ABSTRACT
Background@#Rosacea is a chronic skin inflammatory disorder that almost always occurs on the face, which can cause emotional stress and affect self-esteem. Rosacea is associated with psychiatric disorders, but there have been few studies on the relationship between rosacea and psychiatric disorders in Koreans. @*Objective@#We aimed to investigate the risk of psychiatric disorders in Korean patients with rosacea. @*Methods@#Data were obtained from the Korean National Health Insurance Service-National Sample Cohort. The database was collected according to the Korean Standard Classification of Diseases version 6, which is based on the International Classification of Diseases, 10th revision. This study was conducted with 595 patients diagnosed with rosacea from 2002 to 2013. A total of 2,380 controls were set by performing 1:4 matching for sex, age, and index year. @*Results@#The incidence of psychiatric disorders was higher in patients with rosacea (114/595, 19.16%) than in patients without rosacea (319/2,380, 13.40%), with a significant difference (p＜0.001). Among several types of psychiatric disorders, the prevalence of anxiety disorder and behavioral disorder was significantly higher in the rosacea patients than in patients without rosacea (p=0.008 and p=0.044, respectively). The adjusted hazard ratio for psychiatric disorders in patients with rosacea was 1.543 (95% confidence interval=1.238∼1.922, p＜0.001). @*Conclusion@#Rosacea is associated with many types of psychiatric disorders. Awareness of the psychological impact of rosacea might be helpful in improving patient quality of life.
ABSTRACT
BACKGROUND: In most brain operations, the endotracheal tube is kept in postoperatively for airway maintenance during radiologic examinations. But the endotracheal tube causes tracheal irritation and hemodynamic changes. Inhalation anesthetics can not be administered during transport, and minimal concentration is exhaled for several hours after the end of inhalation. The present study was designed : (1) to determine the end tidal isoflurane concentration after the end of administration ; (2) to investigate the effects of intravenous anesthetics in patients with tracheal intubation during radiologic examination postoperatively. METHODS: We selected forty adult patients who were scheduled for elective neurosurgical operation with postoperative brain CT (computerized tomography). The study was performed in 2 steps; in the step 1 (n = 10), end tidal isoflurane concentration was checked after ending inhalation. In the step 2 (n = 30), patients were divided into one of three groups according to anesthesia method; group I (using isoflurane), group P (change from isoflurane to propofol about an hour before operation end), group M (using midazolam instead of propofol, compared to group P). In each group, the frequency of bucking and incidence of hypertension were checked during postoperative radiologic examinations. RESULTS: Minimal concentrations of isoflurane were detected in exhaled gas for about 2 hours after the end of isoflurane inhalation. The frequency of bucking was significantly lower in the group P and M than in group I (P = 0.002). In group P, the incidence of hypertension was significantly reduced compared to group M and I (P = 0.031). CONCLUSIONS: These results suggest that the change of anesthetic technique (from inhalation to intravenous) in the late period of operation, provides postoperative hemodynamic stability, a more comfortable state and minimal environmental pollution in comparison to inhalation anesthesia only.
Subject(s)
Adult , Humans , Anesthesia , Anesthesia, Inhalation , Anesthesia, Intravenous , Anesthetics, Inhalation , Anesthetics, Intravenous , Brain , Environmental Pollution , Hemodynamics , Hypertension , Incidence , Inhalation , Intubation , Isoflurane , Midazolam , PropofolABSTRACT
BACKGROUND: In most brain operations, the endotracheal tube is kept in postoperatively for airway maintenance during radiologic examinations. But the endotracheal tube causes tracheal irritation and hemodynamic changes. Inhalation anesthetics can not be administered during transport, and minimal concentration is exhaled for several hours after the end of inhalation. The present study was designed : (1) to determine the end tidal isoflurane concentration after the end of administration ; (2) to investigate the effects of intravenous anesthetics in patients with tracheal intubation during radiologic examination postoperatively. METHODS: We selected forty adult patients who were scheduled for elective neurosurgical operation with postoperative brain CT (computerized tomography). The study was performed in 2 steps; in the step 1 (n = 10), end tidal isoflurane concentration was checked after ending inhalation. In the step 2 (n = 30), patients were divided into one of three groups according to anesthesia method; group I (using isoflurane), group P (change from isoflurane to propofol about an hour before operation end), group M (using midazolam instead of propofol, compared to group P). In each group, the frequency of bucking and incidence of hypertension were checked during postoperative radiologic examinations. RESULTS: Minimal concentrations of isoflurane were detected in exhaled gas for about 2 hours after the end of isoflurane inhalation. The frequency of bucking was significantly lower in the group P and M than in group I (P = 0.002). In group P, the incidence of hypertension was significantly reduced compared to group M and I (P = 0.031). CONCLUSIONS: These results suggest that the change of anesthetic technique (from inhalation to intravenous) in the late period of operation, provides postoperative hemodynamic stability, a more comfortable state and minimal environmental pollution in comparison to inhalation anesthesia only.
Subject(s)
Adult , Humans , Anesthesia , Anesthesia, Inhalation , Anesthesia, Intravenous , Anesthetics, Inhalation , Anesthetics, Intravenous , Brain , Environmental Pollution , Hemodynamics , Hypertension , Incidence , Inhalation , Intubation , Isoflurane , Midazolam , PropofolABSTRACT
BACKGROUND: Horner's syndrome, including ptosis and miosis, is a sign of success following stellate ganglion block (SGB). However, it is not sufficient to ensure adequate sympathetic block to the upper extremity. There are numerous recommended local anesthetic volumes for SGB. The aim of this study was to evaluate the effects of differing volumes used in SGB on the elevation of skin temperature of ipsilateral upper extremity, and to find the volume required to elevate skin temperature most frequently. METHODS: Patients with sensory neural hearing loss underwent SGB, repeated daily in the paratracheal approach using different volumes (6, 8, 10, 12 and 16 ml) of 0.2% bupivacaine. Skin temperatures were checked in the hypothenar area before SGB, and 1, 2, 3, 4, 5, 10 and 15 minutes following SGB. Time intervals required for the elevation of skin temperature 1oC above the preblock level, and for the appearance of Horner's syndrome were recorded. RESULTS: Twenty-three patients repeatedly received SGB over 4 times at different volumes. The total SGB was 100 times, and all displayed Horner's syndrome. The total incidence of skin temperature elevation was 48%. Horner's syndrome appeared prior to the elevation of skin temperature (2.0 2.1 vs 5.3 3.8 min). There were significant differences in the incidence of skin temperature elevation, depending on the volume of the local anesthetics; 6 ml (17.6%), 8 ml (34.8%), 10 ml (52.2%), 12 ml (73.9%) and 16 ml (57.1%); greater volumes resulted in high incidences (pearson chi-square test, P = 0.005). The volume of twelve ml resulted in the highest incidence. Each patient needed different minimal volume to lead to the skin temperature elevation; 6 ml (13.1%), 8 ml (21.7%), 10 ml (17.4%), 12 ml (26.1%) and 16 ml (4.4%), and several patients (17.4%) did not have elevated skin temperature at any volumes. CONCLUSIONS: This study reveals that a large volume of local anesthetic (e.g. 12 ml) is needed in SGB for adequate sympathetic blockade to the upper extremity, and that each patient needs a different minimal volume for the skin temperature elevation to occur.
Subject(s)
Humans , Anesthetics, Local , Bupivacaine , Hearing Loss , Horner Syndrome , Incidence , Miosis , Skin Temperature , Skin , Stellate Ganglion , Upper ExtremityABSTRACT
BACKGROUND: Horner's syndrome, including ptosis and miosis, is a sign of success following stellate ganglion block (SGB). However, it is not sufficient to ensure adequate sympathetic block to the upper extremity. There are numerous recommended local anesthetic volumes for SGB. The aim of this study was to evaluate the effects of differing volumes used in SGB on the elevation of skin temperature of ipsilateral upper extremity, and to find the volume required to elevate skin temperature most frequently. METHODS: Patients with sensory neural hearing loss underwent SGB, repeated daily in the paratracheal approach using different volumes (6, 8, 10, 12 and 16 ml) of 0.2% bupivacaine. Skin temperatures were checked in the hypothenar area before SGB, and 1, 2, 3, 4, 5, 10 and 15 minutes following SGB. Time intervals required for the elevation of skin temperature 1oC above the preblock level, and for the appearance of Horner's syndrome were recorded. RESULTS: Twenty-three patients repeatedly received SGB over 4 times at different volumes. The total SGB was 100 times, and all displayed Horner's syndrome. The total incidence of skin temperature elevation was 48%. Horner's syndrome appeared prior to the elevation of skin temperature (2.0 2.1 vs 5.3 3.8 min). There were significant differences in the incidence of skin temperature elevation, depending on the volume of the local anesthetics; 6 ml (17.6%), 8 ml (34.8%), 10 ml (52.2%), 12 ml (73.9%) and 16 ml (57.1%); greater volumes resulted in high incidences (pearson chi-square test, P = 0.005). The volume of twelve ml resulted in the highest incidence. Each patient needed different minimal volume to lead to the skin temperature elevation; 6 ml (13.1%), 8 ml (21.7%), 10 ml (17.4%), 12 ml (26.1%) and 16 ml (4.4%), and several patients (17.4%) did not have elevated skin temperature at any volumes. CONCLUSIONS: This study reveals that a large volume of local anesthetic (e.g. 12 ml) is needed in SGB for adequate sympathetic blockade to the upper extremity, and that each patient needs a different minimal volume for the skin temperature elevation to occur.