Irish journal of medical science
-
The important role played by carers of those with mental health problems is frequently undervalued among healthcare professionals. ⋯ Carer involvement is essential for the complete and effective management of individuals with mental illness. Confidentiality should not be used as a reason for completely excluding carers.
-
Sedentary lifestyles have been associated with increased morbidity and mortality. Radiology as a profession may be sedentary compared to some clinical disciplines. ⋯ Such a difference in calorie intake can have significant long-term health implications in terms of increased weight or BMI. Means of combating this deficit are discussed.
-
Randomized Controlled Trial
Remifentanil requirements for preventing motor response to skin incision in healthy women anesthetized with combinations of propofol and dexmedetomidine titrated to similar Bispectral Index (BIS) values.
It is unclear whether the sedative, analgesic or sympatholytic effects of adjunctive dexmedetomidine contribute to reduced analgesic requirements in general anesthesia. This study aimed to assess the analgesic effect of dexmedetomidine on intraoperative opioid requirements using body movement as observation indicator at similar BIS-guided sedative depth in propofol anesthesia. ⋯ Propofol and its combination with dexmedetomidine have similar opioid requirements for preventing motor response to skin incision when titrated to similar BIS values. These findings indicate that adjunctive dexmedetomidine for general anesthesia has sedative but no opioid sparing effects.
-
Randomized Controlled Trial
Effects on somatosensory and motor evoked potentials of senile patients using different doses of dexmedetomidine during spine surgery.
The aim of this study was to evaluate the effects of different doses of dexmedetomidine (Dex) compounded propofol and fentanyl on intraoperative somatosensory evoked potential (SEP) and motor evoked potential (MEP) monitoring on senile patients. ⋯ Dex did not affect SEPs of senile patients, but inhibited MEPs when larger doses were administered.
-
Endovascular repair (EVAR) for large abdominal aortic aneurysm (AAA) in anatomically suitable patients is associated with low early mortality and morbidity. However, EVAR is associated with a significant risk of late complication and a high cumulative re-intervention rate. Many large experienced centres have offered complex EVAR to challenging aortic anatomies such as abdominal aorto-iliac aneurysm (AAIA). We hypothesised that complex EVAR, for AAIA, would be associated with an increased risk of late graft-related complications. ⋯ EVAR can be carried out with low early mortality but has a significant risk of late complication, the commonest of which is endoleak. Complex EVAR for abdominal aorto-iliac aneurysm can be carried out with comparable results to conventional EVAR. However, high rates of persistent endoleak and inferior mesenteric artery patency, and lack of aneurysm sac shrinkage, would suggest they may be at increased risk of late complications and may benefit from enhanced and extended radiological surveillance.