Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusionAljaž Hojski
, Maja Leitgeb
, Anton Crnjac
, 2015, izvirni znanstveni članek
Opis: Background: Growth factors are key inducers of fibrosis but can also mediate inflammatory responses resulting in increasing pleural effusion and acute respiratory distress syndrome. The primary aim of the study was to analyse growth factors release after performing chemical and mechanical pleurodesis in the first 48 hours at the patients with malignant pleural effusion. The secondary endpoints were to evaluate the effectiveness of the both pleurodeses, symptoms release and the quality of life of patients after the treatment.
Patients and methods: A prospective randomized study included 36 consecutive female patients with breast carcinoma and malignant pleural effusion in an intention-to-treat analysis. We treated 18 patients by means of thoracoscopic mechanical pleurodesis and 18 patients by chemical pleurodesis with talcum applied over a chest tube. We gathered the pleural fluid and serum samples in the following 48 hours under a dedicated protocol and tested them for growth factors levels. A quality of life and visual analogue pain score surveys were also performed.
Results: Median measured serum vascular endothelial growth factor (VEGF) level after chemical pleurodesis was 930.68 pg/ml (95% CI: 388.22-4656.65) and after mechanical pleurodesis 808.54 pg/ml. (95% CI: 463.20-1235.13) (p = 0.103). Median pleural levels of transforming growth factor (TGF) ß1 were higher after performing mechanical pleurodesis (4814.00 pg/ml [95% CI: 2726.51-7292.94]) when compared to those after performing chemical pleurodesis (1976.50 pg/ml [95% CI: 1659.82-5136.26]) (p = 0.078). We observed similar results for fibroblast growth factor (FGF) ß; the serum level was higher after mechanical pleurodesis (30.45 pg/ml [95% CI: 20.40-59.42]), compared to those after chemical pleurodesis (13.39 pg/ml [95% CI: 5.04-74.60]) (p = 0.076). Mechanical pleurodesis was equally effective as chemical pleurodesis in terms of hospital stay, pleural effusion re-accumulation, requiring of additional thoracentesis, median overall survival, but, it shortened the mean thoracic drainage duration (p = 0.030) and resulted in a higher symptoms release and in a better quality of life (p = 0.047).
Conclusions: We recorded an increase in serum VEGF levels after chemical pleurodesis, however on the contrary, an increase in the pleural fluid level of TGF%1 and FGF%] after mechanical pleurodesis with respect to compared group. Although the differences did not reach statistical significance, VEGF, TGFß1 and FGFß remain the most interesting parameters for future research. Considering the mechanisms of growth factors action, we conclude that in our study group mechanical pleurodesis might be more efficient in terms of growth factors release, thoracic drainage duration and resulted in a higher symptoms release and in a better quality of life than chemical pleurodesis.
Ključne besede: malignant pleural effusion, pleurodesis, growth factors, quality of life
Objavljeno: 05.04.2017; Ogledov: 804; Prenosov: 83
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Toxicity of magnetic chitosan micro and nanoparticles as carriers for biologically active substancesMaja Leitgeb
, Katja Vasić
, Gordana Hojnik Podrepšek
, Aljaž Hojski
, Anton Crnjac
, Željko Knez
, 2014, izvirni znanstveni članek
Opis: Nanoparticles of inorganic magnetic core surrounded by layers of functional coatings are potential representatives of nanostructures for immobilization of bio-substances. Magnetic nanoparticles (MNPs) are often bound in aggregates due to a strong magnetic dipole, which has a lot of advantages, such as large surface area for binding biologically active substances. Chitosan is a polysaccharide polymer that is non-toxic, hydrophilic, biocompatible and has hydroxy and amino groups in its structure. Because of these chemical and biological properties it is a desirable bio-product for immobilization of enzymes and for binding of other biologically active substances. Magnetic micro and nanoparticles were synthesized with chitosan by three different methods; microemulsion process, suspension cross-linking technique and covalent binding of chitosan. Toxic effect of the prepared magnetic particles was determined as well and was examined on five different bacterial cultures; Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis and Klebsiella pneumoniae. At concentrations of 10-30 mg of magnetic particles per 0.5 McFarland Standard solution of E. coli and per 400 CFU of S. aureus, P. aeruginosa, E. faecalis in K. pneumonia, no inhibition on the chosen bacterial cultures was detected.
Ključne besede: hitozan, biosubstance, magnetni nanodelci, magnetni mikrodelci, biološko aktivne snovi, toksikološki testi
Objavljeno: 30.12.2015; Ogledov: 983; Prenosov: 43
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ZDRAVSTVENA NEGA PACIENTA S TORAKALNO DRENAŽONadja Povh
, 2013, diplomsko delo
Opis: Diplomsko delo zajema opis zdravstvene nege pacienta s torakalno drenažo. Predstavljena je torakalna drenaža, vrste torakalnih drenaž, prednosti in slabosti torakalnih drenaž, sam kirurški postopek vstavljanja torakalnega drena, spremljanje bolečine pri bolnikih s torakalno drenažo in odstranitev torakalnega drena.
Raziskava je temeljila na deskriptivni metodi dela s študijem domače in tuje literature. Raziskavo smo izvedli s pomočjo anonimnega anketnega vprašalnika, ki je vključeval 28 zaposlenih medicinskih sester in zdravstvenih tehnikov na Oddelku intenzivne kirurgije Splošne bolnišnice dr. Jožeta Potrča Ptuj.
V raziskavi smo želeli ugotoviti, ali so medicinske sestre in zdravstveni tehniki dovolj strokovno usposobljeni oziroma ali se jim zdi, da imajo na tem področju dovolj znanja o torakalni drenaži in alibi si ga želeli pridobiti še več. Skozi diplomsko nalogo smo ugotovili, da si vsi anketiranci želijo dodatna znanja s področja obravnave pacienta s torakalno drenažo.
Ključne besede: Ključne besede: torakalna drenaža, torakalni dren, medicinska sestra, pacient, psihična in fizična priprava bolnika in zdravstvena nega.
Objavljeno: 06.08.2013; Ogledov: 4670; Prenosov: 1380
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