scholarly journals A Miracle That Accelerates Operating Room Functionality: Sugammadex

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Erdal Dogan ◽  
Mehmet Salim Akdemir ◽  
Abdulmenap Guzel ◽  
Mehmet Besir Yildirim ◽  
Zeynep Baysal Yildirim ◽  
...  
Keyword(s):  
Cholinesterase Inhibitors ◽  
Neuromuscular Block ◽  
Good Alternative ◽  
Cylindrical Shape ◽  
Hemodynamic Parameters ◽  
Time Period ◽  
Extubation Time ◽  
Before And After ◽  
Residual Block ◽  
Time Of Administration

Background.Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape.Methods.In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF<0.9) with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered.Results.Time elapsed until sugammadex administration following neostigmine37 ± 6min, following sugammadex it took2.1 ± 0.9min to reach TOF≥ 0.9, and the extubation time was3.2 ± 1.4min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period.Conclusion.Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient.

scholarly journals Sugammadex versus neostigmine in pediatric cancer patients undergoing outpatient surgical procedures

2020 ◽  
Vol 11 (2) ◽  
pp. 2741-2746
Author(s):  
AbdelfattahAbdelsattar Hussein ◽  
Mohamed Mostafa Hegazy ◽  
Mohamed Adly Elramely ◽  
Amani Gaber Mohamed
Keyword(s):  
Surgical Procedures ◽  
Neuromuscular Block ◽  
Pediatric Population ◽  
Good Alternative ◽  
Primary Outcome Measure ◽  
Early Postoperative Period ◽  
Neuromuscular Blocking ◽  
Extubation Time ◽  
Pediatric Cancer Patients ◽  
Residual Curarization

Neuromuscular blocking agents (NMBAs) are still required for the pediatric population. Residual neuromuscular block is a common complication in the early postoperative period. The objective of this study is to compare the efϑicacy of sugammadex versus neostigmine for reversing NMB in pediatric patients with cancer who undergo outpatient surgical procedures. This double-blinded study included 80 children with different oncological diagnoses, aged 2-18 years, scheduled for outpatient surgical procedures. They were randomly divided into two equal groups; Group N received neostigmine 0.03 mg/kg with atropine 0.02 mg/kg and Group S received sugammadex 2 mg/kg at the end of surgery. The patients were clinically assessed for NMB recovery and extubated. The primary outcome measure was the time from NMB reversal to recovery of the TOF ratio to 0.9% (recovery time). The secondary outcomes included the time between reversal injection and extubation (extubation time) and possible adverse events. The time to recovery of the TOF ratio to 0.9 and the time between reversal injection and extubation were signiϑicantly shorter in S Group (p< 0.001). The time to reach TOF ratio of 0.9 was not correlated with age, anesthesia time, or the dose of the neuromuscular blocker. None of the children developed respiratory depression or postoperative residual curarization. Relatively few patients developed arrhythmia, hypotension, and nausea and vomiting with no signiϑicant difference between the two groups. Sugammadex is a good alternative to neostigmine for reversal of neuromuscular block in outpatient surgical procedures in children with cancer; it safely provides faster NMB reversal and extubation time.

scholarly journals Improved dynamics of sharing research findings in the COVID-19 epidemic compared with the SARS and Ebola epidemics

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Javad Khanali ◽  
Mohammad-Reza Malekpour ◽  
Ali-Asghar Kolahi
Keyword(s):  
Numerical Data ◽  
Public Health Emergency ◽  
Value Of Time ◽  
Time Period ◽  
Pubmed Database ◽  
Before And After ◽  
Major Outbreak ◽  
Research Findings ◽  
Emergent Pathogen ◽  
Planning Strategies

Abstract Background When a new or re-emergent pathogen, such as SARS-CoV-2, causes a major outbreak, rapid access to pertinent research findings is crucial for planning strategies and decision making. We researched whether the speed of sharing research results in the COVID-19 epidemic was higher than the SARS and Ebola epidemics. We also researched whether there is any difference in the most frequent topics investigated before and after the COVID-19, SARS, and Ebola epidemics started. Methods We used PubMed database search tools to determine the time-period it took for the number of articles to rise after the epidemics started and the most frequent topics assigned to the articles. Results The main results were, first, the rise in the number of articles occurred 6 weeks after the COVID-19 epidemic started whereas, this rise occurred 4 months after the SARS and 7 months after the Ebola epidemics started. Second, etiology, statistics & numerical data, and epidemiology were the three most frequent topics investigated in the COVID-19 epidemic. However, etiology, microbiology, and genetics in the SARS epidemic, and statistics & numerical data, epidemiology, and prevention & control in the Ebola epidemic were more frequently studied compared with other topics. Third, some topics were studied more frequently after the epidemics started. Conclusions The speed of sharing results in the COVID-19 epidemic was much higher than the SARS and Ebola epidemics, and that there is a difference in the most frequent articles’ topics investigated in these three epidemics. Due to the value of time in controlling epidemics spread, the study highlights the necessity of defining more solutions for rapidly providing pertinent research findings in fighting against the next public health emergency.

Trends in Craniofacial Injuries Associated with the Introduction of Electric Scooter Sharing Services

FACE ◽  
2021 ◽  
pp. 273250162199244
Author(s):  
Elizabeth M. Boudiab ◽  
Thomas D. Zaikos ◽  
Christopher Issa ◽  
Kongkrit Chaiyasate ◽  
Stephen M. Lu
Keyword(s):  
Maxillofacial Surgery ◽  
Age Groups ◽  
Injury Surveillance System ◽  
Patient Demographics ◽  
Time Period ◽  
Electric Scooter ◽  
Before And After ◽  
Trends Over Time ◽  
Patterns Of Injury ◽  
Craniofacial Fractures

Electric scooters are an increasingly common and convenient mode of transportation worldwide and have effectively revolutionized the shared micromobility industry. As electric scooter sharing companies have increased in popularity there has been a concomitant increase in the frequency of all electric scooter-related injuries. The purpose of this study is to describe the most up-to-date trends in craniofacial fractures and lacerations related to electric scooter use among all age groups. We queried the National Electronic Injury Surveillance System (NEISS) for craniofacial fractures and lacerations related to e-scooters between 2010 and 2019. We then compared injury trends over time and between time periods before and after 2017 when electric scooter share apps revolutionized micromobility. We compared incidence of injury overall and by day of the week, patient demographics, and case severity based on clinical disposition. We identified an increase in the frequency of craniofacial lacerations and fractures in the 3 years following the introduction of electric scooter share services in 2017 (2017 and 2019), compared to the 3 years before this time (2014-2016). Young adults (18-39 years) were the age group with the greatest interval increase in craniofacial injuries. There was also an increase in number of craniofacial injuries occurring on Mondays and a decrease number occurring on Fridays in the later time period. Finally, patients who presented with electric scooter-related craniofacial injuries in this later time period showed a higher frequency of overnight observation and hospital admission for their injuries. The number of craniofacial injuries secondary to electric scooter use has increased dramatically since the introduction of share services. Craniofacial fractures and lacerations are a common reason for craniofacial or maxillofacial surgery consultation and understanding these patterns of injury will help prepare surgeons for patient care, preventative education, and public advocacy.

scholarly journals Changes in prolonged sedentary behaviour across the transition to retirement

2020 ◽  
pp. oemed-2020-106532
Author(s):  
Kristin Suorsa ◽  
Anna Pulakka ◽  
Tuija Leskinen ◽  
Jaana Pentti ◽  
Jussi Vahtera ◽  
...  
Keyword(s):  
Sedentary Behaviour ◽  
Sedentary Time ◽  
Gradual Increase ◽  
Occupational Status ◽  
Retirement Transition ◽  
Time Period ◽  
Before And After ◽  
Aging Study ◽  
Transition To Retirement ◽  
Daily Total

BackgroundProlonged sedentary behaviour is associated with a higher risk of cardiometabolic diseases. This longitudinal study examined changes in daily total, prolonged (≥30 min) and highly prolonged (≥60 min) sedentary time across the transition to retirement by gender and occupational status.MethodsWe included 689 aging workers (mean (SD) age before retirement 63.2 (1.6) years, 85% women) from the Finnish Retirement and Aging Study (FIREA). Sedentary time was measured annually using a wrist-worn triaxial ActiGraph accelerometer before and after retirement with on average 3.4 (range 2–4) measurement points.ResultsWomen increased daily total sedentary time by 22 min (95% CI 13 to 31), prolonged sedentary time by 34 min (95% CI 27 to 42) and highly prolonged sedentary time by 15 min (95% CI 11 to 20) in the transition to retirement, and remained at the higher level of sedentary time years after retirement. The highest increase in total and prolonged sedentary time was observed among women retiring from manual occupations. Men had more total and prolonged sedentary time compared with women before and after retirement. Although no changes in men’s sedentary time were observed during the retirement transition, there was a gradual increase of 33 min (95% CI 6 to 60) in prolonged sedentary time from pre-retirement years to post-retirement years.ConclusionThe transition to retirement was accompanied by an abrupt increase in prolonged sedentary time in women but a more gradual increase in men. The retirement transition may be a suitable time period for interventions aiming to decrease sedentary behaviour.

scholarly journals The Effect of Q-Switched Nd:YAG 1064 nm/532 nm Laser in the Treatment of Onychomycosis In Vivo

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Kostas Kalokasidis ◽  
Meltem Onder ◽  
Myrto-Georgia Trakatelli ◽  
Bertrand Richert ◽  
Klaus Fritz
Keyword(s):  
Clinical Study ◽  
Treatment Time ◽  
Prospective Clinical Study ◽  
Self Evaluation ◽  
Time Period ◽  
Level Of Satisfaction ◽  
Before And After ◽  
532 Nm

In this prospective clinical study, the Q-Switched Nd:YAG 1064 nm/532 nm laser (Light Age, Inc., Somerset, NJ, USA) was used on 131 onychomycosis subjects (94 females, 37 males; ages 18 to 68 years). Mycotic cultures were taken and fungus types were detected. The laser protocol included two sessions with a one-month interval. Treatment duration was approximately 15 minutes per session and patients were observed over a 3-month time period. Laser fluencies of 14 J/cm2were applied at 9 billionths of a second pulse duration and at 5 Hz frequency. Follow-up was performed at 3 months with mycological cultures. Before and after digital photographs were taken. Adverse effects were recorded and all participants completed “self-evaluation questionnaires” rating their level of satisfaction. All subjects were well satisfied with the treatments, there were no noticeable side effects, and no significant differences were found treating men versus women. At the 3-month follow-up 95.42% of the patients were laboratory mycologically cured of fungal infection. This clinical study demonstrates that fungal nail infections can be effectively and safely treated with Q-Switched Nd:YAG 1064 nm/532 nm laser. It can also be combined with systemic oral antifungals providing more limited treatment time.

scholarly journals Water Quality and Financial Analysis of a System Combining Rainwater and Greywater in a House

Water ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 930
Author(s):  
Gustavo Rosa ◽  
Enedir Ghisi
Keyword(s):  
Water Consumption ◽  
Potable Water ◽  
Treatment Process ◽  
Financial Analysis ◽  
Good Alternative ◽  
Water Savings ◽  
Financial Benefits ◽  
Before And After ◽  
Local Water ◽  
Water Tariffs

This study aimed to evaluate the installation of a system that combines rainwater to wash clothes and greywater to flush toilets in a house located in Florianópolis, southern Brazil. The evaluation consisted of determining the potable water savings, performing a financial analysis, and verifying the possibility of using rainwater and reusing greywater according to the local legislation. The reduction in potable water consumption was determined by comparing the monthly water and sewage bill, before and after installing the system, combining rainwater and greywater. The financial analysis was performed considering the financial benefits, operational costs, costs for installing the system, and local water tariffs. After installing the system, there was a decrease of 38.0% in the monthly potable water consumption, which represents a decrease of 7.00 m3 in the monthly potable water consumption. The payback periods for the old and new water tariffs were equivalent to, respectively, ten years and seven months, and eight years and five months. Both rainwater and greywater had parameters with concentrations higher than the limits established by the legislation. Therefore, the rainwater had to go through a device for discarding the first flush and needed disinfection; and the greywater needed to go through a treatment process. The results indicated that the system combining rainwater and greywater shows significant potential for potable water savings, which can be a good alternative to the preservation of potable water resources. It is important to note that current studies on rainwater use and greywater reuse are mainly related to non-potable purposes, but it was shown herein that rainwater can be used for washing clothes.

scholarly journals Paediatric attendances of the emergency department in a major Irish tertiary referral centre before and after expansion of free GP care to children under 6: a retrospective observational study

2021 ◽  
Vol 5 (1) ◽  
pp. e000862
Author(s):  
Irina Korotchikova ◽  
Sukainah Al Khalaf ◽  
Ewa Sheridan ◽  
Rory O'Brien ◽  
Colin P Bradley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Observational Study ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Period 2 ◽  
Time Period ◽  
Before And After ◽  
Gp Care

ObjectivesTo examine the characteristics of paediatric attendances to the emergency department (ED) in Cork University Hospital (CUH) before and after the expansion of free general practitioner (GP) care to children under the age of 6 years.DesignThis is a retrospective observational study that used a large administrative dataset.SettingThe study was conducted in major Irish tertiary referral centre that serves a total population of over 1.1 million. It is a public hospital, owned and managed by the health service executive.ParticipantsChildren aged 0–15 years who attended CUH ED during the study period of 6 years (2012–2018) were included in this study (n=76 831).InterventionsFree GP care was expanded to all children aged 0–5 years in July 2015.Main outcome measuresPaediatric attendances to CUH ED were examined before (Time Period 1: July 2012–June 2015) and after (Time Period 2: July 2015–June 2018) the expansion of free GP care to children under 6. Changes in GP referral rates and inpatient hospital admissions were investigated.ResultsPaediatric presentations to CUH ED increased from 35 819 during the Time Period 1 to 41 012 during the Time Period 2 (14.5%). The proportion of the CUH ED attendances through GP referrals by children under 6 increased by over 8% in the Time Period 2 (from 10 148 to 14 028). Although the number of all children who attended CUH ED and were admitted to hospital increased in Time Period 2 (from 8704 to 9320); the proportion of children in the 0–5 years group who attended the CUH ED through GP referral and were subsequently admitted to hospital, decreased by over 3%.ConclusionThe expansion of free GP care has upstream health service utilisation implications, such as increased attendances at ED, and should be considered and costed by policy-makers.

scholarly journals Complexity traits and synchrony of cryptocurrencies price dynamics

2021 ◽  
Author(s):  
Davide Provenzano ◽  
Rodolfo Baggio
Keyword(s):  
Time Series ◽  
Complex Network ◽  
Complex Structures ◽  
Slope Parameter ◽  
Exponential Distributions ◽  
Horizontal Visibility ◽  
Time Period ◽  
Before And After ◽  
Visibility Algorithm ◽  
Similar Complex

AbstractIn this study, we characterized the dynamics and analyzed the degree of synchronization of the time series of daily closing prices and volumes in US$ of three cryptocurrencies, Bitcoin, Ethereum, and Litecoin, over the period September 1,2015–March 31, 2020. Time series were first mapped into a complex network by the horizontal visibility algorithm in order to revel the structure of their temporal characters and dynamics. Then, the synchrony of the time series was investigated to determine the possibility that the cryptocurrencies under study co-bubble simultaneously. Findings reveal similar complex structures for the three virtual currencies in terms of number and internal composition of communities. To the aim of our analysis, such result proves that price and volume dynamics of the cryptocurrencies were characterized by cyclical patterns of similar wavelength and amplitude over the time period considered. Yet, the value of the slope parameter associated with the exponential distributions fitted to the data suggests a higher stability and predictability for Bitcoin and Litecoin than for Ethereum. The study of synchrony between the time series investigated displayed a different degree of synchronization between the three cryptocurrencies before and after a collapse event. These results could be of interest for investors who might prefer to switch from one cryptocurrency to another to exploit the potential opportunities of profit generated by the dynamics of price and volumes in the market of virtual currencies.

Mate Change Enhances Duetting Activity in the Siamang Gibbon (Hylobates Syndactulus)

Behaviour ◽  
1986 ◽  
Vol 96 (1-2) ◽  
pp. 17-27 ◽  
Author(s):  
Thomas Geissmann
Keyword(s):  
Pair Bonding ◽  
Time Period ◽  
Bonding Effect ◽  
Before And After ◽  
Mate Change ◽  
The Status ◽  
Partner Exchange ◽  
Directed Learning ◽  
Singing Activity

AbstractSiamang gibbons produce long and complex duet songs. The hypothesis that duetting may act as advertisement of the presence and the status of a mated pair has repeatedly been suggested for duetting birds. If a pair bonding effect of the duet is actually attained through a partner-directed learning effort resulting in a pair-specific duet, the learning investment should be concentrated into a time period as short as possible in order to avoid competitors. Therefore, after the formation of a new pair, an increase of singing activity should be expected. In order to test this prediction, the singing activity of a pair of captive siamang before and after a partner exchange was compared. In the newly formed pair, an increase in singing activity was observed. Additional observations on a second new pair show a similar trend. In this case, both new mates remained in their familiar place so that their singing activity was unlikely to be affected by the process of establishing a new territory.

The Economic Effects on Acute Care Surgery in a New York City Public Hospital During the COVID Pandemic

2022 ◽  
pp. 000313482110697
Author(s):  
Zhobin Moghadamyeghaneh ◽  
Adedolapo Ojo ◽  
Murwarid Rahimi ◽  
Anthony Paul Kopatsis ◽  
Katherine Kopatsis ◽  
...  
Keyword(s):  
New York ◽  
Acute Care ◽  
Public Hospital ◽  
Economic Effects ◽  
Acute Care Surgery ◽  
Chi Square ◽  
Time Period ◽  
Before And After ◽  
Care Surgery ◽  
Hospital Center

Background Since the start of the COVID-19 pandemic, less acute care surgical procedures have been performed and consequently hospitals have experienced significant revenue loss. We aim to investigate these procedures performed before and after the start of the COVID-19 pandemic, as well as their effect on the economy. Methods This is a retrospective analysis of patients who underwent cholecystectomies and appendectomies during March–May 2019 compared to the same time period in 2020 using Chi-square and t-tests. Results There were 345 patients who presented with appendicitis or cholecystitis to Elmhurst Hospital Center during the March–May 2019 and 2020 time period. There were three times as many total operations, or about 75%, in 2019 (261) compared to 2020 (84). There was a decrease in the number of admissions from 2019 to 2020 for both acute cholecystitis (149 vs 43, respectively) and acute appendicitis (112 vs 41, respectively). The largest decrease in the number of admissions in 2020 compared to 2019 was observed in April 2020 (98 vs 9, P < .01) followed by May [69 vs 20, P < .01], and March [94 vs 55, P < .01]. Corresponding to the decrease in operative patterns was a noticeable six-time reduction in revenue for the procedures in 2019 ($187,283) compared to 2020 ($30,415). Conclusion We observed almost a triple reduction in the number of cholecystitis and appendicitis procedures performed during the 2020 pandemic surge as compared to the 2019 pre-pandemic data. Elmhurst hospital also experienced four times the loss of revenue during the same time period.

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