1,720,991 research outputs found
Perioperative Ketoazidose unter SGLT2-Hemmer
No full textZusammenfassung SGLT2-Inhibitoren stellen eine relativ neue Substanzklasse zur Therapie von Patienten mit Diabetes mellitus dar. Nicht zuletzt aufgrund ihrer seltenen, aber gravierenden Nebenwirkung – der euglykämischen Ketoazidose – sollten Anästhesisten mit den pharmakologischen Eigenschaften und dem Risikoprofil der Substanz vertraut sein. Dieser Fall beschreibt exemplarisch den perioperativen Verlauf einer atypischen Ketoazidose unter Therapie mit SGLT2i.Zusammenfassung SGLT2-Inhibitoren stellen eine relativ neue Substanzklasse zur Therapie von Patienten mit Diabetes mellitus dar. Nicht zuletzt aufgrund ihrer seltenen, aber gravierenden Nebenwirkung – der euglykämischen Ketoazidose – sollten Anästhesisten mit den pharmakologischen Eigenschaften und dem Risikoprofil der Substanz vertraut sein. Dieser Fall beschreibt exemplarisch den perioperativen Verlauf einer atypischen Ketoazidose unter Therapie mit SGLT2i
Qualification requirements for prehospital emergency physicians are too low: we need a higher uniform standard!
No full textLMA-ProSeal (TM) laryngeal mask airway for elective postoperative care on the intensive care unit: A prospective, randomized trial
No full textBackground Compared to an endotracheal tube, laryngeal mask airways are known to cause less hemodynamic alteration during the extubation phase of routine perioperative airway management. This study aims to examine the hypothesis that the LMA-ProSeal (PLMA, The Laryngeal Mask Company Limited, St. Helier, Jersey, Channel Islands) is an adequate tool for elective postoperative care in the intensive care unit (ICU) and potentially associated with less hemodynamic alteration during extubation in the ICU environment compared to an endotracheal tube. Methods Forty-eight patients were enrolled for this prospective randomized, controlled trial and were allocated to either control (ICU-T) or study group (ICU-P). In the ICU-P group, the endotracheal tube was replaced by a PLMA at the end of surgery. Results Forty-patients completed the study. Cardiovascular parameters increased significantly less in the ICU-P group: systolic blood pressure increased by 18.10 +/- 5.57 mmHg versus 34.65 +/- 5.63 mmHg (P < 0.05), mean arterial blood pressure increased by 11.23 +/- 3.25 mmHg versus 22.65 +/- 3.36 mmHg (P < 0.05), and heart rate increased by 9.3 +/- 2.9 versus 12.9 +/- 2.2 min (P < 0.05). Ventilation via the PLMA during transfer from the operation room to the ICU as well as during ICU stay was successful and without any adverse events. Conclusions Removal of the PLMA after recovery from anesthesia was associated with less cardiovascular change compared to the endotracheal tube. Ventilation was possible without reported adverse events during the entire trial. Elective endotracheal tube replacement by the PLMA may be a useful procedure in selected patients
A systematic review of the literature
No full textThe purpose of this study is to identify and evaluate to what extent the literature on team coordination during cardiopulmonary resuscitation (CPR) empirically confirms its positive effect on clinically relevant medical outcome
Paramedic versus emergency physician emergency medical service: role of the anaesthesiologist and the European versus the Anglo-American concept
No full textPurpose of review Much controversy exists about who can provide the best medical care for critically ill patients in the prehospital setting. The Anglo-American concept is on the whole to provide well trained paramedics to fulfil this task, whereas in some European countries emergency medical service physicians, particularly anaesthesiologists, are responsible for the safety of these patients. Recent findings Currently there are no convincing level I studies showing that an emergency physician-based emergency medical service leads to a decrease in overall mortality or morbidity of prehospital treated patients, but many methodical, legal and ethical issues make such studies difficult. Looking at specific aspects of prehospital care, differences in short-term survival and outcome have been reported when patients require cardiopulmonary resuscitation, advanced airway management or other invasive procedures, well directed fluid management and pharmacotherapy as well as fast diagnostic-based decisions. Summary Evidence suggests that some critically ill patients benefit from the care provided by an emergency physician-based emergency medical service, but further studies are needed to identify the characteristics and early recognition of these patient
Prospective Clinical and Fiberoptic Evaluation of the Supreme Laryngeal Mask Airway ™
No full textBackground In March 2007, a new disposable laryngeal mask airway (LMA) became available. The LMA Supreme (The Laryngeal Mask Company Limited, St. Helier, Jersey, Channel Islands) aims to combine the LMA Fastrach feature of easy insertion with the gastric access and high oropharyngeal leak pressures of the LMA ProSeal. Methods The authors performed an evaluative study with the LMA Supreme, size 4, on 100 women to measure the ease of insertion, determinate the laryngeal fit by fiberoptic classification, evaluate the oropharyngeal leak pressure, and report adverse events. Results Insertion of the LMA Supreme was possible in 94 patients (94%) during the first attempt, and in 5 patients (5%) during the second attempt. In one small patient, the LMA Supreme could not be inserted because of limited pharyngeal space. This patient was excluded from further analysis. Insertion of a gastric tube was possible in all patients at the first attempt. The median time for LMA Supreme insertion was 10.0 s (+/-4.7 s; range, 8-30 s). Laryngeal fit, evaluated by fiberscopic view, was rated as optimal in all patients, both immediately after insertion of the LMA Supreme and at the end of surgery. After equalization to room pressure, the mean cuff volume needed to achieve 60 cm H2O cuff pressure was 18.4 ml (+/-3.8 ml; range, 8-31 ml). The mean oropharyngeal leak pressure at the level of 60 cm H2O cuff pressure was 28.1 cm H2O (+/-3.8 cm H2O, range, 21-35 cm H2O). Eight patients (8.1%) complained of a mild sore throat. No patient reported dysphagia or dysphonia. Conclusions Clinical evaluation of the LMA Supreme showed easy insertion, optimal laryngeal fit, and low airway morbidity. Oropharyngeal leak pressure results were comparable to earlier data from the LMA ProSeal
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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