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E MOLKE JENSEN K. A. THIESSEN AA. CHRISTENSEN 《Acta anaesthesiologica Scandinavica》1986,30(2):109-110
The effect of 4 mg oral naloxone on preoperative gastric volume and pH of gastric aspirate was studied in a double-blind, randomized study. Twenty patients received 10 ml of naloxone (4 mg) mixed with 10 ml of orange juice, and 20 patients received 10 ml of isotonic saline mixed with 10 ml of orange juice, 2 h before surgery. Gastric content was obtained immediately after intubation of the trachea. No significant difference in gastric volume and pH of gastric aspirate was found between the two groups. It is concluded that naloxone does not affect gastric emptying and gastric acid secretion to a degree great enough to protect against aspiration of gastric contents into the lungs. 相似文献
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Oluseun A Sowemimo Steven M Yood John Courtney Jessie Moore Miriam Huang Rebecca Ross Ursula McMillian Peter Ojo Randolph B Reinhold 《Surgery for obesity and related diseases》2007,3(1):73-7; discussion 77
BACKGROUND: To study the mortality among morbidly obese patients qualifying for bariatric surgery. Mortality from bariatric surgery for morbid obesity has been widely reported; however, little is known about the mortality in morbidly obese patients who defer surgery. METHODS: Consecutive patients evaluated for bariatric surgery with an initial encounter between 1997 and 2004 were identified. The Social Security Death Index and office records were used to identify mortality through 2006. We conducted telephone interviews to determine whether the 305 patients who did not undergo bariatric surgery at our institution had undergone the surgery elsewhere. Using Cox proportional hazards models, we compared the mortality in patients undergoing surgery with that of those who did not. To evaluate bias resulting from missing data, we conducted analyses assuming that all patients with missing data had (1) undergone surgery and (2) not undergone surgery. RESULTS: A total of 908 patients underwent bariatric surgery (880 patients at our institution and 28 patients elsewhere). A total of 112 patients did not undergo surgery. Data regarding surgery on 165 patients could not be obtained. The mortality in those patients who did not undergo surgery was 14.3% compared with 2.9% for those who did undergo surgery. Adjusting for age, gender, and body mass index, patients who had undergone surgery had an 82% reduction in mortality (hazard ratio 0.18, 95% confidence interval 0.09-0.35, P <.0001). Sensitivity analysis, assuming that all patients with missing data received surgery resulted in an 85% mortality reduction (P <.001) and assuming that patients did not receive surgery resulted in a 50% mortality reduction (P = .04). CONCLUSIONS: Mortality among morbidly obese patients without surgery was 14.3% during the study period. Surgical intervention offered a 50%-85% mortality reduction benefit. 相似文献
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Smoking and female infertility: a systematic review and meta-analysis 总被引:11,自引:10,他引:11
The high prevalence of smoking among women in their reproductive years
continues to be a matter of concern. The negative effects of smoking on
general health are well known, but smoking may also affect fertility. The
objective of the present study was to perform a systematic review of the
literature to determine whether there is an association between smoking and
risk of infertility in women of reproductive age, and to assess the size of
this effect. In the 12 studies used for this meta- analysis, the overall
value of the odds ratio (OR) for risk of infertility in women smokers
versus non-smokers was 1.60 [95% confidence interval (CI) 1.34-1.91].
Studies of subfertile women undergoing in-vitro fertilization (IVF)
treatment also show a reduction in fecundity among women smokers. A
meta-analysis of nine studies found an OR of 0.66 (95% CI 0.49-0.88) for
pregnancies per number of IVF- treated cycles in smokers versus
non-smokers. Despite the potential limitations of meta-analyses of
observational studies, the evidence presented in this review is compelling
because of the consistency of effect across different study designs, sample
size and types of outcome. However, continued reassurance is needed that
the calculated overall effect is not in fact due to confounding variables.
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