First Attempt

2021 ◽  
pp. 125-146
Author(s):  
Martha Gershun ◽  
John D. Lantos
Keyword(s):  
Blood Pressure ◽  
Social Worker ◽  
Recovery Time ◽  
Lung Infection ◽  
Twin Cities ◽  
Open Procedure ◽  
Testing Schedule ◽  
Yom Kippur

This chapter begins with detailing the author's travel to Rochester for the upcoming surgery and the final pre-op tests. The chapter recounts the experience the author went through from the rigorous process and evaluation of managing the evaluation and testing schedule, working to get the blood pressure down, handling the packing and shipping for the lab kits, and staying healthy. It then presents all the risks of the surgery including the possibilities of bleeding and infection, and the unlikely event of needing to convert to an open procedure with a much more significant incision and longer recovery time. It also highlights the author's final appointment scheduled with a social worker assigned to her donor advocate. Ultimately, the chapter focuses on how the author managed her time in Rochester after the recipient's doctors found a lung infection and postponed the surgery. With the sudden turn of events, the chapter narrates the author's plan to just attend Yom Kippur Kol Nidre services, drive to the Twin Cities, and spend Yom Kippur day with her son and daughter-in-law.

Evaluation of Adrenergic Function

2016 ◽  
pp. 635-642
Author(s):  
Phillip A. Low
Keyword(s):  
Blood Pressure ◽  
Recovery Time ◽  
Baroreflex Sensitivity ◽  
Autonomic Function ◽  
Pressure Change ◽  
Pressure Recovery ◽  
Blood Pressure Change ◽  
Noninvasive Evaluation ◽  
Peripheral Neuropathies ◽  
Heart Period

Peripheral adrenergic function is important in the maintenance of postural normotension. It may be impaired in peripheral neuropathies, and this may be manifested as alterations in acral temperature, color, or sweating. Simple, accurate, and reproducible tests of peripheral adrenergic function are now routinely used in clinical autonomic laboratories. For noninvasive evaluation of autonomic function, tests of peripheral adrenergic function can be used to separately evaluate the vagal and adrenergic components of baroreflex sensitivity. The vagal component is derived from the heart period response to blood pressure change and the adrenergic component by the blood pressure recovery time in response to the preceding fall in blood pressure, induced by the Valsalva maneuver.This chapter describes methods used to determine peripheral adrenergic function and their value and shortcomings.

scholarly journals Effect of adding dexmedetomidine or remifentanil to thiopental in patients with mood disorder candidate for electroconvulsive therapy

2020 ◽  
pp. 1-6
Author(s):  
Faezeh Heidarbeigi ◽  
Hamidreza Jamilian ◽  
Anita Alaghemand ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Recovery Time ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean ◽  
Remifentanil Group

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.

scholarly journals Comparison of dexmeditomidine and propofol for hemodynamic and recovery characteristics in dilatation and curettage.

2020 ◽  
Vol 27 (06) ◽  
pp. 1244-1248
Author(s):  
Raza Farrukh ◽  
Waseem Sadiq Awan ◽  
Ahmed Hassan Khan ◽  
Asaad Rizwan Rana ◽  
Ahmed Aziz Jilani ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Control Trial ◽  
Recovery Room ◽  
Recovery Time ◽  
Loading Dose ◽  
Dilatation And Curettage ◽  
Randomized Control ◽  
Group D ◽  
Trial Setting

Objectives: To evaluate the hemodynamic and recovery characteristics of dexmeditomidine and propofol in dilatation and curettage. Study Design: Randomized control trial. Setting: Department of Anaesthesia, DHQ Teaching Hospital Sargodha. Period: March 2016 to December 2017. Material & Methods: Patients undergoing dilatation & curettage were randomly divided into two groups, group P received IV propofol 1.5mg/kg slowly over 5 min and group D received dexmeditomidine at a loading dose of 1µg/kg followed by 0.5 µg/kg/h. During the procedure blood pressure and heart rate were compared in both groups. In the recovery room, recovery time was compared in both groups by using modified aldrete score. Results: In Group D, the decrease in heart rate was statistically significant when compared with group P. Both groups showed a decrease in MAP but results were not statistically significant when compared in both groups. Patients in group D were discharged earlier from recovery room than group P and results were statistically significant. Conclusion: Dexmeditomodine provides better recovery than propofol so it is a suitable drug for day care minor surgical procedures. Similarly dexmeditomidine is superior to propofol by providing less respiratory depression intraopertaively.

Comparison of anesthetic and cardiorespiratory effects of diazepam-butorphanol-ketamine, acepromazine-butorphanol-ketamine, and xylazine-butorphanol-ketamine in ferrets

1998 ◽  
Vol 34 (5) ◽  
pp. 407-416 ◽  
Author(s):  
JC Ko ◽  
TA Smith ◽  
WC Kuo ◽  
CF Nicklin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Body Weight ◽  
Recovery Time ◽  
Ventricular Arrhythmias ◽  
Muscle Relaxation ◽  
Ventilatory Function ◽  
Treatment Groups ◽  
Sedative Effects ◽  
Group A

Ten ferrets were used in a crossover study to determine the sedative effects of intramuscularly administered diazepam (3 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight); acepromazine (0.1 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight); and xylazine (2 mg/kg body weight)-butorphanol (0.2 mg/kg body weight)-ketamine (15 mg/kg body weight). All of the ferrets became laterally recumbent following the administration of each drug combination. The xylazine-butorphanol-ketamine combination induced significantly longer (p less than 0.05) durations of tail-clamp analgesia (mean+/-standard deviation [SD], 81.0+/-19.1 min versus 20.5+/-25.4 min and 30.0+/-26.9 min), dorsal recumbency (mean+/-SD, 94.6+/-13.6 min versus 75. 6+/-34.7 min and 55.2+24.8 min), and muscle relaxation suitable for endotracheal intubation (mean+/-SD, 67.1+/-23.0 min versus 7.0+/-22.1 min and 9.5+/-15.4 min) than the diazepam-butorphanol-ketamine and acepromazine-butorphanol-ketamine combinations, respectively. The recovery time from dorsal recumbency to standing was not significantly different among the three treatment groups. The heart rate was significantly lower in the xylazine-butorphanol-ketamine group; however, systolic blood pressure was not significantly different among the treatment groups. Ventilatory function was more depressed in the diazepam-butorphanol-ketamine and xylazine-butorphanol-ketamine groups than in the acepromazine-butorphanol-ketamine group. A period (approximately 45 minutes) of hypoxia was observed in the xylazine-butorphanol-ketamine-treated ferret. Of the three combinations evaluated in ferrets, xylazine-butorphanol-ketamine was concluded to be the most effective anesthetic combination. However, hypoxemia and ventricular arrhythmias were observed in the xylazine-butorphanol-ketamine-treated ferrets, so the effectiveness of the xylazine-butorphanol-ketamine combination should be weighed against its cardiorespiratory side effects.

Abstract WP450: Stroke Support Group Partnership With Community Wellness Program Provides Education and Interventions Improving Self-Care Outcomes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Nancy M Stoll ◽  
Keyword(s):  
Blood Pressure ◽  
Social Services ◽  
Support Group ◽  
Social Worker ◽  
Well Being ◽  
Blood Chemistry ◽  
Primary Care Providers ◽  
Lifestyle Behaviors ◽  
Care Providers ◽  
Wellness Program

Background and Purpose: The purpose of this program is to offer education and support with attention to post acute transitions. The multidisciplinary team: social worker, dietician, and registered nurse encourage the development of attainable behaviors and activities. Methods: The participants, (311), enrolled in the free three month program of 12 sessions. Upon enrollment blood chemistry, weight, Body Mass Index, and blood pressure are measured and recorded. Subsequent visits include weight and blood pressure measurements. The program is designed to promote a one to one relationship to foster lifestyle behaviors. These consults assist with goal identification and promote self-management. Nutritional education includes healthy eating guidelines. The social worker leads sessions on navigation of social services, financial wellness, accepting change, awareness of emotions, and stress triggers. Stroke prevention, personal risk factors, living with disabilities, importance of care coordination and transition of care are discussed with emphasis on following up with primary care providers and specialists. Results: Participants share results such as increase in physical activity, and feelings of well-being. In 2017 and 2018, outcomes include: 266 of the participants (86% of 311 totals) began the program with a BMI > 25. 145 participants lost a total of 792 pounds with small changes in diet and exercise. 134 participants began the program with a BP > 140/90 mmHg or a diagnosis of hypertension. Of these, 118 or 88% achieved a BP reading of ≤ 140/90 mmHg by their post program evaluation. In the first year of the program, 73 participants (46% of 158) began exercising regularly for the first time. In addition, class evaluations and narratives reveal positive lifestyle and behavioral changes for participants and their families Conclusions: In conclusion, partnering a stroke support group with a wellness program provides an effective collaboration pooling resources and knowledge supporting the patient and caregiver.

scholarly journals Effect of adding dexmedetomidine or remifentanil to thiopental in patients with mood disorder candidate for electroconvulsive therapy

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Faezeh Heidarbeigi ◽  
Hamidreza Jamilian ◽  
Anita Alaghemand ◽  
Alireza Kamali
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Recovery Time ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Significant Difference ◽  
The Mean ◽  
Remifentanil Group

Electroconvulsive therapy (ECT) is one of the appropriate treatments for many neuropsychiatric patients, especially those with mood disorders. Short-term complications of ECT include agitation and postictal. In this study, we compared the addition of dexmedetomidine or remifentanil to thiopental as the main anaesthetic used in ECT. In this double-blind randomised clinical trial, 90 patients with mood disorders (candidates for ECT) were divided into two groups based on their therapy: dexmedetomidine or remifentanil. In the first group (DG), patients were slowly injected intravenously with 0.5 μg/kg dexmedetomidine before induction of anesthesia. In the second group (GR), 100 μg of remifentanil was slowly injected intravenously.In addition, we collected demographic information such as respiratory rate, heart pulse rate, seizure time, mean of arterial blood pressure, recovery duration and the oxygen arterial saturation recorded after recovery. Data obtained were analysed by use of statistical software, SPSS-23. The mean age of both groups was approximately 37 years with the majority being men. There was no significant difference between the two groups in terms of age and sex, blood pressure, heart rate, duration of seizures and arterial oxygen saturation before ECT. The mean blood pressure and heart rate in the recovery group were lower in the dexmedetomidine group than in the remifentanil group and the hemodynamics in the dexmedetomidine group were more stable. The recovery time in the dexmedetomidine group was longer than that of the remifentanil group (p = 0.001). Both groups had approximately the same satisfaction and the rate of agitation after ECT was the same. Both remifentanil and dexmedetomidine as adjuvants lead to a decrease in patients' post-ECT hyperdynamic responses. In our study, we demonstrated that the effect of dexmedetomidine is greater than remifentanil. On the other hand, neither dexmedetomidine nor remifentanil had a negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time, when compared to remifentanil.

scholarly journals Blood pressure and cardiac autonomic modulation at rest, during exercise and recovery time in the young overweight

2016 ◽  
Vol 22 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Jaqueline Alves de Araújo ◽  
Gabriel Kolesny Tricot ◽  
Gisela Arsa ◽  
Marilene Gonçalves Queiroz ◽  
Kamila Meireles dos Santos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Recovery Time ◽  
Autonomic Modulation ◽  
Cardiac Autonomic Modulation

Comparison of 3 Measures of Physical Activity and Associations With Blood Pressure, HDL, and Body Composition in a Sample of Adolescents

2012 ◽  
Vol 9 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Mary O. Hearst ◽  
John R. Sirard ◽  
Leslie Lytle ◽  
Donald R. Dengel ◽  
David Berrigan
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Measurement Instrument ◽  
Twin Cities ◽  
Age And Gender ◽  
Prevalence Estimates ◽  
And Gender ◽  
Physical Activity Recall ◽  
Intended Use ◽  
Activity Questionnaire

Background:The association of physical activity (PA), measured 3 ways, and biomarkers were compared in a sample of adolescents.Methods:PA data were collected on 2 cohorts of adolescents (N = 700) in the Twin Cities, Minnesota, 2007–2008. PA was measured using 2 survey questions [Modified Activity Questionnaire (MAQ)], the 3-Day Physical Activity Recall (3DPAR), and accelerometers. Biomarkers included systolic (SBP) and diastolic blood pressure (DBP), lipids, percent body fat (%BF), and body mass index (BMI) percentile. Bivariate relationships among PA measures and biomarkers were examined followed by generalized estimating equations for multivariate analysis.Results:The 3 measures were significantly correlated with each other (r = .22–.36, P < .001). Controlling for study, puberty, age, and gender, all 3 PA measures were associated with %BF (MAQ = −1.93, P < .001; 3DPAR = −1.64, P < .001; accelerometer = −1.06, P = .001). The MAQ and accelerometers were negatively associated with BMI percentile. None of the 3 PA measures were significantly associated with SBP or lipids. The percentage of adolescents meeting the national PA recommendations varied by instrument.Conclusions:All 3 instruments demonstrated consistent findings when estimating associations with %BF, but were different for prevalence estimates. Researchers must carefully consider the intended use of PA data when choosing a measurement instrument.

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