RESUMO
A randomized, prospective study was conducted on 69 patients comparing recovery after two different anaesthetic techniques for ambulatory colonoscopy. Thirty-five patients received an intravenous fentanyl (1 microg/kg), midazolam (0.05 to 0. 075 mg/kg) and propofol (10 to 20 mg boluses as required) combination. 34 patients received sevoflurane in 67% nitrous oxide. Drug administration was titrated to clinical signs. At baseline and 30, 60, 90 and 120 minutes after the procedure patient performance on a comprehensive battery of psychomotor tests was recorded. Emergence times were noted. Depth of sedation was assessed at 5 minute intervals for 30 minutes after the end of the procedure. Emergence times were faster in the fentanyl/midazolam/propofol group by 2.2 minutes. A lower sedation score was detected at 20 minutes in the sevoflurane/nitrous oxide group. Psychomotor impairment was of a greater magnitude and more prolonged by 30 to 90 minutes in the fentanyl/midazolam/propofol group. It is concluded that a sevoflurane/nitrous oxide anaesthetic has a suitable recovery profile for ambulatory colonoscopy and results in faster recovery of cognitive function compared with a fentanyl, midazolam and propofol combination.
Assuntos
Período de Recuperação da Anestesia , Anestesia por Inalação , Anestesia Intravenosa , Colonoscopia , Desempenho Psicomotor , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestésicos Combinados , Anestésicos Inalatórios , Anestésicos Intravenosos , Fentanila , Humanos , Memória , Éteres Metílicos , Midazolam , Pessoa de Meia-Idade , Óxido Nitroso , Propofol , Estudos Prospectivos , Tempo de Reação , Sevoflurano , Método Simples-CegoRESUMO
UTOPIA (UTilities for OPtimizing Insulin Adjustment) is a prototype computer system proposed to support home data analysis and therapy recommendations for the individual patient. The paper describes methods of analysis and their incorporation into an overall system design that matches the iterative practices at the physician-patient consultation from visit to visit. Four modules support home data display and comparison with clinical measurements; extraction of blood glucose trends and daily cycles using time series analysis, learning relationships between insulin adjustments and changes in time series patterns via a parametric, linear systems model; and advice generation by solving the linear equation for candidate insulin adjustments. Concepts and methods are placed in context, with a discussion of comparable and related research.
Assuntos
Automonitorização da Glicemia , Diabetes Mellitus/tratamento farmacológico , Quimioterapia Assistida por Computador , Sistemas Inteligentes , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Algoritmos , Relação Dose-Resposta a Droga , Humanos , Modelos Lineares , Microcomputadores , Modelos Biológicos , Interface Usuário-ComputadorAssuntos
Coroas , Porcelana Dentária , Dente/anatomia & histologia , Cor , Estética Dentária , Humanos , Óptica e FotônicaRESUMO
A technique has been described which permits the use of desirable natural anterior teeth in complete dentures (Fig. 3). The main characteristic of this technique is the use of cast copings with dowels to which the natural teeth are attached. The cast copings securely fit the natural teeth to the base of the denture (Fig, 4). The use of NATURAL teeth in a denture may encourage discoloration of fracture. Discoloration of the natural teeth may be prevented by the immediate removal of the pulp tissue, the attentive cleaning of the pulp chamber with normal saline, and the storage of the teeth in an atmosphere of 100 per cent humidity. Adequate vertical and horizontal overlaps insure stability of the denture and suitable protection of the natural teeth from cracknig or curshing during function of the denture. If accidental fracture or discoloration of a natural tooth should occur, ti may be replaced by an acrylic resin tooth duplicated from the natural tooth or by an artifical tooth of proper size and color.
