scholarly journals A Comparison of Dexmedetomidine Sedation With and Without Midazolam for Dental Implant Surgery

2012 ◽  
Vol 59 (2) ◽  
pp. 62-68 ◽  
Author(s):  
Ryo Wakita ◽  
Hikaru Kohase ◽  
Haruhisa Fukayama
Keyword(s):  
Patient Satisfaction ◽  
Amnesic Effect ◽  
Group 4 ◽  
Combined Use ◽  
Group 3 ◽  
Group 2 ◽  
Arousal Response ◽  
Dental Implant Surgery ◽  
Group 1

Dexmedetomidine (DEX) has a minimal respiratory depressive effect, which is beneficial for dentistry; however, it has the disadvantage of permitting an intraoperative arousal response such that the patient appears to be suddenly no longer sedated, and it has a variable amnestic effect. Since midazolam (MDZ) in an appropriate dose has a profound amnesic effect, we investigated whether additional MDZ compensates for the disadvantage of DEX and enables a better quality of sedation. Forty-three subjects were randomly divided into 4 groups. In group 1, MDZ (0.02 mg/kg) was administered intravenously, followed by a dose of 0.01 mg/kg every 45 minutes. After the first dose of MDZ, preloading with DEX (2 µg/kg/h for 10 minutes) was started and maintained with a dosage of 0.5 µg/kg/h. In group 2, MDZ was infused in the same manner as in group 1, followed by preloading with DEX (1 µg/kg/h for 10 minutes) and maintenance (0.3 µg/kg/h). In group 3, MDZ was infused 0.03 mg/kg, and a dose of 0.01 mg/kg was given every 30 minutes; DEX was administered at the same as in group 2. In group 4, DEX was infused using the same method as in group 1 without MDZ. The sedation levels, amnesia, and patient satisfaction were also investigated. Group 2 had a lower sedation level and a poor evaluation during the first half of the operation. Group 4 did not exhibit an amnesic effect at the beginning of the operation. An evaluation of the degree of patient satisfaction did not reveal any differences among the groups. Optimal sedation was achieved through the combined use of MDZ (0.02 mg/kg with the addition of 0.01 mg/kg every 45 minutes) and DEX (2 µg/kg/h for 10 minutes followed by 0.5 µg/kg/h).

scholarly journals Single sitting multimodality management of hemorrhoid

2021 ◽  
Vol 8 (11) ◽  
pp. 3302
Author(s):  
Mahendra P. Singh
Keyword(s):  
Variable Number ◽  
Concomitant Treatment ◽  
Stage Management ◽  
Group 4 ◽  
Number Of Patients ◽  
Clinical Complexity ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: It is usual to face clinical complexity in piles patients. They usually present with variable number of pile masses and in different grades of progression. This led to the idea of offering concomitant single stage management in our hemorrhoid patients matching to our criteria. We conducted hospital based descriptive study among the patients coming to my clinical practice falling in grade-1-3.Methods: All the patients falling in grade-1-3 and matching to our criteria were included. The study was conducted   from January 2012 to December 2020. Place of study was basically at two centres: Karamdeep medical centre, Kanpur and Mayo health care, Mohali. Total number of patients were 581. Patients having grade-4 piles and with local co-morbidities were excluded from the study. Modalities of treatment used were sclerotherapy, band ligation and hemorrhoidectomy.Results: Patients managed were divided into four groups – group 1 included patients with piles in grade-1; group-2 included patients having piles in grade-1 and 2; group-3 included patients having piles in grade-1 and 3; and group-4 included patients having piles in grade-1, 2 and 3. Total 952 pile masses were treated in 581 patients. Sclerotherapy was required in 732 (77%) masses, banding in 99 (10.3%) masses and surgery in 122 (12.7%) masses.Conclusions: Concomitant treatment policy proved to be comprehensive way to tackle pile patients of grade-1-3. Mixed and matched method using surgical and non-surgical modalities in a single sitting proved to be beneficial. 86.4% cases were cured this way. Cost of the treatment was economical with lesser complications including local mutilation and better quality of life.

Patient-reported outcomes for determining prognostic groups in veterans with stage IV solid tumors starting systemic therapy.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 48-48
Author(s):  
Victor Tsu-Shih Chang ◽  
Charles B. Scott ◽  
Melanie L. Gonzalez ◽  
Jan Einhorn ◽  
Houling Yan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Solid Tumors ◽  
Systemic Therapy ◽  
Stage Iv ◽  
Group 4 ◽  
Prognostic Groups ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

48 Background: A Recursive Partitioning Analysis (RPA) prognostic algorithm based on quality of life and symptoms predicted 4 groups with distinct median survivals in patients with metastatic solid tumors receiving chemotherapy (ASCO 2013, Abst 9567). We update our findings. Methods: The RPA algorithm is based upon Karnofsky performance status (KPS), Functional Assessment of Cancer Therapy (FACT) physical well-being (PWB) subscale, and Memorial Symptom Assessment Scale Short Form (MSAS-SF) physical symptom distress (PHYS) subscale. Starting in 2007, a convenience sample of Veterans who were prescribed systemic treatment for their cancer was enrolled in an IRB approved protocol, and completed quality of life (FACT- G) and symptom (MSAS SF) questionnaires at the first cycle of treatment. We analyzed records of patients with stage IV metastatic solid tumors enrolled through June 2013, and determined survival as of June 15, 2014. Analyses were performed with STATA 11.0. Results: There were 97 patients(pts). The median age was 64 yrs, range 27-88. Males comprised 95 (98%) pts. First line chemotherapy was given to 78 (80%) pts. The most common primary sites were lung cancer 33 (35%), prostate 17 (17%) and colon 11 (11%) pts. Median KPS was 90% range 40-100%, PWB median 23 (range 6-28), and MSAS SF median PHYS 0.76 (range 0-3.2). Overall median survival was 285 days (range 6-2,358) and 80 pts (82%) had died. There was 1 pt in group 1, 58 in group 2, 12 in group 3, and 23 in group 4. The patient in group 1 had uterine sarcoma. Median survival (days) by RPA group was 155 for group 1, 177 for group 2, 292 for group 3, and 674 for group 4 (p=.011). Conclusions: These preliminary findings suggest that this algorithm is capable of dividing patients with metastatic solid tumor who are starting systemic therapy into prognostic groups. Further development is indicated.

scholarly journals Comparative characteristics of the quality of life of asthma patients with different types of airway hyperresponsiveness to physical stimules

2021 ◽  
pp. 55-61
Author(s):  
N. L. Perelman
Keyword(s):  
Quality Of Life ◽  
Airway Hyperresponsiveness ◽  
Group 4 ◽  
Sf 36 ◽  
Different Types ◽  
Asthma Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To compare the nature and degree of influence of different types of airway hyperresponsiveness (AHR) on the general and specific quality of life (QoL) of patients with asthma and control over the disease.Materials and methods. 234 patients with mild-to-moderate asthma, aged from 18 to 60 years old, were interviewed and examined. Depending on the presence of one or another type of AHR, 4 groups were formed: group 1 included 60 patients with cold AHR, group 2 – 75 patients with hypoosmotic AHR, group 3 – 35 patients with hyperosmotic AHR, group 4 – 64 patients with exercise-induced bronchoconstriction (EIB). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined using the ACT questionnaire. Lung function was assessed by spirometry.Results. When comparing QoL between groups, statistical differences were obtained for most of the SF-36 scales, with the exception of the domains “Role Physical” (RP) and “Bodily Pain” (BP), and their presence and significance varied depending on the types of AHR being compared. The lowest QoL indices were found in group 1 of patients with cold AHR according to the domains “Physical Activity” (PA), RP, BP, and “Role Emotional” (RE). The lowest indices for the domains “General Health” (GH), “Vitality” (V) and “Mental health” (MH) were found in the respondents of the 2nd group. Most of the highest QoL indicators in the compared groups were found in patients of group 4 with EIB in the domains PA, RP, V, RE, and MH. When carrying out a comparative analysis, the maximum number of significant differences was found between the groups with cold AHR and EIB. A comparative study of QoL using a special AQLQ questionnaire showed the lowest indices for the “Activity” and “Symptoms” domains in groups 1 and 2 of asthma patients. In addition, in group 1, the minimum QoL values were recorded for the “General QoL” domain (3.6±0.2 points), and in group 2, for the “Environment” domain (2.9±0.3 compared with 3.9±0.2 points in group 3, p<0.01).Conclusion. This study has demonstrated the multifaceted effect of AHR on health-related QoL, dependent on sensitivity to a particular physical stimulus and the season of maximum trigger action. The subjective assessment of psychosocial functioning is most differentiated according to the GH domain of the SF-36 questionnaire. The greatest negative impact on the QoL indices is exerted by the cold and hypoosmotic AHR, the least – by the EIB. The assessment of QoL allows to get a full picture of the perception of the patient's health level at the moment and in the given conditions.

scholarly journals EPIDURAL ANAESTHESIA

2010 ◽  
Vol 17 (02) ◽  
pp. 318-324
Author(s):  
AZMAT RIAZ ◽  
HAMID SAEED MALIK ◽  
BILAL YASIN
Keyword(s):  
Patient Satisfaction ◽  
Epidural Anaesthesia ◽  
Knee Arthroscopy ◽  
Single Shot ◽  
Care Hospital ◽  
Day Case ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Objectives: To compare the benefits and adverse effects of three different drug combinations when used for single-shot epidural anaesthesia for day-case arthroscopy. Design of Study: Prospective, random, double-blind study. Setting: A 250 bedded secondary care hospital. Period: From October 2005 to Feb 2007. Material and Methods: We studied 75 adult male patients, aged between 23 to 63 years, weight <100 kg, ASA physical status I or II undergoing elective knee arthroscopy as day-case procedure. Patients were randomly divided into three groups ( 25 patients in each group) and single-shot epidural anaesthesia was performed using a total of 20 ml epidural lignocaine 2% (Group 1) bupivacaine 0.5% (Group 2) or a mixture containing lignocaine 2% and bupivacaine 0.5%, 10 ml each (Group 3). Results: Time to achieve maximum height (in minutes) was similar in group-1 and group-3 (10±4 and 11±2), but it was significantly longer in group-2 (20±3). Block time was comparable in group-2 and 3 (130±25 and 118±37) but it was significantly shorter in group-1 (60±20). Post-operative discharge time was longest in the group-2, and comparable in group-1 and 3.The incidence of complications like bradycardia, hypotension, nausea and vomiting were more in group-2 and less in group-1 and group-3. Inadequate anaesthesia was more in group-1 and least in other two groups.Four patients of group-1 needed rescue analgesia and two from same group needed general anaesthesia as compared to none in group-2 and group-3. In 4-point patient satisfaction scale, maximum patients from Group-3 rated it perfect while most patients from group-1 were not satisfied with the quality of anaesthesia. Conclusions: The results of our study show that a 50-50 mixture of lignocaine and bupivacaine withfentanyl 50 μg when used for single-shot epidural anaesthesia for day case knee arthroscopy, provides better quality of analgesia, with fewer incidences of side effects and more patient satisfaction as compared to lignocaine or bupivacaine alone.

scholarly journals Early and long-term results of surgical treatment of Hirschsprung's disease in children

2018 ◽  
Vol 99 (2) ◽  
pp. 230-234
Author(s):  
R S Polukhov
Keyword(s):  
Quality Of Life ◽  
Hospital Stay ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
Group 1

Aim. To assess the safety, functional activity and quality of life of patients with Hirschsprung's disease operated by different methods. Methods. The study included 86 children operated on for Hirschsprung's disease. Patients were divided into four groups: group 1 - 44 (51.2%) patients underwent Duhamel-Martin procedure; group 2 - 14 (16.3%) patients underwent Soave-Boley procedure; group 3 - 22 (25.6%) patients underwent transanal endorectal resection; and group 4 - 16 (18.6%) patients underwent laparoscopical Soave-Georgeson procedure. The results were comparatively evaluated immediately and one year after the surgery. To assess the quality of life after surgery, a visual questionnaire Peds QLtm 4.0 was used. Results. Minimal duration of the surgery and related anesthesia was registered in groups 3 and 4, the difference with groups 2 and 3 being statistically significant (p <0.05). Duration of postoperative pain management in group 1 was 3.2±0.7 days, in group 2 - 3.3±0.7 days, while in groups 3 and 4 - 2.5±0.5 days (р ˂0.05). Minimal hospital stay after the surgery was registered in group 4 (9±2 days), which is less than in group 1 by 1.7 times, in group 2 - by 1,5 times (р ˂0.05). The second shortest hospital stay was observed in patients from group 3 (10±2 days): it was 1.4 and 1.3 times shorter tahn in groups 1 and 2, respectively (р ˂0.05). At the assessment of one-year functional results satisfactory results were obtained in group 1 in 20 (45.46%) patients, in group 2 - in 7 (50%), in group 3 - in 12 (54.55%), in group 4 - in 12 (75%) patients. Unfavorable results were observed in group 1 in 6 (13.64%) patients, in group 2 - in 2 (14.29%), in group 3 - in 2 (9.09%), in group 4 - in 0 (0%). The best quality of life according to all parameters was observed among patients from groups 3 and 4 (р ˂0.05). Conclusion. The quality of life of patients with Hirschsprung's disease after transanal endorectal resection and laparoscopic Soave-Georgeson procedure was higher than after Duhamel-Martin and Soave-Boley procedures; Soave-Boley procedure is preferable due to good regulation of the defecation act by patients.

Can a different pasta making process preserve the starch’s ultrastructure, increasing its digestibility?

2021 ◽  
pp. 1-11
Author(s):  
Antonio Vittorino Gaddi ◽  
Maria Teresa Savo ◽  
Fabio Capello ◽  
Gaetano Castiglione
Keyword(s):  
Cross Sections ◽  
Heat Exposure ◽  
Group 4 ◽  
Group 3 ◽  
Traditional Process ◽  
Group 2 ◽  
Average Size ◽  
Exposure Technique ◽  
Group 1

BACKGROUND: Pasta plays an important role in human nutrition, nevertheless its organoleptic, structural and bromatologic properties have not been completely studied. OBJECTIVE: The study aims to compare the ultrastructure pasta cross-sections produced with reduced mechanic stress and low heat exposure technique (Pietro Massi Technology ™) to common samples obtained with traditional technology in order to assess if a different process can alter the ultrastructure of starch and then, its digestibility. METHODS: A comparative study was performed on the ultrastructure of pasta using scanning electron microscopy (S.E.M). 55 were pasta cross-sections made with Pietro Massi technology, 33 were samples from different pasta factory produced using traditional process, for a total of 88 samples analysed. RESULTS: According to an Index based on what it was observed at one slide at S.E.M we classified samples and compared the number of grains, caves and canals visible, their dimensions in μm and average size of grains. The number of grains in group 1 (9.06±5.01) in group 2 (5.71±5.77), in group 3 (5.93±7.65) resulted significative more elevated compared to group 4 (0.73±2.58); in group 1 and group 2 the number of caves observed was higher than group 4. The size in μm of canals resulted significantly more elevated in group 1 than group 3 (p = 0.008), group 2(p = 0.013), and group 4 (p = 0.02). CONCLUSION: The analysis of average size of caves and canals in μm, the number of caves and grains demonstrated in samples obtained with Massi technology elevated values compared to samples obtained with traditional technique. The number of caves, grains and canals visible in the starch surface demonstrate the high quality of this pasta because they likely ensure penetration of water during cooking, facilitating at the same time the penetration of pancreatic amylases during digestion, suggesting a better digestibility in pasta produced according to this methodology.

scholarly journals Effect of Unbalanced Nourishment on Growth Period to Memory in Mice

2021 ◽  
Vol 1 (1) ◽  
pp. 9-13
Author(s):  
Arief Budi Yulianti ◽  
Widayanti Widayanti ◽  
Ike Rahmawaty
Keyword(s):  
Quality Of Life ◽  
First Generation ◽  
Growth Period ◽  
Group 4 ◽  
Embryo Nutrition ◽  
Group 3 ◽  
Group 2 ◽  
Protein Feed ◽  
Group 1

Quality of life in adulthood is determined by the quality of life of the embryo. Nutrition determines the quality of embryo life. The purpose of this study was to analyze the effects of unbalance nourishment on memory in the mouse. This research is an experimental study using mice as experimental animals.  Twenty-four mice were divided into four groups. Group 1 was given standard nourish (Feed 1), Group 2 was given high carbohydrate (Feed 2), Group 3 was given high protein (Feed 3), Group 4 was given a high fat (Feed 4) from weaning to pregnancy. Parameters measured were a memory with new objects recognition (NOR) methods. The result was mice with unbalance nourishment had memory decrease between after and before treatment. This can be explained by the calorie content of each feed. Feed 2 contains the smallest calories (2.89 Kcal). This means that the nutritional components are not sufficient as well as the calorie needs. Further research is unbalanced nourishment in the first generation will be passed on to the next generation.

scholarly journals Analysis of The Distribution Characteristics of Thoracolumbar Compression Fractures

2020 ◽  
Author(s):  
Ming-Xue Che ◽  
Ming-Xi Liu ◽  
Shao-Kun Zhang ◽  
Zhen-Shan Lv ◽  
Yuan-Zhe Jin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Osteoporotic Fracture ◽  
Financial Burden ◽  
Compression Fracture ◽  
P Value ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background : Vertebral compression fracture (VCF) is the most common osteoporotic fracture which significantly decreases patient’s quality of life and high risk of subsequent osteoporotic fracture. VCFs also result in substantial financial burden on the public health system. Studying the characteristics of VCFs with analyzing the distributional differences by age and sex is meaningful for us to prevent and treat the VCFs.Methods: We retrospectively reviewed the patients with thoracolumbar VCF from December 2012 to June 2018 in our department. A total of 675 cases met the study inclusion criteria for analysis. We divided the patients into four groups by age with every 10 years from 50 to 89 years old. Morbidity in each sex, the occurrence of single- or multisegment fractures and the distribution of fractures from T7 to L5 was calculated for every group. All the data was tested by SPSS.Results: The highest proportion of male patients was in Group 4 (80-89 years old), and the lowest was in Group 2 (60-69 years old). The highest and lowest proportion of female patients was in Group 2 and Group 4, P value < 0.05.The highest proportion of multisegment fractures was in Group 3 (70-79 years old), and the lowest was in Group 1 (50-59 years old). The highest proportion of single-segment fractures was in Group 1, and the lowest was in Group 3, P > 0.05.Compared with the other vertebral fractures, L4 had P <0.05; others were all >0.05.Conclusions: As affected by individualized stress mechanisms of different vertebras and degree of osteoporosis, thoracolumbar VCFs have different characteristics that could assist physicians in carefully selecting treatment regimens to reduce pain and complications and improve the quality of life of patients.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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.

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