scholarly journals Management of post-operative sore throat in patients undergoing endotracheal intubation: literature review

2021 ◽  
Vol 8 (2) ◽  
pp. 855
Author(s):  
Ahmed M. El Sharkawy ◽  
Mustafa M. Rawas ◽  
Amany M. Altoies ◽  
Mohammed A. Al Arbash ◽  
Abdulaziz A. Alzahrani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Cuff Pressure ◽  
Meta Analysis ◽  
Careful Monitoring ◽  
Future Studies ◽  
Common Complaint ◽  
Inflammatory Drugs ◽  
Common Risk Factors

Postoperative sore throat (POST) is a common complaint that is classified as the 8th most undesirable events after general anesthesia. Endotracheal intubation has been estimated to be the commonest factor causing POST. We aim to review the risk factors and preventive measures to reduce the incidence and severity of POST following endotracheal intubation. Although sore throat can be induced by many perioperative factors, endotracheal intubation remains the commonest cause that can induce endothelial injury and a subsequent sore throat. Many risk factors for this association has been reported. The most common risk factors include ages less than 60 years of age, female sex, cough, and asthma, underlying chest diseases, type and timing of the operation, type, and size of the used endotracheal tube. Moreover, the experience of the personnel intubating the patients may have been another risk factor. Medical prevention of POST can be achieved by several agents as steroids, non-steroidal anti-inflammatory drugs (NSAIDS), N-methyl-D-aspartate (NMDA) receptor antagonists, careful monitoring of the tracheal cuff pressure, and licorice application. On the other hand, using lidocaine has been contraindicated according to previous meta-analysis results. Additionally, we recommend that future studies with bigger sample sizes are should be conducted for further validation of the new modalities.

scholarly journals The common risk factors for progression and mortality in COVID-19 patients: a meta-analysis

2021 ◽  
Author(s):  
Li Zhang ◽  
Jie Hou ◽  
Fu-Zhe Ma ◽  
Jia Li ◽  
Shuai Xue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Common Risk Factors ◽  
The Common

scholarly journals Nonsteroidal Anti-Inflammatory Drugs and Risk of Melanoma

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Joanne M. Jeter ◽  
Joseph D. Bonner ◽  
Timothy M. Johnson ◽  
Stephen B. Gruber
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Structured Interview ◽  
Melanoma Risk ◽  
Unadjusted Odds Ratio ◽  
Epidemiologic Evidence ◽  
Inflammatory Drugs ◽  
Chemopreventive Effect ◽  
Anti Inflammatory

Because nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit tumor growthin vitro, we investigated the association between NSAIDs and melanoma to determine if there was epidemiologic evidence of a chemopreventive effect from these medications. Three hundred twenty-seven subjects with incident melanoma and 119 melanoma-free controls completed a structured interview assessing melanoma risk factors. The unadjusted odds ratio (OR) for use of nonaspirin NSAIDs was 0.58 (95% CI 0.31–1.11), in a comparison of subjects with melanoma to controls. After adjustment for melanoma risk factors, the OR was 0.71 (95% CI 0.23–2.02). Aspirin users had an unadjusted OR of 0.85 (95% CI 0.45–1.69) and an adjusted OR of 1.45 (95% CI 0.44–4.74). In this pilot study, we found no evidence of a significant association between analgesic use and melanoma risk when potential confounders are assessed. Based on conflicting reports in the literature, meta-analysis may be appropriate.

scholarly journals DNA methylation of blood cells is associated with prevalent type 2 diabetes in a meta-analysis of four European cohorts

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Diana L. Juvinao-Quintero ◽  
Riccardo E. Marioni ◽  
Carolina Ochoa-Rosales ◽  
Tom C. Russ ◽  
Ian J. Deary ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Dna Methylation ◽  
Association Studies ◽  
Meta Analysis ◽  
Cell Types ◽  
Common Risk Factors ◽  
Variation Explained

Abstract Background Type 2 diabetes (T2D) is a heterogeneous disease with well-known genetic and environmental risk factors contributing to its prevalence. Epigenetic mechanisms related to changes in DNA methylation (DNAm), may also contribute to T2D risk, but larger studies are required to discover novel markers, and to confirm existing ones. Results We performed a large meta-analysis of individual epigenome-wide association studies (EWAS) of prevalent T2D conducted in four European studies using peripheral blood DNAm. Analysis of differentially methylated regions (DMR) was also undertaken, based on the meta-analysis results. We found three novel CpGs associated with prevalent T2D in Europeans at cg00144180 (HDAC4), cg16765088 (near SYNM) and cg24704287 (near MIR23A) and confirmed three CpGs previously identified (mapping to TXNIP, ABCG1 and CPT1A). We also identified 77 T2D associated DMRs, most of them hypomethylated in T2D cases versus controls. In adjusted regressions among diabetic-free participants in ALSPAC, we found that all six CpGs identified in the meta-EWAS were associated with white cell-types. We estimated that these six CpGs captured 11% of the variation in T2D, which was similar to the variation explained by the model including only the common risk factors of BMI, sex, age and smoking (R2 = 10.6%). Conclusions This study identifies novel loci associated with T2D in Europeans. We also demonstrate associations of the same loci with other traits. Future studies should investigate if our findings are generalizable in non-European populations, and potential roles of these epigenetic markers in T2D etiology or in determining long term consequences of T2D.

scholarly journals Tracheal lesion during shoulder surgery: a case report and systemic review of the literature

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Luigi Vetrugno ◽  
Michele Divella ◽  
Daniele Orso ◽  
Cristian Deana ◽  
Giulia Vaccher ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Cuff Pressure ◽  
Orotracheal Intubation ◽  
Shoulder Surgery ◽  
Systemic Review ◽  
Eligibility Criteria ◽  
Tracheal Lesion ◽  
Diagnostic Finding

AbstractPneumomediastinum (PNM) and pneumothorax (PNX) are documented complications of arthroscopic shoulder surgery (ATS). Plexus anesthetic block and tracheal lesions during endotracheal intubation are hypothesized to be the underlying risk factors; however, the actual evidence supporting this hypothesis is scarce.A case of bilateral laterocervical emphysema, subcutaneous edema, and signs of PNM after ATS performed under general anesthesia and supra-scapular nerve block is presented. An up-to-date systematic review of PNM/PNX during orthopedic surgery was performed, involving six databases: PubMed (1996–present), Embase (1974–present), Scopus (2004–present), SpringerLink (1950–present), Ovid Emcare (1995–present), and Google Scholar (2004–present).Twenty-five case studies met the eligibility criteria. In 24 cases, the patient underwent general anesthesia and orotracheal intubation; in 9 of these, a plexus anesthetic block was also performed. One case involved ATS under plexus anesthetic block only. In 10 cases, the diagnostic finding was PNM. In 5 cases, the diagnostic finding was associated with PNX. PNX was detected in 17 cases. In 2 cases, SE was found in the absence of any evidence of either PNM or PNX. A tracheal lesion was identified in 3 cases.Endotracheal intubation and loco-regional anesthesia are not the only predisposing risk factors at play in the pathogenesis of PNM/PNX. Rather, multi-factorial pathogenesis seems more probable, necessitating that specific attention is paid during ATS to the change in patient position on the operating bed, to any slipping of the endotracheal tube, to patient monitoring whilst under the drapes, and to the cuff pressure. PROSPERO registration number: CRD42021260370.

scholarly journals PERBANDINGAN PEMBERIAN DEXAMETHASONE 10 MG INTRAVENA DAN LIDOCAINE SPRAY PADA TINGKAT KENYAMANAN PASCA INTUBASI ENDOTRACHEAL TUBE DI RSUD ARIFIN ACHMAD PROVINSI RIAU

2019 ◽  
Vol 19 (2) ◽  
Author(s):  
Dino Irawan ◽  
Nopian Hidayat
Keyword(s):  
General Anesthesia ◽  
Endotracheal Tube ◽  
General Hospital ◽  
Sore Throat ◽  
Endotracheal Intubation ◽  
Cuff Pressure ◽  
Controlled Trial ◽  
History Of ◽  
The Difference ◽  
Lidocaine Spray

Abstrak. Penelitian ini berjudul perbandingan tingkat kenyamanan pasca pembiusan umum dengan endotracheal tube antara pemberian dexametasone intravena dan lidocaine spray di RSUD Arifin Achmad Provinsi  Riau. Tingkat kenyamanan berupa nyeri tenggorok pada pasien yang menjalani pembiusan umum dengan intubasi endotrakeal dapat dipengaruhi oleh beberapa hal yaitu obat-obatan yang diberikan, teknik insersi, tekanan cuff dan manajemen setelah insersi.Nyeri tenggorok pada pasien yang menjalani anestesi umum dengan intubasi endotrakeal pada umumnya tidak berakibat fatal dan akan menghilang dalam 48-72 jam setelah operasi tetapi hal ini dapat menyebabkan gangguan yang cukup berarti bagi pasien, menambah lama dan biaya rawatan pasien di rumah sakit serta meninggalkan kesan buruk terhadap operasi. Penelitian ini menggunakan pendekatan randomized clinical controlled trial dengan rancangan eksperimental yang dilakukan pada 104 pasien yang menjalani anestesi umum dengan endotrakeal tube di RSUD Arifin Achmad Provinsi Riau pada bulan September-Oktober 2019. Pada hasil penelitian didapatkan bahwa pemberian dexametasone intravena sebelum tindakan intubasi endotrakeal lebih efektif dalam mencegah nyeri tenggorok pasca operasi dibandingkan lidocaine spray (19.2% untuk Dexametasone intravena dan 29.8% pada Lidocaine spray). Secara statistik, perbedaan kejadian nyeri tenggorok antara kelompok Dexametasone intravena dan Lidocaine spray adalah bermakna pada skoring 1 jam post operasi (p 0.05) dan tidak bermakna pada skoring 24 jam post operasi (p0.05). Insidensi nyeri tenggorok terbanyak berdasarkan usia adalah pada kelompok usia 46-55 tahun dan 55-65 tahun, berdasarkan jenis kelamin adalah lebih banyak pada perempuan dibandingkan laki-laki, dan lebih banyak pada pasien yang mempunyai riwayat merokok. Kata kunci: nyeri tenggorok, dexametasone intravena, lidocaine spray, RSUD Arifin Achmad Provinsi Riau Abstract. This study is about the comparison of the level of comfort after general anesthesia with an endotracheal tube between administration of intravenous dexametasone and lidocaine spray in Arifin Achmad General Hospital of Riau Province. The level of comfort in the form of sore throat in patients undergoing general anesthesia with endotracheal intubation can be influenced by several things such as administration of drugs, insertion techniques, cuff pressure and management after insertion. Sore throat in patients undergoing general anesthesia with endotracheal intubation is generally not fatal and will disappear within 48-72 hours after surgery but this can cause significant disruption to the patient, increase the length and cost of patient care in the hospital and leave bad impression from surgery. This study is a randomized clinical controlled trial with an experimental design conducted on 104 patients undergoing general anesthesia with endotracheal tube at Arifin Achmad General Hospital in Riau Province in September-October 2019. The study found that administration of intravenous dexametasone before endotracheal intubation is more effective in preventing postoperative sore throat compared to lidocaine spray (19.2% for intravenous Dexametasone and 29.8% in Lidocaine spray). Statistically, the difference in the incidence of sore throat between the intravenous Dexametasone group and Lidocaine spray was significant at 1 hour postoperative scoring (p 0.05) and not significant at 24 hour postoperative scoring (p 0.05). The highest incidence of sore throat by age is in the age group 46-55 years and 56-65 years, more frequent in women than men, and more frequent in patients who have a history of smoking. Keywords: sore throat, intravenous dexametasone, lidocaine spray, Arifin Achmad General Hospital Riau Province

Gene-Centric Approach Identifies New and Known Loci for Factor VIII Activity and Von Willebrand Factor Antigen In the Candidate Gene Association Resource (CARe) Consortium

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 806-806
Author(s):  
Weihong Tang ◽  
Mary Cushman ◽  
Saonli Basu ◽  
David Green ◽  
Alexander P Reiner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Factor Viii ◽  
Von Willebrand Factor ◽  
Genetic Association Study ◽  
Meta Analysis ◽  
Genetic Determinants ◽  
Candidate Gene Association ◽  
Common Risk Factors ◽  
Von Willebrand ◽  
Willebrand Factor

Abstract Abstract 806 Background Factor VIII and von Willebrand factor (vWF) are important components of the coagulation system that circulate together in plasma as a non-covalent complex. Increased circulating levels of FVIII activity (FVIII:C) and vWF antigen (vWF:Ag) in the top 25% of the population distribution are common risk factors for venous thromboembolism, the third leading vascular disease. FVIII and vWF are genetically controlled but their genetic determinants are not fully understood. Moreover, data from populations other than European Americans (EAs) are limited. We performed a genetic association study for plasma levels of FVIII:C and vWF:Ag using a gene-centric approach in the cohorts of NHLBI-funded Candidate gene Association Resource (CARe) consortium. Methods Nearly 50,000 single nucleotide polymorphisms (SNPs) located in about 2,100 candidate genes were genotyped in 18,556 EAs and 4,844 African Americans (AAs) from the Atherosclerosis Risk in Communities (ARIC), Coronary Artery Risk Development in Young Adults (CARDIA), Cardiovascular Health Study (CHS), Multi-Ethnic Study of Atherosclerosis (MESA), and Framingham Heart Study (FHS, EAs only). Measurements for FVIII:C and vWF:Ag were inverse normal transformed to normalize trait distribution, and adjusted for age, sex, study site and principal components to account for potential population stratification. Results across studies were combined within each ethnic group by meta-analysis. SNPs with minor allele frequency (MAF)-weighted sample size (MAFxN) < 10 were excluded from individual cohorts before the meta-analysis. The threshold for statistical significance was 2.0×10−6 after accounting for the number of independent tests. Results In EAs, four independent regions were identified with p<2.0×10−6, characterized by variants from KNG1 (best SNP rs698078, intronic, p= 4.26×10−7 for FVIII:C), ABO (rs529565, intronic, p<1.0×10−199 for both FVIII:C and vWF:Ag), vWF (rs1063856, missense, p=5.84 ×10−12 for FVIII:C and 1.06 ×10−19 for vWF:Ag), and F8/TMLHE (rs12557310, intronic, p=8.02 ×10−10 for FVIII:C). In AAs, three independent regions emerged, characterized by variants from ABO (rs8176693, intronic, p=2.51 ×10−114 for FVIII:C and 1.66 ×10−89 for vWF:Ag), MET1A (rs2236568, intronic, p=1.69 ×10−6 for FVIII:C), and vWF (rs2229446, missense, p=1.95 ×10−20 for FVIII:C and 1.13 ×10−16 for vWF:Ag). The regions marked by KNG1 and MAT1A have not been previously reported for association with FVIII:C. Notably, the variant rs2229446 in the vWF gene results in an arginine to glutamine substitution at position 2185, is associated with vW disease, and is only present in African, African American, and Asian samples of the HapMap population. Conclusions This large, gene-centric genetic association study for FVIII:C and vWF:Ag identified both new and known common loci. These findings expand our understanding of genetic determinants for the common risk factors for thrombosis in both EA and AA populations. Disclosures: No relevant conflicts of interest to declare.

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