We observed that the prodrug clopidogrel was less effective in inhibiting platelet aggregation with coadministration of atorvastatin during point-of-care function testing. Because is metabolized by cytochrome P450 (CYP) 3A4, we hypothesized might be activated CYP3A4.Platelet measured 44 patients undergoing coronary artery stent implantation treated or plus pravastatin atorvastatin, and 27 volunteers either erythromycin troleandomycin, CYP3A4 inhibitors, rifampin, a inducer. Atorvastatin, but...

Mask ventilation is an essential element of airway management that has rarely been studied as the primary outcome. The authors sought to determine incidence and predictors difficult impossible mask ventilation.A four-point scale grade difficulty in performing (MV) used at authors' institution. They a prospective, observational study identify cases 3 MV (inadequate, unstable, or requiring two providers), 4 (impossible ventilate), intubation. Univariate multivariate analyses variety patient...

Interindividual variability of platelet inhibition after aspirin or clopidogrel administration has been described. Additionally, resistance and occur in some individuals. Because the prodrug is activated by hepatic cytochrome P450 (CYP) 3A4, we hypothesized that interindividual efficacy might be related to differences CYP3A4 metabolic activity.Platelet aggregation was measured before treatment 32 patients undergoing coronary artery stent implantation 35 healthy volunteers. The erythromycin...

Difficulty with pain assessment in individuals who cannot self-report their poses a significant barrier to effective management. However, available tools lack consistent reliability as measures children cognitive impairment (CI). This study evaluated the validity and of revised individualized Face Legs Activity Cry Consolability (FLACC) behavioral tool CI.Children CI scheduled for elective surgery were studied. The FLACC was include specific descriptors parent-identified, unique behaviors...

Emergence agitation (EA) is a postanesthetic problem that interferes with child’s recovery and presents challenge in terms of assessment management. In this prospective cohort study, we sought to determine the incidence EA, evaluate factors associated predictive describe outcomes healthy children. Children aged 3–7 yr who were undergoing general anesthesia for elective outpatient procedures included. All perioperative care was documented, postoperative behaviors postanesthesia unit recorded....

Background Anesthesia for the child who presents surgery with an upper respiratory infection (URI) a challenge anesthesiologist. The Current prospective study was designed to determine incidence of and risk factors adverse events in children URTs undergoing elective surgical procedures. Methods population included 1,078 aged 1 month 18 yr presented procedure. Parents were given short questionnaire detailing their child's demographics, medical history, presence any symptoms URT. Data...

Exposure of pregnant rats to the anesthetic nitrous oxide on ninth day gestation causes fetal resorption, skeletal anomalies, and macroscopic lesions including encephalocele, anophthalmia, microphthalmia, gastroschisis. The inert gas xenon, which has properties similar those oxide, does not cause teratogenic effects under same experimental conditions.

LoRa is a new ISM band wireless technology designed for low power, unlicensed, Long Range operation. LoRaWAN Wide Area Network protocol that incorporates the into networked infrastructure. The indoor and outdoor performance of these technologies, physical layer multi-gateway wide area network, was evaluated across central business district (CBD) Glasgow city (Scotland). results indicated this can be reliable link cost remote sensing applications.

This paper examines the various factors that need to be taken into account in planning of student support open and distance learning systems. The discussed arise from characteristics students, demands academic programmes courses, geographical environment, technological infrastructure, scale programme, requirements management. These interact complex ways, such while none can ignored, given overall priority. elements stand tension with each other, requiring tradeoffs between them represent...

Pain assessment remains difficult in children with cognitive impairment (CI). In this study, we evaluated the validity and reliability of Face, Legs, Activity, Cry, Consolability (FLACC) tool for assessing pain CI. Each child's developmental level ability to self-report were evaluated. The nurse observed scored FLACC before after analgesic administration. Simultaneously, parents a visual analog scale, scores obtained from who able pain. Observations videotaped later viewed by nurses blinded...

After implementation of hospital-wide monitoring standards, a quality assurance (QA) tool was prospectively completed for 1140 children (aged 2.96 +/- 3.7 yr) sedated procedures by nonanesthesiologists. The captured data regarding demographics, medications used, adequacy sedation, monitoring, adverse events, and requirement escalated care. medical records who experienced events were reviewed. Most (99%) monitored with pulse oximetry. Chloral hydrate the most frequently used sedative (74.9%...

Objective. Although sedation-related adverse events in children the hospital setting have been extensively reported, limited data are available regarding after discharge home. Despite nationally recommended criteria, busy outpatient settings, may be sent home into care of their parents a brief recovery from sedation, placing them at risk for an unmonitored setting. Previous studies not addressed issues such as requirement escalation (ie, emergency department visits or hospitalization),...

After implementation of hospital-wide monitoring standards, a quality assurance (QA) tool was prospectively completed for 1140 children (aged 2.96 +/- 3.7 yr) sedated procedures by nonanesthesiologists. The captured data regarding demographics, medications used, adequacy sedation, monitoring, adverse events, and requirement escalated care. medical records who experienced events were reviewed. Most (99%) monitored with pulse oximetry. Chloral hydrate the most frequently used sedative (74.9%...

There is a paucity of information regarding the optimal method presenting risk/benefit to parents pediatric research subjects. This study, therefore, was designed examine effect different message formats on parents' understanding risks and benefits. An Internet-administered survey completed by 4,685 who were randomized receive about study postoperative pain control presented in (text, tables, pictographs). Survey questions assessed participants' gist verbatim their perceptions Pictographs...

Background Consistent with the increasing prevalence of obesity in United States and many countries worldwide, anesthesiologists are now presented a greater number adult pediatric patients who significantly overweight. This prospective study was designed to examine relation between age-adjusted body mass index, preoperative comorbidities, perioperative outcome children. Methods Children aged 2-18 yr undergoing noncardiac elective procedures were classified as overweight or obese based on...

Self-reported pain scores are used widely in clinical and research settings, yet little is known about their interpretability children. In this prospective, observational study we evaluated the relationship between 0 to 10 numerical rating scale (NRS) other self-reported, clinically meaningful outcomes, including perceived need for medicine (PNM), relief (PR), satisfaction (PS) with treatment children postoperatively.This included ages 7 16 years undergoing surgery associated postoperative...

The value of simulation in medical education and procedural skills training is well recognized. Despite this, many mannequin-based trainers are limited by the inability trainee to view internal anatomical structures. This study evaluates usability feasibility a first-person point-of-view-augmented reality (AR) trainer on needle insertion as component central venous catheter placement.Forty subjects, including students anesthesiology residents faculty, participated. Augmented glasses were...

Several studies suggest that placement of an endotracheal tube (ETT) in a child with upper respiratory infection (URI) increases the risk complications.However, development laryngeal mask airway (LMA) has provided anesthesiologists alternative means management. This study was therefore designed to evaluate use LMA children URIs and compare it ETT. The sample consisted 82 pediatric patients (3 mo 16 yr age) who presented for elective surgery URI. Patients were randomly allocated receive...

Background Participation of children in clinical research requires not only parental permission but also the assent child. Although there is no fixed age at which should be sought, investigators obtain from considered able to provide it. This study was designed determine children's understanding elements disclosure for studies they had assented participate. Methods The population included 102 aged 7-18 yr who given their participate a anesthesia or surgical study. Children were interviewed...