Biomed Pap
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Randomized Controlled Trial Comparative Study
Comparison of parturient - controlled remifentanil with epidural bupivacain and sufentanil for labour analgesia: randomised controlled trial.
Epidural analgesia (EA) has significant contraindications including coagulation disorders and parturient refusal. One alternative is intravenous self-administered analgesia using the ultra short-acting opioid remifentanil (rPCA). We compared the efficiency and safety of standard epidural analgesia with parturient-controlled intravenous analgesia using remifentanil as well as personal satisfaction. ⋯ Remifentanil use in obstetric analgesia is a viable alternative to EA, especially in cases of EA contraindications and parturient disapproval.
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Controlled Clinical Trial
Safety and efficacy of sonothrombolysis using bilateral TCD monitoring by diagnostic 2 MHz probes - a pilot study.
Sonothrombolysis is a new treatment method for patients with acute ischemic stroke (IS). Various ultrasound frequencies and intensities are being tested these days. The aim of this pilot study was to assess the safety and efficacy of sonothrombolysis using 2 diagnostic probes and bilateral monitoring in patients with acute occlusion of the middle cerebral artery (MCA). ⋯ In this pilot study, sonothrombolysis using 2 probes and bilateral monitoring is safe but not more effective than standard sonothrombolysis in acute IS patients with MCA occlusion.
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Review Comparative Study
Iterative reconstruction of pulmonary MDCT angiography: effects on image quality, effective dose and estimated organ dose to the breast.
To compare the image characteristics, effective dose and estimated organ dose to the female breast in pulmonary MDCT angiography (MDCTA), reconstructed with either standard filtered back projection (FBP), or iterative reconstruction in image space (IRIS). ⋯ Pulmonary MDCTA utilizing a 100 kV technique, automatic tube current modulation, and iterative image reconstruction offers robust results in routine conditions among an unselected female population, with breast doses being comparable to two-view digital mammography. Moreover, iterative reconstruction offers improvements in both image noise and visual perception of the scans, thus suggesting a potential for further dose reduction.
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Case Reports
Arrhythmias and ECG changes in life threatening hyperkalemia in older patients treated by potassium sparing drugs.
Severe hyperkalemia is a life threatening condition that can cause fatal rhythm disturbance and terminal heart arrest. The most common cause of hyperkalemia in older patients is that of iatrogenic medication-related etiology due to associated polymorbidity, polypharmacy and reduced reserve metabolic capacity. The aim of this paper is to increase awareness in the clinicians of the risk of hyperkalemia in elderly patients treated by potassium sparing drugs. ⋯ Potassium sparing drug therapy in older persons requires more frequent monitoring especially when drugs or their doses are changed, or during concomitant acute illness.
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To assess the influence of continuous venovenous hemofiltration (CVVH) at a filtration rate of 45 mL/kg/h on vancomycin pharmacokinetics in critically ill septic patients with acute kidney injury (AKI). ⋯ CVVH at a filtration rate of 45 mL/kg/h leads to high and rapid extracorporeal removal of vancomycin in critically ill patients. Due to the rapid change in patient clinical status it was impossible to predict a fixed dosage regimen. We recommend blood sampling as early as 6 h after first vancomycin dose with maintenance dose based on vancomycin serum level monitoring.