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Objetivo: examinar el efecto de la técnica de tos de mediana intensidad durante la inyección subcutánea de heparina de bajo peso molecular sobre la severidad del dolor y la satisfacción individual en pacientes de cirugía general. Método: estudio prospectivo, cuasi experimental, que incluyó a 100 pacientes a los que se les prescribió una inyección subcutánea de heparina de bajo peso molecular una vez cada 24 horas. Cada paciente recibió dos inyecciones por el mismo investigador utilizando técnica de inyección estándar con técnica de tos de intensidad media y solo técnica de inyección estándar. Resultados: hubo una diferencia estadísticamente significativa entre las puntuaciones medias de los pacientes sobre la intensidad del dolor y los niveles de satisfacción después de las inyecciones administradas por las dos técnicas (p= 0,000). Además, se encontró que el género afectó la severidad del dolor relacionado con la inyección, pero no afectó el nivel de satisfacción individual. Conclusión: se encontró que la técnica de tos de intensidad media reduce la severidad del dolor y aumenta la satisfacción del paciente de cirugía general que reciben inyecciones subcutáneas de heparina de bajo peso molecular. Registro del ensayo: NCT05681338.
Objective: to examine the effect of the medium intensity coughing technique during subcutaneous low molecular weight heparin injection on pain severity and individual satisfaction in general surgery patients. Method: the prospective, quasi-experimental study included 100 patients who had been prescribed a subcutaneous low molecular weight heparin injection once in 24 hours. Each patient received two injections by the same researcher, one using the standard injection technique with medium intensity coughing technique and the other only the standard injection technique. Results: there was a statistically significant difference between patients' mean scores on pain severity and satisfaction levels after injections administered by the two techniques (p= 0.000). Also, it was found that gender affected pain severity relating to the injection but did not affect the level of individual satisfaction. Conclusion: the medium intensity coughing technique was found to reduce pain severity and increase patient satisfaction in general surgery patients receiving subcutaneous low molecular weight heparin injections. Trial registration: NCT05681338.
Objetivo: examinar o efeito da técnica de tosse de média intensidade durante injeção subcutânea de heparina de baixo peso molecular na intensidade da dor e satisfação individual em pacientes submetidos à cirurgia geral. Método: estudo prospetivo, quasi experimental que incluiu 100 pacientes que haviam recebido uma injeção subcutânea de heparina de baixo peso molecular em 24 horas. Cada paciente recebeu duas injeções pelo mesmo pesquisador usando a técnica de injeção padrão com técnica de tosse de média intensidade e apenas técnica de injeção padrão. Resultados: houve diferença estatisticamente significativa entre as pontuações médias dos pacientes quanto à gravidade da dor e níveis de satisfação após as injeções administradas pelas duas técnicas (p = 0,000). Além disso, verificou-se que o sexo do paciente afetou a intensidade da dor relacionada à injeção, mas não afetou o nível de satisfação individual. Conclusão: a técnica de tosse de média intensidade reduz a intensidade da dor e aumenta a satisfação de pacientes submetidos à cirurgia geral recebendo injeções subcutâneas de heparina de baixo peso molecular. Registro do ensaio clínico: NCT05681338.
Subject(s)
Humans , General Surgery , Pain Measurement , Heparin , Prospective Studies , Patient Satisfaction , Cough , AnticoagulantsABSTRACT
Objective Comparation of the effects of intravenous lidocaine and dexmedetomidine on coughing during extubation after endoscopic thyroidectomy. Methods 60 patients who underwent endoscopic thyroidectomy were randomly divided into group L, group D and group C, each group included 20 cases. Group L were given a loading lidocaine 1.5 mg/kg over 10 minutes before anesthesia induction, followed by a continuous intravenous lidocaine 1.5 mg/ (kg·h) until 30 min before the end of surgery. Group D were given a loading dexmedetomidine 0.5μg/kg over 10 minutes before anesthesia induction, followed by a continuous intravenous dexmedetomidine 0.4 μg/ (kg · h) until 30 min before the end of surgery. Group C were given intravenous infusion of equal volume normal saline. The incidence and severity of coughing were recorded within 2 minutes after extubation. Hemodynamic variables were measured at T0 (before anaesthesia induction) , T1 (immediately after extubation) , and T2 (5 min after extubation). The volume of drainage was recorded within 24 hours after surgery. Results The incidence and grade of cough were significantly lower in group L and group D than in group C (P < 0.05). Compared with group L and group D, MAP and HR were significantly increased in group C at T1 and T2 (P < 0.05). Compared with group C, the volume of drainage was significantly reduced in group L and group D within 24 hours after surgery (P < 0.05).Conclusion Intravenous lidocaine and dexmedetomidine can effectively inhibit coughing during extubation period after endoscopic thyroidectomy, and there is no significant difference between the two treatments.
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[Objective] From the five aspects of WANG Zhongqi medical case, such as Qi syndrome, vomiting, cough, epigastric pain, wet temperature and so on, WANG Zhong Qi's bitterness in the treatment of various diseases, in order to learn and inherit the essence of WANG's academic thought and the characteristics of clinical diagnosis and treatment. [Methods] On the basis of the medical case contained in "WANG Zhongqi's Medical Cases", combined with classic treatise and academic thought of "Neijing", "Treatise on Typhoid Fever", ZHANG Jingyue, LI Dongyuan, YE Guangxi and WANG Zhongqi, this paper illustrates WANG's experience in the treatment of disease with "bitterness method" and analyzes the characteristics of the diagnosis and treatment. [Results] WANG inherited the experience and understanding of ZHANG Zhongjing, YE Tianshi and other doctors in the use of the method of bitterness, but didn't learn without change, depression causing Qi stagnation and bitter opening the pivot; Qi reverse vomiting, bitter descending pungent openning and promoting Qi function; cough of Qi inverse, pungent and bitter having catharsis to purge the lung Qi; for epigastric stomach pain, bitterness regulating middle warmer; damp heat diffusing, light bitter micro pungent regulating Qi function. [Conclusion] WANG's referred to "Neijing", Zhongjing, Dongyuan and YE Gui and had many innovations and flexible methods. It is worthy of further study to apply the method of bittern to the treatment of a variety of dysfunctional diseases of Qi, through the effect of the gasification and blood flow for regulating Qi function, to remove the pathogenic pathogenic factors in the body.
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Objective To investigate the prevalence and influencing factors on respiratory disease related symptoms (coughing,expectoration,persistent coughing and persistent expectoration) in Chinese people ≥40 years old.Methods Data was collected from 162 surveillance points in the China Non-communicable and Chronic Disease Surveillance Project in 2010.A total number of 56 066 people,aged ≥40 years,were selected by multi-stage cluster random sampling method in this study.The prevalence rates of coughing,expectoration,persistent coughing and persistent expectoration were calculated according to gender by x2 test.Multivariate logistic regression model was used to analyze the related influencing factors.Results The prevalence rates of coughing,persistent coughing,expectoration and persistent expectoration in men were significantly higher than that in women (P＜ 0.01).The prevalence rate of respiratory symptoms was positively correlated with age and duration and amount of cigarette smoking (P＜0.01),while negatively correlated with participants' education level (P＜0.01).Results from multivariate logistic regression analysis showed that gender,age,education level,smoking-related parameters,areas of residency (in urban or rural areas),etc.were appeared as influencing factors on the prevalence of respiratory symptoms.Conclusion The symptoms of chronic respiratory diseases appeared prevalent in Chinese population aged ≥40 years.Factors as older age,living in the central/western regions and smoking-related parameters were identified as of higher risks.
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Objective To investigate the prevalence and influencing factors on respiratory disease related symptoms (coughing,expectoration,persistent coughing and persistent expectoration) in Chinese people ≥40 years old.Methods Data was collected from 162 surveillance points in the China Non-communicable and Chronic Disease Surveillance Project in 2010.A total number of 56 066 people,aged ≥40 years,were selected by multi-stage cluster random sampling method in this study.The prevalence rates of coughing,expectoration,persistent coughing and persistent expectoration were calculated according to gender by x2 test.Multivariate logistic regression model was used to analyze the related influencing factors.Results The prevalence rates of coughing,persistent coughing,expectoration and persistent expectoration in men were significantly higher than that in women (P＜ 0.01).The prevalence rate of respiratory symptoms was positively correlated with age and duration and amount of cigarette smoking (P＜0.01),while negatively correlated with participants' education level (P＜0.01).Results from multivariate logistic regression analysis showed that gender,age,education level,smoking-related parameters,areas of residency (in urban or rural areas),etc.were appeared as influencing factors on the prevalence of respiratory symptoms.Conclusion The symptoms of chronic respiratory diseases appeared prevalent in Chinese population aged ≥40 years.Factors as older age,living in the central/western regions and smoking-related parameters were identified as of higher risks.
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<p><b>OBJECTIVE</b>To explore the efficacy of local acupuncture therapy on post-stroke pseudo-bulbar palsy and the clinical advantageous protocol of local acupuncture therapy.</p><p><b>METHODS</b>Eighty patients of post-stroke pseudo-bulbar palsy were randomized into a quick needle insertion group and a routine acupuncture group, 40 cases in each one. The western medicine, such as thrombolysis, lipid regulation, antiplatelet aggregation, antihypertension and hypoglycemic therapy method was all used in the two groups. On the basis of the treatment of western medicine, in the quick needle insertion group, the perpendicular needle insertion was used atpoint, about 8 to 12 mm in depth. When the emptiness feeling presented under the needle, the needle went slowly for 2 mm more depth till cough occurred, and removed afterward. The treatment was given once every day, and totally 20 treatments were required. In the routine acupuncture group, Lianquan (CV 23) was stimulated. The needle was inserted toward the tongue root, about 40 mm in depth. The needle was rotated till the patient felt soreness and distention at the tongue root, and then retained for 30 min. The treatment was given once a day, and totally 20 treatments were required. The water swallow test score and clinical efficacy were evaluated before and after treatment.</p><p><b>RESULTS</b>The curative rate was 80.0% (32/40) in the quick needle insertion group, better than 55.0% (22/40) in the routine acupuncture group (<0.05). The total effective rate was 97.5% (39/40) in the quick needle insertion group and was 90.0% (36/40) in the routine acupuncture group, indicating no significant difference in comparison (>0.05). The water swallow test scores decreased after treatment as compared with those before treatment in the two groups (both<0.01), and the water swallow test scores after treatment of the two groups had no significant difference (>0.05).</p><p><b>CONCLUSIONS</b>Acupuncture at local point is effective for post-stroke pseudo-bulbar palsy.The curative rate of quick needle insertion atpoint is better than routine acupuncture at Lianquan (CV 23).</p>
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An 8-year-old intact male Pekingese (weighing 13 kg) was presented for evaluation of chronic coughing. Thoracic radiography found a redundant tissue swelling (protruded on expiration and collapsed on inspiration) on the ventral neck just cranial to the thoracic inlet. Fluoroscopy also identified that the cranial portion of the right/left cranial lung lobe was seen to protrude through the thoracic inlet into the ventral neck on expiration. On the echocardiogram, there were no abnormal jets in all cardiac valves and no dilation in all cardiac chambers. Based on diagnostic imaging studies, the case was diagnosed as cervical lung lobe herniation.
Subject(s)
Animals , Child , Dogs , Humans , Male , Bays , Cough , Diagnostic Imaging , Fluoroscopy , Heart Valves , Lung , Neck , Radiography, ThoracicABSTRACT
Para determinar fracción espirada final de sevoflurane al retirar tubo orotraqueal y máscara laríngea sin compli-caciones en pacientes pediátricos, se elaboró estudio obser-vacional de tipo descriptivo y, transversal, seleccionando un total de 40 pacientes de pediatría quirúrgica (Hospital Universitario de Caracas) para cirugías urológicas y her-nioplastias, distribuidos en grupo T (tubo orotraqueal) y grupo M (máscara laríngea). Premedicados con Midazo-lam recibieron anestesia inhalatoria y bloqueo regional. Mantenimiento: O2/aire 50/50. Concluida la cirugía se retiró dispositivo según parámetros hemodinámicos, clí-nicos y ventilatorios. Hubo diferencias estadísticamente significativas entre ambos dispositivos para presión arte-rial sistólica y diastólica, tiempo retiro del dispositivo de la vía aérea salida del quirófano (TR) y complicaciones, no para fracción espirada. Se concluyó que para retiro de máscara laríngea y tubo orotraqueal, la fracción espirada final de sevoflurane fue de 0,66 y 0,87 respectivamente, siendo la máscara laríngea el dispositivo más recomenda-do por menor TR y menor número de complicaciones (AU)
To determine end-tidal sevoflurane fraction by removing endotracheal tube and laryngeal mask in pediatric patients without complications was developed observational and descriptive, transversal, selecting a total of 40 surgical pedia-tric patients (Hospital Universitario de Caracas) for surgery hernioplasties urological and distributed in group T (endo-tracheal tube) and group M (laryngeal mask). Premedicated with midazolam received inhalation anesthesia and regional blockade. Maintenance: O2/aire 50/50. Completed surgery withdrew device according to hemodynamic parameters, clinical and ventilator. Significant differences between the two devices for systolic and diastolic blood pressure, while removing the device from the air - out of the operating room (TR), and complications, not fractional exhaled. It was con-cluded that removal of laryngeal mask and endotracheal tube, the end-tidal sevoflurane fraction was 0.66 and 0.87 respectively, and the laryngeal mask device smaller than recommended by TR and fewer complications (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Midazolam/pharmacology , Laryngeal Masks , Sevoflurane/pharmacology , Intubation, Intratracheal/adverse effects , Blood Pressure , Child, Preschool , Laryngismus , Heart RateABSTRACT
Vocal cord paralysis is one of the most serious complications, which, in most situations, is preventable, associated with tracheal intubation. Unilateral vocal cord paralysis following tracheal intubation usually causes hoarseness. Postoperative vocal cord paralysis may be due to mechanical or neurogenic factors. The patient complained of hoarseness one day after operation and coughing on swallowing water ten days after operation. The vocal cords were examined with a fiberoptic nasopharyngolaryngoscopy and the right vocal cord was fixed in the paramedian position. We present a case of unilateral vocal cord paralysis following endotracheal intubation in a 71-year-old male patient with descending colon carcinoma and left renal cell carcinoma.
Subject(s)
Aged , Humans , Male , Carcinoma, Renal Cell , Colon, Descending , Cough , Deglutition , Hoarseness , Intubation , Intubation, Intratracheal , Vocal Cord Paralysis , Vocal Cords , WaterABSTRACT
Vertebral artery dissection (VAD) is a rare cause of young age stroke. This risky condition can be caused by even minor head or neck trauma. None of the previous studies has reported cough-related intracranial vertebral arterial dissection in Korea. We present two cases of cerebral infarctions from VAD induced by severe coughing. We should be alert to clinical manifestations of VAD to make proper diagnosis and to recognize coughing as a potential cause of VAD.
Subject(s)
Cerebral Infarction , Cough , Head , Korea , Neck , Stroke , Vertebral Artery , Vertebral Artery DissectionABSTRACT
PURPOSE: Primary immunodeficiency diseases are rare, innate defects of the immune system. Prompt diagnosis can lead to life-saving treatment and improvement in quality of life. We described the clinical features of primary immunodeficiency diseases which had been diagnosed in our institution during for 18 years. METHODS: Twenty-five patients diagnosed with primary immunodeficiency diseases were analyes in terms of their ages at diagnosis, presenting characteristics, types of primary immunodeficiency diseases and clinical courses. We retrospectively reviewed their medical records between 1990 and 2007 in Busan National University, Busan, Korea. RESULTS: Twenty males and 5 females were studied. Ages at diagnosis were variable, but 15 patiens (60%) were ages <3 years. The most common symptom was chronic coughing, and 12 patients were initially diagnosed as having bronchitis or pneumonia. Most patients had a past history of recurrent bronchitis, pneumonia or upper respiratory infections. Selective IgA deficiency was found in 11 cases (44%), panhypogammaglobulinemia in 3 cases (12%) and common variable immunodeficiency diseases such as DiGeorge syndrome and chronic granulomatous disease in 2 cases (8%), respectively. IgG4 deficiency and hyper IgE syndrome were found in 1 case, respectively. All patients with panhypogammaglobulinemia were regularly treated with IVIG, 1 patient chronic granulomatous disease was regularly treated with IFN-gamma. In many cases, upper respiratory infections, bronchitis, pneumonia, acute gastroenteritis, urinary tract infection were recurrent. CONCLUSIONS: Primary immunodeficiency diseases should be considered in children with recurrent or severe infections, because early diagnosis and treatment can reduce mortality and morbidity.
Subject(s)
Child , Female , Humans , Male , Bronchitis , Common Variable Immunodeficiency , Cough , DiGeorge Syndrome , Early Diagnosis , Gastroenteritis , Granulomatous Disease, Chronic , IgA Deficiency , Immune System , Immunoglobulin G , Immunoglobulins, Intravenous , Job Syndrome , Medical Records , Pneumonia , Quality of Life , Respiratory Tract Infections , Retrospective Studies , Urinary Tract InfectionsABSTRACT
<b>Objective</b>: Opioid analgesics are normally administered as monotherapy. However, we experienced a patient in whom alleviations of cancer pain, coughing and dyspnea were successfully achieved with the combination therapy of morphine and a fentanyl patch (FP), and the case is reported herein. <b>Case Report</b>: A woman in her fifties, suffering from sigmoid colon cancer, liver and lung metastases, and associated pain complicated with coughing and dyspnea, manifested symptomatic alleviations following the facilitation of treatment with morphine sulphate. Taking into consideration that oral intake would become difficult at some time in the future, treatment switchover to FP was planned. However, in view of the efficacy of fentanyl against coughing and dyspnea having not yet been firmly established, a low dose of morphine sulphate for coughing and dyspnea continued and cancer pain was controlled with FP. Thus, through continued combined use of the two ingredients, morphine and fentanyl, until treatment end, symptomatic alleviations of pain, coughing and dyspnea were able to be achieved. <b>Conclusion</b>: For patients experiencing difficulty with oral intake and suffering from coughing and dyspnea in addition to cancer pain, combined use of a low dose of morphine and FP is considered useful in achieving a stable alleviation of such symptoms.
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There were so many causes of chronic coughing including postnasal drip, pneumonia, nasal polyp, asthma, interstinal lung disease etc. Congenital bronchoesophageal fistula was not usually thought as cause of chronic coughing. A 46-year-old female patient suffered from chronic coughing without usual causes. Her chest X-ray viewed normally. She coughed especially after swallowing foods. So we recommended her esophagogram and it revealed broncho-esphageal fistula. She underwent surgical resection of broncho-esophageal fistula. She was well without cough after the surgery. We reported a case of congenital broncho-esphageal fistula that had caused chronic coughing without any evidence of pneumonia, malignancy, tuberculosis, bronchiectasis, inflammation, asthma, nasal polyp, etc. So we should suspect the bronchoesophageal fistula when patients cough chronically with eating, and recommend the esophagogram.