SummaryBackgroundMonitoring of biochemical markers of inflammation in acute mediastinitis (AM) can be useful in the modification of treatment. This study was a retrospective evaluation of selected biochemical parameters with negative impact on the prognosis in surgically treated patients.Material/MethodsThere were 44 consecutive patients treated surgically due to AM of differentiated etiology. Selected biochemical markers (WBC, RBC, HGB, HCT, PLT, CRP, PCT, ionogram, protein and albumins) were assessed before surgery and on the 3rd day after surgery. ANOVA was applied to find factors influencing observations. Numerical data [laboratory parameters] were compared by means of medians.ResultsThe overall hospital mortality rate was 31.82%. In the group of dead patients, there were observed statistically significant lower mean preoperative values of RBC [p=0.0090], HGB [p=0.0286], HCT [p=0.0354], protein [p= 0.0037], albumins [p=0.0003] and sodium [p<0.0001] and elevated values of CRP [P=0.0107] and PCT p<0.0001]. High level of inflammatory markers on day 3 after surgery was found to increase the risk of death – for WBC (by 67%), for CRP (by 88%) and for PCT (by 100%).ConclusionsPoor prognosis was more frequent in patients with preoperative high levels of CRP, PCT, anemia, hypoproteinemia and hyponatremia. The risk of death increases significantly if in the immediate postoperative period no distinct decrease in WBC count and of the CRP and PCT level is observed. In such a situation the patients should be qualified earlier for broadened diagnostic workup and for reoperation.
Introduction: The interstitial lung diseases (ILD) are mainly characterized by: dry cough, dyspnea and exercise desaturation. These symptoms are due, among other causes, to the lack of pulmonary distensibility and to the alteration of the gas exchange. The objective of this study is to demonstrate the effects that a respiratory rehabilitation program (RRP) has in a group of patients with ILD.Method: prospective cohort study that was approved by the Maule Health Service Ethics Committee and all Patients signed an informed consent, which were 10 (3 men, 7 women), age: 72.4±7.9 years with diagnosis of ILD, specifically 7 with usual interstitial pneumonia(UIP), of which three are associated with rheumatoid arthritis(RA), 3 to idiopathic pulmonary fibrosis(IPF) and 1 to chronic hypersensitivity pneumonitis(CHP), 2 with nonspecific interstitial pneumonia (NSIP) and 1 cryptogenic organizing pneumonia(COP), which were subjected to a RRP based on aerobic training of the respiratory and peripheral musculature, during 36 sessions of 60 minutes each, 3 times a week. The measured variables pre and post training were: body mass index(BMI), forced vital capacity(FVC), distance walked through the six minute walking test(6MWT), dyspnea through the modified scale of the medical research council(MMRC), strength of the inspiratory musculature through the maximal inspiratory pressure(MIP), initial saturation of oxygen(ISO2), final saturation of oxygen(FSO2), desaturation of oxygen(DO2) measured with pulse oximetry, diffusing capacity of the lung for carbon monoxide(DLCO) and quality of life through Saint George Respiratory Questionnaire (SGRQ). The statistical analysis was Carried Out with the program SPSS version 23.Results: significant changes (p<0.05) in: FVC, 6MWT, mMRC, MIP, and SGRQ. Non-significant changes (p˃0.05) in: BMI, ISO2, FSO2, DO2, and DLCO. Conclusion: our RRP improved lung function, exercise capacity, dyspnea, respiratory muscle strength and quality of life of the subjects intervened.
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