1,721,152 research outputs found

    FAST-TRACK SURGERY NEL PAZIENTE ANZIANO: PROTOCOLLO INTENSIVO DI ASSISTENZA POST-OPERATORIA

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    Background Il paziente anziano rappresenta un bersaglio potenziale dei protocolli di assistenza postoperatoria anche se l’efficacia e la fattibilità di tali protocolli su questa popolazione sono ancora da determinare. Obiettivi Valutazione di sicurezza, fattibilità di un protocollo di assistenza postoperatoria sul modello “fast-track surgery” potenziato da un dispositivo riabilitativo in pazienti ultra-settantenni dopo chirurgia colo-rettale, con particolare riferimento al recupero funzionale post-operatorio e sulla durata della degenza Metodi Studio clinico monocentrico randomizzato controllato di confronto tra un braccio sperimentale sottoposto a un protocollo sperimentale di assistenza postoperatoria multimodale potenziato da un dispositivo riabilitativo e un braccio di controllo di pazienti sottoposti al protocollo di assistenza tradizionale, in pazienti ultrasettantenni dopo chirurgia colo-rettale. Tutti i pazienti sono stati sottoposti a visita fisiatrica preoperatoria e postoperatoria alla dimissione. Risultati Sono stati arruolati 26 pazienti. Il protocollo sperimentale si è dimostrato sicuro e fattibile. Il dolore post-operatorio è stato inferiore per il gruppo sperimentale anche se non significativo. La ripresa della funzionalità intestinale è stata più precoce per i pazienti del gruppo sperimentale (canalizzazione ai gas 1.8 vs. 2.4 giorni, p<0.001; canalizzazione alle feci 2.3 vs. 3.6 giorni, p<0.001). La mobilizzazione precoce entro i primi 2 giorni è stata possibile nell’80% dei pazienti randomizzati per il gruppo sperimentale contro il 25% del gruppo di controllo (p=0.010), con una significativa riduzione del tempo riabilitativo (seduto 1.7 vs.2.4 giorni, p=0.068; ortostatismo 1.9 vs.3.3 giorni, p=0.003; deambulazione 2.6 vs.3.8 giorni, p=0.013). Il recupero delle prestazioni fisiche è stato simile nei due gruppi anche leggermente migliore per il gruppo sperimentale (variazione % 6MWD -26 vs. -38 metri; p=0.374). La durata della degenza è stata simile nei due gruppi anche se leggermente inferiore per il gruppo sperimentale (9.00 vs. 9.75 giorni, p=0.617). Conclusioni Il protocollo assistenziale postoperatorio sul modello “fast-track surgery” nel paziente anziano sottoposto a chirurgia colorettale è sicuro e fattibile con una riduzione dei tempi di recupero della funzionalità intestinale e delle prestazioni fisiche.Background The elderly patients represent a potential target of enhanced recovery program (ERP) after surgery, even though effectiveness and feasibility of ERP in this population still remain unclear. Objectives Evaluation of safety, feasibility of ERP enhanced by a rehabilitation device in patients 70 years of age or older after colorectal surgery, focusing on postoperative recovery and length-of-hospital-stay. Methods Single-center, randomized, parallel-group trial comparing a multimodal ERP enhanced by a rehabilitation device vs. traditional care in elderly patients undergoing colorectal surgery. All patients underwent preoperative physiatric evaluation in preoperative setting and at time of hospital discharge. Results Twenty-six patients were enrolled. ERP enhanced by a rehabilitation device in elderly patients was safe and feasible. Postoperative pain was lower in the ERP group even if not significant. Recovery of the bowel function was earlier for ERP patients (first flatus 1.8 vs. 2.4 days, p<0.001; defaecation 2.3 vs. 3.6 days, p<0.001). Early mobilization within postoperative day 2 was achieved in the 80% of ERP patients vs. 25% of controls (p=0.010), with a significant reduction of the rehabilitation time (sitting 1.7 vs.2.4 days, p=0.068; standing 1.9 vs.3.3 days, p=0.003; deambulation 2.6 vs.3.8 days, p=0.013). Recovery of physical performance was similar for the two groups albeit better for ERP patients (% variation 6MWD -26 vs. -38 p=0.374). Length-of-hospital-stay was similar although lower for ERP patients (LOS 9.00 vs. 9.75, p=0.617). Conclusions ERP is feasible and safe, with a significant reduction in time to recovery of the bowel function and physical-performance even in the elderly patient

    Potential use of bovine lactoferrin as adjuvant for the modulation of the specific immune response in rainbow trout (Oncorhynchus mykiss W.)

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    The present experiment was carried out in order to evaluate the potential adjuvant effect of bovine lactoferrin (bLF) in modulating the specific antibody (Ab) response to an exogenous protein, the human-c-globulins (HcG), injected intraperitoneally in rainbow trout Oncorhynchus mykiss (Walbaum 1792). Moreover, serum natural antibody (NatAb) level, serum total immunoglobulin (IgM) level and specific Ab response to bLF were also analysed. Experimental data showed that HcG is able to stimulate a specific Ab response when not adjuvanted with Freund’s complete adjuvant (FCA), whereas bLF induces a specific Ab response only if adjuvanted with FCA. Statistical analyses revealed that neither bLF or FCA administered singly had significant effects on serum NatAb and IgM levels, whereas the specific immune response observed against HcG when adjuvanted with bLF was comparable to that achieved when FCA was used as the adjuvant. These results provide evidence of the potential for bLF to be used as an adjuvant for salmonids

    SEMINAL PLASMA OF BROWN TROUT, SALMO TRUTTA FARIO (L.) CONTAINS A FACTOR ABLE TO RETAIN IRON AT ACID PH, TYPICAL FEATURE OF LACTOFERRIN.

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    Blood and seminal plasma of brown trout Salmo trutta fario were analyzed for their iron binding potential adopting two different methods. Seminal plasma showed an iron binding capacity that was retained even if samples were exposed at acid pH, similarly to mammalian lactoferrin that binds ferric iron also at acid pH. This suggests that the iron binding capacity is determined by a factor having a lactoferrin-like activity. Moreover, trout seminal plasma proteins were also analyzed in their pattern by sodium dodecyl sulphate polyacrylamide gel elecrophoresis (SDS-PAGE) and electroblotted onto nitrocellulose membrane. When seminal plasma was subjected to immunoblotting using goat anti-bovine lactoferrin antibodies as a probe, only a single band having an apparent molecular weight of around 80 kDa was specifically detected, showing that this protein has homology with bovine lactoferrin

    Serum disposition of bovine lactoferrin after oral and anal administration and its proteolytic cleavage by gastric transit in rainbow trout (Oncorhynchus mykiss W.)

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    Several studies have shown an immunomodulatory effect of orally administered bovine lactoferrin (LF) in fish, but the process of digestion was not characterized. In the present study, we investigated the fate of bovine LF after oral and anal administration, and studied the appearance of intact LF in the bloodstream and its proteolytic attack during the gastric transit in rainbow trout (Oncorhynchus mykiss) held at 9 C and 18 C. Data obtained showed the presence of intact bovine LF in the bloodstream only after anal administration in fish held at 18 C and the presence of several peptides derived from bovine LF in the gastric content. Immunoblotting analysis showed that only a part of bovine LF-derived peptides reacted with the applied anti-bovine LF antibody. The concentration of intact bovine LF, after 30 min of administration, in the gastric content of fish reared at 18 C, being extremely low, if any, led us to suspect that the immunoregulatory effect of dietary bovine LF shown in fish by several authors is not due to the intact form but to bioactive fragments, originated by the proteolytic attack during the gastric transit, as demonstrated in higher vertebrates. a 2008 Elsevier Ltd. All rights reserved

    A Direct Spectrophotometric Assay for Evaluating Nitrate-Nitrogen in Intensive Aquaculture Systems

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    This paper describes a simple spectrophotometric procedure for determining NO3--N in water samples. In the proposed method, NO2--N of a water sample is first removed from the water with sulfamic acid. Then, NO3--N is reduced to NO2--N using vanadium (III) chloride and a detection reagent is added. When rapid collection of data is necessary, this method can be adapted to a microtechnique using a 96-well microplate, resulting in a detection limit of 5 NO3--N mg/l. Using a larger volume spectrophotometer cell (5 cm) lowers the detection limit to 0.5 NO3--N mg/l. The proposed method is applicable for routine analysis of water in aquaculture systems and wastewaters in which medium-high NO3--N concentrations are expected. Benefits of the method are reduction of the laborious preparation and avoidance of contact with the harmful substances typical of the cadmium reduction method
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