Ocular Surface Disorders in Intensive Care Unit Patients

Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 ± 18.15 years (range 17–74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 ± 5.7 mm/5 min (median 6.5 mm/5 min) in the right, and 7.9 ± 6.3 mm/5 min (median 7 mm/5 min) in the left eyes. Schirmers test results were <5 mm/5 min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders.

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Patients in intensive care unit for COVID-19 pneumonia: the lung ultrasound patterns at admission and discharge. An observational pilot study

The Ultrasound Journal ◽

10.1186/s13089-021-00213-x ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Persona Paolo ◽

Valeri Ilaria ◽

Zarantonello Francesco ◽

Forin Edoardo ◽

Sella Nicolò ◽

...

Keyword(s):

Intensive Care ◽

Lung Ultrasound ◽

Low Cost ◽

Low Frequency ◽

Specific Pattern ◽

University Hospital ◽

Left Hemithorax ◽

Significant Difference ◽

The Right ◽

B Lines

Abstract Background During COVID-19 pandemic, optimization of the diagnostic resources is essential. Lung Ultrasound (LUS) is a rapid, easy-to-perform, low cost tool which allows bedside investigation of patients with COVID-19 pneumonia. We aimed to investigate the typical ultrasound patterns of COVID-19 pneumonia and their evolution at different stages of the disease. Methods We performed LUS in twenty-eight consecutive COVID-19 patients at both admission to and discharge from one of the Padua University Hospital Intensive Care Units (ICU). LUS was performed using a low frequency probe on six different areas per each hemithorax. A specific pattern for each area was assigned, depending on the prevalence of A-lines (A), non-coalescent B-lines (B1), coalescent B-lines (B2), consolidations (C). A LUS score (LUSS) was calculated after assigning to each area a defined pattern. Results Out of 28 patients, 18 survived, were stabilized and then referred to other units. The prevalence of C pattern was 58.9% on admission and 61.3% at discharge. Type B2 (19.3%) and B1 (6.5%) patterns were found in 25.8% of the videos recorded on admission and 27.1% (17.3% B2; 9.8% B1) on discharge. The A pattern was prevalent in the anterosuperior regions and was present in 15.2% of videos on admission and 11.6% at discharge. The median LUSS on admission was 27.5 [21–32.25], while on discharge was 31 [17.5–32.75] and 30.5 [27–32.75] in respectively survived and non-survived patients. On admission the median LUSS was equally distributed on the right hemithorax (13; 10.75–16) and the left hemithorax (15; 10.75–17). Conclusions LUS collected in COVID-19 patients with acute respiratory failure at ICU admission and discharge appears to be characterized by predominantly lateral and posterior non-translobar C pattern and B2 pattern. The calculated LUSS remained elevated at discharge without significant difference from admission in both groups of survived and non-survived patients.

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Autologous Right Auricular Versus PTFE Cavopulmonary Lateral Tunnel: Influence of Surgical Technique on Arrhythmias

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135119874034 ◽

2019 ◽

Vol 10 (6) ◽

pp. 686-693

Author(s):

Sara C. Arrigoni ◽

Freek van den Heuvel ◽

Tineke P. Willems ◽

Nic J.G.M. Veeger ◽

Paul Schoof ◽

...

Keyword(s):

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Growth Potential ◽

Risk Indicators ◽

Lateral Tunnel ◽

Increased Risk ◽

Significant Difference ◽

Long Term Follow Up ◽

Cox Proportional Hazard Regression ◽

The Right

Background: To compare the incidence of arrhythmias and the overall survival at long-term follow-up of the right auricular baffle technique (RA) versus Gore-Tex® (GT) baffle as intra-atrial cavopulmonary lateral tunnel, as well as the Nakata index and tunnel dimensions on cardiac magnetic resonance. Methods: Data were retrospectively collected. Serial 24-hour Holter recordings and cardiac magnetic resonance findings of the two groups were compared. Results: There was no significant difference in the estimated freedom from arrhythmias (87% at 10 years and 78% at 15 years vs 80% at 10 years and 70% at 15 years in RA and GT, respectively; P = .44) nor cumulative survival (86% at 10 years and 84% at 15 years vs 97% at 10 years and 81% at 15 years in RA and GT, respectively; P = .8). Also, no difference between the groups was observed in the Nakata index. The tunnel dimensions on cardiac magnetic resonance were significantly wider in the RA group. In reference to other potential risk indicators, using Cox proportional hazard regression analysis, only age (5 years or older at the time of total cavopulmonary connection) was associated with an increased risk for both arrhythmia and mortality. Conclusions: This study demonstrated that there was no difference in freedom from arrhythmias, Nakata index, or survival between the two groups. This study confirmed the growth potential of the right auricular tunnel. However, the growth of the tunnel did not influence the incidence of arrhythmias.

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PENERAPAN METODEBERMAIN ANAK USIA DINI PADA KELOMPOK B UNTUK MENINGKATKAN KEMAMPUAN BERHITUNG PERMULAAN DI TK AL-FALAH

CERIA (Cerdas Energik Responsif Inovatif Adaptif) ◽

10.22460/ceria.v2i3.p84-91 ◽

2019 ◽

Vol 2 (3) ◽

pp. 84

Author(s):

Rina Septiadiningsih ◽

Euis Rohaety ◽

Lenny Nuraeni

Keyword(s):

Design Research ◽

Sensitive Period ◽

Control Group ◽

P Value ◽

Test Results ◽

Control Group Design ◽

Significant Difference ◽

Post Test ◽

The Right ◽

In The Beginning

Sensitive period is the right time to instill the basis of the importance of counting. In addition to counting skills that must be developed also pay attention to the application of learning used. However, in the learning process, teachers often forget the importance of playing methods. If too often with giving assignments the child will feel bored, therefore what is used is the method of playing. Play method is one method that can be used by teachers to teach the ability to count children in the beginning. Based on this background, the purpose of this study was to determine the effect of the use of playing methods on initial numeracy skills. This study used the Quasi Experiment method with the Nonequevalent Control Group Design research design. The results of the pre test showed that there were no significant differences in the experimental group and the control group with p-value> 0.05, which was 0.135> 0.05 which was tested by the two average test results. While the post-test results showed that the initial numeracy ability after the application of the playing method experienced a significant difference with the p-value <0.05, that is with the results of 0.0001 with the Mann-Whitney test. This method of playing can be used as a learning suggestion for educators to improve their ability to have an early start.

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Abstract 19663: Failed Delayed Sternal Closure Following Neonatal Cardiac Surgery Predicted by High Mean Airway Pressure and Associated with Increased Post-operative Mortality

Circulation ◽

10.1161/circ.130.suppl_2.19663 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Dashiell Massey ◽

Kathryn A Williams ◽

Ravi R Thiagarajan ◽

Frank Pigula ◽

Catherine K Allan

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Cardiopulmonary Bypass ◽

Categorical Variables ◽

Sternal Closure ◽

Increased Risk ◽

Significant Difference ◽

Delayed Sternal Closure ◽

Neonatal Cardiac Surgery

Background: Myocardial edema, increased lung water, and anasarca are common following neonatal cardiac surgery with cardiopulmonary bypass and amplify the risk of hemodynamic instability and inadequate ventilation following sternal closure. Delayed sternal closure (DSC) in the intensive care unit one or more days following surgery is a common strategy to mitigate this risk, but has been associated with increased risk of infection. In addition, failed DSC has previously been identified as a risk factor for mortality. This study sought to identify predictor variables and determine impact of failed DSC. Methods: Records of all neonates undergoing DSC in the cardiac intensive care unit (CICU) following surgery with cardiopulmonary bypass between January 2008 and May 2013 were reviewed. Pre-operative, intra-operative and post-operative variables were compared for those patients who failed DSC versus those who did not. Continuous variables were compared utilizing Wilcoxon’s test and categorical variables using Fisher’s exact test. Results: Of 256 neonates undergoing DSC in the CICU, 22 failed first attempt at DSC. No significant difference between the two groups was appreciated in age, weight, or bypass (cross clamp, circulatory arrest, and total) times. Comparing DSC failures to successes, significantly more failures: followed Stage I palliation (63% vs. 31%); occurred later (post-operative day 4.7 vs. 2.8, p = 0.009); and were proceeded by higher mean airway pressures (9 vs. 8 cm H2O, p = 0.04), peak inspiratory pressure (27 vs. 24, p = 0.002), and inotrope score (12.1 vs. 9.6, p = 0.06). There was no association with systolic blood pressure or lactate prior to DSC. Failed DSC was associated with increased duration of mechanical ventilation (41.6 vs 7.4 days, p < 0.001), length of ICU stay (44.3 vs 12.0 days, p < 0.001), and mortality (38 vs 3%, p < 0.001). Conclusions: Mortality for patients who fail the first ICU attempt at delayed sternal closure is significantly higher than for those with successful sternal closure. Ventilatory pressures but not hemodynamic variables prior to DSC differed significantly between the two groups. First attempt at DSC was later in those who failed, suggesting that clinicians had a priori identified these patients as higher risk.

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Analytical validation of the Percepta genomic sequencing classifier; an RNA next generation sequencing assay for the assessment of Lung Cancer risk of suspicious pulmonary nodules

BMC Cancer ◽

10.1186/s12885-021-08130-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marla K. Johnson ◽

Shuyang Wu ◽

Daniel G. Pankratz ◽

Grazyna Fedorowicz ◽

Jessica Anderson ◽

...

Keyword(s):

Lung Cancer ◽

Genomic Dna ◽

Analytical Performance ◽

Genomic Sequencing ◽

Analytical Sensitivity ◽

Test Results ◽

Bronchial Brushing ◽

Increased Risk ◽

Total Score Range ◽

Significant Difference

Abstract Background Bronchoscopy is a common procedure used for evaluation of suspicious lung nodules, but the low diagnostic sensitivity of bronchoscopy often results in inconclusive results and delays in treatment. Percepta Genomic Sequencing Classifier (GSC) was developed to assist with patient management in cases where bronchoscopy is inconclusive. Studies have shown that exposure to tobacco smoke alters gene expression in airway epithelial cells in a way that indicates an increased risk of developing lung cancer. Percepta GSC leverages this idea of a molecular “field of injury” from smoking and was developed using RNA sequencing data generated from lung bronchial brushings of the upper airway. A Percepta GSC score is calculated from an ensemble of machine learning algorithms utilizing clinical and genomic features and is used to refine a patient’s risk stratification. Methods The objective of the analysis described and reported here is to validate the analytical performance of Percepta GSC. Analytical performance studies characterized the sensitivity of Percepta GSC test results to input RNA quantity, the potentially interfering agents of blood and genomic DNA, and the reproducibility of test results within and between processing runs and between laboratories. Results Varying the amount of input RNA into the assay across a nominal range had no significant impact on Percepta GSC classifier results. Bronchial brushing RNA contaminated with up to 10% genomic DNA by nucleic acid mass also showed no significant difference on classifier results. The addition of blood RNA, a potential contaminant in the bronchial brushing sample, caused no change to classifier results at up to 11% contamination by RNA proportion. Percepta GSC scores were reproducible between runs, within runs, and between laboratories, varying within less than 4% of the total score range (standard deviation of 0.169 for scores on 4.57 scale). Conclusions The analytical sensitivity, analytical specificity, and reproducibility of Percepta GSC laboratory results were successfully demonstrated under conditions of expected day to day variation in testing. Percepta GSC test results are analytically robust and suitable for routine clinical use.

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Analisis Perbedaan Kemampuan Bank Shoot Dari Sisi Kanan Dan Sisi Kiri Pada Anggota Ekstrakurikuler Bolabasket Putra Usia 11-14 Tahun Di Yogyakart

MEDIKORA ◽

10.21831/medikora.v19i1.30918 ◽

2020 ◽

Vol 19 (1) ◽

pp. 24-32

Author(s):

Kukuh Hardopo Putro

Keyword(s):

Random Sampling ◽

Descriptive Study ◽

Statistical Test ◽

Measurement Methods ◽

Survey Method ◽

Test Results ◽

Significance Level ◽

Significant Difference ◽

The Difference ◽

The Right

Permasalahan yang terjadi dalam penelitian ini adalah anggota ekstrakurikuler bolabasket putra usia 11-14 tahun di yogyakarta belum sempurna dalam melakukan bank shoot baik dalam posisi maupun gerakan. Penelitian ini bertujuan untuk mengetahui perbedaan kemampuan bank shoot dari sisi kanan dan dari sisi kiri pada anggota ekstrakurikuler bolabasket putra usia 11-14 tahun di Yogyakarta. Penelitian ini merupakan penelitian deskriptif dengan metode survei. Sampel dalam penelitian ini diambil secara random sampling, yang berjumlah 30 siswa. Instrumen penelitian menggunakan tes bank shoot dari AAHPER dengan validitas 0,609 dan reliabilitas 0.757. Teknik pengumpulan data dengan metode tes dan pengukuran. Analisis data dengan ujji prasyarat dan uji t. Hasil uji statistik diperoleh nilai uji-t bank shoot sisi kanan dan kiri memiliki nilai t hitung -1,417 dan nilai t tabel dengan df 14 pada taraf signifikansi 5% sebesar 2,14. p = 0,178, karena p > 0,05 maka tidak terdapat perbedaan yang signifikan. Sehingga dapat disimpulkan bahwa tidak terdapat perbedaan yang signifikan antara kemampuan bank shoot dari sisi kanan dan kiri pada anggota ekstrakurikuler bolabasket putra usia 11-14 tahun di Yogyakarta. Analysis of the Difference in the Capability of Bank Shoot From the Right and Left Side of Male Bolabasket Extracurricular Members Aged 11-14 Years Old in YogyakartaAbstractProblems that occur in this study are members of male basketball basketball extracurricular members aged 11-14 years in Yogyakarta not yet perfect in doing bank shoots both in position and movement. This study aims to determine the differences in the ability to shoot banks from the right side and from the left side on the extracurricular members of the basketball boy age 11-14 years in Yogyakarta. This research is a descriptive study with a survey method. The sample in this study was taken by random sampling, which amounted to 30 students. The research instrument used a bank shoot test from AAHPER with a validity of 0.609 and reliability of 0.757. Data collection techniques with test and measurement methods. Data analysis with prerequisite tests and t tests. Statistical test results obtained t-test value shoot banks right and left side has a t value of -1.417 and t table value with df 14 at a significance level of 5% of 2.14. p = 0.178, because p> 0.05 there is no significant difference. So it can be concluded that there is no significant difference between the ability to shoot banks from the right and left sides of male basketball extracurricular members aged 11-14 years in Yogyakarta.

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The effect of implementation of evidence-based eye care protocol for patients in the intensive care units on superficial eye disorders

BMC Ophthalmology ◽

10.1186/s12886-021-02034-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Azam Pourghaffari Lahiji ◽

Mohsen Gohari ◽

Samaneh Mirzaei ◽

Khadijeh Nasiriani

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Intensive Care Units ◽

Test Group ◽

Blink Reflex ◽

Control Group ◽

Eye Care ◽

Care Protocol ◽

Eye Disorders ◽

Significant Difference

Abstract Background Superficial eye disorders are one of the most common complications of improper eye care in intensive care units that can lead to corneal ulcers and permanent eye damage. The aim of this study was to determine the effect of the implementation of eye care protocol on the incidence of infection and superficial eye disorders in patients admitted to intensive care units. Methods This study was a cross-over clinical trial that was performed on 32 patients admitted to the intensive care unit with reduced or no blink reflex following loss of consciousness or receiving sedatives. The eye of the test group received eye care according to the protocol and the eye of the control group received the routine care of the ward. The data collection form included demographic and clinical information and the clinical score scale of superficial eye disorders, which were completed in 7 days for both eyes. Data analysis was performed by McNemar and Cochran tests with a 95 % confidence interval. Results In the study of superficial eye disorders, the frequency of dacryorrhea and hyperemia was not significantly different in the second to seventh days in the control and test eyes (P < 0.05). The frequency of xerophthalmia was not significantly different between the control and the test eyes on the second to third days (P < 0.05), but there was a significant difference on the fourth, fifth, sixth, and seventh days (P = 0.0001). Also, the frequency of corneal opacity was not significantly different in the second and third days (P < 0.05), but in the fourth (P < 0.05), fifth, sixth, and seventh days, this difference was significant (P = 0.0001). Conclusions Based on the results, although the implementation of eye care protocol has been able to have a significant effect on reducing ocular complications and problems, routine eye care in the intensive care unit also has clinical effectiveness. Therefore, in order to prevent and completely eliminate eye disorders in the intensive care unit, more evidence and research are needed. Trial registration The trial was retrospectively registered on https://en.irct.ir/trial/43493 on 13 November 2019 (13.11.2019) with registration number [IRCT20140307016870N5].

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Implementation of the E-Pocket Book to Improve Learning Outcomes in Economics at Madrasah Aliyah Madinatussalam, Bandar Khalifah Regency, Indonesia

Budapest International Research and Critics in Linguistics and Education (BirLE) Journal ◽

10.33258/birle.v4i1.1566 ◽

2021 ◽

Vol 4 (1) ◽

pp. 125-131

Author(s):

Nur Afrianti ◽

Dede Ruslan ◽

Muhammad Yusuf

Keyword(s):

Learning Outcomes ◽

Learning Process ◽

Student Learning Outcomes ◽

Vital Role ◽

Higher Learning ◽

Test Results ◽

Teaching Materials ◽

Pocket Book ◽

Significant Difference ◽

The Right

Teaching materials playing a vital role in supporting the learning process in a classroom. The right teaching materials will make the learning process more effective. The problem that is often faced by students is the teaching materials that are not appropriate, so that it lowers student learning outcomes. This causes the low learning outcomes of students in class XI economics MA Madinatusallam. For this reason, researchers try to investigate the effectiveness of e-pocketbook teaching materials. Field test results showed that the experimental class obtained higher learning outcomes than the control class, with a significant difference (p = <.05).

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Pengaruh Pelatihan Tehnik Menyusui Yang Benar Pada Ibu Nifas Primipara Terhadap Ketrampilan Dalam Menyusui

Interest : Jurnal Ilmu Kesehatan ◽

10.37341/interest.v5i1.29 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Triwik Sri Mulati ◽

Dewi Susilowati

Keyword(s):

Sampling Technique ◽

P Value ◽

Test Results ◽

Training Technique ◽

Significant Difference ◽

Before And After ◽

Post Test ◽

Quasi Experimental ◽

The Right ◽

Postpartum Mothers

Abstract: The Right Breastfeeding Techniques, Postpartum Primiparous. The purpose of this study was to prove the influence of breastfeeding technique training right at the primiparous postpartum mother breastfeeding skills. This type of research is a Quasi-Experimental. Samples are 20 primiparous postpartum mothers in the district of Klaten. Sampling technique is purposive consecutive sampling. Analysis of the data used in this research is to test the Wilxocon. The results of this study are the test results Wilxocon between data pretest and post-test 1 shows the p-value = 0.000, where p <0.05 which means there is a significant difference between the value of the skills puerperal women primipara before and after given one training technique of right breastfeeding, In addition test results Wilxocon between data posttest 1 and posttest 2 shows the p-value = 0.000, where p <0.05 which means there is a significant difference between the value of the skills postpartum mother primipara after given one training and after a given number of training courses on breastfeeding technique is correct. Therefore it can be concluded that the correct breastfeeding technique training has proven to improve the skills of breastfeeding on postpartum mother primipara

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Biocompatibility and Comfort during Extended Wear of Mel4 Peptide-Coated Antimicrobial Contact Lenses

Antibiotics ◽

10.3390/antibiotics11010058 ◽

2022 ◽

Vol 11 (1) ◽

pp. 58

Author(s):

Parthasarathi Kalaiselvan ◽

Debarun Dutta ◽

Nagaraju Konda ◽

Pravin Krishna Vaddavalli ◽

Savitri Sharma ◽

...

Keyword(s):

Ocular Surface ◽

Contact Lenses ◽

Front Surface ◽

Back Surface ◽

The Novel ◽

Significant Difference ◽

Delayed Reactions ◽

And Control ◽

Corneal Staining ◽

Lens Wear

(1) Purpose: This study aimed to investigate the effects of Mel4 antimicrobial contact lenses (MACL) on the ocular surface and comfort during extended wear. (2) Methods: A prospective, randomised, double-masked, contralateral clinical trial was conducted with 176 subjects to evaluate the biocompatibility of contralateral wear of MACL. The wearing modality was 14-day extended lens wear for three months. The participants were assessed at lens dispensing, after one night, two weeks, one month and three months of extended wear and one month after study completion. (3) Results: There were no significant differences (p > 0.05) in ocular redness or palpebral roughness between Mel4 and control eyes at any of the study visits. There was no significant difference (p > 0.05) in corneal staining between Mel4 and control eyes. There were no significant differences in front surface wettability or deposits or back surface debris (p > 0.05). No statistically significant differences (p > 0.05) were found in comfort, dryness, CLDEQ-8 scores lens or edge awareness. There was no evidence for delayed reactions on the ocular surface after cessation of lens wear. (4) Conclusion: The novel MACLs showed similar comfort to control lenses and were biocompatible during extended wear. Thus, these lenses were compatible with the ocular surface.

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