Articles: patients.
-
To describe the clinical characteristics and course of γ-hydroxybutyrate (GHB) overdose. ⋯ In our study population, patients who overdosed on GHB presented with a markedly decreased level of consciousness. Coingestion of ethanol or other drugs is common, as are bradycardia, hypothermia, respiratory acidosis, and emesis. Hypotension occurs occasionally. Patients typically regain consciousness spontaneously within 5 hours of the ingestion. [Chin RL, Sporer KA, Cullison B, Dyer JE, Wu TD: Clinical course of γ-hydroxybutyrate overdose. Ann Emerg Med June 1998;31: 716-722.].
-
Clinical biomechanics · Jun 1998
The effects of external mechanical stimulation on the healing of diaphyseal osteotomies fixed by flexible external fixation.
The purpose of this study was to investigate the effect of an externally applied mechanical stimulus on fracture healing under flexible fixation. DESIGN: Stimulation of fracture healing under various conditions of interfragmentary movement in an in vivo fracture model on 41 sheep. ⋯ These results suggest that the optimal interfragmentary movement for acceleration of delayed fracture healing is in the range of 0.5 mm. However, the enhancement of the healing of flexibly-fixed fractures by external application of interfragmentary movement is limited. RELEVANCE: In this model the external application of a mechanical stimulus in addition to the stimulation caused by normal loading and the flexibility of the fixation did not enhance the healing process significantly. It appears that the external application of interfragmentary motion is promising perhaps only for patients unable to stimulate their fracture healing by weight-bearing.
-
Despite its efficacy, bupivacaine has never been considered to be the most suitable agent for achieving anaesthesia and analgesia in the obstetric patient. Ropivacaine is less cardiotoxic than bupivacaine and, at low concentrations, can produce analgesia with minimal motor block, attributes which make it potentially very suitable for use in obstetrics. However, further research is required to ultimately establish ropivacaine's place in obstetric anaesthesia and analgesia. Levobupivacaine, the L isomer of bupivacaine, is of similar potency to bupivacaine but has the advantage of being significantly less cardiotoxic than racemic bupivacaine, which suggests that it might ultimately replace racemic bupivacaine in obstetric practice.
-
Resection of intramedullary spinal cord tumors carries a high risk for surgical damage to the motor pathways. This surgery is therefore optimal for testing the performance of intraoperative motor evoked potential (MEP) monitoring. This report attempts to provide evidence for the accurate representation of patients' pre- and postoperative motor status by combined epidural and muscle MEP monitoring during intramedullary surgery. ⋯ There was no instance in which a patient with stable MEPs developed a motor deficit postoperatively. Intraoperative MEPs adequately represented the motor status of patients undergoing surgery for intramedullary tumors. Because deterioration of the motor status was transient in all cases, it can be considered that impairment of the functional integrity of the motor pathways was detected before permanent deficits occurred.