The Journal of international medical research
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This retrospective study examined the correlation between carboxy haemoglobin (COHb) levels and vital signs in patients with carbon monoxide (CO) intoxication. ⋯ Vital signs cannot be used as a prognostic marker of CO intoxication and, therefore, patients must be monitored closely.
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Randomized Controlled Trial Comparative Study
The incidence of postoperative nausea and vomiting after thyroidectomy using three anaesthetic techniques.
The choice of anaesthetics can affect the incidence of postoperative nausea and vomiting (PONV). This study compared the incidence of PONV in 177 female patients who underwent thyroidectomy, with anaesthesia induced and maintained using one of three regimens: (i) sevoflurane (thiopental sodium 4 - 5 mg/kg and sevoflurane 2.0 - 2.5 vol% in 50% air); (ii) total intravenous anaesthesia (TIVA; propofol-remifentanil [target blood concentrations 2.5 - 3.5 μg/ml and 3.5 - 4.5 ng/ml, respectively]); or (iii) combined inhalation and intravenous anaesthesia (sevoflurane 1.0 vol% in 50% air plus propofol-remifentanil [target blood concentrations 1.5 - 2.5 μg/ml and 2.5 - 3.5 ng/ml, respectively]). ⋯ Overall, the incidence of PONV was significantly lower in the TIVA and combined groups compared with the sevoflurane group (33.9%, 39.0% and 64.4%, respectively). In conclusion, the maintenance of anaesthesia with propofol-remifentanil or sevoflurane-propofol-remifentanil decreased the incidence of PONV compared with sevoflurane alone.
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Randomized Controlled Trial
Intravenous lidocaine for effective pain relief after inguinal herniorrhaphy: a prospective, randomized, double-blind, placebo-controlled study.
This prospective, randomized, double-blind, placebo-controlled study evaluated the effectiveness of intravenous lidocaine to reduce post-operative pain in 64 inguinal herniorrhaphy patients. Intravenous bolus injection of 1.5 mg/kg lidocaine followed by a continuous lidocaine infusion of 2 mg/kg per h was randomly assigned to 32 patients (lidocaine group) and intravenous normal saline bolus injection followed by infusion of normal saline was assigned to 32 other patients (control group). ⋯ Total fentanyl consumption (patient-controlled plus investigator-controlled rescue administration) and the total number of button pushes were significantly lower in the lidocaine group than in the control group. It is concluded that intravenous lidocaine injection reduced post-operative pain after inguinal herniorrhaphy, is easy to administer and may have potential to become routine practice for this type of surgery.
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The prevalence of painful diabetic peripheral neuropathy (DPN) was evaluated in type 1 or type 2 diabetes mellitus patients (n = 4097) attending outpatient clinics across the Middle East. Overall, 53.7% of 3989 patients with DN4 data met the criteria for painful DPN (Douleur Neuropathique-4 [DN4] scores ≥ 4). ⋯ The odds of painful DPN were highest among patients with peripheral vascular disease (OR 4.98), diabetic retinopathy (OR 3.90) and diabetic nephropathy (OR 3.23). Because of the high prevalence and associated suffering, disability and economic burden of painful DPN, it is important that diabetic patients are periodically screened, using a simple instrument such as the DN4, and receive appropriate treatment if symptoms develop.
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Case Reports
Dural metastasis of atypical extraventricular neurocytoma with the codeletion of chromosomes 1p/19q.
Extraventricular neurocytoma (EVN) is a rare neoplasm described in the 2007 World Health Organization classification of tumours of the nervous system. Due to the rarity of the tumour, there is limited literature available. The clinical characteristics, pathological features, biological behaviour and outcome of EVN remain unclear, and there are challenges regarding its diagnosis and management. ⋯ Atypical pathological features included vascular proliferation, the presence of mitosis and a high MIB-1 (an antibody against Ki-67) labelling index. The disease recurred 7 months after the initial complete resection and radiation treatment, presenting with dural metastasis and codeletion of chromosomes 1p/19q. The present case history and treatment course are discussed with respect to the literature.