Postoperative Pain Following Eye Enucleation: A Prospective Observational Study.

Background and Objectives: Enucleation of an eye is the most invasive procedure in ophthalmologic surgery. It can be the result of various diseases (malignant/chronic/trauma/infection) and is nevertheless relatively rare, but leads to the loss of a strongly innervated neuronal organ. This study systematically evaluates postoperative pain levels following enucleation of the eye globe. Materials and Methods: This prospective single-center study enrolled twenty-four patients undergoing enucleation of the eye globe. Perioperatively all patients completed (preoperative day, day of surgery, 1st, 2nd, and 3rd day following surgery) standardized questionnaires concerning their pain experience and treatment-related side-effects (internal protocol, QUIPS, painDETECT®). Patients received usual pain therapy in an unstandardized individual manner. Results: Preoperatively, mean average pain intensity of all included patients was 3.29 ± 2.46 (range, 0-8), 3.29 ± 3.24 (range, 0-8) on the day of surgery, 4.67 ± 1.90 (range, 2-10) on day 1, 3.25 ± 1.39 (range, 1-6) on day 2, and 2.71 ± 1.30 (range, 1-6) on day 3 after surgery. Mean maximum pain intensity was 4.71 ± 3.28 (range, 0-10) preoperatively, 4.04 ± 3.78 (range, 0-10) on the day of surgery, 5.75 ± 2.01 (range, 2-10) on day 1, 4.25 ± 1.89 (range, 2-10) on day 2, and 3.88 ± 1.54 (range, 2-8) on day 3 after surgery. Nineteen patients (79.2%) stated that they would have preferred more pain therapy. Conclusions: Patients undergoing eye enucleation report pain sensations in need of intervention in this university hospital. Thus, effective standardized pain treatment concepts are now a high priority to be established in an interdisciplinary manner containing standardized regimens and continuous regional procedures. Awareness of this problem in the medical team should be sharpened through targeted training and information.

Impact of video quality when evaluating video-assisted cardiopulmonary resuscitation: a randomized, controlled simulation trial.

BACKGROUND: Although not routinely established during cardiopulmonary resuscitation (CPR), video-assisted CPR has been described as beneficial in the communication with emergency medical service (EMS) authorities in out-of-hospital cardiac arrest scenarios. Since the influence of video quality has not been investigated systematically and due to variation of quality of a live-stream video during video-assisted CPR, we investigated the influence of different video quality levels during the evaluation of CPR performance in video sequences. METHODS: Seven video sequences of CPR performance were recorded in high quality and artificially reduced to medium and low quality afterwards. Video sequences showed either correct CPR performance or one of six typical errors: too low and too high compression rate, superficial and increased compression depth, wrong hand position and incomplete release. Video sequences were randomly assigned to the different quality levels. During the randomised and double-blinded evaluation process, 46 paramedics and 47 emergency physicians evaluated seven video sequences of CPR performance in different quality levels (high, medium and low resolution). RESULTS: Of 650 video sequences, CPR performance was evaluable in 98.2%. CPR performance was correctly evaluated in 71.5% at low quality, in 76.8% at medium quality, and in 77.3% at high quality level, showing no significant differences depending on video quality (p = 0.306). In the subgroup analysis, correct classification of increased compression depth showed significant differences depending on video quality (p = 0.006). Further, there were significant differences in correct CPR classification depending on the presented error (p < 0.001). Allegedly errors, that were not shown in the video sequence, were classified in 28.3%, insignificantly depending on video quality. Correct evaluation did not show significant interprofessional differences (p = 0.468). CONCLUSION: Video quality has no significant impact on the evaluation of CPR in a video sequence. Even low video quality leads to an acceptable rate of correct evaluation of CPR performance. There is a significant difference in evaluation of CPR performance depending on the presented error in a video sequence. TRIAL REGISTRATION: German Clinical Trial Register (Registration number DRKS00015297 ) Registered on 2018-08-21.

Analyse und Management von postoperativen Schmerzen nach Sialendoskopie.

OBJECTIVE: Sialendocopy is a minimal-invasive technique used for the diagnosis and treatment of salivary gland diseases. The minimal-invasive character of sialendoscopy can be modified by using different surgical techniques. This is why both general and local anaesthesia are applied to perform this procedure and can be of great influence regarding the postoperative pain of those patients. The following study was performed to investigate the level of postoperative pain after sialendoscopy and its pain management. MATERIAL AND METHODS: 103 patients who were treated with a sialendoscopy of the parotid gland or submandibular gland in local anaesthesia between 2013-2015 were included in the study. The postoperative pain level was evaluated at rest and during periods of stress on the day of surgery and the first and second day after surgery. The pain level was analysed according to the numeric rating scale (NRS 0-10), which is used in the QUIPS project (Quality improvement of postoperative pain). RESULTS: The pain level on the day of surgery was 0,9 ± 1,9 at rest and 0,7 ± 1,4 during periods of stress. On the first postoperative day, pain levels of 1,2 ± 1,8 at rest and 0,9 ± 1,9 during stress were evaluated. On the second day after surgery there was a decrease of pain with a level of 0,75 ± 1,6 at rest and 0,73 ± 1,5 during stress. The analgesic therapy that was mostly used was Metamizol and Ibuprofen. 37,9 % of all patients received analgesic therapy on the day of surgery whereas on the first day after surgery only 26,2 % of all patients and on the second day after surgery only 12,6 % received pain medication. CONCLUSION: Sialendoscopy of the parotid gland and the submandibular gland is associated with moderate postoperative pain, which can be managed by using non-opioid analgesic therapy.

Fragment recruitment on metabolic pathways: comparative metabolic profiling of metagenomes and metatranscriptomes.

MOTIVATION: The sheer scale of the metagenomic and metatranscriptomic datasets that are now available warrants the development of automated protocols for organizing, annotating and comparing the samples in terms of their metabolic profiles. We describe a user-friendly java program FROMP (Fragment Recruitment on Metabolic Pathways) for mapping and visualizing enzyme annotations onto the Kyoto Encyclopedia of Genes and Genomes (KEGG) metabolic pathways or custom-made pathways and comparing the samples in terms of their Pathway Completeness Scores, their relative Activity Scores or enzyme enrichment odds ratios. This program along with our fully configurable PERL-based annotation organization pipeline Meta2Pro (METAbolic PROfiling of META-omic data) offers a quick and accurate standalone solution for metabolic profiling of environmental samples or cultures from different treatments. Apart from pictorial comparisons, FROMP can also generate score matrices for multiple meta-omics samples, which can be used directly by other statistical programs.