Objective An adequate intracuff pressure is important to ensure sufficient sealing function when using supraglottic airway devices to protect the airway from secretions and achieve adequate positive pressure ventilation. The aim of this study is to analyze a feasible and effective alternative Ambu AuraFlex intracuff pressure in child's laparoscopic surgery. Study Design Seventy-two children were included in this study. After insertion of the laryngeal mask airway AuraFlex, oropharyngeal leak pressure (OLP) was measured at intracuff pressures of 10, 30, and 60-cmH2O according to one of six sequences produced on the basis of 3 × 6 Williams crossover design. During the intraoperative period, AuraFlex was maintained using the last intracuff pressure of the allocated sequence. Oropharyngeal leak pressure, peak airway pressure, the fiberoptic view, mucosal change, and complications were assessed at three intracuff pressures. Results The OLP at the intracuff pressure of 10 cmH2O was significantly lower than that of 30 cmH2O (2# 18.1 ± 1.5 vs. 19.5 ± 1.4 cmH2O, p = 0.001; 2.5# 17.7 ± 1.2 vs. 20.2 ± 1.4, p = 0.001) and 60 cmH2O (2# 18.1 ± 1.5 vs. 20.0 ± 1.3 cmH2O, p = 0.002; 2.5# 17.7 ± 1.2 vs. 20.8 ± 1.1, p = 0.003). Compared with the peak airway pressure in pre-and postpneumoperitoneum, the OLP was significantly higher. Subgroup analysis showed no differences in mucosal change and complications. Conclusion Intracuff pressures of 30 may be sufficient for the Ambu AuraFlex in child's laparoscopic surgery, and there may be no added benefit of an intracuff pressure of 60 cmH2O, as oropharyngeal leak pressures were similar.
Epidermoid cysts, previously referred as sebaceous cysts, are common benign skin lesions that lined by surface epidermis and filled with keratin in pathophysiology. 1 The cysts usually occur spontaneously and arise from developmental defect of the sebaceous duct, obstruction of the pilosebaceous follicles or certain penetrating injuries. 2 Epidermoid cysts can occur in any part of the body, especially the head, neck, and trunk. 3 Surgical resection of epidermoid cysts is the main method in conventional treatment. However, obvious scars and recurrences are not rare, which sometimes are tough clinical problems. 4 Here, we report the first case using ultrasound-guided sclerotherapy for a recurrent epidermoid cyst in the right buttock.A 36-year-old female presented to our department in May 2020 and was evaluated for a recurrent mass in the right buttock. The medical history of the patient dated from April 2018 when she accepted a surgery and postoperative pathology result was an epidermoid cyst (Figure 1). On the clinical examination this time, a 1.5 cm surgical scar was noted, and palpation of the right buttock found a 1.0 × 1.0 cm painless mass below the scar. Then ultrasound showed the recurrent hypoechoic solid-like mass (1.3 × 1.1 × 0.8 cm) with clear boundary in the same location under the surgical scar (Figure 2A). The clinical diagnosis was a recurrent epidermoid cyst.
Background Persistent pain following back surgery called failed back surgery syndrome remains a major treatment challenge. The aim of this study is to evaluate the efficacy and safety of electroacupuncture on relieving back pain in FBSS patients. Methods/design This is a randomized, single-blind, single-site, placebo-controlled trial. A total of 144 eligible FBSS patients will be randomly assigned to the electroacupuncture, manual acupuncture, or sham acupuncture group in a 1:1:1 ratio. Each group will receive 2 treatment sessions per week for 12 weeks. The primary outcome will be low back pain intensity based on the 11-point numerical rating scale (NRS). The secondary outcomes include Oswestry Disability Index (ODI) questionnaire, Beck Depression Inventory-II (BDI-II), Pittsburgh Sleep Quality Index (PSQI), and analgesic consumption. All clinical outcomes will be collected at baseline, during the treatment phase (at 8 and 12 weeks), and at the 16-, 24- and 36-week follow-ups. All data will be analyzed based on the intention-to-treat principle and adverse events will be assessed during the trial. Discussion This pilot randomized controlled trial will evaluate the efficacy of electroacupuncture for treating failed back surgery syndrome. The outcomes will determine whether electroacupuncture is efficacious in relieving low back pain as well as improving the quality of life in failed back surgery syndrome patients. Trial registration Chinese Clinical Trial Registry ChiCTR2000040144. Registered on 22 November 2020
Background: To investigate the prevalence of disability in activities of daily living (ADL) in hemodialysis patients and its relationship withphase angle (PhA). Methods: Maintenance hemodialysis patients between November 2019 and January 2020 in a Chinese university hospital were enrolled. Physical function was measured by the basic ADL (BADL) and instrumental ADL (IADL) scales. The association of disability in ADL with PhA was identified by univariable and multivariable logistic regression analysis. The receiver operating characteristic (ROC) curve was used to analyze PhA and to determine the optimal cut-off value of PhA for disability in ADL. Results: This study included 237 hemodialysis patients with a mean age of 60.01 ± 13.55 years. The prevalence of disability in ADL was 43.5%. According to the multivariable analysis, which took age, sex, body mass index, history of hypertension and diabetes mellitus, and duration of dialysis into account, low PhA was shown to be strongly associated with disability in BADL and IADL (per unit decrease of PhA: odds ratio 4.37 [95% CI: 2.49–7.63], and 3.19 [95% CI: 2.03–5.05], respectively). The optimal cut-off values of PhA for disability in BADL and IADL were 4.8 and 5.4, with the area under the ROC curve (AUC) of 0.783 (0.727, 0.835) and 0.799 (0.743, 0.848), respectively. Additionally, females had higher AUC values than males. Conclusions: Low PhA is strongly associated with disability in ADL in hemodialysis patients. Moreover, PhA is helpful in screening for disability in ADL.
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