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Femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK)and small incision lenticule extraction(SMILE)are the mainstream corneal refractive surgeries at present. Despite efficacy, safety and predictability they have showed in refractive error correction, there are still complications relating to femtosecond laser, such as suction loss and opaque bubble layer(OBL), due to that the production of corneal flap or lenticule is dependent on the femtosecond laser. OBL is a complication that is unique to femtosecond laser surgery and the bubbles are generated from photo-disruptive effect towards corneal tissues which consisted of water vapor and carbon dioxide, and OBL gradually formed when the bubbles are trapped in the stroma. The bubbles can influence the intraoperative manipulation and postoperative visual quality. This review discusses the mechanism, grading, classification, and influencing factors of OBL and its effects on intraoperative manipulations and postoperative recovery, in the hope of providing reference and basis for further clinical studies.
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Intact pulmonary hydatid cysts are often discovered incidentally on chest X-rays (CXRs) as rounded opaque lesions with smooth borders. Cyst rupture and infection (complicated hydatid cyst) often change the radiologic appearance delaying diagnosis. Air bubble sign on computed tomography is recognized as a sign of high sensitivity and specificity in the diagnosis of complicated hydatid cysts when compared to other classical radiologic signs. Bronchoscopy is not a preferred investigation in patients with intact hydatid cysts but may have a major role in patients with complicated hydatid cysts with atypical presentation. In the present case series, we attempt to highlight the importance of the 揳ir bubble sign� and the identification of a whitish membrane at bronchoscopy in the diagnosis of complicated hydatid cysts.
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Objective:To introduce a novel method to repair bottoming-out and double-bubble deformity after augmentation mammaplasty with a hammock-shaped capsular flap, and to evaluate its clinical effect of the related complications.Methods:From 2015 to 2019, a total of 16 patients (aged range from 23 to years, with average age of 33.4 years) were treated in the Department of Plastic Surgery, Shanghai Mylike Cosmetic Hospital. We performed a novel hammock-shaped capsular flap with periareolar incision. First of all, the periprosthetic capsule was widely separated from the lower pole of the breasts. Then the inframammary folds were anchored to the chest wall to eliminate the excess the cavity. Finally, the capsular flaps were raised up from both anterior and posterior leaf and resutured by fold tile shaped suture, in order to elevate the inframammary folds in aesthetic revision.Results:Only one case showed mild hematoma and healed after treatment. After 6 months follow-up, all the inframammary folds were elevated to the ideal position, and the double-bubble deformity was corrected with concealed scars and satisfactory shape and symmetry. Meanwhile, recurrent cases and capsule contraction were not observed.Conclusions:For patients with bottoming-out and double-bubble complications after augmentation mammaplasty, the use of hammock-shaped capsular flap can effectively revise the deformation. This technical refinement seems to afford stable outcomes with convenient operation and minor injury and produce satisfactorily clinical effects with fewer complications.
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Resumen OBJETIVO: Evaluar la relación entre la ubicación de la burbuja de aire que contiene los embriones y las tasas de implantación y de gestación clínica. El secundario: estudiar la relación entre la posición de la punta de la cánula, el grosor endometrial y el desplazamiento de la burbuja con esos desenlaces reproductivos. MATERIALES Y MÉTODOS: Estudio retrospectivo, observacional y de análisis de imágenes ecográficas de transferencias de embrión único en estadio de blastocisto practicadas por un mismo especialista en la Fundación IVI, Valencia, España, entre septiembre de 2013 y febrero de 2021. Criterios de selección: grosor endometrial ≥ 6 mm en el último control ecográfico, ausencia de miomas, IMC menor de 30 kg/m2, transferencias atraumáticas efectuadas por el mismo especialista. En función de la ubicación de la burbuja de aire se establecieron tres grupos de estudio (alta: mayor de 0.98 cm, media: 0.98 a 1.44 cm y baja: mayor de 1.44 cm) y para evaluar la asociación entre las categorías se aplicó el cálculo de razón de momios (OR) e IC95%. RESULTADOS: Se estudiaron 342 transferencias de embrión único. La edad media de las pacientes fue 39.70 ± 4.5 años. La relación entre la distancia de la burbuja de aire al fondo uterino y la tasa de implantación fue de 61 ± 9% en el grupo de ubicación alta, 64 ± 9% en el grupo de ubicación media, y de 56 ± 1% en el grupo de ubicación baja (p = 0.437). No se observaron diferencias en la tasa de gestación evolutiva analizada mediante probabilidad de ocurrencia entre grupos, con frecuencias de 0.60 en comparación con 0.64 (OR: 1.42; IC95%: 0.83 a 2.44; p: 0.199) y en la ubicación alta con media, y frecuencias de 0.60 en comparación con 0.56 (OR: 1.22; IC95%: 0.72-2.08; p: 0.462) entre alta y baja. CONCLUSIONES: No se encontró asociación entre la ubicación de la burbuja y las tasas de implantación y de gestación evolutiva. El mayor desplazamiento de la burbuja se asoció con mayores tasas de gestación evolutiva.
Abstract OBJECTIVE: To evaluate the relationship between the location of the air bubble containing the embryos and the implantation and clinical gestation rates. Secondary: to study the relationship between the position of the cannula tip, the endometrial thickness and the displacement of the bubble with these reproductive outcomes. MATERIALS AND METHODS: Retrospective, observational, ultrasound image analysis study of single embryo transfers at blastocyst stage performed by the same specialist at the IVI Foundation, Valencia, Spain, between September 2013 and February 2021. Selection criteria: endometrial thickness ≥ 6 mm at the last ultrasound control, absence of fibroids, BMI less than 30 kg/m2, atraumatic transfers, performed by the same specialist. Based on the location of the air bubble, three study groups were established (high: greater than 0.98 cm, medium: 0.98 to 1.44 cm and low: greater than 1.44 cm) and the odds ratio (OR) and 95%CI were used to evaluate the association between the categories. RESULTS: A total of 342 single embryo transfers were studied. The mean age of the patients was 39.70 ± 4.5 years. The relationship between the distance of the air bubble to the uterine fundus and the implantation rate was 61 ± 9% in the high placement group, 64 ± 9% in the medium placement group, and 56 ± 1% in the low placement group (p = 0.437). No differences were observed in the evolutionary gestation rate analyzed by probability of occurrence between groups, with frequencies of 0.60 compared to 0.64 (OR: 1.42; 95%CI: 0.83 to 2.44; p: 0.199) and high to medium location, and frequencies of 0.60 compared to 0.56 (OR: 1.22; 95%CI: 0.72-2.08; p: 0.462) between high and low. CONCLUSIONS: No association was found between the air bubble localization and implantation or ongoing pregnancy rates. However, a greater displacement of the bubble was associated with higher ongoing pregnancy rates.
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@#AIM: To evaluate the effect of opaque bubble layer(OBL)on the ocular cylotorsion compensation during FS-LASIK procedures. <p>METHODS: Prospectively clinical study. From July 2019 to September 2019, two-hundred FS-LASIK patients(400 eyes)were randomly included into this study. The total OBL incidence, flap-out OBL incidence, flap-in OBL incidence, incidence of dynamic cyclotorsion component(DCC)and incidence of static cyclotorsion component(SCC)were statistically analyzed. <p>RESULTS: OBL developed in 183 eyes of 400 FS-LASIK eyes, with a total OBL incidence of 45.8%. DCC was successfully performed on 397 eyes, with a total DCC incidence of 99.2%. SCC was successfully performed on 293 eyes, with a total SCC incidence of 73.2%. Neither flap-out OBL nor flap-in OBL could disturb the successful implementation of DCC during the operation(<i>P</i>>0.05). Both flap-out OBL and flap-in OBL could impact the SCC implementation and make it fail(<i>P</i><0.05).<p>CONCLUSION: OBL can result in failure of SCC implementation during the FS-LASIK procedures.
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@#AIM: To explore the effect of different energy parameters of femtosecond laser small incision lenticule extraction(SMILE)on stage Ⅰ opaque bubble layer(OBL)and visual quality. <p>METHODS: A retrospective analysis of the clinical data of 216 patients(432 eyes)who came to our hospital for SMILE surgery from July 2018 to December 2019. According to whether stage Ⅰ OBL occurred, they were divided into OBL group(42 eyes)and non-OBL group(390 eyes). The age, visual acuity parameters, corneal parameters, microlens parameters and energy parameters were compared between the two groups, and multivariate regression analysis was used to analyze the relationship between the difference in energy settings and the OBL of stage Ⅰ. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), and modulation transfer function cut-off spatial frequency(MTF<sub>cut-off</sub>), Strehl Ratio(SR)and Objective Scattering Index(OSI)with energy parameters of 130, 135, 140, 145, and 150 nJ before and 1mo after surgery were compared. The correlation between energy parameters and stage Ⅰ OBL, UCVA, BCVA, MTF<sub>cut-off</sub>, SR, OSI were analyzed. <p>RESULTS: Multivariate regression analysis showed that the energy setting with a difference of 5nJ did not show an association with stage Ⅰ OBL. In the different energy parameter groups, LogMAR UCVA, MTF<sub>cut-off</sub>, and OSI at 1mo after surgery were improved compared with preoperatively(<i>P</i><0.05), and the difference between the groups were statistically significant(<i>F</i>=75.712, 15.304, 26.293, all <i>P</i><0.05). SMILE intraoperative energy parameters were negatively correlated with UCVA(<i>r</i>=-0.272), MTF<sub>cut-off</sub>(<i>r</i>=-0.132), and OSI(<i>r</i>=-0.151)1mo after surgery(<i>P</i><0.05). <p>CONCLUSION: When using a 4.5μm dot pitch, in the usual energy range, the lower the energy, the better the postoperative visual quality, but it does not significantly affect the incidence of stage Ⅰ OBL during SMILE surgery.
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Chemotherapy has been a major option in clinic treatment of malignant tumors. However, single chemotherapy faces some drawbacks, such as multidrug resistance, severe side effects, which hinder its clinic application in tumor treatment. Multifunctional nanoparticles loading with chemotherapeutic agent and photosensitizer could be a promising way to efficiently conduct tumor combination therapy. In the current study, a novel pH-sensitive and bubble-generating mesoporous silica-based drug delivery system (denoted as M(a)D@PI-PEG-RGD) was constructed. Ammonium bicarbonate (NH
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At present, there is no guidance or standard document to evaluate the performance of liquid stop membrane for infusion set, and it is impossible to conduct quantitative analysis and quality supervision of product performance. In this paper, a method for measuring bubble point pressure of liquid stop membrane is studied, and the correlation between bubble point pressure and the performance of liquid stop membrane is explored. The results of bubble point pressure test are used as the daily control index of liquid stop performance. It provides a practical reference value for the evaluation of liquid stopping performance of liquid stop membrane.
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Ultrasonic bubble detection has been widely used in predicting the risk of decompression sickness and evaluating the efficiency and safety of decompression procedures. Currently, the widely used SPENCER scale is conducted by using Doppler ultrasound to monitor the bubble signal in the precordial region of subjects. KM grading system is a computerized system based on Doppler ultrasound. The grading score can be converted into SPENCER bubble grading scale score and the bubble grading is precise and suitable for the motion status. On the basis of the above two methods, the KISMAN integrated severity score, extended SPENCER bubble grading and simplified Doppler bubble grading system were established. They not only coordinated analysis of Doppler ultrasound bubble detection results with other risk factors of decompression disease, but also convenient to use computer for processing detection results. With the in-depth application of Fourier technique and empirical mode decomposition in Doppler audio bubble signal detection, methods such as three-parameter fuzzy analysis and energy operator method are playing an important role in automatic bubble analysis. Optimization of detection technology and improvement of sensitivity and accuracy of automatic analysis are important development directions in the field of decompression bubble Doppler grating technology.
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Abstract Micro-RNA-221(miR-221) is one of oncogenic miRNAs that plays a vital role in the development and progression of oral cancers. The aim of this study is to introduce a new gene therapy for oral squamous cell carcinoma by blocking the expression of oncogenic miR-221 by its inhibitor. The present work was performed on squamous cell carcinoma cell line SCC-25 and anti-miR-221 was delivered to the cells using an ultrasound micro bubbles. Assessment of the effect of miR-221 inhibitor on SCC-25 cells was done using MTT assay, cell cycle analysis and apoptosis detection. In addition, reverse transcription-polymerase chain reaction was also used to detect the expression -miR-221 and its target genes. Using ANOVA, statistical analysis of the results showed significant inhibition of cell viability with and induction of cell apoptosis of SCC-25 cell line after transfection. Moreover, the expression of miR-221, Epidermal growth factor receptor (EGFR) and CDKNIB/p27 were downregulated without significant difference. Transfection of SCC-25 by inhibitor of miR-221 resulting in blockage of its expression leading to arresting of tumor growth. These results proved the effective role of micro-RNA inhibitors as novel therapeutic agent for oral cancers.
Resumo Micro-RNA-221 (miR-221) é um dos miRNAs oncogênicos que desempenham um papel vital no desenvolvimento e progressão de carcinomas orais. O objetivo deste estudo é apresentar uma nova terapia gênica para o carcinoma epidermóide oral por meio do bloqueio da expressão do miR-221 oncogênico por seu inibidor. O presente trabalho foi realizado na linhagem de células de carcinoma de células escamosas SCC-25 e o anti-miR-221 foi administrado às células usando micro-bolhas de ultrassom. A avaliação do efeito do inibidor miR-221 em células SCC-25 foi feita usando ensaio de MTT, análise do ciclo celular e detecção de apoptose. Além disso, a reação em cadeia da polimerase com transcrição reversa também foi usada para detectar a expressão -miR-221 e seus genes-alvo. Usando ANOVA, a análise estatística dos resultados mostrou inibição significativa da viabilidade celular e indução da apoptose celular da linhagem celular SCC-25 após a transfecção. Além disso, a expressão de miR-221, receptor do fator de crescimento epidérmico (EGFR) e CDKNIB/p27 foram regulados para baixo sem diferença significativa. A transfecção de SCC-25 por inibidor de miR-221 resultou no bloqueio de sua expressão, levando à interrupção do crescimento do tumor. Esses resultados comprovaram o papel eficaz dos inibidores de micro-RNA como novo agente terapêutico para carcinomas orais.
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Humans , Mouth Neoplasms/genetics , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/therapy , MicroRNAs/antagonists & inhibitors , MicroRNAs/genetics , MicroRNAs/therapeutic use , Mouth Neoplasms/therapy , Genetic Therapy , Apoptosis , Cell Line, Tumor , Cell ProliferationABSTRACT
This study aimed to establish an animal model of decompression-induced lung injury (DILI) secondary to repetitive diving in mice and explore the role of macrophages in DILI and the protective effects of high-concentration hydrogen (HCH) on DILI. Mice were divided into three groups: control group, DILI group, and HCH group. Mice were exposed to hyperbaric air at 600 kPa for 60 min once daily for consecutive 3 d and then experienced decompression. In HCH group, mice were administered with HCH (66.7% hydrogen and 33.3% oxygen) for 60 min after each hyperbaric exposure. Pulmonary function tests were done 6 h after decompression; the blood was harvested for cell counting; the lung tissues were harvested for the detection of inflammatory cytokines, hematoxylin and eosin (HE) staining, and immunohistochemistry; western blotting and polymerase chain reaction (PCR) were done for the detection of markers for M1 and M2 macrophages. Our results showed that bubbles formed after decompression and repeated hyperbaric exposures significantly reduced the total lung volume and functional residual volume. Moreover, repetitive diving dramatically increased proinflammatory factors and increased the markers of both M1 and M2 macrophages. HCH inhalation improved lung function to a certain extent, and significantly reduced the pro-inflammatory factors. These effects were related to the reduction of M1 macrophages as well as the increase in M2 macrophages. This study indicates that repetitive diving damages lung function and activates lung macrophages, resulting in lung inflammation. HCH inhalation after each diving may be a promising strategy for the prevention of DILI.
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Introduction: We examined the thermophysiological effects of ultrafine bubble (UB) bathing in comparison with microbubble (MB) and freshwater (FW) bathing. Subjects and Methods: Seven healthy women aged 35.6±2.9 years provided informed consent to participate in the study. After a 10-min rest, each subject engaged in UB, MB, and FW bathing (on separate days) at 40°C for 10 min. During the experiment, tympanic temperature, local sweat rate, local skin temperature, heat flow, and heart rate variability were continuously recorded. Subjective assessments of thermal sensation and comfort were rated on a visual analog scale between 0 to 100. Results: Increases in tympanic temperature and mean body temperature were highest during MB bathing, and similar increases were observed during UB and FW bathing. Local sweating was highest during MB bathing and lowest during UB bathing. A significant interaction was observed between local sweating during bathing and bathing style (P<0.001). The increase in local sweat rate relative to body temperature was lowest during UB bathing and highest during MB bathing. Discussion: During UB bathing, UBs and MBs that were generated in high concentrations in the bathtub decreased the flow of heat to the body, thereby suppressing an increase in tympanic temperature and yielding the lowest local sweat late. However, during MB bathing, in which a moderate concentration of UBs and MBs were generated, the increase in heat flow due to the convection of hot water exceeded the decrease in heat flow due to the bubbles. Conclusions: The results suggest that bubble properties and convection characteristics altered the balance of heat flow, leading to differences in the thermoregulatory response during and after bathing.
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Introduction: We examined the thermophysiological effects of ultrafine bubble (UB) bathing in comparison with microbubble (MB) and freshwater (FW) bathing. Subjects and Methods: Seven healthy women aged 35.6±2.9 years provided informed consent to participate in the study. After a 10-min rest, each subject engaged in UB, MB, and FW bathing (on separate days) at 40°C for 10 min. During the experiment, tympanic temperature, local sweat rate, local skin temperature, heat flow, and heart rate variability were continuously recorded. Subjective assessments of thermal sensation and comfort were rated on a visual analog scale between 0 to 100. Results: Increases in tympanic temperature and mean body temperature were highest during MB bathing, and similar increases were observed during UB and FW bathing. Local sweating was highest during MB bathing and lowest during UB bathing. A significant interaction was observed between local sweating during bathing and bathing style (P<0.001). The increase in local sweat rate relative to body temperature was lowest during UB bathing and highest during MB bathing. Discussion: During UB bathing, UBs and MBs that were generated in high concentrations in the bathtub decreased the flow of heat to the body, thereby suppressing an increase in tympanic temperature and yielding the lowest local sweat late. However, during MB bathing, in which a moderate concentration of UBs and MBs were generated, the increase in heat flow due to the convection of hot water exceeded the decrease in heat flow due to the bubbles. Conclusions: The results suggest that bubble properties and convection characteristics altered the balance of heat flow, leading to differences in the thermoregulatory response during and after bathing.
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Introduction: Bubble CPAP is an important, simple, noninvasive, and cost effective treatment modality for respiratorydistress in neonates. The aim of our study was to know theoutcome of Bubble CPAP in preterm and term neonatesrequiring respiratory support and to study its failure factors.Material and methods: A retrospective observational studywith Bubble CPAP was done on 100 babies both term andpreterm with respiratory distress requiring for respiratorysupport admitted in NICU of Government General Hospital,Guntur. Monitoring was done clinically, with pulse oximeter,radiologically and with blood gases. Neonates with respiratorydistress secondary to sepsis, necrotizing entero colitis,congenital anomalies like Tetrology of Fallot, cleft lip withcleft palate, congenital diaphragmatic hernia, choanal atresia,who had severe respiratory distress with cardio vascularinstability were excluded in our study.Results: The mean gestational age was 32-34 weeks, birthweight was 1.4 kgs.52% were very low birth weight<1.5kgs. CPAP failure rate was higher in preterm and very lowbirth weight. The most common disease for starting BubbleCPAP was Respiratory Distress Syndrome 56 cases followedby Meconium Aspiration Syndrome 16 cases, congenitalpneumonia, Transient Tachypnea of New Born and BirthAsphyxia. The common complications on CPAP were shock,apnea and nasal damage. Overall failure rate was 36% (36cases). All babies who failed on CPAP were put on mechanicalventilation. Failure among Respiratory Distress Syndromewas about 42%, in Meconium Aspiration Syndrome 31%,congenital pneumonia 35.7%. Higher cases of sepsis andpulmonary hemorrhage were seen in failure group. Overallsurvival rate of the study was 64%(64cases).Conclusion: Bubble Continuous Positive Airway Pressure issafe, effective and easy to use in preterm and term neonateswith mild to moderate Respiratory Distress. The major failurefactors in our study were sepsis, recurrent apnea. The successrate was 64%
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Background: Mechanical neck pain is most prevalent in middle age and a common condition affecting 22 % to 70% of the general population. While the exact aetiology of the pain is unknown, most of the mechanical pain is due to mechanical factors such as sprains and strains of the neck muscles or ligaments. Methods: 60 subjects (male 33, female 27) with mechanical neck pain who fulfilled the inclusion criteria were chosen. After baseline evaluation of history, NPRS, cervical range of motion and Deep Cervical Flexor Endurance (DCF), the subjects were allocated into three groups which received DCF training by modifying the use of pressure biofeedback. Group 1 received DCF Training with Visual Pressure Biofeedback 10 repetition for three sets. Group 2 received DCF training without Visual Pressure Biofeedback 10 repetition three sets. And Group 3 received DCF training with Pressure Biofeedback (without visual input) 3 set of 10 repetitions. After 15 days of intervention, post-intervention measures of the variables were obtained. Results: Data were analyzed using SPSS 1 version. Between-group analyses showed that subjects in Group 1 have a statistically and clinically significant improvement (p-value< .005), pain (NPRS), cervical ROM, DCF endurance and Neck Disability Index when compared to the Group 2 and 3. The pre and post values for all the three groups within the group analysis showed a statistical and clinically significant difference. Conclusion: Deep Cervical Flexor Training with Visual Pressure Biofeedback provides better clinical improvement in terms of pain reduction, cervical flexion and extension ROM, DCF endurance, and Neck Disability Index score.
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BACKGROUND: Bioremoval of phenolic compounds using fungi and bacteria has been studied extensively; nevertheless, trinitrophenol bioremediation using modified Oscillatoria cyanobacteria has been barely studied in the literature. RESULTS: Among the effective parameters of bioremediation, algal concentration (3.18 g·L−1 ), trinitrophenol concentration (1301 mg·L−1 ), and reaction time (3.75 d) were screened by statistical analysis. Oscillatoria cyanobacteria were modified by starch/nZVI and starch/graphene oxide in a bubble column bioreactor, and their bioremoval efficiency was investigated. Modifiers, namely, starch/zero-valent iron and starch/GO, increased trinitrophenol bioremoval efficiency by more than 10% and 12%, respectively, as compared to the use of Oscillatoria cyanobacteria alone. Conclusions: It was found that starch/nano zero-valent iron and starch/GO could be applied to improve the removal rate of phenolic compounds from the aqueous solution.
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Picrates/metabolism , Oscillatoria/metabolism , Picrates/analysis , Starch , Biodegradation, Environmental , Bioreactors , Phenolic Compounds/analysis , Metal Nanoparticles , Wastewater , Graphite , IronABSTRACT
Introduction: Cervical vertebrae are having foramen transversarium in their transverse process. Foramentransversarium’s dimensions and its variations are important for clinicians while handling vertebro basilarinsufficiency cases and also useful for spinal surgeons in spinal decompression procedures like foraminectomy,foraminotomyMaterials & Methods: The present study was done in 90 sub axial vertebrae (C3 to C7) which was collected fromRajah Muthiah Medical College, Chidambaram. Among 90, 56 were typical type and 34 were seventh cervicalvertebrae. Damaged vertebrae were excluded. Antero posterior length, transverse length & depth of foramentransversarium were measured using double tipped compass and digital vernier caliper. Double foramens andabsent foramens were noted.Result: The average antero posterior length of foramen transversarium of typical cervical vertebrae and seventhcervical vertebrae were 5.45 mm ± 0.12 mm and 5.66 mm ± 0.88 mm respectively. The average transverse lengthof foramen transversarium of typical and seventh cervical vertebrae was 6.72 mm ± 0.22 mm and 6.76 mm ± 0.08mm respectively.Conclusion: Anatomical knowledge on the dimensions of foramen transversarium and its variations are importantfor clinicians and neurologists for the various clinical conditions and spinal decompression procedures.
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Objective: To study the use of early labour room Bubble CPAP in preterm neonates born at 28–32 weeks of gestation and to analyse the outcome in relation to need for mechanical ventilation, duration of hospital stay and mortality at the Neonatal Intensive Care Unit (NICU), Tertiary Care Teaching Government Hospital Kurnool, Andhra Pradesh for a period of 1 Year. Methods : Facility Based Interventional Studied (Randomised Control Study) Participants : Study sample of 109 preterm babies of age 28–32 weeks of gestation Cases : 54 cases, neonates with respiratory distress who were started on CPAP in the labour room within 15 minutes of life. Controls : 55 babies, neonates with respiratory distress who were started on CPAP after 15 minutes to 6 hours of life. In the present study, both the groups(cases and controls) were monitored till they were discharged and the need for mechanical ventilation was noted. Clinical diagnosis of RDS was made based on the time of onset of respiratory distress and clinical examination and respiratory scoring(Silverman Anderson Score) . Chest X–ray and routine investigations were done in all neonates. Duration of CPAP and difference in mortality between the two groups was analysed. Outcome : In the present study, preterm neonates born at 28–32 weeks of gestation who were started on early labour room CPAP vs control group outcome is assessed in relation to need for mechanical ventilation and duration of hospital stay and mortality. Results: It is observed that 16 (29.63%) cases required mechanical ventilation whereas 28 (50.91%) preterm neonatesin the control group needed mechanical ventilation. There was a statistically significant difference between the two groups (p < 0.05). The duration of stay in NICU in neonates with early CPAP was significantly less when compared to the controlled group. 30(76.9%) neonates were discharged within 14 days among cases and 16 (48.48%) neonates among control group. There is no difference in mortality between the 2 groups. Conclusions : The following conclusions could be drawn out of the present study on preterm neonates. 1. The early administration of CPAP in the delivery room in preterm neonates developing respiratory distress decreases the need for mechanical ventilation. 2. The duration of stay in NICU in neonates with early CPAP was significantly less. 3. There is no difference in mortality between the two groups.
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Continuous blood purification is a group of extracorporeal blood purification techniques therapy technology,because of its continuous,slow removal of water and solute characteristics,It has become an important auxiliary method in the treatment of criti-cal patients. The clotting of bubble chamber in cardiopulmonary bypass(CPB)is a difficult problem in the process of continuous blood purification treatment. This article elaborates the factors such as the level of bubble chamber,CBP treatment time,blood flow velocity, patient's internal environment,anticoagulant way and so on.We provide a guidance for the targeted nursing intervention of critically pa-tients who are undering CBP treatment.
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Objetivo. Analizar las características de los pacientes menores de 2 años que padecieron una infección respiratoria aguda baja moderada-grave tratados precozmente con presión positiva continua en la vía aérea de burbuja y los factores asociados al éxito de la intervención. Método. Estudio retrospectivo y descriptivo. Niños menores de 2 años internados en Cuidados Intermedios Pediátricos del Hospital Provincial Neuquén entre junio de 2009 y diciembre de 2010. Se aplicó presión positiva continua en la vía aérea de burbuja y se midieron frecuencias cardíacas y respiratorias, puntaje de Tal, saturación y fracción inspirada de oxígeno a las 0, 2, 6, 24 y 48 h. Resultados. Se incluyeron 120 pacientes. La mediana de edad fue 3 meses. La intervención fue exitosa en el 72% de los casos. A las 2 h, un descenso del 15% de la frecuencia respiratoria y de 2 puntos en el puntaje de Tal fueron predictores del éxito, con un OR 6,41 (IC 95%: 2,68-15,36) y 9,07 (IC 95%: 3,72-22,19), respectivamente.Conclusiones. La disminución de la frecuencia respiratoria, de la frecuencia cardíaca y del puntaje de Tal a las 2 horas de inicio fueron predictores de éxito.
Objective. To analyze the characteristics of patients younger than 2 years old who had a moderate to severe acute lower respiratory tract infection and were treated early with bubble continuous positive airway pressure, and factors associated with a successful intervention. Method. Retrospective and descriptive study. Children younger than 2 years old admitted to the Pediatric Intermediate Care Unit of Hospital Provincial Neuquen between June 2009 and December 2010. Bubble continuous positive airway pressure was used, and the following outcomes were measured: heart rate, respiratory rate, Tal's score, oxygen saturation, and fraction of inspired oxygen at 0, 2, 6, 24, and 48 h. Results. One hundred and twenty patients were included. Their median age was 3 months old. The intervention was successful in 72% of patients. At 2 h, a 15% reduction in respiratory rate, and a 2-point decrease in Tal's score were predictors of success, with an odds ratio of 6.41 (95% confidence interval: 2.68-15.36), and of 9.07 (95% confidence interval: 3.72-22.19), respectively. Conclusions. A reduction in respiratory rate, heart rate, and Tal's score at 2 hours of starting the intervention were predictors of success.