Lidocaine aerosol preoperative application for improving the comfort of pediatric patients undergoing tonsillectomy and adenoidectomy: A prospective randomized controlled trial.

Background and Aims: The use of lidocaine aerosol for pediatric tonsil and adenoidectomy has been reported less frequently. We hope to improve the perioperative comfort of pediatric patients undergoing these procedures by applying lidocaine aerosol. Methods: A total of 122 pediatric patients receiving tonsil and adenoidectomy were randomly divided into a lidocaine aerosol group (Group L) and a saline group (Group C), with 61 patients in each group; 2.4% alkaline lidocaine aerosol and saline were sprayed in the pharynx before induction. Our primary outcome were the incidence and rate ratio (RR) of postoperative pharyngeal complications (oropharyngeal dryness, dysphagia, hoarseness, and sore throat) and the pharyngeal comfort score, the latter of which was assessed by the occurrence of the above complications (yes = 0 point, none = 1 point). The secondary outcomes included preoperative and intraoperative blood pressure and heart rate, the incidence of choking during the induction period, the intraoperative opioid dosage, and the pain level and depth of sedation at 2, 6, and 24 h postoperatively. Statistical software used in this study included PASS15.0, SPSS 26.0, and GraphPad Prism 9.3.1, and statistical methods used included the t-test, the χ² test, the Mann-Whitney U test, and the repeated measures analysis of variance. Results: The incidence and RR of postoperative pharyngeal complications such as oropharyngeal dryness (RR: 0.667, 95% confidence interval [CI]: 0.458-0.970, p = 0.03), dysphagia (RR: 0.333, 95% CI: 0.114-0.976, p = 0.03), hoarseness (RR: 0.647, 95% CI: 0.433-0.967, p = 0.03), and sore throat (RR: 0.727, 95% CI: 0.547-0.967, p = 0.03) were significantly lower in Group L than in Group C at 2 h postoperatively, and the incidence and RR of postoperative sore throat was significantly lower in Group L than in Group C at 6 h postoperatively (RR: 0.717, 95% CI: 0.547-0.942, p = 0.01). The postoperative pharyngeal comfort scores were significantly higher in Group L than in Group C at all postoperative time points (p < 0.05). The Ramsay sedation score was significantly higher (p < 0.01) and FLACC (face, legs, activity, crying, and consolability) score was significantly lower (p < 0.01) in Group L than in Group C at 2 h postoperatively. In Group C, the blood pressure and heart rate significantly faster at all time points immediately after intubation and afterward, except at the end of surgery (p < 0.05). Conclusions: In pediatric tonsil and adenoidectomy, the application of lidocaine aerosol before induction can reduce the incidence of postoperative pharyngeal complications, improve the child's postoperative pharyngeal comfort, and better realize perioperative "comfort medical treatment."

The Value of the Optic Nerve Sheath Diameter (ONSD) in Predicting Postdural Puncture Headache (PDPH): A Prospective Observational Study.

BACKGROUND: Postdural puncture headache (PDPH) is one of the serious complications after lumbar puncture, but there is no effective tool to predict it. OBJECTIVES: To explore whether ultrasound measurement of optic nerve sheath diameter (ONSD) as a predictor of PDPH can be a reliable tool supported by reliable protocols and data. STUDY DESIGN: A prospective observational study. SETTING: Department of Anesthesiology. METHODS: This prospective observational study was performed in 156 patients undergoing cesarean section (CS). The patient's ONSD was recorded before anesthesia (T0), 10 minutes after anesthesia (T1), at the end of the operation (T2), at the first postoperative day (T24), at the second postoperative day (T48), and the third postoperative day (T72). During the 3-day follow-up, the patients were evaluated, identified, and divided into a PDPH group and a non-PDPH group. Age, weight, height, ASA, lumbar puncture location, and the number of lumbar puncture attempts were also recorded. We mainly analyzed the changes and differences between the 2 groups of ONSD. RESULTS: Twenty-four patients (15%) developed PDPH. The ONSD was significantly lower in the PDPH group than in the non-PDPH group at T2, T24, T48, and T72. All patients showed a significant reduction in ONSD at T1 compared to T0. Women whose ONSD continued to fall without recovery from T0 to T2 were more likely to experience PDPH (RR 5. 022; 95 CI 3.343 to 7.508). The ONSD at T24 was the best predictor of PDPH (ACU 0. 9787, 95 CI 0.9578 to 0.9996), with a cutoff value of 0.40 cm (sensitivity 92%, specificity 94%). LIMITATIONS: This is a single-center study, and ONSD may vary in different regions or ethnic groups. CONCLUSIONS: We believe that continuous measurements of ONSD may be a useful tool for predicting PDPH.

Social media in dietetics: Insights into use and user networks.

AIM: Social media has transformed the interaction between healthcare professionals and consumers, yet research of its use in dietetics is limited. The aim of this study was to investigate the influence of dietetic user networks on use of social media and test the applicability of a social media metrics tool to determine influential users. METHODS: An online survey about social media use and practices based on the scientific literature was developed and implemented online with dietitians. Feasibility of a social media metrics analysis was conducted via Twitter using the NodeXL metrics tool to determine influential dietetic networks based on four measures of network centrality (betweenness, eigenvector, closeness and degree). RESULTS: The survey (n = 340) revealed social networking sites were the most widely used (by user) (n = 282) and micro-blogging was the most regularly used (by frequency of use). Among respondents who used social media in a professional capacity (n = 130), the greatest benefit was communicating internationally and remotely while the delivery of health care was of least benefit. The majority of respondents (87.3%) indicated their primary efforts were to maintain e-professionalism. Time restraints (18.6%) and not knowing where to start (18.6%) were common barriers to use. Highly influential connections between users were observed from network visualisations of dietitians in Australia and the United States. CONCLUSIONS: Professional use of social media among dietitians needs to be monitored over time for shifts of influential networks. Influential users from key networks can be identified from metrics analyses and should be engaged via professional bodies to upskill new users.

Fine mapping a major QTL for kernel number per row under different phosphorus regimes in maize (Zea mays L.).

Phosphorus (P) is one of the essential macronutrients for plant growth and development. Grain yield is the primary trait of interest in maize breeding programs. Maize grain yield and yield-related traits are seriously affected by P deficiency. Kernel number per row (KN), as one of the major components of grain yield, has attracted the attention of more and more breeders. In our previous study, one major QTL (named qKN), controlling KN under different P regimes was mapped to the interval between molecular markers bnlg1360 and umc1645 on chromosome 10 using a F 2:3 population derived from the cross between maize inbreds 178 and 5,003 (107). In order to understand its genetic basis, we developed a population of near isogenic lines (NILs) and two P regimes were used to fine map and characterize qKN. The QTL qKN was finally localized in a region of ~480 kb. A single qKN allele of inbred 178 increased KN by 6.08-10.76 % in the 5,003 (107) background; qKN acted in a partially dominant manner. Our results will be instrumental for the future identification and isolation of the candidate gene underlying qKN. The tightly linked molecular markers that we developed for qKN will be useful in maize breeding programs for improving KN applying the marker-assisted selection.