scholarly journals A Comparison between Total Intravenous Anaesthesia Using Propofol plus Remifentanil and Propofol plus Sevoflurane in Children undergoing Fibreoptic Bronchoscopy：A Randomized, Single-Blind Study

2021 ◽  
Author(s):  
Fang Chen ◽  
Zhuli Wang ◽  
Bingwu Huang ◽  
Jiachao Lu ◽  
Mengmeng Chen ◽  
...  
Keyword(s):  
Operation Time ◽  
Fibreoptic Bronchoscopy ◽  
Postanesthesia Care Unit ◽  
Clinical Trial Registry ◽  
Intravenous Anaesthesia ◽  
Brush Biopsy ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Single Blind ◽  
Remifentanil Group

Abstract BackgroundFibreoptic bronchoscopy is an important used to evaluate and manage paediatric patients with respiratory disease.This study aimed to compare the effect of two different anaesthesia methods, propofol combined with remifentanil and propofol combined with sevoflurane, on children undergoing fibreoptic bronchoscopy (FOB).Method:Sixty children were enrolled and randomly divided into two groups. In the remifentanil group (Group R), the patients were induced with 4 mg•kg− 1 propofol + 4 µg•kg− 1 remifentanil (slow intravenous injection) and maintained with 0.3–0.5 µg•kg− 1•min− 1 remifentanil. In the sevoflurane group (Group S), the patients were induced with 2 mg•kg− 1 propofol and 8% sevoflurane and maintained with 4–6 vol% sevoflurane. Heart rate (HR), mean blood pressure (MBP) and pulse oxygen saturation (SpO2) were monitored and recorded at four time points: baseline (T0), when the bronchoscope reached glottis (T1), the time of lavage (T2), and the time of brush biopsy (T3). Waking time and the satisfaction score of physicians were recorded, and emergence agitation (EA) was evaluated in the postanesthesia care unit (PACU). Finally, any supplementary medicine or adverse events were also recorded.ResultsCompared with group S, the waking time was significantly shorter and the incidence of EA was significantly lower in Group R. During bronchoscopy, significant differences in MAP or HR were not observed between the two groups at T0. Compared with group S, the HR of group R was significantly decreased at T1, T2 and T3, and MAP was significantly decreased at T1, but the fluctuation range was within 20% of the baseline. A significant difference in SpO2 was not observed between the two groups at any time point. No significant differences in the operation time of FOB, the incidence of complications, such as moving, hypoxemia, bronchospasm, and bucking, or the level of satisfaction were observed between the two groups.ConclusionsTotal intravenous anaesthesia using propofol plus remifentanil in children undergoing fibreoptic bronchoscopy potentially reduces the waking time and decreases the incidence of EA to improve the work efficiency and turnover rate of the outpatient operating room.Trial registrationRegistered at the China Clinical Trial Registry (http://www.chictr.org.cn) (ChiCTR1900026098).

scholarly journals The Effect of Smart Boards on the Cognition and Motivation of Students

2017 ◽  
Vol 7 (1) ◽  
pp. 60 ◽  
Author(s):  
Nitza Davidovitch ◽  
Roman Yavich
Keyword(s):  
Sixth Grade ◽  
Research Literature ◽  
General Level ◽  
Significant Finding ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Technological Developments ◽  
Research Findings ◽  
Measure Change ◽  
Smart Boards

In recent years the research literature has explored technological developments in varied areas that measure change. The current study focuses on the smart board, and its purpose is to examine its effect on the school system. The study was conducted via a questionnaire completed by 130 respondents (boys and girls) in the fifth and sixth grades of two elementary schools in Jerusalem—Efrata and Tali Gilo. Smart boards were introduced in these two schools in recent years.We hypothesized that smart boards improve teaching, based on the teaching measures developed by Nira Hativa of Tel Aviv University: order and organization, level of clarity, interest, and general level of satisfaction. The study’s significant finding is that the greatest improvement since the introduction of smart boards is in the variable of clarity, and a significant difference was found in the favor of sixth grade students. Additionally, a significant difference was found in the variable of interest, in favor of the girls. All four variables appear to be interrelated, and each contributes to the student’s success and to improving the student’s learning process.The research findings illuminate the contribution of technology to teaching, through a case study of smart boards, in the dimension of clarity, found by the study to be a significant criterion of good teaching. Examination of the various technological tools in light of their contribution to the research-proven dimensions of outstanding teaching might enhance the pedagogical contribution of technological developments to teaching.

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 135
Author(s):  
Tomohide Segawa ◽  
Hisashi Koga ◽  
Masahito Oshina ◽  
Katsuhiko Ishibashi ◽  
Yuichi Takano ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Outcome Measure ◽  
Operation Time ◽  
Secondary Outcome ◽  
Invasive Technique ◽  
Lateral Interbody Fusion ◽  
Surgical Methods ◽  
Significant Difference ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

scholarly journals Utility of the optical quality analysis system for decision-making in Nd: YAG laser posterior capsulotomy in patients with light posterior capsule opacity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Lu ◽  
Weijie Zhu ◽  
Yu Fan ◽  
Dong Shi ◽  
Liwei Ma
Keyword(s):  
Area Under The Curve ◽  
Quality Parameters ◽  
Optical Quality ◽  
Quality Analysis ◽  
Posterior Capsule ◽  
Clinical Trial Registry ◽  
Posterior Capsulotomy ◽  
Significant Difference ◽  
Analysis System ◽  
Scattering Index

Abstract Background A prospective cohort study was performed to evaluate whether the Optical Quality Analysis System (OQAS) can serve as a valuable additional indicator for appropriate posterior capsulotomy referral. Methods One hundred and five eyes from 96 patients undergoing capsulotomy were divided into precapsulotomy logMAR CDVA ≤0.1 group and logMAR CDVA > 0.1 group. CDVA, and the Visual Function 14 index (VF-14) score were estimated before and 1 month after capsulotomy. The objective scattering index (OSI) value was measured by using the OQAS. Posterior capsule opacification (PCO) severity was assessed with Evaluation of PCO 2000 (EPCO 2000) software. Results In logMAR CDVA > 0.1 group, the correlations of OSI, logMAR CDVA, EPCO score and VF-14 score were very strong preoperatively. In logMAR CDVA ≤0.1 group, preoperatively, OSI was correlated with logMAR CDVA (r = 0.451), EPCO score (r = 0.789), and VF-14 score (r = 0.852). LogMAR CDVA has weak correlation with VF-14 score (r = − 0.384) and EPCO score (r = 0.566). VF-14 score was correlated with EPCO score (r = − 0.669). In the logMAR CDVA ≤0.1 group, there was no significant difference in logMAR CDVA between precapsulotomy and postcapsulotomy (P > 0.05). In the two groups, all the other optical quality parameters were significantly improved after capsulotomy (P < 0.05). In logMAR CDVA > 0.1 group, the area under the curve of the ROC of the OSI was 0.996 (P = 0.000). In logMAR CDVA ≤0.1 group, the area under the curve of the ROC of the OSI was 0.943 (P = 0.000). Conclusions The OSI was useful for evaluating of PCO and prediction of beneficial capsulotomy. Especially for patients with slight PCO and better visual acuity, OSI is more valuable than CDVA and completely objective examination. Trial registration The study protocol was registered at the Chinese Clinical Trial Registry. Register: ChiCTR1800018842 (Registered Date: October 13th, 2018).

scholarly journals Rheumatologist perspective of the Brazilian consensus for detection of auto antibodies in HEp-2 CELLS

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Isadora Carvalho Medeiros Francescantonio ◽  
Leandro Augusto Rodrigues dos Santos ◽  
Paulo Luiz Carvalho Francescantonio ◽  
Luiz Eduardo Coelho Andrade ◽  
Wilson de Melo Cruvinel
Keyword(s):  
Clinical Practice ◽  
Immunofluorescence Assay ◽  
Chi Square ◽  
Dichotomous Data ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Chi Square Test ◽  
Geographic Regions ◽  
Relevant Pattern ◽  
Structured Questionnaire

Abstract Objective To evaluate the perception of rheumatologists regarding the recommendations of the Brazilian Consensus for detection of Autoantibodies (BCA) on HEp-2 Cells by Indirect Immunofluorescence assay (IFA) and how BCA recommendations help in clinical practice. Methodology A structured questionnaire regarding the BCA recommendations for detection and interpretations of autoantibodies in HEp-2 cells was applied to randomly selected rheumatologists. The results were tabulated using the Microsoft® Excel program, expressed as a simple percentage and the dichotomous data were analyzed using the Chi-square test and the Epi Info® program. Results Four hundred fuorteen rheumatologists participated in the study: 70% of them considered their knowledge of the HEp-2 IFA test satisfactory or excellent, and 43% said they knew the BCA recommendations in general, without distinguishing the edition of the BCA to which they refer. The Revista Brasileira de Rheumatologia/Advances in Rheumatology was the means of dissemination most consulted by specialists (50%). According to the rheumatologists’ opinion, the most relevant pattern was the homogeneous nuclear (78%) and 65% stated they were satisfied with the BCA recommendations at a level of satisfaction greater than or equal to 80%. There was no significant difference in the perception of rheumatologists from the several Brazilian geographic regions. Conclusion Brazilian rheumatologists are aware of the BCA guidelines and most are satisfied with the content published, considering that the BCA recommendations assist positively in the clinical practice. Most rheumatologists recognize the patterns associated with rheumatic autoimmune diseases and have used BCA recommendations to interpret the results of the HEp-2 IFA test.

scholarly journals Laparoscopic proximal gastrectomy with double-tract reconstruction for upper third gastric cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuo-meng Xiao ◽  
Ping Zhao ◽  
Zhi Ding ◽  
Rui Xu ◽  
Chao Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Proximal Gastrectomy ◽  
Operation Time ◽  
Nutrition Status ◽  
Proximal Gastric Cancer ◽  
Double Tract Reconstruction ◽  
Significant Difference ◽  
Laparoscopic Proximal Gastrectomy ◽  
Gastric Cancer Patients ◽  
Upper Third

Abstract Background Proximal gastrectomy with double-tract reconstruction (DTR) has been used for upper third gastric cancer as a function-preserving procedure. However, the safety and feasibility of laparoscopic proximal gastrectomy (LPG) with DTR remain uncertain. This study compared open proximal gastrectomy (OPG) with DTR and LPG with DTR for proximal gastric cancer. Methods Sixty-four patients who had undergone OPG with DTR and forty-six patients who had undergone LPG with DTR were enrolled in this case–control study. The clinical characteristics, surgical outcomes and postoperative nutrition index were analysed retrospectively. Results The operation time was significantly longer in the LGP group than in the OPG group (258.3 min vs 205.8 min; p = 0.00). However, the time to first flatus and postoperative hospital stay were shorter in the LPG group [4.0 days vs 3.5 days (p = 0.00) and 10.6 days vs 9.2 days (p = 0.001), respectively]. No significant difference was found between the two groups in the number of retrieved lymph nodes, complications or reflux oesophagitis. The nutrition status was assessed using the haemoglobin, albumin, prealbumin and weight levels from pre-operation to six months after surgery. No significant difference was found between the groups. Conclusion LPG with DTR can be safely performed for proximal gastric cancer patients by experienced surgeons.

scholarly journals Traditional versus mirror three-dimensional printing technology for isolated acetabular fractures: a retrospective study with a median follow-up of 25 months

2021 ◽  
Vol 49 (6) ◽  
pp. 030006052110285
Author(s):  
Kai Xiao ◽  
Bo Xu ◽  
Lin Ding ◽  
Weiguang Yu ◽  
Lei Bao ◽  
...  
Keyword(s):  
3D Printing ◽  
Three Dimensional ◽  
Operation Time ◽  
Harris Hip Score ◽  
Acetabular Fractures ◽  
Printing Technology ◽  
Three Dimensional Printing ◽  
3D Printing Technology ◽  
Significant Difference

Objective To assess the outcomes of traditional three-dimensional (3D) printing technology (TPT) versus mirror 3D printing technology (MTT) in treating isolated acetabular fractures (IAFs). Methods Consecutive patients with an IAF treated by either TPT or MTT at our tertiary medical centre from 2012 to 2018 were retrospectively reviewed. Follow-up was performed 1, 3, 6, and 12 months postoperatively and annually thereafter. The primary outcome was the Harris hip score (HHS), and the secondary outcomes were major intraoperative variables and key orthopaedic complications. Results One hundred fourteen eligible patients (114 hips) with an IAF (TPT, n = 56; MTT, n = 58) were evaluated. The median follow-up was 25 months (range, 21–28 months). At the last follow-up, the mean HHS was 82.46 ±14.70 for TPT and 86.30 ± 13.26 for MTT with a statistically significant difference. Significant differences were also detected in the major intraoperative variables (operation time, intraoperative blood loss, number of fluoroscopic screenings, and anatomical reduction number) and the major orthopaedic complications (loosening, implant failure, and heterotopic ossification). Conclusion Compared with TPT, MTT tends to produce accurate IAF reduction and may result in better intraoperative variables and a lower rate of major orthopaedic complications.

scholarly journals Intraoperative Nice knots assistance for reduction in displaced comminuted clavicle fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fangning Hu ◽  
Xi Liu ◽  
Fanxiao Liu ◽  
Honglei Jia ◽  
Xiaolong Lv ◽  
...  
Keyword(s):  
Blood Loss ◽  
Rating Scale ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Clinical Results ◽  
Intraoperative Blood Loss ◽  
Traditional Group ◽  
Significant Difference ◽  
Clavicle Fractures ◽  
Displaced Clavicle Fracture

Abstract Purpose The Nice knots have been widely used in orthopedic surgeries to fix torn soft tissue and fracture in recent years. The study aims to investigate the clinical efficacy and prognosis of intraoperative and postoperative Nice Knots-assisted reduction in the treatment of displaced comminuted clavicle fracture. Methods From Jan 2014 to Dec 2019, 75 patients diagnosed with unilateral closed displaced comminuted clavicle fracture were treated with open reduction and internal fixation (ORIF) in this study. Nice knot group (the NK group) included 38 patients and the other 37 patients were in the traditional group (the TK group). The time of operation and the amount of bleeding during operation were recorded. Post-operative clinical outcomes and radiographic results were recorded and compared between these two groups. The Visual Analogue Scale (VAS), Neer score, Rating Scale of the American Shoulder and Elbow Surgeons, Constant-Murley score and complications such as infection, nonunion, implant loosening, fragment displacement and hardware pain were observed in the two groups. Results In the comparison between the two groups, there was no significant difference in age, sex, the cause of displaced clavicle fracture, and other basic information between the two groups. The operation time, intraoperative fluoroscopy time, and intraoperative blood loss were significantly reduced in the NK group (P < 0.01). There were 2 cases of plate fracture in the TK group. The follow-up results showed that there was no significant difference in VAS, Neer score, ASES, and Constant-Murley scores between the two groups. Conclusion The use of Nice knot, in comminuted and displaced clavicle fractures can reduce intraoperative blood loss, shorten operation time, facilitate intraoperative reduction, and achieve satisfactory postoperative clinical results. This study demonstrates that Nice knot is a simple, safe, practical and effective auxiliary reduction method.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

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