BMC research notes
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Randomized Controlled Trial Comparative Study
Influence of perioperative oxygen fraction on pulmonary function after abdominal surgery: a randomized controlled trial.
A high perioperative inspiratory oxygen fraction (FiO2) may reduce the frequency of surgical site infection. Perioperative atelectasis is caused by absorption, compression and reduced function of surfactant. It is well accepted, that ventilation with 100% oxygen for only a few minutes is associated with significant formation of atelectasis. However, it is still not clear if a longer period of 80% oxygen results in more atelectasis compared to a low FiO2.Our aim was to assess if a high FiO2 is associated with impaired oxygenation and decreased pulmonary functional residual capacity (FRC). ⋯ We found no significant difference in oxygenation index or functional residual capacity between patients given 80% and 30% oxygen for a period of approximately 5 hours.
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The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins. ⋯ Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.
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Maternal cardiovascular and pulmonary events during labor and delivery may result in adverse maternal and fetal outcome. Potential etiologies include primary cardiac events, pulmonary embolism, eclampsia, maternal hemorrhage, and adverse medication events. Remifentanil patient-controlled analgesia is an alternative when conventional neuraxial analgesia for labor is contraindicated. Although remifentanil is a commonly used analgesic, its use for labor analgesia is not clearly defined. ⋯ A rapid discussion among the attending obstetric, anesthesia, and nursing teams resulted in consensus to perform an emergent bedside cesarean delivery resulting in an excellent fetal outcome. During maternal cardiopulmonary arrest, a prompt decision to perform a bedside cesarean delivery is essential to avoid significant maternal and fetal morbidity. Under these conditions, rapid collaboration among obstetric, anesthesia, and nursing personnel, and an extensive multi-layered safety process are integral components to optimize maternal and fetal outcomes.
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Clinical Trial
Clonidine in the treatment of adolescent chronic fatigue syndrome: a pilot study for the NorCAPITAL trial.
This pilot study (ClinicalTrials.gov ID: NCT01507701) assessed the feasibility and safety of clonidine in adolescent chronic fatigue syndrome (CFS). Specifically, we assessed clonidine dosage in relation to a) plasma concentration levels, b) orthostatic cardiovascular responses, and c) possible adverse effects. ⋯ Clonidine 50 μg BID seems to be safe enough to proceed from a pilot study to a controlled trial in a select group of adolescents with CFS (ClinicalTrials.gov ID: NCT01040429).
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Tobacco use is a serious public health challenge in North Africa, and health professionals play a vital role in tobacco control. In Egypt, limited data are available on the knowledge and attitudes of health care providers regarding tobacco control policies. Such data are especially relevant due to Egypt's tobacco control laws, adopted in 2007, prohibiting smoking in hospitals and other public places. This study surveyed 49 senior administrative staff, 267 physicians, 254 nurses, and 109 administrative employees working in El-Kasr El-Aini Hospital in Cairo, assessing their knowledge and attitudes regarding Egypt's tobacco control laws and barriers to their effective implementation in health care facilities. We also investigated the hospital's compliance with smoke-free policies. ⋯ Overall, smoke-free policies were poorly enforced in this large teaching hospital in Cairo, Egypt. Interventions to address the identified barriers to their implementation could include the provision of cessation training and services as well as effective communication programs to educate health care workers at all levels regarding the dangers of second-hand smoke exposure and effective measures for protection.