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Subacute thyroiditis (SAT) is an inflammatory disease of the thyroid gland with multiple etiologies and clinical features, often challenging to recognize. The classic presentation is the painful, granulomatous thyroiditis (DeQuervain's) characterized by diffuse swelling of the gland, usually preceded by an upper respiratory tract infection. A painless variant, also referred to as autoimmune subacute thyroiditis, has been documented and is strongly linked to postpartum state, reported following ~10% of pregnancies. It can be differentiated from the former by the presence of anti-thyroid antibodies, which classifies it as an autoimmune thyroiditis. Any spontaneous development of painful swelling of the thyroid gland warrants a complete work up that includes thyroid hormones, thyroid autoimmune panel, acute phase reactant titers, and, if available, imaging that may lead to the diagnosis of an inflammatory or infectious cause of thyroiditis.
Tiroiditis Subaguda, es una enfermedad inflamatoria de la glándula Tiroides que tiene muchas etiologías y características clínicas, y frecuentemente difícil de reconocer. La presentación clásica es: tiroiditis granu-lomatosa dolorosa caracterizada de hinchazón difusa de la glándula del Tiroides, usualmente precedida de una infección respiratoria de las vías áreas superior (como una infección viral). Existe una variante sin dolor, tam-bién referida como tiroiditis subaguda autoinmune, ha sido documentado y es muy ligada al estado postparto, en un 10% de los embarazos. La Tiroiditis postparto Puede ser diferenciada de la anterior por la presencia de anticuerpos lo que la clasifica como una tiroiditis auto-inmune. Cualquier desarrollo espontaneo de una hin-chazón dolorosa de la tiroides garantiza su evaluación de una manera formal, que incluye las hormonas del tiroides, panel tiroideo de autoinmunidad títulos de los factores que reaccionan agudamente, y si está disponible imágenes como una ultrasonografía que conlleva al di-agnóstico de una Tiroiditis inflamatoria o de origen in-feccioso.
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Humans , Female , Adolescent , Thyroiditis, Subacute , Goiter, Nodular , Postpartum ThyroiditisABSTRACT
OBJECTIVE To obser ve the efficacy and safety of rimazo lom for painless gastroscopy sedation in outpatients. METHODS Totally 84 patients who underwent painless gastroscopy were collected from the outpatient department of the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture from March to June in 2021. By random number table method combined with envelope allocation concealment method ，they were randomly divided into observation group and control group ，with 42 cases in each group. The patients in the observation group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+Rimazole toluenesulfonate for injection 0.2 mg/kg. Patients in the control group were slowly injected with Sufentanil citrate injection 0.1 μg/kg+ Propofol emulsion injection 2 mg/kg. Gastroscopy was performed after the patient ’s consciousness disappeared. The sedative efficiency，sedative onset time ，recovery time and the occurrence of adverse drug reaction were observed in 2 groups. The heart rate（HR），mean arterial pressure （MAP），pulse oxygen saturation （SpO2），modified observer ’s assessment of alertness/sedation （MOAA/S）score and Narcotrend score were recorded in 2 groups after entering the room （T0），after anesthesia induction （T1）， when gastroscope entered the throat （T2），at the end of gastroscope withdrawal （T3），5 min after gastroscopy （T4）. RESULTS There was no significant difference in the effective rate of sedation （100％），the incidence of respiratory depression ， nausea and vomiting between the two groups （P＞0.05）. The qq.com onset time of sedation in the observation group was longer than control group ，and the recovery time and the incidence ofhypotension，hypotension to be tre ated，injection pain and bradycardia in observation group were significantly shorter or lower than control group （P＜0.05）. At T 0，there was no significant difference in HR ，MAP，SpO2，MOAA/S score or Narcotrend score between two groups （P＞0.05）. From T 1 to T 4，the HR of control group was significantly lower than that of the same group at T 0，and significantly lower than observation group at the same time（P＜0.05）. From T 1 to T 3，the MAP of two groups were significantly lower than the same group at T 0（P＜0.05），but there were no significant differences between two groups and between T 4 and T 0（P＞0.05）. There was no significant difference in SpO 2 at different time points between two groups and HR at different time points in observation group （P＞0.05）. From T 1 to T 3，MOAA/S score and Narcotrend score of two groups were significantly lower than the same group at T 0，while the MOAA/S score and Narcotrend score at T 1 and T 3 and Narcotrend score at T 3 of observation group were significantly higher than control group at the same time （P＜0.05），and the Narcotrend score of observation group at T 2 was significantly lower than control group at the same time（P＜0.05）；at T 4，there were no significant differences in MOAA/S score and Narcotrend score between two groups （P＞ 0.05）. CONCLUSIONS Remazolam shows good sedative effect and safety for painless gastroscopy.
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AIM: To investigate the effective dose of esketamine for prevention on propofol injection pain in painless abortion. METHODS: From November 2021 to December 2021, thirty patients undergoing painless abortion, aged 20 to 40 years old, ASA physical status or Ⅱ, BMI 19-26 kg/m
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Microneedles have been developed rapidly in the field of transdermal administration in the past few decades. In recent years, the development of microelectronics technology has expanded the applications of microneedles by combining with microelectronic systems, especially in biological diagnosis and treatment. Different types of microneedles have been designed to extract blood and tissue fluids for detection, or as electrodes to directly detect blood sugar, melanoma and pH in real-time in vivo, both show good prospects for real-time detection applications. In this paper, we review the design of materials and structure of microelectronic-based microneedles, and discuss their advances in biological diagnosis.
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Administration, Cutaneous , Drug Delivery Systems , Electrodes , Microinjections , NeedlesABSTRACT
Objective:To assess the influence of age on the safety of propofol mono-sedation for adult patients undergoing painless gastroscopy.Methods:A retrospective study was conducted on data of 321 patients scheduled for painless gastroscopy with propofol mono-sedation. According to the age, patients were divided into youth group (116 cases, 18-44 years), middle-aged group (103 cases, 45-59 years) and elderly group (102 cases, 60-80 years). The procedure time, the total dosage of propofol, the occurrence of airway obstruction or hypoxemia, the use of airway interventions including airway opening maneuvers and facemask ventilation, lowest SpO 2, adverse cardiovascular events (including hypertension, hypotension, tachycardia, and bradycardia), and the use of ephedrine during painless gastroscopy were observed. Results:There was significant difference regarding the total dosage of propofol among youth group (173.2±47.0 mg), middle-aged group (158.8±41.3 mg) and elderly group (137.8±26.3 mg) ( F=21.761, P<0.001). The total dosage of propofol was significantly lower in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017), and that in the middle-aged group was significantly lower than that in the youth group ( P<0.017). The incidence of hypoxemia was 12.9% (15/116) in the youth group, 15.5% (16/103) in the middle-aged group and 25.5% (26/102) in the elderly group, with significant difference among three groups ( χ2=5.711, P=0.017). Moreover, the incidence of hypoxemia was significantly higher in the elderly group compared with the middle-aged group ( P<0.017) and youth group ( P<0.017). The incidences of hypotension, bradycardia and total adverse cardiovascular events were 5.2% (6/116), 4.9% (5/103) and 11.8% (12/102), 1.7% (2/116), 2.9% (3/103) and 7.8% (8/102), and 11.2% (13/116), 10.7% (11/103) and 20.6% (21/102) respectively in youth, the middle-aged and the elderly group. There were no significant differences in the above indicators among the three groups ( P>0.05). However, compared with those of the young and the middle-aged patients, the occurrence of hypotension, bradycardia and total adverse cardiovascular events in the elderly patients were on the rise. There were no significant differences among the three groups in other indices( P>0.05). Conclusion:Total dosage of propofol may need to be decreased gradually with the increase of age of patients undergoing gastroscopy with propofol mono-sedation. Compared with young and middle-aged patients, elderly patients have a significantly higher incidence of hypoxemia, with a tendancy of total adverse cardiovascular events increase, so the safety of painless gastroscopy is reduced for these patients.
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Objective:To evaluate the effect of laryngopharyngeal reflux on sedation-related adverse events in the patients undergoing painless gastroscopy.Methods:Two hundred and eighty-nine American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients of both sexes, aged 18-75 yr, with body mass index 18.5-28.0 kg/m 2, scheduled for elective painless gastrocopy, were selected.Specimens of glottic secretions before and after gastroscopy were collected, and the concentration of human pepsin was measured by enzyme-linked immunosorbent assay.The patients in whom the concentration of pepsin was positive before the examination were excluded (the concentration ≥ 31.34 pg/ml was considered as positive). The patients were divided into laryngopharyngeal reflux group (R group, the concentration of pepsin was positive after gastroscopy) and non-laryngopharyngeal reflux group (N group, the concentration of pepsin was negative after gastroscopy) according to the concentration of pepsin in the secretion samples before and after gastroscopy.The occurrence of hypoxemia, hypotension, bradycardia, bucking and body movement during operation was recorded.The patients were followed up by telephone on the 1st, 3rd and 7th days after operation.The sore throat, hoarseness, nausea and vomiting, cough and expectoration and use of antibiotics were recorded. Results:Compared with group N, the incidence of bucking and hypoxemia was significantly increased, the incidence of sore throat and hoarseness was increased on the 1st day after operation, and the incidence of cough and expectoration was increased on the 1st and 3rd days after gastroscopy in group R ( P<0.05). Conclusion:Laryngopharyngeal reflux can increase the development of intraoperative and postoperative sedation-related adverse events in the patients undergoing painless gastroscopy.
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Objective:To evaluate the effect of virtual painless ward management based on mobile internet on pain management of patients after craniotomy. Methods:From May to October, 2019, 117 patients who accepted virtual painless ward management based on mobile Internet after craniotomy were selected as painless ward group. From December, 2018 to April, 2019, 117 patients previously hospitalized in the same department after craniotomy were selected as control group. The regression equation was established to compare the Numerical Rating Scale (NRS), nursing satisfaction and anxiety rate between two groups, and the general data, such as age, were taken as independent variables into the regression equation. Partial regression coefficient (B), odds ratio (OR) and 95% confidence interval (CI) of the painless ward management after adjustment compared with that of the non-painless ward management were calculated. Results:Multivariate regression analysis showed that, compared with the control group, the score of NRS within four days significantly decreased (B = -2.700, 95%CI -3.167 to -2.232, P < 0.001), the nursing satisfaction significantly increased (B = 0.542, 95%CI 0.289 to 0.795, P < 0.001), and the anxiety rate significantly decreased (B = -2.119, OR = 0.120, 95%CI 0.053 to 0.271, P < 0.001) in the painless ward group. However, the improvement of the anxiety rate might not completely depend on the decrease of NRS score (B = -0.112, OR = 0.894, 95%CI 0.727 to 1.100, P > 0.05). Conclusion:The procedure of virtual painless ward based on mobile internet could obviously improve the management level of analgesia for patients after craniotomy.
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@#A healthy 4-year-old boy presented with a painless lump on his upper lip for three years duration with no significant changes in size. Clinical examination revealed the presence of firm and mobile lump on the labial mucosa measuring approximately 15 mm × 10 mm, slightly pale yellowish compared to the surrounding tissues. The covering mucosa was intact and was non-tender upon palpation. Excisional biopsy was performed under general anaesthesia and the histopathological results revealed the presence of a partially encapsulated pleomorphic adenoma with variable epithelial and stromal components.
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Background: Optimum surgical intervention for low-grade haemorrhoids is unknown. Haemorrhoidal artery ligation (HAL) has been proposed as an efficacious, safe therapy while rubber band ligation (RBL) is a commonly used Out patient treatment.Methods: We compared recurrence after HAL versus RBL in patients with grade II-III haemorrhoids. The diagnosis of hemorrhoids is primarily based on the proctoscopic examination. The study evaluates comparative results of rubber band ligation (RBL) and hemorrhoidectomy. This study was conducted over a period of 1 year from January 2017 to December 2017. It includes 50 patients having second- or third-degree primary hemorrhoids who attended surgical OPD of Tertiary Care Hospital in Gujarat. These 50 patients were selected randomly and divided into two groups of 25 patients each (hemorrhoidectomy group and RBL group). Patients of fissure, fistulae, and malignancy were excluded. All parameters were recorded and finally analysed.Results: Hemorrhoidectomy and RBL are equally effective especially in second-degree hemorrhoids. However, RBL should be considered the first-line treatment in second-degree hemorrhoids because being an outpatient procedure, it is cost effective for the patients, saves many hospital beds for more sick patients, and takes the pressure off the surgical waiting list. Although RBL is not as effective as hemorrhoidectomy in third-degree hemorrhoid, it does improve bleeding and prolapse and is highly recommended for patients who are unfit for surgery.Conclusions: RBL should be considered as the first-line treatment for second-degree hemorrhoid. However, in the third-degree hemorrhoids, hemorrhoidectomy achieves better results, and RBL is recommend as the first-line treatment for those patients in whom there is contraindication for surgery or anesthesia.
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Introduction: Subdural hematoma is a rare but seriouscomplication of accidental dural puncture during epidural orspinal anesthesia. This case report emphasizes the importanceof close follow-up of patients with post dural punctureheadache following accidental dural puncture and methods toidentify development of subdural hematoma in such patients.Case report: a 23-year-old healthy primigravida developedaccidental dural puncture while trying to locate epiduralspace using a Tuohy needle for painless labor. The patientcomplained of headache on the 2nd post-operative day that wassignificantly relieved by analgesics, bed rest and hydration.Later she presented with severe headache that becamepersistent and lost its correlation with change of posture.Other than feeling nauseated she had no other additional signsand symptoms. Diagnosis of the SDH was confirmed via CTand treated surgically. The patient recovered completely.Conclusion: One should consider the possibility of subduralhematoma in patients when postdural puncture headache isprolonged or has a change in the character of headache withor without neurological symptoms for an early successfulintervention.
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Resumo Discute-se a difusão das práticas de parto natural por meio da análise dos livros Parto natural: guia para os futuros pais, escrito pelo obstetra americano Frederick Goodrich Jr. em 1950 e publicado no Brasil a partir de 1955, e Parto natural sem dor, escrito pelo obstetra brasileiro George Beutner, em 1962. Ambos tiveram boa entrada na cultura brasileira e influenciaram a forma de pensar o parto e de parir, tanto no âmbito da obstetrícia brasileira como no que concerne às representações das mulheres. A partir das contribuições de Roger Chartier e das concepções sobre medicalização, concluímos que essas novas práticas de preparação do parto compartilhavam as visões médicas sobre o parto e o nascimento predominantes no período.
Abstract The article explores the dissemination of natural childbirth practices through an analysis of the books Parto natural: guia para os futuros pais, written by U.S. obstetrician Frederick Goodrich Jr. in 1950, under the title Natural Childbirth: a manual for expectant parents, and first published in Brazil in 1955, and of Parto natural sem dor, written by Brazilian obstetrician Beutner in 1962. Both books found a place in Brazilian culture and influenced thinking about childbirth and delivery in the field of Brazilian obstetrics and in representations of women. Based on Roger Chartier's contributions and on concepts of medicalization, we conclude that these new practices for childbirth preparation shared the period's prevalent medical views of childbirth and delivery.
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Humans , Female , Pregnancy , History, 20th Century , Prenatal Care , Delivery, Obstetric/history , Natural Childbirth/history , Reference Books, Medical , Brazil , Parturition , Medicalization/history , Obstetrics/historyABSTRACT
Objective To observe the effect of vaginal delivery history on the dosage of propofol and the quality of postoperative recovery in painless hysteroscopy patients. Methods 120 patients from November 2018 to May 2019 who required painless hysteroscopy were enrolled in the First Affiliated Hospital of Anhui Medical University. According to their previous history, the patients were divided into two groups: the control group (no history of delivery, 60 cases) and the observation group (had a history of delivery, 60 cases). Basic vital signs (MAP, HR) of the two groups were compared at the following five time points: baseline, uterin edilation, immediately, 10 min and 30 min after surgery. The dosage of sufentanil, the total and induced dosage of propofol, the additional cases and dosage of propofol, the time of surgery and recovery, the satisfaction of doctor and patients were recorded. Results Compared with the control group, the observation group showed significant decrease in the total dosage of propofol [(133.3±25.4)mg vs (145.1±27.8)mg], the additional cases [(28,46.7%) vs (39,65%)] and dosage of propofol [(1.0, 2.0)mg vs (0.0,40.0)mg], and shorter recovery time [(32.7±10.2)s vs (42.8±11.5)s] (all P<0.05). The satisfaction of doctor and patients were significantly higher in the observation group than in the control group. There was no significant difference in adverse events between the two groups (P>0.05). Conclusion In painless outpatient hysteroscopy, in order to shorten the recovery time of patients, improve the quality of postoperative recovery, improve the efficiency and safety of painless hysteroscopic surgery, anesthesiologists should reduce the additional dosage of propofol for patients with previous vaginal delivery.
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Objective@#To study the sedative efficacy and safety of nitrous oxide (N2O ) inhalation combined with oral midazolam in children with impacted supernumerary teeth for extraction under sedation and to provide a reference for the selection of anesthetic methods for children undergoing impacted teeth extraction.@*Methods @#Sixty patients aged 5-10 years with maxillary impacted supernumerary teeth were randomly divided into three groups, with 20 in each group, as follows: the N2O group: N2O inhalation sedation before the operation; the midazolam group: oral midazolam sedation before the operation; the combination group: N2O inhalation combined with oral midazolam sedation before the operation. Sedation was performed before extraction under local anesthesia. The Ramsay sedation effect, Houpt behavioral score and incidence of adverse reactions were evaluated after the operation.@*Results@#The Ramsay sedation scale score was significantly higher in the combination group (2.75 ± 0.55) than in the N2O group (2.30 ± 0.47) and the midazolam group (2.40 ± 0.50) (P ＜0.05). Similarly, the Houpt behavioral rating scale score was significantly higher in the combination group (5.25 ± 0.64) than in the N2O group (4.70 ± 0.73) and the midazolam group (4.80 ± 0.69) (P ＜0.05). The adverse reaction rate was lower in the combination group (5%) than in the N2O group (10%) and the midazolam group (10%), but the difference was not significant (χ2=0.436, p=0.804).@*Conclusion@#N2O inhalation combined with oral midazolam sedation in the extraction of impacted supernumerary teeth in children can significantly improve the sedative and therapeutic efficacy and is a safe and effective sedation method.
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Objective To evaluate the effect of three different doses of oxycodone hydrochloride injection on uterine cramping pain and emotion in patients of artificial abortion.Methods Four hundred female patients, aged 17-38 years, BMI 18.5-23.9 kg/m2, falling into ASA physical statusⅠ orⅡ, undergoing elective artificial abortion were randomized into four groups using a random number table:group O1 (oxycodone 0.06 mg/kg), group O2 (oxycodone 0.08 mg/kg), group O3 (oxycodone 0.1 mg/kg), and group F, 100 cases in each.In group O1, group O2 and group O3, oxycodone 0.06, 0.08, 0.1 mg/kg were intravenously injected respectively, while in group F fentanyl1μg/kg was intravenously injected.Then, propofol 2.5 mg/kg was intravenously injected as induced dose.The operation was started when eyelash reflexes disappeared, propofol 0.4 mg/kg was intravenously injected when body movement appeared during the operation.The propofol doses, operation time and recovery time were recorded.HR, MAP, RR before anesthesia (T0), when loss of eyelash reflex (T1), operation (T2) and recovery (T3) were recorded.The uterine cramping pain was assessed with numerical rating scale (NRS) at recovery, 10, 30, 60 min after operation.Patients'satisfaction was recorded after operation.Patients'emotion was assessed with positive and negative affect scale (PANAS) both before and after operation in one hour.Rescue analgesia, nausea and vomiting, dizziness, respiratory depression, pruritus, uroschesis, cognitive dysfunction, sweatiness were recorded.Results The propofol doses and recovery time in groups O2, O3 and F were significantly lower than those in group O1 (P<0.05).The NRS score of uterine cramping pain in groups O1, O2 and O3 were significantly lower than that in group F (P<0.05).Patients'satisfaction in groups O1, O2 and O3 were significantly higher than that in group F (P<0.05).The positive affective score after operation in one hour among the four groups were significantly higher than that before operation (P<0.05), and the negative affective score after operation in one hour among the four groups were significantly lower than that before operation (P<0.05).The positive affective score after operation in one hour in groups O1, O2 and O3 were significantly higher than that in group F (P<0.05), and the rescue analgesia in groups O1, O2 and O3 were significantly lower than that in group F (P<0.05).There were no significant differences among the four groups as to the dizziness, nausea and vomiting.No respiratory depression, pruritus, emergence agitation, cognitive dysfunction, uroschesis and sweatiness were reported.Conclusion Oxycodone 0.08 mg/kg combined with propofol in patients undergoing artificial abortion is effective in preventing uterine cramping pain.Furthermore, the patients'satisfaction and positive affective score can also be improved.
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Resumo Entre 1945-1964 o Brasil vivia uma acelerada modernização. Transformando-se numa sociedade urbana, sob o jugo do higienismo, procurava refutar práticas e costumes considerados tradicionais e arcaicos. Nesse contexto, a figura tradicional da parteira é preterida socialmente para dar espaço ao conhecimento médico, que passa a incidir sobre o partejar e o maternar. Este texto analisa o Boletim da LBA, investigando o processo de medicalização e cientifização da maternidade e do parto, tomando em observação os embates científicos e morais sobre maternidade e parto que ocupavam as páginas da publicação oficial da maior instituição de assistência no país.
Abstract Between 1945 and 1964, Brazil underwent an accelerated process of modernization. Increasingly urbanized and guided by the precepts of social hygiene, the country was keen to refute any practices or customs regarded as traditional or old-fashioned. As such, the traditional figure of the midwife was supplanted by medical knowledge, which came to exert influence on childbirth and motherhood. This text analyzes Boletim da LBA, investigating the medicalization and scientification of childbirth and motherhood and focusing on the scientific and moral clashes about motherhood and childbirth contained in this, the official publication of the country's largest welfare institution.
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Humans , Female , Pregnancy , History, 20th Century , Periodicals as Topic/history , Social Change/history , Delivery, Obstetric/history , Parturition , Medicalization/history , BrazilABSTRACT
Objective To explore the application of body position intervention combined pronase in gastric mucosal cleaning in painless gastroscopy.Methods A total of 200 patients who underwent painless gastroscopy from July 2016 to July 2017 in the digestive endoscopy center were selected as the subjects.According to the random digital table method,the patients were randomly divided into the experimental group and the control group of 100 cases.In the experimental group,before the gastroscope was examined,pronase plus Dimethicone Powder and lidocaine mucilage was used,and then the body position intervention (right supine 5 min-supine 5 min-left lying position 5 min) was examined,and the control group was taken Dimethicone Powder and Lido before the intensive examination.The caking mortar was then placed on the left side of the examination bed 15 min for examination.The upper gastrointestinal tract visual field definition and endoscopic operation time were compared between the two groups under magnifying endoscopy under white light and narrowband imaging.Results In the experimental group,72.0％ (72/100),20.0％ (20/100),6.0％ (6/100) and 2.0％ (2/100) of A,B,C,D grade of the visual field clarity of mucosa under white light were better than 32.0％ (32/100),30.0％ (30/100),13.0％ (13/100) and 25.0％ (25/100) of the control group,respectively.The difference was statistically significant (x2=39.54,P ＜ 0.05).There were 0,6,29 and 65 cases of 1,2,3,4 scores of microvascular visual field intelligibility scores under magnifying endoscopy combined with narrow band imaging in the experimental group,which were better than those in the control group (11,31,28 and 30 cases respectively).The difference between the two groups was statistically significant (Z =-6.07,P ＜ 0.05).The examination time of the experimental group was (10.64 ± 3.83) minutes,which was lower than that of the control group (11.67 ± 4.89) minutes,and the difference was statistically significant (t=1.978,P ＜ 0.05).Conclusions The effect of pronase as an anti mucilage agent combined with body position is obvious,and the effect of dispelling the mucus and removing the mucus is comprehensive,and it can effectively shorten the time of examination.It is worthy of clinical application.
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Objective To evaluate the feasibility and safety of self designed oral-nasal double channel mask in painless gastroscopy. Methods 400 patients who were given intravenous injection Sublimaze followed by Propofol were divided equally at random into two groups. The patients in control group (n = 200) were inhaled oxygen with snuffle tube (4.0 ~ 5.0 L/min) and the patients in experimental group (n = 200) were inhaled oxygen with a self designed oral-nasal double channel mask. Respiration rate, SpO2, duration of operation and dosage of anaesthetic were recorded before and during operation. Result The SpO2decreased markedly and duration of operation obviously prolonged in group I during operation (P < 0.05), there was no statistical difference between the two groups of the respiration rate and dosage of anaesthetic. Conclusion The application of oxygen inhalation with the self designed oral-nasal double channel mask in painless gastroscopy appeared safer than that of oxygen inhalation via snuffle tube. It can be safely used in painless gastroscopy.
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It is well known that the long-term prognosis of postpartum thyroiditis (PPT) is excellent except recurrent PPT in subsequent pregnancies and risk of progression to permanent hypothyroidism in some patients. However, the prospective observation of PPT patients who have neither consecutive gestation nor any evidence of hypothyroidism were limited. We describe three patients who have history of PPT and showed repeated painless thyroiditis in the span of more than ten years. The clinical courses of repeated painless thyroiditis were the transient thyrotoxicosis, self-limited, and not related to pregnancy. Based on the clinical courses of our three patients, it is recommended to remember that transient painless thyroiditis could be repeated as a possible long-term course of the patients with history of PPT.
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Humans , Pregnancy , Hypothyroidism , Postpartum Period , Postpartum Thyroiditis , Prognosis , Prospective Studies , Thyroid Gland , Thyroiditis , ThyrotoxicosisABSTRACT
Objective To observe and compare the incidence of cough among patients with post-infection cough undergoing painless gastroscopy.Methods Seventy-one patients with post-infection cough undergoing painless gastroscopy were enrolled and randomly divided into two groups.The observation group (34 cases) received budesonide nebulization before gastroscopy and the control group (37 cases) was performed gastroscopy directly.We observed the incidence of cough at different time point and the changes of circulationduring the operation. Results The incidence of cough between the observation group and the control group showed statistically significant differences (P＜0.01) . The changes of circulation showed statistical differences between two groups in the process of gastroscopy (P＜0.05).Conclusion Budesonide nebulization supplying can decrease the incidence of post-in-fection cough among patients undergoing painless gastroscopy.
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Objective To investigate the effects of oxycodone hydrochloride combined with propofol on hemodynamics and related indicators in painless fiberoptic bronchoscopy.Methods Ninety patients receiving fiberoptic bronchoscopic examination from January 2016 to May 2017 were selected and divided into the sufentanil+propofol group(group A) and oxycodone hydrochloride+propofol group(group B) according to the random number table method 45 cases in each group.The hemodynamic indicators,intraoperative propofol dosage and incidence rate of adverse reactions in both groups were observed.Results The respiratory rate(RR) in the bronchoscope reaching the glottis(T2) in the group A was significantly higher than that in the group B (P＜ 0.05);mean arterial pressure(MAP),heart rate(HR),blood oxygen saturation(SpO2) and RR at the bronchoscope passing trachea carina(T3) and examination completing(T4) in the group A were significantly higher than those in the group B(P＜0.05).RR at 10 min after the examination completing(T5) in the group A was significantly higher than that in the group B,the difference was statistically significant(P＜0.05).The propofol dosage in the group A was significantlyhigher than that in the group B(P＜0.05);the incidence rate of adverse reactions in the group A was 31.11％,which was significantly higher than 6.67％ in the group B,the difference was statistically significant(P＜0.05).Conclusion Oxycodone hydrochloride combined with propofol can more stabilizes the change of hemodynamic parameters during the bronchofibroscopic examination process compared with sufentanil combined with propofol and can reduce the propofol dosage and incidence rate of adverse reactions.