A single bolus of 40 mg/kg of intravenous magnesium can significantly reduce propofol consumption during endoscopic retrograde cholangiopancreatography, with higher sedation success and lower adverse events, finds a study published in BMCGeriatr
]. Patients in group N received an equal volume of normal saline as a placebo. All patients received standard sedation with propofol. An initial bolus dose of 1 mg/kg propofol was administered over 30 s followed by a continuous intravenous infusion of propofol at a maintenance dose of 2 mg/kg/h. The ERCP procedure was performed after disappearance of the eyelash reflexes by two experienced endoscopists who had performed at least 500 procedures respectively.
At the end of the procedure, all infusion drugs were stopped immediately, and the dose of the agents were recorded. After the procedure, patients were transferred to the post-anesthesia care unit for monitoring. The modified Aldrete Score was used to assess overall recovery of patients. Patients were allowed to be transferred to wards when a score of 9 or more was identified.The primary outcome was total propofol consumption.
Statistical analysis was performed by SPSS version 25.0 . Continuous variables, including physiological parameters, total cumulative dose of propofol, duration of procedure, awakening and recovery time, pain score at 30 min after ERCP, as well as satisfaction of the endoscopists and patients were presented as mean ± SD or medians with the upper and lower quartiles, whereas categorical variables were expressed as frequency and percentages.
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Sniffer dogs can identify lung cancer patients from breath and urine samples - BMC CancerBackground Lung cancer is the most common oncological cause of death in the Western world. Early diagnosis is critical for successful treatment. However, no effective screening methods exist. A promising approach could be the use of volatile organic compounds as diagnostic biomarkers. To date there are several studies, in which dogs were trained to discriminate cancer samples from controls. In this study we evaluated the abilities of specifically trained dogs to distinguish samples derived from lung cancer patients of various tumor stages from matched healthy controls. Methods This single center, double-blind clinical trial was approved by the local ethics committee, project no FF20/2016. The dog was conditioned with urine and breath samples of 36 cancer patients and 150 controls; afterwards, further 246 patients were included: 41 lung cancer patients comprising all stages and 205 healthy controls. From each patient two breath and urine samples were collected and shock frozen. Only samples from new subjects were presented to the dog during study phase randomized, double-blinded. This resulted in a specific conditioned reaction pointing to the cancer sample. Results Using a combination of urine and breath samples, the dog correctly predicted 40 out of 41 cancer samples, corresponding to an overall detection rate of cancer samples of 97.6% (95% CI [87.1, 99.9%]). Using urine samples only the dog achieved a detection rate of 87.8% (95% CI [73.8, 95.9%]). With breath samples, the dog correctly identified cancer in 32 of 41 samples, resulting in a detection rate of 78% (95% CI [62.4, 89.4%]). Conclusions It is known from current literature that breath and urine samples carry VOCs pointing to cancer growth. We conclude that olfactory detection of lung cancer by specifically trained dogs is highly suggestive to be a simple and non-invasive tool to detect lung cancer. To translate this approach into practice further target compounds need to be identified.
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What are the effects of insect consumption on human health?A systematic review of human studies reveals that insect proteins are as good as other protein sources in providing essential amino acids and other health benefits.
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New study links perfluoroalkyl substance exposure to childhood asthma phenotypesNew study links perfluoroalkyl substance exposure to childhood asthma phenotypes eBioMedicine asthma childhoodasthma childhealth perfluoroalkyl research news
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Non-pharmacological interventions to manage psychological distress in patients living with cancer: a systematic review - BMC Palliative CareBackground Psychological distress is common in patients with cancer; interfering with physical and psychological wellbeing, and hindering management of physical symptoms. Our aim was to systematically review published evidence on non-pharmacological interventions for cancer-related psychological distress, at all stages of the disease. Methods We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered on PROSPERO (CRD42022311729). Searches were made using eight online databases to identify studies meeting our inclusion criteria. Data were collected on outcome measures, modes of delivery, resources and evidence of efficacy. A meta-analysis was planned if data allowed. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results Fifty-nine studies with 17,628 participants were included. One third of studies included mindfulness, talking or group therapies. Half of all studies reported statistically significant improvements in distress. Statistically significant intervention effects on distress were most prevalent for mindfulness techniques. Four of these mindfulness studies had moderate effect sizes (d = -0.71[95% CI: -1.04, -0.37] p | 0.001) (d = -0.60 [95% CI: -3.44, -0.89] p | 0.001) (d = -0.77 [CI: -0.146, -1.954] p | 0.01) (d = -0.69 [CI: -0.18, -1.19] p = 0.008) and one had a large effect size (d = -1.03 [95% CI: -1.51, -0.54] p | 0.001). Heterogeneity of studies precluded meta-analysis. Study quality was variable and some had a high risk of bias. Conclusions The majority of studies using a mindfulness intervention in this review are efficacious at alleviating distress. Mindfulness—including brief, self-administered interventions—merits further investigation, using adequately powered, high-quality studies. Systematic review registration This systematic review is registered on PROSPERO, number CRD42022311729.
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Impact of flail chest injury on morbidity and outcome: ten years’ experience at a tertiary care hospital in a developing country - BMC AnesthesiologyBackground One of the worst types of severe chest injuries seen by clinicians is flail chest. This study aims to measure the overall mortality rate among flail chest patients and then to correlate mortality with several demographic, pathologic, and management factors. Methodology A retrospective observational study tracked a total of 376 flail chest patients admitted to the emergency intensive care unit (EICU) and surgical intensive care unit (SICU) at Zagazig University over 120 months. The main outcome measurement was overall mortality. The secondary outcomes were the association of age and sex, concomitant head injury, lung and cardiac contusions, the onset of mechanical ventilation (MV) and chest tubes insertion, the length of mechanical ventilation and ICU stay in days, injury severity score (ISS), associated surgeries, pneumonia, sepsis, the implication of standard fluid therapy and steroid therapy, and the systemic and regional analgesia, with the overall mortality rates. Results The mortality rate was 19.9% overall. The shorter onset of MV and chest tube insertion, and the longer ICU, and hospital length of stay were noted in the mortality group compared with the survived group (P-value less than 0.05). Concomitant head injuries, associated surgeries, pneumonia, pneumothorax, sepsis, lung and myocardial contusion, standard fluid therapy, and steroid therapy were significantly correlated with mortality (P-value less than 0.05). MV had no statistically significant effect on mortality. Regional analgesia (58.8%) had a significantly higher survival rate than intravenous fentanyl infusion (41.2%). In multivariate analysis, sepsis, concomitant head injury, and high ISS were independent predictors for mortality [OR (95% CI) = 568.98 (19.49–16613.52), 6.86 (2.86–16.49), and 1.19 (1.09–1.30), respectively]. Conclusion The current report recorded mortality of 19.9% between flail chest injury patients. Sepsis, concomitant head injury, and higher ISS are the independent
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Boston Medical Center calls for state help after ending policy to help migrantsWith the influx of migrants increasing, some employees at The Boston Medical Center are calling on Massachusetts to issue a state of emergency. The BMC has been working with the state to accommodate migrants for months. Now, with as many as 100 migrants inside each day, the hospital has changed its policy, saying it would focus its attention on migrants…
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