Articles: adult.
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To examine age-related differences in pain, catastrophizing, and affective distress (depression and anxiety) after athletic injury and knee surgery. DESIGN AND SETTING: Participants were assessed with measures of pain intensity, pain-related catastrophizing, depression, and anxiety symptoms at 24 hours after anterior cruciate ligament (ACL) surgery. SUBJECTS: Twenty patients (10 adolescents, 10 adults) with an acute complete tear of the ACL. MEASUREMENTS: Pain was assessed by Visual Analog Scale (VAS), catastrophizing with the Pain Catastrophizing Scale (PCS), depressive symptoms with the Beck Depression Inventory (BDI), and anxiety with the state form of the State-Trait Anxiety Inventory (STAI-S). ⋯ After ACL surgery, athletic adolescents and adults differed significantly in pain, catastrophizing, and anxiety. Catastrophizing seemed to be a particularly strong factor in postoperative pain differences between adolescents and adults, with clinical-management implications. These data indicate the need for continued research into specific pain- and age-related factors during the acute postoperative period for athletes undergoing ACL surgery.
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Rev Bras Anestesiol · Jun 2003
[Processed electroencephalogram in children anesthetized with sevoflurane. Is it feasible?].
EEG-derived bispectral index (BIS), has been indicated as a major substrate for measuring hypnotic effects of anesthetic drugs. However, there are only limited data on the use of EEG in anesthetized children. This study aimed at evaluating changes in BIS, SEF95%, relative delta band frequency amplitude (d%) and suppression rate (SR) in children, correlating these changes with sevoflurane pharmacodynamic variables (EC and EC/MAC) as compared to adults. ⋯ Unlike d%, the variations of which seem brain maturation-related, BIS and SEF95% may be used to monitor sevofluranes anesthetic depth in children aged 0 to 12 years, observing the parameters suggested for adults.
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Interact Cardiovasc Thorac Surg · Jun 2003
Repair of adult Scimitar syndrome with an intra-atrial conduit.
The management of Scimitar syndrome in adulthood is controversial, with no guidelines for surgical correction. We present the case of a 66-year-old woman who presented late in life with Scimitar syndrome and a significant left-to-right shunt. We describe repair using an intra-atrial conduit from the anomalous vein to the foramen ovale, with a successful outcome.
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The past 35 years have provided a wealth of evidence that mechanical ventilation, although potentially life saving, can injure the lungs. Recent evidence suggests that limiting ventilating gas volumes can reduce patient mortality, but may result in progressive parenchymal derecruitment and alveolar hypoventilation, potentially aggravating systemic hypercarbia and hypoxemia. This review summarizes the current recommendations on a controversial, invasive technique termed 'extracorporeal life support' as a means to provide temporary pulmonary support during 'lung-protective' strategies. ⋯ Extracorporeal life support is an invasive technique that can provide support to the failing lung. Clinical trials have demonstrated its efficacy in neonatal and pediatric patients, but data in adults are less clear. An ongoing trial in the UK will soon address this important issue.
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To compare the antipyretic and analgesic effects of a single oral dose of diclofenac potassium 6.25, 12.5 or 25mg with paracetamol 1000mg and placebo in patients with fever resulting from acute febrile sore throat. ⋯ Diclofenac potassium administered as single doses of 12.5 and 25mg significantly reduced fever and throat pain in patients with acute febrile sore throat. The overall efficacy of these doses was rated significantly higher than that of paracetamol 1000mg or placebo. A dose-response relationship was seen between placebo and the three diclofenac doses. On most outcomes, paracetamol 1000mg was similar to or only slightly better than the diclofenac potassium 6.25mg dose. Diclofenac potassium 12.5mg is the lowest unit dose that could be recommended to provide reliable reduction of oral temperature and relief of throat pain.