Obese patients have a significantly higher risk of adverse effects associated with general anesthesia. The purpose of this study was to evaluate the effects of Patient State Index (PSI) monitoring on recovery from anesthesia and the incidence of any postoperative complications among patients undergoing bariatric surgery with total intravenous anesthesia (TIVA) and inhalational anesthesia. Design: This prospective, double-blind, and randomized controlled trial was conducted between February 2017 and August 2017 and included 120 morbidly obese patients (body mass index >40 kg/m 2 ). Methods: Patients were randomly divided into four groups; group P-PSI (n ¼ 30): TIVA with PSI monitoring; group P (n ¼ 30): TIVA without PSI monitoring; group D-PSI (n ¼ 30): desflurane with PSI monitoring; and group D (n ¼ 30): desflurane without PSI monitoring. The discharge time from the postanesthesia care unit (PACU), postoperative complications, and hemodynamic parameters were recorded and evaluated. Findings: No significant differences were found in demographic data, duration of anesthesia, admittance to PACU, discharge from PACU, modified Aldrete scores, and perioperative mean blood pressure and heart rate. Nausea and vomiting scores were significantly lower in group P-PSI, group P, and group D-PSI compared with group D. Conclusions: Although TIVA and inhalational anesthesia can be safely used for obese patients, intraoperative PSI monitoring may decrease the discharge time from PACU and reduces incidence of postoperative nausea and vomiting caused by inhalation anesthetics.
Abrasive waterjet machining is one of the non-traditional methods of the recent years which found itself a wide area of application in the industry for machining of different materials. In this paper, the surface roughness of 6061-T6 and 7075-T6 aluminum alloys are being cut with abrasive waterjet is examined experimentally. The experiments were conducted with different waterjet pressures and traverse speeds. It has been found that the surface roughness obtained by cutting material with high mechanical properties is better than that of obtained by cutting material with inferior mechanical properties.
GirişH astane enfeksiyonları, uygulanan tüm kontrol önlemlerine karşın tüm dünyada halen önemli bir halk sağlığı sorunu olmaya devam etmektedir (1). Hastane enfeksiyonları hastanede yatış süresinin uzamasına, mortalite, morbidite ve tedavi giderlerinin artışına yol açmaktadır (2). The Centers for Disease Control and Prevention's (CDC's) ve National Nosocomial Infections Surveillance (NNIS) tanımlasına göre, yoğun bakım ünitesi (YBÜ) kökenliObjective: This retrospective study aimed to evaluate the effect of a restructured anaesthesia intensive care unit (ICU) on changes in infection rates and infections. Methods: Organisational restructuring was done in the anaesthesia ICU of Firat University Hospital after it was relocated on 14 March 2012. This study was designed to investigate the effect of restructuring on infection rates through a comparison of periods encompassing one year before relocation and one year after relocation. Nosocomial infections were diagnosed according to modified Centers for Disease Control and Prevention (CDC) criteria. In total, 406 patients who were over 18 years old and admitted to the ICU were included; they were hospitalised for 48 h or longer and had non-infectious diseases according to physical examination, laboratory and culture results on admission. The data of 214 patients (Group A) and 192 patients (Group B) were examined. Results: Parameters such as age, gender, primary diagnosis and mean GCS score at admission and mean duration of hospitalisation showed no effect on the rates of infection, but rates of total infection (41.1% vs. 25%), urinary (18.7% vs. 10.4%) and VIP (32.7% vs. 14.6%) were detected in Groups A and B. Statistically significant differences were found for the causative pathogens Pseudomonas (15.4% vs. 6.8%), Acinetobacter (18.2% vs. 12%) and Escherichia (8.9% vs. 2.1%); the mean duration of mechanical ventilation (15.01±16.681 vs. 12.22±17.595) and discharge with improvement (31.8% vs. 44.3%). Conclusion:We detected that restructuring(such as acclimatization, educated staff, hepa filter) caused a significant decline in infection rates. Because ICU staff may be a major cause of infection, we believe that providing education and conducting effective surveillance programs will be the most important factors for reducing infection rates. Keywords: ICU, acclimatisation, HEPA filter Amaç: Bu çalışmada yeniden yapılandırılan Yoğun Bakım Ünite-si'nin (YBÜ) enfeksiyon oranlarındaki değişimleri ve enfeksiyonlar üzerine olan etkisinin retrospektif olarak incelenmesi amaçlanmıştır. Yöntemler: Fırat Üniversitesi Hastanesi Anestezi YBÜ 14 Mart 2012'de yerinin tamamen değiştirilmesi ile yeniden yapılandırıldı. Bu tarihten önceki (Grup A) ve sonraki (Grup B) bir yıl içinde görülen enfeksiyon oranları karşılaştırılarak yeniden yapılandır-manın enfeksiyon oranları üzerine olan etkisi araştırıldı. Nozokomiyal enfeksiyon tanısı modifiye edilen "Centers for Disease Control and Prevention" (CDC) kriterleri, kültür sonuçları, fizik muayene, laboratuvar ve görüntüleme yöntemleriyle bir...
This study presents the investigation of abrasive wear performances for polyamides using a Response Surface Methodology (RSM). Tests were carried out in a pin-on-disc using various conditions against SiC abrasive cloth. Box-Behnken Design of RSM was adopted to study the effect of control factors like load, speed and tensile strength of the tested samples on the volumetric wear rate. The experimental results indicated that the volumetric wear rate increased with increasing load, speed and decreased with increasing the tensile strength, but material property was more effective than other factors. Furthermore, the results of analysis of variance showed that tensile strength was predominant factor on the abrasive wear rate, followed by load and spindle speed. The contributions of tensile strength, load and speed were about 33.55 %, 24.45 % and 21.87 %, respectively, while the contribution of square and 2-way of interaction was about 3.04 % and 11.23 %, respectively.
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