Switching to Degludec is Associated with Reduced Hypoglycaemia, Irrespective of Definition Used or Patient Characteristics: Secondary Analysis of the ReFLeCT Prospective, Observational Study

Background: Previous studies on post-operative pain document that most patients continue to experience pain after surgery. This study was done to record the drug use for post- operative pain in laparotomy and to determine the patient characteristics that affect their pain score.Methods: A prospective observational study in 250 adult patients undergoing laparotomy surgery from General Surgery and Obstetrics and Gynaecology (OBG) at a tertiary care hospital.Results: Among patients recruited, 161 (64.4%) were females, 134 (53.6 %) from surgery department, mean age 37.29±14.9 years. Caesarean section 85 (73.27%) followed by meshplasty 46 (34.3%) were most common.Parenteral tramadol 100mg (40%) was the most common analgesic post-operative, subsequently shifted to oral. Epidural analgesia used in 31 (12.4%) patients, only from surgery department. First analgesic received within 6 hrs in 55.5 % in surgery and 44.5 % in OBG (Pearson χ2 =2.535, p = 0.111) with mean time to first analgesic 2.85±2.33 hrs. Pain score, using Numerical Rating Scale (NRS) recorded for 200 (80%) patients showed 76 (30.4%) had severe pain on day 1 which decreased to 12 (4.8%) on day 3. Speciality (p=0.01) and nature of surgery (p=0.05) were significantly associated with severity of pain. Gender [OR = 0.55 (95% CI = 0.26, 1.19), p=0.13], nature of surgery [2.32 (1.02, 5.32), p=0.05], speciality [0.35 (0.15, 0.80), p=0.01] and surgical category [0.76 (1.01, 5.32), p=0.05] affected pain score on univariate logistic regression, but were not significant on multivariate analysis.Conclusions: Despite the use of opioids and combination analgesics, one third of patients reported severe pain on the first day after surgery.

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Modifying LI‐RADS on Gadoxetate Disodium‐Enhanced MRI : A Secondary Analysis of a Prospective Observational Study

Journal of Magnetic Resonance Imaging ◽

10.1002/jmri.28056 ◽

2022 ◽

Author(s):

Hanyu Jiang ◽

Bin Song ◽

Yun Qin ◽

Meghana Konanur ◽

Yuanan Wu ◽

...

Keyword(s):

Observational Study ◽

Prospective Observational Study ◽

Secondary Analysis ◽

Gadoxetate Disodium ◽

Enhanced Mri

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Abstract 231: Preliminary Experience with Prehospital Pupillometry: A Prospective, Observational Study in Out-of-Hospital Cardiac Arrest

Circulation ◽

10.1161/circ.130.suppl_2.231 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Joshua C Reynolds ◽

Todd Chassee ◽

Mark D Fankhauser ◽

Amy Uber

Keyword(s):

Observational Study ◽

Test Performance ◽

Prospective Observational Study ◽

Objective Assessment ◽

Patient Characteristics ◽

Qualitative Assessment ◽

Prognostic Information ◽

Neurologic Recovery ◽

Shockable Rhythm ◽

Continuous Scale

Objective: Physiologic monitoring & neuroprognostication during resuscitation are relatively crude. Real time assessment of neurophysiology could be useful to guide resuscitative efforts. Objective assessment of the pupillary light reflex [PLR] is feasible during IHCA with a portable pupillometer, & PLR is associated with survival & neurologic outcome. We are conducting a prospective, observational study to assess the translational potential of pupillometry in the prehospital setting for OHCA. Hypotheses: Prehospital pupillometry is feasible & qualitative assessment of PLR is associated with patient outcomes. Methods: Portable pupillometers (NeurOptics, Inc) were deployed for subjects with EMS treated OHCA. Serial recordings were obtained during routine pulse checks until ROSC, termination, or hospital arrival. We qualified PLR as normal/abnormal/absent with Neurologic Pupillary Index (NPiTM), a continuous scale that combines facets of PLR (e.g. % change, velocity, latency). We reviewed prehospital & hospital records to identify patient characteristics & outcomes, tabulated data as means/medians/proportions, & estimated test performance characteristics. Results: From 2/14 - 6/14, a pupillometer was deployed to 38/58 (66%) patients with EMS treated OHCA (63 ± 16 years, 66% male, 33% witnessed, 54% bystander CPR, 11% shockable rhythm). Of 38 subjects, 21 (56%) were transported (19 ROSC & 2 CPR). At the time of submission, follow-up data were available on 27 (71%) patients (6 survived to admission, 4 had therapeutic hypothermia, 3 had cardiac catheterization, 1 survived to discharge with excellent neurologic recovery). In total, 385 readings were attempted (median 8.5 attempts/patient; IQR 6-12). Median 47% (IQR 25%, 67%) readings had usable data. Most (92%) patients had ≥1 usable reading and 9/38 (24%) had any PLR during resuscitation. Conclusion: Prehospital pupillometry is feasible & may yield prognostic information during resuscitation.

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Factors Associated With Normal Physiologic Birth for Women Who Labor In Water: A Secondary Analysis of A Prospective Observational Study

Journal of Midwifery & Women s Health ◽

10.1111/jmwh.13315 ◽

2022 ◽

Author(s):

Jane Carpenter ◽

Ethel Burns ◽

Lesley Smith

Keyword(s):

Observational Study ◽

Prospective Observational Study ◽

Secondary Analysis ◽

Factors Associated

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The Effect of Esophageal Stethoscope Insertion on the Cuff Pressure: a Prospective Observational Study

10.21203/rs.3.rs-130939/v1 ◽

2020 ◽

Author(s):

Jee-Eun Chang ◽

Jung-Man Lee ◽

Jiwon Lee ◽

Jin-Young Hwang ◽

Tae Kyong Kim ◽

...

Keyword(s):

Observational Study ◽

General Anesthesia ◽

Tracheal Tube ◽

Prospective Observational Study ◽

Cuff Pressure ◽

Patient Characteristics ◽

Pressure Change ◽

The Mean ◽

Almost All ◽

Cuff Pressure Increase

Abstract Background: High cuff pressure can induce ischemic injury to the trachea. An esophageal stethoscope can increase the cuff pressure. The purpose of this study was to evaluate the effect of an esophageal stethoscope insertion on the cuff pressure.Methods: Patients, who were scheduled for surgeries under general anesthesia, were enrolled in this prospective observational study. After induction of anesthesia, an anesthesiologist intubated a tracheal tube into the patient’s trachea and inflated the cuff manually. Then, an investigator checked the initial cuff pressure using a manometer. Next, the cuff pressure was adjusted to 24-26 mmHg. The cuff pressure was rechecked after insertion of an esophageal stethoscope. We recorded the change in cuff pressure by esophageal stethoscope.Results: One hundred twelve patients completed this study. The cuff pressure increased by an esophageal stethoscope in almost all patients and the mean cuff pressure change was 3.0 ± 3.4 cmH2O in all patients. Among all subjects, cuff pressure change over 5 cmH2O was recorded in 24 patients. When we compared the patient characteristics between patients whose cuff pressure changed over 5 cmH2O with that of other patients, females were more affected by insertion of an esophageal stethoscope, in terms of cuff pressure increase.Conclusion: Esophageal stethoscope insertion could increase cuff pressure, and females are more affected by it. Therefore, anesthesiologists should check the cuff pressure with a manometer after insertion of an esophageal stethoscope and readjust the pressure appropriately.Trial registration: ClinicalTrials.gov Identifier NCT03375554, registered on 12 December 2017 (https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007N0H&selectaction=Edit&uid=U00026JX&ts=2&cx=-ivu5vz)

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