scholarly journals JUSTIFICATION FOR THE COMBINED USE OF PROPOFOL AND DEXMEDETOMIDINE IN ELECTIVE PROCEDURAL SEDATION

2021 ◽  
pp. 9-27
Author(s):  
M.M. PYLYPENKO ◽  
B.V. MYKHAYLOV
Keyword(s):  
Opioid Analgesics ◽  
Procedural Sedation ◽  
Early Recovery ◽  
Combined Use ◽  
Level Of Consciousness ◽  
Controlled Mechanical Ventilation ◽  
Inflammatory Drugs ◽  
The One ◽  
Higher Doses ◽  
Recovery Of Consciousness

Procedural sedation (PS) is the technique of administering sedatives with or without analgesics to induce a condition in which the patient can tolerate unpleasant procedures while maintaining cardio-respiratory function. Planned PSs are performed with procedures of various invasiveness, painfulness and duration, but by definition, they do not reach the depth of general anesthesia and do not require the use of respiratory support or controlled mechanical ventilation, and even more – muscle relaxants. For effective PS, it is extremely important to establish verbal contact with the patient and achieve a stable emotional state of the patient and carefully explain to him the details of the PS. When choosing the depth of PS, it’s necessary to reach a compromise between the degree of anesthesia and amnesia, on the one hand, and the effectiveness of spontaneous breathing, as well as the possibility of an early recovery of consciousness, on the other. If possible, the problem of pain (when consciousness is partially preserved) or nociceptive stimuli (when the level of consciousness is reduced or absent) is solved separately through the use of local or regional anesthesia. In addition, non-steroidal anti-inflammatory drugs (NSAIDs) and some other drugs with analgesic properties are often used, and opioid analgesics are avoided or used in small or minimal doses. Unlike anesthesia, even deep sedation cannot and should not completely prevent the patient from moving during intense pain / nociceptive stimuli. If necessary, the problem of patient movements is solved not only and not so much by further deepening sedation, but precisely by improving analgesia and/or fixing the patient for the duration of short-term painful manipulations. To achieve these goals, PS is most often used propofol, or its dexmedetomidine or midazolam. This publication focuses on the advantages of using a multimodal approach for prolonged PS, which allows for a significant reduction in the dose of corresponding drugs and rate of complications in comparison with sedation with a single anaesthetic at significantly higher doses.

scholarly journals Antioxidant and Chemopreventive Effect of Aliophen® Formulation Based on Malts and Hops

Antioxidants ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 29
Author(s):  
Idolo Tedesco ◽  
Carmela Spagnuolo ◽  
Stefania Bilotto ◽  
Angelo A. Izzo ◽  
Francesca Borrelli ◽  
...  
Keyword(s):  
Health Effects ◽  
Low Density Lipoprotein ◽  
Antioxidant Properties ◽  
Density Lipoprotein ◽  
Ldl Oxidation ◽  
Preneoplastic Lesions ◽  
Chemically Induced ◽  
Chemopreventive Effect ◽  
The One ◽  
Higher Doses

Experimental and clinical studies evidenced the health effects of moderate consumption of beer, mainly due to the presence of bioactive compounds, such as polyphenols, vitamins, or fibers. To exploit the potential beneficial effect on health and in disease prevention of these compounds, a new beverage based on barley malts and hops named Aliophen® has been designed, through a patented production process, with a high total polyphenolic amount compared to alcohol-free beer and similar to the one present in light and dark beers. In the present study, the antioxidant activity of Aliophen® against low-density lipoprotein (LDL) oxidation and its ability to protect erythrocytes from hemolysis have been characterized. Moreover, the chemopreventive effect of Aliophen® against colon cancer has been assessed, employing a mouse model of chemically induced carcinogenesis using azoxymethane (AOM). Data obtained showed that Aliophen at a low dose (3 mg/kg) inhibited the formation of preneoplastic lesions, polyps, and tumors. At higher doses (300 mg/kg) the protective effect was measured in the first phase of the onset of cancer. The antioxidant properties of Aliophen® were also observed in AOM-treated mice where it increased the serum antioxidant capacity. Based on the data presented, Aliophen® can exert promising health effects, including an anticancer capacity presumably associated with its antioxidant properties.

scholarly journals Comparative analysis of different methods of anesthesia in patients with acute pancreatitis using pain scales

2016 ◽  
Vol 97 (2) ◽  
pp. 217-221
Author(s):  
V N Shilenok ◽  
E V Nikitina
Keyword(s):  
Acute Pancreatitis ◽  
Comparative Analysis ◽  
Visual Analogue Scale ◽  
Pain Intensity ◽  
Epidural Anesthesia ◽  
Analogue Scale ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Aim. To conduct a comparative analysis of used anesthesia methods in patients with acute pancreatitis in intensive care units settings using pain scales.Methods. Depending on the anesthesia type, 44 patients with acute pancreatitis were divided into three groups: the first group received intramuscular injections of nonsteroidal anti-inflammatory drugs and spasmolytics, the second group - intramuscular injections of non-steroidal anti-inflammatory drugs and opioid analgesics, the third group - epidural anesthesia with local anesthetics. Comparative analysis of pain character, intensity was conducted, its dynamics in patients of all groups amid anesthesia was evaluated using a visual analogue scale, verbal rating scale, verbal descriptor scale, McGill pain questionnaire.Results. Baseline pain intensity in patients of all groups was high. Patients estimated this pain as «very strong». The time and the level of pain intensity reduction for various anesthesia types had differences. Pain syndrome was eliminated slower in patients of the second group. By the end of the 1st day, patients of this group continued to complain of «strong» pain. Pain intensity decreased only on the 2nd day - patients reported «moderate» pain. Pain syndrome was not completely eliminated in these patients for 2 days of anesthesia. 97.7% of patients reported that the visual analogue scale is the most acceptable pain assessment scale for them.Conclusion. In patients with acute pancreatitis, the most optimal anesthesia types are intramuscular nonsteroidal anti-inflammatory drugs with spasmolytics and prolonged epidural anesthesia with local anesthetics; intramuscular administration of opioid analgesics with non-steroidal anti-inflammatory drugs is less effective in relieving pain.

scholarly journals Return-to-Function Following Treatment of Dupuytren Contracture With Collagenase Clostridium Histolyticum Versus Fasciectomy

Hand ◽  
2020 ◽  
pp. 155894472091992
Author(s):  
Victoria M. Divino ◽  
Mitch DeKoven ◽  
David Hurley
Keyword(s):  
Opioid Analgesics ◽  
Lower Percentage ◽  
Surrogate Markers ◽  
Collagenase Clostridium Histolyticum ◽  
Clostridium Histolyticum ◽  
Inflammatory Drugs ◽  
Dupuytren Contracture ◽  
The Mean ◽  
Analgesic Use

Background: Dupuytren contracture (DC) treatment with collagenase clostridium histolyticum (CCH) has lower associated treatment costs than fasciectomy, but real-world, postprocedure return-to-function data are limited. Methods: This retrospective study used a US claims database and included adults treated for DC with CCH or fasciectomy (first treatment = index date), who had continuous health plan enrollment ≥360 days preindex and ≥90 days postindex (ie, 90-day follow-up). Analgesic use and physical therapy (PT) and occupational therapy (OT) visits during the follow-up were used as surrogate markers for return-to-function. Results: Overall, 1654 and 2745 patients were included in the CCH and fasciectomy cohorts, respectively. A significantly lower percentage of patients in the CCH versus fasciectomy cohort used opioid analgesics (32.3% vs 82.7%; P < .0001), used nonsteroidal anti-inflammatory drugs (8.6% vs 17.2%; P < .0001), or had ≥1 DC-specific PT or OT visit during follow-up (PT, 38.9% vs 45.3% [ P < .0001]; OT, 32.8% vs 38.0% [ P = .0006]). The mean number of DC-specific PT and OT visits (PT, 2.5 vs 6.4 [ P < .0001]; OT, 1.4 vs 1.9 [ P < .0001]) per patient was significantly lower in the CCH versus fasciectomy cohort. Conclusions: This analysis using surrogate markers suggests that CCH treatment may allow earlier return-to-function than fasciectomy in adults treated for DC.

scholarly journals Consumers' willingness to pay for ethical attributes

2014 ◽  
Vol 32 (6) ◽  
pp. 706-721 ◽  
Author(s):  
Li-Wei Mai
Keyword(s):  
Willingness To Pay ◽  
Design Methodology ◽  
Age Groups ◽  
Mean Value ◽  
Purchase Decision ◽  
Content Type ◽  
Level Of Consciousness ◽  
The Mean ◽  
The One ◽  
Additional Value

Purpose – In recent years, there has been a big increase in the use of ethical attributes as marketing appeals. The purpose of this paper is to examine consumers’ willingness to pay for three selected ethical attributes, namely “Organic”, “Recyclable Packaging” and “Fairtrade” in monetary terms. Design/methodology/approach – A modified choice-based experimental design with manipulation of the key constructs was used to estimate the mean value of how much consumers are willing to pay for the selected attributes attached to a box of premium chocolates. The results are based on the responses of a total of 208 consumers. Findings – Of the three attributes, “Recyclable Packaging” has the strongest influence on the purchase decision, although this attribute generates the least additional value. The aggregated result shows that although consumers are willing to pay more for the product with ethical attributes than the one that is without, still around a half of them are not willing to pay more. In terms of demographics, the results show no significant differences between the two genders or different age groups in their willingness to pay for ethical attributes. As might be expected, willingness to pay was correlated with the level of consciousness of the ethical attributes. Originality/value – The findings of this study help management to think practically about the value consumers willing to pay for the selected attributes. The results show a significant synergy in a combination of ethical attributes in products.

scholarly journals Combined use of stent-retriever and aspiration thrombectomy for cerebral venous sinus thrombosis involving the straight sinus: A case report

2017 ◽  
Vol 23 (6) ◽  
pp. 605-608 ◽  
Author(s):  
Syunsuke Taniguchi ◽  
Kei Harada ◽  
Masahito Kajihara ◽  
Kozo Fukuyama
Keyword(s):  
Sinus Thrombosis ◽  
Anticoagulation Therapy ◽  
Cerebral Venous Sinus Thrombosis ◽  
Stent Retriever ◽  
Venous Sinus ◽  
Aspiration Thrombectomy ◽  
Venous Sinus Thrombosis ◽  
Straight Sinus ◽  
Combined Use ◽  
Level Of Consciousness

Cerebral venous sinus thrombosis (CVST) is generally treated with anticoagulation therapy, however, endovascular therapy is considered for refractory cases. A 42-year-old woman presented with a progressive disturbance in consciousness, and diagnosed CVST in the straight sinus (SS). Recanalization of SS was achieved by emergent thrombectomy using aspiration catheter and stent-retriever system, and her level of consciousness improved immediately. The combined use of them aided the removal of the thrombus located in the SS.

scholarly journals Spinal pain: causes and treatment policy

2018 ◽  
Vol 12 (3) ◽  
pp. 53-60
Author(s):  
Yu. A. Olyunin
Keyword(s):  
Back Pain ◽  
Structural Changes ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Spinal Pain ◽  
Muscle Relaxants ◽  
Medical Problems ◽  
Relieve Pain ◽  
Inflammatory Drugs ◽  
Current Guidelines

Chronic pain in the spine is one of the most urgent medical problems. Clinical and instrumental studies fail to reveal that most patients with back pain have any structural changes that may contribute to its occurrence. It is considered that the pain may be caused by the strain of muscles and ligaments located in the lower back, by the overload of these segments, and by detraining. If the cause of the pain syndrome cannot be established, the pain in the spine is regarded as nonspecific. It is believed that behavioral, psychological, and social factors can play an important role in the development of pain. Therefore, current guidelines propose to apply a biopsychosocial approach in patients with back pain. At the same time, much attention is paid to patient self-treatment, exercise therapy, psychotherapy, and some other auxiliary methods. When nonpharmacological interventions are insufficiently effective, drug therapy is indicated. Nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol, opioid analgesics, and muscle relaxants are used to treat nonspecific spinal pain. Pharmacotherapy is usually initiated with the use of NSAIDs. They can effectively relieve pain sndrome, but the possibilities of their use in a large proportion of patients are significantly limited due to adverse reactions (ARs). Gastrointestinal and cardiovascular ARs most commonly occur. The likelihood of ARs can be substantially reduced by the use of aceclofenac (AirtalR) that is characterized by a favorable gastrointestinal and cardiovascular safety profile. Paracetamol, opioid analgesics, and muscle relaxants are also used in the combination treatment of these patients.

scholarly journals THREE DIMENSIONAL RECONSTRUCTION WORKFLOWS FOR LOST CULTURAL HERITAGE MONUMENTS EXPLOITING PUBLIC DOMAIN AND PROFESSIONAL PHOTOGRAMMETRIC IMAGERY

2017 ◽  
Vol IV-2/W2 ◽  
pp. 319-325 ◽  
Author(s):  
W. Wahbeh ◽  
S. Nebiker
Keyword(s):  
Three Dimensional ◽  
Public Domain ◽  
Bundle Adjustment ◽  
Islamic State ◽  
Model Completeness ◽  
Combined Use ◽  
Dimensional Reconstruction ◽  
Modelling Techniques ◽  
The One ◽  
The Web

In our paper, we document experiments and results of image-based 3d reconstructions of famous heritage monuments which were recently damaged or completely destroyed by the so-called Islamic state in Syria and Iraq. The specific focus of our research is on the combined use of professional photogrammetric imagery and of publicly available imagery from the web for optimally 3d reconstructing those monuments. The investigated photogrammetric reconstruction techniques include automated bundle adjustment and dense multi-view 3d reconstruction using public domain and professional imagery on the one hand and an interactive polygonal modelling based on projected panoramas on the other. Our investigations show that the combination of these two image-based modelling techniques delivers better results in terms of model completeness, level of detail and appearance.

scholarly journals RECOVERY OF CONSCIOUSNESS: OPPORTUNITIES FOR NEUROPSYCHOLOGICAL ASSESSMENT AND REHABILITATION

2021 ◽  
pp. 102-128
Author(s):  
Ekaterina V. Fufaeva ◽  
Yuri V. Mikadze ◽  
Anastasiia N. Cherkasova ◽  
Maria S. Kovyazina ◽  
Maria E. Baulina ◽  
...  
Keyword(s):  
Neuropsychological Assessment ◽  
Brain Lesions ◽  
Disorders Of Consciousness ◽  
Diagnostic Tools ◽  
Clinical Psychologist ◽  
Neuropsychological Rehabilitation ◽  
Rehabilitation System ◽  
Level Of Consciousness ◽  
Practical Guidelines ◽  
Recovery Of Consciousness

Relevance. Neuropsychological rehabilitation and assessment are the priority tasks in practice of a clinical psychologist. The modern rehabilitation system can be considered as a partnership between patients, their families and different specialists participating in the rehabilitation process. The existing approaches to neurorehabilitation are aimed at the earliest possible intervention. It`s of particular importance for patients with disorders of consciousness, whose number has been increasing in connection with the development of medicine in recent decades. This leads to the need to develop tools for specialized neuropsychological assessment and methods of neuropsychological rehabilitation of patients in the early stages of recovery of consciousness. Objective. To summarize neuropsychological diagnostic and rehabilitation experience of working with patients with disorders of consciousness after brain lesions. Methods. We analyze practical guidelines, applied research and our own hands-on experience of working with patients with disorders of consciousness after brain lesions. Results. Based on the analysis, the recommended diagnostic tools are formulated that can be used to identify the current level of consciousness and to assess various parameters of psychic activity of patients with disorders of consciousness. In addition, the main directions and neuropsychological methods of rehabilitation work recommended for recovery of consciousness and continuing to be developed now are highlighted. Conclusion. A new diagnostic and rehabilitation material is presented, which is recommended for use in neuropsychological practice by practicing clinical psychologists with patients with disorders of consciousness after brain lesions.

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