ScienceRise: Medical Science

Postsurgical pain intensity in children on the VAS and FLACC scale across various analgesic techniques. Mathematical prediction as a component of justification

Yaroslav Semkovych — Fri, 31 May 2024 00:00:00 +0300

Nowadays, in pediatric practice, the Visual Analogue Scale (VAS) and the Face, Legs, Activity, Cry, Consolability (FLACC) scale are effective for assessing postsurgical pain. The modern concept of pain management includes a multimodal approach, including regional analgesia techniques.

The aim of the study was to present a mathematical model to assess the efficacy of regional analgesia techniques in managing postsurgical pain intensity on the VAS and FLACC scale up to the fifth day of the study and predict the behaviour of the experimental data function up to day 87 following surgery using the autoregressive probability model.

Materials and Methods. 89 patients operated on the anterior abdominal wall were divided into 3 groups depending on the type of anesthesia. The assessment of pain management quality and the presence of acute pain was conducted using the VAS and FLACC scale on days 1, 2, 3, and 5 post-operatively in all children. The ‘predict’ function in РТС MathCad Prime 7.0. software was used to automate calculating predictions based on the Burg method.

Results. Studying the efficiency of the proposed treatment using regional analgesia techniques versus conventional analgesia enabled the prediction of varying postsurgical pain intensities on the VAS and FLACC scale based on their mathematical models, with coefficient of determination R²=0.9876, R²= 0, 9827, R²=0.9952 for the FLACC scale and R²=0.9868, R²=0,915, R²=0.9774 for the VAS.

Conclusions. The use of regional analgesia techniques in children undergoing anterior abdominal wall surgery has been confirmed to be associated with a significant reduction in postsurgical pain intensity to the fifth day of observation and predicted to remain so up to day 87

Peculiarities of the shape and size of the mandible and the lower dentition with taking into account gender and craniotype

Ruslan Yakymenko, Oleh Vovk — Fri, 31 May 2024 00:00:00 +0300

The aim of the study: establishment of actual intravital craniometric characteristics of the shape and dimensions of the mandible and lower dentition of an adult person depending on gender and craniotype.

Research materials and methods: the work used dry bone preparations of whole or fragmented human skulls of both sexes in the amount of 39 units, from the collection of the Department of Human Anatomy of the Kharkiv National Medical University, and the results of CT studies of the head of adult people without existing bone tissue pathologies, totaling 85 observations. The basis of establishing a craniotype is the principle of calculating the general facial or facial index, which allows classifying anatomical objects according to the shape of the head structure.

Research results: the straight length of the mandible in adult leptoprosops males is from 88.5 mm to 102.4 mm, for women - from 86.3 mm to 100.7 mm; in mesoprosops men, this parameter gradually decreases to the level - from 81.3 mm to 95.7 mm, in women - from 80.7 mm to 94.9 mm; in euryprosops, the index is the smallest and ranges from 79.7 mm to 91.5 mm in males and from 78.5 mm to 90.8 mm in females. The opposite trend with significant ranges of variation is established for the angular width of the bone. Thus, in male leptoprosops, this parameter was determined from 84.6 mm to 97.5 mm, in female representatives - from 83.6 mm to 96.3 mm; in mesoprosops men, it increased from 89.1 mm to 105.3 mm, in women - from 87.9 mm to 103.1 mm; in euryprosops, regardless of sex, it reached its peak values, from 94.5 mm to 116.1 mm and from 92.7 mm to 114.1 mm, respectively. The height of the mandibular body also showed a certain dependence on the type of skull structure, in leptoprosops men it tended to the highest values and was fixed at the level from 29.1 mm to 38.9 mm, as well as in women - from 27.5 mm to 37.8 mm; at the same time, in mesoprosops men, the size decreased from 25.9 mm to 36.3 mm, in women, in turn, from 24.6 mm to 35.1 mm; in euryprosops men, this parameter ranged from 22.3 mm to 33.1 mm, and next to women - from 21.9 mm to 31.9 mm, it was at the level of the lowest indicators. When analyzing such a complex and multidirectional parameter as the arch of the mandible, it was also possible to obtain a characteristic of its dependence on the type of structure of the facial department of the skull. It was established that the range with the smallest values of the length of the arc is characteristic of leptoprosops, ranging from 135.8 mm to 149.4 mm in males and from 133.5 mm to 147.3 mm in females; average indices are characteristic of men - from 139.1 mm to 154.6 mm and women - from 136.4 mm to 151.2 mm with a mesoprosopic craniotype; in euryprosops of both sexes, the index tends to the greatest values at the level of 141.2 mm to 158.3 mm and from 139.7 mm to 155.7 mm, respectively.

Conclusions: the main craniometric parameters of the mandible are significantly dependent on the type of structure of the facial department of the skull. Thus, the leptoprosopic craniotype is characterized by maximum values of longitudinal and height dimensions with minimal indicators of width and arc length. Mesoprosops are characterized by the definition of intermediate, averaged values equidistant from marginal, terminal forms. In representatives with the euryprosopic type of skull structure, a significant decrease in the length and height of the jaw with a significant increase, up to the maximum values, width and length of the arch was observed. At the same time, unlike leptoprosops, which had a shortened and pointed arch, in euryprosops, the arch tended to be smoothed and lengthened. The assessment by sex leads to the fact that all sizes of the lower jaw predominate in men, but, nevertheless, a certain number of differences in indicators were within the limits of statistical error, which does not allow making absolute conclusions in this matter

Features of lipid metabolism in patients with type 2 diabetes mellitus and gout

Yuliia Stoianova — Tue, 25 Jun 2024 00:00:00 +0300

The aim: To study the relationship between lipid metabolism parameters, chemerin, and adenosine monophosphate-activated protein kinase (AMPK) activity in patients with type 2 diabetes mellitus (T2DM), as well as in patients with a combined course of T2DM and gout.

Materials and methods. To assess lipid metabolism disorders, 100 patients were examined and divided into 2 groups: - 1st group – patients with T2DM and gout (n=70), 2nd group – patients with gout (n=30), control group (CG) - practically healthy individuals (n=20). The levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and very low-density lipoprotein cholesterol (VLDL) were analyzed. As markers of insulin resistance (IR), the content of AMPK and chemerin was investigated. Statistical data processing was carried out using the statistical data processing program package version 8.0 STATISTICA (StatSoft Inc).

The results. A significant difference was found between the levels of lipid parameters (except HDL) when comparing patients with the combined pathology of T2DM and gout, with a monocourse of gout and representatives of CG (р<0.001). It was also found that among lipidogram indicators, in all groups, an inverse correlation of AMPK value with LDL level was found (strong for patients of the 1st group and medium strength for representatives of the 2nd group and CG). Another indicator with which AMPK levels in all groups were statistically reliably correlated was TC. The presence of a direct correlation between the levels of LDL and chemerin in the 2nd group and CG, as well as the levels of TC and chemerin in patients with a combination of T2DM with gout and an inverse correlation in the other groups (all p<0.05) was established.

Conclusions: Statistically significant relationships were found between lipid metabolism indicators, chemerin and AMPK activity in patients with T2DM, as well as in patients with combined course of T2DM and gout