower limbs results in the development of the main pathogenetic phenomena of systemic impairments, i.e., stress reactions of the neuroendocrine system, systemic inflammatory response, activation of intravascular blood microcoagulation, oxidative stress, crash-like syndrome, autogenous intoxication, latent organic dysfunctions, forming in the aggregate a pathogenetically vicious circle of impairments with local manifestations, pain reaction, and various critical complications of this nosological entity.
Asunto(s)
Aterosclerosis/patología , Pierna/irrigación sanguínea , Estrés Oxidativo/fisiología , Proteínas de Fase Aguda/metabolismo , Anciano , Anciano de 80 o más Años , Aterosclerosis/metabolismo , Aterosclerosis/cirugía , Citocinas/metabolismo , Femenino , Estudios de Seguimiento , Gangrena , Humanos , Inflamación/metabolismo , Inflamación/patología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Procedimientos Quirúrgicos Vasculares/métodosRESUMEN
A prospective controlled study was conducted in 30 patients with lower extremity atherosclerotic gangrene. Their mean age was 66.1 +/- 9.0 years. Examinations were made before and after high leg amputation. The investigators analyzed the following markers of a systemic inflammatory reaction (SIR): IL-1beta, 6, 8, 10, TNF-alpha, and L-2r. The concentrations of myoglobin (a marker of tissue damage), cortisol and blood glucose (markers of sympathoadrenal system activation), D-dimers (a marker of disseminated intravascular coagulation), C-reactive protein (CRP), lipopolysaccharide-binding protein, and fibrinogen were also measured. The signs of muscle damage (such as elevated myoglobin concentrations), stress, and CRP were detected in patients with atherosclerotic gangrene in the pre- and postoperative periods. The risk of pyoinflammatory complications in the immediate postoperative period may be predicted from the higher levels of acute-phase proteins (CRP), proinflammatory cytokines (IL-6), and myoglobin.
Asunto(s)
Aterosclerosis/complicaciones , Pierna , Complicaciones Posoperatorias , Síndrome de Respuesta Inflamatoria Sistémica , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica , Aterosclerosis/patología , Aterosclerosis/cirugía , Biomarcadores/sangre , Estudios de Casos y Controles , Citocinas/sangre , Femenino , Gangrena/complicaciones , Humanos , Pierna/irrigación sanguínea , Pierna/patología , Pierna/cirugía , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/inmunología , Periodo Posoperatorio , Estudios Prospectivos , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Síndrome de Respuesta Inflamatoria Sistémica/inmunologíaRESUMEN
A prospective study was carried out in order to investigate the system of haemostasis in a total of sixty patients presenting with atherosclerotic gangrene of a lower extremity who were then subjected to high amputation. The operative intervention was preceded and followed by determining the following parameters: antithrombin III (AT-III), fibrinogen (FG), thrombin time (TT), activated partial thromboplastin time (APTT), prothrombin time (PT), the number of the soluble fibrin-monomeric complexes (SFMC) and D-dimers, euglobulin fraction clot lysis time, the amount and aggregation activity of blood platelets. The findings obtained while studying haemostasis in patients with irreversible ischaemia of the lower limbs demonstrated activation of the intravascular microcoagulation of blood prior to the operation. The immediate postoperative period was marked by preservation of the shortened APTT, high concentration of fibrinogen, elevated euglobulin clot lysis time, high concentrations of SFMCs and D-dimers of blood, which created conditions for the development of thrombotic complications even in a relatively stable course of the postoperative period. The authors underline the necessity of determining an optimal mode of prescribing and administering appropriate doses of direct anticoagulants in the early and immediate postoperative period, as well as that of making an appropriate decision of whether or not to use indirect anticoagulants for correction of haemostasis in these patients during the remote postoperative period.
Asunto(s)
Anticoagulantes/uso terapéutico , Aterosclerosis/complicaciones , Aterosclerosis/fisiopatología , Gangrena/tratamiento farmacológico , Gangrena/etiología , Extremidad Inferior/irrigación sanguínea , Extremidad Inferior/fisiopatología , Microcirculación/fisiología , Nadroparina/uso terapéutico , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
Activity of lipid peroxidation processes in blood was studied in 60 patients with atherosclerotic gangrene of the lower extremity subjected to amputation of the extremity in a prospective controlled investigation. Activation of the lipid peroxidation processes with a lower number and less activity of the antioxidant system enzymes was demonstrated in patients with severe critical ischemia of lower extremities. The operation trauma was followed by further stress of the system of free radical oxidation of lipids. The increased concentration of lipid peroxidation products with a decreased or low level of activity of the antioxidant system enzymes allows prognosis of the development of purulent complications at the early postoperative period.
Asunto(s)
Amputación Quirúrgica/métodos , Aterosclerosis , Gangrena , Peroxidación de Lípido/fisiología , Extremidad Inferior , Anciano , Anciano de 80 o más Años , Aterosclerosis/complicaciones , Aterosclerosis/fisiopatología , Aterosclerosis/cirugía , Femenino , Gangrena/etiología , Gangrena/fisiopatología , Gangrena/cirugía , Humanos , Extremidad Inferior/fisiopatología , Extremidad Inferior/cirugía , Masculino , Persona de Mediana Edad , Cuidados Posoperatorios , Cuidados PreoperatoriosRESUMEN
A prospective controlled study was conducted in 48 patients with atherosclerotic gangrene in the postoperative period after above knee amputation. It showed the tension of the cardiovascular and sympathoadrenal systems in patients with atherosclerotic gangrene in the pre- and early postoperative periods. Continuous epidural infusion of a local anesthetic ensures effective pain relief throughout the early postoperative period.
Asunto(s)
Amputación Quirúrgica , Analgesia Epidural , Analgésicos Opioides , Antiinflamatorios no Esteroideos , Pierna/cirugía , Dolor Postoperatorio/terapia , Analgésicos Opioides/administración & dosificación , Analgésicos Opioides/uso terapéutico , Antiinflamatorios no Esteroideos/administración & dosificación , Antiinflamatorios no Esteroideos/uso terapéutico , Glucemia/análisis , Interpretación Estadística de Datos , Esquema de Medicación , Humanos , Hidrocortisona/sangre , Lidocaína/administración & dosificación , Lidocaína/uso terapéutico , Umbral del Dolor , Dolor Postoperatorio/tratamiento farmacológico , Estudios Prospectivos , Resultado del TratamientoRESUMEN
A new evolutionary model with hereditary modes considered as correlated fluctuations of fertility has been proposed. It has been demonstrated that the model allows the global statistical properties of the system to be evaluated, e.g. the ensemble average and the probability of extinction. The results obtained show the increase of instability of a population with the enhancement of inheritance efficiency. The existence of at least an exponential stratification in the population has also been shown. Possible applications of the present model are discussed.
Asunto(s)
Fertilidad/genética , Modelos Biológicos , Animales , Evolución Biológica , Femenino , Masculino , Dinámica Poblacional , Procesos Estocásticos , Teoría de SistemasRESUMEN
Biological polymers have a preferred chirality ond can replicate themselves. Physical arguments provide insight into which of these unique and apparently related properties evolved first, and by what mechanism.
Asunto(s)
Evolución Molecular , Origen de la Vida , Polímeros/química , Alanina/química , Catálisis , Ácidos Nucleicos/química , Fenómenos Físicos , Física , Proteínas/química , EstereoisomerismoRESUMEN
This work discusses the question about the role of chiral purity (homochirality) of nucleotides in the formation of complementary replicas. A qualitative answer to this question can be obtained from molecular models constructed to simulate the chiral defect in the polynucleotidic chain. It shows the necessity of homochirality of nucleotides for the complementarity preservation. The necessity of the strong mirror-symmetry breaking in the abiogenic formation of the self-replicating oligonucleotide structures is discussed in the context of prebiological evolution.