Medicine
-
Review Case Reports
Tibial plateau fractures (AO type B3) combined with tibial tubercle fracture: Case report and review of the literature.
Tibial tuberosity fractures most often occur in the adolescents. Fracture of tibial tuberosity in adults is extremely rare with only 5 reported cases till date. Tibial plateau fractures combined with tibial tubercle fractures are not common. ⋯ Fractures of the partial tibial plateau combined with tibial tubercle are present and should not be ignored. Accurate diagnosis and proper treatment will help achieve favorable outcomes in these patients.
-
Dexmedetomidine is an effective sedative during spinal anesthesia. However, it requires a loading dose, which can result in transient hypertension, hypotension, bradycardia, and/or sinus arrest. In addition, the time required to reach an appropriate depth of sedation may cause anxiety to the patients. Therefore, we examined whether an intravenous bolus of midazolam could replace the loading dose of dexmedetomidine for sedation during surgery in elderly patients who received spinal anesthesia. ⋯ An intravenous bolus of midazolam is a viable alternative to dexmedetomidine loading for sedation during surgery in elderly patients who received spinal anesthesia. This is especially effective for patients who are at high risk for bradycardia or who want a faster sedation.
-
Comparative Study Observational Study
Validation of the behavioral pain scale to assess pain intensity in adult, intubated postcardiac surgery patients: A cohort observational study - POL-BPS.
Patients after cardiac surgery experience significant pain, but cannot communicate effectively due to opioid analgesia and sedation. Identification of pain with validated behavioral observation tool in patients with limited abilities to self-report pain improves quality of care and prevents suffering. Aim of this study was to validate Polish version of behavioral pain scale (BPS) in intubated, mechanically ventilated patients sedated with dexmedetomidine and morphine after cardiac surgery. ⋯ Both mean NRS and BPS scores were significantly higher during nociceptive procedures as compared to assessments at rest, in both sedated and unsedated patients (P < .001). The results of this observational study show that the Polish translation of BPS can be regarded as a useful and validated tool for pain assessment in adult intubated patients. This instrument can be used in both unsedated and sedated cardiac surgery patients with limited communication abilities.
-
Randomized Controlled Trial
Effect of rational emotive behavior therapy on stress management and irrational beliefs of special education teachers in Nigerian elementary schools.
From a rational emotive behavior therapy viewpoint, stress-related disorders originate from irrational beliefs and self-defeating philosophies and attitude. Individuals affected by stress are different from those ones with neurotic problems mainly because the stressed individuals have irrational beliefs about specific, short-term, or more readily identifiable events, in contrast to the more mundane and diffuse difficulties faced by neurotic persons. The present study aimed to examine the impact of a rational emotive behavior therapy (REBT) intervention on the stress levels and irrational beliefs among special education teachers in elementary schools in Nigeria. ⋯ Rational-emotive behavior therapy is an effective therapeutic modality that can be applied by REBT clinicians for the management of stress. Additional clinical assessments will be necessary to further confirm the impact of an REBT intervention on teachers' stress management and irrational beliefs in Nigerian elementary school setting.
-
Case Reports
Α-fetoprotein producing hepatoid gastric adenocarcinoma with neuroendocrine differentiation: A case report.
Hepatoid gastric adenocarcinoma is a rare type of gastric cancer. The phenomenon of neuroendocrine differentiation (NED) in gastrointestinal tumor needs further research. Both hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. However, there is still no specific treatment. ⋯ Hepatoid adenocarcinoma and neuroendocrine differentiation are the factors leading to a poor prognosis of gastric cancer. It relapses easily. Long-term follow-up and regular examinations are necessary to detect relapses.