Yonsei medical journal
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Yonsei medical journal · Sep 2014
Randomized Controlled TrialBispectral index monitoring during anesthesiologist-directed propofol and remifentanil sedation for endoscopic submucosal dissection: a prospective randomized controlled trial.
Endoscopic submucosal dissection (ESD) is a technically difficult and lengthy procedure requiring optimal depth of sedation. The bispectral index (BIS) monitor is a non-invasive tool that objectively evaluates the depth of sedation. The purpose of this prospective randomized controlled trial was to evaluate whether BIS guided sedation with propofol and remifentanil could reduce the number of patients requiring rescue propofol, and thus reduce the incidence of sedation- and/or procedure-related complications. ⋯ BIS-guided propofol infusion combined with remifentanil reduced the number of patients requiring rescue propofol in ESD procedures. However, this finding did not lead to clinical benefits and thus BIS monitoring is of limited use during anesthesiologist-directed sedation.
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Yonsei medical journal · Sep 2014
Randomized Controlled TrialPre-emptive tramadol could reduce pain after ureteroscopic lithotripsy.
Optimal analgesia in ambulatory urology patients still remains a challenge. The aim of this study was to examine if the pre-emptive use of intravenous tramadol can reduce pain after ureteroscopic lithotripsy in patients diagnosed with unilateral ureteral stones. ⋯ Pre-emptive tramadol did reduce early postoperative pain. The patients who received pre-emptive tramadol were less likely to experience severe post-operative pain.
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Yonsei medical journal · Sep 2014
Evaluating the utility of rapid point-of-care potassium testing for the early identification of hyperkalemia in patients with chronic kidney disease in the emergency department.
Severe hyperkalemia leads to significant morbidity and mortality if it is not immediately recognized and treated. The concentration of potassium (K⁺) in the serum increases along with deteriorating renal function. The use of point-of-care K⁺ (POC-K⁺) in chronic kidney disease (CKD) could reduce the time for an accurate diagnosis and treatment, saving lives. We hypothesized that POC-K⁺ would accurately report K⁺ serum level without significant differences compared to reference testing, regardless of the renal function of the patient. ⋯ The results of POC-K⁺ correlate well with values obtained from reference laboratory tests and coincide with changes in serum-creatinine of patients with CKD.
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Yonsei medical journal · Sep 2014
Neck circumference and lowest oxygen saturation are independently associated with high coexistence of hypertension in obstructive sleep apnea.
Obstructive sleep apnea (OSA) is considered an independent risk factor for hypertension. However, it is still not clear which clinical factors are related with the presence of hypertension in OSA patients. We aimed to find different physical features and compare the sleep study results which are associated with the occurrence of hypertension in OSA patients. ⋯ Age and neck circumference should be considered as clinically significant features, and the lowest blood O₂ saturation during sleep should be emphasized in predicting the coexistence or development of hypertension in OSA patients.
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Yonsei medical journal · Sep 2014
Architectural changes of the gastrocnemius muscle after botulinum toxin type A injection in children with cerebral palsy.
This study used ultrasonography (US) to investigate the architectural changes in gastrocnemius muscles (GCM) after botulinum toxin injection (BoNT-A) in children with cerebral palsy (CP). ⋯ Our results demonstrated muscle architectural changes induced by BoNT-A injection. The functional significances of these changes were discussed.