Analysis of predictable factors of intra-operative aneurysm rupture of anterior circulation aneurysm treated by clipping / 中国综合临床

Objective To discuss the predictable factors for the occurrence of intra-operative aneurysm rupture(IAR).Methods A total of 84 patients with 101 aneurysms treated by neurosurgical clipping from September 2009 to September 2014 were retrospectively analyzed.The statistic analysis was performed for the risk factors of IAR such as aneurysm location,aneurysm sac,dome/neck ratio,direction,pre-operative Hunt-Hess Scale,history of hypertension and operation time.Results Eighteen cases (21.4％) occurred LAR (18 (17.8％) of aneurysms) during the operations,2 patients (2.4％) died.Statistic analysis revealed that preoperative Hunt-Hess scale (P =0.042),history of hypertension (P =0.038),aneurysm sac (P =0.012),dome/neck ratio(P=0.027),direction (P =0.010) and operation time (P =0.002) were the predictable factors for the occurrence of IAR,while the location of aneurysm was not included (P =0.199).Conclusion The IAR may be the result of the synthesis of various factors in the occurrence of intracranial aneurysms clipping.Hypertension history,Hunt-Hess scale,direction,aneurysm sac,operation time and dome/neck ratio 1.78-2.89 are the predictable factors for the occurrence of IAR and the combination of various factors leads to the occurrence of IAR.

Factores previsibles en la salud física y psicosocial del cuidador crucial del anciano con demencia en el hogar / Predictable factors in physical and psychosocial health of crucial carer of elderly presenting with dementia at home

Para algunos autores el cuidador crucial es un paciente oculto o desconocido que precisaría de un diagnóstico precoz de su enfermedad y de una oportuna e inmediata intervención. Con el objetivo de caracterizar la correlación existente entre múltiples factores que previsiblemente influyen en la salud del cuidador crucial del anciano con demencia en el hogar, se realizo un estudio con diseño descriptivo de corte transversal en 116 cuidadores, del área de salud Finlay, municipio Camagüey, entre Julio 2006 y diciembre 2008. Se obtuvo como resultados valores significativos en las correlaciones realizadas, y se observó un nivel de capacitación inadecuado del 78,1 por ciento, ausencia de un cuidador sustituto en el 81,6 por ciento, con una relación entre el tiempo como cuidador y el grado de sobrecarga percibida en el 75,8 por ciento de los casos. Esto resultados que nos permitieron proponer recomendaciones preliminares, en aras de mantener o restablecer los factores protectores de la salud física, psicológica y social de los cuidadores cruciales y su repercusión en la atención y el cuidado al anciano con demencia en el hogar(AU)

For some authors the crucial carer is a ùhiddenù or ùunknownù patient in whom it is necessary an early diagnosis of his disease and also of a proper and immediate intervention, To characterize the correlationship between multiple factors that may to influence in the health crucial carer of elderly presenting with dementia at home, a cross-sectional and descriptive study was conducted in 116 carers from the ùFinalyù health area of Camaguey municipality between July, 2006 and December, 2008. As result there were significant values in the correlationships carried out and also an inappropriate training of 78,1 percent, a lack of a substitute carer in the 81,6 percent with a relation to the time as carer and the overload level present in the 75,8 percent of cases. These results allowed us to propose preliminary recommendations to maintain or to restore the factors protecting the physical, psychological and social health of crucial carers and its repercussion on the care and management of elderly presenting with dementia at home(AU)

Predictable Factors of Postoperative Pain Following LASEK

PURPOSE: To determine predictable factors of postoperative pain and cut-off values following LASEK eye surgery. METHODS: Thirty-three eyes of 17 patients who underwent LASEK from May to December 2008 were reviewed. For evaluation of predictive factors, patients' anxiety level was converted to APAIS, HADS, STAI, and VAS preoperatively. Substance P and prostaglandin E2 levels in tears, blood pressure, heart rate, and history of any previous surgery were determined before the procedure. Thirty minutes and 1 day after LASEK, the subjective degree of pain was scored. RESULTS: Patients with high Amsterdam preoperative anxiety scale (APAIS) and Visual analogue scale (VAS) scores showed more postoperative pain (p=0.04, p<0.001). Higher substance P and prostaglandin E2 levels were significantly related with more severe pain after LASEK (p<0.001, p<0.001). Postoperative pain increased significantly, according to cut-off values (p<0.05), APAIS and VAS scores greater than 6, substance P greater than 631.84 pg/ml, and prostaglandin E2 greater than 783.90 pg/ml. CONCLUSIONS: The level of pain after LASEK surgery varies individually, and many factors, including physical and psychological variances, can affect the pain. With higher APAIS/VAS scores and higher concentrations of substance P, prostaglandin E2 portends more severe pain following LASEK.

Predictability of Neurocognitive Functions on the Treatment Effect in Schizophrenia / 신경정신의학

OBJECTIVES: This study was to investigate a wider range of neurocognitive function tests to find out how accurately each subtest could predict the outcomes of treatment in schizophrenics. METHODS: The subjects were 33 inpatients diagnosed as schizophrenia according to DSM-IV. Each subject had a drug wash-out period of at least 1 week, and had been given K-WAIS, WMS-R, and Signal Detection, Decision Reaction Timer, and Motor Performance Series in Vienna Test System just before drug administration. Treatment response was evaluated with BPRS and CGI scales before and 8 weeks after drug treatment. We divided the subjects into responders and non-responders according to the outcomes of the above clinical scales in week 8. The responder group was defined with having 20% increase in BPRS score and a CGI score of less than 3. Then we compared the neuropsychological test results between the two groups. RESULTS: Significantly different results between responders and non-responders were Verbal IQ and Full Scale IQ in K-WAIS, the number of correct responses in Signal Detection and Decision Reaction Timer in Vienna Test System. In discrimination analysis of the two groups using these subtests as variables, we could predict the responders with 66.7% accuracy, even though statistically non-significant. CONCLUSION: Although discriminating between responders and non-responders using neurocognitive function tests were proven to be statistically non-significant, the possibility that neurocognitive function tests can be utilized to predict the treatment outcome in schizophrenia cannot be completely ruled out.