RESUMEN
OBJECTIVES: Sleep disturbances may contribute to the development of delirium, prolonged ICU stay, and increased mortality. There is conflicting data on the effectiveness of earplugs and eye masks for sleep promotion in the ICU. This study evaluates the impact of earplugs and eye masks on sleep quality in postoperative surgical ICU patients at risk for frequent awakenings. DESIGN: Prospective randomized controlled trial. SETTING: Surgical ICU within the University of Texas Southwestern Medical Center. PATIENTS: Adult, female patients admitted to the surgical ICU requiring hourly postoperative assessments following breast free flap surgery between February 2018 and October 2019. INTERVENTIONS: Patients were randomized into an intervention group or a control group. The intervention group received earplugs and eye masks in addition to standard postoperative care, whereas the control group received standard postoperative care. MEASUREMENTS AND MAIN RESULTS: The primary outcome was overall sleep quality assessed via the Richards-Campbell Sleep Questionnaire. Secondary outcomes of patient satisfaction and rates of ICU delirium were assessed with a modified version of the Family Satisfaction in the ICU survey and the Confusion Assessment Method for the ICU. After a planned interim analysis, the study was stopped early because prespecified criteria for significance were attained. Compared with the control group's average Richards-Campbell Sleep Questionnaire total score of 47.3 (95% CI, 40.8-53.8), the intervention group's average Richards-Campbell Sleep Questionnaire total score was significantly higher at 64.5 (95% CI, 58.3-70.7; p = 0.0007). There were no significant between-group differences for Confusion Assessment Method for the ICU scores or modified Family Satisfaction in the ICU survey scores. CONCLUSIONS: These results suggest that earplugs and eye masks are effective in improving sleep quality in ICU patients undergoing frequent assessments. The results strengthen the evidence for nonpharmacologic sleep-promoting adjuncts in the ICU.
Asunto(s)
Dispositivos de Protección de los Oídos/normas , Dispositivos de Protección de los Ojos/normas , Trastornos del Sueño-Vigilia/prevención & control , Adulto , Delirio/diagnóstico , Delirio/epidemiología , Dispositivos de Protección de los Oídos/estadística & datos numéricos , Dispositivos de Protección de los Ojos/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Ruido/efectos adversos , Estudios Prospectivos , Puntuación Fisiológica Simplificada Aguda , Trastornos del Sueño-Vigilia/epidemiología , Encuestas y Cuestionarios , Texas/epidemiologíaRESUMEN
Hatfield, DL, Murphy, KM, Nicoll, JX, Sullivan, WM, and Henderson, J. Effects of different athletic playing surfaces on jump height, force, and power. J Strength Cond Res 33(4): 965-973, 2019-Artificial turfs (ATs) have become more commonplace. Some aspects of performance such as speed seem to be better on ATs, but there are few published studies on the effects of playing surfaces on performance. Furthermore, there is no research that compares performance on ATs, hard surfaces (HSs), and different composite natural surfaces. Forty-three subjects, 21 men (age: 20 ± 1.82 years; height: 177.53 ± 5.87 cm; body mass: 78.44 ± 11.59 kg; and body fat: 11.17 ± 4.45%) and 22 women (age: 25 ± 1.32 years; height: 161.37 ± 6.47 cm; body mass: 60.94 ± 10.24 kg; and body fat: 27.16 ± 7.08%) performed a single countermovement jump (SCMJ), repeated CMJs (RCMJs), and single depth jump (SDJ) on 4 different playing surfaces (peat soil composition turf [NT1], sandy loam composition turf [NT2], 1 AT, and 1 HS. Repeated-measures analysis of variance with Bonferroni post hoc was used to calculate differences in performance across playing surfaces. Statistical significance was set at p ≤ 0.05. Force and jump height were not different across different surfaces. Men had significantly higher force, power, and jump height on all surfaces. Only SCMJ power was lower on NT1 compared with all other surfaces. The difference in power between surfaces was not reproduced when RCMJ and SDJ were performed, and may be due to the increased reactiveness of the stretch-shortening cycle during those jumps. Because of marginal differences between athletic performance and playing surface type, future research comparing playing surface type and other aspects of athletic success such as rate of injury should be considered.
Asunto(s)
Rendimiento Atlético , Movimiento , Fuerza Muscular , Adolescente , Adulto , Femenino , Humanos , Masculino , Propiedades de Superficie , Adulto JovenRESUMEN
A mutant allele (pol3-L612M) of the DNA polymerase delta gene in Saccharomyces cerevisiae that confers sensitivity to the antiviral drug phosphonoacetic acid (PAA) was constructed. We report that PAA-sensitivity tagging DNA polymerases is a useful method for selectively and reversibly inhibiting one type of DNA polymerase. Our initial studies reveal that replication by the L612M-DNA pol delta requires Rad27 flap endonuclease activity since the pol3-L612M strain is not viable in the absence of RAD27 function. The L612M-DNA pol delta also strongly depends on mismatch repair (MMR). Reduced viability is observed in the absence of any of the core MMR proteins-Msh2, Mlh1, or Pms1-and severe sensitivity to PAA is observed in the absence of the core proteins Msh6 or Exo1, but not Msh3. We propose that pol3-L612M cells need the Rad27 flap endonuclease and MMR complexes composed of Msh2/Msh6, Mlh1/Pms1, and Exo1 for correct processing of Okazaki fragments.