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Sample records for 10th postoperative day

  1. Air leakage on the postoperative day: powerful factor of postoperative recurrence after thoracoscopic bullectomy

    PubMed Central

    Jeon, Hyun Woo; Kye, Yeo Kon; Kim, Kyung Soo

    2016-01-01

    Background Primary spontaneous pneumothorax (PSP) is a relatively common disorder in young patients. Although various surgical techniques have been introduced, recurrence after video-assisted thoracoscopic surgery (VATS) remains high. The aim of study was to identify the risk factors for postoperative recurrence after thoracoscopic bullectomy in the spontaneous pneumothorax. Methods From January 2011 through March 2013, two hundreds and thirty two patients underwent surgery because of pneumothorax. Patients with a secondary pneumothorax, as well as cases of single port surgery, an open procedure, additional pleural procedure (pleurectomy, pleural abrasion) or lack of medical records were excluded. The records of 147 patients with PSP undergoing 3-port video-assisted thoracoscopic bullectomy with staple line coverage using an absorbable polyglycolic acid (PGA) sheet were retrospectively reviewed. Results The median age was 19 years (range, 11−34 years) with male predominance (87.8%). Median postoperative hospital stay was 3 days (range, 1−10 days) without mortality. Complications were developed in five patients. A total of 24 patients showed postoperative recurrence (16.3%). Younger age less than 17 years old and immediate postoperative air leakage were risk factors for postoperative recurrence after thoracoscopic bullectomy by multivariate analysis. Conclusions Immediate postoperative air leakage was the risk factor for postoperative recurrence. However, further study will be required for the correlation of air leakage with recurrence. PMID:26904217

  2. 90-day postoperative mortality is a legitimate measure of hepatopancreatobiliary surgical quality

    PubMed Central

    Mise, Yoshihiro; Vauthey, Jean-Nicolas; Zimmitti, Giuseppe; Parker, Nathan H.; Conrad, Claudius; Aloia, Thomas A.; Lee, Jeffery E.; Fleming, Jason B.; Katz, Matthew H. G.

    2015-01-01

    Objective To investigate the legitimacy of 90-day mortality as a measure of hepatopancreatobiliary quality. Summary Background Data The 90-day mortality rate has been increasingly but not universally reported after hepatopancreatobiliary surgery. The legitimacy of this definition as a measure of surgical quality has not been evaluated. Methods We retrospectively reviewed the causes of all deaths that occurred within 365 postoperative days in patients undergoing hepatectomy (n = 2811) and/or pancreatectomy (n = 1092) from January 1997 through December 2012. The rates of surgery-related, disease-related, and overall mortality within 30 days, within 30 days or during the index hospitalization, within 90 days, and within 180 days following surgery were calculated. Results Seventy-nine (3%) surgery-related deaths and 92 (3%) disease-related deaths occurred within 365 days after hepatectomy. Twenty (2%) surgery-related deaths and 112 (10%) disease-related deaths occurred within 365 days after pancreatectomy. The overall mortality rates at 99 day and 118 days optimally reflected surgery-related mortality following hepatobiliary and pancreatic operations, respectively. The 90-day overall mortality rate was a less sensitive but equivalently specific measure of surgery-related death. Conclusions and Relevance The 99-day and 118-day definitions of postoperative mortality optimally reflected surgery-related mortality following hepatobiliary and pancreatic operations, respectively. However, among commonly reported metrics, the 90-day overall mortality rate represents a legitimate measure of surgical quality. PMID:25590497

  3. Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study.

    PubMed

    Campagna, Sara; Antonielli D'Oulx, Maria Delfina; Paradiso, Rosetta; Perretta, Laura; Re Viglietti, Silvia; Berchialla, Paola; Dimonte, Valerio

    2016-01-01

    Background. Because of economic reasons, day surgery rates have steadily increased in many countries and the trend is to perform around 70% of all surgical procedures as day surgery. Literature shows that postoperative pain treatment remains unfulfilled in several fields such as orthopedic and general surgery patients. In Italy, the day surgery program is not yet under governmental authority and is managed regionally by local practices. Aim. To investigate the trends in pain intensity and its relation to type of surgeries and pain therapy protocols, in postoperative patients, discharged from three different Ambulatory Surgeries located in North West Italy (Piedmont region). Method. The present study enrolled 276 patients who undergone different surgical procedures in ambulatory regimen. Patients recorded postoperative pain score twice a day, compliance with prescribed drugs, and pain related reasons for contacting the hospital. Monitoring lasted for 7 days. Results. At discharge, 72% of patients were under weak opioids, 12% interrupted the treatment due to side effects, 17% of patients required extra drugs, and 15% contacted the hospital reporting pain problems. About 50% of patients experienced moderate pain during the first day after surgery. Results from our study show that most of the patients experienced avoidable pain after discharge.

  4. Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study

    PubMed Central

    Antonielli D'Oulx, Maria Delfina; Paradiso, Rosetta; Perretta, Laura; Dimonte, Valerio

    2016-01-01

    Background. Because of economic reasons, day surgery rates have steadily increased in many countries and the trend is to perform around 70% of all surgical procedures as day surgery. Literature shows that postoperative pain treatment remains unfulfilled in several fields such as orthopedic and general surgery patients. In Italy, the day surgery program is not yet under governmental authority and is managed regionally by local practices. Aim. To investigate the trends in pain intensity and its relation to type of surgeries and pain therapy protocols, in postoperative patients, discharged from three different Ambulatory Surgeries located in North West Italy (Piedmont region). Method. The present study enrolled 276 patients who undergone different surgical procedures in ambulatory regimen. Patients recorded postoperative pain score twice a day, compliance with prescribed drugs, and pain related reasons for contacting the hospital. Monitoring lasted for 7 days. Results. At discharge, 72% of patients were under weak opioids, 12% interrupted the treatment due to side effects, 17% of patients required extra drugs, and 15% contacted the hospital reporting pain problems. About 50% of patients experienced moderate pain during the first day after surgery. Results from our study show that most of the patients experienced avoidable pain after discharge. PMID:28115878

  5. Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions.

    PubMed

    Carter, G; Goss, A

    2003-10-01

    This prospective randomized study analyses the use of a prescribed 4.8% tranexamic acid post-operative mouthwash over 2 days vs 5 days to prevent bleeding in patients taking warfarin who require dental extractions. Eighty-five patients therapeutically anticoagulated with warfarin for various conditions, ranging in age from 21 to 86 years and requiring dental extractions, were randomly divided into two groups. Group A postoperatively received a 4.8% tranexamic acid mouthwash to be used over a 2-day period. Group B received the same mouthwash and instructions postoperatively, to be taken over 5 days. All procedures were performed on an ambulatory basis under local anaesthetic by the same surgeon. Patients were reviewed 1, 3, and 7 days postoperatively to assess bleeding. Eighty-two of the 85 patients encountered no postoperative problems. Two patients in group A and one in group B had minor postoperative bleeds that required minor ambulatory intervention to control. This study shows that a 2-day postoperative course of a 4.8% tranexamic acid mouthwash is as equally effective as a 5-day course in controlling haemostasis post-dental extractions in patient's anticoagulated with warfarin.

  6. Music benefits on postoperative distress and pain in pediatric day care surgery.

    PubMed

    Calcaterra, Valeria; Ostuni, Selene; Bonomelli, Irene; Mencherini, Simonetta; Brunero, Marco; Zambaiti, Elisa; Mannarino, Savina; Larizza, Daniela; Albertini, Riccardo; Tinelli, Carmine; Pelizzo, Gloria

    2014-08-12

    Postoperative effect of music listening has not been established in pediatric age. Response on postoperative distress and pain in pediatric day care surgery has been evaluated. Forty-two children were enrolled. Patients were randomly assigned to the music-group (music intervention during awakening period) or the non-music group (standard postoperative care). Slow and fast classical music and pauses were recorded and played via ambient speakers. Heart rate, blood pressure, oxygen saturation, glucose and cortisol levels, faces pain scale and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were considered as indicators of response to stress and pain experience. Music during awakening induced lower increase of systolic and diastolic blood pressure levels. The non-music group showed progressive increasing values of glycemia; in music-group the curve of glycemia presented a plateau pattern (P<0.001). Positive impact on reactions to pain was noted using the FLACC scale. Music improves cardiovascular parameters, stress-induced hyperglycemia. Amelioration on pain perception is more evident in older children. Positive effects seems to be achieved by the alternation of fast, slow rhythms and pauses even in pediatric age.

  7. Association between day of the week of elective surgery and postoperative mortality

    PubMed Central

    Dubois, Luc; Vogt, Kelly; Vinden, Chris; Winick-Ng, Jennifer; McClure, J. Andrew; Roshanov, Pavel S.; Bell, Chaim M.; Garg, Amit X.

    2017-01-01

    BACKGROUND: In prior studies, higher mortality was observed among patients who had elective surgery on a Friday rather than earlier in the week. We investigated whether mortality after elective surgery was associated with day of the week of surgery in a Canadian population and whether the association was influenced by surgeon experience and volume. METHODS: We conducted a population-based retrospective cohort study in the province of Ontario, Canada. We included adults who underwent 1 of 12 elective daytime surgical procedures from Apr. 1, 2002, to Dec. 31, 2012. The primary outcome was 30-day mortality. We used generalized estimating equations to compare outcomes for surgeries performed on different days of the week, adjusting for patient and surgeon factors. RESULTS: A total of 402 899 procedures performed by 1691 surgeons met our inclusion criteria. The median length of hospital stay was 6 (interquartile range 5–8) days. Surgeon experience varied significantly by day of week (p < 0.001), with surgeons operating on Fridays having the least experience. Nearly all of the patients who had their procedure on a Friday had postoperative care on the weekend, as compared with 49.1% of those whose surgery was on a Monday (p < 0.001). We found no difference in the 30-day mortality between procedures performed on Fridays and those performed on Mondays (adjusted odds ratio 1.08, 95% confidence interval 0.97–1.21). INTERPRETATION: Although surgeon experience differed across days of the week, the risk of 30-day mortality after elective surgery was similar regardless of which day of the week the procedure took place. PMID:27754897

  8. Benefit of Oral Feeding as Early as One Day After Elective Surgery for Colorectal Cancer: Oral Feeding on First Versus Second Postoperative Day

    PubMed Central

    Fujii, Takaaki; Morita, Hiroki; Sutoh, Toshinaga; Yajima, Reina; Yamaguchi, Satoru; Tsutsumi, Soichi; Asao, Takayuki; Kuwano, Hiroyuki

    2014-01-01

    The optimal timing of early oral intake after surgery has not been fully established. The objective of this study was to compare early oral intake at postoperative day 1 after resection of colorectal cancer with that of day 2 to identify the optimal timing for resumption of oral intake in such patients. Consecutive patients with colorectal cancer who underwent elective colorectal resection were separated into two groups. Sixty-two patients began a liquid diet on the first postoperative day (POD1 group) and 58 patients began on POD2 (POD2 group) and advanced to a regular diet within the next 24 hours as tolerated. As for gastrointestinal recovery, the first passage of flatus was experienced, on average, on postoperative day 3.1 ± 1.0 in the POD2 group and on day 2.3 ± 0.7 in the POD1 group. The first defecation was also significantly earlier in patients in the POD1 group than those in the POD2 group (POD 3.2 ± 1.2 versus 4.2 ± 1.4, respectively). No statistical difference was found between the two groups in terms of postoperative complications. Our results suggest that very early feeding on POD1 after colorectal resection is safe and feasible and that induced a quicker recovery of postoperative gastrointestinal movement in patients. PMID:24833141

  9. Increased intraocular pressure on the first postoperative day following resident-performed cataract surgery

    PubMed Central

    Kim, J Y; Jo, M-W; Brauner, S C; Ferrufino-Ponce, Z; Ali, R; Cremers, S L; An Henderson, B

    2011-01-01

    Purpose The aim of this study was to investigate the incidence of intraocular pressure (IOP) elevation after resident-performed cataract surgery and to determine variables, which influence postoperative day 1 (POD1) IOP. Methods In all, 1111 consecutive cataract surgeries performed only by training residents between 1 July 2001 and 30 June 2006 were included. Elevated IOP was defined as ≥23 mm Hg. Surgeries were classified according to the presence of POD1-IOP elevation. Fisher's exact test and Student t-test were used to compare both groups. Multivariate analyses using generalized estimating equations were performed to investigate predictor variables associated with POD1-IOP elevation. Results The average preoperative IOP was 16.0±3.2 mm Hg and the average POD1-IOP was 19.3±7.1 mm Hg, reflecting a significant increase in IOP (P<0.001, paired t-test). The incidence of POD1-IOP elevation ≥23 mm Hg was 22.0% (244/1111). Presence of glaucoma and ocular hypertension, higher preoperative IOP, and longer axial length were frequently encountered variables in the POD1-IOP elevation group (all P<0.05). Using a multivariate analysis, presence of glaucoma (P=0.004, OR=2.38; 95% confidence interval (95% CI)=1.31–4.30), presence of ocular hypertension (P=0.003, OR=6.09; 95% CI=1.81–20.47), higher preoperative IOP (P<0.001, OR=3.73; 95% CI=1.92–7.25), and longer axial length (P=0.01, OR=1.15; 95% CI=1.03–1.29) were significant predictive factors for POD1-IOP elevation. Conclusions IOP elevation on the first postoperative day following resident-performed cataract surgery occurred frequently (22.0%). Increased early postoperative IOP was associated with presence of glaucoma and ocular hypertension, higher preoperative IOP, and longer axial length. PMID:21527959

  10. 10th World Earthquake Engineering Conference

    NASA Astrophysics Data System (ADS)

    Ranguelov, Boyko; Housner, George

    The 10th World Conference on Earthquake Engineering (10WCEE) took place from July 19 to 24 in Madrid, Spain. More than 1500 participants from 51 countries attended the conference. All aspects of earthquake engineering were covered and a worldwide update of modern research and practice, as well as future directions in the field, was provided through reports, papers, posters, two keynote lectures, ten state-ofthe-art reports, and eleven special theme sessions.

  11. Very Early Colorectal Anastomotic Leakage within 5 Post-operative Days: a More Severe Subtype Needs Relaparatomy

    PubMed Central

    Li, Yi-Wei; Lian, Peng; Huang, Ben; Zheng, Hong-Tu; Wang, Ming-He; Gu, Wei-Lie; Li, Xin-Xiang; Xu, Ye; Cai, San-Jun

    2017-01-01

    Early anastomotic leakage (AL), usually defined as leakage within 30 post-operative days, represents a severe entity. However, mounting evidence has indicated that majorities of leakage occur within one week after surgery, making late AL rarity. Here we analyzed 101 consecutive colorectal AL, all of which occurred within 30 post-operative days, during Jan 2013 and Dec 2015 in cancer hospital of Fudan University. AL occurring within 5 post-operative days was defined as very early AL (vE-AL). We evaluated risk factors of vE-AL compared with non-vEAL and correlated with post-leakage peritonitis and need of relaparatomy. We found that AL occurred at median time of 7 days after surgery. 23 cases were vE-AL. Reconstruction of post-peritoneum for mid-low rectal carcinoma significantly reduced incidence of vE-AL compared with non-vE-AL (p = 0.042). Patients with vE-AL was associated with presence of peritonitis (p = 0.031), the latter significantly correlated with increased re-operation rate (p = 6.8E-13). Besides, patients with vE-AL trended to correlate with increased re-operation rate after leakage (p = 0.088). In concludsion, vE-AL occurring within 5 post-operative days represents a severe subtype associated with general peritonitis and need of relaparatomy. PMID:28084305

  12. PREFACE: 10th Joint Conference on Chemistry

    NASA Astrophysics Data System (ADS)

    2016-02-01

    The 10th Joint Conference on Chemistry is an international conference organized by 4 chemistry departments of 4 universities in central Java, Indonesia. The universities are Sebelas Maret University, Diponegoro University, Semarang State University and Soedirman University. The venue was at Solo, Indonesia, at September 8-9, 2015. The total conference participants are 133 including the invited speakers. The conference emphasized the multidisciplinary chemical issue and impact of today's sustainable chemistry which covering the following topics: • Material innovation for sustainable goals • Development of renewable and sustainable energy based on chemistry • New drug design, experimental and theoretical methods • Green synthesis and characterization of material (from molecule to functionalized materials) • Catalysis as core technology in industry • Natural product isolation and optimization

  13. Initiation of GnRH agonist treatment on 3-5 days postoperatively in endometriosis patients: a randomized controlled trial.

    PubMed

    Gong, Lili; Zhang, Shaofen; Han, Yi; Long, Qiqi; Zou, Shien; Cao, Yuankui

    2015-08-01

    Seventy patients with stage III or IV endometriosis were randomly assigned to 2 groups after conservative surgery. Group O (n = 35) received 3 cycles of a 28-day gonadotropin-releasing hormone agonist (GnRH-a) treatment (goserelin, 3.6 mg) starting 3-5 days postoperatively. Group M (n = 35) received the same treatment starting on days 1-5 of menstruation. Groups were further subdivided according to add-back treatment. Pre- and posttreated levels of estradiol (E2 ), follicle stimulating hormone (FSH), and luteinizing hormone (LH) and visual analog scale (VAS), Kupperman menopausal index (KMI), and bone mineral density (BMD) scores were recorded. The incidence of uterine bleeding was assessed. In both groups, serum levels of E2 , FSH, and LH and VAS scores decreased significantly after treatment. Spotting was the most frequent bleeding pattern. During cycle 1, the bleeding time in group M was much longer that than that in group O (P =.001), and the bleeding rate in group M was significantly higher than that in group O (P =.024, RR = 1.185). In patients with stage III or IV endometriosis, the efficacy of GnRH-a initiated 3-5 days postoperatively was equivalent to that of GnRH-a initiated on days 1-5 of menstruation. Female patients who initiated GnRH-a treatment 3-5 days postoperatively experienced less uterine bleeding during the first cycle of treatment.

  14. Marijuana Use Among 10th Grade Students - Washington, 2014.

    PubMed

    Shah, Anar; Stahre, Mandy

    2016-12-30

    Some studies have suggested that long-term, regular use of marijuana starting in adolescence might impair brain development and lower intelligence quotient (1,2). Since 2012, purchase of recreational or retail marijuana has become legal for persons aged ≥21 years in the District of Columbia, Alaska, California, Colorado, Maine, Massachusetts, Nevada, Oregon, and Washington, raising concern about increased marijuana access by youths. The law taxing and regulating recreational or retail marijuana was approved by Washington voters in 2012 and the first retail licenses were issued in July 2014; medical marijuana use has been legal since 1998. To examine the prevalence, characteristics, and behaviors of current marijuana users among 10th grade students, the Washington State Department of Health analyzed data from the state's 2014 Healthy Youth Survey (HYS) regarding current marijuana use. In 2014, 18.1% of 10th grade students (usually aged 15-16 years) reported using marijuana during the preceding 30 days; of these students, 32% reported using it on ≥10 days. Among the marijuana users, 65% reported obtaining marijuana through their peer networks, which included friends, older siblings, or at a party. Identification of comprehensive and sustainable public health interventions are needed to prevent and reduce youth marijuana use. Establishment of state and jurisdiction surveillance of youth marijuana use could be useful to anticipate and monitor the effects of legalization and track trends in use before states consider legalizing recreational or retail marijuana.

  15. 10th Arnual Great Moonbuggy Race

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Students from across the United States and as far away as Puerto Rico came to Huntsville, Alabama for the 10th annual Great Moonbuggy Race at the U.S. Space Rocket Center. Sixty-eight teams, representing high schools and colleges from all over the United States, and Puerto Rico, raced human powered vehicles over a lunar-like terrain. Vehicles powered by two team members, one male and one female, raced one at a time over a half-mile obstacle course of simulated moonscape terrain. The competition is inspired by development, some 30 years ago, of the Lunar Roving Vehicle (LRV), a program managed by the Marshall Space Flight Center. The LRV team had to design a compact, lightweight, all-terrain vehicle that could be transported to the Moon in the small Apollo spacecraft. The Great Moonbuggy Race challenges students to design and build a human powered vehicle so they will learn how to deal with real-world engineering problems similar to those faced by the actual NASA LRV team. In this photograph, Team No. 1 from North Dakota State University in Fargo conquers one of several obstacles on their way to victory. The team captured first place honors in the college level competition.

  16. 10th Arnual Great Moonbuggy Race

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Students from across the United States and as far away as Puerto Rico came to Huntsville, Alabama for the 10th annual Great Moonbuggy Race at the U.S. Space Rocket Center. Sixty-eight teams, representing high schools and colleges from all over the United States, and Puerto Rico, raced human powered vehicles over a lunar-like terrain. Vehicles powered by two team members, one male and one female, raced one at a time over a half-mile obstacle course of simulated moonscape terrain. The competition is inspired by development, some 30 years ago, of the Lunar Roving Vehicle (LRV), a program managed by the Marshall Space Flight Center. The LRV team had to design a compact, lightweight, all-terrain vehicle that could be transported to the Moon in the small Apollo spacecraft. The Great Moonbuggy Race challenges students to design and build a human powered vehicle so they will learn how to deal with real-world engineering problems similar to those faced by the actual NASA LRV team. In this photograph, racers from C-1 High School in Lafayette County, Missouri, get ready to tackle the course. The team pedaled its way to victory over 29 other teams to take first place honors. It was the second year in a row a team from the school has placed first in the high school division. (NASA/MSFC)

  17. Lymphopenia at 4 Days Postoperatively Is the Most Significant Laboratory Marker for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

    PubMed Central

    Shigematsu, Hideki; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Nakajima, Hiroshi; Koizumi, Munehisa; Tanaka, Yasuhito

    2016-01-01

    Study Design Case control study. Purpose To identify the most significant laboratory marker for early detection of surgical site infection (SSI) using multiple logistic regression analysis. Overview of Literature SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial. Methods We retrospectively reviewed the laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spinal disease from January 2003 to December 2014. Six laboratory markers for early SSI detection were considered: renewed elevation of the white blood cell count, higher at 7 than 4 days postoperatively; renewed elevation of the C-reactive protein (CRP) level, higher at 7 than 4 days postoperatively; CRP level of >10 mg/dL at 4 days postoperatively; neutrophil percentage of >75% at 4 days postoperatively; lymphocyte percentage of <10% at 4 days postoperatively; and lymphocyte count of <1,000/µL at 4 days postoperatively. Results Ninety patients were enrolled; five developed deep SSI. Multivariate regression analysis showed that a lymphocyte count of <1,000/µL at 4 days postoperatively was the sole significant independent laboratory marker for early detection of SSI (p=0.037; odds ratio, 11.9; 95% confidence interval, 1.2–122.7). Conclusions A lymphocyte count of <1,000/µL at 4 days postoperatively is the most significant laboratory marker for early detection of SSI. PMID:27994779

  18. PREFACE: 10th International LISA Symposium

    NASA Astrophysics Data System (ADS)

    Ciani, Giacomo; Conklin, John W.; Mueller, Guido

    2015-05-01

    large mission in Europe, and a potential comprehensive technology development program followed by a number one selection in the 2020 Decadal Survey in the U.S. The selection of L2 was combined with the selection of L3 and the newly formed eLISA consortium submitted an updated NGO concept under the name eLISA, or Evolved LISA, to the competition. It was widely believed that the launch date of 2028 for L2, would be seen by the selection committee as providing sufficient time to retire any remaining technological risks for LISA. However, the committee selected the 'Hot and Energetic Universe', an X-ray mission, as the science theme for L2 and the 'Gravitational Universe', the eLISA science theme, for L3. Although very disappointed, it was not a surprising decision. LPF did experience further delays just prior to and during the selection process, which may have influenced the decision. The strong technology program in the U.S. never materialized because WFIRST, the highest priority large mission in the 2010 Decadal following JWST, not only moved ahead but was also up-scoped significantly. The L3 selection, the WFIRST schedule, and the missing comprehensive technology development in the U.S. will make a launch of a GW mission in the 2020s very difficult. Although many in the LISA community, including ourselves, did not want to accept this harsh reality, this was the situation just prior to the 10th LISA symposium. However, despite all of this, the LISA team is now hopeful! In May of 2014 the LISA community gathered at the University of Florida in Gainesville to discuss progress in both the science and technology of LISA. The most notable plenary and contributed sessions included updates on the progress of LISA Pathfinder, which remains on track for launch in the second half of 2015(!), the science of LISA which ranges from super-massive black hole mergers and cosmology to the study of compact binaries within our own galaxy, and updates from other programs that share some of

  19. Systematic Review and Meta-Analysis of Pancreatic Amylase Value on Postoperative Day 1 After Pancreatic Resection to Predict Postoperative Pancreatic Fistula.

    PubMed

    Lu, Xiongxiong; Wang, Xinjing; Fang, Yuan; Chen, Hao; Peng, Chenghong; Li, Hongwei; Deng, Xiaxing; Shen, Baiyong

    2016-02-01

    Early detection of postoperative pancreatic fistula (POPF) may help to improve the outcome following pancreatic surgery, and exclusion of POPF may allow early drain removal which can accelerate recovery. The aim of this study was to evaluate the diagnostic accuracy of drain/plasma pancreatic amylase values on postoperative day 1 (DPA1/PPA1) in POPF by means of a systemic review and meta-analysis.Online journal databases and a manual search up to March 2015 were used. Studies clearly documenting DPA1 or PPA1 in predicting overall POPF (Grade 0 vs A+B+C) or clinically relevant POPF (Grade 0+A vs B+C) following pancreatic surgery were selected. Pooled predictive parameters were performed using STATA 12.0.Fifteen studies were finally identified with a total of 4331 patients. The pooled sensitivity and specificity of DPA1 were 0.92 (95% confidence interval (CI) 0.81-0.96) and 0.77 (95% CI 0.64-0.86) for predicting overall POPF and 0.79 (95% CI 0.61-0.90) and 0.83 (95% CI 0.74-0.89) for predicting clinically relevant POPF. The pooled sensitivity and specificity of PPA1 were 0.74 (95% CI 0.63-0.82) and 0.62 (95% CI 0.55-0.70) for overall POPF. After the DPA1 at/over cutoff values for overall POPF or clinically relevant POPF, corresponding post-test probability (Post-test (+)) (if pretest probability was 50%) was 80% and 82% respectively, while, if values were below the cutoff values, the post-test probability (Post-test (-)) was 10% and 20% respectively. Post-test (+) and Post-test (-) of PPA1 for overall POPF were 66% and 30% respectively. In subgroup analysis, the summary sensitivities of cutoff <1000 group and cutoff >1000 group were 0.96 (0.92-0.98) and 0.85 (0.64-0.95), respectively; the summary specificities were 0.59 (0.44-0.72) and 0.86 (0.80-0.91) respectively. Positive LR were 2.3 (1.7-3.3) and 6.2 (3.7-10.2) respectively. Negative LR were 0.06 (0.03-0.14) and 0.18 (0.07-0.47) respectively.DPA1 is a useful predictive test for overall POPF and clinically

  20. Perceived quality in Day Surgery Units Proposal of an enquiry postoperative questionnaire.

    PubMed

    Palumbo, Piergaspare; Perotti, Bruno; Amatucci, Chiara; Pangrazi, Maria Pia; Leuzzi, Barbara; Vietri, Francesco; Illuminati, Giulio

    2016-01-01

    La soddisfazione dei pazienti assume particolare importanza nell’attività chirurgica in Day Surgery, al fine di mantenere ed incrementare la domanda di prestazioni da parte dell’utenza ed inoltre di valutare le abilità e le competenze dello staff clinico dedicato. Sono stati valutati i risultati di un questionario somministrato dal 2007 al 2012, divisi in due gruppi, alla dimissione e a 30 giorni dall’intervento. Tali risultati hanno permesso di valutare i principali vantaggi e limiti del questionario in termini di comprensibilità, di corretto timing di somministrazione, e di utilità per lo staff clinico.

  1. EDITORIAL: STAM celebrates its 10th anniversary STAM celebrates its 10th anniversary

    NASA Astrophysics Data System (ADS)

    Ushioda, Sukekatsu

    2010-02-01

    I would like to extend my warmest greetings to the readers and staff of Science and Technology of Advanced Materials (STAM), on the occasion of its 10th anniversary. Launched in 2000, STAM marks this year an important milestone in its history. This is a great occasion to celebrate. STAM was founded by Tsuyoshi Masumoto in collaboration with Teruo Kishi and Toyonobu Yoshida as a world-class resource for the materials science community. It was initially supported by several materials research societies and was published as a regular peer-reviewed journal. Significant changes occurred in 2008, when the National Institute for Materials Science (NIMS) became solely responsible for all the costs of maintaining the journal. STAM was transformed into an open-access journal published by NIMS in partnership with IOP Publishing. As a result, the publication charges were waived and the entire STAM content, including all back issues, became freely accessible through the IOP Publishing website. The transition has made STAM more competitive and successful in global publication communities, with innovative ideas and approaches. The journal has also changed its publication strategy, aiming to publish a limited number of high-quality articles covering the frontiers of materials science. Special emphasis has been placed on reviews and focus issues, providing recent summaries of hot materials science topics. Publication has become electronic only; however, selected issues are printed and freely distributed at major international scientific events. The Editorial Board has been expanded to include leading experts from all over the world and, together with the Editorial Office, the board members are doing their best to transform STAM into a leading materials science journal. These efforts are paying off, as shown by the rapidly increasing number of article downloads and citations in 2009. I believe that the STAM audience can not only deepen their knowledge in their own specialties but

  2. Lymphopenia and Elevated Blood C-Reactive Protein Levels at Four Days Postoperatively Are Useful Markers for Early Detection of Surgical Site Infection Following Posterior Lumbar Instrumentation Surgery

    PubMed Central

    Shigematsu, Hideki; Koizumi, Munehisa; Nakajima, Hiroshi; Okuda, Akinori; Morimoto, Yasuhiko; Masuda, Keisuke; Tanaka, Yasuhito

    2016-01-01

    Study Design Case-control study. Purpose To identify the characteristics of candidate indexes for early detection of surgical site infection (SSI). Overview of Literature SSI is a serious complication of spinal instrumentation surgery. Early diagnosis and treatment are crucial for the welfare of the patient postoperation. Methods We retrospectively reviewed laboratory data of patients who underwent posterior lumbar instrumentation surgery for degenerative spine disease. The sensitivity and specificity of six laboratory markers for early detection of SSI were calculated: greater elevation of the white blood cell count at day 7 than at day 4 postoperatively, greater elevation of the C-reactive protein (CRP) level at day 7 than at day 4 postoperatively, a CRP level of >10 mg/dL at 4 days postoperatively, neutrophil percentage of >75% at 4 days postoperatively, a lymphocyte percentage of <10% at 4 days postoperatively, and a lymphocyte count of <1,000/µL at 4 days postoperatively. Statistical analysis was via Fisher's exact test and a p-value of <0.05 was considered significant. Results In total, 85 patients were enrolled. Of these, five patients developed deep SSI. The sensitivity and specificity of each index were as follows: index 1, 20.0% and 77.5%; index 2, 20.0% and 83.8%; index 3, 40.0% and 97.5%; index 4, 40.0% and 86.3%; index 5, 0% and 96.3%; and index 6, 80.0% and 80.0%. A significant difference was noted for indexes 3 and 6. Conclusions A CRP level of >10 mg/dL at 4 days postoperatively would be useful for definitive diagnosis of SSI, and a lymphocyte count of <1,000/µL at 4 days postoperatively would be a useful screening test for SSI. Although laboratory markers for early detection of SSI have been frequently reported, we believe that it is important to understand the characteristics of each index for a precise diagnosis. PMID:27114760

  3. Present-day challenges and future solutions in postoperative pain management: results from PainForum 2014

    PubMed Central

    Kuusniemi, Kristiina; Pöyhiä, Reino

    2016-01-01

    This paper is a summary of presentations on postoperative pain control by the authors at the 2014 PainForum meeting in People’s Republic of China. Postoperative pain is often untreated or undertreated and may lead to subsequent chronic pain syndromes. As more procedures migrate to the outpatient setting, postoperative pain control will become increasingly more challenging. Evidence-based guidelines for postoperative pain control recommend pain assessment using validated tools on a consistent basis. In this regard, consistency may be more important than the specific tool selected. Many hospitals have introduced a multidisciplinary acute pain service (APS), which has been associated with improved patient satisfaction and fewer adverse events. Patient education is an important component of postoperative pain control, which may be most effective when clinicians chose a multimodal approach, such as paracetamol (acetaminophen) and opioids. Opioids are a mainstay of postoperative pain control but require careful monitoring and management of side effects, such as nausea, vomiting, dizziness, and somnolence. Opioids may be administered using patient-controlled analgesia systems. Protocols for postoperative pain control can be very helpful to establish benchmarks for pain management and assure that clinicians adhere to evidence-based standards. The future of postoperative pain control around the world will likely involve more and better established APSs and greater communication between patients and clinicians about postoperative pain. The changes necessary to implement and move forward with APSs is not a single step but rather one of continuous improvement and ongoing change. PMID:26893579

  4. [Postoperative hypothyroidism].

    PubMed

    Olifirova, O S; Trynov, N N

    2015-01-01

    There is a number of factors such as the thyroidectomy and limiting subtotal thyroid resection against the background of euthyroidism and initial hypothyroidism (in any extent of operation) which leads to the prediction of early postoperative hypothyroidism origin during 10 days of the postoperative peri- od. The early postoperative hypothyroidism is accompanied by activation processes of lipid peroxide oxidation and at the same time by reduction of antioxidant protection.

  5. Nineth Rib Syndrome after 10th Rib Resection

    PubMed Central

    Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon

    2016-01-01

    The 12th rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the 10th rib was not felt, and an image of the rib-cage confirmed that the left 10th rib was severed. When applying pressure from the legs to the 9th rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with 9th rib syndrome, and ultrasound-guided 9th and 10th intercostal nerve blocks were performed around the tips of the severed 10th rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the 9th rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left 10th rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining 10th rib to impinge on the 9th intercostal nerves, causing pain. PMID:27413484

  6. Removal of foley catheters in live donor kidney transplant recipients on postoperative day 1 does not increase the incidence of urine leaks.

    PubMed

    Siskind, Eric; Sameyah, Emil; Goncharuk, Edwin; Olsen, Elizabeth M; Feldman, Joshua; Giovinazzo, Katie; Blum, Mark; Tyrell, Richard; Evans, Cory; Kuncewitch, Michael; Alexander, Mohini; Israel, Ezra; Bhaskaran, Madhu; Calderon, Kellie; Jhaveri, Kenar D; Sachdeva, Mala; Bellucci, Alessandro; Mattana, Joseph; Fishbane, Steven; D'Agostino, Catherine; Coppa, Gene; Molmenti, Ernesto

    2013-03-01

    Catheterization of the urinary bladder during kidney transplantation is essential. The optimal time to remove the Foley catheter postoperatively is not universally defined. It is our practice to remove the Foley catheter on postoperative day 1 in live donor kidney transplant recipients who meet our standardized protocol criteria. We believe that early removal of Foley catheters increases patient comfort and mobility, decreases the risk of catheter associated urinary tract infections, and allows for decreased hospital length of stay. The hypothetical risk of early removal of Foley catheters would be the increased risk of urine leak. We reviewed 120 consecutive live donor kidney transplant recipients and found that there was not an increased incidence of urine leaks in patients whose Foley catheters were removed on postoperative day 1.

  7. Making a Difference: Education at the 10th International Conference on Zebrafish Development and Genetics

    PubMed Central

    Liang, Jennifer O.; Pickart, Michael A.; Pierret, Chris; Tomasciewicz, Henry G.

    2012-01-01

    Abstract Scientists, educators, and students met at the 10th International Conference on Zebrafish Development and Genetics during the 2-day Education Workshop, chaired by Dr. Jennifer Liang and supported in part by the Genetics Society of America. The goal of the workshop was to share expertise, to discuss the challenges faced when using zebrafish in the classroom, and to articulate goals for expanding the impact of zebrafish in education. PMID:23244686

  8. On Postoperative Day Balloon Angioplasty for Salvage of Newly-Placed, Flow-Limiting Native Arteriovenous Fistula

    PubMed Central

    Park, Jae Young; Yoo, Chang Hyun

    2015-01-01

    Purpose: To report result and usefulness of immediate postoperative balloon angioplasty of de novo arteriovenous fistula (AVF) with limited flow just after creation. Materials and Methods: From January 1, 2012 to March 31, 2014, 1,270 patients received native AVF creations in a single vascular clinic. In twenty-four patients (1.9% of total AVF creation), immediate postoperative balloon angioplasty was performed because of limited flow on palpation (only pulsation or no thrill) just after AVF creation. Medical records were reviewed retrospectively; technical success (restoration of AVF flow)/clinical success (growing as functional AVF) rate, maturation time, primary patency rate and fistula survival outcome were analyzed during a mean 10.8 months of follow-up. Results: Technical/clinical success rate was 95.8% (23/24 cases); AVF flow was restored after balloon angioplasty, and all the flow-restorated AVFs grew as functional AVFs with mean±standard deviation, 4.5±1.5 weeks of maturation time. In seven (30.4%) patients, a secondary balloon angioplasty was needed to enhance maturation. The overall primary patency after immediate postoperative balloon angioplasty was 69.6% at 1 and 6 months and 59.0% at 12 months. There was 1 complication (operation site hematoma). Conclusion: Immediate postoperative balloon angioplasty for salvage of newly-placed, flow-limiting native AVF is a useful, effective and safe procedure. PMID:26217640

  9. 77 FR 21773 - Filing Dates for The New Jersey Special Election in The 10th Congressional District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... Filing Dates for The New Jersey Special Election in The 10th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates for special election. SUMMARY: New Jersey has scheduled... the New Jersey Special Primary and Special General Elections shall file a 12-day Pre-Primary Report...

  10. Byzantine psychosomatic medicine (10th- 15th century).

    PubMed

    Eftychiadis, A C

    1999-01-01

    Original elements of the psychosomatic medicine are examined by the most important byzantine physicians and medico-philosophers during the 10th -15th centuries. These topics concern the psycosomatic unity of the human personality, the psychosomatic disturbances, diseases and interactions, organic diseases, which cause psychical disorders, psychical pathological reactions, which result in somatic diseases, the psychology of the depth of the soul, the psychosomatic pathogenetic reasons of psychiatric and neurological diseases and suicide, the influence of witchcraft on psychosomatic affections, maniac and demoniac patients. The psychosomatic treatment has a holistic preventive and curative character and encloses sanitary and dietary measures, physiotherapy, curative bathing, strong purgation, pharmaceutical preparations proportional to the disease, religious disposition, psychoanalysis and psychotherapy with dialogue and the contribution of the divine factor. The late byzantine medical science contributed mainly to the progress of the psychosomatic medicine and therapeutics. The saint woman physician Hermione (1st -2nd cent.) is considered as the protectress of psychosomatic medicine.

  11. Combination of general anesthesia and peripheral nerve block with low-dose ropivacaine reduces postoperative pain for several days after outpatient arthroscopy

    PubMed Central

    Büttner, Benedikt; Mansur, Ashham; Hinz, José; Erlenwein, Joachim; Bauer, Martin; Bergmann, Ingo

    2017-01-01

    Abstract Background: Effective methods for postoperative pain relief are an important concern in outpatient surgery. For arthroscopies we combine a single-shot peripheral nerve block using low-volume, low-concentration ropivacaine with general anesthesia. We hypothesized that the patients would have less postoperative pain and be more rapidly home ready than after general anesthesia alone. Methods: Patients (American Society of Anesthesiologists I–III, 18–80 years old) scheduled for outpatient arthroscopy on the upper or lower extremity were randomized to have either a combination of peripheral nerve block and general anesthesia (NB + GA, study group) or general anesthesia alone (GA, control group). The relevant nerve was localized by ultrasound and 10 mL ropivacaine 0.2% was injected. General anesthesia was with propofol and remifentanil. Numeric rating scales were used to assess pain and patient satisfaction in the recovery room, on the evening of surgery, and on the following 2 days. Results: A total of 120 patients participated in the study (NB + GA: 61; GA: 59). The percentage of patients reporting relevant pain in the recovery room were 0% versus 44% (P < 0.001), on the evening after surgery 3% versus 80% (P < 0.001), and on days 1 and 2 postsurgery 12% versus 73% and 12% versus 64% (NB + GA vs GA, respectively). Median time to home discharge was NB + GA 34.5 min (range 15–90) versus GA 55 min (20–115) (P < 0.001). Conclusions: The combination of a peripheral nerve block with low-dose ropivacaine and general anesthesia reduced postoperative pain compared with general anesthesia alone for several days after outpatient arthroscopy. It also shortened the time to home discharge. PMID:28178149

  12. [The effect of lung diminishing interventions on immediate postoperative lung function and their modification by various forms of analgesia].

    PubMed

    Horch, R; Krönung, G; Westhofen, P; Giebel, G D

    1990-01-01

    The influence of different lung resection methods on pulmonary function was studied in 34 patients suffering from bronchial carcinoma. Daily measurements from the 1st to 10th postoperative day reveal the greatest losses of function after right upper lobectomy. Lower lobectomies or left upper lobectomy resulted in a less extensive loss of function. Recovery of function mainly occurs in the first 4 days after operation. Centrally acting analgetics are followed by a loss in pulmonary function whereas locally applied analgetics improve early postoperative function.

  13. The Comparative Toxicogenomics Database's 10th year anniversary: update 2015

    PubMed Central

    Davis, Allan Peter; Grondin, Cynthia J.; Lennon-Hopkins, Kelley; Saraceni-Richards, Cynthia; Sciaky, Daniela; King, Benjamin L.; Wiegers, Thomas C.; Mattingly, Carolyn J.

    2015-01-01

    Ten years ago, the Comparative Toxicogenomics Database (CTD; http://ctdbase.org/) was developed out of a need to formalize, harmonize and centralize the information on numerous genes and proteins responding to environmental toxic agents across diverse species. CTD's initial approach was to facilitate comparisons of nucleotide and protein sequences of toxicologically significant genes by curating these sequences and electronically annotating them with chemical terms from their associated references. Since then, however, CTD has vastly expanded its scope to robustly represent a triad of chemical–gene, chemical–disease and gene–disease interactions that are manually curated from the scientific literature by professional biocurators using controlled vocabularies, ontologies and structured notation. Today, CTD includes 24 million toxicogenomic connections relating chemicals/drugs, genes/proteins, diseases, taxa, phenotypes, Gene Ontology annotations, pathways and interaction modules. In this 10th year anniversary update, we outline the evolution of CTD, including our increased data content, new ‘Pathway View’ visualization tool, enhanced curation practices, pilot chemical–phenotype results and impending exposure data set. The prototype database originally described in our first report has transformed into a sophisticated resource used actively today to help scientists develop and test hypotheses about the etiologies of environmentally influenced diseases. PMID:25326323

  14. Post-operative delirium is an independent predictor of 30-day hospital readmission after spine surgery in the elderly (≥65years old): A study of 453 consecutive elderly spine surgery patients.

    PubMed

    Elsamadicy, Aladine A; Wang, Timothy Y; Back, Adam G; Lydon, Emily; Reddy, Gireesh B; Karikari, Isaac O; Gottfried, Oren N

    2017-03-02

    In the last decade, costs of U.S. healthcare expenditures have been soaring, with billions of dollars spent on hospital readmissions. Identifying causes and risk factors can reduce soaring readmission rates and help lower healthcare costs. The aim of this is to determine if post-operative delirium in the elderly is an independent risk factor for 30-day hospital readmission after spine surgery. The medical records of 453 consecutive elderly (≥65years old) patients undergoing spine surgery at Duke University Medical Center from 2008 to 2010 were reviewed. We identified 17 (3.75%) patients who experienced post-operative delirium according to DSM-V criteria. Patient demographics, comorbidities, and post-operative complication rates were collected for each patient. Elderly patients experiencing post-operative delirium had an increased length of hospital stay (10.47days vs. 5.70days, p=0.009). Complication rates were similar between the cohorts with the post-operative delirium patients having increased UTI and superficial surgical site infections. In total, 12.14% of patients were re-admitted within 30-days of discharge, with post-operative delirium patients experiencing approximately a 4-fold increase in 30-day readmission rates (Delirium: 41.18% vs. No Delirium: 11.01%, p=0.002). In a multivariate logistic regression analysis, post-operative delirium is an independent predictor of 30-day readmission after spine surgery in the elderly (p=0.03). Elderly patients experiencing post-operative delirium after spine surgery is an independent risk factor for unplanned readmission within 30-days of discharge. Preventable measures and early awareness of post-operative delirium in the elderly may help reduce readmission rates.

  15. PREFACE: ISEC 2005: The 10th International Superconductive Electronics Conference

    NASA Astrophysics Data System (ADS)

    Rogalla, Horst

    2006-05-01

    The 10th International Superconductive Electronics Conference took place in Noordwijkerhout in the Netherlands, 5-9 September 2005, not far from the birthplace of superconductivity in Leiden nearly 100 years ago. There have been many reasons to celebrate the 10th ISEC: not only was it the 20th anniversary, but also the achievements since the first conference in Tokyo in 1987 are tremendous. We have seen whole new groups of superconductive materials come into play, such as oxide superconductors with maximum Tc in excess of 100 K, carbon nanotubes, as well as the realization of new digital concepts from saturation logic to the ultra-fast RSFQ-logic. We have learned that superconductors not only show s-wave symmetries in the spatial arrangement of the order parameter, but also that d-wave dependence in oxide superconductors is now well accepted and can even be successfully applied to digital circuits. We are now used to operating SQUIDs in liquid nitrogen; fT sensitivity of SQUID magnetometers is not surprising anymore and can even be reached with oxide-superconductor based SQUIDs. Even frequency discriminating wide-band single photon detection with superconductive devices, and Josephson voltage standards with tens of thousands of junctions, nowadays belong to the daily life of advanced laboratories. ISEC has played a very important role in this development. The first conferences were held in 1987 and 1989 in Tokyo, and subsequently took place in Glasgow (UK), Boulder (USA), Nagoya (Japan), Berlin (Germany), Berkeley (USA), Osaka (Japan), Sydney (Australia), and in 2005 for the first time in the Netherlands. These conferences have provided platforms for the presentation of the research and development results of this community and for the vivid discussion of achievements and strategies for the further development of superconductive electronics. The 10th conference has played a very important role in this context. The results in laboratories show great potential and

  16. TAOK3, a novel genome-wide association study locus associated with morphine requirement and postoperative pain in a retrospective pediatric day surgery population

    PubMed Central

    Cook-Sather, Scott D.; Li, Jin; Goebel, Theodora K.; Sussman, Emily M.; Rehman, Mohamed A.; Hakonarson, Hakon

    2014-01-01

    Candidate gene studies have revealed limited genetic bases for opioid analgesic response variability. Genome-wide association studies (GWAS) facilitate impartial queries of common genetic variants, allowing identification of novel genetic contributions to drug effect. Illumina single nucleotide polymorphism (SNP) arrays were used to investigate SNP associations with total morphine requirement as a quantitative trait locus and with postoperative pain in a retrospective population of opioid-naïve children age 4 – 18 y who had undergone day surgery tonsillectomy and adenoidectomy. In an independent replication cohort, significant GWAS-identified SNPs were assayed using Taqman probes. Among 617 comprehensively phenotyped children, the 277 subjects of European Caucasian (EC) ancestry demonstrated nominal association between morphine dose and a series of novel SNPs (top rs795484, p=1.01×10-6 and rs1277441, p=2.77×10-6) at the TAOK3 locus. Age, body mass index, and physical status were included covariates. Morphine requirement averaged 132.4 mcg/kg (SD 40.9). Each minor allele at rs795484 (G>A) contributed +17.6 mcg/kg (95% CI=10.7-24.4) to dose. Effect direction and magnitude were replicated in an independent cohort of 75 EC children (p<0.05). No association with morphine dose was detected in African Americans (AA) (n=241). Postoperative pain scores ≥ 7/10 were associated with rs795484 (G>A) in the EC cohort (OR=2.35, 95% CI=1.56-3.52, p<0.00005) and this association replicated in AA children (OR=1.76, 95% CI=1.14-2.71, p<0.01). Variants in TAOK3 encoding the serine/threonine-protein kinase, TAO3, are associated with increased morphine requirement in children of EC ancestry and with increased acute postoperative pain in both EC and AA subjects. PMID:24909733

  17. Minimum Competency Testing Clarification Hearing (July 10th, 1981).

    ERIC Educational Resources Information Center

    National Inst. of Education (ED), Washington, DC.

    Barbara Jordan served as the hearing officer for three-day adversary evaluation hearings about the pros and cons of minimum competency testing (MCT). This report is the complete transcript of the third day of proceedings. The pro team testimony, led by James Popham, began with William Raspberry, who presented his view of the likely impact of MCT.…

  18. Staged liver resection for perihilar liver tumors using a tourniquet in the umbilical fissure and sequential portal vein embolization on the fourth postoperative day (a modified ALTPS).

    PubMed

    Robles Campos, Ricardo; Brusadin, Roberto; López Conesa, Asunción; Parrilla Paricio, Pascual

    2014-12-01

    Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) achieves the hypertrophy of the future liver remnant in seven days. We achieved the same hypertrophy placing a tourniquet in the parenchimal transection line associating a right portal vein ligation (associating liver tourniquet and right portal vein ligation for staged hepatectomy-ALTPS). In perihiliar tumors a«non touch» technique should be performed. ALPPS y ALTPS do not comply with this technical aspect because a dissection of the hilum is carried out in both procedures during the portal dissection. To avoid this problem we devised a new method called sequential ALTPS. It consists of placing a tourniquet in the umbilical fissure without ligation of the right portal vein during the first stage. Subsequently, on the 4(th) postoperative day we perform a percutaneous right portal vein embolization. We present the first case of this new technique in which we have obtained a hypertrophy of 77% of the future liver remnant seven days after portal vein embolization. In the second stage a right trisectionectomy was performed with inferior vena cava resection with a goretex graft replacement.

  19. ALS user meeting features 10th anniversary celebration

    SciTech Connect

    Robinson, Art

    2003-12-05

    The Advanced Light Source (ALS) saw first light on October 5, 1993, not quite to the day but close to 10 years before the 2003 ALS Users Association meeting, held October 6-8. Fittingly, the proceedings included retrospectives from two of the key players in the early history of the ALS, David Attwood and Jay Marx, and a display of photographs chronicling its construction and commissioning. Science highlights, highlights from young researchers, and posters constituted the meat of the program on Monday and Tuesday morning, while workshops took over Tuesday afternoon and all day Wednesday.

  20. Project TALENT's Nonrespondent Follow-up Survey: The 10th Grade Special Sample. Interim Report.

    ERIC Educational Resources Information Center

    Carrel, Kathleen S.; And Others

    Described are procedures used in the location of a sample of individuals not responding to follow-up questionnaires, eleven years after they were originally interviewed in 1960 as 10th graders. The individuals in question were a subset of more than 400,000 9th, 10th, 11th and 12th grade students used in Project TALENT's longitudinal study of the…

  1. Kepler 453 b - The 10th Kepler Transiting Circumbinary Planet

    NASA Astrophysics Data System (ADS)

    Welsh, William F.; Orosz, Jerome A.; Short, Donald R.; Cochran, William D.; Endl, Michael; Brugamyer, Erik; Haghighipour, Nader; Buchhave, Lars A.; Doyle, Laurance R.; Fabrycky, Daniel C.; Hinse, Tobias Cornelius; Kane, Stephen R.; Kostov, Veselin; Mazeh, Tsevi; Mills, Sean M.; Müller, Tobias W. A.; Quarles, Billy; Quinn, Samuel N.; Ragozzine, Darin; Shporer, Avi; Steffen, Jason H.; Tal-Or, Lev; Torres, Guillermo; Windmiller, Gur; Borucki, William J.

    2015-08-01

    We present the discovery of Kepler-453 b, a 6.2 {R}\\oplus planet in a low-eccentricity, 240.5 day orbit about an eclipsing binary. The binary itself consists of a 0.94 and 0.195 {M}⊙ pair of stars with an orbital period of 27.32 days. The plane of the planet's orbit is rapidly precessing, and its inclination only becomes sufficiently aligned with the primary star in the latter portion of the Kepler data. Thus three transits are present in the second half of the light curve, but none of the three conjunctions that occurred during the first half of the light curve produced observable transits. The precession period is ˜103 years, and during that cycle, transits are visible only ˜8.9% of the time. This has the important implication that for every system like Kepler-453 that we detect, there are ˜11.5 circumbinary systems that exist but are not currently exhibiting transits. The planet's mass is too small to noticeably perturb the binary, and consequently its mass is not measurable with these data; however, our photodynamical model places a 1σ upper limit of 16 {M}\\oplus . With a period 8.8 times that of the binary, the planet is well outside the dynamical instability zone. It does, however, lie within the habitable zone of the binary, making it the third of 10 Kepler circumbinary planets to do so. Based on observations obtained with the Hobby-Eberly Telescope, which is a joint project of the University of Texas at Austin, the Pennsylvania State University, Stanford University, Ludwig-Maximilians-Universität München, and Georg-August-Universität Göttingen.

  2. RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies

    PubMed Central

    Dahlberg, K; Odencrants, S; Hagberg, L

    2016-01-01

    Introduction Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life. Methods and analysis This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either e-assessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery. The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A–C) at 1 and 2 weeks and (D) at 1 and 4 months. Trial registration number NCT02492191; Pre

  3. 10th Anniversary Review: a changing climate for coral reefs.

    PubMed

    Lough, Janice M

    2008-01-01

    Tropical coral reefs are charismatic ecosystems that house a significant proportion of the world's marine biodiversity. Their valuable goods and services are fundamental to the livelihood of large coastal populations in the tropics. The health of many of the world's coral reefs, and the goods and services they provide, have already been severely compromised, largely due to over-exploitation by a range of human activities. These local-scale impacts, with the appropriate government instruments, support and management actions, can potentially be controlled and even ameliorated. Unfortunately, other human actions (largely in countries outside of the tropics), by changing global climate, have added additional global-scale threats to the continued survival of present-day coral reefs. Moderate warming of the tropical oceans has already resulted in an increase in mass coral bleaching events, affecting nearly all of the world's coral reef regions. The frequency of these events will only increase as global temperatures continue to rise. Weakening of coral reef structures will be a more insidious effect of changing ocean chemistry, as the oceans absorb part of the excess atmospheric carbon dioxide. More intense tropical cyclones, changed atmospheric and ocean circulation patterns will all affect coral reef ecosystems and the many associated plants and animals. Coral reefs will not disappear but their appearance, structure and community make-up will radically change. Drastic greenhouse gas mitigation strategies are necessary to prevent the full consequences of human activities causing such alterations to coral reef ecosystems.

  4. Research and Education: The Foundations for Rehabilitation Service Delivery--10th Annual National Rehabilitation Educators Conference April 6th-10th, 2010

    ERIC Educational Resources Information Center

    Chou, Chih Chin

    2010-01-01

    The theme of the 10th annual National Rehabilitation Educators conference emphasized research and teaching ideals in the areas of clinical supervision, evidence-based practice in rehabilitation, rehabilitation counseling process, effective rehabilitation counseling training strategies, accreditation and licensure, rehabilitation ethics, and…

  5. 1. Historic American Buildings Survey Joseph Hill, Photographer August 10th, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. Historic American Buildings Survey Joseph Hill, Photographer August 10th, 1936 (Copied from small photo taken by survey members) OLD APARTMENT HOUSE - Jansonist Colony, Old Apartment House, Main Street, Bishop Hill, Henry County, IL

  6. 16. NORTHEAST CORNER VIEW OF 10TH AND 11TH FLOOR WINDOWS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. NORTHEAST CORNER VIEW OF 10TH AND 11TH FLOOR WINDOWS. CORNER SHOWS THE DIAGONALLY FLUTED SPIRAL DESIGN OF THE RELIEF COLUMN. - Pacific Telephone & Telegraph Company Building, 1519 Franklin Street, Oakland, Alameda County, CA

  7. Report on the 10th International Conference of the Asian Clinical Oncology Society (ACOS 2012).

    PubMed

    Kim, Yeul Hong; Yang, Han-Kwang; Kim, Tae Won; Lee, Jung Shin; Seong, Jinsil; Lee, Woo Yong; Ahn, Yong Chan; Lim, Ho Yeong; Won, Jong-Ho; Park, Kyong Hwa; Cho, Kyung Sam

    2013-04-01

    The 10th International Conference of the Asian Clinical Oncology Society (ACOS 2012) in conjunction with the 38th Annual Meeting of the Korean Cancer Association, was held on June 13 to 15 (3 days) 2012 at COEX Convention and Exhibition Center in Seoul, Korea. ACOS has a 20-year history starting from the first conference in Osaka, Japan, which was chaired by Prof. Tetsuo Taguchi and the ACOS conferences have since been conducted in Asian countries every 2 years. Under the theme of "Work Together to Make a Difference for Cancer Therapy in Asia", the 10th ACOS was prepared to discuss various subjects through a high-quality academic program, exhibition, and social events. The ACOS 2012 Committee was composed of the ACOS Organizing Committee, Honorary Advisors, Local Advisors, and ACOS 2012 Organizing Committee. The comprehensive academic program had a total of 92 sessions (3 Plenary Lectures, 1 Award Lectures, 1 Memorial Lectures, 9 Special Lectures, 15 Symposia, 1 Debate & Summary Sessions, 1 Case Conferences, 19 Educational Lectures, 1 Research & Development Session, 18 Satellite Symposia, 9 Meet the Professors, 14 Oral Presentations) and a total 292 presentations were delivered throughout the entire program. Amongst Free Papers, 462 research papers (110 oral presentations and 352 poster presentations) were selected to be presented. This conference was the largest of all ACOS conferences in its scale with around 1,500 participants from 30 countries. Furthermore, despite strict new financial policies and requirements governing fundraising alongside global economic stagnation, a total of 14 companies participated as sponsors and an additional 35 companies purchased 76 exhibition booths. Lastly, the conference social events provided attendees with a variety of opportunities to experience and enjoy Korea's rich culture and traditions during the Opening Ceremony, Welcome Reception, Invitee Dinner, Banquet, and Closing Ceremony. Overall, ACOS 2012 reinforced and promoted

  8. [Postoperative pain in craniotomy].

    PubMed

    Peón, Andréa Ungaro; Diccini, Solange

    2005-01-01

    In the postoperative period, 47% to 75% of the patients report some degree of pain. This study aimed to evaluate pain in the pre and postoperative period of patients submitted to craniotomy. This prospective research was carried out at the neurosurgery unit of a large Brazilian hospital. For a quantitative evaluation of pain, the verbal numeric 0-10 rating scale was used. Forty patients with a mean age of 36 years were evaluated. In the preoperative period, 34 (85%) patients indicated headache as the main cause of pain. In the postoperative period, 37 (93%) patients complained of pain while three (7%) reported absence of pain. Pain peaks were observed on the 2nd postoperative day, when 12 (32%) of the patients reported severe pain and 10 (27%) moderate pain. Absence of severe pain occurred after the 8th postoperative day. It was concluded that protocols of analgesia in craniotomy are needed, such as training nurses to better evaluate and handle pain.

  9. EPA presents award to Oregon 10th grader for work on marine oil spills

    EPA Pesticide Factsheets

    (Seattle-May 6, 2015) The U.S. Environmental Protection Agency, Region 10 is awarding the President's Environmental Youth Award to 10th grader Sahil Veeramoney for his development of a novel and efficient method to clean up marine oil spills. Veeramoney is

  10. MedlinePlus en español marks its 10th anniversary

    MedlinePlus

    ... medlineplus.gov/spanishanniversary.html MedlinePlus en español Marks its 10 th Anniversary To use the sharing features ... Spanish greatly expands NIH's ability to carry out its mission to communicate with the public.” MedlinePlus en ...

  11. A PAIR OF 10TH CAVALRY AMBULANCES, PARKED NEXT TO ONE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    A PAIR OF 10TH CAVALRY AMBULANCES, PARKED NEXT TO ONE OF THE STABLE LABELED "M.D. 10." PHOTOGRAPH TAKEN CIRCA 1918 (FORT HUACHUCA HISTORICAL MUSEUM, PHOTOGRAPH 1918.00.00.135, PHOTOGRAPHER UNIDENTIFIED, CREATED BY AND PROPERTY OF THE UNITED STATES ARMY) - Fort Huachuca, Cavalry Stables, Clarkson Road, Sierra Vista, Cochise County, AZ

  12. Interracial Best Friendships: Relationship with 10th Graders' Academic Achievement Level

    ERIC Educational Resources Information Center

    Newgent, Rebecca A.; Lee, Sang Min; Daniel, Ashley F.

    2007-01-01

    The authors examined the relationships between interracial best friendships and 10th-grade students' academic achievement. The analysis consisted of data from 13,134 participants in the ELS:2002 database. The results indicated that interracial best friendships for minority students (African Americans, Latino Americans, Asian Americans, and…

  13. The Effect of Case-Based Instruction on 10th Grade Students' Understanding of Gas Concepts

    ERIC Educational Resources Information Center

    Yalçinkaya, Eylem; Boz, Yezdan

    2015-01-01

    The main purpose of the present study was to investigate the effect of case-based instruction on remedying 10th grade students' alternative conceptions related to gas concepts. 128 tenth grade students from two high schools participated in this study. In each school, one of the classes was randomly assigned as the experimental group and the other…

  14. County Data Book, 2000: Kentucky Kids Count. 10th Annual Edition.

    ERIC Educational Resources Information Center

    Albright, Danielle; Hall, Douglas; Mellick, Donna; Miller, Debra; Town, Jackie

    This 10th annual Kids Count data book reports on trends in the well-being of Kentucky's children. The statistical portrait is based on indicators in the areas of well being, child risk factors, and demography. The indicators are as follows: (1) healthy births, including birth weights and prenatal care; (2) maternal risk characteristics, including…

  15. Problem-Based Learning Method: Secondary Education 10th Grade Chemistry Course Mixtures Topic

    ERIC Educational Resources Information Center

    Üce, Musa; Ates, Ismail

    2016-01-01

    In this research; aim was determining student achievement by comparing problem-based learning method with teacher-centered traditional method of teaching 10th grade chemistry lesson mixtures topic. Pretest-posttest control group research design is implemented. Research sample includes; two classes of (total of 48 students) an Anatolian High School…

  16. Changes in Educational Expectations between 10th and 12th Grades across Cohorts

    ERIC Educational Resources Information Center

    Park, Sueuk; Wells, Ryan; Bills, David

    2015-01-01

    The mean levels of educational expectations of American high school students have increased over the past generation; individual educational expectations change as students mature. Using the National Education Longitudinal Study and the Education Longitudinal Study, we examined simultaneously the changes in individuals' expectations from 10th to…

  17. A Structural Model of Student Career Aspiration and Science Education: The 10th Grade Investigation.

    ERIC Educational Resources Information Center

    Wang, Jianjun; Turner, Dianne

    Career aspiration is an important factor articulating student academic preparation and career orientation. On the basis of H. Walberg's educational productivity theory, 10th grade national data from the Longitudinal Study of American Youth have been analyzed to examine structural relations between educational productivity and career aspiration in…

  18. Efficacy of Postoperative Prophylactic Antibiotic Therapy in Third Molar Surgery

    PubMed Central

    Reddy B, Praveen

    2014-01-01

    Introduction: Surgical extraction of mandibular third molar is the most frequently performed procedure in oral surgery. This procedure is associated with significant postoperative sequelae such as trismus, swelling, pain and infection. The need of antibiotic therapy during the removal of mandibular third molar has been a contentious issue. Method: This study investigated a regimen by using amoxycillin and metronidazole in one group and without using antibiotics in the other. Both the groups were assessed postoperatively on the 1st, 2nd, 5th, 7th and 10th days by the same observer for post operative mouth opening (interincisal distance), presence of a purulent discharge at the site of surgery, pain and swelling. Result: Overall, no statistically significant difference was seen between both the treatment groups when interincisal distance, pain, swelling and purulent discharge were considered. Conclusion: The results of this study failed to show any advantage which was associated with the routine postoperative use of antibiotics in asymptomatic third molar surgeries. PMID:24995236

  19. From the corner of N. 10th St. and W. O'Neill ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    From the corner of N. 10th St. and W. O'Neill Ave. Looking west. Housing # 157-162 are on the right, building 156 is straight ahead, and buildings 153, 152, 116, and 115 are to the left. The golf course is directly west of these buildings. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  20. Assessing Compensation Reform: Research in Support of the 10th Quadrennial Review of Military Compensation

    DTIC Science & Technology

    2008-01-01

    heterogeneous. Nested Logit Specification The active/reserve dynamic retention model describes individual behav- ior as a series of choices regarding...for error correlation between the reserve and civilian alternatives, we modify the model to a nested logit form for the reserve or civilian choice ...plex job-tenure decisions in circumstances in which current choices iv Assessing Compensation Reform in Support of the 10th QRMC affect future

  1. 14. CLOSEUP VIEW OF THE 10TH AND 11TH FLOOR WINDOWS. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. CLOSE-UP VIEW OF THE 10TH AND 11TH FLOOR WINDOWS. WINDOWS HAVE WHITE TERRA COTTA SILLS, HEADS AND MULLIONS. ARCHES ARE OF TERRA COTTA INCLUDING ORNAMENTATION ABOVE THE 11TH FLOOR WINDOWS. CIRCULAR ORNAMENTATIONS BETWEEN ARCHES ARE TERRA COTTA PAINTED IN BRONZE COLOR. LOUVERS ON THE WINDOWS ARE NOT PART OF THE ORIGINAL DESIGN. THIS IS THE FRONT ELEVATION. - Pacific Telephone & Telegraph Company Building, 1519 Franklin Street, Oakland, Alameda County, CA

  2. Efficacy and safety profile of combination of tramadol-diclofenac versus tramadol-paracetamol in patients with acute musculoskeletal conditions, postoperative pain, and acute flare of osteoarthritis and rheumatoid arthritis: a Phase III, 5-day open-label study

    PubMed Central

    Chandanwale, Ajay S; Sundar, Subramanian; Latchoumibady, Kaliaperumal; Biswas, Swati; Gabhane, Mukesh; Naik, Manoj; Patel, Kamlesh

    2014-01-01

    Objective We aimed to evaluate the safety and efficacy of a fixed-dose combination (FDC) of tramadol and diclofenac versus a standard approved FDC of tramadol and paracetamol, in patients with acute moderate to severe pain. Methods A total of 204 patients with moderate to severe pain due to acute musculoskeletal conditions (n=52), acute flare of osteoarthritis (n=52), acute flare of rheumatoid arthritis (n=50), or postoperative pain (n=50) were enrolled in the study at baseline. Each disease category was then randomized to receive either of two treatments for 5 days: group A received an FDC of immediate-release tramadol hydrochloride (50 mg) and sustained-release diclofenac sodium (75 mg) (one tablet, twice daily), and group B received an FDC of tramadol hydrochloride (37.5 mg) and paracetamol (325 mg) (two tablets every 4–6 hours, up to a maximum of eight tablets daily). The primary efficacy end points were reductions in pain intensity from baseline at day 3 and day 5 as assessed by a Visual Analog Scale (VAS) score. Results Group A showed a significant reduction in the VAS score for overall pain from baseline on day 3 (P=0.001) and day 5 (P<0.0001) as compared with group B. The combination of tramadol-diclofenac resulted in few mild to moderate adverse events (nausea, vomiting, epigastric pain, and gastritis), which required minimal management, without any treatment discontinuation. The number of adverse events in group A was nine (8.82%) compared with 22 (21.78%) in group B, after 5 days of treatment. Conclusion An FDC of tramadol-diclofenac showed a significantly greater reduction in pain intensity and was well tolerated compared with tramadol-paracetamol, resulting in better analgesia in patients suffering from moderate to severe pain due to acute musculoskeletal conditions, postoperative pain following orthopedic surgery, or acute flare of osteoarthritis and rheumatoid arthritis. PMID:25152629

  3. The Implementation of Effective Teaching Practices in English Classroom for Grades 8th, 9th, and 10th.

    ERIC Educational Resources Information Center

    Al-Hilawani, Yasser A.; And Others

    This study explored teachers' behavior as related to effective teaching practices in 8th, 9th, and 10th grade English classrooms in Jordan. The study also examined some variables that could predict teachers' implementation of effective teaching practices and aimed at finding an estimate of the percentage of students in 8th, 9th, and 10th grades…

  4. An Early Warning System: Predicting 10th Grade FCAT Success from 6th Grade FCAT Performance. Research Brief. Volume 0711

    ERIC Educational Resources Information Center

    Froman, Terry; Brown, Shelly; Lapadula, Maria

    2008-01-01

    This Research Brief presents a method for predicting 10th grade Florida Comprehensive Assessment Test (FCAT) success from 6th grade FCAT performance. A simple equation provides the most probable single score prediction, and give-or-take error margins define high and low probability zones for expected 10th grade scores. In addition, a double-entry…

  5. Development of 10th Grade Norms for the ASVAB (Armed Services Vocational Aptitude Battery).

    DTIC Science & Technology

    1987-05-01

    OPERATIO D R DIVOI ET AL UNCLASSIFIED MAY 87 CRC-562 N88814-87-C-088i F/G 5 /8 NL. EIh EE EEEnhEhhEEEjhh *i ""’ 1. LI.2 IIuu, - 11111-112.2 02. 1125I...APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. 41 "ERFORMING ORGANIZA71ON REPORT %uM8ER(S) 5 . MONITORING ORGANIZATION REPORT NU MBER(S) CRC 562 ASa...copies) ’ 5 ’, Si S .. j’- , CRC 562 /May 1987 DEVELOPMENT OF 10TH GRADE NORMS FOR THE ASVAB D- R. Divgi Gary E. Home Marine Corps Operations Analysis Group

  6. Collaborating to Move Research Forward: Proceedings of the 10th Annual Bladder Cancer Think Tank.

    PubMed

    Kamat, Ashish M; Agarwal, Piyush; Bivalacqua, Trinity; Chisolm, Stephanie; Daneshmand, Sia; Doroshow, James H; Efstathiou, Jason A; Galsky, Matthew; Iyer, Gopa; Kassouf, Wassim; Shah, Jay; Taylor, John; Williams, Stephen B; Quale, Diane Zipursky; Rosenberg, Jonathan E

    2016-04-27

    The 10th Annual Bladder Cancer Think Tank was hosted by the Bladder Cancer Advocacy Network and brought together a multidisciplinary group of clinicians, researchers, representatives and Industry to advance bladder cancer research efforts. Think Tank expert panels, group discussions, and networking opportunities helped generate ideas and strengthen collaborations between researchers and physicians across disciplines and between institutions. Interactive panel discussions addressed a variety of timely issues: 1) data sharing, privacy and social media; 2) improving patient navigation through therapy; 3) promising developments in immunotherapy; 4) and moving bladder cancer research from bench to bedside. Lastly, early career researchers presented their bladder cancer studies and had opportunities to network with leading experts.

  7. [Contribution of the 10th International Classification of Diseases to pediatric and adolescent psychiatry].

    PubMed

    Vojtík, V

    1993-12-01

    The 10th revision of the classification of mental disorders and behavioural disorders is due to description of clinical symptoms and diagnostic criteria more accurate and enriches the activities of departments of child and adolescent psychiatry. Diagnostics, therapy and prevention profit not only from sections dealing with newly conceived disorders which begin in childhood and adolescence but also other sections where problems relating to children and adolescents are pointed out. The Czech translation inovates clinical pictures given in our textbook of Child psychiatry published in 1963 and thus replaces partly a hitherto not published modern Czech textbook of child and adolescent psychiatry.

  8. From the corner of E. Mccloskey Ave. and N. 10th ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    From the corner of E. Mccloskey Ave. and N. 10th St., looking west with building 135 (gas station) on the left. Beyond it is building 119 and to the right of 119 is the gable end of the north side of 120. Beyond and perpendicular to building 120 are 118 and 117. - Fitzsimons General Hospital, Bounded by East Colfax to south, Peoria Street to west, Denver City/County & Adams County Line to north, & U.S. Route 255 to east, Aurora, Adams County, CO

  9. Health Policy Basics: Implementation of the International Classification of Disease, 10th Revision.

    PubMed

    Outland, Brian; Newman, Mary M; William, Margo J

    2015-10-06

    The International Classification of Diseases (ICD) standardizes diagnostic codes into meaningful criteria to enable the storage and retrieval of information regarding patient care. Whereas other countries have been using ICD, 10th Revision (ICD-10), for years, the United States will transition from ICD, Ninth Revision, Clinical Modification (ICD-9-CM), to ICD-10, on 1 October 2015. This transition is one of the largest and most technically challenging changes that the medical community has experienced in the past several decades. This article outlines the implications of moving to ICD-10 and recommends resources to facilitate the transition.

  10. Epigenetics in autoimmune disorders: highlights of the 10th Sjögren's syndrome symposium.

    PubMed

    Lu, Qianjin; Renaudineau, Yves; Cha, Seunghee; Ilei, Gabor; Brooks, Wesley H; Selmi, Carlo; Tzioufas, Athanasios; Pers, Jacques-Olivier; Bombardieri, Stefano; Gershwin, M Eric; Gay, Steffen; Youinou, Pierre

    2010-07-01

    During the 10th International Symposium on Sjögren's Syndrome held in Brest, France, from October 1-3, 2009 (http://www.sjogrensymposium-brest2009.org), the creation of an international epigenetic autoimmune group has been proposed to establish gold standards and to launch collaborative studies. During this "epigenetics session", leading experts in the field presented and discussed the most recent developments of this topic in Sjögren's Syndrome research. The "Brest epigenetic task force" was born and has scheduled a meeting in Ljubljana, Slovenia during the 7th Autoimmunity congress in May 2010.The following is a report of that session.

  11. EDITORIAL: The 10th International Symposium on Measurement Technology and Intelligent Instruments (ISMTII 2011) The 10th International Symposium on Measurement Technology and Intelligent Instruments (ISMTII 2011)

    NASA Astrophysics Data System (ADS)

    Kim, Seung-Woo

    2012-05-01

    Measurement and instrumentation have long played an important role in production engineering, through supporting both the traditional field of manufacturing and the new field of micro/nanotechnology. Papers published in this special feature were selected and updated from those presented at The 10th International Symposium on Measurement Technology and Intelligent Instruments (ISMTII 2011) held at KAIST, Daejeon, South Korea, on 29 June-2 July 2011. ISMTII 2011 was organized by ICMI (The International Committee on Measurements and Instrumentation), Korean Society for Precision Engineering (KSPE), Japan Society for Precision Engineering (JSPE), Chinese Society for Measurement (CSM) and KAIST. The Symposium was also supported by the Korea BK21 Valufacture Institute of Mechanical Engineering at KAIST. A total of 225 papers, including four keynote papers, were presented at ISMTII 2011, covering a wide range of topics, including micro/nanometrology, precision measurement, online & in-process measurement, surface metrology, optical metrology & image processing, biomeasurement, sensor technology, intelligent measurement & instrumentation, uncertainty, traceability & calibration, and signal processing algorithms. The organizing members recommended publication of updated versions of some of the best ISMTII 2011 papers in this special feature of Measurement Science and Technology. As guest editor, I believe that this special feature presents the newest information on advances in measurement technology and intelligent instruments from basic research to applied systems for production engineering. I would like to thank all the authors for their great contributions to this special feature and the referees for their careful reviews of the papers. I would also like to express our thanks and appreciation to the publishing staff of MST for their dedicated efforts that have made this special feature possible.

  12. Effect of day-case unilateral cochlear implantation in adults on general and disease-specific quality of life, postoperative complications and hearing results, tinnitus, vertigo and cost-effectiveness: protocol for a randomised controlled trial

    PubMed Central

    Derks, Laura S M; Wegner, Inge; Smit, Adriana L; Thomeer, Hans G X M; Topsakal, Vedat; Grolman, Wilko

    2016-01-01

    Introduction Cochlear implantation is an increasingly common procedure in the treatment of severe to profound sensorineural hearing loss (SNHL) in children and adults. It is often performed as a day-case procedure. The major drive towards day-case surgery has been from a logistical, economical and societal perspective, but we also speculate that the patient's quality of life (QoL) is at least equal to inpatient surgery if not increased as a result of rapid discharge and rehabilitation. Even though cochlear implantation seems well suited to a day-case approach and this even seems to be common practice in some countries, evidence is scarce and of low quality to guide us towards the preferred treatment option. Methods and analysis A single-centre, non-blinded, randomised, controlled trial was designed to (primarily) investigate the effect on general QoL of day-case cochlear implantation compared to inpatient cochlear implantation and (secondarily) the effect of both methods on (subjective) hearing improvement, disease-specific QoL, tinnitus, vertigo and cost-effectiveness. 30 adult patients with severe to profound bilateral postlingual SNHL who are eligible for unilateral cochlear implantation will be randomly assigned to either the day-case or inpatient treatment group. The outcome measures will be assessed using auditory evaluations, questionnaires (preoperatively, at 1-week, 3-week, 3-month and 1-year follow-up) and costs diaries (weekly during the first month postoperatively, after which once in a month until 1-year follow-up). Preoperative and postoperative outcomes will be compared. The difference in costs and benefit will be represented using the incremental cost utility/effectiveness ratio. The analyses will be carried out on an intention-to-treat basis. Ethics and dissemination This research protocol was approved by the Institutional Review Board of the UMC Utrecht (NL45590.041.13; V.5, November 2015). The trial results will be disseminated through peer

  13. Postoperative astigmatism.

    PubMed

    Swinger, C A

    1987-01-01

    With the numerous significant advances in surgical methodology--e.g., microinstrumentation, the operating microscope, the surgical keratometer, and intraocular lenses--that have been developed over the past two decades, both surgeons and patients have become increasingly aware of the final optic result of any surgical intervention. This is especially so since the development of refractive surgery, where good uncorrected vision is frequently the final arbiter of success. We have progressed to the stage where the optic manipulation of the cornea, whether intentional or otherwise, can be understood in terms of a number of variables. These include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations. Where these have failed and postoperative astigmatism still occurs, a number of surgical procedures are available to reduce the astigmatic error to an acceptable level.

  14. [Thoracopagus symmetricus. On the separation of Siamese twins in the 10th century A. D. by Byzantine physicians].

    PubMed

    Geroulanos, S; Jaggi, F; Wydler, J; Lachat, M; Cakmakci, M

    1993-01-01

    The byzantine author, Leon Diakonos, mentions in 974/975 A.D. a pair of "siamese twins", e.g., a thoracopagus symmetricus. He had seen them personally several times in Asia Minor when they were about 30 years old. This pair is possibly the same that was "successfully" surgically separated after the death of one of the twins in the second half of the 10th century in Constantinople. This operation is mentioned by two historiographs, Leon Grammatikos and Theodoros Daphnopates. Although the second twin survived the operation, he died three days later. In spite of its lethal outcome, the operation left a long-lasting impression on the historians of that time and was even mentioned 150 years later by Johannes Skylitzes. Furthermore, the manuscript of Skylitzes, now in the library of Madrid, contains a miniature illuminating this operation. This is likely to be the earliest written report of a separation of siamese twins illustrating the high standard of byzantine medicine of that time.

  15. Genomic variation in a global village: report of the 10th annual Human Genome Variation Meeting 2008.

    PubMed

    Brookes, Anthony J; Chanock, Stephen J; Hudson, Thomas J; Peltonen, Leena; Abecasis, Gonçalo; Kwok, Pui-Yan; Scherer, Stephen W

    2009-07-01

    The Centre for Applied Genomics of the Hospital for Sick Children and the University of Toronto hosted the 10th Human Genome Variation (HGV) Meeting in Toronto, Canada, in October 2008, welcoming about 240 registrants from 34 countries. During the 3 days of plenary workshops, keynote address, and poster sessions, a strong cross-disciplinary trend was evident, integrating expertise from technology and computation, through biology and medicine, to ethics and law. Single nucleotide polymorphisms (SNPs) as well as the larger copy number variants (CNVs) are recognized by ever-improving array and next-generation sequencing technologies, and the data are being incorporated into studies that are increasingly genome-wide as well as global in scope. A greater challenge is to convert data to information, through databases, and to use the information for greater understanding of human variation. In the wake of publications of the first individual genome sequences, an inaugural public forum provided the opportunity to debate whether we are ready for personalized medicine through direct-to-consumer testing. The HGV meetings foster collaboration, and fruits of the interactions from 2008 are anticipated for the 11th annual meeting in September 2009.

  16. Genomic Variation in a Global Village: Report of the 10th Annual Human Genome Variation Meeting 2008

    PubMed Central

    Brookes, Anthony J.; Chanock, Stephen J.; Hudson, Thomas J.; Peltonen, Leena; Abecasis, Gonçalo; Kwok, Pui-Yan; Scherer, Stephen W.

    2013-01-01

    The Centre for Applied Genomics of the Hospital for Sick Children and the University of Toronto hosted the 10th Human Genome Variation (HGV) Meeting in Toronto, Canada, in October 2008, welcoming about 240 registrants from 34 countries. During the 3 days of plenary workshops, keynote address, and poster sessions, a strong cross-disciplinary trend was evident, integrating expertise from technology and computation, through biology and medicine, to ethics and law. Single nucleotide polymorphisms (SNPs) as well as the larger copy number variants (CNVs) are recognized by ever-improving array and next-generation sequencing technologies, and the data are being incorporated into studies that are increasingly genome-wide as well as global in scope. A greater challenge is to convert data to information, through databases, and to use the information for greater understanding of human variation. In the wake of publications of the first individual genome sequences, an inaugural public forum provided the opportunity to debate whether we are ready for personalized medicine through direct-to-consumer testing. The HGV meetings foster collaboration, and fruits of the interactions from 2008 are anticipated for the 11th annual meeting in September 2009. PMID:19384970

  17. New directions in research: report from the 10th International Conference on AIDS.

    PubMed Central

    Berger, P B

    1995-01-01

    Research findings presented at the 10th International Conference on AIDS, held in Yokohama, Japan, in August 1994, indicate that few advances have been made in standard antiretroviral therapy for HIV infection. The perinatal administration of AZT (zidovudine) was reported to reduce transmission of HIV from mother to child, and its use in combination with acyclovir appears to improve survival among patients with advanced disease. Other research has focused on asymptomatic patients with long-standing HIV infection. Their survival may be related to the activity of cell antiviral factor, a cytokine produced by CD8+ cells. In gene therapy research, one approach involved the genetic alteration of target cells to enable them to render the virus harmless. A second approach consisted of enhancing the function of CD8+ cells to allow them to compensate for dysfunctional CD4+ cells. The author believes that gene therapy may offer the greatest hope of an effective treatment for HIV infection. PMID:7780908

  18. 10th World IHEA and ECHE Joint Congress: health economics in the age of longevity.

    PubMed

    Jakovljevic, Mihajlo B; Getzen, Thomas E; Torbica, Aleksandra; Anegawa, Tomofumi

    2014-12-01

    The 10th consecutive World Health Economics conference was organized jointly by International Health Economics Association and European Conference on Health Economics Association and took place at The Trinity College, Dublin, Ireland in July 2014. It has attracted broad participation from the global professional community devoted to health economics teaching,research and policy applications. It has provided a forum for lively discussion on hot contemporary issues such as health expenditure projections, reimbursement regulations,health technology assessment, universal insurance coverage, demand and supply of hospital services, prosperity diseases, population aging and many others. The high-profile debate fostered by this meeting is likely to inspire further methodological advances worldwide and spreading of evidence-based policy practice from OECD towards emerging markets.

  19. Tuskegee Bioethics Center 10th anniversary presentation: "Commemorating 10 years: ethical perspectives on origin and destiny".

    PubMed

    Prograis, Lawrence J

    2010-08-01

    More than 70 years have passed since the beginning of the Public Health Service syphilis study in Tuskegee, Alabama, and it has been over a decade since President Bill Clinton formally apologized for it and held a ceremony for the Tuskegee study participants. The official launching of the Tuskegee University National Center for Bioethics in Research and Health Care took place two years after President Clinton's apology. How might we fittingly discuss the Center's 10th Anniversary and the topic 'Commemorating 10 Years: Ethical Perspectives on Origin and Destiny'? Over a decade ago, a series of writers, many of them African Americans, wrote a text entitled 'African-American Perspectives on Biomedical Ethics'; their text was partly responsible for a prolonged reflection by others to produce a subsequent work, 'African American Bioethics: Culture, Race and Identity'. What is the relationship between the discipline of bioethics and African American culture? This and related questions are explored in this commentary.

  20. Space Commerce 1994 Forum: The 10th National Space Symposium. Proceedings report

    NASA Astrophysics Data System (ADS)

    Lipskin, Beth Ann; Patterson, Sara; Aragon, Larry; Brescia, David A.; Flannery, Jack; Mossey, Roberty; Regan, Christopher; Steeby, Kurt; Suhr, Stacy; Zimkas, Chuck

    1994-04-01

    The theme of the 10th National Space Symposium was 'New Windows of Opportunity'. These proceedings cover the following: Business Trends in High Tech Commercialization; How to Succeed in Space Technology Business -- Making Dollars and Sense; Obstacles and Opportunities to Success in Technology Commercialization NASA's Commercial Technology Mission -- a New Way of Doing Business: Policy and Practices; Field Center Practices; Practices in Action -- A New Way: Implementation and Business Opportunities; Space Commerce Review; Windows of Opportunity; the International Space Station; Space Support Forum; Spacelift Update; Competitive Launch Capabilities; Supporting Life on Planet Earth; National Security Space Issues; NASA in the Balance; Earth and Space Observations -- Did We Have Cousins on Mars?; NASA: A New Vision for Science; and Space Technology Hall of Fame.

  1. Collaborating to Move Research Forward: Proceedings of the 10th Annual Bladder Cancer Think Tank

    PubMed Central

    Kamat, Ashish M.; Agarwal, Piyush; Bivalacqua, Trinity; Chisolm, Stephanie; Daneshmand, Sia; Doroshow, James H.; Efstathiou, Jason A.; Galsky, Matthew; Iyer, Gopa; Kassouf, Wassim; Shah, Jay; Taylor, John; Williams, Stephen B.; Quale, Diane Zipursky; Rosenberg, Jonathan E.

    2016-01-01

    The 10th Annual Bladder Cancer Think Tank was hosted by the Bladder Cancer Advocacy Network and brought together a multidisciplinary group of clinicians, researchers, representatives and Industry to advance bladder cancer research efforts. Think Tank expert panels, group discussions, and networking opportunities helped generate ideas and strengthen collaborations between researchers and physicians across disciplines and between institutions. Interactive panel discussions addressed a variety of timely issues: 1) data sharing, privacy and social media; 2) improving patient navigation through therapy; 3) promising developments in immunotherapy; 4) and moving bladder cancer research from bench to bedside. Lastly, early career researchers presented their bladder cancer studies and had opportunities to network with leading experts. PMID:27376139

  2. Space Commerce 1994 Forum: The 10th National Space Symposium. Proceedings report

    NASA Technical Reports Server (NTRS)

    Lipskin, Beth Ann (Editor); Patterson, Sara (Editor); Aragon, Larry (Editor); Brescia, David A. (Editor); Flannery, Jack (Editor); Mossey, Roberty (Editor); Regan, Christopher (Editor); Steeby, Kurt (Editor); Suhr, Stacy (Editor); Zimkas, Chuck (Editor)

    1994-01-01

    The theme of the 10th National Space Symposium was 'New Windows of Opportunity'. These proceedings cover the following: Business Trends in High Tech Commercialization; How to Succeed in Space Technology Business -- Making Dollars and Sense; Obstacles and Opportunities to Success in Technology Commercialization NASA's Commercial Technology Mission -- a New Way of Doing Business: Policy and Practices; Field Center Practices; Practices in Action -- A New Way: Implementation and Business Opportunities; Space Commerce Review; Windows of Opportunity; the International Space Station; Space Support Forum; Spacelift Update; Competitive Launch Capabilities; Supporting Life on Planet Earth; National Security Space Issues; NASA in the Balance; Earth and Space Observations -- Did We Have Cousins on Mars?; NASA: A New Vision for Science; and Space Technology Hall of Fame.

  3. Postoperative incentive spirometry use.

    PubMed

    Hassanzadeh, Hamid; Jain, Amit; Tan, Eric W; Stein, Benjamin E; Van Hoy, Megan L; Stewart, Nadine N; Lemma, Mesfin A

    2012-06-01

    The authors hypothesized that the use of incentive spirometry by orthopedic patients is less than the recommended level and is affected by patient-related factors and type of surgery. To determine its postoperative use, the authors prospectively surveyed all patients in their institution's general orthopedic ward who had undergone elective spine surgery or total knee or hip arthroplasty during a consecutive 3-month period in 2010, excluding patients with postoperative delirium or requiring a monitored bed. All 182 patients (74 men, 108 women; average age, 64.5 years; range, 32-88 years; spine group, n=55; arthroplasty group, n=127), per protocol, received preoperative spirometry education by a licensed respiratory therapist (recommended use, 10 times hourly) and reinforcement education by nurses. Patients were asked twice daily (morning and evening) regarding their spirometry use during the previous 1-hour period by a registered nurse on postoperative days 1 through 3. All data were collected by the same 2 nurses using the same standardized questionnaire. Spirometry use was correlated with surgery type, postoperative day/time, and patient's age and sex. Student's t test, Spearman test, and one-way analysis of variance were used to compare differences (P<.05). Spirometry use averaged 4.1 times per hour (range, 0-10 times). No statistical correlations were found between spirometry use and age. Sex did not influence spirometry use. The arthroplasty group reported significantly higher use than did the spine group: 4.3 and 3.5 times per hour, respectively. Mean use increased significantly between postoperative days 1, 2, and 3.

  4. The 8th-10 th January 2009 snowfalls: a case of Mediterranean warm advection event

    NASA Astrophysics Data System (ADS)

    Aguado, F.; Ayensa, E.; Barriga, M.; Del Hoyo, J.; Fernández, A.; Garrido, N.; Martín, A.; Martín, F.; Roa, I. Martínez, A.; Pascual, R.

    2009-09-01

    From 8 th to 10 th of January 2009, significant snowfalls were reported in many areas of the Iberian Peninsula and the Balearic Islands. This relevant event was very important from the meteorological and social impact point of views. The snow affected many zones, especially the regions of Madrid, Castilla & León and Castilla-La Mancha (Spanish central plateau) with the persistence and thickness of solid precipitation. Up to twenty-five centimetres of snow were reported in some places. On 9th of January the snowfalls caused great social and media impact due to the fact that they took place in the early hours in the Madrid metropolitan areas, affecting both air traffic and land transport. The "Madrid-Barajas" airport was closed and the city was collapsed during several hours. A study of this situation appears in the poster. The snowstorm was characterized by the previous irruption of an European continental polar air mass, that subsequently interacted with a wet and warm air mass of Mediterranean origin, all preceded by low level easterly flows. This type of snowfall is called "warm advection". These winter situations are very efficient from precipitation point of view, generating significant snowfalls and affecting a lot of areas.

  5. [Report of the 10th Annual Meeting of the Chinese society of Clinical Oncology].

    PubMed

    Cho, William Chi-Shing

    2008-03-01

    The 10th Annual Meeting of the Chinese Society of Clinical Oncology (CSCO) was held on 19-23 September 2007 in Harbin. The theme of this conference was "putting standard multidisciplinary cancer management into practice" and special reports of standard multidisciplinary management on various cancers were presented. Over 3 500 clinical oncologists and scientists participated in the 2007 CSCO Annual Meeting where more than ten international top experts were invited to exchange valuable experiences with the delegates. The programs consisted of Education Session, Satellite Symposium and Meet the Professor Session. The latest research results were presented as oral presentations and posters at the congress. Several hotspots were particularly highlighted in this report, including innovative radiotherapy and chemotherapy methods, researches on molecular targets and clinical trials of targeted therapy, such as endostatin, volociximab, cetuximab, bevacizumab and temozolomide. The remarkable research results of anti-cancer Chinese medicine, cancer screening and prognosis were also introduced. This article tries to call the attention to some hot topics in the program that are both new and noteworthy, and it may serve as a highlight of this important international cancer research meeting for clinical oncologists and scientists.

  6. Does STES-Oriented Science Education Promote 10th-Grade Students' Decision-Making Capability?

    NASA Astrophysics Data System (ADS)

    Levy Nahum, Tami; Ben-Chaim, David; Azaiza, Ibtesam; Herskovitz, Orit; Zoller, Uri

    2010-07-01

    Today's society is continuously coping with sustainability-related complex issues in the Science-Technology-Environment-Society (STES) interfaces. In those contexts, the need and relevance of the development of students' higher-order cognitive skills (HOCS) such as question-asking, critical-thinking, problem-solving and decision-making capabilities within science teaching have been argued by several science educators for decades. Three main objectives guided this study: (1) to establish "base lines" for HOCS capabilities of 10th grade students (n = 264) in the Israeli educational system; (2) to delineate within this population, two different groups with respect to their decision-making capability, science-oriented (n = 142) and non-science (n = 122) students, Groups A and B, respectively; and (3) to assess the pre-post development/change of students' decision-making capabilities via STES-oriented HOCS-promoting curricular modules entitled Science, Technology and Environment in Modern Society (STEMS). A specially developed and validated decision-making questionnaire was used for obtaining a research-based response to the guiding research questions. Our findings suggest that a long-term persistent application of purposed decision-making, promoting teaching strategies, is needed in order to succeed in affecting, positively, high-school students' decision-making ability. The need for science teachers' involvement in the development of their students' HOCS capabilities is thus apparent.

  7. FOREWORD: 10th Anglo-French Physical Acoustics Conference (AFPAC 2011)

    NASA Astrophysics Data System (ADS)

    Lhémery, Alain; Saffari, Nader

    2012-03-01

    The Anglo-French Physical Acoustics Conference (AFPAC) had its 10th annual meeting in Villa Clythia, Fréjus, France, from 19-21 January 2011. This series of meetings is a collaboration between the Physical Acoustics Group (PAG) of the Institute of Physics and the Groupe d'Acoustique Physique, Sous-marine et UltraSonore (GAPSUS) of the Société Française d'Acoustique. The conference has its loyal supporters whom we wish to thank. It is their loyalty that has made this conference a success. AFPAC alternates between the UK and France and its format has been designed to ensure that it remains a friendly meeting of very high scientific quality, offering a broad spectrum of subjects, welcoming young researchers and PhD students and giving them the opportunity to give their first presentations in an 'international' conference, but with limited pressure. For the third consecutive year AFPAC is followed by the publication of its proceedings in the form of 18 peer-reviewed papers, which cover the most recent research developments in the field of Physical Acoustics in the UK and France. Alain Lhémery CEA, France Nader Saffari UCL, United Kingdom

  8. 10th annual meeting of the Safety Pharmacology Society: an overview.

    PubMed

    Cavero, Icilio

    2011-03-01

    The 10th annual meeting of the Safety Pharmacology (SP) Society covered numerous topics of educational and practical research interest. Biopolymers - the theme of the keynote address - were presented as essential components of medical devices, diagnostic tools, biosensors, human tissue engineering and pharmaceutical formulations for optimized drug delivery. Toxicology and SP investigators - the topic of the Distinguished Service Award Lecture - were encouraged to collaborate in the development of SP technologies and protocols applicable to toxicology studies. Pharmaceutical companies, originally organizations bearing all risks for developing their portfolios, are increasingly moving towards fully integrated networks which outsource core activities (including SP studies) to large contract research organizations. Future nonclinical data are now expected to be of such high quality and predictability power that they may obviate the need for certain expensive and time-consuming clinical investigations. In this context, SP is called upon to extend its risk assessment purview to areas which currently are not systematically covered, such as drug-induced QRS interval prolongation, negative emotions and feelings (e.g., depression), and minor chronic cardiovascular and metabolic changes (e.g., as produced by drugs for type 2 diabetes) which can be responsible for delayed morbidity and mortality. The recently approved ICH S9 guidance relaxes the traditional regulatory SP package in order to accelerate the clinical access to anticancer drugs for patients with advanced malignancies. The novel FDA 'Animal Rule' guidance proposes that for clinical candidates with well-understood toxicities, marketing approval may be granted exclusively on efficacy data generated in animal studies as human clinical investigations for these types of drugs are either unfeasible or unethical. In conclusion, the core messages of this meeting are that SP should consistently operate according to the 'fit

  9. Progression in Complexity: Contextualizing Sustainable Marine Resources Management in a 10th Grade Classroom

    NASA Astrophysics Data System (ADS)

    Bravo-Torija, Beatriz; Jiménez-Aleixandre, María-Pilar

    2012-01-01

    Sustainable management of marine resources raises great challenges. Working with this socio-scientific issue in the classroom requires students to apply complex models about energy flow and trophic pyramids in order to understand that food chains represent transfer of energy, to construct meanings for sustainable resources management through discourse, and to connect them to actions and decisions in a real-life context. In this paper we examine the process of elaboration of plans for resources management in a marine ecosystem by 10th grade students (15-16 year) in the context of solving an authentic task. A complete class ( N = 14) worked in a sequence about ecosystems. Working in small groups, the students made models of energy flow and trophic pyramids, and used them to solve the problem of feeding a small community for a long time. Data collection included videotaping and audiotaping of all of the sessions, and collecting the students' written productions. The research objective is to examine the process of designing a plan for sustainable resources management in terms of the discursive moves of the students across stages in contextualizing practices, or different degrees of complexity (Jiménez-Aleixandre & Reigosa International Journal of Science Education, 14(1): 51-61 2006), understood as transformations from theoretical statements to decisions about the plan. The analysis of students' discursive moves shows how the groups progressed through stages of connecting different models, between them and with the context, in order to solve the task. The challenges related to taking this sustainability issue to the classroom are discussed.

  10. Report: Combustion Byproducts and Their Health Effects: Summary of the 10th International Congress

    PubMed Central

    Dellinger, Barry; D'Alessio, Antonio; D'Anna, Andrea; Ciajolo, Anna; Gullett, Brian; Henry, Heather; Keener, Mel; Lighty, JoAnn; Lomnicki, Slawomir; Lucas, Donald; Oberdörster, Günter; Pitea, Demetrio; Suk, William; Sarofim, Adel; Smith, Kirk R.; Stoeger, Tobias; Tolbert, Paige; Wyzga, Ron; Zimmermann, Ralf

    2008-01-01

    Abstract The 10th International Congress on Combustion Byproducts and their Health Effects was held in Ischia, Italy, from June 17–20, 2007. It is sponsored by the US NIEHS, NSF, Coalition for Responsible Waste Incineration (CRWI), and Electric Power Research Institute (EPRI). The congress focused on: the origin, characterization, and health impacts of combustion-generated fine and ultrafine particles; emissions of mercury and dioxins, and the development/application of novel analytical/diagnostic tools. The consensus of the discussion was that particle-associated organics, metals, and persistent free radicals (PFRs) produced by combustion sources are the likely source of the observed health impacts of airborne PM rather than simple physical irritation of the particles. Ultrafine particle-induced oxidative stress is a likely progenitor of the observed health impacts, but important biological and chemical details and possible catalytic cycles remain unresolved. Other key conclusions were: (1) In urban settings, 70% of airborne fine particles are a result of combustion emissions and 50% are due to primary emissions from combustion sources, (2) In addition to soot, combustion produces one, possibly two, classes of nanoparticles with mean diameters of ~10 nm and ~1 nm. (3) The most common metrics used to describe particle toxicity, viz. surface area, sulfate concentration, total carbon, and organic carbon, cannot fully explain observed health impacts, (4) Metals contained in combustion-generated ultrafine and fine particles mediate formation of toxic air pollutants such as PCDD/F and PFRs. (5) The combination of metal-containing nanoparticles, organic carbon compounds, and PFRs can lead to a cycle generating oxidative stress in exposed organisms. PMID:22476005

  11. Eruption Mechanism of the 10th Century Eruption in Baitoushan Volcano, China/North Korea

    NASA Astrophysics Data System (ADS)

    Shimano, T.; Miyamoto, T.; Nakagawa, M.; Ban, M.; Maeno, F.; Nishimoto, J.; Jien, X.; Taniguchi, H.

    2005-12-01

    Baitoushan volcano, China/North Korea, is one of the most active volcanoes in Northeastern Asia, and the 10th century eruption was the most voluminous eruption in the world in recent 2000 years. The sequence of the eruption reconstructed recently consists mainly of 6 units of deposits (Miyamoto et al., 2004); plinian airfall (unit B), large pyroclastic flow (unit C), plinian airfall with some intra- plinian pyroclastic flows (unit D), sub-plinian airfall (unit E), and large pyroclastic flow (unit F) with base surge (unit G) in ascending order. The magma erupted during steady eruption in earlier phase was comendite (unit B-C; Phase 1), whereas the magma during fluctuating eruptions in later phase is characterized by trachyte to trachyandesite with various amount of comendite (unit D-G; Phase 2). The wide variety in composition and occurrence of banded pumices strongly indicate mixing or mingling of the two magmas just prior to or during the eruption. The initial water contents had been determined for comendite by melt inclusion analyses (ca. 5.2 wt.%; Horn and Schmincke, 2000). Although the initial water content of the trachytic magma has not been correctly determined yet, the reported water contents of trachytic melt inclusions are lower (3-4 wt.%) than those of comenditic melt (Horn and Schmincke, 2000). We investigated juvenile materials of the eruption sequentially in terms of vesicularity, H2O content in matrix glass and textural characteristics. The vesicularity of pumices are generally high (>0.75) for all units. The residual water contents of the comenditic pumices during Phase 1 are relatively uniform (1.6 wt.%), whereas those of the trachytic scoria during Phase 2 and gray pumices during Phase 1 are low (ca. 0.7-1.3 wt.%). These facts may indicate that the difference in the initial water content, rather than the ascent mechanism of magma, controls the steadiness or fluctuation in eruption styles and the mass flux during the eruption.

  12. Postoperative hyperkalemia.

    PubMed

    Ayach, Taha; Nappo, Robert W; Paugh-Miller, Jennifer L; Ross, Edward A

    2015-03-01

    Hyperkalemia occurs frequently in hospitalized patients and is of particular concern for those who have undergone surgery, with postoperative care provided by clinicians of many disciplines. This review describes the normal physiology and how multiple perioperative factors can disrupt potassium homeostasis and lead to severe elevations in plasma potassium concentration. The pathophysiologic basis of diverse causes of hyperkalemia was used to broadly classify etiologies into those with altered potassium distribution (e.g. increased potassium release from cells or other transcellular shifts), reduced urinary excretion (e.g. reduced sodium delivery, volume depletion, and hypoaldosteronism), or an exogenous potassium load (e.g. blood transfusions). Surgical conditions of particular concern involve: rhabdomyolysis from malpositioning, trauma or medications; bariatric surgery; vascular procedures with tissue ischemia; acidosis; hypovolemia; and volume or blood product resuscitation. Certain acute conditions and chronic co-morbidities present particular risk. These include chronic kidney disease, diabetes mellitus, many outpatient preoperative medications (e.g. beta blockers, salt substitutes), and inpatient agents (e.g. succinylcholine, hyperosmolar volume expanders). Clinicians need to be aware of these pathophysiologic mechanisms for developing perioperative hyperkalemia as many of the risks can be minimized or avoided.

  13. School Climate and the Relationship to Student Learning of Hispanic 10th Grade Students in Arizona Schools

    ERIC Educational Resources Information Center

    Nava Delgado, Mauricio

    2011-01-01

    This study provided an analysis of Hispanic 10th grade student academic achievement in the areas of mathematics, reading and writing as measured by the Arizona's Instrument to Measure Standards. The study is based on data of 163 school districts and 25,103 (95%) students in the state of Arizona as published by the Arizona Department of Education.…

  14. A Comparison of 9th and 10th Grade Boys' and Girls' Bullying Behaviors in Two States.

    ERIC Educational Resources Information Center

    Isernhagen, Jody; Harris, Sandy

    This study examined the incidences of bullying behaviors among male and female 9th and 10th graders in rural Nebraska and suburban Texas schools. Nebraska students were predominantly Caucasion, and Texas students were African American, Hispanic American, and Caucasion. Student surveys examined such issues as how often bullying occurred, where it…

  15. Proceedings of the International Conference on Mobile Learning 2014. (10th, Madrid, Spain, February 28-March 2, 2014)

    ERIC Educational Resources Information Center

    Sánchez, Inmaculada Arnedillo, Ed.; Isaías, Pedro, Ed.

    2014-01-01

    These proceedings contain the papers of the 10th International Conference on Mobile Learning 2014, which was organised by the International Association for Development of the Information Society, in Madrid, Spain, February 28-March 2, 2014. The Mobile Learning 2014 International Conference seeks to provide a forum for the presentation and…

  16. Examining General and Specific Factors in the Dimensionality of Oral Language and Reading in 4th-10th Grades

    ERIC Educational Resources Information Center

    Foorman, Barbara R.; Koon, Sharon; Petscher, Yaacov; Mitchell, Alison; Truckenmiller, Adrea

    2015-01-01

    The objective of this study was to explore dimensions of oral language and reading and their influence on reading comprehension in a relatively understudied population--adolescent readers in 4th through 10th grades. The current study employed latent variable modeling of decoding fluency, vocabulary, syntax, and reading comprehension so as to…

  17. Graduate Students Lend Their Voices: Reflections on the 10th Seminar in Health and Environmental Education Research

    ERIC Educational Resources Information Center

    Russell, Joshua; White, Peta; Fook, Tanya Chung Tiam; Kayira, Jean; Muller, Susanne; Oakley, Jan

    2010-01-01

    Graduate students were invited by their faculty advisors to attend the 10th Seminar in Health and Environmental Education Research. Afterward, they were encouraged to comment on their experiences, involvement, and positioning. Two main authors developed survey questions and retrieved, analyzed, and synthesized the responses of four other graduate…

  18. Predicting 3rd Grade and 10th Grade FCAT Success for 2006-07. Research Brief. Volume 0601

    ERIC Educational Resources Information Center

    Froman, Terry; Rubiera, Vilma

    2006-01-01

    For the past few years the Florida School Code has set the Florida Comprehensive Assessment Test (FCAT) performance requirements for promotion of 3rd graders and graduation for 10th graders. Grade 3 students who do not score at level 2 or higher on the FCAT SSS Reading must be retained unless exempted for special circumstances. Grade 10 students…

  19. Factors Related to Alcohol Use among 6th through 10th Graders: The Sarasota County Demonstration Project

    ERIC Educational Resources Information Center

    Eaton, Danice K.; Forthofer, Melinda S.; Zapata, Lauren B.; Brown, Kelli R. McCormack; Bryant, Carol A.; Reynolds, Sherri T.; McDermott, Robert J.

    2004-01-01

    Alcohol consumption by youth can produce negative health outcomes. This study identified correlates of lifetime alcohol use, recent alcohol use, and binge drinking among youth in sixth through 10th grade (n = 2,004) in Sarasota County, Fla. Results from a closed-ended, quantitative survey acknowledged a range of personal, social and environmental…

  20. Students' Transition Experience in the 10th Year of Schooling: Perceptions That Contribute to Improving the Quality of Schools

    ERIC Educational Resources Information Center

    Torres, Ana Cristina; Mouraz, Ana

    2015-01-01

    The study followed students in their 10th year of schooling that entered a new secondary education school in order to examine their perceptions of their previous schools' work and of its relationship with the difficulties they experience when in the transition. The analysis of 155 completed questionnaires of previous students of nine basic…

  1. Investigating the Effects of a DNA Fingerprinting Workshop on 10th Grade Students' Self Efficacy and Attitudes toward Science.

    ERIC Educational Resources Information Center

    Sonmez, Duygu; Simcox, Amanda

    The purpose of this study was investigate the effects of a DNA Fingerprinting Workshop on 10th grade students' self efficacy and attitudes toward science. The content of the workshop based on high school science curriculum and includes multimedia instruction, laboratory experiment and participation of undergraduate students as mentors. N=93…

  2. 3 CFR 8938 - Proclamation 8938 of March 1, 2013. 10th Anniversary of the United States Department of Homeland...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... of the United States Department of Homeland Security 8938 Proclamation 8938 Presidential Documents Proclamations Proclamation 8938 of March 1, 2013 Proc. 8938 10th Anniversary of the United States Department of Homeland SecurityBy the President of the United States of America A Proclamation Ten years ago, when...

  3. Risk Communication and Public Education in Edmonton, Alberta, Canada on the 10th Anniversary of the "Black Friday" Tornado

    ERIC Educational Resources Information Center

    Blanchard-Boehm, R. Denise; Cook, M. Jeffrey

    2004-01-01

    In July 1997, on the 10th anniversary of the great "Black Friday" Tornado, city officials of Edmonton, the print and broadcast media, agencies dealing in emergency management, and the national weather organisation recounted stories of the 1987, F5 tornado that struck Edmonton on a holiday weekend. The information campaign also presented…

  4. Selected Papers from the International Conference on College Teaching and Learning (10th, Jacksonville, Florida, April 1999).

    ERIC Educational Resources Information Center

    Chambers, Jack A., Ed.

    These 20 papers were selected from those presented at the 10th International Conference on College Teaching and Learning. Papers have the following titles and authors: (1) "Case It! A Project to Integrate Collaborative Case-Based Learning into International Undergraduate Biology Curricula" (Bergland, Klyczek, Lundeberg, Mogen, Johnson); (2) "The…

  5. Influence of V-Diagrams on 10th Grade Turkish Students' Achievement in the Subject of Mechanical Waves

    ERIC Educational Resources Information Center

    Tekes, Hanife; Gonen, Selahattin

    2012-01-01

    The purpose of the present study was to examine how the use of V-diagrams one of the learning techniques used in laboratory studies in experiments conducted regarding the 10th grade lesson unit of "waves" influenced students' achievements. In the study, a quasi-experimental design with a pretest and posttest control group was used. The…

  6. Postoperative conversion disorder.

    PubMed

    Afolabi, Kola; Ali, Sameer; Gahtan, Vivian; Gorji, Reza; Li, Fenghua; Nussmeier, Nancy A

    2016-05-01

    Conversion disorder is a psychiatric disorder in which psychological stress causes neurologic deficits. A 28-year-old female surgical patient had uneventful general anesthesia and emergence but developed conversion disorder 1 hour postoperatively. She reported difficulty speaking, right-hand numbness and weakness, and right-leg paralysis. Neurologic examination and imaging revealed no neuronal damage, herniation, hemorrhage, or stroke. The patient mentioned failing examinations the day before surgery and discontinuing her prescribed antidepressant medication, leading us to diagnose conversion disorder, with eventual confirmation by neuroimaging and follow-up examinations.

  7. Fortified Settlements of the 9th and 10th Centuries ad in Central Europe: Structure, Function and Symbolism.

    PubMed

    Herold, Hajnalka

    2012-11-01

    THE STRUCTURE, FUNCTION(S) and symbolism of early medieval (9th-10th centuries ad) fortified settlements from central Europe, in particular today's Austria, Hungary, Czech Republic and Slovakia, are examined in this paper. It offers an overview of the current state of research together with new insights based on analysis of the site of Gars-Thunau in Lower Austria. Special emphasis is given to the position of the fortified sites in the landscape, to the elements of the built environment and their spatial organisation, as well as to graves within the fortified area. The region under study was situated on the SE border of the Carolingian (and later the Ottonian) Empire, with some of the discussed sites lying in the territory of the 'Great Moravian Empire' in the 9th and 10th centuries. These sites can therefore provide important comparative data for researchers working in other parts of the Carolingian Empire and neighbouring regions.

  8. Recovery from post-operative anaemia.

    PubMed

    Wallis, J P; Wells, A W; Whitehead, S; Brewster, N

    2005-10-01

    Acceptance of lower transfusion thresholds and shorter post-operative stays results in patients leaving hospital after surgery with lower haemoglobin (Hb) than previously. We undertook a prospective observational study to assess the haematological response to post-operative anaemia and to determine the utility of quality of life (QoL) measures in assessing the impact of anaemia on such patients. Thirty patients undergoing unilateral hip arthroplasty had blood samples taken and QoL questionnaires administered pre-operatively and at 7, 28 and 56 days post-operatively. Increased erythropoiesis was evident at day 7 post-operatively. Approximately two-thirds of the post-operative Hb deficit was corrected by day 28. There was evidence of functional iron deficiency in more than one-quarter of patients at day 56. QoL scores used did not show any relationship with Hb in the post-operative period. Red cell 2,3-diphosphoglycerate (2,3DPG) levels increased in proportion to the degree of post-operative anaemia. We concluded that substantial recovery of Hb occurs between day 7 and day 28 post-operatively. Complete recovery of Hb may be delayed beyond day 56 due to development of iron deficiency. Patients are at significant risk of developing post-operative iron deficiency depending on operative blood loss and pre-operative iron stores. Increased red cell 2,3DPG may offset the effect of anaemia on oxygen delivery. We found no evidence that anaemia produces a measurable effect on chosen QoL scores in the post-operative period.

  9. The Earlier the Better? Taking the AP® in 10th Grade. Research Report No. 2012-10

    ERIC Educational Resources Information Center

    Rodriguez, Awilda; McKillip, Mary E. M.; Niu, Sunny X.

    2013-01-01

    In this report, the authors examine the impact of scoring a 1 or 2 on an AP® Exam in 10th grade on later AP Exam participation and performance. As access to AP courses increases within and across schools, a growing number of students are taking AP courses and exams in the earlier grades of high school. Using a matched sample of AP and no-AP…

  10. The 10th Anniversary of September 11 and Our Response to the Nation's Youth

    ERIC Educational Resources Information Center

    Sulkowski, Michael L.; Lazarus, Philip J.

    2011-01-01

    Ten Septembers ago, people witnessed the worst terrorist attack ever committed on American soil. Most Americans can still see the images of airplanes violently crashing into buildings. On that fateful September day in 2001, the National Association of School Psychologists (NASP) was faced with the challenge of trying to support the needs of…

  11. Proceedings of the Navy Symposium on Aeroballistics (10th) Held at the Sheraton Motor Inn, Fredericksburg, Virginia, on 15-16-17 July 1975. Volume 2

    DTIC Science & Technology

    1975-07-17

    Technical Report AFATL’.TR-73-l II, Air Force Armament Laboratoiv, May. 1973. 147 10th Navy Symposium on Aeroballistics Vol. 2 t 13. Miko , R. J., and...a’ the boiling temperature (or 322 10th Navy Symposium on Aeroballistics Ii!- Vol. 2 WD2503 FLOW CONTROL VALVE PISTON VALVE TADFLOWMETER PLUG WAND FL

  12. The Effect of Using the "SQP2RS via WTL" Strategy through Science Context to 10th Graders' Reading Comprehension in English in Palestine

    ERIC Educational Resources Information Center

    Qabaja, Ziad Mohammed Mahmoud; Nafi', Jamal Subhi Ismail; Abu-Nimah, Maisa' Issa Khalil

    2016-01-01

    The study aimed at investigating the effect of using the "SQP2RS via WTL" strategy through science context to 10th graders' reading comprehension in English in Bethlehem district in Palestine. The study has been applied on a purposeful sample of 10th grade students at public schools in Bethlehem district in the academic year 2015/2016.…

  13. Evaluation of the 10th Grade Computerized Mathematics Curriculum from the Perspective of the Teachers and Educational Supervisors in the Southern Region in Jordan

    ERIC Educational Resources Information Center

    Al-Tarawneh, Sabri Hassan; Al-Qadi, Haitham Mamdouh

    2016-01-01

    This study aimed at evaluating the 10th grade computerized mathematics curriculum from the perspective of the teachers and supervisors in the southern region in Jordan. The study population consisted of all the teachers who teach the 10th grade in the southern region, with the total of (309) teachers and (20) supervisors. The sample consisted of…

  14. Early enteral nutrition therapy in congenital cardiac repair postoperatively: A randomized, controlled pilot study

    PubMed Central

    Sahu, Manoj Kumar; Singal, Anuradha; Menon, Ramesh; Singh, Sarvesh Pal; Mohan, Alka; Manral, Mala; Singh, Divya; Devagouru, V.; Talwar, Sachin; Choudhary, Shiv Kumar

    2016-01-01

    .20) than those in the intervention group. Similarly, infants in control group stayed for longer duration in the ICU (13.2 ± 8.9 days) and hospital (16.5 ± 9.8 days) as compared to the intervention group (11.0 ± 6.1 days; 14.1 ± 7.0 days) (P = 0.14 and 0.17, respectively). The LOIS and LOHS were decreased by 2.2 and 2.4 days, respectively, in the intervention group compared to control group. The infection rate (3/25; 5/25) and mortality rate (1/25; 2/25) were lower in the intervention group than those in the control group. The energy intake in the intervention group was 40 kcal more (i.e., 127.2 ± 56.1 kcal vs. 87.1 ± 38.3 kcal) than the control group on the 10th postoperative day. Conclusions: Early enteral/oral feeding after cardiac surgery is feasible and recommended. In addition, enriching the EBM is helpful in achieving the maximum possible calorie intake in the postoperative period. EN therapy might help in providing adequate nutrition, and it decreases ventilation duration, infection rate, LOIS, LOHS, and mortality. PMID:27716696

  15. Is the 10th and 11th Intercostal Space a Safe Approach for Percutaneous Nephrostomy and Nephrolithotomy?

    SciTech Connect

    Muzrakchi, Ahmed Al; Szmigielski, W. Omar, Ahmed J.S.; Younes, Nagy M.

    2004-09-15

    The aim of this study was to determine the rate of complications in percutaneous nephrostomy (PCN) and nephrolithotomy (PCNL) performed through the 11th and 10th intercostal spaces using our monitoring technique and to discuss the safety of the procedure. Out of 398 PCNs and PCNLs carried out during a 3-year period, 56 patients had 57 such procedures performed using an intercostal approach. The 11th intercostal route was used in 42 and the 10th in 15 cases. One patient had two separate nephrostomies performed through the 10th and 11th intercostal spaces. The technique utilizes bi-planar fluoroscopy with a combination of a conventional angiographic machine to provide anterior-posterior fluoroscopy and a C-arm mobile fluoroscopy machine to give a lateral view, displayed on two separate monitors. None of the patients had clinically significant thoracic or abdominal complications. Two patients had minor chest complications. Only one developed changes (plate atelectasis, elevation of the hemi-diaphragm) directly related to the nephrostomy (2%). The second patient had bilateral plate atelectasis and unilateral congestive lung changes after PCNL. These changes were not necessarily related to the procedure but rather to general anesthesia during nephrolithotomy. The authors consider PCN or PCNL through the intercostal approach a safe procedure with a negligible complication rate, provided that it is performed under bi-planar fluoroscopy, which allows determination of the skin entry point just below the level of pleural reflection and provides three-dimensional monitoring of advancement of the puncturing needle toward the target entry point.

  16. Coping with the 10th anniversary of 9/11: Muslim Americans' sadness, fear, and anger.

    PubMed

    Rodriguez Mosquera, Patricia M; Khan, Tasmiha; Selya, Arielle

    2013-01-01

    The events of 9/11 marked an increase in prejudice, discrimination, and other forms of unfair treatment toward Muslim Americans. We present a study that examined the emotions of Muslim Americans in the days preceding the ten-year 9/11 anniversary. We measured the antecedents (concerns) and consequences (coping) of sadness, fear, and anger. The 9/11 anniversary precipitated intense concerns with loss and discrimination, and intense feelings of sadness, fear, and anger. We measured three coping responses: rumination, avoidance of public places, and religious coping. Participants engaged in all three coping responses, with seeking solace in one's religion being the most frequent response. Moreover, emotions mediated the relationship between concerns and coping responses. Sadness accounted for the association between concern with loss and rumination. Fear explained the association between concern with discrimination and avoidance. Anger accounted for the association between concern with discrimination and religious coping.

  17. Factors related to alcohol use among 6th through 10th graders: the Sarasota County Demonstration Project.

    PubMed

    Eaton, Danice K; Forthofer, Melinda S; Zapata, Lauren B; Brown, Kelli R; Bryant, Carol A; Reynolds, Sherri T; McDermott, Robert J

    2004-03-01

    Alcohol consumption by youth can produce negative health outcomes. This study identified correlates of lifetime alcohol use, recent alcohol use, and binge drinking among youth in sixth through 10th grade (n = 2,004) in Sarasota County, Fla. Results from a closed-ended, quantitative survey acknowledged a range of personal, social, and environmental influences. Breadth of these influences supports a need for multifaceted, community-based interventions for effective prevention of youth alcohol use. This study was unique because it represents population-specific research in which community partners are using the findings to develop community-specific social marketing interventions to prevent underage drinking and promote alternative behaviors.

  18. Analysis and test for space shuttle propellant dynamics (1/10th scale model test results). Volume 1: Technical discussion

    NASA Technical Reports Server (NTRS)

    Berry, R. L.; Tegart, J. R.; Demchak, L. J.

    1979-01-01

    Space shuttle propellant dynamics during ET/Orbiter separation in the RTLS (return to launch site) mission abort sequence were investigated in a test program conducted in the NASA KC-135 "Zero G" aircraft using a 1/10th-scale model of the ET LOX Tank. Low-g parabolas were flown from which thirty tests were selected for evaluation. Data on the nature of low-g propellant reorientation in the ET LOX tank, and measurements of the forces exerted on the tank by the moving propellent will provide a basis for correlation with an analytical model of the slosh phenomenon.

  19. Cold winters in Poland in the period from 10th century to the first decade of 21st century

    NASA Astrophysics Data System (ADS)

    Limanowka, D.; Cebulak, E.; Pyrc, R.

    2010-09-01

    Extreme weather phenomena together with their exceptional course and intensity have always been dangerous for people. In the historical documents such phenomena were marked as basic disasters. First notes about weather phenomena were made in Polish lands in the 10th century. Research included extremely cold and snowy winters which were described in historical documents as a extreme meteorological phenomena. Data from the period of instrumental measurements in the 20th century were studied in detail. The results were referred to last 500 years. The information obtained gives approximate image of extreme winters in the historical times in Polish lands. All available multi-proxy data were used

  20. [Peri- and postoperative use of low molecular weight heparin in peripheral vascular surgery].

    PubMed

    Samama, C M; Mouren, S; Bridel, M P; Combe, S; Koskas, F; Kieffer, E; Viars, P

    1990-01-01

    A pilot study has been conducted in ten consecutive patients undergoing femoro-popliteal reconstruction or distal vascular surgery under epidural anaesthesia. Immediately before arterial cross-clamping, enoxaparin (E) (75 anti-Xa IU.kg-1) was injected intravenously (i.v.). During surgery, washing of the saphenous or polytetrafluoroethylene (PTFE) graft has been performed using enoxaparin. Enoxaparin (75 anti-Xa IU.kg-1) was administered subcutaneously (S.C.) 8 hours after the i.v. injection, and then every 12 hours during 10 days. The patency of the vascular reconstruction and the side-effects of E administration were evaluated clinically before and during surgery, then by a daily clinical examination. Echo-Doppler and/or arteriography were also performed preoperatively and on the 10th postoperative day. Haematocrit, platelet count, activated partial thromboplastin time, prothrombin time, thrombin time, fibrinogen and anti-Xa activity were assessed. None of the patients developed venous or arterial thrombosis and all the by-pass grafts remained patient. Only one minor surgical bleeding occurred on the first post operative day, despite anti-Xa levels in the expected range. One patient developed minor haematomas at the injection site. No bleeding was observed. Further randomized studies comparing LMWH and UH are required in order to substantiate these preliminary clinical and biological findings.

  1. Healing with animals in the Levant from the 10th to the 18th century

    PubMed Central

    Lev, Efraim

    2006-01-01

    Animals and products derived from different organs of their bodies have constituted part of the inventory of medicinal substances used in various cultures since ancient times. The article reviews the history of healing with animals in the Levant (The Land of Israel and parts of present-day Syria, Lebanon, and Jordan, defined by the Muslims in the Middle Ages as Bilad al-Sham) in the medieval and early Ottoman periods. Intensive research into the phenomenon of zootherapy in the medieval and early Ottoman Levant has yielded forty-eight substances of animal origin that were used medicinally. The vast majority of these substances were local and relatively easy to obtain. Most of the substances were domestic (honey, wax, silkworm, etc.), others were part of the local wildlife (adder, cuttle fish, flycatcher, firefly, frog, triton, scorpion, etc.), part of the usual medieval household (milk, egg, cheese, lamb, etc.), or parasites (louse, mouse, stinkbug, etc.). Fewer substances were not local but exotic, and therefore rare and expensive (beaver testicles, musk oil, coral, ambergris, etc.). The range of symptoms that the substances of animal origin were used to treat was extensive and included most of the known diseases and maladies of that era: mainly hemorrhoids, burns, impotence, wounds, and skin, eye, and stomach diseases. Changes in the moral outlook of modern societies caused the use of several substances of animal origin to cease in the course of history. These include mummy, silkworm, stinkbug, scarabees, snail, scorpion, and triton. PMID:16504024

  2. 28 CFR 5.800 - Ten-day filing requirement.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Ten-day filing requirement. 5.800 Section... REGISTRATION ACT OF 1938, AS AMENDED § 5.800 Ten-day filing requirement. The 10-day filing requirement provided... is deposited in the U.S. mails no later than the 10th day of the period....

  3. 28 CFR 5.800 - Ten-day filing requirement.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Ten-day filing requirement. 5.800 Section... REGISTRATION ACT OF 1938, AS AMENDED § 5.800 Ten-day filing requirement. The 10-day filing requirement provided... is deposited in the U.S. mails no later than the 10th day of the period....

  4. 28 CFR 5.800 - Ten-day filing requirement.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Ten-day filing requirement. 5.800 Section... REGISTRATION ACT OF 1938, AS AMENDED § 5.800 Ten-day filing requirement. The 10-day filing requirement provided... is deposited in the U.S. mails no later than the 10th day of the period....

  5. 28 CFR 5.800 - Ten-day filing requirement.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Ten-day filing requirement. 5.800 Section... REGISTRATION ACT OF 1938, AS AMENDED § 5.800 Ten-day filing requirement. The 10-day filing requirement provided... is deposited in the U.S. mails no later than the 10th day of the period....

  6. Preoperative Sleep Disruption and Postoperative Delirium

    PubMed Central

    Leung, Jacqueline M.; Sands, Laura P.; Newman, Stacey; Meckler, Gabriela; Xie, Yimeng; Gay, Caryl; Lee, Kathryn

    2015-01-01

    Study Objectives: To describe preoperative and postoperative sleep disruption and its relationship to postoperative delirium. Design: Prospective cohort study with 6 time points (3 nights pre-hospitalization and 3 nights post-surgery). Setting: University medical center. Patients: The sample consisted of 50 English-speaking patients ≥ 40 years of age scheduled for major non-cardiac surgery, with an anticipated hospital stay ≥ 3 days. Interventions: None. Measurements and results: Sleep was measured before and after surgery for a total of 6 days using a wrist actigraph to quantify movement in a continuous fashion. Postoperative delirium was measured by a structured interview using the Confusion Assessment Method. Sleep variables for patients with (n = 7) and without (n = 43) postoperative delirium were compared using the unpaired Student t-tests or χ2 tests. Repeated measures analysis of variance for the 6 days was used to examine within-subject changes over time and between group differences. The mean age of the patients was 66 ± 11 years (range 43–91 years), and it was not associated with sleep variables or postoperative delirium. The incidence of postoperative delirium observed during any of the 3 postoperative days was 14%. For the 7 patients who subsequently developed postoperative delirium, wake after sleep onset (WASO) as a percentage of total sleep time was significantly higher (44% ± 22%) during the night before surgery compared to the patients who did not subsequently developed delirium (21% ± 20%, p = 0.012). This sleep disruption continued postoperatively, and to a greater extent, for the first 2 nights after surgery. Patients with WASO < 10% did not experience postoperative delirium. Self-reported sleep disturbance did not differ between patients with vs. without postoperative delirium. Conclusions: In this pilot study of adults over 40 years of age, sleep disruption was more severe before surgery in the patients who experienced postoperative

  7. Fortified Settlements of the 9th and 10th Centuries ad in Central Europe: Structure, Function and Symbolism

    PubMed Central

    Herold, Hajnalka

    2012-01-01

    THE STRUCTURE, FUNCTION(S) and symbolism of early medieval (9th–10th centuries ad) fortified settlements from central Europe, in particular today’s Austria, Hungary, Czech Republic and Slovakia, are examined in this paper. It offers an overview of the current state of research together with new insights based on analysis of the site of Gars-Thunau in Lower Austria. Special emphasis is given to the position of the fortified sites in the landscape, to the elements of the built environment and their spatial organisation, as well as to graves within the fortified area. The region under study was situated on the SE border of the Carolingian (and later the Ottonian) Empire, with some of the discussed sites lying in the territory of the ‘Great Moravian Empire’ in the 9th and 10th centuries. These sites can therefore provide important comparative data for researchers working in other parts of the Carolingian Empire and neighbouring regions. PMID:23564981

  8. PREFACE: 10th International Conference on Clustering Aspects of Nuclear Structure and Dynamics (CLUSTER'12)

    NASA Astrophysics Data System (ADS)

    Lovas, R. G.; Dombrádi, Zs; Kiss, G. G.; Kruppa, A. T.; Lévai, G.

    2013-04-01

    As Editors of this Proceedings volume and organizers as well as participants of the Conference, let us sum up a few facts about the Conference and let us add some subjective notes. The conference was held at Köolcsey Centre, a prestigious site of scientific and business meetings and cultural events in the city of Debrecen, Hungary, 24-28 September 2012. The city was chosen as the home of the Institute of Nuclear Research of the Hungarian Academy of Sciences, the home institution of the organizers. The Institute was visited by some of the participants. The organizing team was complemented by some belonging to the University of Debrecen, which made it possible to hold the conference dinner in the marvellous covered 'ceremonial court' of the University. The participants were taken for an excursion and wine tasting to a wine cellar at Tokaj, centre of, historically, the most significant wine producing area in Hungary. By coincidence, the closing day coincided with the day of what is called the Researchers' Night in the European Union. That night, (or rather, that evening) every year there is a public lecture in the Institute of Nuclear Research for a general audience, mainly secondary-school pupils. The public lecture scheduled on this occasion was held by one of the participants of the conference who represented the world outside Hungary and yet was able to deliver a talk in Hungarian. He is Professor Kálmán Varga, Vanderbilt University. The title of his talk was Simulation of Nanosystems ( http://kutatokejszakaja.hu/2012/esemenynaptar/esemeny.php?id=112&menu_id=4). There were 115 registered participants, representing 22 countries of Europe, Africa, Asia, Central, South and North America. We had 44 plenary talks and 47 talks presented in parallel sessions. In the Programme list the talks are arranged following the session structure of the Conference. In this list the invited speakers are marked by asterisks. All the talks in the plenary sessions were invited talks

  9. Predictors of intent to pursue a college health science education among high achieving minority 10(th) graders.

    PubMed

    Zebrak, Katarzyna A; Le, Daisy; Boekeloo, Bradley O; Wang, Min Qi

    Minority populations are underrepresented in fields of science, perhaps limiting scientific perspectives. Informed by recent studies using Social Cognitive Career Theory, this study examined whether three conceptual constructs: self-efficacy, perceived adult support, and perceptions of barriers, as well as several discrete and immutable variables, were associated with intent to pursue college science education in a sample (N = 134) of minority youth (70.1% female and 67.2% African American). A paper-and-pencil survey about pursuit of college science was administered to 10th graders with a B- or better grade point average from six high schools in an underserved community. Results indicated that the three conceptual constructs were bivariate correlates of intent to pursue college science education. Only perceived adult support and knowing whether a parent received college education were significant predictors in multivariate modeling. These results build on previous research and provide further insight into youth decision-making regarding pursuit of college science.

  10. Predictors of intent to pursue a college health science education among high achieving minority 10th graders

    PubMed Central

    Zebrak, Katarzyna A.; Le, Daisy; Boekeloo, Bradley O.; Wang, Min Qi

    2014-01-01

    Minority populations are underrepresented in fields of science, perhaps limiting scientific perspectives. Informed by recent studies using Social Cognitive Career Theory, this study examined whether three conceptual constructs: self-efficacy, perceived adult support, and perceptions of barriers, as well as several discrete and immutable variables, were associated with intent to pursue college science education in a sample (N = 134) of minority youth (70.1% female and 67.2% African American). A paper-and-pencil survey about pursuit of college science was administered to 10th graders with a B- or better grade point average from six high schools in an underserved community. Results indicated that the three conceptual constructs were bivariate correlates of intent to pursue college science education. Only perceived adult support and knowing whether a parent received college education were significant predictors in multivariate modeling. These results build on previous research and provide further insight into youth decision-making regarding pursuit of college science. PMID:25598654

  11. The Interpretations and Applications of Boethius's Introduction to the Arithmetic II,1 at the End of the 10th Century

    NASA Astrophysics Data System (ADS)

    Otisk, Marek

    This paper deals with comments and glosses to the first chapter of the second book of Boethius's Introduction to Arithmetic from the last quarter of the 10th century. Those texts were written by Gerbert of Aurillac (Scholium ad Boethii Arithmeticam Institutionem l. II, c. 1), Abbo of Fleury (commentary on the Calculus by Victorius of Aquitaine, the so-called De numero, mensura et pondere), Notker of Liège (De superparticularibus) and by the anonymous author (De arithmetica Boetii). The main aim of this paper is to show that Boethius's statements about the converting numerical sequences to equality from this work could be interpreted minimally in two different ways. This paper discussed also the application of this topic in other liberal arts (like astronomy, music, grammar etc.) and in playing game called rithmomachia, the medieval philosophers' game.

  12. Optical and microphysical properties of mineral dust and biomass burning aerosol observed over Warsaw on 10th July 2013

    NASA Astrophysics Data System (ADS)

    Janicka, Lucja; Stachlewska, Iwona; Veselovskii, Igor; Baars, Holger

    2016-04-01

    Biomass burning aerosol originating from Canadian forest fires was widely observed over Europe in July 2013. Favorable weather conditions caused long-term westward flow of smoke from Canada to Western and Central Europe. During this period, PollyXT lidar of the University of Warsaw took wavelength dependent measurements in Warsaw. On July 10th short event of simultaneous advection of Canadian smoke and Saharan dust was observed at different altitudes over Warsaw. Different origination of both air masses was indicated by backward trajectories from HYSPLIT model. Lidar measurements performed with various wavelength (1064, 532, 355 nm), using also Raman and depolarization channels for VIS and UV allowed for distinguishing physical differences of this two types of aerosols. Optical properties acted as input for retrieval of microphysical properties. Comparisons of microphysical and optical properties of biomass burning aerosols and mineral dust observed will be presented.

  13. Postoperative pain assessment after septorhinoplasty.

    PubMed

    Wittekindt, D; Wittekindt, C; Schneider, G; Meissner, W; Guntinas-Lichius, O

    2012-06-01

    Postoperative pain after septorhinoplasty and its optimal management has not been described in detail. Fifty-two adult septorhinoplasty patients were included in a prospective cohort single center study. Patients' and surgical characteristics were evaluated. Outcome and process parameters were analyzed using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Management (QUIPS) on the first postoperative day. Pain during the first operative day after septorhinoplasty was moderate. Pain management predominately consisted of remifentanil intraoperatively, metamizole in the recovery room, in combination with piritramide in one-third of the patients, and metamizole on ward. Patients younger than 31 years were less satisfied with pain management (P = 0.018). Open rhinoplasty was associated with less satisfaction with pain management (P = 0.007). Use of rib grafts led to more mobility, breathing, sleeping and mood disturbances (P = 0.003, 0.047; 0.047; 0.022, respectively). Preoperative pain counseling was followed by higher satisfaction, less breathing and mood disturbances after surgery (P = 0.021; 0.004; 0.046, respectively). Opioids in the recovery room in addition to non-opioids and treatment with non-opioids on ward led to less maximal pain (P = 0.027 and 0.040, respectively). We conclude that QUIPS is an easy tool to evaluate the quality of postoperative pain management following rhinoplasty. Preoperative pain counseling, specific care for patients with rib grafts, consequent use of opioids in the recovery room in addition to non-opioids, and use of non-opioids on ward seem to be effective to improve pain management after septorhinoplasty.

  14. International Classification of Diseases 10th edition-based disability adjusted life years for measuring of burden of specific injury

    PubMed Central

    Kim, Yu Jin; Shin, Sang Do; Park, Hye Sook; Song, Kyoung Jun; Cho, Jin Sung; Lee, Seung Chul; Kim, Sung Chun; Park, Ju Ok; Ahn, Ki Ok; Park, Yu Mi

    2016-01-01

    Objective We aimed to develop an International Classification of Diseases (ICD) 10th edition injury code-based disability-adjusted life year (DALY) to measure the burden of specific injuries. Methods Three independent panels used novel methods to score disability weights (DWs) of 130 indicator codes sampled from 1,284 ICD injury codes. The DWs were interpolated into the remaining injury codes (n=1,154) to estimate DWs for all ICD injury codes. The reliability of the estimated DWs was evaluated using the test-retest method. We calculated ICD-DALYs for individual injury episodes using the DWs from the Korean National Hospital Discharge Injury Survey (HDIS, n=23,160 of 2004) database and compared them with DALY based on a global burden of disease study (GBD-DALY) regarding validation, correlation, and agreement for 32 injury categories. Results Using 130 ICD 10th edition injury indicator codes, three panels determined the DWs using the highest reliability (person trade-off 1, Spearman r=0.724, 0.788, and 0.875 for the three panel groups). The test-retest results for the reliability were excellent (Spearman r=0.932) (P<0.001). The HDIS database revealed injury burden (years) as follows: GBD-DALY (138,548), GBD-years of life disabled (130,481), and GBD-years of life lost (8,117) versus ICD-DALY (262,246), ICD-years of life disabled (255,710), and ICD-years of life lost (6,537), respectively. Spearman’s correlation coefficient of the DALYs between the two methods was 0.759 (P<0.001), and the Bland-Altman test displayed an acceptable agreement, with exception of two categories among 32 injury groups. Conclusion The ICD-DALY was developed to calculate the burden of injury for all injury codes and was validated with the GBD-DALY. The ICD-DALY was higher than the GBD-DALY but showed acceptable agreement. PMID:28168229

  15. Day to Day

    ERIC Educational Resources Information Center

    Jurecki, Dennis

    2006-01-01

    A clean, healthy and safe school provides students, faculty and staff with an environment conducive to learning and working. However, budget and staff reductions can lead to substandard cleaning practices and unsanitary conditions. Some school facility managers have been making the switch to a day-schedule to reduce security and energy costs, and…

  16. Understanding postoperative fatigue.

    PubMed

    Rose, E A; King, T C

    1978-07-01

    Performance characteristics of the central nervous, cardiovascular, respiratory and muscular systems in man postoperatively have received little investigative attention, despite the well known syndrome of postoperative fatigue. The impairmen in perception and psychomotor skills that has been shown to result from caloric restriction, bedrest, sedation and sleep deprivation suggests that a similar deficit may occur after surgical procedures. After a simple elective surgical procedure, maximal oxygen uptake decreases and the adaptability of heart rate to submaximal workloads is impaired. Similar deleterious effects on cardiorespiratory performance have been documented with starvation and bedrest; an understanding of cardiorespiratory performance postoperatively awaits further investigation. Maximal muscular force of contraction is also impaired by caloric restriction and bedrest, suggesting that similar effects may be seen in the postoperative state, although this has not been studied. A better understanding of the syndrome of postoperative fatigue could be achieved by a descriptive analysis of physiologic performance postoperatively. Such descriptive data could form the basis for objective evaluation of therapeutic measures intended to improve performance, such as nutritional supplementation and pharmacologic intervention. The observation that exercise with the patient in the supine position may decrease the impairment in maximal aerobic power otherwise expected in immobilized patients suggests that controlled exercise therapy may be of value in reducing physiologic impairment postoperatively.

  17. The 10th anniversary of the Junior Members and Affiliates of the European Academy of Allergy and Clinical Immunology.

    PubMed

    Skevaki, Chrysanthi L; Maggina, Paraskevi; Santos, Alexandra F; Rodrigues-Alves, Rodrigo; Antolin-Amerigo, Dario; Borrego, Luis Miguel; Bretschneider, Isabell; Butiene, Indre; Couto, Mariana; Fassio, Filippo; Gardner, James; Xatzipsalti, Maria; Hovhannisyan, Lilit; Hox, Valerie; Makrinioti, Heidi; O Neil, Serena E; Pala, Gianni; Rudenko, Michael; Santucci, Annalisa; Seys, Sven; Sokolowska, Milena; Whitaker, Paul; Heffler, Enrico

    2011-12-01

    This year is the 10th anniversary of the European Academy of Allergy and Clinical Immunology (EAACI) Junior Members and Affiliates (JMAs). The aim of this review is to highlight the work and activities of EAACI JMAs. To this end, we have summarized all the initiatives taken by JMAs during the last 10 yr. EAACI JMAs are currently a group of over 2380 clinicians and scientists under the age of 35 yr, who support the continuous education of the Academy's younger members. For the past decade, JMAs enjoy a steadily increasing number of benefits such as free online access to the Academy's journals, the possibility to apply for Fellowships and the Mentorship Program, travel grants to attend scientific meetings, and many more. In addition, JMAs have been involved in task forces, cooperation schemes with other scientific bodies, organization of JMA focused sessions during EAACI meetings, and participation in the activities of EAACI communication platforms. EAACI JMA activities represent an ideal example of recruiting, training, and educating young scientists in order for them to thrive as future experts in their field. This model may serve as a prototype for other scientific communities, several of which have already adapted similar policies.

  18. XAFS study of copper and silver nanoparticles in glazes of medieval middle-east lustreware (10th-13th century)

    NASA Astrophysics Data System (ADS)

    Padovani, S.; Puzzovio, D.; Sada, C.; Mazzoldi, P.; Borgia, I.; Sgamellotti, A.; Brunetti, B. G.; Cartechini, L.; D'Acapito, F.; Maurizio, C.; Shokoui, F.; Oliaiy, P.; Rahighi, J.; Lamehi-Rachti, M.; Pantos, E.

    2006-06-01

    It has recently been shown that lustre decoration of medieval and Renaissance pottery consists of silver and copper nanoparticles dispersed in the glassy matrix of the ceramic glaze. Here the findings of an X-ray absorption fine structure (XAFS) study on lustred glazes of shards belonging to 10th and 13rd century pottery from the National Museum of Iran are reported. Absorption spectra in the visible range have been also measured in order to investigate the relations between colour and glaze composition. Gold colour is mainly due to Ag nanoparticles, though Ag+, Cu+ and Cu2+ ions can be also dispersed within the glassy matrix, with different ratios. Red colour is mainly due to Cu nanoparticles, although some Ag nanoparticles, Ag+ and Cu+ ions can be present. The achievement of metallic Cu and the absence of Cu2+ indicate a higher reduction of copper in red lustre. These findings are in substantial agreement with previous results on Italian Renaissance pottery. In spite of the large heterogeneity of cases, the presence of copper and silver ions in the glaze confirms that lustre formation is mediated by a copper- and silver-alkali ion exchange, followed by nucleation and growth of metal nanoparticles.

  19. Energy-drink consumption and its relationship with substance use and sensation seeking among 10th grade students in Istanbul.

    PubMed

    Evren, Cuneyt; Evren, Bilge

    2015-06-01

    Aim of this study was to determine the prevalence and correlates of energy-drink (ED) consumption among 10th grade students in Istanbul/Turkey. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul. The questionnaire included sections about demographic data, self-destructive behavior and use of substances including tobacco, alcohol and drugs. Also Psychological Screening Test for Adolescents (PSTA) was used. The analyses were conducted based on the 4957 subjects. Rate of those reported a ED consumption once within last year was 62.0% (n=3072), whereas rate of those reported ED consumption at least once in a month was 31.1%. There were consistent, statistically significant associations between genders, lifetime substance use (tobacco, alcohol and drug use), measures of sensation seeking, psychological problems (depression, anxiety, anger, impulsivity) and self-destructive behavior (self-harming behavior and suicidal thoughts) with ED consumption. In logistic regression models male gender, sensation seeking, life-time tobacco, alcohol and drug use predicted all frequencies of ED consumption. In addition to these predictors, anger and self-harming behavior also predicted ED consumption at least once in a month. There were no interactions between the associations of lifetime tobacco, alcohol and drug use with ED consumption. The findings suggest that the ED consumption of male students is related with three clusters of substances (tobacco, alcohol and drug) through sensation seeking and these relationships do not interact with each other.

  20. [Chronic postoperative pain].

    PubMed

    Cachemaille, Matthieu; Blanc, Catherine

    2016-06-22

    Chronic postoperative pain remains a frequent pathology whose global impact approximates 20 and 30% and accounts for 20% of the consultations in a pain center. Risk factors consider firstly each patient's feature and comorbidity and also different surgical procedures with their technical approach. Neuropathic pain compared to nociceptive pain is a great component in the postoperative period and needs to be recognized by specific tests (DN4). Pain prevention involves risk factors' detection, appropriate anesthetic support and effective postoperative pain management. Treatment is based on the type of pain and includes a multimodal analgesia with interventional pain therapy.

  1. [Characteristics of postoperative peritonitis].

    PubMed

    Lock, J F; Eckmann, C; Germer, C-T

    2016-01-01

    Postoperative peritonitis is still a life-threatening complication after abdominal surgery and approximately 10,000 patients annually develop postoperative peritonitis in Germany. Early recognition and diagnosis before the onset of sepsis has remained a clinical challenge as no single specific screening test is available. The aim of therapy is a rapid and effective control of the source of infection and antimicrobial therapy. After diagnosis of diffuse postoperative peritonitis surgical revision is usually inevitable after intestinal interventions. Peritonitis after liver, biliary or pancreatic surgery is managed as a rule by means of differentiated therapy approaches depending on the severity.

  2. Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th grade Chinese adolescent binge drinkers.

    PubMed

    Johnson, C Anderson; Xiao, Lin; Palmer, Paula; Sun, Ping; Wang, Qiong; Wei, Yonglan; Jia, Yong; Grenard, Jerry L; Stacy, Alan W; Bechara, Antoine

    2008-01-31

    The primary aim of this study was to test the hypothesis that adolescent binge drinkers, but not lighter drinkers, would show signs of impairment on tasks of affective decision-making as measured by the Iowa Gambling Test (IGT), when compared to adolescents who never drank. We tested 207 10th grade adolescents in Chengdu City, China, using two versions of the IGT, the original and a variant, in which the reward/punishment contingencies were reversed. This enables one to distinguish among different possibilities of impaired decision-making, such as insensitivity to long-term consequences, or hypersensitivity to reward. Furthermore, we tested working memory capacity using the Self-ordered Pointing Test (SOPT). Paper and pencil questionnaires were used to assess drinking behaviors and school academic performance. Results indicated that relative to never-drinkers, adolescent binge drinkers, but not other (ever, past 30-day) drinkers, showed significantly lower net scores on the original version of the IGT especially in the latter trials. Furthermore, the profiles of behavioral performance from the original and variant versions of the IGT were consistent with a decision-making impairment attributed to hypersensitivity to reward. In addition, working memory and school academic performance revealed no differences between drinkers (at all levels) and never-drinkers. Logistic regression analysis showed that after controlling for demographic variables, working memory, and school academic performance, the IGT significantly predicted binge-drinking. These findings suggest that a "myopia" for future consequences linked to hypersensitivity to reward is a key characteristic of adolescents with binge-drinking behavior, and that underlying neural mechanisms for this "myopia" for future consequences may serve as a predisposing factor that renders some adolescents more susceptible to future addictive behaviors.

  3. Carpenter, tractors and microbes for the development of logical-mathematical thinking - the way 10th graders and pre-service teachers solve thinking challenges

    NASA Astrophysics Data System (ADS)

    Gazit, Avikam

    2012-12-01

    The objective of this case study was to investigate the ability of 10th graders and pre-service teachers to solve logical-mathematical thinking challenges. The challenges do not require mathematical knowledge beyond that of primary school but rather an informed use of the problem representation. The percentage of correct answers given by the 10th graders was higher than that of the pre-service teachers. Unlike the 10th graders, some of whom used various strategies for representing the problem, most of the pre-service teachers' answers were based on a technical algorithm, without using control processes. The obvious conclusion drawn from the findings supports and recommends expanding and enhancing the development of logical-mathematical thinking, both in specific lessons and as an integral part of other lessons in pre-service frameworks.

  4. Postoperative permanent pressure alopecia.

    PubMed

    Chang, Zi Yun; Ngian, Jan; Chong, Claudia; Chong, Chin Ted; Liew, Qui Yin

    2016-04-01

    A 49-year-old Chinese female underwent elective laparoscopic assisted Whipple's surgery lasting 12 h. This was complicated by postoperative pressure alopecia at the occipital area of the scalp. Pressure-induced hair loss after general anaesthesia is uncommon and typically temporary, but may be disconcerting to the patient. We report this case of postoperative permanent pressure alopecia due to its rarity in the anaesthesia/local literature, and review the risk factors for its development.

  5. Examining General and Specific Factors in the Dimensionality of Oral Language and Reading in 4th–10th Grades

    PubMed Central

    Foorman, Barbara R.; Koon, Sharon; Petscher, Yaacov; Mitchell, Alison; Truckenmiller, Adrea

    2015-01-01

    The objective of this study was to explore dimensions of oral language and reading and their influence on reading comprehension in a relatively understudied population—adolescent readers in 4th through 10th grades. The current study employed latent variable modeling of decoding fluency, vocabulary, syntax, and reading comprehension so as to represent these constructs with minimal error and to examine whether residual variance unaccounted for by oral language can be captured by specific factors of syntax and vocabulary. A 1-, 3-, 4-, and bifactor model were tested with 1,792 students in 18 schools in 2 large urban districts in the Southeast. Students were individually administered measures of expressive and receptive vocabulary, syntax, and decoding fluency in mid-year. At the end of the year students took the state reading test as well as a group-administered, norm-referenced test of reading comprehension. The bifactor model fit the data best in all 7 grades and explained 72% to 99% of the variance in reading comprehension. The specific factors of syntax and vocabulary explained significant unique variance in reading comprehension in 1 grade each. The decoding fluency factor was significantly correlated with the reading comprehension and oral language factors in all grades, but, in the presence of the oral language factor, was not significantly associated with the reading comprehension factor. Results support a bifactor model of lexical knowledge rather than the 3-factor model of the Simple View of Reading, with the vast amount of variance in reading comprehension explained by a general oral language factor. PMID:26346839

  6. Creating Cultures of Peace: Pedagogical Thought and Practice. Selected Papers from the 10th Triennial World Conference (September 10-15, 2001, Madrid, Spain)

    ERIC Educational Resources Information Center

    Benton, Jean E., Ed.; Swami, Piyush, Ed.

    2007-01-01

    The 10th Triennial World Conference of the World Council for Curriculum and Instruction (WCCI) was held September 10-15, 2001 in Madrid, Spain. The theme of the conference was "Cultures of Peace." Thirty-four papers and presentations are divided into nine sections. Part I, Tributes to the Founders of WCCI, includes: (1) Tribute to Alice…

  7. Carpenter, Tractors and Microbes for the Development of Logical-Mathematical Thinking--The Way 10th Graders and Pre-Service Teachers Solve Thinking Challenges

    ERIC Educational Resources Information Center

    Gazit, Avikam

    2012-01-01

    The objective of this case study was to investigate the ability of 10th graders and pre-service teachers to solve logical-mathematical thinking challenges. The challenges do not require mathematical knowledge beyond that of primary school but rather an informed use of the problem representation. The percentage of correct answers given by the 10th…

  8. Trends in Substance Use among 6th-to 10th-Grade Students from 1998 to 2010: Findings from a National Probability Study

    ERIC Educational Resources Information Center

    Brooks-Russell, Ashley; Farhat, Tilda; Haynie, Denise; Simons-Morton, Bruce

    2014-01-01

    Of the handful of national studies tracking trends in adolescent substance use in the United States, only the Health Behavior in School-Aged Children (HBSC) study collects data from 6th through 10th graders. The purpose of this study was to examine trends from 1998 to 2010 (four time points) in the prevalence of tobacco, alcohol, and marijuana use…

  9. Perceptions of 9th and 10th Grade Students on How Their Environment, Cognition, and Behavior Motivate Them in Algebra and Geometry Courses

    ERIC Educational Resources Information Center

    Harootunian, Alen

    2012-01-01

    In this study, relationships were examined between students' perception of their cognition, behavior, environment, and motivation. The purpose of the research study was to explore the extent to which 9th and 10th grade students' perception of environment, cognition, and behavior can predict their motivation in Algebra and Geometry courses. A…

  10. An Examination of the Conditions of School Facilities Attended by 10th-Grade Students in 2002. E.D. TAB. NCES 2006-302

    ERIC Educational Resources Information Center

    Mike Planty; Jill F. DeVoe; Jeffrey A. Owings; Kathryn Chandler

    2005-01-01

    This report presents key findings from the Education Longitudinal Study of 2002 (ELS:2002) Facilities Checklist for all ELS:2002 public and private schools and students in the 10th grade. The facilities instrument was administered as a part of the ELS:2002 and focused on the conditions of school facilities, including disrepair, cleanliness,…

  11. Advances in Classification Research. Volume 10. Proceedings of the ASIS SIG/CR Classification Research Workshop (10th, Washington, DC, November 1-5, 1999). ASIST Monograph Series.

    ERIC Educational Resources Information Center

    Albrechtsen, Hanne, Ed.; Mai, Jens-Erik, Ed.

    This volume is a compilation of the papers presented at the 10th ASIS (American Society for Information Science) workshop on classification research. Major themes include the social and cultural informatics of classification and coding systems, subject access and indexing theory, genre analysis and the agency of documents in the ordering of…

  12. The Basic Program of Vocational Agriculture in Louisiana. Ag I and Ag II (9th and 10th Grades). Volume I. Bulletin 1690-I.

    ERIC Educational Resources Information Center

    Louisiana State Dept. of Education, Baton Rouge. Div. of Vocational Education.

    This document is the first volume of a state curriculum guide on vocational agriculture for use in the 9th and 10th grades in Louisiana. Three instructional areas are profiled in this volume: orientation to vocational agriculture, agricultural leadership, and soil science. The three units of the orientation area cover introducing beginning…

  13. The Kidney in Critical Cardiac Disease: Proceedings From the 10th International Conference of the Pediatric Cardiac Intensive Care Society.

    PubMed

    Cooper, David S; Basu, Rajit K; Price, Jack F; Goldstein, Stuart L; Krawczeski, Catherine D

    2016-03-01

    The field of cardiac intensive care continues to advance in tandem with congenital heart surgery. The focus of intensive care unit care has now shifted to that of morbidity reduction and eventual elimination. Acute kidney injury (AKI) after cardiac surgery is associated with adverse outcomes, including prolonged intensive care and hospital stays, diminished quality of life, and increased long-term mortality. Acute kidney injury occurs frequently, complicating the care of both postoperative patients and those with heart failure. Patients who become fluid overloaded and/or require dialysis are at high risk of mortality, but even minor degrees of AKI portend a significant increase in mortality and morbidity. Clinicians continue to seek methods of early diagnosis and risk stratification of AKI to prevent its adverse sequelae. Previous conventional wisdom that survivors of AKI fully recover renal function without subsequent consequences may be flawed.

  14. Postoperative intravenous morphine titration.

    PubMed

    Aubrun, F; Mazoit, J-X; Riou, B

    2012-02-01

    Relief of acute pain during the immediate postoperative period is an important task for anaesthetists. Morphine is widely used to control moderate-to-severe postoperative pain and the use of small i.v. boluses of morphine in the post-anaesthesia care unit allows a rapid titration of the dose needed for adequate pain relief. The essential principle of a titration regimen must be to adapt the morphine dose to the pain level. Although morphine would not appear to be the most appropriate choice for achieving rapid pain relief, this is the sole opioid assessed in many studies of immediate postoperative pain management using titration. More than 90% of the patients have pain relief using a protocol of morphine titration and the mean dose required to obtain pain relief is 12 (7) mg, after a median of four boluses. Sedation is frequent during i.v. morphine titration and should be considered as a morphine-related adverse event and not evidence of pain relief. The incidence of ventilatory depression is very low when the criteria to limit the dose of i.v. morphine are enforced. Morphine titration can be used with caution in elderly patients, in children, or in obese patients. In practice, i.v. morphine titration allows the physician to meet the needs of individual patients rapidly and limits the risk of overdose making this method the first step in postoperative pain management.

  15. VLAP: results immediately post-op

    NASA Astrophysics Data System (ADS)

    Cowles, Robert S.

    1996-05-01

    Visual laser ablation of the prostate (VLAP) has been shown to be as effective with fewer complications than TURP in the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia. Questions have been raised about VLAP regarding prolonged irritative and obstructive voiding symptoms postoperatively. It is postulated that these symptoms are due to the slow slough of necrotic debris following VLAP. In an effort to improve upon the technique of VLAP, patients underwent lasing of the prostate in the routine manner (2, 4, 8, and 10 o'clock positions with sixty watts for sixty seconds) using Nd:YAG free beam energy. A bladder neck incision was then performed using a contact laser fiber. International prostate symptom score assessments were done preoperatively; one week and six weeks postoperatively. Post void residual urine volumes and prostate size were also evaluated. The findings indicate that symptom scores and post void residual urine volumes have significantly improved within ten days postoperatively using this technique.

  16. Analysis of physics textbooks for 10th and 11th grades in accordance with the 2013 secondary school physics curriculum from the perspective of project-based learning

    NASA Astrophysics Data System (ADS)

    Kavcar, Nevzat; Erdem, Aytekin

    2017-02-01

    This study aims to investigate the 10th and 11th grade Physics textbooks in accordance with the 2013 Secondary School Physics Curriculum from the perspective of project-based learning method and to share the results with the physics education public. The research was carried out in the 2015-2016 academic year as part of an undergraduate course taught in physics teaching program at a faculty of education; and 10 senior students of physics teachercandidates participated in the study. The research method is the survey model based on qualitative research approach. Data collection tools consist of the reports written by the participants who examined the curriculum and textbooks for project-based learning problems. According to research findings, most of the educational gains in the 10th and 11th grade physics textbooks were supported with experimental activities; however, project-based assignments are needed.

  17. Report of the 10(th) Asia-Pacific Federation of Societies for Surgery of the Hand Congress (Organising Chair and Scientific Chair).

    PubMed

    A, Roohi Sharifah; Abdullah, Shalimar

    2016-10-01

    A report on the 10(th) Asia-Pacific Federation of Societies for the Surgery of the Hand and 6(th) Asia-Pacific Federation of Societies for Hand Therapists is submitted detailing the numbers of attendees participating, papers presented and support received as well the some of the challenges faced and how best to overcome them from the local conference chair and scientific chair point of view.

  18. Injuries and Physical Fitness Before and After Deployments of the 10th Mountain Division to Afghanistan and the 1st Cavalry Division to Iraq, September 2005 - October 2008

    DTIC Science & Technology

    2008-10-01

    determined using the McNemar Test. The McNemar Test allows comparison of frequency data involving repeated measures on the same individuals.(71) (3...and After Deployment of the 10thMt Cohort (n=505 Men) Injury Index Injury Incidence p-value ( McNemar Test) Predeployment Postdeployment Period 1...Injury Incidence Before and After Deployment of the 1stCav Cohort – Men (n=3242) Injury Index Injury Incidence p-value ( McNemar Test) Predeployment

  19. Nursing documentation of postoperative pain management.

    PubMed

    Idvall, Ewa; Ehrenberg, Anna

    2002-11-01

    Previous studies have shown that nursing documentation is often deficient in its recording of pain assessment and treatment. In Sweden, documentation of the care process, including assessment, is a legal obligation. The aim of this study was to describe nursing documentation of postoperative pain management and nurses' perceptions of the records in relation to current regulations and guidelines. The sample included nursing records of postoperative care on the second postoperative day from 172 patients and 63 Registered Nurses from surgical wards in a central county hospital in Sweden. The records were reviewed for content and comprehensiveness based on regulations and guidelines for postoperative pain management. Three different auditing instruments were used. The nurses were asked if the documentation concurred with current regulations and guidelines. The result showed that pain assessment was based mainly on patients' self-report, but less than 10% of the records contained notes on systematic assessment with a pain assessment instrument. Pain location was documented in 50% of the records and pain character in 12%. About 73% of the nurses reported that the documentation concurred with current regulations and guidelines. The findings indicate that significant flaws existed in nurses' recording of postoperative pain management, of which the nurses were not aware.

  20. Comparison of methods to facilitate postoperative bowel function.

    PubMed

    Crainic, Christina; Erickson, Kathie; Gardner, Janet; Haberman, Sheri; Patten, Pam; Thomas, Pat; Hays, Victoria

    2009-01-01

    Improving postoperative return of bowel function after abdominal surgery is an important nursing and medical goal. One promising intervention to achieve this goal is to have patients chew gum several times per day in the early postoperative period to stimulate the cephalic-vagal reflex and bowel peristalsis. A study to determine if return of gastrointestinal function after abdominal surgery could be hastened by the simple intervention of chewing gum or sucking on hard candy three times per day is described.

  1. Keratophakia--postoperative astigmatism.

    PubMed

    Swinger, C A; Troutman, R C; Forman, J S

    1987-01-01

    Forty-nine cases of primary keratophakia and 13 cases of secondary keratophakia were analyzed for postoperative astigmatism. For primary cases, the surgically induced astigmatism was 1.55 D, whereas for secondary cases it was 0.19 D (insignificant). There was a tendency for both procedures to induce against-the-rule astigmatism, and both procedures were found capable of producing irregular astigmatism.

  2. Expanding Support Roles for 10th Medical Regiment: Pre and Post Health Screenings of National Guard Soldiers and Airmen

    DTIC Science & Technology

    2007-01-01

    Success in this undertaking has led the MDNG to request similar assistance from the 10MEDRGT in their Family Assistance Soldier Reintegration Program...Guard (MDARNG), the PDHRA program manager for the MDARNG, conducted the first of several ninety minute sessions to orient MDDF and Veterans ...acceptance of needed socioemotional treatment. Results of the PDHRA Before the day was out, the clinical evaluators along with NG and Veteran

  3. Modeling the Temporal Evolution of Postoperative Complications

    PubMed Central

    Feld, Shara I.; Cobian, Alexander G.; Tevis, Sarah E.; Kennedy, Gregory D.; Craven, Mark W.

    2016-01-01

    Post-operative complications have a significant impact on patient morbidity and mortality; these impacts are exacerbated when patients experience multiple complications. However, the task of modeling the temporal sequencing of complications has not been previously addressed. We present an approach based on Markov chain models for characterizing the temporal evolution of post-operative complications represented in the American College of Surgeons National Surgery Quality Improvement Program database. Our work demonstrates that the models have significant predictive value. In particular, an inhomogenous Markov chain model effectively predicts the development of serious complications (coma longer than a day, cardiac arrest, myocardial infarction, septic shock, renal failure, pneumonia) and interventional complications (unplanned re-intubation, longer than 2 days on a ventilator and bleeding transfusion). PMID:28269851

  4. Postoperative fluid management

    PubMed Central

    Kayilioglu, Selami Ilgaz; Dinc, Tolga; Sozen, Isa; Bostanoglu, Akin; Cete, Mukerrem; Coskun, Faruk

    2015-01-01

    Postoperative care units are run by an anesthesiologist or a surgeon, or a team formed of both. Management of postoperative fluid therapy should be done considering both patients’ status and intraoperative events. Types of the fluids, amount of the fluid given and timing of the administration are the main topics that determine the fluid management strategy. The main goal of fluid resuscitation is to provide adequate tissue perfusion without harming the patient. The endothelial glycocalyx dysfunction and fluid shift to extracellular compartment should be considered wisely. Fluid management must be done based on patient’s body fluid status. Patients who are responsive to fluids can benefit from fluid resuscitation, whereas patients who are not fluid responsive are more likely to suffer complications of over-hydration. Therefore, common use of central venous pressure measurement, which is proved to be inefficient to predict fluid responsiveness, should be avoided. Goal directed strategy is the most rational approach to assess the patient and maintain optimum fluid balance. However, accessible and applicable monitoring tools for determining patient’s actual fluid need should be further studied and universalized. The debate around colloids and crystalloids should also be considered with goal directed therapies. Advantages and disadvantages of each solution must be evaluated with the patient’s specific condition. PMID:26261771

  5. Preoperative anemia and postoperative outcomes after hepatectomy

    PubMed Central

    Tohme, Samer; Varley, Patrick R.; Landsittel, Douglas P.; Chidi, Alexis P.; Tsung, Allan

    2015-01-01

    Background Preoperative anaemia is associated with adverse outcomes after surgery but outcomes after liver surgery specifically are not well established. We aimed to analyze the incidence of and effects of preoperative anemia on morbidity and mortality in patients undergoing liver resection. Methods All elective hepatectomies performed for the period 2005–2012 recorded in the American College of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database were evaluated. We obtained anonymized data for 30-day mortality and major morbidity (one or more major complication), demographics, and preoperative and perioperative risk factors. We used multivariable logistic regression models to assess the adjusted effect of anemia, which was defined as (hematocrit <39% in men, <36% in women), on postoperative outcomes. Results We obtained data for 12,987 patients, of whom 4260 (32.8%) had preoperative anemia. Patients with preoperative anemia experienced higher postoperative major morbidity and mortality rates compared to those without anemia. After adjustment for predefined variables, preoperative anemia was an independent risk factor for postoperative major morbidity (adjusted OR 1.21, 1.09–1.33). After adjustment, there was no significant difference in postoperative mortality for patients with or without preoperative anemia (adjusted OR 0.88, 0.66–1.16). Conclusion Preoperative anemia is independently associated with an increased risk of major morbidity in patients undergoing hepatectomy. Therefore, it is crucial to readdress preoperative blood management in anemic patients prior to hepatectomy. PMID:27017165

  6. EDITORIAL: The 10th International Conference on New Developments and Applications in Optical Radiometry (NEWRAD 2008) The 10th International Conference on New Developments and Applications in Optical Radiometry (NEWRAD 2008)

    NASA Astrophysics Data System (ADS)

    Ikonen, Erkki

    2009-08-01

    This special issue of Metrologia contains selected papers from the NEWRAD 2008 Conference, held in Daejeon, Korea, on 12-16 October 2008. NEWRAD 2008 continues a series of conferences on radiometry entitled 'New Developments and Applications in Optical Radiometry', which have taken place as follows: Cambridge, MA, USA (1985) Teddington, UK (1988) Davos, Switzerland (1990) Baltimore, MD, USA (1992) Berlin, Germany (1994) Tucson, AZ, USA (1997) Madrid, Spain (1999) Gaithersburg, MD, USA (2002) Davos, Switzerland (2005) Daejeon, Korea (2008) As the first NEWRAD Conference arranged in Asia, NEWRAD 2008 opened a new era for this series of conferences. The conference was followed by a Workshop on High Temperature Fixed Points and meetings of the Working Groups of the Consultative Committee for Photometry and Radiometry (CCPR). The organizer of all these events was Dr In Won Lee of the Korea Research Institute of Standards and Science (KRISS). The NEWRAD Scientific Committee thanks him and his team for their tremendous efforts which maintained and developed the high standards of previous NEWRAD Conferences. The specific themes of NEWRAD 2008 included optical measurements related to displays, energy and terahertz applications. Furthermore, half a day of sessions was devoted to both remote sensing and to few-photon sources and detectors. A total of 140 papers were presented, including 11 invited and 30 contributed talks. The conference proceedings containing two-page extended abstracts were distributed to the participants as a paper volume and on a USB memory stick. The authors of selected contributions were invited to submit a full paper for this special issue. The submitted papers were handled by the normal reviewing procedures of Metrologia. On behalf of the Scientific Committee, I thank the reviewers and editorial staff of Metrologia for careful processing of the manuscripts. It is evident that this special issue, like its predecessors, will serve as an important

  7. [Postoperative analgesia and dexamethasone].

    PubMed

    Miralles, F S; Cárceles, M D; Micol, J A; Hernández, J; del Pino, A

    1989-01-01

    A randomized, double-blind, prospective study was carried out in 100 patients who had undergone some type of surgical treatment in order to evaluate the degree of pain and relief of pain, the degree of achieved analgesia according to the opinion of the observer and consumption of analgesic agents. The evaluation was carried out on seven occasions during the first 12 hours of the postoperative period. Patients received dexamethasone (4 mg before or after the operation or 8 mg after the operation), 6-methylprednisolone (16 mg at the end of the operation) or nothing (control group). Regardless of type, dose or timing of administration of the drugs, all patients receiving corticosteroids presented less pain, more relief of pain (expressed by themselves or in opinion of the observer) and needed lower doses of analgesics during the studied time.

  8. Imaging of postoperative shoulder instability.

    PubMed

    De Filippo, M; Pesce, A; Barile, A; Borgia, D; Zappia, M; Romano, A; Pogliacomi, F; Verdano, M; Pellegrini, A; Johnson, K

    2017-03-01

    Postoperative imaging in shoulder instability is still a challenge for radiologists due to various postsurgical anatomical findings that could be considered pathologic in treated shoulder. For this reason is very important a deep knowledge about surgical procedures, anatomical changes after surgery and the appropriate diagnostic imaging modalities to work up the symptomatic postoperative shoulder. Postoperative imaging options include use conventional radiography, magnetic resonance imaging (MRI), MRI arthrography, computed tomography (CT) and CT arthrography. The purpose of our review is to explain the different surgical procedures and to describe postoperative changes detected with radiological imaging.

  9. [Congresses of the Croatian Medical Association regarding unpublished proceedings of the 10th congress in Zadar on September 25-28, 1996].

    PubMed

    Drazancić, Ante

    2011-01-01

    The first annual meeting of Croatian physicians, with characteristics of a congress, was held in 1899 at the 25th anniversary of the Croatian Medical Association. From 1954 to 1996, during almost 60 years of existence of the Croatian Medical Association, ten congresses of the Association were held. The congresses were during the development of modern medicine devoted to different medical questions, including some problems of national pathology, of the structure and restructuring of health care. The work and the content of congresses were published in the proceedings except for the 8th Congress in 1987 and the 10th in 1996. By reading main lectures, invited lectures and free papers the knowledge of that period can be gained. Many papers are even today actual, even today it could be learned from them. With more details, using published proceedings the 9th congress and the 10th congress are described on the basis preserved program, of a brief report in home journal and ample preserved correspondence. The national medical congres dedicated to technology advancement and to numerous problems of national pathology may be actual even today. They could help to solve many problems of health care, contribute to its improvement and convey consensus on its further development.

  10. Dinosaur Day!

    ERIC Educational Resources Information Center

    Nakamura, Sandra; Baptiste, H. Prentice

    2006-01-01

    In this article, the authors describe how they capitalized on their first-grade students' love of dinosaurs by hosting a fun-filled Dinosaur Day in their classroom. On Dinosaur Day, students rotated through four dinosaur-related learning stations that integrated science content with art, language arts, math, and history in a fun and time-efficient…

  11. CEMI Days

    SciTech Connect

    2015-07-01

    CEMI Days are an important channel of engagement between DOE and the manufacturing industry to identify challenges and opportunities for increasing U.S. manufacturing competitiveness. CEMI Days that are held at manufacturing companies’ facilities can include tours of R&D operations or other points of interest determined by the host company.

  12. Hypothermic anesthesia attenuates postoperative proteolysis.

    PubMed Central

    Johnson, D J; Brooks, D C; Pressler, V M; Hulton, N R; Colpoys, M F; Smith, R J; Wilmore, D W

    1986-01-01

    The catabolic response that commonly occurs after major operation is characterized by net skeletal muscle proteolysis and accelerated nitrogen excretion. This response was absent in patients undergoing cardiac surgical procedures associated with the combination of cardiopulmonary bypass, narcotic anesthesia, neuromuscular blockade, and hypothermia. Forearm nitrogen release was 422 +/- 492 nmol/100 ml X min on the first postoperative day, approximately 25% of preoperative values (1677 +/- 411, p less than 0.05). Nitrogen excretion and the degree of negative nitrogen balance were comparable to levels observed in nonstressed, fasting subjects. The potential role of hypothermia, high-dose fentanyl anesthesia, and neuromuscular blockade in modifying the catabolic response to laparotomy and retroperitoneal dissection was further evaluated in animal studies. Six hours after operation, amino acid nitrogen release from the hindquarter was 84% less than control values (p less than 0.05). Nitrogen excretion and urea production were also reduced compared to normothermic controls. It is concluded that the combination of hypothermia, narcotic anesthesia, and neuromuscular blockade attenuates the catabolic response to injury and thus may be useful in the care of critically ill surgical patients. PMID:3767477

  13. Career Day

    NASA Video Gallery

    NASA's 2013 Career Days was a joint collaboration between NASA Langley and the Newport News Shipbuilding where 600 high school students from Virginia took on two design challenges -- designing a ca...

  14. Perceptions of High Achieving African American/Black 10th Graders from a Low Socioeconomic Community Regarding Health Scientists and Desired Careers

    PubMed Central

    Boekeloo, Bradley; Randolph, Suzanne; Timmons-Brown, Stephanie; Wang, Min Qi

    2014-01-01

    Measures are needed to assess youth perceptions about health science careers to facilitate research aimed at facilitating youth pursuit of health science. Although the Indiana Instrument provides an established measure of perceptions regarding nursing and ideal careers, we were interested in learning how high achieving 10th graders from relatively low socioeconomic areas who identify as Black/African American (Black) perceive health science and ideal careers. The Indiana Instrument was modified, administered to 90 youth of interest, and psychometrically analyzed. Reliable subscales were identified that may facilitate parsimonious, theoretical, and reliable study of youth decision-making regarding health science careers. Such research may help to develop and evaluate strategies for increasing the number of minority health scientists. PMID:25194058

  15. Potential use of biomarkers in acute kidney injury: report and summary of recommendations from the 10th Acute Dialysis Quality Initiative consensus conference.

    PubMed

    Murray, Patrick T; Mehta, Ravindra L; Shaw, Andrew; Ronco, Claudio; Endre, Zoltan; Kellum, John A; Chawla, Lakhmir S; Cruz, Dinna; Ince, Can; Okusa, Mark D

    2014-03-01

    Over the last decade there has been considerable progress in the discovery and development of biomarkers of kidney disease, and several have now been evaluated in different clinical settings. Although there is a growing literature on the performance of various biomarkers in clinical studies, there is limited information on how these biomarkers would be utilized by clinicians to manage patients with acute kidney injury (AKI). Recognizing this gap in knowledge, we convened the 10th Acute Dialysis Quality Initiative meeting to review the literature on biomarkers in AKI and their application in clinical practice. We asked an international group of experts to assess four broad areas for biomarker utilization for AKI: risk assessment, diagnosis, and staging; differential diagnosis; prognosis and management; and novel physiological techniques including imaging. This article provides a summary of the key findings and recommendations of the group, to equip clinicians to effectively use biomarkers in AKI.

  16. Langerhans cell histiocytosis or tuberculosis on a medieval child (Oppidum de la Granède, Millau, France - 10th-11th centuries AD).

    PubMed

    Colombo, Antony; Saint-Pierre, Christophe; Naji, Stephan; Panuel, Michel; Coqueugniot, Hélène; Dutour, Olivier

    2015-06-01

    In 2008, a skeleton of a 1 - 2.5-year-old child radiocarbon dated from the 10th - 11th century AD was discovered on the oppidum of La Granède (Millau, France). It presents multiple cranial osteolytic lesions having punched-out or geographical map-like aspects associated with sequestrum and costal osteitis. A multi 3D digital approach (CT, μCT and virtual reconstruction) enabled us to refine the description and identify the diploic origin of the lytic process. Furthermore, precise observation of the extent of the lesions and associated reorganization of the skeletal micro-structure were possible. From these convergent pieces of evidence, the differential diagnosis led to three possibilities: Langerhans cell histiocytosis, tuberculosis, or Langerhans cell histiocytosis and tuberculosis.

  17. [Effects of a Kampo medicine on postoperative infection].

    PubMed

    Iwagaki, Hiromi; Saito, Shinya

    2013-09-01

    We studied the effects of preoperative administration of Hochuekkito (TJ-41) on the host response of patients undergoing gastrectomy or colectomy in a prospective, randomized, multicenter clinical trial. Forty-eight patients were randomized into two groups: one received 7.5 g/day of TJ-41 for 7 days before surgery (n = 22); and the other served as the control group (n = 26). The body temperature and pulse rate in patients in the TJ41 group were significantly better controlled during the study compared with those in the control group. The concentration of serum cortisol on the first postoperative day in the TJ-41 group was also significantly lower compared with that in the control group. These results clearly indicate that the preoperative administration of TJ-41 may ameliorate an excessive postoperative inflammatory response and prolonged immunosuppressed state, resulting in fewer postoperative infectious complications.

  18. Capitol Day

    NASA Technical Reports Server (NTRS)

    2009-01-01

    Stennis Space Center Director Gene Goldman visits with Mississippi Gov. Haley Barbour during NASA Day at the Capitol activities on Feb. 19. During the visit, Goldman presented the governor with a model of the J-2X rocket engine currently in development. Stennis engineers did early component testing for the new engine.

  19. Inspire Day

    ERIC Educational Resources Information Center

    Bohach, Barbara M.; Meade, Birgitta

    2014-01-01

    The authors collaborated on hosting a "Spring Inspire Day." planned and delivered by preservice elementary teachers as a social studies/science methods project. Projects that have authentic application opportunities can make learning meaningful for prospective teachers as well as elementary students. With the impetus for an integrated…

  20. Postoperative complications of spine surgery.

    PubMed

    Swann, Matthew C; Hoes, Kathryn S; Aoun, Salah G; McDonagh, David L

    2016-03-01

    A variety of surgical approaches are available for the treatment of spine diseases. Complications can arise intraoperatively, in the immediate postoperative period, or in a delayed fashion. These complications may lead to severe or even permanent morbidity if left unrecognized and untreated [1-4]. Here we review a range of complications in the early postoperative period from more benign complications such as postoperative nausea and vomiting (PONV) to more feared complications leading to permanent loss of neurological function or death [5]. Perioperative pain management is covered in a separate review (Chapter 8).

  1. [Management of postoperative pancreatic fistula].

    PubMed

    Hackert, T; Büchler, M W

    2015-06-01

    The occurrence of a postoperative pancreatic fistula is one of the most important complications following pancreatic resections. The frequency of this complication varies between 3 % after pancreatic head resection and up to 35 % following distal pancreatectomy. In 2005, the international definition of postoperative pancreatic fistula was standardized according to the approach of the International Study Group of Pancreatic Surgery (ISGPS) including an A-C grading system of the severity. Consequently, results from different studies have become comparable and the historically reported fistula rates can be evaluated more critically. The present review summarises the currently available data on incidence, risk factors, fistula-associated complications and management of postoperative pancreatic fistula.

  2. Imaging of the Postoperative Orbit.

    PubMed

    Learned, Kim O; Nasseri, Farbod; Mohan, Suyash

    2015-08-01

    Imaging evaluation of the postoperative orbit remains challenging even for the expert neuroradiologist. This article provides a simplified framework for understanding the complex postoperative appearances of the orbit, in an attempt to enhance the diagnostic accuracy of postoperative computed tomography and MR imaging of the orbit. Readers are familiarized with the normal appearances of common eye procedures and orbit reconstructions to help avoid interpretative pitfalls. Also reviewed are imaging features of common surgical complications, and evaluation of residual/recurrent neoplasm in the setting of oncologic imaging surveillance.

  3. [Postoperative imaging of the shoulder].

    PubMed

    Wörtler, K; Rummeny, E J

    2004-06-01

    Correct interpretation of imaging findings in the postoperative shoulder is impaired by surgical distortion of normal anatomy and possible artifacts. Advanced postoperative imaging of the shoulder in addition to the selection of the best suited modality necessitates familiarity with the surgical procedure that has been performed and its consecutive morphological changes. This article reviews the most common arthroscopic and open techniques used for treatment of shoulder instability, lesions of the superior labral-bicipital complex, primary impingement, and rotator cuff tears, their typical postoperative imaging findings, as well as the diagnostic performance of cross sectional imaging techniques in the detection of recurrent lesions and complications.

  4. Laparoscopic Surgery Can Reduce Postoperative Edema Compared with Open Surgery

    PubMed Central

    Guo, Dong; Gong, Jianfeng; Cao, Lei; Wei, Yao; Guo, Zhen

    2016-01-01

    Aim. The study aimed to investigate the impact of laparoscopic surgery and open surgery on postoperative edema in Crohn's disease. Methods. Patients who required enterectomy were divided into open group (Group O) and laparoscopic group (Group L). Edema was measured using bioelectrical impedance analysis preoperatively (PRE) and on postoperative day 3 (POD3) and postoperative day 5 (POD5). The postoperative edema was divided into slight edema and edema by an edema index, defined as the ratio of total extracellular water to total body water. Results. Patients who underwent laparoscopic surgery had better clinical outcomes and lower levels of inflammatory and stress markers. A total of 31 patients (26.05%) developed slight edema and 53 patients (44.54%) developed edema on POD3. More patients developed postoperative edema in Group O than in Group L on POD3 (p = 0.006). The value of the edema index of Group O was higher than that of Group L on POD3 and POD5 (0.402 ± 0.010 versus 0.397 ± 0.008, p = 0.001; 0.401 ± 0.009 versus 0.395 ± 0.007, p = 0.039, resp.). Conclusions. Compared with open surgery, laparoscopic surgery can reduce postoperative edema, which may contribute to the better outcomes of laparoscopic surgery over open surgery. PMID:27777583

  5. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Day; business day; school day. 300.11 Section 300.11... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.11 Day; business day; school day. (a) Day means calendar day unless otherwise indicated as business day or school day. (b) Business...

  6. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Day; business day; school day. 300.11 Section 300.11... CHILDREN WITH DISABILITIES General Definitions Used in This Part § 300.11 Day; business day; school day. (a) Day means calendar day unless otherwise indicated as business day or school day. (b) Business...

  7. Takotsubo Cardiomyopathy Occurring in the Postoperative Period.

    PubMed

    Deniz, Süleyman; Bakal, Ömer; İnangil, Gökhan; Şen, Hüseyin; Özkan, Sezai

    2015-02-01

    Takotsubo cardiomyopathy simulates acute myocardial infarction, and it is characterised by reversible left ventricular failure. A case of Takotsubo cardiomyopathy diagnosed after emergency angiography performed in a patient with evidence of acute myocardial infarction in the postoperative period will be described in this report. Transurethral resection of a bladder tumour (TUR-BT) was performed in a 92-year-old male patient by the urology clinic. The patient was transferred to the post-anaesthesia care unit after the operation. An echocardiography was performed because of the sudden onset of dyspnoea, tachycardia (140-150 beats per minute, rhythm-atrial fibrillation) and ST-segment elevation on electrocardiography (ECG) at the first postoperative hour, and midapical dyskinesia was detected at the patient. An immediate angiography was performed due to suspicion of acute coronary syndrome. Patent coronary arteries and temporary aneurysmatic dilatation of the apex of the heart were revealed by angiography. As a result of these findings, the patient was diagnosed with Takotsubo cardiomyopathy by the cardiology service. The patient was discharged uneventfully following 10 days in the intensive care unit. Aneurysm of the apex of the left ventricle and normal anatomy of the coronary arteries in the angiography have diagnostic value for Takotsubo cardiomyopathy. Diuretics (furosemide) and beta-blockers (metoprolol) are commonly used for the treatment of Takotsubo cardiomyopathy. Even though Takotsubo cardiomyopathy is a rare and benign disease, it should be kept in mind in patients suspected for acute myocardial infarction in the postoperative period.

  8. Reduction of postoperative adhesion development.

    PubMed

    Diamond, Michael P

    2016-10-01

    Despite use of meticulous surgical techniques, and regardless of surgical access via laparotomy or laparoscopy, postoperative adhesions develop in the vast majority of women undergoing abdominopelvic surgery. Such adhesions represent not only adhesion reformation at sites of adhesiolysis, but also de novo adhesion formation at sites of surgical procedures. Application of antiadhesion adjuvants compliment the benefits of meticulous surgical techniques, providing an opportunity to further reduce postoperative adhesion development. Improved understanding of the pathophysiology of adhesion development and distinguishing variations in the molecular biologic mechanisms from adhesion-free peritoneal repair represent future opportunities to improve the reduction of postoperative adhesions. Optimization of the reduction of postoperative adhesions will likely require identification of unique, personalized approaches in each individual, representing interindividual variation in peritoneal repair processes.

  9. Postoperative electromyographic profile in human jejunum.

    PubMed Central

    Ducerf, C; Duchamp, C; Pouyet, M

    1992-01-01

    The postoperative electromyographic profile of the proximal jejunum and its evolution during recovery from surgery were defined in fasted humans after cholecystectomy. An intraluminal probe supporting four groups of bipolar electrodes was transnasally inserted at the end of surgery to allow continuous recording of jejunal electrical activity over 4 consecutive days. Electromyographic activity was characterized by an early reappearance of phase 3 of migrating myoelectric complexes (MMC) lasting 5.2 +/- 0.6 minutes and occurring at 38.1 +/- 3.1-minute intervals at day 1 after surgery. During the 4 days after surgery, there was an increased duration of MMC, mainly consisting of phase 2 occurrence with an increased duration and lengthening of the MMC cycle. The amplitude of spikes during phase 3 increased. During the postoperative period, characterized by an inversion of the circadian rhythm, the velocity of propagation was higher (p less than 0.05) between 18:00 and 06:00 (4.0 +/- 0.5 cm/minute) than between 06:00 and 18:00 (3.1 +/- 0.3 cm/minute). In contrast, the duration of phase 2 was lower during nighttime (18:00 to 06:00) than during daytime. The authors conclude that during the early (1 to 2 days) period after cholecystectomy, the jejunal electromyographic activity is limited to phase 3 activity, but that a normal fasted pattern is recovered after 4 days. A progressive reorganization and coordination of the intestinal tract may account for this delay. PMID:1543395

  10. Imaging in the Age of Precision Medicine: Summary of the Proceedings of the 10th Biannual Symposium of the International Society for Strategic Studies in Radiology.

    PubMed

    Herold, Christian J; Lewin, Jonathan S; Wibmer, Andreas G; Thrall, James H; Krestin, Gabriel P; Dixon, Adrian K; Schoenberg, Stefan O; Geckle, Rena J; Muellner, Ada; Hricak, Hedvig

    2016-04-01

    During the past decade, with its breakthroughs in systems biology, precision medicine (PM) has emerged as a novel health-care paradigm. Challenging reductionism and broad-based approaches in medicine, PM is an approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. It involves integrating information from multiple sources in a holistic manner to achieve a definitive diagnosis, focused treatment, and adequate response assessment. Biomedical imaging and imaging-guided interventions, which provide multiparametric morphologic and functional information and enable focused, minimally invasive treatments, are key elements in the infrastructure needed for PM. The emerging discipline of radiogenomics, which links genotypic information to phenotypic disease manifestations at imaging, should also greatly contribute to patient-tailored care. Because of the growing volume and complexity of imaging data, decision-support algorithms will be required to help physicians apply the most essential patient data for optimal management. These innovations will challenge traditional concepts of health care and business models. Reimbursement policies and quality assurance measures will have to be reconsidered and adapted. In their 10th biannual symposium, which was held in August 2013, the members of the International Society for Strategic Studies in Radiology discussed the opportunities and challenges arising for the imaging community with the transition to PM. This article summarizes the discussions and central messages of the symposium.

  11. Evaluation of elemental status of ancient human bone samples from Northeastern Hungary dated to the 10th century AD by XRF

    NASA Astrophysics Data System (ADS)

    János, I.; Szathmáry, L.; Nádas, E.; Béni, A.; Dinya, Z.; Máthé, E.

    2011-11-01

    The present study is a multielemental analysis of bone samples belonging to skeletal individuals originating from two contemporaneous (10th century AD) cemeteries (Tiszavasvári Nagy-Gyepáros and Nagycserkesz-Nádasibokor sites) in Northeastern Hungary, using the XRF analytical technique. Emitted X-rays were detected in order to determine the elemental composition of bones and to appreciate the possible influence of the burial environment on the elemental content of the human skeletal remains. Lumbar vertebral bodies were used for analysis. Applying the ED(P)XRF technique concentration of the following elements were determined: P, Ca, K, Na, Mg, Al, Cl, Mn, Fe, Zn, Br and Sr. The results indicated post mortem mineral exchange between the burial environment (soil) and bones (e.g. the enhanced levels of Fe and Mn) and referred to diagenetic alteration processes during burials. However, other elements such as Zn, Sr and Br seemed to be accumulated during the past life. On the basis of statistical analysis, clear separation could not be observed between the two excavation sites in their bone elemental concentrations which denoted similar diagenetic influences, environmental conditions. The enhanced levels of Sr might be connected with the past dietary habits, especially consumption of plant food.

  12. The 10th GCC Closed Forum: rejected data, GCP in bioanalysis, extract stability, BAV, processed batch acceptance, matrix stability, critical reagents, ELN and data integrity and counteracting fraud.

    PubMed

    Cape, Stephanie; Islam, Rafiq; Nehls, Corey; Allinson, John; Safavi, Afshin; Bennett, Patrick; Hulse, James; Beaver, Chris; Khan, Masood; Karnik, Shane; Caturla, Maria Cruz; Lowes, Steve; Iordachescu, Adriana; Silvestro, Luigi; Tayyem, Rabab; Shoup, Ron; Mowery, Stephanie; Keyhani, Anahita; Wakefield, Andrea; Li, Yinghe; Zimmer, Jennifer; Torres, Javier; Couerbe, Philippe; Khadang, Ardeshir; Bourdage, James; Hughes, Nicola; Awaiye, Kayode; Matthews, Brent; Fatmi, Saadya; Johnson, Rhonda; Satterwhite, Christina; Yu, Mathilde; Lin, Jenny; Cojocaru, Laura; Fiscella, Michele; Thomas, Eric; Kurylak, Kai; Kamerud, John; Lin, Zhongping John; Garofolo, Wei; Savoie, Natasha; Buonarati, Mike; Boudreau, Nadine; Williard, Clark; Liu, Yansheng; Warrino, Dominic; Kale, Prashant; Adcock, Neil; Shekar, Radha; O'Connor, Edward; Ritzen, Hanna; Sanchez, Christina; Hayes, Roger; Bouhajib, Mohammed; Savu, Simona Rizea; Stouffer, Bruce; Tabler, Edward; Tu, Jing; Briscoe, Chad; der Strate, Barry van; Rhyne, Paul; Conliffe, Phyllis; DuBey, Ira; Yamashita, Jim; Tang, Daniel; Groeber, Elizabeth; Vija, Jenifer; Malone, Michele; Osman, Mohamed

    2017-03-24

    The 10th Global CRO Council (GCC) Closed Forum was held in Orlando, FL, USA on 18 April 2016. In attendance were decision makers from international CRO member companies offering bioanalytical services. The objective of this meeting was for GCC members to meet and discuss scientific and regulatory issues specific to bioanalysis. The issues discussed at this closed forum included reporting data from failed method validation runs, GCP for clinical sample bioanalysis, extracted sample stability, biomarker assay validation, processed batch acceptance criteria, electronic laboratory notebooks and data integrity, Health Canada's Notice regarding replicates in matrix stability evaluations, critical reagents and regulatory approaches to counteract fraud. In order to obtain the pharma perspectives on some of these topics, the first joint CRO-Pharma Scientific Interchange Meeting was held on 12 November 2016, in Denver, Colorado, USA. The five topics discussed at this Interchange meeting were reporting data from failed method validation runs, GCP for clinical sample bioanalysis, extracted sample stability, processed batch acceptance criteria and electronic laboratory notebooks and data integrity. The conclusions from the discussions of these topics at both meetings are included in this report.

  13. Urban and rural infant-feeding practices and health in early medieval Central Europe (9th-10th Century, Czech Republic).

    PubMed

    Kaupová, Sylva; Herrscher, Estelle; Velemínský, Petr; Cabut, Sandrine; Poláček, Lumír; Brůžek, Jaroslav

    2014-12-01

    In the Central European context, the 9th and 10th centuries are well known for rapid cultural and societal changes concerning the development of the economic and political structures of states as well as the adoption of Christianity. A bioarchaeological study based on a subadult skeletal series was conducted to tackle the impact of these changes on infant and young child feeding practices and, consequently, their health in both urban and rural populations. Data on growth and frequency of nonspecific stress indicators of a subadult group aged 0-6 years were analyzed. A subsample of 41 individuals was selected for nitrogen and carbon isotope analyses, applying an intra-individual sampling strategy (bone vs. tooth). The isotopic results attest to a mosaic of food behaviors. In the urban sample, some children may have been weaned during their second year of life, while some others may have still been consuming breast milk substantially up to 4-5 years of age. By contrast, data from the rural sample show more homogeneity, with a gradual cessation of breastfeeding starting after the age of 2 years. Several factors are suggested which may have been responsible for applied weaning strategies. There is no evidence that observed weaning strategies affected the level of biological stress which the urban subadult population had to face compared with the rural subadult population.

  14. Climate Change, Risks and Natural Resources didactic issues of educational content geography of Bulgaria and the world in 9th and 10th grade

    NASA Astrophysics Data System (ADS)

    Dermendzhieva, Stela; Nejdet, Semra

    2017-03-01

    The purpose of this paper is to follow "Climate change, risks and Natural Resources" in the curriculum of Geography of Bulgaria and the world in 9th and 10th grade and to interpret some didactic aspects. Analysis of key themes, concepts and categories related to the environment, events and approaches to environmental protection and the environmentally sound development of sectors of the economy is didikticheski targeted. Considering the emergence and development of geo-ecological issues, their scope and their importance to the environment, systematize some species and some approaches to solving them. Geography education in grade 9 and 10 involves acquiring knowledge, developing skills and composing behaviors of objective perception and assessment of the reality of globed, regional and local aspect. The emerging consumer and individualistic culture snowballing globalization, are increasingly occurring global warming, declining biodiversity form new realities which education must respond appropriately. The objective, consistency, accessibility and relevance in real terms are meaningful, logical accents. Whether and how reproduced in the study of Geography of Bulgaria and the world is the subject of research study in this report. Geoecological structuring of topics, concepts and categories can be done in different signs. In terms of their scope are local, national or regional, and global. Matter and interdisciplinary approach, which is to reveal the unity of the "man-society-nature" to clarify the complexity of their character with a view to forming a harmonious personality with high Geoecological consciousness and culture, and the activities carried out in their study.

  15. The Royal Book by Haly Abbas from the 10th century: one of the earliest illustrations of the surgical approach to skull fractures.

    PubMed

    Aciduman, Ahmet; Arda, Berna; Kahya, Esin; Belen, Deniz

    2010-12-01

    Haly Abbas was one of the pioneering physicians and surgeons of the Eastern world in the 10th century who influenced the Western world by his monumental work, The Royal Book. The book was first partly translated into Latin by Constantinus Africanus in the 11th century without citing the author's name. Haly Abbas was recognized in Europe after full translation of The Royal Book by Stephen of Antioch in 1127. The Royal Book has been accepted as an early source of jerrah-names (surgical books) in the Eastern world. The chapters regarding cranial fractures in Haly Abbas' work include unique management strategies for his period with essential quotations from Paul of Aegina's work Epitome. Both authors preferred free bone flap craniotomy in cranial fractures. Although Paul of Aegina, a Byzantine physician and surgeon, was a connection between ancient traditions and Islamic interpretation, Haly Abbas seemed to play a bridging role between the Roman-Byzantine and the School of Salerno in Europe.

  16. Comparison of Dawn and Dusk Precipitating Electron Energy Populations Shortly After the Initial Shock for the January 10th, 1997 Magnetic Cloud

    NASA Technical Reports Server (NTRS)

    Spann, J.; Germany, G.; Swift, W.; Parks, G.; Brittnacher, M.; Elsen, R.

    1997-01-01

    The observed precipitating electron energy between 0130 UT and 0400 UT of January 10 th, 1997, indicates that there is a more energetic precipitating electron population that appears in the auroral oval at 1800-2200 UT at 030) UT. This increase in energy occurs after the initial shock of the magnetic cloud reaches the Earth (0114 UT) and after faint but dynamic polar cap precipitation has been cleared out. The more energetic population is observed to remain rather constant in MLT through the onset of auroral activity (0330 UT) and to the end of the Polar spacecraft apogee pass. Data from the Ultraviolet Imager LBH long and LBH short images are used to quantify the average energy of the precipitating auroral electrons. The Wind spacecraft located about 100 RE upstream monitored the IMF and plasma parameters during the passing of the cloud. The affects of oblique angle viewing are included in the analysis. Suggestions as to the source of this hot electron population will be presented.

  17. Perioperative Non-Invasive Indocyanine Green-Clearance Testing to Predict Postoperative Outcome after Liver Resection

    PubMed Central

    Haegele, Stefanie; Reiter, Silvia; Wanek, David; Offensperger, Florian; Pereyra, David; Stremitzer, Stefan; Fleischmann, Edith; Brostjan, Christine; Gruenberger, Thomas; Starlinger, Patrick

    2016-01-01

    Background Postoperative liver dysfunction may lead to morbidity and mortality after liver resection. Preoperative liver function assessment is critical to identify preexisting liver dysfunction in patients prior to resection. The aim of this study was to evaluate the predictive potential of perioperative indocyanine green (ICG)-clearance testing to prevent postoperative liver dysfunction and morbidity using standardized outcome parameters in a routine Western-clinical-setting. Study Design 137 patients undergoing partial hepatectomy between 2011 and 2013, at the general hospital of Vienna, were included. ICG-clearance was recorded one day prior to surgery as well as on the first and fifth postoperative day. Postoperative liver dysfunction was defined according to the International Study Group of Liver Surgery and evaluation of morbidity was based on the Dindo-Clavien classification. Statistical analyses were based on non-parametric tests. Results Preoperative reduced ICG—plasma disappearance rate (PDR) as well as increased ICG—retention rate at 15 min (R15) were able to significantly predict postoperative liver dysfunction (Area under the curve = PDR: 0.716, P = 0.018; R15: 0.719, P = 0.016). Furthermore, PDR <17%/min. or R15 >8%, were able to accurately predict postoperative complications prior to surgery. In addition to this, ICG-clearance on postoperative day 1 comparably predicted postoperative liver dysfunction (Area under the curve = PDR: 0.895; R15: 0.893; both P <0.001), specifically, PDR <10%/min or R15 >20% on postoperative day 1 predicted poor postoperative outcome. Conclusion PDR and R15 may represent useful parameters to distinguish preoperative high and low risk patients in a Western collective as well as on postoperative day 1, to identify patients who require closer monitoring for potential complications. PMID:27812143

  18. Post-operative urinary retention.

    PubMed

    Steggall, Martin; Treacy, Colm; Jones, Mark

    Urinary retention is a common complication of surgery and anaesthesia. The risk of post-operative urinary retention is increased following certain surgical procedures and anaesthetic modalities, and with patients' advancing age. Patients at increased risk of post-operative urinary retention should be identified before surgery or the condition should be identified and treated in a timely manner following surgery. If conservative measures do not help the patient to pass urine, the bladder will need to be drained using either an intermittent catheter or an indwelling urethral catheter, which can result in catheter-associated urinary tract infections. This article provides an overview of normal bladder function, risk factors for developing post-operative urinary retention, and treatment options. Guidance drawn from the literature aims to assist nurses in identifying at-risk patients and inform patient care.

  19. Assessment of pain during rest and during activities in the postoperative period of cardiac surgery

    PubMed Central

    de Mello, Larissa Coelho; Rosatti, Silvio Fernando Castro; Hortense, Priscilla

    2014-01-01

    Objective to assess the intensity and site of pain after Cardiac Surgery through sternotomy during rest and while performing five activities. Method descriptive study with a prospective cohort design. A total of 48 individuals participated in the study. A Multidimensional Scale for Pain Assessment was used. Results postoperative pain from cardiac surgery was moderate during rest and decreased over time. Pain was also moderate during activities performed on the 1st and 2nd postoperative days and decreased from the 3rd postoperative day, with the exception of coughing, which diminished only on the 6th postoperative day. Coughing, turning over, deep breathing and rest are presented in decreased order of intensity. The region of the sternum was the most frequently reported site of pain. Conclusion the assessment of pain in the individuals who underwent cardiac surgery during rest and during activities is extremely important to adapt management and avoid postoperative complications and delayed surgical recovery. PMID:24553714

  20. NNSA Administrator Thomas D'Agostino delivers remarks at DOE's Commemorative Veterans Day Program

    ScienceCinema

    Administrator D'Agostino

    2016-07-12

    Administrator D'Agostino, a Navy veteran, was part of a November 2009 program at DOE headquarters in Washington, D.C., celebrating Veterans Day and commemorating the 10th anniversary of the DOE Veterans Task Force. Veterans comprise nearly 30 percent of NNSA's workforce, and many NNSA employees are currently on active duty.

  1. Daily Stress and Emotional Well-Being among Asian American Adolescents: Same-Day, Lagged, and Chronic Associations

    ERIC Educational Resources Information Center

    Kiang, Lisa; Buchanan, Christy M.

    2014-01-01

    Daily-diary data from 180 Asian American 9th-10th graders (58% female, 75% second generation; "M" age = 14.97 years) were used to investigate how family, school, and peer stress are each associated with same-day and next-day (lagged) well-being, and vice versa. Hierarchical linear modeling provided support for reciprocal links when…

  2. The impact of high-stakes, state-mandated student performance assessment on 10th grade English, mathematics, and science teachers' instructional practices

    NASA Astrophysics Data System (ADS)

    Vogler, Kenneth E.

    The purpose of this study was to determine if the public release of student results on high-stakes, state-mandated performance assessments influence instructional practices, and if so in what manner. The research focused on changes in teachers' instructional practices and factors that may have influenced such changes since the public release of high-stakes, state-mandated student performance assessment scores. The data for this study were obtained from a 54-question survey instrument given to a stratified random sample of teachers teaching at least one section of 10th grade English, mathematics, or science in an academic public high school within Massachusetts. Two hundred and fifty-seven (257) teachers, or 62% of the total sample, completed the survey instrument. An analysis of the data found that teachers are making changes in their instructional practices. The data show notable increases in the use of open-response questions, creative/critical thinking questions, problem-solving activities, use of rubrics or scoring guides, writing assignments, and inquiry/investigation. Teachers also have decreased the use of multiple-choice and true-false questions, textbook-based assignments, and lecturing. Also, the data show that teachers felt that changes made in their instructional practices were most influenced by an "interest in helping my students attain MCAS assessment scores that will allow them to graduate high school" and by an "interest in helping my school improve student (MCAS) assessment scores," Finally, mathematics teachers and teachers with 13--19 years of experience report making significantly more changes than did others. It may be interpreted from the data that the use of state-mandated student performance assessments and the high-stakes attached to this type of testing program contributed to changes in teachers' instructional practices. The changes in teachers' instructional practices have included increases in the use of instructional practices deemed

  3. Comparison of problematic behaviours of 10th and 11th year Southern English adolescents. Part 2: Current drink, drug and sexual activity of children with smoking parents.

    PubMed

    Cox, Malcolm; Pritchard, Colin

    2007-01-01

    To determine parental and school influences upon the behaviour and attitudes of adolescents of smoking versus non-smoking parents and of those "liking and disliking" school. Utilising a self-administered confidential standardised questionnaire, a representative sample of Southern English 10th and 11th year secondary school pupils was obtained. Current drink, drug and sexual behaviour were explored and data on adolescents whose parents smoked was extrapolated and compared against adolescents of non-smoking parents. Pupils reporting "liking school" were compared against those "not liking school" and all results statistically analysed. There were 17% smoking mothers [SM] and 23% smoking fathers [SF]. The focus is upon students of SF whose adolescents are significantly more often engaged in substance misuse (38-18%), drinking in pubs (31%-15%), binge drinking (32%-18%), and under-age sexual activity (27%-14%) plus smoking (51%-32%), truanting (43%-23%), vandalism (32%-22%) and stealing (19%-11%). SM students had higher incidence of sexual behaviour (33%-13%) and unprotected sex (21%-6%). Students of smoking parents were less well informed and had significantly more negative attitudes about social behaviour and responsibility. "Liking school" was associated to significantly lower rates of problematic behaviour, which predominately was not related to the social background of the pupils. The smoking father criteria carries a social class bias, nonetheless these parents need to be aware of the particular behaviour of their children and their increased risk. SF do not "cause" the behaviour rather it reflects something of the nature of the adolescent's relationship to parents, school and society.

  4. Early fetal gender determination using real-time PCR analysis of cell-free fetal DNA during 6th-10th weeks of gestation.

    PubMed

    Khorram Khorshid, Hamid Reza; Zargari, Maryam; Sadeghi, Mohammad Reza; Edallatkhah, Haleh; Shahhosseiny, Mohammad Hassan; Kamali, Koorosh

    2013-05-07

    Nowadays, new advances in the use of cell free fetal DNA (cffDNA) in maternal plasma of pregnant women has provided the possibility of applying cffDNA in prenatal diagnosis as a non-invasive method. In contrary to the risks of invasive methods that affect both mother and fetus, applying cffDNA is proven to be highly effective with lower risk. One of the applications of prenatal diagnosis is fetal gender determination, which is important in fetuses at risk of sex-linked genetic diseases. In such cases by obtaining the basic information of the gender, necessary time management can be taken in therapeutic to significantly reduce the necessity of applying the invasive methods. Therefore in this study, the probability of detecting sequences on the human Y-chromosome in pregnant women has been evaluated to identify the gender of fetuses. Peripheral blood samples were obtained from 80 pregnant women with gestational age between 6th to 10th weeks and the fetal DNA was extracted from the plasma. Identification of SRY, DYS14 & DAZ sequences, which are not presentin the maternal genome, was performed using Real-Time PCR. All the obtained results were compared with the actual gender of the newborns to calculate the test accuracy. Considerable 97.3% sensitivity and 97.3% specificity were obtained in fetal gender determination which is significant in the first trimester of pregnancy. Only in one case, false positive result was obtained. Using non-invasive method of cffDNAs in the shortest time possible, as well as avoiding invasive tests for early determination of fetal gender, provides the opportunity of deciding and employing early treatment for fetuses at risk of genetic diseases.

  5. Using Self-Assembled Monolayers to Model Cell Adhesion to the 9th and 10th Type III Domains of Fibronectin†

    PubMed Central

    2009-01-01

    Most mammalian cells must adhere to the extracellular matrix (ECM) to maintain proper growth and development. Fibronectin is a predominant ECM protein that engages integrin cell receptors through its Arg-Gly-Asp (RGD) and Pro-His-Ser-Arg-Asn (PHSRN) peptide binding sites. To study the roles these motifs play in cell adhesion, proteins derived from the 9th (containing PHSRN) and 10th (containing RGD) type III fibronectin domains were engineered to be in frame with cutinase, a serine esterase that forms a site-specific, covalent adduct with phosphonate ligands. Self-assembled monolayers (SAMs) that present phosphonate ligands against an inert background of tri(ethylene glycol) groups were used as model substrates to immobilize the cutinase-fibronectin fusion proteins. Baby hamster kidney cells attached efficiently to all protein surfaces, but only spread efficiently on protein monolayers containing the RGD peptide. Cells on RGD-containing protein surfaces also displayed defined focal adhesions and organized cytoskeletal structures compared to cells on PHSRN-presenting surfaces. Cell attachment and spreading were shown to be unaffected by the presence of PHSRN when compared to RGD alone on SAMs presenting higher densities of protein, but PHSRN supported an increased efficiency in cell attachment when presented at low protein densities with RGD. Treatment of suspended cells with soluble RGD or PHSRN peptides revealed that both peptides were able to inhibit the attachment of FN10 surfaces. These results support a model wherein PHSRN and RGD bind competitively to integrins―rather than a two-point synergistic interaction―and the presence of PHSRN serves to increase the density of ligand on the substrate and therefore enhance the sticking probability of cells during attachment. PMID:20560553

  6. IBC’s 23rd Annual Antibody Engineering, 10th Annual Antibody Therapeutics International Conferences and the 2012 Annual Meeting of The Antibody Society

    PubMed Central

    Klöhn, Peter-Christian; Wuellner, Ulrich; Zizlsperger, Nora; Zhou, Yu; Tavares, Daniel; Berger, Sven; Zettlitz, Kirstin A.; Proetzel, Gabriele; Yong, May; Begent, Richard H.J.; Reichert, Janice M

    2013-01-01

    The 23rd Annual Antibody Engineering, 10th Annual Antibody Therapeutics international conferences, and the 2012 Annual Meeting of The Antibody Society, organized by IBC Life Sciences with contributions from The Antibody Society and two Scientific Advisory Boards, were held December 3–6, 2012 in San Diego, CA. The meeting drew over 800 participants who attended sessions on a wide variety of topics relevant to antibody research and development. As a prelude to the main events, a pre-conference workshop held on December 2, 2012 focused on intellectual property issues that impact antibody engineering. The Antibody Engineering Conference was composed of six sessions held December 3–5, 2012: (1) From Receptor Biology to Therapy; (2) Antibodies in a Complex Environment; (3) Antibody Targeted CNS Therapy: Beyond the Blood Brain Barrier; (4) Deep Sequencing in B Cell Biology and Antibody Libraries; (5) Systems Medicine in the Development of Antibody Therapies/Systematic Validation of Novel Antibody Targets; and (6) Antibody Activity and Animal Models. The Antibody Therapeutics conference comprised four sessions held December 4–5, 2012: (1) Clinical and Preclinical Updates of Antibody-Drug Conjugates; (2) Multifunctional Antibodies and Antibody Combinations: Clinical Focus; (3) Development Status of Immunomodulatory Therapeutic Antibodies; and (4) Modulating the Half-Life of Antibody Therapeutics. The Antibody Society’s special session on applications for recording and sharing data based on GIATE was held on December 5, 2012, and the conferences concluded with two combined sessions on December 5–6, 2012: (1) Development Status of Early Stage Therapeutic Antibodies; and (2) Immunomodulatory Antibodies for Cancer Therapy. PMID:23575266

  7. Effect of cooperative learning strategies on student verbal interactions and achievement during conceptual change instruction in 10th grade general science

    NASA Astrophysics Data System (ADS)

    Lonning, Robert A.

    This study evaluated the effects of cooperative learning on students' verbal interaction patterns and achievement in a conceptual change instructional model in secondary science. Current conceptual change instructional models recognize the importance of student-student verbal interactions, but lack specific strategies to encourage these interactions. Cooperative learning may provide the necessary strategies. Two sections of low-ability 10th-grade students were designated the experimental and control groups. Students in both sections received identical content instruction on the particle model of matter using conceptual change teaching strategies. Students worked in teacher-assigned small groups on in-class assignments. The experimental section used cooperative learning strategies involving instruction in collaborative skills and group evaluation of assignments. The control section received no collaborative skills training and students were evaluated individually on group work. Gains on achievement were assessed using pre- and posttreatment administrations of an investigator-designed short-answer essay test. The assessment strategies used in this study represent an attempt to measure conceptual change. Achievement was related to students' ability to correctly use appropriate scientific explanations of events and phenomena and to discard use of naive conceptions. Verbal interaction patterns of students working in groups were recorded on videotape and analyzed using an investigator-designed verbal interaction scheme. The targeted verbalizations used in the interaction scheme were derived from the social learning theories of Piaget and Vygotsky. It was found that students using cooperative learning strategies showed greater achievement gains as defined above and made greater use of specific verbal patterns believed to be related to increased learning. The results of the study demonstrated that cooperative learning strategies enhance conceptual change instruction. More

  8. The Federal Forecasters Conference--1999. Papers and Proceedings (10th, Washington, DC, June 24, 1999) and Selected Papers from the International Symposium on Forecasting (19th, Washington, DC, June 27-30, 1999).

    ERIC Educational Resources Information Center

    Gerald, Debra E., Ed.

    The 10th Federal Forecasters Conference provided a forum where 127 forecasters from different federal agencies and other organizations met to discuss various aspects of the conference's theme, "Forecasting in the New Millennium," that could be applied in the United States. A keynote address, "Procedures for Auditing Federal Forecasts" by J. Scott…

  9. Mountain Dew[R] or Mountain Don't?: A Pilot Investigation of Caffeine Use Parameters and Relations to Depression and Anxiety Symptoms in 5th- and 10th-Grade Students

    ERIC Educational Resources Information Center

    Luebbe, Aaron M.; Bell, Debora J.

    2009-01-01

    Background: Caffeine, the only licit psychoactive drug available to minors, may have a harmful impact on students' health and adjustment, yet little is known about its use or effects on students, especially from a developmental perspective. Caffeine use in 5th- and 10th-grade students was examined in a cross-sectional design, and relations and…

  10. Material Analysis and Processing Systems: A 9th and/or 10th Grade Industrial Education Curriculum Designed To Fulfill the Kansas State Department of Vocational Education's Level 2 Course Requirements.

    ERIC Educational Resources Information Center

    Dean, Harvey R., Ed.

    The teacher developed curriculum guide provides the industrial education teacher with the objectives, equipment lists, material, supplies, references, and activities necessary to teach students of the 9th and/or 10th grade the concepts of interrelationships between material analysis and processing systems. Career information and sociological…

  11. The Internet Time Lag: Anticipating the Long-Term Consequences of the Information Revolution. A Report of the Annual Aspen Institute Roundtable on Information Technology (10th, Aspen, Colorado, August 2-5, 2001).

    ERIC Educational Resources Information Center

    Schwartz, Evan I.

    This is a report of the 10th annual Aspen Institute Roundtable on Information Technology (Aspen, Colorado, August 2-5, 2001). Participants were also polled after the events of September 11, and these comments have been integrated into the report. The mission of this report is to take a wide-ranging look at the trends that are defining the next new…

  12. Power Conversion and Transmission Systems: A 9th and/or 10th Grade Industrial Education Curriculum Designed To Fulfill the Kansas State Department of Vocational Education's Level 2 Course Requirements.

    ERIC Educational Resources Information Center

    Dean, Harvey R., Ed.

    The document is a guide to a 9th and 10th grade industrial education course investigating the total system of power--how man controls, converts, transmits, and uses energy; the rationale is that if one is to learn of the total system of industry, the subsystem of power must be investigated. The guide provides a "body of knowledge" chart…

  13. A new postoperative otoplasty dressing technique using cyanoacrylate tissue adhesives.

    PubMed

    Vetter, Miriam; Foehn, Matthias; Wedler, Volker

    2010-04-01

    There are many techniques for cosmetic surgery of the ears and also many different procedures for postoperative treatment. The postoperative dressing is described as important for a successful outcome. We present our method of postoperative dressing in the form of liquid bonding. Cyanoacrylate tissue adhesives as liquid bonding agents are used for fixation of the pinna at the mastoid area. After 10-14 days the bonding can be easily removed. No huge dressings, tapes, or plasters are necessary. The patients are satisfied with the light dressing; they do not feel ashamed to appear in public. We have found this dressing technique to be simple and economical, especially because of the use of the bonding for skin closure before. It can be used after otoplasty with an anterior or a posterior approach.

  14. Are we ready for day-case partial nephrectomy?

    PubMed

    Bernhard, Jean-Christophe; Payan, Anne; Bensadoun, Henri; Cornelis, François; Pierquet, Grégory; Pasticier, Gilles; Robert, Grégoire; Capon, Grégoire; Ravaud, Alain; Ferriere, Jean-Marie

    2016-06-01

    Fast-track and day-case surgeries are gaining more and more importance. Their development was eased by the diffusion of minimal invasive surgical strategies and the consequential morbidity reduction. In the field of kidney cancer, seven cases of ambulatory radical nephrectomy were previously reported in the international literature. Regarding robotic partial nephrectomy (PN), short postoperative pathways resulting in patients' discharge on postoperative day 1 were shown to be safe and feasible. We report our initial experience of robot-assisted PN discharged on postoperative day zero and discuss the criteria for adequate patient selection. Indeed, outpatient PN will obviously not be suitable for all patients, and careful selection will be mandatory. Both specific baseline patient's factors and postoperative events will have to be recognized for the first ones and prevented for the second ones. Safety, patient satisfaction, cost efficiency, and reproducibility will be the key factors to assess and promote day-case PN.

  15. Common Post-Op Ear Drops Tied to Eardrum Perforations in Kids

    MedlinePlus

    ... gov/news/fullstory_164372.html Common Post-Op Ear Drops Tied to Eardrum Perforations in Kids Rate ... 2017 (HealthDay News) -- Children who suffer through multiple ear infections are often candidates for ear tube surgery. ...

  16. Standing adult human phantoms based on 10th, 50th and 90th mass and height percentiles of male and female Caucasian populations

    NASA Astrophysics Data System (ADS)

    Cassola, V. F.; Milian, F. M.; Kramer, R.; de Oliveira Lira, C. A. B.; Khoury, H. J.

    2011-07-01

    Computational anthropomorphic human phantoms are useful tools developed for the calculation of absorbed or equivalent dose to radiosensitive organs and tissues of the human body. The problem is, however, that, strictly speaking, the results can be applied only to a person who has the same anatomy as the phantom, while for a person with different body mass and/or standing height the data could be wrong. In order to improve this situation for many areas in radiological protection, this study developed 18 anthropometric standing adult human phantoms, nine models per gender, as a function of the 10th, 50th and 90th mass and height percentiles of Caucasian populations. The anthropometric target parameters for body mass, standing height and other body measures were extracted from PeopleSize, a well-known software package used in the area of ergonomics. The phantoms were developed based on the assumption of a constant body-mass index for a given mass percentile and for different heights. For a given height, increase or decrease of body mass was considered to reflect mainly the change of subcutaneous adipose tissue mass, i.e. that organ masses were not changed. Organ mass scaling as a function of height was based on information extracted from autopsy data. The methods used here were compared with those used in other studies, anatomically as well as dosimetrically. For external exposure, the results show that equivalent dose decreases with increasing body mass for organs and tissues located below the subcutaneous adipose tissue layer, such as liver, colon, stomach, etc, while for organs located at the surface, such as breasts, testes and skin, the equivalent dose increases or remains constant with increasing body mass due to weak attenuation and more scatter radiation caused by the increasing adipose tissue mass. Changes of standing height have little influence on the equivalent dose to organs and tissues from external exposure. Specific absorbed fractions (SAFs) have also

  17. IBC's 23rd Antibody Engineering and 10th Antibody Therapeutics Conferences and the Annual Meeting of The Antibody Society: December 2-6, 2012, San Diego, CA.

    PubMed

    Marquardt, John; Begent, Richard H J; Chester, Kerry; Huston, James S; Bradbury, Andrew; Scott, Jamie K; Thorpe, Philip E; Veldman, Trudi; Reichert, Janice M; Weiner, Louis M

    2012-01-01

    Now in its 23rd and 10th years, respectively, the Antibody Engineering and Antibody Therapeutics conferences are the Annual Meeting of The Antibody Society. The scientific program covers the full spectrum of challenges in antibody research and development from basic science through clinical development. In this preview of the conferences, the chairs provide their thoughts on sessions that will allow participants to track emerging trends in (1) the development of next-generation immunomodulatory antibodies; (2) the complexity of the environment in which antibodies must function; (3) antibody-targeted central nervous system (CNS) therapies that cross the blood brain barrier; (4) the extension of antibody half-life for improved efficacy and pharmacokinetics (PK)/pharmacodynamics (PD); and (5) the application of next generation DNA sequencing to accelerate antibody research. A pre-conference workshop on Sunday, December 2, 2012 will update participants on recent intellectual property (IP) law changes that affect antibody research, including biosimilar legislation, the America Invents Act and recent court cases. Keynote presentations will be given by Andreas Plückthun (University of Zürich), who will speak on engineering receptor ligands with powerful cellular responses; Gregory Friberg (Amgen Inc.), who will provide clinical updates of bispecific antibodies; James D. Marks (University of California, San Francisco), who will discuss a systems approach to generating tumor targeting antibodies; Dario Neri (Swiss Federal Institute of Technology Zürich), who will speak about delivering immune modulators at the sites of disease; William M. Pardridge (University of California, Los Angeles), who will discuss delivery across the blood-brain barrier; and Peter Senter (Seattle Genetics, Inc.), who will present his vision for the future of antibody-drug conjugates. For more information on these meetings or to register to attend, please visit www

  18. New archeointensity data from French Early Medieval pottery production (6th-10th century AD). Tracing 1500 years of geomagnetic field intensity variations in Western Europe

    NASA Astrophysics Data System (ADS)

    Genevey, Agnès; Gallet, Yves; Jesset, Sébastien; Thébault, Erwan; Bouillon, Jérôme; Lefèvre, Annie; Le Goff, Maxime

    2016-08-01

    Nineteen new archeointensity results were obtained from the analysis of groups of French pottery fragments dated to the Early Middle Ages (6th to 10th centuries AD). They are from several medieval ceramic production sites, excavated mainly in Saran (Central France), and their precise dating was established based on typo-chronological characteristics. Intensity measurements were performed using the Triaxe protocol, which takes into account the effects on the intensity determinations of both thermoremanent magnetization anisotropy and cooling rate. Intensity analyses were also carried out on modern pottery produced at Saran during an experimental firing. The results show very good agreement with the geomagnetic field intensity directly measured inside and around the kiln, thus reasserting the reliability of the Triaxe protocol and the relevance of the quality criteria used. They further demonstrate the potential of the Saran pottery production for archeomagnetism. The new archeointensity results allow a precise and coherent description of the geomagnetic field intensity variations in Western Europe during the Early Medieval period, which was until now poorly documented. They show a significant increase in intensity during the 6th century AD, high intensity values from the 7th to the 9th century, with a minimum of small amplitude at the transition between the 7th and the 8th centuries and finally an important decrease until the beginning of the 11th century. Together with published intensity results available within a radius of 700 km around Paris, the new data were used to compute a master curve of the Western European geomagnetic intensity variations over the past 1500 years. This curve clearly exhibits five intensity maxima: at the transition between the 6th and 7th century AD, at the middle of the 9th century, during the 12th century, in the second part of the 14th century and at the very beginning of the 17th century AD. Some of these peaks are smoothed, or

  19. Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors.

    PubMed

    Kain, Zeev N; Caldwell-Andrews, Alison A; Maranets, Inna; McClain, Brenda; Gaal, Dorothy; Mayes, Linda C; Feng, Rui; Zhang, Heping

    2004-12-01

    Based on previous studies, we hypothesized that the clinical phenomena of preoperative anxiety, emergence delirium, and postoperative maladaptive behavioral changes were closely related. We examined this issue using data obtained by our laboratory over the past 6 years. Only children who underwent surgery and general anesthesia using sevoflurane/O(2)/N(2)O and who did not receive midazolam were recruited. Children's anxiety was assessed preoperatively with the modified Yale Preoperative Anxiety Scale (mYPAS), emergence delirium was assessed in the postanesthesia care unit, and behavioral changes were assessed with the Post Hospital Behavior Questionnaire (PHBQ) on postoperative days 1, 2, 3, 7, and 14. Regression analysis showed that the odds of having marked symptoms of emergence delirium increased by 10% for each increment of 10 points in the child's state anxiety score (mYPAS). The odds ratio of having new-onset postoperative maladaptive behavior changes was 1.43 for children with marked emergence status as compared with children with no symptoms of emergence delirium. A 10-point increase in state anxiety scores led to a 12.5% increase in the odds that the child would have a new-onset maladaptive behavioral change after the surgery. This finding is highly significant to practicing clinicians, who can now predict the development of adverse postoperative phenomena, such as emergence delirium and postoperative behavioral changes, based on levels of preoperative anxiety.

  20. Postoperative Pain in Children After Dentistry Under General Anesthesia

    PubMed Central

    Wong, Michelle; Copp, Peter E.; Haas, Daniel A.

    2015-01-01

    The objective of this study was to determine the prevalence, severity, and duration of postoperative pain in children undergoing general anesthesia for dentistry. This prospective cross-sectional study included 33 American Society of Anesthesiology (ASA) Class I and II children 4–6 years old requiring multiple dental procedures, including at least 1 extraction, and/or pulpectomy, and/or pulpotomy of the primary dentition. Exclusion criteria were children who were developmentally delayed, cognitively impaired, born prematurely, taking psychotropic medications, or recorded baseline pain or analgesic use. The primary outcome of pain was measured by parents using the validated Faces Pain Scale-Revised (FPS-R) and Parents' Postoperative Pain Measure (PPPM) during the first 72 hours at home. The results showed that moderate-to-severe postoperative pain, defined as FPS-R ≥ 6, was reported in 48.5% of children. The prevalence of moderate-to-severe pain was 29.0% by FPS-R and 40.0% by PPPM at 2 hours after discharge. Pain subsided over 3 days. Postoperative pain scores increased significantly from baseline (P < .001, Wilcoxon matched pairs signed rank test). Moderately good correlation between the 2 pain measures existed 2 and 12 hours from discharge (Spearman rhos correlation coefficients of 0.604 and 0.603, P < .005). In conclusion, children do experience moderate-to-severe pain postoperatively. Although parents successfully used pain scales, they infrequently administered analgesics. PMID:26650492

  1. Postoperative singultus: an osteopathic approach.

    PubMed

    Petree, Kristie; Bruner, Jonathan

    2015-03-01

    Singultus, or hiccups, is a common medical condition. Despite exponential leaps in medicine, the pathophysiologic cause remains poorly defined. Persistent singultus has been associated with conditions such as pulmonary embolism and myocardial infarction. Singultus is also a well-known postoperative complication. The criterion standard of care for patients with singultus involves ruling out lethal pathologic causes, attempting physical stimulation with Valsava maneuvers or drinking water, and, if no relief has been achieved, administering drugs to ease the symptoms. The authors report a case of a man whose postoperative singultus was successfully managed with osteopathic manipulative treatment. This approach addresses many of the possible underlying neuromechanical causes of the aberrant reflex with minimal potential for adverse effects. Physicians should consider osteopathic manipulative treatment in the care of patients with singultus.

  2. Postoperative (pressure) alopecia following sacrocolpopexy.

    PubMed

    Bagaria, Madhu; Luck, Ali Maria

    2015-06-01

    Postoperative alopecia is a rare occurrence seen after a variety of surgical procedures performed under general anesthesia. The speculated cause is pressure-induced ischemia due to prolonged head immobilization. This case describes a patient who developed this complication after undergoing sacrocolpopexy. A 57-year-old postmenopausal Caucasian female was consented to undergo a robotic-assisted sacrocolpopexy, perineoplasty, and midurethral sling with possible conversion to an open procedure. The indication was symptomatic proximal and distal rectocele with foreshortened vagina. It was converted to laparotomy due to difficult presacral dissection. Her total operative time was 540 with 240 min in the Trendelenburg position. No intraoperative hypotension or excessive blood loss was noted. She started complaining of scalp pain in the postoperative recovery area. She developed soreness, crusting, and later alopecia in the same area. It was noted at her 3-week office visit. Referral was made for dermatology and anesthesiology evaluation. There was spontaneous full recovery by the 5th month. Postoperative alopecia is a rare condition mimicking alopecia areata but it is preceded by inciting events. There is some evidence to suggest that it is a preventable condition by frequent head repositioning during surgery. This case report is intended to increase the surgeon's awareness about this rare complication as its occurrence can be distressing for the patient.

  3. Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery

    PubMed Central

    Bydon, Mohamad; Abt, Nicholas B.; Macki, Mohamed; Brem, Henry; Huang, Judy; Bydon, Ali; Tamargo, Rafael J.

    2014-01-01

    Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P < 0.001) and an increased 30-day morbidity rate of 25.9% versus 14.14% in non-anemic patients (P < 0.001). The 30-day morbidity rates for all patients undergoing cranial procedures were stratified by diagnosis: 26.5% aneurysm, 24.7% sellar tumor, 19.7% extra-axial tumor, 14.8% intra-axial tumor, 14.4% arteriovenous malformation, and 5.6% pain. Following multivariable regression, the 30-day mortality in anemic patients was threefold higher than in non-anemic patients (4.1% vs 1.3%; OR = 2.77; 95% CI: 1.65-4.66). The odds of postoperative morbidity in anemic patients were significantly higher than in non-anemic patients (OR = 1.29; 95% CI: 1.03-1.61). There was a significant difference in postoperative morbidity event odds with a hematocrit level above (OR = 1.07; 95% CI: 0.78-1.48) and below (OR = 2.30; 95% CI: 1.55-3.42) 33% [hemoglobin (Hgb) 11 g/dl]. Conclusions: Preoperative anemia in elective cranial neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity. PMID

  4. Transdermal Buprenorphine Patches for Postoperative Pain Control in Abdominal Surgery

    PubMed Central

    Kumar, Santosh; Singh, Prithvi Kumar; Verma, Reetu; Chandra, Girish; Bhatia, Vinod Kumar; Singh, Dinesh; Bogra, Jaishri

    2016-01-01

    Introduction Buprenorphine is a semi-synthetic derivative of thebaine; its low concentration is sufficient to provide effective pain relief. Aim To evaluate the efficacy of transdermal buprenorphine patch in postoperative pain management. Materials and Methods After ethical approval and taking informed consent from the patients, they were randomized into three groups (n=30 in each group) using a computer generated random number table. Group A: placebo patch; Group B: buprenorphine (10mg) patch and Group C: buprenorphine (20mg) patch. Haemodynamic and analgesic effects were compared by using analysis of variance (ANOVA) followed by Turkey’s post hoc test. The proportion of side effects was compared using the Chi-square test. Results Haemodynamic changes were not statistically different in all the three groups A, B and C, whereas at the end of surgery VAS score of Group A subjects was significantly higher (4.93±0.98) as compared to Group B (1.73±0.64) and Group C (1.40±0.50). On 2nd postoperative day, no pain was reported by the Group C patients and on 4th day after surgery, no pain was reported by Group B patients. Conclusion The transdermal buprenorphine patch (20mg) was effective in attenuating postoperative pain, maintaining haemodynamic stability requiring no rescue analgesia, with fewer postoperative rescue analgesic requirements in low dose of buprenorphine patch (10mg) group. PMID:27504383

  5. Prevention of postoperative tooth sensitivity: a preliminary clinical trial.

    PubMed

    Sobral, M A P; Garone-Netto, N; Luz, M A A C; Santos, A P

    2005-09-01

    The purpose of this study was to evaluate clinically the effects of pre-treatments with a 35% hydroxyethyl metacrylate/5% glutaraldehyde dentine desensitizer (Gluma Desensitizer) and a 2% chlorexidine-based cavity disinfectant (Cav-Clean) on postoperative sensitivity. Three premolar teeth with no pain symptoms were selected from each one of 17 patients, totalling 51 teeth, for which Class II restoration using a composite was indicated. Each one of the three premolar teeth of the same patient was submitted to a different treatment. After acid etching, only a dental adhesive was applied to the first tooth, which served as the control. Gluma Desensitizer dentinal desensitizer was applied to the second premolar tooth prior to applying the dental adhesive. Cav-Clean cavity disinfectant was used on the third premolar tooth before applying the dental adhesive. Only one tooth was restored per session, and all premolar teeth were restored with a condensable composite, according to current restoration technique guidelines. Sensitivity to different stimuli (cold, heat, sweet and dental floss) was assessed on Day 1, Day 4 and Day 7 by questionnaire following restorative procedures. The results of this clinical research showed that, as far as the investigated stimuli and postoperative course are concerned, there was no statistically significant difference in the three different treatments (P>0.05). Postoperative sensitivity resulting from Class II restorations using composite resin cannot be completely eliminated with the prior use of a dentinal desensitizer or a cavity disinfectant. In day-to-day clinical treatment, postoperative sensitivity may possibly be related to the technique employed.

  6. Predicting postoperative fever and bacterial colonization on packing material following endoscopic endonasal surgery.

    PubMed

    Nomura, Kazuhiro; Yamanaka, Yurika; Sekine, Yasuhiro; Yamamoto, Hiroki; Esu, Yoshihiko; Hara, Mariko; Hasegawa, Masayo; Shinnabe, Akihiro; Kanazawa, Hiromi; Kakuta, Risako; Ozawa, Daiki; Hidaka, Hiroshi; Katori, Yukio; Yoshida, Naohiro

    2017-01-01

    Postoperative fever following endoscopic endonasal surgery is a rare occurrence of concern to surgeons. To elucidate preoperative and operative predictors of postoperative fever, we analyzed the characteristics of patients and their perioperative background in association with postoperative fever. A retrospective review of 371 patients who had undergone endoscopic endonasal surgery was conducted. Predictors, including intake of antibiotics, steroids, history of asthma, preoperative nasal bacterial culture, duration of operation, duration of packing and intraoperative intravenous antibiotics on the occurrence of postoperative fever, and bacterial colonization on the packing material, were analyzed retrospectively. Fever (≥38 °C) occurred in 63 (17 %) patients. Most incidences of fever occurred on postoperative day one. In majority of these cases, the fever subsided after removal of the packing material without further antibiotic administration. However, one patient who experienced persistent fever after the removal of packing material developed meningitis. History of asthma, prolonged operation time (≥108 min), and intravenous cefazolin administration instead of cefmetazole were associated with postoperative fever. Odds ratios (ORs) for each were 2.3, 4.6, and 2.0, respectively. Positive preoperative bacterial colonization was associated with postoperative bacterial colonization on the packing material (OR 2.3). Postoperative fever subsided in most patients after removal of the packing material. When this postoperative fever persists, its underlying cause should be examined.

  7. Optimal Timing for Hemoglobin Concentration Determination after Total Knee Arthroplasty: Day 1 versus Day 2

    PubMed Central

    Khalfaoui, Mahdi Yacine; Godavitarne, Charles; Wilkinson, Michael C P

    2017-01-01

    Purpose Postoperative hemoglobin (Hb) determination remains an essential parameter for quantifying blood loss following total knee replacement (TKR) surgery and guiding transfusion practice. In this study we aimed to ascertain the optimal timing for Hb determination postoperatively and assess its relationship to serum hematocrit (Hct). Materials and Methods This was a retrospective cohort analysis of 61 consecutive patients undergoing preoperative, day 1 and day 2 Hb and Hct concentration determination following TKR surgery. This was a single centre study in the United Kingdom. Results The mean fall in Hb concentration at day 1 was 2.9 g/dL in comparison to 3.3 g/dL at day 2. This indicated a significant difference of 0.39 g/dL (p=0.023). A total of 5 patients required blood transfusions following day 2 Hb determination. Postoperative Hct values varied in close relation with the Hb concentration with no significant differences demonstrated. Our study reveals a significant change between day 1 and day 2 Hb concentrations following TKR surgery, with no significant differing information provided through Hct determination. Conclusions Our results support the use of delayed routine testing at day 2 following surgery as it is likely to more accurately reflect ongoing hidden blood loss into the joint cavity and within soft tissue planes. PMID:28231649

  8. Differences in postoperative opioid consumption in patients prescribed patient-controlled analgesia versus intramuscular injection.

    PubMed

    Everett, Bronwyn; Salamonson, Yenna

    2005-12-01

    The purpose of this study was to examine differences in opioid consumption in patients prescribed patient-controlled analgesia (PCA) versus intramuscular injection (IMI) in the early postoperative period after open abdominal surgery. A retrospective audit of 115 patients elicited demographic and clinical data. No significant differences were found between the demographic variables of the PCA and IMI groups. There was a significant difference in the mean opioid dose used during the first 3 postoperative days (p < .01). Mean opioid consumption was 136.89 mg for the PCA group and 50.79 mg for the IMI group. Although there was a reduction in the amount of opioid consumed over the first 3 postoperative days, the PCA group consistently consumed more opioid analgesia compared with the IMI group. Furthermore, there was a disproportionate reduction in opioid consumption between the two groups from Day 1 (r = .34; p < .01) to Day 3 (r = .14; p = .14). This study shows that the amount of analgesia consumed during the postoperative period by patients who had abdominal surgery varied markedly depending on the mode of analgesia (PCA or IMI). The difference in analgesic consumption was also found to increase throughout the 3-day postoperative period. This divergence in the amount of opioid consumption between patients who were prescribed PCA and patients who were prescribed IM analgesia heightens the need for vigilance in assessment and management of pain during the early postoperative period, particularly in patients prescribed IM analgesia on an "as-needed" basis.

  9. Postoperative Hyperthermia of Unknown Origin Treated With Dantrolene Sodium

    PubMed Central

    Inada, Hirohito; Jinno, Shigeharu; Kohase, Hikaru; Fukayama, Haruhisa; Umino, Masahiro

    2005-01-01

    An 11-year-old girl was scheduled for alveolar cleft bone grafting with an iliac bone under general anesthesia. Anesthesia was performed with 70% nitrous oxide, 30% oxygen, and propofol. On the first and second postoperative day, persistent hyperthermia was observed. Because the administration of diclofenac sodium had not been effective for the hyperthermia, dantrolene sodium was given. Her body temperature gradually dropped and returned to normal level on the fifth postoperative day. The hyperthermia in the present case might have been caused by a rapidly elevated muscle metabolism in response to pain and stress after the propofol anesthesia. The oral administration of dantrolene sodium successfully lowered the patient's high body temperature. PMID:15859445

  10. Immunologic and Infectious Diseases in Pediatric Cardiac Critical Care: Proceedings of the 10th International Pediatric Cardiac Intensive Care Society Conference.

    PubMed

    Axelrod, David M; Alten, Jeffrey A; Berger, John T; Hall, Mark W; Thiagarajan, Ravi; Bronicki, Ronald A

    2015-10-01

    Since the inception of the Pediatric Cardiac Intensive Care Society (PCICS) in 2003, remarkable advances in the care of children with critical cardiac disease have been developed. Specialized surgical approaches, anesthesiology practices, and intensive care management have all contributed to improved outcomes. However, significant morbidity often results from immunologic or infectious disease in the perioperative period or during a medical intensive care unit admission. The immunologic or infectious illness may lead to fever, which requires the attention and resources of the cardiac intensivist. Frequently, cardiopulmonary bypass leads to an inflammatory state that may present hemodynamic challenges or complicate postoperative care. However, inflammation unchecked by a compensatory anti-inflammatory response may also contribute to the development of capillary leak and lead to a complicated intensive care unit course. Any patient admitted to the intensive care unit is at risk for a hospital acquired infection, and no patients are at greater risk than the child treated with mechanical circulatory support. In summary, the prevention, diagnosis, and management of immunologic and infectious diseases in the pediatric cardiac intensive care unit is of paramount importance for the clinician. This review from the tenth PCICS International Conference will summarize the current knowledge in this important aspect of our field.

  11. Administrative simplification: change to the compliance date for the International Classification of Diseases, 10th Revision (ICD-10-CM and ICD-10-PCS) medical data code sets. Final rule.

    PubMed

    2014-08-04

    This final rule implements section 212 of the Protecting Access to Medicare Act of 2014 by changing the compliance date for the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) for diagnosis coding, including the Official ICD-10-CM Guidelines for Coding and Reporting, and the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) for inpatient hospital procedure coding, including the Official ICD-10-PCS Guidelines for Coding and Reporting, from October 1, 2014 to October 1, 2015. It also requires the continued use of the International Classification of Diseases, 9th Revision, Clinical Modification, Volumes 1 and 2 (diagnoses), and 3 (procedures) (ICD-9-CM), including the Official ICD-9-CM Guidelines for Coding and Reporting, through September 30, 2015.

  12. The effects of Western music on postoperative pain in Taiwan.

    PubMed

    Good, M; Chin, C C

    1998-02-01

    Music is a method nurses can use to help relieve pain, however little is known about its effectiveness across cultures. In this study, Western music was tested for its effectiveness in reducing postoperative pain in 38 Taiwanese patients, and its acceptability was explored. A pretest and post-test experimental design was used with visual analogue scales to measure sensation and distress of pain. Before surgery, subjects were randomly assigned to receive tape recorded music or the usual care. Those who were assigned to the music group chose among 5 types of sedative music. On postoperative Day 1 and Day 2, the effectiveness of the tape-recorded music was investigated during 15 minutes of rest in bed. Patients were interviewed on Day 3 to determine their liking for the music, its calming effects, and the helpfulness of the music. Repeated measures analysis of variance showed a significant interaction between time and group in the distress of pain on Day 1, but not on Day 2, and in pain sensation on Day 2, but not Day 1. Subjects from Taiwan were similar to subjects in a previous study in the United States in their liking for the music, and in reports of the helpfulness of the music for pain sensation and distress, but fewer Taiwanese found the music calming, and they had different choices: more chose harp music and fewer chose jazz than subjects in the U.S. study, and some would prefer Buddhist hymns or popular songs heard in Taiwan. Findings support the use of culturally acceptable music in addition to analgesic medication for the sensation and distress of postoperative pain.

  13. Pulmonary artery stump thrombosis developed during the late postoperative period

    PubMed Central

    Kaya, Seyda Ors; Samancilar, Ozgur; Ceylan, Kenan Can

    2016-01-01

    A 73-year-old man underwent left pneumonectomy for squamous cell lung carcinoma 3 years ago. The postoperative and follow-up periods were uneventful. A thrombus was detected in the left pulmonary artery stump during the last chest computed tomography (CT) scan. Anticoagulant treatment was applied: intravenous heparin for 3 days followed by oral warfarin. The follow-up chest CT examination revealed regression in the size of the thrombus. PMID:27785144

  14. Markov Chain evaluation of acute postoperative pain transition states

    PubMed Central

    Tighe, Patrick J.; Bzdega, Matthew; Fillingim, Roger B.; Rashidi, Parisa; Aytug, Haldun

    2016-01-01

    Prior investigations on acute postoperative pain dynamicity have focused on daily pain assessments, and so were unable to examine intra-day variations in acute pain intensity. We analyzed 476,108 postoperative acute pain intensity ratings clinically documented on postoperative days 1 to 7 from 8,346 surgical patients using Markov Chain modeling to describe how patients are likely to transition from one pain state to another in a probabilistic fashion. The Markov Chain was found to be irreducible and positive recurrent, with no absorbing states. Transition probabilities ranged from 0.0031 for the transition from state 10 to state 1, to 0.69 for the transition from state zero to state zero. The greatest density of transitions was noted in the diagonal region of the transition matrix, suggesting that patients were generally most likely to transition to the same pain state as their current state. There were also slightly increased probability densities in transitioning to a state of asleep or zero from the current state. Examination of the number of steps required to traverse from a particular first pain score to a target state suggested that overall, fewer steps were required to reach a state of zero (range 6.1–8.8 steps) or asleep (range 9.1–11) than were required to reach a mild pain intensity state. Our results suggest that Markov Chains are a feasible method for describing probabilistic postoperative pain trajectories, pointing toward the possibility of using Markov decision processes to model sequential interactions between pain intensity ratings and postoperative analgesic interventions. PMID:26588689

  15. [Postoperative radiotherapy of prostate cancer].

    PubMed

    Guérif, S; Latorzeff, I; Lagrange, J-L; Hennequin, C; Supiot, S; Garcia, A; François, P; Soulié, M; Richaud, P; Salomon, L

    2014-10-01

    Between 10 and 40% of patients who have undergone a radical prostatectomy may have a biologic recurrence. Local or distant failure represents the possible patterns of relapse. Patients at high-risk for local relapse have extraprostatic disease, positive surgical margins or seminal vesicles infiltration or high Gleason score at pathology. Three phase-III randomized clinical trials have shown that, for these patients, adjuvant irradiation reduces the risk of tumoral progression without higher toxicity. Salvage radiotherapy for late relapse allows a disease control in 60-70% of the cases. Several research in order to improve the therapeutic ratio of the radiotherapy after prostatectomy are evaluate in the French Groupe d'Étude des Tumeurs Urogénitales (Gétug) and of the French association of urology (Afu). The Gétug-Afu 17 trial will provide answers to the question of the optimal moment for postoperative radiotherapy for pT3-4 R1 pN0 Nx patients, with the objective of comparing an immediate treatment to a differed early treatment initiated at biological recurrence. The Gétug-Afu 22 questions the place of a short hormonetherapy combined with image-guided, intensity-modulated radiotherapy (IMRT) in adjuvant situation for a detectable prostate specific antigen (PSA). The implementation of a multicenter quality control within the Gétug-Afu in order to harmonize a modern postoperative radiotherapy will allow the development of a dose escalation IMRT after surgery.

  16. Postoperative discomfort of dental rehabilitation under general anesthesia

    PubMed Central

    Cantekin, Kenan; Yildirim, Mustafa Denizhan; Delikan, Ebru; Çetin, Seçil

    2014-01-01

    Objective: To find out postoperative discomfort in children undergoing dental rehabilitation under general anesthesia (DRGA). Methods: This study involved 78 (4 to 10 year-old) healthy patients who were scheduled for DRGA and were needed extensive dental treatment because of severe caries, and showed high dental fear and/or behavioral management problems. The children had to be fit for DRGA administration by fulfilling the American Society of Anesthesiologists physical status I or II and no associated mental health or communication problems. Data were collected by structured interview either face to face (immediately post operation) or using a telephone (post operation after discharge). One of the study’s investigators recorded all data related to the immediate postoperative period during the child’s stay in the post-anesthesia care unit (PACU). The questionnaire consisted of questions related to postoperative problems experienced by the patient in the period after their day-stay attendance. The questionnaire, consisting of questions regarding and generally related to the child’s activities. In addition, pain was assessed using the face, legs, activity, cry, consolability (FLACC) scale. Results: The prevalence of postoperative problems was 46 out of 78 (59%). The mean FLACC score was 1.8 (SD=2.1). Some of the patients having more than one reported problem. Forty-one percent of the children showed nasal discomfort (P<0.01). Thirty-three percent and 43% of the children experienced throat or mouth discomfort. The most common experienced postoperative symptom after DRGA was bleeding. Nasal bleeding, however, was an uncommon complication and did not cause serious morbidity or mortality in children intubated nasotracheally. In addition, postoperative discomfort was related to number of the extractions. Children who had 4 or more extractions were more likely to experience pain. Findings associated with other bodily functions were assessed. Nausea and vomiting were

  17. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...

  18. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...

  19. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Day; business day; school day. 300.11 Section 300.11 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION ASSISTANCE TO STATES FOR THE EDUCATION...

  20. Uniform qualitative electrophysiological changes in postoperative rest tremor.

    PubMed

    Kovacs, Norbert; Balas, Istvan; Illes, Zsolt; Kellenyi, Lorant; Doczi, Tamas P; Czopf, Jozsef; Poto, Laszlo; Nagy, Ferenc

    2006-03-01

    Ablation and deep brain stimulation (DBS) can treat pharmacologically uncontrollable tremor. Here, we compared the postoperative electrophysiological changes in resting hand tremor after 32 ablations and 12 DBS implantations in patients with severe tremor-dominant idiopathic Parkinson's disease (PD) and essential tremor (ET). Short- and long-term accelerometric data were acquired after surgery and were compared to the preoperative tremor. After effective surgical treatments, significant rest tremor reduction and increase in both frequency and approximate entropy (ApEn) were detected in all PD cases, irrespective of the type and target of intervention. However, the long-term effect of DBS implantation on tremor reduction was significantly better compared to that after ablative treatments. In cases of thalamotomy, the postoperative increase in frequency and ApEn was significantly larger in essential tremor compared to PD, suggesting that the etiology of tremor may influence the size of the similar changes. However, cases where clinical tremor re-emerged 6 to 12 months after the surgery, no change in frequency and ApEn was detected on the second postoperative day, despite an initial tremor reduction and clinical improvement similar to the effective operations. Our results suggest that uniform postoperative changes in rest tremor and the increase in frequency and ApEn could be due to attenuation of pathological oscillators and might be immediate indicators of the effectiveness of neurosurgical treatments relieving tremor.

  1. Does Apolipoprotein E Genotype Increase Risk of Postoperative Delirium?

    PubMed Central

    Vasunilashorn, Sarinnapha; Ngo, Long; Kosar, Cyrus M.; Fong, Tamara G.; Jones, Richard N.

    2015-01-01

    Objectives To determine whether Apolipoprotein E (ApoE) is associated with postoperative delirium incidence, severity, and duration in older patients free of dementia at baseline. Design, Setting, Participants We examined 557 non-demented patients age ≥70 undergoing major non-cardiac surgery enrolled in the Successful Aging after Elective Surgery (SAGES) Study. Measurements We considered three ApoE measures: ε2, ε4 carriers vs. non-carriers, and a three-category ApoE measure. Delirium was determined using the Confusion Assessment Method (CAM) and chart review. We used generalized linear models to estimate the association between ApoE and delirium incidence, severity (peak CAM Severity [CAM-S] score), and days. Results ApoE ε2 and ε4 was present in 15% and 19% respectively, and postoperative delirium occurred in 24%. Among patients with delirium, the mean peak CAM-S score was 8.0 (standard deviation 4), with most patients experiencing one or two delirium days (51% or 28%, respectively). After adjusting for age, sex, surgical procedure, and preoperative cognitive function, ApoE ε4 and ε2 carrier status were not associated with postoperative delirium: RR for ε4=1.0, 95% confidence interval (CI) 0.7-1.5 and RR for ε2=0.9, 95% CI 0.6-1.4. No association between ApoE and delirium severity or number of delirium days was observed. Conclusions In older surgery patients free of dementia, our findings do not support the hypothesis that the ApoE genotype does not confer either risk or protection in postoperative delirium incidence, severity, or duration. Thus, an important genetic risk factor for Alzheimer's Disease does not affect risk of delirium. PMID:26238230

  2. Computed tomography of the postoperative lumbar spine

    SciTech Connect

    Teplick, J.G.; Haskin, M.E.

    1983-11-01

    In the postoperative patient ordinary radiographs of the spine generally add very little information, revealing the usual postoperative bone changes and often postoperative narrowing of the intervertebral space. Myelography may sometimes be informative, showing evidence of focal arachnoiditis or a focal defect at the surgical site. However, the latter finding is difficult to interpret. As experience with high-resolution CT scanning of the lumbar spine has been increasing, it is becoming apparent that this noninvasive and easily performed study can give considerably more information about the postoperative spine than any of the other current imaging methods. About 750 patients with previous lumbar laminectomies had CT scanning within a 28 month period.

  3. Post-operative morbidity following the use of the inverted periosteal graft: A case series.

    PubMed

    Gupta, Gazal Kaushelendra; Kulkarni, Mihir Raghavendra; Thomas, Betsy Sara

    2014-01-01

    Post-operative complications following flap surgeries or mucogingival procedures are important factors influencing patient's perception of periodontal procedures. Hence, it is important to foresee such complications and take adequate measures pre- and post-operatively. We treated five consecutive cases of gingival recession in the maxillary canine-premolar area using the inverted periosteal graft with a coronally positioned flap technique. Following each of these surgeries, the patients complained of post-operative swelling the next day involving the canine space or buccal space area. The swelling persisted for at least 5 days, however, it was painless. This paper highlights the post-operative complications associated with the said procedure and makes a case for detail enquiry in the form of controlled studies.

  4. Effects of ketoprofen for prevention of postoperative cognitive dysfunction in aged rats.

    PubMed

    Kawano, Takashi; Takahashi, Tetsuya; Iwata, Hideki; Morikawa, Akihiro; Imori, Satoko; Waki, Sayaka; Tamura, Takahiko; Yamazaki, Fumimoto; Eguchi, Satoru; Kumagai, Naoko; Yokoyama, Masataka

    2014-12-01

    Postoperative cognitive dysfunction is a common geriatric complication that may be associated with increased mortality. Here, we investigated the effects of postoperative analgesia with ketoprofen on cognitive functions in aged animals and compared its effectiveness to morphine. Rats were randomly allocated to one of four groups: isoflurane anesthesia without surgery (group C), isoflurane anesthesia with laparotomy (group IL), and isoflurane anesthesia with laparotomy plus postoperative analgesia with ketoprofen or morphine. There was no difference in postoperative locomotor activity among groups. In group IL, postoperative pain levels assessed by the Rat Grimace Scale significantly increased until 8 h after surgery, which was similarly inhibited by both ketoprofen and morphine. Cognitive function was assessed using radial arm maze testing for 12 consecutive days from postoperative day 3. Results showed that the number of memory errors in group IL were significantly higher than those in goup C. However, both ketoprofen and morphine could attenuate the increase in memory errors following surgery to a similar degree. Conversely, ketoprofen showed no effect on cognitive function in the nonsurgical rats that did not experience pain. Our findings suggest that postoperative analgesia with ketoprofen can prevent the development of surgery-associated memory deficits via its pain-relieving effects.

  5. Prediction of early postoperative infections in pediatric liver transplantation by logistic regression

    NASA Astrophysics Data System (ADS)

    Uzunova, Yordanka; Prodanova, Krasimira; Spassov, Lubomir

    2016-12-01

    Orthotopic liver transplantation (OLT) is the only curative treatment for end-stage liver disease. Early diagnosis and treatment of infections after OLT are usually associated with improved outcomes. This study's objective is to identify reliable factors that can predict postoperative infectious morbidity. 27 children were included in the analysis. They underwent liver transplantation in our department. The correlation between two parameters (the level of blood glucose at 5th postoperative day and the duration of the anhepatic phase) and postoperative infections was analyzed, using univariate analysis. In this analysis, an independent predictive factor was derived which adequately identifies patients at risk of infectious complications after a liver transplantation.

  6. The method of early postoperative alimentation by needle-catheter jejunostomy.

    PubMed

    Bodoky, G; Harsányi, L

    1989-01-01

    It is well established that the nutritional state greatly influences tolerance during the operation. Authors present a new procedure for the early postoperative enteral alimentation having not been used in Hungary so far. Twelve hours after operation, a pump-operated, gradually increasing amount of oligopeptide food-preparation and concentrate is introduced continuously into the second jejunal loop intraoperatively. Using this method, a caloric intake of 9572 kJ can be achieved already from the fourth postoperative day onwards. Based on our experience gained from 32 patients, the method can be recommended for an up-to-date postoperative enteral alimentation.

  7. Early diagnosis of acute postoperative renal transplant rejection

    SciTech Connect

    Tisdale, P.L.; Collier, B.D.; Kauffman, H.M.; Adams, M.B.; Isitman, A.T.; Hellman, R.S.; Rao, S.A.; Joestgen, T.; Krohn, L.

    1985-05-01

    A prospective evaluation of In-111 labeled autologous platelet scintigraphy for the early diagnosis of acute postoperative renal transplant rejection was undertaken. To date, 28 consecutive patients between 7 and 14 days post-op have been injected with 500..mu..Ci of In-111 platelets followed by imaging at 24 and 48 hours. Activity within the renal transplant exceeding activity in the adjacent iliac vessels was considered to be evidence of rejection, and both chemical evidence and clinical impression of rejection at 5 days after completion of imaging was accepted as proof of ongoing or incipient rejection at the time of scintigraphy. In addition, to visual inspection, independent quantitative analysis compared the area-normalized activity over the transplant with the adjacent iliac vessels (normal <1.0). For 5 patients, positive In-111 scintigraphy was present before convincing clinical evidence of rejection. In-111 platelet scintigraphy is useful not only to confirm the clinical diagnosis of rejection but also to establish the early, pre-clinical diagnosis of incipient acute postoperative renal transplant rejection.

  8. Postoperative Endophthalmitis Caused by Staphylococcus haemolyticus following Femtosecond Cataract Surgery

    PubMed Central

    Wong, Margaret; Baumrind, Benjamin R.; Frank, James H.; Halpern, Robert L.

    2015-01-01

    A 53-year-old Caucasian man underwent femtosecond cataract surgery and then presented with pain and hand motions vision 1 day following surgery. Anterior segment examination showed a 2-mm-layered hypopyon, a well-centered intraocular lens in the sulcus, and an obscured view to the fundus. B-scan ultrasonography showed significant vitritis and that the retina was attached. A tap and an injection of vancomycin 1 mg per 0.1 ml and of ceftazidime 2.25 mg per 0.1 ml were performed. The tap eventually yielded culture results positive for Staphylococcus haemolyticus, which was sensitive to vancomycin. We report a case of endophthalmitis that occurred on postoperative day 1 following complicated cataract surgery. This is an uncommon bacterium that is not widely reported in the literature as a cause of endophthalmitis in the postoperative period. We urge clinicians to consider S. haemolyticus as an offending agent, especially when the infection presents very early and aggressively in the postoperative period. PMID:26951642

  9. Predictors of Postoperative Complications After Trimodality Therapy for Esophageal Cancer

    SciTech Connect

    Wang, Jingya; Wei, Caimiao; Tucker, Susan L.; Myles, Bevan; Palmer, Matthew; Hofstetter, Wayne L.; Swisher, Stephen G.; Ajani, Jaffer A.; Cox, James D.; Komaki, Ritsuko; Liao, Zhongxing; Lin, Steven H.

    2013-08-01

    Purpose: While trimodality therapy for esophageal cancer has improved patient outcomes, surgical complication rates remain high. The goal of this study was to identify modifiable factors associated with postoperative complications after neoadjuvant chemoradiation. Methods and Materials: From 1998 to 2011, 444 patients were treated at our institution with surgical resection after chemoradiation. Postoperative (pulmonary, gastrointestinal [GI], cardiac, wound healing) complications were recorded up to 30 days postoperatively. Kruskal-Wallis tests and χ{sup 2} or Fisher exact tests were used to assess associations between continuous and categorical variables. Multivariate logistic regression tested the association between perioperative complications and patient or treatment factors that were significant on univariate analysis. Results: The most frequent postoperative complications after trimodality therapy were pulmonary (25%) and GI (23%). Lung capacity and the type of radiation modality used were independent predictors of pulmonary and GI complications. After adjusting for confounding factors, pulmonary and GI complications were increased in patients treated with 3-dimensional conformal radiation therapy (3D-CRT) versus intensity modulated radiation therapy (IMRT; odds ratio [OR], 2.018; 95% confidence interval [CI], 1.104-3.688; OR, 1.704; 95% CI, 1.03-2.82, respectively) and for patients treated with 3D-CRT versus proton beam therapy (PBT; OR, 3.154; 95% CI, 1.365-7.289; OR, 1.55; 95% CI, 0.78-3.08, respectively). Mean lung radiation dose (MLD) was strongly associated with pulmonary complications, and the differences in toxicities seen for the radiation modalities could be fully accounted for by the MLD delivered by each of the modalities. Conclusions: The radiation modality used can be a strong mitigating factor of postoperative complications after neoadjuvant chemoradiation.

  10. When Every Day Is Professional Development Day

    ERIC Educational Resources Information Center

    Tienken, Christopher H.; Stonaker, Lew

    2007-01-01

    In the Monroe Township (New Jersey) Public Schools, teachers' learning occurs daily, not just on one day in October and February. Central office and school-level administrators foster job-embedded teacher growth. Every day is a professional development day in the district, but that has not always been so. How did the district become a system with…

  11. Topical fluorouracil. II. Postoperative administration in an animal model of glaucoma filtering surgery.

    PubMed

    Heuer, D K; Gressel, M G; Parrish, R K; Folberg, R; Dillberger, J E; Altman, N H

    1986-01-01

    Unilateral posterior lip sclerectomies were performed in ten owl monkeys. Five milligrams of fluorouracil was injected subconjunctivally in each operated eye immediately after surgery. Three drops (approximately 2.4 mg/drop) of fluorouracil were instilled ten minutes apart in each operated eye twice daily on postoperative days 1 through 7 and once daily on postoperative days 8 through 15, 17, 19, and 21. One monkey died on the seventh postoperative day; its death could not be attributed to systemic fluorouracil toxicity. All of the operated eyes had filtering blebs after the full course of fluorouracil, but seven also had corneal epithelial defects. By the seventh postoperative week, two of the operated eyes manifested moderately severe corneal opacification. Ten weeks postoperatively, the electroretinographic a- and b-wave amplitudes averaged 17% and 12% less, respectively, in the seven operated eyes without clinically significant corneal opacification than in the unoperated fellow eyes. Only two eyes had blebs after the 12th postoperative week. Histopathologic examination was performed on five eyes, of which only two revealed patent sclerostomies. Although topical fluorouracil appears to delay bleb scarring, the corneal findings suggest that it may be more toxic than subconjunctival fluorouracil.

  12. Which deep breathing device should the postoperative patient use?

    PubMed

    Lederer, D H; Van de Water, J M; Indech, R B

    1980-05-01

    A study was undertaken to compare the use of three types of deep-breathing devices in patients undergoing upper-abdominal operations. Seventy-nine patients were divided into three groups, each receiving preoperative bedside testing of pulmonary function and instruction in the use of one of three randomly assigned deep-breathing devices thought to be representative of those currently available (Triflo II, Bartlett-Edwards Incentive Spirometer, or Spirocare). Repeat testing and instruction were provided daily during each of the first five postoperative days. There were few statistically significant differences in pulmonary function, vital signs and white blood cell count, and no difference in length of postoperative stay. No device was uniformly acceptable to patients, and none was used as frequently as recommended. When left at the bedside and only one daily reinforcement of instructions, the three devices showed no clinically important differences.

  13. Principles of postoperative anterior cruciate ligament rehabilitation

    PubMed Central

    Saka, Tolga

    2014-01-01

    It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, “ossified” knowledge or modalities really prove themselves in the literature? Could questions such as “is postoperative brace use really necessary?”, “what are the benefits of early restoration of the range of motion (ROM)?”, “to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?”, “how early can proprioception training and open chain exercises begin?”, “should strengthening training start in the immediate postoperative period?” be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper. PMID:25232521

  14. Epidural Analgesia in the Postoperative Period

    DTIC Science & Technology

    2001-10-01

    violations. VI ABSTRACT Postoperative pain is an unwanted side effect of surgery, and is associated with many postoperative complications...This descriptive study was conducted to determine which surgical patients experienced the most analgesia with the fewest side effects when...epidural medication, side effects , incidence of breakthrough pain, and treatments were recorded and cross-tabulated. The following surgical categories

  15. One-Day vs Two-Day Epidural Analgesia for Total Knee Arthroplasty (TKA): A Retrospective Cohort Study

    PubMed Central

    Corbett, Kelly L; Reichmann, William M; Katz, Jeffrey N; Beagan, Carolyn; Corsello, Paul; Ghazinouri, Roya; Dang, Bachyen; Mikulinsky, Regina; Losina, Elena; Wright, John

    2010-01-01

    Introduction: Over 500,000 total knee arthroplasties (TKAs) are performed annually in the US, yet postoperative pain management varies widely. In patients managed with epidural analgesia, the epidural catheter is generally removed on the second postoperative day. We compared in-hospital outcomes associated with removing the epidural catheter on postoperative day 1 (POD1-group) vs on postoperative day 2 (POD2-group) among patients undergoing TKA. Methods: We identified 89 patients who had TKA performed by a single surgeon from January through July 2007, and who were managed with epidural analgesia. This study took advantage of a change of policy from removing the epidural on the second postoperative day prior to March 2007 (n = 34) to removing the epidural on the first postoperative day thereafter (n = 55). Data were obtained by medical record review and analyzed with bivariate and multivariate techniques. Outcomes included knee range of motion (ROM), pain (0-10 scale), distance walked, narcotic usage, and length of stay. Results: The mean patient age was 68 ± 10 years. We did not identify clinically important differences in preoperative characteristics across groups. Patients in the POD1- group had a shorter length of stay (median of 3 vs 4 days in the POD2-group, p<0.001). The POD1-group also walked a greater distance on the second postoperative day (mean of 38 feet vs 9 feet in the POD2-group, p < 0.002). We did not observe a difference between the two groups with respect to change in passive ROM, pain on the second postoperative day, or narcotic usage. The POD1-group had more restricted continuous passive motion settings on the second postoperative day than the POD2-group (50° vs 65°, p = 0.031), and the POD1-group had somewhat worse passive range of motion at discharge (e.g. passive flexion 82o vs 76o in the POD2- group, p = 0.078). Conclusion: The balance between a shorter hospital stay and earlier walking achievement with the POD1-strategy-- vs better ROM

  16. Postoperative surgical complications of lymphadenohysterocolpectomy

    PubMed Central

    Marin, F; Pleşca, M; Bordea, CI; Voinea, SC; Burlănescu, I; Ichim, E; Jianu, CG; Nicolăescu, RR; Teodosie, MP; Maher, K; Blidaru, A

    2014-01-01

    Rationale The current standard surgical treatment for the cervix and uterine cancer is the radical hysterectomy (lymphadenohysterocolpectomy). This has the risk of intraoperative accidents and postoperative associated morbidity. Objective The purpose of this article is the evaluation and quantification of the associated complications in comparison to the postoperative morbidity which resulted after different types of radical hysterectomy. Methods and results Patients were divided according to the type of surgery performed as follows: for cervical cancer – group A- 37 classic radical hysterectomies Class III Piver - Rutledge -Smith ( PRS ), group B -208 modified radical hysterectomies Class II PRS and for uterine cancer- group C -79 extended hysterectomies with pelvic lymphadenectomy from which 17 patients with paraaortic lymphnode biopsy . All patients performed preoperative radiotherapy and 88 of them associated radiosensitization. Discussion Early complications were intra-abdominal bleeding ( 2.7% Class III PRS vs 0.48% Class II PRS), supra-aponeurotic hematoma ( 5.4% III vs 2.4% II) , dynamic ileus (2.7% III vs 0.96% II) and uro - genital fistulas (5.4% III vs 0.96% II).The late complications were the bladder dysfunction (21.6% III vs 16.35% II) , lower limb lymphedema (13.5% III vs 11.5% II), urethral strictures (10.8% III vs 4.8% II) , incisional hernias ( 8.1% III vs 7.2% II), persistent pelvic pain (18.91% III vs 7.7% II), bowel obstruction (5.4% III vs 1.4% II) and deterioration of sexual function (83.3% III vs 53.8% II). PRS class II radical hysterectomy is associated with fewer complications than PRS class III radical hysterectomy , except for the complications of lymphadenectomy . A new method that might reduce these complications is a selective lymphadenectomy represented by sentinel node biopsy . In conclusion PRS class II radical hysterectomy associated with neoadjuvant radiotherapy is a therapeutic option for the incipient stages of cervical cancer

  17. The Effect of Diclofenac Mouthwash on Periodontal Postoperative Pain

    PubMed Central

    Yaghini, Jaber; Abed, Ahmad Moghareh; Mostafavi, Seyed Abolfazl; Roshanzamir, Najmeh

    2011-01-01

    Background: The need to relieve pain and inflammation after periodontal surgery and the side effects of systemic drugs and advantages of topical drugs, made us to evaluate the effect of Diclofenac mouthwash on periodontal postoperative pain. Methods: In this double-blind, randomized clinical trial study 20 quadrants of 10 patients(n = 20) aged between 22-54 who also acted as their own controls, were treated using Modified Widman Flap procedure in two quadrants of the same jaw with one month interval between the operations. After the operation in addition to ibuprofen 400 mg, one quadrant randomly received Diclofenac mouthwash (0/01%) for 30 seconds, 4 times a day (for a week) and for the contrary quadrant, ibuprofen and placebo mouthwash was given to be used in the same manner. The patients scored the number of ibuprofen consumption and their pain intensity based on VAS index in a questionnaire in days 1, 2, 3 and the first week after operation. The findings were analysed using two-way ANOVA, t-test and Wilcoxon. P-value less than 0.05 considered to be significant. Results: There was a significant difference between the mean values of pain intensity of two quadrants in four periods (P = 0.031). But, there was no significant difference between the average ibuprofen consumption in two groups (P = 0.51). Postoperative satisfaction was not significantly different in two quadrants (P = 0.059). 60% of patients preferred Diclofenac mouthwash. Conclusion: Diclofenac mouthwash was effective in reducing postoperative periodontal pain but it seems that it isn’t enough to control postoperative pain on its own. PMID:22013478

  18. EDITORIAL: Selected papers from the 10th International Workshop on Micro and Nanotechnology for Power Generation and Energy Conversion Applications (PowerMEMS 2010) Selected papers from the 10th International Workshop on Micro and Nanotechnology for Power Generation and Energy Conversion Applications (PowerMEMS 2010)

    NASA Astrophysics Data System (ADS)

    Reynaerts, Dominiek; Vullers, Ruud

    2011-10-01

    This special section of Journal of Micromechanics and Microengineering features papers selected from the 10th International Workshop on Micro and Nanotechnology for Power Generation and Energy Conversion Applications (PowerMEMS 2010). The workshop was organized in Leuven, Belgium from 30 November to 3 December 2010 by Katholieke Universiteit Leuven and the imec/Holst Centre. This was a special PowerMEMS Workshop, for several reasons. First of all, we celebrated the 10th anniversary of the workshop: the first PowerMEMS meeting was organized in Sendai, Japan in 2000. None of the organizers or participants of this first meeting could have predicted the impact of the workshop over the next decade. The second reason was that, for the first time, the conference organization spanned two countries: Belgium and the Netherlands. Thanks to the advances in information technology, teams from Katholieke Universiteit Leuven (Belgium) and the imec/Holst Centre in Eindhoven (the Netherlands) have been able to work together seamlessly as one team. The objective of the PowerMEMS Workshop is to stimulate innovation in micro and nanotechnology for power generation and energy conversion applications. Its scope ranges from integrated microelectromechanical systems (MEMS) for power generation, dissipation, harvesting, and management, to novel nanostructures and materials for energy-related applications. True to the objective of the PowerMEMSWorkshop, the 2010 technical program covered a broad range of energy related research, ranging from the nanometer to the millimeter scale, discussed in 5 invited and 52 oral presentations, and 112 posters. This special section includes 14 papers covering vibration energy harvesters, thermal applications and micro power systems. Finally, we wish to express sincere appreciation to the members of the International Steering Committee, the Technical Program Committee and last but not least the Local Organizing Committee. This special issue was edited in

  19. Introduction to the special issue on the joint meeting of the 19th IEEE International Symposium on the Applications of Ferroelectrics and the 10th European Conference on the Applications of Polar Dielectrics.

    PubMed

    Tsurumi, Takaaki

    2011-09-01

    The joint meeting of the 19th IEEE International Symposium on the Applications of Ferroelectrics and the 10th European Conference on the Applications of Polar Dielectrics took place in Edinburgh from August 9-12, 2010. The conference was attended by 390 delegates from more than 40 different countries. There were 4 plenary speakers, 56 invited speakers, and a further 222 contributed oral presentations in 7 parallel session. In addition there were 215 poster presentations. Key topics addressed at the conference included piezoelectric materials, leadfree piezoelectrics, and multiferroics.

  20. Postoperative radicular neuroma. Case report.

    PubMed

    Erman, T; Tuna, M; Göçer, A I; Idan, F; Akgül, E; Zorludemir, S

    2001-11-15

    Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering from sciatica. In spite of this belief, sciatic pain may continue after the surgery. The recurrence of sciatic and/or back pain after primary discectomy is called the "failed back surgery syndrome." The rate of the complications involved in standard lumbar discectomy ranges from 5.4 to 14%. One of the complications of the lumbar disc surgery is nerve root injury. The complication rate of this injury ranges from 0.7 to 2.2%. Postoperative radicular neuroma must be considered in differential diagnosis for the patient who has failed back surgery syndrome. In this study the authors evaluate a patient who had undergone surgery for lumbar disc herniation and suffered intractable pain. A traumatic radicular neuroma is demonstrated and the pertinent literature is presented.

  1. Management of postoperative spinal infections

    PubMed Central

    Hegde, Vishal; Meredith, Dennis S; Kepler, Christopher K; Huang, Russel C

    2012-01-01

    Postoperative surgical site infection (SSI) is a common complication after posterior lumbar spine surgery. This review details an approach to the prevention, diagnosis and treatment of SSIs. Factors contributing to the development of a SSI can be split into three categories: (1) microbiological factors; (2) factors related to the patient and their spinal pathology; and (3) factors relating to the surgical procedure. SSI is most commonly caused by Staphylococcus aureus. The virulence of the organism causing the SSI can affect its presentation. SSI can be prevented by careful adherence to aseptic technique, prophylactic antibiotics, avoiding myonecrosis by frequently releasing retractors and preoperatively optimizing modifiable patient factors. Increasing pain is commonly the only symptom of a SSI and can lead to a delay in diagnosis. C-reactive protein and magnetic resonance imaging can help establish the diagnosis. Treatment requires acquiring intra-operative cultures to guide future antibiotic therapy and surgical debridement of all necrotic tissue. A SSI can usually be adequately treated without removing spinal instrumentation. A multidisciplinary approach to SSIs is important. It is useful to involve an infectious disease specialist and use minimum serial bactericidal titers to enhance the effectiveness of antibiotic therapy. A plastic surgeon should also be involved in those cases of severe infection that require repeat debridement and delayed closure. PMID:23330073

  2. Postoperative high-dose intravenous iron sucrose with low dose erythropoietin therapy after total hip replacement.

    PubMed

    Yoon, Jiyeol; Kim, Sungmin; Lee, Soo Chan; Lim, Hongsub

    2010-12-01

    Erythropoietin combined with parenteral iron sucrose therapy is an alternative to blood transfusion in anemic patients. It was shown to be effective in surgical patients in several previous studies when used in conjunction with other methods. However, there are no guidelines about safety limits in dosage amounts or intervals. In this study, we report a case of significant postoperative hemorrhage managed with high dose parenteral iron sucrose, low dose erythropoietin, vitamin B(12), vitamin C, and folic acid. An 80-year-old female patient presented for severe anemia after a total hip arthroplasty and refused an allogenic blood transfusion as treatment. The preoperative hemoglobin of 12.2 g/dL decreased to 5.3 g/dL postoperatively. She received the aforementioned combination of iron sucrose, erythropoietin, and vitamins. A total of 1,500 mg of intravenous iron sucrose was given postoperatively for 6 consecutive days. Erythropoietin was also administered at 2,000 IU every other day for a total of 12,000 IU. The patient was discharged in good condition on the twelfth postoperative day with a hemoglobin of 8.5 g/dL. Her hemoglobin was at 11.2 g/dL on the twentieth postoperative day.

  3. Deep brain stimulation: postoperative issues.

    PubMed

    Deuschl, Günther; Herzog, Jan; Kleiner-Fisman, Galit; Kubu, Cynthia; Lozano, Andres M; Lyons, Kelly E; Rodriguez-Oroz, Maria C; Tamma, Filippo; Tröster, Alexander I; Vitek, Jerrold L; Volkmann, Jens; Voon, Valerie

    2006-06-01

    Numerous factors need to be taken into account when managing a patient with Parkinson's disease (PD) after deep brain stimulation (DBS). Questions such as when to begin programming, how to conduct a programming screen, how to assess the effects of programming, and how to titrate stimulation and medication for each of the targeted sites need to be addressed. Follow-up care should be determined, including patient adjustments of stimulation, timing of follow-up visits and telephone contact with the patient, and stimulation and medication conditions during the follow-up assessments. A management plan for problems that can arise after DBS such as weight gain, dyskinesia, axial symptoms, speech dysfunction, muscle contractions, paresthesia, eyelid, ocular and visual disturbances, and behavioral and cognitive problems should be developed. Long-term complications such as infection or erosion, loss of effect, intermittent stimulation, tolerance, and pain or discomfort can develop and need to be managed. Other factors that need consideration are social and job-related factors, development of dementia, general medical issues, and lifestyle changes. This report from the Consensus on Deep Brain Stimulation for Parkinson's Disease, a project commissioned by the Congress of Neurological Surgeons and the Movement Disorder Society, outlines answers to a series of questions developed to address all aspects of DBS postoperative management and decision-making with a systematic overview of the literature (until mid-2004) and by the expert opinion of the authors. The report has been endorsed by the Scientific Issues Committee of the Movement Disorder Society and the American Society of Stereotactic and Functional Neurosurgery.

  4. [Postoperative complications in plastic surgery].

    PubMed

    Vogt, P M

    2009-09-01

    aspects of postoperative complication management in plastic surgery.

  5. Gender differences in post-operative pain and patient controlled analgesia use among adolescent surgical patients.

    PubMed

    Logan, Deirdre E; Rose, John B

    2004-06-01

    The aim of this study was to explore gender differences in anticipatory emotional distress, coping strategies, post-operative pain perception, and patient-controlled analgesia (PCA) use among adolescent surgical patients. One hundred and two 12-18-year-old adolescents undergoing surgeries with overnight hospital stay were recruited. Participants completed pre-operative measures of anxiety and anticipated pain. Post-operatively, they reported on coping skills, post-operative anxiety, and pain. Data on PCA use were recorded from medical records. Girls reported higher levels of pre-operative state anxiety and anticipated more pain. After surgery, girls and boys differed on their lowest daily pain ratings and average daily pain ratings, with girls reporting more pain in both cases. Reports of highest daily pain were similar across genders. Gender was found to moderate the relationship between anticipatory distress and post-operative pain, such that higher anticipatory distress before surgery predicted more post-operative pain for girls, but not for boys. Patterns of PCA use did not vary by gender on post-operative days 0 or 1. Findings suggest that adolescent boys' and girls' pain experiences are different in several important respects, although somewhat less divergent than has been reported in samples of adult males and females. Results have implications for the development of targeted intervention strategies to help adolescents cope effectively with acute post-operative pain.

  6. Schoolwide Literacy Days.

    ERIC Educational Resources Information Center

    Polder, Darlene D.

    2000-01-01

    Describes 10 "literacy day" activities that one California elementary school has used successfully schoolwide, typically one such day per month, to make reading fun and purposeful, while developing a sense of community. Includes: spread-a-quilt day; teacher exchange day; turn off the TV; Dr. Seuss day; community readers; schoolwide…

  7. Nurses' strategies for managing pain in the postoperative setting.

    PubMed

    Manias, Elizabeth; Bucknall, Tracey; Botti, Mari

    2005-03-01

    Acute pain is a significant problem in the postoperative setting. Patients report a lack of information about pain-control measures and ineffective pain control. Nurses continue to rely on pharmacologic measures and tend to under-administer analgesics. The purpose of this study was to determine the strategies nurses used to manage patients' pain in the postoperative setting. It also sought to examine the effect of context, including organization of care, nurses' prioritization of work activities, and pressures during a working shift, on their pain-management strategies. An observational design was used in two surgical units of a metropolitan teaching hospital in Melbourne, Australia. Six fixed observation times were identified as key periods for pain activities, each comprising a 2-hour duration. An observation period was examined at least 12 times, resulting in the completion of 74 observations and the identification of 316 pain cases. Fifty-two nurses were observed during their normal day's work with postoperative patients. Six themes were identified: managing pain effectively; prioritizing pain experiences for pain management; missing pain cues for pain management; regulators and enforcers of pain management; preventing pain; and reactive management of pain. The findings highlighted the critical nature of communication between clinicians and patients and among clinicians. It also demonstrated the influence of time on management strategies and the relative importance that nurses place on nonpharmacologic measures in actual practice. This research, which portrays what happens in actual clinical practice, has facilitated the identification of new data that were not evident from other research studies.

  8. Postoperative nausea and vomiting: A simple yet complex problem

    PubMed Central

    Shaikh, Safiya Imtiaz; Nagarekha, D.; Hegade, Ganapati; Marutheesh, M.

    2016-01-01

    Postoperative nausea and vomiting (PONV) is one of the complex and significant problems in anesthesia practice, with growing trend toward ambulatory and day care surgeries. This review focuses on pathophysiology, pharmacological prophylaxis, and rescue therapy for PONV. We searched the Medline and PubMed database for articles published in English from 1991 to 2014 while writing this review using “postoperative nausea and vomiting, PONV, nausea-vomiting, PONV prophylaxis, and rescue” as keywords. PONV is influenced by multiple factors which are related to the patient, surgery, and pre-, intra-, and post-operative anesthesia factors. The risk of PONV can be assessed using a scoring system such as Apfel simplified scoring system which is based on four independent risk predictors. PONV prophylaxis is administered to patients with medium and high risks based on this scoring system. Newer drugs such as neurokinin-1 receptor antagonist (aprepitant) are used along with serotonin (5-hydroxytryptamine subtype 3) receptor antagonist, corticosteroids, anticholinergics, antihistaminics, and butyrophenones for PONV prophylaxis. Combination of drugs from different classes with different mechanism of action are administered for optimized efficacy in adults with moderate risk for PONV. Multimodal approach with combination of pharmacological and nonpharmacological prophylaxis along with interventions that reduce baseline risk is employed in patients with high PONV risk. PMID:27746521

  9. [Late postoperative apnea in a premature newborn infant].

    PubMed

    Marco, J; Mohamed-Mabrok, M; Battich, I; Torres, J; Moral, V

    1992-01-01

    We report the case of a premature newborn child (36 weeks) who was operated on a teratoma of the sacrum when he was 12 days old and weighed 2,950 g. The patient presented a late postoperative apnea 17 hours after anesthesia. The anesthetic technique consisted of lumbar epidural blockade with 0.33% bupivacaine at a dose of 2.25 ml and superficial inhalation anesthesia with 0.5% isoflurane. Relaxing muscular agents used in this case were succinylcholine (3 mg) for orotracheal intubation and pancuronium bromide (0.3 mg) for maintaining the anesthetic level. The immediate postoperative phase was uneventful but 17 hours after surgery the patient presented apnea, bradycardia (40 beats/min), and marked cyanosis requiring assisted ventilation with bag and mask during 3 min and initial cardiac massage. Recovery of heart rate was immediate and recovery of ventilation was progressive. The patient was treated with caffeine during one week and no relapses occurred. Pneumocardiographic recordings obtained later on revealed sporadic short lasting episodes of apnea (shorter than 15 s) sometimes associated with bradycardia (40 beats/min lower than baseline). There were no apparent intercurrent or precipitating factors for this apnea. We believe that the present clinical picture corresponds to a late postoperative apnea of unknown origin which required reanimation measures and that until present, there are no reported complications of the anesthetic technique that can explain this episode.

  10. Adult Day Care

    MedlinePlus

    ... Page Resize Text Printer Friendly Online Chat Adult Day Care Adult Day Care Centers are designed to provide care and ... adults who need assistance or supervision during the day. Programs offer relief to family members and caregivers, ...

  11. Pulmonary tuberculosis presenting as post-operative fever of unknown origin.

    PubMed

    Bogue, Patrick; Bolland, Mhairi; How, Peter; Benziger, Harrison

    2017-01-06

    Post-operative fever is common following emergency surgery. Investigation and management of post-operative fever can be challenging when a clear source of sepsis is not evident or the underlying source of infection is not recognised. We herein report a case of secondary pulmonary tuberculosis presenting as post-operative fever following emergency laparotomy for a perforated duodenal ulcer. This case of tuberculosis was diagnosed on day 41 post-operatively and prior inconclusive results meant that we relied mainly on re-visiting history and examination in order to identify 3 targeted investigations: plain chest X-ray, sputum sample and blood test. Accordingly, the co-management of this complex patient achieved a good outcome.

  12. Day-case surgery: enhanced recovery with flumazenil.

    PubMed Central

    Birch, B R; Anson, K M; Clifford, E; Miller, R A

    1990-01-01

    In an open, randomized, parallel group study of 84 adult patients undergoing elective day-case urological surgery the specific benzodiazepine antagonist flumazenil was shown to reverse effectively subjective postoperative sedation due to midazolam and enabled 83% of patients to recover and be ready for potential discharge within 15 min of surgery (control group 24% p less than 0.001). The significantly shorter recovery time has benefits in terms of increased patient cooperation and reduced demands on postoperative nursing care. The implications of these findings for day-case surgery are discussed. PMID:2118572

  13. [Non-invasive mechanical ventilation in postoperative patients. A clinical review].

    PubMed

    Esquinas, A M; Jover, J L; Úbeda, A; Belda, F J

    2015-11-01

    Non-invasive ventilation (NIV) is a method of ventilatory support that is increasing in importance day by day in the management of postoperative respiratory failure. Its role in the prevention and treatment of atelectasis is particularly important in the in the period after thoracic and abdominal surgeries. Similarly, in the transplanted patient, NIV can shorten the time of invasive mechanical ventilation, reducing the risk of infectious complications in these high-risk patients. It has been performed A systematic review of the literature has been performed, including examining the technical, clinical experiences and recommendations concerning the application of NIV in the postoperative period.

  14. Reducing Unnecessary Postoperative Complete Blood Count Testing in the Pediatric Intensive Care Unit

    PubMed Central

    Dewan, Maya; Galvez, Jorge; Polsky, Tracey; Kreher, Genna; Kraus, Blair; Ahumada, Luis; McCloskey, John; Wolfe, Heather

    2017-01-01

    Context: Complete blood count (CBC) testing commonly occurs to determine the need for blood transfusions after surgical procedures. Many clinicians believe postoperative CBCs are “routine.” Objective: To decrease unnecessary routine CBC testing in a low-risk cohort of postoperative patients in the pediatric intensive care unit (PICU) at The Children’s Hospital of Philadelphia by 50% in 6 months. Design: Quality-improvement study. Data from our institution regarding frequency of ordering laboratory studies and transfusion requirements were collected for prior quality-improvement work demonstrating the safety and feasibility of avoiding routine postoperative CBCs in this cohort. Baseline survey data were gathered from key stakeholders on attitudes about and utilization of routine postoperative laboratory testing. Patient and clinician data were shared with all PICU clinicians. Simple Plan-Do-Study-Act cycles involving education, audit, and feedback were put into place. Main Outcome Measures: Percentage of postoperative patients receiving CBCs within 48 hours of PICU admission. Balancing measures were hemoglobin level below 8 g/dL in patients for whom CBCs were sent and blood transfusions up to 7 days postoperatively for any patients in this cohort. Results: Sustained decreases below our 50% goal were seen after our interventions. There were no hemoglobin results below 8 g/dL or surgery-related blood transfusions in this cohort within 7 days of surgery. Estimated hospital charges related to routine postoperative CBCs decreased by 87% during 6 postintervention months. Conclusion: A simple approach to a systemic problem in the PICU of unnecessary laboratory testing is feasible and effective. By using local historical data, we were able to identify a cohort of patients for whom routine postoperative CBC testing is unnecessary. PMID:28241909

  15. Postoperative Delirium in the Geriatric Patient

    PubMed Central

    Schenning, Katie J.; Deiner, Stacie G.

    2015-01-01

    SYNOPSIS Postoperative delirium, a common complication in older surgical patients, is independently associated with increased morbidity and mortality. Patients over the age of 65 years receive greater than 1/3 of the over 40 million anesthetics delivered yearly in the United States. This number is expected to increase with the aging of the population. Thus, it is increasingly important that perioperative clinicians who care for geriatric patients have an understanding of the complex syndrome of postoperative delirium. PMID:26315635

  16. Epidural Analgesia in the Postoperative Period

    DTIC Science & Technology

    2001-10-01

    an unwanted side effect of surgery, and is associated with many postoperative complications. This descriptive study was conducted to determine which...surgical patients experienced the most analgesia with the fewest side effects when receiving epidural analgesia in the postoperative period. A...hospital. A description of the patients age, gender, type of surgery, type of epidural medication, side effects , incidence of breakthrough pain, and

  17. [Caloric substrates in postoperative parenteral nutrition].

    PubMed

    De Salvo, L; Romairone, E; Ansaldo, G L; Mattioli, G

    1991-05-31

    The paper describes the carbohydrate, lipidic and nitrogen metabolism of the postoperative period which is subdivided into an early and a late phase. Since the metabolism of caloric substrates in the early postoperative period is a stress metabolism with glucose intolerance and wide protein catabolism, the authors emphasise that an insufficient caloric intake is worse than the fasting state and suggest that alternative caloric sources, such as branched chain amino acids, fatty acids and, even, ketonic bodies, should be used.

  18. CGH Supports World Cancer Day Every Day

    Cancer.gov

    We celebrate World Cancer Day every year on February 4th. This year the theme “We can. I can.” invites us to think not only about how we can work with one another to reduce the global burden of cancer, but how we as individuals can make a difference. Every day the staff at CGH work to establish and build upon programs that are aimed at improving the lives of people affected by cancer.

  19. Effect of unrestricted bottle-feeding on early postoperative course after cleft palate repair.

    PubMed

    Kim, Eun Key; Lee, Taik Jong; Chae, Soo Wook

    2009-09-01

    Although bottle-feeding after cheiloplasty is widely accepted, postoperative feeding regimen after palatoplasty is still controversial. The aim of this prospective randomized study was to evaluate the effect of bottle-feeding on early postoperative course after palatoplasty in a relatively homogeneous group of patients. Eighty-two consecutive patients with nonsyndromic cleft palate undergoing 2-flap palatoplasty by a single surgeon were randomized to feeding from a bottle with the usual nipple (G1, N = 42) or to feeding with a spoon, cup, or syringe (G2, N = 40). Complication rates, postoperative sedative use, oral intake for the first 6 days, and relative weight gain at 1 and 2 months were compared. There were no significant complications such as bleeding or respiratory problem. The overall complication rate including wound dehiscence and oronasal fistula was similar in G1 and G2 (11.9% versus 12.5%, P = 1.000) as was postoperative sedative use and mean daily oral intake for the first 5 days. Mean intake on the sixth day was significantly higher in G1. There were no significant between-group differences in relative weight gain after 1 and 2 months. In conclusion, bottle-feeding had no adverse effect on the early postoperative course after palatoplasty including complication rate, oral intake, and weight gain. These findings suggest that an unrestricted feeding regimen is appropriate immediately after palatoplasty.

  20. Adult Day Services

    MedlinePlus

    A Smart Choice Adult Day Services Comparison At-a-Glance 1 Adult Day Services Assisted Living Home Care Nursing Homes Live at home with family ... supervision Nursing care available as needed during the day Flexibility to receive care only on days when ...

  1. [Postoperative peritonitis: pronostic factors of mortality].

    PubMed

    Marzougui, Y; Missaoui, K; Hannachi, Z; Dhibi, Y; Kouka, J; Dziri, C; Houissa, M

    2014-01-01

    The postoperative peritonitis (POP) remains formidable conditions due to a high mortality rate of between 20 and 80%. The purpose of this study is to identify risk factors for mortality. This study is a retrospective, descriptive analysis carried out over a period of 09 years (1/1/2003 - 30/11/2011) and interesting 102 patients supported for POP following general surgery. Achieved in department of General Surgery B Charles Nicolle hospital Tunis. The parameters measured included epidemiological data, data related to the Initial Surgical Intervention and reoperation for POP, terms of management and evolution. Bacteriological data were also seized. The incidence of POP was 0.90%. The average age of our patients was 58 +/- 19 years with a sex ratio of 1.08. Forty-seven percent of our patients belonged to the ASAII class. The initial operation was performed urgently in 49 patients (48%) with a majority belonging to the class II Altemeier (49.01%). Colorectal pathology (373%) and hepatobiliay (176%) were the most frequent reasons for the initial intervention. The frequency of clinical signs were fever (75.5%), hypothermia (6.9%), abdominal pain (725%), abdominal distension (46.1%), productive gastric aspiration (30.4%), abdominal defense (25.5%), externalizing the digestive fluid (25.5%), vomiting (19.6%), diarrhea (12.7%), tachycardia (569%), oliguria (42.2%), respiratory failure (40.2%), hypotension (35.3%), neuropsychiatric disorders ( 23.5%) and jaundice (69%). The treatment period was 2.95 +/- 3.16 days. The surgical recovery time was 78 days +/- 5.66. At the time of reoperation, the APACHE II score was 8.43 +/- 6.26 and 25.1 +/- MPI score 8.53. The POP was generalized in 52.9% of cases with purulent peritoneal fluid in 51% of cases. The most common cause was the dropping of the anastomosis (59.8%). Empirical antibiotic therapy was appropriate in 69.44 % of cases. The mortality rate was 39.2%. Multivariate analysis using multiple logistic regression identified the

  2. Management of acute postoperative pain with continuous intercostal nerve block after single port video-assisted thoracoscopic anatomic resection

    PubMed Central

    Hsieh, Ming-Ju; Wang, Kuo-Cheng; Liu, Hung-Pin; Gonzalez-Rivas, Diego; Wu, Ching-Yang; Liu, Yun-Hen; Wu, Yi-Cheng; Chao, Yin-Kai

    2016-01-01

    Background Effective postoperative pain control for thoracic surgery is very important, not only because it reduces pulmonary complications but also because it accelerates the pace of recovery. Moreover, it increases patients’ satisfaction with the surgery. In this study, we present a simple approach involving the safe placement of intercostal catheter (ICC) after single port video-assisted thoracoscopic surgery (VATS) anatomic resection and we evaluate postoperative analgesic function with and without it. Methods We identified patients who underwent single port anatomic resection with ICC placed intraoperatively as a route for continuous postoperative levobupivacaine (0.5%) administration and retrospectively compared them with a group of single port anatomic resection patients without ICC. The operation time, postoperative day 0, 1, 2, 3 and discharge day pain score, triflow numbers, narcotic requirements, drainage duration and post-operative hospital stay were compared. Results In total, 78 patients were enrolled in the final analysis (39 patients with ICC and 39 without). We found patients with ICC had less pain sensation numerical rating scale (NRS) on postoperative day 0, 1 (P=0.023, <0.001) and better triflow performance on postoperative day 1 and 2 (P=0.015, 0.032). In addition, lower IV form morphine usage frequency and dosage (P=0.009, 0.017), shorter chest tube drainage duration (P=0.001) and postoperative stay (P=0.005) were observed in the ICC group. Conclusions Continuous intercostal nerve blockade by placing an ICC intraoperatively provides effective analgesia for patients undergoing single port VATS anatomic resection. This may be considered a viable alternative for postoperative pain management. PMID:28149550

  3. 78 FR 73075 - World AIDS Day, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-04

    ..., helping to dramatically reduce new infections and AIDS- related deaths. This year we celebrate the 10th... to Fight AIDS, Tuberculosis and Malaria's Replenishment Conference to enlist new partners,...

  4. Postoperative analgesia comparing levobupivacaine and ropivacaine for brachial plexus block

    PubMed Central

    Watanabe, Kunitaro; Tokumine, Joho; Lefor, Alan Kawarai; Moriyama, Kumi; Sakamoto, Hideaki; Inoue, Tetsuo; Yorozu, Tomoko

    2017-01-01

    Abstract Background: On a pharmacologic basis, levobupivacaine is expected to last longer than ropivacaine. However, most reports of these anesthetics for brachial plexus block do not suggest a difference in analgesic effect. The aim of this study is to compare the postoperative analgesic effects of levobupivacaine and ropivacaine when used for treating ultrasound-guided brachial plexus block. Methods: A total of 62 patients undergoing orthopedic surgery procedures were prospectively enrolled and randomized to receive levobupivacaine (group L, N = 31) or ropivacaine (group R, N = 31). The duration of analgesia, offset time of motor block, need for rescue analgesics, and sleep disturbance on the night of surgery were recorded. Pain score was recorded on the day of surgery, and on postoperative days 1 and 2. Results: There was no difference in the time interval until the first request for pain medication comparing the two groups (group L: 15.6 [11.4, 16.8] hours; group R: 12.5 [9.4, 16.0] hours, P = 0.32). There was no difference in the duration of motor block (group L: 12.2 [7.6, 14.4] hours; group R: 9.4 [7.9, 13.2] hours, P = 0.44), pain score (P = 0.92), need for rescue analgesics (group L: 55%; group R: 65%, P = 0.6), or rate of sleep disturbance (group L: 61%, group R: 58%, P = 1.0) on comparing the two groups. Conclusions: There was no difference in postoperative analgesia comparing levobupivacaine and ropivacaine when used for brachial plexus block. PMID:28328862

  5. Risk factors for postoperative complications in total thyroidectomy

    PubMed Central

    Caulley, Lisa; Johnson-Obaseki, Stephanie; Luo, Lindy; Javidnia, Hedyeh

    2017-01-01

    Abstract Thyroid cancer incidence is increasing, and with it, an increase in total thyroidectomy. There are limited studies comparing outcomes in total thyroidectomy performed in the inpatient versus outpatient setting. The objective of this study was to perform a comparative analysis of risk factors and outcomes of postoperative morbidity and mortality in total thyroidectomy performed as an inpatient versus outpatient surgery. Retrospective cohort study of data from the 2005 to 2014 multi-institutional, risk-adjusted American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. A multivariate regression model with corresponding odds ratios and 95% confidence intervals was used to determine 30-day morbidity and mortality after total thyroidectomies, and also risk factors of postoperative outcomes. From 2005 to 2014, 40,025 total thyroidectomies were performed (48.5% inpatient, 51.5% outpatient). The 30-day complication rate for all total thyroidectomies was 7.74%. Multivariate logistic regression analysis was performed to control for potential confounding variables. Preoperative factors that affected complications rates for inpatient thyroidectomies included: age ≥70, non-Caucasian race, dependent functional status, history of congestive heart failure, smoking history, bleeding disorder, wound infection, and preoperative sepsis (P < 0.05). In addition, preoperative factors affecting complications in thyroidectomy performed as an outpatient surgery included malignant thyroid pathology (P  0.05). We identified a subset of preoperative conditions that affect risk of complications after total thyroidectomy. Recommendations for patient selection for outpatient total thyroidectomies should be modified to account for pre-existing conditions that increase the risk of postoperative morbidity. PMID:28151852

  6. A Post-operative Feeding Protocol to Improve Outcomes for Neonates With Critical Congenital Heart Disease.

    PubMed

    Newcombe, Jennifer; Fry-Bowers, Eileen

    2017-01-04

    Neonates with critical congenital heart disease (CCHD) are vulnerable to malnutrition during the post-operative period due to hypermetabolism and hypercatabolism. To improve nutritional outcomes during hospitalization, a nurse led post-operative enteral feeding protocol was implemented at a large U.S. children's hospital. During an eight-month implementation period, twenty-one neonates met protocol inclusion criteria. Days for neonates to achieve goal caloric feedings (120kcal/kg/day) were decreased. A one-way repeated measures analysis of variance showed serum albumin levels and serial anthropometric measurements improved significantly throughout hospitalization (p<0.005). Results from this quality improvement project show standardizing nutritional care for neonates with CCHD during the post-operative period is an effective way to improve nutritional outcomes and shorten length of hospital stay.

  7. Spinal epidural abscess and meningitis following short-term epidural catheterisation for postoperative analgaesia.

    PubMed

    van Rappard, Juliaan R M; Tolenaar, Jip L; Smits, Anke B; Go, Peter M N Y H

    2015-08-20

    We present a case of a patient with a spinal epidural abscess (SEA) and meningitis following short-term epidural catheterisation for postoperative pain relief after a laparoscopic sigmoid resection. On the fifth postoperative day, 2 days after removal of the epidural catheter, the patient developed high fever, leucocytosis and elevated C reactive protein. Blood cultures showed a methicillin-sensitive Staphylococcus aureus infection. A photon emission tomography scan revealed increased activity of the spinal canal, suggesting S. aureus meningitis. A gadolinium-enhanced MRI showed a SEA that was localised at the epidural catheter insertion site. Conservative management with intravenous flucloxacillin was initiated, as no neurological deficits were seen. At last follow-up, 8 weeks postoperatively, the patient showed complete recovery.

  8. Every Day Is National Lab Day

    ERIC Educational Resources Information Center

    Bull, Glen

    2010-01-01

    President Barack Obama recently issued a call for increased hands-on learning in U.S. schools in an address at the National Academy of Sciences. Obama concluded that the future of the United States depends on one's ability to encourage young people to "create, and build, and invent." In this article, the author discusses National Lab Day (NLD)…

  9. Highlights of 10th plasma chemistry meeting

    NASA Technical Reports Server (NTRS)

    Kitamura, K.; Hashimoto, H.; Hozumi, K.

    1981-01-01

    The chemical structure is given of a film formed by plasma polymerization from pyridine monomers. The film has a hydrophilic chemical structure, its molecular weight is 900, and the molecular system is C55H50N10O3. The electrical characteristics of a plasma polymerized film are described. The film has good insulating properties and was successfully applied as video disc coating. Etching resistance properties make it possible to use the film as a resist in etching. The characteristics of plasma polymer formed from monomers containing tetramethyltin are discussed. The polymer is in film form, displays good adhesiveness, is similar to UV film UV 35 in light absorption and is highly insulating.

  10. 10th Anniversary P.S.

    ScienceCinema

    None

    2016-07-12

    John Adams parle de la préhistoire du P.S. avec présentation des dias. Le DG B.Gregory prend la parole. Les organisateurs présentent sous la direction du "Prof.Ocktette"(?) un sketch très humoristique (p.e.existence de Quark etc.....)

  11. Trafficking in Persons Report 10th Edition

    DTIC Science & Technology

    2010-06-01

    prohibits most forms of human trafficking through its 2007 Organic Law on the Right of Women to a Violence-Free Life . Article 56 of this law...www.timmatsui.com 20: REUTERS 21: (left) Jacqueline Abromeit/bigStockPhoto.com 21: ( right ) Environmental Justice Foundation/ www.ejfoundation.org 22: Jacques-Jean...prosecuted, and more instances of this human rights abuse have been pre- vented. Countries that once denied the existence of human trafficking now work

  12. 10th International Meeting on Cholinesterases

    DTIC Science & Technology

    2009-10-01

    the cholinesterase field. This trend hopefully will persist in the future at next meeting, the 11th Meeting on Cholinesterases, which will be held in...BY PYRIDOSTIGMINE BROMIDE OF MARMOSET HEMI-DIAPHRAGM FUNCTION AND ACETYLCHOLINESTERASE ACTIVITY AFTER SOMAN EXPOSURE Yang Gao (Rochester, USA

  13. Part C Updates. 10th Edition

    ERIC Educational Resources Information Center

    Goode, Sue; Lazara, Alex; Danaher, Joan

    2008-01-01

    "Part C Updates" is a compilation of information on various aspects of the Early Intervention Program for Infants and Toddlers with Disabilities (Part C) of the Individuals with Disabilities Education Act (IDEA). This is the tenth volume in a series of compilations, which included two editions of Part H Updates, the former name of the…

  14. 10th Anniversary P.S.

    SciTech Connect

    2005-10-28

    John Adams parle de la préhistoire du P.S. avec présentation des dias. Le DG B.Gregory prend la parole. Les organisateurs présentent sous la direction du "Prof.Ocktette"(?) un sketch très humoristique (p.e.existence de Quark etc.....)

  15. Children's Budget 2016. 10th Anniversary Edition

    ERIC Educational Resources Information Center

    Monsif, John, Ed.; Gluck, Elliott, Ed.

    2016-01-01

    Federal spending dedicated to children represents just 7.83 percent of the federal budget in fiscal year 2016, and total spending on children's programs has decreased by five percent in the last two years, according to "Children's Budget 2016." The federal government makes more than 200 distinct investments in children. These include…

  16. Surgical audit in day care myringoplasty.

    PubMed

    Subramaniam, S; Abdul, R

    2006-10-01

    Day-case surgery is preferred for adults, allowing post-operative fast recovery in family environment and support. Myringoplasty using the traditional method of underlay temporalis fascia or tragal perichondrium is usually performed as an in-patient. From 2003 to 2004, 22 myringoplasty procedures were performed in a dedicated day surgery unit at the Hospital Melaka. We report the retrospectively review of the outcome results of these procedures. None of the patients need admission overnight. There were no surgical or anesthetic complications noted and this series suggests that day-case surgery is a safe and desirable practice for patients undergoing myringoplasty. However, there should be the facility for admission if required.

  17. Alveolar recruitment strategy during cardiopulmonary bypass does not improve postoperative gas exchange and lung function.

    PubMed

    Scherer, Mirela; Dettmer, Sebastian; Meininger, Dirk; Deschka, Heinz; Geyer, Galina; Regulla, Caroline; Moritz, Anton

    2009-03-01

    Pulmonary dysfunction with impairment of lung function and oxygenation is one of the most serious problems in the early postoperative period after cardiac surgery. In this study we investigated the effect of alveolar recruitment strategy during cardiopulmonary bypass on postoperative gas exchange and lung function. This prospective randomized study included 32 patients undergoing elective myocardial revascularization with cardiopulmonary bypass. In 16 patients 5 cm H(2)O of positive end-expiratory pressure was applied after intubation and maintained until extubation (Group I). In the other 16 patients (group II) a positive end expiratory pressure (PEEP) of 5 cm H(2)O was maintained as well but was increased to 14 cm H(2)O every 20 min for 2 min during cross clamp. Measurements were taken preoperatively, before skin incision, before and after (3, 24, 48 h) cardiopulmonary bypass and before discharge (6th postoperative day). Postoperative gas exchange, extravascular lung water and lung function showed no significant difference between the groups. Postoperative pulmonary function variables were lower in both groups compared to baseline values. In patients with normal preoperative pulmonary function, application of an alveolar recruitment strategy during cardiopulmonary bypass does not improve postoperative gas exchange and lung function after cardiac surgery.

  18. Effect of different adhesive strategies on the post-operative sensitivity of class I composite restorations

    PubMed Central

    Sancakli, Hande Sar; Yildiz, Esra; Bayrak, Isil; Ozel, Sevda

    2014-01-01

    Objective: To evaluate the post-operative sensitivity of occlusal restorations using different dentin adhesives performed by an undergraduate and a post-doctorate dentist. Materials and Methods: One hundred and eighty-eight molar occlusal restorations were placed in 39 patients (ages between 18 and 30) using 3 different kind of adhesive systems; Optibond FL (OBF), Clearfil Protect Bond (CPB), and iBond (IB) by a post-doctorate dentist or a fifth-year dental student according to the manufacturers’ instructions. Post-operative sensitivity to cold and air was evaluated using a Visual Analog Scale (VAS) after 24 hours, 30, 90, and 180 days. Data were analyzed using the Mann-Whitney U and Friedman tests (P < 0.05). Results: Post-operative sensitivity scores for OBF and CPB were higher for the dental student (P < 0.05), while IB scores did not differ statistical significantly according to the operator (P > 0.05). Conclusion: Operator skill and experience appears to play a role in determining the outcome of post-operative sensitivity of multi-step adhesive systems although the post-operative sensitivity was low. It is suggested that the less experienced clinicians (rather than experienced clinicians) should better use the self-etching dentin bonding systems with reduced application steps to minimize the potential risk of post-operative sensitivity of dental adhesives. PMID:24966741

  19. Prediction of adrenocortical insufficiency after pituitary adenoma surgery using postoperative basal cortisol levels.

    PubMed

    Hána, V; JeŽková, J; Kosák, M; Kršek, M; Marek, J; Netuka, D; Hill, M; Hána, V

    2015-01-01

    Our aim was to analyze the correlation of early postoperative cortisol levels in patients after transsphenoidal pituitary adenoma surgery compared to the standard dose ACTH test and Insulin tolerance test (ITT) several months later. We retrospectively reviewed data from 94 patients operated for pituitary adenoma in years 2009-2012. The comparison of day 7 (median) postoperative basal cortisol levels and 3.6 months (median) after pituitary adenoma surgery stimulation test - standard dose 250 microg 1-24ACTH test in 83 patients or ITT in 11 patients were performed. All 16 patients with early postoperative cortisol levels >500 nmol/l proved a sufficient response in the stimulation tests. At basal cortisol levels of 370-500 nmol/l the sufficient response was found in 96 % (27/28) of patients. In the postoperative basal cortisol levels 200-370 nmol/l we found a preserved corticotroph axis later on in 88 % (28/32) of cases. Patients with basal cortisol levels 100-200 nmol/l had a maintained corticotroph axis function in 8/11 cases - 73 %. All patients with an early postoperative basal cortisol level above 500 nmol/l proved in the stimulation tests a preserved corticotroph axis function. The interval 370-500 nmol/l showed a minimal risk of postoperative adrenal insufficiency.

  20. Randomized Clinical Trial for Early Postoperative Complications of Ex-PRESS Implantation versus Trabeculectomy: Complications Postoperatively of Ex-PRESS versus Trabeculectomy Study (CPETS).

    PubMed

    Arimura, Shogo; Takihara, Yuji; Miyake, Seiji; Iwasaki, Kentaro; Gozawa, Makoto; Matsumura, Takehiro; Tomomatsu, Takeshi; Takamura, Yoshihiro; Inatani, Masaru

    2016-05-17

    We compared early postoperative complications between trabeculectomy and Ex-PRESS implantation. Enrolled patients with 39 primary open-angle or 25 exfoliative glaucoma were randomly assigned to receive trabeculectomy (trabeculectomy group) or Ex-PRESS implantation (Ex-PRESS group). Primary outcomes were early postoperative complications, including postoperative anterior chamber inflammation, frequencies of hyphema, flat anterior chamber, choroidal detachment, hypotonic maculopathy, and the change of visual acuity. The postoperative flare values in trabeculectomy group were higher than those in the Ex-PRESS group (overall, P = 0.004; and 10 days, P = 0.02). Hyphema occurred significantly more frequently in the trabeculectomy group (P = 0.0025). There were no significant differences of the other primary outcomes between the two groups. Additionally, duration of anterior chamber opening was significantly shorter in the Ex-PRESS group (P = 0.0002) and the eyes that had iris contact with Ex-PRESS tube had significantly shallower anterior chambers than did the eyes without the iris contact (P = 0.013). The Ex-PRESS implantation prevented early postoperative inflammation and hyphema in the anterior chamber and shortened the duration of anterior chamber opening. Iris contact with the Ex-PRESS tube occurred more frequently in eyes with open-angle glaucoma and shallow anterior chambers.

  1. [Postoperative necrotizing fasciitis: a rare and fatal complication].

    PubMed

    Ghezala, Hassen Ben; Feriani, Najla

    2016-01-01

    Postoperative parietal complications can be exceptionally severe and serious threatening vital prognosis. Necrotizing fasciitis is a rare infection of the skin and deep subcutaneous tissues, spreading along fascia and adipose tissue. It is mainly caused by group A streptococcus (streptococcus pyogenes) but also by other bacteria such as Vibrio vulnificus, Clostridium perfringens or Bacteroides fragilis. Necrotizing fasciitis is a real surgical and medical emergency. We report, in this study, a very rare case of abdominal parietal gangrene occurring in a 75-year-old woman on the fifth day after surgery for an ovarian cyst. Evolution was marked by occurrence of a refractory septic shock with a rapidly fatal course on the third day of management.

  2. Every Day Is Mathematical

    ERIC Educational Resources Information Center

    Barger, Rita H.; Jarrah, Adeeb M.

    2012-01-01

    March 14 is special because it is Pi Day. Mathematics is celebrated on that day because the date, 3-14, replicates the first three digits of pi. Pi-related songs, websites, trivia facts, and more are at the fingertips of interested teachers and students. Less celebrated, but still fairly well known, is National Metric Day, which falls on October…

  3. Day Care: Everybody's Problem.

    ERIC Educational Resources Information Center

    Office of Child Development (DHEW), Washington, DC.

    This document reports on statistics regarding the need for day care facilities for children under the age of six. It also gives suggestions for making better use of local day care resources. Statistics show that: (1) There are more than 5 million children in this country under the age of 6 whose mothers work; (2) There are licensed day care…

  4. Growing degree day calculator

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Degree-day benchmarks indicate discrete biological events in the development of insect pests. For the Sparganothis fruitworm, we have isolated all key development events and linked them to degree-day accumulations. These degree-day accumulations can greatly improve treatment timings for cranberry IP...

  5. Day Care Evaluation Manual.

    ERIC Educational Resources Information Center

    Council for Community Services in Metropolitan Chicago, IL.

    This manual presents instruments for evaluating the program and facilities of day care centers and family day care homes serving nonhandicapped children aged 3-5. Chapter 1 discusses child care evaluation in general and outlines the rationale underlying this evaluation system (including the principle that day care evaluation should assess program…

  6. Ultrasound-guided quadratus lumborum block as a postoperative analgesic technique for laparotomy.

    PubMed

    Kadam, Vasanth Rao

    2013-10-01

    The quadratus lumborum (QL) block as a postoperative analgesic method following abdominal surgery has been described by Blanco for superficial surgeries but not used for major laparotomy. This ipsilateral QL block had low pain scores and opioid use on day one with sensory block upto T8-L1. The options of various volume used and pros and cons are discussed.

  7. Postoperative maladaptive behavioral changes in children.

    PubMed

    Yuki, Koichi; Daaboul, Dima G

    2011-06-01

    Induction of anesthesia can be a very stressful period for a child and his family and can be associated with increased risk of psychological disturbances. These disturbances are categorized as preoperative anxiety, emergence delirium and postoperative behavioral changes. Several tools have been developed to measure these psychological manifestations as well as the baseline personality traits of these patients. Postoperative negative behavioral changes, such as sleep and eating disorders, separation anxiety, temper tantrum, aggression toward authorities, may occur in up to 60% of all children undergoing general anesthesia. Several studies found a strong association between these postoperative behavioral changes, the distress of the child on induction and his individual personality characteristics, although a cause-effect relationship could not be determined. Understanding the risk factors for behavior changes helps us determine the best way for prevention and treatment of these changes in the perioperative period.

  8. Simplified cesarean section: a strategic surgical approach to minimize postoperative infectious morbidity.

    PubMed

    Pelosi

    1998-07-01

    Objective: A simplified method of cesarean delivery aimed at minimizing postoperative morbidity is illustrated.Methods: Two hundred consecutive cesarean deliveries were performed by the authors' simplified cesarean technique. Mean patient age was 27 years (range 17-46), and mean weight was 169 pounds (range 112-414). Indications for cesarean delivery included dystocia or failure to progress in labor (38%), repeat cesarean (32%), malpresentation (11.5%), fetal distress (9.5%), and other (9%).Results: Simplified cesarean delivery was successfully completed in all cases. Mean operating time was 16 minutes (range 9-33), mean blood loss was 460 mL (range 100-1150), and mean postsurgical hospitalization time was 72 hours (range 36-120). No bowel, bladder, or vascular injuries occurred. Postoperative febrile morbidity occurred in one patient (0.5%), ileus occurred in one patient (0.5%), and blood transfusion was administered to one patient (0.5%). No cases of wound infection, wound dehiscence, hematoma, or incisional hernia occurred. All patients were ambulatory on the first postoperative day. All but one patient (99.5%) tolerated a regular diet on the first postoperative day.Conclusions: The authors' technique of cesarean section appears to be a safe and efficient method for cesarean delivery associated with minimal postoperative infectious morbidity and rapid resumption of bowel and ambulatory function.

  9. Effects of lidocaine and adrenaline combination on postoperative edema and ecchymosis in rhinoplasty.

    PubMed

    Gun, R; Yorgancılar, E; Yıldırım, M; Bakır, S; Topcu, I; Akkus, Z

    2011-07-01

    Nasal osteotomies are the most important cause of periorbital edema and ecchymosis. Injection of lidocaine and adrenaline is recommended to reduce bleeding. Whilst the lidocaine and adrenaline combination (LAC) is claimed to reduce postoperative ecchymosis and edema, this effect remains to be proven conclusively. This study, on 48 patients, was designed to investigate the effects of LAC injection on postoperative edema/ecchymosis in rhinoplasty. LAC was applied at a random side prior to the lateral osteotomy. The opposite side was used as a control. The relationship between edema/ecchymosis and the degree of LAC on the injected and uninjected sides was evaluated on the first, third and seventh day postoperatively. The relationships between edema and ecchymosis with operation time and intraoperative systolic blood pressure were also evaluated. Bleeding was reduced on the side treated with LAC (p=0.050). The degrees of edema/ecchymosis increased with increases in the duration of operation and the systolic blood pressure on the first postoperative day for the LAC-applied side (p<0.05). This correlation was not observed on the opposite side (p>0.05). Application of LAC reduces bleeding during rhinoplasty and pain control postoperatively but reduced edema and ecchymosis should not be expected following LAC application.

  10. Orthotopic liver transplantation: reversible Doppler US findings in the immediate postoperative period.

    PubMed

    Sanyal, Rupan; Lall, Chandana G; Lamba, Ramit; Verma, Sadhna; Shah, Shetal N; Tirkes, Temel; Berry, William A; Sandrasegaran, Kumaresan

    2012-01-01

    Orthotopic liver transplantation (OLT) is the only definitive treatment for irreversible acute liver failure and chronic liver disease. In the immediate postoperative period after OLT, patients are closely monitored with Doppler ultrasonography (US) to detect treatable vascular complications and ensure graft survival. The first postoperative Doppler US examination is performed fairly early on the first postoperative day, before surgical wound closure has been performed. The immediate postoperative images, obtained when the effects of surgery are very recent, often reveal an array of findings that may appear alarming but that tend to normalize within a few days and are compatible with changes related to the surgery itself. These findings include a starry-sky appearance of reperfusion hepatic edema, transient foci of increased echogenicity, pneumobilia, small fluid collections, perihepatic hematomas, pleural effusion, temporary elevation of hepatic arterial velocity, transient elevation of resistive index (RI), decreased RI with tardus parvus waveform, increased portal venous flow and mono- or biphasic waveforms of the hepatic veins. Most of these changes revert to normal in the first postoperative week; deterioration atypical of transient changes requires further evaluation.

  11. Antinociceptive effects of vitexin in a mouse model of postoperative pain

    PubMed Central

    Zhu, Qing; Mao, Li-Na; Liu, Cheng-Peng; Sun, Yue-Hua; Jiang, Bo; Zhang, Wei; Li, Jun-Xu

    2016-01-01

    Vitexin, a C-glycosylated flavone present in several medicinal herbs, has showed various pharmacological activities including antinociception. The present study investigated the antinociceptive effects of vitexin in a mouse model of postoperative pain. This model was prepared by making a surgical incision on the right hindpaw and von Frey filament test was used to assess mechanical hyperalgesia. Isobolographical analysis method was used to examine the interaction between vitexin and acetaminophen. A reliable mechanical hyperalgesia was observed at 2 h post-surgery and lasted for 4 days. Acute vitexin administration (3–10 mg/kg, i.p.) dose-dependently relieved this hyperalgesia, which was also observed from 1 to 3 days post-surgery during repeated daily treatment. However, repeated vitexin administration prior to surgery had no preventive value. The 10 mg/kg vitexin-induced antinociception was blocked by the opioid receptor antagonist naltrexone or the GABAA receptor antagonist bicuculline. The doses of vitexin used did not significantly suppress the locomotor activity. In addition, the combination of vitexin and acetaminophen produced an infra-additive effect in postoperative pain. Together, though vitexin-acetaminophen combination may not be useful for treating postoperative pain, vitexin exerts behaviorally-specific antinociception against postoperative pain mediated through opioid receptors and GABAA receptors, suggesting that vitexin may be useful for the control of postoperative pain. PMID:26763934

  12. Dysfunction of pre- and post-operative cardiac autonomic nervous system in elderly patients with diabetes mellitus.

    PubMed

    Zhang, Junlong; Tu, Weifeng; Dai, Jianqiang; Lv, Qing; Yang, Xiaoqi

    2011-01-01

    The pre- and post-operative cardiac autonomic nervous functions were compared in elderly, non-cardiac surgery patients with diabetes mellitus (DM) and without diabetes mellitus (NDM). A group of 30 unpremedicated elderly patients scheduled to undergo elective non-cardiac surgery were studied, including 15 DM patients and 15 NDM patients. Each component of heart rate variability (HRV) analysis in the frequency domain was monitored with Holter during the nights of the day before and on 1st and 2nd day after operation. After surgery, total power (TP), high frequency (HF), low frequency (LF) and very low frequency (VLF) significantly decreased as compared to the baseline values before operation in both groups (p<0.05). The LF/HF ratio was significantly changed in DM group but did not change in NDM group. On the 2nd postoperative day, TP, HF, LF and VLF in DM group were further decreased as compared to those on the 1st postoperative day and were significantly lower than those in NDM group (p<0.01 or 0.05), but these indices in NDM group did not show significant decreases. Surgery induced the cardiac autonomic nervous dysfunction in elderly patients not only with DM but also without diabetes. On the 2nd postoperative day, the disturbances of cardiac autonomic nervous activity were more sever in DM patients, compared to the 1st postoperative day, but was not significantly more sever than in the NDM patients.

  13. Management of postoperative complications: general approach.

    PubMed

    Sanguineti, V Ana; Wild, Jason R; Fain, Mindy J

    2014-05-01

    The goal of postoperative management is to promote early mobility and avoid postoperative complications, recognizing the potentially devastating impact of complications on elderly patients with hip fracture. The recommended approach involves early mobilization; freedom from tethers (indwelling urinary catheters and other devices); effective pain control; treating malnutrition; preventing pressure ulcers; reducing risk for pulmonary, urinary, and wound infections; and managing cognition. This carefully structured and patient-centered management provides older, vulnerable patients their best chance of returning to their previous level of functioning as quickly and safety as possible.

  14. Pathogenesis of postoperative oral surgical pain.

    PubMed Central

    Ong, Cliff K. S.; Seymour, R. A.

    2003-01-01

    Pain is a major postoperative symptom in many oral surgical procedures. It is a complex and variable phenomenon that can be influenced by many factors. Good management of oral surgical pain requires a detailed understanding of the pathogenesis of surgical pain. This article aims at reviewing postoperative pain from a broad perspective by looking into the nociception, neuroanatomy, neurophysiology, and neuropharmacology of pain. Therapeutic recommendations are made after reviewing the evidence from the literature for maximizing the efficacy of pain management techniques for oral surgical pain. PMID:12722900

  15. Postoperative global amnesia reversed with flumazenil.

    PubMed

    Rinehart, Joseph B; Baker, Brandee; Raphael, Darren

    2012-07-01

    Global postoperative amnesia (profound anterograde and retrograde amnesia) is rare and usually attributed to transient global amnesia-a poorly understood condition with no broadly accepted mechanism. We report an incident of probable transient global amnesia in a patient after endoscopic retrograde cholangiopancreatogram under general anesthesia, which was successfully treated with flumazenil. On the basis of the results of flumazenil administration in this and a previous case report, we would recommend a trial dose of 0.2 mg for cases of global postoperative amnesia, repeated if the first dose seems effective.

  16. Fish Oil and Post-Operative Atrial Fibrillation – Results of the Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation (OPERA) Trial

    PubMed Central

    Mozaffarian, Dariush; Marchioli, Roberto; Macchia, Alejandro; Silletta, Maria G.; Ferrazzi, Paolo; Gardner, Timothy J.; Latini, Roberto; Libby, Peter; Lombardi, Federico; O’Gara, Patrick T.; Page, Richard L.; Tavazzi, Luigi; Tognoni, Gianni

    2013-01-01

    Context Post-operative atrial fibrillation/flutter (AF) is one of the most common complications of cardiac surgery and significantly increases morbidity and healthcare utilization. A few small trials have evaluated whether long-chain n-3-polyunsaturated fatty acids (PUFA) reduce post-op AF, with mixed results. Objective To determine whether peri-operative n-3-PUFA supplementation reduces post-op AF. Design Randomized, double-blind, placebo-controlled, multinational, clinical trial. Patients A total of 1,516 patients scheduled for cardiac surgery across 28 centers in the US, Italy, and Argentina, enrolled between Aug 2010 and Jun 2012. Inclusion criteria were broad; the main exclusions were regular use of fish oil or absence of sinus rhythm at enrollment. Forty-eight percent of screened patients and 94% of eligible patients were enrolled. Intervention Patients were randomized to receive fish oil (1 g capsules containing ≥840 mg n-3-PUFA as ethyl esters) or placebo, with pre-operative loading of 10g over 3-5 days (or 8g over 2 days) followed post-operatively by 2g/d until hospital discharge or post-op day10, whichever first. Main Outcome Measures The primary endpoint was occurrence of post-op AF >30 sec. We also evaluated post-op AF lasting >1hr, resulting in symptoms, or treated with cardioversion; other secondary post-op AF endpoints; other tachyarrhythmias; hospital utilization; and major adverse cardiovascular events, 30-day mortality, bleeding, and other adverse events. All endpoints and analyses plans were prespecified. Results At enrollment, mean±SD age was 64±13 years, 72.2% were male, and 51.8% had planned valvular surgery. The primary endpoint occurred in 233 (30.7%) and 227 (30.0%) patients assigned to placebo and n-3-PUFA, respectively (OR=0.96, 95%CI=0.77-1.20; P=0.74). None of the secondary endpoints were significantly different, including post-op AF that was sustained, symptomatic, or treated (n=231 [30.5%] vs. n=224 [29.6%], P=0.70) or number of

  17. Propofol for Anesthesia and Postoperative Sedation Resulted in Fewer Inflammatory Responses than Sevoflurane Anesthesia and Midazolam Sedation after Thoracoabdominal Esophagectomy.

    PubMed

    Nakanuno, Ryuichi; Yasuda, Toshimichi; Hamada, Hiroshi; Yoshikawa, Hiroshi; Nakamura, Ryuji; Saeki, Noboru; Kawamoto, Masashi

    2015-09-01

    Responses to surgical stress can be modulated by anesthetics. We prospectively compared the effects of two different anesthetic/sedative techniques on the peak postoperative bladder temperature (BT) and the postoperative C-reactive protein (CRP) level. Twenty patients who were scheduled to undergo elective thoracoabdominal esophagectomy were allocated to receive either propofol anesthesia followed by propofol sedation (PP group, n = 10) or sevoflurane anesthesia followed by midazolam sedation (SM group, n = 10). In each case, the patient's peak bladder temperature was measured on the morning after surgery, and their serum CRP levels were assessed on postoperative days (POD) 1, 2, and 3. The patients' postoperative clinical courses were also evaluated. The peak postoperative BT (degrees C) (37.6 ± 0.4 vs. 38.2 ± 0.6, respectively; p < 0.05) and the CRP level on POD 2 (mg/dl) (14.3 ± 3.9 vs. 20.6 ± 3.9, respectively; p < 0.05) were lower in the PP group than in the SM group. The peak postoperative BT was positively correlated with the CRP level on POD 2 (R = 0.533, p < 0.05). There were no significant differences between the clinical course-related parameters in both groups. Propofol anesthesia and postoperative propofol sedation resulted in a reduced peak postoperative BT and lower CRP levels on POD 2 after esophagectomy than sevoflurane anesthesia followed by midazolam sedation.

  18. The development of a small bowel volvulus in the early postoperative period following a distal gastrectomy: report of a case.

    PubMed

    Sakamoto, T; Miyata, M; Nakamuro, M; Izukura, M; Kamiike, W; Matsuda, H

    1994-01-01

    A 51-year-old Japanese man who underwent a standard distal gastrectomy for cancer of the stomach developed abdominal pain when oral intake was commenced on the 6th postoperative day after an uneventful postoperative course. Complete obstruction of the jejunum led to a sudden deterioration in his general condition and a laparotomy was performed, revealing counterclockwise rotation of the mesenterium. The necrotic portion of the small intestine was removed, while 10 cm of the upper jejunum and 100 cm of the terminal ileum were preserved. His second postoperative course was uneventful apart from the development of "intestinal hurry," which is now under medical control 9 months after his second laparotomy.

  19. Comparison between IV Paracetamol and Tramadol for Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy

    PubMed Central

    Singh, Vivek

    2016-01-01

    Introduction Efforts to use safer drug with minimal side effects for postoperative analgesia are growing day by day for surgeries of shorter duration or which may require day care only, search for ideal agent has been a never ending process. Aim The aim of the present study was to compare the efficacy of intravenous Paracetamol and Tramadol for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Materials and Methods This study was done at Department of Anaesthesiology, Era’s Medical College, Lucknow, India. Sixty ASA-I or II patients between 18-55 years of age, scheduled for laparoscopic cholecystectomy were randomly allocated to two groups of 30 each. Group A received IV infusion of paracetamol 1g in 100 ml solution, while Group B received IV infusion of Tramadol 100 mg in 100 ml NS at 0 (first complain of pain postoperatively), 6, 12 and 18 hours respectively. Pain intensity was measured by a 10 point Visual Analogue Scale (0→no pain and 10→worst imaginable pain) VAS at T(0)→just before analgesic administration, at 0.5, 1.5, 3, 6, 12, 18 and 24 hours thereafter, in addition to HR, SBP, DBP. Statistical Analysis: Chi-square test, Student t-test and p-values <0.05 was considered significant. Results During postoperative follow-up intervals, paracetamol showed significantly lower VAS scores as compared to tramadol at 1.5 hour, 3 hour, 6 hour, 12 hour and 24 hour follow up intervals. One patient in tramadol group had nausea postoperatively (p>0.05). No adverse effect attributable to paracetamol was noticed. Conclusion Intravenous Paracetamol can be advocated as an effective and safe analgesic agent for postoperative pain relief. PMID:27656532

  20. A prospective study on postoperative discomfort after 20-gauge pars plana vitrectomy

    PubMed Central

    Yu, Ji-guo; Ni, Fang; Xiang, Yi; Feng, Yi-fan; Wang, Jue; Fu, Xun-an

    2015-01-01

    Purpose To evaluate postoperative pain and other irritation symptoms after 20-gauge (20G) pars plana vitrectomy. Materials and methods A total of 110 consecutive patients were enrolled in our studies, and 87 patients who underwent the conventional 20G pars plana vitrectomy were included in the final analysis. All vitrectomies were performed using the same surgical technique by the same surgeon. Patients were examined before surgery and 1 day, 3 days, 7 days, 1 month, and 2 months postoperatively. The main outcome measures include patient age and sex, intraocular pressure (IOP), ocular pain, pain score, pain medication use, and other irritation symptoms comprising itching, foreign body sensation, burning, photophobia, and dryness. The pain was evaluated using the Numerical Rating Scale scored from 0 to 10. Results Postoperative pain was relatively common during the first day after surgery, as it was reported by 43 (49.4%) patients. Then, the prevalence gradually decreased to eleven (12.6%) patients at 2 months. Most patients reported mild or moderate pain, with a pain score of 1–5, but only four patients were given analgesics for ocular pain. A postoperative rise of IOP was noted in 25 patients at day 1. Most of these patients with high IOP reported moderate pain. Other ocular irritation symptoms were varied after surgery. There was still one-quarter of patients that had foreign body sensation and dryness symptoms at month 2 after surgery. Conclusion Mild and moderate ocular pain were relatively common after 20G vitrectomy, which is more often associated with elevated IOP. Other irritation symptoms were also presented after surgery and could affect the life quality of patients. Therefore, the discomforts after 20G pars plana vitrectomy should be of concern, and timely management should be provided as part of routine postoperative care. PMID:26244010

  1. The surgical team and outcomes management: focus on postoperative ileus.

    PubMed

    Carter, Susan

    2006-04-01

    Postoperative ileus (POI) is defined as the impairment of bowel motility that occurs almost universally after major open abdominal procedures, as well as other abdominal and nonabdominal procedures. For the majority of affected patients, POI generally lasts approximately three to five days, but longer duration is not uncommon. The causes of POI are multifactorial, but can be broadly categorized into two groups: those related to the surgical procedure and those related to pharmacologic interventions (opioids). The fact that POI is generally transient and therefore self-limited should not deter the surgical team from seeking improved ways to mitigate its associated adverse effects, which can be substantial and immensely uncomfortable for the patient, and can have far-reaching implications regarding overall hospitalization costs for many types of surgeries. Optimization of POI management and prevention efforts is a responsibility of all members of the surgical team and can drastically affect the overall clinical outcome of major abdominal surgery. Depending on the individual team member's role, different perspectives and strategies may be used to achieve improved outcomes, including but not limited to hospitalization costs related to care and length of stay, resource utilization, and, perhaps most critically, patient quality of life not only immediately after surgery but also after discharge. The ability to reliably and significantly decrease the duration of POI should be readily recognized as an important objective in the management of this condition. Opioids will continue to be a mainstay of postoperative care regimens, but new agents such as peripherally acting mu-opioid-receptor antagonists may offer a unique clinical advantage by helping to reduce the adverse gastrointestinal effects of opioids while preserving their desired benefits for postoperative analgesia.

  2. Postoperative chylothorax: a case for recycling?

    PubMed

    Thomson, I A; Simms, M H

    1993-08-01

    Postoperative chylothorax in a patient who was rapidly deteriorating despite conservative treatment is described. A system of recycling chyle from the pleural space through a filter and pump into the subclavian vein is discussed. The history of reinfusion of chyle is reviewed.

  3. Postoperative nausea and vomiting following orthognathic surgery

    PubMed Central

    Phillips, C.; Brookes, C. D.; Rich, J.; Arbon, J.; Turvey, T. A.

    2015-01-01

    The purpose of this study was to assess the incidence and risk factors associated with postoperative nausea (PON) and vomiting (POV) after orthognathic surgery. A review of the clinical records of consecutively enrolled subjects (2008–2012) at a single academic institution was conducted between 9/2013 and 3/2014. Data on the occurrence of PON and POV and potential patient-related, intraoperative, and postoperative explanatory factors were extracted from the medical records. Logistic models were used for the presence/absence of postoperative nausea and vomiting separately. Data from 204 subjects were analyzed: 63% were female, 72% Caucasian, and the median age was 19 years. Thirty-three percent had a mandibular osteotomy alone, 27% a maxillary osteotomy alone, and 40% had bimaxillary osteotomies. Sixty-seven percent experienced PON and 27% experienced POV. The most important risk factors for PON in this series were female gender, increased intravenous fluids, and the use of nitrous oxide, and for POV were race, additional procedures, and morphine administration. The incidence of PON and POV following orthognathic surgery in the current cohort of patients, after the introduction of the updated 2007 consensus guidelines for the management of postoperative nausea and vomiting, has not decreased substantially from that reported in 2003–2004. PMID:25655765

  4. Advancing Age and 30-Day Adverse Outcomes Following Non-Emergent General Surgical Operations

    PubMed Central

    Gajdos, Csaba; Kile, Deidre; Hawn, Mary T.; Finlayson, Emily; Henderson, William G.; Robinson, Thomas N.

    2014-01-01

    Background While some single center studies have demonstrated that major surgical operations are safe to perform in older adults, most multicenter database studies find advancing age to independently predict adverse postoperative outcomes. We hypothesized that thirty-day postoperative mortality, complications, failure to rescue rates and postoperative length of stay will increase with advancing age. Design Retrospective cohort study. Setting Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Participants Patients undergoing non-emergent major general surgical operations between 2005 and 2008 were studied. Measures Postoperative outcomes of interest were complications occurring within 30 days of the index operation, return to OR within 30 days, failure to rescue after a postoperative complication, post-surgical length of stay and 30 day mortality. Results A total of 165,600 patients were studied. The rates of postoperative mortality, overall morbidity, and each type of postoperative complication increased as age increased. The rates of failure to rescue after each type of postoperative complication also increased with age. Mortality rates in patients ≥80 following renal insufficiency (43.3%), stroke (36.5%), myocardial infarction (35.6%), and pulmonary complications (25-39%) were particularly high. Median postoperative length of stay increased with age following surgical site infection, UTI, pneumonia, return to OR, and overall morbidity, but not after venous thromboembolism, stroke, myocardial infarction, renal insufficiency, failure to wean from the ventilator or reintubations. Conclusion Thirty-day mortality, complications and failure to rescue rates increase with advancing age following non-emergent general surgical operations. Patients over 80 years of age have especially high mortality following renal, cardiovascular, and pulmonary complications. As patient age advances, surgeons need to be

  5. Prevalence of acute post-operative pain in patients in adult age-group undergoing inpatient abdominal surgery and correlation of intensity of pain and satisfaction with analgesic management: A cross-sectional single institute-based study

    PubMed Central

    Singh, Prashant Kumar; Saikia, Priyam; Lahakar, Mangala

    2016-01-01

    Background and Aims: Considering the paucity of regional data, this study was designed to investigate the prevalence of post-operative pain and determine if there exists any correlation between the intensity of post-operative pain and patient's level of satisfaction with their pain management after inpatient abdominal surgery at an academic tertiary care government centre. Methods: Pain intensity was measured in 120 patients with numeric rating scale at the fifth post-operative hour, second and third post-operative day. A questionnaire was used to measure the level of satisfaction with nurse's and doctor's response to their pain and overall pain management. Results: The prevalence of post-operative pain was 84.17%, 92.5% and 96.66% at the fifth post-operative hour, second and third post-operative day, respectively. Less number of patients experienced severe intensity pain on the third post-operative day (P = 0.00046), whereas the number of patients experiencing mild pain increased (P < 0.000) compared to the fifth post-operative hour. The number of patients with complete analgesia decreased on the third post-operative day (P = 0.001 compared to fifth post-operative day). The Spearman correlation coefficient between pain score on the third post-operative day and level of satisfaction with nurse's response, doctor's response to pain and the overall pain management was − 0.0218 (P = 0.8107), 0.1307 (P = 0.1553) and 0.0743 (P = 0.4195), respectively. Conclusion: There is a high prevalence of acute post-operative pain in patients undergoing inpatient abdominal surgery at our institute. There is a weak correlation between the intensity of pain and level of satisfaction with pain management. PMID:27761037

  6. Effect of azidocillin, erythromycin, clindamycin and doxycycline on postoperative complications after surgical removal of impacted mandibular third molars.

    PubMed

    Bystedt, H; Nord, C E; Nordenram, A

    1980-06-01

    Treatment of osteitis after surgical removal of the third molar of the mandible is still a clinical problem. A total of 140 patients undergoing operations for removal of an impacted third molar of the mandible, were included in a double-blind study. Placebo or antibiotics - azidocillin, erythromycin, clindamycin and doxycycline - were given to the patients preoperatively and for the following 7 days. The concentrations in serum, alveolar serum and mandibular bone were measured and the postoperative courses - pain, trismus, swelling and wound-healing - were recorded. No correlation was obtained between the antibiotic concentration and the postoperative complaints, except in the azidocillin group on day 2, in which fewer complaints were noticed in patients with high concentrations of the drug at the time of operations. The 80 patients in the antibiotic groups responded significantly better with respect to wound-healing than the 60 patients in the placebo groups. Only 15 operations lasted more than 15 min and the three of them which subsequently resulted in alveolitis were in the placebo groups. Antibiotics significantly reduced pain on day 7 postoperatively. In general, no statistically significant differences in trismus and swelling could be demonstrated between the patient groups. However, there was a significant difference between the placebo and doxycycline groups with respect to swelling (day 2 postoperative, P < 0.01; day 5 postoperative, P < 0.05). Thus systemically administered antibiotics offered only slight advantages in routine operations of impacted third mandibular molars, but could decrease the rate of infections after traumatic operations.

  7. Hybrid minimally invasive esophagectomy for cancer: impact on postoperative inflammatory and nutritional status.

    PubMed

    Scarpa, M; Cavallin, F; Saadeh, L M; Pinto, E; Alfieri, R; Cagol, M; Da Roit, A; Pizzolato, E; Noaro, G; Pozza, G; Castoro, C

    2016-11-01

    The purpose of this case-control study was to evaluate the impact of hybrid minimally invasive esophagectomy for cancer on surgical stress response and nutritional status. All 34 consecutive patients undergoing hybrid minimally invasive esophagectomy for cancer at our surgical unit between 2008 and 2013 were retrospectively compared with 34 patients undergoing esophagectomy with open gastric tubulization (open), matched for neoadjuvant therapy, pathological stage, gender and age. Demographic data, tumor features and postoperative course (including quality of life and systemic inflammatory and nutritional status) were compared. Postoperative course was similar in terms of complication rate. Length of stay in intensive care unit was shorter in patients undergoing hybrid minimally invasive esophagectomy (P = 0.002). In the first postoperative day, patients undergoing hybrid minimally invasive esophagectomy had lower C-reactive protein levels (P = 0.001) and white cell blood count (P = 0.05), and higher albumin serum level (P = 0.001). In this group, albumin remained higher also at third (P = 0.06) and seventh (P = 0.008) postoperative day, and C-reactive protein resulted lower at third post day (P = 0.04). Hybrid minimally invasive esophagectomy significantly improved the systemic inflammatory and catabolic response to surgical trauma, contributing to a shorter length of stay in intensive care unit.

  8. Influence of state anxiety and trate anxiety in postoperative in oral surgery

    PubMed Central

    Recio-Lora, Concha; Castillo-Dalí, Gabriel; Ruiz-de-León-Hernández, Gonzalo; Hita-Iglesias, Pilar; Serrera-Figallo, Maria A.; Segura-Egea, Juan J.; Gutiérrez-Pérez, José L

    2014-01-01

    Introduction: The aim of this article was to study the influence of anxiety (both state and trait) in postoperative recovery after extraction of third molar together, to establish the role of each of the aspects of anxiety in the results you obtained in an independent and complementary way. Material and Methods: We performed a prospective study of a consecutive series of 88 patients who underwent lower third molar extractions. Before being provided with any information about the operation, patients were asked to complete the Spielberger State-Trait Anxiety Inventory-Trait and State. We have evaluated postoperative swelling and pain, patients completed a 10-point visual analog scale (VAS) at home each day (at approximately the same time of day as the operation) until day 8 after surgery, when the sutures were removed. Results: Regarding postoperative variables between positive and negative trait anxiety groups, consumption of analgesic drugs was higher in positive trait anxiety group in a statistically significant way, while these differences were detected only on specific occasions regarding pain and swelling. Discussion: In the present study, anxiety was taken into account and showed a significant effect in explaining postoperative pain and taking analgesics. Key words:Anxiety, satisfaction, third molar surgery, Spielberger state-trait anxiety inventory. PMID:24608206

  9. Postoperative adjuvant therapy of breast cancer. Oncology Overview

    SciTech Connect

    Not Available

    1984-12-01

    Oncology Overviews are a service of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute, intended to facilitate and promote the exchange of information between cancer scientists by keeping them aware of literature related to their research being published by other laboratories throughout the world. Each Oncology Overview represents a survey of the literature associated with a selected area of cancer research. It contains abstracts of articles which have been selected and organized by researchers associated with the field. Contents: Postoperative chemotherapy; Postoperative radiotherapy; Postoperative hormone therapy; Postoperative immunotherapy and chemoimmunotherapy; Postoperative multimodal therapy; Prognostic factors in postoperative adjuvant therapy.

  10. [Infants in Day Care].

    ERIC Educational Resources Information Center

    Pawl, Jeree, Ed.; And Others

    1990-01-01

    This newsletter theme issue looks at infant day care models including those emphasizing early intervention with special needs infants. The lead article, "Infants in Day Care: Reflections on Experiences, Expectations and Relationships," by Jeree H. Pawl, stresses the importance of understanding infants' and toddlers' capacities and needs in…

  11. Rainy Day Activities.

    ERIC Educational Resources Information Center

    Texas Child Care, 1997

    1997-01-01

    Experienced caregivers plan ahead for rainy days. This article describes specific rainy day activities for young children, such as books and crafts to learn about rain (rain in a jar, making a rainbow), simple cooking activities (taffy pull, cinnamon candy tea), and games (mummy wrap, hunt the thimble, rain lotto). (EV)

  12. Science Challenge Day

    ERIC Educational Resources Information Center

    Siegel, Deborah

    2013-01-01

    Science fairs can be good motivators, but as extracurricular activities, they leave some students behind. However, by staging a Science Challenge Day at school, educators can involve all students in doing everything from choosing activities to judging projects. This article presents a model for running a successful Science Challenge Day. The…

  13. RED-LETTER DAYS

    EPA Science Inventory

    The word "red-letter" is an adjective meaning "of special significance." It's origin is from the practice of marking Christian holy days in red letters on calendars. The "red-letter days" to which I refer occurred while I was a graduate student of ...

  14. Family Science Day

    ERIC Educational Resources Information Center

    McCubbins, Sara; Thomas, Bethany; Vetere, Michael

    2014-01-01

    This article describes a family-friendly science day event that encourages scientific discovery through hands-on activities, while also providing an opportunity to learn about scientific careers from actual research scientists and science educators, thereby raising awareness of the importance of STEM in our society. The one-day event bought…

  15. The Presidents' Day Game

    ERIC Educational Resources Information Center

    Maxwell, D. Jackson

    2008-01-01

    The history behind the holiday commonly called "Presidents' Day" is a bit confusing. It started as a federal holiday called Washington's Birthday. It was a day set aside to honor George Washington for his accomplishments as a founding father of the country. Later, many northern states began to recognize Abraham Lincoln's Birthday as well for his…

  16. Day of the Dead

    ERIC Educational Resources Information Center

    Dann, Tammy; Murphy, Amy

    2012-01-01

    Foreign Language in Elementary School (FLES) teachers in the West Des Moines schools incorporate the Day of the Dead into the fourth grade curriculum each year. The teachers discuss the Day of the Dead celebration at the Art Center, and many ask for volunteers from fourth grade to participate in the event. Student presentations include a wide…

  17. School Building Day, 2001.

    ERIC Educational Resources Information Center

    Council of Educational Facility Planners, International, Scottsdale, AZ.

    This document presents information and development materials about "School Building Day" (an event spotlighting the school facility and developing support and pride in the community's schools) to help local school districts conduct their own "School Building Day" to be held on April 20th of 2001. Included are lists of suggested…

  18. Convergent Validity of Three Methods for Measuring Postoperative Complications

    PubMed Central

    Fritz, Bradley A.; Escallier, Krisztina E.; Abdallah, Arbi Ben; Oberhaus, Jordan; Becker, Jennifer; Geczi, Kristin; McKinnon, Sherry; Helsten, Dan L.; Sharma, Anshuman; Wildes, Troy S.; Avidan, Michael S.

    2016-01-01

    Background Anesthesiologists need tools to accurately track postoperative outcomes. The accuracy of patient report in identifying a wide variety of postoperative complications after diverse surgical procedures has not previously been investigated. Methods In this cohort study, 1,578 adult surgical patients completed a survey at least 30 days after their procedure asking if they had experienced any of 18 complications while in the hospital after surgery. Patient responses were compared to the results of an automated electronic chart review and (for a random subset of 750 patients) to a manual chart review. Results from automated chart review were also compared to those from manual chart review. Forty-two randomly selected patients were contacted by telephone to explore reasons for discrepancies between patient report and manual chart review. Results Comparisons between patient report, automated chart review, and manual chart review demonstrated poor-to-moderate positive agreement (range, 0 to 58%) and excellent negative agreement (range, 82 to 100%). Discordance between patient report and manual chart review was frequently explicable by patients reporting events that happened outside the time period of interest. Conclusions Patient report can provide information about subjective experiences or events that happen after hospital discharge, but often yields different results from chart review for specific in-hospital complications. Effective in-hospital communication with patients and thoughtful survey design may increase the quality of patient-reported complication data. PMID:27028469

  19. Respiratory stimulant drugs in the post-operative setting.

    PubMed

    Golder, Francis J; Hewitt, Matthew M; McLeod, James F

    2013-11-01

    Drug-induced respiratory depression (DIRD) is a common problem encountered post-operatively and can persist for days after surgery. It is not always possible to predict the timing or severity of DIRD due to the number of contributing factors. A safe and effective respiratory stimulant could improve patient care by avoiding the use of reversal agents (e.g., naloxone, which reverses analgesia as well as respiratory depression) thereby permitting better pain management by enabling the use of higher doses of analgesics, facilitate weaning from prolonged ventilation, and ameliorate sleep-disordered breathing peri-operatively. The purpose of this review is to discuss the current pharmaceutical armamentarium of drugs (doxapram and almitrine) that are licensed for use in humans as respiratory stimulants and that could be used to reverse drug-induced respiratory depression in the post-operative period. We also discuss new chemical entities (AMPAkines and GAL-021) that have been recently evaluated in Phase 1 clinical trials and where the initial regulatory registration would be as a respiratory stimulant.

  20. The influence of physique on dose conversion coefficients for idealised external photon exposures: a comparison of doses for Chinese male phantoms with 10th, 50th and 90th percentile anthropometric parameters.

    PubMed

    Lv, Wei; He, Hengda; Liu, Qian

    2017-03-22

    For evaluating radiation risk, the construction of anthropomorphic computational phantoms with a variety of physiques can help reduce the uncertainty that is due to anatomical variation. In our previous work, three deformable Chinese reference male phantoms with 10th, 50th and 90th percentile body mass indexes and body circumference physiques (DCRM-10, DCRM-50 and DCRM-90) were constructed to represent underweight, normal weight and overweight Chinese adult males, respectively. In the present study, the phantoms were updated by correcting the fat percentage to improve the precision of radiological dosimetry evaluations. The organ dose conversion coefficients for each phantom were calculated and compared for four idealized external photon exposures from 15 keV to 10 MeV, using the Monte Carlo method. The dosimetric results for the three deformable Chinese reference male phantom (DCRM) phantoms indicated that variations in physique can cause as much as a 20% difference in the organ dose conversion coefficients. When the photon energy was <50 keV, the discrepancy was greater. The irradiation geometry and organ position can also affect the difference in radiological dosimetry between individuals with different physiques. Hence, it is difficult to predict the conversion coefficients of the phantoms from the anthropometric parameters alone. Nevertheless, the complex organ conversion coefficients presented in this report will be helpful for evaluating the radiation risk for large groups of people with various physiques.

  1. Development and implementation of a dedicated postoperative evaluation service to improve compliance of postoperative visits

    PubMed Central

    Vacanti, Joshua Charles; Urman, Richard Dennis; Sarin, Pankaj; Liu, Xiaoxia; Kodali, Bhavani Shankar

    2015-01-01

    Background and Aims: Postoperative patient evaluation is an integral component of perioperative care. An audit of our anesthesia department's records demonstrated a compliance rate of <50%. We postulated that the development of clinical anesthesia service dedicated to performing such evaluations would improve compliance significantly. Materials and Methods: This retrospective study examined postoperative follow-up completion rate at a large academic center. Data were collected from 58,000 anesthetics during three periods, between each of which an intervention was introduced. The first period examined completion rate when postoperative evaluations were left to the team performing the anesthetic. During the second period, this task was delegated to groups of anesthesiologists based on surgical subspecialty; these smaller groups utilized rotating residents. The third period examined completion rate after implementation of a postoperative evaluation service. All periods utilized the department's electronics database to identify operative patients. The number of adverse anesthesia events reported was also recorded. Results: A significant difference in the proportions of compliance with postoperative evaluations among all three periods was detected. Compliance was 47% during period one and improved to 66% during period two. During period three, which employed a postoperative evaluation service, compliance was 83%. The number of adverse events reported per month increased significantly following the first study period from 95 reported monthly events to 215 and 201 in the second and third periods, respectively. Conclusion: By creating a dedicated postoperative evaluation service using available technology, we improved postoperative evaluation completion rate from 47% to 83%, and demonstrated a significant increase in the number of adverse events reported. Based on this, we support the deployment of a dedicated service as a quality improvement initiative. PMID:25788778

  2. [Effect of practical use of preoperative immunonutrition with impact on prevention of postoperative pneumonia after esophagectomy].

    PubMed

    Kano, Masayuki; Nabeya, Yoshihiro; Akutsu, Yasunori; Shuto, Kiyohiko; Uesato, Masaya; Miyazawa, Yukimasa; Matsubara, Hisahiro

    2009-11-01

    To clarify the clinical benefits of administering immune-enhancing diet, Impact,we examined retrospectively the effect of preoperative immunonutrition with Impact on prevention of postoperative pneumonia after esophagectomy. In 47 patients without preoperative radiotherapy, no patient who preoperatively administered Impact>or=2,250 mL failed to develop pneumonia. The patients whose postoperative hospital stay was more than 30 days were administered Impactpostoperative pneumonia and a long hospital stay after surgery.

  3. Surgical Treatment of Orbital Blowout Fractures: Complications and Postoperative Care Patterns.

    PubMed

    Shew, Matthew; Carlisle, Michael P; Lu, Guanning Nina; Humphrey, Clinton; Kriet, J David

    2016-11-01

    Orbital fractures are a common result of facial trauma. Sequelae and indications for repair include enophthalmos and/or diplopia from extraocular muscle entrapment. Alloplastic implant placement with careful release of periorbital fat and extraocular muscles can effectively restore extraocular movements, orbital integrity, and anatomic volume. However, rare but devastating complications such as retrobulbar hematoma (RBH) can occur after repair, which pose a risk of permanent vision loss if not addressed emergently. For this reason, some surgeons take the precaution of admitting patients for 24-hour postoperative vision checks, while others do not. The incidence of postoperative RBH has not been previously reported and existing data are limited to case reports. Our aim was to examine national trends in postoperative management and to report the incidence of immediate postoperative complications at our institution following orbital repair. A retrospective assessment of orbital blowout fractures was undertaken to assess immediate postoperative complications including RBH. Only patients treated by a senior surgeon in the Department of Otolaryngology were included in the review. In addition, we surveyed AO North America (AONA) Craniomaxillofacial faculty to assess current trends in postoperative management. There were 80 patients treated surgically for orbital blowout fractures over a 9.5-year period. Nearly all patients were observed overnight (74%) or longer (25%) due to other trauma. Average length of stay was 17 hours for those observed overnight. There was one (1.3%) patient with RBH, who was treated and recovered without sequelae. Results of the survey indicated that a majority (64%) of responders observe postoperative patients overnight. Twenty-nine percent of responders indicated that they send patients home the same day of surgery. Performance of more than 20 orbital repairs annually significantly increased the likelihood that faculty would manage patients on

  4. Preoperative concentration of beta-lipotropin immunoreactive material in cerebrospinal fluid: a predictor of postoperative pain?

    PubMed

    Matejec, Reginald; Schulz, Axel; Mühling, Jörg; Uhlich, Holger; Bödeker, Rolf-Hasso; Hempelmann, Gunter; Teschemacher, Hansjörg

    2006-02-01

    Levels of beta-endorphin immunoreactive material (IRM) in cerebrospinal fluid (CSF) have been reported to correlate inversely with postoperative morphine requirement. Considering proopiomelanocortin (POMC) derivatives as predictors for sensitivity to postoperative pain, we determined authentic beta-endorphin (beta-endorphin(1-31)), beta-lipotropin IRM, N-acetyl-beta-endorphin IRM and ACTH in CSF of 17 patients undergoing hip or knee arthroplasty, before surgery (t(A)), immediately after termination of propofol infusion and still under spinal anesthesia (t(B)), under postoperative pain (t(C)) and one day after surgery (t(D)); patients rated their severity of pain on a visual analogue scale (VAS) at those four times. In all patients CSF concentrations of N-acetyl-beta-endorphin IRM and beta-lipotropin IRM were found to be increased after terminating the propofol infusion with spinal anesthesia still effective at t(B). Patients did not feel pain at times t(A), t(B) or t(D); however, they reported moderate to considerable pain at t(C). There were no correlations of postoperative pain severity at t(C) with ACTH, beta-endorphin(1-31) or N-acetyl-beta-endorphin IRM concentrations in CSF. In contrast, we observed significant inverse correlations (Spearman's rank correlation coefficients between -0.83 and -0.85, p<0.01) for postoperative pain severity with beta-lipotropin IRM concentrations in CSF at t(C), and, in addition, at t(A), t(B) and t(D); thus, postoperative pain severity appeared to be dependent on a central system controlling sensitivity to pain, linked to a POMC system releasing beta-lipotropin IRM into CSF and already active at times t(A) and t(B). We conclude that beta-lipotropin IRM in CSF might be considered to serve as a predictor of sensitivity to postoperative pain.

  5. A comparative study of postoperative pain for open thyroidectomy versus bilateral axillo-breast approach robotic thyroidectomy using a self-reporting application for iPad

    PubMed Central

    Chai, Young Jun; Song, Junho; Kang, Jiyoung; Woo, Jung-Woo; Song, Ra-Yeong; Kwon, Hyungju; Kim, Su-Jin; Choi, June Young

    2016-01-01

    Purpose Postoperative pain for robotic thyroid surgeries including bilateral axillo-breast approach (BABA) has not been well studied. In this study, we have developed a self-reporting application (SRA) for iPad and prospectively collected pain scores from open thyroidectomy (OT) and BABA robotic thyroidectomy (RT) patients. Methods Female patients who underwent total thyroidectomy for papillary thyroid carcinoma were included. Patients recorded pain scores for throat, anterior neck, posterior neck, chest, and back on postoperative days 1, 2, and 3. Once discharged, on postoperative day 14, a survey was also conducted on satisfaction of SRA and cosmesis. Results A total of 54 patients were enrolled (27 BABA RT and 27 OT). There were no significant differences between the 2 groups in clinicopathological characteristics and postoperative complication rates. Postoperative pain scores at days 1, 2, 3, and 14 were not significantly different between the groups for throat, anterior neck, posterior neck, or back. Postoperative analgesic requirements were similar between the 2 groups. Wound satisfaction scores were significantly higher in the BABA RT group (BABA RT 7.4 vs. OT 5.7; P = 0.016). Satisfaction scores for the usefulness of SRA were above 7.2 for all four questionnaire items on the 10-point scale. Conclusion Postoperative pain for BABA RT is equivalent to OT but offers greater cosmetic satisfaction for patients. A mobile device application such as SRA may facilitate proper assessment and management of pain in postoperative patients. PMID:27186567

  6. Postoperative irradiation impairs or enhances wound strength depending on time of administration

    SciTech Connect

    Vegesna, V.; McBride, W.H.; Withers, H.R.

    1995-08-01

    Irradiation can complicate surgical wound healing, yet little is known of the importance of the time between surgery and irradiation on this process. This study investigated the impact of post-operative irradiation on gain in wound tensile strength in a murine skin model. Irradiation on the same day as wounding or to 2-day-old wounds reduced wound tensile strength. In contrast, postoperative irradiation delivered at 7, 9 and 14 days transiently enhanced wound tensile strength, as measure d 3 but not 4 or 5 weeks later. This effect was independent of the inclusion (hemi-body) or exclusion (skin alone) of the hematopoietic system in the field of irradiation. Radiation-enhanced wound tensile strength was greater and occurred earlier after higher radiation doses. Even though the effect of irradiation in enhancing wound tensile strength is transitory, it could be important in assisting early wound healing. 14 refs., 3 figs., 1 tab.

  7. An interesting case of acute, severe postoperative hyponatraemia following carotid endarterectomy.

    PubMed

    Parkinson, Fran; Hopper, Andrew Neil; Eggert, Sabine; Ferguson, Colin J

    2013-05-30

    A 62-year-old man with no major comorbidities became acutely hyponatraemic on the second postoperative day following a routine carotid endarterectomy. He developed a headache, became hypertensive and confused, and then had a seizure and required intubation and admission to the intensive care unit. A CT angiogram of his head and carotid arteries was normal, as was a subsequent MRI head. His serum and urine osmolality were low. He was treated by fluid restriction and his hyponatraemia resolved over 3 days. On discontinuation of sedation the patient woke up appropriately. The cause of his hyponatraemia was initially a mystery but when questioned by the medical team he admitted that he drank about 5 litres of water in the afternoon on the second postoperative day. At this point the diagnosis of dilutional hypervolaemic hyponatraemia secondary to water intoxication could be made.

  8. Use of postoperative irradiation for the prevention of heterotopic bone formation after total hip replacement

    SciTech Connect

    Sylvester, J.E.; Greenberg, P.; Selch, M.T.; Thomas, B.J.; Amstutz, H.

    1988-03-01

    Formation of heterotopic bone (HTB) following total hip replacement may partially or completely ankylose the joint space, causing pain and/or limiting the range of motion. Patients at high risk for formation of HTB postoperatively include those with previous HTB formation, heterotopic osteoarthritis, and active rheumatoid spondylitis. Patients in these high risk groups have a 63-69% incidence of post-operative HTB formation, usually seen radiographically by 2 months post-operation. From 1980-1986 twenty-nine hips in 28 consecutively treated patients were irradiated post-operatively at the UCLA Center for the Health Sciences. The indication for irradiation was documented HTB formation previously in 26 of the 27 hips presented below. From 1980-1982 patients received 20 Gray (Gy) in 2 Gy fractions; from 1982-1986 the dose was reduced to 10 Gy in 2 Gy fractions. Twenty-seven hips in 26 patients completed therapy and were available for evaluation, with a minimum of 2 month follow-up, and a median follow-up of 12 months. Three of 27 hips developed significant HTB (Brooker grade III or IV) post-operatively, whereas 5 of 27 hips developed minor, nonsymptomatic HTB (Brooker grade I). When irradiation was begun by postoperative day 4, 0 of 17 hips formed significant HTB. If irradiation began after post-operative day 4, 3 of 10 hips formed significant HTB (Brooker grade III or IV). These 3 hips received doses of 10 Gy in one hip and 20 Gy in the other 2 hips. There were no differences in the incidence or severity of side effects in the 10 Gy vs. the 20 Gy treatment groups. Eighteen hips received 10 Gy, 8 hips 20 Gy and, 1 hip 12 Gy. In conclusion, 10 Gy in 5 fractions appears as effective as 20 Gy in 10 fractions at preventing post-operative formation of HTB. For optimal results, treatment should begin as early as possible prior to post-operative day 4.

  9. The Effect of Immunonutrition on the Postoperative Complications in Thymoma with Myasthenia Gravis

    PubMed Central

    Xin, Yanzhong; Cai, Hongfei; Wu, Lihui

    2016-01-01

    Object. To test whether preoperative immunonutrition is efficacious in reducing postoperative complications in patients of thymoma with myasthenia gravis (MG). Material and Methods. A total of 244 patients operated on for thymoma with myasthenia gravis were prospectively assigned to two groups, each receiving seven-day preoperative and seven-day postoperative nutrition. The patients in immunonutrition group were given oral immunonutrition (IN). The patients in control group received oral standard nutrition. Immunonutritional and inflammatory biomarkers (IgA, IgG, IgM, CD3t, CD4t, CD8t, CD4t/CD8t ratio, NK-cell, prealbumin, albumin, white blood cells counts, and C-reactive protein) and clinical variables (age, gender, BMI, performance status, type of thymoma, type of MG, operative time, pathology, operative approach, postoperative complications, quantity of drainage, hospital stays) were examined. Results. A significant reduction in the length of hospital stay, quantity of drainage, and postoperative complications was observed in the IN group (p < 0.05). An increase in the level of IgA, IgG, IgM, CD3+T, CD4+T, CD4+T/CD8+T, WBC, CRP, and NK-cell in the IN group was observed after thymectomy, while a decrease was seen with regard to prealbumin and albumin (p < 0.05). Conclusion. Preoperative immunonutrition support is effective in reducing postoperative complications in patients of thymoma with MG. It helps to lower the risk of postoperative infectious complications and hospital stays. PMID:27956763

  10. Effects of remifentanil versus nitrous oxide on postoperative nausea, vomiting, and pain in patients receiving thyroidectomy

    PubMed Central

    Kim, Min Kyoung; Yi, Myung Sub; Kang, Hyun; Choi, Geun-Joo

    2016-01-01

    Abstract Remifentanil and nitrous oxide (N2O) are 2 commonly used anesthetic agents. Both these agents are known risk factors for postoperative nausea and vomiting (PONV). However, remifentanil and N2O have not been directly compared in a published study. Remifentanil can induce acute tolerance or hyperalgesia, thus affecting postoperative pain. The objective of this retrospective study is to compare the effects of remifentanil and N2O on PONV and pain in patients receiving intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy. We analyzed the electronic medical records of 992 patients receiving fentanyl-based IV-PCA after thyroidectomy at Chung-Ang University Hospital from January 1, 2010 to April 30, 2016. We categorized the patients according to anesthetic agents used: group N2O (n = 745) and group remifentanil (n = 247). The propensity score matching method was used to match patients in the 2 groups based on their covariates. Finally, 128 matched subjects were selected from each group. There were no differences between groups for all covariates after propensity score matching. The numeric rating scale for nausea (0.55 ± 0.88 vs 0.27 ± 0.76, P = 0.01) was higher and complete response (88 [68.8%] vs 106 [82.8%], P = 0.001) was lower in group N2O compared with group remifentanil on postoperative day 0. However, the visual analog scale score for pain (3.47 ± 2.02 vs 3.97 ± 1.48, P = 0.025) was higher in group remifentanil than group N2O on postoperative day 0. In patients receiving IV-PCA after thyroidectomy, postoperative nausea was lower but postoperative pain was higher in group remifentanil. PMID:27741140

  11. Efficacy of intra-articular magnesium for postoperative analgesia in total hip arthroplasty

    PubMed Central

    Xu, Xinxian; Wen, Hong; Hu, Yuezheng; Liu, Zhongtang; Pan, Xiaoyun

    2017-01-01

    The aim of the present study was to compare the efficacy of intra-articular magnesium sulphate and a saline placebo for postoperative pain control following total hip arthroplasty (THA). Sixty patients underwent THA and were randomly allocated into two groups to receive intra-articular injections of either 10 ml magnesium sulphate (100 mg/ml; magnesium group, n=30) or 10 ml normal saline solution (control group, n=30). Postoperative analgesia was maintained by intravenous morphine injection. The outcome measurements were visual analogue score (VAS), morphine consumption and Harris hip score (HHS). The two groups were well matched. The outcome of VAS at rest was significantly lower at postoperative hours 6 and 12 in the magnesium group as compared with the control group, although the difference was insignificant preoperatively and at postoperative hours 2, 4, 24 and 48, and days 3, 7 and 14. This indicator during activity was also lower in the magnesium group at postoperative hour 24 than that of the control group, although the difference was insignificant preoperatively and at hour 48, and days 7 and 14. The consumption of morphine (the total quantity) at 0–6, 6–12 and 0–48 h in the magnesium group was significantly lower than in the control group, although no significant differences were observed at 12–24 and 24–48 h between the groups. The improvements of HHS from preoperative to postoperative scores were statistically significant, however, no significant differences were identified between groups. Thus, the findings indicate that intra-articular magnesium sulphate injections provided improved pain control and reduced the need for morphine when compared with a saline placebo following THA. PMID:28357078

  12. Influence of ethnicity on the perception and treatment of early post-operative pain

    PubMed Central

    Scott, Simon; Griffin-Teall, Nicola; Thompson, Jonathan

    2015-01-01

    Background: Previous studies indicated that patients from Black, Asian and minority ethnic (BAME) groups tend to receive less analgesics compared to Caucasian (White) patients after similar surgical procedures. Most such data originated from North America and suggested that health-care professionals may perceive the expression of excessive pain by BAME patient groups as an exaggerated response to pain, rather than sub-optimal treatment. There are limited data comparing acute pain management between South Asian and White British patients. Objective: We aimed to investigate correlation between patients’ ethnicity and disparities of early post-operative pain perception/management, in an ethnically diverse population. Methods: We conducted a retrospective case note review of acute post-operative pain after total abdominal hysterectomy (TAH) in 60 South Asian and 60 age-matched White British females. Data for 140 variables (pre-, intra- and post-operative) for each patient were recorded. We used propensity score matching to produce 30 closely matched patients in each group minimizing effects of recorded co-variates. Data were analysed with and without propensity score matching. Results: There were no significant differences in acute post-operative pain scores, morphine requirements, pain management, adverse effects or duration of post-operative care unit stay between South Asian and White British patients. The median duration of hospital stay of South Asian patients was longer (4.5 days versus 3.0 days, p < 0.001). Conclusion: We conclude that in an institution where both patients and health-care professionals are from an ethnically diverse population, neither post-operative pain nor pain management are influenced significantly by South Asian ethnicity. PMID:26516573

  13. Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy.

    PubMed

    Anandh, B; Madhusudan Reddy, K R; Mohanty, A; Umamaheswara Rao, G S; Chandramouli, B A

    2002-09-01

    During our initial experience with endoscopic third ventriculostomies, we observed intraoperative bradycardia and postoperative hyperkalemia. The present study was carried out to verify the consistency of these initial observations. Intraoperative heart rate (HR) changes and postoperative serum K + changes were studied prospectively in 20 patients of endoscopic third ventriculostomy. Another 6 patients who underwent endoscopic procedures other than ventriculostomy acted as controls. The anaesthetic technique and intraoperative and postoperative fluid regimen were similar in all patients. Serum K + concentrations were measured intraoperatively and once a day for the next 5 days. The third ventriculostomy group exhibited a significant slowing of the heart rate during the fenestration of the floor of the third ventricle (112 +/- 26 to 101 +/- 28 bpm, p < 0.001) and also at the time of the reversal of the neuromuscular block at the end of surgery (104 +/- 29 to 96 +/- 33 bpm, p < 0.01). The control group did not exhibit similar changes in the heart rate. The postoperative increase in serum K + values in the ventriculostomy group (0.82 +/- 0.55 mmol/L) was higher than that in the control group (0.10 +/- 0.44 mmol/L) (p < 0.01). Endoscopic third ventriculostomy is associated with a significant bradycardia at the time of fenestration and at the time of reversal of the neuromuscular block. The procedure is also associated with a postoperative increase in serum K + values. We propose a mechanism involving distortion of the posterior hypothalamus, which accounts for the bradycardia and postoperative hyperkalemia.

  14. Effectiveness of Submucosal Dexamethasone to Control Postoperative Pain & Swelling in Apicectomy of Maxillary Anterior Teeth

    PubMed Central

    Shah, Shahzad Ali; Khan, Irfanullah; Shah, Humera Shahzad

    2011-01-01

    Purpose The purpose of this study was to evaluate the effect of submucosal dexamethasone injection to control postoperative pain and swelling in apicectomy of maxillary anterior teeth. Methods A randomized, controlled trial comprising 60 adult patients (68.3% male, 31.7% female) with no local or systemic problems was conducted. Patients were randomly divided into two groups: Group A was given 4mg dexamethasone injection perioperatively. Group B (control group) was treated conventionally without any steroid injection. Postoperative pain and swelling was evaluated using a visual analog scale (VAS). Objective measurements of facial pain and swelling were performed daily up to six days postoperatively. Results Dexamethasone group showed significant reduction in pain and swelling postoperatively compared with the control. Conclusion Submucosal dexamethasone 4mg injection is an effective therapeutic strategy for swift and comfortable improvement after surgical procedure and has a significant effect on reducing postoperative pain and swelling. The treatment offers a simple, safe, painless, noninvasive and cost effective therapeutic option for moderate and severe cases. PMID:23267293

  15. Thermography as a quantitative imaging method for assessing postoperative inflammation

    PubMed Central

    Christensen, J; Matzen, LH; Vaeth, M; Schou, S; Wenzel, A

    2012-01-01

    Objective To assess differences in skin temperature between the operated and control side of the face after mandibular third molar surgery using thermography. Methods 127 patients had 1 mandibular third molar removed. Before the surgery, standardized thermograms were taken of both sides of the patient's face using a Flir ThermaCam™ E320 (Precisions Teknik AB, Halmstad, Sweden). The imaging procedure was repeated 2 days and 7 days after surgery. A region of interest including the third molar region was marked on each image. The mean temperature within each region of interest was calculated. The difference between sides and over time were assessed using paired t-tests. Results No significant difference was found between the operated side and the control side either before or 7 days after surgery (p > 0.3). The temperature of the operated side (mean: 32.39 °C, range: 28.9–35.3 °C) was higher than that of the control side (mean: 32.06 °C, range: 28.5–35.0 °C) 2 days after surgery [0.33 °C, 95% confidence interval (CI): 0.22–0.44 °C, p < 0.001]. No significant difference was found between the pre-operative and the 7-day post-operative temperature (p > 0.1). After 2 days, the operated side was not significantly different from the temperature pre-operatively (p = 0.12), whereas the control side had a lower temperature (0.57 °C, 95% CI: 0.29–0.86 °C, p < 0.001). Conclusions Thermography seems useful for quantitative assessment of inflammation between the intervention side and the control side after surgical removal of mandibular third molars. However, thermography cannot be used to assess absolute temperature changes due to normal variations in skin temperature over time. PMID:22752326

  16. Factors affecting postoperative range of motion after total knee arthroplasty.

    PubMed

    Gatha, Nehal M; Clarke, Henry D; Fuchs, Robin; Scuderi, Giles R; Insall, John N

    2004-10-01

    One hundred thirty five patients with osteoarthritis who underwent total knee arthroplasty (TKA) were evaluated to determine whether specific pre- and postoperative variables were correlated with the postoperative range of motion. Age, sex, pre- and postoperative range of motion, pre- and postoperative Knee Society scores, intraoperative patellar thickness before and after resurfacing, pre- and postoperative radiographic patellar height (as determined by the Insall-Salvati and Blackburn-Peel ratios), and preoperative radiographic alignment were recorded for each patient. Regression analysis was performed to identify whether any variables were correlated with the postoperative range of motion or Knee Society scores. The only variable that was significantly correlated with postoperative range of motion was the preoperative range of motion. This study suggests that among the variables evaluated, the preoperative range of motion was the only significant predictor of postoperative range of motion.

  17. Day care health risks

    MedlinePlus

    ... This infection causes diarrhea, stomach cramps, and gas. Ear infections, colds, coughs, sore throats, and runny noses ... Head lice and scabies are other common health problems that occur in day care centers. You can ...

  18. Career Day 2012

    NASA Video Gallery

    More than 200 high school juniors and seniors with interests in science, technology, engineering and math met one-on-one with professionals at NASA's Langley Research Center during Career Day 2012,...

  19. Pregnancy - identifying fertile days

    MedlinePlus

    ... between days 7 and 20 of a woman's menstrual cycle. In order to become pregnant, having sex every ... hours of ovulation. If you have an irregular menstrual cycle, an ovulation predictor kit can help you know ...

  20. Temporal variability of readmission determinants in postoperative vascular surgery patients

    PubMed Central

    Lin, MJ; Baky, F; Housley, BC; Kelly, N; Pletcher, E; Balshi, JD; Stawicki, SP; Evans, DC

    2016-01-01

    Introduction: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from “short-term” to “long-term” determinants at 30-, 180-, and 360-day postoperative cutoff points. Methods: Following IRB approval, medical records of patients who underwent ERDA at two institutions were retrospectively reviewed between 2008 and 2014. Abstracted data included patient demographics, procedural characteristics, the American Society of Anesthesiologists score, Goldman Criteria for perioperative cardiac assessment, the Charlson comorbidity index, morbidity, mortality, and readmission (at 30-, 180-, and 360-days). Univariate analyses were performed for readmissions at each specified time point. Variables reaching statistical significance of P < 0.20 were included in multivariate analyses for factors independently associated with readmission. Results: A total of 450 of 744 patients who underwent ERDA with complete medical records were included. Patients underwent either an extremity revascularization (e.g. bypass or endarterectomy, 406/450) or a noncatheter dialysis access procedure (44/450). Sample characteristics included 262 (58.2%) females, mean age 61.4 ± 12.9 years, 63 (14%) emergent procedures, and median operative time 164 min. Median hospital length of stay (index admission) was 4 days. Cumulative readmission rates at 30-, 180-, and 360-day were 12%, 27%, and 35%, respectively. Corresponding mortality rates were 3%, 7%, and 9%. Key factors independently associated with 30-, 180-, and 360-day readmissions evolved over the study period

  1. [The endoscopic management of postoperative biliary fistulae].

    PubMed

    Uribarrena, R; Simón, M A; Sebastián, J J; Gomollón, F; Bajador, E; Botella, M T; Cabrera, T

    1994-10-01

    We report a series of 15 patients with a postoperative biliary fistula treated by endoscopic sphincterotomy. The exact location of the bile leak was revealed by ERCP in 13 cases (87%): cystic duct remnant in 6 (39%), intrahepatic biliary tree in 4 (26%), and main bile duct in 3 (20%). In all cases a distal obstacle (ie: retained stones, hydatid material) to bile flow was also found in ERCP. Treatment consisted of endoscopic sphincterotomy and subsequent removal of the distal obstacle, and could be completed in 13 (87%) cases. In our experience the treatment of postoperative biliary fistula with a distal obstruction bile flow by endoscopic sphincterotomy is a safe and effective procedure, and should be recommended as the first option in those patients.

  2. Post-operative pulmonary complications after thoracotomy

    PubMed Central

    Sengupta, Saikat

    2015-01-01

    Pulmonary complications are a major cause of morbidity and mortality in the post-operative period after thoracotomy. The type of complications and the severity of complications depend on the type of thoracic surgery that has been performed as well as on the patient's pre-operative medical status. Risk stratification can help in predicting the possibility of the post-operative complications. Certain airway complications are more prone to develop with thoracic surgery. Vocal cord injuries, bronchopleural fistulae, pulmonary emboli and post-thoracic surgery non-cardiogenic pulmonary oedema are some of the unique complications that occur in this subset of patients. The major pulmonary complications such as atelectasis, bronchospasm and pneumonia can lead to respiratory failure. This review was compiled after a search for search terms within ‘post-operative pulmonary complications after thoracic surgery and thoracotomy’ on search engines including PubMed and standard text references on the subject from 2000 to 2015. PMID:26556921

  3. Postoperative pelvic pain: An imaging approach.

    PubMed

    Farah, H; Laurent, N; Phalippou, J; Bazot, M; Giraudet, G; Serb, T; Poncelet, E

    2015-10-01

    Postoperative pelvic pain after gynecological surgery is a readily detected but unspecific sign of complication. Imaging as a complement to physical examination helps establish the etiological diagnosis. In the context of emergency surgery, vascular, urinary and digestive injuries constitute the most frequent intraoperative complications. During the follow-up of patients who had undergone pelvic surgery, imaging should be performed to detect recurrent disease, postoperative fibrosis, adhesions and more specific complications related to prosthetic material. Current guidelines recommend using pelvic ultrasonography as the first line imaging modality whereas the use of pelvic computed tomography and/or magnetic resonance imaging should be restricted to specific situations, depending on local availability of equipment and suspected disease.

  4. Stennis Day Camper

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Sara Beth Casey, 5, proudly displays her artwork, 'Planets.' Sara Beth created the art as a student of Stennis Day Camp, a free camp for Stennis Space Center employees' children whose schools have not resumed since Hurricane Katrina hit the region on Aug. 29. The camp has registered nearly 200 children and averages 100 children each day. The camp will continue until all schools are back in session.

  5. Sun-Earth Days

    NASA Astrophysics Data System (ADS)

    Thieman, J.; Ng, C.; Lewis, E.; Cline, T.

    2010-08-01

    Sun-Earth Day is a well-coordinated series of programs, resources and events under a unique yearly theme highlighting the fundamentals of heliophysics research and missions. A menu of activities, conducted throughout the year, inspire and educate participants. Sun-Earth Day itself can vary in date, but usually is identified by a celebration on or near the spring equinox. Through the Sun-Earth Day framework we have been able to offer a series of coordinated events that promote and highlight the Sun, its connection to Earth and the other planets. Sun-Earth Day events are hosted by educators, museums, amateur astronomers and scientists and occur at schools, community groups, parks, planetaria and science centers around the globe. Sun-Earth Day raises the awareness and knowledge of formal and informal education audiences concerning space weather and heliophysics. By building on the success of Sun-Earth Day yearly celebrations, we seek to affect people of all backgrounds and ages with the wonders of heliophysics science, discovery, and exploration in ways that are both tangible and meaningful to their lives.

  6. Postoperative Rehabilitation After Rotator Cuff Repair

    PubMed Central

    Mollison, Scott; Shin, Jason J.; Glogau, Alexander; Beavis, R. Cole

    2017-01-01

    Background: Postoperative rehabilitation after arthroscopic rotator cuff repair (ARCR) remains controversial and suffers from limited high-quality evidence. Therefore, appropriate use criteria must partially depend on expert opinion. Hypothesis/Purpose: The purpose of the study was to determine and report on the standard and modified rehabilitation protocols after ARCR used by member orthopaedic surgeons of the American Orthopaedic Society for Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA). We hypothesized that there will exist a high degree of variability among rehabilitation protocols. We also predict that surgeons will be prescribing accelerated rehabilitation. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A 29-question survey in English language was sent to all 3106 associate and active members of the AOSSM and the AANA. The questionnaire consisted of 4 categories: standard postoperative protocol, modification to postoperative rehabilitation, operative technique, and surgeon demographic data. Via email, the survey was sent on September 4, 2013. Results: The average response rate per question was 22.7%, representing an average of 704 total responses per question. The most common immobilization device was an abduction pillow sling with the arm in neutral or slight internal rotation (70%). Surgeons tended toward later unrestricted passive shoulder range of motion at 6 to 7 weeks (35%). Strengthening exercises were most commonly prescribed between 6 weeks and 3 months (56%). Unrestricted return to activities was most commonly allowed at 5 to 6 months. The majority of the respondents agreed that they would change their protocol based on differences expressed in this survey. Conclusion: There is tremendous variability in postoperative rehabilitation protocols after ARCR. Five of 10 questions regarding standard rehabilitation reached a consensus statement. Contrary to our hypothesis, there was a trend toward later

  7. Postoperative radiation and implant capsule contraction

    SciTech Connect

    Caffee, H.H.; Mendenhall, N.P.; Mendenhall, W.M.; Bova, F.J.

    1988-01-01

    Occasionally radiation is required as adjunctive therapy following mastectomy for breast cancer. The effects of radiation on a developing implant capsule are unknown, but they are very important in relation to the increased use of immediate reconstruction. Experiments were performed on rabbits to study the effects of postoperative radiation therapy on capsule contraction and thickness. The results of these experiments suggest that radiation has no effect on implant capsules.

  8. Postoperative Chemoradiotherapy for Extrahepatic Bile Duct Cancer

    SciTech Connect

    Park, Jin-hong; Choi, Eun Kyung; Ahn, Seung Do; Lee, Sang-wook; Song, Si Yeol; Yoon, Sang Min; Kim, Young Seok; Lee, Yu Sun; Lee, Sung-Gyu; Hwang, Shin; Lee, Young-Joo; Park, Kwang-Min; Kim, Tae Won; Chang, Heung Moon; Lee, Jae-Lyun; Kim, Jong Hoon

    2011-03-01

    Purpose: To evaluate the effect of postoperative concurrent chemoradiotherapy using three-dimensional conformal radiotherapy and to identify the prognostic factors that influence survival in patients with extrahepatic bile duct cancer. Methods and Materials: We retrospectively analyzed the data from 101 patients with extrahepatic bile duct cancer who had undergone postoperative concurrent chemoradiotherapy using three-dimensional conformal radiotherapy. Of the 101 patients, 52 (51%) had undergone complete resection (R0 resection) and 49 (49%) had microscopic or macroscopic residual tumors (R1 or R2 resection). The median radiation dose was 50 Gy. Also, 85 patients (84%) underwent concurrent chemotherapy with 5-fluorouracil. Results: The median follow-up period was 47 months for the surviving patients. The 5-year overall survival rate was 34% for all patients. A comparison between patients with R0 and R1 resection indicated no significant difference in the 5-year overall survival (44% vs. 33%, p = .2779), progression-free survival (35% vs. 22%, p = .3107), or locoregional progression-free survival (75% vs. 63%, p = .2784) rates. An analysis of the first failure site in the 89 patients with R0 or R1 resection indicated isolated locoregional recurrence in 7 patients. Elevated postoperative carbohydrate antigen 19-9 level was an independent prognostic factor for overall survival (p = .001) and progression-free survival (p = .033). A total of 3 patients developed Grade 3 or greater late toxicity. Conclusion: Adjuvant concurrent chemoradiotherapy using three-dimensional conformal radiotherapy appears to improve locoregional control and survival in extrahepatic bile duct cancer patients with R1 resection. The postoperative carbohydrate antigen 19-9 level might be a useful prognostic marker to select patients for more intensified adjuvant therapy.

  9. Predicting postoperative gait in cerebral palsy.

    PubMed

    Galarraga C, Omar A; Vigneron, Vincent; Dorizzi, Bernadette; Khouri, Néjib; Desailly, Eric

    2016-11-09

    In this work, postoperative lower limb kinematics are predicted with respect to preoperative kinematics, physical examination and surgery data. Data of 115 children with cerebral palsy that have undergone single-event multilevel surgery were considered. Preoperative data dimension was reduced utilizing principal component analysis. Then, multiple linear regressions with 80% confidence intervals were performed between postoperative kinematics and bilateral preoperative kinematics, 36 physical examination variables and combinations of 9 different surgical procedures. The mean prediction errors on test vary from 4° (pelvic obliquity and hip adduction) to 10° (hip rotation and foot progression), depending on the kinematic angle. The unilateral mean sizes of the confidence intervals vary from 5° to 15°. Frontal plane angles are predicted with the lowest errors, however the same performance is achieved when considering the postoperative average signals. Sagittal plane angles are better predicted than transverse plane angles, with statistical differences with respect to the average postoperative kinematics for both plane's angles except for ankle dorsiflexion. The mean prediction errors are smaller than the variability of gait parameters in cerebral palsy. The performance of the system is independent of the preoperative state severity of the patient. Even if the system is not yet accurate enough to define a surgery plan, it shows an unbiased estimation of the most likely outcome, which can be useful for both the clinician and the patient. More patients' data are necessary for improving the precision of the model in order to predict the kinematic outcome of a large number of possible surgeries and gait patterns.

  10. Stair-Climbing Test Predicts Postoperative Cardiopulmonary Complications and Hospital Stay in Patients with Non-Small Cell Lung Cancer

    PubMed Central

    Dong, Jingsi; Mao, Yousheng; Li, Jiagen; He, Jie

    2017-01-01

    Background There is currently no reliable method to predict major postoperative cardiopulmonary complications for patients with non-small cell lung cancer (NSCLC). In this study, we hypothesized that exercise oxygen desaturation (EOD) and heart rate change results in a stair-climbing test (SCT) would predict postoperative cardiopulmonary complications for patients with NSCLC. Material/Methods We examined 171 patients (41 females and 130 males) with NSCLC by preoperative SCT from January 2010 to July 2015. Among them, 27 underwent wedge resection, 122 underwent lobectomy, and 22 underwent pneumonectomy. The correlation between postoperative cardiopulmonary complications and parameters of SCT and pulmonary function test (PFT) parameters were analyzed retrospectively. Results The overall 30-day postoperative morbidity of the patients was 46/171 (26.9%), with death occurring in 3/171(1.8%). The age, FEV1%, MVV, height of climbing, EOD, and heart rate change were found to be significantly different between the group with postoperative cardiopulmonary complications and those without. Binary logistic regression analysis showed that EOD and heart rate change were independently correlated with postoperative cardiopulmonary complications. In addition, a model predicting the probability of postoperative cardiopulmonary complication based on logistic regression for multivariable analysis was used to confirm our findings. Conclusions A symptom-limited SCT with oxygen saturation monitoring is a safe, simple, and low-cost method to evaluate cardiopulmonary function preoperatively. PMID:28336909

  11. Stair-Climbing Test Predicts Postoperative Cardiopulmonary Complications and Hospital Stay in Patients with Non-Small Cell Lung Cancer.

    PubMed

    Dong, Jingsi; Mao, Yousheng; Li, Jiagen; He, Jie

    2017-03-24

    BACKGROUND There is currently no reliable method to predict major postoperative cardiopulmonary complications for patients with non-small cell lung cancer (NSCLC). In this study, we hypothesized that exercise oxygen desaturation (EOD) and heart rate change results in a stair-climbing test (SCT) would predict postoperative cardiopulmonary complications for patients with NSCLC. MATERIAL AND METHODS We examined 171 patients (41 females and 130 males) with NSCLC by preoperative SCT from January 2010 to July 2015. Among them, 27 underwent wedge resection, 122 underwent lobectomy, and 22 underwent pneumonectomy. The correlation between postoperative cardiopulmonary complications and parameters of SCT and pulmonary function test (PFT) parameters were analyzed retrospectively. RESULTS The overall 30-day postoperative morbidity of the patients was 46/171 (26.9%), with death occurring in 3/171(1.8%). The age, FEV1%, MVV, height of climbing, EOD, and heart rate change were found to be significantly different between the group with postoperative cardiopulmonary complications and those without. Binary logistic regression analysis showed that EOD and heart rate change were independently correlated with postoperative cardiopulmonary complications. In addition, a model predicting the probability of postoperative cardiopulmonary complication based on logistic regression for multivariable analysis was used to confirm our findings. CONCLUSIONS A symptom-limited SCT with oxygen saturation monitoring is a safe, simple, and low-cost method to evaluate cardiopulmonary function preoperatively.

  12. Relationship between anesthesia and postoperative endophthalmitis

    PubMed Central

    Lai, Hou-Chuan; Tseng, Wei-Cheng; Pao, Shu-I; Wong, Chih-Shung; Huang, Ren-Chih; Chan, Wei-Hung; Wu, Zhi-Fu

    2017-01-01

    Abstract Previous study showed that patients under general anesthesia (GA) had nasopharyngeal secretions on the face at the end of ocular surgery, especially in propofol-based total intravenous anesthesia (TIVA), it might induce postoperative endophthalmitis. Therefore, we conducted a retrospective study to compare the incidence of endophthalmitis after ocular surgery under topical, inhalation anesthesia, and propofol-based TIVA in our medical center from 2011 to 2015. A total of 21,032 patients were included, and we evaluated epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of ocular surgery, method of antibiotic prophylaxis, vitreous culture, and vision outcome in these patients. Fifteen endophthalmitis cases among 21,032 operations reported, equaling an incidence of 0.071%. The incidence rates under topical, inhalation anesthesia, and propofol-based TIVA were 0.083%, 0.039%, and 0%, respectively (P = 0.39). Moreover, the risk of endophthalmitis under GA (0.024%) was significantly lower than topical anesthesia (0.083%) (P < 0.001). We also found that elder was the risk factor for endophthalmitis following ocular surgery. In conclusion, propofol-based TIVA or inhalation anesthesia did not increase the risk of endophthalmitis after ocular surgery. Thus, GA was not a risk factor for postoperative endophthalmitis. By contrast, elder was the risk factor for postoperative endophthalmitis. PMID:28328861

  13. Periprosthetic Infection following Primary Hip and Knee Arthroplasty: The Impact of Limiting the Postoperative Surveillance Period.

    PubMed

    Roth, Virginia R; Mitchell, Robyn; Vachon, Julie; Alexandre, Stéphanie; Amaratunga, Kanchana; Smith, Stephanie; Vearncombe, Mary; Davis, Ian; Mertz, Dominik; Henderson, Elizabeth; John, Michael; Johnston, Lynn; Lemieux, Camille; Pelude, Linda; Gravel, Denise

    2017-02-01

    BACKGROUND Hip and knee arthroplasty infections are associated with considerable healthcare costs. The merits of reducing the postoperative surveillance period from 1 year to 90 days have been debated. OBJECTIVES To report the first pan-Canadian hip and knee periprosthetic joint infection (PJI) rates and to describe the implications of a shorter (90-day) postoperative surveillance period. METHODS Prospective surveillance for infection following hip and knee arthroplasty was conducted by hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) using standard surveillance definitions. RESULTS Overall hip and knee PJI rates were 1.64 and 1.52 per 100 procedures, respectively. Deep incisional and organ-space hip and knee PJI rates were 0.96 and 0.71, respectively. In total, 93% of hip PJIs and 92% of knee PJIs were identified within 90 days, with a median time to detection of 21 days. However, 11%-16% of deep incisional and organ-space infections were not detected within 90 days. This rate was reduced to 3%-4% at 180 days post procedure. Anaerobic and polymicrobial infections had the shortest median time from procedure to detection (17 and 18 days, respectively) compared with infections due to other microorganisms, including Staphylococcus aureus. CONCLUSIONS PJI rates were similar to those reported elsewhere, although differences in national surveillance systems limit direct comparisons. Our results suggest that a postoperative surveillance period of 90 days will detect the majority of PJIs; however, up to 16% of deep incisional and organ-space infections may be missed. Extending the surveillance period to 180 days could allow for a better estimate of disease burden. Infect Control Hosp Epidemiol 2017;38:147-153.

  14. The Effect of Unilateral Spinal Anaesthesia and Psoas Compartment with Sciatic Block on the Postoperative Pain Management in Total Knee Artroplastic Surgery

    PubMed Central

    Unal, Dogus; Guzel, Yunus

    2017-01-01

    Purpose. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. Materials and Method. 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. Results. Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group. The decrease observed in the 5th, 10th, and 20th minute MAP values in the USA group was statistically significant according to the control MAP value. Concerning within group comparisons, the decrease in 5th, 10th, and 20th minute heart rate values in the USA group was statistically significant compared with the control measurement value. The mean beginning time of sensory and motor blocks in the PCS group was found to be at a significantly advanced level compared with that in the USA group. Conclusions. The PCS block technique using bupivacaine hydrochloride ensured a higher haemodynamic efficiency in the perioperative period in high-risk elderly patients undergoing total knee arthroplasty. This trial is registered with ClinicalTrials.gov Identifier: NCT03021421. PMID:28255259

  15. The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis

    PubMed Central

    Wu, Ming-Shun; Chen, Kee-Hsin; Chen, I-Fan; Huang, Shihping Kevin; Tzeng, Pei-Chuan; Yeh, Mei-Ling; Lee, Fei-Peng; Lin, Jaung-Geng; Chen, Chiehfeng

    2016-01-01

    Background Postoperative pain resulting from surgical trauma is a significant challenge for healthcare providers. Opioid analgesics are commonly used to treat postoperative pain; however, these drugs are associated with a number of undesirable side effects. Objective This systematic review and meta-analysis evaluated the effectiveness of acupuncture and acupuncture-related techniques in treating postoperative pain. Data Source MEDLINE, Cochrane Library, and EMBASE databases were searched until Sep 30, 2014. Study Eligibility Criteria Randomized controlled trials of adult subjects (≥ 18 years) who had undergone surgery and who had received acupuncture, electroacupuncture, or acupoint electrical stimulation for managing acute post-operative pain were included. Results We found that patients treated with acupuncture or related techniques had less pain and used less opioid analgesics on Day 1 after surgery compared with those treated with control (P < 0.001). Sensitivity analysis using the leave-one-out approach indicated the findings are reliable and are not dependent on any one study. In addition, no publication bias was detected. Subgroup analysis indicated that conventional acupuncture and transcutaneous electric acupoint stimulation (TEAS) were associated with less postoperative pain one day following surgery than control treatment, while electroacupuncture was similar to control (P = 0.116). TEAS was associated with significantly greater reduction in opioid analgesic use on Day 1 post surgery than control (P < 0.001); however conventional acupuncture and electroacupuncture showed no benefit in reducing opioid analgesic use compared with control (P ≥ 0.142). Conclusion Our findings indicate that certain modes of acupuncture improved postoperative pain on the first day after surgery and reduced opioid use. Our findings support the use of acupuncture as adjuvant therapy in treating postoperative pain. PMID:26959661

  16. Hyperbaric oxygen preconditioning attenuates postoperative cognitive impairment in aged rats.

    PubMed

    Sun, Li; Xie, Keliang; Zhang, Changsheng; Song, Rui; Zhang, Hong

    2014-06-18

    Cognitive decline after surgery in the elderly population is a major clinical problem with high morbidity. Hyperbaric oxygen (HBO) preconditioning can induce significant neuroprotection against acute neurological injury. We hypothesized that HBO preconditioning would prevent the development of postoperative cognitive impairment. Elderly male rats (20 months old) underwent stabilized tibial fracture operation under general anesthesia after HBO preconditioning (once a day for 5 days). Separate cohorts of animals were tested for cognitive function with fear conditioning and Y-maze tests, or euthanized at different times to assess the blood-brain barrier integrity, systemic and hippocampal proinflammatory cytokines, and caspase-3 activity. Animals exhibited significant cognitive impairment evidenced by a decreased percentage of freezing time and an increased number of learning trials on days 1, 3, and 7 after surgery, which were significantly prevented by HBO preconditioning. Furthermore, HBO preconditioning significantly ameliorated the increase in serum and hippocampal proinflammatory cytokines tumor necrosis factor-α, interleukin-1 β (IL-1β), IL-6, and high-mobility group protein 1 in surgery-challenged animals. Moreover, HBO preconditioning markedly improved blood-brain barrier integrity and caspase-3 activity in the hippocampus of surgery-challenged animals. These findings suggest that HBO preconditioning could significantly mitigate surgery-induced cognitive impairment, which is strongly associated with the reduction of systemic and hippocampal proinflammatory cytokines and caspase-3 activity.

  17. Octreotide for treatment of postoperative alimentary tract fistulas.

    PubMed

    Paran, H; Neufeld, D; Kaplan, O; Klausner, J; Freund, U

    1995-01-01

    Eighteen patients with postoperative fistulas of the gastrointestinal tract were treated with the somatostatin analog octreotide between November 1989 and November 1992. Fourteen patients had enterocutaneous fistulas: seven from the duodenum and seven from the ileum. Another three patients had pancreatic fistulas, and one patient had a biliary fistula. Within 24 hours of octreotide treatment, a mean reduction of 52% in the intestinal fistulas' output, 40% in the pancreatic fistulas, and 30% in the biliary fistula was noted. In the intestinal fistulas group the closure rate was 72% after a mean of 11 days. Early closure (mean 6 days) was achieved in all three pancreatic fistulas. In the patient with the biliary fistula a 30% reduction was observed twice following the administration of octreotide, and an increase occurred when it was withheld. The reduction rate of the secretions in high-output intestinal fistulas (> 500 ml/day) was higher than in the low-output fistulas (63 +/- 8% versus 39 +/- 4%, p < 0.05). Fistula output and the initial response to octreotide treatment had no value in predicting spontaneous healing. In conclusion, octreotide is a valuable tool for the conservative treatment of fistulas of the digestive tract. It is especially valuable for management of high-output enteric fistulas and pancreatic fistulas.

  18. The effect of various kinematics on postoperative pain after instrumentation: a prospective, randomized clinical study

    PubMed Central

    Arslan, Hakan; Khalilov, Ruslan; Doğanay, Ezgi; Karatas, Ertugrul

    2016-01-01

    ABSTRACT Objective: To evaluate various kinematic movements on postoperative pain using a Reciproc system. Material and Methods: Fifty-six molar teeth were divided into four groups according to kinematics as follows: continuous rotation, 360° CCW – 30° CW, 270° CCW – 30° CW, and 150° CCW – 30° CW. Preoperative and postoperative pain levels using visual analogue scale (VAS), percussion pain, and analgesic intake were recorded for each subject. Postoperative pain levels at 1, 3, 5, and 7 d were evaluated. Data were analyzed statistically using the Kruskal-Walis, Mann-Whitney-U, one-way analysis of variance, and chi-square tests (p=0.05). Results: Continuous rotation resulted in more pain at Day 1 when compared with the reciprocating groups (360° CCW – 30° CW and 270° CCW – 30° C) (p<0.05). Conclusions: Continuous rotation resulted in more postoperative pain at Day 1 than in reciprocating groups, and thereafter no significant pain was found among the groups. PMID:27812621

  19. Postoperative Pain Management in Latino Families: Parent Beliefs about Analgesics Predict Analgesic Doses Provided to Children

    PubMed Central

    Rosales, Alvina; Fortier, Michelle A.; Campos, Belinda; Kain, Zeev N.

    2015-01-01

    Background/Objectives The present study examined whether parental perceptions of children’s pain impacted home-based pain management following outpatient surgery in a sample of Latino families from low socioeconomic backgrounds. Methods Latino parents of children (n = 161) who underwent outpatient surgery were recruited for this study and completed measures assessing attitudes on pain and analgesic use (Parental Pain Expression Perceptions and Medication Attitudes Questionnaire) before their child’s surgery. Parents also rated their child’s pain after their child’s surgery using the Parent Postoperative Pain Measure and collected data on the amount of analgesics they gave to their child on the first postoperative day. Hierarchical regression analyses examined whether parental attitudes predicted pain assessment and management at home. Results A majority of parents reported multiple misconceptions regarding children’s pain and fears of side effects as well as avoidance of analgesic use. For example, over 80% reported believing that a child always tells their parents when they are in pain. Hierarchical regression analyses found that more fear and avoidance regarding analgesic use for children’s pain predicted parents’ providing fewer doses of analgesic to their children on the first postoperative day (β = −0.21, p = 0.028). Conclusions Preoperative parents’ beliefs regarding analgesics for treatment of children’s pain may adversely impact parent postoperative analgesic administration at home in Latino families. PMID:26792407

  20. State anxiety and depression as factors modulating and influencing postoperative pain in dental implant surgery. A prospective clinical survey

    PubMed Central

    Gómez-de Diego, Rafael; Cutando-Soriano, Antonio; Montero-Martín, Javier; Prados-Frutos, Juan C.

    2014-01-01

    Objetives: To determine whether preoperative state anxiety and depression modulate or influence objective and subjective postoperative pain following dental implant insertion. Study Design: Prospective, clinical study with 7-day follow-up of a sample of 105 subjects who preoperatively completed the state anxiety questionnaire (STAI-E) and Beck Depression Inventory (BDI) and postoperatively, at 2 and 7 days, recorded objective pain with the Semmes-Weinstein mechanical esthesiometer (SW test) and subjective pain with the Visual Analog Scale (VAS). Results: 85.6% and 81.5% of patients, respectively, recorded no signs of state anxiety or depression. The correlation between anxiety and depression for both maxillary bones was the lower (P=0.02). The correlation between subjective and objective pain at 2 and 7 days, and the anatomic regions intervened, was statistically significant in the mandible at day 7 (P<0.01), and highly significant (P<0.001) for the other variables. The correlation between state anxiety and objective pain at day 7 was nearly statistically significant (P=0.07). Conclusions: The correlation between state anxiety and depression, and objective and subjective pain at day 7 was not statistically significant. A strong correlation was found between objective and subjective pain in the immediate postoperative period. Key words:Anxiety, depression, postoperative pain, dental implants. PMID:24880447

  1. Positive predictive values of International Classification of Diseases, 10th revision codes for dermatologic events and hypersensitivity leading to hospitalization or emergency room visit among women with postmenopausal osteoporosis in the Danish and Swedish national patient registries

    PubMed Central

    Adelborg, Kasper; Christensen, Lotte Brix; Munch, Troels; Kahlert, Johnny; Trolle Lagerros, Ylva; Tell, Grethe S; Apalset, Ellen M; Xue, Fei; Ehrenstein, Vera

    2017-01-01

    Background Clinical epidemiology research studies, including pharmacoepidemiology and pharmacovigilance studies, use routinely collected health data, such as diagnoses recorded in national health and administrative registries, to assess clinical effectiveness and safety of treatments. We estimated positive predictive values (PPVs) of International Classification of Diseases, 10th revision (ICD-10) codes for primary diagnoses of dermatologic events and hypersensitivity recorded at hospitalization or emergency room visit in the national patient registries of Denmark and Sweden among women with postmenopausal osteoporosis (PMO). Methods This validation study included women with PMO identified from the Danish and Swedish national patient registries (2005–2014). Medical charts of the potential cases served as the gold standard for the diagnosis confirmation and were reviewed and adjudicated by physicians. Results We obtained and reviewed 189 of 221 sampled medical records (86%). The overall PPV was 92.4% (95% confidence interval [CI], 85.1%–96.3%) for dermatologic events, while the PPVs for bullous events and erythematous dermatologic events were 52.5% (95% CI, 37.5%–67.1%) and 12.5% (95% CI, 2.2%–47.1%), respectively. The PPV was 59.0% (95% CI, 48.3%–69.0%) for hypersensitivity; however, the PPV of hypersensitivity increased to 100.0% (95% CI, 67.6%–100.0%) when restricting to diagnostic codes for anaphylaxis. The overall results did not vary by country. Conclusion Among women with PMO, the PPV for any dermatologic event recorded as the primary diagnosis at hospitalization or at an emergency room visit was high and acceptable for epidemiologic research in the Danish and Swedish national patient registries. The PPV was substantially lower for hypersensitivity leading to hospitalization or emergency room visit.

  2. IBC's 23rd Annual Antibody Engineering, 10th Annual Antibody Therapeutics international conferences and the 2012 Annual Meeting of The Antibody Society: December 3-6, 2012, San Diego, CA.

    PubMed

    Klöhn, Peter-Christian; Wuellner, Ulrich; Zizlsperger, Nora; Zhou, Yu; Tavares, Daniel; Berger, Sven; Zettlitz, Kirstin A; Proetzel, Gabriele; Yong, May; Begent, Richard H J; Reichert, Janice M

    2013-01-01

    The 23rd Annual Antibody Engineering, 10th Annual Antibody Therapeutics international conferences, and the 2012 Annual Meeting of The Antibody Society, organized by IBC Life Sciences with contributions from The Antibody Society and two Scientific Advisory Boards, were held December 3-6, 2012 in San Diego, CA. The meeting drew over 800 participants who attended sessions on a wide variety of topics relevant to antibody research and development. As a prelude to the main events, a pre-conference workshop held on December 2, 2012 focused on intellectual property issues that impact antibody engineering. The Antibody Engineering Conference was composed of six sessions held December 3-5, 2012: (1) From Receptor Biology to Therapy; (2) Antibodies in a Complex Environment; (3) Antibody Targeted CNS Therapy: Beyond the Blood Brain Barrier; (4) Deep Sequencing in B Cell Biology and Antibody Libraries; (5) Systems Medicine in the Development of Antibody Therapies/Systematic Validation of Novel Antibody Targets; and (6) Antibody Activity and Animal Models. The Antibody Therapeutics conference comprised four sessions held December 4-5, 2012: (1) Clinical and Preclinical Updates of Antibody-Drug Conjugates; (2) Multifunctional Antibodies and Antibody Combinations: Clinical Focus; (3) Development Status of Immunomodulatory Therapeutic Antibodies; and (4) Modulating the Half-Life of Antibody Therapeutics. The Antibody Society's special session on applications for recording and sharing data based on GIATE was held on December 5, 2012, and the conferences concluded with two combined sessions on December 5-6, 2012: (1) Development Status of Early Stage Therapeutic Antibodies; and (2) Immunomodulatory Antibodies for Cancer Therapy.

  3. Jupiter Night and Day

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Day and night side narrow angle images taken on January 1, 2001 illustrating storms visible on the day side which are the sources of visible lightning when viewed on the night side. The images have been enhanced in contrast. Note the two day-side occurrences of high clouds, in the upper and lower parts of the image, are coincident with lightning storms seen on the darkside. The storms occur at 34.5 degrees and 23.5 degrees North latitude, within one degree of the latitudes at which similar lightning features were detected by the Galileo spacecraft. The images were taken at different times. The storms' longitudinal separation changes from one image to the next because the winds carrying them blow at different speeds at the two latitudes.

  4. Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management.

    PubMed

    Good, Marion; Albert, Jeffrey M; Arafah, Baha; Anderson, Gene Cranston; Wotman, Stephen; Cong, Xiaomei; Lane, Deforia; Ahn, Sukhee

    2013-07-01

    The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications. The present study was designed to determine whether two interventions, patient teaching (PT) for pain management and relaxation/music (RM), reduced cortisol levels, an indicator of stress, following abdominal surgery. Patients (18-75 years) were randomly assigned to receive PT, RM, a combination of the two, or usual care; the 205 patients with both pre- and posttest cortisol values were analyzed. A 2 × 2 factorial design was used to compare groups for PT effects and RM effects. Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2. Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay. Comparisons using analysis of covariance (ANCOVA), controlling for baseline levels, showed no PT effect or RM effect on cortisol in the morning or afternoon. Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group. Although in previous studies, RM reduced pain and music reduced cortisol on Day 1, in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2. The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day.

  5. Increased Risk of Postthoracotomy Pain Syndrome in Patients with Prolonged Hospitalization and Increased Postoperative Opioid Use

    PubMed Central

    Jacob, Adam K.; Passe, Melissa A.; Mantilla, Carlos B.

    2016-01-01

    Background. Postthoracotomy pain syndrome (PTPS) is unfortunately very common following thoracotomy and results in decreased quality of life. The purpose of this retrospective study was to determine perioperative patient, surgical, and analgesic characteristics associated with the development of PTPS. Methods. Sixty-six patients who presented to the Mayo Clinic Rochester Pain Clinic were diagnosed with PTPS 2 months or more after thoracotomy with postoperative epidural analgesia. These patients were matched with sixty-six control patients who underwent thoracotomy with postoperative epidural analgesia and were never diagnosed with PTPS. Results. Median (IQR) hospital stay was significantly different between control patients (5 days (4, 6)) compared with PTPS patients (6 days (5, 8)), P < 0.02. The total opioid equivalent utilized in oral morphine equivalents in milligrams for the first three days postoperatively was significantly different between control patients and PTPS patients. The median (IQR) total opioid equivalent utilized was 237 (73, 508) for controls and 366 (116, 874) for PTPS patients (P < 0.005). Conclusion. Patients with a prolonged hospital stay after thoracotomy were at an increased risk of developing PTPS, and this is a novel finding. Patients who utilize higher oral morphine equivalents for the first 3 days were also at increased risk for PTPS. PMID:27340565

  6. Negative oncologic impact of poor postoperative pain control in left-sided pancreatic cancer

    PubMed Central

    Min, Eun-Ki; Chong, Jae Uk; Hwang, Ho Kyoung; Pae, Sang Joon; Kang, Chang Moo; Lee, Woo Jung

    2017-01-01

    AIM To investigate the association between postoperative pain control and oncologic outcomes in resected pancreatic ductal adenocarcinoma (PDAC). METHODS From January 2009 to December 2014, 221 patients were diagnosed with PDAC and underwent resection with curative intent. Retrospective review of the patients was performed based on electronic medical records system. One patient without records of numerical rating scale (NRS) pain intensity scores was excluded and eight patients who underwent total pancreatectomy were also excluded. NRS scores during 7 postoperative days following resection of PDAC were reviewed along with clinicopathologic characteristics. Patients were stratified into a good pain control group and a poor pain control group according to the difference in average pain intensity between the early (POD 1, 2, 3) and late (POD 5, 7) postoperative periods. Cox-proportional hazards multivariate analysis was performed to determine association between postoperative pain control and oncologic outcomes. RESULTS A total of 212 patients were dichotomized into good pain control group (n = 162) and poor pain control group (n = 66). Median follow-up period was 17 mo. A negative impact of poor postoperative pain control on overall survival (OS) was observed in the group of patients receiving distal pancreatectomy (DP group; 42.0 mo vs 5.0 mo, P = 0.001). Poor postoperative pain control was also associated with poor disease-free survival (DFS) in the DP group (18.0 mo vs 8.0 mo, P = 0.001). Patients undergoing pancreaticoduodenectomy or pylorus-preserving pancreaticoduodenectomy (PD group) did not show associations between postoperative pain control and oncologic outcomes. Poor patients’ perceived pain control was revealed as an independent risk factor of both DFS (HR = 4.157; 95%CI: 1.938-8.915; P < 0.001) and OS (HR = 4.741; 95%CI: 2.214-10.153; P < 0.001) in resected left-sided pancreatic cancer. CONCLUSION Adequate postoperative pain relief during the early

  7. Impact of hypertonic saline on postoperative complications for patients undergoing upper gastrointestinal surgery

    PubMed Central

    Hong, Siqi; Shang, Qingjuan; Geng, Qiankun; Yang, Yang; Wang, Yan; Guo, Chunbao

    2017-01-01

    Abstract The aim of this study was to explore the impact of 3% hypertonic saline (HS) intragastric administration for patients who underwent upper gastrointestinal surgery. During the postoperative period, 3% HS has been suggested as a means to improve the intestinal edema and reduce gastrointestinal complications. The medical records of 111 patients with HS intragastric administration following upper gastrointestinal surgery and 268 patients, served as control, were reviewed retrospectively. Propensity score matching was performed to adjust for selected baseline variables. Clinical outcomes, including early gastrointestinal function recovery, postoperative complications, and length of hospital stay, were compared according to the HS intragastric administration or not. HS intragastric administration was associated with prompt postoperative gastrointestinal function recovery, including first flatus (risk ratio [RR], 1.32; 95% confidence interval [CI], 0.89–1.65; P = 0.048) and feeding within 3 postoperative days (RR (95% CI), 0.57 (0.49–0.77); P = 0.036). Early ileus occurred in 25 of 108 patients with HS treatment versus 36 of 108 patients without HS treatment (RR (95% CI), 1.43 (0.63–2.15); P = 0.065). The patients with HS experienced a lower overall postoperative complication (odds ratio [OD] 0.57; 95% CI, 0.33–1.09; P = 0.063), including trend toward a decrease for infectious complications (15[13.9] vs 23[21.3]; P = 0.11; OD, 0.59; 95% CI, 0.29–1.22). There was a decreased incidence of anastomotic leakage (1[0.9] vs 7[6.5]; P = 0.033) and postoperative ileuas (5[4.6%] vs 11[10.2%]; P = 0.096) in the HS administration patients. Our study demonstrated beneficial postoperative clinical effects of HS intragastric administration in patients who had undergone upper gastrointestinal surgery, such as prompt postoperative gastrointestinal function recovery and reduced overall postoperative complications, which may be attributed to a

  8. Postoperative complications after thoracic surgery for lung cancer.

    PubMed

    Maugeri, Laura; Corbo, Giuseppe Maria; Valente, Salvatore

    2004-01-01

    Postoperative complications and related risk factors after lung reduction surgery are analyzed based on a review of the literature. In particular the pathogenesis of some of postoperative respiratory disorders is carefully assessed. Most commonly cardiac arrhythmias, respiratory failure, bronchopleural fistula are observed. Main risk factors for postoperative complications are old age, chronic obstructive pulmonary disease, coronary disease, poor nutritional state, neoadjuvant therapy. Attention should be paid to all these factors, both in preoperative assessment and postoperative care, to prevent and promptly treat postoperative complications.

  9. 21-Day Content Screen

    EPA Pesticide Factsheets

    Under PRIA, EPA has 21 days after it receives the pesticide application and the fee to conduct an initial screen of the application’s contents for completeness and for the applicant to make necessary corrections. This page provides the checklists we use.

  10. Day Care: Nutrition.

    ERIC Educational Resources Information Center

    Foster, Florence P.; And Others

    This collection of 12 short, bilingual papers on nutrition and preschool children is part of a series of papers on various aspects of day care published by the Canadian Department of Health and Welfare. Each paper is presented in both English and French. Topics dealt with include an overview of children's nutritional needs; development of…

  11. 90-Day Cycle Handbook

    ERIC Educational Resources Information Center

    Park, Sandra; Takahashi, Sola

    2013-01-01

    90-Day Cycles are a disciplined and structured form of inquiry designed to produce and test knowledge syntheses, prototyped processes, or products in support of improvement work. With any type of activity, organizations inevitably encounter roadblocks to improving performance and outcomes. These barriers might include intractable problems at…

  12. We Love Science Day.

    ERIC Educational Resources Information Center

    Kepler, Lynne

    1986-01-01

    Describes the goals and outcomes of the "We Love Science Day" programs that resulted from the inservice course, "Creative Integration of Science in Elementary Education" for Pennsylvania teachers. Provides samples of the hands-on activities that were offered to students, parents, and teachers. Includes a calendar of…

  13. Word of the Day

    ERIC Educational Resources Information Center

    Abrar-Ul-Hassan, Shahid

    2010-01-01

    Independent lexical development initiatives empower and equip language learners with skills to boost their lexical repertoires. Language instructors can train learners to be autonomous word learners. A sample activity, namely word of the day, is presented in this article. The activity is an independent lexical learning task, which aims to develop…

  14. Every Child, Every Day

    ERIC Educational Resources Information Center

    Allington, Richard L.; Gabriel, Rachael E.

    2012-01-01

    We know more now than we ever did before about how to make every child a successful reader, write Allington and Gabriel in this research review. Yet, few students regularly receive the best reading instruction we know how to give. The authors present research supporting their recommendation that every child, every day, should (1) read something he…

  15. Make a Splash Day

    ERIC Educational Resources Information Center

    Coverdale, Greg; Rust, April; Jensen, Belinda

    2004-01-01

    At the annual, all-day events-sponsored by Project WET (Water Education for Teachers) and held in nearly every state across the country each September--students participate in interactive activities and exhibits to learn about water resources and explore how human behaviors, such as development and recreation, can affect the quality of the…

  16. Sun-Earth Day

    NASA Technical Reports Server (NTRS)

    2007-01-01

    Michael Sandras, a member of the Pontchartrain Astronomical Society, explains his solar telescope to students of Second Street in Bay St. Louis, Hancock County and Nicholson elementary schools in StenniSphere's Millennium Hall on April 10. The students participated in several hands-on activities at Stennis Space Center's Sun-Earth Day celebration.

  17. An Earth Day Reader.

    ERIC Educational Resources Information Center

    Moser, Don, Ed.

    1990-01-01

    Presents what the author believes to be some of the most important environmental books published since Earth Day 1970. Discusses each selection and how it provides the historical background, basic information, and appreciation necessary to understand the character of our environmental dilemma and our need to address it. (MCO)

  18. First Day of School

    ERIC Educational Resources Information Center

    Bort, Nancy

    2004-01-01

    In this brief article, the author, a science teacher at F. C. Hammond Middle School in Alexandria, Virginia, describes how the setting up of a simple science experiment on the first day of school can get students excited about learning science. The experiment involves heating a small amount of water in a flask, then covering the opening of the…

  19. One Play a Day

    ERIC Educational Resources Information Center

    Blankenship, Mark

    2007-01-01

    Undergraduate theater students rarely get the chance to work on a major world premiere, but this year hundreds of them will. Currently, more than 70 colleges and universities are participating in "365 Days/365 Plays," an ambitious project from Pulitzer Prize-winning playwright Suzan-Lori Parks. Every week, as they mount their portion of this epic…

  20. Fabulous Weather Day

    ERIC Educational Resources Information Center

    Marshall, Candice; Mogil, H. Michael

    2007-01-01

    Each year, first graders at Kensington Parkwood Elementary School in Kensington, Maryland, look forward to Fabulous Weather Day. Students learn how meteorologists collect data about the weather, how they study wind, temperature, precipitation, basic types/characteristics of clouds, and how they forecast. The project helps the students grow in…

  1. Oxidative Stress Biomarkers and Incidence of Postoperative Atrial Fibrillation in the Omega-3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) Trial

    PubMed Central

    Wu, Jason H Y; Marchioli, Roberto; Silletta, Maria G; Masson, Serge; Sellke, Frank W; Libby, Peter; Milne, Ginger L; Brown, Nancy J; Lombardi, Federico; Damiano, Ralph J; Marsala, Joann; Rinaldi, Mauro; Domenech, Alberto; Simon, Caterina; Tavazzi, Luigi; Mozaffarian, Dariush

    2015-01-01

    Background Animal study results point to oxidative stress as a key mechanism triggering postoperative atrial fibrillation (PoAF), yet the extent to which specific biomarkers of oxidative stress might relate to PoAF risk in humans remains speculative. Methods and Results We assessed the association of validated, fatty acid–derived oxidative stress biomarkers (F2-isoprostanes, isofurans, and F3-isoprostanes) in plasma and urine, with incident PoAF among 551 cardiac surgery patients. Biomarkers were measured at enrollment, the end of surgery, and postoperative day 2. PoAF lasting ≥30 seconds was confirmed with rhythm strip or electrocardiography and centrally adjudicated. Outcomes were assessed until hospital discharge or postoperative day 10, whichever occurred first. Urine level of each oxidative stress biomarker rose at the end of surgery (2- to 3-fold over baseline, P<0.001) and subsequently declined to concentrations comparable to baseline by postoperative day 2. In contrast, plasma concentrations remained relatively stable throughout the perioperative course. Urine F2-isoprostanes and isofurans at the end of surgery were 20% and 50% higher in subjects who developed PoAF (P≤0.009). While baseline biomarker levels did not associate significantly with PoAF, end of surgery and postoperative day 2 isoprostanes and isofurans demonstrated relatively linear associations with PoAF. For example, the end of surgery extreme quartile multivariate adjusted OR (95% CI) for urine isofurans and F3-isoprostanes were 1.95 (1.05 to 3.62; P for trend=0.01) and 2.10 (1.04 to 2.25, P for trend=0.04), respectively. The associations of biomarkers with PoAF varied little by demographics, surgery type, and medication use (P≥0.29 for each). Conclusions These novel results add to accumulating evidence supporting the likely key pathogenic role of elevated oxidative stress in PoAF. Clinical Trial Registration URL: Clinicaltrials.gov Unique identifier: NCT00970489. PMID:25994442

  2. [Readaptation after total intravenous anesthesia in one-day surgery].

    PubMed

    Buravtsev, V A; Medvinskiĭ, I D

    1997-01-01

    The authors analyze the stages of readaptation and recovery of clear consciousness in the immediate postoperative period in 200 patients administered one of the four variants of intravenous anesthesia in a one-day surgical hospital. The purpose of this work was to optimize the anesthetic care and the readaptation period. The stages of readaptation were assessed by psychophysiological testing. This process coursed most smoothly after propofol-phentanyl and hypnomidate-phentanyl anesthesia. Readaptation after sombrevin-phentanyl coursed reliably slower. The longest recovery was observed after calipsol-diazepam anesthesia, despite drug stimulation. This type of narcosis is irrational for one-day surgery, for it requires prolonged postoperative monitoring and thus makes the hospital stay longer.

  3. The Postoperative Pain Assessment Skills pilot trial

    PubMed Central

    McGillion, Michael; Dubrowski, Adam; Stremler, Robyn; Watt-Watson, Judy; Campbell, Fiona; McCartney, Colin; Victor, J Charles; Wiseman, Jeffrey; Snell, Linda; Costello, Judy; Robb, Anja; Nelson, Sioban; Stinson, Jennifer; Hunter, Judith; Dao, Thuan; Promislow, Sara; McNaughton, Nancy; White, Scott; Shobbrook, Cindy; Jeffs, Lianne; Mauch, Kianda; Leegaard, Marit; Beattie, W Scott; Schreiber, Martin; Silver, Ivan

    2011-01-01

    BACKGROUND/OBJECTIVES: Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs’ assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method – deteriorating patient-based simulation (DPS) – versus SPs for improving HCPs’ pain knowledge and assessment skills. METHODS: Seventy-two HCPs were randomly assigned to a 3 h SP or DPS simulation intervention. Measures were recorded at baseline, immediate postintervention and two months postintervention. The primary outcome was HCPs’ pain assessment performance as measured by the postoperative Pain Assessment Skills Tool (PAST). Secondary outcomes included HCPs knowledge of pain-related misbeliefs, and perceived satisfaction and quality of the simulation. These outcomes were measured by the Pain Beliefs Scale (PBS), the Satisfaction with Simulated Learning Scale (SSLS) and the Simulation Design Scale (SDS), respectively. Student’s t tests were used to test for overall group differences in postintervention PAST, SSLS and SDS scores. One-way analysis of covariance tested for overall group differences in PBS scores. RESULTS: DPS and SP groups did not differ on post-test PAST, SSLS or SDS scores. Knowledge of pain-related misbeliefs was also similar between groups. CONCLUSIONS: These pilot data suggest that DPS is an effective simulation alternative for HCPs’ education on postoperative pain assessment, with improvements in performance and knowledge comparable with SP-based simulation. An equivalence trial to examine the effectiveness of deteriorating patient-based simulation versus standardized patients is warranted. PMID:22184553

  4. Effectiveness of postoperative intravenous acetaminophen (Acelio) after gastrectomy: A propensity score-matched analysis.

    PubMed

    Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

    2016-11-01

    The aim of this study was to investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance recovery after gastrectomy.Opioid use is reportedly associated with delayed recovery of gastrointestinal (GI) peristalsis and postoperative nausea/vomiting (PONV) despite of acceptable efficacy for pain control.Of 147 and 96 consecutive patients who underwent gastrectomy for gastric cancer before and after introduction of postoperative scheduled intravenous acetaminophen, propensity score matched population was created and short-term clinical outcomes were compared.Significant defervescence was demonstrated in Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (P < 0.001), whereas no significant difference was observed in postoperative inflammatory parameters. The incidence of postoperative complications was similar between the groups. The number of patient-controlled analgesia (PCA) pushes was significantly reduced in the A-group (P = 0.007) and the frequency of use of other nonopioid analgesics was also significantly reduced in the A-group (P < 0.001). Both daily and cumulative opioid use was significantly reduced in the A-group (P < 0.001). The time to first flatus and defecation was decreased in the A-group (P < 0.001 and P = 0.038, respectively). The incidence of PONV was significantly reduced from 26.0% to 12.5% after introduction of intravenous acetaminophen (P = 0.017), and hospital stay tended to be decreased in the A-group (13.2 vs 14.7 days, P = 0.069)Postoperative scheduled intravenous acetaminophen decreased opioid use and may be associated with enhanced recovery after gastrectomy.

  5. Predictive Role of Intraoperative Plasma Fibrinogen for Postoperative Portal Venous Flow in Living Donor Liver Transplantation.

    PubMed

    Chae, Min Suk; Park, Chul Soo; Oh, Su A; Hong, Sang Hyun

    2017-02-14

    BACKGROUND Previous studies have reported poor graft regeneration after living donor liver transplantation (LDLT) due to inappropriate portal venous flow (PVF). In this study, we investigated the perioperative factors affecting postoperative PVF after LDLT. MATERIAL AND METHODS The perioperative data of 366 LDLT patients were retrospectively reviewed. The average PVF on postoperative days 1, 3, and 5 was measured and dichotomized at a cut-off value for patient survival of 1,477 mL/min. Perioperative variables, including coagulation profiles, were compared between high and low postoperative PVF groups. The factors potentially significant (p<0.1) for a low postoperative PVF were evaluated in a univariate analysis, followed by the development of a predictive model for a low postoperative PVF. RESULTS A low post-LDLT PVF was determined in 113 patients (30.9%). The univariate analysis identified systemic hypertension, LDLT duration, average mean blood pressure, and insulin administration as the significantly related factors. Other significant factors were a plasma fibrinogen, at the anhepatic phase and 1 h after graft reperfusion, as well as the platelet count at the anhepatic phase. After multivariate adjustment, plasma fibrinogen 1 h after graft reperfusion against a recipient background of systemic hypertension was independently associated with a low mean postoperative PVF. CONCLUSIONS A low mean PVF during the early post-LDLT period was independently related to the plasma fibrinogen level 1 h after graft reperfusion, and to a history of systemic hypertension. Thus, the practice of aggressive supplementation of plasma fibrinogen during the immediate post-reperfusion period merits serious consideration.

  6. Incidence, Predictors, and Impact of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Military Veterans

    PubMed Central

    Cornwell, Lorraine D.; Bakshi, Ankur; Rachlin, Eric; Preventza, Ourania; Rosengart, Todd K.; Coselli, Joseph S.; LeMaire, Scott A.; Petersen, Nancy J.; Pattakos, Greg; Bakaeen, Faisal G.

    2016-01-01

    Little is known about the frequency and clinical implications of postoperative atrial fibrillation in military veterans who undergo coronary artery bypass grafting (CABG). We examined long-term survival data, clinical outcomes, and associated risk factors in this population. We retrospectively reviewed baseline, intraoperative, and postoperative data from 1,248 consecutive patients with similar baseline risk profiles who underwent primary isolated CABG at a Veterans Affairs hospital from October 2006 through March 2013. Multivariable logistic regression identified predictors of postoperative atrial fibrillation. Kaplan-Meier analysis was used to evaluate long-term survival (the primary outcome measure), morbidity, and length of hospital stay. Postoperative atrial fibrillation occurred in 215 patients (17.2%). Independent predictors of this sequela were age ≥65 years (odds ratios [95% confidence intervals], 1.7 [1.3–2.4] for patients of age 65–75 yr and 2.6 [1.4–4.8] for patients >75 yr) and body mass index ≥30 kg/m2 (2.0 [1.2–3.2]). Length of stay was longer for patients with postoperative atrial fibrillation than for those without (12.7 ± 6.6 vs 10.3 ± 8.9 d; P ≤0.0001), and the respective 30-day mortality rate was higher (1.9% vs 0.4%; P=0.014). Seven-year survival rates did not differ significantly. Older and obese patients are particularly at risk of postoperative atrial fibrillation after CABG. Patients who develop the sequela have longer hospital stays than, but similar long-term survival rates to, patients who do not. PMID:27777519

  7. The role of age and comorbidities in postoperative outcome of mitral valve repair

    PubMed Central

    Bonnet, Vincent; Boisselier, Clément; Saplacan, Vladimir; Belin, Annette; Gérard, Jean-Louis; Fellahi, Jean-Luc; Hanouz, Jean-Luc; Fischer, Marc-Olivier

    2016-01-01

    Abstract The average age of patients undergoing mitral valve repair is increasing each year. This retrospective study aimed to compare postoperative complications of mitral valve repair (known to be especially high-risk) between 2 age groups: under and over the age of 80. Patients who underwent mitral valve repair were divided into 2 groups: group 1 (<80 years old) and group 2 (≥80 years old). Baseline characteristics, pre- and postoperative hemodynamic data, surgical characteristics, and postoperative follow-up data until hospital discharge were collected. A total of 308 patients were included: 264 in group 1 (age 63 ± 13 years) and 44 in group 2 (age 83 ± 2 years). Older patients had more comorbidities (atrial fibrillation, history of cardiac decompensation, systemic hypertension, pulmonary hypertension, and chronic kidney disease) and they presented more postoperative complications (50.0% vs 33.7%; P = 0.043), with a longer hospital stay (8.9 ± 6.9 vs 6.6 ± 4.6 days; P = 0.005). To assess the burden of age, a propensity score was awarded to postoperative complications. Active smoking, chronic pulmonary disease, chronic kidney disease, associated ischemic heart disease, obesity, and cardio pulmonary by-pass duration were described as independent risk factors. When matched on this propensity score, there was no difference in morbidity or mortality between group 1 and group 2. Older patients suffered more postoperative complications, which were related to their comorbidities and not only to their age. PMID:27336886

  8. Rethinking Science and Technology Education To Meet the Demands of Future Generations in a Changing World. International Organization for Science and Technology Education (IOSTE) Symposium Proceedings (10th, Foz do Iguacu, Parana, Brazil, July 28-August 2, 2002). Volumes I [and] II.

    ERIC Educational Resources Information Center

    Bizzo, Nelio, Ed.; Kawasaki, Clarice Sumi, Ed.; Ferracioli, Laercio, Ed.; Leyser da Rosa, Vivian, Ed.

    This document is the proceedings of the 10th annual meeting of the International Organization for Science and Technology Education (IOSTE). Papers include: (1) "Liberal Education, Information Assessment and Argumentation in Science-LIA" (Andreas Quale, Anders Isnes, Terje Kristensen, and Ketil Mathiassen); (2) "Placing the History…

  9. PIALA 2000: Libraries and Archives--Where Information and Language Literacy Begin [and] Engaged Readers and Writers in Multicultural Island Communities. Selected Papers from the 10th Pacific Islands Association of Libraries and Archives Conference Joint with the 13th Annual Regional Language Arts Conference (Tumon, Guam, November 9-11, 2000)

    ERIC Educational Resources Information Center

    Cohen, Arlene, Ed.; Quan, Clarisa G., Ed.

    2004-01-01

    This proceedings combines presentations from the jointly held 10th Annual PIALA 2000 Conference and the 13th Annual Regional Language Arts Conference. The volume begins with the welcoming remarks of Mary L. Silk, Christine Ku Scott-Smith, Antonio R. Umpingco, Delia Munoz Rosal, Lawrence Kasperbauer, Rosie Tainatongo, Richard S. Tom, Mary L.…

  10. [Postoperative radiation therapy in lung carcinom].

    PubMed

    Bouchaab, H; Peters, S; Ozsahin, M; Peguret, N; Gonzales, M; Lovis, A

    2014-05-21

    Locally advanced non-small-cell lung carcinoma (NSCLC) is a very heterogeous disease, the role of postoperative radiation therapy (PORT) in pN2 patients with completly resected NSCLC remains controversial. Although an improvment in local control has been described in several studies, the effect on survival has been contradictory or inconclusive. Retrospective evaluation suggest a positive effect of PORT in high risk patients with pN2 disease: RI-resected NSCLC, bulky and multilevel N2. However further evaluation of PORT in prospectively randomized studies in completely resected pN2 NSCLC is needed.

  11. Kindergarten Evaluation Study: Full-Day Alternate Day Programs.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Education, St. Paul.

    In this evaluation study, two groups of children who attended kindergarten either one-half day every day or full-day on alternate days were compared. An opinion survey was conducted to obtain the observations of parents, kindergarten teachers, and elementary principals in relation to the all-day alternate day schedule in 55 school districts. Data…

  12. Flight Day 2 Highlights

    NASA Technical Reports Server (NTRS)

    2003-01-01

    The STS-107 second flight day begins with a shot of the Spacehab Research Double Module. Live presentations of experiments underway inside of the Spacehab Module are presented. Six experiments are shown. As part of the Space Technology and Research Student Payload, students from Australia, China, Israel, Japan, New York, and Liechtenstein are studying the effect that microgravity has on ants, spiders, silkworms, fish, bees, granular materials, and crystals. Mission Specialist Kalpana Chawla is seen working with the zeolite crystal growth experiment.

  13. Microgravity Day for Educators

    NASA Technical Reports Server (NTRS)

    2001-01-01

    The arnual conference for the Educator Resource Center Network (ERCN) Coordinators was held at Glenn Research Center at Lewis Field in Cleveland, Ohio. The conference included participants from NASA's Educator Resource Centers located throughout the country. The Microgravity Science Division at Glenn sponsored a Microgravity Day for all the conference participants. Kathy Higgins of the National Center for Microgravity Research at GRC explains educational resources to teachers. This image is from a digital still camera; higher resolution is not available.

  14. Preoperative use of incentive spirometry does not affect postoperative lung function in bariatric surgery.

    PubMed

    Cattano, Davide; Altamirano, Alfonso; Vannucci, Andrea; Melnikov, Vladimir; Cone, Chelsea; Hagberg, Carin A

    2010-11-01

    Morbidly obese patients undergoing general anesthesia for laparoscopic bariatric surgery are considered at increased risk of a postoperative decrease in lung function. The purpose of this study was to determine whether a systematic use of incentive spirometry (IS) prior to surgery could help patients to preserve their respiratory function better in the postoperative period. Forty-one morbidly obese (body mass index [BMI] > 40 kg/m²) candidates for laparoscopic bariatric surgery were consented in the study. All patients were taught how to use an incentive spirometer but then were randomized blindly into 2 groups. The control group was instructed to use the incentive spirometer for 3 breaths, once per day. The treatment group was requested to use the incentive spirometer for 10 breaths, 5 times per day. Twenty experimental (mean BMI of 48.9 ± 5.67 kg/m²) and 21 control patients (mean BMI of 48.3 ± 6.96 kg/m²) were studied. The initial mean inspiratory capacity (IC) was 2155 ± 650.08 (SD) cc and 2171 ± 762.98 cc in the experimental and control groups, respectively. On the day of surgery, the mean IC was 2275 ± 777.56 cc versus 2254.76 ± 808.84 cc, respectively. On postoperative day 1, both groups experienced a significant drop of their IC, with volumes of 1458 ± 613.87 cc (t test P < 0.001) and 1557.89 ± 814.67 cc (t test P < 0.010), respectively. Our results suggest that preoperative use of the IS does not lead to significant improvements of inspiratory capacity and that it is a not a useful resource to prevent postoperative decrease in lung function.

  15. [Bacteriological profile and antibiotic treatment of postoperative peritonitis].

    PubMed

    Missaoui, K; Marzougui, Y; Kouka, J; Dhibi, Y; Hannachi, Z; Dziri, C; Houissa, M

    2014-01-01

    During the postoperative peritonitis (PPO) the main stay of treatment is the choice of probabilistic antibiotictherapy, it is also the main prognostic factor The aim of our study was to identify anappropriate antibiotic protocol to the current ecology of our unit. It was a retrospective study including 102 patients over a period of 09 years from 1 January 2003 to 3O November 2011. All of them are supported for the treatments off postoperative peritonitis in surgical intensive care unit of a service of general surgery a university hospital Charles Nicolle of Tunis. All bacteriological data (germs and sensitivity), and the terms of therapeutic modality for the empirical antibiotic therapy were listed. The incidence of PPO was Q90%.The average age of our patients was 57 +/- 18 years. The sex ratio was 1.08. One hundred and seven (107) microorganisms were isolated from 72 samples (44 microbial mono, 28 multi microbial). The frequency of gram-positive cocci (GPC) was 16.82%, the Gram-negative bacilli (BGN) was 82.2%. The Enterobacteriaceae have proved particularity resistant. Thus, the ampicillin resistance was 87.14%, that the C3G was 33.80%, the Piperacillin to Tazobactam combination, was 36.5% and that the association Ticarcillin-clavulanic acid was 43.6%. For non-fermenting BGN, Pseudomonas aeruginosa was sensitive to ticarcillin in 80% of cases, to ceftazidime in 66.6% of cases, PiperacillinTazobactam--in 71.43% of cases, imipenem in 85 72% of cases, colimycin in 100% of cases and Amiklin in 71.43% of cases. For CGP, enterococci were resistant to ampicillin in 50% of cases and vancomycin in 0% of cases. The majority of patients received triple antibiotic therapy (59.8%) or combination therapy (34.3%). The main associations were: cefotaxime + Gentamycin + Metronidazole (35.2%), Amikacin Imipenem + + Metronidazole (12.7%), Imipenem + amikacin (9.8%), Piperacillin / Tazobactam + amikacin (9.8%) + amikacin and ertapenem (5.88%). Probabilitic antibiotic therapy was

  16. PEarly Postoperative Emergency Department Care of Abdominal Transplant Recipients1

    PubMed Central

    McElroy, Lisa M.; Schmidt, Kathryn A.; Richards, Christopher T.; Lapin, Brittany; Abecassis, Michael M.; Holl, Jane L.; Adams, James; Ladner, Daniela P.

    2015-01-01

    Background Research on post-transplant care has predominantly focused on predictors of readmission with little attention to emergency department (ED) visits. The goal of this study was to describe early postoperative ED care of transplant recipients. Methods A secondary database analysis of adult patients who underwent abdominal organ transplantation between January 1, 2008 and December 31, 2013 and sought ED care within one year post-transplantation was conducted. Survival was compared using the Kaplan-Meier method with log-rank test. Cox proportional hazards regression analysis was performed to adjust for pertinent covariates. Results A total of 1,900 abdominal organ transplants were performed during the study period. Of these, 37% (N=711) transplant recipients sought care in the ED (1,343 total visits) with 1.89 mean ED visits per recipient. Of recipients seen in the ED, 58% received a kidney transplant and 28% received a liver transplant, with 45% of recipients presenting within the first 60 postoperative days. The most common chief complaints were gastroenterological (17%) and abnormal laboratory values or vital signs (17%). In total, 74% of recipients were readmitted and 50% of admitted patients were discharged in less than 24 hours. Transplant recipients with ED visits had lower 3-year graft (81% vs. 87%; p<0.001) and patient (89% vs. 93%; p=0.002) survival. Conclusion Transplant recipients have a high frequency of ED visits in the first post-transplantation year and high rates of subsequent hospital admission. Further investigation is needed to understand what drives recipient presentation to the ED and create care models that achieve the best outcomes. PMID:26050012

  17. Postoperative cognitive changes after total knee arthroplasty under regional anesthesia

    PubMed Central

    Jeon, Young-Tae; Kim, Byung-Gun; Park, Young Ho; Sohn, Hye-Min; Kim, Jungeun; Kim, Seung Chan; An, Seong Soo; Kim, SangYun

    2016-01-01

    Abstract Background: The type of postoperative cognitive decline after surgery under spinal anesthesia is unknown. We investigated the type of postoperative cognitive decline after total knee arthroplasty (TKA). Neuropsychological testing was conducted and the changes in cerebrospinal fluid (CSF) biomarkers after surgery were evaluated. Methods: Fifteen patients who required bilateral TKA at a 1-week interval under spinal anesthesia were included. Neuropsychological tests were performed twice, once the day before the first operation and just before the second operation (usually 1 week after the first test) to determine cognitive decline. Validated neuropsychological tests were used to examine 4 types of cognitive decline: memory, frontal-executive, language-semantic, and others. Concentrations of CSF amyloid peptide, tau protein, and S100B were measured twice during spinal anesthesia at a 1-week interval. The patients showed poor performance in frontal-executive function (forward digit span, semantic fluency, letter-phonemic fluency, and Stroop color reading) at the second compared to the first neuropsychological assessment. Results: S100B concentration decreased significantly 1 week after the operation compared to the basal value (638 ± 178 vs 509 ± 167 pg/mL) (P = 0.019). Amyloid protein β1–42, total tau, and phosphorylated tau concentrations tended to decrease but the changes were not significant. Conclusion: Our results suggest that frontal-executive function declined 1 week after TKA under spinal anesthesia. The CSF biomarker analysis indicated that TKA under regional anesthesia might not cause neuronal damage. PMID:28033253

  18. Surgically placed abdominal wall catheters on postoperative analgesia and outcomes after living liver donation.

    PubMed

    Khan, James; Katz, Joel; Montbriand, Janice; Ladak, Salima; McCluskey, Stuart; Srinivas, Coimbatore; Ko, Raynauld; Grant, David; Bradbury, Ashleene; LeManach, Yannick; Clarke, Hance

    2015-04-01

    Living donor liver resections are associated with significant postoperative pain. Epidural analgesia is the gold standard for postoperative pain management, although it is often refused or contraindicated. Surgically placed abdominal wall catheters (AWCs) are a novel pain modality that can potentially provide pain relief for those patients who are unable to receive an epidural. A retrospective review was performed at a single center. Patients were categorized according to their postoperative pain modality: intravenous (IV) patient-controlled analgesia (PCA), AWCs with IV PCA, or patient-controlled epidural analgesia (PCEA). Pain scores, opioid consumption, and outcomes were compared for the first 3 postoperative days. Propensity score matches (PSMs) were performed to adjust for covariates and to confirm the primary analysis. The AWC group had significantly lower mean morphine-equivalent consumption on postoperative day 3 [18.1 mg, standard error (SE)=3.1 versus 28.2 mg, SE=3.0; P=0.02] and mean cumulative morphine-equivalent consumption (97.2 mg, SE=7.2 versus 121.0 mg, SE=9.1; P=0.04) in comparison with the IV PCA group; the difference in cumulative-morphine equivalent remained significant in the PSMs. AWC pain scores were higher than those in the PCEA group and were similar to the those in the IV PCA group. The AWC group had a lower incidence of pruritus and a shorter hospital stay in comparison with the PCEA group and had a lower incidence of sedation in comparison with both groups. Time to ambulation, nausea, and vomiting were comparable among all 3 groups. The PSMs confirmed all results except for a decrease in the length of stay in comparison with PCEA. AWCs may be an alternative to epidural analgesia after living donor liver resections. Randomized trials are needed to verify the benefits of AWCs, including the safety and adverse effects.

  19. Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer.

    PubMed

    Li, B; Liu, H Y; Guo, S H; Sun, P; Gong, F M; Jia, B Q

    2015-06-29

    The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P < 0.05), anal exhaust time (78.8 ± 9.3 vs 85.3 ± 8.4 h, P < 0.05), and length of hospitalization (7.73 ± 2.13 vs 9.77 ± 1.76 days, P < 0.01) differed significantly. Treatment costs in thousands of dol-lars were 31.24 ± 3.21 for the experimental group and 35.61 ± 2.32 for the control group; this difference was statistically significant (P < 0.01). The incidence of postoperative complications did not significantly differ between the experimental and control groups [14.0% (21/150) vs 17.3% (26/150), P > 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P < 0.05). CD8(+) cell counts were significantly lower in the experimental group than the control group (P < 0.05). Postsurgical oral EEN can improve nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

  20. Preoperative platelet count and postoperative blood loss in patients undergoing hip surgery: an inverse correlation.

    PubMed

    Monreal, M; Lafoz, E; Llamazares, J; Roncales, J; Roca, J; Granero, X

    1996-01-01

    In a previous study we tried to assess the clinical usefulness of platelet count (PlC) to confirm whether postoperative pulmonary embolism could be suspected early. Unexpectedly, the 19 patients who subsequently developed pulmonary embolism had significantly lower mean PlC levels even before surgery. In an attempt to discover whether the preoperative PlC levels were associated with a different incidence of postoperative blood loss, we decided to retrospectively study the relationship between preoperative PlC levels and the consequences of blood loss. There were 459 consecutive patients undergoing hip surgery. After excluding 5 patients who died during the first 3 postoperative days, and 16 patients who bled from a definitive anatomic site, there were 438 patients. Blood loss was considered to be excessive when two or more of the following conditions were present: (1) total transfusion requirements exceeding 1,000 ml whole blood or 2 units of packed red cells; (2) a drop in hemoglobin level of 5 g/dl or more, and (3) a hemoglobin level below 8 g/dl at any moment during the first 8 postoperative days. Blood loss was considered to be excessive in 91 patients. Preoperative PlC levels were significantly lower in these patients as compared to patients without the condition (204 +/- 52 vs. 236 +/- 79 x 10(9) liter-1; p = 0.0002). When patients were classified according to the quartiles of preoperative PlC, the odds ratio of developing excessive blood loss was 0.69 (95% CI: 0.38-1.26) in patients in the second quartile; 0.57 (95% CI: 0.30-1.06) in the third quartile, and 0.27 (95% CI: 0.13-0.57) in patients in the highest quartile. After adjusting for age, sex, type of surgery and type of prophylaxis, the preoperative PlC levels maintained a statistically significant inverse correlation with postoperative blood loss.

  1. Dexmedetomidine improves early postoperative cognitive dysfunction in aged mice.

    PubMed

    Qian, Xiao-Lan; Zhang, Wei; Liu, Ming-Zheng; Zhou, Yu-Bing; Zhang, Jing-Min; Han, Li; Peng, You-Mei; Jiang, Jin-hua; Wang, Qing-Duan

    2015-01-05

    Postoperative cognitive dysfunction (POCD) is a frequent complication following major surgery in the elderly. However, the exact pathogenic mechanisms are still unknown. Dexmedetomidine, a selective alpha 2 adrenal receptor agonist, was revealed anesthesia and brain protective role. The present study aimed to examine whether dexmedetomdine protects against POCD induced by major surgical trauma under general anesthesia in aged mice. In the present study, cognitive function was assessed by Y-maze. Proinflammatory cytokines interleukin-1β (IL-1β) and tumor necrosis factor (TNF-α), apoptosis-related factor caspase-3 and Bax were detected by real-time PCR, Western blot or immunohistochemistry. The results showed that anesthesia alone caused weak cognitive dysfunction on the first day after general anesthesia. Cognitive function in mice with splenectomy under general anesthesia was significantly exacerbated at the first and third days after surgery, and was significantly improved by dexmedetomidine administration. Splenectomy increased the expression of IL-1β, TNF-α, Bax and caspase-3 in hippocampus. These changes were significantly inversed by dexmedetomidine. These results suggest that hippocampal inflammatory response and neuronal apoptosis may contribute to POCD, and selective alpha 2 adrenal receptor excitation play a protective role.

  2. EARLY POSTOPERATIVE COMPLICATIONS IN ROUX-EN-Y GASTRIC BYPASS

    PubMed Central

    STOLL, Aluisio; ROSIN, Leandro; DIAS, Mariana Fernandes; MARQUIOTTI, Bruna; GUGELMIN, Giovana; STOLL, Gabriela Fanezzi

    2016-01-01

    ABSTRACT Background: Roux-en-Y gastric bypass is one of the most common bariatric surgery and leads to considerable weight loss in the first months. Aim: To quantify the main early postoperative complications in patients submitted to the gastric bypass. Method: Observational retrospective cohort. Data of 1051 patients with class II obesity associated with comorbidities or class III obesity submitted to the gastric bypass with 30 days of follow-up starting from the date of the surgery. Results: The age average was 36 years with a predominance of females (81.1%). The mean preoperative body mass index was 43 kg/m². The major complication was fistula (2.3%), followed by intestinal obstruction (0.5%) and pulmonary embolism (0.5%). Death occurred in 0.6% of the cases. Conclusion: In the period of 30 days after surgery the overall complication rate was 3.8%; reoperation was necessary in 2.6% and death occurred in 0.6%. Fistula was the main complication and the leading cause of hospitalization in intensive care unit, reoperation and death. PMID:27683781

  3. [Postoperative findings in the spinal column].

    PubMed

    Lieb, J M; Ulmer, S; Kelm, J; Shariat, K; Stippich, C; Ahlhelm, F J

    2011-09-01

    Postoperative imaging after spinal surgery is usually performed to document the correct positioning of implants or to rule out complications if patients still suffer from pain after surgery. Depending on the question various imaging modalities can be used all of which have benefits and limitations. Conventional X-ray is used for the documentation of the correct positioning of spinal implants, stability (olisthesis) and during follow-up to rule out fractures or instability of the implants, whereas soft tissue changes cannot be completely assessed. Besides these indications, imaging is usually performed because of ongoing symptoms (pain for the most part) of the patients. Soft tissue changes including persistent or recurrent herniated disc tissue, hematoma or infection can best be depicted using magnetic resonance imaging (MRI) which should be performed within the immediate postoperative period to be able to distinguish physiological development of scar tissue from inflammatory changes in the area of the surgical approach. Often imaging alone cannot differentiate between these and imaging can therefore only be considered as an adjunct. Computed tomography is the modality of choice for the evaluation of bony structures and an adjunct of new therapies such as image-guided application of cement for kyphoplasty or vertebroplasty.

  4. [Postoperative management of hip and knee endoprostheses].

    PubMed

    Seitz, S; Rüther, W

    2012-10-01

    Rheumatoid arthritis is often accompanied by massive destruction of the smaller and larger joints even with early therapy using antirheumatic drugs. In these cases total joint arthroplasty is the only surgical option, especially for the knee and hip joint. Knowledge of the specific disease-related postoperative characteristics is a prerequisite for the successful treatment of patients with rheumatoid arthritis. As dislocation of the arthroplastic joint does not occur more often in rheumatoid arthritis, the risk of periprosthetic infection is increased due to the use of biologicals. Therefore, a perioperative optimization is obligatory. In order to facilitate independence in daily living physiotherapy in combination with aids such as arthritis crutches, gripping pliers or raised toilet seat need to be started as soon as possible after surgical treatment. To achieve this goal it is recommended to refer patients with inflammatory arthritis to inpatient rehabilitation facilities. With respect to the specific postoperative treatment after joint replacement the long-term results are comparable with those from patients with primary osteoarthritis.

  5. Postoperative Alterations in Taste and Smell

    PubMed Central

    Elterman, Kelly Galina; Mallampati, Seshagiri Rao; Kaye, Alan David; Urman, Richard Dennis

    2014-01-01

    Context: Alterations in taste and smell, including but not limited to anosmia, ageusia, hypogeusia, and dysgeusia, have been described in association with various medications, including anesthetic agents. Frequently, these symptoms occur 1-2 weeks after medication administration and last several months. While such a phenomenon is a rare occurrence, it nonetheless can significantly impact patients’ satisfaction and quality of life. Evidence Acquisition: The methodology consisted of a thorough literature search using the MEDLINE and Cochrane databases utilizing keywords such as anosmia, ageusia, olfactory disorders, postoperative, and anesthesia. Results: Our results yielded several previously published case report, and were not limited to a specific type of anesthesia. Based on available literature, we review the physiology of taste and smell as well as the medications associated with loss of these senses. We describe perioperative agents that could lead to postoperative complications associated with anosmia and and ageusia. Conclusions: Based on available literature recommendations for anesthesiologists caring for patients at risk for this occurrence are presented in this review. The symptoms are usually temporary as in the majority of the patients the sensory receptor cells are able to regenerate themselves after injury. Anesthesia providers need to aware of this phenomenon to be able to reassure patients and possibly avoid anesthetic techniques associated with anosmia and ageusia. PMID:25599025

  6. Percutaneous management of postoperative anastomotic biliary strictures.

    PubMed

    Saad, Wael E A

    2008-06-01

    Postoperative anastomotic biliary strictures can occur after surgery in bile ducts belonging to transplanted or native (nontransplanted) livers. The majority of postoperative anastomotic strictures encountered by interventional radiologists are most likely in liver transplant recipients due to the large and growing liver transplant recipient population worldwide compared with patients with native livers and biliary enteric anastomoses. They occur after 2.5 to 13% of liver transplantations and they represent at least one-half of biliary strictures encountered after liver transplantation. Anastomotic biliary strictures are considered technical in nature, accentuated by fibrosis and scarring that may be secondary to, if not exacerbated by, graft ischemia. There are numerous variables in the percutaneous transhepatic balloon dilation protocols applied to treat anastomotic biliary strictures. These include (1) types of balloons, (2) how long balloons are inflated, (3) how frequently patients return for additional dilation sessions, and (4) the interval(s) at which they return. No alteration in these variables has proven to improve long-term patency. In addition, new technology such as cutting balloons and stents has not been fully evaluated to determine their effect on long-term patency. The current article describes the overall theme of balloon dilation protocols for the management of anastomotic biliary strictures and discusses possible future management of such strictures.

  7. Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction.

    PubMed

    Trindade, P A K; Giglio, F P M; Colombini-Ishikiriama, B L; Calvo, A M; Modena, K C S; Ribeiro, D A; Dionísio, T J; Brozoski, D T; Lauris, J R P; Faria, F A C; Santos, C F

    2011-03-01

    In this study, 53 patients received piroxicam, administered orally or sublingually, after undergoing removal of symmetrically positioned lower third molars, during two separate appointments. This study used a randomized, blind, cross-over protocol. Objective and subjective parameters were recorded for comparison of postoperative results for 7 days after surgery. Patients treated with oral or sublingual piroxicam reported low postoperative pain scores. The patients who received piroxicam orally took a similar average amount of analgesic rescue medication compared with patients who received piroxicam sublingually (p>0.05). Patients exhibited similar values for mouth opening measured just before surgery and immediately following suture removal 7 days later (p>0.05), and showed no significant differences between routes of piroxicam administration for swelling control during the second or seventh postoperative days (p>0.05). In summary, pain, trismus and swelling after lower third molar extraction, independent of surgical difficulty, could be controlled by piroxicam 20mg administered orally or sublingually and no significant differences were observed between the route of delivery used in this study.

  8. Effect of Acupuncture on Postoperative Ileus after Distal Gastrectomy for Gastric Cancer

    PubMed Central

    Jung, Se Yun; Chae, Hyun Dong; Kang, Ung Rae; Kwak, Min Ah

    2017-01-01

    Purpose Acupuncture has recently been accepted as a treatment option for managing postoperative ileus (POI) and various functional gastrointestinal disorders. Therefore, we conducted a prospective randomized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery. Materials and Methods Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were randomly assigned to acupuncture or non-acupuncture (NA) groups at 1:1 ratio. The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1. The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph. The secondary outcome measure was the surgical outcome, including the times to first flatus, first defecation, start of water intake, and start of soft diet, as well as length of hospital stay and laboratory findings. Results The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group. A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time (P<0.0001). The acupuncture group showed relatively better surgical outcomes than those in the NA group, but the differences were not statistically significant. Conclusions In this clinical trial, acupuncture promoted the passage of sitz markers, which may reflect the possibility of reducing POI after distal gastrectomy. PMID:28337359

  9. Hypothermia Increases Tissue Plasminogen Activator Expression and Decreases Post-Operative Intra-Abdominal Adhesion

    PubMed Central

    Lee, Chien-Chang; Wang, Hsuan-Mao; Chou, Tzung-Hsin; Wu, Meng-Che; Hsueh, Kuang-Lung; Chen, Shyr-Chyr

    2016-01-01

    Background Therapeutic hypothermia during operation decreases postoperative intra-abdominal adhesion formation. We sought to determine the most appropriate duration of hypothermia, and whether hypothermia affects the expression of tissue plasminogen activator (tPA). Methods 80 male BALB/c mice weighing 25–30 g are randomized into one of five groups: adhesion model with infusion of 15°C saline for 15 minutes (A); 30 minutes (B); 45 minute (C); adhesion model without infusion of cold saline (D); and sham operation without infusion of cold saline (E). Adhesion scores and tPA levels in the peritoneum fluid levels were analyzed on postoperative days 1, 7, and 14. Results On day 14, the cold saline infusion groups (A, B, and C) had lower adhesion scores than the without infusion of cold saline group (D). However, only group B (cold saline infusion for 30 minutes) had a significantly lower adhesion scores than group D. Also, group B was found to have 3.4 fold, 2.3 fold, and 2.2 fold higher levels of tPA than group D on days 1, 7, and 14 respectively. Conclusions Our results suggest that cold saline infusion for 30 minutes was the optimum duration to decrease postoperative intra-abdominal adhesion formation. The decrease in the adhesion formations could be partly due to an increase in the level of tPA. PMID:27583464

  10. Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

    PubMed Central

    Pugalenthi, Amudhan; Protic, Mladjan; Gonen, Mithat; Kingham, T. Peter; D’ Angelica, Michael I.; Dematteo, Ronald P.; Fong, Yuman; Jarnagin, William R.; Allen, Peter J.

    2016-01-01

    INTRODUCTION Pancreaticoduodenectomy (PD) performed for pancreatic ductal adenocarcinoma (PDA) has a postoperative morbidity of 40–50%. In this study, we analyzed the impact of high grade complications after PD for PDA on overall survival. METHODS 596 patients that underwent PD for PDA between 2001–2009 were identified from a prospective database. Complications were defined and graded (1–5) as per our Institutional Surgical Secondary Events Program. High grade complications were defined as ≥ grade 3. Postoperative mortality (≤ 90 days) was excluded. Univariate and multivariate analyses were performed to identify factors associated with overall survival. RESULTS Median survival was 24 months. Overall complication rate was 51% (301/596). Low grade complications were recorded in 266 patients (45%) and high grade complications in 22% (n= 129). Our 90 day mortality was 3.7% (n= 22). Anastomotic fistula/ leak/abscess rate was 14% (n= 82). Multivariate Cox-Regression analysis identified node positivity, estimated blood loss (EBL) > 600 ml, length of stay (LOS) > 10 days, margin positivity and vascular procedures as predictors of decreased overall survival (p < 0.05). High grade complications were not associated with overall survival (p = 0.948). CONCLUSION In this study, the occurrence of high grade postoperative complications was not associated with overall survival. PMID:26678349

  11. Morphine Plus Bupivacaine Vs. Morphine Peridural Analgesia in Abdominal Surgery: The Effects on Postoperative Course in Major Hepatobiliary Surgery

    PubMed Central

    Barzoi, G.; Carluccio, S.; Bianchi, B.; Vassia, S.; Colucci, G.

    2000-01-01

    Anaesthesia and surgical procedures lead to a reduction of intestinal motility, and opioids may produce a postoperative ileus, that might delay postoperative feeding. The aim of this prospective randomised study is to test whether or not different kinds of epidural analgesia (Group A: morphine 0.00 17 mg/kg/h and bupivacaine 0.125% – 0.058 mg/kg/h; Group B: morphine alone 0.035mg/kg/12h in the postoperative period) allow earlier postoperative enteral feeding, enhance intestinal motility a passage of flatus and help avoid complications, such as nausea, vomiting, ileus, diarrhoea, pneumonia or other infective diseases. We included in the study 60 patients (28 males and 32 females) with a mean age of 61.2 years (range 50–70) and with an ASA score of 2 or 3. All patients had hepato–biliary-pancreatic neoplasm and were candidates for major surgery. We compared two different pharmacological approaches, i.e., morphine plus bupivacaine (30 patients, Group A)versus morphine alone (30 patients, Group B). Each medication was administered by means of a thoracic epidural catheter for the control of postoperative pain. In the postoperative course we recorded every 6 hours peristaltic activity. We also noted morbidity (pneumonia, wound sepsis) and mortality. Effective peristalsis was present in all patients in Group A within the first six postoperative hours; in Group B, after 30 hours. Six patients in Group A had bowel motions in the first postoperative day, 11 in the second day, 10 in the third day and 3 in fourth day, while in Group B none in the first day, two in the second, 7 in the third, 15 in the fourth, and 6 in the fifth: the difference between the two groups was significant (P<0.05 in 1st, 2nd, 4th and 5th days). Pneumonia occurred in 2 patients of Group A, and in 10 of Group B (P<0.05). We conclude that epidural analgesia with morphine plus bupivacaine allowed a move rapid return to normal gut activity and early enteral nutrition compared with epidural analgesia

  12. Postoperative bleeding risk for cutaneous surgery in the head and neck region with continued phenprocoumon therapy.

    PubMed

    Eichhorn, Wolfgang; Barsukov, Evgeny; Al-Dam, Ahmed; Gröbe, Alexander; Smeets, Ralf; Eichhorn, Marc; Heiland, Max; Kluwe, Lan; Blessmann, Marco

    2014-07-01

    In a total of 171 surgical procedures for lesions in the head and neck region in patients in whom phenprocoumon therapy was not stopped, 16 (9%) postoperative bleeding events were observed over a follow-up period of two weeks. Local measures were sufficient in all cases except one severe case where blood transfusion was needed and anticoagulant treatment was stopped for 7 days. The bleeding risk was significantly higher for the surgical procedures of the nose than those in other areas (21% versus 6%, P = 0.014), but was not influenced by the international normalized ratio (INR) of blood coagulation, size, site and type of the lesion, surgical procedure, and sex and age of the patients. The bleeding rate in patients not on any anticoagulation therapy was significantly lower (6/211 = 3%). Across both groups, just over 80% of the bleeding episodes were within the first two days (55% on the same day and 32% on the next day) of the surgery. No bleeding was recorded after 5 days. Our data suggest that cutaneous surgery in the head and neck region can be safely performed with continued phenprocoumon therapy in most cases in an INR range of 1.3-3.4, but rarely severe bleeding does occur and can be managed with a close-contact follow-up and with 24-h on call services during the first two days postoperatively.

  13. Surgical outcomes associated with postoperative atrial fibrillation after robotic-assisted pulmonary lobectomy: retrospective review of 208 consecutive cases

    PubMed Central

    Ng, Emily P.; Velez-Cubian, Frank O.; Rodriguez, Kathryn L.; Thau, Matthew R.; Moodie, Carla C.; Garrett, Joseph R.; Fontaine, Jacques P.

    2016-01-01

    Background In this study, we sought to investigate the effect of post-operative atrial fibrillation (POAF) after robotic-assisted video-thoracoscopic pulmonary lobectomy on comorbid postoperative complications, chest tube duration, and hospital length of stay (LOS). Methods We retrospectively analyzed prospectively collected data from 208 consecutive patients who underwent robotic-assisted pulmonary lobectomy by one surgeon for known or suspected lung cancer. Postoperatively, 39 (18.8%) of these patients experienced POAF during their hospital stay. The occurrence of postoperative complications other than POAF, chest tube duration, and hospital LOS were analyzed in patients with POAF and without POAF. Statistical significance (P≤0.05) was determined by unpaired Student’s t-test or by Chi-square test. Results Of patients with POAF, 46% also had other concurrent postoperative complications, while only 31% of patients without POAF experienced complications. The average number of postoperative complications experienced by patients with POAF was significantly higher than that experienced by those without POAF (0.9 vs. 0.4, P<0.05). Median chest tube duration in POAF patients (6 days) was significantly higher than in patients without POAF (4 days). A similar result was also seen with hospital LOS, with the median hospital LOS of 8 days in POAF patients being significantly longer than in those without POAF, whose median hospital LOS was 4 days. No other significant difference was detected between the two groups of patients. Conclusions This study demonstrated the association between the incidence of POAF and a more complicated hospital course. Further studies are needed to determine whether confounders were involved in this association. PMID:27621862

  14. Milrinone Use is Associated With Postoperative Atrial Fibrillation Following Cardiac Surgery

    PubMed Central

    Fleming, Gregory A.; Murray, Katherine T.; Yu, Chang; Byrne, John G.; Greelish, James P.; Petracek, Michael R.; Hoff, Steven J.; Ball, Stephen K.; Brown, Nancy J.; Pretorius, Mias

    2009-01-01

    Background Postoperative atrial fibrillation (AF), a frequent complication following cardiac surgery, causes morbidity and prolongs hospitalization. Inotropic drugs are commonly used perioperatively to support ventricular function. This study tested the hypothesis that the use of inotropic drugs is associated with postoperative AF. Methods and Results We evaluated perioperative risk factors in 232 patients who underwent elective cardiac surgery. All patients were in sinus rhythm at surgery. Sixty-seven (28.9%) patients developed AF a mean of 2.9±2.1 days after surgery. Patients who developed AF stayed in the hospital longer (P<0.001) and were more likely to die (P=0.02). Milrinone use was associated with an increased risk of postoperative AF (58.2% versus 26.1% in non-users, P<0.001). Older age (63.4±10.7 versus 56.7±12.3 years, P<0.001), hypertension (P=0.04), lower preoperative ejection fraction (P=0.03), mitral valve surgery (P=0.02), right ventricular dysfunction (P=0.03), and higher mean pulmonary artery pressure (PAP) (27.1±9.3 versus 21.8±7.5 mmHg, P=0.001) were also associated with postoperative AF. In multivariable logistic regression, age (P<0.001), ejection fraction (P=0.02), and milrinone use (odds ratio 4.86, 95% CI 2.31-10.25, P<0.001) independently predicted postoperative AF. When data only from patients with pulmonary artery catheters were analyzed and PAP was included in the model, age, milrinone use (odds ratio 4.45, 95% CI 2.01-9.84, P<0.001), and higher PAP (P=0.02) were associated with an increased risk of postoperative AF. Adding other potential confounders or stratifying analysis by mitral valve surgery did not change the association of milrinone use with postoperative AF. Conclusion Milrinone use is an independent risk factor for postoperative AF following elective cardiac surgery. PMID:18824641

  15. An aspirin a day.

    PubMed

    Majerus, Philip W

    2014-01-01

    The title of this article is also its punch line. The thesis that I will prove is that every adult, with a few exceptions, should take one 325 mg aspirin tablet each day. The drug is extraordinary and is beneficial in myriad ways. In this dosage the toxicity of the treatment is minimal. Since the drug is sold "over the counter", not requiring prescription, it is cheap and its benefits are easily underestimated. I do not use extensive reference citations; but just tell the story of aspirin.

  16. Rapid emergence of day-care anaesthesia: A review

    PubMed Central

    Gangadhar, SB; Gopal, TM; Sathyabhama; Paramesh, KS

    2012-01-01

    The number of day-care surgeries is increasing every day. The boundaries of day-care surgeries are being redefined on a continual basis. Multi-dimensional benefits to the patient, hospital and national economy are the driving forces behind the changing scenario on the horizon of day surgery. The literature search included Google, medlinx, pubmed and medline. We have attempted to look at the controversies in patient selection with comorbidities, pre-operative assessment and an acceptable ASA grade of patients. An attempt is also made to look at suitable surgical procedures, a pathway of introducing procedures, which are still complex and specialist procedures in challenging environment. The techniques of general anaesthesia, central neuraxial blocks, regional nerve blocks with indwelling catheters and monitoring techniques are deliberated upon. Finally the most important post-operative issues of discharge criteria, including recovery after spinal anaesthetic, oral fluid intake, voiding and travel after day surgery, are considered. PMID:23087454

  17. Influence of gum-chewing on postoperative bowel activity after laparoscopic surgery for gastric cancer

    PubMed Central

    Ge, Bujun; Zhao, Hongmei; Lin, Rui; Wang, Jialiang; Chen, Quanning; Liu, Liming; Huang, Qi

    2017-01-01

    Abstract Background: In some studies, gum-chewing was demonstrated to have a beneficial effect on resumption of bowel function; however, other contradictory findings in other studies refute the effects of gum-chewing on peristaltic movements and digestive system stimulation. In addition, most previous studies were after colorectal or gynecology surgery, whereas few reports focused on the effect of gum-chewing after gastrectomy. The aim of this randomized controlled trial was to assess the effectiveness of gum-chewing on postoperative bowel function in patients who had undergone laparoscopic gastrectomy. Methods: From March 2014 to March 2016, 75 patients with gastric cancer received elective laparoscopic surgery in Shanghai Tongji hospital and were postoperatively randomly divided into 2 groups: 38 in a gum-chewing (Gum) group and 37 in a control (No gum) group. The patients in the Gum group chewed sugarless gum 3 times daily, each time for at least 15 minutes, until the day of postoperative exhaust defecation. Results: The mean time to first flatus (83.4 ± 35.6 vs. 79.2 ± 24.2 hours; P = 0.554) and the mean time to first defecation (125.7 ± 41.2 vs. 115.4 ± 34.2 hours; P = 0.192) were no different between the no gum and Gum groups. There was also no significant difference in the incidence of postoperative ileus (P = 0.896) and postoperative hospital stay (P = 0.109) between the 2 groups. The postoperative pain score at 48 hours (P = 0.032) in the Gum group was significantly higher than in the no gum group. There was no significant difference between the 2 groups in regards to patient demographics, comorbidities, duration of surgery, complications, and nausea/vomiting score. Conclusion: Gum-chewing after laparoscopic gastrectomy did not hasten the return of gastrointestinal function. In addition, gum-chewing may increase patient pain on the second postoperative day. PMID:28353600

  18. Preoperative oral health care reduces postoperative inflammation and complications in oral cancer patients

    PubMed Central

    Shigeishi, Hideo; Ohta, Kouji; Fujimoto, Shinichi; Nakagawa, Takayuki; Mizuta, Kuniko; Ono, Shigehiro; Shimasue, Hiroshi; Ninomiya, Yoshiaki; Higashikawa, Koichiro; Tada, Misato; Ishida, Fumi; Okui, Gaku; Okumura, Toshiya; Fukui, Akiko; Kubozono, Kazumi; Yamamoto, Kazuhiro; Ishida, Yoko; Seino, Sayaka; Hashikata, Miho; Sasaki, Kazuki; Naruse, Takako; Rahman, Mohammad Zeshaan; Uetsuki, Ryo; Nimiya, Akiko; Takamoto, Megumi; Dainobu, Kana; Tokikazu, Tomoko; Nishi, Hiromi; Sugiyama, Masaru; Takechi, Masaaki

    2016-01-01

    The records of 70 patients with oral cancer who were treated at a single institution between 2008 and 2014 were reviewed. The body temperature, white blood cell count, and C-reactive protein (CRP) levels were compared between those who had received preoperative oral care (oral care group) and those who had not received any (non-oral care group). When the patients were divided into those who underwent minimally invasive surgery and those who underwent severely invasive surgery, the mean CRP level in the early postoperative period was lower in the oral care group as compared with the non-oral care group in those who underwent minimally invasive surgery as well as those who underwent severely invasive surgery. However, the mean CRP level was most evidently reduced in the severely invasive group on days 1 and 3–5. However, no significant differences were observed with regard to the percentage of postoperative infectious complications (for example, surgical site infection, anastomotic leak and pneumonia) between the oral care (13.6%) and non-oral care (20.8%) groups, though a reduced prevalence of postoperative complications following preoperative oral care was noted. The results of the present study suggest that preoperative oral care can decrease inflammation during the early postoperative stage in patients with oral cancer who undergo severely invasive surgery. PMID:27588111

  19. EARLY POSTOPERATIVE MAGNETIC RESONANCE IMAGING FINDINGS IN FIVE DOGS WITH CONFIRMED AND SUSPECTED BRAIN TUMORS.

    PubMed

    Chow, Kathleen Ella; Tyrrell, Dayle; Long, Sam Nicholas

    2015-01-01

    Early postoperative neuroimaging has been performed in people for over 20 years to detect residual brain tumor tissue and surgical complications. The purpose of this retrospective study was to describe characteristics observed using early postoperative magnetic resonance imaging in a group of dogs undergoing craniotomy for brain tumor removal. Two independent observers came to a consensus opinion for presence/absence of the following MRI characteristics: residual tumor tissue; hemorrhage and ischemic lesions; abnormal enhancement (including the margins of the resection cavity, choroid plexus, meninges) and signal intensity changes on diffusion-weighted imaging. Five dogs were included in the study, having had preoperative and early postoperative MRI acquired within four days after surgery. The most commonly observed characteristics were abnormal meningeal enhancement, linear enhancement at margins of the resection cavity, hemorrhage, and a thin rim of hyperintensity surrounding the resection cavity on diffusion-weighted imaging. Residual tumor tissue was detected in one case of an enhancing tumor and in one case of a tumor containing areas of hemorrhage preoperatively. Residual tumor tissue was suspected but could not be confirmed when tumors were nonenhancing. Findings supported the use of early postoperative MRI as a method for detecting residual brain tumor tissue in dogs.

  20. A comparison of postoperative early enteral nutrition with delayed enteral nutrition in patients with esophageal cancer.

    PubMed

    Wang, Gongchao; Chen, Hongbo; Liu, Jun; Ma, Yongchen; Jia, Haiyong

    2015-06-02

    We examined esophageal cancer patients who received enteral nutrition (EN) to evaluate the validity of early EN compared to delayed EN, and to determine the appropriate time to start EN. A total of 208 esophagectomy patients who received EN postoperatively were divided into three groups (Group 1, 2 and 3) based on whether they received EN within 48 h, 48 h-72 h or more than 72 h, respectively. The postoperative complications, length of hospital stay (LOH), days for first fecal passage, cost of hospitalization, and the difference in serum albumin values between pre-operation and post-operation were all recorded. The statistical analyses were performed using the t-test, the Mann-Whitney U test and the chi square test. Statistical significance was defined as p < 0.05. Group 1 had the lowest thoracic drainage volume, the earliest first fecal passage, and the lowest LOH and hospitalization expenses of the three groups. The incidence of pneumonia was by far the highest in Group 3 (p = 0.019). Finally, all the postoperative outcomes of nutritional conditions were the worst by a significant margin in Group 3. It is therefore safe and valid to start early enteral nutrition within 48 h for postoperative esophageal cancer patients.

  1. [The efficacy of prophylactic administration of SBT/ABPC for postoperative infection in neurosurgical operations].

    PubMed

    Idomari, Koji; Sakai, Keiichi; Takasawa, Hisayoshi; Miyairi, Yosuke; Yako, Takehiro; Murata, Takahiro; Sakamoto, Michio; Nitta, Junpei; Hongo, Kazuhiro; Kobayashi, Sigeaki; Aoki, Toshiki; Kobayashi, Satoshi

    2002-10-01

    We investigated prospectively the efficacy of sulbactam sodium/ampicillin sodium (SBT/ABPC), which is a combination drug of ampicillin and beta-lactamase inhibitor, as a preventive drug against postoperative infection in the field of neurological surgery. One hundred and six patients were given SBT/ABPC as follows: Before anesthetic induction at surgery, 1.5 g of SBT/ABPC was administrated by intravenous drip infusion, and further doses were continued at 12-hour intervals for 5 to 7 days. We assessed postoperative infection, type of surgery, duration of operation, and amount of hemorrhage. Search for related side effects and bacteriological examinations of the nasal cavity and throat before and after treatment were performed. The result was that postoperative infection was found in none of the patients. Adverse reactions due to SBT/ABPC such as apparent skin symptoms or gastrointestinal symptoms were not observed. Considering infections highly resistant to MRSA, SBT/ABPC would be effective to prevent postoperative infection in neurosurgical operations and could be used safely.

  2. Preoperative Acute Inflammatory Markers as Predictors for Postoperative Complications in Primary Total Knee Arthroplasty

    PubMed Central

    Godoy, Gustavo; Sumarriva, Gonzalo; Ochsner, J. Lockwood; Chimento, George; Schmucker, Dana; Dasa, Vinod; Meyer, Mark

    2016-01-01

    Background: C-reactive protein (CRP) has been suggested as an independent risk factor for cardiovascular pathology in the nonsurgical setting. While postoperative CRP and erythrocyte sedimentation rate (ESR) have an established role in aiding the diagnosis of periprosthetic joint infections, some authors suggest a link between preoperative CRP and postoperative complications in patients undergoing total joint arthroplasty. Methods: We conducted a retrospective cohort study of 351 patients who underwent unilateral primary total knee arthroplasty by a single surgeon during a 28-month period (January 2013 through April 2015). Patient medical records were reviewed for the following complications occurring within 90 days postoperatively: myocardial infarction, arrhythmia, pulmonary embolism, wound infection, acute renal failure, and reoperation. Results: We found no statistically significant link between postoperative complications and preoperative CRP levels (P=0.5005) or ESR levels (P=0.1610). Conclusion: The results of this study do not support the routine inclusion of CRP and ESR analysis as part of the preoperative evaluation for elective total knee arthroplasty. PMID:27999506

  3. Does body mass index and position of impacted lower third molar affect the postoperative pain intensity?

    PubMed

    Matijević, Marko; Uzarević, Zvonimir; Gvozdić, Vlatka; Leović, Dinko; Ivanisević, Zrinka; Matijević-Mikelić, Valentina; Bogut, Irella; Vcev, Aleksandar; Macan, Darko

    2012-12-01

    The main objective of this study was to determine to which extent body mass index and position of impacted lower third molar was affecting the pain intensity in the first seven postoperative days. The study was conducted following the extraction of the lower third molar in 108 patients. Depending on the type of information given to each particular patient, the patients were divided in two groups: the test group where patients were given detailed standard written and verbal instructions and the control group which received only standard written instructions about treatment after surgery. Using canonical discriminant analysis we investigated the influence of body mass index and the position of impacted lower third molar on postoperative pain intensity in two groups of patients. Results of this study showed that the body mass index or the tooth position did not have influence on intensity of postoperative pain. The body mass index and the position of impacted lower third molar do not affect the postoperative pain intensity.

  4. Assessment of post-operative pain and its management among patients undergoing craniotomy.

    PubMed

    Saramma, P P; Mathew, Rikku

    2013-01-01

    Pain assessment and its management in patients undergoing craniotomy, especially those with communication barriers, continue to present challenges to nurses. The present study was undertaken to assess the level of post-operative pain suffered by patients after craniotomy, to identify the activities that increase/relieve pain and to find out association between pain score of patients and selected variables. A self-prepared validated questionnaire and Wong Bakers Faces pain scale were used as the tools. The post-operative pain was mild to moderate and decreased from first to third postoperative day. Pain relief was adequate with the combination therapy of non-narcotic analgesics and non-steroidal anti-inflammatory drugs. The study revealed that there was no significant difference between the pain perception and age or gender of the patient. The activities that increased pain were surgical dressing removal and position changing. Nursing staff should focus on assessing and managing post-operative pain to improve quality of nursing care in order to improve the comfort of craniotomy patients.

  5. An audit of post-operative nausea and vomiting, following cardiac surgery: scope of the problem.

    PubMed

    Mace, Lisa

    2003-01-01

    Post-operative nausea and vomiting is a major problem for patients following cardiac surgery. The literature in this area identifies that there are a number of individual patient and post-operative factors which increase the risk of post-operative nausea and vomiting, including female gender, non-smoker, age, use of opioids, pain and anxiety. An audit involving 200 patients, who had undergone cardiac surgery was implemented to assess/evaluate the incidence of nausea and vomiting for this patient group. Data collected included information relating to nausea and vomiting, pain, consumption of morphine and other individual patient variables. The results suggest that nausea and vomiting, is experienced by a large number of patients after cardiac surgery (67%), with the majority suffering on the first day after surgery. The duration of nausea and vomiting for most is short, but for a significant number (7%) it can last up to one-quarter of their initial post-operative course. The paper discusses key implications for practice arising from this project.

  6. Comparison between two thoracotomy closure techniques: postoperative pain and pulmonary function*

    PubMed Central

    Leandro, Juliana Duarte; Rodrigues, Olavo Ribeiro; Slaets, Annie France Frere; Schmidt, Aurelino F.; Yaekashi, Milton L.

    2014-01-01

    OBJECTIVE: To compare two thoracotomy closure techniques (pericostal and transcostal suture) in terms of postoperative pain and pulmonary function. METHODS: This was a prospective, randomized, double-blind study carried out in the Department of Thoracic Surgery of the Luzia de Pinho Melo Hospital das Clínicas and at the University of Mogi das Cruzes, both located in the city of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age) undergoing posterolateral or anterolateral thoracotomy. The patients were randomized into two groups by the type of thoracotomy closure: pericostal suture (PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during the immediate and late postoperative periods was assessed by a visual analogic scale and the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC, FEV1/FVC ratio, and PEF) were determined in the preoperative period and on postoperative days 21 and 60. RESULTS: Pain intensity was significantly greater in the PS group than in the TS group. Between the preoperative and postoperative periods, there were decreases in the spirometry variables studied. Those decreases were significant in the PS group but not in the TS group. CONCLUSIONS: The patients in the TS group experienced less immediate and late post-thoracotomy pain than did those in the PS group, as well as showing smaller reductions in the spirometry parameters. Therefore, transcostal suture is recommended over pericostal suture as the thoracotomy closure technique of choice. PMID:25210961

  7. Systemic Trans- and Postoperative Evaluations of Patients Undergoing Dental Implant Surgery

    PubMed Central

    Goiato, Marcelo Coelho; Junior, Joel Ferreira Santiago; Pellizzer, Eduardo Piza; Moreno, Amália; Villa, Luiz Marcelo Ribeiro; de Carvalho Dekon, Stefan Fiuza; de Carvalho, Paulo Sérgio Perri; dos Santos, Daniela Micheline

    2016-01-01

    OBJECTIVE: The aims of this study were to examine the trans- and postoperative systemic characteristics of patients undergoing dental implant surgery and to investigate the relationship between pre- and post- surgery anxiety levels. MATERIAL AND METHODS: Thirty-nine patients were analyzed in 3 call centers to determine anxiety levels, pain levels, and preoperative and postoperative histories using the State–Trait (STAI) questionnaire. RESULTS: A total of 93 dental implants were installed, with a success rate of 100%. The most frequently reported systemic disease was hypertension. There was a significantly higher rate of effective clamping (torque) to the mandibular bone than to the maxillary bone. The association between postoperative surgical complications and longer operative time was not significant, but there was a significant correlation between the alteration of mouth opening and daily routine activities and a significant decrease in anxiety levels between the day of surgery and the postoperative time point (p=0.006). CONCLUSION: A longer surgical time was associated with surgery-related complications and with a higher anxiety index on the preoperative evaluation. PMID:27074177

  8. Three-day fever.

    PubMed

    Akakpo, A J

    2015-08-01

    Three-day fever is a viral disease caused by an Ephemerovirus of the family Rhabdoviridae, transmitted by arthropod vectors. It is common in tropical and sub-tropical regions, where it affects mainly domestic cattle and buffaloes, especially in intensive dairy or fattening production systems. It is of economic importance because it reduces milk production and fertility and causes abortion. The disease is generally benign. It manifests in several susceptible subjects simultaneously, with a sudden episode of fever accompanied by muscle involvement with arthritis, stiffness of the limbs, and lameness, followed by rapid recovery. The presence of a serofibrinous exudate in the joints is indicative of the disease. Clinical diagnosis is often difficult in the absence of pathognomonic signs. Epidemiological factors (proliferation of arthropod vectors), associated with a short-lived fever and the presence of many immature neutrophils, point strongly to three-day fever. In the absence of any specific treatment, the symptoms are treated with antibiotics and anti-inflammatories. Medical prophylaxis currently uses live attenuated vaccines, pending the development of recombinant vaccines, which are giving promising results.

  9. Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

    PubMed Central

    Tsamoudaki, Stella; Ntomi, Vasileia; Yiannopoulos, Ioannis; Christianakis, Efstratios; Pikoulis, Emmanuel

    2015-01-01

    Background Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results A total of 301 children with a mean age of 7.56 ± 2.61 years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results. PMID:26495079

  10. The use of topical aqueous suppressants in the prevention of postoperative intraocular pressure elevation following pars plana vitrectomy with long-acting gas tamponade.

    PubMed Central

    Mittra, R A; Pollack, J S; Dev, S; Han, D P; Mieler, W F; Connor, T B

    1998-01-01

    PURPOSE: To determine if topical aqueous suppressant therapy applied after pars plana vitrectomy (PPV) with gas tamponade successfully prevents postoperative elevation of intraocular pressure (IOP). METHODS: A prospective, controlled study was performed on patients who met inclusion criteria and underwent PPV with gas tamponade (SF6 18%-20% or C3F8 12%-16%) over a 1-year period. Treatment eyes received topical aqueous suppressants at the end of surgery. Postoperative IOP checks were performed at 4 to 6 hours, 1 day, and 1 week. RESULTS: Twenty-one control (C) and 20 treatment (T) eyes met the inclusion criteria. The IOP (in mm Hg) measured at 4 to 6 hours (23.05 [C], 14.73 [T] and 1 day (23.24 [C], 17.28 [T]) postoperatively showed a statistically significant difference between the groups (P = .0038) at 4 to 6 hours, and a trend toward significance (P = .057) at 1 day. Eleven control and 3 treatment eyes had an IOP spike above 25 mm Hg at 4 to 6 hours or 1 day postoperatively (P = .02), and 6 control and 1 treatment eye had a postoperative IOP above 30 mm Hg. A pressure rise above 40 mm Hg was seen in 2 control eyes and no treatment eyes. CONCLUSIONS: Use of topical aqueous suppressants following PPV with long-acting gas tamponade is effective in preventing significant postoperative IOP elevation in a majority of cases. PMID:10360287

  11. Immediate postoperative complications in transsphenoidal pituitary surgery: A prospective study

    PubMed Central

    Chowdhury, Tumul; Prabhakar, Hemanshu; Bithal, Parmod K.; Schaller, Bernhard; Dash, Hari Hara

    2014-01-01

    Background: Considering the important role of pituitary gland in regulating various endocrine axes and its unique anatomical location, various postoperative complications can be anticipated resulting from surgery on pituitary tumors. We examined and categorized the immediate postoperative complications according to various tumor pathologies. Materials and Methods: We carried out a prospective study in 152 consecutive patients and noted various postoperative complications during neurosurgical intensive care unit stay (within 48 hrs of hospital stay) in patients undergoing transsphenoidal removal of pituitary tumors. Results: In our series, various groups showed different postoperative complications out of which, cerebrospinal fluid leak was the commonest followed by diabetes insipidus, postoperative nausea and vomiting, and hematoma at operation site. Conclusion: Various immediate postoperative complications can be anticipated in transsphenoidal pituitary surgery even though, it is considered to be relatively safe. PMID:25191182

  12. Single dose dipyrone for acute postoperative pain

    PubMed Central

    Derry, Sheena; Faura, Clara; Edwards, Jayne; McQuay, Henry J; Moore, R Andrew

    2014-01-01

    Background Dipyrone (metamizole) is a non-steroidal anti-inflammatory drug used in some countries to treat pain (postoperative, colic, cancer, and migraine); it is banned in others because of an association with life-threatening blood agranulocytosis. This review updates a 2001 Cochrane review, and no relevant new studies were identified, but additional outcomes were sought. Objectives To assess the efficacy and adverse events of single dose dipyrone in acute postoperative pain. Search methods The earlier review searched CENTRAL, MEDLINE, EMBASE, LILACS and the Oxford Pain Relief Database to December 1999. For the update we searched CENTRAL, MEDLINE,EMBASE and LILACS to February 2010. Selection criteria Single dose, randomised, double-blind, placebo or active controlled trials of dipyrone for relief of established moderate to severe postoperative pain in adults. We included oral, rectal, intramuscular or intravenous administration of study drugs. Data collection and analysis Studies were assessed for methodological quality and data extracted by two review authors independently. Summed total pain relief over six hours (TOTPAR) was used to calculate the number of participants achieving at least 50% pain relief. Derived results were used to calculate, with 95% confidence intervals, relative benefit compared to placebo, and the number needed to treat (NNT) for one participant to experience at least 50% pain relief over six hours. Use and time to use of rescue medication were additional measures of efficacy. Information on adverse events and withdrawals was collected. Main results Fifteen studies tested mainly 500 mg oral dipyrone (173 participants), 2.5 g intravenous dipyrone (101), 2.5 g intramuscular dipyrone (99); fewer than 60 participants received any other dose. All studies used active controls (ibuprofen, paracetamol, aspirin, flurbiprofen, ketoprofen, dexketoprofen, ketorolac, pethidine, tramadol, suprofen); eight used placebo controls. Over 70% of participants

  13. Use of Kaolin-impregnated Gauze for Improvement of Intraoperative Hemostasis and Postoperative Wound Healing in Blepharoplasty

    PubMed Central

    Czyz, Craig N.; Stacey, Andrew W.; Cahill, Kenneth V.; Foster, Jill A.

    2016-01-01

    Purpose: Kaolin is a mineral shown to be effective in controlling hemorrhage when combined with standard gauze and applied to wounds. This study investigates the application of kaolin to control intraoperative bleeding and promote wound healing in eyelid surgery. Methods: This prospective, randomized, double-blind study recruited patients who underwent eyelid surgery. Following skin incision, kaolin-impregnated gauzewas placed in one eyelid wound bed and cotton gauze in the other, then removed. Distinct, individual areas of bleeding were recorded. Standardized photographs were obtained postoperatively on Day 1, 4, and 7. Photographs were graded for edema and ecchymosis by four blinded observers. Patients also completed a survey inquiring which side had more bruising, swelling, and pain at each return visit. Results: A total of 46 patients completed the study. The number of intraoperative bleeding sites for kaolin versus plain gauze was not significantly different (p=0.96). Photographic grading by blinded observers did not identify any statistically significant differences in postoperative edema at any time point between lids. There was a statistically significant difference for ecchymosis at postoperative Day 4 (p=0.009) and Day 7 (p=0.016). Patient surveys did not show any difference in perceived edema, ecchymosis, or pain between lids. Conclusion: Intraoperative hemostasis was not affected by the use of kaolin-impregnated gauze. The effectiveness of kaolin in wound healing showed improved ecchymosis at Days 4 and 7 when assessed by blinded observers. Patients did not notice any improvement in postoperative edema, ecchymosis, or pain. PMID:27386052

  14. Prospective double-blind clinical trial evaluating the effectiveness of Bromelain in the third molar extraction postoperative period

    PubMed Central

    de la Barrera-Núñez, María C.; Yáñez-Vico, Rosa M.; Batista-Cruzado, Antonio; Heurtebise-Saavedra, Jean M.; Castillo-de Oyagüe, Raquel

    2014-01-01

    Objectives: To evaluate the anti-inflammatory and analgesic effect of Bromelain (pineapple extract) administered orally in the postoperative after extraction of impacted lower molars. Study Design: This is a prospective, placebo-controlled, unicentric, double-blind study; the sample size was 34 patients. The pre and postoperative outcomes, evaluated on the third (D3) and eighth day (D8), included inflamtion, pain and oral aperture, as well as the need for analgesics. One group received bromelain 150mg per day for three days and 100mg on days 4 to 7. The other group received placebo in the same dosage. All outcomes werrecorded quantitatively and analyzed with the Mann-Whitney U test for independent samples. Results: Although there were no statistically significant differences between the treatment groups, a trend towards less inflammation and improved oral aperture was observed in the group that received bromelain, compared to the group that received placebo. This trend can be attributed completely to random reasons, since there is no statistical difference in the results. Conclusions: Further studies are necessary to analyze different administration patterns and doses of bromelain for the use in the postoperative of impacted third molars. Key words:Tooth extraction, third molar, postoperative period, bromeline, clinical study. PMID:24316697

  15. Antithymocyte globulin induction allows a prolonged delay in the initiation of cyclosporine in heart transplant patients with postoperative renal dysfunction.

    PubMed

    Cantarovich, Marcelo; Giannetti, Nadia; Barkun, Jeffrey; Cecere, Renzo

    2004-09-15

    The authors evaluated the efficacy of antithymocyte globulin (ATG) induction and delayed initiation of cyclosporine (CsA) in heart transplant (HTx) patients with postoperative renal dysfunction (RD). The authors compared 15 adult HTx patients with postoperative RD (serum creatinine [SCr] > or =150 microM) to 17 controls without postoperative RD. ATG was given daily (1.5 mg/kg/day for 5 days) in controls and every 2 to 5 days in RD patients (total lymphocyte count <200/mm). All patients received corticosteroids and mycophenolate mofetil. The initiation of CsA was delayed in RD patients until SCr had decreased to less than 150 microM (day 12 +/- 8 vs. 2 +/- 1, P<0.0001). One-year patient survival and acute rejection rates were 87% and 27% in RD patients and 88% and 59% in controls, respectively (P=not significant). SCr improved in RD patients and did not differ from controls after the first month. The authors' results suggest that marked prolongation of the period of ATG induction permits a safe delay in the initiation of CsA in HTx patients with postoperative RD.

  16. Postoperative alopecia: a case report and literature review.

    PubMed

    Boyer, J D; Vidmar, D A

    1994-11-01

    Postoperative alopecia is the temporary or permanent loss of hair that occurs following prolonged immobilization during general anesthesia and intubation. The clinical and histopathologic aspects of a typical case are described and the literature reviewed. Localized pressure-induced ischemia is the likely cause. Patients at highest risk for permanent hair loss include those subject to cardiac or gynecologic surgical procedures where the combined intraoperative and postoperative intubation time exceeds twenty-four hours. Frequent intraoperative and postoperative head repositioning provides excellent prophylaxis.

  17. [Antioxidant therapy in combined treatment of postoperative intestinal paresis].

    PubMed

    Magomedov, M A

    2004-01-01

    Method of treatment of postoperative intestinal paresis with antioxidant emoxipin in experiment demonstrated that stabilization of redox processes and antioxidant systems in intestinal tissues leads to compensation of energy deficiency and recovery of intestinal peristalsis. Clinical use of this method in combined treatment of patients with postoperative intestinal paresis in acute generalized peritonitis reduces time of postoperative intestinal paresis and intoxication, lethality reduced 1,7-fold.

  18. [Clinical and functional considerations in some cases of postoperative endophthalmitis].

    PubMed

    Muşat, O; Toma, Oana; Cristescu, R; Coman, Corina; Asandi, R; Burcea, M

    2013-01-01

    We present 3 cases of postsurgery endophthalmitis, with good initial operatory technique, which were admitted in our hospital within variable time, to which a second surgery was performed, with good postoperative evolution, without any inflammatory signs and preserving the eye. We analyse the pre and post-operative treatment of endophthalmitis, but also the ways to prevent the appearance of this post-operative complication.

  19. Proceedings, Dean's Day 1999

    SciTech Connect

    Zanner, M.A.

    1999-03-01

    On January 14--15, 1999, Sandia National Laboratories sponsored Deans Day, a conference for the Deans of Engineering and other executive-level representatives from 29 invited universities. Through breakout sessions and a wrap-up discussion, university and Sandia participants identified activities to further develop their strategic relationships. The four primary activities are: (A) concentrate joint efforts on current and future research strengths and needs; (B) attract the best students (at all grade levels) to science and engineering; (C) promote awareness of the need for and work together to influence a national science and technology R and D policy; and (D) enable the universities and Sandia to be true allies, jointly pursuing research opportunities and funding from government agencies and industry.

  20. MR imaging evaluation of the postoperative meniscus.

    PubMed

    Russo, A; Capasso, R; Varelli, C; Laporta, A; Carbone, M; D'Agosto, G; Giovine, S; Zappia, M; Reginelli, A

    2017-03-01

    MR imaging has been widely evaluated in the assessment of patients with recurrent or residual symptoms following meniscal surgery. Importantly, the causes of such symptoms may relate to failure or complication of the surgical procedure, a possible recurrent or residual meniscal tear, or may be related to other causes of joint symptoms, including tears of the contralateral meniscus, or local hyaline cartilage, or marrow abnormalities subjacent to or distant to the meniscal surgical site. The complex diagnostic issues involved in the MR imaging evaluation of the postoperative meniscus were identified in early MR imaging studies. The knowledge of the normal MR imaging appearance of the knee after the more common repair procedures will allow radiologists to recognize complications associated with such procedures. In this article, we discuss the MR imaging evaluation of the knee after meniscal surgery.

  1. Hair Transplantation: Preventing Post-operative Oedema.

    PubMed

    Gholamali, Abbasi; Sepideh, Pojhan; Susan, Emami

    2010-05-01

    Swelling or oedema of forehead or eyelids is a common consequence of hair transplantation surgery. However, this results in increased morbidity and absence from work due to unaesthetic appearance. To study various physical and therapeutic modalities to reduce or completely prevent the occurrence of such oedema. Three hundred forty hair transplant patients were recruited in the study and were categorized into 8 groups depending upon the intervention employed. There were 32 dropouts in the study due to various reasons. Patients who were administered steroid with tumescent solution had the highest number of patients without oedema, with only 3 out of 117 patients developing oedema. Physical measures like position of head during sleeping, application of occlusion bands or ice packs did not show satisfactory results. Addition of triamcinolone to tumescent anaesthetic solution is a very effective technique of preventing post-operative swelling.

  2. Management of postoperative complications of lymphadenectomy

    PubMed Central

    Charruf, Amir Zeide; de Oliveira, Rodrigo José; Jacob, Carlos Eduardo; Cecconello, Ivan; Zilberstein, Bruno

    2016-01-01

    Gastric cancer remains a disease with poor prognosis, mainly due to its late diagnosis. Surgery remains as the only treatment with curative intent, where the goal is radical resection with free-margin gastrectomy and extended lymphadenectomy. Over the last two decades there has been an improvement on postoperative outcomes. However, complications rate is still not negligible even in high volume specialized centers and are directly related mainly to the type of gastric resection: total or subtotal, combined with adjacent organs resection and the extension of lymphadenectomy (D1, D2 and D3). The aim of this study is to analyze the complications specific-related to lymphadenectomy in gastric cancer surgery. PMID:28138657

  3. Post-operative consequences of hemodynamic optimization.

    PubMed

    Lazkani, A; Lebuffe, G

    2016-12-01

    Hemodynamic optimization begins with a medical assessment to identify the high-risk patients. This stratification is needed to customize the choice of hemodynamic support that is best adapted to the patient's level of risk, integrating the use of the least invasive procedures. The macro-circulatory hemodynamic approach aims to maintain a balance between oxygen supply (DO2) and oxygen demand (VO2). Volume replacement plays a crucial role based on the titration of fluid boluses according to their effect on measured stroke volume or indices of preload dependency. Good function of the microcirculatory system is the best guarantee to achieve this goal. An assessment of the DO2/VO2 ratio is needed for guidance in critical situations where tissue hypoxia may occur. Overall, all of these strategies are based on objective criteria to guide vascular replacement and/or tissue oxygenation in order to improve the patient's post-operative course by decreasing morbidity and hospital stay.

  4. Postoperative conversion disorder in a pediatric patient.

    PubMed

    Judge, Amy; Spielman, Fred

    2010-11-01

    According to the Diagnostic and Statistical Manual IV (DSM IV), conversion disorder is classified as a somatoform illness and defined as an alteration or loss of physical function because of the expression of an underlying psychological ailment. This condition, previously known as hysteria, hysterical neurosis, or conversion hysteria occurs rarely, with an incidence of 11-300 cases per 100,000 people (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edn. Washington, DC: American Psychiatric Association, 1994). Presentation after an anesthetic is exceptional. After thorough review of the literature, fewer than 20 cases have been documented, with only two instances in patients younger than 18 years of age after general anesthesia; both were mild in nature. We present a severe case of postoperative conversion disorder that developed upon emergence from anesthesia in a previously healthy 16-year-old girl following direct laryngoscopy with vocal fold injection.

  5. Postoperative radionuclide evaluation of osteoid osteomas

    SciTech Connect

    Ghelman, B.; Vigorita, V.J.

    1983-02-01

    Five cases of clinically suspected osteoid osteomas were studied by preoperative injection of technetium-99m methylene disphosphonate, intraoperative localization with a radiation-sensitive scintillation probe, and postoperative examination of the entire tissue specimen (including the presumed nidus and surrounding bone). Microradiography and light microscopy were also used. In addition, a new autoradiography technique was introduced in which the excised surgical specimen was placed on undeveloped x-ray film for pathologic localization, diagnosis of the lesions, and a study of the relative intensity of radioactive uptake in the nidus vs. surrounding bone. Autoradiography revealed that the nidus showed the greatest concentration of radioactivity, followed by the surrounding bone. The authors conclude that /sup 99m/Tc can be used clinically in localizing osteoid osteomas and that preoperative and intraoperative scanning can assist in conservative surgical excision. For small lesions, autoradiography assists the pathologist in identifying an osteoid osteoma.

  6. [Postoperative infectious-inflammatory complications of endoscopic surgery for urolithiasis].

    PubMed

    Akilov, F A; Mukhtarov, Sh T; Giiasov, Sh I; Mirkhamidov, D Kh; Nasirov, F R; Muratova, N B

    2013-01-01

    Retrospective analysis of 1027 percutaneous radioendoscopic surgeries for upper urinary tract stones was performed. Postoperative acute pyelonephritis was the most common complication (11.2%), the frequency of which was significantly dependent on the presence of source of infection in the urinary tract, and the frequency of intra- and postoperative complications. When performing PPN, patients with urolithiasis and with the presence of the initial infection in the urinary tract, intra- and postoperative complications should be referred to the group of patients with a high risk of postoperative infectious and inflammatory complications. The analysis showed that the development of acute pyelonephritis after PPN increases the cost of treatment by 25%.

  7. Critical care nursing in acute postoperative neurosurgical patients.

    PubMed

    Brooks, Christin

    2015-03-01

    The nursing discipline is vital throughout patients' hospital progression. One of the most critical moments in the hospital stay is the postoperative period. Neurosurgical patients require a high level of nursing care and vigilance and additional postoperative monitoring in intensive care units designed specifically for this demographic. In the postoperative setting, patient care must be transferred from anesthesia to nursing in a manner that is continuous and safe. This article focuses on neurosurgical patients in the postoperative period, the assessment of these patients, and critical care nursing, with emphasis on common issues and interventions for this dynamic patient population.

  8. Evaluation of adjuvant postoperative radiotherapy for lung cancer

    SciTech Connect

    Chung, C.K.; Stryker, J.H.; O'Neill, M. Jr.; DeMuth, W.E. Jr.

    1982-11-01

    One hundred eighteen patients with lung cancer were retrospectively analyzed to determine whether postoperative radiotherapy (RT) improves survival. Patterns of treatment failure and three year NED (no evidence of disease) survival rates were assessed according to extent of tumor spread, histology, and treatment method. Patients with hilar or mediastinal node metastases were at higher risk of local failure compared to those with negative nodes. Postoperative RT reduced local recurrence and improved 3 year survival among patients with positive nodes. However, postoperative RT did not improve survival among those with negative nodes. Our data indicated that patients with positive hilar or mediastinal nodes may require postoperative RT to improve survival.

  9. Postoperative pyoderma gangrenosum: a rare complication after appendectomy.

    PubMed

    Faghihi, G; Abtahi-Naeini, B; Nikyar, Z; Jamshidi, K; Bahrami, A

    2015-01-01

    Pyoderma gangrenosum (PG) is an uncommon inflammatory ulcerative skin disease. It is characterized by painful progressive necrosis of the wound margins. Rarely, postoperative pyoderma gangrenosum (PPG) manifests as a severe disturbance of wound healing following surgical interventions. Only rare cases of this complication have been reported after appendectomy. We report a case of PPG in a 29-year-old female after appendectomy. She was successfully treated with oral prednisolone. Postoperative pyoderma gangrenosum should be kept in mind in the differential diagnosis of any postoperative delayed wound healing, because this disease is simply distinguished from a postoperative wound.

  10. [Postoperative respiratory therapy using incentive spirometry].

    PubMed

    Mang, H; Weindler, J; Zapf, C L

    1989-04-01

    The optimal methods of prophylaxis and therapy of postoperative respiratory complications in surgical patients are still open to discussion. In spite of numerous recent clinical investigations, there is still no specific and universally acceptable therapeutic concept. In our department, we identify patients at risk of pulmonary complications by adequate screening, i.e. medical history, physical examination, chest X-ray, and spirometry. In the postoperative period there are a sequence of stages starting with early mobilization, respiratory therapy (including incentive spirometry and IPPB), and when necessary, controlled mechanical ventilation. We have measured and documented the flows and volumes required of patients using various types of incentive spirometer. In addition, we review on the literature and describe our experience with the technique, handling, and organization of sustained maximal inspiration (SMI). After thoracic or major upper abdominal surgery, all lung volumes decrease due to impairment of rib cage movement, changes in chest wall muscle tone, an increase in lung recoil, and airway closure. At the end of each expiration some of the smallest airways collapse either partly or totally. This process continues to some extent until, normally, a deep breath recruits the alveoli. Sighs to the limit of total lung capacity or oscillations of the expiratory baseline ought to be responsible for this effect in healthy humans; the same purpose is intended in incentive spirometry. For this therapy, it is mandatory that the central airways are not occluded by mucus and that the patient is able to breath volumes exceeding his normal tidal volume.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Nefopam and Ketamine Comparably Enhance Postoperative Analgesia

    PubMed Central

    Kapfer, Barbara; Alfonsi, Pascal; Guignard, Bruno; Sessler, Daniel I.; Chauvin, Marcel

    2005-01-01

    Summary Opioids alone sometimes provide insufficient postoperative analgesia. Co-administration of drugs may reduce opioid use and to improve opioid efficacy. We therefore tested the hypothesis that administration of ketamine or nefopam, to postoperative patients with pain only partly alleviated by morphine, limits the amount of subsequent opioid necessary to produce adequate analgesia. Patients (n=77) recovering from major surgery were given up to 9 mg intravenous morphine. Those still suffering from pain were randomly assigned to blinded administration of: 1) isotonic saline (Control, n=21); 2) ketamine 10 mg (Ketamine, n=22); or, 3) nefopam 20 mg (Nefopam, n=22). Three-mg morphine boluses were subsequently given at 5-minute intervals until adequate analgesia was obtained, or 60 minutes elapsed after the beginning of the study drug administration, or ventilation became insufficient (respiratory rate < 10 breath/minute or saturation by pulse oxymetery < 95%). Supplemental morphine (i.e., after test drug administration) requirements were significantly greater in the Control group [17 ± 10 (SD) mg] than in the Nefopam (10 ± 5 mg, P < 0.005) or Ketamine (9 ± 5 mg, P < 0.001) groups. Morphine titration was successful in all Ketamine and Nefopam patients, but failed in four Control patients (two from respiratory toxicity and two from persistent pain). Tachycardia and profuse sweating were more frequent in patients given nefopam and sedation was greater with ketamine; however, the incidence of other potential complications did not differ between groups. Implications We conclude that ketamine 10 mg and nefopam 20 mg comparably potentiate opioid analgesia, each reducing opioid need by approximately 40%. Ketamine administration was associated with sedation whereas nefopam produced tachycardia and sweating. However, none of the side effects was serious. Either drug can thus be used to potentiate opioid analgesia. PMID:15616073

  12. Temporal Changes in Survival after Cardiac Surgery Are Associated with the Thirty-Day Mortality Benchmark

    PubMed Central

    Maxwell, Bryan G; Wong, Jim K; Miller, D Craig; Lobato, Robert L

    2014-01-01

    Objective To assess the hypothesis that postoperative survival exhibits heterogeneity associated with the timing of quality metrics. Data Sources Retrospective observational study using the Nationwide Inpatient Sample from 2005 through 2009. Study Design Survival analysis was performed on all admission records with a procedure code for major cardiac surgery (n = 595,089). The day-by-day hazard function for all-cause in-hospital mortality at 1-day intervals was analyzed using joinpoint regression (a data-driven method of testing for changes in hazard). Data Extraction Methods A comprehensive analysis of a publicly available national administrative database was performed. Principal Findings Statistically significant shifts in the pattern of postoperative mortality occurred at day 6 (95 percent CI = day 5–8) and day 30 (95 percent CI = day 20–35). Conclusions While the shift at day 6 plausibly can be attributed to the separation between routine recovery and a complicated postoperative course, the abrupt increase in mortality at day 30 has no clear organic etiology. This analysis raises the possibility that this observed shift may be related to clinician behavior because of the use of 30-day mortality as a quality metric, but further studies will be required to establish causality. PMID:24713085

  13. Tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of chest tube postoperatively

    PubMed Central

    Cui, Fei; Liu, Jun; Li, Shuben; Yin, Weiqiang; Xin, Xu; Shao, Wenlong

    2016-01-01

    Background To assess the feasibility and safety of tubeless video-assisted thoracoscopic surgery (VATS) under non-intubated, intravenous anesthesia with spontaneous ventilation and no placement of a chest tube postoperatively compared with VATS under intubated anesthesia with single-lung mechanical ventilation. Methods A total of 91 patients undergoing tubeless VATS (60 sympathectomies, 22 bullae resections, and 9 mediastinal tumor resections) between December 2012 and December 2015 were included. Additionally, 82 patients were treated by VATS by the same team while under intubated general anesthesia (52 sympathectomies, 19 bullae resections, and 11 mediastinal tumor resections). Comprehensive early outcome data, including intraoperative and postoperative variables, were compared between the subgroups. Results In total, 89 patients in the tubeless group underwent an effective operation and exhibited good postoperative recovery, while 2 (one sympathectomy and one bullae resection) had their operation aborted for some reason. The tubeless group showed advantages in the postoperative fasting time, the mean duration of the postoperative hospital stay, and postoperative pain scores, while no significant difference was found in intraoperative blood loss, the operation time or postoperative complications between the tubeless group and the intubated group. Furthermore, 83% (49/59) of sympathectomies, 81% (17/21) of bullae resections, and 56% (5/9) of mediastinal tumor resections were achieved via day surgery. Conclusions In this study, our experience has shown that tubeless VATS is a safe and feasible surgery with certain advantages in selected patients with thoracic disease and that we can achieve day surgery in these cases. PMID:27621880

  14. Effects of buprenorphine, meloxicam, and flunixin meglumine as postoperative analgesia in mice.

    PubMed

    Tubbs, Jacquelyn T; Kissling, Grace E; Travlos, Greg S; Goulding, David R; Clark, James A; King-Herbert, Angela P; Blankenship-Paris, Terry L

    2011-03-01

    C57BL/6NCrl male mice (n = 60; age, 6 to 7 wk) underwent partial hepatectomy or no surgery and were given 1 of 3 analgesics pre- and postoperatively. Food and water consumption, body weight, running wheel activity, locomotor activity, and serum corticosterone concentrations were measured before and after surgery. Mice that were surgically manipulated weighed significantly less on days 1 through 3 after surgery than did mice not manipulated surgically. On the day of surgery, the surgery groups consumed significantly less feed (-1.5±0.35 g) than did nonsurgery groups. There were no differences in water consumption on any day between surgery and nonsurgery groups or among the 3 analgesic groups. For running wheel activity, significant decreases in the surgery groups were seen at day 1 after surgery compared with baseline. Surgery groups that received buprenorphine and meloxicam returned to baseline activity levels on day 2 after surgery. Open-field testing revealed no significant differences in locomotor activity in any groups; however, posttreatment locomotor activity in the buprenorphine nonsurgery group was increased compared with baseline, and posttreatment locomotor activity in the flunixin meglumine surgery group was decreased compared with baseline. Serum corticosterone concentrations were within normal limits regardless of treatment in all groups. Comparison of the overall results indicated that meloxicam and buprenorphine, at the dose given, appear to be suitable postoperative analgesics for partial hepatectomy in mice. Flunixin meglumine at the given dosage (2.5 mg/kg) may not provide adequate analgesia for partial hepatectomy.

  15. Electro-acupuncture to prevent prolonged postoperative ileus: A randomized clinical trial

    PubMed Central

    Meng, Zhi-Qiang; Garcia, M Kay; Chiang, Joseph S; Peng, Hui-Ting; Shi, Ying-Qiang; Fu, Jie; Liu, Lu-Ming; Liao, Zhong-Xing; Zhang, Ying; Bei, Wen-Ying; Thornton, Bob; Palmer, J Lynn; McQuade, Jennifer; Cohen, Lorenzo

    2010-01-01

    AIM: To examine whether acupuncture can prevent prolonged postoperative ileus (PPOI) after intraperitoneal surgery for colon cancer. METHODS: Ninety patients were recruited from the Fudan University Cancer Hospital, Shanghai, China. After surgery, patients were randomized to receive acupuncture (once daily, starting on postoperative day 1, for up to six consecutive days) or usual care. PPOI was defined as an inability to pass flatus or have a bowel movement by 96 h after surgery. The main outcomes were time to first flatus, time to first bowel movement, and electrogastroenterography. Secondary outcomes were quality of life (QOL) measures, including pain, nausea, insomnia, abdominal distension/fullness, and sense of well-being. RESULTS: No significant differences in PPOI on day 4 (P = 0.71) or QOL measures were found between the groups. There were also no group differences when the data were analyzed by examining those whose PPOI had resolved by day 5 (P = 0.69) or day 6 (P = 0.88). No adverse events related to acupuncture were reported. CONCLUSION: Acupuncture did not prevent PPOI and was not useful for treating PPOI once it had developed in this population. PMID:20039456

  16. Changes in mood state after day case forefoot surgery.

    PubMed

    Mandy, Anne; Feeney, Sally

    2014-01-01

    Limited published data exploring patients' emotional recovery after day case foot surgery are available. The aim of the present study was to explore the changes in patient mood from preoperatively to 8 weeks postoperatively after outpatient forefoot surgery. The patients completed the Profile of Mood States-Bipolar™ questionnaire, Speilberger State-Trait Anxiety Inventory, and a 10-cm visual analog scale to measure pain preoperatively and again at 1, 2, and 8 weeks postoperatively. Of the 6 mood subscales, 3 showed statistically significant improvements by 8 weeks postoperatively: composed-anxious (Student's t test, t = -5.319; df = 84; p = .05); confident-unsure (t = -2.074; df = 84; p = .02); and clearheaded-confused (t = -2.46; df = 84; p = .007). Furthermore, the decrease in anxiety and pain was statistically significant after foot surgery. These findings have contributed to the understanding of patients' psychological needs in relation to outpatient day case foot surgery, and foot and ankle surgeons' understanding of patients' mood and anxiety levels can contribute to improving patient care and enhancing patient-practitioner relationships, which, in turn, could improve patients' perceived outcomes of their surgery.

  17. No Treatment Day School.

    PubMed

    DeJong, Judith A; Holder, Stanley R

    2006-01-01

    At the No Treatment Day School, less than 15% of students used the dormitory during the school week. Located in the heart of a reservation and serving local students, the K-12 school enrolled over 1,000 students. The site received Therapeutic Residential Model funding for the 2001-2002 school year. Initial evaluation of this site found an array of daunting problems throughout the school structure and functioning. There were some successes, including implementation of the Morningside reading program in the elementary school and some response from the community to the comprehensive evaluation report which provided an overview of the situation to policy-makers and community members. However instability in the system and a mid-year change in leadership complicated the process of implementation. By the end of the first year, it was clear that the feasibility of the original proposal was questionable and that an overhaul of the school's system and culture was necessary before a Therapeutic Residential Model could be implemented or significant change could come about. Therapeutic Residential Model funding was terminated at the end of the school year. As there was no substantial implementation of a Therapeutic Residential Model program, data gathered were utilized as representing a naturally occurring control or minimal treatment site.

  18. The triple day.

    PubMed

    Smith, V

    1980-08-01

    The risks are high and the returns low when Peruvian women work outside the home, but they have few other options. Most have large families, and their husbands scramble to earn a few dollars. For some women the day begins at 3:30 a.m. when they go to Lima to peddle fish, combs, or whatever commodity is available. The poor women who live in the pueblos jovenes of Lima, the newly formed outskirts, have banded together in a Christian group called Luz y Esperanza, or Light and Hope. The group has a 10-year history of coping with unsanitary water and resultant health problems, child care, and lack of electricity. The women began with neighborhood issues but have also developed an interest in trade unions and other less local concerns. Members have also started to attend union meetings in Lima and involved themselves in recent trade union struggles. The development of the women's political consciousness is closely intertwined with their Christian faith. They believe Christ is the source of the energy they need to persevere.

  19. Postoperative Change in Ocular Torsion in Intermittent Exotropia: Relationship with Postoperative Surgical Outcomes

    PubMed Central

    Lee, Ju-Yeun; Hwang, Sungsoon; Oh, Shin Yeop; Park, Kyung-Ah; Oh, Sei Yeul

    2016-01-01

    The aim of this study was to determine whether objective ocular torsion in intermittent exotropia (IXT) changes after recession surgery, and to evaluate the relationship between change in ocular torsion and clinical parameters in IXT. Sixty patients between 3 and 14 years of age underwent lateral rectus (LR) recession for IXT. Digital fundus photographs were obtained from both eyes of each subject and the disc-foveal angle (ocular torsion) was calculated using image software. We compared the preoperative and postoperative amount of ocular torsion, and analyzed the correlation between the difference in ocular torsion (DOC) and clinical parameters including age, duration of strabismus, stereoacuity, amount of preoperative exodeviation, and mean dose response. We categorized the patients according to DOC value: positive DOC value as group 1, and negative DOC value as group 2. A correlation between ocular torsion dominance and fixation preference was also investigated using the Kappa test. The mean ocular torsion was 15.8 ± 4.6 degrees preoperatively and 13.7 ± 5.1 degrees postoperatively. Compared with preoperative values, the mean ocular torsion showed a significant decrease after LR recession (p<0.001), and a greater preoperative ocular torsion was significantly associated with the amount of DOC (r = 0.37, p<0.001). Degree of stereopsis, mean dose-response, and postoperative exodeviation were significantly different between group 1 (positive DOC) and group 2 (negative DOC) (p<0.001, 0.030, and 0.001 respectively). The Kappa test showed that there was a significant correlation between the dominance of ocular torsion and fixation preference (p = 0.020). Therefore, change in ocular torsion after LR recession can be a useful supplementary indicator for evaluating the degree of fusional control and for predicting postoperative surgical response in IXT. PMID:27622574

  20. Therapy and Prevention of Postoperative Urosepsis of Ureter Endoscopic Lithotripsy for Non-infection.

    PubMed

    Shen, Jun; Sun, Fa; Chen, Fang-Min; Wu, Zhi-Ping; Li, Sheng-Wen

    2016-03-20

    Objective To analyze the risk factors causing postoperative urosepsis in ureter endoscopic lithotripsy without infection preoperatively, in order to make a more effective and safer preventive and therapeutic strategy.Methods From January 2010 to January 2015, 5 ureteral calculus patients undergoing ureter endoscopic lithotripsy with holmium laser were retrospectively enrolled in this clinical study. These patients suffered urosepsis postoperatively confirmed by the clinical presentations and laboratory Results, while they had no infection in their blood and urine preoperatively. Without delay, 5 patients were treated by anti-inflammation and anti-shock.Results The vasopressor drug was stopped gradually after 12-36 hours. The body temperature was recovered to normal in 2 or 3 days, and the blood and urine test Results were not abnormal in 7 days. At last, 5 patients were all cured.Conclusions Stone and operation themselves are potential factors to cause urosepsis after ureter endoscopic lithotripsy. Especially for patients who had not presented infection preoperatively, careful preparation preoperatively, corrective manipulation, low pressure irrigation, drainage and controlling time during operation, and early diagnosis, appropriate treatment postoperatively are the key to cure and prevent urosepsis.

  1. Effect of postoperative use of nasal oxygen catheter supplementation in wound healing following total knee arthroplasty

    PubMed Central

    Helito, Camilo Partezani; Junqueira, Jader Joel Machado; Gobbi, Ricardo Gomes; Angelini, Fábio Janson; Rezende, Marcia Uchoa; Tírico, Luis Eduardo Passarelli; Demange, Marco Kawamura; da Mota e Albuquerque, Roberto Freire; Pécora, José Ricardo; Camanho, Gilberto Luis

    2014-01-01

    OBJECTIVES: Healing is an event that is fundamental to the success of total knee arthroplasty. The aims of the present study were to compare the rates of complications related to wound healing between two groups of volunteers submitted to total knee arthroplasty and to evaluate the effects of postoperative oxygen supplementation by means of a nasal catheter. METHOD: A total of 109 patients who underwent total knee arthroplasty were randomized into two groups, namely, groups that did and did not receive postoperative oxygen supplementation via a nasal catheter. The surgical wound was monitored every day during the hospital stay and on the 7th, 14th, 21st, 30th and 42nd postoperative days. Characteristics related to healing were observed, including hyperemia, dehiscence, necrosis, phlyctenules and deep and superficial infection. RESULTS: There were no cases of deep infection. Hyperemia was statistically correlated with the total number of complications in the groups, with oxygen demonstrated to be a protective factor against hyperemia. Approximately 30% of the patients who exhibited hyperemia had other complications, independent of oxygen supplementation. CONCLUSION: Oxygen supplementation following total knee arthroplasty was shown to be effective in diminishing hyperemia around the operative wound. The development of hyperemia was a precursor to other complications, irrespective of whether oxygen supplementation was used. PMID:25518030

  2. Reducing Postoperative Pain from Tonsillectomy Using Monopolar Electrocautery by Cooling the Oropharynx

    PubMed Central

    Vieira, Lucas; Nissen, Leonardo; Sela, Gustavo; Amara, Yara; Fonseca, Vinicius

    2014-01-01

    Objective Evaluate intraoperative cooling of the oropharynx to reduce postoperative pain in tonsillectomy using monopolar electrocautery. Methods Sixty-six patients, age 1 to 12 years, were selected for the study, 33 in the control group and 33 in the experimental group. After randomization, patients underwent subcapsular dissection and hemostasis with monopolar electrocautery. Patients in the experimental group had the oropharynx cooled after tonsil dissection and hemostasis for 10 minutes. The procedure was done through the oral cavity by irrigation with 500 mL of 0.9% saline, in temperatures between 5°C and 10°C, for 5 minutes. The evaluation of postoperative pain was made with the pain visual analog scale (VAS) for 10 days. As complementary data on the evaluation of pain, we recorded daily use of ketoprofen for pain relief. Results Pain after tonsillectomy assessed by VAS was significantly lower in the experimental group at days 0, 5, and 6 (p < 0.05). There were no differences in the use of ketoprofen between the groups. Conclusion Cooling of the oropharynx after tonsillectomy promotes clinically significant reduction in postoperative pain, without additional complications. PMID:25992083

  3. High-Protein Diet Improves Postoperative Weight Gain After Massive Small-Bowel Resection

    PubMed Central

    Sun, Raphael C.; Choi, Pamela M.; Diaz-Miron, Jose; Sommovilla, Joshua; Guo, Jun; Erwin, Christopher R.

    2016-01-01

    Introduction Short bowel syndrome (SBS) is a morbid clinical condition that results from massive small-bowel resection (SBR). After SBR, there is a dramatic weight loss in the acute postoperative period. Our aim was to determine the impact of a high-protein diet (HPD) on weight gain and body composition in mice after SBR. Methods C57BL/6 mice underwent 50 % proximal SBR. Postoperatively, mice were randomly selected to receive standard rodent liquid diet (LD) (n=6) or an isocaloric HPD (n=9) for 28 days. Mice weights were recorded daily. Body composition analyses were obtained weekly. Student's t test was used for statistical comparisons with p<0.05 considered significant. Results Mice that were fed HPD after SBR returned to baseline weight on average at postoperative day (POD) 8 versus mice that were fed LD that returned to baseline weight on average at POD 22. Total fat mass and lean mass were significantly greater by POD 14 within the HPD group. Both groups of mice demonstrated normal structural adaptation. Conclusion HPD results in greater weight gain and improved body composition in mice after SBR. This finding may be clinically important for patients with SBS since improved weight gain may reduce the time needed for parenteral nutrition. PMID:25519080

  4. In vivo evaluation of in situ polysaccharide based hydrogel for prevention of postoperative adhesion.

    PubMed

    Lou, Weiwei; Zhang, Hualin; Ma, Jianfeng; Zhang, Dafeng; Liu, Chuantong; Wang, Siqian; Deng, Zhennan; Xu, Haihong; Liu, Jinsong

    2012-10-01

    In this paper, the carboxymethyl chitosan/oxidized dextran hydrogel was developed and its potency application in the prevention of postoperative adhesion was investigated. The developed hydrogel showed porous and interconnected interior structure with pore size about 250 μm, which was sensitive to lysozymic solution (1.5 μg/ml) with almost complete degradation after 4 weeks of in vitro incubation. In vivo study suggested that the developed hydrogel showed the great capacity on the prevention of postoperative adhesions in rat model. According to the result of histopathological examination, it clearly showed that the mesothelial cell layer of abdominal wall and cecum were completely recovered after 7 days of surgery in 3% carboxymethyl chitosan/oxidized dextran hydrogel group, while obvious adhesion between abdominal wall and cecum was observed as treatment with saline solution or 3% carboxymethyl chitosan solution after 1 day of surgery. All these results suggested that the developed biodegradable hydrogel might have potential application in the prevention of postoperative adhesion.

  5. Effect of using pump on postoperative pleural effusion in the patients that underwent CABG

    PubMed Central

    Özülkü, Mehmet; Aygün, Fatih

    2015-01-01

    Objective The present study investigated effect of using pump on postoperative pleural effusion in patients who underwent coronary artery bypass grafting. Methods A total of 256 patients who underwent isolated coronary artery bypass grafting surgery in the Cardiovascular Surgery clinic were enrolled in the study. Jostra-Cobe (Model 043213 105, VLC 865, Sweden) heart-lung machine was used in on-pump coronary artery bypass grafting. Off-pump coronary artery bypass grafting was performed using Octopus and Starfish. Proximal anastomoses to the aorta in both on-pump and off-pump techniques were performed by side clamps. The patients were discharged from the hospital between postoperative day 6 and day 11. Results The incidence of postoperative right pleural effusion and bilateral pleural effusion was found to be higher as a count in Group 1 (on-pump) as compared to Group 2 (off-pump). But the difference was not statistically significant [P>0.05 for right pleural effusion (P=0.893), P>0.05 for bilateral pleural effusion (P=0.780)]. Left pleural effusion was encountered to be lower in Group 2 (off-pump). The difference was found to be statistically significant (P<0.05, P=0.006). Conclusion Under the light of these results, it can be said that left pleural effusion is less prevalent in the patients that underwent off-pump coronary artery bypass grafting when compared to the patients that underwent on-pump coronary artery bypass grafting. PMID:27163421

  6. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery

    PubMed Central

    Costa, Altair da Silva; Bachichi, Thiago; Holanda, Caio; Rizzo, Luiz Augusto Lucas Martins De

    2016-01-01

    ABSTRACT Objective: To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. Methods: This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks. PMID:28117476

  7. A sequential comparison of postoperative voiding function between two different transobturator sling procedures

    PubMed Central

    Choi, Don Kyoung; Jung, Ha Bum; Lee, Young Goo; Kim, Ki Kyung; Cho, Sung Tae

    2016-01-01

    Introduction We evaluated sequential postoperative voiding function of two types of sling procedures (Monarc® and ALIGN®) in patients with stress urinary incontinence. Methods Ninety-one women diagnosed with urodynamic stress incontinence were randomly assigned to the study. All enrolled patients underwent Monarc or ALIGN procedure. They were postoperatively evaluated at one day, one week, one month, three months, 12 months, and 24 months. The voiding function was evaluated with uroflowmetry and post-void residual urine. Patients were asked if voiding had changed after surgery and had to complete the incontinence quality of life scale (I-QoL) questionnaire at 12 months. Results The Monarc (n=47) and ALIGN (n=44) groups had similar demographic characteristics. The maximal flow rate (Qmax) was significantly decreased on the first day after surgery and gradually increased during the following weeks. Comparing the two groups at one week, the ALIGN group had a significantly decreased Qmax than the Monarc group (17.6 ± 5.2 vs. 20.7 ± 5.0; p=0.004). However, at one, three, 12, and 24 months, there were no significant differences between the two groups. Conclusions This study demonstrated that an absorbable tensioning suture in the Monarc mesh could increase Qmax compared to ALIGN at one week after surgery. An absorbable tensioning suture may reduce the risk of an early postoperative voiding dysfunction compared to other meshes that do not have this. PMID:28096921

  8. 010. Coronary artery bypass in prior left pneumonectomy postoperative use of iloprost

    PubMed Central

    Ignatiadis, Agisilaos; Ampatzidou, Fotini; Kechagioglou, George; Antoniou, Konstantinos; Michail, Nikolaos; Karaiskos, Theodoros; Sileli, Maria; Drossos, George

    2015-01-01

    Background The rare procedure of coronary artery bypass in a prior left pneumonectomy patient characterized by postoperative cardiopulmonary complications. Acute right heart failure due to anatomic and physiologic changes because of pneumonectomy is the most serious complication. It is very helpful to prevent this condition by reducing pulmonary vascular resistance index which represents the right heart afterload. In our case we have recorded the favorable hemodynamic effects of inhaled Iloprost. Methods A 60-year-old man presented to our department with acute coronary syndrome. He had undergone a left pneumonectomy nine years ago because of bronchial carcinoma. Coronary angiography, which was performed during acute coronary syndrome, revealed left main disease (70% stenosis) and 50% stenosis in right coronary artery. Pulmonary function tests revealed severe restrictive disease: forced vital capacity (FVC): 1.47 L (30% of predicted) and forced expiratory volume (FEV) 1: 1.41 L (25% of predicted). Coronary artery bypass surgery (CABG) procedure was successfully completed with cardiopulmonary bypass (CPB) and patient was transferred in ICU. Patient’s inotropic support was 0.1 μg/kg/min Epinephrine and 0.06 μg/kg/min Noradrenaline. In the ICU, in order to avoid RV dysfunction the patient was ventilated with low tidal volume, Vt 6 mL/kg and with low positive end-expiratory pressure (PEEP). He was under careful fluid balance. Hemodynamic profile revealed high values of PVRI. This undesirable high RV afterload was managed with inhaled Iloprost (prostacyclin analogue) because of its elective pulmonary vessels dilator properties. Results The patient was extubated 5 hours postoperatively. Postoperative vigorous chest physiotherapy and bronchodilation due to transient brochospasm contributed to the uncomplicated respiratory function. The patient discharged on 7th postop day. Conclusions CABG in postpneumonectomy patients is a challenging procedure. The use of selective

  9. Extent of resection and postoperative functional declination of Klekamp's type A intramedullary tumors in adult patients

    PubMed Central

    Rabadán, Alejandra T.; Hernandez, Diego; Paz, Leonardo

    2016-01-01

    Background: The most commonly primary intramedullary spinal cord tumors (ISCT) in adults are the noninfiltrative lesions, corresponding to Klekamp's type A classification. There are few reports exclusively considering this type of lesions, their resectability and postoperative functional declination risk, and to our knowledge, none from Latin America. This led us to evaluate our results to provide information that might contribute to the decision making process in our region. Methods: A retrospective observational study was conducted comprising a cohort of 21 adults having primary Klekamp's type A ISCT. Diagnosis was made by magnetic resonance imaging (MRI), along with diffusion tensor/tractography in the last 7 cases. Preoperative functional status was assessed using the McCormick's modified scale (mMs), which was also used for the postoperative assessment within postoperative 90 days period. MRI was used to confirm the extent of resection. Results: Radical resection was obtained in 20/21 cases. The postoperative functional status was stable in 42.8% of the cases, and in 57.4% was even better than in the preoperative period. Temporary declination was observed in 2 cases in the early postoperative period. There were 2 cases with complications; one patient had cerebrospinal fluid fistula with meningitis, which was conservatively resolved, and another patient died from pulmonary embolism. Conclusion: Although the number of patients in this series does not allow to conclude from a statistical point of view, the outcomes showed that the modern surgery of Klekamp's type A ISCT permits a complete resection with low functional declination risk. PMID:28144469

  10. Improved pain management in pediatric postoperative liver transplant patients using parental education and non-pharmacologic interventions.

    PubMed

    Sharek, Paul J; Wayman, Karen; Lin, Eugenia; Strichartz, Debra; Sentivany-Collins, Sandy; Good, Julie; Esquivel, Carlos; Brown, Michelle; Cox, Kenneth

    2006-03-01

    A pain management intervention, consisting of pretransplant parental education and support, pre- and postoperative behavioral pediatrics consultation, postoperative physical and occupational therapy consultation, and implementation of non-pharmacologic pain management strategies, was introduced to all pediatrics patients receiving liver transplants at Lucile Packard Children's Hospital beginning August 2001. Children receiving transplants pre-intervention (May, 2000 to February, 2001) and post-intervention (August, 2001 to March, 2002) were compared using pain scores, parent perception of pain ratings, length of stay, ventilator days, total cost, and opioid use. A total of 27 children were evaluated (13 historical control, 14 intervention). The two populations did not differ on age at transplant (mean age 53.8 vs. 63.6 months), sex (46.1% vs. 50% male), ethnicity (53.8% vs. 57.1% white, non-Hispanic) weight at transplant (17.5 vs. 24.7 kg), percent with biliary atresia as the primary reason for transplant (42.9% vs. 69.2%), percent with status 1 transplant listing score (38.5% vs. 50.0%), or public insurance status (30.8 vs. 57.2% with Medicaid). No differences were found in mean pediatric intensive care unit (PICU) postoperative length of stay (6.7 vs. 5.3 days), total postoperative length of stay (17.5 vs. 17.5 days), total inpatient length of stay (27.0 vs. 24.4 days), time to extubation (30 vs. 24.3 h), total cost (dollar 147,983 vs. dollar 157,882) or opioid use through postoperative day (POD) 6 (0.24 vs. 0.25 mg/kg/day morphine equivalent). A decrease in mean pain score between POD 0 and 6 (2.82 vs. 2.12; p = 0.047), a decrease in mean parental pain perception score (3.1 vs. 2.1; p = 0.001), and an increase in number of pain assessments per 12 h shift (3.43 vs. 6.79; p < 0.005) were seen. A comprehensive non-pharmacologic postoperative pain management program in children receiving a liver transplant was associated with decreased pain scores, improved parent

  11. AAS 227: Day 4

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2016-01-01

    Editors Note:This week were at the 227th AAS Meeting in Kissimmee, FL. Along with several fellow authors from astrobites.com, I will bewritingupdates on selectedevents at themeeting and posting at the end of each day. Follow along here or atastrobites.com, or catch ourlive-tweeted updates from the@astrobites Twitter account. The usual posting schedule for AAS Nova will resumenext week.Welcome to Day 4 of the winter American Astronomical Society (AAS) meeting in Kissimmee! Several of us are attending the conference this year, and we will report highlights from each day here on astrobites. If youd like to see more timely updates during the day, we encourage you to follow @astrobites on twitter or search the #aas227 hashtag.Helen B. Warner Prize: Origins of Structure in Planetary Systems (by Erika Nesvold)Another excellent prize lecture started off todays sessions. The Helen B. Warner Prize is awarded for achievement in observational or theoretical astrophysics by a young researcher (no more than eight years after their Ph.D.). This years Warner Prize was presented to Ruth Murray-Clay of UC Santa Barbara. For her award lecture, Murray-Clay told us all about planetary system architecture: the number, masses, and orbits of planets in a given system.Ruth Murray-Clay [photo from http://web.physics.ucsb.edu/ ~murray/biocv.html]The underlying question motivating this type of research is: How rare is the Solar System? In other words, how likely is it that a given planetary system will have rocky planets close to their star, gas giants farther out, and ice giants at the outer reaches of the system? Answering this question will help us solve the physics problem of how and where planets form, and will also help us on our search for other planets like Earth.The data on exoplanet population from transit and radial velocity observations and from direct imaging tell us that our Solar System is not common (many systems we observe have much more eccentric gas giants), but that doesnt

  12. Day-case laparoscopic hernia repair.

    PubMed

    Evans, D S; Ghaneh, P; Khan, I M

    1996-10-01

    Some 114 patients (median age 52 years) underwent laparoscopic hernia repair as a day-case procedure. Twenty-one patients had bilateral and 11 recurrent hernias. Some 113 patients underwent transabdominal preperitoneal mesh repair but one required conversion to open operation. Mean operating time was 24 min for unilateral and 38 min for bilateral repair. In an operating session of 3.5 h, up to five patients (mean 4.4) underwent surgery and as many as seven hernias were repaired. More than 10 per cent of patients were found to have a previously undiagnosed hernia on the opposite side. A total of 111 patients were discharged home on the day of surgery. Major complications included one omental bleed and one small bowel obstruction. Seroma was the commonest minor complication and occurred in 7 per cent of patients. More than 35 per cent of patients needed no postoperative analgesia. To date there has been one recurrence (follow-up range 2-18 months).

  13. International Women's Day speech.

    PubMed

    Kazibwe, S W

    1993-01-01

    The objectives of the International Women's Day are: 1) to celebrate the struggle for women's rights in the economic, social, political, and cultural domain; 2) to reaffirm women's solidarity in the struggle for peace; 3) and to show what women have achieved. In 1988, Uganda's government of the National Resistance Movement created the Ministry of Women in Development. The period 1988-1990 was one of consultations, needs assessment, planning, and recruiting staff for the Ministry. From 1990 to 1993, measurable results have been achieved. The Ministry's gender concerns pertained to the sector policies of the Ministries of Agriculture, Animal Industry and Fisheries, Education, Health, Water, Energy, Minerals, and Environment Protection. Under the Umbrella Project for Women in Development, gender sensitization has been achieved with policy makers in ministries, at district level, and in the media. Gender issues have also been incorporated in the National Political School Curriculum. The Ministry has also trained a corps of 73 women trainers from 38 districts. The Ministry, with funding from DANIDA, collected women's views on the constitution through meetings and seminars in all the districts in the country. Recommendations were submitted in a consolidated report to the Constitution Commission. A pilot para-legal scheme is successfully being implemented in Kamuli district. A community-based pool of legal advisors has been developed. Legal matters that affect both women and men are undertaken at the community level. The economic emancipation of women is a crucial part of the Ministry's mandate. In conjunction with NGOs, pilot credit programs are being run in Mukono, Jinja, Mbale, and Kapchorwa districts. Cross-sectoral programs are in close collaboration with the rural water and sanitation program, the Northern Uganda rehabilitation program, and the integrated Basic Education Pilot Project to be implemented in 8 districts.

  14. AAS 227: Day 3

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2016-01-01

    Editors Note:This week were at the 227th AAS Meeting in Kissimmee, FL. Along with several fellow authors from astrobites.com, I will bewritingupdates on selectedevents at themeeting and posting at the end of each day. Follow along here or atastrobites.com, or catch ourlive-tweeted updates from the@astrobites Twitter account. The usual posting schedule for AAS Nova will resumenext week.Welcome to Day 3 of the winter American Astronomical Society (AAS) meeting in Kissimmee! Several of us are attending the conference this year, and we will report highlights from each day here on astrobites. If youd like to see more timely updates during the day, we encourage you to follow @astrobites on twitter or search the #aas227 hashtag.Henry Norris Russell Lecture: Viewing the Universe with Infrared Eyes: The Spitzer Space Telescope (by Erika Nesvold)The Henry Norris Russell Award is the highest honor given by the AAS, for a lifetime of eminence in astronomy research. This years award went to Giovanni Fazio of the Harvard-Smithsonian Center for Astrophysics. Fazio became a leader in gamma ray astronomy before switching mid-career to the study of infrared astronomy, and he gave his award lecture on the latter subject, specifically on the Spitzer Space Telescope, one of the most successful infrared telescopes of all time.Artists rendering of the Spitzer space telescope. [NASA/JPL-Caltech]Spitzer has been operating for more than twelve years, and has resulted in over six thousand papers in refereed journals in that time. The telescope sits in an Earth-trailing orbit around the Sun, and is now farther from the Earth (1.4 AU) than the Earth is from the Sun. Fazio gave the audience a fascinating overview of the science done by Spitzer over more than a decade. One of the most productive areas of research for Spitzer is the study of exoplanets, which hadnt even been discovered when the Spitzer Telescope was first conceived. Spitzers high sensitivity and ability to observe exoplanets over

  15. Franco, the Early Days

    NASA Astrophysics Data System (ADS)

    Siemssen, R. H.

    2004-04-01

    As this meeting is to honour Franco on the occasion of his 60 birthday I thought that it might be fitting to report on some early reminiscences of Franco of the pre-IBA days. Franco first came to Groningen in 1972 for a seminar on the invitation of Alex Lande. Alex and Franco had known each other from the Niels Bohr Institute in Copenhagen, where they had collaborated. In 1972 both Alex and I had been freshly appointed at Groningen, Alex on the Faculty of the Theory Department, and I myself as the new director of the KVI. A position for a Senior Scientist in theory had been newly created at the KVI with the aim to establish a strong in-house theory group. Needless to say that everyone who met Franco was deeply impressed by him. We thus were extremely happy to be able to entice Franco to join the KVI as a Senior Scientist in 1974, after he had spent a few weeks in Groningen in 1973 as a visitor. So characteristic of Franco he immediately took a strong interest in the experimental program as evidenced by the following publications on the weak-coupling description of three-nucleon pickup in the (p, α) reaction [1] and the spreading width of deep-hole states [2]. Both topics appear to have maintained their actuality, looking at the many papers that have been published since on these and related topics. But this brief citation of the "other Franco" would not do justice to him without mentioning the diverse palette of Franco's work also listed in the KVI 1974 Annual Report, reflecting Franco's extremely broad and diversified scientific interests. [3-10]...

  16. The Impact of Demographic, Clinical, Symptom and Psychological Characteristics on the Trajectories of Acute Postoperative Pain After Total Knee Arthroplasty

    PubMed Central

    Miaskowski, Christine; Rustøen, Tone; Rosseland, Leiv Arne; Paul, Steven M.; Cooper, Bruce A.; Lerdal, Anners

    2017-01-01

    Objective. Total knee arthroplasty is a painful procedure. No studies have evaluated modifiable predictors of acute postoperative pain trajectories during hospitalization. Methods. Consecutive patients (N = 188) were enrolled in a longitudinal cohort study and completed a demographic questionnaire, as well as the Brief Pain Inventory, Hospital Depression and Anxiety Scale, Lee Fatigue Scale, Fatigue Severity Scale, and Brief Illness Perception Questionnaire on the day before surgery. Clinical data were extracted from medical records. Setting and Patients. Each patient completed a pain diary that assessed pain at rest and with activity, and hours per day in pain every evening from day of surgery until postoperative day 3. Using hierarchical linear modeling, we investigated which demographic, clinical, symptom, and psychological characteristics predicted initial levels as well as the trajectories of acute pain at rest and with activity, and hours per day in pain. Results. Higher levels of all three acute pain characteristics on the day of surgery resulted in worse trajectories. Higher pain scores with rest and with activity on the day of surgery were associated with more days with femoral block, higher average dose of opioids, and higher emotional response to osteoarthritis. Higher number of comorbidities, higher average dose of opioids, and lower perceived control predicted more hours per day in pain on the day of surgery. Conclusions. This study identified several potentially modifiable predictors of worsening pain trajectories following total knee arthroplasty. Optimal pain management warrants identification of these high-risk patients and treatment of modifiable risk factors. PMID:27165969

  17. Day-case laparoscopic cholecystectomy: analysis of the factors allowing early discharge.

    PubMed

    Tebala, Giovanni Domenico; Belvedere, Angela; Keane, Sean; Khan, Abdul Qayyum; Osman, Abdelsalam

    2017-03-21

    Despite a number of studies have already demonstrated that majority of patients can be safely discharged early after laparoscopic cholecystectomy, this approach did not gain widespread diffusion yet. The present study was set up to assess safety and feasibility of 24 h or same-day discharge after laparoscopic cholecystectomy and to identify the prognostic factors. Perioperative variables of 229 patients undergoing cholecystectomy have been analyzed. Primary endpoints were: postoperative length of stay, rate of patients discharged within 24 h, and rate of those discharged on the same day. Secondary endpoints were rate of 30-day readmission and rate of 30-day postoperative complications. Two-hundred twenty-three cases have been started by laparoscopy. Conversion rate was 3.1%. Overall mean postoperative stay was 1.8 ± 3.5 days (median 1 day). Seventy-eight percent of patients have been discharged within 24 h, and 22.3% have been discharged on the same day. Postoperative morbidity was 2.2%. Readmission rate was 3.9%. At univariate analysis, factors related to early discharge were age (more or less than 65), diagnosis (simple symptomatic gallstones vs complicated gallstones), ASA score, timing of operation (elective vs emergency), history of CBD stones, laparoscopic operation, and use of drain. No single factor was significantly related to readmission rate, but the use of drains in laparoscopic cases. At multivariate analysis, only elective operation, simple symptomatic gallstones, no history of CBD stones, laparoscopic approach, and no abdominal drain resulted independently associated with discharge within 24 h from the operation. The predictive models are all fit and significant. Early postoperative discharge within 24 h should be considered in all patients with simple symptomatic gallstones who had laparoscopic cholecystectomy. Same-day discharge should be considered if no drain was left at the end of the operation.

  18. Survival outcomes of hepatocellular carcinoma resection with postoperative complications – a propensity-score-matched analysis

    PubMed Central

    Chok, Kenneth S.H.; Chan, Millies M.Y.; Dai, Wing Chiu; Chan, Albert C.Y.; Cheung, Tan To; Wong, Tiffany C.L.; She, Wong Hoi; Lo, Chung Mau

    2017-01-01

    Abstract Curative resection remains the only hope of cure for hepatocellular carcinoma (HCC), but postoperative complications can have a significant impact on long-term survival. However, only scarce data on such impact can be found in the literature. This retrospective study reviewed the prospectively collected data of patients who underwent primary liver resection for HCC at our hospital during the period from December 1989 to December 2014. Patients with and without postoperative complications were compared. A 1:1 propensity score matching was adopted by matching age, comorbidity, Model of End-stage Liver Disease score, tumor stage, and extent of resection. Totally 1710 patients were eligible for the study. Four hundred and sixty-one (27.0%) of them developed postoperative complications while 1249 (73.0%) did not. After propensity score matching, 922 patients were compared in a 1:1 ratio (461 with postoperative complications and 461 without). Patients who developed postoperative complications were demographically similar to patients who did not, but had more intraoperative blood loss and transfusion (both P < 0.001), longer hospital stay (17 vs 9 days; P < 0.001), worse hospital mortality (12.1% vs 0%; P < 0.001), and shorter overall survival (P < 0.001). On multivariate analysis, factors that might have affected overall survival were cancer stage (HR 1.22, P < 0.001), tumor size (HR 1.02, P = 0.005), tumor number (HR 1.08, P < 0.001), venous invasion (HR 1.38, P = 0.003), extent of resection (HR 1.19, P = 0.045), intraoperative blood loss (HR 1.11, P < 0.001), postoperative complication (HR 1.37, P < 0.001), and era effect (HR 1.27, P = 0.01). Patients should be monitored closely after HCC resection. Prompt treatment of postoperative complications may be salvational. PMID:28328851

  19. Postoperative Depression of Tumour-directed Cell-mediated Immunity in Patients with Malignant Disease

    PubMed Central

    Cochran, A. J.; Spilg, W. G. S.; Mackie, Rona M.; Thomas, Catherine E.

    1972-01-01

    Leucocytes from 46 melanoma patients, 45 breast carcinoma patients, and 95 control donors were tested by the leucocyte migration test against the supernatants of homogenates of malignant melanomas, breast carcinomas, simple breast tumours, and breasts showing simple cystic disease. By comparison with controls inhibition of migration occurred significantly more frequently when tumour patients' leucocytes were exposed to extracts of histogenetically similar tumours. Cell-mediated immunity to tumour-associated antigens was measured in 12 patients with breast carcinoma and 12 with malignant melanoma immediately before surgical operation and in the postoperative period. All patients tested before operation showed significant inhibition of migration on contact with extracts of histogenetically similar tumours. Postoperatively the degree of leucocyte migration inhibition was reduced in all patients with melanoma and breast carcinoma. Significant inhibition of leucocyte migration returned in most patients 6-22 days after operation. PMID:5077468

  20. Ruptured Hemangioma of a Native Kidney: An Unusual Cause of Postoperative Hemorrhage in Kidney Transplant Recipients.

    PubMed

    Poznańska, Grażyna; Wlazlak, Michał; Hogendorf, Piotr; Szymański, Dariusz; Strzelczyk, Janusz; Durczyński, Adam

    2017-03-14

    BACKGROUND Retroperitoneal bleeding as a consequence of non-traumatic kidney or allograft rupture is well known, but there are no reports on hemorrhagia from a native kidney after allogeneic renal transplantation. Therefore, we present the first such case to be published and highlight the possibility of this complication after renal transplantation. CASE REPORT We report the case of a 28-year-old male patient who developed early post-transplant hemorrhagia from a ruptured native kidney. The patient underwent left-sided nephrectomy. Histopathological examination revealed ruptured hemangioma of the patient's native left kidney. The further postoperative period was not complicated. The patient was discharged on the 18th postoperative day, with good transplant function. CONCLUSIONS Transplantologists should be aware of the fact that in patients with uncontrolled blood pressure, native kidney hemangioma may rupture in the early post-transplant period, and it can be a life-threating and difficult to diagnose complication.