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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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Cerebral blood flow and metabolism in severely head-injured children. Part 1: Relationship with GCS score, outcome, ICP, and PVI 总被引:5,自引:0,他引:5
J P Muizelaar A Marmarou A A DeSalles J D Ward R S Zimmerman Z Li S C Choi H F Young 《Journal of neurosurgery》1989,71(1):63-71
The literature suggests that in children with severe head injury, cerebral hyperemia is common and related to high intracranial pressure (ICP). However, there are very few data on cerebral blood flow (CBF) after severe head injury in children. This paper presents 72 measurements of cerebral blood flow ("CBF15"), using the 133Xe inhalation method, with multiple detectors over both hemispheres in 32 children aged 3 to 18 years (mean 13.6 years) with severe closed head injury (average Glasgow Coma Scale (GCS) score 5.4). In 25 of the children, these were combined with measurements of arteriojugular venous oxygen difference (AVDO2) and of cerebral metabolic rate of oxygen (CMRO2). In 30 patients, the first measurement was taken approximately 12 hours postinjury. In 18 patients, an indication of brain stiffness was obtained by withdrawal and injection of ventricular cerebrospinal fluid and calculation of the pressure-volume index (PVI) of Marmarou. The CBF and CMRO2 data were correlated with the GCS score, outcome, ICP, and PVI. Early after injury, CBF tended to be lower with lower GCS scores, but this was not statistically significant. This trend was reversed 24 hours postinjury, as significantly more hyperemic values were recorded the lower the GCS score, with the exception of the most severely injured patients (GCS score 3). In contrast, mean CMRO2 correlated positively with the GCS score and outcome throughout the course, but large standard deviations preclude making predictions based on CMRO2 measurements in individual patients. Early after injury, there was mild uncoupling between CBF and CMRO2 (CBF above metabolic demands, low AVDO2) and, after 24 hours, flow and metabolism were completely uncoupled with an extremely low AVDO2. Consistently reduced flow as found in only four patients; 28 patients (88%) showed hyperemia at some point in their course. This very high percentage of patients with hyperemia, combined with the lowest values of AVDO2 found in the literature, indicates that hyperemia or luxury perfusion is more prevalent in this group of patients. The three patients with consistently the highest CBF had consistently the lowest PVI: thus, the patients with the most severe hyperemia also had the stiffest brains. Nevertheless, and in contrast to previous reports, no correlation could be established between the course of ICP or PVI and the occurrence of hyperemia, nor was there a correlation between the levels of CBF and ICP at the time of the measurements. The authors argue that this lack of correlation is due to: 1) a definition of hyperemia that is too generous, and 2) the lack of a systematic relationship between CBF and cerebral blood volume 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.
相似文献