Prevalence Of Myofascial Dysfunctions In Breast Cancer Survivors

Background: After breast cancer treatment, many complications are seen in breast cancer survivors (BCS). In that musculoskeletal dysfunctions are common. These dysfunctions are one of the common sources of pain and disability. A recent study states that extreme pain after breast cancer treatment is often. Severe pain can be a source of a lot of limitations and psychological distress. Before the time assessment and rehabilitation can be inserted to reduce pain level, improve strength and mobility which will be helpful in minimize restrictions in daily living and improve quality of life (QOL). The objectives of the study were as follows: To determine the prevalence of myofascial dysfunctions in BCS. To study the association of myofascial dysfunctions and demographic variables in BCS. Methods: A total of 74 females who underwent breast cancer surgeries along with chemotherapy or radiotherapy or hormone therapy, were included based on inclusion criteria. Subjects were assessed for pectoralis tightness, postmastectomy pain syndrome (PMPS), rotator cuff diseases, adhesive capsulitis, lymphedema and axillary web syndrome (AWS) by using Visual Analogue Scale (VAS), Musculoskeletal Assessment and pectoral tightness test. Results: Primary outcomes used for the result were Musculoskeletal Assessment, Visual Analogue Scale, posture Assessment, pectoral tightness test. The most common type of myofascial dysfunctions was Pectoral tightness (p=0.1344), post-mastectomy pain syndrome (p=0.0116), rotator cuff disease (p= 0.1344), adhesive capsulitis (p= 0.9388) and axillary web syndrome (p= 0.9193) and the result was extremely significant. Conclusion: The major postoperative myofascial dysfunctions above the age of 50 years are pectoralis tightness, rotator cuff, and then by adhesive capsulitis and that of below 50 years was adhesive capsulitis followed by lymphedema and by rotator cuff disease.

The Pentax airway scope versus the Macintosh laryngoscope: Comparison of hemodynamic responses and concentrations of plasma norepinephrine to tracheal intubation / 대한마취과학회지

BACKGROUND: The Pentax Airway Scope (AWS) is a video laryngoscope designed to facilitate tracheal intubation with a high-resolution image. The Pentax AWS has been reported to cause less hemodynamic stress than the Macintosh laryngoscope. The aims of this study are to investigate the differences in hemodynamic responses and norepinephrine concentrations to tracheal intubation between procedures using he Pentax AWS and the Macintosh laryngoscope. METHODS: Forty patients (American Society of Anesthesiologists class I-II, age range: 18-60 years) were randomly assigned to be intubated with either the Pentax AWS or the Macintosh laryngoscope while under general anesthesia. Routine monitoring, including invasive arterial blood pressure and bispectral index, were applied. Thiopental (4 mg/kg), fentanyl (1 microg/kg), midazolam (0.05 mg/kg), and rocuronium (0.6 mg/kg) were administered for anesthetic induction. Systolic, diastolic, and mean blood pressures and heart rates were recorded pre-intubation, immediately post-intubation (T0), and over the following 10 minutes at one minute intervals (T1, T2, T3, T4, T5em leaderT10). Patient blood was sampled for norepinephrine concentrations pre-intubation (baseline) and post-intubation (T1). Evidence of sore throat was evaluated 30 min and 24 hr after extubation. Data were transformed to % basal and expressed as mean +/- SD. RESULTS: The systolic, diastolic, and mean blood pressure, and heart rate at T0 and T4 were significantly different between the two groups. There was no significant difference in plasma norepinephrine between the two groups. The difference in incidence of sore throat was not significant between the two groups. CONCLUSIONS: Pentax-AWS for tracheal intubation has greater hemodynamic stability than the Macintosh blade laryngoscope.

Validity and reliability of Chinese version of alcohol withdrawal scale(AWS) / 中华行为医学与脑科学杂志

Objective To evaluate the validity and reliability of the Chinese version of Alcohol Withdrawal Scale (AWS). Methods Totally 175 patients diagnosed as alcohol dependence according to the criteria of ICD-10 were studied. Intraclass correlation coefficient (ICC) analysis was applied for examining interrater consistency and Cronbach' s α for internal consistency. Factor analysis was used to examine the construct validity. Correlation analysis between AWS and CGI,Revised Clinic Institute Alcohol Withdrawal Syndrome Scale(CIWA-Ar) were conducted to evaluate the criterion validity. Based on clinical criteria,ROC curve was calculated so as to test the discriminative ability and establish the cut-off point of the scale. Results ( 1 ) Reliability: ICC value was 0.93,and Cronbach's α was 0.83,which indicated good interrater and internal consistency. (2) Validity:the correlation coefficients of the two subscale with the total scale score were 0.78,0.83 respectively. The correlation coefficients between the subscale were 0. 81 and factor analysis revealed that each item of the scale had relatively high load on the primary factor (0.409 ～0.926). At the time of admission,the total score of the AWS was positively correlated with that of CGI ( r = 0.71, P < 0.05 ). The total score of the AWS also was positively correlated with that of CIWA-Ar ( r = 0. 86, P<0. 05). As treatment went on,total score of the AWS showed a downward trend,at the end of the first week,the total score of the AWS was positively correlated with that of CGI ( r = 0.62, P<0.05). (3)The cut-off point of AWS for mild alcohol withdrawal state was determined as ≥3. With this cut-off point,AWS had both high sensitivity (92.1% ) and specificity (73.5% ) ,and the area under curve (AUC) was 0. 91. The cut-off point of AWS for moderate withdrawal state was determined as ≥7, and the sensitivity and specificity of AWS were 94.3 % and 89.7 % respectively, with the AUC of 0.94. The cut-off point of AWS for severe withdrawal state was determined as ≥ 10. With this cut-off point AWS had both high sensitivity (94. 9% ) and high specificity (92.6% ) .with the AUC of 0.93. Conclusion AWS has good reliability and validity and can reflect the change of the disease and the efficacy of treatment.

A comparative study on the efficacy and cardiovascular response generated by macintosh and pentax-AWS video laryngoscopic endotracheal intubation methods / 대한마취과학회지

BACKGROUND: The Pentax-AWS is a newly developed rigid video laryngoscope. In comparison to the Macintosh laryngoscope, it offers a significantly improved laryngeal view and facilitates endotracheal intubation. The present study was performed to compare the general efficiency and the cardiovascular responses generated by Macintosh and Pentax-AWS systems during endotracheal intubation. METHODS: This study included 120 patients with American Society of Anesthesiologists (ASA) physical status class 1 or 2 requiring tracheal intubation for elective surgery. All patients were randomly allocated into two groups: Pentax-AWS (group P) and Macintosh (group M). Induction of anesthesia was performed using fentanyl, thiopental and succinylcholine intravenously. Systolic, mean and diastolic blood pressure (SBP, MBP, DBP) and heart rate (HR) were recorded just prior to induction, 1, 3, and 5 minutes after intubation. RESULTS: There were no significant differences in SBP, MBP, DBP and HR between both groups. However, group P showed a higher POGO (Percentage of Glottic Opening) score than group M during endotracheal intubation. CONCLUSIONS: Use of Pentax-AWS in endotracheal intubation did not increase hemodynamic changes compared to the use of Macintosh laryngoscope. Furthermore, Pentax-AWS offered an improved laryngeal view during endotracheal intubation.

The use of Pentax-Aws(R) for difficult intubation due to postburn contracture: Two cases report / 대한마취과학회지

The causes of difficult intubation associated with post-burn contracture from the face to the upper torso include the limitations of neck movement and opening the mouth. Fiberoptic oral intubation can be the final alternative technique that overcomes those difficulties. However, a small inter-incisor gap about 2 cm, a fixed head or neck position and the large tongue in these cases makes fiberoptic intubation difficult. The Pentax-AWS video display unit (Pentax-AWS(R), Pentax, Japan) (Pentax-AWS) allows indirect visualization of the glottis without a straightened line of orophalyngolaryngeal axis and its attached tracheal tube and this makes the intubation easier. We experienced rapid, easy intubation with Pentax-AWS following multiple attempts of fiberoptic intubation or confirming a bad glottic view with a Macintosh laryngoscope. Further study is needed on the availibility of Pentax-AWS and comparing it with fiberoptic intubation for the management of a difficult airway.