scholarly journals Preanesthetic Evaluation and Assessment of Children with Down's Syndrome

2007 ◽  
Vol 7 ◽  
pp. 242-251 ◽  
Author(s):  
Letterio B. Santamaria ◽  
Carmelo Di Paola ◽  
Federica Mafrica ◽  
Vincenzo Fodale
Keyword(s):  
Cardiac Disease ◽  
Gold Standard ◽  
Preoperative Evaluation ◽  
Focus Attention ◽  
Metabolic Alterations ◽  
Reduced Dimensions ◽  
Spine Abnormalities ◽  
Potential Risks ◽  
Method Of Evaluation ◽  
Preanesthetic Evaluation

During preoperative evaluation for anesthesia in the Down patient, it is important to focus attention on the functional conditions of the patient and systems that frequently show anomalies. One of the challenges of evaluating pre-operative conditions and potential risks in the Down patient is the lack of a gold-standard evaluation score; cervical spine abnormalities, reduced dimensions and malformations of the airways, neurological changes, respiratory and cardiac disease, as well as endocrinological and metabolic alterations. We suggest, as a possible method of evaluation for patients with mental retardation and possible malformations, a new scale which takes the functional and mental conditions into account: the Sensorial, Psychological, Anatomical, Biological, Operational and Surgical (SPABOS) Compliance Score.

Surgical Management of Patients With 22q11.2 Deletion Syndrome

2019 ◽  
Vol 4 (5) ◽  
pp. 857-869
Author(s):  
Oksana A. Jackson ◽  
Alison E. Kaye
Keyword(s):  
Surgical Management ◽  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
22Q11.2 Deletion Syndrome ◽  
Deletion Syndrome ◽  
22Q11.2 Deletion ◽  
Surgical Decision ◽  
Obstructive Sleep ◽  
Spine Abnormalities ◽  
Speech Assessment

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.

Should endometrial biopsy under direct hysteroscopic visualization using the grasp technique become the new gold standard for the preoperative evaluation of the patient with endometrial cancer?

2020 ◽  
Vol 158 (2) ◽  
pp. 347-353 ◽  
Author(s):  
Attilio Di Spiezio Sardo ◽  
Maria Chiara De Angelis ◽  
Luigi Della Corte ◽  
Jose Carugno ◽  
Brunella Zizolfi ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Gold Standard ◽  
Preoperative Evaluation ◽  
Endometrial Biopsy

scholarly journals Accuracy of CBCT Linear Measurements to Determine the Height of Alveolar Crest to the Mental Foramen

2021 ◽  
Vol 13 (1) ◽  
pp. 1-5
Author(s):  
Mahnaz Sheikhi ◽  
Seyed Ali Saleh Gholami ◽  
Maryam Ghazizadeh
Keyword(s):  
Dental Implant ◽  
Gold Standard ◽  
Imaging Techniques ◽  
Preoperative Evaluation ◽  
Mental Foramen ◽  
Detailed Knowledge ◽  
Slice Thickness ◽  
Cross Sectional ◽  
Implant Placement ◽  
Alveolar Crest

Background: Detailed knowledge of the three-dimensional (3D) anatomical structures in precise treatment planning prior to implant placement is necessary. The choice of imaging techniques plays an important role in achieving the required information to measure exact dimensions. Cone beam computed tomography (CBCT) has increasingly been used for diagnosis and treatment in the fields of periodontology, endodontic, and orthodontics. It is also used as the preoperative evaluation of patients who are candidates for dental implant treatment. Dental implant placement is an important application of CBCT in dentistry. One of the features of CBCT is the possibility of changing the slice thickness while reviewing images. In this study, we examined the linear measurement accuracy of CBCT for determining the height of alveolar crest to the mental foramen in cross-sectional view with different slice thicknesses and in tangential view. Methods: We used five dry human mandibles in this study. Then the distance from the highest tip of alveolar crest to the upper border of mental foramen was measured by digital caliper (as gold standard) and on CBCT images in cross sectional view with 1, 3, 5, 7 and 9 mm slice thicknesses and in tangential view. Data were analyzed using IBM SPSS Statistics software version 22, paired t test, and inter class correlation. Results: Data were collected by evaluation of 5 dry mandible and 240 measurements. There were significant differences only in tangential view and 1 mm slice thickness option in cross-sectional view with the gold standard (P=0.003 and P=0.018 respectively). The results did not show any differences between the observers (P<0.001). Conclusions: Our results indicated that cross-sectional view is more accurate than tangential view, and 3 and 5 mm slice thicknesses are preferred for measurement.

Anesthesia for Common Cardiac Lesions

2018 ◽  
Author(s):  
Douglas Atkinson ◽  
Viviane G Nasr
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Cardiopulmonary Bypass ◽  
Surgical Procedures ◽  
Cardiac Disease ◽  
Congenital Heart ◽  
Preoperative Evaluation ◽  
Venous Pressure ◽  
Preoperative Assessment ◽  
Catheterization Laboratory

Congenital heart disease is the most common congenital malformation with an incidence of 4 to 10 per 1,000 live births. Anesthesiologists are required to manage these patients when they present for surgical or percutaneous interventions, including definitive and/or palliative procedures. The preoperative evaluation of the cardiac patient includes a thorough physical examination, laboratory testing, and diagnostic imaging such as echocardiography and magnetic resonance imaging. The perioperative management of children with cardiac disease requires a thorough understanding of the underlying pathophysiology, invasive monitoring such as arterial pressure and central venous pressure, and different surgical procedures and interventions in the catheterization laboratory. In addition, understanding cardiopulmonary bypass including perfusion, temperature, and acid-base is a must. This chapter presents a systematic approach for the preoperative assessment of children with cardiac disease and management on cardiopulmonary bypass and discusses the different surgical procedures and catheterization laboratory interventions, indications, and potential complications. This review contains 1 figure, 9 tables, and 23 references. Key Words: associated anomalies, cardiac surgical procedures, cardiopulmonary bypass, congenital heart disease, intraoperative monitoring, inotropes, interventional catheterization, preoperative evaluation, vasodilators

Analysis on Ensemble Methods for the Prediction of Cardiovascular Disease

2021 ◽  
Vol 11 (10) ◽  
pp. 2529-2537
Author(s):  
C. Murale ◽  
M. Sundarambal ◽  
R. Nedunchezhian
Keyword(s):  
Cardiac Disease ◽  
Nearest Neighbor ◽  
Naive Bayes ◽  
Ensemble Methods ◽  
Naïve Bayes ◽  
K Nearest Neighbor ◽  
Reduced Dimensions ◽  
The People ◽  
Ensemble Algorithms ◽  
Better Than

Coronary Heart disease is one of the dominant sources of death and morbidity for the people worldwide. The identification of cardiac disease in the clinical review is considered one of the main problems. As the amount of data grows increasingly, interpretation and retrieval become even more complex. In addition, the Ensemble learning prediction model seems to be an important fact in this area of study. The prime aim of this paper is also to forecast CHD accurately. This paper is intended to offer a modern paradigm for prediction of cardiovascular diseases with the use of such processes such as pre-processing, detection of features, feature selection and classification. The pre-processing will initially be performed using the ordinal encoding technique, and the statistical and the features of higher order are extracted using the Fisher algorithm. Later, the minimization of record and attribute is performed, in which principle component analysis performs its extensive part in figuring out the “curse of dimensionality.” Lastly, the process of prediction is carried out by the different Ensemble models (SVM, Gaussian Naïve Bayes, Random forest, K-nearest neighbor, Logistic regression, decision tree and Multilayer perceptron that intake the features with reduced dimensions. Finally, in comparison to such success metrics the reliability of the proposal work is compared and its superiority has been confirmed. From the analysis, Naïve bayes with regards to accuracy is 98.4% better than other Ensemble algorithms.

scholarly journals Risks and benefits of rapid clozapine titration

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Jeannie D. Lochhead ◽  
Michele A. Nelson ◽  
Alan L. Schneider
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Gold Standard ◽  
Therapeutic Response ◽  
Treatment Resistance ◽  
Risks And Benefits ◽  
Emotional Suffering ◽  
Life Threatening ◽  
Potential Risks ◽  
Care Costs

Clozapine is often considered the gold standard for the treatment of schizophrenia. Clinical guidelines suggest a gradual titration over 2 weeks to reduce the risks of adverse events such as seizures, hypotension, agranulocytosis, and myocarditis. The slow titration often delays time to therapeutic response. This raises the question of whether, in some patients, it may be safe to use a more rapid clozapine titration. The following case illustrates the potential risks associated with the use of multiple antipsychotics and rapid clozapine titration. We present the case of a young man with schizophrenia who developed life threatening neuroleptic malignant syndrome (NMS) during rapid clozapine titration and treatment with multiple antipsychotics. We were unable to find another case in the literature of NMS associated with rapid clozapine titration. This case is meant to urge clinicians to carefully evaluate the risks and benefits of rapid clozapine titration, and to encourage researchers to further evaluate the safety of rapid clozapine titration. Rapid clozapine titration has implications for decreasing health care costs associated with prolonged hospitalizations, and decreasing the emotional suffering associated with uncontrolled symptoms of psychosis. Clozapine is considered the most effective antipsychotic available thus efforts should focus on developing strategies that would allow for safest and most efficient use of clozapine to encourage its utilization for treatment resistance schizophrenia.

scholarly journals Successful Management of a Suspected Case of Meperidine-Induced Anaphylaxis in Cesarean Delivery

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Gelareh Biazar ◽  
Farnoush Farzi ◽  
Yasmin Chaibakhsh ◽  
Mohammad Reza Habibi ◽  
Mahsa Khosousi Sani ◽  
...  
Keyword(s):  
Gold Standard ◽  
Intravenous Dose ◽  
Suspected Case ◽  
Medical Team ◽  
Single Intravenous Dose ◽  
Successful Management ◽  
Standard Drug ◽  
Surgical Incision ◽  
Case Presentation ◽  
Potential Risks

Introduction: Meperidine is known as the gold standard drug for shivering after spinal anesthesia (SA). This drug has been used widely and safely during the Cesarean Section (CS). Case Presentation: This case report presents an anaphylaxis reaction to a single intravenous dose of 25 mg meperidine, aiming to control shivering during CS under SA a few minutes after surgical incision. Conclusions: The condition was well managed with timely intervention. This rare fetal reaction to meperidine is worthy of reporting to make the medical team aware of the potential risks of anaphylaxis due to many routine safe drugs.

scholarly journals An analysis of clinical trials registered with CTRI in India from 2007 to 2015

2016 ◽  
Vol 3 (3) ◽  
pp. 155
Author(s):  
Vihang S. Chawan ◽  
Sagar V. Badwane ◽  
Kalpesh V. Gawand ◽  
Maheshi U. Chhaya
Keyword(s):  
Clinical Trials ◽  
Gold Standard ◽  
Evidence Based ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Negative Results ◽  
Potential Risks ◽  
Wide Gap ◽  
Based Medicine ◽  
Positive Results

<p class="abstract"><strong>Background:</strong> Clinical trials are gold standard in the field of evidence based medicine. Registration of clinical trials facilitates the dissemination of information among clinicians, researchers and patients. Earlier, researchers were interested only in publishing positive results of their study. The negative results were never published resulting in bias in reporting the results of such clinical trials. It is now mandatory to register all clinical trials done in India at National Institute of Medical Statistics (NIMS) hosted at Clinical Trial Registry - India (CTRI) website to ensure transparency, accountability and accessibility of clinical trials. This study was planned to analyze the number of clinical trials registered under CTRI from 2007 to 2015. The information regarding the registration of clinical trials was accessed from the website www.ctri.nic.in.</p><p class="abstract"><strong>Methods:</strong> The information on registered clinical trials was obtained from the website www.ctri.nic.in. The clinical trials registered with CTRI from 2007 to 2015 were noted for analysis.</p><p class="abstract"><strong>Results:</strong> Maximum number of clinical trials registered in the year 2015 (1113), followed by year 2014 (1089), 2013 (990), 2012 (959) and 2011 (748) while least number of clinical trials registered in the year 2007 (32). Results revealed that there is wide gap the number of clinical trials registered in between year 2007 to 2015 and also revealed that number of clinical trials registered are increasing in order from year 2007 to year 2015.  </p><strong>Conclusions:</strong> The registrations of clinical trials improve the reliability of data generated, assist clinicians to interpret research, minimizes duplication of trials and prevents exposure of volunteers to potential risks.

scholarly journals Použitie kompresného oblečenia u bežcov: áno, nie?

2016 ◽  
Vol 10 (2) ◽  
pp. 76-86
Author(s):  
Ivan Struhár
Keyword(s):  
Physical Activity ◽  
Gold Standard ◽  
Scientific Literature ◽  
Potential Effect ◽  
Sport Performance ◽  
Basic Information ◽  
Compression Pressure ◽  
Venous Flow ◽  
Potential Risks ◽  
Objective View

The main aim of this article is to emphasize the potential effect of compression clothing in a group of runners. We want to provide an objective view on evaluation of the advantages or potential risks in the use of compression clothing (socks or calf sleeves). This work is not a metanalysis, the purpose of this study provides basic information about the use of compression clothing. The work focuses on selected parameters which directly or indirectly determine the sport performance and affects the ability to repeat the sport performance. The scientific literature describes only two potential effects of compression clothing (increased venous flow and reduced muscle oscillation). As with most trends that come and go in sports, it takes a while to evaluate with the practice for the science. In our work, we focus on selected parameters with regard compression value. Based on scientific sources, the effect of compression clothing for sport performance and recovery is unclear. It is also caused by applied compression which is not also written in scientific literature. At this point, we want to emphasize this fact is probably important not only for future study design but also for customers. It makes sense if the different compression pressure lead to different results then it should exist the gold standard depending on the pressure and types of physical activity.

Sign in / Sign up

Export Citation Format

Share Document