Chinese Med J Peking
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Chinese Med J Peking · Mar 2012
Randomized Controlled TrialComparison of the effectiveness of dexmedetomidine versus propofol target-controlled infusion for sedation during coblation-assisted upper airway procedure.
Sedation for the coblation-assisted upper airway procedure has lacked easy modulation between appropriate pain control and airway protection. This study aimed to compare the effectiveness of dexmedetomidine versus target controlled propofol infusion in providing sedation during a coblation-assisted upper airway procedure. ⋯ Dexmedetomidine in conjunction with local anesthesia offered better analgesia and conscious sedation for a coblation-assisted upper airway procedure as well as less airway obstruction, apnea and greater haemodynamic stability.
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Chinese Med J Peking · Mar 2012
Epidemiological features and risk factors of sepsis-associated encephalopathy in intensive care unit patients: 2008-2011.
Encephalopathy is a common complication of sepsis, and its onset can occur at any stage of sepsis and implies worse prognosis. However, the incidence, epidemiology, and pathogenesis of sepsis-associated encephalopathy remain controversial. The purpose of this study was to investigate the epidemiological features and risk factors for sepsis-associated encephalopathy. ⋯ Encephalopathy increases mortality rate in septic patients. Clinical intervention to reduce risk factors and thereby morbidity and mortality depends on a correct understanding of the differences between patients with sepsis and patients with both sepsis and encephalopathy.
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Chinese Med J Peking · Mar 2012
Impact of angina prior to acute ST-elevation myocardial infarction on short-term outcomes after primary percutaneous coronary intervention: results from the Shanghai Registry of Acute Coronary Syndrome (SRACE).
The clinical significance of ischemic chest pain before acute ST-elevation myocardial infarction (STEMI) remains an interesting issue of investigation particularly in the era of percutaneous coronary intervention (PCI). This study aimed to assess the impact of angina prior to STEMI on short-term clinical outcomes in patients with acute STEMI undergoing primary PCI. ⋯ Presence of angina prior to acute STEMI is associated with better outcome at a 30-day clinical follow-up in patients undergoing primary PCI.
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Chinese Med J Peking · Mar 2012
Plasma neutrophil-gelatinase-associated lipocalin and cystatin C could early diagnose contrast-induced acute kidney injury in patients with renal insufficiency undergoing an elective percutaneous coronary intervention.
Contrast induced acute kidney injury (CIAKI) is an important complication in the use of iodinated contrast media (CM). Our study was to evaluate the neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C for early diagnosis of CIAKI. ⋯ Single measurement of NGAL or cystatin C had poor sensitivity and specificity; however, the relative increasing 25% of NGAL at 4 hours after CM exposure demonstrated higher diagnostic values for CIAKI. Combining relative increasing plasma NGAL with relative increasing plasma cystatin C might perform better for early diagnosis of CIAKI.
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Varicella is a self-limited disease, but sometimes it may be associated with some serious life-threatening complications. Necrotizing fasciitis is a rare complication of varicella. This is a case of a 7-year-old girl with septic shock caused by necrotizing fasciitis as a complication of varicella. ⋯ Usually patients with varicella were admitted to pediatric or infectious disease department but not surgical departments; so that the clinicians should be aware that varicella may be complicated by life-threatening surgical infections. Necrotizing fasciitis should be suspected in patients of varicella who showed an increasing pain and swelling in any body areas associated with increasing fever and local erythema. Early identification, surgical drainage and debridement are essential for successful treatment of necrotizing fasciitis.