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Moderate sedatives have been increasingly used to improve patient comfort during flexible bronchoscopy (FB). However, routine use of moderate sedation during FB is controversial because its efficacy and safety are not well established.This study aims to evaluate the efficacy and safety of moderate sedation during FB.A search was made of Medline, EMBASE, and the Cochrane Library to May 2014.Randomized controlled trials (RCTs) and quasi-RCTs were included.The main analysis was designed to examine the efficacy of moderate sedation during FB in sedation than no-sedation.The willingness to repeat FB was significantly more in sedation than no-sedation (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.11–4.73; P = 0.02; I2 = 22.5). The duration of FB was shorter in sedation group than no-sedation group (standardized mean difference [SMD] −0.21; 95% CI −0.38 to −0.03; P = 0.02; I2 = 78.3%). Event of hypoxia was not significantly different between sedation and no-sedation groups (OR 0.86; 95% CI 0.42–1.73; P = 0.67; I2 = 0%). The SpO2 during procedure was not different between sedation and no-sedation groups (SMD −0.14; 95% CI −0.37 to 0.08; P = 0.21; I2 = 49.9%). However, in subgroup analysis without supplemental oxygen, the SpO2 was significantly lower in sedation than no-sedation group (SMD −0.45; 95% CI −0.78 to −0.11; P = 0.01; I2 = 0.0%).According to this meta-analysis, moderate sedation in FB would be useful in patients who will require repeated bronchoscopies as well as safe in respiratory depression. To our knowledge, although the various sedative drugs are already used in the real field, this analysis was the first attempt to quantify objective results. We anticipate more definite and studies designed to elucidate standardized outcomes for moderate sedation in FB. 相似文献
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Seulbi Lee Hyesook Park Soontae Kim Eun-Kyung Lee Jiyoung Lee Young Sun Hong Eunhee Ha 《International journal of hygiene and environmental health》2019,222(3):533-540
Background
It has been reported that particulate matter (PM) is associated with cardiovascular diseases (CVD) while metabolic syndrome is also an important risk factor for CVD. However, few studies have investigated the epidemiological association between PM and metabolic syndrome.Objective
To investigate the association between one-year exposure to PM with an aerodynamic diameter <2.5?μm (PM2.5) and the risk of metabolic syndrome in Korean adults without CVD.Methods
Exposure to PM2.5 was assessed using a Community Multiscale Air Quality (CMAQ) model. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III. Andersen and Gill model with time-varying covariates, considering recurrent events, was used to investigate the association between one-year average PM2.5 and the risk of incident metabolic syndrome in 119,998 adults from the national health screening cohort provided by Korea National Health Insurance from 2009 to 2013.Results
Higher risk of metabolic syndrome, waist-based obesity, hypertension, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia were significantly associated with a 10-μg/m3 increase in PM2.5 [adjusted hazard ratio (HR): 1.070, 1.510, 1.499, 1.468, 1.627 and 1.380, respectively]. In addition, the risk of metabolic syndrome associated with PM2.5 exposure was significant in the consistently obese group (obese at baseline and endpoint).Conclusion
Exposure to one-year average PM2.5 is associated with an increased risk of metabolic syndrome and its components in adults without CVD. These associations are particularly prominent in the consistently obese group (obese at baseline and endpoint). Our findings indicate that PM2.5 affects the onset of MS and its components which may lead to increase the risk of CVD. 相似文献8.
目的:建立UPLC-MS/MS分析方法同时测定玳玳果黄酮降脂提取物效应组分新橙皮苷和柚皮苷在大鼠10种脏器组织中含量,分布规律及特征。方法:采用UPLC-MS/MS技术建立提取物效应组分新橙皮苷及柚皮苷在大鼠心、肝、脾、肺、肾、脑、胃、小肠、脂质、肌肉组织中的定量分析方法;大鼠给药后分别于0.33,0.67,1,4,8 h的5个时间点,分别摘取以上10种脏器组织,测定脏器组织及血液中效应组分的质量浓度,采用DAS(V 2.0)药动学软件对各样本的药物浓度-时间数据进行房室拟合,并计算不同组织效应组分的药-时曲线下面积(AUC)及平均滞留时间(MRT)。结果:所建立的UPLC-MS/MS定量分析方法具备良好的专属性、标准曲线及线性范围良好、方法准确度与精密度、定量下限均符合有关规定;玳玳果黄酮降脂提取物效应组分在血液中的分布符合一室模型,除肾脏及脑组织外,其余脏器中提取物效应组分的房室特征多为静脉注射的二室模型,柚皮苷在肾脏中的拟合结果为非静脉注射的二室模型,新橙皮苷在脑组织拟合结果为静脉注射的三室模型,给药后8 h各组织中效应组分新橙皮苷及柚皮苷AUC值大小顺序均为小肠 > 胃 > 肾 > 脂质 ≈ 脾脏 > 肺 > 肌肉 > 肝 > 心 > 脑,效应组分在各脏器中均无明显蓄积;效应组分在血液、肾脏、肝脏中的滞留时间较长,MRT均大于2 h,脂质最短,MRT不足1 h;各脏器中新橙皮苷的药-时曲线下面积约是柚皮苷的3倍,而心、肝、肾中则是3.5,2.1和3.4倍。结论:玳玳果黄酮降脂提取物效应组分在大鼠组织中分布迅速,达峰时间早于血液;效应组分在肠道内消除缓慢,给药8 h后在各脏器中的含量均显著下降且无特异的蓄积部位。研究结果揭示玳玳果黄酮降脂提取物效应组分在大鼠体内的分布特征及规律,为进一步理解玳玳果黄酮降脂提取物在体内的作用靶点及机制奠定了基础。 相似文献
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声带运动障碍的病因和临床表现复杂多变,涉及多学科,从病因上分为神经源性和非神经源性。对于神经源性声带运动障碍的诊治,首先通过喉镜等检查明确有无声带运动障碍及严重程度,值得注意的是声带纵向张力变化障碍也属于运动障碍的范畴;然后采用喉肌电图(LEMG)检查进行定性分析,在确诊神经源性损伤后,进一步对神经损伤部位进行定位诊断并查找导致神经损伤的病因;同时根据喉部神经电生理评估结果,判断预后。最后综合上述的评估结果制定相应的治疗策略。 相似文献
10.
目的 探讨温室作业对蔬菜种植人员职业性肌肉骨骼疾患(WMSDs)的影响。方法 采用流行病学横断面调查方法,选取西北某地区602人作为研究对象,其中温室作业人员(温室组)307人、非温室作业人员(非温室组)295人。通过问卷调查和体格检查,收集研究对象个人基本信息和各部位WMSDs检出信息。采用卡方检验进行组间WMSDs检出率的比较、Logistic回归模型进行多因素分析。结果 温室组WMSDs检出率为84.04%,高于非温室组(60.68%)(χ2=41.265,P<0.001)。温室组颈部、肩部、下背部、手部和腿部5个部位WMSDs检出率分别为36.2%、29.0%、62.2%、20.2%和51.1%,均显著高于非温室组(24.7%、18.6%、41.4%、12.2%和26.4%)(P<0.05)。温室组2个部位、3个部位和≥4个部位WMSDs检出率分别为25.1%、16.9%和19.2%,亦显著高于非温室组(18.3%、9.2%和10.2%),但两组间单一部位WMSDs检出率差异无统计学意义。校正性别、年龄等因素后,从事温室作业能增加作业人员WMSDs的风险(OR=3.558,95%CI 2.338~5.414),女性患病风险(OR=4.682,95%CI 2.600~8.433)高于男性(OR=2.667,95%CI 1.421~5.007)。结论 温室作业可增加蔬菜种植人员WMSDs的患病风险,多部位WMSDs尤其值得关注。 相似文献