scholarly journals A Comparison of the Incidence and Nature of Cardiac Dysrhythmias Occurring during Enflurane and Isoflurane Anaesthesia for Dental Surgery

1987 ◽  
Vol 15 (2) ◽  
pp. 179-184 ◽  
Author(s):  
M. R. C. Rodrigo ◽  
T. M. Moles ◽  
P. K. Lee
Keyword(s):  
Blood Pressure ◽  
Sinus Tachycardia ◽  
Third Molar ◽  
Chinese Patients ◽  
Dental Surgery ◽  
Cardiac Dysrhythmias ◽  
Life Threatening ◽  
The Difference ◽  
Clinically Significant ◽  
Ventricular Ectopics

The incidence and nature of dysrhythmias with equipotent concentrations of enflurane and isoflurane during dental surgery were compared. Seventy-six Chinese patients between 17–30 years, of ASA Grade I, randomly received either enflurane or isoflurane with N2O and O2 for spontaneous ventilation during third molar extractions. The cardiac rhythm and the blood pressure were continuously monitored during the procedure. The incidence of dysrhythmias with both enflurane and isoflurane was low and the difference not statistically significant. During surgery one patient exhibited unifocal ventricular ectopics with isoflurane. Sinus tachycardia was common with both agents. No life-threatening dysrhythmias were seen with either agent and no clinically significant lowering of blood pressure occurred in association with the exhibited dysrhythmias. In this Chinese population, as in other studies, the incidence of dysrhythmias with both agents was low thus showing no difference between the races.

scholarly journals The bowel and beyond: extracolonic findings from CT colonography

2021 ◽  
Author(s):  
Gerard Lambe ◽  
Peter Hughes ◽  
Louise Rice ◽  
Caoimhe McDonnell ◽  
Mark Murphy ◽  
...  
Keyword(s):  
Ct Colonography ◽  
Surgical Intervention ◽  
Potential Significance ◽  
Age And Gender ◽  
Abdominal Aortic ◽  
Life Threatening ◽  
Extracolonic Findings ◽  
The Difference ◽  
Clinically Significant ◽  
And Gender

AbstractCT colonography has emerged as the investigation of choice for suspected colorectal cancer in patients when a colonoscopy in incomplete, is deemed high risk or is declined because of patient preference. Unlike a traditional colonoscopy, it frequently reveals extracolonic as well as colonic findings. Our study aimed to determine the prevalence, characteristics and potential significance of extracolonic findings on CT colonography within our own institution. A retrospective review was performed of 502 patients who underwent CT colonography in our institution between January 1, 2010 and January 4, 2015. Of 502 patients, 60.63% had at least one extracolonic finding. This was close to other similar-sized studies (Kumar et al. Radiology 236(2):519–526, 2005). However, our rate of E4 findings was significantly higher than that reported in larger studies at 5.3%(Pooler et al. AJR 206:313–318, 2016). The difference may be explained by our combination of symptomatic/screening patients or by the age and gender distribution of our population. Our study lends support to the hypothesis that CT colonography may be particularly useful in identifying clinically significant extracolonic findings in symptomatic patients. CT colonography may allow early identification of extracolonic malignancies and life-threatening conditions such as an abdominal aortic aneurysm at a preclinical stage when they are amenable to medical or surgical intervention. However, extracolonic findings may also result in unnecessary investigations for subsequently benign findings.

scholarly journals Non-invasive methods for studying the dynamics of blood pressure

2019 ◽  
Vol 24 (6) ◽  
pp. 637-645
Author(s):  
S. Yu. Ivanov ◽  
B. B. Bondarenko
Keyword(s):  
Blood Pressure ◽  
Measurement Methods ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Invasive Method ◽  
Discrete Measurement ◽  
The Difference ◽  
Clinically Significant ◽  
Invasive Control ◽  
Korotkoff Sounds

The paper summarizes the main methods of automatic non-invasive assessment of the blood pressure (BP) dynamics. The advantages and disadvantages of BP measurement according to Korotkoff sounds and the oscillations in the brachial cuff are discussed. Currently, BP is measured during deflation of the cuff, while the pressure in the cuff should be inflated (by about 20–30 mm Hg) above the systolic BP. The BP level before measurement can be unknown, thereby increases the possibility of raising the pressure in the cuff above the optimum. In connection with this, recently, methods for determining BP during inflation of the cuff have been proposed. The BP value, determined both by Korotkov’s tone and by oscillometry during inflation, differs from that during the deflation of the cuff. The difference varies with age and BP and in a number of cases is clinically significant. The causes and consequences of such differences are discussed. In intensive care units and in operating rooms, continuous BP measurement is necessary. In comparison with the discrete measurement of BP, it allows to detect timely hypotension, to evaluate its duration, which improves the management of the patients. The invasive method of BP detection has known limitations and complications which stimulated the development of devices for non-invasive BP control. Despite the comparisons of the accuracy of such measurement methods, this issue continues to be debated. Thus, the methods of non-invasive control of BP level, discussed in this review, reflect both their advantages and limitations, which dictates the need for further research in this field.

Abstract P118: Antihypertensive Treatment Guided By Genetics: Pearl-ht, The Randomized Proof-of-concept Trial Comparing Rostafuroxin With Losartan

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Lorena Citterio ◽  
Giuseppe Bianchi ◽  
Daniele Cusi ◽  
Mara Ferrandi ◽  
Chiara Livia Lanzani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sh2 Domain ◽  
Primary Hypertension ◽  
Chinese Patients ◽  
Gene Variants ◽  
Selective Blockade ◽  
Endogenous Ouabain ◽  
Genes Encoding ◽  
The Difference ◽  
Post Hoc

Primary hypertension contributes to more than 50% of all the worldwide cardiovascular deaths. Current antihypertensive therapy is still targeting the physiological mechanisms regulating blood pressure, but not the “causal” ones. So far, genetic studies have been unable to prove gene causation in human primary hypertension. In this study we compared a standard antihypertensive losartan treatment with a pharmacogenomics-guided rostafuroxin treatment in never-treated Caucasian and Chinese patients with primary hypertension (PEARL-HT trial registration: EudraCT: 2010-022073-34, ClinicalTrials.gov: NCT01320397). Rostafuroxin is a digitoxigenin derivative that selectively disrupts the binding to the cSrc-SH2 domain of mutant α-adducin and of the ouabain-activated Na-K pump at 10 -11 M. Of 902 patients screened, 172 were enrolled in Italy and 107 in Taiwan. After stratification for country and genetic background, patients were randomized to rostafuroxin or losartan, being the difference in the fall in Office Systolic Blood Pressure (OSBP) after two-month treatment the primary endpoint. Three pharmacogenomic profiles (P) were examined, considering: P1, adding to the gene variants included in the subsequent P2, the variants detected by post-hoc analysis of a previous trial; P2, variants of genes encoding enzymes for endogenous ouabain (EO) synthesis ( LSS and HSD3B1 ), EO transport ( MDR1/ABCB1 ), adducin ( ADD1 and ADD3 ); P3, variants of the LSS gene only. In Caucasians, the group differences (rostafuroxin 50 μg minus losartan 50 mg in OSBP mmHg) were significant both in P2 adjusted for genetic heterogeneity (P2a) and P3 LSS rs2254524 AA [9.8 (0.6-19.0), P =0.038 and 13.4 (25.4-2.5), P =0.031, respectively]. In human H295R cells transfected with LSS A and LSS C variants, the EO production was greater in the former ( P =0.038); this difference was abolished by rostafuroxin at 10 -11 M. Chinese patients had a similar drop in OSBP to Caucasians with losartan but no change in OSBP with rostafuroxin. These results show that the selective blockade of mutant adducin and endogenous ouabain pressor mechanisms by rostafuroxin improves the therapy of primary hypertension in in Caucasians carriers of the related gene variants.

Assessing dopamine concentrations: an evidence-based approach

2000 ◽  
Vol 9 (2) ◽  
pp. 130-139 ◽  
Author(s):  
KD Blad ◽  
S Lookinland ◽  
G Measom ◽  
AE Bond ◽  
M Williams
Keyword(s):  
Mathematical Model ◽  
Adverse Drug Event ◽  
Excess Volume ◽  
Drug Event ◽  
Evidence Based ◽  
Actual Volume ◽  
Life Threatening ◽  
The Difference ◽  
Clinically Significant ◽  
Vasoactive Medications

BACKGROUND: Both overmedication and undermedication can be potentially life threatening. If the actual volume of a 100-mL intravenous bag used to mix dopamine solutions is greater than the labeled volume, overdilution of medication can occur, resulting in an ineffective hemodynamic response in patients and thus an unintended adverse drug event. OBJECTIVES: To determine the actual fluid volumes of 100-mL intravenous bags, compare the actual volumes of 100-mL bags from the 3 major manufacturers of intravenous bags, and determine if the excess volume is sufficient to cause a clinically significant overdilution of dopamine. METHODS: A comparative descriptive design was used. The volumes of 162 intravenous bags of 100 mL of 5% dextrose in water (32 lot numbers with various expiration dates) were measured. Visual volume was confirmed by using a 250-mL graduated cylinder. Volume by weight was determined with a calibrated laboratory-quality electronic scale. On the basis of a mathematical model, any overfill greater than 110 mL was considered clinically significant. RESULTS: The difference between actual and labeled volumes was statistically and clinically significant. Mean visual volume was 110.20 mL (range, 107-114 mL). Mean weighed volume was 109.26 mL (range, 106.15-112.09 mL). The fluid volumes among bags from the 3 major IV companies differed significantly (P < .001). CONCLUSIONS: The overfill in sufficient numbers of 100-mL intravenous bags was enough to cause clinically significant overdilution of dopamine. When dopamine or other vasoactive medications are mixed, either an in-line buret or premixed bags of the drugs should be used to prevent an unintended adverse drug event.

Highly Variable Femoral Morphology in Osteoarthritic Chinese: Are Prostheses Today Sufficiently Suitable?

2017 ◽  
Vol 30 (09) ◽  
pp. 936-942 ◽  
Author(s):  
Yunjie Zhang ◽  
Xiaofeng Wang ◽  
Zongming Wu ◽  
Qing Xia ◽  
Yunchao Shao
Keyword(s):  
Three Dimensional ◽  
Frontal Plane ◽  
Chinese Patients ◽  
Aspect Ratios ◽  
Dimensional Reconstruction ◽  
Posterior Condylar ◽  
Total Knee ◽  
The Mean ◽  
The Difference ◽  
Clinically Significant

AbstractWe aimed to retrospectively investigate the morphology of the resected surfaces of femurs in Chinese patients who underwent total knee arthroplasty (TKA) and to assess the suitability of contemporary femoral components. Measurements on three-dimensional reconstruction after virtual bone cutting were performed on 142 knees from Chinese TKA candidates. The anteroposterior (AP) and mediolateral (ML) dimensions, aspect ratio (ML/AP), and posterior condylar angle (PCA) were measured in the axial plane; the height and length of medial and lateral anterior condyles and the maximal width of the anterior condyles were measured in the frontal plane. Femurs were matched to the prosthesis with the closest AP size. The ML dimensions of femurs were compared with the ML dimensions of the prosthesis. The AP and ML dimensions were significantly larger in male knees (p < 0.01), whereas the difference of aspect ratios was not found to be significantly different between genders (p = 0.26). Both medial and lateral heights of the anterior condyles were significantly higher in men after normalization by AP (p < 0.01 and p < 0.05, respectively). The mean PCA averaged 3.8 degrees for Chinese subjects. The overall prevalence of clinically significant overhang was 6.4% in males and 4.8% in females. The design of femoral prosthesis with alternative ML dimensions of the femoral component is a solution to sufficiently avoid overhang while retaining ideal coverage when dealing with a high variation. Chinese men had higher anterior condyles than women after normalization by AP dimension. The mean PCA was 3.8 degrees for all patients with high variability.

scholarly journals A Study of Intravenous Sedation with Diazepam and Midazolam for Dentistry in Hong Kong Chinese

1986 ◽  
Vol 14 (4) ◽  
pp. 404-411 ◽  
Author(s):  
M. R. C. Rodrigo ◽  
R. N. W. Clark
Keyword(s):  
Hong Kong ◽  
Local Anaesthesia ◽  
Third Molar ◽  
Anterograde Amnesia ◽  
Operating Conditions ◽  
Hong Kong Chinese ◽  
Chinese Patients ◽  
Intravenous Sedation ◽  
Dental Surgery ◽  
Third Molar Extraction

Fifty Hong Kong Chinese patients between 20-40 years, of ASA Gd I, undergoing third molar extraction were randomly allocated into two groups. For conscious sedation, to supplement local anaesthesia, one group received intravenous diazepam and the other intravenous midazolam. The majority in the study had never heard of intravenous sedation being available to supplement local anaesthesia during dental surgery and when given the chance to experience this method the majority found it highly acceptable. None preferred general anaesthesia for dental surgery. In this study midazolam had more advantages to the patient than diazepam; quicker onset of sedation, less pain during injection, profound anterograde amnesia and fewer postoperative complications being the main features. However, both drugs produced good operating conditions. Incidence of thrombophlebitis was low with both drugs, and may be so in Chinse compared with non-Chinese.

scholarly journals Glycemic Control and Management in Pharmacist-Led Diabetic Clinic vs. Physician-Led Diabetic Clinic

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 14
Author(s):  
Sultan M. Alghadeer ◽  
Bashayr Alsuwayni ◽  
Abdulmohsen K. Almuwayjid ◽  
Mohammed S. Almadi ◽  
Abdullah M. Mubarak ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Fasting Blood Glucose ◽  
Self Care ◽  
Foot Care ◽  
Diabetic Clinic ◽  
Lipid Panel ◽  
Life Threatening ◽  
The Difference

Background and Objectives: Globally, diabetes Mellitus (DM) is a life-threatening disease that, if it remains uncontrolled, can lead to mortality or serious complications. Despite the noticeable benefits of clinical pharmacist in managing diabetes, some institutions in Saudi Arabia are reluctant to establish a pharmacist-led diabetic clinic for monitoring and follow-up. The objective of this study is to assess the glycemic control by comparing the reduction in hemoglobin A1c (HbA1c) percentage between patients followed in the pharmacist-led diabetic clinics vs. those followed in physician-led diabetic clinics. Materials and Methods: A retrospective observational study with a 12-month follow-up were used to detect the difference in the glycemic control by comparing the reduction in HbA1c percentage from the baseline, and average changes in HbA1c, fasting blood glucose (FBG), blood pressure (BP), and lipid panel between the two groups. The level of self-care was assessed by Summary of Diabetes Self-Care Activities (SDSCA) Questionnaire. Results: The study involved 52 patients who visited the diabetic clinic at a community teaching hospital. Exactly 24 patients were followed by the pharmacist-led diabetic clinics, while 28 were followed by physician-led diabetic clinics. HbA1c baseline was 8.7% and 8.4% for pharmacist and physician, respectively. The average difference in HbA1c for the pharmacist-led diabetic clinics vs. the physician-led diabetic clinics was not statistically significant (8.67 vs. 8.56; p = 0.77). Moreover, no difference in the glucose profile, lipid panel, and blood pressure were seen between the two groups. However, the median HbA1c change from baseline between the two groups significantly favored the pharmacist-led clinic (0.7 vs. 0.003; p = 0.04).The average of responses in all four aspects of the SDSCA (diet, exercise, blood sugar testing, and foot care) was also higher among patients in the pharmacist-led diabetic clinic. Conclusions: Pharmacist-led diabetic clinics for glycemic control and follow-up showed efficient results that encourage the comprehensive and integral inter-professional patient care.

The Effects of a Caffeine Placebo and Experimenter Expectation on Blood Pressure, Heart Rate, Well-Being, and Cognitive Performance

2001 ◽  
Vol 6 (1) ◽  
pp. 15-25 ◽  
Author(s):  
Harald Walach ◽  
Stefan Schmidt ◽  
Yvonne-Michelle Bihr ◽  
Susanne Wiesch
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Cognitive Task ◽  
Well Being ◽  
Control Group ◽  
Double Blind ◽  
Main Effect ◽  
The Difference ◽  
Being There ◽  
To Receive

We studied the effect of experimenter expectations and different instructions in a balanced placebo design. 157 subjects were randomized into a 2 × 4 factorial design. Two experimenters were led to expect placebos either to produce physiological effects or not (pro- vs. antiplacebo). All subjects except a control group received a caffeine placebo. They were either made to expect coffee, no coffee, or were in a double-blind condition. Dependent measures were blood pressure, heart rate, well-being, and a cognitive task. There was one main effect on the instruction factor (p = 0.03) with the group “told no caffeine” reporting significantly better well-being. There was one main effect on the experimenter factor with subjects instructed by experimenter “proplacebo” having higher systolic blood pressure (p = 0.008). There was one interaction with subjects instructed by experimenter “proplacebo” to receive coffee doing worse in the cognitive task than the rest. Subjects instructed by experimenter “antiplacebo” were significantly less likely to believe the experimental instruction, and that mostly if they had been instructed to receive coffee. Contrary to the literature we could not show an effect of instruction, but there was an effect of experimenters. It is likely, however, that these experimenter effects were not due to experimental manipulations, but to the difference in personalities.

PENGARUH TERAPI TERTAWA TERHADAP PENURUNAN TEKANAN DARAH LANSIA DI UPT PANTI WREDHA BUDHI DHARMA YOGYAKARTA

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Niken Setyaningrum ◽  
Andri Setyorini ◽  
Fachruddin Tri Fitrianta
Keyword(s):  
Blood Pressure ◽  
Data Analysis ◽  
The Elderly ◽  
Control Group ◽  
Group Comparison ◽  
Control Blood Pressure ◽  
Men And Women ◽  
Treatment Of Hypertension ◽  
Before And After ◽  
The Difference

ABSTRACTBackground: Hypertension is one of the most common diseases, because this disease is suffered byboth men and women, as well as adults and young people. Treatment of hypertension does not onlyrely on medications from the doctor or regulate diet alone, but it is also important to make our bodyalways relaxed. Laughter can help to control blood pressure by reducing endocrine stress andcreating a relaxed condition to deal with relaxation.Objective: The general objective of the study was to determine the effect of laughter therapy ondecreasing elderly blood pressure in UPT Panti Wredha Budhi Dharma Yogyakarta.Methods: The design used in this study is a pre-experimental design study with one group pre-posttestresearch design where there is no control group (comparison). The population in this study wereelderly aged over> 60 years at 55 UPT Panti Wredha Budhi Dharma Yogyakarta. The method oftaking in this study uses total sampling. The sample in this study were 55 elderly. Data analysis wasused to determine the difference in blood pressure before and after laughing therapy with a ratio datascale that was using Pairs T-TestResult: There is an effect of laughing therapy on blood pressure in the elderly at UPT Panti WredhaBudhi Dharma Yogyakarta marked with a significant value of 0.000 (P <0.05)

Analysis of the quality of early diagnostics of cardiovascular diseases in students of educational institutions of Khabarovsk (according to the data of preventive examinations)

2020 ◽  
pp. 13-16
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Sinus Tachycardia ◽  
Blood Pressure Level ◽  
Educational Institutions ◽  
Conduction Disturbances ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

To identify the prevalence of early pathology of cardiovascular diseases, a survey of 400 200 girls) in the age group 15 and 17 years old was conducted as a part of routine medical of the level of blood pressure (BP) was carried out, with the calculation of the average level pressure on the basis of three separate measurements estimated by percentile tables for a registration of a standard resting ECG in 12 leads. According to the results of the survey, into 3 groups: with an increase in blood pressure above 95 ‰ (group 1 – 16 people), which recorded in males (p<0,05); Group 2 (67 people) – adolescents with a normal blood pressure level and group 3 of adolescents with a decrease in blood pressure below 5 ‰ changes in the form of rhythm and conduction disturbances were noted in almost every a predominance of sinus tachycardia in the first group. In the third group of adolescents, form of ectopic rhythm and pacemaker migration were significantly more frequently only 78 % of adolescents were referred for consultation and in-depth examination by a pediatric cardiologist.

Sign in / Sign up

Export Citation Format

Share Document