Medicine
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Randomized Controlled Trial
Serum magnesium levels during magnesium sulfate infusion at 1 gram/hour versus 2 grams/hour as a maintenance dose to prevent eclampsia in women with severe preeclampsia: A randomized clinical trial.
Magnesium sulfate is the ideal drug for the prevention and treatment of eclampsia. Nevertheless, the best regimen for protection against eclampsia with minimal side effects remains to be established. This study aimed to compare serum magnesium levels during intravenous infusion of magnesium sulfate at 1 gram/hour versus 2 grams/hour as a maintenance dose to prevent eclampsia in pregnant and postpartum women with severe preeclampsia. ⋯ Magnesium sulfate therapy at the maintenance dose of 1 gram/hour was just as effective as the 2-gram maintenance dose, with fewer side effects.
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Randomized Controlled Trial
Effects of dexmedetomidine vs sufentanil during percutaneous tracheostomy for traumatic brain injury patients: A prospective randomized controlled trial.
Percutaneous tracheostomy, almost associated with cough reflex and hemodynamic fluctuations, is a common procedure for traumatic brain injury (TBI) patients, especially those in neurosurgery intensive care units (NICUs). However, there are currently a lack of effective preventive measures to reduce the risk of secondary brain injury. The aim of this study was to compare the effect of dexmedetomidine (DEX) vs sufentanil during percutaneous tracheostomy in TBI patients. ⋯ During percutaneous tracheostomy, compared with sufentanil, DEX (1 μg·kg for 10 minutes, then adjusted to 0.2-0.7 μg·kg·hour) can provide the desired attenuation of the hemodynamic response without increased adverse events. Consequently, DEX could be used safely and effectively during percutaneous tracheostomy in TBI patients.
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Patients with large defects in the annulus fibrosus following lumbar discectomy have high rates of symptomatic reherniation. The Barricaid annular closure device provides durable occlusion of the annular defect and has been shown to significantly lower the risk of symptomatic reherniation in a large European randomized trial. However, the performance of the Barricaid device in a United States (US) population has not been previously reported. ⋯ 3.
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Observational Study
A study on the paraspinal muscle surface electromyography in acute nonspecific lower back pain.
Aim of this study was to determine if surface electromyography (sEMG) could provide objective data in monitoring the alteration of signal amplitude of myoelectric activity of the paraspinal muscles in the patients with acute nonspecific lower back pain (ANLBP), and to explore the correlation between sEMG data and symptom relief in the ANLBP patients before and after massage therapy. Forty-five ANLBP patients and 20 healthy subjects were enrolled into this study. Patients were given massage therapy for 1 week. ⋯ In addition, AEMG alteration at maintained flexion position was significantly correlated with improvement of VAS or DFTF. Myoelectric activity of the paraspinal muscles in the ANLBP patients was different from that of healthy subjects. Massage therapy not only relived patients' symptoms, but also normalized myoelectric activity of the paraspinal muscles in the ANLBP patients.
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Comparative Study
Finite element analysis of spiral plate and Herbert screw fixation for treatment of midshaft clavicle fractures.
Both spiral plate and Herbert screw fixations have been clinically adopted for treating midshaft displaced clavicle fractures. However, the biomechanical properties of the 2 implant fixations have not yet been thoroughly evaluated. Here we report the results of a finite element analysis of the biomechanical properties of midshaft clavicle fractures treated with Herbert screw and spiral plate fixation. ⋯ Spiral plate fixation provides greater stability, but is associated with stress shielding. These results demonstrate that Herbert screw fixation is suitable for the treatment of simple displaced clavicluar fractures, but excessive shoulder activity and weight-bearing should be avoided after the operation. Therefore, spiral plate fixation may be preferred for patients requiring an early return to activity.