92 research outputs found
Incidence of persistent postoperative pain after hepatectomies with 2 regimes of perioperative analgesia containing ketamine
Studies designed to assess persistent postoperative pain (PPP) incidence after hepatectomies are lacking. Our aim was to assess PPP incidence 6 months after hepatectomies with intravenous (IV) or epidural (EPI) analgesia containing ketamine. Prospective observational comparative study between 2 cohorts of patients submitted to hepatectomy. Patients received 1 of 2 analgesic regimes containing ketamine: EPI group or IV group. Visual analog scale (VAS), Neuropathic Pain Symptom Inventory (NPSI), Pain Catastrophizing Scale (PCS), and quantitative sensorial testing (QST: to determine area of hyperalgesia/allodynia) were assessed preoperatively and postoperatively at 2 h, 24 h, 7 days, 1 month, and 6 months. VAS ≥ 1 at 1 and 6 months was considered indicative of PPP and VAS > 3 was considered as not controlled pain. Side effects and complications were registered. Forty-four patients were included: 23 in EPI group and 21 in IV group. Patients in IV group were older and had more comorbidities. No patient presented VAS > 3 at 1 or 6 months. VAS ≥ 1 at 1 and 6 months was 36.4% and 22.7%, respectively. No differences in VAS, NPSI, or PCS were found between groups. Allodynia/hyperalgesia area did not differ between groups and was infrequent and slight. Pain pressure threshold in the wound vertical component was significantly higher in EPI group after 7 days. IV group showed more cognitive side effects. Incidence of PPP at 6 months after open hepatectomies with EPI or IV analgesia containing ketamine was lower than previously reported for other abdominal surgeries. Ketamine influence on low PPP incidence and hyperalgesia cannot be discarded
Simulación para formar en la competencia de valoración preanestésica: diseño común para residentes de primer año de anestesiología y enfermeras de anestesia
Introducción. La valoración preanestésica (VP) es una competencia compleja que debe adquirir el residente de anestesia tempranamente. La incorporación de enfermería especializada en la VP ha demostrado ser segura y eficaz. No existen recomendaciones para el entrenamiento en VP. La simulación puede ser una metodología apropiada para acortar el tiempo de adquisición de la competencia. Objetivo. Describir detalladamente el diseño y aplicación de un taller de simulación para formar residentes de anestesiología y enfermeras posgraduadas en la competencia VP. Sujetos y métodos. Taller de dos horas de duración con casos clínicos en formato video y ejecutados mediante técnica de role-playing. Los componentes fueron dos videos de grabación propia (el primero, de una VP con errores, y el otro, con una VP correctamente realizada), una plantilla para que cada alumno valorara en los videos los componentes técnicos y no técnicos de las competencias de la VP y una encuesta de satisfacción para alumnos e instructores. En el grupo de residentes se añadieron tres escenarios de VP de pacientes complejos. Resultados. Se analizaron las encuestas de los 10 residentes de dos promociones y de 60 enfermeras. La satisfacción de los dos tipos de alumnos y de los instructores sobre el aprendizaje fue muy alta. En el caso de las enfermeras, más del 85% de las alumnas de las promociones que recibieron el taller superaron la estación VP de la evaluación clínica objetiva estructurada (ECOE) frente a sólo el 20% de la promoción anterior. Conclusiones. El taller de VP con formato video y role-playing permite entrenar la competencia VP a residentes de anestesia y enfermeras posgraduadas, mejorando el rendimiento de éstas en la ECOE
Measurement of and Production in Collisions at = 1.96 TeV
The Standard Model predictions for and production are
tested using an integrated luminosity of 200 pb of \ppbar collision data
collected at the Collider Detector at Fermilab. The cross sections are measured
selecting leptonic decays of the and bosons, and photons with
transverse energy GeV that are well separated from leptons. The
production cross sections and kinematic distributions for the and
are compared to SM predictions.Comment: 7 pages, 4 figures, submitted to PR
Measurement of the ttbar Production Cross Section in ppbar Collisions at sqrt(s) = 1.96 TeV
We present a measurement of the top quark pair production cross section in
ppbar collisions at sqrt(s)=1.96 TeV using 318 pb^{-1} of data collected with
the Collider Detector at Fermilab. We select ttbar decays into the final states
e nu + jets and mu nu + jets, in which at least one b quark from the t-quark
decays is identified using a secondary vertex-finding algorithm. Assuming a top
quark mass of 178 GeV/c^2, we measure a cross section of 8.7 +-0.9 (stat)
+1.1-0.9 (syst) pb. We also report the first observation of ttbar with
significance greater than 5 sigma in the subsample in which both b quarks are
identified, corresponding to a cross section of 10.1 +1.6-1.4(stat)+2.0-1.3
(syst) pb.Comment: Accepted for publication in Physics Review Letters, 7 page
Top quark mass measurement using the template method at CDF
We present a measurement of the top quark mass in the lepton+jets and
dilepton channels of decays using the template method. The data
sample corresponds to an integrated luminosity of 5.6 fb of
collisions at Tevatron with TeV, collected with the CDF II
detector. The measurement is performed by constructing templates of three
kinematic variables in the lepton+jets and two kinematic variables in the
dilepton channel. The variables are two reconstructed top quark masses from
different jets-to-quarks combinations and the invariant mass of two jets from
the decay in the lepton+jets channel, and a reconstructed top quark mass
and , a variable related to the transverse mass in events with two
missing particles, in the dilepton channel. The simultaneous fit of the
templates from signal and background events in the lepton+jets and dilepton
channels to the data yields a measured top quark mass of Comment: submitted to Phys. Rev.
Evidence for the exclusive decay Bc+- to J/psi pi+- and measurement of the mass of the Bc meson
We report first evidence for a fully reconstructed decay mode of the
B_c^{\pm} meson in the channel B_c^{\pm} \to J/psi \pi^{\pm}, with J/psi \to
mu^+mu^-. The analysis is based on an integrated luminosity of 360 pb$^{-1} in
p\bar{p} collisions at 1.96 TeV center of mass energy collected by the Collider
Detector at Fermilab. We observe 14.6 \pm 4.6 signal events with a background
of 7.1 \pm 0.9 events, and a fit to the J/psi pi^{\pm} mass spectrum yields a
B_c^{\pm} mass of 6285.7 \pm 5.3(stat) \pm 1.2(syst) MeV/c^2. The probability
of a peak of this magnitude occurring by random fluctuation in the search
region is estimated as 0.012%.Comment: 7 pages, 3 figures. Version 3, accepted by PR
Measurement of the ttbar Production Cross Section in ppbar Collisions at sqrt{s}=1.96 TeV using Lepton + Jets Events with Secondary Vertex b-tagging
We present a measurement of the ttbar production cross section using events
with one charged lepton and jets from ppbar collisions at a center-of-mass
energy of 1.96 TeV. In these events, heavy flavor quarks from top quark decay
are identified with a secondary vertex tagging algorithm. From 162 pb-1 of data
collected by the Collider Detector at Fermilab, a total of 48 candidate events
are selected, where 13.5 +- 1.8 events are expected from background
contributions. We measure a ttbar production cross section of 5.6^{+1.2}_{-1.1}
(stat.) ^{+0.9}_{0.6} (syst.) pb.Comment: 28 pages, 20 figures. Published in Physical Review
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
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