Background: This study evaluated the ability of dexmedetomidine to provide analgesia and sedation for outpatient colonoscopy, examining outcomes including cardiorespiratory variables, side effects, and discharge readiness.
Methods: Sixty-four patients were randomly assigned to one of three treatment regimens. In group D, patients received 1 [mu]g/kg dexmedetomidine over 15 min followed by an infusion of 0.2 [mu]g [middle dot] kg-1 [middle dot] h-1. Group P received meperidine (1 mg/kg) with midazolam (0.05 mg/kg), and group F received fentanyl (0.1-0.2 mg intravenous) on demand. The assessment included measurements of heart rate, blood pressure, oxygen saturation, respiratory rate, quality of sedation/analgesia, and an evaluation of the recovery time.
Results: The study was terminated before the planned 90 patients had been recruited because of adverse events in group D. In all groups, negligible hemoglobin oxygen saturation and respiratory rate variations were observed. In group D, there was a significantly larger decrease in heart rate (to approximately 40 beats/min in 2 of 19 cases) and blood pressure (to less than 50% of the initial value in 4 of 19 patients). Supplemental fentanyl was required in 47% of patients receiving dexmedetomidine to achieve a satisfactory level of analgesia (vs. 42.8% of patients in group P and 79.2% of patients in group F). Vertigo (5 patients), nausea/vomiting (5 patients), and ventricular bigeminy (1 patient) were observed only in group D. Time to home readiness was longest in group D (85 +/- 74, 39 +/- 21, and 32 +/- 13 min in groups D, P and F, respectively; P = 0.007). 相似文献
In the presented paper the authors evaluate the long-term results of treatment for inflammatory and thromboembolic complications in knee joint alloplasty with cemented endoprostheses. The clinical material spanning the years 1998-2003 are 15 patients with analysed complications, it determine 9% of all operated. They have evaluated achieved results using the HSS knee rating scale in their own modification. As far as the authors are concerned, venographic examination is a prerequisite for appropriate care of the patients following knee joint alloplasty who might have deep venous thrombosis. It is necessary to provide similar treatment when developing infections are suspected in the perioperative period and in cases of late infections. Consequently, antibiotic therapy and a possible quick bacteriological checkup for healing a postoperative wound is a prerequisite for successful treatment. Achieved results induce statement, that thromboembolic and inflammatory complications caused at most operated chronic vein insufficiency, deficit of range of motion at operated joint and gait insufficiency. Thromboembolic complications was always related with inflammation of knee joint alloplasty in our own material. 相似文献
OBJECTIVES: Resin-modified glass ionomer cements (RMGI) are hybrid materials prepared by incorporation of polymerizable components (typically 2-hydroxyethyl methacrylate (HEMA) with possible addition of multifunctional methacrylates) into a conventional acid-base mixture (a polymeric acid with powdered calcium fluoro-aluminosilicate glasses). During setting, the photopolymerization process and the acid-base reaction affect each other. The aim of this work was to examine the effect of a 45% aqueous solution of poly(acrylic acid) (PAA) and the liquid component of a commercial glass ionomer cement on HEMA and triethyleneglycol dimethacrylate (TEGDMA) photopolymerization. METHODS: The polymerization was initiated by 2,2-dimethoxy-2-phenylacetophenone (DMPA) and camphorquinone (CQ)/coinitiator system. The reaction course was monitored under Ar and air by isothermal differential scanning calorimetry. RESULTS: The main effect of addition of polyacid solution (PAA and commercial) up to 10wt% to HEMA on the polymerization initiated with DMPA was earlier onset of autoacceleration. For the process initiated by the CQ-based system, the addition of 5wt% of PAA solution strongly accelerated the polymerization and increased the conversion, both in Ar atmosphere as well as in air. TEGDMA photopolymerization was not influenced or slightly retarded by the presence of 3wt% of PAA solution (the upper limit of solubility), depending on the initiating system used. SIGNIFICANCE: Under initiation conditions used in curing of commercial dental products (CQ-based two component initiating system), the presence of polyacid-aqueous solution in HEMA-based photocurable component increases markedly the polymerization rate and the conversion both in Ar atmosphere as well as in air. This result contributes to a characterization of the setting process of RMGIs. 相似文献
Results of investigations on the kinetics of thermal polymerization of mixed single-crystalline diacetylenes are reported. The polymerization was studied at 333 K on a series of mixed 1 (pTS)– 3 (pFBS) crystals of various compositions. The polymer contents were determined from the measurements of electric permittivities of the samples during polymerization. A simple qualitative model was put forward to explain changes in the kinetics of polymerization as function of the composition of mixed crystals. At early stages of polymerization, the process of initiation of the growth of polymer chains seems to be dependent on the concentration of defects associated with a misfit between pTS and pFBS molecules. 相似文献
Early results (12 weeks after surgery) of the lumbar spinal stenosis operative treatment were assessed in the group of 36 patients (aged 40-65 years). In 72% of patients posterior fusion was applied. In the results evaluation lumbar pain, low extremities pain, neurogenic claudicat ion, sensory disturbances and functional status were taken in account. A significant decrease in low extremities and lumbar pain was observed. Some sensory disturbances after operative treatment did not affect general high patients assessment of the performed surgical procedures (positive 80.5% cases). 相似文献
Although the pathogenesis of schizophrenia is unknown, there are data which indicate that the disease may be due to neurodevelopmental disturbances. Cell recognition molecules such as N-CAM and L1 antigen are involved in cell-cell interactions during development and in plasticity of the nervous system and could therefore be altered in relation to ongoing or established pathological processes. Using the Western blot technique, we found significant increases in N-CAM immunoreactive proteins and decreases in L1 antigen in the CSF of schizophrenic patients as compared to normal controls. The decrease in L1 antigen was observed in the 140-kDa band, and N-CAM was increased only in the 120-kDa band. The 120-kDa band of N-CAM and the 140-kDa band of L1 antigen were prominent components of CSF, but in serum these bands were minor or not detectable. Neuroleptic treatment did not significantly change either N-CAM or L1 antigen concentrations in CSF. It is possible that these CSF proteins are derived from CNS cells as secreted soluble N-CAM isoforms and L1 peptides. Our results suggest the possibility of a specific pattern of abnormal cellular function in the CNS in schizophrenia. 相似文献
Two outstanding features of the flowering plant family Winteraceae are the occlusion of their stomatal pores by cutin plugs and the absence of water-conducting xylem vessels. An adaptive relationship between these two unusual features has been suggested whereby stomatal plugs restrict gas exchange to compensate for the presumed poor conductivity of their vesselless wood. This hypothesized connection fueled evolutionary arguments that the vesselless condition is ancestral in angiosperms. Here we show that in Drimys winteri, a tree common to wet forests, these stomatal occlusions pose only a small fixed resistance to water loss. In addition, they modify the humidity response of guard cells such that under high evaporative demand, leaves with plugs lose water at a faster rate than leaves from which the plugs have been experimentally removed. Instead of being adaptations for drought, we present evidence that these cuticular structures function to maintain photosynthetic activity under conditions of excess water on the leaf surface. Stomatal plugs decrease leaf wettability by preventing the formation of a continuous water film that would impede diffusion of CO2 into the leaf. Misting of leaves had no effect on photosynthetic rate of leaves with plugs, but resulted in a marked decrease (≈40%) in leaves from which the plugs had been removed. These findings do not support a functional association between stomatal plugs and hydraulic competence and provide a new perspective on debates surrounding the evolution of vessels in angiosperms. 相似文献
Wild rodents and the subadult Ixodes ricinus (L.) ticks infesting them were examined for the presence of Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner s.l. in a sylvatic habitat in west central Poland during May-September 2002. In total, 818 feeding ticks were recovered from 73 infested yellow-necked mice, Apodemus flavicollis Melchior; in addition, bank voles, Clethrionomys glareolus Schreber, were rarely captured and proved to be weakly parasitized. Only 2.7% of A. flavicollis and 2.2% of 320 engorging larvae were polymerase chain reaction (PCR) positive for the bacterium. All spirochete-PCR-positive samples yielded exclusively B. burgdorferi s.s. This genospecies was also the most prevalent in questing nymphs and accounted for 87.5% of the total number of Borrelia infections in nymphal ticks collected during May and June 2 yr later. The presence of the same genospecies both in naturally engorged larvae and blood-positive animals as well as the high predominance of B. burgdorferi s.s. in questing nymphs strongly differs from most study sites investigated in Europe. This unique pattern of Borrelia-diversity in both rodents and ticks seems to be determined by highly site-specific host vertebrate cenosis, and yellow-necked mice are involved in the maintenance of B. burgdorferi s.s. in the forest habitat. However, the transmission efficiency of this spirochete from the mice to the I. ricinus vector seems to be very low. The research provides additional information on the complexity of B. burgdorferi s.l. ecology in Europe, pointing to the importance of the local host community. 相似文献
Two new genera and three new species of feather mites (Astigmata, Pterolichoidea, Analgoidea) are described from two closely
related species of cockatoos, Cacatua galerita (type host) and C. sulphurea (Psittaciformes, Cacatuidae): Astrolabelichus caudatus gen. nov., sp. nov. (Pterolichidae), Psittophagus lacunosus sp. nov. (Pterolichidae), and Cacatualges microdiscus gen. nov., sp. nov. (Xolalgidae). The presence of the same set of mite species on these two species of parrots points to
a very close affinity of Cacatua sulphurea and C. galerita and gives additional support for the recent hypothesis of the conspecificity of these birds. 相似文献