Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

2000 ◽  
Vol 93 (3) ◽  
pp. 662-669 ◽  
Author(s):  
Tomiei Kazama ◽  
Ken Takeuchi ◽  
Kazuyuki Ikeda ◽  
Takehiko Ikeda ◽  
Mutsuhito Kikura ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Hemodynamic Responses ◽  
Verbal Command ◽  
Group 3 ◽  
Group 2 ◽  
Somatic Response ◽  
Group 1

Background Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups. Methods Propofol sedation at target plasma concentrations from 0.5 to 4.0 microgram/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups. Results Cp50ls concentrations were 2.23 microgram/ml (group 1), 1.75 microgram/ml (group 2), and 1.40 microgram/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 microgram/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 microgram/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations. Conclusions The authors determined the propofol concentration necessary for gastroscopy and showed that increasing age reduces it. Propofol concentration that suppresses somatic response induces loss of consciousness in almost all young patients.

scholarly journals National Surveillance of Injury in Children and Adolescents in the Republic of Korea: 2011–2017

2020 ◽  
Vol 17 (23) ◽  
pp. 9132
Author(s):  
Soo Hyun Park ◽  
Ji Young Min ◽  
Won Cul Cha ◽  
Ik Joon Jo ◽  
Taerim Kim
Keyword(s):  
Brain Injuries ◽  
Pediatric Population ◽  
Age Groups ◽  
Prevention Strategies ◽  
Group 4 ◽  
Group 3 ◽  
The Republic ◽  
Group 2 ◽  
Prevention Potential ◽  
Group 1

Understanding age-specific injury patterns allows the continued improvement of prevention strategies. This is a retrospective study analyzing the Korea Emergency Department-Based Injury In-depth Surveillance data, including those aged ≤19 years old between January 2011 and December 2017. In this study, we focused on changes in the modes of injury and severity, and prevention potential by dividing the patients into four age groups: group 1 (0–4 years), group 2 (5–9 years), group 3 (10–14 years), and group 4 (15–19 years). The most common mode of injury in younger age groups 1 and 2 was a fall or slip. Most injuries in older age groups 3 and 4 were unintentional and intentional collisions combined. Traumatic brain injuries (2.1%), intensive care unit admissions (1.8%), and overall death (0.4%) were the highest in group 4. The proportions of severe and critical injury (EMR-ISS ≥ 25) were 7.5% in group 4, 3.2% in group 3, 2.5% in group 1, and 1% in group 2. This study presents a comprehensive trend of injuries in the pediatric population in South Korea. Our results suggest the importance of designing specific injury-prevention strategies for targeted groups, circumstances, and situations.

scholarly journals Interaction Between Age and Change in Velocity During a Baseball Training Program

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092793
Author(s):  
Christopher Antonacci ◽  
Thomas R. Atlee ◽  
Peter N. Chalmers ◽  
Christopher Hadley ◽  
Meghan E. Bishop ◽  
...  
Keyword(s):  
Training Program ◽  
Age Groups ◽  
Maximum Velocity ◽  
Age Group ◽  
Significant Difference ◽  
Group 3 ◽  
Baseball Pitchers ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

Background: Pitching velocity is one of the most important metrics used to evaluate a baseball pitcher’s effectiveness. The relationship between age and pitching velocity after a lighter ball baseball training program has not been determined. Purpose/Hypothesis: The purpose of this study was to examine the relationship between age and pitching velocity after a lighter ball baseball training program. We hypothesized that pitching velocity would significantly increase in all adolescent age groups after a lighter baseball training program, without a significant difference in magnitude of increase based on age. Study Design: Cohort study; Level of evidence, 2. Methods: Baseball pitchers aged 10 to 17 years who completed a 15-week training program focused on pitching mechanics and velocity improvement were included in this study. Pitchers were split into 3 groups based on age (group 1, 10-12 years; group 2, 13-14 years; group 3, 15-17 years), and each group trained independently. Pitch velocity was assessed at 4 time points (sessions 3, 10, 17, and 25). Mean, maximum, and mean change in pitch velocity between sessions were compared by age group. Results: A total of 32 male baseball pitchers were included in the analysis. Mean/maximum velocity increased in all 3 age groups: 3.4/4.8 mph in group 1, 5.3/5.5 mph in group 2, and 5.3/5.2 mph in group 3. While mean percentage change in pitch velocity increased in all 3 age groups (group 1, 6.5%; group 2, 8.3%; group 3, 7.6%), the magnitude of change was not significantly different among age groups. Program session number had a significant effect on mean and maximum velocity, with higher mean and maximum velocity seen at later sessions in the training program ( P = .018). There was no interaction between age and program session within either mean or maximum velocity ( P = .316 and .572, respectively). Conclusion: Age had no significant effect on the magnitude of increase in maximum or mean baseball pitch velocity during a velocity and mechanics training program in adolescent males.

scholarly journals Screening for MELAS mutations in young patients with stroke of undetermined origin

2007 ◽  
Vol 65 (2b) ◽  
pp. 371-376 ◽  
Author(s):  
Adriana Bastos Conforto ◽  
Fabio Iuji Yamamoto ◽  
Sueli Mieko Oba-Shinjo ◽  
Julio Guy C. Pinto ◽  
Maurício Hoshino ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Healthy Subjects ◽  
Young Patients ◽  
Clinical Findings ◽  
Melas Syndrome ◽  
Mitochondrial Mutations ◽  
A3243g Mutation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

PURPOSE: It has been suggested that mitochondrial disease may be responsible for a substantial proportion of strokes of indetermined origin. We have preliminarily screened for MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) mutations in young patients with cryptogenic strokes. METHOD: The mitochondrial mutations A3243G and T3271C were investigated in 38 subjects aged less than 46 years. Group 1: 15 patients with cryptogenic strokes; Group 2: 3 patients with diagnosis of MELAS syndrome, including stroke-like episodes; Group 3: 20 healthy subjects. RESULTS: The A3243G mutation was absent in all subjects in Groups 1 and 3 but was present in all subjects in Group 2. CONCLUSION: Our results do not support screening for these mutations to diagnose oligosymptomatic forms of MELAS in cryptogenic strokes in the absence of other features of the syndrome. We suggest that clinical findings should guide mitochondrial genetic testing.

scholarly journals Plasma fatty acids in de novo lipogenesis pathway are associated with diabetogenic indicators among adults: NHANES 2003–2004

2018 ◽  
Vol 108 (3) ◽  
pp. 622-632 ◽  
Author(s):  
Elaine A Yu ◽  
Peter J Hu ◽  
Saurabh Mehta
Keyword(s):  
Fatty Acids ◽  
De Novo ◽  
Plasma Concentrations ◽  
The United States ◽  
Structure Study ◽  
De Novo Lipogenesis ◽  
Group 3 ◽  
Group 2 ◽  
Study Participants ◽  
Group 1

ABSTRACT Background Insulin regulates fatty acids (FAs) in the blood; conversely, FAs may mediate insulin sensitivity and are potentially modifiable risk factors of the diabetogenic state. Objective The objective of our study was to examine the associations between plasma concentrations of FAs, fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) among individuals (n = 1433) in the NHANES (2003–2004). Design Plasma concentrations of 24 individual FAs were considered individually and in subgroups, per chemical structure. Study participants were categorized in diabetogenic groups: Group 1 (HbA1c ≥6.5% or FPG ≥126 mg/dL), Group 2 (HbA1c 5.7% to <6.5% or FPG 100 to <126 mg/dL), and Group 3 (HbA1c <5.7% and FPG <100 mg/dL). We assessed associations between diabetogenic groups and plasma FAs in multivariate multinomial regressions (with Group 3 as the reference). Results Overall, 7.0% of study participants were in Group 1; 33.3% were in Group 2. Plasma concentrations of several individual FAs, including even-chain saturated FAs (SFAs; myristic, palmitic, stearic acids) and monounsaturated FAs (MUFAs; cis-vaccenic, oleic acids), were respectively associated with greater odds of Groups 1 and 2 status, adjusting for covariates. Higher concentrations of SFA and MUFA subgroups (highest compared with lowest quartile) were associated with increased odds of Group 2 status [SFAs adjusted OR (aOR): 1.51 (95% CI: 1.05, 2.18); MUFAs aOR: 1.78 (95% CI: 1.11, 2.85)]. Higher eicosapentaenoic acid plasma concentration was associated with decreased odds of Group 1 status [quartile 4 aOR: 0.41 (95% CI: 0.17, 0.95)]. Conclusions Higher plasma concentrations of SFAs and MUFAs, primary de novo lipogenesis products, were associated with elevated FPG and HbA1c in a nationally representative study population in the United States. Additional studies are necessary to elucidate potential causal relationships between FAs (from endogenous production and dietary consumption) and diabetogenic indicators, as well as clinical implications for managing diabetes and prediabetes.

Lumbar Plexus in Children

2004 ◽  
Vol 101 (2) ◽  
pp. 445-450 ◽  
Author(s):  
Lukas Kirchmair ◽  
Birgit Enna ◽  
Gottfried Mitterschiffthaler ◽  
Bernhard Moriggl ◽  
Manfred Greher ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Age Groups ◽  
Posterior Part ◽  
Lumbar Plexus ◽  
Ultrasound Guided ◽  
Psoas Major Muscle ◽  
Group 3 ◽  
Group 2 ◽  
Paravertebral Region ◽  
Group 1

Background Pediatric regional anesthesia has gained increasing interest over the past decades. The current study was conducted to investigate the lumbar paravertebral region and the lumbar plexus at L3-L4 and L4-L5 by means of sonography to obtain fundamentals for the performance of ultrasound-guided posterior lumbar plexus blocks. Methods Thirty-two children (12 boys, 20 girls) with American Society of Anesthesiologists physical status I or II were enrolled in the current study. The lumbar paravertebral region was visualized at L3-L4 and L4-L5 on two corresponding posterior sonograms (longitudinal, transverse). The lumbar plexus had to be delineated, and skin-plexus distances were measured. In a series of five pediatric patients undergoing inguinal herniotomy, ultrasound-guided posterior lumbar plexus blocks at L4-L5 were performed. Results The children were stratified into three age groups (group 1: > 3 yr and </= 5 yr; group 2: > 5 yr and </= 8 yr; group 3: > 8 yr and </= 12 yr). The lumbar plexus could be delineated at L3-L4 and L4-L5 in 19 of 20 cases in group 1, in 17 of 20 cases in group 2, in 22 of 24 cases at L3-L4 in group 3, and in 16 of 24 cases at L4-L5 in group 3. In all patients, the lumbar plexus was situated within the posterior part of the psoas major muscle. Skin-plexus distances showed statistical significant differences between groups 1 and 3 and between groups 2 and 3. The strongest positive correlation existed between skin-plexus distances and the children's weight. Ultrasound guidance enabled safe und successful posterior approaches to the lumbar plexus, thus resulting in effective anesthesia and analgesia of the inguinal region. Conclusions Sonography of the lumbar plexus in children proved to be feasible. Skin-plexus distances correlated with the children's weight rather than with their age. The sonographic findings were fundamental for the performance of successful ultrasound-guided posterior approaches in a small group of pediatric patients.

PITUITARY LH AND FSH SECRETION AND RESPONSIVENESS IN WOMEN OF OLD AGE

1976 ◽  
Vol 81 (3) ◽  
pp. 673-679 ◽  
Author(s):  
Hugo Scaglia ◽  
Martha Medina ◽  
Ada L. Pinto-Ferreira ◽  
Guadalupe Vazques ◽  
Carlos Gual ◽  
...  
Keyword(s):  
Plasma Levels ◽  
Plasma Concentrations ◽  
Group 4 ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
Post Menopausal ◽  
Episodic Fluctuations ◽  
Lh Rh ◽  
Group 1

ABSTRACT The plasma concentrations and episodic fluctuations of immunoreactive FSH and LH as well as the pituitary sensitivity to LH-RH stimulation were evaluated in post-menopausal women. The subjects were divided into 4 groups according to age. Group 1: 60–70 years old (n=11), group 2: 70–80 years old (n=22), group 3: 80–90 years old (n=31) and group 4: 90–100 years old (n=8). Standards used in gonadotrophin radioimmunoassays included the LER-907 preparation and a pooled post-menopausal serum. Since it was found that circulating gonadotrophins have an immunological pattern different from that shown by the pituitary preparation, the results were expressed in mIU/ml calculated accordingly to the immunological behaviour of pooled post-menopausal sera. The mean (± se) plasma levels of FSH (mIU/ml) were: group 1: 105.9 ± 9.5, group 2: 149.3 ± 10.5, group 3: 124.8 ± 7.1 and group 4: 149.4 ± 25.3. The mean (± se) plasma levels of LH (mIU/ml) were: group 1: 81.9 ± 12.5, group 2: 95.4 ± 9.9, group 3: 84.3 ± 7.7 and group 4: 113.5 ± 19.1. No statistically significant differences were observed among the 4 groups. One patient from each group was randomly selected in order to evaluate their LH and FSH episodic release as well as their pituitary responsiveness to exogenous stimulation. A pulsatile plasma pattern of gonadotrophin and a normal pituitary response to LH-RH injection were observed in the 4 patients studied. The results are interpreted as demonstrating that normal pituitary gonadotrophin function and pituitary reserve and responsiveness to exogenous stimulation are maintained in women of advanced age.

scholarly journals How safe are elective craniotomies in elderly patients in neurosurgery today? A prospective cohort study of 1452 consecutive cases

2020 ◽  
pp. 1-9
Author(s):  
Ralph T. Schär ◽  
Shpend Tashi ◽  
Mattia Branca ◽  
Nicole Söll ◽  
Debora Cipriani ◽  
...  
Keyword(s):  
Cohort Study ◽  
Blood Loss ◽  
Elderly Patients ◽  
Age Groups ◽  
Head Ct ◽  
Estimated Blood Loss ◽  
Group 3 ◽  
Group 2 ◽  
The Impact ◽  
Group 1

OBJECTIVEWith global aging, elective craniotomies are increasingly being performed in elderly patients. There is a paucity of prospective studies evaluating the impact of these procedures on the geriatric population. The goal of this study was to assess the safety of elective craniotomies for elderly patients in modern neurosurgery.METHODSFor this cohort study, adult patients, who underwent elective craniotomies between November 1, 2011, and October 31, 2018, were allocated to 3 age groups (group 1, < 65 years [n = 1008], group 2, ≥ 65 to < 75 [n = 315], and group 3, ≥ 75 [n = 129]). Primary outcome was the 30-day mortality after craniotomy. Secondary outcomes included rate of delayed extubation (> 1 hour), need for emergency head CT scan and reoperation within 48 hours after surgery, length of postoperative intensive or intermediate care unit stay, hospital length of stay (LOS), and rate of discharge to home. Adjustment for American Society of Anesthesiologists Physical Status (ASA PS) class, estimated blood loss, and duration of surgery were analyzed as a comparison using multiple logistic regression. For significant differences a post hoc analysis was performed.RESULTSIn total, 1452 patients (mean age 55.4 ± 14.7 years) were included. The overall mortality rate was 0.55% (n = 8), with no significant differences between groups (group 1: 0.5% [95% binominal CI 0.2%, 1.2%]; group 2: 0.3% [95% binominal CI 0.0%, 1.7%]; group 3: 1.6% [95% binominal CI 0.2%, 5.5%]). Deceased patients had a significantly higher ASA PS class (2.88 ± 0.35 vs 2.42 ± 0.62; difference 0.46 [95% CI 0.03, 0.89]; p = 0.036) and increased estimated blood loss (1444 ± 1973 ml vs 436 ± 545 ml [95% CI 618, 1398]; p <0.001). Significant differences were found in the rate of postoperative head CT scans (group 1: 6.65% [n = 67], group 2: 7.30% [n = 23], group 3: 15.50% [n = 20]; p = 0.006), LOS (group 1: median 5 days [IQR 4; 7 days], group 2: 5 days [IQR 4; 7 days], and group 3: 7 days [5; 9 days]; p = 0.001), and rate of discharge to home (group 1: 79.0% [n = 796], group 2: 72.0% [n = 227], and group 3: 44.2% [n = 57]; p < 0.001).CONCLUSIONSMortality following elective craniotomy was low in all age groups. Today, elective craniotomy for well-selected patients is safe, and for elderly patients, too. Elderly patients are more dependent on discharge to other hospitals and postacute care facilities after elective craniotomy.Clinical trial registration no.: NCT01987648 (clinicaltrials.gov).

Comparisons of the BASIC-Memory and Learning Test and the WISC-IV Under Developmental Aspects

2008 ◽  
Vol 216 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Anja C. Lepach ◽  
Franz Petermann ◽  
Sören Schmidt
Keyword(s):  
Age Groups ◽  
Semantic Knowledge ◽  
School Type ◽  
Memory And Learning ◽  
Group 3 ◽  
Group 2 ◽  
Learning Test ◽  
Matrix Reasoning ◽  
Pearson Correlations ◽  
Group 1

This study compares results of a new children memory and learning test, the BASIC-MLT and the latest Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) in a nonclinical German sample (N = 103). All participants were assessed with both instruments (order balanced). Pearson correlations were computed between subtest, scale and IQ scores from the intelligence scales and the scores from the BASIC-MLT separate for three defined age groups (Group 1: 6 to < 10 years, Group 2: 10 to < 13 years, Group 3: 13 to 16 years). Moderate to high correlations were found between Full Scale IQ (FSIQ) and BASIC-MLT’s memory quotient (MQ). Referring to Siegler’s (1998 , 2004 ) memory theories the relations of reasoning (Matrix Reasoning), semantic knowledge (Vocabulary), working memory (Letter-Number Sequencing) and processing speed (Symbol Search) were focused for further investigation. Significant correlations can be found for Matrix Reasoning and MQ in Group 1 only. For Vocabulary significant correlations can be found in Group 2 (p < .05) and Group 3 (p < .01). Letter-Number Sequencing has significant correlations with MQ in all age groups and Symbol Search in none. Comparisons of t-mean deviations in scales and subtests showed no significant differences in Group 1 and only few significant differences for Group 2 and Group 3. Results of children above 10 years of age are influenced by school type.

scholarly journals The Influence of Age on Lignocaine Pharmacokinetics in Young Puppies

1986 ◽  
Vol 14 (2) ◽  
pp. 135-139 ◽  
Author(s):  
C. L. Hastings ◽  
T. C. K. Brown ◽  
R. L. Eyres ◽  
R. C. Oppenheim
Keyword(s):  
Age Groups ◽  
Elimination Rate ◽  
Central Compartment ◽  
Volume Of Distribution ◽  
Pharmacokinetic Data ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Eight mongrel puppies were studied at intervals of a few weeks. Lignocaine 4mg/kg was infused over 60 seconds. Frequent samples were taken over 30 minutes for plasma lignocaine assay. Initially the concentrations were significantly higher in the oldest group (178–191 days) but after 10 minutes the youngest group (3–16 days) had significantly higher levels than the other groups. Pharmacokinetic data derived included the rate constants k21, k12 (drug movement between two compartments), k10 (elimination from the central compartment), and the volume of distribution (Vβ). The elimination rate constant k10 was significantly lower in Group 1 (3–16 days) than all other groups and Group 2 (37–57 days) was lower than Group 4 (178–191 days). The calculated β half-life was significantly longer in the youngest group than the others. There was no significant difference in the volume of distribution between these age groups — up to 6 months.

scholarly journals Acute carbon monoxide poisoning with low saturation of carboxyhaemoglobin: a forensic retrospective study in Shanghai, China

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zheng Liu ◽  
Hang Meng ◽  
Juntian Huang ◽  
Pascal Kwangwari ◽  
Kaijun Ma ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Age Groups ◽  
Co Poisoning ◽  
Gas Leakage ◽  
Outdoor Spaces ◽  
Group 3 ◽  
Group 2 ◽  
In Fire ◽  
Group 1

AbstractCarbon monoxide (CO) poisoning is a common cause of death, leading to morbidity and mortality worldwide. Features of the CO poisoning with low carboxyhemoglobin (COHb) levels remain to be characterized. This study collected a total of 307 CO poisoning cases from Shanghai Public Security Bureau, an official organization that handles the most complicated and life-threatening cases across Shanghai municipality in China, and regrouped these cases into three categories: group 1, 10% < COHb% < 30% (n = 58); group 2, 30% ≤ COHb% < 50% (n = 79); group 3, COHb% ≥ 50% (n = 170). Epidemiological, demographic, and forensic aspects of the CO poisoning cases, particularly those with low COHb levels, were analyzed. Our results showed that group 2 and 3 were mostly observed in younger victims (≤ 30 years), while group 1 equally distributed to all age groups (p = 0.03). All the CO poisoning from group 2 and 3 occurred in enclosed spaces, whereas cases from group 1 died additionally in outdoor spaces (p = 0.01). 81.03% of group 1 cases died in fire circumstances, while only 45.57% from group 2 and 30.59% from group 3 were fire-related (p = 0.00). Accordingly, group 1 was mostly related with fire burns, while group 2 or 3 were largely associated with gas leakage (p = 0.00). A combination with alcohol, but not other psychotropic drugs, associated with significant higher levels of blood COHb% in fire-unrelated (p = 0.021) but not fire-related cases (p = 0.23). Five extremely low COHb% (< 30%)-related poisoning deaths were negative of any cardiopulmonary pathology and psychoactive substances. In conclusion, CO poisoning with low COHb% significantly associates with fire circumstances and outdoor spaces and has no age preference. Further diagnostic markers mandates to be identified in order to avoid disputes in cases of extremely low COHb%-related poisoning.

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