The combination of 500-mL colloid preload and 500-mL crystalloid coload did not reduce the total ephedrine dose or improve other maternal outcomes compared with 1000-mL crystalloid coload. The IVC was reliably viewed before and during cesarean delivery, and its diameters significantly changed over time and differed between the 2 groups.
IntroductionUltrasonography may facilitate neuraxial blocks in obstetrics. This randomized controlled trial aimed to compare preprocedural ultrasonography with landmark palpation for spinal anesthesia in obese parturients undergoing cesarean delivery.Methods280 American Society of Anesthesiologists (ASA) physical status II–III parturients with body mass index ≥35 kg/m2, full-term singleton pregnancy, undergoing elective cesarean delivery under spinal anesthesia, were randomly assigned to two equal groups (ultrasonography and palpation); preprocedural systematic ultrasound approach and conventional landmark palpation were performed, respectively. Patients and outcome assessors were blinded to the study group. All ultrasound and spinal anesthetic procedures were performed by a single experienced anesthesiologist. The primary outcome was the number of needle passes required to obtain free cerebrospinal fluid (CSF) flow. Secondary outcomes were the number of skin punctures required to obtain free CSF flow, success rate at the first needle pass, success rate at the first skin puncture, duration of the spinal procedure, patient satisfaction and incidence of vascular puncture, paresthesia, failure to obtain CSF flow and failed spinal block.ResultsThere were no significant differences in primary or secondary outcomes between the two groups. The median (IQR) of the number of needle passes required to obtain free CSF flow was 3 (1–7) in ultrasonography group and 3 (1–7) in palpation group; p=0.62.ConclusionsPreprocedural ultrasonography did not decrease the number of needle passes required to obtain free CSF flow or improve other outcomes compared with landmark palpation during spinal anesthesia performed by a single experienced anesthesiologist in obese parturients undergoing cesarean delivery.Trial registration numberNCT03792191;https://clinicaltrials.gov/ct2/show/NCT03792191
Offshore oil and gas fields have gained tremendous importance for the world's energy supply. Our ability to tap into these reserves is one of the main reasons that the predictions of the "Club of Rome" in 1972 about diminishing hydrocarbon reserves and "limits to growth" turned out to be pessimistic. As the transport of oil and gas products in a multiphase manner is increasingly stretched over greater distances with development in more hostile environments, especially when designing large-scale ultra-deepwater production network, it is mandatory to ensure sustaining reliable and robustness operations as the access to subsea infrastructure becomes increasingly limited and to reduce the influence on the downstream facilities. An integrated multiphase dynamic model was used to optimize operating procedures for initial well clean-up and ramp-up to production from a sizeable deepwater production system before first gas. This approach was essential to create and test start-up scenarios given several well and reservoir uncertainties. On the other hand, the transient analysis was performed to optimize the system's time-dependent operations, e.g., 215 KM pipelines start-up and shutdown; production Ramp-up; maximum no-touch time without hydrates; Depressurization of the network to remove hydrates and ensure flaring system adequacy; Optimized well routing; and Hydrodynamic slugging. All the simulations accounted for the uncertainty of the associated controlling parameters. In this paper, we will present how we developed the integrated model. We will show how we used the simulation as a guidance tool to develop appropriate procedures for different transient operations. The framework presented here applies to any similar deepwater field with extra-long tie-back. This model is a handy tool not only for engineering simulation but for operator training and real-time surveillance as well.
Oncoplastic breast surgery (OPS) is a new strategy for expanding breast-conserving surgical options, lowering mastectomies rates, and preventing deformities. OPS is based on the use of plastic surgical reconstruction after breast cancer removal. The study aims to assess volume displacement oncoplastic procedures for early primary breast cancer in terms of recurrence and cosmoses. A case series study was done on 20 patients with early breast cancer who underwent oncoplastic volume displacementtechniques in the period from March 2019 to March 2021 in Kafrelsheikh University Hospital, Egypt. OPS techniques included were Racquet, Benelli, Batwing and Grisotti technique. The study concluded that OPS are oncologically safe (100%) with no recurrence and a better aesthetic outcome (90%).Keywords: Mastectomy, Breast Cancer, Plastic, Oncoplastic.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.