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Objective To choose a better version of Rivermead Behavioral Memory Test(RBMT)to assess memory function of patients with mild traumatic brain injury(TBI).Methods From April,2015 to Febrary,2017,40 mild TBI patients and 40 healthy people were re-cruited as TBI group and control group respectively.Both groups completed the Chinese version of RBMT-II first,and 24 hours to 48 hours later,completed the Chinese version of RBMT-III.The raw score of each test and the number of perfect scores and floor performance were scored and compared.Results Compared with the control group,TBI group got lower scores in six subtests of RBMT-II(F>2.131,P<0.05) and twelve subtests of RBMT-III(F>2.035,P<0.05).Administration of the RBMT-III resulted in less participants performing at or near indi-vidual subtest's ceiling than RBMT-II,mainly in the picture recognition,face recognition,the line instant memories,the line delay memo-ries,letters delayed recall and orientation date(Z>2.117,P<0.05).Also administration of the RBMT-III resulted in less floor performance than those of RBMT-II,mainly in remembering the name and the appointment(Z>2.138,P<0.05).Conclusion RBMT-III has substantial im-provement over the original RBMT-II,as it reduces the problem of ceiling and floor performance and the number of misclassifications.
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PURPOSE: The Korean Knee score (KKS) was designed to reflect the floor-sitting lifestyle that necessitates high knee flexion. The purpose of this study is to assess whether the KKS reflects the floor-sitting lifestyle more accurately than the previously developed Knee Society clinical rating system. In addition, the presence of ceiling effects was compared between the two rating systems. MATERIALS AND METHODS: Eighty-one consecutive patients (120 knees) who were assessed regularly after total knee arthroplasty (TKA) on an outpatient basis between January 2012 and December 2012 were enrolled. All patients were asked to complete a questionnaire to assess the Knee Society Knee score (KSKS), Knee Society Function score (KSFS), and KKS. RESULTS: At the final follow-up, the mean KSKS, KSFS, and KKS were 91.2, 86.0, and 70.1, respectively, and the scores were similar between the > or =125degrees maximum flexion group and 125degrees maximum flexion group (15.13 vs. 11.24, p=0.001). The number of cases with the highest possible score was 24 (20%) for the KSKS and 47 (39%) for the KSFS, whereas none of the cases obtained the highest possible KKS. According to the standard deviation method, more substantial ceiling effects were present in the KSKS (83 cases, 69.1%) and KSFS (67 cases, 55.8%) than in the KKS (23 cases, 19.2%). CONCLUSIONS: Although, the KKS was effective in reducing the ceiling effect, it demonstrated limited improvement in assessing the ability to perform high knee flexion after TKA. However, the 'floor life' subdomain of KSS appeared to be valid for evaluating high flexion of the knee.
Subject(s)
Humans , Arthroplasty , Follow-Up Studies , Knee , Life Style , Outpatients , Surveys and QuestionnairesABSTRACT
Objective To evaluate the reliability and validity of SF-36 in patients with advanced schistosomiasis,so as to proride scientific basis for the selection of suitable tools for health measure.Methods A Chinese version of SF-36 scale was applied to evaluate the health of patients with advanced schistosomiasis by a household survey in Hanshou County of Hunan Province and Jiangling County of Hubei Province,then the reliability and validity of the scale were tested.Results Atotal of 326 patients were investigated in the two counties.The split-half reliability(with a split-half coefficient of 0.95) and the internal consistency (Cronbach'α coefficients of the eight dimensions ranged from 0.86 to 0.88)were satisfying;the convergent and discriminative validity were high with the test successful rates of 97.14%and 87.86%,respectively;the criterion validity was acceptable with a correlation coefficient between the total score of SF-36 and EQ-5D+C VAS score of 0.70.However,the construct validity seemed to be not so reasonable as only 2 dimensions out of 8 were completely in accordance with the theoretical model on factor loading.The percentages of floor effect and ceiling effect in most dimensions were not significant except RP and RE(with the percentages of floor effect of 50.31%and 48.16%,respectively).Conclusions SF-36 is appropriate to be used in patients with advanced schistosomiasis.but some items need to be improved according to the local settings of endemic areas.
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BACKGROUND: Rocuronium is considered a good candidate for rapid-sequence induction of anesthesia. Increased dose of rocuronium shortens the onset time but prolongs the duration of action. However, the ceiling effect of onset time appears when larger doses are used.Clinical trials have not shown the exact dose of ceiling effect. We performed this study to find dose producing the ceiling effect of onset time. METHODS: One hundred forty young male adults were randomized to oneof seven doses of rocuronium:0.6, 0.7, 0.8, 0.9, 1.0, 1.1 or 1.2 mg/kg.Anesthesia was induced with IV thiopental sodium and maintained with sevoflurane after tracheal intubation. Neuromuscular block was monitored with acceleromyography using single twitch.The onset time, the recovery of single twitch to 10% and also the changes in hemodynamics were checked. RESULTS: A dose of up to 1.0 mg/kg shortens the onset time but no further decrement was seen with doses larger than 1.0 mg/kg.The recovery time was prolonged as doses were increased but there were no differences in the hemodynamics. CONCLUSIONS: This study showed that in young male adults under IV induction with thiopental sodium, the ceiling effect of onset time appeared with rocuronium doses in excess of 1.0 mg/kg.
Subject(s)
Adult , Humans , Male , Androstanols , Anesthesia , Hemodynamics , Intubation , Methyl Ethers , Neuromuscular Blockade , ThiopentalABSTRACT
BACKGROUND: Skin incision has been used as a standard stimulus in most concentration versus response relationship studies for anesthetics. However, skin incision is not the most intense stimulation and inconvenient method during operation. Mean arterial blood pressure, but not heart rate, is convenient and predicts surgical stress as well as propofol blood concentration. We evaluated the effects of different fentanyl concentration on propofol-fentanyl-N20 anesthesia using mean arterial blood pressure as an indicator of surgical stress during operation. METHODS: Eighty ASA I or II patients (age: 20~55 yrs) scheduled for spine fusion were randomly allocated to four groups according to expected fentanyl blood concentration (Group 1, 2, 3, 4: 0, 1.5, 3.0, 4.5 ng/ml respectively, n=20 for each group). Fentanyl was infused according to isoconcentration nomogram, and propofol infusion rate was titrated by changes of mean arterial blood pressure (0~12 mg/kg/hr). Fifteen minutes before expected end of surgery, propofol and fentanyl infusion were discontinued. Thereafter IV-PCA using fentanyl was applied for postoperative pain relief. Average propofol flow rate, recovery of orientation, verbal rating scale were cheked. RESULTS: Group 2, 3, 4 showed decreased average propofol flow rate, delayed recovery and decreased postoperative 24 hr fentanyl requirement for pain relief gradually compared with group 1. Group 4 showed ceiling effect in terms of average propofol flow rate, recovery of orientation and 24 hr fentanyl requirement for postoprerative pain relief compared with group 1~3. CONCLUSIONS: Keep the fentanyl concentration below 3.0~4.5 ng/ml and titrate propofol flow rate was reasonable method for adequate control of drug infusion during a propofol-fentanyl-N20 anesthesia.