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Sample records for 5th postoperative day

  1. 75 FR 63478 - 5th Annual PHEMCE Stakeholders Workshop and BARDA Industry Day

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ...The Department of Health and Human Services (HHS) is pleased to announce the upcoming 5th Annual Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) Stakeholders Workshop and BARDA Industry Day to be held January 10-12, 2011 at the Walter E. Washington Convention Center in Washington, DC. This annual PHEMCE event will bring together private- and public-sector stakeholders......

  2. 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

  3. Postoperative Care of Patients Undergoing Same-Day Laparoscopic Cholecystectomy.

    PubMed

    Brenner, Patricia; Kautz, Donald D

    2015-07-01

    Elective laparoscopic cholecystectomies are common outpatient surgical procedures. After briefly discussing cholecystectomy and its indications, best practices in phase I, phase II, and phase III recovery are discussed. Typical pharmaceutical regimens for controlling pain and postoperative nausea and vomiting are summarized. By implementing best practices, nurses can prevent and recognize complications. The criteria for discharge, extended recovery, and inpatient admission are discussed, along with the required patient discharge teaching using the teach-back technique, as well as patient and family teaching needs in the immediate postoperative period. Nurses can optimize the patient's surgical experience and promote safety by implementing best practices in all phases of recovery from laparoscopic cholecystectomy. PMID:26119606

  4. Outcome of hospital discharge on postoperative Day 1 following uncomplicated tethered spinal cord release.

    PubMed

    Poonia, Seerat; Graber, Sarah; Corbett Wilkinson, C; O'neill, Brent R; Handler, Michael H; Hankinson, Todd C

    2016-06-01

    OBJECTIVE Postoperative management following the release of simple spinal cord-tethering lesions is highly variable. As a quality improvement initiative, the authors aimed to determine whether an institutional protocol of discharging patients on postoperative day (POD) 1 was associated with a higher rate of postoperative CSF leaks than the prior protocol of discharge on POD 2. METHODS This was a single-center retrospective review of all children who underwent release of a spinal cord-tethering lesion that was not associated with a substantial fascial or dural defect (i.e., simple spinal cord detethering) during 2 epochs: prior to and following the institution of a protocol for discharge on POD 1. Outcomes included the need for and timing of nonroutine care of the surgical site, including return to the operating room, wound suturing, and nonsurgical evaluation and management. RESULTS Of 169 patients identified, none presented with CSF-related complications prior to discharge. In the preintervention group (n = 113), the postoperative CSF leak rate was 4.4% (5/113). The mean length of stay was 2.3 days. In the postintervention group, the postoperative CSF leak rate was 1.9% (1/53) in the patients with postdischarge follow-up. The mean length of stay in that group was 1.3 days. CONCLUSIONS At a single academic children's hospital, a protocol of discharging patients on POD 1 following uncomplicated release of a simple spinal cord-tethering lesion was not associated with an increased rate of postoperative CSF leaks, relative to the previous protocol. The rates identified are consistent with the existing literature. The authors' practice has changed to discharge on POD 1 in most cases. PMID:26849810

  5. 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. PMID:25635217

  6. Music Benefits on Postoperative Distress and Pain in Pediatric Day Care Surgery

    PubMed Central

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

    2014-01-01

    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. PMID:25635217

  7. Postoperative Morbidity by Procedure and Patient Factors Influencing Major Complications Within 30 Days Following Shoulder Surgery

    PubMed Central

    Shields, Edward; Iannuzzi, James C.; Thorsness, Robert; Noyes, Katia; Voloshin, Ilya

    2014-01-01

    Background: Little data are available to prioritize quality improvement initiatives in shoulder surgery. Purpose: To stratify the risk for 30-day postoperative morbidity in commonly performed surgical procedures about the shoulder completed in a hospital setting and to determine patient factors associated with major complications. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study utilized the National Surgical Quality Improvement Program (NSQIP) database from the years 2005 to 2010. Using Current Procedural Terminology codes, the database was queried for shoulder cases that were divided into 7 groups: arthroscopy without repair; arthroscopy with repair; arthroplasty; clavicle/acromioclavicular joint (AC) open reduction and internal fixation (ORIF)/repair; ORIF of proximal humeral fracture; open tendon release/repair; and open shoulder stabilization. The primary end point was any major complication, with secondary end points of incisional infection, return to the operating room, and venothromboembolism (VTE), all within 30 days of surgery. Results: Overall, 11,086 cases were analyzed. The overall major complication rate was 2.1% (n = 234). Factors associated with major complications on multivariate analysis included: procedure performed (P < .001), emergency case (P < .001), pulmonary comorbidity (P < .001), preoperative blood transfusion (P = .033), transfer from an outside institution (P = .03), American Society of Anesthesiologists (ASA) score (P = .006), wound class (P < .001), dependent functional status (P = .027), and age older than 60 years (P = .01). After risk adjustment, open shoulder stabilization was associated with the greatest risk of major complications relative to arthroscopy without repair (odds ratio [OR], 5.56; P = .001), followed by ORIF of proximal humerus fracture (OR, 4.90; P < .001) and arthroplasty (OR, 4.40; P < .001). These 3 groups generated over 60% of all major complications. Open shoulder

  8. Thirty-Day Postoperative Death Rate at an Academic Medical Center

    PubMed Central

    Calland, J. Forrest; Adams, Reid B.; Benjamin, Daniel K.; O’Connor, Matthew J.; Chandrasekhara, Vinay; Guerlain, Stephanie; Jones, Rayford Scott

    2002-01-01

    Objective To improve understanding of perioperative deaths at an academic medical center. Summary Background Data Because published data have typically focused on specific patient populations, diagnoses, or procedures, there are few data regarding surgical deaths and complications in institutional or regional studies. Specifically, surgical adverse events and errors are generally not studied comprehensively. This limits the overall understanding of complications and deaths. Methods Data from all operations performed in the main operating suite of the University of Virginia Health Sciences Center from January 1 to June 30, 1999, were compared with state death records to gain a dataset of patients dying within 30 days of surgery. All clinical records from patients who died were screened for adverse events and subsequently reviewed by three surgeons who identified adverse events and errors and performed comparisons with survivors. Results One hundred nineteen deaths followed 7,379 operations performed on 6,296 patients, yielding a patient death rate of 1.9%. Patients dying within 30 days of surgery were older and had higher American Society of Anesthesiologists scores. Of 119 deaths, 86 (72.3%) were attributable to the patient’s primary disease. Twenty-three patient deaths (19.3% of all deaths, 0.37% of all patients) could not be attributed to the patient’s primary disease and thus were suspicious for an adverse event (AE) as the cause of the death. Of the 23 deaths suspicious for AE, 15 (12.6% of all deaths, and 65.2% of AE deaths) followed an error in care and thus were classified as potentially preventable, affecting 0.24% of the study population. Conclusions Overall, the 30-day postoperative death rate was low in the total surgical population at an academic medical center. Errors and AEs were associated with 12.6% and 19.3% of deaths, respectively. Retrospective review inadequately characterized the nature of AEs and failed to determine causality. Prospective

  9. Influence of depression, catastrophizing, anxiety, and resilience on postoperative pain at the first day after otolaryngological surgery

    PubMed Central

    Suffeda, Alexander; Meissner, Winfried; Rosendahl, Jenny; Guntinas-Lichius, Orlando

    2016-01-01

    Abstract The aim was to assess the association between objectified preoperative psychological factors and postoperative pain at the first day after otolaryngological surgery in accordance with other predictors of postoperative pain. Eighty-two (82) patients (59% male, median age 56 years) were included between January and May 2015. The psychological assessment the day before surgery included the Patient Health Questionnaire (PHQ-9), pain catastrophizing scale (PCS), State-Trait Operation Anxiety (STOA) inventory, and the resilience scale (RS-13). On first postoperative day, patients were rated their pain using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale (NRS, 0–10) for determination of patient's maximal pain. QUIPS allowed standardized assessment of patients’ characteristics, pain parameters, and outcome. The influence of preoperative and postoperative parameters on patients’ maximal postoperative pain was estimated by univariate and multivariate statistical analysis. The mean maximal pain was 3.2 ± 2.9. In univariate analysis, higher PHQ-9 score more than 4 (P = 0.010), higher STOA trait anxiety (P = 0.044), and higher STOA total score (P = 0.043) were associated to more postoperative pain. In multivariate analysis higher PHQ-9 score remained an independent predictor for severe pain (beta = 0.302; 95% confidence interval [CI]: 0.054–0.473; P = 0.014). When all parameters were included into multivariate analysis, 2 of all somatic, psychological, and treatment factors were associated with severe maximal pain: more depression (PHQ-9; beta = 0.256; 95% CI: 0.042–0.404; P = 0.017), and use of opioids in the recovery room (beta = 0.371; 95% CI: 0.108–0.481; P = 0.002). Otolaryngological surgery covers the spectrum from low to severe postoperative pain and is therefore a good model for pain management studies. A set of somatic and psychological parameters seems

  10. 168. GENERAL VIEW FROM 5TH AVE. VIEW SOUTH, ACROSS 5TH ...

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

    168. GENERAL VIEW FROM 5TH AVE. VIEW SOUTH, ACROSS 5TH AVE., TOWARD BUILDING 506 (ON LEFT) AND BUILDING 435. - Quonset Point Naval Air Station, Roger Williams Way, North Kingstown, Washington County, RI

  11. Patient compliance with postoperative analgesia after day case surgery: a multisite observational study of patients in North East London

    PubMed Central

    Fahmy, Nisreen; Siah, Julian; Umo-Etuk, Joanna

    2016-01-01

    Background: Pain is the commonest reason for delayed discharge and readmission post day surgery with up to 45% of patients reported to suffer moderate-to-severe post-surgical pain 24 hours after discharge. The importance of post-surgical pain management extends beyond the acute phase when one considers that all chronic post-surgical pain was once acute. Although much focus is given to perioperative analgesia, a patient’s pain management once discharged can be overlooked, whilst at this time the patient’s pain management is within their own hands. Methods: We conducted this multisite observational study of adult patients undergoing day case surgery. After obtaining patient consent data was collected on the operation, intra- and postoperative analgesia administered and discharge analgesia prescribed. Patients were then contacted at home by telephone 48 hours after discharge and asked about their postoperative pain and analgesia requirements. Results: Of 150 patients consented for the enrolment, we were able to obtain postoperative analgesia data on 100. A total of 68% of patients reported pain following discharge with 26% reporting severe pain, defined as a pain score of ⩾7. A total 68% of patients were prescribed and dispensed analgesia, and of those, 83% were compliant with their analgesia. Thus, we conclude that in this patient group, the incidence of postoperative pain was not due to lack of patient compliance, but inadequate analgesia prescription. Discussion: We recognise that our data reflect a patient population in North East London but suggest that the results may still be relevant to a wider patient group across the United Kingdom as the incidence of postoperative pain in our study was similar to published figures. Better patient satisfaction with postoperative analgesia may be obtained with more patient- and surgery-specific analgesic prescription. PMID:27551418

  12. Kids & Family Reading Report™. 5th Edition

    ERIC Educational Resources Information Center

    Scholastic Inc., 2015

    2015-01-01

    This report presents the 5th Edition of Scholastic's biannual study of children's and parents' attitudes and behaviors about reading. The latest research touches on reading aloud to children of all ages, the impact of reading independently for fun at school and at home, the importance of frequent reading, and the books children want most to read.…

  13. BOOK REVIEW: ENVIRONMENTAL ENGINEERING, 5TH EDITION

    EPA Science Inventory

    Book Review of Environmental Engineering, 5th Edition (Joseph A. Salvato, Nelson L. Nemerow, Franklin J. Agardy (Editors), John Wiley and Sons, Inc. Hoboken, New Jersey. 2003.). Author wrote review per the request of the Editor-in-Chief of the Journal of Environmental Quality.

  14. 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

  15. Thirty-Day Postoperative Mortality Among Individuals With HIV Infection Receiving Antiretroviral Therapy and Procedure-Matched, Uninfected Comparators

    PubMed Central

    King, Joseph T.; Perkal, Melissa F.; Rosenthal, Ronnie A.; Gordon, Adam J.; Crystal, Stephen; Rodriguez-Barradas, Maria C.; Butt, Adeel A.; Gibert, Cynthia L.; Rimland, David; Simberkoff, Michael S.; Justice, Amy C.

    2016-01-01

    IMPORTANCE Antiretroviral therapy (ART) has converted human immunodeficiency virus (HIV) infection into a chronic condition, and patients now undergo a variety of surgical procedures, but current surgical outcomes are inadequately characterized. OBJECTIVE To compare 30-day postoperative mortality in patients with HIV infection receiving ART with the rates in uninfected individuals. DESIGN, SETTING, AND PARTICIPANTS Retrospective analysis of nationwide electronic medical record data from the US Veterans Health Administration Healthcare System, October 1, 1996, to September 30, 2010. Common inpatient surgical procedures were grouped using the Healthcare Cost and Utilization Project Clinical Classification System to match HIV-infected and uninfected patients in a 1:2 ratio. Data on 1641 patients with HIV infection receiving combination ART who were undergoing inpatient surgery were compared with data on 3282 procedure-matched, uninfected comparators. Poisson regression models of 30-day postoperative mortality were adjusted for procedure year, age, Charlson Comorbidity Index score, hemoglobin level, albumin level, HIV infection, CD4 cell count, and HIV-1 RNA level. MAIN OUTCOMES AND MEASURES All-cause 30-day postoperative mortality. RESULTS The most common procedures in both groups were cholecystectomy (10.5%), hip arthroplasty (10.5%), spine surgery (9.8%), herniorrhaphy (7.4%), and coronary artery bypass grafting (7.0%). In patients with HIV infection, CD4 cell distributions were 80.0% with 200/µL or more, 16.3% with 50/µL to 199/µL, and 3.7% with less than 50/µL; 74.1% of patients with HIV infection had undetectable HIV-1 RNA. Human immunodeficiency virus infection was associated with higher 30-day postoperative mortality compared with the mortality in uninfected patients (3.4% [56 patients]) vs 1.6% [53]); incidence rate ratio [IRR], 2.11; 95% CI, 1.41–3.17; P < .001). CD4 cell count was inversely associated with mortality, but HIV-1 RNA provided no

  16. Changes in Day 1 Post-Operative Intraocular Pressure Following Sutureless 23-Gauge and Conventional 20-Gauge Pars Plana Vitrectomy

    PubMed Central

    Gosse, Emily; Newsom, Richard; Hall, Peter; Lochhead, Jonathan

    2013-01-01

    Background/Aims: The benefits associated with transconjunctival sutureless vitrectomy techniques are continuing to be defined. The purpose of this study was to compare the incidence of extreme changes in day 1 intraocular pressure (IOP) following 23-gauge sutureless vitrectomy compared with conventional 20-gauge vitrectomy. Methods: Fifty consecutive 23-gauge and 50 consecutive 20-gauge cases were included; eyes with a history of previous vitreoretinal surgery were excluded. 23-gauge surgery was completed with passive fluid air exchange where no long acting tamponade was indicated. The surgery remained sutureless unless a leak was visible at the end of the procedure. Data were collected by retrospective case note review. Statistical analysis was carried out using Fisher’s exact and chi-square tests. Results: Twenty-two percent (11/50) of 23-gauge vitrectomies required suturing of one or more ports. On the first post-operative day hypotony (IOP<5mmHg) occurred in 1/50 eyes in the 20- and 23-gauge groups. Raised pressure (IOP>21mmHg) occurred in 30% (15/50) of eyes in the 20-gauge group and 8% (4/50) of eyes in the 23-gauge group; IOP>30mmHg only occurred in the 20-gauge group (3/50). Conclusion: Fluid air exchange following 23-gauge vitrectomy is associated with very low risk of day 1 hypotony. This predominantly sutureless technique appears to reduce the incidence and magnitude of early post-operative IOP elevation compared with conventional 20-gauge vitrectomy. PMID:24015163

  17. Multifrequency Catalogue of Blazars - 5th Edition

    NASA Astrophysics Data System (ADS)

    Massaro, E.; Maselli, A.; Leto, C.; Marchegiani, P.; Perri, M.; Giommi, P.; Piranomonte, S.

    2014-12-01

    The 5th Edition of the Multifrequency Catalogue of Blazars is one of the most complete lists of Active Galactic Nuclei whose emission properties are recognised as typical of blazars. It includes the list of sources and an essential compilation of multifrequency data from radio to gamma rays. The source list for the entire sky is also available online at the ASDC web site (http://www.asdc.asi.it/bzcat/) where it is frequently updated to add new blazars and to improve the database.

  18. Effects of erythropoietin on posttraumatic place learning in fimbria-fornix transected rats after a 30-day postoperative pause.

    PubMed

    Malá, Hana; Rodriguez Castro, Maria; Dall Jørgensen, Katrine; Mogensen, Jesper

    2007-10-01

    Human recombinant erythropoietin (EPO) has been shown to exert neuroprotective effects following both vascular and mechanical brain injury. Previously, we showed that behavioral symptoms associated with mechanical lesions of the hippocampus are nearly abolished due to EPO treatment. In these studies, the EPO administration took place simultaneously with the infliction of brain injury and the rehabilitation training started 6-7 days postoperatively. In the present study, we tested whether the therapeutic effect of EPO on the acquisition of an allocentric eight-arm radial maze spatial task also manifests itself if the rehabilitative training is postponed. Postoperatively, the animals were left without any specific stimulation for 30 days. The current results show an improved behavioral performance of the EPO-treated lesioned group relative to the saline-treated lesioned group, and confirm EPO's therapeutic effect even in case of postponed rehabilitation. However, compared to the control group, the EPO-treated lesioned group demonstrated an impaired task acquisition. All subjects eventually recovered functionally. Subsequently, the animals were given behavioral challenges during which the cue constellation in the room was changed. The challenges revealed that, although the EPO-treated lesion group had achieved the same level of task proficiency as the control group, the cognitive mechanisms mediating the task performance in the EPO-treated lesion group (as well as in the saline-treated lesion group) were dissimilar from those mediating the task in the control group. Both the EPO-treated and the saline-treated lesion group demonstrated an increased dependency on the original cue configuration. PMID:17970627

  19. 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

  20. 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

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

    PubMed

    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

  2. Some mice feature 5th pharyngeal arch arteries and double-lumen aortic arch malformations.

    PubMed

    Geyer, Stefan H; Weninger, Wolfgang J

    2012-01-01

    A 5th pair of pharyngeal arch arteries (PAAs) has never been identified with certainty in mice. Murines in general are considered to not develop a 5th pair. If true, the significance of the mouse as a model for researching the genesis of malformations of the great intrathoracic arteries is limited. We aimed to investigate whether mouse embryos develop a 5th pair of PAAs and to identify malformations known to be caused by defective remodelling of the 5th PAAs. We employed the high-resolution episcopic microscopy method for creating digital volume data and three-dimensional (3D) computer models of the great intrathoracic arteries of 30 mouse embryos from days 12-12.5 post conception and 180 mouse fetuses from days 14.5 and 15.5 post conception. The 3D models of the fetuses were screened for the presence of a double-lumen aortic arch malformation. We identified such a malformation in 1 fetus. The 3D models of the embryos were analysed for the presence of 5th PAAs. Six of the 30 embryos (20%) showed a 5th PAA bilaterally, and an additional 9 (30%) showed a 5th PAA unilaterally. Our results prove that some mice do develop a 5th pair of PAAs. They also show that malformations which occur rarely in humans and result from defective remodelling of the left 5th PAA can be identified in mice as well. Thus, the mouse does represent an excellent model for researching the mechanisms driving PAA remodelling and the genesis of malformations of the great intrathoracic arteries. PMID:22287557

  3. Influence of depression, catastrophizing, anxiety, and resilience on postoperative pain at the first day after otolaryngological surgery: A prospective single center cohort observational study.

    PubMed

    Suffeda, Alexander; Meissner, Winfried; Rosendahl, Jenny; Guntinas-Lichius, Orlando

    2016-07-01

    The aim was to assess the association between objectified preoperative psychological factors and postoperative pain at the first day after otolaryngological surgery in accordance with other predictors of postoperative pain. Eighty-two (82) patients (59% male, median age 56 years) were included between January and May 2015. The psychological assessment the day before surgery included the Patient Health Questionnaire (PHQ-9), pain catastrophizing scale (PCS), State-Trait Operation Anxiety (STOA) inventory, and the resilience scale (RS-13). On first postoperative day, patients were rated their pain using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale (NRS, 0-10) for determination of patient's maximal pain. QUIPS allowed standardized assessment of patients' characteristics, pain parameters, and outcome. The influence of preoperative and postoperative parameters on patients' maximal postoperative pain was estimated by univariate and multivariate statistical analysis. The mean maximal pain was 3.2 ± 2.9. In univariate analysis, higher PHQ-9 score more than 4 (P = 0.010), higher STOA trait anxiety (P = 0.044), and higher STOA total score (P = 0.043) were associated to more postoperative pain. In multivariate analysis higher PHQ-9 score remained an independent predictor for severe pain (beta = 0.302; 95% confidence interval [CI]: 0.054-0.473; P = 0.014). When all parameters were included into multivariate analysis, 2 of all somatic, psychological, and treatment factors were associated with severe maximal pain: more depression (PHQ-9; beta = 0.256; 95% CI: 0.042-0.404; P = 0.017), and use of opioids in the recovery room (beta = 0.371; 95% CI: 0.108-0.481; P = 0.002). Otolaryngological surgery covers the spectrum from low to severe postoperative pain and is therefore a good model for pain management studies. A set of somatic and psychological parameters seems to allow the

  4. Five days of postoperative antimicrobial therapy decreases infectious complications following pancreaticoduodenectomy in patients at risk for bile contamination

    PubMed Central

    Sourrouille, Isabelle; Gaujoux, Sebastien; Lacave, Guillaume; Bert, François; Dokmak, Safi; Belghiti, Jacques; Paugam-Burtz, Catherine; Sauvanet, Alain

    2013-01-01

    ObjectivesPancreaticoduodenectomy (PD) is associated with high morbidity, in part as a result of infectious complications increased by preoperative bile contamination. The aim of the present study was to assess the effect on the incidence of infectious complications of short-term antimicrobial therapy (AMT) in high-risk patients. MethodsPatients with a high risk for positive intraoperative bile culture (i.e. those with ampulloma or pancreatic adenocarcinoma with preoperative endoscopic procedures) (high-risk group, n = 99) were compared with low-risk patients (i.e. those with pancreatic adenocarcinoma without preoperative endoscopic procedures) (low-risk group, n = 76). The high-risk group received a 5-day course of perioperative AMT secondarily adapted to the bile antibiogram. The low-risk group received only the usual antimicrobial prophylaxis. ResultsPositive bile cultures were significantly more frequent in high-risk patients (81% versus 12%; P < 0.001). The overall rate of infectious complications was lower in the high-risk group (29% versus 46%; P = 0.018). The statistically significant decrease in the rate of infectious complications reflected reduced rates of urinary tract infections, pulmonary infections and septicaemia. Rates of wound infection (3% versus 5%; P = 0.639) and intra-abdominal abscess (7% versus 7%; P = 0.886) were similar in the high- and low-risk groups, as was the need for curative AMT. ConclusionsThis exploratory study suggests that a postoperative short course of AMT in patients at high risk for biliary contamination reduces the overall rate of infectious complications after PD. The adaptation of perioperative antimicrobial policy to the patient's risk for bile contamination seems promising and should be further evaluated. PMID:23458261

  5. Evaluation of postoperative pain scores following ultrasound guided transversus abdominis plane block versus local infiltration following day surgery laparoscopic cholecystectomy-retrospective study

    PubMed Central

    Kadam, Vasanth Rao; Howell, Stuart; Kadam, V.

    2016-01-01

    Background and Aims: Postoperative pain for day surgery laparoscopic cholecystectomy has traditionally been managed with the surgeon infiltrating the wound with local anesthetic (LA). However, transversus abdominis plane (TAP) block has recently been used, although its superiority over LA remains uncertain. The primary aim was to compare LA and TAP block pain scores and analgesia used. The secondary aim was to assess satisfaction score and cost. Material and Methods: This retrospective study was commenced after ethics committee approval and ANZ clinical trial registry (ACTRN: 12612000737831). The data were collected from the theatre database and medical records of patients presenting for day case laparoscopic cholecystectomy. The sample included patients who received either bilateral port site LA infiltration with 20 ml of 0.25% Bupivacaine or bilateral TAP block with 20 ml of 0.5% ropivacaine and fentanyl postoperative pain protocol. The patients with incomplete medical records were excluded as were those admitted to an inpatient ward. Demographics and clinical characteristics were obtained from the hospital record along with pain score and postsurgery analgesia use. Postoperative pain satisfaction scores were collected by telephonic interview 30-180 days postsurgery. Results: Of 51 patients analyzed, 19 were in TAP group 29 in LA group. There were no significant differences between the LA and TAP groups with respect to postoperative pain scores (P = 0.31) or patient satisfaction scores (1 and 2+) (P = 0.36). However, fentanyl consumption in the recovery room was significantly lower in TAP group (P = 0.0079.). The consumables cost were >3 times higher in the TAP when compared to LA group. Conclusion: The performance of the TAP block with respect to pain management was comparable to LA. However, LA remains more cost effective. PMID:27006547

  6. [The effectiveness of auricular micro-needle acupuncture in the early postoperative period under conditions of day surgical unit].

    PubMed

    Vorob'ev, V V; Dymnikov, A A

    2000-01-01

    The authors have developed a method of auricular microneedle analgesia--setting the microneedles in the area of the auricle floor for the period of up to 5 days which could reduce the pain syndrome. PMID:11209231

  7. 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

  8. Working Together for Student Achievement. 5th Biennial Joint Report

    ERIC Educational Resources Information Center

    Washington State Board of Education, 2014

    2014-01-01

    The Washington state Board of Education (SBE) and the Professional Educator Standards Board (PESB) submitted this 5th biennial joint report to the Governor, Legislative Education Committees, and Superintendent of Public Instruction. The report outlines the collaborative work of the Boards, highlights accomplishments, and provides goals and…

  9. 5th Conference on Aerospace Materials, Processes, and Environmental Technology

    NASA Technical Reports Server (NTRS)

    Cook, M. B. (Editor); Stanley, D. Cross (Editor)

    2003-01-01

    Records are presented from the 5th Conference on Aerospace Materials, Processes, and Environmental Technology. Topics included pollution prevention, inspection methods, advanced materials, aerospace materials and technical standards,materials testing and evaluation, advanced manufacturing,development in metallic processes, synthesis of nanomaterials, composite cryotank processing, environmentally friendly cleaning, and poster sessions.

  10. 5th Latin American pesticide residue workshop (LAPRW 2015)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This invited editorial proceedings article introduces the 6 research papers published in the special topical collection for the 5th Latin American Pesticide Residue Workshop held in Santiago, Chile, May 10-13, 2015. The meeting was a great success with more than 50 talks, 140 posters, 21 vendors, a...

  11. PREFACE: 5th Workshop of Young Researchers in Astronomy & Astrophysics

    NASA Astrophysics Data System (ADS)

    Forgács-Dajka, Emese; Plachy, Emese; Molnár, László

    2010-04-01

    The 5th Workshop of Young Researchers in Astronomy and Astrophysics was held on 2-4 September 2009 at the Eötvös University in Budapest, Hungary. This meeting fits into a conference series which can already be considered a tradition where the younger generation has the opportunity to present their work. The event was also a great opportunity for senior astronomers and physicists to form new connections with the next generation of researchers. The selection of invited speakers concentrated on the researchers currently most active in the field, mostly on a post-doctoral/tenure/fresh faculty position level. A number of senior experts and PhD students were also invited. As the conference focused on people rather than a specific field, various topics from theoretical physics to planetology were covered in three days. The programme was divided into six sections: Physics of the Sun and the Solar System Gravity and high-energy physics Galactic and extragalactic astronomy, cosmology Celestial mechanics and exoplanets Infrared astronomy and young stars Variable stars We had the pleasure of welcoming 10 invited review talks from senior researchers and 42 contributed talks and a poster from the younger generation. Participants also enjoyed the hospitality of the pub Pál at the Pálvölgyi-cave after giving, hearing and disputing countless talks. Brave souls even descended to the unbuilt, adventurous Mátyásvölgyi-cave. Memories of the conference were shadowed though. Péter Csizmadia, one of our participants and three other climbers attempted a first ever ascent to the Ren Zhong Feng peak in Sichuan, China, but they never returned from the mountains. Péter departed to China shortly after the conference, with best wishes from participants and friends. We dedicate this volume to his memory. The organisers thankthe Physics Doctoral School of Eötvös University for its hospitality. The workshop was supported by the Mecenatúra and Polányi Mihály Programmes of the National

  12. 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

  13. 5th Annual Global College of Neuroprotection and Neuroregeneration.

    PubMed

    Sharma, Hari Shanker

    2008-06-01

    The 5th Global College of Neuroprotection and Neuroregeneration (GCNN) was held in the historic charming capital city of Bucharest, Romania in JW Marriott Grand Hotel on 3-6 March, 2008. The meeting was a unique blend of basic researchers and clinicians across the Globe presenting their recent findings in neuroprotection and neuroregeneration in a beautiful exotic ambience. More than 300 students and researchers attended the congress and participated in deliberations. Over 60 representatives from various pharmaceutical industries from all over the world supported this event. This meeting was held for the first time as a joint venture with GCNN and the Society for study on Neuroproetction and Neuroplasticity (SSNN), and was a grand success both scientifically and socially. Thus, these joint meetings of the two societies (GCNN and SSNN) will continue in future in different European cities for the coming 5 years. PMID:18505353

  14. 167. GENERAL VIEW DOWN 5TH AVE. VIEW TO SOUTHWEST DOWN ...

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

    167. GENERAL VIEW DOWN 5TH AVE. VIEW TO SOUTHWEST DOWN 5TH AVE. SHOWING FROM LEFT TO RIGHT, BUILDING 504, 436, 11, AND 155. - Quonset Point Naval Air Station, Roger Williams Way, North Kingstown, Washington County, RI

  15. PREFACE: 5th Baltic Conference on Silicate Materials

    NASA Astrophysics Data System (ADS)

    Mezinskis, G.; Bragina, L.; Colombo, P.; Frischat, G. H.; Grabis, J.; Greil, P.; Deja, J.; Kaminskas, R.; Kliava, J.; Medvids, A.; Nowak, I.; Siauciunas, R.; Valancius, Z.; Zalite, I.

    2011-12-01

    Logo This Volume of IOP Conference Series: Materials Science and Engineering presents a selection of the contributions to the 5th Baltic Conference on Silicate Materials (BaltSilica2011) held at Riga Technical University, Riga, Latvia from 23-25 May 2011. The conference was organized by Riga Technical University (Latvia) and Kaunas University of Technology (Lithuania). The series of Baltic conferences on silicate materials was started since 2004: the first conference was held in Riga, Latvia, 2004; the second conference was held in Kaunas, Lithuania 2005; the third was held again in Riga, Latvia, 2007, and the fourth was held in Kaunas, Lithuania 2009. BaltSilica 2011 was attended by around 50 participants from Latvia, Lithuania, Estonia, Germany, Poland, Italy, France, Ukraine and Russia. In comparison with previous silicate materials conferences, the broadening of participating countries is an indication of the interest of scientists, engineers and students to exchange research ideas, latest results, and to find new research topics for cooperation in the fields of silicate, high temperature materials, and inorganic nanomaterials. The scientific programme included 8 invited plenary lectures 23 oral presentations and 25 posters [1]. Scientific themes covered in the conference and in this special issue: Natural and Artificial Stone Materials; Traditional and New Ceramic and Glass-Like Materials; Nanoparticles and Nanomaterials. This volume consists of 23 selected proceeding papers. The Editor of this special issue is grateful to all the contributors to BaltSilica 2011. I am also very grateful to the scientific committee, the local organizing committee, the session chairs, the referees who refereed the submitted articles to this issue, and to students from the Department of Silicate, High Temperature and Inorganic Nanomaterials Technology of the Riga Technical University who ensured the smooth running of the conference. Particular thanks goes to eight plenary

  16. Managing Haemophilia for Life: 5th Haemophilia Global Summit.

    PubMed

    Hermans, Cedric; Dolan, Gerry; Jennings, Ian; Windyga, Jerzy; Lobet, Sébastien; Rodríguez-Merchán, E Carlos; Di Minno, Matteo Nicola Dario; Jiménez-Yuste, Víctor; O'Mahony, Brian

    2015-10-01

    The 5th Haemophilia Global Summit was held in Barcelona, Spain, in September 2014. The programme was designed by an independent Scientific Steering Committee of haemophilia experts and explored issues relevant to the practical management of haemophilia, as well as key opportunities and challenges for care in the future. The topics outlined in this supplement were selected by the Scientific Steering Committee for their relevance to improving haemophilia care globally. In this supplement from the meeting, Gerry Dolan explores pharmacokinetics and dynamics in haemophilia, and Gerry Dolan and Ian Jennings jointly address the role of the laboratory in haemophilia care. The potential benefits of low-dose prophylaxis regimens for people with haemophilia in the developing world are reviewed by Jerzy Windyga, and the question of whether 'Future haemophilia research should be undertaken in the developing world' is debated by Jerzy Windyga and Cedric Hermans. Management strategies for ankle arthropathy are discussed by Sébastien Lobet and E. Carlos Rodríguez-Merchán, and the use of ultrasound for the early detection of haemophilic arthropathy is addressed by Matteo Nicola Dario Di Minno and Víctor Jiménez-Yuste. Finally, the role of patients in the future of haemophilia care is reviewed by Brian O'Mahony. PMID:26350039

  17. 5th Bionanotox and Applications International Research Conference, Peabody, Little Rock, Arkansas, USA

    NASA Astrophysics Data System (ADS)

    Sabb, Taneicie; Chowdhury, Parimal

    2011-06-01

    "BioNanoTox and Toxicity: using Technology to Advance Discovery" was this year's theme at the 5th BioNanoTox and Applications International Research Conference held at the Peabody Hotel, Little Rock, Arkansas on November 4-5th, 2010. This year, the international participation in this conference increased to 25 countries spanning the globe. The conference began with opening remarks by Paul Howard, Associate Director of the National Center for Toxicological Research, Food and Drug Administration, Jefferson, Arkansas, United States. Two keynote speakers, Dr. Ananth V. Annapragada and Dr. Merle G. Paule presented lectures on "Toxicity of Novel Nanoparticles for CT imaging" and "The Biology of Neurotoxicity: using Technology to Advance Discovery", respectively. Teachers, students, faculty, and scientists presented oral and poster presentations on fundamental and translational research related to BioNanoTox and related fields of science. Six presentation sessions were held over the two-day conference. There were 31 presentations and 39 posters from disciplines ranging from biology to chemistry, toxicology, nanotechnology, computational sciences, mathematics, engineering, plant science, and biotechnology. Poster presentation awards were presented to three high school students, three high school teachers, and three college students. In addition to poster awards a memorial, travel, and BioNanoTox award were presented. This year's meeting paved the way for a more outstanding meeting for the future.

  18. Teaching 5th grade science for aesthetic understanding

    NASA Astrophysics Data System (ADS)

    Girod, Mark A.

    Many scientists speak with great zeal about the role of aesthetics and beauty in their science and inquiry. Few systematic efforts have been made to teach science in ways that appeal directly to aesthetics and this research is designed to do just that. Drawing from the aesthetic theory of Dewey, I describe an analytic lens called learning for aesthetic understanding that finds power in the degree to which our perceptions of the world are transformed, our interests and enthusiasm piqued, and our actions changed as we seek further experiences in the world. This learning theory is contrasted against two other current and popular theories of science learning, that of learning for conceptual understanding via conceptual change theory and learning for a language-oriented or discourse-based understanding. After a lengthy articulation of the pedagogical strategies used to teach for aesthetic understanding the research is described in which comparisons are drawn between students in two 5th grade classrooms---one taught for the goal of conceptual understanding and the other taught for the goal of aesthetic understanding. Results of this comparison show that more students in the treatment classroom had aesthetic experiences with science ideas and came to an aesthetic understanding when studying weather, erosion, and structure of matter than students in the control group. Also statistically significant effects are shown on measures of interest, affect, and efficacy for students in the treatment class. On measures of conceptual understanding it appears that treatment class students learned more and forgot less over time than control class students. The effect of the treatment does not generally depend on gender, ethnicity, or prior achievement except in students' identity beliefs about themselves as science learners. In this case, a significant interaction for treatment class females on science identity beliefs did occur. A discussion of these results as well as elaboration and

  19. Overlay improvement by ASML HOWA 5th alignment strategy

    NASA Astrophysics Data System (ADS)

    Wang, Raf; Chiang, CY; Hsu, Wilson; Yang, Richer; Shih, Todd; Chen, Jackie; Chiu, Jonathan; Lin, Wythe

    2009-12-01

    Overlay control is more challenging when DRAM volume production continues to shrink its critical dimention (CD) to 70nm and beyond. Effected by process, the overlay behavior at wafer edge is quite different from wafer center. The big contribution to worse overlay at wafer edge which causes yield loss is misalignment. The analysis in wafer edge suggests that high order uncorrectable overlay residuals are often observed by certain process impact. Therefore, the basic linear model used for alignment correction is not sufficient and it is necessary to introduce an advanced alignment correction model for wafer edge overlay improvement. In this study, we demonstrated the achievement of moderating the poor overlay at wafer edge area by using a high order wafer alignment strategy. The mechanism is to use non-linear correction methods of high order models ( up to 5th order), with support by the function High Order Wafer Alignment (known as HOWA) in scanner. Instead of linear model for the 6 overlay parameters which come from average result, HOWA alignment strategy can do high order fitting through the wafer to get more accurate overlay parameters which represent the local wafer grid distortion better. As a result, the overlay improvement for wafer edge is achieved. Since alignment is a wafer dependent correction, with HOWA the wafer to wafer overlay variation can be improved dynamically as well. In addition, the effects of different mark quantity and sampling distribution from HOWA are also introduced in this paper. The results of this study indicate that HOWA can reduce uncorrectable overlay residual by 30~40% and improve wafer-to-wafer overlay variation significantly. We conclude that HOWA is a noteworthy strategy for overlay improvement. Moreover, optimized alignment mark numbers and distribution layout are also key factors to make HOWA successful.

  20. The utility of a 5th nap in multiple sleep latency test

    PubMed Central

    Lykouras, Dimosthenis; Rees, Kate

    2016-01-01

    Background This is the first study that aimed to look specifically at the utility of the 5th nap in the multiple sleep latency test (MSLT), a test used to assist in the diagnosis of narcolepsy. Methods Data was retrospectively collected from the Sleep Disorders Centre of a Tertiary Hospital on patients that had a 5th nap during their MSLT from the 08th November 2011 to 12th November 2014. Results Fifty-three patients had a 5th nap performed out of 378 MSLT studies. In 16% of cases a diagnosis of narcolepsy was given directly due to the inclusion of the 5th nap on the MSLT. Here a 5th nap allowed diagnostic criteria of mean sleep latency <8 minutes and >2 SOREMPS to be met. In 53% of cases the mean sleep latency increased due to 5th nap inclusion; the mean sleep latency of the first four naps was 5.6 vs. 6.7 after inclusion of the 5th nap. Conclusions The 5th nap is not often performed within the MSLT studies. Our study shows that only a few patients may benefit from a 5th nap opportunity which also led to increase of the mean sleep latency at the expense of extra time, cost, labour and increased patient anxiety. PMID:26904269

  1. 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

  2. POSTOPERATIVE DELIRIUM

    PubMed Central

    Whitlock, Elizabeth L.; Vannucci, Andrea; Avidan, Michael S.

    2013-01-01

    Delirium is an unfortunately common complication seen during the postoperative course. Because of its significant association with physical and cognitive morbidity, clinicians should be aware of evidence-based practices relating to the diagnosis, treatment, and prevention of postoperative delirium. Here, we review selected recent literature pertaining to the epidemiology and impact of the condition, perioperative risk factors for its development and/or exacerbation, and strategies for management of delirium, with additional attention to the intensive care unit population. PMID:21483389

  3. 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

  4. Black sea surface temperature anomaly on 5th August 1998 and the ozone layer thickness

    NASA Astrophysics Data System (ADS)

    Manev, A.; Palazov, K.; Raykov, St.; Ivanov, V.

    2003-04-01

    BLACK SEA SURFACE TEMPERATURE ANOMALY ON 5th AUGUST 1998 AND THE OZONE LAYER THICKNESS A. Manev , K. Palazov , St. Raykov, V. Ivanov Solar Terrestrial Influences Laboratory, Bulgarian Academy of Sciences amanev@abv.bg This paper focuses on the peculiarities of the Black Sea surface temperature anomaly on 05.08.1998. Researching the daily temperature changes in a number of control fields in the course of 8-10 years, we have found hidden correlations and anomalous deviations in the sea surface temperatures on a global scale. Research proves the statistical reliability of the temperature anomaly on the entire Black Sea surface registered on 04.-05.08.1998. In the course of six days around these dates the temperatures are up to 2°C higher than the maximum temperatures in this period in the other seven years. A more detailed analysis of the dynamics of the anomaly required the investigation of five Black Sea surface characteristic zones of 75x75 km. The analysis covers the period 20 days - 10 days before and 10 days after the anomaly. Investigations aimed at interpreting the reasons for the anomalous heating of the surface waters. We have tried to analyze the correlation between sea surface temperature and the global ozone above the Black Sea by using simultaneously data from the two satellite systems NOAA and TOMS. Methods of processing and comparing the data from the two satellite systems are described. The correlation coefficients values for the five characteristic zones are very high and close, which proves that the character of the correlation ozone - sea surface temperature is the same for the entire Black Sea surface. Despite the high correlation coefficient, we have proved that causality between the two phenomena at the time of the anomaly does not exit.

  5. Need for Specific Sugar-Sweetened Beverage Lessons for 4th and 5th Graders

    PubMed Central

    Bea, Jennifer W.; Jacobs, Laurel; Waits, Juanita; Hartz, Vern; Martinez, Stephanie H.; Standfast, Rebecca D.; Farrell, Vanessa A.; Bawden, Margine; Whitmer, Evelyn; Misner, Scottie

    2015-01-01

    Objective Consumption of sugar-sweetened beverages (SSB) is linked to obesity. We hypothesized that school-based nutrition education would decrease SSB consumption. Design Self-selected interventional cohort with random selection for pre and post measurements Setting Arizona SNAP-Ed eligible schools Participants Randomly selected (9%) 4th and 5th grade classroom students Intervention The University of Arizona Nutrition Network (UANN) provided general nutrition education training and materials to teachers, to be delivered to their students. The UANN administered behavioral questionnaires to students in both Fall and Spring. Main Outcome Measure(s) Change in SSB consumption Analyses Descriptive statistics were computed for student demographics and beverage consumption on the day prior to testing. Paired t-tests evaluated change in classroom averages. Linear regression assessed potential correlates of SSB consumption. Results Fall mean SSB consumption was 1.1 (±0.2) times; mean milk and water intake were 1.6 (±0.2) and 5.2 (±0.7) times, respectively. Beverage consumption increased (3.2%) in springtime, with increased SSBs (14.4%) accounting for the majority (p=0.006). Change in SSB consumption was negatively associated with baseline SSB and water consumption, but positively associated with baseline milk fat (p≤0.05). Conclusions and Implications The results suggest the need for beverage specific education to encourage children to consume more healthful beverages in warmer weather. PMID:25239840

  6. Work Values of 5th, 8th, and 11th Grade Students

    ERIC Educational Resources Information Center

    Hales, Loyde W.; Fenner, Bradford

    1972-01-01

    Self Realization, Job Security, Money, and Altruism were found to be the most important work values, with 5th and 8th grade students differing from 11th grade students on Altruism and Self Realization. (Author)

  7. 25. April 5th one month's work. View looking north. Storehouse ...

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

    25. April 5th one month's work. View looking north. Storehouse #1 under construction, storehouse #2 site work in progress toward foreground. - U.S. Navy Fleet Supply Base, Storehouse No. 1, 830 Third Avenue, Brooklyn, Kings County, NY

  8. 17. 4th floor roof, view south, 4th and 5th floor ...

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

    17. 4th floor roof, view south, 4th and 5th floor setback to left and atrium structure to right - Sheffield Farms Milk Plant, 1075 Webster Avenue (southwest corner of 166th Street), Bronx, Bronx County, NY

  9. 6. 5TH FLOOR, VIEW NORTH OF KETTLE SOAP STORAGE TANKS ...

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

    6. 5TH FLOOR, VIEW NORTH OF KETTLE SOAP STORAGE TANKS (RIGHT) AND WEIGH HOPPERS OVER SITES OF REMOVED AMALGAMATORS (LEFT) - Colgate & Company Jersey City Plant, Building No. B-14, 54-58 Grand Street, Jersey City, Hudson County, NJ

  10. Storm Peak Laboratory 5th-6th Grade Climate and Weather Program

    NASA Astrophysics Data System (ADS)

    McCubbin, I. B.; Hallar, A. G.

    2008-12-01

    science. At the end of the day each student has a data sheet with measurements recorded from 5 locations of different elevations to take back to the classroom. Following the field trip, SPL scientists and educators visit the school for a follow-up to help children grasp concepts, represent their data set collected in graphical formats, answer questions, and evaluate students" learning. Currently, approximately 250 students annually participate in the SPL 5th and 6th grade climate education program.

  11. Freezing Rain Diagnostic Study Over Eastern Canada Using the 5th Generation Canadian Regional Climate Model

    NASA Astrophysics Data System (ADS)

    Bresson, É.; Paquin, D.; Laprise, R.; Theriault, J. M.; de Elía, R.

    2015-12-01

    Northeastern North America is often affected by freezing rain events during the cold season. They can have significant consequences (from road accidents, to severe power outages) despite their intensity and duration. The 1998 Ice Storm over Eastern Canada and Northeastern United States is an example of an extreme event with catastrophic consequences. A total of up to 150 mm of ice accumulated during 10 days were observed in some areas. This natural disaster has highlighted the need to better understand how such phenomena will evolve with future climate scenario. The goal is to investigate the feasibility of using regional climate modeling to diagnose the occurrence of freezing rain events over Quebec (Canada). To address this issue, we used the 5th generation of the Canadian Regional Climate Model (CRCM5), from 1979 to 2014. An empirical method (Bourgouin, 2000) developed to determine the type of winter precipitations was chosen to diagnose freezing rain events. The study focused in the Montreal area and the St. Lawrence River Valley (Quebec, Canada). The sensitivity of the model to horizontal resolution was explored by using three resolutions: 0.44°, 0.22° and 0.11°. In general, freezing rain was diagnosed consistently at all resolutions but the higher one (0.11°) produced more realistic results due to a better representation of the orography. Using the higher resolution, the results showed that the climatology of the freezing rain occurrence in the Montreal area is comparable to available observations. It also suggested that the role of the specific orography of the region with the St. Lawrence River Valley can impact the characteristics of freezing rain events in this area. Overall, this study will contribute to a better preparedness for such events in the future. High resolution regional climate simulations are essential to improve the reproduction of local scale orographically-forced phenomena.

  12. FOREWORD: 5th International Workshop on New Computational Methods for Inverse Problems

    NASA Astrophysics Data System (ADS)

    Vourc'h, Eric; Rodet, Thomas

    2015-11-01

    This volume of Journal of Physics: Conference Series is dedicated to the scientific research presented during the 5th International Workshop on New Computational Methods for Inverse Problems, NCMIP 2015 (http://complement.farman.ens-cachan.fr/NCMIP_2015.html). This workshop took place at Ecole Normale Supérieure de Cachan, on May 29, 2015. The prior editions of NCMIP also took place in Cachan, France, firstly within the scope of ValueTools Conference, in May 2011, and secondly at the initiative of Institut Farman, in May 2012, May 2013 and May 2014. The New Computational Methods for Inverse Problems (NCMIP) workshop focused on recent advances in the resolution of inverse problems. Indeed, inverse problems appear in numerous scientific areas such as geophysics, biological and medical imaging, material and structure characterization, electrical, mechanical and civil engineering, and finances. The resolution of inverse problems consists of estimating the parameters of the observed system or structure from data collected by an instrumental sensing or imaging device. Its success firstly requires the collection of relevant observation data. It also requires accurate models describing the physical interactions between the instrumental device and the observed system, as well as the intrinsic properties of the solution itself. Finally, it requires the design of robust, accurate and efficient inversion algorithms. Advanced sensor arrays and imaging devices provide high rate and high volume data; in this context, the efficient resolution of the inverse problem requires the joint development of new models and inversion methods, taking computational and implementation aspects into account. During this one-day workshop, researchers had the opportunity to bring to light and share new techniques and results in the field of inverse problems. The topics of the workshop were: algorithms and computational aspects of inversion, Bayesian estimation, Kernel methods, learning methods

  13. Reflecting on the 5th World Environmental Education Congress, Montreal, 2009

    ERIC Educational Resources Information Center

    Jickling, Bob

    2010-01-01

    This article traces the development of the World Environmental Congress movement and its establishment as an important international forum. Reflecting on the 5th Congress, it notes the particular contribution of the Congress theme, "Our Common Home". Finally, it considers environmental education's place alongside other parallel transformative…

  14. A Network Sets Things in Motion: TEDD Celebrates its 5(th) Anniversary.

    PubMed

    2015-01-01

    At the Annual Meeting at ZHAW Waedenswil on 22 October 2015, the TEDD-Network (Tissue Engineering for Drug Development and Substance Testing) celebrated its 5(th) anniversary. Since its foundation, TEDD has become an internationally renowned competence centre and includes currently 91 members from academia and industry. They cover the entire development and value chain. PMID:26671055

  15. Urban 5th Graders Conceptions during a Place-Based Inquiry Unit on Watersheds

    ERIC Educational Resources Information Center

    Endreny, Anna Henderson

    2010-01-01

    This study aimed to determine how 33 urban 5th grade students' science conceptions changed during a place-based inquiry unit on watersheds. Research on watershed and place-based education was used as a framework to guide the teaching of the unit as well as the research study. A teacher-researcher designed the curriculum, taught the unit and…

  16. The 5th World Environmental Education Congress, 2009: A Research Project

    ERIC Educational Resources Information Center

    Jickling, Bob; Sauve, Lucie; Briere, Laurence; Niblett, Blair; Root, Emily

    2010-01-01

    This paper contextualizes the 5th World Environmental Education Congress, discusses the theoretical underpinnings of the Congress theme "Earth Our Common Home," and relates this theorizing to the research project that was woven through the Congress. We provide a rationale for engaging in this research project, as an invitation for Congress…

  17. 10. Interior view, working house, scale floor (5th level). View ...

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

    10. Interior view, working house, scale floor (5th level). View facing across floor toward no. 2 scale and garner. Tile structure at left center is weighmaster's shack; view facing east. - Saint Anthony Elevator No. 3, 620 Malcom Avenue, Southeast, Minneapolis, Hennepin County, MN

  18. An Investigation of Science and Technology Teachers' Views on the 5th Grade Science Course

    ERIC Educational Resources Information Center

    Dasdemir, Ikramettin

    2014-01-01

    This study was conducted to explore the science and technology teachers' views on the implementation of 5th grade science course. Open-ended questions were used as a data collection tool. The study sample consisted of 28 science and technology teachers working in Erzurum in 2012-2013 education year. The data gathered were analysed via content…

  19. Vocabulary and Syntactic Knowledge Factors in 5th Grade Students' Reading Comprehension

    ERIC Educational Resources Information Center

    Mokhtari, Kouider; Niederhauser, Dale S.

    2013-01-01

    In this study, we examined 5th grade students' levels of vocabulary knowledge and syntactic awareness relative to their reading comprehension performance. The aim was to explore the contributions of vocabulary and syntactic awareness as potential sources of reading comprehension difficulty for these readers. Overall, we found that both vocabulary…

  20. 78 FR 53454 - Filing Dates for the Louisiana Special Elections in the 5th Congressional District

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... From the Federal Register Online via the Government Publishing Office FEDERAL ELECTION COMMISSION Filing Dates for the Louisiana Special Elections in the 5th Congressional District AGENCY: Federal Election Commission. ACTION: Notice of filing dates for special election. SUMMARY: Louisiana has...

  1. The 5th edition of the Roma-BZCAT. A short presentation

    NASA Astrophysics Data System (ADS)

    Massaro, E.; Maselli, A.; Leto, C.; Marchegiani, P.; Perri, M.; Giommi, P.; Piranomonte, S.

    2015-05-01

    The 5th edition of the Roma-BZCAT Multifrequency Catalogue of Blazars is available in a printed version and online at the ASDC website (http://www.asdc.asi.it/bzcat); it is also in the NED database. It presents several relevant changes with respect to the past editions which are briefly described in this paper.

  2. A Longitudinal Study of a 5th Grade Science Curriculum Based on the 5E Model

    ERIC Educational Resources Information Center

    Scott, Timothy P.; Schroeder, Carolyn; Tolson, Homer; Huang, Tse-Yang; Williams, Omah M.

    2014-01-01

    The Center for Mathematics and Science Education at Texas A&M University contracted with Region 4 Education Service Center (ESC) and a large, diverse school district to conduct a longitudinal study from 2005-2009. The state achievement test scores of 5th graders who were taught using a Grade 5 science textbook designed by Region 4 ESC were…

  3. Socially, Developmentally, and Academically Appropriate Prevention Curriculum for 5th Graders

    ERIC Educational Resources Information Center

    Harthun, Mary L.; Dustman, Patricia A.; Reeves, Leslie J.; Marsiglia, Flavio F.; Hecht, Michael L.

    2009-01-01

    This paper reports on a process in which program designers, classroom teachers, and students worked together to adapt the 7th grade "keepin' it REAL" prevention curriculum to a developmentally, socially, and academically appropriate curriculum for 5th graders. A Community-Based Participatory Research methodology (CBPR), combined with a 9-step…

  4. Oral Persuasion: A Saleable Work Skill. Occupation Simulation Packet. Grades 5th-6th.

    ERIC Educational Resources Information Center

    Lee, Dennis W.

    This teacher's guide contains simulated work experiences for 5th and 6th grade students using the isolated skill concept - oral persuasion. Teacher instructions include objectives, evaluation, and sequence of activities. The guide contains pre-tests and post-tests with instructions and answer keys. Two pre-skill activities are suggested, such as…

  5. 9. 5TH FLOOR, INTERIOR DETAIL TO EAST OF SOAP BIN ...

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

    9. 5TH FLOOR, INTERIOR DETAIL TO EAST OF SOAP BIN No. 4: UPPER SCREWS MOVED SOAP CHIPS HORIZONTALLY FROM BIN TO BIN; LOWER LEFT-AND RIGHT-HAND SCREWS MOVED CHIPS TO CHUTE LEADING TO 3RD FLOOR SOAP MILLS - Colgate & Company Jersey City Plant, Building No. B-14, 54-58 Grand Street, Jersey City, Hudson County, NJ

  6. How Arizona Compares: Real Numbers and Hot Topics. Policy Choices. 5th Edition

    ERIC Educational Resources Information Center

    Morrison Institute for Public Policy, 2005

    2005-01-01

    Morrison Institute for Public Policy is pleased to present "How Arizona Compares: Real Numbers and Hot Topics," the 5th edition of Arizona "Policy Choices." The Arizona "Policy Choices" volumes seek to do more than report. They are designed to assist decision making, stimulate debate, and serve as references. Arizona "Policy Choices" volumes have…

  7. The Effect of Progressive Sentence Development Activities on 5th Graders' Description Skills

    ERIC Educational Resources Information Center

    Hamzadayi, Ergun

    2015-01-01

    The aim of this study was to examine the effect of progressive sentence development activities on 5th graders' description skills. The study was conducted based on the pretest-posttest quasi-experimental model with a control group. A total of 58 students participated in the study; 29 in the control group, and 29 in the experimental group. The…

  8. Successfully Promoting 21st Century Online Research Skills: Interventions in 5th-Grade Classrooms

    ERIC Educational Resources Information Center

    Kingsley, Tara L.; Cassady, Jerrell C.; Tancock, Susan M.

    2015-01-01

    This quantitative study was developed to explore the ability to impact elementary student 21st Century online research skills with a planned classroom intervention curriculum. The repeated measures quasi-experimental study randomly assigned all 5th grade classes in a Midwestern, suburban school (n = 418) to a 12-week intervention or control…

  9. Effects of temperature and modified atmospheres on diapausing 5th instar codling moth metabolism

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Diapausing 5th instars of codling moth, Cydia pomonella, are serious quarantine pests of in-shell walnuts. Previous research indicates that heat treatments in combination with high concentrations of carbon dioxide and low concentrations of oxygen may be effective for controlling this pest in walnuts...

  10. 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

  11. 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. PMID:25698564

  12. Clinical experimental studies of postoperative infusion analgesia.

    PubMed

    Knoche, E; Dick, W; Bowdler, I; Gundlach, G

    1983-01-01

    Thirty postoperative patients, after undergoing abdominal hysterectomy and standard general anesthesia, were randomly allocated to three groups and received, in the recovery ward, a continuous infusion of either pentazocine, piritramide, or ketamine. The patients rated their pain on a 15-cm visual analog scale. Patients in group 1 received pentazocine. Mean dosage was 0.12 mg/kg/hr on the day of operation, 0.1 mg/kg/hr on the first postoperative day, and only 0.07 mg/kg/hr on the second postoperative day. Pentazocine blood levels averaged 50 micrograms/L. Patients in group 2 received piritramide. Mean dosage was 0.038 mg/kg/hr on the day of operation, 0.024 mg/kg/hr on the first postoperative day, and 0.019 mg/kg/hr on the second postoperative day. Blood levels of piritramide were not determined because no satisfactory assay is available. Patients in group 3 received ketamine. Mean dosage was 0.32 mg/kg/hr on the day of operation, 0.28 mg/kg/hr on the first postoperative day, and 0.29 mg/kg/hr on the second postoperative day. Ketamine blood levels ranged between 120 and 180 micrograms/L. None of the three analgesics caused any important hemodynamic or respiratory side effects. Pentazocine and piritramide were more effective analgesics than ketamine was. Ketamine also had a higher incidence of side effects. PMID:6627285

  13. Face lift postoperative recovery.

    PubMed

    Mottura, A Aldo

    2002-01-01

    The purpose of this paper is to describe what I have studied and experienced, mainly regarding the control and prediction of the postoperative edema; how to achieve an agreeable recovery and give positive support to the patient, who in turn will receive pleasant sensations that neutralize the negative consequences of the surgery.After the skin is lifted, the drainage flow to the flaps is reversed abruptly toward the medial part of the face, where the flap bases are located. The thickness and extension of the flap determines the magnitude of the post-op edema, which is also augmented by medial surgeries (blepharo, rhino) whose trauma obstruct their natural drainage, increasing the congestion and edema. To study the lymphatic drainage, the day before an extended face lift (FL) a woman was infiltrated in the cheek skin with lynfofast (solution of tecmesio) and the absorption was observed by gamma camera. Seven days after the FL she underwent the same study; we observed no absorption by the lymphatic, concluding that a week after surgery, the lymphatic network was still damaged. To study the venous return during surgery, a fine catheter was introduced into the external jugular vein up to the mandibular border to measure the peripheral pressure. Following platysma plication the pressure rose, and again after a simple bandage, but with an elastic bandage it increased even further, diminishing considerably when it was released. Hence, platysma plication and the elastic bandage on the neck augment the venous congestion of the face. There are diseases that produce and can prolong the surgical edema: cardiac, hepatic, and renal insufficiencies, hypothyroidism, malnutrition, etc. According to these factors, the post-op edema can be predicted, the surgeon can choose between a wide dissection or a medial surgery, depending on the social or employment compromises the patient has, or the patient must accept a prolonged recovery if a complex surgery is necessary. Operative

  14. 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. PMID:27041258

  15. Comparative study of two anesthesia methods according to postoperative complications and one month mortality rate in the candidates of hip surgery

    PubMed Central

    Heidari, Saied Morteza; Soltani, Hasanali; Hashemi, Saied Jalal; Talakoub, Reihanak; Soleimani, Bahram

    2011-01-01

    BACKGROUND: Surgery for hip fractures can be done under general or neuraxial anesthesia. This study aimed to compare these two methods concerning their postoperative complications, duration of operation, hospitalization and the mortality rate within a period of one month after surgery. METHODS: 400 patients aged more than 30 years old and scheduled for elective operative fixation of fractured hip, randomly enrolled in two equal groups of general (GA) and neuraxial (NA) anesthesia. Hemoglobin level was measured before and 6 hours, 2, 3 and 5 days after the surgery. The intra and postoperative blood loss, duration of surgery, the severity of pain at the time of discharge from recovery and at the 2nd, 3rd and 5th postoperative days were recorded. Statistical analysis was performed using SPSS version 12.0 by Mann-Whitney, chi-square, and t tests. P < 0.05 was considered significant. RESULTS: Both groups were similar regarding age, weight, and gender ratio. There was no significant difference in baseline hemoglobin, duration of surgery, length of hospitalization before surgery and the type of surgery. The mean of intraoperative blood loss and visual analogue score (VAS) in recovery and at the 3rd postoperative day, and also the length of hospitalization after surgery were significantly less in neuraxial anesthesia group. Both groups showed a significant decrease in hemoglobin values on the 2nd and 3rd postoperative days comparing to the baseline (p < 0.001). CONCLUSIONS: The morbidity and mortality rates of patients undergoing hip surgery were similar in both methods of anesthesia, but postoperative pain, blood loss, and duration of hospitalization were more in patients undergoing general anesthesia. PMID:22091252

  16. VizieR Online Data Catalog: The Roma BZCAT - 5th edition (Massaro+, 2015)

    NASA Astrophysics Data System (ADS)

    Massaro, E.; Giommi, P.; Leto, C.; Marchegiani, P.; Maselli, A.; Perri, M.; Piranomonte, S.; Sclavi, S.

    2016-02-01

    In the 5th Edition we use similar denomination of blazars adopted in the previous editions. Each blazar is identified by a code, with 5BZ for all blazars, a fourth letter that specifies the type (B, G, Q or U), followed by the truncated equatorial coordinates (J2000). We introduced the edition number before the letters BZ to avoid possible confusion due to the fact that several sources changed their old names because of the new adopted classification. The codes are defined in the "Note (G1)" below. The 5th edition contains 1151 BZB sources, 92 of which are reported as candidates because we could not find their optical spectra in the literature, 1909 BZQ sources, 274 BZG sources and 227 BZU objects (1 data file).

  17. An 8 x 10 to the 5th bit bubble memory cell for spacecraft applications

    NASA Technical Reports Server (NTRS)

    Becker, F. J.; Murray, G. W.; Bohning, O. D.; Stermer, R. L.

    1980-01-01

    A multiple chip magnetic bubble memory cell design developed for NASA embodies the low power, low weight, environmental tolerance and reliability necessary for successful operation in spacecraft launch and mission environments. Packaging of multiple chips in a common magnetic bias, drive coil assembly reduces weight and volume overhead per chip and also reduces the number of coil drive components required. This 8 x 10 to the 5th bit cell is conduction cooled and provides a metal and ceramic sealed hermetic chip environment.

  18. Instantaneous frequency measurement by in-fiber 0.5th order fractional differentiation

    NASA Astrophysics Data System (ADS)

    Poveda-Wong, L.; Carrascosa, A.; Cuadrado-Laborde, C.; Cruz, J. L.; Díez, A.; Andrés, M. V.

    2016-07-01

    We experimentally demonstrate the possibility to retrieve the instantaneous frequency profile of a given temporal light pulse by in-fiber fractional order differentiation of 0.5th-order. The signal's temporal instantaneous frequency profile is obtained by simple dividing two temporal intensity profiles, namely the intensities of the input and output pulses of a spectrally-shifted fractional order differentiation. The results are supported by the experimental measurement of the instantaneous frequency profile of a mode-locked laser.

  19. Proceedings of the 5th International Symposium on Blue Laser and Light Emitting Diodes (ISBLLED-2004)

    NASA Astrophysics Data System (ADS)

    Suh, Eun-Kyung; Yoon, Euijoon; Lee, Hyung Jae

    2004-09-01

    The 5th International Symposium on Blue Laser and Light Emitting Diodes (ISBLLED-2004) was held in Gyeongju, Korea, 15-19 March 2004. The purpose of the symposium was to provide a forum for scientists and engineers to discuss recent progress and future trends in the rapidly advancing wide band gap semiconductor science and technologies and their applications in blue laser and light emitting diodes.

  20. Postoperative circadian disturbances.

    PubMed

    Gögenur, Ismail

    2010-12-01

    An increasing number of studies have shown that circadian variation in the excretion of hormones, the sleep wake circle, the core body temperature rhythm, the tone of the autonomic nervous system and the activity rhythm are important both in health and in disease processes. An increasing attention has also been directed towards the circadian variation in endogenous rhythms in relation to surgery. The attention has been directed to the question whether the circadian variation in endogenous rhythms can affect postoperative recovery, morbidity and mortality. Based on the lack of studies where these endogenous rhythms have been investigated in relation to surgery we performed a series of studies exploring different endogenous rhythms and factors affecting these rhythms. We also wanted to examine whether the disturbances in the postoperative circadian rhythms could be correlated to postoperative recovery parameters, and if pharmacological administration of chronobiotics could improve postoperative recovery. Circadian rhythm disturbances were found in all the examined endogenous rhythms. A delay was found in the endogenous rhythm of plasma melatonin and excretion of the metabolite of melatonin (AMT6s) in urine the first night after both minor and major surgery. This delay after major surgery was correlated to the duration of surgery. The amplitude in the melatonin rhythm was unchanged the first night but increased in the second night after major surgery. The amplitude in AMT6s was reduced the first night after minimally invasive surgery. The core body temperature rhythm was disturbed after both major and minor surgery. There was a change in the sleep wake cycle with a significantly increased duration of REM-sleep in the day and evening time after major surgery compared with preoperatively. There was also a shift in the autonomic nervous balance after major surgery with a significantly increased number of myocardial ischaemic episodes during the nighttime period. The

  1. Effects of the 5th and 7th Grade Enhanced Versions of the "keepin' it REAL" Substance Use Prevention Curriculum

    ERIC Educational Resources Information Center

    Elek, Elvira; Wagstaff, David A.; Hecht, Michael L.

    2010-01-01

    This study assessed the outcomes of adapting the culturally-grounded, middle school, substance-use prevention intervention, "keepin' it REAL" ("kiR"), to target elementary school students and to address acculturation. At the beginning of 5th grade, 29 schools were randomly assigned to conditions obtained by crossing grade of implementation (5th,…

  2. Measuring Listening Comprehension Skills of 5th Grade School Students with the Help of Web Based System

    ERIC Educational Resources Information Center

    Acat, M. Bahaddin; Demiral, Hilmi; Kaya, Mehmet Fatih

    2016-01-01

    The main purpose of this study is to measure listening comprehension skills of 5th grade school students with the help of web based system. This study was conducted on 5th grade students studying at the primary schools of Eskisehir. The scale used in the process of the study is "Web Based Listening Scale". In the process of the study,…

  3. The Effects of Reading from the Screen on the Reading Motivation Levels of Elementary 5th Graders

    ERIC Educational Resources Information Center

    Aydemir, Zeynep; Ozturk, Ergun

    2012-01-01

    This study aims to explore the effects of reading from the screen on elementary 5th grade students' reading motivation levels. It used the randomized control-group pretest-posttest model, which is a true experimental design. The study group consisted of 60 students, 30 experimental and 30 control, who were attending the 5th grade of a public…

  4. PREFACE: 5th DAE-BRNS Workshop on Hadron Physics (Hadron 2011)

    NASA Astrophysics Data System (ADS)

    Jyoti Roy, Bidyut; Chatterjee, A.; Kailas, S.

    2012-07-01

    The 5th DAE-BRNS Workshop on Hadron Physics was held at the Bhabha Atomic Research Centre (BARC), Mumbai from 31 October to 4 November 2011. This workshop series, supported by the Board of Research in Nuclear Sciences, Department of Atomic Energy (BRNS, DAE), Govt. of India, began ten years ago with the first one being held at BARC, Mumbai in October 2002. The second one was held at Puri in 2005, organized jointly by Institute of Physics, Bhubneswar and Saha Institute of Nuclear Physics, Kolkata. The 3rd and 4th ones took place, respectively, at Shantineketan in 2006, organized by Visva Bharati University, and at Aligarh in 2008, organized by Aligarh Muslim University, Aligarh. The aim of the present workshop was to bring together the experts and young researchers in the field of hadron physics (both experiment and theory) and to have in-depth discussions on the current research activities in this field. The format of the workshop was: a series of review lectures by various experts from India and abroad, the presentation of advanced research results by researchers in the field, and a review of major experimental programs being planned and pursued in major laboratories in the field of hadron physics, with the aim of providing a platform for the young participants for interaction with their peers. The upcoming international FAIR facility at GSI is a unique future facility for studies of hadron physics in the charm sector and hyper nuclear physics. The Indian hadron physics community is involved in this mega science project and is working with the PANDA collaboration on the development of detectors, simulation and software tools for the hadron physics programme with antiprotons at FAIR. A one-day discussion session was held at this workshop to discuss India-PANDA activities, the current collaboration status and the work plan. This volume presents the workshop proceedings consisting of lectures and seminars which were delivered during the workshop. We are thankful to

  5. Preface to Special Topic: Selected Papers from the 5th International Conference on Optofluidics.

    PubMed

    Fan, Shih-Kang; Yang, Zhenchuan

    2016-01-01

    The 5th International Conference on Optofluidics (Optofluidics 2015) was held in Taipei, Taiwan, July 26-29, 2015. The aim of this conference was to provide a forum to promote scientific exchange and to foster closer networks and collaborative ties between leading international researchers in optics and micro/nanofluidics across various disciplines. The scope of Optofluidics 2015 was deliberately broad and interdisciplinary, encompassing the latest advances and the most innovative developments in micro/nanoscale science and technology. Topics ranged from fundamental research to its applications in chemistry, physics, biology, materials, and medicine. PMID:27076863

  6. Preface to Special Topic: Selected Papers from the 5th International Conference on Optofluidics

    PubMed Central

    Fan, Shih-Kang; Yang, Zhenchuan

    2016-01-01

    The 5th International Conference on Optofluidics (Optofluidics 2015) was held in Taipei, Taiwan, July 26–29, 2015. The aim of this conference was to provide a forum to promote scientific exchange and to foster closer networks and collaborative ties between leading international researchers in optics and micro/nanofluidics across various disciplines. The scope of Optofluidics 2015 was deliberately broad and interdisciplinary, encompassing the latest advances and the most innovative developments in micro/nanoscale science and technology. Topics ranged from fundamental research to its applications in chemistry, physics, biology, materials, and medicine. PMID:27076863

  7. A Social Medium: ASM's 5th Cell-Cell Communication in Bacteria Meeting in Review

    PubMed Central

    Federle, Michael J.

    2015-01-01

    The 5th American Society for Microbiology Conference on Cell-Cell Communication in Bacteria (CCCB-5), which convened from 18 to 21 October 2014 in San Antonio, TX, highlighted recent advances in our understanding of microbial intercellular signaling. While the CCCB meetings arose from interests in pheromone signaling and quorum sensing, it was evident at CCCB-5 that the cell-cell communication field is continuing to mature, expanding into new areas and integrating cutting-edge technologies. In this minireview, we recap some of the research discussed at CCCB-5 and the questions that have arisen from it. PMID:25917904

  8. EDITORIAL: 'Best article' prize for the 5th anniversary of Environmental Research Letters 'Best article' prize for the 5th anniversary of Environmental Research Letters

    NASA Astrophysics Data System (ADS)

    Kammen, Dan; Wright, Guillaume

    2011-12-01

    To celebrate the 5th anniversary of Environmental Research Letters (ERL) the publishers of the journal, IOP Publishing, have awarded a prize for the five best articles published in ERL since the journal began in 2006. The procedure for deciding the winning articles was as thorough as possible to ensure that the most outstanding articles would win the prize. A shortlist of 25 nominated research articles, five for each year since ERL was launched, which were chosen based on a range of criteria including novelty, scientific impact, readership, broad appeal and wider media coverage, was selected. The ERL Editorial Board then assessed and rated these 25 articles in order to choose a winning article for each year. We would like to announce that the following articles have been awarded ERL's 5th anniversary best article prize: 2006/7 The Bodélé depression: a single spot in the Sahara that provides most of the mineral dust to the Amazon forest Ilan Koren, Yoram J Kaufman, Richard Washington, Martin C Todd, Yinon Rudich, J Vanderlei Martins and Daniel Rosenfeld 2006 Environ. Res. Lett. 1 014005 2008 Causes and impacts of the 2005 Amazon drought Ning Zeng, Jin-Ho Yoon, Jose A Marengo, Ajit Subramaniam, Carlos A Nobre, Annarita Mariotti and J David Neelin 2008 Environ. Res. Lett. 3 014002 2009 How difficult is it to recover from dangerous levels of global warming? J A Lowe, C Huntingford, S C B Raper, C D Jones, S K Liddicoat and L K Gohar 2009 Environ. Res. Lett. 4 014012 2010 Is physical water scarcity a new phenomenon? Global assessment of water shortage over the last two millennia Matti Kummu, Philip J Ward, Hans de Moel and Olli Varis 2010 Environ. Res. Lett. 5 034006 2011 Implications of urban structure on carbon consumption in metropolitan areas Jukka Heinonen and Seppo Junnila 2011 Environ. Res. Lett. 6 014018 Our congratulations go to these authors. In recognition of their outstanding work, we are delighted to offer all of the authors of the winning articles free

  9. EDITORIAL: 'Best article' prize for the 5th anniversary of Environmental Research Letters 'Best article' prize for the 5th anniversary of Environmental Research Letters

    NASA Astrophysics Data System (ADS)

    Kammen, Dan; Wright, Guillaume

    2011-12-01

    To celebrate the 5th anniversary of Environmental Research Letters (ERL) the publishers of the journal, IOP Publishing, have awarded a prize for the five best articles published in ERL since the journal began in 2006. The procedure for deciding the winning articles was as thorough as possible to ensure that the most outstanding articles would win the prize. A shortlist of 25 nominated research articles, five for each year since ERL was launched, which were chosen based on a range of criteria including novelty, scientific impact, readership, broad appeal and wider media coverage, was selected. The ERL Editorial Board then assessed and rated these 25 articles in order to choose a winning article for each year. We would like to announce that the following articles have been awarded ERL's 5th anniversary best article prize: 2006/7 The Bodélé depression: a single spot in the Sahara that provides most of the mineral dust to the Amazon forest Ilan Koren, Yoram J Kaufman, Richard Washington, Martin C Todd, Yinon Rudich, J Vanderlei Martins and Daniel Rosenfeld 2006 Environ. Res. Lett. 1 014005 2008 Causes and impacts of the 2005 Amazon drought Ning Zeng, Jin-Ho Yoon, Jose A Marengo, Ajit Subramaniam, Carlos A Nobre, Annarita Mariotti and J David Neelin 2008 Environ. Res. Lett. 3 014002 2009 How difficult is it to recover from dangerous levels of global warming? J A Lowe, C Huntingford, S C B Raper, C D Jones, S K Liddicoat and L K Gohar 2009 Environ. Res. Lett. 4 014012 2010 Is physical water scarcity a new phenomenon? Global assessment of water shortage over the last two millennia Matti Kummu, Philip J Ward, Hans de Moel and Olli Varis 2010 Environ. Res. Lett. 5 034006 2011 Implications of urban structure on carbon consumption in metropolitan areas Jukka Heinonen and Seppo Junnila 2011 Environ. Res. Lett. 6 014018 Our congratulations go to these authors. In recognition of their outstanding work, we are delighted to offer all of the authors of the winning articles free

  10. PREFACE: The 5th International Symposium in Quantum Theory and Symmetries (QTS5)

    NASA Astrophysics Data System (ADS)

    Arratia, O.; Calzada, J. A.; Gómez-Cubillo, F.; Negro, J.; del Olmo, M. A.

    2008-02-01

    This volume of Journal of Physics: Conference Series contains the Proceedings of the 5th International Symposium in Quantum Theory and Symmetries (QTS5), held in Valladolid, Spain, 22-28 July 2007. This is the fifth of a series of conferences previously held in Goslar (Germany) 1999, QTS1; Cracow (Poland) 2001, QTS2; Cincinnati (USA) 2003, QTS3, and Varna (Bulgaria) 2005, QTS4. The QTS5 symposium gathered 181 participants from 39 countries working in different fields on Theoretical Physics. The spirit of the QTS conference series is to join researchers in a wide variety of topics in Theoretical Physics, as a way to make accessible recent results and the new lines of different fields. The QTS5 conference offered the following list of topics: Symmetries in String Theory, Quantum Gravity and related Symmetries in Quantum Field Theories, Conformal and Related Field Theories, Lattice and Noncommutative Theories, Gauge Theories Quantum Computing, Information and Control Foundations of Quantum Theory Quantum Optics, Coherent States, Wigner Functions Dynamical and Integrable Systems Symmetries in Condensed Matter and Statistical Physics Symmetries in Particle Physics, Nuclear, Atomic and Molecular Nonlinear Quantum Mechanics Time Asymmetric Quantum Mechanics SUSY Quantum Mechanics, PT symmetries and pseudo-Hamiltonians Mathematical Methods for Symmetries and Quantum Theories Symmetries in Chemistry Biology and other Sciences Papers accepted for publication in the present issue are based on the contributions from the participants in the QTS5 conference after a peer review process. In addition, a special issue of Journal Physics A: Mathematical and Theoretical contains contributions from plenary speakers, some participants as well as contributions from other authors whose works fit into the topics of the conference. The organization of the conference had the following pattern. In the morning there were five plenary or general sessions for all the participants, which aimed to

  11. PREFACE: The 5th International Symposium on Quantum Theory and Symmetries (QTS5)

    NASA Astrophysics Data System (ADS)

    Gadella, M.; Izquierdo, J. M.; Kuru, S.; Negro, J.; del Olmo, M. A.

    2008-08-01

    This special issue of Journal of Physics A: Mathematical and Theoretical appears on the occasion of the 5th International Symposium on Quantum Theory and Symmetries (QTS5), held in Valladolid, Spain, from 22-28 July 2007. This is the fith in a series of conferences previously held in Goslar (Germany) 1999, QTS1; Cracow (Poland) 2001, QTS2; Cincinnati (USA) 2003, QTS3; and Varna (Bulgaria) 2005, QTS4. The QTS5 symposium gathered 181 participants from 39 countries working in different fields of theoretical physics. The spirit of the QTS conference series is to join researchers in a wide variety of topics in theoretical physics, as a way of making accessible recent results and the new lines of different fields. This is based on the feeling that it is good for a physicist to have a general overview as well as expertise in his/her own field. There are many other conferences devoted to specific topics, which are of interest to gain deeper insight in many technical aspects and that are quite suitable for discussions due to their small size. However, we believe that general conferences like this are interesting and worth keeping. We like the talks, in both plenary and parallel sessions, which are devoted to specific topics, to be prepared so as to be accessible to any researcher in any branch of theoretical physics. We think that this objective is compatible with rigour and high standards. As is well known, similar methods and techniques can be useful for many problems in different fields. We hope that this has been appreciated during the sessions of the QTS5 conference. The QTS5 conference offered the following list of topics: 1. Symmetries in string theory, quantum gravity and related topics 2. Symmetries in quantum field theories, conformal and related field theories, lattice and noncommutative theories, gauge theories 3.Quantum computing, information and control 4. Foundations of quantum theory 5. Quantum optics, coherent states, Wigner functions 6. Dynamical and

  12. PREFACE: The 5th International Symposium in Quantum Theory and Symmetries (QTS5)

    NASA Astrophysics Data System (ADS)

    Arratia, O.; Calzada, J. A.; Gómez-Cubillo, F.; Negro, J.; del Olmo, M. A.

    2008-02-01

    This volume of Journal of Physics: Conference Series contains the Proceedings of the 5th International Symposium in Quantum Theory and Symmetries (QTS5), held in Valladolid, Spain, 22-28 July 2007. This is the fifth of a series of conferences previously held in Goslar (Germany) 1999, QTS1; Cracow (Poland) 2001, QTS2; Cincinnati (USA) 2003, QTS3, and Varna (Bulgaria) 2005, QTS4. The QTS5 symposium gathered 181 participants from 39 countries working in different fields on Theoretical Physics. The spirit of the QTS conference series is to join researchers in a wide variety of topics in Theoretical Physics, as a way to make accessible recent results and the new lines of different fields. The QTS5 conference offered the following list of topics: Symmetries in String Theory, Quantum Gravity and related Symmetries in Quantum Field Theories, Conformal and Related Field Theories, Lattice and Noncommutative Theories, Gauge Theories Quantum Computing, Information and Control Foundations of Quantum Theory Quantum Optics, Coherent States, Wigner Functions Dynamical and Integrable Systems Symmetries in Condensed Matter and Statistical Physics Symmetries in Particle Physics, Nuclear, Atomic and Molecular Nonlinear Quantum Mechanics Time Asymmetric Quantum Mechanics SUSY Quantum Mechanics, PT symmetries and pseudo-Hamiltonians Mathematical Methods for Symmetries and Quantum Theories Symmetries in Chemistry Biology and other Sciences Papers accepted for publication in the present issue are based on the contributions from the participants in the QTS5 conference after a peer review process. In addition, a special issue of Journal Physics A: Mathematical and Theoretical contains contributions from plenary speakers, some participants as well as contributions from other authors whose works fit into the topics of the conference. The organization of the conference had the following pattern. In the morning there were five plenary or general sessions for all the participants, which aimed to

  13. Exploratory Factor Analysis of Diagnostic and Statistical Manual, 5th Edition, Criteria for Posttraumatic Stress Disorder.

    PubMed

    McSweeney, Lauren B; Koch, Ellen I; Saules, Karen K; Jefferson, Stephen

    2016-01-01

    One change to the posttraumatic stress disorder (PTSD) nomenclature highlighted in the Diagnostic and Statistical Manual, 5th Edition (DSM-5; American Psychiatric Association, 2013) is the conceptualization of PTSD as a diagnostic category with four distinct symptom clusters. This article presents exploratory factor analysis to test the structural validity of the DSM-5 conceptualization of PTSD via an online survey that included the PTSD Checklist-5. The study utilized a sample of 113 college students from a large Midwestern university and 177 Amazon Mechanical Turk users. Participants were primarily female, Caucasian, single, and heterosexual with an average age of 32 years. Approximately 30% to 35% of participants met diagnostic criteria for PTSD based on two different scoring criteria. Results of the exploratory factor analysis revealed five distinct symptom clusters. The implications for the classification of PTSD are discussed. PMID:26669983

  14. Genomics into Healthcare: The 5th Pan Arab Human Genetics Conference and 2013 Golden Helix Symposium

    PubMed Central

    Fortina, Paolo; AlKhaja, Najib; Al Ali, Mahmoud Taleb; Hamzeh, Abdul Rezzak; Nair, Pratibha; Innocenti, Federico; Patrinos, George P.; Kricka, Larry J.

    2014-01-01

    The joint 5th Pan Arab Human Genetics conference and 2013 Golden Helix Symposium, “Genomics into Healthcare” was coorganized by the Center for Arab Genomic Studies (http://www.cags.org.ae) in collaboration with the Golden Helix Foundation (http://www.goldenhelix.org) in Dubai, United Arab Emirates from 17 to 19 November, 2013. The meeting was attended by over 900 participants, doctors and biomedical students from over 50 countries and was organized into a series of nine themed sessions that covered cancer genomics and epigenetics, genomic and epigenetic studies, genomics of blood and metabolic disorders, cytogenetic diagnosis and molecular profiling, next-generation sequencing, consanguinity and hereditary diseases, clinical genomics, clinical applications of pharmacogenomics, and genomics in public health. PMID:24526565

  15. Dental health in antique population of Vinkovci - Cibalae in Croatia (3rd-5th century).

    PubMed

    Peko, Dunja; Vodanović, Marin

    2016-08-01

    Roman city Cibalae (Vinkovci) - the birthplace of Roman emperors Valentinian I and Valens was a very well developed urban ares in the late antique what was evidenced by numerous archaeological findings. The aim of this paper is to get insight in dental health of antique population of Cibalae. One hundred individuals with 2041 teeth dated to 3rd - 5th century AD have been analyzed for caries, antemortem tooth loss, periapical diseases and tooth wear. Prevalence of antemortem tooth loss was 4.3% in males, 5.2% in females. Prevalence of caries per tooth was 8.4% in males, 7.0% in females. Compared to other Croatian antique sites, ancient inhabitants of Roman Cibalae had rather good dental health with low caries prevalence and no gender differences. Statistically significant difference was found between males in females in the prevalence of periapical lesions and degree of tooth wear. Periapical lesions were found only in males. PMID:27598951

  16. Theoretical studies of Ir5Th and Ir5Ce nanoscale precipitates in Ir

    SciTech Connect

    Morris, James R; Averill, Frank; Cooper, Valentino R

    2014-01-01

    Experimentally, it is known that very small amounts of thorium and/or cerium added to iridium metal form a precipitate, Ir5Th / Ir5Ce, which improves the high temperature mechanical properties of the resulting alloys. We demonstrate that there are low-energy configurations for nano-scale precipitates of these phases in Ir, and that these coherent arrangements may assist in producing improved mechanical properties. One precipitate/matrix orientation gives a particularly low interfacial energy, and a low lattice misfit. Nanolayer precipitates with this orientation are found to be likely to form, with little driving force to coarsen. The predicted morphology of the precipitates and their orientation with the matrix phase provide a potential experiment that could be used to test these predictions.

  17. APTWG: The 5th Asia-Pacific Transport Working Group Meeting

    NASA Astrophysics Data System (ADS)

    Gao, X.; Ghim, Y.-C.; Sun, Y. W.; Gao, Z.; Inagaki, S.; Chen, W.; Zhang, T.; Wang, Z. X.

    2016-03-01

    This conference report gives a summary on the contributed papers and discussions presented at the 5th Asia-Pacific Transport Working Group Meeting held at Dalian, China from 9-12 June 2015. The main goal of the working group is to develop a predictive understanding of the basic mechanisms responsible for particle, momentum and energy transport in magnetically confined plasmas. The topics of the meeting in 2015 were organized under five main headings: (1) turbulence suppression and transport barrier formation, (2) effect of magnetic topology on MHD activity and transport, (3) non-diffusive contribution of momentum and particle transport, (4) non-local transport and turbulence spreading and coupling and (5) energetic particles and instability. The Young Researchers’ Forum which was held at this meeting is also described in this report.

  18. Recurrent Idiopathic Catatonia: Implications beyond the Diagnostic and Statistical Manual of Mental Disorders 5th Edition

    PubMed Central

    Caroff, Stanley N.; Hurford, Irene; Bleier, Henry R.; Gorton, Gregg E.; Campbell, E. Cabrina

    2015-01-01

    We describe a case of recurrent, life-threatening, catatonic stupor, without evidence of any associated medical, toxic or mental disorder. This case provides support for the inclusion of a separate category of “unspecified catatonia” in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) to be used to classify idiopathic cases, which appears to be consistent with Kahlbaum’s concept of catatonia as a distinct disease state. But beyond the limited, cross-sectional, syndromal approach adopted in DSM-5, this case more importantly illustrates the prognostic and therapeutic significance of the longitudinal course of illness in differentiating cases of catatonia, which is better defined in the Wernicke-Kleist-Leonhard classification system. The importance of differentiating cases of catatonia is further supported by the efficacy of antipsychotics in treatment of this case, contrary to conventional guidelines. PMID:26243853

  19. Postoperative splinting for isolated digital nerve injuries in the hand.

    PubMed

    Vipond, Nicole; Taylor, William; Rider, Mark

    2007-01-01

    Digital nerve injuries in the hand are common and can result in significant impairment and functional restriction. Despite this, there is relatively little literature, particularly with respect to postoperative rehabilitation. Splinting after repair, purported to protect the repaired nerve from excessive stretch is still commonly used. Recent cadaveric studies indicate postoperative rehabilitation is not necessary with resection up to 2.5mm. A randomized controlled trial was therefore undertaken to determine whether splinting after isolated 5th degree digital nerve transection is in fact necessary. Twenty-six subjects were recruited over a two-year period and randomized to either three weeks of hand-based splinting or free active motion. ANCOVA indicated no differences in sensibility at six months between the two groups. Subjects also reported their greatest functional limitations were because of hyperesthesia. Although this study is underpowered, these limited results suggest splinting may not be required postoperatively. PMID:17658415

  20. The 5th Symposium on Post-Transcriptional Regulation of Plant Gene Expression (PTRoPGE)

    SciTech Connect

    Karen S. Browning; Marie Petrocek; Bonnie Bartel

    2006-06-01

    The 5th Symposium on Post-Transcriptional Regulation of Plant Gene Expression (PTRoPGE) will be held June 8-12, 2005 at the University of Texas at Austin. Exciting new and ongoing discoveries show significant regulation of gene expression occurs after transcription. These post-transcriptional control events in plants range from subtle regulation of transcribed genes and phosphorylation, to the processes of gene regulation through small RNAs. This meeting will focus on the regulatory role of RNA, from transcription, through translation and finally degradation. The cross-disciplinary design of this meeting is necessary to encourage interactions between researchers that have a common interest in post-transcriptional gene expression in plants. By bringing together a diverse group of plant molecular biologist and biochemists at all careers stages from across the world, this meeting will bring about more rapid progress in understanding how plant genomes work and how genes are finely regulated by post-transcriptional processes to ultimately regulate cells.

  1. Numerical Fluid Dynamics Symposium, 5th, Tokyo, Japan, Dec. 19-21, 1991, Proceedings

    NASA Astrophysics Data System (ADS)

    1991-07-01

    Various papers on numerical fluid dynamics are presented. Individual topics discussed include: numerical analysis (NA) of shock structure problems, CFD development and a future high-speed computer, simulating vortex motion by 3D method, application of CFD to turbomachine design, numerical simulation (NS) of converging shock waves, NS of unsteady 3D shock wave phenomenon, 5th-order accurate compact upwind scheme, development of a multidimensional upwind scheme, fortified solution algorithm, large-eddy simulation of a bound jet, construction of collision model of diatomic molecules, VSL analysis of nonequilibrium flows around a hypersonic body, NA of chemically nonequilibrium flow, topological transition of flow past some axisymmetric bodies, modeling of scalar transport in free turbulence, a contribution to general application of the vortex method. Also addressed are: vortex simulation of artificial control of mixing layers, 3D motion of vortex filaments, Navier-Stokes simulation of 2D mixing layer, active control of vortex shedding frequency by a jet, direct NS of homogeneous turbulent sheer flow, NA of fuel spray jet by Eulerian method, NS of ignition using a premixed pulsed jet, NS of a scram jet combustor flow, numerical simulation of supersonic flow CO chemical laser, adaptive grid generation using optimal control theory, NS of characteristics of the Stalker tube, imcompressible flow solver using velocity vector and a new variable, unsteady analysis of helicopter rotor.

  2. Two Successful Outreach Programs at Storm Peak Laboratory: GRASP for Undergraduates and Partnership for 5th Grade Science Education

    NASA Astrophysics Data System (ADS)

    Hallar, A. G.; McCubbin, I. B.; Wright, J.

    2007-12-01

    The Desert Research Institute operates a high elevation facility, Storm Peak Laboratory (SPL), located on the Steamboat Springs Ski Resort at an elevation 10,500 ft. SPL provides an ideal location for long-term atmospheric research. The SPL mission statement is to ensure that the laboratory will continue to integrate climate research and education by advancing discovery and understanding within the field of pollution, aerosol and cloud interactions. During the last year, SPL has created two successful outreach programs reaching very different audiences. First, to engage students from local elementary schools, SPL established a 5th grade climate education program. This program is based on a partnership between SPL and Yampatika's&penvironmental educators. Yampatika is a non-profit outdoor environmental education organization. The program spans three days for each school and includes five elementary schools. During the first day, educators from Yampatika visit each classroom to introduce the concepts of climate and weather as well as teach students how to use scientific equipment. During the field program on the second day, students measure and record information about temperature, pressure, relative humidity, wind speed, and particle concentration while they travel to SPL via the gondola (in winter) or Suburban (in fall). Once at the laboratory, students tour the facility, discuss SPL research activities, and explore application of these activities to their curriculum. Following the field trip, Yampatika educators and SPL scientists will visit the school for a follow-up to help children explore concepts, answer questions, and evaluate students" learning. The second program, Geoscience Research at Storm Peak (GRASP), was designed to engage students from underrepresented groups and created a partnership between three Minority Serving Institutions and the University of Nevada, Reno (UNR). Undergraduate students from Tennessee State University, Howard University

  3. Postoperative Spine Infections.

    PubMed

    Pawar, Abhijit Yuvaraj; Biswas, Samar Kumar

    2016-02-01

    Postoperative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and postoperative care, wound infection continues to compromise patient outcome after spinal surgery. Spinal instrumentation also has an important role in the development of postoperative infections. This review analyses the risk factors that influence the development of postoperative infection. Classification and diagnosis of postoperative spinal infection is also discussed to facilitate the choice of treatment on the basis of infection severity. Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief. Management protocols to manage SS infections in spine surgery are also reviewed. PMID:26949475

  4. Postoperative Spine Infections

    PubMed Central

    Biswas, Samar Kumar

    2016-01-01

    Postoperative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and postoperative care, wound infection continues to compromise patient outcome after spinal surgery. Spinal instrumentation also has an important role in the development of postoperative infections. This review analyses the risk factors that influence the development of postoperative infection. Classification and diagnosis of postoperative spinal infection is also discussed to facilitate the choice of treatment on the basis of infection severity. Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief. Management protocols to manage SS infections in spine surgery are also reviewed. PMID:26949475

  5. 5th International conference on Physics and Astrophysics of Quark Gluon Plasma

    NASA Astrophysics Data System (ADS)

    Sinha, Bikash; Alam, Jan-E.; Nayak, Tapan K.

    2006-11-01

    The 5th International Conference on Physics and Astrophysics of Quark Gluon Plasma (ICPAQGP 2005) was held on 8 - 12 February 2005 at the Variable Energy Cyclotron Centre and Saha Institute of Nuclear Physics campus, Kolkata, India. The conference was enriched by the august presence of about 300 participants representing 18 countries across the globe. It had plenary talks and oral presentations, which form a part of these proceedings. Besides invited and contributed talks there were also a large number of poster presentations. The conference was energized by discussions of fresh experimental data from RHIC on strong elliptic flow, jet quenching, single photon spectra etc. Moreover, new theoretical results were brought to the discussion forum during this conference. Colour glass condensates, hydrodynamical flow, jet quenching and sQGP were intensely debated by the participants. The highlight of ICPAQGP 2005 was the presentation of fresh experimental results from the RHIC-IV run. The ICPAQGP series, since its inception in 1988, has placed emphasis on the role of quark matter in the fields of astrophysics and cosmology. The subsequent conferences held in 1993, 1997, 2001 and 2005 had also retained this focus. The conference was preceded by a Fest Colloquium in honour of Professor Bikash Sinha. Professor Sinha, regarded as the pioneer in establishing quark gluon plasma research in India, has successfully encouraged a group of young Indian researchers to devote themselves wholeheartedly to QGP research - both theoretical and experimental. Members of the International Advisory Committee played a pivotal role mainly in the selection of speakers. The contributions of the Organizing Committee in all aspects, from selecting the contributory talks posters down to arranging local hospitality, were much appreciated. We thank the members of both committees for making ICPAQGP 2005 an interesting platform for scientific deliberation. The ICPAQGP 2005 was supported financially by

  6. Development of a Three-Dimensional Finite Element Chest Model for the 5(th) Percentile Female.

    PubMed

    Kimpara, Hideyuki; Lee, Jong B; Yang, King H; King, Albert I; Iwamoto, Masami; Watanabe, Isao; Miki, Kazuo

    2005-11-01

    Several three-dimensional (3D) finite element (FE) models of the human body have been developed to elucidate injury mechanisms due to automotive crashes. However, these models are mainly focused on 50(th) percentile male. As a first step towards a better understanding of injury biomechanics in the small female, a 3D FE model of a 5(th) percentile female human chest (FEM-5F) has been developed and validated against experimental data obtained from two sets of frontal impact, one set of lateral impact, two sets of oblique impact and a series of ballistic impacts. Two previous FE models, a small female Total HUman Model for Safety (THUMS-AF05) occupant version 1.0Beta (Kimpara et al. 2002) and the Wayne State University Human Thoracic Model (WSUHTM, Wang 1995 and Shah et al. 2001) were integrated and modified for this model development. The model incorporated not only geometrical gender differences, such as location of the internal organs and structure of the bony skeleton, but also the biomechanical differences of the ribs due to gender. It includes a detailed description of the sternum, ribs, costal cartilage, thoracic spine, skin, superficial muscles, intercostal muscles, heart, lung, diaphragm, major blood vessels and simplified abdominal internal organs and has been validated against a series of six cadaveric experiments on the small female reported by Nahum et al. (1970), Kroell et al. (1974), Viano (1989), Talantikite et al. (1998) and Wilhelm (2003). Results predicted by the model were well-matched to these experimental data for a range of impact speeds and impactor masses. More research is needed in order to increase the accuracy of predicting rib fractures so that the mechanisms responsible for small female injury can be more clearly defined. PMID:17096277

  7. Patterns of Irregular Burials in Western Europe (1st-5th Century A.D.)

    PubMed Central

    Milella, Marco; Mariotti, Valentina; Belcastro, Maria Giovanna; Knüsel, Christopher J.

    2015-01-01

    Background Irregular burials (IB—burials showing features that contrast with the majority of others in their geographic and chronological context) have been the focus of archaeological study because of their relative rarity and enigmatic appearance. Interpretations of IB often refer to supposed fear of the dead or to social processes taking place in time-specific contexts. However, a comprehensive and quantitative analysis of IB for various geographical contexts is still lacking, a fact that hampers any discussion of these burials on a larger scale. Methods Here, we collected a bibliographic dataset of 375 IB from both Britain and Continental Europe, altogether spanning a time period from the 1st to the 5th century AD. Each burial has been coded according to ten dichotomous variables, further analyzed by means of chi-squared tests on absolute frequencies, non-metric multidimensional scaling, and cluster analysis. Results Even acknowledging the limits of this study, and in particular the bias represented by the available literature, our results point to interesting patterns. Geographically, IB show a contrast between Britain and Continental Europe, possibly related to historical processes specific to these regions. Different types of IB (especially prone depositions and depositions with the cephalic extremity displaced) present a series of characteristics and associations between features that permit a more detailed conceptualization of these occurrences from a socio-cultural perspective that aids to elucidate their funerary meaning. Conclusions and Significance Altogether, the present work stresses the variability of IB, and the need to contextualize them in a proper archaeological and historical context. It contributes to the discussion of IB by providing a specific geographic and chronological frame of reference that supports a series of hypotheses about the cultural processes possibly underlying their occurrence. PMID:26115408

  8. Postoperative pain: nurses' knowledge and patients' experiences.

    PubMed

    Francis, Lavonia; Fitzpatrick, Joyce J

    2013-12-01

    The aim of this study was to determine nurses' knowledge and attitudes regarding postoperative pain and identify postoperative patients' pain intensity experiences. The assessment and management of acute postoperative pain is important in the care of postoperative surgical patients. Inadequate relief of postoperative pain can contribute to postoperative complications such as atelectasis, deep vein thrombosis, and delayed wound healing. A pilot study with an exploratory design was conducted at a large teaching hospital in the eastern United States. The convenience samples included 31 nurses from the gastrointestinal and urologic surgical units and 14 first- and second-day adult postoperative open and laparoscopic gastrointestinal and urologic patients who received patient-controlled analgesia (PCA). The Knowledge and Attitudes Survey Regarding Pain was used to measure nurses' knowledge about pain management. The Short-Form McGill Pain Questionnaire (SF-MPQ) was used to measure patients' pain intensity. The nurses' mean score on the Knowledge and Attitudes Survey Regarding Pain was 69.3%. Patients experienced moderate pain, as indicated by the score on the SF-MPQ. There is a need to increase nurses' knowledge of pain management. PMID:24315258

  9. WWW.com: A Brief Intervention to Bolster a 5th Grader's Regrouping Skills in Math

    ERIC Educational Resources Information Center

    Waugh, Matthew; Harrison, Gina L.

    2014-01-01

    This study examined the efficacy of a brief math intervention using cognitive behaviour instruction (CBI) supplemented by a mnemonic cue system for a 5th grade student with math computation and fluency difficulties. Regrouping operations in addition and subtraction were the targeted skills. Curriculum-based measurements were conducted at the end…

  10. Proceedings of the International Conference on Educational Data Mining (EDM) (5th, Chania, Greece, June 19-21, 2012)

    ERIC Educational Resources Information Center

    International Educational Data Mining Society, 2012

    2012-01-01

    The 5th International Conference on Educational Data Mining (EDM 2012) is held in picturesque Chania on the beautiful Crete island in Greece, under the auspices of the International Educational Data Mining Society (IEDMS). The EDM 2012 conference is a leading international forum for high quality research that mines large data sets of educational…

  11. Comparing Science Learning among 4th-, 5th-, and 6th-Grade Students: STS versus Textbook-Based Instruction

    ERIC Educational Resources Information Center

    Yager, Robert E.; Choi, AeRan; Yager, Stuart O.; Akcay, Hakan

    2009-01-01

    Fifteen 4th-, 5th-, and 6th-grade teachers from five school districts each taught two sections of science--one with a Science-Technology-Society (STS) approach and the other with a more traditional textbook approach in which basic science concepts were the major organizers. Local, current, and personally relevant issues provided the context and…

  12. Process Evaluation of "Learn Young, Learn Fair": A Stress Management Programme for 5th and 6th Graders

    ERIC Educational Resources Information Center

    Kraag, Gerda; Van Breukelen, Gerard; Lamberts, Petra; Vugts, Odette; Kok, Gerjo; Fekkes, Minne; Abu-Saad, Huda Huijer

    2007-01-01

    This article describes the process evaluation of a stress management program called "Learn Young, Learn Fair" for 5th and 6th graders. Studies, reviews and meta-analyses of prevention programs report that a common limitation in studies is the restricted documentation of process factors that contribute to the success of interventions. Program…

  13. Communicating Science to Impact Learning? A Phenomenological Inquiry into 4th and 5th Graders' Perceptions of Science Information Sources

    ERIC Educational Resources Information Center

    Gelmez Burakgazi, Sevinc; Yildirim, Ali; Weeth Feinstein, Noah

    2016-01-01

    Rooted in science education and science communication studies, this study examines 4th and 5th grade students' perceptions of science information sources (SIS) and their use in communicating science to students. It combines situated learning theory with uses and gratifications theory in a qualitative phenomenological analysis. Data were gathered…

  14. From Cooks to Carpenters: Measuring - A Saleable Work Skill. Occupation Simulation Packet. Grades 5th-6th.

    ERIC Educational Resources Information Center

    Kennedy, Helena

    This teacher's guide contains simulated work experiences for 5th and 6th grade students using the isolated skill concept - measuring. Teacher instructions include objectives, evaluation, and sequence of activities. The guide contains pre-tests and post-tests with instructions and answer keys. Three pre-skill activities are suggested, such as…

  15. Brief Report: Data on the Stanford-Binet Intelligence Scales (5th Ed.) in Children with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Coolican, Jamesie; Bryson, Susan E.; Zwaigenbaum, Lonnie

    2008-01-01

    The Fifth Edition of the Stanford-Binet Intelligence Scales (SB5; Roid, G. H. (2003). "Stanford Binet intelligence scales" (5th ed.). Itasca, IL: Riverside Publishing) is relatively new, with minimal published research on general populations and none with special populations. The present study provides information on the cognitive profiles of…

  16. [Postoperative nutritional management for esophageal cancer patients].

    PubMed

    Ikeda, Kenichiro; Kimura, Y

    2008-07-01

    High incidence of malnutrition is found in esophageal cancer patients. It is well known that to maintain good nutritional preoperative condition is very important to prevent postoperative morbidity and mortality. Hence, preoperative oral or nasogastric feeding is recommended when the patient is malnourished, at a total dose of 30 kcal/kg/day. During postoperative period, enteral nutrition should be primarily performed because of its favorable effects on immune-status and intestinal integrity to avoid septic complications. It is also important to keep circulatory volume sufficient to provide oxygen demand during catabolic phase, which leads earlier recovery from critical illness. Enteral nutrition should be immediately started afterward. An initial dose of 5-10 kcal/kg/day of the enteral nutrition is performed from the 1st or 2nd postoperative day and gradually increased to the full dose at 30 kcal/kg/ day. In cases of not administering scheduled dose of the enteral nutrition, either total or peripheral parenteral nutrition is required complementing total caloric intake. When total parenteral nutrition is used, blood glucose level should be controlled less than 150 mg/dl by pertinently administering insulin or limiting glycemic intake. Immunonutrition is promising nutritional management for critical surgical patients such as those performed esophageal cancer surgery. Continuing immune-enhancing diet at a dose of 750 to 1,000 ml/day for 5 to 7 days before surgery is necessary to bring good postoperative outcome. PMID:20715418

  17. [Clinical experimental studies of postoperative infusion analgesia].

    PubMed

    Dick, W; Knoche, E; Grundlach, G; Klein, I

    1983-06-01

    30 postoperative patients, who had undergone abdominal gynaecological surgery with standard general anaesthesia were randomly divided into three groups and received, in the recovery ward, a continuous infusion of either pentazocine, piritramid, or ketamine. The patients rated their pain on a 15 cm pain analogue score. Group I pentazocine: Mean dosage on the day of operation 0.12 mg/kg/h, 0.1 mg/kg/h on the first and only 0.07 mg/kg/h on the second postoperative day. Pentazocine blood levels were on average 50 micrograms/l. Group II piritramid: Mean dosage on the day of operation 0.038 mg/kg/h, 0.024 mg/kg/h on the first and 0.019 mg/kg/h on the second postoperative day. Blood levels of piritramid were not determined because there is no satisfactory assay available. Group III ketamine: mean dosage on the day of operation 0.32 mg/kg/h, 0.28 mg/kg/h on the first and 0.29 mg/kg/h on the second postoperative day. Ketamine blood levels lay between 120 and 180 micrograms/l. The three analgesics did not cause any important haemodynamic or respiratory side effects. Pentazocine and piritramid were the most effective analgesics, ketamine was the least effective with a high incidence of side effects. PMID:6412586

  18. Risk factors for postoperative ileus

    PubMed Central

    Kutun, Suat; Ulucanlar, Haluk; Tarcan, Oguz; Demir, Abdullah; Cetin, Abdullah

    2011-01-01

    Purpose This study aimed to examine extended postoperative ileus and its risk factors in patients who have undergone abdominal surgery, and discuss the techniques of prevention and management thereof the light of related risk factors connected with our study. Methods This prospective study involved 103 patients who had undergone abdominal surgery. The effects of age, gender, diagnosis, surgical operation conducted, excessive small intestine manipulation, opioid analgesic usage time, and systemic inflammation on the time required for the restoration of intestinal motility were investigated. The parameters were investigated prospectively. Results Regarding the factors that affected the restoration of gastrointestinal motility, resection operation type, longer operation period, longer opioid analgesics use period, longer nasogastric catheter use period, and the presence of systemic inflammation were shown to retard bowel motility for 3 days or more. Conclusion Our study confirmed that unnecessary analgesics use in patients with pain tolerance with non-steroid anti-inflammatory drugs, excessive small bowel manipulation, prolonged nasogastric catheter use have a direct negative effect on gastrointestinal motility. Considering that an exact treatment for postoperative ileus has not yet been established, and in light of the risk factors mentioned above, we regard that prevention of postoperative ileus is the most effective way of coping with intestinal dysmotility. PMID:22111079

  19. Health in the 5th 5-years Development Plan of Iran: Main Challenges, General Policies and Strategies.

    PubMed

    Vosoogh Moghaddam, A; Damari, B; Alikhani, S; Salarianzedeh, Mh; Rostamigooran, N; Delavari, A; Larijani, B

    2013-01-01

    Access to the right to the highest attainable level of health is a constitutional right that obliges governments and other players to take step to increase all individuals' chances of obtaining good health. At the least, health and education are two crucial requirements for this as well. Iran's vision 2025 is going to lead the country to a developed state with the highest rank of economic, scientific and technological status in the region. Enjoying health, welfare, food security, social security, equal opportunities, etc, are also considered as part of characteristics of Iranian society in 2025. Although health system of Iran has many achievements in providing health services specially for the poor following the Islamic Revolution of 1979, but the evidences gathered to develop the 5(th) 5-years economical, social and cultural plan (5(th)5YDP:2011-2015), listed a variety of main challenges in stewardship, financing, resources generation and service provision functions of the existing health system. Thus, to overcome the main challenges, about 11% of general policies of 5(th)5YDP are directly address health related issues with emphasizing on healthy human and comprehensive health approach with considering: Integration of policy making, planning, evaluation, supervision and public financing; Developing both quantity and quality of health insurance system and reducing out-of-pocket expenditures for health services to 30% by the end of the 5th plan. The strategies of 5(th)5YDP adopted by the parliament as an Act will change the health system fundamentally through tuning the main drivers; so, its implementation needs brave leaders, capable managers, motivated technical staff and social mobilization. PMID:23865015

  20. PREFACE: 5th International EEIGM/AMASE/FORGEMAT Conference on Advanced Materials Research

    NASA Astrophysics Data System (ADS)

    Ayadi, Zoubir; Czerwiec, Thierry; Horwat, David; Jamart, Brigitte

    2009-07-01

    This issue of IOP Conference Series: Materials Science and Engineering, contains manuscripts of talks that will be presented at the 5th International EEIGM/AMASE/FORGEMAT Conference on Advanced Materials Research that will be held at the Ecole Européenne d'Ingénieurs en Génie des Matériaux - European School of Materials Science and Engineering (EEIGM) in Nancy on November 4-5 2009. The conference will be organized by the EEIGM. The aim of the conference is to bring together scientists from the six European universities involved in the EEIGM and in the ''Erasmus Mundus'' AMASE Master (Advanced Materials Science and Engineering) programmes and in the Tempus FORGEMAT European project: Nancy-Université - EEIGM/INPL (Nancy, France), Universität des Saarlandes (Saarbrücken, Germany), Universitat Politècnica de Catalunya - ETSEIB (Barcelona, Spain), Luleå Tekniska Universitet (Luleå, Sweden), Universidad Politecnica de Valencia - ETSII (Valencia, Spain) and AGH University of Science and Technology, (Kralow, Poland). This conference is also open to other universities who have strong links with the EEIGM and it will provide a forum for exchange of ideas, cooperation and future directions by means of regular presentations, posters and a round-table discussion. After careful refereeing of all manuscripts, equally shared between the four editors, 26 papers have been selected for publication in this issue. The papers are grouped together into different subject categories: polymers, metallurgy, ceramics, composites and nanocomposites, simulation and characterization. The editors would like to take this opportunity to thank all the participants who submitted their manuscripts during the conference and responded in time to the editors' request at every stage from reviewing to final acceptance. The editors are indebted to all the reviewers for painstakingly reviewing the papers at very short notice. Special thanks are called for the sponsors of the conference including

  1. News from the "5th International Meeting on Inflammatory Bowel Diseases" CAPRI 2010.

    PubMed

    Latella, Giovanni; Fiocchi, Claudio; Caprili, Renzo

    2010-12-01

    At the "5th International Meeting on Inflammatory Bowel Diseases selected topics of inflammatory bowel disease (IBD), including the environment, genetics, the gut flora, the cell response and immunomodulation were discussed in order to better understand specific clinical and therapeutic aspects. The incidence of IBD continues to rise, both in low and in high-incidence areas. It is believed that factors associated with 'Westernization' may be conditioning the expression of these disorders. The increased incidence of IBD among migrants from low-incidence to high-incidence areas within the same generation suggests a strong environmental influence. The development of genome-wide association scanning (GWAS) technologies has lead to the discovery of more than 100 IBD loci. Some, as the Th 17 pathway genes, are shared between Crohn's disease (CD) and ulcerative colitis (UC), while other are IBD subtype-specific (autophagy genes, epithelial barrier genes). Disease-specific therapies targeting these pathways should be developed. Epigenetic regulation of the inflammatory response also appears to play an important role in the pathogenesis of IBD. The importance of gut flora in intestinal homeostasis and inflammation was reinforced, the concepts of eubiosis and dysbiosis were introduced, and some strategies for reverting dysbiosis to a homeostatic state of eubiosis were proposed. The current status of studies on the human gut microbiota metagenome, metaprotome, and metabolome was also presented. The cell response in inflammation, including endoplasmic reticulum (ER) stress responses, autophagy and inflammasome-dependent events were related to IBD pathogenesis. It was suggested that inflammation-associated ER stress responses may be a common trait in the pathogenesis of various chronic immune and metabolic diseases. How innate and adaptive immunity signaling events can perpetuate chronic inflammation was discussed extensively. Signal transduction pathways provide intracellular

  2. Postoperative pain management.

    PubMed

    Nett, Michael P

    2010-09-01

    Although the long-term results following traditional total joint arthroplasty are excellent, postoperative pain management has been suboptimal. Under-treatment of pain is a focus of growing concern to the orthopedic community. Poorly controlled postoperative pain leads to undesirable outcomes, including immobility, stiffness, myocardial ischemia, atelectasis, pneumonia, deep venous thrombosis, anxiety, depression, and chronic pain. Over the past decade, the attempt to minimize postoperative complications, combined with the move toward minimally invasive surgery and early postoperative mobilization, has made pain management a critical aspect of joint replacement surgery. Effective protocols are currently available; all include a multimodal approach. Debate continues regarding the ideal approach; however, reliance on narcotic analgesia alone is suboptimal. PMID:20839719

  3. EDITORIAL: 5th International Symposium on Particle Image Velocimetry, PIV'03

    NASA Astrophysics Data System (ADS)

    Sung, Hyung Jin; Kim, Kyung Chun; Lee, Sang Joon

    2004-06-01

    The advent of particle image velocimetry (PIV) in the late 20th century brought about a paradigm change in the technique of flow field measurement, from point measurement to field measurement. This revolution is a result of the recent advances in computers, video cameras, optics and lasers and a deeper understanding of the theory of image processing, and such advances continue by keeping pace with leading-edge technologies such as biotechnology, nanotechnology and so forth. Recently, the PIV technique has been extended in new directions such as stereoscopic PIV, holographic PIV, dynamic PIV, micro PIV and simultaneous PLIF/PIV techniques. This special issue contains research dealing with many of the most recent developments in PIV. The papers were selected from more than 120 papers presented at the 5th International Symposium on Particle Image Velocimetry (PIV'03) held in Busan, Korea, during 22-24 September 2003. Special thanks are due to the invited speakers who have contributed their original work to this special issue, which will enhance the academic reputation of Measurement Science and Technology (MST). Fourteen papers were selected by the Scientific Committee of PIV'03. After the standard refereeing process of MST, nine papers were finally accepted for publication. The selected papers can be categorized into three groups: new PIV algorithms and evaluation methods, three-dimensional velocity field measurement techniques and micro/bio PIV applications. As a new PIV technique, Lecuona et al introduced PIV evaluation algorithms for industrial applications having high shear flow structures. Billy et al used a single-pixel-based cross-correlation method for measuring flow inside a microchannel. Foucaut et al carried out PIV optimization using spectral analysis for the study of turbulent flows. Doh et al applied a 3D PTV method to the wake behind a sphere using three CCD cameras. Hori and Sakakibara developed a high-speed scanning stereoscopic PIV system and

  4. The 5th Conference on Asian Trends in Prostate Cancer Hormone Therapy.

    PubMed

    Akaza, Hideyuki; Moore, Malcolm A; Chang, Shu-Jen; Cheng, Christopher; Choi, Han Yong; Esuvaranathan, Kesavan; Hinotsu, Shiro; Hong, Sung-Joon; Kim, Choung-Soo; Kim, Wun-Jae; Murai, Masaru; Naito, Seiji; Soebadi, Doddy; Song, Jae-Mann; Umbas, Rainy; Usami, Michiyuki; Xia, Shujie; Yang, Chi-Rei

    2007-01-01

    The Conference on Asian Trends in Prostate Cancer Hormone Therapy is an annual forum for Asian urologists now in its 5th year. The 2006 conference, held in Bali, Indonesia, was attended by 27 leading urologic oncologists from China, Indonesia, Japan, Korea, Singapore, and Taiwan and featured a packed program of presentations and discussions on a wide range of topics such as relationships among clinicians and the newly opened Asia Regional Office for Cancer Control of the International Union Against Cancer (UICC), detection rates of prostate cancer by biopsy in each of the 6 Asian countries, and favored treatment modalities for hormone-refractory prostate cancer (HRPC) in each country. The first session of the conference kicked off with a keynote lecture entitled "Activities of the UICC ARO". UICC's new office will be the nerve center for its activities in the Asia region. Along with the Asian Pacific Organization for Cancer Prevention (APOCP), UICC aims to shift the focus of attention to cancer control. As such APOCP's long-running publication the APJCP is to be re-launched as the Asian Pacific Journal of Cancer Control. Although UICC is primarily concerned with cancer, several risk factors for cancer are common also to other non-communicable diseases such as diabetes and heart disease, and an important strategy is to implement measures to control these various pathologic conditions as a whole. Apart from contributing to an Asian prostate cancer registry the UICC-ARO will provide training courses, working groups, and assistance in collecting and processing data. The keynote lecture was followed by a roundtable discussion on possible ways in which clinicians from each Asian country can work with UICC. A number of suggestions were put forth including better registration, epidemiology research, possible implementation of UICC prostate cancer guidelines, early detection and screening, and roles of diet and phytotherapy. The underlying reasons for the large but

  5. PREFACE: 5th International Workshop on Top Quark Physics (TOP2012)

    NASA Astrophysics Data System (ADS)

    Salamanna, G.; Boisvert, V.; Cerrito, L.; Khan, A.; Moretti, S.; Owen, M.; Schwanenberger, C.

    2013-07-01

    The 5th International Workshop on Top Quark Physics (TOP 2012) took place in Winchester, UK, from the 16-21 September. It gathered students as well as people active in the top quark sector and provided a framework to highlight the newest results and matters related to top quark physics. Discovered in 1995, the top quark is the sixth and heaviest of all quarks, and it is the only one with a lifetime short enough to be observed 'naked'. This makes it an important testing ground in the search for new physics. In fact, the fact of its mass being so much larger than the other quarks, hints at its special role in the Higgs mechanism. For the same reason, in many models of New Physics, new heavy resonances are expected to couple mostly with top quarks. Even if no new particles are observed, the direct correlation between its angular momentum and that of its detectable decay products allows us to probe indirectly New Physics in action when top quarks are created. In this edition of the TOP conference series, for the first time, the agenda was equally balanced between 'traditional' measurements and the now vast number of searches for physics BSM in the top quark sector, thanks mostly to the amount of data collected at the LHC in its Run I. New results were presented by both the Tevatron and the LHC collaborations: improved ttbar and single top cross-section measurements, refined techniques to measure the top quark mass and a large number of results on properties such as spin correlation and W boson polarization in top quark decays were shown. More technical discussions on the experimental issues, both from the detector and the simulation side also took place, drawing together experimentalists and theorists. Reviews of the latest results on ttbar asymmetry both from CDF and D0 and from ATLAS and CMS were shown, and theorists active in the field made some interesting points on this hot topic. Additionally, results on the search for fourth generation fermions and new

  6. PREFACE: The 5th International Conference on Radiotherapy Gel Dosimetry (DOSGEL 2008)

    NASA Astrophysics Data System (ADS)

    Maris, Thomas G.; Pappas, Evangelos

    2009-07-01

    The International Conference on Radiotherapy Gel Dosimetry (DOSGEL) is held every two years. Its purpose is to bring together basic science and clinical researchers, medical physicists and clinicians from around the world to discuss the state-of-the-art of the gel dosimetry technique and to set the directions and trends for its future improvements. Gel dosimetry can be broadly defined as using a gel that can react to the absorption of ionizing radiation, and that can retain this information which can subsequently be retrieved by an external imaging modality. Examples of radiation-sensitive gels include, but are not limited to, polymer gel dosimeters, Fricke gel dosimeters and others. Imaging modalities that are of general use in this field are (in alphabetical order) magnetic resonance imaging (MRI), optical light computed tomography and x-ray computed tomography. This volume comprises the proceedings of the 5th International Conference on Radiotherapy Gel Dosimetry (DOSGEL 2008). The conference, organised by the University of Crete, Medical Physics Department, took place in Hersonissos, Crete, Greece from 29 September to 3 October 2008. The meeting aimed to continue the series of biannual DOSGEL conferences and focused on the promotion of gel dosimetry techniques by setting the trends for their future improvements. The main scientific session topics of DOSGEL 2008 were the following: Chemistry and fundamental properties of polymer gel dosimeters Gel dosimetry with Optical Computed Tomography Gel dosimetry with Magnetic Resonance Imaging Gel dosimetry with other than Optical CT and MR scan Techniques Other 3D dosimeters Gel dosimetry applications Local Organizing Committee Thomas G Maris (University of Crete, Greece, Chairman DOSGEL 2008) John Damilakis (University of Crete, Greece) Evangelos Pappas (University of Crete, Greece) Antonios Papadakis (University of Crete, Greece) Fotini Zacharopoulou (University of Crete, Greece) John Stratakis (University of Crete

  7. Overview of the 80(th) Annual Scientific Meeting of the Japanese Circulation Society - The Past, Present and Future of Cardiovascular Medicine in Japan - - The 5(th) Anniversary of the Great East Japan Earthquake.

    PubMed

    Takahashi, Jun; Satoh, Kimio; Fukuda, Koji; Sugimura, Koichiro; Matsumoto, Yasuharu; Nakano, Makoto; Tsuburaya, Ryuji; Aoki, Tatsuo; Hao, Kiyotaka; Nishimiya, Kensuke; Ito, Kenta; Sakata, Yasuhiko; Shimokawa, Hiroaki

    2016-07-25

    The 80(th)Annual Scientific Meeting of the Japanese Circulation Society was held in Sendai, Japan, on March 18-20, 2016, which coincided with the 5(th)anniversary of the Great East Japan Earthquake that hit the Tohoku area on March 11, 2011. Thus, the main themes for this meeting were "The Past, Present and Future of Cardiovascular Medicine in Japan" and "The 5(th)Anniversary of the Great East Japan Earthquake". Despite the provincial location, approximately 15,000 people attended during the 3-day meeting, and there were in-depth discussions in each of the various sessions on these themes. Especially, to our great pleasure, the Japanese Royals, Emperor Akihito and Empress Michiko, kindly visited the panel exhibition of the Great East Japan Earthquake and spoke words of appreciation to us. The meeting successfully completed and we sincerely appreciate the great cooperation and support from all affiliates. (Circ J 2016; 80: 1689-1694). PMID:27385500

  8. 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…

  9. Socioeconomic assessment of the proposed inactivation of the 5th Fighter Interceptor Squadron Minot Air Force Base, North Dakota

    SciTech Connect

    Kerley, C.R.; Sage, P.L.; Fichera, J.P.; Lufkin, P.; Stadelman, D.

    1988-12-01

    This assessment examines the potential socioeconomic impacts of inactivating the 5th Fighter Interceptor Squadron (FIS) at Minot Air Force Base (AFB), North Dakota. The study focuses on employment, population, and income impacts and estimates their effects on housing, community services, utilities, transportation, recreation and tourism, and public finance. This assessment is intended primarily for the use of Air Force and community planners concerned with the local consequences of the inactivation. 10 refs., 46 tabs.

  10. Postoperative Spine Infections

    PubMed Central

    Evangelisti, Gisberto; Andreani, Lorenzo; Girardi, Federico; Darren, Lebl; Sama, Andrew; Lisanti, Michele

    2015-01-01

    Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of postoperative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication. PMID:26605028

  11. Mountain Medicine Papers. Proceedings of the Mountain Medicine Symposium (5th, Issaquah, Washington, 1976).

    ERIC Educational Resources Information Center

    Mitchell, Dick; And Others

    The proceedings of the fifth symposium on mountain and survival medicine include the program for the 4-day conference which was addressed by 21 guest lecturers from Canada, Nepal, and the United States. The proceedings include abstracts for and background information on the authors of 17 papers. It also includes the texts of 13 symposium papers:…

  12. Summative assessment of 5th year medical students’ clinical reasoning by script concordance test: requirements and challenges

    PubMed Central

    2012-01-01

    Background The Script Concordance Test (SCT) has not been reported in summative assessment of students across the multiple domains of a medical curriculum. We report the steps used to build a test for summative assessment in a medical curriculum. Methods A 51 case, 158-question, multidisciplinary paper was constructed to assess clinical reasoning in 5th-year. 10–16 experts in each of 7 discipline-based reference panels answered questions on-line. A multidisciplinary group considered reference panel data and data from a volunteer group of 6th Years, who sat the same test, to determine the passing score for the 5th Years. Results The mean (SD) scores were 63.6 (7.6) and 68.6 (4.8) for the 6th Year (n = 23, alpha = 0.78) and and 5th Year (n = 132, alpha =0.62) groups (p < 0.05), respectively. The passing score was set at 4 SD from the expert mean. Four students failed. Conclusions The SCT may be a useful method to assess clinical reasoning in medical students in multidisciplinary summative assessments. Substantial investment in training of faculty and students and in the development of questions is required. PMID:22571351

  13. Emotional and Behavioral Disorders in 1.5th Generation, 2nd Generation Immigrant Children, and Foreign Adoptees.

    PubMed

    Tan, Tony Xing

    2016-10-01

    Existing theories (e.g., acculturative stress theory) cannot adequately explain why mental disorders in immigrants are less prevalent than in non-immigrants. In this paper, the culture-gene co-evolutionary theory of mental disorders was utilized to generate a novel hypothesis that connection to heritage culture reduces the risk for mental disorders in immigrant children. Four groups of children aged 2-17 years were identified from the 2007 United States National Survey of Children's Health: 1.5th generation immigrant children (n = 1378), 2nd generation immigrant children (n = 4194), foreign adoptees (n = 270), and non-immigrant children (n = 54,877). The 1.5th generation immigrant children's connection to their heritage culture is stronger than or similar to the 2nd generation immigrants, while the foreign adoptees have little connection to their birth culture. Controlling for age, sex, family type and SES, the odds for having ADD/ADHD, Conduct Disorder, Anxiety Disorder, and Depression diagnosis were the lowest for the 1.5th generation immigrant children, followed by the 2nd generation immigrant children and the foreign adoptees. The foreign adoptees and non-adopted children were similar in the odds of having these disorders. Connection to heritage culture might be the underlying mechanism that explained recent immigrants' lower rates of mental disorders. PMID:26972324

  14. The Hetu'u Global Network: Using the rare June 5th/6th Transit of Venus to Bring Astronomy to the Remote Easter Island

    NASA Astrophysics Data System (ADS)

    Faherty, Jacqueline; Rodriguez, D.

    2013-01-01

    There are rare times in astronomy when a celestial event, visible in broad daylight, can be used to measure a fundamental parameter and inspire a globe full of school age students. The June 5th/6th transit of Venus was one such event. In celebration, nine astronomy postdocs from the Chilean mainland traveled to Easter Island to lead a series of astronomy outreach activities over three days, culminating in a transit-viewing event. Our team dubbed "Equipo Hetu'u" or "Team Star" in the Rapa Nui (Easter Island native) language spent two days giving astronomy talks and doing hands-on demonstrations at the Museo Antropologico P. Sebastian Englert. In the final day-and-a-half leading up to the transit, we visited the science classes in the majority of the schools on the island, in order to spread the message about the once-in-a-lifetime transit event, highlighting how we planned on using it to measure the distance to the Sun. We estimate over 25% 1500 people) of this remote island participated in one or more of our organized activities. Our experience with this project is an excellent lesson on how to organize, lead, and fully execute a major outreach endeavor that inspires hundreds with minimal resources (save the spectacular event provided by the cosmos).

  15. [Some immunologic aspects in postoperative peritonitis].

    PubMed

    Perfil'ev, D F

    1998-01-01

    Examination of blood serum and cellular elements of 45 patients with postoperative diffuse purulent peritonitis shows that in the majority of examined persons before and in the first days after the operation immunodepression exists. The dynamics of immunologic disturbances (antibody titers, phagocytosis, immunoglobulines, T- and B-lymphocytes) are sufficiently informative and as a rule, correlate with clinical course of peritonitis. Adequate reaction of the organism to infection resulted in a favourable outcome. Low values of immunologic indices in postoperative period necessitate the use of stimulant therapy in combined treatment of this complication. PMID:9916429

  16. Teacher and Parent Views on the Instruction of 5th Grade Students by Branch Teachers in the 4+4+4 Education System

    ERIC Educational Resources Information Center

    Yildizhan, Yusuf Hayri

    2015-01-01

    The objective of this study is to examine the teacher and parent views on the instruction of 5th grade students by branch teachers. This study is designed according to the phenomenology design and uses qualitative data. In order to collect data, open-ended questions were asked to 18 teachers and 16 parents of 5th grade students on the subject, and…

  17. Management of Postoperative Respiratory Failure.

    PubMed

    Mulligan, Michael S; Berfield, Kathleen S; Abbaszadeh, Ryan V

    2015-11-01

    Despite best efforts, postoperative complications such as postoperative respiratory failure may occur and prompt recognition of the process and management is required. Postoperative respiratory failure, such as postoperative pneumonia, postpneumonectomy pulmonary edema, acute respiratory distress-like syndromes, and pulmonary embolism, are associated with high morbidity and mortality. The causes of these complications are multifactorial and depend on preoperative, intraoperative, and postoperative factors, some of which are modifiable. The article identifies some of the risk factors, causes, and treatment strategies for successful management of the patient with postoperative respiratory failure. PMID:26515943

  18. Peppermint oil: a treatment for postoperative nausea.

    PubMed

    Tate, S

    1997-09-01

    This paper describes a research study to investigate the efficacy of peppermint oil as a treatment for postoperative nausea. It uses a three-condition experimental design using statistical analysis to compare groups. The Kruskal-Wallis test was used to establish significance and the Mann-Whitney test to differentiate significance between the groups. The control, placebo and experimental groups of gynaecological patients were compared, using variables known to affect postoperative nausea. They were found to be homogeneous for the purposes of the study. A statistically significant differences was demonstrated on the day of operation, using the Kruskal-Wallis test, P = 0.0487. Using the Mann-Whitney test the difference was shown to be between the placebo and experimental group (U = 3; P = 0.02). The experimental group also required less traditional antiemetics and received more opioid analgesia postoperatively. The total cost of the treatment was 48 pence per person. PMID:9378876

  19. Postoperative endophthalmitis by Flavimonas oryzihabitans.

    PubMed

    Tsai, Chien-Kuang; Liu, Chi-Chang; Kuo, Hsi-Kung

    2004-11-01

    A 55-year-old man suffered from blurred vision of the left eye (visual acuity was counting fingers/5-10 cm) 8 days after undergoing cataract surgery. After thorough ophthalmologic examinations with gram-negative bacillus justified on smear of vitreous specimen, postoperative endophthalmitis (os) was impressed. Intravitreous injection of 1.0 mg of vancomycin, 0.4 mg of amikacin, and 0.4 mg of dexamethasone was given twice and vitreous fluid culture was also performed. However, the inflammatory condition was not well controlled. Because the results of vitreous fluid culture revealed Flavimonas oryzihabitans infection which is sensitive to piperacillin, we performed the 3rd intravitreous injection of 1.0 mg of piperacillin and 0.4 mg of dexamethasone. The inflammatory condition was under control and the visual acuity of left eye improved. For patients with ocular diseases, postoperative endophthalmitis by Flavimonas oryzihabitans is a rare condition. According to the results of this case, intravitreous injection of piperacillin was effective against the pathogen. PMID:15796259

  20. Tryptophan Supplementation and Postoperative Delirium – A Randomized Controlled Trial

    PubMed Central

    Robinson, Thomas N.; Dunn, Christina L.; Adams, Jill C.; Hawkins, Carrie L.; Tran, Zung V.; Raeburn, Christopher D.; Moss, Marc

    2014-01-01

    Background/Objectives Tryptophan deficiency has been associated with increased incidence of postoperative delirium. Therefore, we hypothesized that the post-operative administration of tryptophan would be beneficial for elderly surgical patients who are at higher risk of developing post-operative delirium. Design Randomized, double-blind, placebo controlled trial. Setting: Participants A total of 325 individuals aged 60 years and older undergoing major elective operations requiring a postoperative intensive care unit admission. Intervention L-tryptophan, 1 gram orally, three times daily or placebo was started following the operation and continued for up to three days postoperatively. Measurements Delirium and its motor subtypes were measured using the Confusion Assessment Method-ICU and the Richmond Agitation and Sedation Scale. The primary outcome for between groups comparison was the incidence of excitatory (mixed and hyperactive) postoperative delirium. The secondary outcomes for comparison were the incidence and duration of overall postoperative delirium. Results The overall incidence of postoperative delirium was 39% (116) (95% confidence interval 34% to 44%). The percentages of patients with excitatory delirium in the tryptophan and placebo groups were 17% and 9% (p=0.176), and the duration of excitatory delirium was 3.3±1.7 and 3.1±1.9 days (p=0.741). The percentage of patients with overall delirium in the tryptophan and placebo groups was 40% and 37% (p=0.597), and the duration of overall delirium was 2.9±1.8 and 2.4±1.6 days (p=0.167). Conclusion Postoperative tryptophan supplementation in older adults undergoing major elective operations requiring postoperative intensive care unit admission demonstrated no efficacy in reducing the incidence of postoperative excitatory delirium or overall delirium, and the duration of excitatory or overall delirium. PMID:25112175

  1. 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. PMID:12427178

  2. 5-Step Methodology for Evaluation and Adaptation of Print Patient Health Information to Meet the <5th Grade Readability Criterion

    PubMed Central

    Hill-Briggs, Felicia; Schumann, Kristina P.; Dike, Ogechi

    2012-01-01

    Background In the setting of declining U.S. literacy, new policies include use of clear communication and low literacy accessibility practices with all patients. Reliable methods for adapting health information to meet such criteria remain a pressing need. Objectives To report method validation (Study 1) and method replication (Study 2) procedures and outcomes for a 5-step method for evaluating and adapting print health information to meet the current low literacy criterion of <5th grade readability. Materials Sets of 18 and 11 publicly-disseminated patient education documents developed by a university-affiliated medical center. Measures Three low-literacy criteria were strategically targeted for efficient, systematic evaluation and text modification to meet a <5th grade reading level: sentence length <15 words, writing in active voice, and use of common words with multisyllabic words (>2–3 syllables) minimized or avoided. Inter-rater reliability for the document evaluations was determined. Results Training in the methodology resulted in inter-rater reliability of 0.99–1.00 in Study 1 and 0.98–1.00 in Study 2. Original documents met none of the targeted low literacy criteria. In Study 1, following low-literacy adaptation, mean reading grade level decreased from 10.4±1.8 to 3.8±0.6 (p<0.0001), with consistent achievement of criteria for words per sentence, passive voice, and syllables per word. Study 2 demonstrated similar achievement of all target criteria, with a resulting decrease in mean reading grade level from 11.0±1.8 to 4.6±0.3 (p < 0.0001). Conclusions The 5-step methodology proved teachable and efficient. Targeting a limited set of modifiable criteria was effective and reliable in achieving <5th grade readability. PMID:22354210

  3. Validation of the 5th and 95th Percentile Hybrid III Anthropomorphic Test Device Finite Element Model

    NASA Technical Reports Server (NTRS)

    Lawrence, C.; Somers, J. T.; Baldwin, M. A.; Wells, J. A.; Newby, N.; Currie, N. J.

    2014-01-01

    NASA spacecraft design requirements for occupant protection are a combination of the Brinkley criteria and injury metrics extracted from anthropomorphic test devices (ATD's). For the ATD injury metrics, the requirements specify the use of the 5th percentile female Hybrid III and the 95th percentile male Hybrid III. Furthermore, each of these ATD's is required to be fitted with an articulating pelvis and a straight spine. The articulating pelvis is necessary for the ATD to fit into spacecraft seats, while the straight spine is required as injury metrics for vertical accelerations are better defined for this configuration. The requirements require that physical testing be performed with both ATD's to demonstrate compliance. Before compliance testing can be conducted, extensive modeling and simulation are required to determine appropriate test conditions, simulate conditions not feasible for testing, and assess design features to better ensure compliance testing is successful. While finite element (FE) models are currently available for many of the physical ATD's, currently there are no complete models for either the 5th percentile female or the 95th percentile male Hybrid III with a straight spine and articulating pelvis. The purpose of this work is to assess the accuracy of the existing Livermore Software Technology Corporation's FE models of the 5th and 95th percentile ATD's. To perform this assessment, a series of tests will be performed at Wright Patterson Air Force Research Lab using their horizontal impact accelerator sled test facility. The ATD's will be placed in the Orion seat with a modified-advanced-crew-escape-system (MACES) pressure suit and helmet, and driven with loadings similar to what is expected for the actual Orion vehicle during landing, launch abort, and chute deployment. Test data will be compared to analytical predictions and modelling uncertainty factors will be determined for each injury metric. Additionally, the test data will be used to

  4. 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. PMID:20552850

  5. A report on 5th congress of Asia Pacific Pediatric Cardiac Society, New Delhi, India, 6-9 March 2014

    PubMed Central

    Gupta, Saurabh K; Saxena, Anita

    2015-01-01

    The 5th Congress of Asia Pacific Pediatric Cardiac Society was held in New Delhi from 6-9 March 2014. This article describes the journey of preparing and hosting one of the largest international events in the specialty of Pediatric Cardiac Care ever held in India. A total of 938 delegates, including 400 from outside India, participated. The scientific program was inclusive keeping in mind the diverse background of delegates from the member nations. Large numbers of research papers were presented, mostly by fellows in training. PMID:25684899

  6. IBA investigations of loose garnets from Pietroasa, Apahida and Cluj-Someşeni treasures (5th century AD)

    NASA Astrophysics Data System (ADS)

    Bugoi, R.; Oanţă-Marghitu, R.; Calligaro, T.

    2016-03-01

    This paper reports the archaeometric investigations of 418 loose garnets from Pietroasa and Cluj-Someşeni treasures and Apahida II and III princely grave inventories (5th century AD). The chemical composition of the gems was determined by external beam micro-PIXE technique at the AGLAE accelerator of C2RMF, Paris, France. Complementary observations made by Optical Microscopy revealed details on the gemstones cutting and polishing and permitted to identify certain mineral inclusions. The compositional results evidenced several types of garnets from the pyralspite series, suggesting distinct provenances for these Early Medieval gems.

  7. Postoperative pain management

    PubMed Central

    Kolettas, Alexandros; Lazaridis, George; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Papaiwannou, Antonis; Lampaki, Sofia; Karavergou, Anastasia; Pataka, Athanasia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Mpakas, Andreas; Tsakiridis, Kosmas; Fassiadis, Nikolaos; Zarogoulidis, Konstantinos

    2015-01-01

    Postoperative pain is a very important issue for several patients. Indifferent of the surgery type or method, pain management is very necessary. The relief from suffering leads to early mobilization, less hospital stay, reduced hospital costs, and increased patient satisfaction. An individual approach should be applied for pain control, rather than a fix dose or drugs. Additionally, medical, psychological, and physical condition, age, level of fear or anxiety, surgical procedure, personal preference, and response to agents given should be taken into account. The major goal in the management of postoperative pain is minimizing the dose of medications to lessen side effects while still providing adequate analgesia. Again a multidisciplinary team approach should be pursued planning and formulating a plan for pain relief, particularly in complicated patients, such as those who have medical comorbidities. These patients might appear increase for analgesia-related complications or side effects. PMID:25774311

  8. Immediate postoperative feeding in urological surgery.

    PubMed

    Seidmon, E J; Pizzimenti, K V; Blumenstock, F A; Huben, R P; Wajsman, Z; Pontes, J E

    1984-06-01

    The value of immediate postoperative enteral hyperalimentation with an elemental diet (high nitrogen Vivonex, full strength) at 125 cc per hour for 4 days was assessed in patients after radical urological surgery. Of 32 patients studied 21 received an elemental diet using a Vivonex Moss tube, which is a 3-lumen tube with esophagogastric decompression and simultaneous duodenal feeding, and the remaining 11 had a nasogastric tube only without nutritional support. We have used a selected group of parameters, including serum albumin, serum transferrin, creatinine height index, weight loss, total lymphocyte count, nitrogen balance and plasma fibronectin. All patients in the Moss tube group approached or achieved positive nitrogen balance by 4 days postoperatively, whereas the nasogastric tube group remained in negative nitrogen balance. Postoperative paralytic ileus was prevented in the majority of patients in the Moss tube group while receiving full nutritional support. We have found that the use of the Moss tube is a reasonable approach for postoperative alimentation. The tube is relatively easy to insert and well tolerated, and its use is a less expensive alternative to parenteral hyperalimentation. PMID:6427479

  9. Impact of Postoperative Venous Thromboembolism on Postoperative Morbidity, Mortality, and Resource Utilization after Hepatectomy.

    PubMed

    Newhook, Timothy E; LaPar, Damien J; Walters, Dustin M; Gupta, Shruti; Jolissaint, Joshua S; Adams, Reid B; Brayman, Kenneth L; Zaydfudim, Victor M; Bauer, Todd W

    2015-12-01

    The impact of venous thromboembolism (VTE) after hepatectomy on patient morbidity, mortality, and resource usage remains poorly defined. Better understanding of thromboembolic complications is needed to improve perioperative management and overall outcomes. About 3973 patients underwent hepatectomy within NSQIP between 2005 and 2008. Patient characteristics, operative features, and postoperative correlates of VTE were compared with identify risk factors for VTE and to assess its overall impact on postoperative outcomes. Overall incidence of postoperative VTE was 2.4 per cent. Risk factors for postoperative VTE included older age, male gender, compromised functional status, degree of intraoperative blood transfusion, preoperative albumin level (all P < 0.05), and extent of hepatectomy (P = 0.004). Importantly, major postoperative complications, including acute renal failure, pneumonia, sepsis, septic shock, reintubation, prolonged ventilation, cardiac arrest, and reoperation were all associated with higher rates of VTE (all P < 0.05). Operative mortality was increased among patients with VTE (6.5% vs 2.4%, P = 0.03), and patients with VTE had a 2-fold increase in hospital length of stay (12.0 vs 6.0 days, P < 0.001). Postoperative VTE remains a significant source of morbidity, mortality, and increased resource usage after hepatectomy in the United States. Routine aggressive VTE prophylaxis measures are imperative to avoid development of VTE among patients requiring hepatectomy. PMID:26736156

  10. It takes a community to define a discipline: the 5th anniversary of Environmental Research Letters It takes a community to define a discipline: the 5th anniversary of Environmental Research Letters

    NASA Astrophysics Data System (ADS)

    Kammen, Dan

    2012-03-01

    commentary environment, a unique service in itself, and also a specific forum for research published in ERL. Individual topics often come up that warrant not only single articles, but collections of assessments, and ERL has published focus issues in key areas of environmental science including: tropical deforestation, wind energy, the Deepwater Horizon oil spill and climate engineering. ERL is currently publishing seven high-quality focus issues in cutting-edge areas such as arctic vegetation dynamics and cryospheric changes. Research letters appearing in ERL have received regular and significant coverage in the wider media, with several major news outlets and agencies choosing to cover ERL research, such as Nature, BBC News, New Scientist, The Guardian, Scientific American, Le Monde and many others. 4.The future community of ERL The process of community support will take many forms at ERL. The journal is growing—we have published the highest number of articles ever in a single volume in 2011 and are looking to continue this growth through into 2012. ERL had an over 50% increase in submissions from 2010 to 2011. One initiative to mark the journal's 5th anniversary was the 'Best articles' collection [1] a nominated compilation of articles showcasing the quality of published work in ERL as well as the subject area breadth. Co-authors of the five winning articles have been awarded free publication in ERL until the end of 2012. We can also see the open access model working, in that our articles are highly downloaded outside of the traditionally strong geographical areas of academia (North America and Western Europe), showing that the journal's readership is geographically diverse with high interest from Asia, South America and Africa. The journal is committed to progress and innovation; coming soon will be a set of new communication tools and online innovations, including: Video abstracts from the start of 2012 (for example, the video commentary published alongside this

  11. PREFACE: 5th International Conference on Materials and Applications for Sensors and Transducers (IC-MAST2015)

    NASA Astrophysics Data System (ADS)

    Hristoforou, E.; Vlachos, D. S.; Giouroudi, I.; Kar-Narayan, S.; Potirakis, S.

    2016-03-01

    The 5th International Conference on Materials and Applications for Sensors and Transducers, Mykonos island, Greece, hosted about 110 oral and poster papers and more than 90 participants. IC-MAS, as an international annual conference which tries to meet the needs for various types of sensors, particularly those which may be manufactured by low cost methods (i.e. hybrid sensors, smart specialization devices, particular applications not necessarily requiring integrated micro-nano technologies), covering all types of materials and physical effects, appears to be a necessity. IC-MAST has been established as a high quality international conference by: I. Gathering together multinational researchers from all over the world, working in different materials for sensors and transducers and technical applications of sensors, but also in some cases in the management of the data coming from sensors and transducers. The careful selection of the conference place (like Aegean Sea, Budapest, Prague, Bilbao, Mykonos etc) allows for enjoying the local hospitality and sightseeing. II. Emphasizing in hybrid sensors and smart specialization devices produced by inexpensive methods, without excluding of course micro-nano technology, from all kinds of solid state, liquid and gaseous materials, as well as in particular transducer applications (design and development, as well as use of sensing data) III. Innovatively implementing the Virtual Paper Concept, allowing for large impact of research works presented in the conference by authors who either have no time or no funding support for visiting a conference; this year more than 12 virtual papers are presented in the 5th IC MAST, following a standardized procedure via the our robust and reliable Conference Site (www.icmast.net!) > IV. Allowing for lengthy technical and managerial discussions in terms of sensor, material and instrumentation development; furthermore, the different research groups gathered together are offered the particular

  12. Primary School 5th and 8th Graders' Understanding and Mental Models about the Shape of the World and Gravity

    ERIC Educational Resources Information Center

    Öztürk, Ayse; Doganay, Ahmet

    2013-01-01

    This study investigated primary school 5th and 8th graders' understanding and mental models related to the shape of the world and gravity, and how these models reflected the fact and what kind of a change there is from 5th to 8th graders. This research is based on a cross-sectional design. The study was conducted in a low socioeconomic level…

  13. Postoperative Autologous Reinfusion in Total Knee Replacement

    PubMed Central

    Crescibene, A.; Martire, F.; Gigliotti, P.; Rende, A.; Candela, M.

    2015-01-01

    Surgeries for total knee replacement (TKR) are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p = 0.08) and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p = 0.03). Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p < 0.01), and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR. PMID:26442168

  14. Macracanthorhynchus hirudinaceus Eggs in Canine Coprolite from the Sasanian Era in Iran (4(th)/5(th) Century CE).

    PubMed

    Mowlavi, Gholamreza; Makki, Mahsasadat; Heidari, Zahra; Rezaeian, Mostafa; Mohebali, Mehdi; Araujo, Adauto; Boenke, Nicole; Aali, Abolfazl; Stollner, Thomas; Mobedi, Iraj

    2015-01-01

    Present paper is the second publication introducing the paleoparasitological findings from animal coprolites obtained from archeological site of Chehrabad salt mine in northwestern Iran. The current archeological site is located in northwest of Iran, dated to the Sassanian Era (4(th)/5(th) century CE). In the summer 2012 the carnivore coprolite was obtained within the layers in the mine and were thoroughly analyzed for parasites using TSP rehydration technique. Eggs of 0 were successfully retrieved from the examined coprolite and were confidently identified based on reliable references. Identifying of M. hirudinaceus eggs in paleofeces with clear appearance as demonstrated herein, is much due to appropriate preservation condition has been existed in the salt mine .The present finding could be regarded as the oldest acanthocephalan infection in Iran. PMID:26246822

  15. Macracanthorhynchus hirudinaceus Eggs in Canine Coprolite from the Sasanian Era in Iran (4th/5th Century CE)

    PubMed Central

    MOWLAVI, Gholamreza; MAKKI, Mahsasadat; HEIDARI, Zahra; REZAEIAN, Mostafa; MOHEBALI, Mehdi; ARAUJO, Adauto; BOENKE, Nicole; AALI, Abolfazl; STOLLNER, Thomas; MOBEDI, Iraj

    2015-01-01

    Present paper is the second publication introducing the paleoparasitological findings from animal coprolites obtained from archeological site of Chehrabad salt mine in northwestern Iran. The current archeological site is located in northwest of Iran, dated to the Sassanian Era (4th/5th century CE). In the summer 2012 the carnivore coprolite was obtained within the layers in the mine and were thoroughly analyzed for parasites using TSP rehydration technique. Eggs of 0 were successfully retrieved from the examined coprolite and were confidently identified based on reliable references. Identifying of M. hirudinaceus eggs in paleofeces with clear appearance as demonstrated herein, is much due to appropriate preservation condition has been existed in the salt mine .The present finding could be regarded as the oldest acanthocephalan infection in Iran. PMID:26246822

  16. 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

  17. Physiopathology and control of postoperative pain.

    PubMed

    Pflug, A E; Bonica, J J

    1977-06-01

    Potent systemic (narcotic) analgesics, when given in doses sufficient to produce ample pain relief, usually also produce mental and respiratory depression and, at times, circulatory impairment, that prolong postoperative morbidity. Complications due to morphine sulfate or meperidine hydrochloride can be minimized by titrating the patient's pain with small intravenous doses of narcotics (morphine sulfate, 2 to 3 mg, or meperidine hydrochloride, 15 to 25 mg) administered slowly at 15- to 20-minute intervals until the pain is relieved. On the third or fourth postoperative day, acetaminophen tablets usually suffice to provide relief of pain with little or no risk to patients. Continuous segmental epidural block or intercostal block, with or without splanchnic block, provide excellent pain relief that, in contrast to the narcotic, is complete. These are especially useful after operations on the chest or abdomen or the lower extremity. Regional analgesia is especially indicated in patients not adequately relieved from severe postoperative pain with narcotics, or when these drugs are contraindicated by advanced pulmonary, renal, or hepatic disease. Continuous caudal analgesia is also effective to completely releive severe postoperative pain in the lower limbs and perineum. PMID:871249

  18. Postoperative pain in children.

    PubMed

    Goddard, J M; Pickup, S E

    1996-06-01

    An audit project was designed to assess and improve the provision of postoperative analgesia in a children's hospital. Pain assessment for all children and analgesia standards for our institution were introduced prior to data collection. Data were collected on consecutive samples of 316 and 325 children undergoing surgery as inpatients during 10-week periods. Change was initiated between the two periods in response to our findings; our action plan involved education, changes to documentation, the widespread use of diclofenac in children over 2 years of age and recommendations for the prescription of analgesia. The initial prescription of analgesia increased from 95% to 98% (p = 0.019), administration of analgesia to children experiencing bad or severe pain increased from 57% to 71% (p = 0.032) and the number of children experiencing severe pain reduced from 17% to 11% (p = 0.050). Application of audit, by a clinical nurse specialist, enabled us to achieve and demonstrate improvements in the prescription, administration and effectiveness of postoperative analgesia. PMID:8694218

  19. [Retroperitoneal postoperative necrotizing fasciitis].

    PubMed

    Fichev, G; Poromanski, I; Marina, M

    2000-01-01

    This is a report on clinical experience had with 17 patients presenting necrotizing fasciitis--a complication ever more frequently encountered. The case material is distributed in two group differing by origin and clinical course of the complication. In group one (n = 11) it is a matter of postoperative development of postoperative complication, consistent with the classical "per continuitatem" and "per contiguitatem" mechanisms, while in group two (n = 6) the process originates, evolves and speads within the retroperitoneal space proper. Comprehensive microbiological examinations performed in 13 cases show that in either group different microorganisms are identified. In group one aerobic-anaerobic mixed infection is documented in all patients, with predominance of Enterobacteroidaceae among aerobic ones. In group two, anaerobic bacterial species, mainly Clostridium sp, prevail in all the isolates. The clinical study points to a substantial difference in the time of septic complication occurrence, as well as between the clinical picture of the two species. Accordingly, the final results are radically different--in group one survivorship amounts to 62.6%, whereas in group two--to 16.6% only. PMID:11692928

  20. Keratoplasty postoperative treatment update.

    PubMed

    Shimmura-Tomita, Machiko; Shimmura, Shigeto; Satake, Yoshiyuki; Shimazaki-Den, Seika; Omoto, Masahiro; Tsubota, Kazuo; Shimazaki, Jun

    2013-11-01

    Immunosuppressive therapy is the main postoperative treatment for keratoplasty, but there are considerable differences in protocols for the use of steroids and other immunosuppressants. Therefore, we conducted 2 prospective randomized clinical trials and 1 prospective nonrandomized clinical trial on keratoplasty postoperative treatment. One study evaluated the efficacy and safety of long-term topical corticosteroids after a penetrating keratoplasty was performed. Patients who underwent keratoplasty and maintained graft clarity for >1 year were randomly assigned to either a steroid or a no-steroid group. At the 12-month follow-up, the no-steroid group developed significantly more endothelial rejection than did the steroid group. A second study elucidated the effectiveness and safety of systemic cyclosporine in high-risk corneal transplantation. The patients were assigned to a systemic cyclosporine or control group. At a mean follow-up of 42.7 months, no difference was observed in the endothelial rejection rates and graft clarity loss between the 2 groups. A third study elucidated the effectiveness and the safety of systemic tacrolimus in high-risk corneal transplantation. Of 11 consecutive eyes decompensated despite systemic cyclosporine treatment, there was no irreversible rejection in eyes treated with tacrolimus, which was significantly better than in previous penetrating keratoplasty with systemic cyclosporine treatment. Prognosis after keratoplasty in patients with keratoconus is relatively good, but special attention is required for patients with atopic dermatitis. Postkeratoplasty atopic sclerokeratitis (PKAS) is a severe form of sclerokeratitis after keratoplasty in atopic patients. Our retrospective study showed that 35 eyes of 29 patients from a total of 247 keratoconus eyes undergoing keratoplasty were associated with atopic dermatitis, of which 6 eyes of 5 patients developed PKAS. Eyes with PKAS had a significantly higher incidence of atopic blepharitis

  1. Kindergarten: All Day Every Day?

    ERIC Educational Resources Information Center

    Oelerich, Marjorie L.

    This paper reports findings that all-day every-day educational programs have positive effects on kindergarten children. Also included is a Minnesota Association for Childhood Education (MACE) position paper which advocates the provision of full-day kindergarten programs and details seven criteria that a quality full-day program must meet. Efforts…

  2. Limited efficacy of early postoperative jejunal feeding.

    PubMed

    Hayashi, J T; Wolfe, B M; Calvert, C C

    1985-07-01

    Twenty patients underwent placement of a jejunal catheter for early postoperative feeding at the time of upper abdominal operations, and a control group of 11 patients underwent operative procedures of similar magnitude without jejunostomy. Advancement of the rate of feeding to target intake over 6 to 7 days was attempted. Complications from the feeding led to cessation or curtailment of intake in 65 percent of the patients. Specific complications included abdominal pain and distention, diarrhea, and retrograde reflux of the feeding into the stomach. No statistically significant difference in nitrogen balance was demonstrated between the fed and unfed groups, presumably due to the limitations of nutrient delivery or absorption in the fed groups or elevated breath hydrogen excretion in patients with abdominal pain and distention suggests that the nature of the nutrients, particularly complex carbohydrates, is a factor in the development of feeding complications. Caution must be exercised in advancing the rate of postoperative jejunal feeding. PMID:3925800

  3. Comparison of the effect of naproxen, etodolac and diclofenac on postoperative sequels following third molar surgery: A randomised, double-blind, crossover study

    PubMed Central

    Akbulut, Nihat; Atakan, Cemal; Çölok, Gülümser

    2014-01-01

    Objectives: To compare the three non-steroidal anti-inflammatory agents (NSAIDs) diclofenac potassium, etodolac and naproxen sodium in relation to pain, swelling and trismus following impacted third molar surgery. Study Design: The study was a randomized and a double-blinded study which included 42 healthy young individuals with impacted third molars and bone retention. Patients were randomly assigned to 3 groups (n: 14) to which diclofenac potassium, naproxen sodium and etodolac were administered orally an hour before the operation. Impacted third molars were surgically extracted with local anaesthesia. Visual analog scales (VAS) were used to assess the pain in the 6th, 12th hours and on the 1st, 2nd, 3rd, 5th, and 7th days postoperatively. Swelling was evaluated using ultrasound (US) and mouth opening (trismus) was measured with a composing stick pre and post operatively on the 2nd and 7th days respectively. Results: Regarding pain alleviation, diclofenac potassium was better than naproxen sodium and naproxen sodium was better than etodolac but these differences were not statistically significant. US measurements showed that the swelling on postoperative 2nd day was significantly lowest with diclofenac potassium as compared to others (p= 0.027) while naproxen sodium and etodolac acted similarly (p=0.747). No difference was noted regarding trismus in any of the groups. Conclusions: NSAIDs (diclofenac, naproxen and etodolac) are somehow similarly effective for controlling pain and trismus following extraction of mandibular third molars but diclofenac potassium surpasses others in reduction of swelling. Key words:Diclofenac potassium, naproxen sodium, etodolac, impacted third molar surgery, pain, swelling, trismus. PMID:24316711

  4. Communicating Science to Impact Learning? A Phenomenological Inquiry into 4th and 5th Graders' Perceptions of Science Information Sources

    NASA Astrophysics Data System (ADS)

    Gelmez Burakgazi, Sevinc; Yildirim, Ali; Weeth Feinstein, Noah

    2016-04-01

    Rooted in science education and science communication studies, this study examines 4th and 5th grade students' perceptions of science information sources (SIS) and their use in communicating science to students. It combines situated learning theory with uses and gratifications theory in a qualitative phenomenological analysis. Data were gathered through classroom observations and interviews in four Turkish elementary schools. Focus group interviews with 47 students and individual interviews with 17 teachers and 10 parents were conducted. Participants identified a wide range of SIS, including TV, magazines, newspapers, internet, peers, teachers, families, science centers/museums, science exhibitions, textbooks, science books, and science camps. Students reported using various SIS in school-based and non-school contexts to satisfy their cognitive, affective, personal, and social integrative needs. SIS were used for science courses, homework/project assignments, examination/test preparations, and individual science-related research. Students assessed SIS in terms of the perceived accessibility of the sources, the quality of the content, and the content presentation. In particular, some sources such as teachers, families, TV, science magazines, textbooks, and science centers/museums ("directive sources") predictably led students to other sources such as teachers, families, internet, and science books ("directed sources"). A small number of sources crossed context boundaries, being useful in both school and out. Results shed light on the connection between science education and science communication in terms of promoting science learning.

  5. Clinical development of new prophylactic antimalarial drugs after the 5th Amendment to the Declaration of Helsinki

    PubMed Central

    Dow, Geoffrey S; Magill, Alan J; Ohrt, Colin

    2008-01-01

    Malaria is of continuing concern in nonimmune traveling populations. Traditionally, antimalarial drugs have been developed as agents for dual indications (treatment and prophylaxis). However, since 2000, when the 5th Amendment to the Declaration of Helsinki (DH2000) was adopted, development of new malaria prophylaxis drugs in this manner has ceased. As a consequence, there may not be any new drugs licensed for this indication in the foreseeable future. Major pharmaceutical companies have interpreted DH2000 to mean that the traditional development paradigm may be considered unethical because of doubt over the likelihood of benefit to endemic populations participating in clinical studies, the use of placebo, and the sustainability of post-trial access to study medications. In this article, we explore the basis of these concerns and suggest that the traditional development paradigm remains ethical under certain circumstances. We also consider alternative approaches that may be more attractive to sponsors as they either do not use placebo, or utilize populations in endemic countries who may unambiguously benefit. These approaches represent the way forward in the future, but are at present unproven in clinical practice, and face numerous regulatory, logistical and technical challenges. Consequently, in the short term, we argue that the traditional clinical development paradigm remains the most feasible approach and is ethical and consistent with the spirit of DH2000 under the appropriate circumstances. PMID:19209263

  6. Attitudes towards General Practice: a comparative cross-sectional survey of 1st and 5th year medical students

    PubMed Central

    Kruschinski, Carsten; Wiese, Birgitt; Hummers-Pradier, Eva

    2012-01-01

    Objective: Positive attitudes towards General Practice can be understood as a prerequisite for becoming a General Practitioner (GP) and for collaboration with GPs later on. This study aimed to assess attitudes of medical students at the beginning and the end of medical school. Methods: A total of 160 1st year students at Hannover Medical School were surveyed. Their attitudes were compared to those of 287 5th year students. Descriptive, bi- and multivariate analyses were performed to investigate influences of year of study and gender. Results: Year of study and gender both were associated with the attitudes towards General Practice. The interest in General Practice and patient-orientation (communication, care of older patients with chronic diseases) was higher in 1st year students compared to more advanced students. Female students valued such requirements more than male students, the differences in attitudes between the years of study being more pronounced in male students. Conclusion: Despite some limitations caused by the cross-sectional design, the attitudes towards General Practice competencies changed to their disadvantage during medical school. This suggests a formative influence of the strategies used in medical education. Educational strategies, however, could be used to bring about a change of attitudes in the other direction. PMID:23255966

  7. Fast food consumption and food prices: evidence from panel data on 5th and 8th grade children.

    PubMed

    Khan, Tamkeen; Powell, Lisa M; Wada, Roy

    2012-01-01

    Fast food consumption is a dietary factor associated with higher prevalence of childhood obesity in the United States. The association between food prices and consumption of fast food among 5th and 8th graders was examined using individual-level random effects models utilizing consumption data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), price data from American Chamber of Commerce Researchers Association (ACCRA), and contextual outlet density data from Dun and Bradstreet (D&B). The results found that contextual factors including the price of fast food, median household income, and fast food restaurant outlet densities were significantly associated with fast food consumption patterns among this age group. Overall, a 10% increase in the price of fast food was associated with 5.7% lower frequency of weekly fast food consumption. These results suggest that public health policy pricing instruments such as taxes may be effective in reducing consumption of energy-dense foods and possibly reducing the prevalence of overweight and obesity among US children and young adolescents. PMID:22292115

  8. Historical and future land carbon cycle, results from the 5th Coupled Model Intercomparison Project (CMIP5)

    NASA Astrophysics Data System (ADS)

    Friedlingstein, Pierre; Anav, Alessandro; Murray-Tortarolo, Guillermo; Wenzel, Sabrina; Cox, Peter; Eyring, Veronika

    2014-05-01

    The 5th Coupled Model Intercomparison Project (CMIP5) provided a unique source of Earth System Models simulations, generating an unprecedented range of analysis of many components of the climate system. In this presentation we will focus on the land carbon cycle, its response to the historical perturbation and its projected response in the future under the forcing of the different Representative Concentration Pathways (RCPs) scenarios. There is a broad agreement across models on the evolution of the carbon exchange between the atmosphere and the land since the beginning of the industrial revolution. Carbon sink driven by atmospheric CO2 increase more than compensates now the carbon sources due to land use changes, consistent with independent estimates. The future of the land carbon cycle is significantly more uncertain, even for a given RCP scenario. There is no overall agreement across models on the sign of the land carbon sink by the end of the 21st century, land carbon cycle sensitivity to atmospheric CO2 increase and climate change being strongly model dependent. Model evaluation and use of emerging constraint should help reduce uncertainties in future carbon cycle projections.

  9. Fast Food Consumption and Food Prices: Evidence from Panel Data on 5th and 8th Grade Children

    PubMed Central

    Khan, Tamkeen; Powell, Lisa M.; Wada, Roy

    2012-01-01

    Fast food consumption is a dietary factor associated with higher prevalence of childhood obesity in the United States. The association between food prices and consumption of fast food among 5th and 8th graders was examined using individual-level random effects models utilizing consumption data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), price data from American Chamber of Commerce Researchers Association (ACCRA), and contextual outlet density data from Dun and Bradstreet (D&B). The results found that contextual factors including the price of fast food, median household income, and fast food restaurant outlet densities were significantly associated with fast food consumption patterns among this age group. Overall, a 10% increase in the price of fast food was associated with 5.7% lower frequency of weekly fast food consumption. These results suggest that public health policy pricing instruments such as taxes may be effective in reducing consumption of energy-dense foods and possibly reducing the prevalence of overweight and obesity among US children and young adolescents. PMID:22292115

  10. Bond Strength of 5th, 6th and 7th Generation Bonding Agents to Intracanal Dentin of Primary Teeth

    PubMed Central

    Afshar, Hossein; Baradaran Nakhjavani, Yahya; Rahro Taban, Sedighe; Baniameri, Zahra; Nahvi, Azam

    2015-01-01

    Objectives: This in-vitro study sought to assess the push-out bond strength of a total etch and 2 self-etch bonding systems to intracanal dentin of primary anterior teeth (PAT). Materials and Methods: Thirty-six primary anterior teeth were randomly divided into 3 groups of 5th generation (Single Bond 2), 6th generation (Clearfil SE) and 7th generation (Single Bond Universal) bonding agents. The canal orifice was restored with composite resin and the push-out test was carried out to assess the bond strength. After applying the push-out load, specimens were evaluated under a light microscope at 40X magnification. One-way ANOVA and log-rank test on Kaplan-Meier curves were applied for the comparison of bond strength among the 3 groups. Results: The mean± standard deviation (SD) bond strength was 13.6±5.33 MPa for Single Bond 2, 13.85±5.86 MPa for Clearfil SE and 12.28±5.24 MPa for Single Bond Universal. The differences in bond strength among the 3 groups were not statistically significant (P>0.05). Conclusion: All three bonding agents are recommended for use with composite posts in PAT. However, due to high technical sensitivity of the Total Etch system, single or two-step self etch systems may be preferred for uncooperative children. PMID:26056518

  11. Final Report for DOE Support of 5th the International Workshop on Oxide Surfaces (IWOX-V)

    SciTech Connect

    Charles T. Campbell

    2007-02-02

    The 5th International Workshop on Oxide Surfaces (IWOX-V) was held at Granlibakken Conference center in Lake Tahoe, CA, January 7-12. The total attendance was ~90. The breakdown of attendees by country is as follows: USA 41 Germany 18 Japan 7 UK 5 Italy 5 France 4 Austria 3 Denmark 3 Cech. Repub. 1 Ireland 1 New Zealand 1 India 1 The technical program included oral sessions on the electronic and magnetic properties of oxide surfaces, surface and interface structure, advances in theory, surface defects, thin film oxides on metals and on oxides, thin film metals on oxides, surface photochemistry, surface reactivity, and interactions with water. Two evening poster sessions had similar themes. As in previous years, the program stimulated significant interest and discussion among the attendees. The local expenses (food and lodging, $918 per person) for eight foreign invited speakers were covered by BES funds. In addition, partial reimbursement for travel ($328 per person) was supported by BES funds for two more foreign invited speakers.

  12. Local anesthetic infusion pumps improve postoperative pain after inguinal hernia repair: a randomized trial.

    PubMed

    Sanchez, Barry; Waxman, Kenneth; Tatevossian, Raymond; Gamberdella, Marla; Read, Bruce

    2004-11-01

    Pain after an open inguinal hernia repair may be significant. In fact, some surgeons feel that the pain after open repair justifies a laparoscopic approach. The purpose of this study was to determine if the use of local anesthetic infusion pumps would reduce postoperative pain after open inguinal hernia repair. We performed a prospective, double-blind randomized study of 45 open plug and patch inguinal hernia repairs. Patients were randomized to receive either 0.25 per cent bupivicaine or saline solution via an elastomeric infusion pump (ON-Q) for 48 hours, at 2 cc/h. The catheters were placed in the subcutaneous tissue and removed on postoperative day 3. Both groups were prescribed hydrocodone to use in the postoperative period at the prescribed dosage as needed for pain. Interviews were conducted on postoperative days 3 and 7, and patient's questionnaires, including pain scores, amount of pain medicine used, and any complications, were collected accordingly. During the first 5 postoperative days, postoperative pain was assessed using a visual analog scale. Twenty-three repairs were randomized to the bupivicaine group and 22 repairs randomized to the placebo group. In the bupivicaine group, there was a significant decrease in postoperative pain on postoperative days 2 through 5 with P values <0.05. This significant difference continued through postoperative day 5, 2 days after the infusion pumps were removed. Patients who had bupivicaine instilled in their infusion pump had statistically significant lower subjective pain scores on postoperative days 2 through 5. This significant difference continued even after the infusion pumps were removed. Local anesthetic infusion pumps significantly decreased the amount of early postoperative pain. Pain relief persisted for 2 days after catheter and pump removal. PMID:15586515

  13. Postoperative Peritoneal Adhesions

    PubMed Central

    Ryan, Graeme B.; Grobéty, Jocelyne; Majno, Guido

    1971-01-01

    This paper describes an experimental model of peritoneal adhesions, in the rat, based on two relatively minor accidents that may occur during abdominal surgery in man: drying of the serosa, and bleeding. Drying alone had little effect; drying plus bleeding consistently produced adhesions to the dried area. Fresh blood alone produced adhesions between the three membranous structures [omentum and pelvic fat bodies (PFBs)]. The formation of persistent adhesions required whole blood. Preformed clots above a critical size induced adhesions even without previous serosal injury; they were usually captured by the omentum and PFBs. If all three membranous structures were excised, the clots caused visceral adhesions. The protective role of the omentum, its structure, and the mechanism of omental adhesions, are discussed. These findings are relevant to the pathogenesis of post-operative adhesions in man. ImagesFig 3Fig 4Fig 5Fig 6Fig 7Fig 12Fig 13Fig 1Fig 2Fig 14Fig 15Fig 8Fig 9Fig 10Fig 11 PMID:5315369

  14. Implementing SPRINTT [Student Polar Research with IPY National(and International)Teacher Training] in 5th Grade Science

    NASA Astrophysics Data System (ADS)

    Glass, D. S.

    2009-12-01

    I implemented the new NSF-funded SPRINTT (Student Polar Research with IPY National (and International) Teacher Training) curriculum with a 5th grade science class. SPRINTT, developed at U.S. Satellite Laboratory, Inc., is a 5-8 week science program teaching 5th through 10th graders to investigate climate change using polar data. The program includes perspectives of both Western scientists and the indigenous Northern population. The course contains three phases: Phase 1 includes content, data interpretation, and hands-on experiments to study Frozen Water, Frozen Land, and Food; Phase 2 (optional) includes further content on specific polar topics; and Phase 3 is a scaffolded research investigation. Before the course, teachers were trained via live webinars. This curriculum capitalizes on children’s innate fascination with our planet’s final frontier and combines it with the politically and scientifically relevant topic of climate change. In 2009, I used SPRINTT with 23 heterogeneous fifth grade students at National Presbyterian School in Washington DC for an environmental science unit. Overall, it was a success. The students met most of the learning objectives and showed enthusiasm for the material. I share my experiences to help other educators and curriculum developers. The Phase 1 course includes earth science (glaciers, sea ice, weather and climate, greenhouse gases, seasons, and human impacts on environments), life science (needs of living things, food and energy transfer, adaptations, and ecosystems and biomes) and physical science (phases of matter). Tailoring the program, I focused on Phase 1, the most accessible material and content, while deemphasizing the more cumbersome Phase 3 online research project. Pre-assessments documented the students’ misconceptions and informed instruction. The investigations were appropriately educational and interesting. For example, students enjoyed looking at environmental factors and their impact on the people in the

  15. Postoperative respiratory morbidity: identification and risk factors.

    PubMed

    Mitchell, C; Garrahy, P; Peake, P

    1982-04-01

    Two hundred consecutive patients admitted for general surgery were studied prospectively to evaluate the contribution of risk factors to postoperative respiratory morbidity (PORM). PORM was expressed both in terms of individual clinical features present on the second postoperative day (when the incidence was greatest), and as an aggregate score incorporating many clinical features. The importance of recognised risk factors, such as previous respiratory disease, cigarette smoking, upper abdominal procedures and the duration of surgery was confirmed, in that these factors were associated with some of the individual clinical features of PORM. The relative importance and independent contribution of these risk factors were assessed by their association with the aggregate score. A naso-gastric tube (NGT) present for 24 hours postoperatively was the factor more associated with PORM. The NGT identified patients at risk more clearly than, and independently of, the next most important factor, upper abdominal surgery. The duration of surgery did not contribute to PORM after the influence of NGT and site of surgery had been considered. Previous respiratory disease predisposed to PORM, and was best identified by, in order of importance, an observed productive cough, a reduced one second forced expiratory volume, and purulent sputum. After the incidence of these factors had been considered, cigarette smoking and a history of a chronic productive cough did not contribute further to PORM. PMID:6952867

  16. 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. PMID:27366464

  17. When should orthostatic blood pressure changes be evaluated in elderly: 1st, 3rd or 5th minute?

    PubMed

    Soysal, Pinar; Aydin, Ali Ekrem; Koc Okudur, Saadet; Isik, Ahmet Turan

    2016-01-01

    Detection of orthostatic hypotension (OH) is very important in geriatric practice, since OH is associated with mortality, ischemic stroke, falls, cognitive failure and depression. It was aimed to determine the most appropriate time for measuring blood pressure in transition from supine to upright position in order to diagnose OH in elderly. Comprehensive geriatric assessment (CGA) including Head up Tilt Table (HUT) test was performed in 407 geriatric patients. Orthostatic changes were assessed separately for the 1st, 3rd and 5th minutes (HUT1, HUT3 and HUT5, respectively) taking the data in supine position as the basis. The mean age, recurrent falls, presence of dementia and Parkinson's disease, number of drugs, alpha-blocker and anti-dementia drug use, and fasting blood glucose levels were significantly higher in the patients with versus without OH; whereas, albumin and 25-hydroxy vitamin D levels were significantly lower (p<0.05). However, different from HUT3 and HUT5, Charlson Comorbidity Index and the prevalence of diabetes mellitus were higher, the use of antidiabetics, antipsychotics, benzodiazepine, opioid and levodopa were more common (p<0.05). Statistical significance of the number of drugs and fasting blood glucose level was prominent in HUT1 as compared to HUT3 (p<0.01, p<0.05). Comparison of the patients that had OH only in HUT1, HUT3or HUT5 revealed no difference in terms of CGA parameters. These results suggests that orthostatic blood pressure changes determined at the 1st minute might be more important for geriatric practice. Moreover, 1st minute measurement might be more convenient in the elderly as it requires shorter time in practice. PMID:27077324

  18. Intraocular tissue ablation using an optical fibre to deliver the 5th harmonic of a Nd:YAG

    NASA Astrophysics Data System (ADS)

    Miller, Joseph; Yu, Xiaobo; Yu, Paula K.; Cringle, Stephen J.; Yu, Dao-Yi

    2009-02-01

    We report the evaluation of a system which delivers the 5th harmonic of an Nd:YAG (213nm) via optical fibre to ocular tissue sites. The 213nm beam is concentrated, using a hollow glass taper, prior to launch into 200 μm or 600 μm core diameter silica/silica optical fibre. The fibre tip was tapered to enhance the fluence delivered. An operating window of fluence values that could be delivered via 330 - 1100mm lengths of optical fibre was determined. The lower value of 0.2J/cm2 determined by the ablation threshold of the tissue and the upper value of 1.3J/cm2 by the launch, transmission and tip characteristics of the optical fibre. The fluence output decreased as a function of both transmitted pulse energy and number of pulses transmitted. Fresh retinal tissue was cleanly ablated with minimal damage to the surrounding tissue. Lesions were generated using 1, 3 and 10 pulses with fluences from 0.2 to 1.0J/cm2. The lesion depth demonstrated clear dose dependence. Lesions generated in ex vivo preparations of human trabecular meshwork in a fluid environment also demonstrated dose dependence, 50 pulses being sufficient to create a hole within the trabecular meshwork extending to Schlemm's canal. The dose dependence of the ablation depth combined with the ability of this technique to create a conduit through to Schlemm's canal demonstrates the potential of this technique for ophthalmological applications requiring precise and controlled intraocular tissue removal and has potential applications in the treatment and management of glaucoma.

  19. 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…

  20. 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.

  1. Day Care.

    ERIC Educational Resources Information Center

    Merro, John; And Others

    Interviews on the quality of day care in the United States are presented in this transcript of a program broadcast in the National Public Radio weekly series, "Options in Education." Writers, day care center personnel and others describe and evaluate the current situation. Federal legislation concerning children is examined, and researchers…

  2. EDITORIAL: PLASMA 2006: The 5th International Conference on the Intrinsic Josephson Effect and Plasma Oscillations in High-TC Superconductors

    NASA Astrophysics Data System (ADS)

    Warburton, Paul; Yurgens, August

    2007-02-01

    The 5th International Conference on the Intrinsic Josephson Effect and Plasma Oscillations in High-TC Superconductors (known as `PLASMA' for short) took place in London from July 17th to 19th 2006. The meeting was organised jointly by the Superconductivity Group of the Institute of Physics and the European Science Foundation network `Arrays of Quantum Dots and Josephson Junctions' (AQDJJ). It was sponsored by the UK Engineering and Physical Sciences Research Council, AQDJJ, the Japan Society for the Promotion of Physics and the National Institute of Materials Science (NIMS). The meeting was chaired by Paul Warburton of University College London who wishes to put on record his thanks to the conference sponsors for their generosity, without which the conference could not have taken place. Since the previous PLASMA conference in Tsukuba in 2004 the most significant advance in intrinsic Josephson junction (IJJ) research has arguably been the observation of macroscopic quantum tunnelling in IJJs. At the time of the conference this had been observed by both the RIEC/NIMS/AIST collaboration in Japan and by Paul M\\"uller's group in Erlangen. We therefore felt that the conference presented an ideal and timely opportunity for the IJJ community to learn from the more established community of researchers on macroscopic quantum phenomena in low-TC superconductors---and indeed vice versa. As a result a number of leading researchers from the field of low-TC Josephson qubit devices gave several illuminating presentations. Other sessions included those on Josephson vortex dynamics in layered systems and terahertz oscillations in IJJs, in addition to a lively poster session on the first evening. The conference was rounded off by an excellent summary of the highlights of the meeting given by Professor Hu-Jong Lee. The conference organisers would like to thank all those who made the meeting possible and contributed to its smooth running. In addition to the international organising

  3. Indian Health Career Handbook and Report on Ned Hatathli Seminar for Southern Arizona Indian Students (5th, Tucson, Arizona, February 6-7, 1975).

    ERIC Educational Resources Information Center

    Taylor, Arnold, Ed.; And Others

    Utilizing comments from teachers, professionals, college and high school students, this report is derived from the 5th Ned Hatathli Seminar, sponsored by the Navajo Health Authority, and presents factual information relative to American Indian participation in Indian Health careers. The following major speeches are presented: (1) "The Practice of…

  4. Engaging Minds. Proceedings of the National Academy for Integration of Research, Teaching and Learning Annual Conference (5th, Galway, Ireland, June 9-10, 2011)

    ERIC Educational Resources Information Center

    National Academy for Integration of Research, Teaching and Learning (NJ1), 2011

    2011-01-01

    This publication contains the papers presented at the 5th Annual Conference of National Academy for Integration of Research, Teaching and Learning (NAIRTL) and the 9th Galway Symposium. Presenters from across Ireland and overseas share their perspectives. The theme of engagement touches on the very heart of what a "higher" education should be…

  5. Immediate and Short-Term Effects of the 5th Grade Version of the "keepin' it REAL" Substance Use Prevention Intervention

    ERIC Educational Resources Information Center

    Hecht, Michael L.; Elek, Elvira; Wagstaff, David A.; Kam, Jennifer A.; Marsiglia, Flavio; Dustman, Patricia; Reeves, Leslie; Harthun, Mary

    2009-01-01

    This study assessed the immediate and short-term outcomes of adapting a culturally-grounded middle school program, "keepin' it REAL", for elementary school students. After curriculum adaptation, 10 schools were randomly assigned to the intervention in 5th grade with follow-up boosters in 6th grade; 13 schools were randomly assigned to the control…

  6. International Roundtable on The Lifelong Learning and New Technologies Gap: Reaching the Disadvantaged (5th, Philadelphia, Pennsylvania, December 8-10, 1999). Preliminary Report.

    ERIC Educational Resources Information Center

    National Center on Adult Literacy, Philadelphia, PA.

    Three elements defined the focus of the 5th Roundtable: lifelong learning, the new technologies gap, and reaching the disadvantaged. Participants referred frequently to the digital divide, a term that captures differential access to and use of information and communication technology (ICT). The questions that guided discussion related to ICT and…

  7. Evaluation of the Effects of Argumentation Based Science Teaching on 5th Grade Students' Conceptual Understanding of the Subjects Related to "Matter and Change"

    ERIC Educational Resources Information Center

    Çinar, Derya; Bayraktar, Sule

    2014-01-01

    The aim of this study is to evaluate the effects of Argumentation Based Science Teaching on 5th grade students' conceptual understanding of the subjects related to "Matter and Change". This research is a qualitative research and its design is a multiple (compare) case study. In this study, semi-structured interviews related to the…

  8. Evaluation of the Effects of Argumentation Based Science Teaching on 5th Grade Students' Conceptual Understanding of the Subjects Related to "Matter and Change"

    ERIC Educational Resources Information Center

    Çinar, Derya; Bayraktar, Sule

    2014-01-01

    The aim of this study is to evaluate the effects of Argumentation Based Science Teaching on 5th grade students' conceptual understanding of the subjects related to "Matter and Change". This research is a qualitative research and its design is a multiple (compare) case study. In this study, semi-structured interviews related to the…

  9. Measures of self-efficacy and norms for low-fat milk consumption are reliable and related to beverage consumption among 5th graders at school lunch

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The objective was to determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders. Two hundred seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy ...

  10. Determination of Motivation of 5th Grade Students Living in Rural and Urban Environments towards Science Learning and Their Attitudes towards Science-Technology Course

    ERIC Educational Resources Information Center

    Kenar, Ismail; Köse, Mücahit; Demir, Halil Ibrahim

    2016-01-01

    In this research, determination of motivation of 5th grade students living in rural and urban environments towards science learning and their attitudes towards science-technology course is aimed. This research is conducted based on descriptive survey model. Samples are selected through teleological model in accordance with the aim of this…

  11. The Effect of Direct Instruction Strategy on Math Achievement of Primary 4th and 5th Grade Students with Learning Difficulties

    ERIC Educational Resources Information Center

    Al-Makahleh, Ahmad Abdulhameed Aufan

    2011-01-01

    This study seeks to verify the effect of direct instruction strategy on Math achievment of students with learning difficulties in the fourth and fifth grade levels and measure the improvement in their attitudes to Mathematics. Sample consisted of sixty (60) students with Math learning difficulties attending 4th and 5th grade level resource rooms…

  12. Color Duplex Assessment of 4th and 5th Internal Mammary Artery Perforators: The Pedicles of the Medially Based Lower Pole Breast Flaps

    PubMed Central

    Abdel-Monem, Kareem; Elshahat, Ahmed; Abou-Gamrah, Sherif; Eldin Abol-Atta, Hossam; Abd Eltawab, Reda; Massoud, Karim

    2012-01-01

    Objective: Reconstruction of a breast after mastectomy using the contralateral lower pole breast flap is an appealing procedure because it uses the tissues that were going to be excised during reduction of the sound breast to achieve symmetry. Literature mentioned that these flaps are supplied by the lower internal mammary artery perforators (IMAPs) with no further details. The aim of this study was to determine the site, size, and number of the 4th and 5th IMAPs by using preoperative color Duplex ultrasound and intraoperative exploration. Method: Twenty breasts in 10 patients who presented for reduction mammoplasty were included in this study. Preoperative color duplex was used to determine IMAPs in the 4th and 5th intercostal spaces. These perforators were localized intraoperatively. Intravenous fluorescein injection was used to determine the perfusion of the lower pole breast flap on the basis of these perforators. Results: Statistically, the 4th IMAPs diameters were significantly larger than the 5th IMAPs diameters (P < .05). The lower pole breast flap was perfused through these perforators. Conclusion: Color Duplex ultrasound is an accurate tool to preoperatively determine the 4th and 5th IMAPs. PMID:22292100

  13. Final technical report: Partial support for US participants in the 5th International Marine Biotechnology Conference, Townsville, Australia, Sept 29 - Oct 5, 2000

    SciTech Connect

    Zohar, Yonathan; Hill, R.; Robb, F.

    2001-04-09

    Funding was provided for US participants in the 5th International Marine Biotechnology Conference held in Townsville, Australia from September 29 to October 5, 2000. DOE funds were used for travel awards for six US participants in this conference. DOE funds were successfully used to advance participation of US scientists in the important emerging field of marine biotechnology.

  14. An Analysis of the Learning Activities Covered in the 5th Grade Science Textbooks Based on 2005 and 2013 Turkish Science Curricula

    ERIC Educational Resources Information Center

    Aydogdu, Cemil; Idin, Sahin

    2015-01-01

    The aim of this study is to analyze the learning activities covered in 5th grade elementary science textbooks which depend on 2005 and 2013 elementary science curricula. Two elementary science textbooks [which] depend on 2005 science curriculum and two elementary science textbooks [which] depend on 2013 science curriculum were researched. The…

  15. An Analysis of the Learning Activities Covered in the 5th Grade Science Textbooks Based on 2005 and 2013 Turkish Science Curricula

    ERIC Educational Resources Information Center

    Aydogdu, Cemil; Idin, Sahin

    2015-01-01

    The aim of this study is to analyze the learning activities covered in 5th grade elementary science textbooks which depend on 2005 and 2013 elementary science curricula. Two elementary science textbooks depends on 2005 science curriculum and two elementary science textbooks depend on 2013 science curriculum were researched. The study is a…

  16. The Social Interactions of Students with Disabilities in a 5th Grade Level Inclusive Classroom and the Effect on Academic Achievement

    ERIC Educational Resources Information Center

    Marshall-Reed, Estella

    2010-01-01

    This dissertation is a qualitative, ethnographic case study of 3 students with disabilities. The purpose of this research study was to observe and collect descriptive accounts of the social interactions that exist between the cultures in a 5th grade level inclusive classroom, such as the interactions between the special education students, general…

  17. Comparison of the Leiter International Performance Scale-Revised and the Stanford-Binet Intelligence Scales, 5th Edition, in Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Grondhuis, Sabrina Nicole; Mulick, James A.

    2013-01-01

    A review of hospital records was conducted for children evaluated for autism spectrum disorders who completed both the Leiter International Performance Scale-Revised (Leiter-R) and Stanford-Binet Intelligence Scales, 5th Edition (SB5). Participants were between 3 and 12 years of age. Diagnoses were autistic disorder (n = 26, 55%) and pervasive…

  18. U.S. Dietary and Physical Activity Guideline Knowledge and Corresponding Behaviors among 4th and 5th Grade Students: A Multi-Site Pilot Study

    ERIC Educational Resources Information Center

    Bea, Jennifer W.; Martinez, Stephanie; Armstrong-Florian, Traci; Farrell, Vanessa; Martinez, Cathy; Whitmer, Evelyn; Hartz, Vern; Blake, Samuel; Nicolini, Ariana; Misner, Scottie

    2014-01-01

    Knowledge of U.S. dietary and physical activity recommendations and corresponding behaviors were surveyed among 4th and 5th graders in five Arizona counties to determine the need for related education in SNAP-Ed eligible schools. A <70% target response rate was the criterion. Participants correctly identified recommendations for: fruit, 20%;…

  19. EUNIS '99: Information Technology Shaping European Universities. Proceedings of the International European University Information Systems (5th, Espoo, Finland, June 7-9, 1999).

    ERIC Educational Resources Information Center

    1999

    This document presents the proceedings from the 5th International European University Information Systems (EUNIS) Conference on Information Technology that took place in Helsinki, Finland on June 7-9, 1999. Topics of the conference proceedings were divided into five tracks (A through E): Use of Information Technology in Learning and Teaching;…

  20. 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...

  1. Integration of physical activity and technology motion devices within a combined 5th and 6th grade science curriculum

    NASA Astrophysics Data System (ADS)

    Finn, Kevin Eugene

    Background: National recommendations to increase school-based physical activity and promote academic success advise incorporating movement into traditional classroom lessons. Classroom-based physical activities have favorable associations with indicators of cognitive functioning, academic behaviors, and academic achievement. Purpose: This study analyzed the Active Science framework, which incorporated school-based physical activity within interactive science classroom lessons. Specifically, the study measured the effects of the Active Science framework on student physical activity levels in the classroom, student learning of science inquiry skills and content knowledge, and student perceptions of physical activity and science. A secondary purpose was to evaluate the teachers' perceptions on the implementation of the framework. Subjects: Participants were 37 Hispanic girls (age=11.1 +/-0.8 yr) in mixed 5th/6th grade science classes in a private, urban middle school. Methods: Physical activity levels of the students during the Active Science framework were measured using pedometers and heart rate monitors. Pre- and post-tests were used to assess the levels of learning achieved by the students in science inquiry skills and content during the Active Science framework. Student perceptions and attitudes toward science and physical activity were measured during student focus groups and pre-post perception surveys. Lesson plan evaluations completed by the teachers and structured interviews provided data on implementation of the framework. Results: Physical activity results showed heart rate (146 +/-9 bpm); maximal heart rate (196 +/-10.6 bpm); time (35 +/-2.5 mins); steps (3050 +/-402.7); calories (99 +/-8.4 kcal); and distance (1.1 +/-0.2 miles) while performing the activity portion of the science lessons were consistent with national recommendations for accumulating school-based physical activity. Significant increases in science content and skills test scores with a 22

  2. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

    PubMed

    Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H M G; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

    2014-10-01

    We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19,600 anaesthetics (95% confidence interval 1:16,700-23,450). However, there was considerable variation across subtypes of techniques or subspecialities. The incidence with neuromuscular block (NMB) was ~1:8200 (1:7030-9700), and without, it was ~1:135,900 (1:78,600-299,000). The cases of AAGA reported to NAP5 were overwhelmingly cases of unintended awareness during NMB. The incidence of accidental awareness during Caesarean section was ~1:670 (1:380-1300). Two-thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental, rapid sequence induction, obesity, difficult airway management, NMB, and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One-third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, mostly due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex, age (younger adults, but not children), obesity, anaesthetist seniority (junior trainees), previous awareness, out-of-hours operating, emergencies, type of surgery (obstetric, cardiac, thoracic), and use of NMB. The following factors were not risk factors for accidental awareness: ASA physical status, race, and use or omission

  3. Effect on Physical Activity of a Randomized Afterschool Intervention for Inner City Children in 3rd to 5th Grade

    PubMed Central

    Crouter, Scott E.; de Ferranti, Sarah D.; Whiteley, Jessica; Steltz, Sarah K.; Osganian, Stavroula K.; Feldman, Henry A.; Hayman, Laura L.

    2015-01-01

    Background Less than 45% of U.S. children meet the 60 min.d-1 physical activity (PA) guideline. Structured after-school PA programing is one approach to help increase activity levels. This study aimed to evaluate the feasibility and short-term impact of a supervised after-school PA and nutrition education program on activity levels. Methods Forty-two 3rd-5th graders from an inner-city school in Boston, MA were randomly assigned to a 10-wk after-school program of either: 1) weekly nutrition education, or 2) weekly nutrition education plus supervised PA 3 d.wk-1 at a community-based center. At baseline and follow-up, PA was measured using accelerometry and fitness (VO2max) was estimated using the PACER 15-m shuttle run. Additional measures obtained were non-fasting finger stick total cholesterol (TC) and glucose levels, waist circumference (WC), body mass index (BMI), percent body fat (%BF), and blood pressure (BP). Values are presented as mean±SE, unless noted otherwise. Results Thirty-six participants completed the study (mean±SD; age 9.7±0.9 years). Participants attended >80% of the sessions. After adjusting for accelerometer wear time and other design factors, light and moderate-to-vigorous PA (MVPA) increased in the nutrition+PA group (+21.5±14.5 and +8.6±8.0 min.d-1, respectively) and decreased in the nutrition only group (-35.2±16.3 and -16.0±9.0 min.d-1, respectively); mean difference between groups of 56.8±21.7 min.d-1 (light PA, p = 0.01) and 24.5±12.0 min.d-1 (MVPA, p = 0.04). Time spent in sedentary behaviors declined in the nutrition+PA group (-14.8±20.7 min.d-1) and increased in the nutrition only group (+55.4±23.2 min.d-1); mean difference between groups of -70.2±30.9 min.d-1 (p = 0.02). Neither group showed changes in TC, BP, WC, %BF, BMI percentile, or fitness (p>0.05). Conclusions The supervised afterschool community-based nutrition and PA program was well accepted and had high attendance. The changes in light PA and MVPA has potential

  4. PREFACE: PASREG 2005: The 5th International Workshop on Processing and Applications of Superconducting (RE)BCO Large Grain Materials

    NASA Astrophysics Data System (ADS)

    Murakami, Masato; Cardwell, David; Salama, Kamel; Izumi, Mitsuru

    2006-07-01

    Large grain, (RE)BCO bulk superconductors fabricated by top-seeded melt growth (TSMG) have outstanding potential for a variety of engineering applications such as magnetic separators, flywheel energy storage, magnetic bearings and permanent magnet-like devices due to their ability to generate large magnetic fields. Recent developments in materials and systems research has led to the manufacture of proto-type devices for use in magnetron sputtering, magnetic stirrers and a mobile magnetic separator based on bulk materials technology. This issue contains selected papers presented at the 5th International Workshop on the Processing and Applications of Superconducting (RE)BCO Large Grain Materials held on 21-23 October 2005 at Tokyo Marine University to report progress made in this field over the previous two years. The workshop followed those held previously in Cambridge, UK (1997), Morioka, Japan (1999), Seattle, USA (2001), and Jena, Germany (2003). A total of 76 papers were presented at this workshop, of which 27 were presented in oral form and 49 were presented as posters. This issue contains a total of 36 selected papers in the following categories of bulk (RE)BCO large grain material: processing, characterization, and applications. The editors are grateful for the support of many colleagues both within and outside the immediate bulk community who reviewed the manuscripts to guarantee their high technical quality. Finally, the attendees wish to acknowledge the efforts of Professor Mitsuru Izumi and his research staff from Tokyo Marine University for being generous hosts during the workshop, and the efforts of Professor Masato Murakami for the overall organization of the meeting. The International PASREG Board selected the following distinguished researchers as recipients of the 2005 PASREG Award of Excellence to acknowledge their contribution to the development of bulk high temperature superconductors: • Dr Michael Strasik (Boeing, Seattle, USA) • Dr Hiroshi

  5. [Impulse galvanization in postoperative urination disorders].

    PubMed

    Kölbl, H; Riss, P

    1988-03-01

    In this study we examined the therapeutic effect of impulse-galvanization in patients with voiding difficulties after anterior vaginal repair. Patients (n = 56/79) revealing residual urine until the sixth postoperative day were studied. Considering the onset of the first spontaneous micturition and the lack of residual urine no significant difference was found in the group undergoing impulse-galvanization (n = 19) compared to a group without therapy (n = 37). By adjuvant treatment with alpha-sympathicolytics, spasmolytics or tranquilizers patients with impulse-galvanization and the comparative group were found to be without residual urine 11.2 and 13 days after surgery, respectively (p less than 0.001). PMID:3259522

  6. 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…

  7. Postoperative psychosis after heart surgery.

    PubMed

    Sveinsson, I S

    1975-10-01

    One hundred heart surgery patients were followed throughout their postoperative periods to assess the incidence and etiology of postcardiotomy delirium. Factors evaluated were: age, sex, history of previous psychiatric illness, history of cerebrovascular disease, cardiac diagnosis and operation, time of anesthesia, time of bypass, time spent in the intensive-care unit, and amount of sleep during the postoperative period. Six patients developed delirium, five of whom had a lucid postoperative interval; four patients had perceptual disturbances only, without loss of contact with reality; three had neurological symptoms with mild confusion; 87 kept a clear mental state. The following factors tended to be related to the occurrence of delirium and perceptual disturbances: history of preoperative psychiatric illness, advanced age, severity of preoperative and postoperative illness, and time spent in the intensive-care unit. Sleep deprivation consistently preceded onset of these symptoms with one exception. Operative factors did not seem to be of major importance. While postoperative delirium probably has multidetermined causes, the author believes that sleep deprivation superimposed on the other contributory condition is a common precipitating factor. Suggestions about the prevention and treatment of delirium are made. PMID:1177486

  8. Immediate postoperative enteral feeding results in impaired respiratory mechanics and decreased mobility.

    PubMed Central

    Watters, J M; Kirkpatrick, S M; Norris, S B; Shamji, F M; Wells, G A

    1997-01-01

    OBJECTIVE: The authors set out to determine whether immediate enteral feeding minimizes early postoperative decreases in handgrip and respiratory muscle strength. SUMMARY BACKGROUND DATA: Muscle strength decreases considerably after major surgical procedures. Enteral feeding has been shown to restore strength rapidly in other clinical settings. METHODS: A randomized, controlled, nonblinded clinical trial was conducted in patients undergoing esophagectomy or pancreatoduodenectomy who received immediate postoperative enteral feeding via jejunostomy (fed, n = 13), or no enteral feeding during the first 6 postoperative days (unfed, n = 15). Handgrip strength, vital capacity, forced expiratory volume in one second (FEV1), and maximal inspiratory pressure (MIP) were measured before surgery and on postoperative days 2, 4, and 6. Fatigue and vigor were evaluated before surgery and on postoperative day 6. Mobility was assessed daily after surgery using a standardized descriptive scale. Postoperative urine biochemistry was evaluated in daily 24-hour collections. RESULTS: Postoperative vital capacity (p < 0.05) and FEV1 (p = 0.07) were consistently lower (18%-29%) in the fed group than in the unfed group, whereas grip strength and maximal inspiratory pressure were not significantly different. Postoperative mobility also was lower in the fed patients (p < 0.05) and tended to recover less rapidly (p = 0.07). Fatigue increased and vigor decreased after surgery (both p < or = 0.001), but changes were similar in the fed and unfed groups. Intensive care unit and postoperative hospital stay did not differ between groups. CONCLUSIONS: Immediate postoperative jejunal feeding was associated with impaired respiratory mechanics and postoperative mobility and did not influence the loss of muscle strength or the increase in fatigue, which occurred after major surgery. Immediate postoperative enteral feeding should not be routine in well-nourished patients at low risk of nutrition

  9. Proceedings for the 5th Asia-Pacific Conference on Disaster Medicine: creating an agenda for action.

    PubMed

    De Grace, M; Ericson, D; Folz, H; Greene, W; Ho, K; Pearce, L

    2001-01-01

    Disaster medicine has come to the forefront and has become the focus of interest not only in the medical community, but also in the eyes of the public. The 5th APCDM was convened in Vancouver, Canada, 27-30 September 2000. It brought together over 300 delegates from 32 countries to share their experiences and thoughts regarding disaster events and how to effectively manage them. The conference was devoted to the task of establishing priorities and creating an Agenda for Action. From the discussions, key actions required were defined: COMMUNICATIONS: (1) Identify existing regional telehealth groups and gather lessons to be learned from them; (2) Form a telehealth advisory group to work with regional groups to compile telehealth initiatives, identify international protocols in telehealth already in existence, and solicit feedback before setting international standards; and (3) Increase corporate partnerships in the fields of telehealth and telecommunications, and invite corporations to send delegates to future APCDM meetings. This should be an initiative of the APCDM, the World Association of Disaster and Emergency Medicine (WADEM), or the European Society of Emergency Medicine. EDUCATION AND RESEARCH: (1) Formalize education in disaster medicine and management. The World Health Organization and WADEM should take a leadership role; (2) WADEM is requested to hold a conference with a focus on qualitative research; (3) WHO is requested to continue the provision of international research teams, but to advocate for the development of national disaster research infrastructure; (4) Make research findings and reports available on web sites of such organizations as WHO and PAHO; (5) Develop the translation of research for community utilization. The WHO and PAHO are organizations that are requested to consider this action; and (6) WADEM/APCDM are requested to focus future conferences on applied research. INFORMATION AND DATA: (1) Create an "Information and Data Clearinghouse

  10. [Surgical controversy. Limiting postoperative scarring].

    PubMed

    Lachkar, Y

    2005-06-01

    Postoperative follow-up of glaucoma surgery must be rigorous and carried out over the long term. Data acquired on the make-up of the filtering bleb justifies using postoperative anti-inflammatory drugs, even if the eye is clinically quiet. When using antimetabolites, the risk factors for failure must be well known and either 5-fluorouracile or mitomycin should be chosen depending on the level of risk of scarring. Their use in needle revision must be adapted case by case. anti-TGF-beta-2 antibody, currently being investigated, may prove advantageous in the very near future. PMID:16208245

  11. Postoperative biological and clinical outcomes following uncomplicated pancreaticoduodenectomy

    PubMed Central

    Lermite, Emilie; Wu, Tao; Sauvanet, Alain; Mariette, Christophe; paye, François; Muscari, Fabrice; Cunha, Antonio Sa; Sastre, Bernard; Arnaud, Jean-Pierre

    2016-01-01

    Backgrounds/Aims The aim of this study was to describe clinical and biological changes in a group of patients who underwent pancreaticoduodenectomy (PD) without any complication during the postoperative period. These changes reflect the "natural history" of PD, and a deviation should be considered as a warning sign. Methods Between January 2000 and December 2009, 131 patients underwent PD. We prospectively collected and retrospectively analyzed demographic data, pathological variables, associated pathological conditions, and preoperative, intraoperative, and postoperative variables. Postoperative variables were validated using an external prospective database of 158 patients. Results The mean postoperative length of hospital stay was 20.3±4 days. The mean number of days until removal of nasogastric tube was 6.3±1.6 days. The maximal fall in hemoglobin level occurred on day 3 and began to increase after postoperative day (POD) 5, in patients with or without transfusions. The white blood cell count increased on POD 1 and persisted until POD 7. There was a marked rise in aminotransferase levels at POD 3. The peak was significantly higher in patients with hepatic pedicle occlusion (866±236 IU/L versus 146±48 IU/L; p<0.001). For both γ-glutamyl transpeptidase and alkaline phosphatase, there was a fall on POD1, which persisted until POD 5, followed with a stabilization. Bilirubin decreased progressively from POD 1 onwards. Conclusions This study facilitates a standardized biological and clinical pathway of follow-up. Patients who do not follow this recovery indicator could be at risk of complications and additional exams should be made to prevent consequences of such complications. PMID:26925147

  12. Successful treatment of postoperative pyoderma gangrenosum with cyclosporin.

    PubMed

    Schöfer, H; Baur, S

    2002-03-01

    Postoperative pyoderma gangrenosum (PPG), also known as postoperative progressive gangrene of Cullen, is a rare and rapidly evolving complication of surgical procedures. Since the first description by Cullen in 1924 (Surg Gynecol Obstet 1924; 38: 579-582) various case reports have been published. Even in typical cases PPG is often misdiagnosed and therefore wrongly treated; the unknown aetiology makes treatment difficult. The therapies used for pyoderma gangrenosum include systemic corticosteroids, azathioprine, dapsone, mercaptopurine, sulphasalazine, sulphapyridine, thalidomide, cyclophosphamide, clofazimine, isotretinoin, immunoglobulins and cyclosporin. We report on two patients with PPG following breast surgery who were successfully treated with low-dose cyclosporin (2.5-5 mg/kg per day). PMID:12046819

  13. Impact of surgical approach on postoperative delirium in elderly patients undergoing gastrectomy: laparoscopic versus open approaches

    PubMed Central

    Shin, Young-Hee; Jeong, Hee-Joon

    2015-01-01

    Background Postoperative delirium is a frequent complication in elderly patients undergoing major abdominal surgery and is associated with a poor outcome. We compared postoperative delirium in elderly patients following laparoscopic gastrectomy (LG) versus open gastrectomy (OG). Methods In total, 130 patients aged ≥ 65 years with gastric cancer undergoing LG and OG were enrolled prospectively. Postoperative delirium and cognitive status were assessed daily using the Confusion Assessment Method (CAM) and Mini-Mental Status Examination (MMSE), respectively, for 3 days postoperatively. For CAM-positive patients, delirium severity was then assessed using the Delirium Index (DI). Results In total, 123 subjects (LG, n = 60; OG, n = 63) were included in the analysis. In both groups, the overall incidences of postoperative delirium were similar: 31.6% (19/60) in the LG group and 41.2% (26/63) in the OG group. When considering only those with delirium, the severity, expressed as the highest DI score, was similar between the groups. A decline in cognitive function (reduction in MMSE ≥ 2 points from baseline) during 3 days postoperatively was observed in 23 patients in the LG group (38.3%) and 27 patients in the OG group (42.9%) (P = 0.744). In both groups, postoperative cognitive decline was significantly associated with postoperative delirium (P < 0.001). Conclusions We found that, compared with traditional open gastrectomy, laparoscopic gastrectomy did not reduce either postoperative delirium or cognitive decline in elderly patients with gastric cancer. PMID:26257851

  14. Alvimopan, for Postoperative Ileus Following Bowel Resection

    PubMed Central

    Delaney, Conor P.; Wolff, Bruce G.; Viscusi, Eugene R.; Senagore, Anthony J.; Fort, John G.; Du, Wei; Techner, Lee; Wallin, Bruce

    2007-01-01

    Objective: To obtain further analysis regarding specific outcomes and alvimopan doses in bowel resection (BR) patients. Summary Background Data: Although postoperative ileus (POI) is common after BR, there is currently no recognized treatment or prevention available. Alvimopan, a novel, peripherally active mu-opioid receptor antagonist, accelerated GI recovery after BR or hysterectomy in 3 phase III trials. Methods: A pooled retrospective subset analysis of BR patients in alvimopan phase III trials was performed. Randomized BR patients received alvimopan 6 mg (n = 397), 12 mg (n = 413), or placebo (n = 402) ≥2 hours before surgery and twice daily until hospital discharge for ≤7 days. The primary endpoint of each trial was time to recovery of GI function. Hospital discharge order (DCO) written, readmission, and morbidities were also assessed. Cox proportional hazard models were used to analyze treatment effects on time-to-event endpoints. Results: Alvimopan (6 or 12 mg) significantly accelerated GI recovery (GI-3; hazard ratio = 1.28 and 1.38, respectively; P ≤ 0.001 for both). Alvimopan significantly accelerated time to DCO written by 16 hours for 6 mg and 18 hours for 12 mg (P < 0.001 for both) from a mean of 147 hours for placebo. Alvimopan-treated patients had reduced postoperative morbidity compared with placebo, and incidence of prolonged hospital stay or readmission was significantly reduced (P < 0.001). Tolerability profiles were similar among groups. Conclusions: Alvimopan significantly accelerated GI recovery in BR patients. A 12-mg dose provided more consistent benefits across both sexes and all ages. Postoperative morbidity rates, prolonged hospital stay, and rates of hospital readmission were significantly reduced. Alvimopan reduces the consequences of POI after BR. PMID:17435541

  15. Effect of Anatomical Modeling on Space Radiation Dose Estimates: A Comparison of Doses for NASA Phantoms and 5th, 50th, and 95th Percentile UF Hybrid Phantoms

    NASA Technical Reports Server (NTRS)

    Bahadori, A.; VanBaalen, M.; Shavers, M.; Semones, E.; Dodge, C.; Bolch, W.

    2010-01-01

    The estimate of absorbed dose to individual organs of a space crewmember is affected by the geometry of the anatomical model of the astronaut used in the radiation transport calculation. For astronaut dosimetry, NASA currently uses the computerized anatomical male (CAM) and computerized anatomical female (CAF) stylized phantoms to represent astronauts in its operational radiation dose analyses. These phantoms are available in one size and in two body positions. In contrast, the UF Hybrid Adult Male and Female (UFHADM and UFHADF) phantoms have organ shapes based on actual CT data. The surfaces of these phantoms are defined by non-uniform rational B-spline surfaces, and are thus flexible in terms of body morphometry and extremity positioning. In this study, UFHADM and UFHADF are scaled to dimensions corresponding to 5th, 50th, and 95th percentile (PCTL) male and female astronauts. A ray-tracing program is written in Visual Basic 2008, which is then used to create areal density maps for dose points corresponding to various organs within the phantoms. The areal density maps, along with appropriate space radiation spectra, are input into the NASA program couplet HZETRN/BRYNTRN, and organ doses are calculated. The areal density maps selected tissues and organs of the 5th, 50th, and 95th PCTL male and female phantoms are presented and compared. In addition, the organ doses for the 5th, 50th, and 95th PCTL male and female phantoms are presented and compared to organ doses for CAM and CAF.

  16. Valentine's Day

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Context image for PIA02174 Valentine's Day

    This isolated mesa [lower left center of the image] has an almost heart-shaped margin. Happy Valentine's Day from Mars.

    Image information: VIS instrument. Latitude 29.4N, Longitude 79.1E. 18 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  17. FOREWORD: The 5th International Colloquium on Atomic Spectra and Oscillator Strengths for Astrophysical and Laboratory Plasmas

    NASA Astrophysics Data System (ADS)

    Tchang-Brillet, Wad Lydia; Wyart, Jean-François; Zeippen, Claude

    1996-01-01

    The 5th International Colloquium on Atomic Spectra and Oscillator Strengths for Astrophysical and Laboratory Plasmas was held in Meudon, France, from August 28 to 31 1995. It was the fifth in a series started by the Atomic Spectroscopic Group at the University of Lund, Sweden, in 1983. Then followed the meetings in Toledo, USA, Amsterdam, The Nether- lands and Gaithersburg, USA, with a three year period. The original title of the series ended with "... for Astrophysics and Fusion Research" and became more general with the 4th colloquium in Gaithersburg. The purpose of the present meeting was, in line with tradition, to bring together "producers" and "users" of atomic data so as to ensure optimal coordination. Atomic physicists who study the structure of atoms and their radiative and collisional properties were invited to explain the development of their work, emphasizing the possibilities of producing precise transition wavelengths and relative line intensities. Astrophysicists and laboratory plasma physicists were invited to review their present research interests and the context in which atomic data are needed. The number of participants was about 70 for the first three meetings, then exploded to 170 at Gaithersburg. About 140 participants, coming from 13 countries, attended the colloquium in Meudon. This large gathering was partly due to a number of participants from Eastern Europe larger than in the past, and it certainly showed a steady interest for interdisciplinary exchanges between different communities of scientists. This volume includes all the invited papers given at the conference and, in the appendix, practical information on access to some databases. All invited speakers presented their talks aiming at good communication between scientists from different backgrounds. A separate bound volume containing extended abstracts of the poster papers has been published by the Publications de l'Observatoire de Paris, (Meudon 1996), under the responsibility of

  18. A Comparison of In-Channel Dead Zone and Hyporheic Zone Transient Storage Parameter Estimates Between a 1st and 5th Order Stream

    NASA Astrophysics Data System (ADS)

    Briggs, M.; Gooseff, M.; Morkeski, K.; Wollheim, W.; Hopkinson, C.; Peterson, B.; Vorosmarty, C.

    2007-12-01

    A major enhancement to our understanding of how watersheds function would be the ability to discriminate between in-channel dead zone ( DZ) and hyporheic zone ( HZ) transient storage, and an evaluation of how these properties scale across stream orders. The nature of DZ storage is to display faster exchange rates with the main channel and less overall sediment contact time than HZ storage. These differences have great significance to many in-stream processes such as nutrient cycling. The combination of high slope, coarse bed material and fluvial structure endemic to many 1st order streams can provide greater forcing of hyporheic flow paths than occurs within the lower gradient 5th order streams. Conversely many 5th order reaches exhibit large side pool and back eddy DZ areas not common along 1st order streams. This study builds on existing methods to delineate the DZ and HZ from the integrated signal of a conservative solute's breakthrough curve ( BTC). Data for this comparison were collected over the summer of 2007 within the Ipswich River watershed, a basin which drains into Plum Island Sound on the north shore of Massachusetts, USA. The conservative solute NaCl was injected into both a 1st order medium gradient stream and a 5th order low gradient stream. The BTCs collected in thalwegs from the NaCl injections were simulated using a version of the solute transport model OTIS containing two zones of transient storage. Hydrometric measurements of stream velocity were used to estimate average main channel cross sectional area ( A) and DZ cross sectional area ( ASDZ) for each reach to constrain parameter estimates and avoid model equifinality between the storage zones. Initial values for the exchange rate between main channel flow and DZ storage ( αDZ) were estimated from DZ BTCs. Our results indicate that although the overall storage zone is much larger in proportion to the main channel for the 1st order reach than for the 5th order reach, the percentage of median

  19. Circadian variation in unexpected postoperative death.

    PubMed

    Rosenberg, J; Pedersen, M H; Ramsing, T; Kehlet, H

    1992-12-01

    Unexpected deaths still occur following major surgical procedures. The cause is often unknown but may be cardiac or thromboembolic in nature. Postoperative ischaemia, infarction and sudden cardiac death may be triggered by episodic or constant arterial hypoxaemia, which increases during the night. This study examined the circadian variation of sudden unexpected death following abdominal surgery between 1985 and 1989 inclusive. Deaths were divided into those occurring during the day (08.00-16.00 hours), evening (16.00-24.00 hours) and night (24.00-08.00 hours). Twenty-three deaths were considered to have been totally unexpected. Of 16 such patients undergoing autopsy, pulmonary embolism was the cause of death in five. In the remaining 11 patients, death occurred at night in eight (P < 0.005). Five of the seven patients without an autopsy died at night (P < 0.04); overall, 13 of 18 unexpected deaths occurred at night-time. These results suggest a need for further studies of sleep- and respiration-related effects on postoperative nocturnal cardiac function. The efficacy of monitoring during this apparent high-risk period should be evaluated. PMID:1486424

  20. Hydrology day

    NASA Astrophysics Data System (ADS)

    Morel-Seytoux, H. J.

    Registration for the Hydrology Day sponsored by the Front Range Branch of AGU on April 23 at Colorado State University in Fort Collins, Colorado, totaled 121 participants, of whom 61 were students.Thirty-one individuals joined the Front Range Branch. Three students from Colorado State University won the awards for best paper in their category: Thomas W. Anzia (Sr.), ‘A Comprehensive Table of Standard Deviates for Confidence Limits on Extreme Events’ Victor Nazareth (M.S.), ‘Aquifer Properties from Single-Hole Aquifer Tests’ and Roy W. Koch (Ph.D.), ‘A Physically Based Derivation of the Distribution of Excess Precipitation.’ Judges for the awards were Dr. Bittinger, Resource Consultants, Fort Collins; George Leavesley and Daniel Bauer, USGS, Water Resources Division, Denver; Scott Tucker, Executive Director, Denver Urban Drainage and Flood Control District; Charles Brendecke, Department of Civil Engineering, Univ. of Colorado, Boulder.

  1. Postoperative Pain in Children After Dentistry Under General Anesthesia.

    PubMed

    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

  2. Acute Postoperative Endophthalmitis Caused by Staphylococcus lugdunensis▿

    PubMed Central

    Chiquet, C.; Pechinot, A.; Creuzot-Garcher, C.; Benito, Y.; Croize, J.; Boisset, S.; Romanet, J. P.; Lina, G.; Vandenesch, F.

    2007-01-01

    Acute postoperative endophthalmitis caused by Staphylococcus lugdunensis is infrequently reported in clinical studies. Five cases of acute postcataract surgery endophthalmitis caused by S. lugdunensis were taken from a multicenter prospective study conducted in four university-affiliated hospitals in France (2004 to 2005). These cases were characterized by severe ocular inflammation occurring with a mean delay of 7.6 days after cataract surgery, severe visual loss (hand motions or less in three cases), and dense infiltration of the vitreous. Each of these patients was initially treated by using a standard protocol with intravitreal (vancomycin and ceftazidime), systemic, and topical antibiotics. Given the severity of the endophthalmitis, even though bacteria were sensitive to intravitreal antibiotics, pars plana vitrectomy was needed in four cases. The final visual prognosis was complicated by severe retinal detachment in three cases. The microbiological diagnosis was reached by using conventional cultures with specific biochemical tests and eubacterial PCR amplification followed by direct sequencing. PMID:17392442

  3. The effect of postoperative positive end-expiratory pressure on postoperative bleeding after off-pump coronary artery bypass grafting

    PubMed Central

    Salihoglu, Ece; Celik, Sezai; Ugurlucan, Murat; Caglar, Ilker Murat; Turhan-Caglar, Fatma Nihan; Isik, Omer

    2014-01-01

    Introduction To compare postoperative prophylactic use of two positive end-expiratory pressure (PEEP) levels in order to prevent postoperative bleeding in patients undergoing off-pump coronary artery bypass grafting (CABG) surgery. Material and methods Sixty patients undergoing an elective off-pump CABG operation were included in this prospective, nonrandomized clinical trial. Patients were divided into two groups as receiving either 5 cm H2O (group 1) or 8 cm H2O PEEP (group 2) after the operation until being extubated. Chest tube outputs, use of blood products and other fluids, postoperative hemoglobin levels, accumulation of pleural and pericardial fluid after the removal of chest tubes, and duration of hospital stay were recorded and compared. Results Low- and high-pressure PEEP groups did not differ with regard to postoperative chest tube outputs, amounts of transfusions and crystalloid/colloid infusion requirements, or postoperative hemoglobin levels. However, low-pressure PEEP application was associated with significantly higher pleural (92 ±37 ml vs. 69 ±29 ml, p = 0.03) and pericardial fluid (17 ±5 ml vs. 14 ±6 ml, p = 0.04) accumulation. On the other hand, high-pressure PEEP application was associated with significantly longer duration of hospitalization (6.25 ±1.21 days vs. 5.25 ±0.91 days, p = 0.03). Conclusions Prophylactic administration of postoperative PEEP levels of 8 cm H2O, although safe, does not seem to reduce chest-tube output or transfusion requirements in off-pump CABG when compared to the lower level of PEEP. Further studies with larger sample sizes are warranted to confirm the benefits and identify ideal levels of PEEP administration in this group of patients. PMID:25395944

  4. 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. PMID:26676613

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... included in the designation of business day, as in § 300.148(d)(1)(ii)). (c)(1) School day means any day... 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....

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

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... included in the designation of business day, as in § 300.148(d)(1)(ii)). (c)(1) School day means any day... 34 Education 2 2010-07-01 2010-07-01 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....

  7. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... included in the designation of business day, as in § 300.148(d)(1)(ii)). (c)(1) School day means any day... 34 Education 2 2014-07-01 2013-07-01 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....

  8. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... included in the designation of business day, as in § 300.148(d)(1)(ii)). (c)(1) School day means any day... 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....

  9. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... included in the designation of business day, as in § 300.148(d)(1)(ii)). (c)(1) School day means any day... 34 Education 2 2013-07-01 2013-07-01 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....

  10. Postoperative Care of the Facial Laceration

    PubMed Central

    Medel, Nicholas; Panchal, Neeraj; Ellis, Edward

    2010-01-01

    The purpose of this investigation is to examine factors involved in the postoperative care of traumatic lacerations. An evidence-based comprehensive literature review was conducted. There are a limited number of scientifically proven studies that guide surgeons and emergency room physicians on postoperative care. Randomized controlled trials must be conducted to further standardize the postoperative protocol for simple facial lacerations. PMID:22132257

  11. 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

  12. Postoperative cognitive dysfunction: Involvement of neuroinflammation and neuronal functioning.

    PubMed

    Hovens, Iris B; Schoemaker, Regien G; van der Zee, Eddy A; Absalom, Anthony R; Heineman, Erik; van Leeuwen, Barbara L

    2014-05-01

    Postoperative cognitive dysfunction (POCD) has been hypothesized to be mediated by surgery-induced inflammatory processes, which may influence neuronal functioning either directly or through modulation of intraneuronal pathways, such as the brain derived neurotrophic factor (BDNF) mediated pathway. To study the time course of post-surgical (neuro)inflammation, changes in the BDNF-pathway and POCD, we subjected 3months old male Wistar rats to abdominal surgery and implanted a jugular vein catheter for timed blood sampling. Cognition, affective behavior and markers for (neuro)inflammation, BDNF and neurogenesis were assessed at 1, 2 and 3weeks following surgery. Rats displayed changes in exploratory activity shortly after surgery, associated with postoperatively elevated IL-6 plasma levels. Spatial learning and memory were temporarily impaired in the first 2weeks following surgery, whereas non-spatial cognitive functions seemed unaffected. Analysis of brain tissue revealed increased neuroinflammation (IL-1B and microgliosis) 7days following surgery, decreased BDNF levels on postoperative day 14 and 21, and decreased neurogenesis until at least 21days following surgery. These findings indicate that in young adult rats only spatial learning and memory is affected by surgery, suggesting hippocampal dependent cognition is especially vulnerable to surgery-induced impairment. The observed differences in time course following surgery and relation to plasma IL-6 suggest cognitive dysfunction and mood changes comprise distinct features of postoperative behavioral impairment. The postoperative changes in neuroinflammation, BDNF and neurogenesis may represent aspects of the underlying mechanism for POCD. Future research should be aimed to elucidate how these players interact. PMID:24517920

  13. Neuroimaging of the Postoperative Spine.

    PubMed

    Bellini, Matteo; Ferrara, Marco; Grazzini, Irene; Cerase, Alfonso

    2016-08-01

    Operative treatments of the spine are becoming increasingly more common for the availability of a wide range of surgical and minimally invasive procedures. MR imaging allows for excellent evaluation of both normal and abnormal findings in the postoperative spine. This article provides the basic tools to evaluate complications after different operative procedures and offers an overview on the main topics a radiologist may encounter during his or her professional carrier. PMID:27417403

  14. (S)Partners for Heart Health: a school-based program for enhancing physical activity and nutrition to promote cardiovascular health in 5th grade students

    PubMed Central

    Carlson, Joseph J; Eisenmann, Joey C; Pfeiffer, Karin A; Jager, Kathleen B; Sehnert, Scott T; Yee, Kimbo E; Klavinski, Rita A; Feltz, Deborah L

    2008-01-01

    Background The American Heart Association Position Statement on Cardiovascular Health Promotion in Public Schools encourages school-based interventions for the primary prevention of cardiovascular disease (CVD) through risk factor prevention or reduction in children with an emphasis on creating an environment that promotes healthy food choices and physical activity (PA). In an effort to address issues related to CVD risk factors including obesity in Michigan children, a multi-disciplinary team of Michigan State University (MSU) faculty, clinicians, and health profession students was formed to "(S)partner" with elementary school physical education (PE) teachers and MSU Extension staff to develop and implement a cost-effective, sustainable program aimed at CVD risk factor prevention and management for 5th grade students. This (S)partnership is intended to augment and improve the existing 5th grade PE, health and nutrition curriculum by achieving the following aims: 1) improve the students' knowledge, attitudes and confidence about nutrition, PA and heart health; 2) increase the number of students achieving national recommendations for PA and nutrition; and 3) increase the number of students with a desirable CVD risk factor status based on national pediatric guidelines. Secondary aims include promoting school staff and parental support for heart health to help children achieve their goals and to provide experiential learning and service for MSU health profession students for academic credit. Methods/Design This pilot effectiveness study was approved by the MSU IRB. At the beginning and the end of the school year students undergo a CVD risk factor assessment conducted by MSU medical students and graduate students. Key intervention components include eight lesson plans (conducted bi-monthly) designed to promote heart healthy nutrition and PA behaviors conducted by PE teachers with assistance from MSU undergraduate dietetic and kinesiology students (Spartners). The final

  15. Routing cancer immunology and immunotherapy from the lab to the clinic 4–5 th March 2014, Center for Applied Medical Research and University Clinic, Pamplona, Spain

    PubMed Central

    2014-01-01

    New approaches to generate effective anticancer responses by either inducing immune responses or inhibiting immunosuppression are under development to improve efficacy in patients. On March 4-5th, 2014, a symposium was held in Pamplona, Spain, to report the new strategies showing preclinical and clinical results regarding translational research efforts on the topic. Participants interacted through oral presentations of 15 speakers and further discussions on topics that included novel therapeutic agents for cancer immunotherapy, viral vectors and interferon-based approaches, experimental tumor imaging and immunostimulatory monoclonal antibodies. Promising agents to target cancer cells and therapeutic approaches that are under translation from bench to patients were presented. PMID:25060862

  16. Health effects of different dietary iron intakes: a systematic literature review for the 5th Nordic Nutrition Recommendations

    PubMed Central

    Domellöf, Magnus; Thorsdottir, Inga; Thorstensen, Ketil

    2013-01-01

    Background The present literature review is part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. Objective The objective of this systematic literature review was to assess the health effects of different intakes of iron, at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation), in order to estimate the requirement for adequate growth, development, and maintenance of health. Methods The initial literature search resulted in 1,076 abstracts. Out of those, 276 papers were identified as potentially relevant. Of those, 49 were considered relevant and were quality assessed (A, B, or C). An additional search on iron and diabetes yielded six articles that were quality assessed. Thus, a total of 55 articles were evaluated. The grade of evidence was classified as convincing (grade 1), probable (grade 2), suggestive (grade 3), and inconclusive (grade 4). Results There is suggestive evidence that prevention or treatment of iron deficiency (ID) and iron deficiency anemia (IDA) improves cognitive, motoric, and behavioral development in young children, and that treatment of IDA improves attention and concentration in school children and adult women. There is insufficient evidence to show negative health effects of iron intakes in doses suggested by the NNR 4. There is insufficient evidence to suggest that normal birth weight, healthy, exclusively breast-fed infants need additional dietary iron before 6 months of life in the Nordic countries. An iron concentration of 4–8 mg/L in infant formulas seems to be safe and effective for normal birth weight infants. There is probable evidence that iron supplements (1–2 mg/kg/day) given up to 6 months of age to infants with low birth weight (<2,500 g) prevents IDA and possibly reduce the risk of behavioral problems later on. There is probable evidence that ID and IDA in

  17. [Postoperative pulmonary complications: prophylaxis after noncardiac surgery].

    PubMed

    Hofer, S; Plachky, J; Fantl, R; Schmidt, J; Bardenheuer, H J; Weigand, M A

    2006-04-01

    Postoperative pulmonary complications are a major problem after upper abdominal or thoracoabdominal surgery. They lead to a prolonged ICU stay as well as increased costs and are one of the main causes of early postoperative mortality. Even after uncomplicated operations, postoperative hypoxemia occurs in 30-50% of patients. Acute respiratory failure involves a disturbance in gas exchange. The mortality ranges from 10 to 60% according to the severity of respiratory failure. The most important complications are interstitial and alveolar pulmonary edema, atelectasis, postoperative pneumonia, hypoventilation, and aspiration. Preoperative optimization, postoperative prophylaxis according to a stepwise approach, and early mobilization decrease the rate of complications. PMID:16575614

  18. Science Across Borders: 5th Annual Natural Health Product Research Conference—March 26–29, 2008, Toronto, Canada

    PubMed Central

    2010-01-01

    Canada is experiencing a growing interest in the use of alternative therapies and products particularly natural health products (NHP). In 1997, Canadians spent around C$ 2 billion on NHP. In an attempt to catch with this popularity of NHP use, Canadian researchers and administrators from academia, industry and government jointly established the Natural Health Product Research Society of Canada (NHPRS). Since its formation, NHPRS has been organizing an annual meeting which brings together world renowned researchers and experts in the area of NHP research. For 2008, the annual NHPRS meeting took place in Toronto from the 26th to 29th of March with a focus on ‘Science Across Borders: Global Natural Health Products Research’. The scientific program was spread into three days of plenary lectures and oral presentations. The different sessions containing these talks were on: ethnobotany around the world; chemical analysis of NHP; product standards and quality control; ethnomedicine; novel analytical approaches; systemic research, nutrisciences and molecular medicine; and drug development from NHP. The meeting proved to be a great success in terms of the speakers that were invited and based on the data that was presented which highlighted recent research taking place in the field of NHP not only in Canada but from many parts of the world. PMID:18955362

  19. Is Early Enteral Nutrition Better for Postoperative Course in Esophageal Cancer Patients?

    PubMed Central

    Kobayashi, Kazuaki; Koyama, Yu; Kosugi, Shin-ichi; Ishikawa, Takashi; Sakamoto, Kaoru; Ichikawa, Hiroshi; Wakai, Toshifumi

    2013-01-01

    We retrospectively examined esophageal cancer patients who received enteral nutrition (EN) to clarify the validity of early EN compared with delayed EN. A total of 103 patients who underwent transthoracic esophagectomy with three-field lymphadenectomy for esophageal cancer were entered. Patients were divided into two groups; Group E received EN within postoperative day 3, and Group L received EN after postoperative day 3. The clinical factors such as days for first fecal passage, the dose of postoperative albumin infusion, differences of serum albumin value between pre- and postoperation, duration of systematic inflammatory response syndrome (SIRS), incidence of postoperative infectious complication, and use of total parenteral nutrition (TPN) were compared between the groups. The statistical analyses were performed using Mann-Whitney U test and Chi square test. The statistical significance was defined as p < 0.05. Group E showed fewer days for the first fecal passage (p < 0.01), lesser dose of postoperative albumin infusion (p < 0.01), less use of TPN (p < 0.01), and shorter duration of SIRS (p < 0.01). However, there was no significant difference in postoperative complications between the two groups. Early EN started within 3 days after esophagectomy. It is safe and valid for reduction of albumin infusion and TPN, for promoting early recovery of intestinal movement, and for early recovery from systemic inflammation. PMID:24067386

  20. Postoperative risk following uvulopalatopharyngoplasty for obstructive sleep apnea.

    PubMed

    Burgess, L P; Derderian, S S; Morin, G V; Gonzalez, C; Zajtchuk, J T

    1992-01-01

    A study was conducted to assess oxygenation and respiratory changes on the first and second postoperative nights after uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea (OSA). Twelve patients were postoperatively evaluated with 8-hour nocturnal polysomnography on four occasions: (1) PREOP--night before UPPP, (2) POPN1--first postoperative night, (3) POPN2--second postoperative night, and (4) 3MOS--3-month follow-up study. Results demonstrate that apnea index (AI) and respiratory disturbance index (RDI) were significantly improved at 3MOS from PREOP levels: AI (p less than 0.01) and RDI (p less than 0.05). There were no statistical differences from PREOP to POPN1 or POPN2 for AI, RDI, lowest oxyhemoglobin saturation (LSAT), or number of desaturations (#DESAT). One of twelve patients dropped LSAT greater than 10% from PREOP to POPN1 or POPN2 (82% PREOP to 71% POPN2). Patients were grouped by PREOP LSAT greater than or equal to 80% or less than 80%, and the postoperative change in LSAT was evaluated by comparing PREOP to a value averaging POPN1 and POPN2. Patients with LSAT greater than or equal to 80% decreased by 2.6%; patients with LSAT less than 80% improved by 6.2%. This change in LSAT between groups was statistically different (p = 0.02). These data suggest that in the majority of patients, preoperative indices remain unchanged for at least 2 days after surgery, even for patients who demonstrated improvement at 3 months. However, worsening does occur in some patients. On the basis of the results of this study and clinical experience with the postoperative course, a selective management protocol is outlined. PMID:1734375

  1. Effectiveness of preoperative analgesics on postoperative dental pain: a study.

    PubMed Central

    Zacharias, M.; Hunter, K. M.; Baker, A. B.

    1996-01-01

    Patients undergoing extractions of third molar teeth under general anesthesia were given a placebo, diclofenac (a nonsteroidal anti-inflammatory drug) 100 mg, or methadone (an opiate) 10 mg 60 to 90 min prior to surgery, and their pain scores and postoperative medication requirements were measured for 3 days. All patients received local anesthetic blocks and analgesic drugs during the perioperative period. There were no significant differences between the three groups in the pain scores and medication requirements during the period of study. It was concluded that preoperative use of nonsteroidal anti-inflammatory drugs and opiates may not offer a preemptive analgesic effect in patients who have had adequate analgesia during the surgery. Continued use of analgesic drugs during the postoperative period is perhaps more useful for this purpose. There appears to be a higher incidence of vomiting following opiates (methadone), precluding its clinical use in day-care patients. PMID:10323113

  2. Effect of postoperative extradural morphine on lower urinary tract function.

    PubMed

    Husted, S; Djurhuus, J C; Husegaard, H C; Jepsen, J; Mortensen, J

    1985-02-01

    The effect of postoperative extradurally administered morphine on lower urinary tract function was studied in female patients undergoing uterine surgery. Urodynamic measurements were made on the day before and on the day after the operation, using a DISA 2-channel carbon dioxide (CO2) cystomictrograph. In ten patients without postoperative urinary retention no changes in cystometry were found during morphine administration, while two patients who developed acute urinary retention had a marked increase in bladder capacity and of detrusor pressure. In contrast, the urethral pressure profile was unchanged in both groups of patients. Intravenously administered naloxone tended to normalize the bladder capacity in the patients with urinary retention. These findings seem to indicate a marked effect in some patients of extradurally administered morphine and the acute urinary retention, following morphine administration, may be treated with naloxone. PMID:3976331

  3. It takes a community to define a discipline: the 5th anniversary of Environmental Research Letters It takes a community to define a discipline: the 5th anniversary of Environmental Research Letters

    NASA Astrophysics Data System (ADS)

    Kammen, Dan

    2012-03-01

    process of community building. ERL sought and continues to seek ways to lead this conversation. 1. Open access and equity First, all ERL articles and data sets are entirely open access. Once published, the materials are free to all users, affluent and poor, anywhere in the world. This is vital for a number of reasons. Environmental stress, degradation, and the creation of innovative solutions involves a global dialog, where traditional expensive subscription and single article costs, as some journals charge, are a complete barrier to researchers, fledgling entrepreneurs, and the public sector in developing nations and in poor communities. Instead, ERL charges authors a fee, generally covered by research grants. Further, we have been able to waive the open access article charge for authors based in areas of the world where this fee may prove prohibitive, as it can be in many developing countries. In this open access format, ERL publishes cutting-edge original research letters, commentary-style 'Perspective' pieces and editorial articles. ERL is committed to staying at the forefront of the 'gold standard' for open access publishing of articles and data—something that journals are increasingly taking up—and as new ideas come in as to how to improve this process, we will look to put them into practice. 2. Build a network researching sustainability Second, a journal that reaches across so many disciplines needs to be a place where results are not only reviewed and published quickly, but are then accessible to a broad audience, and are available for debate and conversation. ERL strives to maintain a 90 day timeline from submission to fully peer-reviewed publication online. This process in particular has only been possible with the incredible support of two groups: (1) the dedication of IOP Publishing and the amazingly talented staff they have been able to identify and recruit to work on ERL, and (2) the journal's Editorial Board. We have a team of Editors made up of the

  4. Using a Spreadsheet to Compute the Maximum Wind Sector 99.5th Percentile X/Q Value in Accordance with DOE-STD-3009-2014.

    PubMed

    Vickers, Linda

    2016-05-01

    The U.S. Department of Energy Standard 3009-2014 requires one of two methods to determine the simple Gaussian relative concentration (X/Q) of pollutant at plume centerline downwind to a receptor for a 2-h exposure duration from a ground-level release (i.e., less than 10 m height) which are (1) the 99.5th percentile X/Q for the directionally-dependent method and (2) the 95th percentile X/Q for the directionally-independent method. This paper describes how to determine the simple Gaussian 99.5th percentile X/Q for the directionally-dependent method using an electronic spreadsheet. Refer to a previous paper to determine the simple Gaussian 95th percentile X/Q for the directionally-independent method using an electronic spreadsheet (Vickers 2015). The method described herein is simple, quick, accurate, and transparent because all of the data, calculations, and results are visible for validation and verification. PMID:27023153

  5. The 5th IUPAP International Conference on Women in Physics: Making progress in the number of women in physics around the world

    NASA Astrophysics Data System (ADS)

    Cunningham, Beth

    2015-04-01

    A short report on the 5th IUPAP International Conference on Women in Physics (ICWIP) will be presented. In particular, a summary of the structure of the 5th ICWIP that occurred in Waterloo, Canada in August 2014 will be provided and placed into context of the previous four conferences. In addition, a synopsis of the recent efforts that are happening around the world to encourage girls and women to participate in physics will be given. Several US projects have been very successful in introducing girls to science and physics (e.g., ``Expanding Your Horizons'' intervention) and encouraging undergraduate women physics majors to continue into physics careers (e.g., Conferences for Undergraduate Women in Physics). Projects from other countries, such as the Juno Project in the UK that rates physics departments on their climate for women, might be implemented by US physics professional societies as well as colleges and universities. Several projects originating from the conference will be described: the new ``HERstories: Encouraging words from women in physics'' video based on interviews with delegates of the Conference, the My STEM Story project (http://mystemstory.wlu.ca), and the proceedings of the conference. Partial support provided by NSF #PHY-1419453.

  6. [Postoperative vomitting and gastroatonia following aorto-bifemoral bypass operations during halothane-combination anaesthesia and neuroleptanaesthesia (author's transl)].

    PubMed

    Menzel, T; Langbein, L; Liebenshütz, F; Henneberg, U

    1977-02-01

    44 patients are analysed for the frequency of postoperative vomiting and the amount of gastroatonia following aorto-femoral bypass operations during neuroleptanaesthesia and halothane combination anasthesia. More than 60% of patients develop gastroatonia during both methods of anaesthesia. However it is less apparent on the first postoperative day after neuroleptanaesthesia and does not affect as many patients as after halothane combination anaesthesia. Postoperative vomiting is significantly more frequent after halothan combination anaesthesia than after neuroleptanaesthesia. PMID:842814

  7. 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. PMID:9542366

  8. Postoperative analgesia in elderly patients.

    PubMed

    Falzone, Elisabeth; Hoffmann, Clément; Keita, Hawa

    2013-02-01

    Elderly people represent the fastest-growing segment of our society and undergo surgery more frequently than other age groups. Effective postoperative analgesia is essential in these patients because inadequate pain control after surgery is associated with adverse outcomes in elderly patients. However, management of postoperative pain in older patients may be complicated by a number of factors, including a higher risk of age- and disease-related changes in physiology and disease-drug and drug-drug interactions. Physiological changes related to aging need to be carefully considered because aging is individualized and progressive. Assessment of pain management needs to include chronological age, biological age with regard to renal, liver and cardiac functions, and the individual profile of pathology and prescribed medications. In addition, ways in which pain should be assessed, particularly in patients with cognitive impairment, must be considered. Cognitively intact older patients can use most commonly used unidimensional pain scales such as the visual analogue scale (VAS), verbal rating scale (VRS), numeric rating scale (NRS) and facial pain scale (FPS). VRS and NRS are the most appropriate pain scales for the elderly. In older patients with mild to moderate cognitive impairment, the VRS is a better tool. For severe cognitively impaired older patients, behavioural scales validated in the postoperative context, such as Doloplus-2 or Algoplus, are appropriate. For postoperative pain treatment, most drugs (e.g. paracetamol, nonsteroidal anti-inflammatory drugs, nefopam, tramadol, codeine, morphine, local anaesthetics), techniques (e.g. intravenous morphine titration, subcutaneous morphine, intravenous or epidural patient-controlled analgesia, intrathecal morphine, peripheral nerve block) and strategies (e.g. anticipated intraoperative analgesia or multimodal analgesia) used for acute pain management can be used in older patients. However, in view of pharmacokinetic

  9. PREFACE: 5th International Workshop DICE2010: Space-Time-Matter - Current Issues in Quantum Mechanics and Beyond

    NASA Astrophysics Data System (ADS)

    Diósi, Lajos; Elze, Hans-Thomas; Fronzoni, Leone; Halliwell, Jonathan; Prati, Enrico; Vitiello, Giuseppe; Yearsley, James

    2011-07-01

    These proceedings present the Invited Lectures and Contributed Papers of the Fifth International Workshop on Decoherence, Information, Complexity and Entropy - DICE 2010, held at Castello Pasquini, Castiglioncello (Tuscany), 13-17 September 2010. These proceedings are intended to document the stimulating exchange of ideas at this conference for both the interested public and the wider scientific community, as well as for the participants. The number of participants attending this series of meetings has been growing steadily, which reflects its increasing attraction. Our intention to bring together leading researchers, advanced students, and renowned scholars from various areas in order to stimulate new ideas and their exchange across the borders of specialization seems to bear fruit. In this way, the series of meetings has continued successfully from the beginning with DICE 2002 [1], followed by DICE 2004 [2], DICE 2006 [3], and DICE 2008 [4], uniting more than 100 participants representing almost 30 countries worldwide. It has been a great honour and inspiration to have Professor Luc Montagnier (Nobel Prize for Medicine 2008) from the World Foundation for AIDS Research and Prevention with us, who presented the lecture DNA waves and water (included in this volume). The discussions took place under the wider theme Space-Time-Matter - current issues in quantum mechanics and beyond in the very pleasant and inspiring atmosphere of Castello Pasquini, which - with its beautiful surroundings, overlooking the Tuscany coast - hosted the conference very successfully for the second time. The five-day program was grouped according to the following topics: Gravity and Quantum Mechanics Quantum Coherent Processes in Biology / Many-Body Systems From Quantum Foundations to Particle Physics The Deep Structure of Spacetime Quantum - Relativity - Cosmology A Public Roundtable Discussion formed an integral part of the program under the theme Sull' Onda Della Coerenza" - le nuove

  10. PREFACE: 5th Symposium on Large TPCs for Low Energy Rare Event Detection and Workshop on Neutrinos from Supernovae

    NASA Astrophysics Data System (ADS)

    Irastorza, Igor G.; Scholberg, Kate; Colas, Paul; Giomataris, Ioannis

    2011-08-01

    The Fifth International Symposium on large TPCs for low-energy rare-event detection was held at the auditorium of the Astroparticle and Cosmology (APC) Laboratory in Paris, on 14-17 December 2010. As for all previous meetings, always held in Paris in 2008, 2006, 2004 and 2002, it brought together a significant community of physicists involved in rare event searches and/or development of time projection chambers (TPCs). As a novelty this year, the meeting was extended with two half-day sessions on Supernova physics. These proceedings also include the contributions corresponding to the supernova sessions. The purpose of the meeting was to present and discuss the status of current experiments or projects involving the use of TPCs to search for rare events, like low-energy neutrinos, double beta decay, dark matter or axion experiments, as well as to discuss new results and ideas in the framework of the last developments of Micro Pattern Gaseous Detectors (MPGD), and how these are being - or could be - applied to these searches. As in previous meetings in this series, the format included an informal program with some recent highlighted results, rather than exhaustive reviews, with time for discussion and interaction. The symposium, the fifth of the series, is becoming consolidated as a regular meeting place for the synergic interplay between the fields of rare events and TPC development. The meeting started with a moving tribute by Ioannis Giomataris to the memory of George Charpak, who recently passed away. We then moved on to the usual topics like the status of some low-energy neutrino physics and double beta decay experiments, dark matter experiments with directional detectors, axion searches, or development results. A relevant subject this time was the electroluminescence in Xe TPCs, covered by several speakers. Every time the conference program is enriched with original slightly off-topic contributions that trigger the curiosity and stimulate further thought. As

  11. Safety of undiluted intracameral moxifloxacin without postoperative topical antibiotics in cataract surgery.

    PubMed

    Zhou, Andrew Xingyu; Messenger, Wyatt Boyer; Sargent, Steven; Ambati, Balamurali Krishna

    2016-08-01

    The objective of this study is to evaluate the safety of undiluted 0.5 % intracameral moxifloxacin for postoperative endophthalmitis prophylaxis in cataract surgery patients without the use of additional postoperative topical antibiotics. All phacoemulsification cataract surgeries performed by a single surgeon (B.A.) at the John A. Moran Eye Center from June 2012 to May 2015 were reviewed retrospectively. From June 2012 to April 2014, patients were given topical 0.5 % moxifloxacin postoperatively. From May 2014 to May 2015, all patients were given moxifloxacin intracamerally with no antibiotics postoperatively. The follow-up period was 1 month after surgery. Preoperative visual acuity and postoperative visual acuity, corneal edema, and anterior chamber reaction were recorded and compared between the two groups. 384 cataract surgeries were performed during the study period. None of the 384 eyes in the study developed endophthalmitis. Of those 384 eyes, 222 were included in the study for analysis based on the inclusion and exclusion criteria. 131 were part of the topical antibiotic group and 91 were part of the intracameral group. The differences in uncorrected visual acuity at 1 day postoperatively (p = 0.595) and best corrected visual acuity at 1 month postoperatively (p = 0.099) were not statistically significant. Differences in corneal edema (p = 0.370) and anterior chamber reaction (p = 0.069) at 1 day postoperatively and corneal edema (p = 0.512) and anterior chamber reaction (p = 0.512) at 1 month postoperatively were also not statistically significant. Undiluted 0.5 % moxifloxacin can be safely injected intracamerally following cataract surgery without additional postoperative antibiotic prophylaxis to prevent endophthalmitis without adverse effects on patient outcomes. PMID:26577588

  12. Influence of postoperative enteral nutrition on postsurgical infections.

    PubMed Central

    Beier-Holgersen, R; Boesby, S

    1996-01-01

    BACKGROUND: This study was undertaken to test the hypothesis that early enteral nutrition might reduce the incidence of serious complications after major abdominal surgery. METHODS: In a randomised double blind prospective trial 30 patients received Nutri-drink and 30 patients received placebo through a nasoduodenal feeding tube. On the day of operation the patients were given median 600 ml of either nutrition or placebo, 60 ml per hour. On the first postoperative day the patients received either 1000 ml (median) of nutrition or placebo, on day 2 1200 ml (median) nutrition, 1400 ml placebo, on day 3 1000 ml (median) nutrition, 1150 ml placebo, and on day 4 1000 ml (median) nutrition, 800 ml placebo. All patients were followed up for 30 days by the same investigator. RESULTS: The two groups were similar with regard to nutritional status and type of operation. The rate of postoperative infectious complications was significantly lower in the nutrition group, two of 30 compared with 14 of 30 in the placebo group (p = 0.0009). CONCLUSION: Early enteral nutrition given to patients after major abdominal surgery results in an important reduction in infectious complications. PMID:9038665

  13. Vitamin D – a systematic literature review for the 5th edition of the Nordic Nutrition Recommendations

    PubMed Central

    Lamberg-Allardt, Christel; Brustad, Magritt; Meyer, Haakon E.; Steingrimsdottir, Laufey

    2013-01-01

    concerning bone health, total mortality and the risk of falling. Moreover, the effect was often only seen in persons with low basal 25(OH)D concentrations. In addition, most intervention studies leading to these conclusions report that intervention with vitamin D combined with calcium and not vitamin D alone gives these benefits. It was difficult to establish an optimal 25(OH)D concentration or vitamin D intake based on the SLRs, but there are evidence that a concentration of ≥50 nmol/l could be optimal. The dose–response studies relating vitamin D intake (fortification and supplementation) to S-25(OH)D suggested that an intake of 1–2.5 µg/day will increase the serum concentration by 1–2 nmol/l but this is dependent on the basal concentration with a response being greater when the basal concentration is low. Conclusion Data show that a S-25(OH)D concentration of 50 nmol/l would reflect a sufficient vitamin D status. Results from this review support that the recommendation in NNR 2004 needs to be re-evaluated and increased for all age groups beyond 2 years of age. We refer to the total intake from food as well as supplements, given minimal sun exposure. Limited sunshine, however, does not reflect the situation for the majority of the Nordic population in the summertime. It should also be emphasized that there are large differences in results depending on assay methods and laboratories measuring 25(OH)D, adding to the uncertainty of determining an appropriate target concentration. Moreover, the dose–response of vitamin D on serum 25(OH)D-concentrations is not well established and is dependent on the basal concentrations, sunshine exposure and dietary intake. We advise that these uncertainties should be taken into account when setting the final Nordic recommendations. PMID:24106457

  14. PREFACE: 5th International Workshop DICE2010: Space-Time-Matter - Current Issues in Quantum Mechanics and Beyond

    NASA Astrophysics Data System (ADS)

    Diósi, Lajos; Elze, Hans-Thomas; Fronzoni, Leone; Halliwell, Jonathan; Prati, Enrico; Vitiello, Giuseppe; Yearsley, James

    2011-07-01

    These proceedings present the Invited Lectures and Contributed Papers of the Fifth International Workshop on Decoherence, Information, Complexity and Entropy - DICE 2010, held at Castello Pasquini, Castiglioncello (Tuscany), 13-17 September 2010. These proceedings are intended to document the stimulating exchange of ideas at this conference for both the interested public and the wider scientific community, as well as for the participants. The number of participants attending this series of meetings has been growing steadily, which reflects its increasing attraction. Our intention to bring together leading researchers, advanced students, and renowned scholars from various areas in order to stimulate new ideas and their exchange across the borders of specialization seems to bear fruit. In this way, the series of meetings has continued successfully from the beginning with DICE 2002 [1], followed by DICE 2004 [2], DICE 2006 [3], and DICE 2008 [4], uniting more than 100 participants representing almost 30 countries worldwide. It has been a great honour and inspiration to have Professor Luc Montagnier (Nobel Prize for Medicine 2008) from the World Foundation for AIDS Research and Prevention with us, who presented the lecture DNA waves and water (included in this volume). The discussions took place under the wider theme Space-Time-Matter - current issues in quantum mechanics and beyond in the very pleasant and inspiring atmosphere of Castello Pasquini, which - with its beautiful surroundings, overlooking the Tuscany coast - hosted the conference very successfully for the second time. The five-day program was grouped according to the following topics: Gravity and Quantum Mechanics Quantum Coherent Processes in Biology / Many-Body Systems From Quantum Foundations to Particle Physics The Deep Structure of Spacetime Quantum - Relativity - Cosmology A Public Roundtable Discussion formed an integral part of the program under the theme Sull' Onda Della Coerenza" - le nuove

  15. A novel postoperative immobilization model for murine Achilles tendon sutures.

    PubMed

    Shibuya, Yoichiro; Takayama, Yuzo; Kushige, Hiroko; Jacinto, Sandra; Sekido, Mitsuru; Kida, Yasuyuki S

    2016-08-01

    The body's motion and function are all in part effected by a vital tissue, the tendon. Tendon injury often results in limited functioning after postoperative procedures and even for a long time after rehabilitation. Although numerous studies have reported surgical procedures using animal models which have contributed to both basic and clinical research, modeling of tendon sutures or postoperative immobilizations has not been performed on small experimental animals, such as mice. In this study we have developed an easy Achilles tendon suture and postoperative ankle fixation model in a mouse. Right Achilles tendons were incised and 10-0 nylons were passed through the proximal and distal ends using a modified Kessler method. Subsequently, the right ankle was immobilized in a plantarflexed position with novel splints, which were made from readily available extension tubes. Restriction of the tendon using handmade splints reduced swelling, as opposed to fixating with the usual plaster of Paris. Using this method, the usage of the right Achilles tendons began on postoperative days 13.5 ± 4.6, which indicated healing within two weeks. Therefore our simple short-term murine Achilles tendon suture procedure is useful for studying immediate tendon repair mechanisms in various models, including genetically-modified mice. PMID:26678297

  16. [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. PMID:25195116

  17. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

    PubMed

    Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

    2014-10-01

    We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030-9700), and without it was ~1:135 900 (1:78 600-299 000). The cases of accidental awareness during general anaesthesia reported to 5th National Audit Project were overwhelmingly cases of unintended awareness during neuromuscular blockade. The incidence of accidental awareness during caesarean section was ~1:670 (1:380-1300). Two thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental; rapid sequence induction; obesity; difficult airway management; neuromuscular blockade; and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, most due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex; age (younger adults, but not children); obesity; anaesthetist seniority (junior trainees); previous awareness; out-of-hours operating; emergencies; type of surgery (obstetric, cardiac, thoracic); and use of neuromuscular blockade. The following factors were

  18. Nurses management of post-operative pain.

    PubMed

    Buckley, H

    2000-06-01

    Nurses have the responsibility of adequately managing patients' post-operative pain. This literature review assesses whether nurses' management of post-operative pain is adequate or not, according to the literature findings. The findings reveal that nurses' management of patients' post-operative pain is not adequate and implies the concurrent need for improved nurse education and practice. The findings also indicate a need for ongoing research of this phenomenon. PMID:11855003

  19. Adaptive and regulatory mechanisms in aged rats with postoperative cognitive dysfunction

    PubMed Central

    Bi, Yanlin; Liu, Shuyun; Yu, Xinjuan; Wang, Mingshan; Wang, Yuelan

    2014-01-01

    Inflammation may play a role in postoperative cognitive dysfunction. 5′ Adenosine monophosphate-activated protein kinase, nuclear factor-kappa B, interleukin-1β, and tumor necrosis factor-α are involved in inflammation. Therefore, these inflammatory mediators may be involved in postoperative cognitive dysfunction. Western immunoblot analysis revealed 5′ adenosine monophosphate-activated protein kinase and nuclear factor-kappa B in the hippocampus of aged rats were increased 1–7 days after splenectomy. Moreover, interleukin-1β and tumor necrosis factor-α were upregulated and gradually decreased. Therefore, these inflammatory mediators may participate in the splenectomy model of postoperative cognitive dysfunction in aged rats. PMID:25206851

  20. Comparison of Values in 5th, 6th, 7th and 8th Grade Primary Education Music Class Students'? Workbooks According to Rokeach?s and Akbas's Value Classifications

    ERIC Educational Resources Information Center

    Çakirer, H. Serdar

    2014-01-01

    The aim of the present study is to compare the values in the songs of 5th, 6th, 7th and 8th grade primary education music classes students? workbooks according to the value categorizations proposed by Rockeach and Akbas and which values among the categories mentioned are taught to the students in the 5th, 6th, 7th and 8th grade primary education…

  1. Anxiolytic use in the postoperative care unit.

    PubMed

    Jellish, W Scott; O'Rourke, Michael

    2012-09-01

    Postoperative anxiety has received less attention historically than preoperative anxiety. Recognition that anxiety occurs throughout the perioperative period has led to increased interest in identifying and treating anxiety in the postoperative period. This article outlines the causes of postoperative anxiety, how it is classified, the effects of anxiety on outcomes after surgery, and some of the clinical procedures that produce the highest levels of anxiety for patients. In addition, an attempt is made to delineate the major risk factors for developing postoperative anxiety and the classic therapeutic modalities used to reduce symptoms and treat the psychological manifestations of anxiety. PMID:22989589

  2. Using Community-based Participatory Research to Adapt keepin’ it REAL: Creating a Socially, Developmentally, and Academically Appropriate Prevention Curriculum for 5th Graders

    PubMed Central

    Harthun, Mary L.; Dustman, Patricia A.; Reeves, Leslie J.; Marsiglia, Flavio F.; Hecht, Michael L.

    2010-01-01

    This paper reports on a process in which program designers, classroom teachers, and students worked together to adapt the 7th grade “keepin’ it REAL” prevention curriculum to a developmentally, socially, and academically appropriate curriculum for 5th graders. A Community-Based Participatory Research methodology (CBPR), combined with a 9-step adaptation model, emphasized a collaborative approach, both transformative and empowering. Essential adaptation elements were the Risk-to-Resiliency Continuum; the teaching of a wide range of skills including risk assessment, decision making, and resistance strategies; and, maintaining the theoretical grounding of Narrative Theory, Communication Competence, and Focus Theory of Norms. This paper describes how CBPR methodology can be conducted successfully while focusing on sustained theoretical grounding and effective research practices in a school-based setting. PMID:21057596

  3. Investigation of the aerodynamic performance and noise characteristics of a 1/5th scale model of the Dowty Rotol R212 propeller

    NASA Astrophysics Data System (ADS)

    Trebble, W. J. G.

    1983-11-01

    The four-bladed Dowty Rotol R212 propeller (NACA 16 sections) was studied at 1/5th scale (0.7 m diameter) in 1.5 m acoustic tunnel. Propeller power absorption and thrust were measured over a range of rotational speeds up to 8000 rev/min at mainstream speeds from 15 to 60 m/sec for a range of blade settings. Slipstream wake surveys show outward movement of the position of the peak pressure as propeller loading is increased. Noise analysis demonstrates the predominance of multiple tones whose number and intensity increase with helical-tip Mach number. An empirical formula shows that the fundamental tone sound pressure level varies with tip speed and power loading in an identical manner to that observed on an ARA-D section propeller.

  4. [Synthesis of juvenile hormones in vitro by the corpora allata of 5th stage larva of Locusta migratoria migratorioides (R and F) (Insecta, Orthopteroida)].

    PubMed

    Caruelle, J P; Baehr, J C; Cassier, P

    1979-04-01

    Corpora allata of Locusta migratoria 5th stage larvae synthesize J.H.1, J.H.2 and J.H.3 in vitro. The C.A. of insects of different ages exbit different rates of J.H. synthesis. J.H.1 and J.H.2 synthesis is less than 1 ng/48 h/gland. During the same time the J.H.3 production may be as much as 25.6 ng/gland. J.H. synthetic activity is the same between right and left C.A. The release of J.H. from the C.A. occurs immediately following synthesis. These results are compared with in vivo haemolymphatic J.H. levels. PMID:113127

  5. Systematically frameshifting by deletion of every 4th or 4th and 5th nucleotides during mitochondrial transcription: RNA self-hybridization regulates delRNA expression.

    PubMed

    Seligmann, Hervé

    2016-01-01

    In mitochondria, secondary structures punctuate post-transcriptional RNA processing. Recently described transcripts match the human mitogenome after systematic deletions of every 4th, respectively every 4th and 5th nucleotides, called delRNAs. Here I explore predicted stem-loop hairpin formation by delRNAs, and their associations with delRNA transcription and detected peptides matching their translation. Despite missing 25, respectively 40% of the nucleotides in the original sequence, del-transformed sequences form significantly more secondary structures than corresponding randomly shuffled sequences, indicating biological function, independently of, and in combination with, previously detected delRNA and thereof translated peptides. Self-hybridization decreases delRNA abundances, indicating downregulation. Systematic deletions of the human mitogenome reveal new, unsuspected coding and structural informations. PMID:27018206

  6. Parasite-Antigen Driven Expansion of IL-5− and IL-5+ Th2 Human Subpopulations in Lymphatic Filariasis and Their Differential Dependence on IL-10 and TGFβ

    PubMed Central

    Anuradha, Rajamanickam; George, Parakkal Jovvian; Hanna, Luke E.; Chandrasekaran, Vedachalam; Kumaran, P. Paul; Nutman, Thomas B.; Babu, Subash

    2014-01-01

    Background Two different Th2 subsets have been defined recently on the basis of IL-5 expression – an IL-5+Th2 subset and an IL-5−Th2 subset in the setting of allergy. However, the role of these newly described CD4+ T cells subpopulations has not been explored in other contexts. Methods To study the role of the Th2 subpopulation in a chronic, tissue invasive parasitic infection (lymphatic filariasis), we examined the frequency of IL-5+IL-4+IL-13+ CD4+ T cells and IL-5−IL-4 IL-13+ CD4+ T cells in asymptomatic, infected individuals (INF) and compared them to frequencies (Fo) in filarial-uninfected (UN) individuals and to those with filarial lymphedema (CP). Results INF individuals exhibited a significant increase in the spontaneously expressed and antigen-induced Fo of both Th2 subpopulations compared to the UN and CP. Interestingly, there was a positive correlation between the Fo of IL-5+Th2 cells and the absolute eosinophil and neutrophil counts; in addition there was a positive correlation between the frequency of the CD4+IL-5−Th2 subpopulation and the levels of parasite antigen – specific IgE and IgG4 in INF individuals. Moreover, blockade of IL-10 and/or TGFβ demonstrated that each of these 2 regulatory cytokines exert opposite effects on the different Th2 subsets. Finally, in those INF individuals cured of infection by anti-filarial therapy, there was a significantly decreased Fo of both Th2 subsets. Conclusions Our findings suggest that both IL-5+ and IL-5−Th2 cells play an important role in the regulation of immune responses in filarial infection and that these two Th2 subpopulations may be regulated by different cytokine-receptor mediated processes. PMID:24498448

  7. Ethics of treating postoperative pain.

    PubMed

    Jones, James W; McCullough, Laurence B

    2012-02-01

    You received a call advising that Mr S. H. Irk was in the emergency room having considerable wound pain following an above-knee amputation you performed 6 months ago. You discharged him from your clinic 6 weeks postoperatively to his primary care physician, still complaining of more pain than usual. Your examination, clinical lab tests, and X-rays do not reveal any serious problems, but he is writhing in pain and begging for relief. Mr Irk has been to a number of different physicians in the interlude including a chiropractor, a pain specialist, several primary care physicians, and a psychiatrist without relief. He has braced up with increasing amounts of analgesics, the latest of which was oral Dilaudid. His last source of pain meds on the street has dried up. You admit him with orders for analgesics. What should your treatment plan be? PMID:22264808

  8. 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.

  9. Markov chain evaluation of acute postoperative pain transition states.

    PubMed

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

    2016-03-01

    Previous investigations on acute postoperative pain dynamicity have focused on daily pain assessments, and so were unable to examine intraday variations in acute pain intensity. We analyzed 476,108 postoperative acute pain intensity ratings, which were clinically documented on postoperative days 1 to 7 from 8346 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 0 to state 0. 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 0 from the current state. An 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 0 (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 using Markov chains is 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

  10. Gender Affects Early Postoperative Outcomes of Rotator Cuff Repair

    PubMed Central

    Ye, Hee-Uk; Jung, Jae-Won; Lee, Young-Kuk

    2015-01-01

    Background The literature does not provide consistent information on the impact of patients' gender on recovery after rotator cuff repair. The purpose of this study was to determine whether gender affects pain and functional recovery in the early postoperative period after rotator cuff repair. Methods Eighty patients (40 men and 40 women) were prospectively enrolled. Pain intensity and functional recovery were evaluated, using visual analog scale (VAS) pain score and range of motion on each of the first 5 postoperative days, at 2 and 6 weeks and at 3, 6, and 12 months after surgery. Perioperative medication-related adverse effects and postoperative complications were also assessed. Results The mean VAS pain score was significantly higher for women than men at 2 weeks after surgery (p = 0.035). For all other periods, there was no significant difference between men and women in VAS pain scores, although women had higher scores than men. Mean forward flexion in women was significantly lower than men at 6 weeks after surgery (p = 0.033) and the mean degree of external rotation in women was significantly lower than men at 6 weeks (p = 0.007) and at 3 months (p = 0.017) after surgery. There was no significant difference in medication-related adverse effects or postoperative complications. Conclusions Women had more pain and slower recovery of shoulder motion than men during the first 3 months after rotator cuff repair. These findings can serve as guidelines for pain management and rehabilitation after surgery and can help explain postoperative recovery patterns to patients with scheduled rotator cuff repair. PMID:26217471

  11. Nuclear Electricity. 5th Edition.

    ERIC Educational Resources Information Center

    Hore-Lacy, Ian

    Educators must address the need for young people to be informed about both the scientific concepts and the reasons for controversy when dealing with controversial issues. Young people must be given the opportunity to form their own opinions when presented with evidence for conflicting arguments. Previous editions of "Nuclear Electricity" have…

  12. Environmental chemistry. 5th edition

    SciTech Connect

    Manahan, S.E. . Dept. of Chemistry)

    1991-01-01

    This book is organized around several major sections: aquatic Chemistry, atmospheric chemistry, the geosphere and hazardous wastes, toxicological chemistry, and resources and energy. Specific topics discussed in the book include a general introduction to environment chemistry, basic principles of aquatic chemistry, water pollution and water treatment, the essential role of microorganisms in aquatic chemical phenomena, atmospheric chemistry, a discussion of major threats to the global atmosphere (particularly greenhouse gases and ozone-depleting chemicals), the geosphere and hazardous substances, soil chemistry, and the nature and sources of hazardous wastes. The environmental chemistry of hazardous wastes, their treatment, minimization, and recycling, and the effects of these hazardous substances in also presented.

  13. 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.

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

    PubMed

    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

  15. 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

  16. Correlation of fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer

    PubMed Central

    Xing, Xuezhong; Wang, Haijun; Qu, Shining; Huang, Chulin; Zhang, Hao; Wang, Hao; Sun, Kelin

    2015-01-01

    Background To investigate the association between fluid balance and postoperative pulmonary complications in patients after esophagectomy for cancer in a high volume cancer center. Methods Data of patients who admitted to intensive care unit (ICU) after esophagectomy at Cancer Hospital of Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) between September 2008 and October 2010 were retrospectively collected and reviewed. Results There were 85 males and 15 females. Among them, 39 patients developed postoperative pulmonary complications and hospital death was observed in 3 patients (3.0%). Univariable analysis showed that patients who developed postoperative pulmonary complications had more cumulative fluid balance in day 1 to 2 (2,669±1,315 vs. 3,815±1,353 mL, P<0.001; and 4,307±1,627 vs. 5,397±2,040 mL, P=0.014, respectively) compared with patients who did not have postoperative pulmonary complications. Multivariable regression analysis demonstrated that only more cumulative fluid balance in day 1 (P=0.008; OR =1.001; 95% CI, 1.000-1.002) was independent risk factor for postoperative pulmonary complications. Conclusions Positive fluid balance in postoperative day 1 is predictive of pulmonary complications in patients after esophagectomy for cancer. PMID:26716037

  17. Acute postoperative pain predicts chronic pain and long-term analgesic requirements after breast surgery for cancer.

    PubMed

    Fassoulaki, A; Melemeni, A; Staikou, C; Triga, A; Sarantopoulos, C

    2008-01-01

    Postoperative pain and analgesic requirements may be associated with chronic pain. The aim of the study was to investigate this association. We studied 98 patients who had cancer breast surgery and served as controls in four previous studies, receiving placebo. We compared the pain and analgesic requirements 0-9 h and 1-6 days postoperatively: a) between patients with chronic pain 3 months postoperatively versus patients without and b) between those patients who consumed analgesics at home versus those who did not. Patients with chronic pain had experienced higher intensity pain at rest the first 9 postoperative hours (VAS-rest p = 0.033). Patients requiring analgesics at home had consumed postoperatively more opioids (p = 0.005) and more paracetamol (p = 0.037). These patients had experienced pain of higher intensity the first 9 postoperative hours (VAS-rest p = 0.022, VAS-movement p = 0.009) as well as during the six postoperative days (VAS-rest p = 0.013, VAS-movement p = 0.001). Higher intensities of acute postoperative pain are associated with chronic pain development. Higher analgesic needs and higher acute postoperatively pain intensity are associated with long-term analgesic consumption. PMID:19235522

  18. 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

  19. Improving the management of postoperative pain.

    PubMed

    Layzell, Mandy

    Despite developments in knowledge of pain control, many patients still experience unnecessary postoperative pain. This article reports on an audit of postoperative pain and its management in one trust. The results led to the development of a new system using standard prescriptions to empower nurses to manage patients' pain. PMID:16010842

  20. Evaluation of progestogens for postoperative adhesion prevention.

    PubMed

    Beauchamp, P J; Quigley, M M; Held, B

    1984-10-01

    Progesterone (P) has been shown to have potent antiinflammatory and immunosuppressive properties. Previous reports have suggested that the use of P decreases postoperative adhesion formation. To further evaluate the role of pharmacologic doses of progestogens in adhesion prevention, 42 mature New Zealand White rabbits underwent standardized injuries to the uterine horns, fimbriae, and pelvic peritoneum and received one of six treatments. Group S had intraperitoneal placement of normal saline (0.9%); group H received intraperitoneal placement of 32% dextran 70; group IM-P received intramuscular P-in-oil 10 days before and after laparotomy in addition to intraperitoneal saline; group IP-P had intraperitoneal placement of an aqueous P suspension; group DP received medroxyprogesterone acetate intraperitoneally; and group C received no intramuscular or intraperitoneal adhesion-prevention agents. The animals were sacrificed 6 weeks after laparotomy, and the adhesions were scored. Intraperitoneal saline (group S) significantly reduced the amount of adhesions when compared with the control group (C) (P less than 0.05). No significant difference was observed when group S was compared with group H. Intramuscular P added to saline (group IM-P) did not cause further reduction in adhesions when compared with group S. Both group IP-P and group DP had more adhesions than did group S (P less than 0.01). These data fail to support previous claims regarding adhesion prevention by the use of locally or parenterally administered progestogens. PMID:6237937

  1. 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

  2. Postoperative Outcomes After Robotic Versus Abdominal Myomectomy

    PubMed Central

    Griffin, Leanne; Feinglass, Joe; Garrett, Ariane; Henson, Anne; Cohen, Leeber; Chaudhari, Angela

    2013-01-01

    Background and Objectives: Differences in postoperative outcomes comparing robotic-assisted laparoscopic myomectomy (RALM) with abdominal myomectomy (AM) have rarely been reported. The objective of this study was to compare surgical, quality-of-life, and residual fibroid outcomes after RALM and AM. Methods: Consecutive patients who underwent RALM (n = 16) were compared with AM patients (n = 23) presenting with a uterine size of <20 weeks. Study patients participated in a telephone interview at 6 weeks and underwent a no-cost ultrasonographic examination at 12 weeks after surgery to obtain quality-of-life and residual fibroid outcomes. Medical records were reviewed to obtain surgical outcomes. Results: Longer operative times (261.1 minutes vs 124.8 minutes, P < .001) and a 3-fold unfavorable difference in operative efficiency (73.7 g vs 253.0 g of specimen removed per hour, P < .05) were observed with RALM compared with AM. Patients undergoing RALM had shorter lengths of hospital stay (1.5 days vs 2.7 days, P < .001). Reduction of patient symptoms and overall satisfaction were equal. RALM patients were more likely to be back to work within 1 month (85.7% vs 45.0%, P < .05). Residual fibroid volume in the RALM group was 5 times greater than that in the AM group (17.3 cm3 vs 3.4 cm3, P < .05). Conclusion: RALM and AM were equally efficacious in improving patient symptoms. Although operative times were significantly longer with RALM, patients had a quicker recovery, demonstrated by shortened lengths of stay and less time before returning to work. However, greater residual fibroid burden was observed with RALM when measured 12 weeks after surgery. PMID:24018077

  3. Teaching a Machine to Feel Postoperative Pain: Combining High-Dimensional Clinical Data with Machine Learning Algorithms to Forecast Acute Postoperative Pain

    PubMed Central

    Tighe, Patrick J.; Harle, Christopher A.; Hurley, Robert W.; Aytug, Haldun; Boezaart, Andre P.; Fillingim, Roger B.

    2015-01-01

    Background Given their ability to process highly dimensional datasets with hundreds of variables, machine learning algorithms may offer one solution to the vexing challenge of predicting postoperative pain. Methods Here, we report on the application of machine learning algorithms to predict postoperative pain outcomes in a retrospective cohort of 8071 surgical patients using 796 clinical variables. Five algorithms were compared in terms of their ability to forecast moderate to severe postoperative pain: Least Absolute Shrinkage and Selection Operator (LASSO), gradient-boosted decision tree, support vector machine, neural network, and k-nearest neighbor, with logistic regression included for baseline comparison. Results In forecasting moderate to severe postoperative pain for postoperative day (POD) 1, the LASSO algorithm, using all 796 variables, had the highest accuracy with an area under the receiver-operating curve (ROC) of 0.704. Next, the gradient-boosted decision tree had an ROC of 0.665 and the k-nearest neighbor algorithm had an ROC of 0.643. For POD 3, the LASSO algorithm, using all variables, again had the highest accuracy, with an ROC of 0.727. Logistic regression had a lower ROC of 0.5 for predicting pain outcomes on POD 1 and 3. Conclusions Machine learning algorithms, when combined with complex and heterogeneous data from electronic medical record systems, can forecast acute postoperative pain outcomes with accuracies similar to methods that rely only on variables specifically collected for pain outcome prediction. PMID:26031220

  4. Perioperative local infiltration anesthesia with ropivacaine has no effect on postoperative pain after total hip arthroplasty

    PubMed Central

    Hofstad, Janne Kristin; Winther, Siri B; Rian, Torbjørn; Foss, Olav A; Husby, Otto S; Wik, Tina S

    2015-01-01

    Background and purpose — The local infiltration analgesia (LIA) technique has been widely used to reduce opioid requirements and to improve postoperative mobilization following total hip arthroplasty (THA). However, the evidence for the efficacy of LIA in THA is not yet clear. We determined whether single-shot LIA in addition to a multimodal analgesic regimen would reduce acute postoperative pain and opioid requirements after THA. Patients and methods — 116 patients undergoing primary THA under spinal anesthesia were included in this randomized, double-blind, placebo-controlled trial. All patients received oral opioid-sparing multimodal analgesia: etoricoxib, acetaminophen, and glucocorticoid. The patients were randomized to receive either 150 mL ropivacaine (2 mg/mL) and 0.5 mL epinephrine (1 mg/mL) or 150 mL 0.9% saline. Rescue analgesic consisted of morphine and oxycodone as needed. The primary endpoint was pain during mobilization in the recovery unit. Secondary endpoints were pain during mobilization on the day after surgery and total postoperative opioid requirements on the first postoperative day. Results — The levels of pain during mobilization—both in the recovery unit and on the day after surgery—and consumption of opioids on the first postoperative day were similar in the 2 groups. Interpretation — LIA did not provide any extra analgesic effect after THA over and above that from the multimodal analgesic regimen used in this study. PMID:25997827

  5. Postoperative recurrence of cystic hydatidosis

    PubMed Central

    Prousalidis, John; Kosmidis, Christophoros; Anthimidis, Georgios; Kapoutzis, Konstantinos; Karamanlis, Eleutherios; Fachantidis, Epaminondas

    2012-01-01

    Background Surgical management is the basic treatment for hydatid disease. Overall, the recurrence rate appears to be high (4.6%–22.0%). The purpose of this study was to report our results in the management of recurrent hydatid disease, evaluating the methods for identifying recurrence, prognostic factors and therapeutic options. Methods We retrospectively reviewed the medical records of patients who underwent surgery for cystic hydatidosis between 1970 and 2003. Results Of the 584 patients who underwent surgery during our study period, follow-up was complete for 484 (82.8%). Cysts recurred in 51 patients (8.7%). Abdominal ultrasonography and computed tomography appeared to be efficient for diagnosing recurrence. The 2 most important determinants for recurrence were minute spillage of the hydatid cyst and inadequate treatment owing to missing cysts or incomplete pericystectomy. All but 2 recurrences required surgery. There were 14 postoperative complications for a rate of 27.0%. Thirteen re-recurrences were observed in the follow-up of these patients and also required surgery. Conclusion Avoidance of minute spillage of cyst contents and cautious removal of the parasite with as much of the pericyst as possible are fundamental objectives of primary hydatid surgery. Conservative surgery (removal of the cyst contents plus partial pericystectomy with drainage when necessary) plus chemotherapy and local sterilization is suggested for both primary and secondary operations and appears to achieve satisfactory long-term results. Radical surgery (resection, cystopericystectomy) is preferred only in select patients. PMID:21939605

  6. Offshore observations of aftershocks following the January 5th 2013 Mw 7.5 Queen Charlotte-Fairweather fault earthquake, southeast Alaska

    NASA Astrophysics Data System (ADS)

    Roland, E. C.; Gulick, S. P.; Levoir, M. A.; Haeussler, P. J.

    2013-12-01

    We present initial results from a rapid-response ocean bottom seismometer (OBS) deployment that recorded aftershock activity on the Queen Charlotte-Fairweather (QC-F) fault following the Mw 7.5 earthquake on January 5th 2013 near Craig, Alaska. This earthquake was the second of two Mw > 7 events on this fault system in a 3 month time period; the Craig earthquake followed a Mw 7.8 thrust event that occurred in October 2012, west of Haida Gwaii, British Columbia. Although the QC-F is a major plate boundary fault, little is known about the regional fault structure, interseismic coupling, and rheological controls on the depth distribution of seismic slip along the continent-ocean transform. The majority of the QC-F fault system extends offshore western British Columbia and southeast Alaska, making it difficult to characterize earthquakes and fault deformation with land-based seismic and geodetic instruments. This experiment is the first ever offshore seismometer deployment to record earthquake activity along this northern segment of the QC-F system, and was set in motion with help from the US Coast Guard, who provided a vessel and crew to deploy and recover the OBS array on short notice. The seismic array utilized 6 GeoPro short period OBS from the University of Texas Institute for Geophysics, which recorded approximately 3 weeks of aftershock activity in April-May of 2013. Combining high-quality local OBS recordings with land-based seismic observations from Alaska Earthquake Information Center (AEIC) stations to the east, we present more precise aftershock locations and depths that help to better characterize fault zone architecture along the northern section of the QC-F. Although moment tensor solutions indicate that the January 5th mainshock sustained slip consistent with Pacific-North America plate motions, aftershock focal mechanisms indicate some interaction with neighboring faults, such as the Chatham Straight fault. This new OBS dataset will also help to

  7. The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent and medicolegal issues.

    PubMed

    Cook, T M; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Pandit, J J

    2014-10-01

    The 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia yielded data related to psychological aspects from the patient, and the anaesthetist, perspectives; patients' experiences ranged from isolated auditory or tactile sensations to complete awareness. A striking finding was that 75% of experiences were for < 5 min, yet 51% of patients (95% CI 43-60%) experienced distress and 41% (95% CI 33-50%) suffered longer-term adverse effect. Distress and longer-term harm occurred across the full range of experiences but were particularly likely when the patient experienced paralysis (with or without pain). The patient's interpretation of what is happening at the time of the awareness seemed central to later impact; explanation and reassurance during suspected accidental awareness during general anaesthesia or at the time of report seemed beneficial. Quality of care before the event was judged good in 26%, poor in 39% and mixed in 31%. Three quarters of cases of accidental awareness during general anaesthesia (75%) were judged preventable. In 12% of cases of accidental awareness during general anaesthesia, care was judged good and the episode not preventable. The contributory and human factors in the genesis of the majority of cases of accidental awareness during general anaesthesia included medication, patient and education/training. The findings have implications for national guidance, institutional organisation and individual practice. The incidence of 'accidental awareness' during sedation (~1:15 000) was similar to that during general anaesthesia (~1:19 000). The project raises significant issues about information giving and consent for both sedation and anaesthesia. We propose a novel approach to describing sedation from the patient's perspective which could be used in communication and consent. Eight (6%) of the patients had resorted

  8. Xylitol Gum Chewing to Achieve Early Postoperative Restoration of Bowel Motility After Laparoscopic Surgery.

    PubMed

    Gong, Yunhui; Zhang, Qianwen; Qiao, Lin; Lv, Donghao; Ruan, Jiaying; Chen, Hongqin; Gong, Junming; Shi, Gang

    2015-08-01

    Our objective was to evaluate the effects of postoperative xylitol gum chewing on gastrointestinal functional recovery after laparoscopy. Altogether, 120 patients undergoing elective gynecologic laparoscopy were randomly divided into 2 groups of 60 each (final numbers: 53 controls, 56 patients). Controls underwent a routine postoperative regimen. Starting 6 hour after surgery, study patients chewed mint-flavored, sugarless xylitol gum until flatus occurred thrice a day. Other postoperative management was routine. First bowel sounds, first flatus, first bowel movement, and discharge times were recorded. Symptoms included abdominal distension, nausea, and vomiting. First flatus and first bowel sounds occurred significantly (P<0.001) earlier in the study patients. No significant differences were found for first defecation time, hospitalization duration, or mild/severe intestinal obstruction (all P>0.05). Thus, xylitol gum chewing after laparoscopy can effectively shorten the time to first flatus and helps with postoperative gastrointestinal functional recovery. It is simple, convenient, and well tolerated. PMID:26121546

  9. Cornelia de Lange syndrome: further delineation of phenotype, cohesin biology and educational focus, 5th Biennial Scientific and Educational Symposium abstracts.

    PubMed

    Kline, Antonie D; Calof, Anne L; Schaaf, Cheri A; Krantz, Ian D; Jyonouchi, Soma; Yokomori, Kyoko; Gauze, Maria; Carrico, Cheri S; Woodman, Julie; Gerton, Jennifer L; Vega, Hugo; Levin, Alex V; Shirahige, Katsuhiko; Champion, Michele; Goodban, Marjorie T; O'Connor, Julia T; Pipan, Mary; Horsfield, Julia; Deardorff, Matthew A; Ishman, Stacey L; Dorsett, Dale

    2014-06-01

    Cornelia de Lange syndrome (CdLS) is the prototype for the cohesinopathy disorders that have mutations in genes associated with the cohesin subunit in all cells. Roberts syndrome is the next most common cohesinopathy. In addition to the developmental implications of cohesin biology, there is much translational and basic research, with progress towards potential treatment for these conditions. Clinically, there are many issues in CdLS faced by the individual, parents and caretakers, professionals, and schools. The following abstracts are presentations from the 5th Cornelia de Lange Syndrome Scientific and Educational Symposium on June 20-21, 2012, in conjunction with the Cornelia de Lange Syndrome Foundation National Meeting, Lincolnshire, IL. The research committee of the CdLS Foundation organizes the meeting, reviews and accepts abstracts and subsequently disseminates the information to the families. In addition to the basic science and clinical discussions, there were educationally-focused talks related to practical aspects of management at home and in school. AMA CME credits were provided by Greater Baltimore Medical Center, Baltimore, MD. PMID:24504889

  10. Consensus for Radiotherapy in Hepatocellular Carcinoma from The 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials

    PubMed Central

    Park, Hee Chul; Yu, Jeong Il; Cheng, Jason Chia-Hsien; Zeng, Zhao Chong; Hong, Ji Hong; Wang, Michael Lian Chek; Kim, Mi Sook; Chi, Kwan Hwa; Liang, Po-Ching; Lee, Rheun-Chuan; Lau, Wan-Yee; Han, Kwang Hyub; Chow, Pierce Kah-Hoe; Seong, Jinsil

    2016-01-01

    A consensus meeting to develop practice guidelines and to recommend future clinical trials for radiation therapy (RT), including external beam RT (EBRT), and selective internal RT (SIRT) in hepatocellular carcinoma (HCC) was held at the 5th annual meeting of the Asia-Pacific Primary Liver Cancer Expert consortium. Although there is no randomized phase III trial evidence, the efficacy and safety of RT in HCC has been shown by prospective and retrospective studies using modern RT techniques. Based on these results, the committee came to a consensus on the utility and efficacy of RT in the management of HCC according to each disease stage as follows: in early and intermediate stage HCC, if standard treatment is not compatible, RT, including EBRT and SIRT can be considered. In locally advanced stage HCC, combined EBRT with transarterial chemoembolization or hepatic arterial infusion chemotherapy, and SIRT can be considered. In terminal stage HCC, EBRT can be considered for palliation of symptoms and reduction of morbidity caused by the primary tumor or its metastases. Despite the currently reported benefits of RT in HCC, the committee agreed that there is a compelling need for large prospective studies, including randomized phase III trial evidence evaluating the role of RT. Specifically studies evaluating the efficacy and safety of sequential combination of EBRT and SIRT are strongly recommended. PMID:27493892

  11. Vitamin D status and associated occupational factors in Korean wage workers: data from the 5th Korea national health and nutrition examination survey (KNHANES 2010–2012)

    PubMed Central

    2014-01-01

    Objectives Vitamin D deficiency is increasing worldwide. However, few studies have attempted to examine the vitamin D status of wage workers and the correlation between vitamin D deficiency and working conditions. Hence, we aimed to evaluate the prevalence of vitamin D deficiency and the association between occupational conditions and vitamin D deficiency among Korean wage workers. Methods Wage workers aged 20–65 years from the 5th Korea National Health and Nutrition Examination Survey (KNHANES 2010–2012; n = 5409) were included in our analysis. We measured the prevalence of vitamin D deficiency and identified the correlations with the working conditions of these subjects. Results The prevalence of vitamin D deficiency in male and female subjects was 69.5% and 83.1%, respectively. Among the male subjects, a significant correlation between vitamin D deficiency and working conditions was observed among shift workers, office workers, and permanent workers. No significant correlation with any type of working conditions was observed among female subjects. Conclusion The prevalence of vitamin D deficiency among Korean wage workers was very high and was found to correlate significantly with working conditions, likely because of insufficient exposure to sunlight associated with certain types of work. Wage workers require more frequent outdoor activity and nutrition management to maintain sufficient vitamin D level. PMID:25852939

  12. [The current situation and issues of medical English education and suggestions toward improvement--reports from the 5th meeting of the Japan Society for Medical English Education].

    PubMed

    Ohashi, Hiroshi

    2002-12-01

    This is a report from the 5th academic meeting of the Japan Society for Medical English Education held at Kawasaki University of Medical Welfare on August 3rd and 4th of 2002. It also includes a course description of our English courses, their problems and some suggestions for improvement. First, I report several papers presented at the meeting that are useful and suggestive for the English education at our university in order to bring them to everyone's attention and to improve our English program. The topics of the papers include; what "Medical English" is; reports of English courses taught by medical doctors; reports of English courses for developing specific proficiencies such as listening, writing summaries and delivering oral presentations. Next, I give a course description of our present English program and point out some problems that should be dealt with. In this connection, I make several suggestions for future improvement. Lastly, I refer to the "strategies to educate the Japanese who can use English", which were proposed recently by the Ministry of Education, Culture, Sports, Science and Technology and suggest our improvement be in line with these strategies. PMID:12506860

  13. Consensus for Radiotherapy in Hepatocellular Carcinoma from The 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials.

    PubMed

    Park, Hee Chul; Yu, Jeong Il; Cheng, Jason Chia-Hsien; Zeng, Zhao Chong; Hong, Ji Hong; Wang, Michael Lian Chek; Kim, Mi Sook; Chi, Kwan Hwa; Liang, Po-Ching; Lee, Rheun-Chuan; Lau, Wan-Yee; Han, Kwang Hyub; Chow, Pierce Kah-Hoe; Seong, Jinsil

    2016-07-01

    A consensus meeting to develop practice guidelines and to recommend future clinical trials for radiation therapy (RT), including external beam RT (EBRT), and selective internal RT (SIRT) in hepatocellular carcinoma (HCC) was held at the 5th annual meeting of the Asia-Pacific Primary Liver Cancer Expert consortium. Although there is no randomized phase III trial evidence, the efficacy and safety of RT in HCC has been shown by prospective and retrospective studies using modern RT techniques. Based on these results, the committee came to a consensus on the utility and efficacy of RT in the management of HCC according to each disease stage as follows: in early and intermediate stage HCC, if standard treatment is not compatible, RT, including EBRT and SIRT can be considered. In locally advanced stage HCC, combined EBRT with transarterial chemoembolization or hepatic arterial infusion chemotherapy, and SIRT can be considered. In terminal stage HCC, EBRT can be considered for palliation of symptoms and reduction of morbidity caused by the primary tumor or its metastases. Despite the currently reported benefits of RT in HCC, the committee agreed that there is a compelling need for large prospective studies, including randomized phase III trial evidence evaluating the role of RT. Specifically studies evaluating the efficacy and safety of sequential combination of EBRT and SIRT are strongly recommended. PMID:27493892

  14. [Acute myocardial infarction in the postoperative period following pneumonectomy].

    PubMed

    López Alvarez, S; Bonome González, C; Izquierdo Villarroya, B; Barbeito Vilariño, M J; Etxainz Alvarez, A; Alvarez Refojo, F

    2002-11-01

    A 72-year-old man, smoker, with insuline-dependent diabetes and dislipemia underwent left pneumonectomy. Several episodes of intraoperative hemodynamic instability associated with electrocardiographic ST segment alterations were attributed to surgical manipulation; ischemia was not suspected. Cardiorespiratory failure, related to extensive anterior infarction, developed a few minutes after admission to the postoperative intensive care unit (PICU). Cardiopulmonary resuscitation and mechanical ventilation were required. The patient responded to treatment with beta blockers, platelet antiaggregants and statins. Tube was removed a few hours later and the patient was discharged from the PICU on the fifth day. Pneumonectomy has a high rate of morbidity and mortality, with complications mainly arising in the lung and heart. Risk from anesthesia is considered to be great in this procedure, and for that reason it is essential to identify intraoperative myocardial ischemia so that it can be treated aggressively. In patients at high cardiovascular risk who undergo lung resection, intraoperative episodes of myocardial ischemia are associated with a high incidence of postoperative miocardial infarction. Therefore, careful postoperative monitoring is needed and measures should be taken to prevent angina. Early extubation should be avoided. PMID:12516493

  15. [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. PMID:25892605

  16. Comparison of postoperative pain: piezoelectric device versus microdrill.

    PubMed

    Crippa, Barbara; Salzano, Francesco Antonio; Mora, Renzo; Dellepiane, Massimo; Salami, Angelo; Guastini, Luca

    2011-09-01

    Piezosurgery® is a recently developed system for cutting bone with microvibrations. The objective of this study was to compare the severity of pain over the first 10 postoperative days in a group of 70 patients who underwent intact canal wall mastoidectomy, with the piezoelectric device, and to compare the results with traditional method by means of microdrill (70 patients). The subjective perception of pain was evaluated on a scale from 0 to 10, such that 0 represented no pain and 10 represented maximum pain; the severity was recorded as null when the score was 0; slight, when it was 1-4; moderate, when it was 5-7; or severe, when it was 8-10. Compared with microdrill, the patients that underwent surgery with the piezoelectric device showed a significant (P < 0.05) lower postoperative pain on day 1 (52 vs. 26 patients presented a slight pain, 12 vs. 37 presented a moderate pain, and 6 vs. 7 presented a severe pain) and day 3 (68 vs. 44 patients presented a slight pain, 2 vs. 23 presented a moderate pain, and 0 vs. 3 presented a severe pain). These results highlight as the piezoelectric device is a safe and minimally invasive tool. PMID:21327729

  17. Naproxen 500 mg bid versus acetaminophen 1000 mg qid: effect on swelling and other acute postoperative events after bilateral third molar surgery.

    PubMed

    Bjørnsson, G A; Haanaes, H R; Skoglund, L A

    2003-08-01

    A controlled, randomized, double-blind crossover study, in which the patients acted as their own controls, was carried out to test the efficacy of naproxen 500 mg x 2 versus acetaminophen 1000 mg x 4 for 3 days on the postoperative course following third molar surgery. Acetaminophen reduced the mean swelling on the 3rd postoperative day by 22.4% (p = 0.023) compared to that after naproxen. On the 6th postoperative day, there was 20.9% less mean swelling with naproxen (p = 0.44), although the total swelling measurements were much less than those measured on the 3rd postoperative day. Summed pain intensity (SUMPI3.5-11) on the day of surgery revealed no statistically significant difference between the acetaminophen or naproxen regimen with the exception of 0.5 hours (p = 0.002) and 1 hour (p = 0.009) after first medication when acetaminophen gave less pain than naproxen. Since the drug regimens were different, summed PI for the first acetaminophen dose interval (SUMPI3.5-6) and the first naproxen dose interval (SUMPI3.5-9) was calculated. There was a tendency toward a statistically significant difference in favor of acetaminophen for SUMPI3.5-6 (p = 0.055) but no statistically significant difference (p = 0.41) between the treatments with respect to SUMPI3.5-9. Naproxen was statistically superior (p < or = 0.002) to acetaminophen at 08:00, 12:00, and 16:00 hours on the 1st postoperative day and at 08:00 hours on the 2nd postoperative day, when the pain intensity level was lower than that on the day of surgery. A 3-day acetaminophen regimen reduces acute postoperative swelling better than naproxen on the 3rd postoperative day after third molar surgery but not on the 6th postoperative day when the total swelling is less. PMID:12953342

  18. 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…

  19. Postoperative ultrasonography of the musculoskeletal system

    PubMed Central

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-01-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  20. [Management of postoperative hemorrhage following thyroid surgery].

    PubMed

    Lorenz, K; Sekulla, C; Kern, J; Dralle, H

    2015-01-01

    The incidence of postoperative hemorrhage following thyroid surgery stands at 1%-2 %. This low incidence contrasts with the significant potential complications of postoperative hemorrhage. Influencing factors and measures mentioned in the literature and own studies are discussed. Although an improvement in the postoperative hemorrhage rate was to be expected indirectly due to the increasing use of coagulation-relevant medication, there has been neither an increase in incidence nor a reduction in resultant complications, including primarily recurrent vocal cord paresis, tracheotomy and mortality. Factors that influence surgical success include a meticulous technique and caution, as well as ensuring intensive and qualified postoperative monitoring for a minimum of 4-6 h, thereby permitting immediate revision surgery at any time. PMID:25532753

  1. Efficacy of intrathecal esmolol on heat-evoked responses in a postoperative pain model.

    PubMed

    Ono, Hitomi; Ohtani, Norimasa; Matoba, Atsuko; Kido, Kanta; Yasui, Yutaka; Masaki, Eiji

    2015-01-01

    Perioperative tachycardia and hypertension are often treated with esmolol, a short-acting β1-adrenoceptor antagonist. Besides its cardiac effect, esmolol is reported to exert antinociceptive effects. This study examined the efficacy of intrathecal (IT) esmolol on pain responses in a postoperative pain model. Male Sprague-Dawley rats (250-300 g) were anesthetized with sevoflurane and an IT catheter was implanted. Six days after catheter implantation, a postoperative pain model was established by plantar incision under sevoflurane anesthesia. Withdrawal latencies were assessed by applying a focused radiant heat source before plantar incision; 1 day after the incision (before esmolol administration); and 5, 10, and 15 minutes after bolus administration of IT esmolol. Plantar incision produced hypersensitivity in the postoperative pain model expressed as decreased withdrawal latency to heat stimulation (before incision: 13.9 ± 0.29 seconds and 1 day after incision: 6.3 ± 0.26 seconds). These decreased latencies caused by incision were significantly increased by esmolol administration (40 μg, 80 μg) at 5 minutes (10.7 ± 1.16 seconds, 10.5 ± 1.16 seconds). No postoperative antinociceptive effects of esmolol were observed at 10 or 15 minutes. IT administration of esmolol produced antinociceptive effects of short duration in a rat postoperative pain model. These results suggest that IT esmolol could offer a new strategy for managing perioperative pain, although an alternative approach is necessary to lengthen the duration of the analgesia. PMID:23411610

  2. [New approach to postoperative delirium treatment].

    PubMed

    Pasechnik, I N; Makhlaĭ, A V; Tepliakova, A N; Gubaĭdullin, R R; Sal'nikov, P S; Borisov, A Iu; Berezenko, M N

    2015-01-01

    The efficiency of different drugs for sedation was studied in 51 patients after large abdominal operations complicated by postoperative delirium. Diagnosis of postoperative delirium was established according to CAM-ICU criteria. Dexmedetomidine has demonstrated significantly decreased duration of delirium and hospital stay in intensive care unit in comparison with haloperidol. Besides, patients which received dexmedetomidine preserved opportunity for verbal contact. Also these patients interacted better with department's stuff. PMID:26031955

  3. Current issues in postoperative pain management.

    PubMed

    Rawal, Narinder

    2016-03-01

    Postoperative pain has been poorly managed for decades. Recent surveys from USA and Europe do not show any major improvement. Persistent postoperative pain is common after most surgical procedures, and after thoracotomy and mastectomy, about 50% of patients may experience it. Opioids remain the mainstay of postoperative pain treatment in spite of strong evidence of their drawbacks. Multimodal analgesic techniques are widely used but new evidence is disappointing. Regional anaesthetic techniques are the most effective methods to treat postoperative pain. Current evidence suggests that epidural analgesia can no longer be considered the 'gold standard'. Perineural techniques are good alternatives for major orthopaedic surgery but remain underused. Infiltrative techniques with or without catheters are useful for almost all types of surgery. Simple surgeon-delivered local anaesthetic techniques such as wound infiltration, preperitoneal/intraperitoneal administration, transversus abdominis plane block and local infiltration analgesia can play a significant role in improvement of postoperative care, and the last of these has changed orthopaedic practice in many institutions. Current postoperative pain management guidelines are generally 'one size fits all'. It is well known that pain characteristics such as type, location, intensity and duration vary considerably after different surgical procedures. Procedure-specific postoperative pain management recommendations are evidence based, and also take into consideration the role of anaesthetic and surgical techniques, clinical routines and risk-benefit aspects. The role of acute pain services to improve pain management and outcome is well accepted but implementation seems challenging. The need for upgrading the role of surgical ward nurses and collaboration with surgeons to implement enhanced recovery after surgery protocols with regular audits to improve postoperative outcome cannot be overstated. PMID:26509324

  4. The dynamic of nasogastric decompression after esophagectomy and its predictive value of postoperative complications

    PubMed Central

    Zhao, Yan; Guo, Jie; You, Bin; Hou, Shengcai; Hu, Bin

    2016-01-01

    Background To investigate the regularity and the influence factors of nasogastric decompression volume after esophagectomy, and explore whether the volume of nasogastric decompression can be employed as a predictor for postoperative complications of esophageal carcinoma. Methods Consecutive 247 patients with esophageal cancer who underwent esophagectomy were retrospectively evaluated. The volume of postoperative nasogastric decompression was recorded and the regularity based on it was described. The single and multiple factors regression analysis were used to find out relative factors of the nasogastric decompression volume among the patients without postoperative complication. Gender, age, height, weight, tobacco or alcohol exposure, location of the tumor, histological type, pathological staging, operation time, surgical procedures, anastomotic position and gastric conduit reconstruction were considered as the independent variable. Then, verify the former regression models using the data of patients with postoperative complications. Results In trend analysis, the curve estimation revealed a quadratic trend in the relationship between nasogastric decompression volume and postoperative days (R2 =0.890, P=0.004). The volume of postoperative nasogastric decompression was described by daily drainage (mL) =82.215 + 69.620 × days − 6.604 × days2. The results of multiple linear stepwise regression analysis showed that gastric conduit reconstruction (β=0.410, P=0.000), smoking (β=−0.231, P=0.000), age (β=−0.193, P=0.001) and histological type of the tumor (β=−0.169, P=0.006) were significantly related to the volume of nasogastric decompression. The average drainage in 5 days after surgery =262.287 + 132.873 × X1 − 72.160 × X2 − 27.904 × X3 − 36.368 × X4 (X1, gastric conduit reconstruction; X2, smoking; X3, histological type; X4, age). The nasogastric decompression of the patients with delayed gastric emptying, and lung infection statistically differ

  5. Percutaneous Management of Postoperative Duodenal Stump Leakage with Foley Catheter

    SciTech Connect

    Oh, Jung Suk Lee, Hae Giu Chun, Ho Jong; Choi, Byung Gil; Lee, Sang Hoon; Hahn, Seong Tai; Ohm, Joon Young

    2013-10-15

    Purpose: This study was designed to evaluate retrospectively the safety and efficacy of the percutaneous management of duodenal stump leakage with a Foley catheter after subtotal gastrectomy. Methods: Ten consecutive patients (M:F = 9:1, median age: 64 years) were included in this retrospective study. The duodenal stump leakages were diagnosed in all the patients within a median of 10 days (range, 6-20). At first, the patients underwent percutaneous drainage on the day of or the day after confirmation of the presence of duodenal stump leakage, and then the Foley catheters were replaced at a median of 9 days (range, 6-38) after the percutaneous drainage. Results: Foley catheters were placed successfully in the duodenal lumen of all the patients under a fluoroscopic guide. No complication was observed during and after the procedures in all the patients. All of the patients started a regular diet 1 day after the Foley catheter placement. The patients were discharged at a median of 7 days (range, 5-14) after the Foley catheter placement. The catheters were removed in an outpatient clinic 10-58 days (median, 28) after the Foley catheter placement. Conclusions: Fluoroscopy-guided percutaneous Foley catheter placement may be a safe and effective treatment option for postoperative duodenal stump leakage and may allow for shorter hospital stays, earlier oral intake, and more effective control of leakage sites.

  6. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent, and medicolegal issues.

    PubMed

    Cook, T M; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H M G; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Pandit, J J

    2014-10-01

    The 5th National Audit Project (NAP5) of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia (AAGA) yielded data related to psychological aspects from the patient, and the anaesthetist, perspectives; patients' experiences ranged from isolated auditory or tactile sensations to complete awareness. A striking finding was that 75% of experiences were for <5 min, yet 51% of patients [95% confidence interval (CI) 43-60%] experienced distress and 41% (95% CI 33-50%) suffered longer term adverse effect. Distress and longer term harm occurred across the full range of experiences but were particularly likely when the patient experienced paralysis (with or without pain). The patient's interpretation of what is happening at the time of the awareness seemed central to later impact; explanation and reassurance during suspected AAGA or at the time of report seemed beneficial. Quality of care before the event was judged good in 26%, poor in 39%, and mixed in 31%. Three-quarters of cases of AAGA (75%) were judged preventable. In 12%, AAGA care was judged good and the episode not preventable. The contributory and human factors in the genesis of the majority of cases of AAGA included medication, patient, and education/training. The findings have implications for national guidance, institutional organization, and individual practice. The incidence of 'accidental awareness' during sedation (~1:15,000) was similar to that during general anaesthesia (~1:19,000). The project raises significant issues about information giving and consent for both sedation and anaesthesia. We propose a novel approach to describing sedation from the patient's perspective which could be used in communication and consent. Eight (6%) of the patients had resorted to legal action (12, 11%, to formal complaint) at the time of reporting. NAP5 methodology provides a standardized template that might usefully inform

  7. 5th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention: summary of key research and implications for policy and practice - operations research.

    PubMed

    Kort, Rodney

    2010-01-01

    Operations research was added as a fourth scientific track to the pathogenesis conference series at the 5th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2009) in recognition of the importance of this growing research field and the need for applied research to inform and evaluate the scale up of some key interventions in HIV treatment, care and prevention.Several studies demonstrated how task shifting and the decentralization of health services can leverage scarce health care resources to support scale-up efforts. For example, a Ugandan study comparing home-based and facility-based antiretroviral therapy (ART) delivery found that both delivered equivalent clinical outcomes, but home-based delivery resulted in substantial cost savings to patients; and a retrospective cohort analysis of an HIV care programme in Lesotho demonstrated that devolving routine patient management to nurses and trained counsellors resulted in impressive gains in annual enrolment, retention in care and other clinical indicators.Studies also demonstrated how the use of trained counsellors and public health advisors could effectively expand both clinical and public health capacity in low-income settings. Studies evaluating the impact of integrating HIV and TB care resulted in improved treatment outcomes in coinfected populations, the development of environmental interventions to reduce TB transmission, and uncovering of the extent of multi-drug-resistant and extremely drug-resistant tuberculosis (MDR-TB and XDR-TB) in KwaZulu-Natal, South Africa.Some mathematical modelling and cost-effectiveness studies presented at this meeting addressed interventions to increase retention in care, and strengthened the evidentiary basis for universal voluntary testing and immediate ART on reducing HIV transmission; debate continued about the relative merits of clinical versus laboratory monitoring. Finally, a provocative plenary presentation outlined the shortfalls of current prevention

  8. Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey

    PubMed Central

    Yoon, Jin-Ha; Jung, Pil Kyun; Roh, Jaehoon; Seok, Hongdeok; Won, Jong-Uk

    2015-01-01

    Background Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Methods Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Results Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09–1.70) for males and 1.38 (1.11–1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks’ experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6–8 hours of nighttime sleep. Conclusion In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated. PMID:26080022

  9. 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

    2015-01-01

    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. PMID:26294360

  10. 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

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

    PubMed Central

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

    2016-01-01

    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. PMID:27184606

  12. 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 poets; original…

  13. Lower-extremity amputation with immediate postoperative prosthetic placement.

    PubMed

    Folsom, D; King, T; Rubin, J R

    1992-10-01

    To study the efficacy of an immediate postoperative prosthesis (IPOP) program, a retrospective review of 167 major lower-extremity amputations was performed. Patient enrollment in the IPOP program was based on the individual's potential for rehabilitation and participation in an aggressive postoperative physical therapy regimen, as determined by the surgeon, prosthetist, physical therapist, and social worker. Indications for amputation were intractable infection and/or severe unreconstructable arterial insufficiency. Sixty-five patients underwent 69 amputations with IPOP (59 below knee; 10 above knee). Successful program completion was defined as independent ambulation and occurred in 86% of those patients enrolled. The average interval from amputation to ambulation was 15.2 days for the below-knee amputees and 9.3 days for the above-knee amputees. Failure to complete the program occurred in 14% of patients and was due to noncompliance, stump infection, stump trauma, and death. The results of this review support the use of IPOP after major lower-extremity amputation. PMID:1415937

  14. How Do 4th, 5th, and 6th Grade Students' Categories of Cognitive Reflections in Interviews on Derivational Morphology Compare to Their Upper Level Spelling Inventory Orthographic Knowledge?

    ERIC Educational Resources Information Center

    Smith, Darcie D.

    2012-01-01

    Eighty-seven 4th, 5th and 6th grade students were administered the "Derivational Relatedness Interview" (DRI) (Templeton, Smith, Moloney, Van Pelt, & Ives, 2009). The purpose of this instrument is to explore students' understanding of derivational morphology. During the same week, the subjects were also administered an Upper…

  15. 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…

  16. A Study on Reading Comprehension Skills of Primary School 5th Grade Students--Learning Basic Reading and Writing Skills through Phonics-Based Sentence Method or Decoding Method

    ERIC Educational Resources Information Center

    Kusdemir Kayiran, Bilge; Karabay, Aysegul

    2012-01-01

    This research aims at investigating the influence of two methods implemented in primary reading and writing teaching programs--phonics-based sentence method and decoding (analysis) method--on primary school 5th grade students' reading comprehension achievement. Also, the study considers the relationship between socio-economic status and reading…

  17. A Response to Lawrence Ferrara's Chapter Four in R. Phelps, R. Sadoff, E. Warburton, and L. Ferrara, "A Guide to Research in Music Education," 5th Edition (Lanham, Maryland, Scarecrow Press, Inc., 2005)

    ERIC Educational Resources Information Center

    Heller, Jack

    2006-01-01

    A reply to Lawrence Ferrara's Chapter 4 in R. Phelps, R. Sadoff, E. Warburton, and L. Ferrara, "A Guide to Research in Music Education," 5th Edition is presented. It it curious that Ferrara disagrees with Jack Heller and Edward J. P. O'Connor's view that "philosophy" is not "research," yet in the chapter headings in the book A Guide to Research in…

  18. Different MMSE Score Is Associated with Postoperative Delirium in Young-Old and Old-Old Adults

    PubMed Central

    Wang, Meijuan; Zhu, Yingbo; Li, Cheng; Li, Guodong; Marcantonio, Edward R.; Xie, Zhongcong; Shen, Yuan

    2015-01-01

    Background Postoperative delirium is one of the most common postoperative complications in geriatric patients. Mini-mental state examination (MMSE) assesses cognitive function in patients and is associated with postoperative delirium. However, whether there is an age-dependent relationship between preoperative MMSE score and postoperative delirium remains unknown. Methods We therefore set out to investigate the association between preoperative MMSE score and postoperative delirium in young-old (≤80 year-old, 75.46±4.69 years, 27.0% male, n = 63) and old-old (>80 year-old, 84.51±3.46 years, 20.9% male, n = 67) participants, who had repairs of hip fractures under general anesthesia. The Confusion Assessment Method and Memorial Delirium Assessment Scale were administrated before surgery, and on the first, second and fourth days after surgery, to assess the incidence and severity of the delirium, respectively. A receiver operating characteristic curve analysis was used to calculate the optimal cutoff score of MMSE in predicting postoperative delirium. Results Thirty-four (26.2%) of 130 patients (80.12±6.12 years, 23.8% male) developed postoperative delirium. Preoperative MMSE scores were negatively associated with higher incidences and greater severity of postoperative delirium. The optimal cutoff scores of MMSE associated with postoperative delirium for young-old and old-old participants were 18.4 and 21.4, with a sensitivity of 60% and 83.8%, and a specificity of 92.5% and 62.8%, respectively. Conclusion The data demonstrated the optimal cutoff score of MMSE associated with postoperative delirium in young-old adults might be lower than that in old-old adults. Pending further investigation, these findings suggest that the association between preoperative MMSE score and postoperative delirium is age-dependent. PMID:26460750

  19. Enhanced recovery program is safe and improves postoperative insulin resistance in gastrectomy

    PubMed Central

    Fujikuni, Nobuaki; Tanabe, Kazuaki; Tokumoto, Noriaki; Suzuki, Takahisa; Hattori, Minoru; Misumi, Toshihiro; Ohdan, Hideki

    2016-01-01

    AIM: To assess the safety of enhanced recovery after surgery (ERAS) program in gastrectomy and influences on nutrition state and insulin-resistance. METHODS: Our ERAS program involved shortening the fasting periods and preoperative carbohydrate loading. Eighty gastrectomy patients were randomly assigned to either the conventional group (CG) or ERAS group (EG). We assessed the clinical characteristics and postoperative outcomes prospectively. The primary endpoint was noninferiority in timely discharge from the hospital within 12 d. Secondary endpoints were the incidence of aspiration at anesthesia induction, incidence of postoperative complications, health related quality of life (HRQOL) using the SF8 Health Survey questionnaire, nutrition state [e.g., albumin, transthyretin (TTR), retinal-binding protein (RBP), and transferrin (Tf)], the homeostasis model assessment-insulin resistance (HOMA-R) index, postoperative urine volume, postoperative weight change, and postoperative oral intake. RESULTS: The ERAS program was noninferior to the conventional program in achieving discharge from the hospital within 12 d (95.0% vs 92.5% respectively; 95%CI: -10.0%-16.0%). There was no significant difference in postoperative morbidity between the two groups. Adverse events such as vomiting and aspiration associated with the induction of general anesthesia were not observed. There were no significant differences with respect to postoperative urine volume, weight change, and oral intake between the two groups. EG patients with preoperative HOMA-R scores above 2.5 experienced significant attenuation of their HOMA-R scores on postoperative day 1 compared to CG patients (P = 0.014). There were no significant differences with respect to rapid turnover proteins (TTR, RBP and Tf) or HRQOL scores using the SF8 method. CONCLUSION: Applying the ERAS program to patients who undergo gastrectomy is safe, and improves insulin resistance with no deterioration in QOL. PMID:27231517

  20. Postoperative wound infection associated with Vibrio parahaemolyticus in a patient without exposure to seawater.

    PubMed Central

    Ahsan, N; Conter, R L; Appelbaum, P C

    1988-01-01

    This report describes a case of wound infection associated with Vibrio parahaemolyticus. The patient had ingested steamed crabs 7 days before admission for surgical treatment of intestinal obstruction due to colon carcinoma. The Vibrio sp. was isolated from postoperative wound drainage as well as from stool. Recovery was uneventful. PMID:3384932

  1. Zingiber officinale (ginger)--an antiemetic for day case surgery.

    PubMed

    Phillips, S; Ruggier, R; Hutchinson, S E

    1993-08-01

    The effect of powdered ginger root was compared with metoclopramide and placebo. In a prospective, randomised, double-blind trial the incidence of postoperative nausea and vomiting was measured in 120 women presenting for elective laparoscopic gynaecological surgery on a day stay basis. The incidence of nausea and vomiting was similar in patients given metoclopramide and ginger (27% and 21%) and less than in those who received placebo (41%). The requirement for postoperative antiemetics was lower in those patients receiving ginger. The requirements for postoperative analgesia, recovery time and time until discharge were the same in all groups. There was no difference in the incidence of possible side effects such as sedation, abnormal movement, itch and visual disturbance between the three groups. Zingiber officinale is an effective and promising prophylactic antiemetic, which may be especially useful for day case surgery. PMID:8214465

  2. First Day of Life

    MedlinePlus

    ... Things to Know About Zika & Pregnancy The First Day of Life KidsHealth > For Parents > The First Day ... continue What Your Baby Does on the First Day Many parents are surprised to see how alert ...

  3. 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

  4. Premedication with cyclooxygenase-2 inhibitor meloxicam reduced postoperative pain in patients after oral surgery.

    PubMed

    Aoki, T; Yamaguchi, H; Naito, H; Shiiki, K; Izawa, K; Ota, Y; Sakamoto, H; Kaneko, A

    2006-07-01

    The efficacy of the selective cyclooxygenase-2 (COX-2) inhibitor meloxicam for treatment of postoperative oral surgical pain was assessed in a randomized controlled trial. Patients undergoing unilateral mandibular 3rd molar extraction surgery were allocated to 3 groups, A, B and C. After oral premedication of meloxicam 10 mg in group A, ampiroxicam 27 mg in group B and placebo in group C, surgery was completed within 30 min under local anaesthesia using 2% lidocaine. For postoperative pain relief the patients were allowed to take oral loxoprofen (60 mg per tablet). Postoperative pain was evaluated at the clinic on the 1st, 7th and 14th postoperative day (POD) using a visual analogue scale (VAS), as was the number of loxoprofen tablets consumed, and the results were compared among the 3 groups with statistical significance of P<0.05. VAS scores on 1 POD were significantly lower in group A than in group C. Loxoprofen consumption on the day of surgery and 1 POD was significantly lower in group A than in group C (P<0.01). Total analgesic consumption was significantly lower in groups A and B than in group C (P<0.02). The COX-2 inhibitor, meloxicam 10 mg used for premedication reduced postoperative pain compared with control in oral surgery. PMID:16540287

  5. Impact of the interval between coronary angiography and off-pump coronary bypass surgery on postoperative renal function

    PubMed Central

    Kim, Na-young; Kim, So Yeon; Lee, Na Hyung

    2010-01-01

    Background Postoperative acute kidney injury (AKI) is a significant complication after coronary artery bypass surgery. Prior coronary angiography increases the likelihood of AKI due to the use of a radiocontrast dye. This study examined the effect of coronary angiography on the postoperative renal function after off-pump coronary artery bypass surgery (OPCAB). Methods The records of 110 patients who required OPCAB were reviewed. These patients also had at least two of the following conditions: chronic kidney disease, hypertension, diabetes mellitus, emergency surgery, congestive heart failure, age >75 years, hematocrit <30%, a left ventricular ejection fraction <40%, or the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. The patients were divided into two groups; coronary angiography performed within two days of OPCAB (Control group, n = 55), and coronary angiography performed more than two days before OPCAB (Angio group, n = 55). The serum creatinine (SCr) and serum cystatin C levels were measured on the day before surgery, as well as on postoperative days 1, 2, 3 and 7. The estimated glomerular filtration rate (eGFR) was also obtained on those days. AKI was defined as an increase in Cr ≥50% or ≥0.3 mg/dl within 48 hours. Results The postoperative changes in the SCr, cystatin C and eGFR were similar in the two groups. The incidence of AKI and renal replacement therapy were similar in the two groups. Conclusions Coronary angiography performed within two days of OPCAB does not affect the postoperative renal function. PMID:20498792

  6. Effect of Chronic Rhinosinusitis With or Without Nasal Polyp on Quality of Life in South Korea: 5th Korea National Health and Nutrition Examination Survey Korean

    PubMed Central

    Kim, Do Hyun; Han, Kyungdo; Kim, Soo Whan

    2016-01-01

    Objectives This is the first study of its kind to investigate the relationship between chronic rhinosinusitis (CRS) with or without nasal polyps (NP) and health-related quality of life (HRQoL) in the general adult Korean population. We sought to evaluate the association after adjustment for confounding factors. We also evaluated HRQoL according to presence of NP in CRS patients. Methods In this cross-sectional study we used nationally representative samples from the 5th Korea National Health and Nutrition Examination Survey (2010–2012). A total of 17,490 participants were included in the study, of which 613 were diagnosed with CRS. Univariate analysis was conducted on healthy versus CRS groups, segregated by gender with weighted prevalence of demographic characteristics, socioeconomic status, and comorbid diseases. Subanalysis was carried out to evaluate the relationship between CRS with or without NP and HRQoL using EuroQol 5-dimension (EQ-5D) and visual analog scale (EQ-VAS). The odds ratios for EQ-5D were estimated by multiple logistic regression analyses with confounder adjustment. Results Weighted prevalence of CRS of adult male was found to be 3.7% and CRS with nasal polyps (CRSwNP) 0.5%, while female CRS was 3.3% and CRSwNP 0.3%. There was no significant difference between the groups (P#x0003d;0.332). The scores for female, EQ-5D index (P for trend<0.001) and EQ-VAS (P for trend=0.002) showed decreasing trend from healthy participants to CRS without nasal polyps (CRSsNP) and from CRSsNp to CRSwNP. After adjusting for demographic characteristics, socioeconomic status, and comorbid diseases, EQ-5D scores; EQ-5D index (P<0.001) and EQ-VAS (P<0.001) exhibited poorer HRQoL compared to healthy participants, exclusively within the female group. Conclusion These data suggest that female patients with CRS are at higher risk of poor HRQoL. In addition, HRQoL of female CRSwNP was lower compared to those of CRSsNP and healthy participants. PMID:27090274

  7. [Results of a clinical trial with ambroxol as to postoperative therapy of bronchitis (author's transl)].

    PubMed

    Kranicke, R

    1978-01-01

    The clinical testing of trans-4-[(2-amino-3,5-dibromo-benzyl)amino]cyclohexanol-hydrochloride (ambroxol, NA 872) in surgical patients was carried out over a period of 7 days. Regular application of 60 mg/day showed a clear improvement in subjective symptoms, particularly in cases of bronchitic syndrome. In some patients improvement could be demonstrated objectively by means of sputum viscosimetry. The clinical effect is principally one of facilitation of expectoration and fluidification of mucus, which often prior to therapy is rather viscous. This leads to a favourable influence of the post-operative treatment period. As a rule the substance is well-tolerated. The recommended dose of the drug for the average treatment is 2 ampoules/day i.v. (30 mg) and a single to twice daily inhalation of 2 ml (15 mg) for 5--7 days post-operatively. PMID:581994

  8. Biomarkers of postoperative delirium and cognitive dysfunction

    PubMed Central

    Androsova, Ganna; Krause, Roland; Winterer, Georg; Schneider, Reinhard

    2015-01-01

    Elderly surgical patients frequently experience postoperative delirium (POD) and the subsequent development of postoperative cognitive dysfunction (POCD). Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers. PMID:26106326

  9. Recent Advances in Postoperative Pain Management

    PubMed Central

    Vadivelu, Nalini; Mitra, Sukanya; Narayan, Deepak

    2010-01-01

    Good pain control after surgery is important to prevent negative outcomes such as tachycardia, hypertension, myocardial ischemia, decrease in alveolar ventilation, and poor wound healing. Exacerbations of acute pain can lead to neural sensitization and release of mediators both peripherally and centrally. Clinical wind up occurs from the processes of N-Methyl D-Aspartate (NMDA) activation, wind up central sensitization, long-term potentiation of pain (LTP), and transcription-dependent sensitization. Advances in the knowledge of molecular mechanisms have led to the development of multimodal analgesia and new pharmaceutical products to treat postoperative pain. The new pharmacological products to treat postoperative pain include extended-release epidural morphine and analgesic adjuvants such as capsaicin, ketamine, gabapentin, pregabalin dexmetomidine, and tapentadol. Newer postoperative patient-controlled analgesia (PCA) in modes such as intranasal, regional, transdermal, and pulmonary presents another interesting avenue of development. PMID:20351978

  10. MR imaging of the postoperative knee.

    PubMed

    Gnannt, Ralph; Chhabra, Avneesh; Theodoropoulos, John S; Hodler, Juerg; Andreisek, Gustav

    2011-11-01

    Advances in orthopedic and arthroscopic surgical procedures of the knee such as, knee replacement, ligamentous reconstruction as well as articular cartilage and meniscus repair techniques have resulted in a significant increase in the number of patients undergoing knee arthroscopy or open surgery. As a consequence postoperative MR imaging examinations increase. Comprehensive knowledge of the normal postoperative MR imaging appearances and abnormal findings in the knee associated with failure or complications of common orthopedic and arthroscopic surgical procedures currently undertaken is crucial. This article reviews the various normal and pathological postoperative MR imaging findings following anterior and posterior cruciate ligament, medial collateral ligament and posterolateral corner reconstruction, meniscus and articular cartilage surgery as well as total knee arthroplasty with emphasis on those surgical procedures which general radiologists will likely be faced in their daily clinical routine. PMID:22002752

  11. Evaluation for postoperative recurrence of Crohn disease.

    PubMed

    Swoger, Jason M; Regueiro, Miguel

    2012-06-01

    Disease recurrence following resective surgery for Crohn disease remains a challenging clinical problem, and more studies are needed to better define risk stratification and treatment recommendations in the postoperative setting. Endoscopy remains the gold standard for the assessment of postoperative disease recurrence, and all Crohn disease patients who undergo surgery should undergo ileocolonoscopy within 6 to 12 months of surgery. The degree of endoscopic recurrence in the neoterminal ileum during this procedure provides prognostic information regarding the severity of the future disease course. WCE, MRE, and SICUS are all promising noninvasive modalities to assess for postoperative Crohn disease activity. However, further studies are needed to better define scoring systems, operating characteristics and variability, and prognostic data for each of these modalities. In patients at risk for early disease recurrence, more aggressive prophylactic therapy should be considered, in hopes of delivering true “top-down” therapy that may offer maximum impact in altering the natural history of Crohn disease. PMID:22500519

  12. Metabolic dysfunction in lymphocytes promotes postoperative morbidity.

    PubMed

    Edwards, Mark R; Sultan, Pervez; del Arroyo, Ana Gutierrez; Whittle, John; Karmali, Shamir N; Moonesinghe, S Ramani; Haddad, Fares S; Mythen, Michael G; Singer, Mervyn; Ackland, Gareth L

    2015-09-01

    Perioperative lymphopenia has been linked with an increased risk of postoperative infectious complications, but the mechanisms remain unclear. We tested the hypothesis that bioenergetic dysfunction is an important mechanism underlying lymphopenia, impaired functionality and infectious complications. In two cohorts of patients (61-82 years old) undergoing orthopaedic joint replacement (n=417 and 328, respectively), we confirmed prospectively that preoperative lymphopenia (≤1.3 x 10(9)·l(-1); <20% white cell count; prevalence 15-18%) was associated with infectious complications (relative risk 1.5 (95% confidence interval 1.1-2.0); P=0.008) and prolonged hospital stay. Lymphocyte respirometry, mitochondrial bioenergetics and function were assessed (n=93 patients). Postoperative lymphocytes showed a median 43% fall (range: 26-65%; P=0.029; n=13 patients) in spare respiratory capacity, the extra capacity available to produce energy in response to stress. This was accompanied by reduced glycolytic capacity. A similar hypometabolic phenotype was observed in lymphocytes sampled preoperatively from chronically lymphopenic patients (n=21). This hypometabolic phenotype was associated with functional lymphocyte impairment including reduced T-cell proliferation, lower intracellular cytokine production and excess apoptosis induced by a range of common stressors. Glucocorticoids, which are ubiquitously elevated for a prolonged period postoperatively, generated increased levels of mitochondrial reactive oxygen species, activated caspase-1 and mature interleukin (IL)-1β in human lymphocytes, suggesting inflammasome activation. mRNA transcription of the NLRP1 inflammasome was increased in lymphocytes postoperatively. Genetic ablation of the murine NLRP3 inflammasome failed to prevent glucocorticoid-induced lymphocyte apoptosis and caspase-1 activity, but increased NLRP1 protein expression. Our findings suggest that the hypometabolic phenotype observed in chronically lymphopenic

  13. Pre- to Post-operative Changes in Physical Activity: Report from the Longitudinal Assessment of Bariatric Surgery-2

    PubMed Central

    King, Wendy C; Hsu, Jesse Y; Belle, Steven H; Courcoulas, Anita P; Eid, George M; Flum, David R; Mitchell, James E; Pender, John R; Smith, Mark D; Steffen, Kristine J; Wolfe, Bruce M

    2011-01-01

    Background Numerous studies report that bariatric surgery patients report more physical activity (PA) after surgery than before, but the quality of PA assessment has been questionable. Methods The Longitudinal Assessment of Bariatric Surgery-2 is a 10-center longitudinal study of adults undergoing bariatric surgery. Of 2458 participants, 455 were given an activity monitor, which records steps/minute, and an exercise diary before and 1 year after surgery. Mean step/day, active minutes/day, and high-cadence minutes/week were calculated for 310 participants who wore the monitor at least 10 hours/day for at least 3 days at both time points. Pre- and post-surgery PA were compared for differences using the Wilcoxon signed-rank test. Generalized Estimating Equations identified independent pre-operative predictors of post-operative PA. Results PA increased significantly (p<.0001) pre- to post-operative for all PA measures. Median values pre- and post-operative were: 7563 and 8788 steps/day; 309 and 340 active minutes/day; and 72 and 112 high-cadence minutes/week, respectively. However, depending on the PA measure, 24–29% of participants were at least 5% less active post-operative than pre-operative. Controlling for surgical procedure, sex, age and BMI, higher PA preoperative independently predicted higher PA post-operative (p<.0001, all PA measures). Less pain, not having asthma and self-report of increasing PA as a weight loss strategy pre-operative also independently predicted more high-cadence minutes/week post-operative (p<.05). Conclusion The majority of adults increase their PA level following bariatric surgery. However, most remain insufficiently active and some become less active. Increasing PA, addressing pain and treating asthma prior to surgery may have a positive impact on post-operative PA. PMID:21944951

  14. Risk factors associated with postoperative pain after ophthalmic surgery: a prospective study

    PubMed Central

    Lesin, Mladen; Dzaja Lozo, Mirna; Duplancic-Sundov, Zeljka; Dzaja, Ivana; Davidovic, Nikolina; Banozic, Adriana; Puljak, Livia

    2016-01-01

    Background Risk factors associated with postoperative pain intensity and duration, as well as consumption of analgesics after ophthalmic surgery are poorly understood. Methods A prospective study was conducted among adults (N=226) who underwent eye surgery at the University Hospital Split, Croatia. A day before the surgery, the patients filled out questionnaires assessing personality, anxiety, pain catastrophizing, sociodemographics and were given details about the procedure, anesthesia, and analgesia for each postoperative day. All scales were previously used for the Croatian population. The intensity of pain was measured using a numerical rating scale from 0 to 10, where 0 was no pain and 10 was the worst imaginable pain. The intensity of pain was measured before the surgery and then 1 hour, 3 hours, 6 hours, and 24 hours after surgery, and then once a day until discharge from the hospital. Univariate and multivariate analyses were performed. Results A multivariate analysis indicated that independent predictors of average pain intensity after the surgery were: absence of premedication before surgery, surgery in general anesthesia, higher pain intensity before surgery and pain catastrophizing level. Independent predictors of postoperative pain duration were intensity of pain before surgery, type of anesthesia, and self-assessment of health. Independent predictors of pain intensity ≥5 during the first 6 hours after the procedure were the type of procedure, self-assessment of health, premedication, and the level of pain catastrophizing. Conclusion Awareness about independent predictors associated with average postoperative pain intensity, postoperative pain duration, and occurrence of intensive pain after surgery may help health workers to improve postoperative pain management in ophthalmic surgery. PMID:26858525

  15. Differential Postoperative Effects of Volatile Anesthesia and Intraoperative Remifentanil Infusion in 7511 Thyroidectomy Patients

    PubMed Central

    Jo, Jun-Young; Choi, Seong-Soo; Yi, Jung Min; Joo, Eun Young; Kim, Ji Hyun; Park, Se Ung; Sim, Ji-Hoon; Karm, Myong-Hwan; Ku, Seungwoo

    2016-01-01

    Abstract Although remifentanil is used widely by many clinicians during general anesthesia, there are recent evidences of opioid-induced hyperalgesia as an adverse effect. This study aimed to determine if intraoperative remifentanil infusion caused increased pain during the postoperative period in patients who underwent a thyroidectomy. A total of 7511 patients aged ≥ 20 years, who underwent thyroidectomy between January 2009 and December 2013 at the Asan Medical Center were retrospectively analyzed. Enrolled patients were divided into 2 groups: group N (no intraoperative remifentanil and only volatile maintenance anesthesia) and group R (intraoperative remifentanil infusion including total intravenous anesthesia and balanced anesthesia). Following propensity score matching analysis, 2582 patients were included in each group. Pain scores based on numeric rating scales (NRS) were compared between the 2 groups at the postoperative anesthetic care unit and at the ward until 3 days postoperation. Incidences of postoperative complications, such as nausea, itching, and shivering were also compared. The estimated NRS pain score on the day of surgery was 5.08 (95% confidence interval [CI] 4.97–5.19) in group N patients and 6.73 (95% CI 6.65–6.80) in group R patients (P < 0.001). There were no statistically significant differences in NRS scores on postoperative days 1, 2, and 3 between the 2 groups. Postoperative nausea was less frequent in group R (31.4%) than in group N (53.5%) (P < 0.001). However, the incidence of itching was higher in group R (4.3%) than in group N (0.7%) (P < 0.001). Continuous infusion of remifentanil during general anesthesia can cause higher intensity of postoperative pain and more frequent itching than general anesthesia without remifentanil infusion immediately after thyroidectomy. Considering the advantages and disadvantages of continuous remifentanil infusion, volatile anesthesia without opioid may be a good choice for minor

  16. 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

  17. 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

  18. Perioperative synbiotics decrease postoperative complications in periampullary neoplasms: a randomized, double-blind clinical trial.

    PubMed

    Sommacal, Heloisa Martins; Bersch, Vivian Pierri; Vitola, Santo Pascoal; Osvaldt, Alessandro Bersch

    2015-01-01

    Periampullary neoplasms are rapidly progressive tumors with a poor prognosis and high morbidity and mortality rates, which have a negative influence on patient outcomes. Some probiotics and prebiotics have the ability to protect the intestinal barrier and prevent bacterial translocation, infection, and postoperative complications. We evaluated the use of synbiotics in a prospective, double-blind study of patients undergoing surgery for periampullary neoplasms (PNs) and assessed the effect of these agents on nutritional status, postoperative complications, antibiotic use, length of hospital stay, and mortality. Patients were randomized to receive probiotics and prebiotics-synbiotics--group S [Lactobacillus acidophilus 10, 1 × 10(9)CFU, Lactobacillus rhamnosus HS 111, 1 × 10(9) CFU, Lactobacillus casei 10, 1 × 10(9) CFU, Bifidobacterium bifidum, 1 × 10(9)CFU, and fructooligosaccharides (FOS) 100 mg]--or placebo-controls--group C, twice daily, for a total of 14 days. Risk, clinical status, and postoperative complication rates were assessed. Twenty-three patients were allocated to each group. The incidence of postoperative infection was significantly lower in group S (6 of 23 patients, 26.1%) than in group C (16 of 23 patients, 69.6%) (P = 0.00). Duration of antibiotic therapy was also shorter in group S (mean = 9 days vs. 15 days in group C; P = 0.01). Noninfectious complications were less common in group S (6 of 23 vs. 14 of 23 patients in group C; P = 0.03). Mean length of hospital stay was 12 ± 5 days in group S vs. 23 ± 14 days in group C (P = 0.00). No deaths occurred in group S, whereas 6 deaths occurred in group C (P = 0.02). Perioperative administration of synbiotics reduces postoperative mortality and complication rates in patients undergoing surgery for PNs. PMID:25803626

  19. 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 ...

  20. Family Day Care Associations.

    ERIC Educational Resources Information Center

    Bookman, Robert

    This paper presents information on the organization and accomplishments of Family Day Care Associations, organized groups of individuals who provide day care services in their own homes. Although primarily based on experiences of day care mothers in New York State, the paper presents information relevant to day care providers in any area.…

  1. [Dexmedetomidine use for postoperative adrenergic analgesia and sedation in abdominal surgery].

    PubMed

    Gur'ianov, V A; Nosenko, M M; Gadzhibekov, N Ch; Ialich, A Iu; Aliautdin, R N; Tolmachev, G N

    2013-01-01

    Comparative study of postoperative analgesia and sedation with trimeperidine and dexmedetomidine and their effects on haemodynamics and vegetative nervous system was performed. Assessment of analgesia and sedation during vagotonia (first part of the study) and hypokinetic type of haemodynamics (second part of the study) was carried out with visual analogue scale (VAS) and Richmond scale. Results of the study showed that dexmedetomidine is more effective and safer than trimeperidine for analgesia and sedation in patients with spontaneous breathing after abdominal surgery. Dexmedetomidine use allows keeping optimal type of haemodynamics and vegetative nervous system parameters on first day of postoperative period. PMID:24749259

  2. 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. PMID:15917741

  3. 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

  4. 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

  5. Acute postoperative endophthalmitis by Gemella haemolysans

    PubMed Central

    Nalamada, Suma; Jalali, Subhadra; Reddy, Ashok Kumar

    2010-01-01

    Endophthalmitis is a rare and serious post-surgical complication. We report a case of acute postoperative endophthalmitis after an uneventful cataract surgery caused by a commensal organism, Gemella haemolysans. The patient was successfully treated with vitrectomy and intravitreal antibiotics like vancomycin, along with topical cefazolin. PMID:20413936

  6. Postoperative sore throat: a systematic review.

    PubMed

    El-Boghdadly, K; Bailey, C R; Wiles, M D

    2016-06-01

    Postoperative sore throat has a reported incidence of up to 62% following general anaesthesia. In adults undergoing tracheal intubation, female sex, younger age, pre-existing lung disease, prolonged duration of anaesthesia and the presence of a blood-stained tracheal tube on extubation are associated with the greatest risk. Tracheal intubation without neuromuscular blockade, use of double-lumen tubes, as well as high tracheal tube cuff pressures may also increase the risk of postoperative sore throat. The expertise of the anaesthetist performing tracheal intubation appears to have no influence on the incidence in adults, although it may in children. In adults, the i-gel(™) supraglottic airway device results in a lower incidence of postoperative sore throat. Cuffed supraglottic airway devices should be inflated sufficiently to obtain an adequate seal and intracuff pressure should be monitored. Children with respiratory tract disease are at increased risk. The use of supraglottic airway devices, oral, rather than nasal, tracheal intubation and cuffed, rather than uncuffed, tracheal tubes have benefit in reducing the incidence of postoperative sore throat in children. Limiting both tracheal tube and supraglottic airway device cuff pressure may also reduce the incidence. PMID:27158989

  7. Management of common postoperative complications: delirium.

    PubMed

    Javedan, Houman; Tulebaev, Samir

    2014-05-01

    Delirium is a common postoperative surgical complication associated with poor outcomes. The complexity of delirium demands that each patient be assessed individually and a tailored prevention and treatment regimen be put in place. Nonpharmacologic and pharmacologic strategies are available to achieve this goal. PMID:24721366

  8. 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.

  9. 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

  10. Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery

    PubMed Central

    Kodra, Nertila; Shpata, Vjollca; Ohri, Ilir

    2016-01-01

    BACKGROUND: Incidence of postoperative pulmonary complications (PPC) in patients undergoing non-cardiothoracic surgery remains high and the occurrence of these complications has enormous implications for the patient and the health care system. AIM: The aim of the study was to identify risk factors for PPC in patients undergoing abdominal surgical procedures. MATERIALS AND METHODS: A prospective cohort study in abdominal surgical patients, admitted to the emergency and surgical ward of the UHC of Tirana, Albania, was conducted during the period: March 2014-March 2015. We collected data on the occurrence of a symptomatic and clinically significant PPC using clinical, laboratory, and radiology data. We evaluated the relations between PPCs and various pre-operative or intra-operative factors to identify risk factors. RESULTS: A total of 450 postoperative patients admitted to the surgical emergency and surgical ward were studied. The mean age were 59.85 ±13.64 years with 59.3% being male. Incidence of PPC was 27.3% (123 patients) and hospital length of stay was 4.93 ± 4.65 days. Length of stay was substantially prolonged for those patients who developed PPC (7.48 ± 2.89 days versus 3.97± 4.83 days, p < 0.0001. PPC were identified as risk factors for mortality, OR: 21.84; 95% CI: 11.66-40.89; P < 0.0001. The multivariate regression analysis identified as being independently associated with an increased risk of PPC: age ≥ 65 years (OR 11.41; 95% CI: 4.84-26.91, p < 0.0001), duration of operation ≥ 2.5 hours (OR 8.38; 95% CI: 1.52-46.03, p = 0.01, history of previous pulmonary diseases (OR 11.12; 95% CI: 3.28-37.65, P = 0.0001) and ASA > 2 (OR 6.37; 95% CI: 1.54-26.36, P = 0.01). CONCLUSION: We must do some efforts in reducing postoperative pulmonary complications, firstly to identify which patients are at increased risk, and then following more closely high-risk patients because those patients are most likely to benefit. PMID:27335597

  11. Can urinary excretion rate of 8-isoprostrane and malonaldehyde predict postoperative cognitive dysfunction in aging?

    PubMed

    Cheng, Qinghao; Wang, Jiawan; Wu, Anshi; Zhang, Rujin; Li, Lei; Yue, Yun

    2013-09-01

    Oxidative stress has been associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD). However, little is known about oxidative stress in postoperative cognitive dysfunction (POCD) in aging. The aim of this study was to investigate urinary excretion rate of 8-isoprostane:creatinine (U8-isoPG:Cr) and malonaldehyde:creatinine (UMDA:Cr) to predict short-term POCD in elderly patients undergoing general and orthopedic surgery. 72 patients aged above 65 years were enrolled in this prospective observational study. Each patient underwent cognitive testing to determine POCD performed by an investigator before surgery and 1 week after surgery. Morning urine was collected at baseline, 1, 2, and 7 days postoperatively. U8-isoPG was performed using enzymelinked immunosorbent assay (ELISA), and UMDA levels were measured by chemiluminescence detection. Creatinine levels were also analyzed if differences in the oxidative biomarkers were observed in the urine creatinine concentration. (1). Of 72 patients who completed cognitive testing, postoperative cognitive dysfunction was detected in 29.2 % (n = 21) of patients in 7 days. (2) U8-isoPG:Cr levels in 7 days postoperatively were significantly higher in POCD patients compared with the non-POCD group (p = 0.01). When measuring change from baseline, U8-isoPG:Cr levels were higher than that of control groups (p = 0.01). (3) UMDA:Cr levels were significantly elevated in 1 and 2 days postoperatively in both groups (p < 0.05). U8-isoPG:Cr level seems to be a valuable marker to detect lipid peroxidation early in POCD patients. However, it will also be important to take into account or reduce potential confounders to improve the identification of changes in the status of oxidative stress as a marker for POCD. PMID:23380806

  12. Postoperative pain management with transdermal fentanyl after forefoot surgery: a randomized, placebo-controlled study

    PubMed Central

    Merivirta, Riika; Pitkänen, Mikko; Alanen, Jouko; Haapoja, Elina; Koivisto, Mari; Kuusniemi, Kristiina

    2015-01-01

    Background Quality of life is decreased in patients with hallux valgus deformity, mainly because of pain. Significant improvement is usually achieved by surgery. However, postoperative pain can be moderate to severe for 2–3 days. The aim of the present study was to evaluate the use of transdermal fentanyl for postoperative pain management after forefoot surgery. Methods Sixty patients undergoing hallux valgus or hallux rigidus surgery were allocated to receive a patch delivering either fentanyl 12 μg/hour or placebo for postoperative pain. The consumption of rescue opioid oxycodone, the primary outcome measure, was evaluated daily until the fourth postoperative day. Total consumption of oxycodone during the study period was also assessed. Pain scores and possible adverse effects were evaluated every 6 hours during the first 24 hours and on the fourth postoperative day. Results The use of rescue opioid was low in both groups, the median (range) consumption of oxycodone being 10 (0–50) mg on the day of surgery (no difference between the groups, P=0.31) and 0 (0–35) mg thereafter. The total combined consumption was 10 (0–105) mg in the fentanyl group and 20 (0–70) mg in the placebo group (P=0.23). There were no statistically significant differences in pain scores or adverse effects between the groups. Conclusion As a part of multimodal analgesia with ibuprofen and acetaminophen, a patch delivering fentanyl 12 μg/hour did not significantly decrease the consumption of rescue opioid or pain scores after forefoot surgery. PMID:25653553

  13. The Impact of Preoperative Serum anti-TNFα Therapy Levels on Early Postoperative Outcomes in Inflammatory Bowel Disease Surgery

    PubMed Central

    Lau, Cheryl; Dubinsky, Marla; Melmed, Gil; Vasiliauskas, Eric; Berel, Dror; McGovern, Dermot; Ippoliti, Andrew; Shih, David; Targan, Stephan; Fleshner, Phillip

    2016-01-01

    Objective Assess the impact of preoperative serum anti-TNFα drug levels on 30-day postoperative morbidity in inflammatory bowel disease patients. Summary Background Data Studies on the association of anti-TNFα drugs and postoperative outcomes in IBD are conflicting due to variable pharmacokinetics of anti-TNFα drugs.. It remains to be seen whether preoperative serum anti-TNFα drug levels correlate with postoperative morbidity. Methods 30 days postoperative outcomes of consecutive IBD surgical patients with serum drawn within 7 days pre-operatively, were studied. The total serum level of 3 anti-TNF-α drugs (infliximab, adalimumab, certolizumab) was measured, with ≥0.98 µg/ml considered as detected. Data was also reviewed according to a clinical cut off value of 3 µg/ml. Results 217 patients (123 Crohn’s disease (CD) and 94 ulcerative colitis (UC)) were analyzed. 75 of 150 (50%) treated with anti-TNFα therapy did not have detected levels at the time of surgery. In the UC cohort, adverse postoperative outcomes rates between the undetectable and detectable groups were similar when stratified according to type of UC surgery. In the CD cohort, there was a higher but statistically insignificant rate of adverse outcomes in the detectable vs undetectable groups. Using acut-off level of 3 µg/ml, postoperative morbidity (OR=2.5, p=0.03) and infectious complications (OR=3.0, p=0.03) were significantly higher in the ≥ 3 µg/ml group. There were higher rates of postoperative morbidity (p=0.047) and hospital readmissions (p=0.04) in the ≥ 8 µg/ml compared to < 3 µg/ml group. Conclusion Increasing preoperative serum anti-TNFα drug levels are associated with adverse postoperative outcomes in CD but not UC patients. PMID:24950263

  14. 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)…

  15. 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.

  16. Riley-Day syndrome

    MedlinePlus

    Riley-Day syndrome is an inherited disorder that affects nerves throughout the body. ... Riley-Day syndrome is passed down through families (inherited). A person must inherit a copy of the defective gene ...

  17. Riley-Day syndrome

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/001387.htm Riley-Day syndrome To use the sharing features on this page, please enable JavaScript. Riley-Day syndrome is an inherited disorder that affects nerves ...

  18. 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.

  19. Effect of Intraoperative Dexmedetomidine Infusion on Postoperative Bowel Movements in Patients Undergoing Laparoscopic Gastrectomy

    PubMed Central

    Cho, Jin Sun; Kim, Hyoung-Il; Lee, Ki-Young; An, Ji Yeong; Bai, Sun Joon; Cho, Ju Yeon; Yoo, Young Chul

    2015-01-01

    Abstract Sympathetic hyperactivation is one of the causes of postoperative ileus, which occurs frequently after abdominal surgery and adversely influences the patient's prognosis. We aimed to investigate whether dexmedetomidine (DEX) could attenuate postoperative ileus in patients undergoing laparoscopic gastrectomy. Ninety-two patients were randomized to the control (n = 46) or DEX group (n = 46). DEX was administered at a loading dose of 0.5 μg/kg for 10 minutes, followed by an infusion rate of 0.4 μg/kg/h from insufflation of the pneumoperitoneum to the end of surgery. The primary goal was to compare postoperative bowel movements by evaluating the time to first flatus. The balance of the autonomic nervous system, duration of postoperative hospital stay, and pain scores were assessed. The time to first flatus was shorter in the DEX group compared with the control group (67.2 ± 16.8 hours vs 79.9 ± 15.9 hours, P < 0.001). The low-frequency/high-frequency power ratio during pneumoperitoneum increased in the control group, compared with baseline values and the DEX group. The length of postoperative hospital stay was shorter in the DEX group compared with the control group (5.4 ± 0.7 days vs 5.8 ± 1.1 days, P = 0.04). Patients in the DEX group had lower pain scores and required fewer analgesics at 1 hour postoperatively. DEX facilitated bowel movements and reduced the length of hospital stay in patients undergoing laparoscopic gastrectomy. This may be attributed to the sympatholytic and opioid-sparing effects of DEX.

  20. Lucky guess or knowledge: a cross-sectional study using the Bland and Altman analysis to compare confidence-based testing of pharmacological knowledge in 3rd and 5th year medical students.

    PubMed

    Kampmeyer, Daniela; Matthes, Jan; Herzig, Stefan

    2015-05-01

    Multiple-choice-questions are common in medical examinations, but guessing biases assessment results. Confidence-based-testing (CBT) integrates indicated confidence levels. It has been suggested that correctness of and confidence in an answer together indicate knowledge levels thus determining the quality of a resulting decision. We used a CBT approach to investigate whether decision quality improves during undergraduate medical education. 3rd- and 5th-year students attended formative multiple-choice exams on pharmacological issues. Students were asked to indicate their confidence in a given answer. Correctness of answers was scored binary (1-correct; 0-wrong) and confidence levels were transformed to an ordinal scale (guess: 0; rather unsure: 0.33; rather sure: 0.66; very sure: 1). 5th-year students gave more correct answers (73 ± 16 vs. 49 ± 13 %, p < 0.05) and were on average more confident regarding the correctness of their answers (0.61 ± 0.18 vs. 0.46 ± 0.13, p < 0.05). Correlation of these parameters was stronger for 5th-year students (r = 0.81 vs. r = 0.52), but agreement of confidence and correctness ('centration') was lower. By combining the Bland-and-Altman approach with categories of decision-quality we found that 5th-year students were more likely to be 'well-informed' (41 vs. 5 %), while more 3rd-students were 'uninformed' (24 vs. 76 %). Despite a good correlation of exam results and confidence in given answers increased knowledge might be accompanied by a more critical view at the own abilities. Combining the statistical Bland-and-Altman analysis with a theoretical approach to decision-quality, more advanced students are expected to apply correct beliefs, while their younger fellows are rather at risk to hesitate or to act amiss. PMID:25103688

  1. Comparison of side effects between buprenorphine and meloxicam used postoperatively in Dutch belted rabbits (Oryctolagus cuniculus).

    PubMed

    Cooper, Coreen S; Metcalf-Pate, Kelly A; Barat, Christopher E; Cook, Judith A; Scorpio, Diana G

    2009-05-01

    One of the challenges facing veterinarians and investigators who use rabbits (Oryctolagus cuniculus) as a surgical model in biomedical research is choosing an appropriate and efficacious postoperative analgesic without systemic complications and side effects. The objective of this study was to evaluate the gastrointestinal side effects associated with the postoperative use of buprenorphine in Dutch Belted rabbits. We also evaluated the analgesic meloxicam as an alternative to opioid administration during the postoperative period. Rabbits were assigned to 1 of 3 treatment groups during the postoperative period after routine ovariohysterectomy: buprenorphine (n = 10), meloxicam (n = 10), and incisional infiltration with bupivicaine (no treatment control; n = 10). Feed intake, fecal production, weight loss, urine output, and other physiologic parameters were monitored and behavior and pain assessments were performed for 7 d after surgery and compared with baseline values collected before surgery. All rabbits showed decreased pellet consumption, fecal production, and weight on day 1 after surgery. This effect was severe in some rabbits that received bupivicaine; therefore treatment of this entire group with metoclopramide, fluids, and hay was instituted to reverse gut stasis. No significant difference in feed consumption and fecal production was present between the buprenorphine- and meloxicam-treated groups. On the basis of these results, meloxicam appears to be a suitable alternative or adjunct to buprenorphine for alleviating postoperative pain with minimal risk of anorexia and gastrointestinal ileus. PMID:19476717

  2. Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

    PubMed Central

    Chen, Chun-Ming; Lai, Steven; Chen, Ker-Kong; Lee, Huey-Er

    2015-01-01

    Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback. PMID:26543855

  3. Effects of reflexotherapy on acute postoperative pain and anxiety among patients with digestive cancer.

    PubMed

    Tsay, Shiow-Luan; Chen, Hsiao-Ling; Chen, Su-Chiu; Lin, Hung-Ru; Lin, Kuan-Chia

    2008-01-01

    Even after receiving analgesia, patients with gastric and liver cancer still report moderate levels of postoperative pain. The purpose of the study was to investigate the efficacy of foot reflexotherapy as adjuvant therapy in relieving pain and anxiety in postoperative patients with gastric cancer and hepatocellular cancer. The study design was a randomized controlled trial. Data were collected from 4 surgical wards of a medical center in 2005 in Taipei, Taiwan. Sixty-one patients who had received surgery for gastric cancer or hepatocellular carcinoma were randomly allocated to an intervention (n = 30) or control (n = 31) group. Patients in the intervention group received the usual pain management plus 20 minutes of foot reflexotherapy during postoperative days 2, 3, and 4. Patients in the control group received usual pain management. Outcome measures included the short-form McGill Pain Questionnaire, visual analog scale for pain, summary of the pain medications consumed, and the Hospital Anxiety and Depression Scale. Results demonstrated that studied patients reported moderately high levels of pain and anxiety postoperatively while patients were managed with patient-controlled analgesia. Using generalized estimation equations and controlling for confounding variables, less pain (P < .05) and anxiety (P < .05) over time were reported by the intervention group compared with the control group. In addition, patients in the intervention group received significantly less opioid analgesics than the control group (P < .05). Findings from this study provide nurses with an additional treatment to offer postoperative digestive cancer patients. PMID:18490886

  4. 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

  5. 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...

  6. 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…

  7. Postoperative ventilatory and circulatory effects of heating after aortocoronary bypass surgery. Postoperative external heat supply.

    PubMed

    Joachimsson, P O; Nyström, S O; Tydén, H

    1987-08-01

    The effects of postoperative external heat supply on shivering, oxygen uptake, carbon dioxide production, ventilatory requirements and haemodynamic variables were studied postoperatively after aortocoronary bypass surgery in 24 men with stable angina pectoris. After hypothermic cardiopulmonary bypass (CPB) at 25 degrees C, the patients were rewarmed to a nasopharyngeal temperature of at least 38 degrees C, resulting in a rectal temperature of about 34 degrees C before termination of CPB. Twelve patients, forming the control group, were given no other external heat supply. In another group (n = 12), the "radiant heat supply group", additional external heat was provided postoperatively, the main source of which was a thermal ceiling supplemented with heated, humidified respiratory gases. In this latter group the postoperative rewarming was accomplished earlier and was converted into a mainly passive process. Shivering, oxygen uptake, CO2 production and ventilation volumes were significantly reduced compared with the control group. Cardiac index and stroke index were higher and systemic oxygen extraction was lower in the radiant heat supply group. Postoperative hypertension and vasoconstriction were greatly decreased, suggesting that residual hypothermia is an important cause of the postoperative vasoconstriction. PMID:3115049

  8. Annual National Vocational and Technical Teacher Education Seminar Proceedings (5th, Atlanta, Ga., Oct. 25-28, 1971): Assessment of Graduate Programs. Final Report.

    ERIC Educational Resources Information Center

    Gorman, Anna M., Ed.; And Others

    A total of 126 leaders in vocational and technical education from 44 states and the District of Columbia participated in a 3-day seminar conducted to focus attention on the concepts of evaluation and accountability in graduate programs in vocational education. Reaction panels and discussion groups were stimulated by these major presentations: (1)…

  9. PREFACE: MEM07: The 5th Annual Workshop on Mechanical and Electromagnetic Properties of Composite Superconductors (Princeton, NJ, USA, 21 24 August 2007)

    NASA Astrophysics Data System (ADS)

    Larbalestier, D. C.; Osamura, K.; Hampshire, D. P.

    2008-05-01

    MEM07 was the 5th international workshop concentrating on the mechanical and electrical properties of composite superconductors, which are the technological conductor forms from which practical superconducting devices are made. Such superconducting conductors respond to important challenges we currently face, especially those concerned with the proper management of the world's energy resources. Superconductivity provides a means to address the challenges in the generation, transmission and distribution, and use of energy. For energy generation, the ITER Fusion Tokomak (now underway in France) provides exciting new challenges for the whole superconductivity community, due to the enormous size and strong fields of the plasma confinement superconducting magnets that will form the largest and most powerful superconducting machine yet built. Significant attention was paid at MEM07 to the modeling, characterization, testing and validation of the high-amperage Nb3Sn cable-in-conduit conductors needed for ITER. As for electric energy industry uses, there was much discussion of both first generation (Bi,Pb)2Sr2Ca2Cu3Ox conductors and the rapidly emerging second generation coated conductors made from YBa2Cu37-x. High-performing, affordable conductors of these materials are vital for large capacity transmission cables, energy storage systems, fault current limiters, generators and motors—many prototypes of which are being pursued in technologically advanced countries. There is a broad consensus that the prototype stage for high-current-high-field superconducting applications is nearing its end and that large scale applications are technologically feasible. However full industrialization of large-scale superconducting technologies in electric utility applications will benefit from continuous improvement in critical current, lower ac loss, higher strength and other vital conductor properties. The establishment of optimal procedures for the system design accompanying scale

  10. Quality of sleep in postoperative surgical oncologic patients.

    PubMed

    Barichello, Elizabeth; Sawada, Namie Okino; Sonobe, Helena Megumi; Zago, Márcia Maria Fontão

    2009-01-01

    This study aimed to evaluate surgical-oncologic patients' quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) questionnaire. It is an exploratory study with transversal-observational design, in 46 postoperative head & neck and urology cancer patients. The PSQI questionnaire was used to evaluate the subjective quality of sleep and the occurrence of sleep disorders. Six PSQI components were statistically significant and 78.3% of the interviewees had impaired subjective quality of sleep. Among factors leading to sleep disorders we point out: taking too long to fall asleep; waking up in the middle of the night; getting up to go to the bathroom and napping during the day. This study is expected to sensitize the nursing team regarding the need to investigate quality of sleep and causes of its disorders in cancer survivors for an effective course of action. PMID:19820854

  11. Fournier's Gangrene as a Postoperative Complication of Inguinal Hernia Repair

    PubMed Central

    Dinc, Tolga; Kayilioglu, Selami Ilgaz; Sozen, Isa; Yildiz, Baris Dogu; Coskun, Faruk

    2014-01-01

    Fournier's gangrene is the necrotizing fasciitis of perianal, genitourinary, and perineal regions. Herein, we present a case of scrotal Fournier's gangrene as a postoperative complication of inguinal hernia repair. A 51-year-old male with giant indirect hernia is presented. Patient underwent inguinal hernia repair, and after an unproblematic recovery period, he was discharged. He applied to our outpatient clinic on the fifth day with swollen and painful scrotum and it turned out to be Fournier's gangrene. Polypropylene mesh was not infected. Patient recovered and was discharged after repeated debridements. Basic principles in treatment of Fournier's gangrene are comprised of initial resuscitation, broad-spectrum antibiotics therapy, and early aggressive debridement. In the management of presented case, aggressive debridement was made right after diagnosis and broad-spectrum antibiotics were given to the hemodynamically stable patient. In these circumstances, the important question is whether we could prevent occurrence of Fournier's gangrene. PMID:25506030

  12. 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

  13. 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

  14. Parapharyngeal space hemangiopericytoma treated with surgery and postoperative radiation--a case report.

    PubMed

    Fareed, Muhammad Mohsin; Al Amro, Abdullah Suleiman Mazaed; Akasha, Rashad; Al Assiry, Mansour; Al Asiri, Mushabbab; Tonio, Mutahir; Bayoumi, Yasser

    2012-01-01

    Hemangiopericytoma (HPC) is a rare tumor of uncertain malignant potential arising from mesenchymal cells with pericytic differentiation. It accounts for 3-5% of soft tissue sarcomas and 1% of vascular tumors. It usually presents in 5th to 6th decade of life. Most common sites are limbs, pelvis and head and neck. About 20% of all hemangiopericytomas are seen in head and neck, mostly in adults. Usually it presents in orbit, nasal cavity, oral cavity, jaw, parotid gland, parapharyngeal space, masticator space and jugular foramen. Long term follow up is important because of imprecise nature of the histological criteria for prediction of biologic behavior.We report herein a case of HPC in 66-year-old man, who presented in our department with headache, nasal obstruction and dysphagia. A neck computer tomography scan and magnetic resonance imaging showed a large left parapharyngeal mass bulging into nasopharynx and oropharynx with extension to pharyngeal mucosal surface and causing narrowing of airways and total obstruction of left posterior nostril. Angiography showed a highly vascular neoplasm. Initially he was managed as a case of schwannoma and embolization was done but with no response. An attempt to do complete surgical resection was made, but due to its critical position, it was not possible. During surgery, highly vascularised tumor was found. The histopathologic examination revealed a vascular tumor consistent with hemangiopericytoma G-II. The patient had normal postoperative course of healing and was given adjuvant radiation. He is on regular follow up without signs of recurrence or metastases.In summary, parapharyngeal space is a rare site of presentation for hemangiopericytoma which is highly vascular tumor, requiring extensive work up including magnetic resonance imaging, computed tomography scan and angiography. Complete surgical excision should be attempted. Postoperative radiation is indicated in cases of incomplete resection. PMID:22480217

  15. Critic appraisal. Postoperative sensitivity with indirect restorations.

    PubMed

    Farias, David; Walter, Ricardo; Swift, Edward J

    2014-01-01

    Postoperative sensitivity is characterized by short and sharp pain, and often experienced after cementation of indirect restorations. Factors associated with the occurrence of post-cementation sensitivity include type of cement, removal of smear layer by acid-etching, aggressive tooth preparation, inadequate provisional restorations, and patient's age. Its prevention is based on either interfering with mechanoreceptor activity or occluding the dentinal tubules. Regarding the latter, application of dentin desensitizers may be effective for blocking the tubules and significantly reducing dentin permeability and consequently postoperative sensitivity. This Critical Appraisal will present available clinical data where traditional materials such as zinc phosphate and glass ionomer cements (GIC) as well as self-adhesive resin-based cements were used. PMID:24761824

  16. Cardiac Transplant Postoperative Management and Care.

    PubMed

    Freeman, Regi; Koerner, Erika; Clark, Courtney; Halabicky, Kathy

    2016-01-01

    Heart failure impacts a multitude of individuals each year. Treatment is based on the progression of the disease and severity of symptoms. Cardiac transplant is the gold standard treatment of advanced heart failure, although the availability of organs limits the number of transplants received each year. Postoperative care and monitoring for cardiac transplant is complex and requires specialized nurses and providers at transplant centers for successful outcomes. This article outlines cardiac transplant from preoperative care through transplant, as well as posttransplant monitoring and care including discharge. Special attention is focused on management in the intensive care unit setting and potential complications that can occur in the immediate postoperative period. Interventions for potential complications are also highlighted. PMID:27254638

  17. 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

  18. Cardiac risk assessment: decreasing postoperative complications.

    PubMed

    Thanavaro, Joanne L

    2015-02-01

    Preoperative cardiac assessment helps identify patients undergoing noncardiac surgery who are at risk for significant postoperative cardiac complications and those who may benefit from additional preoperative evaluation and perioperative care. Advanced practice nurses can identify surgery- and patient-related risks by conducting a thorough health history and physical examination. Multiple risk indices and evidence-based guidelines are available to inform health care providers regarding patient evaluation and strategies to reduce postoperative cardiac risk. In general, preoperative tests are recommended only if the findings will influence medical therapy or perioperative monitoring or will require postponement of surgery until a cardiac condition can be corrected or stabilized. Medication management is a crucial component of the preoperative assessment; providers may need to initiate the use of beta-blockers and make decisions regarding continuing or withholding antiplatelet and anticoagulant therapy. Preoperative cardiac risk stratification, medication reconciliation, and device management are essential for providing safe care for patients. PMID:25645037

  19. Auditing Analgesic Use in Post-operative Setting in a Teaching Hospital

    PubMed Central

    Bathini, Prapthi

    2015-01-01

    Introduction: Managing postoperative pain efficiently is one important therapeutic challenge in the hospitals. Combination use of analgesics is in vogue, where in drugs from the opioid and non-opioid group are given synergistically. The aim of this study is to audit the use of different analgesics on the first postoperative day. Effort has been made to look into the drug or drug combinations used and other factors associated with their use. Materials and Methods: Retrospective, cross sectional observational study was conducted over a period of 11 months in a tertiary care teaching hospital at Hyderabad with approval from institutional ethics committee. Medical records of 649 patients on the first postoperative day were analysed for analgesics by various indicators. Results: Average number of drugs per encounter was 4.23. Percentage of patients prescribed drugs from national essential drug list/WHO was 81.94%. Most common analgesic (monotherapy) prescribed was tramadol followed by diclofenac and the most common combination drugs prescribed were tramadol+Paracetamol. The most common route of administration was intravenous. All the drugs except piroxicam, were in the lower limit of the recommended daily dose. Conclusion: The present study gives an idea of the overall pattern of analgesic drug use in postoperative patients. The drug combinations used, the most common single use drug can be made out. The health professionals can be encouraged to prescribe by generic name and from the National List of Essential Medicines NLEMs. PMID:26023565

  20. Impact on red blood cell immunity patterns in postoperative phase following total hip arthroplasty

    PubMed Central

    Yu, Defu; Fu, Changma; Yu, Runze

    2014-01-01

    Objective In this study, we aimed to measure changes in red blood cell (RBC) immunity and cytokine levels after performing total hip replacement surgery. Material and methods Twenty patients receiving total hip arthroplasty were investigated by measuring presurgical and postoperative RBC natural tumor erythrocyte rosette rate (NTERR), RBC C3b receptor rosette rate (RC3bRR), RBC membrane CD35, CD58 and CD59 expression and cytokine levels [including tumor necrosis factor α (TNF-α), interleukin 2 (IL-2), interferon γ (IFN-γ), interleukin 10 (IL-10) and prostaglandin E2 (PGE2)]. Blood samples were collected on the day before surgery and on the first day after hip arthroplasty. Results Postoperative NTERR and RC3bRR were significantly lower than presurgical levels (p < 0.05). The RBC membrane CD35, CD58 and CD59 expressions were significantly decreased in the postoperative phase compared to pre-operative levels. Importantly, RBC promoting lymphocyte proliferation rates were significantly reduced after surgery. In addition, postoperative TNF-α, IL-2 and IFN-γ levels in RBC and lymphocyte culture fluid were lower than those pre-operation, whereas IL-10 and PGE2 were significantly increased compared to presurgical levels (p < 0.05). Conclusions The modification of RBC immune function may be involved in the occurrence and development of the infection following hip arthroplasty, and this suggests a novel strategy to prevent such infection. PMID:26155151

  1. 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

  2. Perspectives on the importance of postoperative ileus.

    PubMed

    Sanfilippo, Filippo; Spoletini, Gabriele

    2015-04-01

    Post-operative ileus (POI) is a common condition after surgery. Failure to restore adequate bowel function after surgery generates a series of complications and it is associated to patients frustration and discomfort, worsening their perioperative experience. Even mild POI can be source of anxiety and could be perceived as a drop out from the "straight-forward" pathway. Enhanced recovery programmes have emphasized the importance of early commencement of oral diet, avoiding the ancient dogmata of prolonged gastric decompression and fasting. These protocols with early oral feeding and mobilization have led to improved perioperative management and have decreased hospital length of stay, ameliorating patient's postoperative experience as well. Nonetheless, the incidence of POI is still high especially after major open abdominal surgery. In order to decrease the incidence of POI, minimally-invasive surgical approaches and minimization of surgical manipulation have been suggested. From a pharmacological perspective, a meta-analysis of pro-kinetics showed beneficial results with alvimopan, although its use has been limited by the augmented risk of myocardial infarction and the high costs. A more simple approach based on the postoperative use of chewing-gum has provided some benefits in restoring bowel function. From an anaesthesiological perspective, epidural anaesthesia/analgesia does not only reduce the postoperative consumption of systemic opioids but directly improve gastrointestinal function and should be considered where possible, at least for open surgical procedures. POI represents a common and debilitating complication that should be challenged with multi-disciplinary approach. Prospective research is warranted on this field and should focus also on patient s reported outcomes. PMID:25753356

  3. 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.

  4. Postoperative irradiation in carcinoma of the prostate

    SciTech Connect

    Pilepich, M.V.; Walz, B.J.; Baglan, R.J.

    1984-10-01

    Twenty-eight patients received postoperative radiotherapy with curative intent following either radical prostatectomy (18 patients) or enucleative prostatectomy (10 patients). In patients undergoing radical prostatectomy, the indications for postoperative radiotherapy included positive margins in 13, close margins in 2, and seminal vesicle involvement in 3 patients. The majority of patients (82%) received total dose to the prostatic bed in excess of 6500 rad. In over 80% of the patients, the pelvic lymphatics are also treated (to a total dose of 4000-5000 rad). All of the patients irradiated after radical prostatectomy clinically remained disease-free locally. Approximately one-half of the patients in both the enucleation and radial prostatectomy groups developed evidence of distant metastases. The complications of treatment have been comparable to those in patients treated with radiotherapy only. The continence status has not been affected significantly. All patients with incontinence following completion of radiotherapy had documented impairment of continence prior to radiotherapy. Postoperative radiotherapy administered following either radical or enucleative prostatectomy was tolerated well and resulted in excellent local control.

  5. Pathophysiology and prevention of postoperative peritoneal adhesions

    PubMed Central

    Arung, Willy; Meurisse, Michel; Detry, Olivier

    2011-01-01

    Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fibrin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peritoneal adhesions have been investigated. Their role aims in activating fibrinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting collagen synthesis or creating a barrier between adjacent wound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional findings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clinical studies are still necessary to evaluate the effectiveness of the several proposed prevention strategies of postoperative peritoneal adhesions. PMID:22147959

  6. Adjuvant postoperative radiation therapy for colonic carcinoma.

    PubMed Central

    Willett, C G; Tepper, J E; Skates, S J; Wood, W C; Orlow, E C; Duttenhaver, J R

    1987-01-01

    One hundred thirty-three patients with Stage B2, B3, and C colonic carcinoma had resection for curative intent followed by adjuvant postoperative radiotherapy to the tumor bed. The 5-year actuarial local control and disease-free survival rates for these 133 patients were 82% and 61%, respectively. Stage for stage, the development of local regional failure was reduced for patients receiving postoperative radiotherapy compared with a historic control series. Local recurrence occurred in 8%, 21%, and 31% of patients with Stage B3, C2, and C3 tumors who had radiation therapy, respectively, whereas the local failure rates were 31%, 36%, and 53% in patients treated with surgery alone. There was a 13% and 12% improvement in the 5-year disease-free survival rate in the patients with Stage B3 and C3 lesions who had radiotherapy compared with the historic controls. For patients with Stage C disease, local control and disease-free survival rates decreased progressively with increasing nodal involvement; however, local control and disease-free survival rates were higher in the patients who had radiotherapy than in those who had surgery alone. Failure patterns in the patients who had radiotherapy did not show any notable changes compared with those for patients who had surgery alone. Postoperative radiation therapy for Stage B3, C2, and C3 colonic carcinoma is a promising treatment approach that deserves further investigation. PMID:3689006

  7. [Intraoperative and postoperative complications of splenectomy].

    PubMed

    Petrović, M; Popovic, M; Knezević, S; Matić, S; Gotić, M; Milovanović, A; Zuvela, M; Artiko, V; Dugalić, V; Ranković, V

    2002-01-01

    Spleen is being surgically removed because of trauma, in diagnostic and-or therapeutical purposes because of the benignant and malignant diseases. The percentage of morbidity during and after splenectomy is relatively low. During surgery might occur bleeding, trauma of the pancreatic tail, stomach, lineal flexure of the colon, left hemidiafragm, left suprarenal gland and upper pole of the left kidney, which must be correspondingly reclaimed during the same intervention. In the early postoperative period, postoperative bleeding, subfrenic abscess, pulmonal atelectasis, bronchopneumonia and left pleural extravasations might occur. Especially is important notification of these events in due time and adequate conservative and surgical treatment. After splenectomy, there is an increase of the number of trombocytes, which might lead to the tromboembolic complications. In the prevention of these complications in the postoperative period prolonged antiagregation therapy is suggested. Postsplenectomy sepsis is very late, general complication of splenectomy, which occurs because of the lower immunity in the child age. To prevent these complications, partial splenectomies, reimplantations of the spleen, prolonged application of the penicillin medicines after splenectomy and antipneumococcal vaccine are performed. PMID:12587454

  8. Optimizing postoperative sexual function after radical prostatectomy

    PubMed Central

    Tutolo, Manuela; Briganti, Alberto; Suardi, Nazareno; Gallina, Andrea; Abdollah, Firas; Capitanio, Umberto; Bianchi, Marco; Passoni, Niccolò; Nini, Alessandro; Fossati, Nicola; Rigatti, Patrizio

    2012-01-01

    Erectile dysfunction (ED) is one of the complications associated with pelvic surgery. The significance of ED as a complication following pelvic surgery, especially radical prostatectomy (RP), lies in the negative impact that it has on patients’ sexual and overall life. In the literature, rates of ED following RP range from 25% to 100%. Such variety is associated with pelvic dissection and conservation of neurovascular structures. Another important factor impacting on postoperative ED is the preoperative erectile function of the patient. Advances in the knowledge of pelvic anatomy and pathological mechanisms led to a refinement of pelvic surgical techniques, with attention to the main structures that if damaged compromise erectile function. These improvements resulted in lower postoperative ED rates and better erectile recovery, especially in patients undergoing RP. Furthermore, surgery alone is not sufficient to prevent this complication, and thus, several medical strategies have been tested with the aim of maximizing erectile function recovery. Indeed it seems that prevention of postoperative ED must be addressed by a multimodal approach. The aim of this review is to give a picture of recent knowledge, novel techniques and therapeutic approaches in order to reach the best combination of treatments to reduce the rate of ED after pelvic surgery. PMID:23205061

  9. 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

  10. Increased Risk of Postthoracotomy Pain Syndrome in Patients with Prolonged Hospitalization and Increased Postoperative Opioid Use.

    PubMed

    Kinney, Michelle A O; 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

  11. Risk Factors for 30-Day Hospital Readmission among General Surgery Patients

    PubMed Central

    Kassin, Michael T; Owen, Rachel M; Perez, Sebastian; Leeds, Ira; Cox, James C; Schnier, Kurt; Sadiraj, Vjollca; Sweeney, John F

    2012-01-01

    Background Hospital readmission within 30-days of an index hospitalization is receiving increased scrutiny as a marker of poor quality patient care. This study identifies factors associated with 30-day readmission following General Surgery procedures. Study Design Using standard National Surgical Quality Improvement Project (NSQIP) protocol, preoperative, intraoperative, and postoperative outcomes were collected on patients undergoing inpatient General Surgery procedures at a single academic center between 2009 and 2011. Data were merged with our institutional clinical data warehouse to identify unplanned 30-day readmissions. Demographics, comorbidities, type of procedure, postoperative complications, and ICD-9 coding data were reviewed for patients who were readmitted. Univariate and multivariate analysis was utilized to identify risk factors associated with 30-day readmission. Results 1442 General Surgery patients were reviewed. 163 (11.3%) were readmitted within 30 days of discharge. The most common reasons for readmission were gastrointestinal complaint/complication (27.6%), surgical infection (22.1%), and failure to thrive/malnutrition (10.4%). Comorbidities associated with risk of readmission included disseminated cancer, dyspnea, and preoperative open wound (p<0.05 for all variables). Surgical procedures associated with higher rates of readmission included pancreatectomy, colectomy, and liver resection. Postoperative occurrences leading to increased risk of readmission were blood transfusion, postoperative pulmonary complication, wound complication, sepsis/shock, urinary tract infection, and vascular complications. Multivariable analysis demonstrates that the most significant independent risk factor for readmission is the occurrence of any postoperative complication (OR 4.20, 95% CI 2.89–6.13). Conclusions Risk factors for readmission after General Surgery procedures are multi-factorial; however, postoperative complications appear to drive readmissions in

  12. Popular Chat Day Q & A

    MedlinePlus

    ... Day / Popular Chat Day Q & A Popular Chat Day Q & A Print Read students’ most popular questions ... Cool Order Free Materials National Drugs & Alcohol Chat Day Chat Day Participant FAQs Popular Chat Day Q & ...

  13. My Lucky Day

    ERIC Educational Resources Information Center

    Olvey, Maura

    2010-01-01

    Teaching based on problem solving brings challenges for the teacher, primarily that of finding problems with multiple access points that accommodate all students. This article narrates the author's lucky day as she discovers the Four fours problem which impacted her passion for teaching math. The day she presented the Four fours problem to her…

  14. 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…

  15. 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…

  16. 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…

  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 activities and…

  18. 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…

  19. 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)

  20. 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 ...

  1. Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis

    PubMed Central

    2013-01-01

    Background The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery. Methods Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables. Results 179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p = 0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p = 0.02 and p = 0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p = 0.02). The length of the intensive care unit stay (p < 0.001) was significantly longer in the infection group compared to the control group. Conclusions Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences

  2. Prospective Study on the Incidence of Postoperative Venous Thromboembolism in Korean Patients with Colorectal Cancer

    PubMed Central

    Lee, Eunyoung; Kang, Sung-Bum; Choi, Sang Il; Chun, Eun Ju; Kim, Min Jeong; Kim, Duck-Woo; Oh, Heung-Kwon; Ihn, Myong Hoon; Kim, Jin Won; Bang, Soo-Mee; Lee, Jeong-Ok; Kim, Yu Jung; Kim, Jee Hyun; Lee, Jong Seok; Lee, Keun-Wook

    2016-01-01

    Purpose Pharmacologic thromboprophylaxis is routinely recommended for Western cancer patients undergoing major surgery for prevention of venous thromboembolism (VTE). However, it is uncertainwhetherroutine administration of pharmacologic thromboprophylaxis is necessary in all Asian surgical cancer patients. This prospective study was conducted to examine the incidence of and risk factors for postoperative VTE in Korean colorectal cancer (CRC) patients undergoing major abdominal surgery. Materials and Methods This study comprised two cohorts, and none of patients received perioperative pharmacologic thromboprophylaxis. In cohort A (n=400), patients were routinely screened for VTE using lower-extremity Doppler ultrasonography (DUS) on postoperative days 5-14. In cohort B (n=148), routine DUS was not performed, and imaging was only performed when there were symptoms or signs that were suspicious for VTE. The primary endpoint was the VTE incidence at 4 weeks postoperatively in cohort A. Results The postoperative incidence of VTE was 3.0% (n=12) in cohort A. Among the 12 patients, eight had distal calf vein thromboses and one had symptomatic thrombosis. Age ≥ 70 years (odds ratio [OR], 5.61), ≥ 2 comorbidities (OR, 13.42), and white blood cell counts of > 10,000/μL (OR, 17.43) were independent risk factors for postoperative VTE (p < 0.05). In cohort B, there was one case of VTE (0.7%). Conclusion The postoperative incidence of VTE, which included asymptomatic cases, was 3.0% in Korean CRC patients who did not receive pharmacologic thromboprophylaxis. Perioperative pharmacologic thromboprophylaxis should be administered to Asian CRC patients on a risk-stratified basis. PMID:26582397

  3. 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

  4. Postoperative Bowel Function, Symptoms and Habits in Women After Vaginal Reconstructive Surgery

    PubMed Central

    Ballard, Alicia; Parker-Autry, Candace; Lin, Chee Paul; Markland, Alayne D.; Ellington, David R.; Richter, Holly E.

    2015-01-01

    Introduction and Hypothesis To characterize postoperative bowel symptoms in women undergoing vaginal prolapse reconstructive surgery randomized to preoperative bowel preparation versus regular diet. Methods Subjects (N = 121) completed two bowel diaries: a 7-day bowel diary immediately prior to surgery and a 14-day diary postoperatively. Self-reported bowel diary data and symptoms included the time to first bowel movement (BM), daily number of BMs, Bristol Stool Form Scale score, pain and urgency associated with BM, episodes of fecal incontinence, and use of laxatives. Antiemetic use was abstracted from medical records. Outcomes were compared between groups using chi-squared/Fisher's exact test or Student's t-test as appropriate. Results Mean time to first postoperative BM was similar between the bowel prep (n=60) and control groups (n=61), 81.2 ± 28.9 vs 78.6± 28.2 hrs, p=0.85. With the first BM, there were no differences between bowel preparation and control groups regarding pain (17.2% vs 27.9%, p=0.17), fecal urgency with defecation (56.9% vs 52.5%, p=0.63), fecal incontinence (14% vs 15%, p=0.88) and >1 use of laxatives (93.3% vs 96.7% p=0.44), respectively. Antiemetic use was similar in both groups (48.3% vs 55.7%, respectively, p=0.42). Conclusions There were no differences in return of bowel function and other bowel symptoms postoperatively between randomized groups. Lack of bowel preparation does not impact the risk of painful defecation postoperatively. This information may be used to inform patients regarding expectations for bowel function after vaginal reconstructive surgery. PMID:25672646

  5. Utility of Early Post-operative High Resolution Volumetric MR Imaging after Transsphenoidal Pituitary Tumor Surgery

    PubMed Central

    Patel, Kunal S.; Kazam, Jacob; Tsiouris, Apostolos J.; Anand, Vijay K.; Schwartz, Theodore H.

    2014-01-01

    Objective Controversy exists over the utility of early post-operative magnetic resonance imaging (MRI) after transsphenoidal pituitary surgery for macroadenomas. We investigate whether valuable information can be derived from current higher resolution scans. Methods Volumetric MRI scans were obtained in the early (<10 days) and late (>30 days) post-operative periods in a series of patients undergoing transsphenoidal pituitary surgery. The volume of the residual tumor, resection cavity, and corresponding visual field tests were recorded at each time point. Statistical analyses of changes in tumor volume and cavity size were calculated using the late MRI as the gold standard. Results 40 patients met the inclusion criteria. Pre-operative tumor volume averaged 8.8 cm3. Early postoperative assessment of average residual tumor volume (1.18 cm3) was quite accurate and did not differ statistically from late post-operative volume (1.23 cm3, p=.64), indicating the utility of early scans to measure residual tumor. Early scans were 100% sensitive and 91% specific for predicting ≥ 98% resection (p<.001, Fisher’s exact test). The average percent decrease in cavity volume from pre-operative MRI (tumor volume) to early post-operative imaging was 45% with decreases in all but 3 patients. There was no correlation between the size of the early cavity and the visual outcome. Conclusions Early high resolution volumetric MRI is valuable in determining the presence or absence of residual tumor. Cavity volume almost always decreases after surgery and a lack of decrease should alert the surgeon to possible persistent compression of the optic apparatus that may warrant re-operation. PMID:25045791

  6. 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. PMID:25546011

  7. [Postoperative pain therapy in Germany. Status quo].

    PubMed

    Pogatzki-Zahn, E M; Meissner, W

    2015-10-01

    A great deal of progress has been made in the field of postoperative pain therapy in the last 20 years. Beginning from clinical trials on the effectiveness of individual procedures, such as epidural anesthesia and patient-controlled analgesia, a wide range of healthcare services research as well as basic research with human and animal experiments has been established. Whereas health services research in the 1980s and 1990s focused more on the implementation of acute pain services, outcome-oriented research approaches are nowadays the center of attention. Acute pain registries and pain certification projects initiated in Germany have to be mentioned particularly in this respect. Basic research papers from recent years increasingly address specific aspects of acute postoperative pain and have provided translational approaches that are applied around the world for studying neurobiological mechanisms of postoperative pain. At the same time, interdisciplinary cooperation in research projects has led to a better understanding of complex correlations regarding predictors and mechanisms (including psychosocial aspects) of acute and in recent times also chronic pain after surgery. In parallel, evidence-based medicine has found its way into acute pain medicine in Germany. In 2007, clinical acute pain therapy in Germany was enhanced by S3 level guidelines for the first time; however, the implementation is still incomplete. In future, questions concerning mechanism-based therapy of acute pain need to be equally in the center of attention of research, such as prevention of persisting pain after surgery and acute pain of different origins. PMID:26289394

  8. Estimation of Genetic Parameters for First Lactation Monthly Test-day Milk Yields using Random Regression Test Day Model in Karan Fries Cattle.

    PubMed

    Singh, Ajay; Singh, Avtar; Singh, Manvendra; Prakash, Ved; Ambhore, G S; Sahoo, S K; Dash, Soumya

    2016-06-01

    A single trait linear mixed random regression test-day model was applied for the first time for analyzing the first lactation monthly test-day milk yield records in Karan Fries cattle. The test-day milk yield data was modeled using a random regression model (RRM) considering different order of Legendre polynomial for the additive genetic effect (4th order) and the permanent environmental effect (5th order). Data pertaining to 1,583 lactation records spread over a period of 30 years were recorded and analyzed in the study. The variance component, heritability and genetic correlations among test-day milk yields were estimated using RRM. RRM heritability estimates of test-day milk yield varied from 0.11 to 0.22 in different test-day records. The estimates of genetic correlations between different test-day milk yields ranged 0.01 (test-day 1 [TD-1] and TD-11) to 0.99 (TD-4 and TD-5). The magnitudes of genetic correlations between test-day milk yields decreased as the interval between test-days increased and adjacent test-day had higher correlations. Additive genetic and permanent environment variances were higher for test-day milk yields at both ends of lactation. The residual variance was observed to be lower than the permanent environment variance for all the test-day milk yields. PMID:26954137

  9. Estimation of Genetic Parameters for First Lactation Monthly Test-day Milk Yields using Random Regression Test Day Model in Karan Fries Cattle

    PubMed Central

    Singh, Ajay; Singh, Avtar; Singh, Manvendra; Prakash, Ved; Ambhore, G. S.; Sahoo, S. K.; Dash, Soumya

    2016-01-01

    A single trait linear mixed random regression test-day model was applied for the first time for analyzing the first lactation monthly test-day milk yield records in Karan Fries cattle. The test-day milk yield data was modeled using a random regression model (RRM) considering different order of Legendre polynomial for the additive genetic effect (4th order) and the permanent environmental effect (5th order). Data pertaining to 1,583 lactation records spread over a period of 30 years were recorded and analyzed in the study. The variance component, heritability and genetic correlations among test-day milk yields were estimated using RRM. RRM heritability estimates of test-day milk yield varied from 0.11 to 0.22 in different test-day records. The estimates of genetic correlations between different test-day milk yields ranged 0.01 (test-day 1 [TD-1] and TD-11) to 0.99 (TD-4 and TD-5). The magnitudes of genetic correlations between test-day milk yields decreased as the interval between test-days increased and adjacent test-day had higher correlations. Additive genetic and permanent environment variances were higher for test-day milk yields at both ends of lactation. The residual variance was observed to be lower than the permanent environment variance for all the test-day milk yields. PMID:26954137

  10. On the inability of magnetically constricted transition regions to account for the 10 to the 5th to 10 to the 6th K plasma in the quiet solar atmosphere

    NASA Technical Reports Server (NTRS)

    Dowdy, James F., Jr.; Moore, Ronald L.; Emslie, A. Gordon

    1987-01-01

    Static models of the plasma in the quiet solar atmosphere incorporating not only conduction and radiation but also the effects of large magnetic constrictions are examined. It is found that the bulk of the solar plasma at temperatures below 7 x 10 to the 5th K cannot be produced by a conductive transition region when it is modeled by flux tubes with constriction compatible with observations. The present findings suggest that the major portion of the UEV plasma may be maintained in an ensemble of small, individual magnetic loops located within the supergranular network and having peak temperatures ranging from chromospheric to coronal values.

  11. Noninvasive ventilation in large postoperative flail chest.

    PubMed

    Piastra, Marco; De Luca, Daniele; Zorzi, Giulia; Ruggiero, Antonio; Antonelli, Massimo; Conti, Giorgio; Pietrini, Domenico

    2008-12-01

    An 11-year-old male developed a severe respiratory failure due to a iatrogenic flail chest following a surgery for removing a large chest wall area. A rare Ewing sarcoma was histologically diagnosed and intensive chemotherapy was administered. Postoperatively, because of the failure in ventilation weaning, the patient was electively extubated and noninvasive positive pressure ventilation through face-mask was provided. Respiratory support avoided asynchronous paradoxical movements and achieved pneumatic stabilization. Clinical and respiratory improvement allowed a successful weaning from ventilator. PMID:18798557

  12. Postoperative pain management after supratentorial craniotomy.

    PubMed

    Verchère, Eric; Grenier, Bruno; Mesli, Abdelghani; Siao, Daniel; Sesay, Mussa; Maurette, Pierre

    2002-04-01

    The aim of this study was to compare the analgesic efficacy of three different postoperative treatments after supratentorial craniotomy. Sixty-four patients were allocated prospectively and randomly into three groups: paracetamol (the P group, n = 8), paracetamol and tramadol (the PT group, n = 29), and paracetamol and nalbuphine (the PN group, n = 27). General anesthesia was standardized with propofol and remifentanil using atracurium as the muscle relaxant. One hour before the end of surgery, all patients received 30 mg/kg propacetamol intravenously then 30 mg/kg every 6 hours. Patients in the PT group received 1.5 mg/kg tramadol 1 hour before the end of surgery. For patients in the PN group, 0.15 mg/kg nalbuphine was injected after discontinuation of remifentanil, because of its mu-antagonist effect. Postoperative pain was assessed in the fully awake patient after extubation (hour 0) and at 1, 2, 4, 8, and 24 hours using a visual analog scale (VAS). Additional tramadol (1.5 mg/kg) or 0.15 mg/kg nalbuphine was administered when the VAS score was > or = 30 mm. Analgesia was compared using the Mantha and Kaplan-Meier methods. Adverse effects of the drugs were also measured. The three groups were similar with respect to the total dose of remifentanil received (0.27 +/- 0.1 mircog/kg/min). In all patients, extubation was obtained within 6 +/- 3 minutes after remifentanil administration. Postoperative analgesia was ineffective in the P group; therefore, inclusions in this group were stopped after the eighth patient. Postoperative analgesia was effective in the two remaining groups because VAS scores were similar, except at hour 1, when nalbuphine was more effective (P = .001). Nevertheless, acquiring such a result demanded significantly more tramadol than nalbuphine (P < .05). More cases of nausea and vomiting were observed in the PT group but the difference was not significant (P < .06). In conclusion, pain after supratentorial neurosurgery must be taken into account

  13. Modified levator aponeurotic advancement with delayed postoperative office revision.

    PubMed

    Mauriello, J A; Abdelsalam, A

    1998-07-01

    The results of a "modified" levator aponeurotic advancement were reviewed to determine the appropriate indications and optimum timing for office revision after blepharoptosis repair. The levator advancement was modified as follows: 1) elimination of epinephrine from the local anesthetic so as not to stimulate the Müller muscle, 2) use of a 6-0 silk rather than a monofilament nonabsorbable suture to secure the advanced levator to avoid possible cheese-wiring and late recurrence, and 3) excision of a strip of preseptal orbicularis muscle just above the tarsal border to create surgically apposed "raw" surfaces for a firm attachment of the "advanced" levator. Office adjustments were delayed for at least 8 days after surgery and were performed as late as 14 days after surgery. Of the 122 consecutive aponeurotic advancements in 110 patients (12 bilateral cases), five (4.1%) patients were candidates for revision in that the operated eyelid was greater than 1 mm from desired height. All such eyelids were undercorrected by 2.0 mm to 2.5 mm. Four of the five underwent revision at 8, 11, and 14 days (two patients) after surgery. The fifth patient did not undergo revision. Four patients with overcorrections from 2.0 mm to 2.5 mm resolved with eyelid massage. It is concluded that the number of office revisions may be reduced if delayed for at least 8 days after surgery. This delay allows for resolution of postoperative edema and objective prediction of final eyelid position. The advantages of this "modified" levator advancement procedure are discussed. PMID:9700735

  14. 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 ...

  15. 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,...

  16. 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.

  17. 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

  18. Can bedside patient-reported numbness predict postoperative ambulation ability for total knee arthroplasty patients with nerve block catheters?

    PubMed Central

    Mudumbai, Seshadri C.; Ganaway, Toni; Kim, T. Edward; Howard, Steven K.; Giori, Nicholas J.; Shum, Cynthia

    2016-01-01

    Background Adductor canal catheters offer advantages over femoral nerve catheters for knee replacement patients because they produce less quadriceps muscle weakness; however, applying adductor canal catheters in bedside clinical practice remains challenging. There is currently no patient-reported outcome that accurately predicts patients' physical function after knee replacement. The present study evaluates the validity of a relatively new patient-reported outcome, i.e., a numbness score obtained using a numeric rating scale, and assesses its predictive value on postoperative ambulation. Methods We conducted a retrospective cohort study pooling data from two previously-published clinical trials using identical research methodologies. Both studies recruited patients undergoing knee replacement; one studied adductor canal catheters while the other studied femoral nerve catheters. Our primary outcome was patient-reported numbness scores on postoperative day 1. We also examined postoperative day 1 ambulation distance and its association with postoperative numbness using linear regression, adjusting for age, body mass index, and physical status. Results Data from 94 subjects were included (femoral subjects, n = 46; adductor canal subjects, n = 48). Adductor canal patients reported decreased numbness (median [10th–90th percentiles]) compared to femoral patients (0 [0–5] vs. 4 [0–10], P = 0.001). Adductor canal patients also ambulated seven times further on postoperative day 1 relative to femoral patients. There was a significant association between postoperative day 1 total ambulation distance and numbness (Beta = –2.6; 95% CI: –4.5, –0.8, P = 0.01) with R2 = 0.1. Conclusions Adductor canal catheters facilitate improved early ambulation and produce less patient-reported numbness after knee replacement, but the correlation between these two variables is weak. PMID:26885299

  19. Cognitive Function is Linked to Adherence to Bariatric Postoperative Guidelines

    PubMed Central

    Spitznagel, Mary Beth; Galioto, Rachel; Limbach, Kristen; Gunstad, John; Heinberg, Leslie

    2013-01-01

    Background Impairment in cognitive function is found in a significant subset of individuals undergoing bariatric surgery and recent work shows this impairment is associated with smaller postoperative weight loss. Reduced cognitive function could contribute to poorer adherence to postoperative guidelines, though this has not been previously examined. Objectives The current study examined the relationship between cognitive function and adherence to bariatric postoperative guidelines. We expected that higher cognitive function would be associated with better adherence to postoperative guidelines. Setting Data were collected through the bariatric service of a major medical center. Methods Thirty-seven bariatric surgery patients completed cognitive testing and a self-report measure of adherence to postoperative bariatric guidelines during their 4–6 week postoperative appointment. Results Strong correlations were observed between adherence to postoperative guidelines and cognitive indices of attention, executive function, and memory. Conclusions Results demonstrate that cognitive performance is strongly associated with adherence to postoperative guidelines shortly after bariatric surgery. Further work is needed to clarify if this relationship is present at later postoperative stages, and the degree to which this relationship mediates postoperative weight loss outcomes. PMID:23791534

  20. Effect of preoperative suggestion on postoperative gastrointestinal motility.

    PubMed Central

    Disbrow, E A; Bennett, H L; Owings, J T

    1993-01-01

    Autonomic behavior is subject to direct suggestion. We found that patients undergoing major operations benefit more from instruction than from information and reassurance. We compared the return of intestinal function after intra-abdominal operations in 2 groups of patients: the suggestion group received specific instructions for the early return of gastrointestinal motility, and the control group received an equal-length interview offering reassurance and nonspecific instructions. The suggestion group had a significantly shorter average time to the return of intestinal motility, 2.6 versus 4.1 days. Time to discharge was 6.5 versus 8.1 days. Covariates including duration of operation, amount of intraoperative bowel manipulation, and amount of postoperative narcotics were also examined using the statistical model analysis of covariance. An average savings of $1,200 per patient resulted from this simple 5-minute intervention. In summary, the use of specific physiologically active suggestions given preoperatively in a beleivable manner can reduce the morbidity associated with an intra-abdominal operation by reducing the duration of ileus. PMID:8342264

  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

    2015-01-01

    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. PMID:25460022

  2. Phase I study of postoperative radiotherapy concurrent with S-1 in patients with gastric cancer.

    PubMed

    Qiu, Meng; Peng, Xing-chen; Bi, Feng; Wang, Xin; Li, Qiu; Xu, Feng; Li, Zhi-ping; Shen, Ya-li; Liu, Ji-yan; Zhao, Ya-qing; Cao, Dan; Gou, Hong-feng; Yang, Yu; Chen, Ye; Yi, Cheng

    2015-07-01

    Postoperative chemoradiotherapy (CRT) with concurrent 5-fluorouracil is the standard care for gastric cancer patients after curative surgery. The previous studies revealed that the subgroup of patients with high recurrence risk would benefit most from adjuvant CRT. S-1, a novel oral fluorouracil, has showed very effective in metastatic gastric cancer and became the standard option for gastric cancer with D2 dissection. The safety and dosage of S-1 combined with postoperative radiotherapy have not yet been evaluated. This study is to determine the maximum tolerate dose (MTD) and dose-limiting toxicity (DLT) of S-1 given concurrently with postoperative high-dose radiotherapy in gastric cancer. Patients with more advanced stage (pT4 and/or pN+) after R0 resection were recruited. Eligible patients received one cycle standard SOX (S-1 plus oxaliplatin) chemotherapy, then S-1 monotherapy with concurrent radiotherapy for 6 weeks, followed by additional three cycles of SOX. During the concurrent CRT, S-1 was administered on every radiotherapy treatment day according to a predefined dose-escalation schedule. Radiotherapy (3D-RT or IMRT) was given to a total dose of 50.4 Gy in 28 fractions. DLT was defined as grade 3 or 4 hematologic and non-hematologic toxicity. From March 2011 to October 2012, 21 patients were enrolled at five dose levels: 40 (n = 3), 50 (n = 3), 60 (n = 6), 70 (n = 6) and 80 mg/m(2)/day (n = 3). D2-dissection was performed in 18 patients (85.7 %) and 15 patients (71.4 %) had stage III disease. The most common dose-related toxicity was anorexia, nausea and vomiting, fatigue and leucopenia. DLT was occurred in one patient at 60 mg/m(2)/day (grade 3 fatigue), one patient at 70 mg/m(2)/day (grade 3 vomiting and anorexia), two patients at 80 mg/m(2)/day (one with grade 3 vomiting and anorexia; another with grade 3 febrile leucopenia). Four patients did not complete CRT as planned. Overall, this phase I study demonstrated that postoperative CRT with daily S-1

  3. Resident involvement in postoperative conversations: an underused opportunity

    PubMed Central

    Lorenzen, Allison W.; Sherman, Scott K.; Rosenbaum, Marcy; Kapadia, Muneera R.

    2016-01-01

    Background Because of established attending-patient and family relationships and time constraints, residents are often excluded from the immediate postoperative conversation with family. Interpersonal and communication skills are a core competency, and the postoperative conversation is an opportunity to develop these skills. Our objective is to assess attitudes, experience, and comfort regarding resident participation during postoperative conversations with families. Materials and methods Residents and attending surgeons in an academic surgery center were surveyed regarding resident involvement in the postoperative conversation with families. Paper surveys wereadministeredanonymously.Nonparametricstatisticscomparedresponses. Results There were 45 survey respondents (23 residents, 22 attendings). All residents rated postoperative conversations with families, as “important” or “very important”. Residents reported being “comfortable” or “very comfortable” with postoperative conversations. However, on average, residents reported fewer than 10 postoperative conversation experiences per year. Feedback was received by <30% on postoperative communication skills, but 88% wanted feedback. Most attendings reported it is “important” or “very important” for residents to communicate well with families during postoperative conversations, but rated residents’ performance as significantly lower than the residents’ self-assessments (P < 0.001). Attendings on average were only “somewhat comfortable” or “moderately comfortable” with residents conducting postoperative conversations with families, and only 68% reported allowing residents to do so. When bad news was involved, only 27% allowed resident participation. Most attendings (86%) believed residents need more opportunities with postoperative conversations. Conclusions Although most residents reported being comfortable with postoperative conversations, these survey results indicate that they have

  4. Tonsillectomy and Adenoids PostOp

    MedlinePlus

    ... patient comes home Most children take seven to ten days to recover from the surgery. Some may ... scabs fall off in small pieces five to ten days after surgery. Bleeding : With the exception of ...

  5. 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

  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. The Impact of Educational Status on the Postoperative Perception of Pain

    PubMed Central

    Mimigianni, Christina; Raptis, Demetris; Sourtse, Gionous; Sgourakis, George; Karaliotas, Constantine

    2015-01-01

    Background Postoperative (PO) pain interferes with the recovery and mobilization of the surgical patients. The impact of the educational status has not been studied adequately up to now. Methods This prospective study involved 400 consecutive general surgery patients. Various factors known to be associated with the perception of pain including the educational status were recorded as was the preoperative and postoperative pain and the analgesia requirements for the 1st PO week. Based on the educational status, we classified the patients in 3 groups and we compared these groups for the main outcomes: i.e. PO pain and PO analgesia. Results There were 145 patients of lower education (junior school), 150 patients of high education (high school) and 101 of higher education (university). Patients of lower education were found to experience more pain than patients of higher education in all postoperative days (from the 2nd to the 6th). No difference was identified in the type and quantity of the analgesia used. The subgroup analysis showed that patients with depression and young patients (< 40 years) had the maximum effect. Conclusions The educational status may be a significant predictor of postoperative pain due to various reasons, including the poor understanding of the preoperative information, the level of anxiety and depression caused by that and the suboptimal request and use of analgesia. Younger patients (< 40), and patients with subclinical depression are mostly affected while there is no impact on patients over 60 years old. PMID:26495081

  8. 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

  9. Postoperative delirium in the elderly surgical patient.

    PubMed

    Sieber, Frederick E

    2009-09-01

    Delirium is a common complication in the geriatric population following cardiac and noncardiac procedures. Postoperative delirium is a significant financial burden on the United States health care system and is independently associated with prolonged hospital stay, increased risk of early and long term mortality, increased physical dependence, and an increased rate of nursing home placement. The Confusion Assessment Method (CAM) is a bedside rating scale developed to assist nonpsychiatrically trained clinicians in the rapid and accurate diagnosis of delirium. The CAM has been adapted for use in ventilated intensive care unit (ICU) patients in the form of the CAM-ICU. The onset of delirium involves an interaction between predisposing and precipitating risk factors for delirium. The mainstay of delirium management is prevention. The approach involves control or elimination of modifiable risk factors. It is controversial whether anesthetic technique determines delirium. However, important modifiable risk factors under the anesthesiologist's control include adequate postoperative pain management, careful drug selection, and embracing and participating in a multidisciplinary care model for these complicated patients. PMID:19825486

  10. Novel delivery systems for postoperative analgesia.

    PubMed

    Palmer, Pamela P; Royal, Mike A; Miller, Ronald D

    2014-03-01

    Moderate-to-severe postoperative pain is usually controlled using a multimodal approach, including opioids. Intravenously administered patient-controlled analgesia (IV PCA) with opioids, popular for over 40 years, enables patients to control their level of analgesia and has advantages over a nurse-administered approach, including more satisfied patients and improved pain relief. Unfortunately, IV PCA has drawbacks such as device programming errors, medication prescribing errors, pump malfunction, limitations on patient mobility, IV patency issues, and transmission of infection. Furthermore, the setup of an infusion pump is often complex, time-consuming, and requires witnessed confirmation. Complicating IV PCA is the problem of commonly used compounds, morphine and hydromorphone, having significantly reduced brain/effector-site permeability and active metabolites, both of which create the risk of delayed adverse events. Novel patient-controlled modalities that incorporate rapid effector site-permeating opioids and non-invasive routes of administration offer great promise to enhance both patient and caregiver experiences with postoperative analgesia systems. PMID:24815968

  11. Ondansetron-droperidol combination vs. ondansetron or droperidol monotherapy in the prevention of postoperative nausea and vomiting

    PubMed Central

    Angelidi, Maria; Pandazi, Aggeliki; Tzirogiannis, Konstantinos N.; Panoutsopoulos, Georgios I.; Kostopanagiotou, Georgia

    2015-01-01

    Introduction Laparoscopic cholecystectomy is associated with a high incidence of postoperative nausea and vomiting. In this study we investigated comparatively the efficacy of combination therapy with ondansetron plus droperidol versus monotherapy with each agent alone in preventing postoperative nausea and vomiting following elective laparoscopic cholecystectomy. Material and methods One hundred twenty-seven patients who underwent elective laparoscopic cholecystectomy under general anesthesia were included in the study, and assigned to one of the following three groups according to the antiemetic drug given intravenously at the end of the surgery: droperidol 1.25 mg in group D, ondansetron 4 mg in group O, and a combination of droperidol and ondansetron at the doses mentioned above in group D + O. Incidence of postoperative nausea and vomiting, and doses of given rescue antiemetics were recorded during the first postoperative day. The total drug cost per patient spent for postoperative nausea and vomiting management (including prophylactic antiemetics plus rescue postoperative antiemetics) was calculated. Results Combination therapy significantly reduced postoperative nausea and vomiting at 30 min, 3 h and 6 h after surgery compared with group D (p < 0.01 for all time points) and O (p < 0.01 at 30 min, p < 0.05 at 3 h) and required less rescue antiemetic treatment (p < 0.01). Total antiemetic cost analyses revealed no significant differences among the three groups (p > 0.05). Conclusions Pretreatment with ondansetron plus droperidol is more effective than monotherapy in preventing postoperative nausea and vomiting following laparoscopic cholecystectomy, without increasing the cost comparatively. PMID:25995753

  12. SURGEONS EXPECT PATIENTS TO BUY-IN TO POSTOPERATIVE LIFE SUPPORT PREOPERATIVELY: RESULTS OF A NATIONAL SURVEY

    PubMed Central

    Schwarze, Margaret L.; Redmann, Andrew J.; Alexander, G. Caleb; Brasel, Karen J.

    2013-01-01

    Objective Evidence suggests that surgeons implicitly negotiate with their patients preoperatively about the use of life supporting treatments postoperatively as a condition for performing surgery. We sought to examine whether this surgical buy-in behavior is present among a large, nationally representative sample of surgeons who routinely perform high risk operations. Design Using findings from a qualitative study, we designed a survey to determine the prevalence of surgical buy-in and its consequences. Respondents were asked to consider their response to a patient at moderate risk for prolonged mechanical ventilation or dialysis who has a preoperative request to limit postoperative life supporting treatment. We used bivariate and multivariate analysis to identify surgeon characteristics associated with a) preoperatively creating an informal contract with the patient defining agreed upon limitations of postoperative life support and b) declining to operate on such patients. Setting and subjects US-mail based survey of 2100 cardiothoracic, vascular and neurosurgeons. Interventions None. Measurements and Main Results The adjusted response rate was 56%. Nearly two-thirds of respondents (62%) reported they would create an informal contract with the patient describing agreed upon limitations of aggressive therapy and a similar number (60%) endorsed sometimes or always refusing to operate on a patient with preferences to limit life support. After adjusting for potentially confounding covariates, the odds of preoperatively contracting about life supporting therapy were more than twofold greater among surgeons who felt it was acceptable to withdraw life support on postoperative day 14 as compared to those who felt it was not acceptable to withdraw life support on postoperative day 14 (odds ratio 2.1, 95% confidence intervals 1.3-3.2). Conclusions Many surgeons will report contracting informally with patients preoperatively about the use of postoperative life support

  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. External Nursing Applications in the Supportive Management of Prolonged Postoperative Ileus: Description of Interventions and Case Report.

    PubMed

    Deckers, Bernhard; von Schoen-Angerer, Tido; Voggenreiter, Bernd; Vagedes, Jan

    2016-01-01

    Prolonged postoperative ileus is a common but clinically challenging problem that leads to patient discomfort and prolonged hospitalization; the condition is managed through a multimodular program of supportive measures. In anthroposophic nursing, the management of prolonged postoperative ileus involves additional tools, including external abdominal compresses and massages with plant or silver-containing oils and ointments. We describe 3 typical techniques: Oxalis tincture compresses, Thuja/Argentum ointment compresses, and massage with "Wala Melissenöl" (containing Melissa officinalis, Carvum cari, Foeniculum amari, and Origanum majorana). A 61-year-old man with chronic pain from adhesions after multiple abdominal surgical procedures developed a prolonged postoperative ileus after an elective ileostomy reversal. Following slow recovery during the first postoperative days, he began vomiting. A nasogastric tube was inserted, and daily Oxalis tincture compresses and massage with "Wala Melissenöl" and Thuja/Argentum ointment compresses were applied on the abdomen. The patient's symptoms gradually improved over the next 10 days. No prokinetic medications were needed to manage this episode. External abdominal nursing applications with plant substances and silver can be an additional tool in the management of prolonged postoperative ileus. PMID:27309410

  15. 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

  16. EDITORIAL: Artificial Muscles: Selected papers from the 5th World Congress on Biomimetics, Artificial Muscles and Nano-Bio (Osaka, Japan, 25-27 November 2009) Artificial Muscles: Selected papers from the 5th World Congress on Biomimetics, Artificial Muscles and Nano-Bio (Osaka, Japan, 25-27 November 2009)

    NASA Astrophysics Data System (ADS)

    Shahinpoor, Mohsen

    2011-12-01

    The 5th World Congress on Biomimetics, Artificial Muscles and Nano-Bio and the 4th International Conference on Artificial Muscles were held in Osaka, Japan, 23-27 November 2009. This special section of Smart Materials and Structures is devoted to a selected number of research papers presented at this international conference and congress. Of the 76 or so papers presented at the conference, only 10 papers were finally selected, reviewed and accepted for this special section, following the regular reviewing procedures of the journal. This special section is focused on polymeric artificial muscles, electroactive polymers, multifunctional nanocomposites and their applications. In particular, an electromechanical model for self-sensing ionic polymer-metal composite actuating devices with patterned surface electrodes is presented which discusses the concept of creating self-sensing ionic polymer-metal composite (IPMC) actuating devices with patterned surface electrodes where actuator and sensor elements are separated by a grounded shielding electrode. Eventually, an electromechanical model of the device is also proposed and validated. Following that, there is broad coverage of polytetrahydrofurane-polyethylene oxide-PEDOT conducting interpenetrating polymer networks (IPNs) for high speed actuators. The conducting polymer (poly(3,4-ethylenedioxythiophene)) is incorporated within the IPNs, which are synthesized from polyethylene oxide (PEO)/polytetrahydrofurane (PTHF) networks. PEO/PTHF IPNs are prepared using poly(ethylene glycol) methacrylate and dimethacrylate and hydroxythelechelic PTHF as starting materials. The conducting IPN actuators are prepared by oxidative polymerization of 3,4-ethylenedioxithiophene (EDOT) using FeCl3 as an oxidizing agent within the PEO/PTHF IPN host matrix. Subsequently, giant and reversible magnetorheology of carrageenan/iron oxide magnetic gels are discussed and the effect of magnetic fields on the viscoelastic properties

  17. Thunder day increase

    NASA Astrophysics Data System (ADS)

    Hilberg, Steven D.

    1984-04-01

    A report issued by the Illinois State Water Survey concludes that annual values of thunder days for North America exhibited a general increase of about 15% from 1901 to 1945, followed by a general decrease of 10% from 1945 to 1980. A study of the variability of thunder days across North America showed a general decrease with time, particularly after 1940. A major finding of this study is that frequencies of thunderstorms over areas as large as the North American continent show major long-term trends.The report, “Temporal Distribution of Global Thunder Days,” summarizes the results of a 1-year study by Stanley A. Changnon, Jr., and Chin-Fei Hsu of the temporal variations of thunder-day records during 1901-1980 using quality weather records from weather stations scattered around the globe. A thunder day is recorded when one or more peals of thunder are heard anytime during the 24-hour period from midnight to midnight, which is consistent with the definition of a thunderstorm used at first-order weather stations since 1897. They found most stations in the northern hemisphere north of 45° latitude exhibited a general increase in thunder activity from 1901 to 1980. The project was funded by the National Science Foundation.

  18. 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.

  19. A team approach to the prevention of unplanned postoperative hypothermia.

    PubMed

    Bitner, Jason; Hilde, Leana; Hall, Kenneth; Duvendack, Tammy

    2007-05-01

    Postoperative hypothermia (ie, a core temperature lower than 96.8 degrees F [36 degrees C]), is a problem frequently seen in surgical patients, especially those undergoing total joint replacement. Patients who experience hypothermia may have increased recovery times and postoperative complications. A team of clinical staff members and personnel from the performance improvement (PI) department of a hospital used a PI model to incorporate use of preoperative forced-air warming blankets that resulted in improved postoperative core temperatures. PMID:17499055

  20. The effect of bi-level positive airway pressure on postoperative pulmonary function following gastric surgery for obesity.

    PubMed

    Ebeo, C T; Benotti, P N; Byrd, R P; Elmaghraby, Z; Lui, J

    2002-09-01

    The severely obese patient has varying degrees of intrinsic reduction of expiratory flow rates and lung volumes. Thus, the severely obese patient is predisposed to postoperative atelectasis, ineffective clearing of respiratory secretions, and other pulmonary complications. This study evaluated the effect of bi-level positive airway pressure (BiPAP) on pulmonary function in obese patients following open gastric bypass surgery Patients with a body mass index (BMI) of at least 40 kg/m2 who were undergoing elective gastric bypass were eligible to be randomized to receive either BiPAP during the first 24 h postoperatively or conventional postoperative care. Patients with significant cardiovascular and pulmonary diseases were excluded from the study. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), peak expiratory flow rate (PEFR), and percent hemoglobin oxygen saturation (SpO2) were measured preoperatively, and on postoperative days 1, 2, and 3. Twenty-seven patients were entered in the study 14 received BiPAP and 13 received conventional postoperative care. There was no significant difference preoperatively between the study and control groups in regards to age, BMI, FVC, FEV1.0, PEFR or SpO2. Postoperatively expiratory flow was decreased in both groups. However, the FVC and FEV1.0 were significantly higher on each of the three consecutive postoperative days in the patients who received BiPAP therapy. The SpO2 was significantly decreased in the control group over the same time period. Prophylactic BiPAP during the first 12-24 h postoperatively resulted in significantly higher measures of pulmonary function in severely obese patients who had undergone elective gastric bypass surgery. These improved measures of pulmonary function, however, did not translate into fewer hospital days or a lower complication rate in our study population of otherwise healthy obese patients. Further study is necessary to determine if BiPAP therapy in the first 24

  1. 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

  2. Postoperative pyoderma gangrenosum: A rare complication after appendectomy

    PubMed Central

    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. PMID:25511218

  3. Alterations in resting oxygen consumption in women exposed to 10 days of cold air

    SciTech Connect

    Armstrong, D.W.; Thomas, J.R. )

    1991-03-11

    Repeated exposure to cold air reduces the metabolic response to cold air exposure in man. The purpose of this investigation was to measure the change in resting metabolic rate (RMR) with exposure to 22C air and 4C air during a 12 day period. Four women sat in 22C air for 45 min followed by 45 min in 4C air each day for ten days. The authors measured RMR during a 45 min period in 22C air followed by 45 min in 4C air on four days. All subjects began their morning exposures on a Monday within 2 days of the onset of menses completing the study on a Friday, 12 days later. Subjects dressed in a T-shirt, shorts and cotton socks. During 45 min of exposure to warm air, RMR remained steady at 10% of VO{sub 2peak} on Day 1 and 10% on Day 5. RMR during exposure to warm air significantly increased to 13% of VO{sub 2peak} on Day 8 and remained elevated at 13% on Day 12. During exposure to cold air RMR peaked at 31% of CO{sub 2peak} by the 5th min on Day 1. Peak RMR on Day 5 was significantly lower. Pea RMR in the cold remained lower on Days 8 and 12. During cold exposure RMR peaked and then declined to steady-state during min 15 to 45. Steady-state RMR during cold exposure was significantly lower on Day 5, Day 7 and Day 12 when compared to the 23% of VO{sub 2peak} on Day 1. The authors found that RMR in cold air is significantly attenuated by Day 5 and remains lower through Day 12. RMR during warm air exposure is elevated 3% by Day 8 after five (5) days of repeated cold exposure followed by two (2) days without exposure to cold air, and RMR remains elevated on Day 12.

  4. Marketing Your Day Camp.

    ERIC Educational Resources Information Center

    Coleman, George

    1997-01-01

    Marketing strategies for day camps include encouraging camp staff to get involved in organizations involving children, families, and communities; holding camp fairs; offering the use of camp facilities to outside groups; hosting sport leagues and local youth outings; planning community fairs; and otherwise involving the camp in the community. (LP)

  5. 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…

  6. 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…

  7. Family Day Care Handbook.

    ERIC Educational Resources Information Center

    Community Coordinated Child Care (4-C) in Dane County, Inc., Madison, WI.

    This handbook provides both general and specific information on child development and child care to help adults who are providing child care in their homes. Information is presented in six sections which describe: (1) the family day care system, the occupation of caregiver, and the development of relationships; (2) development of a health program,…

  8. 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…

  9. 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…

  10. 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)

  11. 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.

  12. Scheduling: Seven Period Day

    ERIC Educational Resources Information Center

    Williamson, Ronald

    2010-01-01

    Driven by stable or declining financial resources many school districts are considering the costs and benefits of a seven-period day. While there is limited evidence that any particular scheduling model has a greater impact on student learning than any other, it is clear that the school schedule is a tool that can significantly impact teacher…

  13. 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 extracurricular science…

  14. 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…

  15. International School Library Day.

    ERIC Educational Resources Information Center

    Clyde, Laurel A.

    2001-01-01

    Describes the development of an International School Library Day and discusses activities in Australian school libraries. Highlights include the development of Web pages; sponsorship by national, state, or provincial associations; publicity materials; joint activities with other countries; student involvement; and activities with public libraries.…

  16. 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…

  17. Seize the Day

    ERIC Educational Resources Information Center

    Berkey, Tim

    2008-01-01

    In order to improve what happens in classrooms, a considerable amount of work needs to take place between teachers and principals. This can only happen if campus leaders make dramatic shifts in how and where they spend their daily time. Principals can have a greater impact on teaching and learning by transforming their work one day at a time. The…

  18. 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…

  19. Use of continuous local anesthetic infusion in the management of postoperative split-thickness skin graft donor site pain.

    PubMed

    Hernandez, Jorge L Reguero; Savetamal, Alisa; Crombie, Roselle E; Cholewczynski, Walter; Atweh, Nabil; Possenti, Paul; Schulz, John T

    2013-01-01

    Donor sites from split-thickness skin grafts (STSG) impose significant pain on patients in the early postoperative period. We report the use of continuous local anesthetic infusion as a method for the management of postoperative STSG donor site pain. Patients undergoing single or dual, adjacent STSG harvest from the thigh (eight patients) or back (one patient) were included in this study. Immediately after STSG harvest, subcutaneous catheters were placed for continuous infusion of local anesthetic. Daily donor site-specific pain severity scores were prospectively recorded in nine patients receiving local anesthetic infusion. Patient characteristics, technical aspects, and postoperative complications were identified in the study. The thigh was the anatomic location chosen for most donor sites. A single catheter was placed for donor sites limited to 4 inches in width or less. A dual catheter system was used for those wider than 4 inches. An elastomeric pump delivered continuously a total of 4 ml/hr of a solution of 0.5% bupivacaine. The average anesthetic infusion duration was 3.1 days. A substantial decrease in worst, least, and average donor site pain scores was found from the first 24 hours to the second postoperative day in our patients, a treatment trend that continued through postoperative day 3. One patient developed minor anesthetic leakage from the catheter insertion site; and in three cases, accidental dislodgement of the catheters occurred. There were no cases of donor site secondary infection. All donor sites were completely epithelialized at 1-month follow-up. Continuous local anesthetic infusion is technically feasible and may represent an option for postoperative donor site pain control after STSG harvesting. Relative cost-benefit of the technique remains to be determined. PMID:23271060

  20. Differential Postoperative Effects of Volatile Anesthesia and Intraoperative Remifentanil Infusion in 7511 Thyroidectomy Patients: A Propensity Score Matching Analysis.

    PubMed

    Jo, Jun-Young; Choi, Seong-Soo; Yi, Jung Min; Joo, Eun Young; Kim, Ji Hyun; Park, Se Ung; Sim, Ji-Hoon; Karm, Myong-Hwan; Ku, Seungwoo

    2016-02-01

    Although remifentanil is used widely by many clinicians during general anesthesia, there are recent evidences of opioid-induced hyperalgesia as an adverse effect. This study aimed to determine if intraoperative remifentanil infusion caused increased pain during the postoperative period in patients who underwent a thyroidectomy. A total of 7511 patients aged ≥ 20 years, who underwent thyroidectomy between January 2009 and December 2013 at the Asan Medical Center were retrospectively analyzed. Enrolled patients were divided into 2 groups: group N (no intraoperative remifentanil and only volatile maintenance anesthesia) and group R (intraoperative remifentanil infusion including total intravenous anesthesia and balanced anesthesia). Following propensity score matching analysis, 2582 patients were included in each group. Pain scores based on numeric rating scales (NRS) were compared between the 2 groups at the postoperative anesthetic care unit and at the ward until 3 days postoperation. Incidences of postoperative complications, such as nausea, itching, and shivering were also compared. The estimated NRS pain score on the day of surgery was 5.08 (95% confidence interval [CI] 4.97-5.19) in group N patients and 6.73 (95% CI 6.65-6.80) in group R patients (P < 0.001). There were no statistically significant differences in NRS scores on postoperative days 1, 2, and 3 between the 2 groups. Postoperative nausea was less frequent in group R (31.4%) than in group N (53.5%) (P < 0.001). However, the incidence of itching was higher in group R (4.3%) than in group N (0.7%) (P < 0.001). Continuous infusion of remifentanil during general anesthesia can cause higher intensity of postoperative pain and more frequent itching than general anesthesia without remifentanil infusion immediately after thyroidectomy. Considering the advantages and disadvantages of continuous remifentanil infusion, volatile anesthesia without opioid may be a good choice for minor surgeries

  1. [Do abuse of nicotine and alcohol have an effect on the incidence of postoperative bacterial infections?].

    PubMed

    Stopinski, J; Staib, I; Weissbach, M

    1993-10-01

    In a prospective study we evaluated patients with the diagnosis of 1. groin hernia (n1 = 57), 2. gall bladder stones (n2 = 80) and 3. carcinoma of the colon (n3 = 76). The whole group included 213 patients who underwent clean, clean-contaminated or contaminated operations. All wound infections and post-operative bacterial infections like pneumonia or urinal infection were registered. The patients were asked for risk factors at the time of hospitalisation. 7.1% of all patients admitted an intake of alcohol of more than 60 g/day and 15.6% of the patients smoked more than 20 cigarettes a day. We found a four times higher risk to get a postoperative infection for patients with an intake of more than 60 g alcohol a day. The rate of infection for smokers of more than 20 cigarettes a day is two times higher than for non smokers or persons who smoke less than 20 cigarettes a day. PMID:8276911

  2. 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. PMID:21031066

  3. [How to control postoperative pain: intravenous route].

    PubMed

    Occella, P; Vivaldi, F

    2003-12-01

    Intravenous administration of analgesic drugs is one of the most common ways to control post-operative pain. It can be used in almost all kinds of surgical interventions and particularly those of medium and high complexity. Besides, when other techniques are contraindicated because of clinical and/or managing problems, intravenous way finds its best application. Among analgesic drugs NSAID (ketorolac) and opioids (tramadol, morphine, buprenorphine) are most frequently used. As to administration techniques, elastomeric pump is, according to personal experience, a simple-to-manage, practical and precise device with lower cost respect to other administration set. Elastomeric pump is a single use reservoir that allows continuous administration of drugs with a uniform pre-set infusion speed. Finally, guide-lines, showing pre-load and infusion doses of analgesic drugs, based on pain intensity, are presented. PMID:14663417

  4. 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.

  5. [ULTRASOUND MONITORING FEATURES OF POSTOPERATIVE HEPATIC ECHINOCOCCOSIS].

    PubMed

    Melia, Kh; Kokaia, N; Manjgaladze, M

    2016-01-01

    The aim of the study was to investigate ultrasound features (US) of liver after post operative anti-parasite recurrence treatment of patients with echinococcosis. The clinical analyses of 50 patients were carried out. It was concluded that the use of ultrasound can provide valuable data to the clinician to assess and monitor anti parasitic therapy echinococcosis of liver in post operative period. During the monitoring the positive dynamics of disease was observed in 94,5% of cases, in 5% оf cases toxic hepatites with septic complication was diagnosed, and in 0,5% of cases the disease recurrence was revealed. Ultrasound semiotics of liver after post operative anti-parasite recurrence treatment of patients with echinococcosis was presented. Control and monitoring of patients in the postoperative period echinococcosis with appropriate antirelapse antiparasitic therapy should be held not less than 1-5 years. PMID:26870968

  6. Post-operative strabismus control and motor alignment for basic intermittent exotropia

    PubMed Central

    Chew, Fiona Lee Min; Gesite-de Leon, Bhambi Uellyn; Quah, Boon Long

    2016-01-01

    AIM To assess strabismus control and motor ocular alignment for basic exotropia surgery at 5y follow-up. METHODS The medical records of 80 consecutive patients aged less than 17 years of age, who underwent surgery for basic exotropia by a single surgeon between years 2000 to 2009 and completed a minimum of 5y follow-up post-operatively were reviewed. Pre- and post-operative characteristics were documented at 1wk, 6mo, 1, 3 and 5y follow-up. Subjects at 5-year follow-up were assigned to the success group if they had a post-operative angle of deviation within 10 prism diopters of exotropia or within 5 prism diopters of esotropia for distance on prism cover test, and had moderate to good strabismus control. The remaining subjects were assigned to the failure group. RESULTS Post-operative surgical success at one week was 75%, which decreased to 41% at 5y follow-up. The success group was noted to have more patching pre-operatively (P=0.003). The duration of patching a day (P=0.020) and total duration of patching pre-operatively (P=0.030) was higher in the success group. Surgical success at 1y (P=0.004) and 3y (P=0.002) were associated with higher surgical success at 5y follow-up. CONCLUSION Post-operative motor alignment and strabismus control for basic exotropia surgery at 1y and beyond is associated with higher exotropia surgery success at 5-year follow-up. There is an association between pre-operative patching and 5-year surgical success of basic intermittent exotropia surgery. PMID:27500110

  7. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction

    PubMed Central

    Schuepbach, Jonas; Dassonville, Olivier; Poissonnet, Gilles; Demard, Francois

    2007-01-01

    Background Bone scintigraphy was performed to monitor anastomotic patency and bone viability. Methods In this retrospective study, bone scans were carried out during the first three postoperative days in a series of 60 patients who underwent microvascular bone grafting for reconstruction of the mandible or maxilla. Results In our series, early bone scans detected a compromised vascular supply to the bone with high accuracy (p < 10-6) and a sensitivity that was superior to the sensitivity of clinical monitoring (92% and 75% respectively). Conclusion When performing bone scintigraphy during the first three postoperative days, it not only helps to detect complications with high accuracy, as described in earlier studies, but it is also an additional reliable monitoring tool to decide whether or not microvascular revision surgery should be performed. Bone scans were especially useful in buried free flaps where early postoperative monitoring depended exclusively on scans. According to our experience, we recommend bone scans as soon as possible after surgery and immediately in cases suspicious of vascularized bone graft failure. PMID:17448223

  8. 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

  9. 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

  10. 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

  11. Pre- and post-operative management of dental implant placement. Part 1: management of post-operative pain.

    PubMed

    Bryce, G; Bomfim, D I; Bassi, G S

    2014-08-01

    Although dental implant placements have high success rates and a low incidence of morbidity, post-operative pain and complications with the healing process have been reported. There is little guidance available regarding optimal pre- and post-operative management of dental implant placement. This first paper discusses the mechanisms of pain associated with dental implant placement and offers guidance to clinicians on optimal pre- and post-operative pain management regimes. The second paper aims to discuss pre- and post-operative means of reducing the risk of early healing complications. PMID:25104691

  12. Extensive surgical and comprehensive postoperative medical management for cystic fibrosis chronic rhinosinusitis

    PubMed Central

    Virgin, Frank W.; Rowe, Steven M.; Wade, Mary B.; Gaggar, Amit; Leon, Kevin J.; Young, K. Randall

    2012-01-01

    Background: Chronic rhinosinusitis has a major impact on the quality of life of patients with cystic fibrosis (CF) and may contribute to progression of chronic lung disease. Despite multiple sinus surgeries, maxillary sinus involvement is a recurrent problem. The modified endoscopic medial maxillectomy (MEMM) permits debridement in the clinic, improves mucus clearance with nasal irrigations, and increases access for topical delivery of therapeutics. However, clinical outcomes of aggressive sinus surgery with regimented postoperative medical treatment have not been systematically evaluated. Methods: CF patients completed the 22-Item Sinonasal Outcome Test questionnaires before sinus surgery (and bilateral MEMM) and at sequential postoperative visits. Objective measures included Lund-Kennedy endoscopic score and pulmonary function tests (forced expiratory volume at 1 second percent [FEV1%] predicted). Culture-directed antibiotic therapy, prednisone, and topical irrigations were initiated postoperatively. Results: Twenty-two patients (mean age, 26.5 years; 4.9 prior sinus operations) underwent MEMM and sinus surgery. Symptom scores were significantly reduced at 60 days (primary outcome, 64.7 ± 18.4 presurgery versus 27.5 ± 15.3 postsurgery; p < 0.0001) and up to a year postoperatively (27.6 ± 12.6; p < 0.0001). Endoscopic scores were also reduced after surgery (10.4 ± 1.1 presurgery versus 5.7 ± 2.4 [30 days], 5.7 ± 1.4 [60 days], 5.8 ± 1.3 [120 days], and 6.0 ± 1.1 [1 year]; p < 0.0001)]. There were no differences in FEV1% predicted up to 1 year postoperatively, but hospital admissions secondary to pulmonary exacerbations significantly decreased (2.0 ± 1.4 versus 3.2 ± 2.4, respectively; p < 0.05). Conclusion: Prospective evaluation indicates sinus surgery with MEMM is associated with marked improvement in sinus disease outcomes. Additional studies are necessary to confirm whether this treatment paradigm is associated with improved CF pulmonary disease

  13. Thirty-day outcomes underestimate endocrine and exocrine insufficiency after pancreatic resection

    PubMed Central

    Lim, Pei-Wen; Dinh, Kate H.; Sullivan, Mary; Wassef, Wahid Y.; Zivny, Jaroslav; Whalen, Giles F.; LaFemina, Jennifer

    2016-01-01

    Background Long-term incidence of endocrine and exocrine insufficiency after pancreatectomy is poorly described. We analyze the long-term risks of pancreatic insufficiency after pancreatectomy. Methods Subjects who underwent pancreatectomy from 2002 to 2012 were identified from a prospective database (n = 227). Subjects who underwent total pancreatectomy or pancreatitis surgery were excluded. New post-operative endocrine and exocrine insufficiency was defined as the need for new pharmacologic intervention within 1000 days from resection. Results 28 (16%) of 178 subjects without pre-existing endocrine insufficiency developed post-operative endocrine insufficiency: 7 (25%) did so within 30 days, 8 (29%) between 30 and 90 days, and 13 (46%) after 90 days. 94 (43%) of 214 subjects without pre-operative exocrine insufficiency developed exocrine insufficiency: 20 (21%) did so within 30 days, 29 (31%) between 30 and 90 days, and 45 (48%) after 90 days. Adjuvant radiation was associated with new endocrine insufficiency. On multivariate regression, pancreaticoduodenectomy and chemotherapy were associated with a greater risk of exocrine insufficiency. Conclusion Reporting 30-day functional outcomes for pancreatic resection is insufficient, as nearly 45% of subjects who develop disease do so after 90 days. Reporting of at least 90-day outcomes may more reliably assess risk for post-operative endocrine and exocrine insufficiency. PMID:27037206

  14. 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.

  15. Postoperative Change in Ocular Torsion in Intermittent Exotropia: Relationship with Postoperative Surgical Outcomes.

    PubMed

    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

  16. Anterior cruciate ligament reconstruction as a day case with extended recovery.

    PubMed

    Haug; Sørensen; Dichmann

    2000-10-01

    The aim of this study was to describe the procedures and the postoperative outcome of arthroscopic anterior cruciate ligament (ACL) reconstruction when carried out a day case with extended recovery. Between December 1995 and September 1998, 91 patients underwent surgery using bone-patellatendon-bone autografts and interference screw fixation. Additional surgical procedures were performed on 35 of the patients. The patient records were evaluated for a mean of 17 months (1-33 months) postoperatively. The course of treatment was. (1) Evaluation and KLT-arthrometer test 14 days preoperatively. (2) Surgery, cryocuff, bupivacain, paracetamol, NSAID and ketobemidon for postoperative pain control. (3) Discharge from hospital within 24 h. (4) Physiotherapy after 14 days. (5) Follow-up after 6 weeks with bandage removal and after 6 months. Eight patients required one further day of hospitalisation due to pain (four), nausea (one), haematoma (two) and prolonged anaesthesia (one). Five patients were readmitted to hospital for a mean of 8 (3-16) days postoperatively. Three patients underwent re-surgery due to haematoma/rupture of the scar. No deep infections were found. We concluded that this effective method of ACL-reconstruction can be carried out safely as a day case procedure with extended recovery to the benefit of the patients. PMID:11063947

  17. Postoperative Cerebrospinal Fluid Leakage Associated With Total En Bloc Spondylectomy.

    PubMed

    Yokogawa, Noriaki; Murakami, Hideki; Demura, Satoru; Kato, Satoshi; Yoshioka, Katsuhito; Hayashi, Hiroyuki; Ishii, Takayoshi; Igarashi, Takashi; Fang, Xiang; Tsuchiya, Hiroyuki

    2015-07-01

    Cerebrospinal fluid (CSF) leakage is a serious postoperative complication associated with total en bloc spondylectomy. The authors examined the risk factors for CSF leakage after this procedure. A total of 72 patients underwent total en bloc spondylectomy at the authors' institution between May 2010 and April 2013. Postoperative CSF leakage was observed in 17 of the 72 patients (23.6%). The results of univariate analysis suggested that age 54 years or older, preoperative surgical site irradiation, resection of 3 or more vertebral bodies, and dural injury were significant risk factors for postoperative CSF leakage after total en bloc spondylectomy. Multivariate analysis showed that preoperative surgical site irradiation was the only significant risk factor for postoperative CSF leakage (adjusted odds ratio, 5.22; 95% confidence interval, 1.03-26.45, P=.046). The authors also assessed the course of treatment for postoperative CSF leakage in each patient. Of 17 patients with postoperative CSF leakage, 13 recovered without further complications, but 4 required reoperation (2 for wound dehiscence, 1 for surgical site infection, and 1 for severe intracranial hypotension). All 4 patients who required reoperation had a history of surgical site irradiation. Thus, this study suggests that careful consideration should be given to postoperative CSF leakage in patients with a history of surgical site irradiation. These findings may contribute to the management of postoperative CSF leakage associated with total en bloc spondylectomy and supplement the information given to the patient in the process of obtaining informed consent. PMID:26186316

  18. Management of Postoperative Spondylodiscitis with and without Internal Fixation.

    PubMed

    Wang, Xiang; Tao, Hairong; Zhu, Yanhui; Lu, Xiongwei; Hu, Xiaopeng

    2015-01-01

    Postoperative spondylodiscitis is relatively uncommon. This complication is associated with increased cost, and long-term of inability to work, and even morbidity. Although the majority of postoperative spondylodiscitis cases can be well managed by conservative treatment, postoperative spondylodiscitis after internal fixation and those cases that are unresponsive to the conservative treatment present challenges to the surgeon. Here, a review was done to analyze the treatment of postoperative spondylodiscitis with/without internal fixation. This review article suggested that majority of postoperative spondylodiscitis without internal fixation could be cured by conservative treatment. Either posterior or anterior debridement can be used to treat postoperative spondylodiscitis without internal fixation when conservative treatment fails. In addition, minimally invasive debridement and drainage may also be an alternative treatment. In case of postoperative spondylodiscitis after internal fixation, surgical treatment was required. In the cervical spine, it can be well managed by anterior debridement, removal of internal fixation, and reconstruction of the spinal stability by using bone grafting/cage/anterior plate. Postoperative spondylodiscitis after internal fixation is successfully managed by combined anterior debridement, fusion with posterior approach and removal of pedicle screw or extension of pedicle screw beyond the lesion site, in the thoracic and lumbar spine. PMID:26242325

  19. [The metabolism of panthenol in patients with postoperative intestinal atony].

    PubMed

    Sachs, M; Asskali, F; Lanaras, C; Förster, H; Bockhorn, H

    1990-12-01

    The aim of this study was the examination of the metabolism and mechanism of action of D-pantothenyl alcohol in patients with postoperative intestinal atony. Seven metabolically healthy patients were examined on the 4th day following colorectal surgery, before bowel activity had started. Increased urinary excretion of the vitamin pantothenic acid was noted following the intravenous application of 2 gm of D-pantothenyl alcohol. Ten to 30% of the administered dose D-pantothenyl alcohol is excreted in the urine as pantothenic acid within 24 h. Simultaneously, the urinary excretion of beta-alanine, a pantothenic acid component, is increased. D-pantothenyl alcohol was metabolized to pantothenic acid in all the patients examined. Pantothenic acid is a component of coenzyme A, a key substance in the intermediary pathway of metabolism. Coenzyme A plays a role in the synthesis of acetylcholine from choline (a co-enzyme of cholinacetylase). Peristalsis induced by D-pantothenyl alcohol may be due to the increased synthesis of coenzyme A and acetylcholine in the autonomic nerve plexus of the intestinal tract. PMID:2080639

  20. Risk Factors for Postoperative Retention After Hemorrhoidectomy: A Cohort Study.

    PubMed

    Qi-Ming, Xue; Jue-Ying, Xiang; Ben-Hui, Chen; Jing, Wu; Ning, Li

    2015-01-01

    The objective of this study was to identify the risk factors for urinary retention after hemorrhoidectomy. With the approval of West China Hospital of Sichuan University Ethics Board, data were abstracted from 961 charts of patients who underwent hemorrhoidectomy from January 1, 2009, to June 30, 2011. The outcome was urinary retention in the first 24 hours after surgery. Risk factors were identified using multivariable logistic regression, and they were expressed as odds ratios or 95% confidence intervals. The overall urinary retention rate was 14.8% (n = 142). Significant risk factors associated with postoperative urinary retention included female gender, anesthesia methods, severity of hemorrhoid, a large amount of intravenous fluid administered perioperatively, and length of hospital stay. Logistic regression analysis revealed that female gender (odds ratio, 2.607; p < .01), sacral anesthesia (odds ratio, 2.481; p = .02), more than 3 hemorrhoids resected (odds ratio, 2.658; p < .01), hemorrhoids having 4 degrees of severity (odds ratio, 3.101; p < .01), intravenous fluids > 700 ml (odds ratio, 1.597; p = .02), and length of stay more than 7 days (odds ratio, 1.852; p < .01) were significant predictors of urinary retention post-hemorrhoidectomy. PMID:25974011

  1. The effect of a pre- and post-operative orthogeriatric service on cognitive function in patients with hip fracture. The protocol of the Oslo Orthogeriatrics Trial

    PubMed Central

    2012-01-01

    Background Hip fractures mainly affect older people. It is associated with high morbidity and mortality, and in particular a high frequency of delirium. Incident delirium following hip fracture is associated with an increased risk of dementia in the following months, but it is still not firmly established whether this is an association or a causal relationship. Orthogeriatric units vary with respect to content and timing of the intervention. One main effect of orthogeriatric care may be the prevention of delirium, especially if preoperative and postoperative care are provided. Thus, the aim of Oslo Orthogeriatric Trial, is to assess whether combined preoperative and postoperative orthogeriatric care can reduce the incidence of delirium and improve cognition following hip fracture. Methods/design Inclusion and randomisation will take place in the Emergency Department, as soon as possible after admission. All patients with proximal femur fractures are eligible, irrespective of age, pre-fracture function and accommodation, except if the fracture is caused by a high energy trauma or the patient is terminally ill. The intervention is pre-and post-operative orthogeriatric care delivered on a dedicated acute geriatric ward. The primary outcome measure is a composite endpoint combining the Clinical Dementia Rating Scale (CDR) and the 10 word memory task at four months after surgery. Secondary outcomes comprise incident delirium, length of stay, cognition, mobility, place of residence, activities of daily living and mortality, measured at 4 and 12 months after surgery. We have included 332 patients in the period 17th September 2009 to 5th January 2012. Discussion Our choice of outcome measures and our emphasis of orthogeriatric care in the preoperative as well as the postoperative phase will enable us to provide new knowledge on the impact of orthogeriatric care on cognition. Trials registration ClinicalTrials.gov NCT01009268 PMID:22817102

  2. Clinical results of renal artery embolization to control postoperative hemorrhage after partial nephrectomy

    PubMed Central

    Jeon, Chang Ho; Yoon, Chang Jin; Byun, Seok-Soo; Lee, Sang Eun

    2016-01-01

    Background With the wider application of nephron-sparing surgery, there has been an increase in the occurrence of postoperative hemorrhage. However, despite such an increase, there are only a limited number of reports regarding renal artery embolization (RAE) for the management of postoperative bleeding after nephron-sparing surgery, especially after robot-assisted laparoscopic partial nephrectomy (RALPN). Purpose To evaluate the safety and clinical efficacy of transcatheter RAE for postoperative hemorrhage after open partial nephrectomy (OPN) and RALPN. Material and Methods A total of 29 patients (17 men, 12 women; age range, 31–70 years) who were referred to our hospital for postoperative hemorrhage after partial nephrectomy, between December 2003 and December 2014, were selected. We retrospectively reviewed patients’ clinical data, angiographic findings, embolization details, and clinical outcomes. Results Embolization was performed in patients who underwent OPN (25/29) and RALPN (4/29). The angiographic findings were as follows: renal artery pseudoaneurysm (n = 18), contrast extravasation (n = 8), and arteriovenous fistula (n = 3). Fiber-coated microcoil and n-butyl-2-cyanoacrylate (NBCA) was administered to the targeted bleeding renal arteries in 12 and 11 patients, respectively. In six patients, fiber-coated microcoil and NBCA were used concurrently. Technical and clinical successes were achieved in all patients (100%). Bleeding cessation was achieved in all patients, and no further relevant surgeries or interventions were required for hemorrhage control. There were no episodes of hemorrhagic recurrence during the follow-up period (median, 20 days; range, 7–108 days). Conclusion Angiography and RAE identified the origin of bleeding and could successfully preserve the residual renal function. PMID:27570638

  3. Acupuncture for post anaesthetic recovery and postoperative pain: study protocol for a randomised controlled trial

    PubMed Central

    2014-01-01

    Background We report on the design and implementation of a study protocol entitled Acupuncture randomised trial for post anaesthetic recovery and postoperative pain - a pilot study (ACUARP) designed to investigate the effectiveness of acupuncture therapy performed in the perioperative period on post anaesthetic recovery and postoperative pain. Methods/Design The study is designed as a randomised controlled pilot trial with three arms and partial double blinding. We will compare (a) press needle acupuncture, (b) no treatment and (c) press plaster acupressure in a standardised anaesthetic setting. Seventy-five patients scheduled for laparoscopic surgery to the uterus or ovaries will be allocated randomly to one of the three trial arms. The total observation period will begin one day before surgery and end on the second postoperative day. Twelve press needles and press plasters are to be administered preoperatively at seven acupuncture points. The primary outcome measure will be time from extubation to ‘ready for discharge’ from the post anaesthesia care unit (in minutes). The ‘ready for discharge’ end point will be assessed using three different scores: the Aldrete score, the Post Anaesthetic Discharge Scoring System and an In-House score. Secondary outcome measures will comprise pre-, intra- and postoperative variables (which are anxiety, pain, nausea and vomiting, concomitant medication). Discussion The results of this study will provide information on whether acupuncture may improve patient post anaesthetic recovery. Comparing acupuncture with acupressure will provide insight into potential therapeutic differences between invasive and non-invasive acupuncture techniques. Trial registration NCT01816386 (First received: 28 October 2012) PMID:25047046

  4. EDITORIAL: Artificial Muscles: Selected papers from the 5th World Congress on Biomimetics, Artificial Muscles and Nano-Bio (Osaka, Japan, 25-27 November 2009) Artificial Muscles: Selected papers from the 5th World Congress on Biomimetics, Artificial Muscles and Nano-Bio (Osaka, Japan, 25-27 November 2009)

    NASA Astrophysics Data System (ADS)

    Shahinpoor, Mohsen

    2011-12-01

    The 5th World Congress on Biomimetics, Artificial Muscles and Nano-Bio and the 4th International Conference on Artificial Muscles were held in Osaka, Japan, 23-27 November 2009. This special section of Smart Materials and Structures is devoted to a selected number of research papers presented at this international conference and congress. Of the 76 or so papers presented at the conference, only 10 papers were finally selected, reviewed and accepted for this special section, following the regular reviewing procedures of the journal. This special section is focused on polymeric artificial muscles, electroactive polymers, multifunctional nanocomposites and their applications. In particular, an electromechanical model for self-sensing ionic polymer-metal composite actuating devices with patterned surface electrodes is presented which discusses the concept of creating self-sensing ionic polymer-metal composite (IPMC) actuating devices with patterned surface electrodes where actuator and sensor elements are separated by a grounded shielding electrode. Eventually, an electromechanical model of the device is also proposed and validated. Following that, there is broad coverage of polytetrahydrofurane-polyethylene oxide-PEDOT conducting interpenetrating polymer networks (IPNs) for high speed actuators. The conducting polymer (poly(3,4-ethylenedioxythiophene)) is incorporated within the IPNs, which are synthesized from polyethylene oxide (PEO)/polytetrahydrofurane (PTHF) networks. PEO/PTHF IPNs are prepared using poly(ethylene glycol) methacrylate and dimethacrylate and hydroxythelechelic PTHF as starting materials. The conducting IPN actuators are prepared by oxidative polymerization of 3,4-ethylenedioxithiophene (EDOT) using FeCl3 as an oxidizing agent within the PEO/PTHF IPN host matrix. Subsequently, giant and reversible magnetorheology of carrageenan/iron oxide magnetic gels are discussed and the effect of magnetic fields on the viscoelastic properties

  5. One Cold Autumn Day

    PubMed Central

    de Schweinitz, Peter

    2015-01-01

    Behavioral change is at the heart of effective primary care, but when patients don’t change, how do we account for our days? In this personal essay, I relate an encounter with a patient who wants to quit smoking, lose weight, and control her diabetes. I am discouraged when she deflects my recommendations, but a colleague’s comment encourages a deeper inquiry. Knowing the patient’s story and deepening the conversation, however, do not guarantee change. The experience reminds me why patience, humility, and faith are core values of the primary care physician. PMID:25964410

  6. Preventing 30-day readmissions.

    PubMed

    Stevens, Sherri

    2015-03-01

    Preventing 30-day readmissions to hospitals is a top priority in the era of health care reform. New regulations will be costly to health care facilities because of payment guidelines. The most frequently readmitted medical conditions are acute myocardial infarction, heart failure, and pneumonia. The transition from the hospital and into the home has been classified as a vulnerable time for many patients. During this time of transition patients may fail to fully understand their discharge instructions. Ineffective communication, low health literacy, and compliance issues contribute to readmissions. Telehealth and the use of technology may be used to prevent some readmissions. PMID:25680492

  7. Early postoperative small bowel obstruction: open vs laparoscopic

    PubMed Central

    Goussous, Naeem; Kemp, Kevin M.; Bannon, Michael P.; Kendrick, Michael L.; Srvantstyan, Boris; Khasawneh, Mohammad A.; Zielinski, Martin D.

    2016-01-01

    BACKGROUND The window for safe reoperation in early postoperative (<6 weeks) small bowel obstruction (ESBO) is short and intimately dependent on elapsed time from the initial operation. Laparoscopic procedures create fewer inflammatory changes than open laparotomies. We hypothesize that it is safer to reoperate for ESBO after laparoscopic procedures than open. METHODS Review of patients who underwent re-exploration for ESBO from 2003 to 2009 was performed. Based on the initial operation, patients were classified as “open” or “laparoscopic.” The Revised Accordion Severity Grading System was used to define complications as minor (1 to 2) or severe (3 to 6). RESULTS There were 189 patients identified (age 55 years, 48% male): 130 open and 59 laparoscopic. Adhesive disease was more common (65% vs 42%, P <.01), while strictures were less frequent (5% vs 14% P = .03), in the open group. The open group had a greater rate of malignancy, days to re-exploration, and severity of complications. There was no difference in the rates of minor complications, enterotomy, and mortality. ESBO after laparoscopic surgery was more commonly caused by a focal source (85% vs 63%). Eighty-three patients (64 open, 19 laparoscopic) underwent re-exploration at or beyond 14 days. Within this subgroup, there were more severe complications (25% vs 5%) after open procedures with equivalent mortality (4% vs 0%). CONCLUSIONS Laparoscopic approaches confer a lower rate of adhesive disease and severity of complications in early SBO as compared with open surgery even if performed after 2 weeks of index procedure. PMID:25457244

  8. Regression Analysis by Example. 5th Edition

    ERIC Educational Resources Information Center

    Chatterjee, Samprit; Hadi, Ali S.

    2012-01-01

    Regression analysis is a conceptually simple method for investigating relationships among variables. Carrying out a successful application of regression analysis, however, requires a balance of theoretical results, empirical rules, and subjective judgment. "Regression Analysis by Example, Fifth Edition" has been expanded and thoroughly…

  9. Designing Effective Instruction. 5th Edition

    ERIC Educational Resources Information Center

    Morrison, Gary R.; Ross, Steven M.; Kemp, Jerrold E.

    2006-01-01

    This valuable resource provides instructional designers with the guidance they need to meet the challenge of creating effective and efficient instruction. Maintaining a careful balance between theory and application, the Fifth Edition presents a practical, easy-to-follow approach to instructional design that can be applied to K-12 classrooms,…

  10. Radiology of bone diseases. 5th edition

    SciTech Connect

    Greenfield, G.

    1990-01-01

    This book reports on anatomy, physiology, and biochemistry of bone. This book presents alterations in overall characteristics such as density and bone texture. It describes Salterations in specific anatomic regions of bone, as well ad discuss solitary bone lesions. The style in which the diseases are grouped according to specific regions and morphologic alterations rather than by individual pathologic condition is the most powerful aspect of this format.

  11. 5TH BIOTECHNOLOGICAL INVESTIGATIONS OCEAN MARGINS PROGRAM

    SciTech Connect

    DR. ARTURO MASSOL, PROGRAM CHAIR; DR. ROSA BUXEDA, PROGRAM CO-CHAIR

    2004-01-08

    BI-OMP supports DOE's mission in Climate Change Research. The program provides the fundamental understanding of the linkages between carbon and nitrogen cycles in ocean margins. Researchers are providing a mechanistic understanding of these cycles, using the tools of modern molecular biology. The models that will allow policy makers to determine safe levels of greenhouse gases for the Earth System.

  12. 5th Annual Monoclonal Antibodies Conference

    PubMed Central

    2009-01-01

    The conference, which was organized by Visiongain and held at the BSG Conference Center in London, provided an excellent opportunity for participants to exchange views on the development, production and marketing of therapeutic antibodies, and discuss the current business environment. The conference included numerous interactive panel and group discussions on topics such as isotyping for therapeutic antibodies (panel chair: Nick Pullen, Pfizer), prospects for fully human monoclonal antibodies (chair: Christian Rohlff, Oxford BioTherapeutics), perspectives on antibody manufacturing and development (chair: Bo Kara, Avecia), market impact and post-marketing issues (chair: Keith Rodgers, Bodiam Consulting) and angiogenesis inhibitors (chair: David Blakey, AstraZeneca). PMID:20073132

  13. Measurement in Physical Education. 5th Edition.

    ERIC Educational Resources Information Center

    Mathews, Donald K.

    Concepts of measurement in physical education are presented in this college-level text to enable the preservice physical education major to develop skills in determining pupil status, designing effective physical activity programs, and measuring student progress. Emphasis is placed upon discussion of essential statistical methods, test…

  14. Peace Corps 5th Annual Report.

    ERIC Educational Resources Information Center

    Peace Corps, Washington, DC.

    Projects, operations, and future plans are covered in this annual report for the fifth year of the Peace Corps. An introduction overviews past and future activities of the Peace Corps and its volunteers. Section 2 reviews the year 1966 and covers these topics: the new director, Jack Vaughn; countries in which new programs were begun; the…

  15. Cost-effectiveness analysis of a postoperative clinical care pathway in head and neck surgery with microvascular reconstruction

    PubMed Central

    2013-01-01

    Background The objective of this study is to evaluate the cost-effectiveness of a postoperative clinical care pathway for patients undergoing major head and neck oncologic surgery with microvascular reconstruction. Methods This is a comparative trial of a prospective treatment group managed on a postoperative clinical care pathway and a historical group managed prior to pathway implementation. Effectiveness outcomes evaluated were total hospital days, return to OR, readmission to ICU and rate of pulmonary complications. Costing perspective was from the government payer. Results 118 patients were included in the study. All outcomes demonstrated that the postoperative pathway group was both more effective and less costly, and is therefore a dominant clinical intervention. The overall mean pre- and post-pathway costs are $22,733 and $16,564 per patient, respectively. The incremental cost reduction associated with the postoperative pathway was $6,169 per patient. Conclusion Implementing the postoperative clinical care pathway in patients undergoing head and neck oncologic surgery with reconstruction resulted in improved clinical outcomes and reduced costs. PMID:24351020

  16. Postoperative portal vein thrombosis and gastric hemorrhage associated with late-onset hemorrhage from the common hepatic artery after pancreaticoduodenectomy.

    PubMed

    Watanobe, Ikuo; Ito, Yuzuru; Akimoto, Eigo; Sekine, Yuuki; Haruyama, Yurie; Amemiya, Kota; Miyano, Shozo; Kosaka, Taijiro; Machida, Michio; Kitabatake, Toshiaki; Kojima, Kuniaki

    2016-02-01

    Portal vein thrombosis (PVT) is a rare but serious postoperative complication of pancreaticoduodenectomy (PD). We reported a case of late-onset postoperative PVT with hemorrhage from the common hepatic artery (CHA) in a 73-year-old man who underwent pylorus-preserving pancreaticoduodenectomy (PPPD) for duodenum papilla cancer, followed by reconstruction using the modified Child's technique. The pancreaticojejunostomy was achieved by end-to-side, 2-layer invagination anastomosis without pancreatic duct stenting. Drain removal and hospital discharge were scheduled on postoperative day (POD) 18, but blood-stained fluid in the drain and sudden hematemesis were noted. Emergency surgery was performed because PVT and imaging findings were suggestive of necrosis of the lifted jejunum. Although no jejunal necrosis was identified during surgery, bleeding from the side of the CHA was detected and the bleeding point was suture-closed to achieve hemostasis. We suspected late-onset postoperative arterial hemorrhage and subsequent hematoma formation, which caused portal vein compression and PVT formation. We chose a conservative treatment strategy for PVT, taking into account the operation time, intraoperative vital signs and blood flow in the portal vein. Despite the complicated postoperative course, he was discharged home in a fully ambulatory state on POD 167. PMID:26925150

  17. Postoperative portal vein thrombosis and gastric hemorrhage associated with late-onset hemorrhage from the common hepatic artery after pancreaticoduodenectomy

    PubMed Central

    Ito, Yuzuru; Akimoto, Eigo; Sekine, Yuuki; Haruyama, Yurie; Amemiya, Kota; Miyano, Shozo; Kosaka, Taijiro; Machida, Michio; Kitabatake, Toshiaki; Kojima, Kuniaki

    2016-01-01

    Portal vein thrombosis (PVT) is a rare but serious postoperative complication of pancreaticoduodenectomy (PD). We reported a case of late-onset postoperative PVT with hemorrhage from the common hepatic artery (CHA) in a 73-year-old man who underwent pylorus-preserving pancreaticoduodenectomy (PPPD) for duodenum papilla cancer, followed by reconstruction using the modified Child's technique. The pancreaticojejunostomy was achieved by end-to-side, 2-layer invagination anastomosis without pancreatic duct stenting. Drain removal and hospital discharge were scheduled on postoperative day (POD) 18, but blood-stained fluid in the drain and sudden hematemesis were noted. Emergency surgery was performed because PVT and imaging findings were suggestive of necrosis of the lifted jejunum. Although no jejunal necrosis was identified during surgery, bleeding from the side of the CHA was detected and the bleeding point was suture-closed to achieve hemostasis. We suspected late-onset postoperative arterial hemorrhage and subsequent hematoma formation, which caused portal vein compression and PVT formation. We chose a conservative treatment strategy for PVT, taking into account the operation time, intraoperative vital signs and blood flow in the portal vein. Despite the complicated postoperative course, he was discharged home in a fully ambulatory state on POD 167. PMID:26925150

  18. 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. PMID:26601454

  19. Pterygia: Single-fraction postoperative beta irradiation

    SciTech Connect

    Beyer, D.C. )

    1991-02-01

    A retrospective evaluation was performed with records of 128 patients with 146 eyes that underwent applications of strontium-90 after pterygium excisions performed between 1982 and 1988. With a median follow-up of 13 months, 135 eyes were evaluable. Most pterygia (127 of 135) were treated with a single postoperative application of Sr-90 that delivered 3,000 cGy of beta radiation in one fraction. The actuarial freedom from relapse was 87%; all recurrences occurred within the first 18 months, and 46% of these within the first 3 months. Of the 13 recurrences, 10 have been re-treated with surgery and a second course of beta irradiation with excellent results. All eight eyes for which follow-up was available had no evidence of disease. The ultimate control rate was 96.3% for the series. Correlation of various treatment parameters, including age, bilaterality, prior recurrence, and interval from surgery to irradiation, was performed, and no statistically significant difference was seen. No serious complications have developed. Transient conjunctivitis and photophobia were almost universally seen, with five cases lasting beyond 5 months. The authors conclude that a single application of Sr-90 after surgery is effective and safe in managing pterygia.

  20. Self-care and postoperative dressing management.

    PubMed

    Dawn Hunt, Sharon

    2016-08-11

    As the increasing burden on healthcare costs continues to rise, posing clinical and financial challenges for all healthcare providers attempting to provide optimal, evidence-based wound care, the situation appears to be reaching the tipping point with regard to reduced resources, increasing patient groups with complex wounds and financial restraints. It is clearly time for action and new ways of working that include empowering patients and carers to take appropriate ownership within their personal wound-care journey. This observational evaluation explores 10 community-based patients presenting with postoperative acute surgical wounds; it examines and evaluates the patients' experience with regard to self-care satisfaction, Leukomed Control product satisfaction and actual traditional/personal costs incurred up to a 4-week period. The evaluation highlights not only an overall positive improvement within patient satisfaction and experience, alongside optimised wound progression and related cost savings, but also offers a valuable insight into the promotion and success of patients taking ownership of their wound-care journey. PMID:27523771