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The SVA was divided into balanced spine (BS; SVA ≤40mm) and imbalanced spine (IS; SVA >40mm) groups. All individuals were classified into LC+BS, LC+IS, LD+BS, and LD+IS groups. The relationships among the four groups and low back pain (LBP), Oswestry Disability Index (ODI), and knee pain were examined.
SKD was significantly correlated with SVA, SS, PI, PT, and knee-femoral angle. ODI was significantly higher in the LC+IS group than in the LD+BS group (p<0.05). Knee pain prevalence was significantly higher in the LC+IS and LC+BS groups than in the LD+IS group (p<0.05).
SVA/SKD ratio is useful for evaluating global alignment. Our findings are significant because they highlight the importance of SKD with respect to knee pain, LBP, and LBP- related disabilities.
SVA/SKD ratio is useful for evaluating global alignment. Our findings are significant because they highlight the importance of SKD with respect to knee pain, LBP, and LBP- related disabilities.
Cesarean delivery is one of the most common procedures performed worldwide. We conducted this prospective cohort study to evaluate the association between local anesthetic infiltration (LAI) pain prior to spinal anesthesia and pain and morphine consumption within 24 h after cesarean delivery (primary outcomes). A secondary objective was to assess the association between LAI pain and pain at one month postoperatively.
Recruitment of 216 eligible women scheduled for elective cesarean delivery. Local infiltration before spinal anesthesia was performed using a 24-gauge needle and 3 mL 2% plain lidocaine. All subjects received 2.2 mL 0.5% hyperbaric bupivacaine with 200 µg morphine for spinal anesthesia. A 0-10 verbal numerical rating scale was used to assess LAI pain severity, and subsequent pain at 24 h, 1, 3 and 12 months.
We found a moderate correlation between LAI pain intensity and severity of acute pain at rest (rho=0.56, P <0.001) and with movement (rho=0.58, P <0.001) and a weak correlation with morphine consumption (rho=0.17, P=0.01) within 24 h postoperatively. We also found a positive correlation between LAI pain and the severity of persistent wound pain at rest (rho=0.30, P <0.001) and with movement (rho=0.52, P <0.001) at 1 month. The incidence of wound pain at 1, 3 and 12 months postoperatively was 37.1%, 7.0% and 1.4%, respectively.
Pain from LAI prior to spinal anesthesia is significantly associated with subsequent postoperative pain both acutely and at one month in women scheduled for elective cesarean delivery under spinal anesthesia.
Pain from LAI prior to spinal anesthesia is significantly associated with subsequent postoperative pain both acutely and at one month in women scheduled for elective cesarean delivery under spinal anesthesia.
Intravenous dexmedetomidine 30 µg reduces shivering after cesarean delivery but can result in sedation and dry mouth. We hypothesized that prophylactic administration of 10 µg of IV dexmedetomidine would reduce the patient-reported severity of shivering after cesarean delivery, without an increased incidence of side effects.
After institutional review board approval and informed written consent, women undergoing scheduled cesarean delivery with spinal or combined spinal-epidural anesthesia were randomized to receive either intravenous normal saline or dexmedetomidine 10 µg immediately after delivery. The primary outcome was a patient-rated subjective shivering score using a 10-cm visual analog scale at 30 and 60 min after arrival in the Post-Anesthesia Care Unit. selleck chemical Secondary outcomes included subjective scores for pain, nausea, itching, dry mouth, and sedation, as well as 24-h medication administration and investigator-rated observations of shivering, vomiting, pruritus, and sedation. Repeated measures ANOVA with Tukey-Kramer multiple-comparison test was applied for primary outcomes.
One hundred patients were enrolled, and 85 completed the study and were included in analysis. The mean ± SD shivering score in the dexmedetomidine group was significantly lower by repeated measures analysis than among controls across the first 60 min (P=0.0002), and individually at both 30 and 60 min (placebo 1.8 ± 2.6 vs. dexmedetomidine 0.6 ± 1.4 at 30 min; 1.2 ± 2.1 vs. 0.3 ± 0.6 at 60 min; both P <0.01). Patient-rated and observer-rated side effects did not significantly differ between groups.
Prophylactic administration of intravenous dexmedetomidine 10 µg after delivery reduces shivering without notable side effects.
Prophylactic administration of intravenous dexmedetomidine 10 µg after delivery reduces shivering without notable side effects.
Recent advances in medical imaging like MRI, CT-Scan, Doppler ultrasound, etc. have made it possible to study the hemodynamics of cardiovascular system having different levels of vessel abnormalities.
Within this work, we have developed two different personalized lumped-parameter models of the human carotid arteries having elastic and viscoelastic vessel wall behaviors. The data used in developing the models of the carotid arteries is taken from a healthy subject and a patient having mild carotid stenosis (55%) near a bifurcation using doppler ultrasound. The data consists measurements of blood flow velocities and geometrical parameters at selected locations. Prior to the measurements, the key measurable geometrical parameters are identified by normalized local sensitivity analysis.
Finally, both developed and personalized models of carotid arteries are validated against the blood flow measurements obtained near carotid bifurcation. We observe a good agreement between model simulations and blood flow measurements taken near the bifurcation i.e. (r=0.94) for the healthy subject and (r=0.96) for the patient having a stenosis near the bifurcation.
This work provides further evidence, that the hemodynamics near a bifurcation can be modelled well with a 0D approach, even with different levels of stenosis.
This work provides further evidence, that the hemodynamics near a bifurcation can be modelled well with a 0D approach, even with different levels of stenosis.