scholarly journals Effect of Injection Pressure of Infiltration Anesthesia to the Jawbone

2016 ◽  
Vol 63 (3) ◽  
pp. 131-138 ◽  
Author(s):  
Kenji Yoshida ◽  
Eri Tanaka ◽  
Hiroyoshi Kawaai ◽  
Shinya Yamazaki
Keyword(s):  
Local Anesthetic ◽  
White Male ◽  
Injection Pressure ◽  
Time Interval ◽  
Time Intervals ◽  
Lidocaine Concentration ◽  
The Mean ◽  
High Concentrations ◽  
Infiltration Anesthesia ◽  
Local Anesthetic Infiltration

To obtain effective infiltration anesthesia in the jawbone, high concentrations of local anesthetic are needed. However, to reduce pain experienced by patients during local anesthetic administration, low-pressure injection is recommended for subperiosteal infiltration anesthesia. Currently, there are no studies regarding the effect of injection pressure on infiltration anesthesia, and a standard injection pressure has not been clearly determined. Hence, the effect of injection pressure of subperiosteal infiltration anesthesia on local anesthetic infiltration to the jawbone was considered by directly measuring lidocaine concentration in the jawbone. Japanese white male rabbits were used as test animals. After inducing general anesthesia with oxygen and sevoflurane, cannulation to the femoral artery was performed and arterial pressure was continuously recorded. Subperiosteal infiltration anesthesia was performed by injecting 0.5 mL of 2% lidocaine containing 1/80,000 adrenaline, and injection pressure was monitored by a pressure transducer for 40 seconds. After specified time intervals (10, 20, 30, 40, 50, and 60 minutes), jawbone and blood samples were collected, and the concentration of lidocaine at each time interval was measured. The mean injection pressure was divided into 4 groups (100 ± 50 mm Hg, 200 ± 50 mm Hg, 300 ± 50 mm Hg, and 400 ± 50 mm Hg), and comparison statistical analysis between these 4 groups was performed. No significant change in blood pressure during infiltration anesthesia was observed in any of the 4 groups. Lidocaine concentration in the blood and jawbone were highest 10 minutes after the infiltration anesthesia in all 4 groups and decreased thereafter. Lidocaine concentration in the jawbone increased as injection pressure increased, while serum lidocaine concentration was significantly lower. This suggests that when injection pressure of subperiosteal infiltration anesthesia is low, infiltration of local anesthetic to the jawbone may be reduced, while transfer to oral mucosa and blood may be increased.

scholarly journals Time Intervals From Onset of Clinical Manifestations to Treatment in Patients With Cancer at Hospital General San Felipe, Tegucigalpa, Honduras

2019 ◽  
pp. 1-7
Author(s):  
José A. Sánchez ◽  
Mayra G. Handal ◽  
Juan F. Vílchez Rodriguez ◽  
Sinthia I. Mejía ◽  
Annye P. Pagoaga
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Clinical Staging ◽  
Time Interval ◽  
Pathology Report ◽  
Time Intervals ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
The Mean ◽  
Mean Time

PURPOSE In cancer, clinical staging is related to outcomes, and this is linked to the evolution of the disease over time. In Honduras, cancer mortality is high, and time intervals from onset of symptoms to treatment of cancer are not known. We conducted a cross-sectional study to determine these intervals. PATIENTS AND METHODS This investigation was carried out from April 25 to August 30, 2018, and included 202 patients at the main cancer referral center in Honduras. For the purposes of the study, information was obtained from patients, their caregiver, medical records, or treatment cards. Patients older than age 18 years were included after informed consent was signed. RESULTS The mean time interval from onset of symptoms to cancer treatment was 232 days. Different intervals of time were identified, and the mean of these intervals was calculated in days as follows: 68 days from onset of symptoms to first medical evaluation; 146 days from first evaluation to oncologist consultation; 26 days from cancer specialist to the pathology report; and 86 days from the histopathologic diagnosis to the beginning of treatment. Once diagnosis was established, the average elapsed times to chemotherapy, radiotherapy, surgery, and chemoradiotherapy were 88, 102, 76, and 154 days, respectively ( P < .05, when surgery is compared against chemotherapy and radiotherapy). CONCLUSION The mean time interval from symptom presentation to treatment in patients with cancer is more than 7 months. This could explain the advanced stages of disease seen at the time of treatment in Honduras, which decrease chance of cure and increase the mortality rate of cancer). Appropriate intervention to decrease these intervals must be taken to reduce mortality.

scholarly journals Error growth and dynamical vectors during southern hemisphere blocking

2004 ◽  
Vol 11 (1) ◽  
pp. 99-118 ◽  
Author(s):  
M. Wei ◽  
J. S. Frederiksen
Keyword(s):  
Southern Hemisphere ◽  
Normal Modes ◽  
Time Interval ◽  
Random Perturbations ◽  
Time Intervals ◽  
Amplification Factors ◽  
Fast Growing ◽  
A Value ◽  
The Mean ◽  
Basic States

Abstract. The structural organization of initially random perturbations or "errors" evolving in a barotropic tangent linear model with time-dependent basic states taken from observations, is examined for cases of block development, maturation and decay in the Southern Hemisphere atmosphere during April, November and December 1989. We determine statistical results relating the structures of evolved errors to singular vectors (SVs), Lyapunov vectors (LVs) and finite-time normal modes (FTNMs). The statistics of 100 evolved error fields are studied for six day periods or longer and compared with the growth and structures of leading fast growing SVs, LVs and FTNMs. The SVs are studied in the kinetic energy (KE), enstrophy (EN) and streamfunction (SF) norms, while all FTNMs and the first LV are norm independent. The mean of the largest pattern correlations between the 100 error fields and dynamical vectors, taken over the five fastest growing SVs, in any of the three norms, or over the five fastest growing FTNMs, increases with increasing time interval to a value close to 0.6 after six days. Corresponding pattern correlations with the five fastest growing LVs are slightly lower. The leading dynamical vectors (SVs 1, FTNM1 or LV 1) generally, but not always, give the largest pattern correlations with the error fields. It is found that viscosity slightly increases the average correlations between the evolved errors and LV 1 and evolved SVs 1. Mean pattern correlations with fast growing dynamical vectors increase further for time intervals longer than six days. The properties of the dynamical vectors during Southern Hemisphere blocking are briefly outlined. After a few days integration, the structures of the leading evolved SVs in the KE, EN and SF norms, are in general quite similar and also similar to some of the dominant FTNMs that are norm independent. For optimization times of six days or less, the evolved SVs and FTNMs are, in general, different from the dominant LVs on the same day. Nevertheless, amplification factors of the first FTNMs and first LVs are very similar, and also similar to, but slightly larger than, the mean amplification factor of 100 initially random perturbations in the SF norm, while the amplification factors in the SF norm of KE SVs 1 and SF SV 1 are much higher. For longer optimization times, the first SVs and the first FTNM increasingly turn towards the leading LV with convergence achieved within a month.

Assessment of Fatigue Thresholds in 50-m All-Out Swimming

2014 ◽  
Vol 9 (6) ◽  
pp. 959-965 ◽  
Author(s):  
Susana M. Soares ◽  
Ricardo J. Fernandes ◽  
J. Leandro Machado ◽  
José A. Maia ◽  
Daniel J. Daly ◽  
...  
Keyword(s):  
Fatigue Threshold ◽  
Velocity Variation ◽  
Time Interval ◽  
Stroke Index ◽  
Time Intervals ◽  
Front Crawl ◽  
Mean Velocity ◽  
Individual Level ◽  
Variation Patterns ◽  
The Mean

Context:It is essential to determine swimmers’ anaerobic potential and better plan training, understanding physiological effects of the fatigue.Purpose:To study changes in the characteristics of the intracyclic velocity variation during an all-out 50-m swim and to observe differences in speed and stroking parameters between these changes.Methods:28 competitive swimmers performed a 50-m front-crawl all-out test while attached to a speedometer. The velocity–time (v[t]) curve off all stroke cycles was analyzed per individual using a routine that included a wavelet procedure, allowing the determination of the fatigue thresholds that divide effort in time intervals.Results:One or 2 fatigue thresholds were observed at individual level on the v(t) curve. In males, when 1 fatigue threshold was identified, the mean velocity and the stroke index dropped (P < .05) in the second time interval (1.7 ± 0.0 vs 1.6 ± 0.0 m/s and 3.0 ± 0.2 vs 2.8 ± 0.3 m/s, respectively). When 2 fatigue thresholds were identified, the mean velocity of the first time interval was higher than that of the third time interval (P < .05), for both male (1.7 ± 0.0 vs 1.6 ± 0.1 m/s) and female (1.5 ± 0.1 vs 1.3 ± 0.1 m/s) swimmers.Conclusion:One or 2 fatigue thresholds were found in the intracyclic velocity-variation patterns. Concurrently, changes in velocity and stroke parameters were also observed between time intervals. This information could allow coaches to obtain new insights into delaying the degenerative effects of fatigue and maintain stable stroke-cycle characteristics over a 50-m event.

scholarly journals Lidocaine Concentration in Oral Tissue by the Addition of Epinephrine

2016 ◽  
Vol 63 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Eri Tanaka ◽  
Kenji Yoshida ◽  
Hiroyoshi Kawaai ◽  
Shinya Yamazaki
Keyword(s):  
Oral Mucosa ◽  
Local Anesthetic ◽  
High Performance ◽  
White Male ◽  
Systemic Absorption ◽  
Mucosal Tissue ◽  
High Concentration ◽  
Time Points ◽  
Lidocaine Concentration ◽  
Anesthetic Concentration

The vasoconstrictive effect due to the addition of epinephrine to local anesthetic has been clearly shown by measuring blood-flow volume or blood anesthetic concentration in oral mucosal tissue. However, there are no reports on the measurement of anesthetic concentration using samples directly taken from the jawbone and oral mucosal tissue. Consequently, in this study, the effect of lidocaine concentration in the jawbone and oral mucosal tissue by the addition of epinephrine to the local anesthetic lidocaine was considered by quantitatively measuring lidocaine concentration within the tissue. Japanese white male rabbits (n = 96) were used as test animals. General anesthesia was induced by sevoflurane and oxygen, and then cannulation to the femoral artery was performed while arterial pressure was constantly recorded. Infiltration anesthesia was achieved by 0.5 mL of 2% lidocaine containing 1 : 80,000 epinephrine in the upper jawbone (E+) and 0.5 mL of 2% of epinephrine additive–free lidocaine (E0) under the periosteum. At specified time increments (10, 20, 30, 40, 50, and 60 minutes), samples from the jawbone, oral mucosa, and blood were collected, and lidocaine concentration was directly measured by high-performance liquid chromatography. No significant differences in the change in blood pressure were observed either in E+ or E0. In both E+ and E0 groups, the serum lidocaine concentration peaked 10 minutes after local anesthesia and decreased thereafter. At all time increments, serum lidocaine concentration in E+ was significantly lower than that in E0. There were no significant differences in measured lidocaine concentration between jawbone and mucosa within either the E+ or the E0 groups at all time points, although the E0 group had significantly lower jawbone and mucosa concentrations than the E+ group at all time points when comparing the 2 groups to each other. Addition of epinephrine to the local anesthetic inhibited systemic absorption of local anesthetic into the blood such that a high concentration could be maintained in the tissue. Epinephrine-induced vasoconstrictive effect was observed not only in the oral mucosa but also in the jawbone.

Angles, Traction, and Time after Delivery of Fetal Head: Interobserver Variation of Novel Visual Analogs

2017 ◽  
Vol 34 (14) ◽  
pp. 1424-1429 ◽  
Author(s):  
Nana-Ama Ankumah ◽  
Vidya Chauhan ◽  
Claudia Pedroza ◽  
Rodney McLaren ◽  
Sean Blackwell ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Interobserver Agreement ◽  
Interobserver Variability ◽  
Time Interval ◽  
Poor Agreement ◽  
Fetal Head ◽  
Time Intervals ◽  
The Mean ◽  
Mean Time ◽  
Singleton Pregnancies

Objective The objective was to ascertain interobserver variability for assessment of Angles of fetal head manipulation, Traction exerted on the fetal head, and Time interval from the emergence of the head to the feet (ATT) at vaginal delivery. Materials and Methods Singleton pregnancies of ≥36 weeks with vaginal delivery were included. Visual analogs were created to assess angles and traction, and mobile phone stopwatch was used to assess the time interval. The intraclass coefficient (ICC) was calculated to determine interobserver variability. Results Thirty-seven deliveries were analyzed. For the two observers, the median angle for downward manipulation was –5° vs –20° (interquartile range [IQR], –5 to –5 vs –30 to –10), ICC of 0.09 (poor agreement; 95% confidence interval [CI] –0.09, 0.32), and that for upward manipulation was 10° vs 20° (IQR, 10–15 vs 10–30), ICC of 0.25 (poor agreement; 95% CI –0.05, 0.52). ICC for lateral manipulation could not be calculated as it was not noted in 98% of deliveries. Mean traction was 2.5 versus 5.0, ICC of 0.36 (poor agreement; 95% CI –0.09, 0.72). The mean time intervals were 14.9 versus 14.0 seconds, ICC of 0.94 (excellent agreement, 95% CI 0.88–0.97). Conclusion With exception of time interval, interobserver agreement was poor in estimation of fetal head manipulation and traction.

scholarly journals Color Tissue Doppler to Analyze Fetal Cardiac Time Intervals: Normal Values and Influence of Sample Gate Size

2016 ◽  
Vol 39 (01) ◽  
pp. 56-68 ◽  
Author(s):  
Arne Willruth ◽  
Johannes Steinhard ◽  
Christian Enzensberger ◽  
Roland Axt-Fliedner ◽  
Ulrich Gembruch ◽  
...  
Keyword(s):  
Relaxation Times ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Frame Rate ◽  
Doppler Imaging ◽  
Time Interval ◽  
Third Trimester ◽  
Time Intervals ◽  
The Mean ◽  
Color Tissue Doppler

Abstract Purpose To assess the time intervals of the cardiac cycle in healthy fetuses in the second and third trimester using color tissue Doppler imaging (cTDI) and to evaluate the influence of different sizes of sample gates on time interval values. Materials and Methods Time intervals were measured from the cTDI-derived Doppler waveform using a small and large region of interest (ROI) in healthy fetuses. Results 40 fetuses were included. The median gestational age at examination was 26 + 1 (range: 20 + 5 – 34 + 5) weeks. The median frame rate was 116/s (100 – 161/s) and the median heart rate 143 (range: 125 – 158) beats per minute (bpm). Using small and large ROIs, the second trimester right ventricular (RV) mean isovolumetric contraction times (ICTs) were 39.8 and 41.4 ms (p = 0.17), the mean ejection times (ETs) were 170.2 and 164.6 ms (p < 0.001), the mean isovolumetric relaxation times (IRTs) were 52.8 and 55.3 ms (p = 0.08), respectively. The left ventricular (LV) mean ICTs were 36.2 and 39.4 ms (p = 0.05), the mean ETs were 167.4 and 164.5 ms (p = 0.013), the mean IRTs were 53.9 and 57.1 ms (p = 0.05), respectively. The third trimester RV mean ICTs were 50.7 and 50.4 ms (p = 0.75), the mean ETs were 172.3 and 181.4 ms (p = 0.49), the mean IRTs were 50.2 and 54.6 ms (p = 0.03); the LV mean ICTs were 45.1 and 46.2 ms (p = 0.35), the mean ETs were 175.2 vs. 172.9 ms (p = 0.29), the mean IRTs were 47.1 and 50.0 ms (p = 0.01), respectively. Conclusion Isovolumetric time intervals can be analyzed precisely and relatively independent of ROI size. In the near future, automatic time interval measurement using ultrasound systems will be feasible and the analysis of fetal myocardial function can become part of the clinical routine.

How to avoid the faster-is-slower effect in competitive evacuation?

2021 ◽  
Vol 2021 (12) ◽  
pp. 123405
Author(s):  
Hongpeng Qiu ◽  
Xinyu Yang ◽  
Xingchao Chen ◽  
Yuanyuan Xiong ◽  
Jian Ma ◽  
...  
Keyword(s):  
Probability Distribution ◽  
Power Law ◽  
Flow Rate ◽  
Cumulative Probability ◽  
Time Interval ◽  
Time Intervals ◽  
Interesting Phenomenon ◽  
Series Of Experiments ◽  
The Mean ◽  
Mean Time

Abstract The faster-is-slower (FIS) effect is an interesting phenomenon in crowd dynamics. However, the validity of FIS was not universally accepted without objection. A series of experiments was conducted by using a group of young students in a room evacuating through a narrow exit at two locations, i.e. a center exit and a corner exit. The mean time intervals of two consecutive persons passing through a center exit were 1.14 ± 0.09, 1.31 ± 0.43 and 1.42 ± 0.93 s at low, medium and high competitiveness, respectively, i.e. which was the FIS effect. However, the mean time intervals of two consecutive persons passing through a corner exit were 1.04 ± 0.07 and 0.85 ± 0.17 s at low and high competitiveness, respectively, which was contrary to the FIS effect. Furthermore, two series of circulation movement at high competiveness were studied in which all students were required to re-enter the room from another opening after getting out of the room and this process continued until the end of a test. The mean time interval of consecutive persons passing through the exits was around 2.39 ± 4.29 and 0.77 ± 0.25 s for the center exit and corner exit respectively, and the flow rate of the corner exit was around 3 times that of the center exit. The complementary cumulative probability distribution of the time intervals between consecutive students Δt was studied and it followed a power law, i.e. P Δ t ∼ Δ t − a l p h a . However, the study showed that alpha alone cannot well represent the efficiency of an evacuation. The experiment demonstrated that the FIS effect can be avoided by relocating the exit to the corner and the flow rate can be greatly improved, particularly in high competiveness conditions.

scholarly journals Factors Determining Retreatment Time Interval of Rituximab in Korean Patients With Rheumatoid Arthritis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ji-Won Kim ◽  
Ju-Yang Jung ◽  
Kichul Shin ◽  
Chang-Hee Suh ◽  
Hyoun-Ah Kim
Keyword(s):  
Rheumatoid Arthritis ◽  
Biologic Agents ◽  
University Hospital ◽  
Time Interval ◽  
Time Intervals ◽  
Factors Associated ◽  
On Demand ◽  
Persistence Rates ◽  
The Mean

Unlike other biologic agents for rheumatoid arthritis (RA) that are administered at regular intervals even without flare, rituximab can be administered according to the timing of retreatment determined by the physician. Recently, there has been a tendency to prefer on-demand administration for disease flares rather than regular retreatment. We aimed to investigate the retreatment patterns of rituximab in patients with RA and to identify factors associated with extension of the time interval between retreatment courses. This study included RA patients on rituximab treatment who were enrolled in the Korean Rheumatology Biologics registry (KOBIO) or treated at Ajou University Hospital. Previous or current concomitant conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), corticosteroids, number of previous biologic agents, withdrawal, and time intervals of rituximab retreatment were collected. In case of treatment failure, the reasons such as lack of efficacy, adverse events, and others, were also identified. A total of 82 patients were enrolled. The mean follow-up period from the first cycle of rituximab was 46.1 months, and the mean interval between the retreatment courses was 16.3 months. The persistent rates of rituximab after 5 years was 72.4%. Concomitant use of at least two csDMARDs (β = 4.672; 95% CI: 0.089–9.255, p = 0.046) and concomitant use of corticosteroids (β = 7.602; 95% CI: 0.924–14.28, p = 0.026) were independent factors for extending the time interval between the retreatment courses. In conclusion, RA patients treated with rituximab in Korea show high persistence rates. Concomitant use of two or more csDMARDs and concomitant use of corticosteroids with rituximab are associating factors of extending the retreatment time interval. These findings should be considered when selecting rituximab as a treatment for patients with RA.

scholarly journals Recovery of yeast from vented blood culture bottles

1975 ◽  
Vol 2 (1) ◽  
pp. 18-20
Author(s):  
G D Roberts ◽  
C Horstmeier ◽  
M Hall ◽  
J A Washington
Keyword(s):  
Blood Culture ◽  
Clinical Studies ◽  
Brain Heart Infusion ◽  
Blood Cultures ◽  
Time Interval ◽  
Time Intervals ◽  
The Mean ◽  
Mean Time ◽  
Brain Heart Infusion Medium

Rates of isolation of yeasts from blood cultures were significantly enhanced by venting vacuum blood culture bottles in studies of both stimulated and patients' blood cultures; however, the time interval to detection of positivity of yeasts in the clinical studies was significantly (P less than 0.01) shorter in a vented bottle with biphasic brain heart infusion medium than in a vented bottle with soybean-casein digest broth. The mean time intervals to detection of positivity were 2.6 days in the former and 5.2 days in the latter.

Oncological outcomes in extended intervals time betweeen preoperative chemoradiation with capecitabine and surgery in operable rectal adenocarcinoma: Experience at the National Cancer Institute of Peru.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15158-e15158
Author(s):  
Miguel Angel Muñoz ◽  
Manuel Giancarlo Palacios ◽  
Jenny Malca ◽  
Paola Catherine Montenegro ◽  
Iván Chávez ◽  
...  
Keyword(s):  
Overall Survival ◽  
National Cancer Institute ◽  
Rectal Adenocarcinoma ◽  
Disease Free Survival ◽  
Time Interval ◽  
Time Intervals ◽  
Free Survival ◽  
Distal Edge ◽  
The Mean ◽  
Disease Free

e15158 Background: The literature reports that longer interval between the end of neoadjuvantchemoradiotherapy (CRT) and surgery is associated with a better rate of pathologic complete response (pCR) in rectal cáncer. Optimal interval remains to be defined. The effects of the extended time intervals on the prognosis are not clear. The objective was to assess whether extended time intervals ( < 8, 8-12, > 12-20 and > 20 weeks) between the end of neoadjuvant CRT and surgery improve overall survival (OS), disease-free survival (DFS) and pathological outcomes Methods: Aretrospective study was conducted for 124 patients with rectal adenocarcinoma without evidence of metástasis (T1-4/N0-2/M0) at the time of diagnosis that underwent surgery with curative intent after neoadjuvant CRT with capecitabine and obtained R0 or R1 resection between January 2010 to December 2014 at National Cancer Institute of Peru. Patients undergoing emergency surgery and R2 resection have been excluded. Survival curves were calculated according to Kaplan-Meier method and compared with log-rank test Results: Of the 124 patients, 72 were women (58.1%). The average age was 59.5 years. All received neoadjuvant CRT. Rates of pCR in the four groups were 25.0%, 10.3%, 7.7% and 17.2%, respectively. No significant difference was found between the association of the radial (P = 0.418) and distal edge (P = 0.487), with time interval groups and similarly with resected (P = 0.308) and compromised nodules (p = 0.783). The median OS follow-up time was 39.5 months and for DFS was 34 months. No significant differences were observed in OS (p = 0.739) and DFS (p = 0.902) according to the four groups studied. Conclusions: We found that amplifying the time interval at 31.9 weeks did not change the mean radial and distal edge. It does not affect the mean of resected and compromised nodules and does not improve overall survival and disease-free survival. The present study is the only one that reports these results at these time intervals. It allows to extend the intervals of time for future studies that finally will define the best time interval for the surgery.

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