The Predictive Value of Diaphragm Thickness Fraction on Postoperative Pulmonary Complications after Digestive Cancer Curative Surgery
Published on: 14th August, 2023
Background: Postoperative Pulmonary Complications (PPCs) escalate mortality, hospitalization, and costs. This study aimed to predict PPCs after curative digestive cancer surgery using thickness fraction (TFdi) determined by ultrasonography. Methods: A prospective study was conducted over a period of 9 months. Diaphragmatic ultrasound was performed pre-surgery and repeated postoperatively (within 24 hours of ICU admission, then day 3). Right and left hemidiaphragm thickness at end-expiration (TEE) and peak-inspiration (TPI) were measured using ultrasonography. The maximal diaphragm thickening fraction during inspiration (TFdi,max) was calculated: TFdi,max = (TPI–TEE)/TEE. Patients were classified into No-PPCs and PPCs groups. Results: 159 patients participated, 55 (34.6%) developed PPCs. ICU stay was longer in PPCs patients with more deaths. TFdi,max decreased postoperatively and remained lower in PPCs patients [44.83% ± 11.07 vs. 31.54% ± 8.45; p < 0.001]. The receiver operating characteristic curve yielded an area under the curve of 0.83 [95% IC: 0.754 – 0.887]. TFdi,max < 37% had 72.7% sensitivity (95% IC: 59.0% – 83.8%) and 80.8% specificity (95% IC: 71.8% – 87.8%), Positive and negative Likelihood Ratios were 3.7 (95% IC: 2.4 – 5.7) and 0.3 (95% IC:0.2 – 0.5), respectively. In multiple logistic regression, preoperative risk factors for PPCs included TFdi,max < 37% [OR: 7.10; 95% CI: 1.71 – 18.60; p < 0.001] and supramesocolic surgery [OR: 9.94; 95% CI: 3.62 – 27.29; p < 0.001]. Epidural administration was protective [OR: 0.21; 95% CI: 0.052 – 0.87; p = 0.031]. Conclusion: A low preoperative TFdi,max identifies high-risk PPCs patients after digestive cancer surgery, aiding targeted preventive strategies like inspiratory muscle preoperative training.
Effects of Preoperative Training on Static and Dynamic Balance among Female Athletes with Injured ACL
Published on: 2nd October, 2024
Aims: The purpose of this research was to study the effects of preoperative training on static and dynamic balance among female athletes with injured ACLs. Methods: This semi-experimental study involved a 2-group pretest-post-test design. Subjects were 36 (19 control and 17 experimental) female athletes with injured ACLs, that were chosen with the available sampling method. The experimental group did the preoperative training in the eight weeks and the control group did not participate in any training program during this period. Static and dynamic balance and lower body muscle strength were measured. The paired sample T-test was used to compare pre and post-test results and the independent sample T-test achieved comparisons between the two groups. Results: The results indicated that static (with eyes opened and closed) dynamic balance and muscle strength were improved significantly (p < 0.05) in the exercise group, but no significant change (p > 0.05) was found in the control group. Also, significant differences were found in improvement changes results between the two groups (p < 0.05). Conclusion: Results of the study confirmed that preoperative training can have a beneficial effect on improving static and dynamic balance among female athletes with injured ACLs.
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