scholarly journals Endotracheal intubation without the use of muscle relaxants in patients with myasthenia gravis

2009 ◽  
Vol 62 (9-10) ◽  
pp. 412-416 ◽  
Author(s):  
Gordana Vlajkovic ◽  
Radomir Sindjelic ◽  
Dejan Markovic ◽  
Milica Terzic ◽  
Vesna Bumbasirevic
Keyword(s):  
Myasthenia Gravis ◽  
Endotracheal Intubation ◽  
Muscle Relaxants ◽  
Double Blind ◽  
Intubating Conditions ◽  
Patient Consent ◽  
The Mean ◽  
Student’S T ◽  
Oxide Group ◽  
Student’S T Test

Introduction. Although muscle relaxants have been widely used to facilitate endotracheal intubation, the administration of these drugs in myasthenic patients may be associated with adverse events. Material and methods. After obtaining Institutional Reviewing Board approval and informed, patient consent, 30 patients with myasthenia gravis were enrolled in a prospective, double-blind, randomized clinical trial. We compared intubating conditions (ease of laryngoscopy, vocal cords, cough, jaw relaxation, limb movement) following fentanyl 2 mg/kg and propofol 2 mg/kg (group PRO, n = 15) vs fentanyl 2 mg/kg and sevoflurane 5% in a 1:2 mixture of oxygen and nitrous oxide (group SEVO, n = 15). The statistical analysis was performed using Student's t test and Chi-quadrate test, p<0.05 being regarded as significant. Results. The overall intubating conditions were excellent in 67% of patients in the group PRO vs 80% of patients in the group SEVO (p>0.05). One patient in each group had clinically unacceptable conditions for intubation. The mean intubation score was 5.7?1.0 in the group PRO vs 5.9?0.9 in the group SEVO (p>0.05). Three patients receiving propofol and one patient receiving sevoflurane had mild hoarseness after the surgery (p>0.05). Conclusion. Both propofol and sevoflurane, supplemented with fentanyl, provide good intubating conditions without the use of muscle relaxants in patients with myasthenia gravis.

Does the Ambulance Environment Adversely Affect the Ability to Perform Oral Endotracheal Intubation?

1996 ◽  
Vol 11 (2) ◽  
pp. 141-143 ◽  
Author(s):  
John E. Gough ◽  
Stephen H. Thomas ◽  
Lawrence H. Brown ◽  
James E. Reese ◽  
C. Keith Stone
Keyword(s):  
Endotracheal Intubation ◽  
Emergency Medical Technicians ◽  
Significant Difference ◽  
The Mean ◽  
Student’S T ◽  
Restrictive Environment ◽  
Injured Patients ◽  
First Time ◽  
Mean Time ◽  
Student’S T Test

AbstractObjective:Oral endotracheal intubation (ETI) is the preferred method of controlling the airway in critically ill or injured patients. It was postulated that time could be saved if intubation was performed in the ambulance en route to the hospital. This study was designed to determine whether the ambulance environment adversely affected the ability of emergency medical technicians at the advanced-intermediate level (EMT-AI) to perform oral ETI.Hypothesis:The restrictive environment of a moving ambulance would affect adversely the ability of EMT-AIs to perform ETI compared with a controlled setting. This would result in a significant increase in the time necessary to perform ETI in the ambulance compared with a controlled setting not complicated by restrictive space and motion.Methods:Twenty on-duty EMT-AIs were recruited to volunteer for this prospective, nonrandomized, nonblinded trial. All participants performed three consecutive oral ETIs on an airway mannequin in two settings: 1) in the back of a moving ambulance; and 2) on a table in the rescue squad station. Of the participants, 10 performed the intubations in the ambulance first; the remainder performed the intubations at the station first. Time for intubation with the mannequin was recorded by stopwatch. The mean times for intubation in both settings were compared by Student's t-test (p<0.05).Results:All intubation attempts were successful. The mean time for intubation in the station was 13.0±3.4 seconds. The mean time in the ambulance setting was 13.2±5.3 seconds. There was no significant difference between the intubation times in the two settings (p = 0.88).Conclusion:The environment of a moving ambulance does not appear to hinder the ability of EMT-AIs to perform oral ETI in a laboratory setting with a mannequin model.

scholarly journals Distances between mandibular posterior teeth and the WALA ridge in Peruvians with normal occlusion

2017 ◽  
Vol 22 (6) ◽  
pp. 56-60 ◽  
Author(s):  
Carla Y. Kong-Zárate ◽  
Marcos J. Carruitero ◽  
Will A. Andrews
Keyword(s):  
Age Groups ◽  
Test Results ◽  
Posterior Teeth ◽  
Normal Occlusion ◽  
Tooth Type ◽  
The Mean ◽  
Student’S T ◽  
Mandibular Posterior Teeth ◽  
Digital Caliper ◽  
Student’S T Test

ABSTRACT Objective: The purposes of this investigation were to determine the horizontal distances between the mandibular posterior teeth and the WALA ridge in a sample of Peruvians with normal occlusion and to compare them by tooth type, sex, arch side, and age groups. Methods: 65 dental casts of subjects with normal occlusion were collected. Posterior teeth, except for third molars, were evaluated. The horizontal distances between the occluso-gingival midpoints of the buccal surfaces (FA points) of each tooth and the WALA ridge were measured using a modified digital caliper. The values between each different tooth type within the sample were compared using the ANOVA and Scheffe tests, while comparisons by sex, arch side and age groups, using the Student’s t-test. Results: The mean distances in the sample was 0.96 mm for first premolars, 1.45 mm for second premolars, 2.12 mm for first molars and 2.55 mm for second molars. Statistically significant differences between each of the four tooth types were found. There were no significant differences found between sex, arch side and age groups. Conclusion: The horizontal distances between the mandibular posterior teeth and the WALA ridge increased progressively from the first premolars to the second molars in Peruvians with normal occlusion. The WALA ridge was a good landmark to evaluate the positions of posterior teeth in Peruvians with normal occlusion.

Topographic Analysis of Steady-State Visual Evoked Potentials (SVEPs) in The Medium Frequency Range in Migraine With and Without Aura

Cephalalgia ◽  
1992 ◽  
Vol 12 (4) ◽  
pp. 244-249 ◽  
Author(s):  
Franco M Puca ◽  
Marina de Tommaso ◽  
Maria A Savarese ◽  
Sergio Genco ◽  
Addolorata Prudenzano
Keyword(s):  
Steady State ◽  
Frequency Range ◽  
Medium Frequency ◽  
Topographic Analysis ◽  
Absolute Power ◽  
Interhemispheric Coherence ◽  
The Mean ◽  
Student’S T ◽  
Medium Frequency Range ◽  
Student’S T Test

Topographic analysis of SVEPs in the medium frequencies range was performed in 30 migraineurs without aura, 20 migraineurs with aura and in 20 control subjects. The mean absolute power values of the fundamental component F1, the subharmonic F1/2 and the first harmonic F2, corrected by logarithmic transformation, were computed in each group and then compared using Student's t-test. The interhemispheric coherence of the F1 component was also evaluated. The 18, 21 and 27 Hz F1 components were increased in both migraineurs with and without aura, particularly in the temporo-parietal regions. The 24 Hz F1 component was augmented only in migraineurs without aura in the parieto-occipital regions in comparison with migraineurs with aura and controls. Migraine with aura patients had a reduced interhemispheric coherence mostly of 12 Hz and 15 Hz F1 components in frontal and temporo-parietal regions. Results of the study confirm abnormalities of SVEPs in migraineurs with and without aura. These consist of widespread increases of F1 components in the medium frequency range over the temporo-parietal regions.

Correlates of Ageism Among Health Care Professionals Working With Older Adults

2018 ◽  
Vol 30 (3) ◽  
pp. 303-312 ◽  
Author(s):  
Ziyafet Uğurlu ◽  
Sultan Kav ◽  
Azize Karahan ◽  
Ebru Akgün Çıtak
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Data Analysis ◽  
Health Care Professionals ◽  
Educational Status ◽  
Descriptive Study ◽  
Descriptive Statistics ◽  
The Mean ◽  
Student’S T ◽  
Student’S T Test

Introduction: The changing proportion of older adults in society necessitates the need to determine the attitudes of health care professionals toward older adults. The purpose of this study was to explore attitudes of ageism and its correlates among health care professionals working with older adults. Method: This descriptive study was conducted in seven hospitals in five cities in Turkey. A total of 628 health care professionals participated in this study. The Fraboni Scale of Ageism (FSA) was used to collect data. Descriptive statistics, student’s t test, one-way analysis of variance and multivariate linear regression were used for data analysis. Results: The mean total score from the FSA was 56.9 ( SD = 8.0). Education (β = −.18, p < .001) and difficulty with the care of older adults (β = −.10, p < .05) were statistically significant predictors of the FSA score. Conclusions: The attitudes of health care professionals toward older adults were generally positive and affected by difficulty in providing care and the educational status of the health care professionals.

scholarly journals ANALGESIC EFFICACY OF EPIDURAL MORPHINE AND CLONIDINEIN PATIENTS UNDERGOING DECOMPRESSION OF THE LUMBAR CANAL: A PROSPECTIVE RANDOMIZED TRIAL

2017 ◽  
Vol 16 (3) ◽  
pp. 188-192
Author(s):  
BRUNO RONCAGLIO ◽  
RAPHAEL FERNANDES CALHAU ◽  
CHARBEL JACOB JÚNIOR ◽  
IGOR MACHADO CARDOSO ◽  
JOSÉ LUCAS BATISTA JÚNIOR ◽  
...  
Keyword(s):  
Epidural Morphine ◽  
Randomized Study ◽  
Analgesic Efficacy ◽  
Control Group ◽  
Lumbar Arthrodesis ◽  
The Mean ◽  
Group 2 ◽  
Student’S T ◽  
Microsoft Office ◽  
Student’S T Test

ABSTRACT Objective: To evaluate the postoperative analgesic efficacy in patients undergoing lumbar canal decompression using epidural morphine and clonidine at the Hospital Santa Casa de Vitória - ES, Brazil. Methods: Prospective, randomized study of 60 patients with stenosis of the lumbar canal up to two levels with surgical indication, in which decompression of the canal was performed in association with lumbar arthrodesis. In group 1 we performed conventional postoperative analgesia and in group 2, in addition to conventional analgesia, we associated epidural morphine and clonidine. We used VAS as a means of analyzing pain intensity at 1, 12, and 36 hours after surgery. The statistical analysis was performed using Microsoft Office/Excel and the software GraphPad Prism (San Diego, CA, USA). Results: The mean age of patients was 47 years, and 52% were female. The mean VAS in the first hour, 12th, and 36th hours after surgery in the control group was 5.44, 2.13, and 0.55 respectively. In the morphine-clonidine group it was 6.96; 2.21 and 0.60. Comparing one group with another in its absolute values through the Mann-Whitney test, as well as comparing the pain variations between the 1st and 12th hour (1h X 12h) and between the 12th hour and 36th hour (12h x 36h ) through Student’s t test it became clear that there was no statistical difference between groups (p > 0.05). Conclusions: The addition of epidural morphine and clonidine to conventional analgesia is not beneficial to reduce postoperative pain in patients undergoing lumbar canal decompression.

scholarly journals Effect of ondansetron on spinal induced hypotension in caesarean deliveries

2020 ◽  
Vol 8 (4) ◽  
pp. 193-199
Author(s):  
Pujan Balla ◽  
Anil Shrestha ◽  
Ninadini Shrestha ◽  
Navindra Bista ◽  
Moda Nath Marhatta
Keyword(s):  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
P Value ◽  
Chi Square ◽  
Induced Hypotension ◽  
Intergroup Comparison ◽  
Chi Square Test ◽  
The Mean ◽  
Student’S T ◽  
Student’S T Test

Background: Spinal anesthesia is the preferred technique of anesthesia employed for caesarean sections. However, it is very often complicated by hypotension. Different drugs and techniques have been used to prevent the hypotension induced by spinal anesthesia. In this study, the effect of ondansetron on the prevention of hypotension after spinal anesthesia was evaluated. Objectives: To determine the effect of prophylactic ondansetron on prevention of spinal induced hypotension in elective caesarean section. Methodology: Eighty-six parturients planned for elective caesarean deliveries were randomized into two groups of 43 each. Group O received Ondansetron 4 mg (4 ml) and Group S received Normal Saline (4 ml) intravenously 10 minutes prior to spinal anesthesia. Blood pressure, heart rate, phenylephrine requirements, occurrence of nausea and vomiting and APGAR scores of neonates were compared between the groups. Hemodynamic data was analyzed using Student’s t-test for intergroup comparison and ANOVA was used for intragroup comparison. Categorical data was analyzed using Pearson Chi-Square test. For all determinants, p-value <0.05 was considered significant. Results: Occurrence of hypotension in Group O (20.9 %) was significantly lower than in Group S (72.1%) (p < 0.05). The mean arterial pressure was significantly higher in Group O at 2, 6, 8, 12 and 14 minutes (p < 0.05). The use of phenylephrine (37.21 mcg vs. 146.51 mcg, p < 0.05) and occurrence of nausea (11.6%, vs. 41.9% p < 0.002) was significantly lower in ondansetron group. Conclusion: Ondansetron is effective in preventing spinal induced hypotension in elective caesarean sections.

scholarly journals Fishery regulamentation or ethnoknowledge? The dilemma of the management of the mapará fisheries on the lower Tocantins river in northern Brazil

2021 ◽  
Vol 10 (11) ◽  
pp. e131101118963
Author(s):  
Esther Mirian Cardoso ◽  
Paulo Allison Costa da Mata ◽  
Matheus dos Santos Souza ◽  
Maria Clara Pinheiro de Souza ◽  
Victoria Isaac
Keyword(s):  
Socioeconomic Development ◽  
Economic Importance ◽  
Chi Square ◽  
Great Economic Importance ◽  
Chi Square Test ◽  
Northern Brazil ◽  
The Mean ◽  
Tocantins River ◽  
Student’S T ◽  
Student’S T Test

The fishery of mapará (Hypophthalmus marginatus) is of great economic importance in the Amazon region. Despite this, it is observed that the current norms of management disagree with the ethnoknowledge of fishermen of the Tocantins river. Therefore, there are many seizures and fines in the Tocantins Low region. This work appeared as a demand of the fishermen of the region and had as purpose to test the pertinence of the fishing legislation on the capture of the species and to provide subsidies for the adaptation of the norms to the local reality. For this, a mapará fishery was taken on the Pindobal Grande river, in the municipality of Igarapé-Miri, in the state of Pará. A sample of the captured individuals was collected, and identification, sexing and biometry were done. Fishing was described, and the sex ratio tested with the Chi-Square test and the mean length differences between the sexes with the Student's t-test. The results were compared with current legislation and literature data. The captured mapará individuals were mostly above 30 cm, as determined by legislation. It is concluded that, despite using a network that is prohibited, the capture of the species in the region acts selectively, due to the ethno-cognition and the fisherman's action ("taleiro"). Therefore, it is necessary that the legislation be revised, seeking the reconciliation between the conservation of ecosystems, the traditional knowledge and the socioeconomic development of the region.

scholarly journals ‘Blood in pee’ campaign: Increased demand on secondary care with no change in cancers diagnosed

2018 ◽  
Vol 12 (1) ◽  
pp. 15-19
Author(s):  
Kunjan Patel ◽  
Susan Jane Hall ◽  
Kamath Shraddha ◽  
Richard Stanford ◽  
Simon Williams ◽  
...  
Keyword(s):  
Cancer Awareness ◽  
Level Of Evidence ◽  
Awareness Campaigns ◽  
Economic Background ◽  
Kolmogorov Smirnov ◽  
The Mean ◽  
Student’S T ◽  
The Impact ◽  
Index Of Multiple Deprivation ◽  
Student’S T Test

Objective: As part of the national Be Clear on Cancer campaign, the ‘blood in pee’ campaign was launched in 2013. We aimed to evaluate the impact of the campaign on 2-week wait (2WW) referrals and the resulting diagnoses of malignancy at a single trust, and secondly, to evaluate the socio-economic background of patients referred. Patients and methods: Suspected cancer 2WW patients in the 3 months pre- and post-campaign were included. Demographics, investigations and diagnoses were recorded. A Kolmogorov–Smirnov test demonstrated a normal distribution. The data were treated as parametric and analysed with the unpaired Student’s t-test. Results: Referrals for visible haematuria significantly increased by 52% from 135 pre-campaign to 205 post-campaign ( p = 0.03). There was a fall in the proportion of patients diagnosed with malignancy from 20.27% pre-campaign to 15.36% post-campaign. The mean index of multiple deprivation score of referrals did not change: p = 0.43. Conclusion: This campaign has increased referrals without increasing the proportion of malignancies diagnosed, placing large demand on services without benefit or extra funding. Nor has the campaign effectively reached deprived socio-economic groups. There is little evidence as to the efficacy of untargeted cancer awareness campaigns and further work is needed to improve their pick-up of malignancies. Level of evidence: 2C

scholarly journals THE RELIABILITY OF THE BOLTON RATIO WHEN APPLIED TO THE INDONESIAN POPULATION

2017 ◽  
Vol 10 (10) ◽  
pp. 176
Author(s):  
Joko Kusnoto
Keyword(s):  
T Test ◽  
Tooth Size ◽  
Crown Width ◽  
Indonesian Population ◽  
Significant Difference ◽  
The Mean ◽  
Anterior Ratio ◽  
Overall Ratio ◽  
Student’S T ◽  
Student’S T Test

  Objective: The objective of this study is to determine whether Bolton ratio can be applied clinically to the Indonesian population and to determine a more suitable Bolton ratio for the Indonesian population.Methods: This study was conducted on 120 readily available study models of treated cases comprising 37 males and 83 females. Two investigators separately measured the mesiodistal crown width of maxillary and mandibular tooth on each study model using sliding calipers. According to Bolton’s method, the overall and anterior ratios from each sample were calculated and the mean was generated. Using Student’s t-test with a 95% confidence interval, the investigators compared whether there is a significant difference between the ratio from Bolton’s samples and the ratio from the Indonesian samples.Results: The result of this study showed that, for Indonesian samples, the overall ratio is 89.7±2.05, while the anterior ratio is 76.4±2.76. Student’s t-test showed that there is a statistically significant difference (p<0.05) between the results of this study and that of Bolton’s study for both the anterior and overall ratios.Conclusion: It can be concluded that there is a difference between Indonesian population and Caucasian population in tooth size and Bolton ratio value. Therefore, original Bolton ratio value cannot be used as an accurate diagnostic tool for Indonesian population.

scholarly journals Inhibition of Demineralization at Restoration Margins of Z100 and Tetric EvoCeram Bulk Fill in Dentin and Enamel

2019 ◽  
Vol 6 (2) ◽  
pp. 36
Author(s):  
Cristina Leon-Pineda ◽  
Kevin Donly
Keyword(s):  
Light Microscopy ◽  
Polarized Light ◽  
In Vitro Study ◽  
The Other ◽  
Solution Ph ◽  
Class V ◽  
The Mean ◽  
Student’S T ◽  
Student’S T Test

Recurrent caries is still considered the main reason restorations need to be replaced. There are different materials available now that promise to reduce the possibility of recurrent caries by releasing fluoride and inhibiting restoration marginal caries. The purpose of this in vitro study was to evaluate the demineralization inhibition potential of a non-fluoride-releasing resin (Z100TM 3M, St. Paul, MN, USA) and a glass containing resin-based composite (Tetric EvoCeram Bulk Fill, Ivoclar/Vivadent AG, Schaan, Liechtenstein), which contains fluoride. Class V preparations were placed on 22 premolars; the gingival margin was below the cementoenamel junction and the occlusal margin was placed above the cemento-enamel junction. Ten teeth were randomly selected to be restored with Z100 while the other 10 were restored with Tetric EvoCeram Bulk Fill. Both groups were restored following manufacturer’s instructions. All teeth had an acid resistant varnish placed within one millimeter of the preparation margins. Both groups were placed in artificial caries challenge solution (pH 4.4). At the end of the 4 days; 100 µm buccolingual sections were obtained for each tooth; these were photographed under polarized light microscopy and the demineralized areas adjacent to the restorations were measured and quantified. The mean (±S.D.) area (µm2) of demineralization from the occlusal margin (enamel) and dentin margin were: Z100 2781.889 ± 1045.213; 3960.455 ± 705.964 and for Tetric EvoCeram Bulk Fill 1541.545 ± 1167.027; 3027.600 ± 512.078. Student’s t-test indicated that there was significantly less enamel and dentin demineralization adjacent to Tetric EvoCeram Bulk Fill compared to Z100; there was significantly less demineralization in enamel compared to dentin in both Tetric EvoCeral Bulk Fill and Z100. Tetric EvoCeram Bulk Fill performed better inhibiting demineralization at restoration margins when compared to Z100 and provided better demineralization inhibition in enamel than cementum/dentin.

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