La Tunisie médicale
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La Tunisie médicale · Feb 2014
Case ReportsUltrasound-guided spinal anesthesia in an obese patient.
We describe the case of 62-year-old man with a body mass index of 53, hypertension, diabetes mellitus and obstructive sleep apnea that was proposed for transurethral resection of prostate under spinal anesthesia. The surface landmark-guided approach was difficult and was abandoned after many unsuccessful attempts. Spinal anesthesia was achieved in one attempt with ultrasound guidance using the midline approach at the identified level. The trajectory was determined from the transducer angle.
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La Tunisie médicale · Jan 2014
Randomized Controlled TrialLidocaine reduces endotracheal tube associated side effects when instilled over the glottis but not when used to inflate the cuff: A double blind, placebo-controlled, randomized trial.
Tracheal intubation results in an alteration of the laryngeal mucosa which can lead to undesirable effects at emergence from anaesthesia. Local anesthetics, when administered topically, may represent an interesting alternative to reduce these side effects. ⋯ When instilled onto the glottis before intubation, lidocaine reduced both the incidence of coughing and the severity of postoperative sore throat in surgery of less than 120 minutes. Intracuff lidocaine was not effective to reduce neither coughing nor sore throat severity.
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La Tunisie médicale · Jan 2014
[Discordance between spine and hip Bone Mineral Density measurement using DXA in osteoporosis diagnosis: prevalence and risk factors].
Diagnostic discordance for osteoporosis is the presence of different categories of T-scores in 2 skeletal sites of an individual patient, falling into 2 different diagnostic categories identified by the World Health Organization classification. ⋯ Clinicians should expect that at least half of patients tested by DXA will demonstrate T-score discordance between spine and total hip measurement sites. T-score discordance can occur for a variety of reasons related to physiologic and pathologic patient factors as well as the performance or analysis of DXA itself.