Articles: adult.
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Rev Bras Anestesiol · Jun 2004
[Relationship between dexmedetomidine continuous infusion and end-tidal sevoflurane concentration, monitored by bispectral analysis.].
General inhalational anesthesia associated with intravenous agents provides analgesia and hypnosis of better quality. Dexmedetomidine is a specific a2-adrenergic agonist with these characteristics and is known by providing hemodynamic stability. This study aimed at evaluating the effects of dexmedetomidine continuous infusion on end-tidal sevoflurane concentration (ETsevo) in general anesthesia, monitored by EEG spectral index (BIS). ⋯ The association of dexmedetomidine continuous infusion (0,5 microg.kg-1.h-1) to inhalational anesthesia with sevoflurane provided end-tidal sevoflurane concentration decrease while maintaining hemodynamic stability.
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Adverse reactions to food resulting in gastrointestinal symptoms are common in the general population. Although only a minority of individuals complaining of such symptoms have immune-mediated reactions to food (food allergy), gastrointestinal food allergies do exist in both children and adults. This review provides an update on the pathogenesis and clinical management of food allergy manifesting in the gut, emphasizing recent developments in the field. ⋯ These new findings have important implications for the diagnosis and management of food allergies. The availability of recombinant allergens will improve methods to diagnose and treat food allergy, and genetic engineering will allow future therapies such as vaccination against food allergy. Emerging knowledge of the role of the gut flora in mucosal immunity will enhance strategies to prevent and treat food allergy using probiotics such as Lactobacillus GG. Such new approaches will extend existing options for managing food allergy and preventing anaphylaxis.
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Recent articles indicate that at the present time disastrous respiratory outcomes during the perioperative management of patients with obstructive sleep apnea are a major problem for the anesthesia community. ⋯ Adult obese patients with suspected or sleep test confirmed obstructive sleep apnea present a formidable challenge throughout the perioperative period. Tracheal intubation and extubation decisions in obese patients with either a presumptive or sleep study diagnosis of obstructive sleep apnea must be made within the context that there may be excess tissue in the pharynx. If opioids are used in the extubated postoperative obese patient with sleep apnea, then one must seriously consider the need for continuous visual and electronic monitoring. Institutional and national society guidelines on these matters are badly needed.
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Conf Proc IEEE Eng Med Biol Soc · Jan 2004
The effect of age on the grip force control in lateral grip.
In the paper we present the grip force tracking system for the evaluation of grip force control. We developed a grip measuring device which can be used for the computer assisted measurements of the grip force in real time. The device was used as an input to a force-tracking task where the subject applied the grip force according to the visual feedback from the computer screen. ⋯ The largest variability among subjects was observed in the group of children and older adults. No significant difference in force control was found between the dominant and non-dominant hand. The grip force tracking system presented is aimed to be used for the evaluation of grip force control in patients with different sensory-motor impairments.
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Ont Health Technol Assess Ser · Jan 2004
Left ventricular assist devices: an evidence-based analysis.
The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of using implantable ventricular assist devices in the treatment of end-stage heart failure. ⋯ LVAD support as a bridge-to-transplant has been shown to improve the survival rate, functional status and quality of life of patients on the heart transplant waiting list. However, due to the shortage of donor hearts and the current heart transplant algorithm, LVAD support for transplant candidates of all age groups would likely result in an expansion of the waiting list and prolonged use of LVAD with significant budget implications but without increasing the number of heart transplants. Limited level 4 evidence showed that LVAD support in children yielded survival rates comparable to those in the adult population. The introduction of LVAD in the pediatric population would be more cost-effective and might not have a negative effect on the transplant waiting list.