RESUMO
PURPOSE: This research was done to assess the effectiveness of two manual reduction techniques for elbow subluxation and to determine which technique was less painful during trial of manual reduction. METHODS: A prospective, controlled, randomized survey was conducted on children who presented to the Emergency Department (ED) of an inner-city university hospital with clinical features and physical findings suggestive of an elbow subluxation between Mar 1, 2007 and February 28, 2008. We evaluated the success rate of each reduction technique and the pain scale during trial of manual reduction. We classified each group into 2 subgroups (under 3 years of age and over 3 years of age) for evaluating the pain score. The degree of pain was determined using the FLACC scale (under 3 years of age) and faces pain scale (over 3 years of age). RESULTS: One hundred and four children were enrolled in our study and they were equally divided into a supination group (SG) and a pronation group (PG). There was no statistically significant difference with regards to the demographic data between the two groups. The success rate for the SG was 85.7% and for PG was 91.7% (p=0.32). For patients under 3 years of age, the FLACC scale for the SG was 5.14 and for PG was 3.82 (p=0.01). For patients over 3 years of age, the face pain scale for the SG was 5.5 and for PG was 5.54 (p=0.83). CONCLUSION: Both reduction techniques are useful for reducing elbow subluxations. In case of children under 3 years old, we believe that the pronation technique is a better option due to lesser pain produced compared to the supination technique.
Assuntos
Criança , Humanos , Luxações Articulares , Cotovelo , Articulação do Cotovelo , Emergências , Dor Facial , Medição da Dor , Pronação , Estudos Prospectivos , SupinaçãoRESUMO
The incidence of serious cardiac complications associated with esophagogastro-duodenoscopic examination is very rare. An episode of cardiac arrest developed in 49-year-old during endoscopic examination. The patient had no history of pulmonary or ischemic heart disease. After cardiopulmonary resuscitation, he recovered completely. In this patient, we were able to demonstrate a focal spasm by coronary angiography.
Assuntos
Humanos , Pessoa de Meia-Idade , Reanimação Cardiopulmonar , Angiografia Coronária , Vasoespasmo Coronário , Endoscopia do Sistema Digestório , Parada Cardíaca , Incidência , Isquemia Miocárdica , EspasmoRESUMO
The incidence of serious cardiac complications associated with esophagogastro-duodenoscopic examination is very rare. An episode of cardiac arrest developed in 49-year-old during endoscopic examination. The patient had no history of pulmonary or ischemic heart disease. After cardiopulmonary resuscitation, he recovered completely. In this patient, we were able to demonstrate a focal spasm by coronary angiography.
Assuntos
Humanos , Pessoa de Meia-Idade , Reanimação Cardiopulmonar , Angiografia Coronária , Vasoespasmo Coronário , Endoscopia do Sistema Digestório , Parada Cardíaca , Incidência , Isquemia Miocárdica , EspasmoRESUMO
BACKGROUND/AIMS: Polyethylene glycol (PEG) electrolyte lavage solution is now commonly used for peroral colonic preparation. However, the need to ingest a large volume reduces patient acceptance and may limit compliance, thereby resulting in improper preparation. This study was designed to assess whether adding of magnesium oxide or cisapride to PEG solution decreased the volume of PEG solution required without compromising the quality of the preparation. METHODS: One hundred thirty seven patients undergoing outpatient colonoscopy were randomly chosen to receive one of three preparations (Group A: 4 L PEG; Group B: 2 L PEG plus cisapride 20 mg; Group C: 2 L PEG plus magnesium oxide 2 g). Endoscopist was blinded as to the method of preparation and scored the degree of colonic preparation (1 to 4). RESULTS: Mean scores of preparation in group A, B, and C were 2.85, 2.69, and 2.20, respectively (p=0.001). There were significant differences of the degree of preparation between group A and group C, between group B and group C, but not between group A and group B. CONCLUSIONS: Two liters of PEG plus cisapride induced equally effective colonic preparation compared to four liter PEG solution. This results show that the addition of cisapride to PEG solution can reduce volume of PEG solution during colonoscopy preparation.