Benefits of using intrathecal buprenorphine

Background: General anesthesia draws attention to the most commonly used modalities for post cesarean delivery pain relief in systemic administration of opioids, while the administration of small dose of intrathecal opioid during spinal anesthesia can be a possible alternative. The aim of this study was to evaluate the effects of buprenorphine on cesarean section prescribed intrathecally. Methods: This double blind randomized clinical trial study was conducted in patients for cesarean section under spinal anesthesia. The patients were randomly divided into case and control groups. Case group (208 patients) received 65-70 mg of 5% lidocaine plus 0.2 ml of buprenorphine while the same amount of 5% lidocaine diluted with 0.2 ml of normal saline was given to 234 cases in the control group. Hemodynamic changes and neonatal APGAR scores (Appearance, Pulse, Grimace, Activity, Respiration) were recorded. Pain score was recorded according to the visual analog scale. This study was registered in the Iranian Registry of clinical Trials; IRCT2013022112552N1. Results: The mean age of case and control groups was 24.4±5.38 and 26.84±5.42 years, respectively. Systolic blood pressure was not significantly different until the 45th minute but diastolic blood pressure showed a significant difference at the 15th and the 60th minutes (P<0.001). Heart rate changes were significantly different between cases and controls at the initial 5th, 15th and after 60th minutes (P<0.001). Pain-free period was significantly different between two groups (1.25 h versus 18.73 h) (P<0.001). Conclusion: The results show that prescription of intratechal buprenorphine prolongs the duration of analgesia without any significant considerable side effects

Transfusion-related acute lung injury in multiple traumatized patients

Background: Many of the multiple traumatized patients who refer to the hospital need transfusion. Transfusion-related acute lung injury (TRALI) is a serious clinical syndrome associated with the transfusion of plasma-containing blood components. In the article, we present a case of TRALI following transfusion of packed red blood cells Case Presentation: A 24 year old male referred to Shahid Beheshti Hospital due to multiple trauma with left femoral and humerus fractures. Due to severe anemia he received 3 units of packed red blood cells. The symptoms of TRALI began 2 hours after transfusion. He was transferred to intensive care unit (ICU) due to metabolic acidosis and severe hypoxia. The TRALI was confirmed after ruling out the other probable pulmonary diseases. He recovered and was discharged. Conclusion: Transfusion related acute lung injury should be considered in any case receiving transfusion of plasma containing blood components

Serum lactate as a prognostic factor in coronary artery bypass graft operation by on pump method

Background: Lactic acidosis in cardiac surgical patients is a manifestation of systemic inflammation and excess pro-inflammatory cytokine production. This investigation was designed to integrate basic concepts about lactate acidosis with a clinically used of serum lactate in patients under coronary artery bypass surgery (CABG) by on pump method. Methods: From August to September 2012, 15 patients scheduled for routine cardiac surgery entered to our sample and followed up two weeks. Lactate concentration in arterial blood sample was studied. Method of surgery duration of cardiopulmonary bypass, aorta cross clamp timing, hemodynamic parameters, inotrope dosage and patient outcome were documented. The data were collected and analyzed. Results: The mean age of the patients was 62±14 years. The patients with a poor outcome had significantly higher lactate levels in ABG samples (p0.05). The PH of ABG samples did not generally correlate with the ABG lactate concentration (r=0.116, p=0.68). Increased lactate concentration was reliably associated with patient hemodynamic parameters, inotrope dosage, duration of on pump time and aorta cross clamp time. Conclusion: This study demonstrates a correlation between serum lactate levels and patient prognosis after CABG surgery by on pump method

Using Global Positioning System to Compare Training Monotony and Training Strain of Starters and Non-Starters across of Full-Season in Professional Soccer Players

Soccer is an attractive and popular team sport that has high physiological and fitness stress, and therefore requires special and controlled training programs during the season. The aim of this study was to describe the weekly average and changes in training monotony (TM) and training strain (TS) throughout different periods of the season in professional football players based on the number of accelerations and decelerations, and also to analyze the difference between starters and non-starters players in TM and TS. Nineteen professional players from a soccer team competing in the Iranian Premier League (age, 28 +/- 4.6 years; height, 181.6 +/- 5.8 cm; body mass, 74.5 +/- 5.6 kg, and body mass index, 21.8 +/- 1.0 kg/m(2)) participated in a cohort study. Participants were divided into two groups based on the time of participation in the weekly competition: starters (N = 10) or non-starters (N = 9). The physical activities of the players were recorded during the training sessions and competitive matches of 43 weeks using GPSPORTS systems Pty Ltd. During pre- and end-season TS was not significantly different between starters and non-starters, while during early- and mid-season starters showed a higher TS than non-starter (p < 0.05). TS was higher during early- and mid-season compared to pre- and end-season. In all zones on both the TM and TS variables, non-starters experienced higher change percentages and coefficient of variation. TM during the season in all zones of accelerations was not significantly different between starters and non-starters. while during mid-season starters showed a higher TM than non-starters in all zones of decelerations (p < 0.05). TM data showed fluctuations and w-shaped graphs in the week-by-week survey. These results indicate that training during early- and mid-season is not enough for the physical development of non-starters soccer players. Coaches should be more careful when designing training for non-starters players, and they could consider the use of game simulation, preparatory match or intra-team match, or individual training programs

Seasonal incidence of type I diabetes mellitus in the north of Iran

Background: Type I diabetes mellitus (T1DM) with growing frequency which is considered as a world health threatening problem is an autoimmune disease with insulinupenia. Considering the relationship between the incidence of T1DM and environmental factors, the aim of this study was to assess seasonal incidence of T1DM and its association with birth season. Methods: This cross-sectional study was conducted on 112 diabetic patients (66 males, 46 females) less than 18 years, referred to Pediatric Endocrine Clinic (Amirkola Children's Hospital) during 2011-2017. All the needed information was extracted from the patient's files and asking questions of their parents. Data were collected in a checklist. Comparison between different seasons and age groups was done by Pearson's chi-square test. Data were analyzed using SPSS 19 and p&#163;0.05 was considered significant level. Results: The mean age of the patients during diagnosis of T1DM was 7.34&#177;3.70 years. The incidence of T1DM was significantly increased in the cold seasons (especially winter) (P&#60;0.008). A more increased incidence was seen in cold seasons in the aged group of 5-9 years old compared to other groups. However, no significant difference was found in all groups in terms of birth season. Conclusions: The results of this study suggest the effects of season as an environmental factor on diabetes incidence. This seasonal diversity is more prominent in the age less than 10 years. So, attention to maintaining the public health and to preventing from viral infections in cold seasons is recommended

Analysis of Continuous Gait Data Requires Temporal Alignment of Gait Phases

A statistical method for comparing time-continuous curves, such as the kinematics of gait cycles, is statistical parametric mapping analysis (SPM) (Pataky, 2010). According to a recent study, SPM results were sensitive to how each stride\u27s beginning was defined (Honert & Pataky, 2021). Nonetheless, for meaningful comparisons between gait cycles, temporal alignment of phases within a stride may be required (Helwig et al., 2011). With both temporally aligned and unaligned gait data, the goal was to evaluate SPM results for different walking speeds using various gait cycle definitions. Participants in this study were 10 young, healthy adults. To figure out the preferred overground speed, an instrumented mat was employed. While subjects walked at speeds of 80, 90, 100, 110, and 120% of the preferred pace, a ten-camera Vicon motion capture system, Conventional Gait Model 2.4, and Nexus 2.13 software were used to collect biomechanical data of the legs. Using customized MATLAB code, 100 gait cycles at each speed for each participant were chosen and temporally aligned to the five gait phases (loading response, mid and terminal stance, pre-swing, initial and mid swing, and terminal swing) based on kinematic events of interest. Five distinct stride definitions were used in SPM using a one-way repeated measures ANOVA, both with and without the temporal alignment of gait phases. SPM results for unaligned gait data varied between different stride definitions but were consistent for data that was temporally aligned. SPM\u27s results for aligned data consistently demonstrate that time normalization, not stride definition, is what makes SPM sensitive. For a point-by-point comparison of gait kinematics using SPM, the phases must be time-aligned.https://digitalcommons.odu.edu/gradposters2023_healthsciences/1010/thumbnail.jp

Acute and chronic workload ratios of perceived exertion, global positioning system, and running-based variables between starters and non-starters: a male professional team study

The study aim was 2-fold (i) to describe and compare the in-season variations of acute: chronic workload ratio (ACWR) coupled, ACWR uncoupled, and exponentially weighted moving average (EWMA) through session-rated perceived exertion (s-RPE), total distance (TD), high-speed running distance (HSRD), and sprint distance across different periods of a professional soccer season (early, mid, and end-season) between starters and non-starters; (ii) to analyze the relationship the aforementioned measures across different periods of the season for starters and non-starters. Twenty elite soccer players (mean±SD age, 29.4±4.4 y; height, 1.8±0.1m; and body mass, 74.8±2.3kg). They were divided into starter and non-starter groups and were evaluated for 20weeks. ACWR had general changes throughout the season. At the beginning and end of the mid-season, the highest ACWR was observed in three parameters: s-RPE, TD, and HSRD. ACWR and EWMA through sprint distance were higher at the beginning of the early-season than at any other time of the season. The ACWR coupled of s-RPE shows a significant higher value for non-starters than starters (p=0.015; g=−1.01 [−1.98, −0.09]) and the ACWR coupled of TD shows a significant higher value for starters than non-starters in early-season (p<0.01; g=3.01 [1.78, 4.46]) and shows a significant higher value for non-starters than starters in mid-season (p<0.01; g=−2.52 [−3.83, −1.39]), and end-season (p<0.01; g=−2.57 [−3.89, −1.43]). While the EWMA of TD shows a significant higher value for starters than non-starters in early season (p<0.01; g=2.25 [1.17, 3.49]) and mid-season (p<0.01; g=2.42 [1.31, 3.71]), and shows a significant higher value for non-starters than starters in end-season (p<0.01; g=−2.23 [−3.47, −1.16]). Additionally, we found some correlations between external and internal load measures during three periods of the in-season. The study’s main finding was that the indexes of ACWR and EWMA were useful to detect differences between period and between playing status with the exception for the sprint variable. In addition, the necessary work for non-starter players’ improvement is not done during training, and these players lose their readiness as the season progresses. Consequently, these players perform poorly during the match. Therefore, coaches and their staff should consider devising new activities to keep non-starter players physically fit. This deficit must be accounted for in training because they compete in fewer matches and have less burden than starters.info:eu-repo/semantics/publishedVersio

Spiritual health and life satisfaction in older adults in Shahrekord hospitals, 2013

Background and aims: It is in high importance to pay attention to different aspects of health and well-being in the elderly age. So, this study was conducted with the aim of investigating the association between spiritual health and life satisfaction in the elderly hospitalized in Shahrekord hospitals. Methods: In this cross-sectional study, 308 elderly hospitalized in medical internal and surgical wards were enrolled into study by convenience sampling in 2013. The tools of gathering data were Spiritual Well-Being Scale and Life satisfaction Scale questionnaires. After collecting data, they were analyzed using SPSS software and independent t-test and one-way ANOVA tests. Results: Spiritual health in 51.3% of the elderly was low and the mean score for spiritual health was 86.16±18.61. Spiritual health was significantly associated with marital status, age, and number of children (P≤0.001). Life satisfaction was high (slightly satisfied, satisfied and very satisfied) in 63.9% of the elderly with mean score of 20.80±5.8 Life satisfaction was associated with demographic characteristics such as gender (P=0.002), social status (P=0.001), and number of children (P=0.001). There was a positive, significant association between spiritual health and life satisfaction (P≤0.001). Conclusion: Over half of the elderly reported their spiritual health in low level, but most of them had a high level of life satisfaction. Therefore, it seems necessary to conduct religious interventions to promote spiritual health in hospitalized elderly