The use and safety of intramuscular midazolam during in-office botulinum toxin injections in pediatric patients

2021 ◽  
pp. 1-6
Author(s):  
Mariam N. Mian ◽  
Nadia Alwasiah ◽  
Ariel Savitz
Keyword(s):  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Medication Administration ◽  
Traumatic Experiences ◽  
Chronic Obstructive ◽  
Average Dose ◽  
Respiratory Events ◽  
Outpatient Procedures ◽  
Prolonged Sedation ◽  
Student’S T

PURPOSE: Pediatric outpatient procedures can be traumatic experiences for patients. This retrospective study, evaluates intramuscular midazolam as a safe option for anxiolysis during spasticity management injections. METHODS: We performed a retrospective chart review of 72 patients from a Tertiary Pediatric Hospital Outpatient Clinic. One hundred and twenty injections were administered over two years by a single practitioner. Comorbidities included asthma, sleep apnea, chronic obstructive disease, and epilepsy. Duration of sedation, safety of midazolam as determined through the use of the REACT (Respiration, Energy, Alertness, Circulation, Temperature) score, and frequency of side effects (prolonged sedation, breakthrough crying, medication reversal, and emergent evaluation) were recorded. A student’s t test evaluated the relationship between the above comorbidities and duration of sedation. RESULTS: The average duration of sedation was 29 minutes (95% CI 26.51–31.35) with an average dose of midazolam of 0.20 mg/kg (95% CI 0.9–0.21). None of the subjects required medication reversal or emergent evaluation. 39% of the patients had prolonged sedation (> 30 minutes after medication administration), 22% had breakthrough crying, and 0% had respiratory events requiring oxygen, intubation or an emergency evaluation. No statistical significance found between the comorbidities and duration of sedation. CONCLUSION: Intramuscular midazolam is a possible effective anxiolytic medication strategy for outpatient pediatric injections. Additional studies are needed to ensure its safety and efficacy.

Scientific Substantiation of the Innovative Model of Catering for Cadet Corps Students

2020 ◽  
pp. 31-35
Author(s):  
Novikova ◽  
SP Romanenko ◽  
MA Lobkis
Keyword(s):  
Correlation Coefficient ◽  
School Environment ◽  
Developmental Disorders ◽  
Pearson Correlation ◽  
Statistical Significance ◽  
Regression Analyses ◽  
Healthy Nutrition ◽  
Innovative Model ◽  
Scientific Substantiation ◽  
Student’S T

Introduction: In the Russian Federation, much attention is traditionally paid to military education and training. A special place in its structure is occupied by the system of cadet classes and corps. A distinctive feature of the learning mode in such institutions is a combined effect of standard and specific factors of indoor school environment and intensive physical activity owing to sports, applied military and drill training. No evidence-based methods of establishing nutrient requirements of children in modern conditions of cadet corps have been developed so far, which predetermines the potential of transforming nutrition from a health-saving factor into a health risk factor. Our objective was to provide a scientific substantiation of the model of healthy nutrition for students of cadet-type educational establishments. Methods: The statistical significance of the correlation was evaluated using the Student’s t-test. Correlation and regression analyses were used to assess cause-and-effect relationships. The Pearson correlation coefficient (rxy) was used as an indicator of the strength of the relationship between quantitative indicators x and y, both having a normal distribution. Correlation coefficient (rxy) values were interpreted in accordance with the Chaddock scale. For the purpose of statistical modeling, the method of multiple linear regressions was used. Conclusions: We substantiated the innovative model of organizing healthy nutrition for students of cadet-type schools based on the correlation and regression analyses with determination of statistical significance of the studied characteristics. Its efficiency indicators include an increase in average functional capabilities of students by more than 10 % and a reduction in the probability of developmental disorders by more than 25 %.

scholarly journals Higher Caloric Refeeding Is Safe in Hospitalised Adolescent Patients with Restrictive Eating Disorders

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Elizabeth K. Parker ◽  
Sahrish S. Faruquie ◽  
Gail Anderson ◽  
Linette Gomes ◽  
Andrew Kennedy ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Weight Gain ◽  
Statistical Significance ◽  
Caloric Intake ◽  
Tube Feeding ◽  
Retrospective Chart Review ◽  
Refeeding Syndrome ◽  
Restrictive Eating ◽  
Weight Restoration ◽  
The Mean

Introduction. This study examines weight gain and assesses complications associated with refeeding hospitalised adolescents with restrictive eating disorders (EDs) prescribed initial calories above current recommendations.Methods. Patients admitted to an adolescent ED structured “rapid refeeding” program for >48 hours and receiving ≥2400 kcal/day were included in a 3-year retrospective chart review.Results. The mean (SD) age of the 162 adolescents was 16.7 years (0.9), admission % median BMI was 80.1% (10.2), and discharge % median BMI was 93.1% (7.0). The mean (SD) starting caloric intake was 2611.7 kcal/day (261.5) equating to 58.4 kcal/kg (10.2). Most patients (92.6%) were treated with nasogastric tube feeding. The mean (SD) length of stay was 3.6 weeks (1.9), and average weekly weight gain was 2.1 kg (0.8). No patients developed cardiac signs of RFS or delirium; complications included 4% peripheral oedema, 1% hypophosphatemia (<0.75 mmol/L), 7% hypomagnesaemia (<0.70 mmol/L), and 2% hypokalaemia (<3.2 mmol/L). Caloric prescription on admission was associated with developing oedema (95% CI 1.001 to 1.047;p=0.039). No statistical significance was found between electrolytes and calories provided during refeeding.Conclusion. A rapid refeeding protocol with the inclusion of phosphate supplementation can safely achieve rapid weight restoration without increased complications associated with refeeding syndrome.

scholarly journals A comparative study of chest CT findings regarding the effects of regional dust exposure on patients with COPD living in urban areas and rural areas near cement plants

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Junghyun Kim ◽  
Bom Kim ◽  
So Hyeon Bak ◽  
Yeon-Mok Oh ◽  
Woo Jin Kim
Keyword(s):  
Sex Education ◽  
Rural Areas ◽  
Urban Areas ◽  
Smoking Status ◽  
Statistical Significance ◽  
Dust Exposure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Wall Area ◽  
Copd Patients

Abstract Background The clinical and radiological presentation of chronic obstructive pulmonary disease (COPD) is heterogenous depending on the characterized sources of inflammation. This study aimed to evaluate COPD phenotypes associated with specific dust exposure. Methods This study was designed to compare the characteristics, clinical outcomes and radiological findings between two prospective COPD cohorts representing two distinguishing regions in the Republic of Korea; COPD in Dusty Area (CODA) and the Korean Obstructive Lung Disease (KOLD) cohort. A total of 733 participants (n = 186 for CODA, and n = 547 for KOLD) were included finally. A multivariate analysis to compare lung function and computed tomography (CT) measurements of both cohort studies after adjusting for age, sex, education, body mass index, smoking status, and pack-year, Charlson comorbidity index, and frequency of exacerbation were performed by entering the level of FEV1(%), biomass exposure and COPD medication into the model in stepwise. Results The mean wall area (MWA, %) became significantly lower in COPD patients in KOLD from urban and metropolitan area than those in CODA cohort from cement dust area (mean ± standard deviation [SD]; 70.2 ± 1.21% in CODA vs. 66.8 ± 0.88% in KOLD, p = 0.028) after including FEV1 in the model. COPD subjects in KOLD cohort had higher CT-emphysema index (EI, 6.07 ± 3.06 in CODA vs. 20.0 ± 2.21 in KOLD, p < 0.001, respectively). The difference in the EI (%) was consistently significant even after further adjustment of FEV1 (6.12 ± 2.88% in CODA vs. 17.3 ± 2.10% in KOLD, p = 0.002, respectively). However, there was no difference in the ratio of mean lung density (MLD) between the two cohorts (p = 0.077). Additional adjustment for biomass parameters and medication for COPD did not alter the statistical significance after entering into the analysis with COPD medication. Conclusions Higher MWA and lower EI were observed in COPD patients from the region with dust exposure. These results suggest that the imaging phenotype of COPD is influenced by specific environmental exposure.

scholarly journals Chronic obstructive pulmonary disease and malnutrition: why are we not winning this battle?

2003 ◽  
Vol 29 (2) ◽  
pp. 107-115 ◽  
Author(s):  
Ivone Martins Ferreira
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Statistical Significance ◽  
Nutritional Therapy ◽  
Nutritional Supplementation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Randomized Controlled Studies ◽  
Cytokine Inhibitors

OBJECTIVES: To review the mechanisms involved in the origin of malnutrition in patients with chronic obstructive pulmonary disease (COPD), and to make a systematic review of randomized controlled studies, to clarify the contribution of nutritional supplementation in patients with stable COPD. METHOD: A systematic review of articles published in the field of nutrition, in any language and from several sources, including Medline, Embase, Cinahl, and the Cochrane Registry on COPD, as well as studies presented at congresses in the US and Europe. RESULTS: Studies on nutritional supplementation for more than two weeks showed a very small effect, not reaching statistical significance. A linear regression study found that old age, relative anorexia, and high inflammatory response are associated with non-response to nutritional therapy. CONCLUSION: Currently, there is no evidence that nutritional supplementation is truly effective in patients with COPD. Factors associated with non-response suggest a relationship with the degree of inflammation, including high TNF-alpha levels. Measuring inflammation markers may be useful to determine prognosis and adequate therapy. Treatment with anti-inflammatory cytokines or cytokine inhibitors seems promising for the future.

The Effects of Oral Almitrine on Pattern of Breathing and Gas Exchange in Patients with Chronic Obstructive Pulmonary Disease

1984 ◽  
Vol 66 (4) ◽  
pp. 435-442 ◽  
Author(s):  
J. R. Stradling ◽  
C. G. Nicholl ◽  
D. Cover ◽  
E. E. Davies ◽  
J. M. B. Hughes ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gas Exchange ◽  
Pulmonary Disease ◽  
Low Dose ◽  
Statistical Significance ◽  
Chronic Obstructive ◽  
Inspiratory Flow Rate ◽  
Obstructive Pulmonary Disease ◽  
Oxygen Breathing ◽  
Arterial Po2

1. Almitrine at a low dose of 100 mg orally significantly raises Pao2 and lowers Paco2 in patients with chronic obstructive pulmonary disease, compared with placebo, when they were breathing air or 28% oxygen. 2. The estimated ideal alveolar — arterial Po2 difference was less after almitrine compared with placebo, when patients were breathing either air or 28% oxygen. 3. After almitrine overall ventilation breathing air increased by 10% but this did not reach statistical significance. During 28% oxygen breathing almitrine hardly altered overall ventilation but the inspiratory duty cycle (Ti/Ttot.) decreased and mean inspiratory flow rate (VT/Ti) increased compared with placebo. These changes were significant on a paired t-test (P<0.05). 4. Changes in both volume and pattern of breathing may explain the improved gas exchange in the lung after almitrine.

scholarly journals Therapeutic efficacy of connective tissue autotransplants with periosteum and platelet rich plasma in the management of gingival recession

2013 ◽  
Vol 70 (7) ◽  
pp. 664-669 ◽  
Author(s):  
Bojan Jovicic ◽  
Zoran Lazic ◽  
Milica Nedic ◽  
Stevo Matijevic ◽  
Aleksandra Gostovic-Spadijer
Keyword(s):  
Connective Tissue ◽  
Surgical Procedures ◽  
Platelet Rich Plasma ◽  
Statistical Significance ◽  
Surgical Techniques ◽  
Gingival Recession ◽  
Contralateral Side ◽  
Test Results ◽  
Keratinized Tissue ◽  
Student’S T

Background/Aim. Gingival recession progression in clinical practaice has influenced the development of various surgical procedures and techniques for solving esthetic imperfections and subjective difficulties coused by gingival recession. The aim of this study was to verify efficacy of surgical procedures and to compare both of surgical procedures through the keratinized tissue width. Methods. The study included 20 teeth with gingival recesion, M?ller class I and II. Ten teeth with gingival recession were treated with connective tissue autotransplants with periosteum in combination with coronary guided surgical flap (CTG group). On the contralateral side 10 teeth with gingival recession were treated with the same surgical procedures but in combination with platelet-rich plasma (CTGPRP group). We measured the keratinized tissue width. For statistical significance we used the Student's t-test. Results. The study reveled a statistical significance in reducing vertical deepress of recession by both used treatments. Root deepness in CTG and CTG-PRP group was 90% and 93.5%, respectively. With both surgical techniques we achieved larger zone of keratinized gingiva but with a wide zone of keratinized tissue in CTG - the PRP group. Conclusion. The concept regeneration technique with PRP and with the stimulating influence of platele activated growth factors results in the regeneration of deep periodontal tissue as an important prerequisite for the successful treatment of gingival recession.

scholarly journals The mortality of ill infants with false tooth extraction in a rural Ugandan emergency department

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Amyna Husain ◽  
M. Douglas Baker ◽  
Mark C. Bisanzo ◽  
Martha W. Stevens
Keyword(s):  
Emergency Department ◽  
Tooth Extraction ◽  
Chart Review ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Cultural Practice ◽  
Fluid Bolus ◽  
Significant Difference ◽  
To Receive

False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE−) was 14% (P=0.22). The FTE+ study group, and FTE− comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE− infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE− infants.

scholarly journals Isolation and structure elucidation of anti-malarial principles from Terminalia mantaly H. Perrier stem bark

2021 ◽  
Vol 15 (1) ◽  
pp. 282-292
Author(s):  
Babatunde Samuel ◽  
Yemi Adekola Adekunle
Keyword(s):  
Statistical Significance ◽  
Solvent System ◽  
Stem Bark ◽  
P Value ◽  
Resonance Spectroscopy ◽  
Global Public Health ◽  
1H And 13C Nmr ◽  
Malaria Therapy ◽  
Student’S T

Emergence of malaria parasite resistance to drugs has raised global public health concerns for a compelling need to develop improved malaria therapy. This study is a bio-guided isolation of triterpenoid antimalarial compounds from Terminalia mantaly. Methanol extract of the plant was subjected to column chromatography, and eluted with a ternary solvent system gradient-wise. Two compounds, 1 and 2, were isolated and characterised by spectroscopic data (IR, 1H and 13C NMR, COSY, HMQC, HMBC) and by comparison with literature. Isolated compounds were investigated for antimalarial property by spectrophotometric determination of inhibition of β-Hematin formation, absorbance taken at 405 nm. Results were analysed using Graghpad Prism® (6.0) and presented as mean IC50±SEM. Statistical significance, determined using Student’s t-test and one-way ANOVA, set at p-value of 0.05. Quantitative β-Hematin formation inhibitory activities gave IC50±SEM values of (compound 1; 4.434±0.47), (compound 2; 5.140±4.2) with (chloroquine; 0.335±0.1 mg/ml). Compound 1 was identified as 2,3,19,23-tetrahydroxyolean-12-en-28-oic acid glucopyranoside (arjunglucoside I), and compound2 as its aglycone, 2,3,19,23-tetrahydroxyolean-12-en-28-oic acid (arjungenin). This study provided credence for folkloric use of Terminalia mantaly to treat malaria, and this observed activity was probably due to these isolated triterpenoids.Keywords: β-Hematin, triterpenoids, nuclear magnetic resonance spectroscopy

scholarly journals Radiographic assessment of the percutaneous Bianchi system technique for treatment of hallux valgus

2021 ◽  
Vol 15 (2) ◽  
pp. 140-145
Author(s):  
Tércio Manoel de Vasconcelos Silva ◽  
Marcus Vinicius Mota Garcia Moreno ◽  
Janice de Souza Guimarães ◽  
Túlio Eduardo Vieira Marçal ◽  
Thiago Batista Faleiro ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Statistical Significance ◽  
Case Series ◽  
Deformity Correction ◽  
Level Of Evidence ◽  
Paired Samples ◽  
Valgus Angle ◽  
Assessment Period ◽  
System Technique ◽  
Student’S T

Objective: To present initial radiographic results of surgical correction of the hallux valgus angle (HVA) and the intermetatarsal angle (IMA) using the percutaneous Bianchi system (PBS) technique. Methods: Seventeen patients with moderate to severe hallux valgus (HV) were exclusively treated with the PBS technique and assessed radiographically preoperatively and during the postoperative period, from January 2019 to January 2020. The degree of deformity correction was recorded, based on the HVA and the IMA. Stata (v. 14.0) software was used for statistical analyses. Pre-surgical and post-surgical mean HVA and IMA were compared using Student’s t test for paired samples and the McNemar test was used to compare HVA and IMA categories. Statistical significance was set at 5% and 95% confidence intervals were estimated. Results: Both HVA and IMA were reduced significantly during the assessment period. Mean radiographic correction of the HVA was 15.1° and mean radiographic correction of the IMA was 7.3. Conclusions: According to the results presented, use of the PBS technique achieved adequate correction of the radiographic parameters of the patients who underwent the treatment as proposed, although it is necessary to conduct additional studies with longer follow-up to achieve a higher recommendation level. Level of Evidence IV; Therapeutic Studies; Case Series.

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