Relationship of percutaneous tracheostomy timing with APACHE II and SOFA scores on the first day of ICU for critically ill patients

Objective: Our study aimed to assess the relation between APACHE II and SOFA scores of critically ill patients on their first day of admission and the timing of percutaneous dilatational tracheotomy (PDT).Methods: Following approval of the Ethics Board of Health Sciences University Istanbul Bağcılar Educational Research Hospital (25.08.2016-2016/495), data of all 91 patients who had been treated with PDT in the ICU between June 1, 2014 and June 1, 2016 have been retrospectively evaluated. We recorded the following information: demographical data (such as age, sex, body mass index) that could be obtained from patient records, APACHE II and SOFA scores on their first day in ICU, and PDT timing.Results: There was no statistically significant difference observed between the timing of the PDT and APACHE II and SOFA scores (p>0.05).Conclusion: Our results showed that most of the patients with PDT had an APACHE II score of 15-24. We noticed that the number of patients with an APACHE II score of 24 and higher was notably lower than the number of patients with scores between 15-24. The fact that the life expectancy for the patient group with a high APACHE II score is low may call the tracheostomy decision into question. On the other hand, no relation was found between differences in APACHE II and SOFA scores and the starting time of PDT

Individual or Group Psychoeducation: Motivation and Continuation of Patients with Bipolar Disorders

Bipolar disorder is a lifelong devastating illness with recurrent mood episodes. Pharmacologic treatments have limited efficacy in long-term prophylactic treatment. Psychosocial interventions and structured psychotherapies as add-on treatments have been shown effective in relapse prevention in the last decade. Psychoeducation of patients and families seems to be a useful first step in the psychological treatment of bipolar disorder. However, the content and dimensions of efficacy of well-structured psychoeducation have not yet been established. The patient's perspective may have an impact on efficacy in the areas of attitude, motivation, and continuation/dropout rate. These factors are compared and discussed in individual and group psychoeducation using data from two ongoing studies. The variables of two studies in the recruitment phase were compared. Bipolar patients were more willing to attend individual psychoeducation than group psychoeducation, which resulted in lower dropout rates, but did not reach a level of statistical significance. It was concluded that patients with bipolar disorder are less willing to attend and continue group psychoeducation than individual psychoeducation. Patient preferences, motivations, and the positive and negative aspects of group and individual psychoeducation should be kept in mind when psychoeducation is planned

Effectiveness of Individual Psychoeducation on Recurrence in Bipolar Disorder; A Controlled Study

This research was conducted as an controlled experimental study which aimed to determine the effectiveness of individual psychoeducation program on recurrence rate during 1 year follow up period. The study included eighty-two patients who had been diagnosed with bipolar disorder. There were no hospitalizations in intervention group, while 7.3% of control patients experienced hospitalizations; recurrence rates were 18.9% in the intervention group patients and 34.1% in the control group patients, but statistical significant difference between the groups was not found. Four sessions of individual psychoeducation may have some positive effects but seem to be ineffective for preventing recurrences in patients with bipolar disorder during one year prospective follow up. (c) 2015 Elsevier Inc. All rights reserved

A Sample Individual Psychoeducation Model for Bipolar Disorder

Individual psychoeducation model for bipolar disorder is a four-session program aiming to provide various knowledge and skills to bipolar disorder patients about their disorder and developed by the authors and can easily be applied by practitioners and researchers working in this field. The program consists of four sessions; introduction to the psychoeducation program and information about the disorder, symptoms, developing an emergency plan to prevent the recurrence of the disorder and legal rights, assessing effects and side effects of drugs, and communication and problem-solving skills. The purpose of this study is to introduce the individual psychoeducation model for bipolar disorder and mention the results of similar psychoeducation studies. The results of the study show that the individual psychoeducation program for bipolar disorder may be an appropriate and effective program for patients

Syncope as a subject of the risk assessment of pulmonary thromboembolism to be used for: A cross-sectional study

WOS: 000437844500017PubMed: 29498800IntroductionSyncope is infrequent in pulmonary thromboembolism (PTE) yet might be indicative of haemodynamic instability. the prognostic role of syncope in PTE has not been well documented. ObjectivesIn this study, the association between risk classification of the European Society of Cardiology and syncope was investigated in the normotensive PTE patients. MethodsWe retrospectively screened electronic medical records of patients who were admitted in 2 tertiary care hospital and diagnosis of PTE with computed tomography pulmonary angiography. Patients with hypotension (high risk) at the time of admission were excluded from the study. ResultsOf 5% patients (16/322) had syncope with the proportion of 81.3% (13/16) in the intermediate high risky group, 18.7% (3/16) in intermediate low risk group and 0% in low risk group. Mortality rate was higher in subjects with syncope (25% vs 11.1%) although it was not it was not statistically significant (P=NS). in those with syncope, the central venous thrombus was more frequent than those without it (78.6% vs 30.1%, P=.008). Only heart rate and intermediate high-risk group were retained as independent predictors of syncope selection in the multivariate logistic regression. ConclusionAlthough syncope is positively correlated with the severity of PTE, it does not predict the prognosis alone. Nonetheless, syncope in patients with PTE can be considered as an important alarming stimulus for clinical course

A reinserção do estilete não afeta a incidência de cefaleia pós-punção dural (CPPD) após raquianestesia La reinserción del estilete no afecta la incidencia de cefalea pos punción dural (CPPD) posteriormente a la raquianestesia Reinsertion of the stylet does not affect incidence of post dural puncture headaches (PDPH) after spinal anesthesia

JUSTIFICATIVA E OBJETIVOS: Este estudo foi conduzido para investigar os efeitos da reinserção do estilete em cefaleia pós-punção dural (CPPD) após raquianestesia. MÉTODOS: Foram selecionados para este estudo 630 pacientes submetidos a cirurgia eletiva com raquianestesia. Os pacientes foram randomicamente designados para dois grupos: Grupo A (reinserção do estilete antes da retirada da agulha) e Grupo B (retirada da agulha sem reinserção do estilete). Os pacientes foram observados durante 24 horas no hospital e avaliados quanto à CPPD no terceiro e sétimo dias do estudo. RESULTADOS: No geral, a incidência da CPPD foi de 10,8% (68 pacientes). Trinta e três desses pacientes (10,5%) que estavam no Grupo A e 35 (11,1%) no grupo B tiveram CPPD. Não houve diferença significativa entre os dois grupos em relação à CPPD. CONCLUSÕES: Ao contrário da punção lombar diagnóstica, a reinserção do estilete após raquianestesia com agulhas tipo Quincke de calibre 25 não reduz a incidência de CPPD.JUSTIFICATIVA Y OBJETIVOS: Este estudio fue hecho para investigar los efectos de la reinserción del estilete en la cefalea pos punción dural (CPPD) después de la raquianestesia. MÉTODOS: Un total de 639 pacientes sometidos a la cirugía electiva con raquianestesia se seleccionaron para este estudio. Los pacientes fueron aleatoriamente designados para dos grupos: Grupo A (reinserción del estilete antes de la retirada de la aguja) y Grupo B (retirada de la aguja sin la reinserción del estilete). Los pacientes fueron observados durante 24 horas en el hospital y evaluados CPPD en el tercero y en el séptimo día del estudio. RESULTADOS: En general, la incidencia de CPPD fue de un 10,8% (68 pacientes). Treinta y tres de ellos (10,5%) que estaban en el Grupo A (reinserción del estilete antes de la retirada de la aguja) y 35 (11,1%) en el grupo B (retirada de la aguja sin la reinserción del estilete) tuvieron CPPD. No hubo diferencia significativa entre los dos grupos con relación a la CPPD. CONCLUSIONES: Al contrario de la punción lumbar diagnóstica, la reinserción del estilete posterior a la raquianestesia con agujas tipo Quincke de calibre 25 no reduce la incidencia de CPPD.BACKGROUND AND OBJECTIVES: This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH). METHODS: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3rd and the 7th day of the study. RESULTS: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH. CONCLUSIONS: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH

Reinsertion of the Stylet does not affect Incidence of Post Dural Puncture Headaches (PDPH) after Spinal Anesthesia

Background and objectives: : This study was conducted to investigate the effects of reinsertion of the stylet after a spinal anesthesia procedure on the Post Dural Puncture Headache (PDPH) Methods: We have enrolled into this study 630 patients who were undergoing elective operations with spinal anesthesia and randomized them to Group A (stylet replacement before needle removal) and Group B (needle removal without stylet replacement). These patients were observed for the duration of 24 hours in the hospital and they were checked for PDPH on the 3rd and the 7th day of the study. Results: Overall, the PDPH incidence was at 10.8% (68 patients). Thirty-three of these patients (10.5%) who were in Group A (stylet replacement before needle removal) and the other 35 patients (11.1%) who were in Group B (needle removal without stylet replacement) experienced PDPH. There was no significant difference between the two groups with respect to the PDPH. Conclusions: In contrary to the diagnostic lumbar puncture, reinsertion of the stylet after spinal anesthesia with 25-gauge Quincke needles does not reduce the incidence of PDPH. Keywords: Anesthesia, Spinal, Post-Dural Puncture Headache

Structural and electronic properties of SnO2

WOS: 000324523500010Highly transparent polycrystalline thin film of SnO2 (tin dioxide) was deposited using a simple and low cost spray pyrolysis method. The film was prepared from an aqueous solution of tin tetrachloride (stannic chloride) onto glass substrates at 400 degrees C. A range of diagnostic techniques including X-ray diffraction (XRD), UV-visible absorption, atomic force microscopy (AFM), scanning electron microscopy (SEM), and synchrotron-based X-ray photoelectron spectroscopy (XPS) were used to investigate structural, optical, and electronic properties of the resulting film. Deposited film was found to be polycrystalline. A mixture of SnO and SnO2 phases was observed. The average crystallite size of similar to 21.3 nm for SnO2 was calculated by Rietveld method using XRD data. The oxidation states of the SnO2 thin film were confirmed by the shape analysis of corresponding XPS O 1s, Sn 3d, and Sn 4d peaks using the decomposition procedure. The analysis of the XPS core level peaks showed that the chemical component is non-stoichiometric and the ratio of oxygen to tin (O/Sn) is 1.85 which is slightly under stoichiometry. (c) 2013 Elsevier B.V. All rights reserved.Office of Science, Office of Basic Energy Sciences, of the US Department of Energy [DE-AC02-05CH11231]The authors are grateful to the Advanced Light Source, Berkeley, California USA for providing synchrotron-based XPS facility. The Advanced Light Source is supported by the Director, Office of Science, Office of Basic Energy Sciences, of the US Department of Energy under Contract No. DE-AC02-05CH11231

Continuous Endotracheal Tube Cuff Pressure Control Decreases Incidence of Ventilator-Associated Pneumonia in Patients with Traumatic Brain Injury

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