The clinical appearance and treatment of intraoperative hypoxemia

Aim: Intraoperative hypoxemia is often due to atelectasis which can be improved by recruitment maneuvers. Aim of the study: a) to investigate intraoperative hypoxemia in surgical patients and its correlation to specific demographic data, b) to investigate the effectiveness of recruitment maneuvers in improving oxygenation. Materials and methods: 430 patients undergoing elective general surgery were studied. Demographic data recorded age, sex, ASA-PS classification BW, BMI, AH, CAD, DM type and duration of surgery. Their predictive value for hypoxemia was evaluated. Hypoxemia was defined as PaO₂/FiΟ₂<300. Patients with hypoxemia were allocated to 4 study groups: Group A: 3 hyperinflations at 40cmH₂O and PEEP χ², Group Β: PEEP 10cmH₂O, Group C: 3 hyperinflations and PEEP 5cmH₂O, Group D: no intervention. The impact of these interventions on oxygenation was evaluated. Statistical analysis ROC and χ² for the predictive value of demographic data repeated measures ANOVA for the comparison between groups. Results-Conclusions: 150/430 (34.8%) patients developed hypoxemia. Positive predictive value was observed for age BMI duration of surgery and AH. The administration of 3 hyperinflations and PEEP 10cmH₂O is more efficient than the other maneuvers in improving intraoperative oxygenation.Εισαγωγή-Σκοπός: Η διεγχειρητική διαταραχή της οξυγόνωσης οφείλεται συχνά στις ατελεκτασίες που αντιμετωπίζονται με χειρισμούς επιστράτευσης κυψελίδων. Σκοπός της μελέτης: α) η διερεύνηση της υποξυγοναιμίας στο γενικό χειρουργικό πληθυσμό και η συσχέτιση της με προδιαθεσικούς παράγοντες από τα δημογραφικά δεδομένα, β) η διερεύνηση της αποτελεσματικότητας των χειρισμών επιστράτευσης. Υλικό-Μέθοδος: Μελετήθηκαν 430 ασθενείς. Καταγράφηκαν τα έξης δημογραφικά δεδομένα ηλικία, φύλο, κατηγορία ASA, PS, ΒΣ, BMI, AY, ΣΝ, ΣΔ, κάπνισμα, είδος και διάρκεια επέμβασης και διερευνήθηκε η προγνωστική τους άξια για την εμφάνιση υποξυγοναιμίας. Ως υποξυγοναιμία ορίστηκε ο λόγος PaO₂/FiΟ₂<300. Οι ασθενείς που εμφάνισαν υποξυγοναιμία χωρίστηκαν σε 4 ομάδες μελέτης. Ομάδα Α: 3 υπερεμφυσήσεις στα 40cmH₂O και PEEP 10cmH₂O, Ομάδα Β: PEEP 10cmH₂O, Ομάδα Γ: 3 υπερεμφυσήσεις και PEEP 5cmH₂O, Ομάδα Δ: καμία παρέμβαση. Αξιολογήθηκε η επίδραση των χειρισμών αυτών στην οξυγόνωση. Στατιστική ανάλυση ROC και χ² για την προγνωστική αξία των δημογραφικών και ANOVA επαναλαμβανόμενων μετρήσεων για τη σύγκριση των ομάδων. Αποτελέσματα-Συμπεράσματα: 150/430 (34,8%) ασθενείς εμφάνισαν υποξυγοναιμία. Θετική προγνωστική άξια εμφανίζουν ηλικία BMI διάρκεια επέμβασης Α Υ. Η χορήγηση 3 υπερεμφυσήσεων και PEEP 10cmH₂O πλεονεκτεί έναντι των άλλων χειρισμών στη βελτίωση της διεγχειρητικής οξυγόνωσης

Biomimetic and biodegradable cellulose acetate scaffolds loaded with dexamethasone for bone implants

There is, as a matter of fact, an ever increasing number of patients requiring total hip replacement (Pabinger, C.; Geissler, A. Osteoarthritis Cartilage 2014, 22, 734–741). Implant-associated acute inflammations after an invasive orthopedic surgery are one of the major causes of implant failure. In addition, there are instability, aseptic loosening, infection, metallosis and fracture (Melvin, J. S.; Karthikeyan, T.; Cope, R.; Fehring, T. K. J. Arthroplasty 2014, 29, 1285–1288). In this work, a drug-delivery nanoplatform system consisting of polymeric celluloce acetate (CA) scaffolds loaded with dexamethasone was fabricated through electrospinning. Atomic force microscopy (AFM) and scanning electron microscopy (SEM) indicated the successful fabrication of these structures. Cytotoxicity studies were performed by using MTT assay, methylene-blue staining and SEM fixation and showed very good cell adhesion and proliferation, indicating the cytocompatibility of these fibrous scaffolds. Drug-release kinetics was measured for the evaluation of a controllable and sustained release of anti-inflammatory drug onto the engineered implants and degradation study was conducted in order to assess the mass loss of polymers. This drug-delivery nanoplatform as coating on titanium implants may be a promising approach not only to alleviate but also to prevent implant-associated acute inflammations along with a simultaneous controlled release of the drug

COVID-19-Associated Pulmonary Aspergillosis (CAPA) in Northern Greece during 2020–2022: A Comparative Study According to the Main Consensus Criteria and Definitions

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) has emerged as an important complication among patients with acute respiratory failure due to SARS-CoV-2 infection. Almost 2.5 years since the start of the COVID-19 pandemic, it continues to raise concerns as an extra factor that contributes to increased mortality, which is mostly because its diagnosis and management remain challenging. The present study utilises the cases of forty-three patients hospitalised between August 2020 and February 2022 whose information was gathered from ten ICUs and special care units based in northern Greece. The main aim was to describe the gained experience in diagnosing CAPA, according to the implementation of the main existing diagnostic consensus criteria and definitions, and present the different classification of the clinical cases due to the alternative algorithms