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Early management of head injury.

Patients with head injury need effective help. The restoration of disturbed ventilation and an impaired general circulation is important. Concomitant injuries, which occur in about 40% of cases, should be recognized. Priority must be given to treating large lesions of vital organs. Hypoxia and hypotension should be avoided because they produce secondary brain damage. Unconscious patients are intubated and ventilated. In a few cases a laryngeal mask could be applied. Intravenous hypnotics, narcotics and benzodiazepines are used. Inhalational anesthetics, among them N2O, are harmful and should b

Effect of inhalational anesthesia on cerebral circulation in Moyamoya disease.

To clarify the effects of inhalational anesthesia on cerebral circulation in patients with Moyamoya disease, the authors measured regional cortical blood flow (CoBF), jugular bulb oxygen saturation (SjO2), and frontal regional oxygen saturation (rSO2) by near infra-red spectroscopy under total intravenous and inhalational anesthesia in 13 patients undergoing revascularization procedures. Cortical blood flow decreased in some regions under inhaled anesthesia in all cases, and the mean value decreased significantly (p<0.01). Patients' SjO2 levels rose during inhalational anesthesia in 10 of 11 c

Validation of Noninvasive Measurement of Cardiac Output Using Inert Gas Rebreathing in a Cohort of Patients With Heart Failure and Reduced Ejection Fraction.

BACKGROUND: Cardiac output (CO) is a key indicator of cardiac function in patients with heart failure. No completely accurate method is available for measuring CO in all patients. The objective of this study was to validate CO measurement using the inert gas rebreathing (IGR) method against other noninvasive and invasive methods of CO quantification in a cohort of patients with heart failure and reduced ejection fraction. METHODS AND RESULTS: The study included 97 patients with heart failure and reduced ejection fraction (age 42±15.5 years; 64 patients (65.9%) had idiopathic dilated cardiomyo

Anaesthetic considerations in a patient with lepromatous leprosy.

PURPOSE: To consider the anaesthetic problems in a patient with lepromatous leprosy undergoing general anaesthesia. CLINICAL FEATURES: A 52 yr old man with lepromatous leprosy for five years was booked for elective radical nephrectomy. He received 100 mg dapsone per day po. The patient was asymptomatic for cardiovascular disease but his electrocardiogram showed complete left bundle branch block, inferior wall ischaemia with echocardiogram findings of 58% ejection fraction and left ventricular diastolic dysfunction. Other preoperative investigations (haemogram, serum urea and creatinine, liver

Subcutaneous administration of fentanyl in childbirth: an observational study on the clinical effectiveness of fentanyl for mother and neonate.

OBJECTIVE: to explore the maternal and neonatal effects of fentanyl administered subcutaneously to women during labour. DESIGN: two methods … tal group consisted of those who had utilised only subcutaneous fentanyl for pain relief (n=75), or nitrous oxide and oxygen prior to being administered subcutaneous fentanyl (n=196). Stratified random selection based on parity and age was used to determine the control group, which consisted of women who used no pharmacological pain relief (n=196). The pilot st …

[Anesthesia and intensive therapy for a patient with mitochondrial myopathy].

Since 1983 we have been involved in the diagnostic work-up and emergency treatment of a female patient now 48 years old who has a mitochondr … ions of infectious Port-A-Cath systems. We used etomidate, propofol and fentanyl or alfentanil with nitrous oxide and oxygen for induction and maintenance of anaesthesia. Muscle relaxation was induced with vecuronium or atracurium. All cardiovascular, respiratory, metabolic and temperature measurements stayed in normal ranges. After the extensive vascular repai …

[Hypoxemia after general anesthesia].

BACKGROUND: Studies conducted shortly after the implementation of pulse oximetry (PO) into clinical practice 20-25 years ago revealed that m … atory pressure, mode of ventilation, the choice of opioid and muscle relaxant as well as the use of nitrous oxide. Patient-dependent risk factors had the strongest impact on hypoxemia. In about 80% of the university hospitals neither PO nor supplemental oxygen is used during transportation of the patient from the OR to the PACU. CONCLUSIONS: The use of opioids …

[Common variable immunodeficiency associated with autoimmune thrombocytopenia: anesthetic management].

A 44-year-old man diagnosed of common variable immunodeficiency associated with thrombopenia due to autoimmunity required anesthesia for anal fissure repair and hemorrhoidectomy. Hemostatic complications developed after surgery, with extreme thrombopenia (1,000 platelets/pl) and analytical changes that necessitated administration of six units of platelets from apheresis, as well as immunoglobulins, antifibrinolytic agents (e-aminocaproic acid) and granulocytic colony stimulating factors. Anesthesia for such patients is reviewed, with emphasis on careful management of the airways, preparation o

Endodontics in Systemically Compromised Patients

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… oxide | Not in 1st trimester • Spontaneous abortions with nitrous oxide | Avoid Barbiturates and benzodiazepines | No • Cleft lip/palate with benzodiazepines | D Local Anesthesia Local anesthetics are most commonly used medications by dentists. … Intranasal nitrous oxide use is very controversial because there is risk of reduced uterine blood flow or teratogenic effects when it is used in high concentrations [ 76 ]. …

Xenon preconditioning reduces brain damage from neonatal asphyxia in rats.

Xenon attenuates on-going neuronal injury in both in vitro and in vivo models of hypoxic-ischaemic injury when administered during and after the insult. In the present study, we sought to investigate whether the neuroprotective efficacy of xenon can be observed when administered before an insult, referred to as 'preconditioning'. In a neuronal-glial cell coculture, preexposure to xenon for 2 h caused a concentration-dependent reduction of lactate dehydrogenase release from cells deprived of oxygen and glucose 24 h later; xenon's preconditioning effect was abolished by cycloheximide, a protein

Preoperative analgesics for additional pain relief in children and adolescents having dental treatment.

BACKGROUND: Fear of dental pain is a major barrier to treatment for children who need dental care. The use of preoperative analgesics has th … ears of age. We excluded children and adolescents having dental treatment under sedation (including nitrous oxide/oxygen) or general anaesthesia. DATA COLLECTION AND ANALYSIS: Two review authors assessed titles and abstracts of the articles obtained from the searches for eligibility, undertook data extraction and assessed the risk of bias in the included studi …

Case Report: Case of subacute combiled deгенерация спинного мозга в связи с хроническим атрофическим гастритом, макроцитической анемией и положительными антисульфатидом IgM и IgG антителами.

Антисульфатидные антитела являются автоантиорганизмами, связанными с различными неврологическими расстройствами. Они были выявлены в нескольких условиях, включая синдром Гильен-Барре, множественный склероз и хронический подстрекательский демиелинизирующий полинропат. Субакустическое комбинированное дегенерирование спинного мозга вызвано главным образом дефицитом витамина В12. Хроническая атрофическая гастритис — сложное состояние, характеризующееся атрофацией и воспалением желудочно-кишечной слизи. На сегодняшний день не было зарегистрировано ни одного случая, когда пациенты с субакутальным ко

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… It results from both dietary and non-dietary causes and is typically secondary to malnutrition syndromes such as chronic alcoholism, strict vegetarianism, gastrectomy, and nitrous oxide abuse. … Other causes of VitB12 deficiency include insufficient dietary intake owing to vegetarianism, gastrectomy, alcoholism with atrophic gastritis, and nitrous oxide abuse. …

Identification of iron metabolism-related predictive markers of endometriosis and endometriosis-relevant ovarian cancer.

Endometriosis is associated with ovarian cancers, mainly endometrioid and clear-cell carcinomas. Iron metabolism has been shown to play a role in endometriosis. Therefore, it is vital to explore the relationship between iron metabolism and ovarian cancer and to identify novel markers for diagnostics and therapeutics. The endometriosis dataset GSE51981 and the ovarian cancer dataset GSE26712 were obtained from the gene expression omnibus database, and differentially expressed genes were identified. Iron metabolism genes were obtained from molecular signatures database, and hub genes from the 3