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Sample records for analgesia pca intravenosa

  1. Periarticular infiltration for pain relief after total hip arthroplasty: a comparison with epidural and PCA analgesia.

    Science.gov (United States)

    Pandazi, Ageliki; Kanellopoulos, Ilias; Kalimeris, Konstantinos; Batistaki, Chrysanthi; Nikolakopoulos, Nikolaos; Matsota, Paraskevi; Babis, George C; Kostopanagiotou, Georgia

    2013-11-01

    Epidural and intravenous patient-controlled analgesia (PCA) are established methods for pain relief after total hip arthroplasty (THA). Periarticular infiltration is an alternative method that is gaining ground due to its simplicity and safety. Our study aims to assess the efficacy of periarticular infiltration in pain relief after THA. Sixty-three patients undergoing THA under spinal anaesthesia were randomly assigned to receive postoperative analgesia with continuous epidural infusion with ropivacaine (epidural group), intraoperative periarticular infiltration with ropivacaine, clonidine, morphine, epinephrine and corticosteroids (infiltration group) or PCA with morphine (PCA group). PCA morphine provided rescue analgesia in all groups. We recorded morphine consumption, visual analog scale (VAS) scores at rest and movement, blood loss from wound drainage, mean arterial pressure (MAP) and adverse effects at 1, 6, 12, 24 h postoperatively. Morphine consumption at all time points, VAS scores at rest, 6, 12 and 24 h and at movement, 6 and 12 h postoperatively were lower in infiltration group compared to PCA group (p PCA group (p PCA with morphine after THA, providing better pain relief and lower opioid consumption postoperatively. Infiltration seems to be equally effective to epidural analgesia without having the potential side effects of the latter.

  2. Efficacy and tolerability of intravenous morphine patient-controlled analgesia (PCA) in women undergoing cesarean delivery.

    Science.gov (United States)

    Andziak, Marta; Beta, Jarosław; Barwijuk, Michal; Issat, Tadeusz; Jakimiuk, Artur J

    2015-06-01

    The aim of the study was to evaluate analgesic efficacy and tolerability of patient-controlled analgesia (PCA) with intravenous morphine. Our observational study included 50 women who underwent a Misgav-Ladach or modified Misgav-Ladach cesarean section. Automated PCA infusion device (Medima S-PCA Syringe Pump, Medima, Krakow, Poland) was used for postoperative pain control. Time of morphine administration or initiation of intravenous patient-controlled analgesia (IV PCA) with morphine was recorded, as well as post-operative pain at rest assessed by a visual analogue scale (VAS). All patients were followed up for 24 hours after discharge from the operating room, taking into account patient records, worst pain score at rest, number of IV PCA attempts, and drug consumption. Median of total morphine doses used during the postoperative period was 42.9mg (IQR 35.6-48.5), with median infusion time of 687.0 min. (IQR 531.0-757.5). Pain severity and total drug consumption improved after the first 3 hours following cesarean delivery (p PCA attempts per patient was 33 (IQR: 24-37), with median of 11 placebo attempts (IQR: 3-27). Patient-controlled analgesia with morphine is an efficient and acceptable analgesic method in women undergoing cesarean section.

  3. Age-related postoperative morphine requirements in children following major surgery--an assessment using patient-controlled analgesia (PCA)

    DEFF Research Database (Denmark)

    Hansen, Tom Giedsing; Henneberg, Steen Winther; Hole, P

    1996-01-01

    To investigate if small children require less morphine for postoperative analgesia than do older children and adolescents we analysed the morphine consumption pattern of 28 consecutive children on intravenous patient-controlled analgesia (PCA) following major surgery. The median age-specific morp......To investigate if small children require less morphine for postoperative analgesia than do older children and adolescents we analysed the morphine consumption pattern of 28 consecutive children on intravenous patient-controlled analgesia (PCA) following major surgery. The median age...

  4. Analgesia postoperatoria en la queiloplastia del lactante. Estudio comparativo: bloqueo infraorbitario intraoral bilateral con bupivacaína 0,25% con adrenalina vs. analgesia intravenosa con tramadol Postoperative analgesia for the management of chieloplasty in the breast-fed baby. Comparative study: bilateral intraoral blockade of the infraorbitary nerve with bupivacaine 0.25% plus adrenaline versus intravenous analgesia with tramadol

    OpenAIRE

    J. A. Delgado; A. Martínez-Tellería; M. E. Cano; J. Galera; R. Fernández-Valades; A. Ruiz-Montes

    2005-01-01

    Objetivo: Comparar la eficacia y duración del bloqueo del nervio infraorbitario intraoral bilateral frente a la analgesia intravenosa convencional con tramadol en el control del dolor postoperatorio en lactantes sometidos a queiloplastia por labio leporino. Material y métodos: Tras la realización de una adecuada valoración preanestésica y la obtención del consentimiento informado de los padres, realizamos un estudio prospectivo, controlado aleatorizado y doble ciego en 25 niños, ASA I, con ed...

  5. Patient perspectives of patient-controlled analgesia (PCA) and methods for improving pain control and patient satisfaction.

    Science.gov (United States)

    Patak, Lance S; Tait, Alan R; Mirafzali, Leela; Morris, Michelle; Dasgupta, Sunavo; Brummett, Chad M

    2013-01-01

    This study aimed to (1) identify patient-controlled analgesia (PCA) attributes that negatively impact patient satisfaction and ability to control pain while using PCA and (2) obtain data on patient perceptions of new PCA design features. We conducted a prospective survey study of postoperative pain control among patients using a PCA device. The survey was designed to evaluate patient satisfaction with pain control, understanding of PCA, difficulties using PCA, lockout-period management, and evaluation of new PCA design features. A total of 350 eligible patients completed the survey (91%). Patients who had difficulties using PCA were less satisfied (P PCA. Forty-nine percent of patients reported not knowing if they would receive medicine when they pushed the PCA button, and of these, 22% believed that this uncertainty made their pain worse. The majority of patients preferred the proposed PCA design features for easier use, including a light on the button, making it easier to find (57%), and a PCA button that vibrates (55%) or lights up (70%), alerting the patient that the PCA pump is able to deliver more medicine. A majority of patients, irrespective of their satisfaction with PCA, preferred a new PCA design. Certain attributes of current PCA technology may negatively impact patient experience, and modifications could potentially address these concerns and improve patient outcomes.

  6. Age-related postoperative morphine requirements in children following major surgery--an assessment using patient-controlled analgesia (PCA)

    DEFF Research Database (Denmark)

    Hansen, T G; Henneberg, S W; Hole, P

    1996-01-01

    To investigate if small children require less morphine for postoperative analgesia than do older children and adolescents we analysed the morphine consumption pattern of 28 consecutive children on intravenous patient-controlled analgesia (PCA) following major surgery. The median age......-specific morphine requirements between 2 comparable groups of children aged 4-8 years and 9-15 years were compared. We used the Pharmacia-Deltec pump in all children and the same settings: a bolus dose of 25 microgram/kg, an 8 minutes lockout interval and no background infusion. In addition, all children received...... paracetamol as a supplemently to the morphine. In this study children aged 4-8 years had significantly higher total postoperative morphine requirements compared to children aged 9-15 years, i.e. 11.6 microgram/kg/hour and 7.5 microgram/kg/hour respectively (p = 0.037). Hence, we conclude that children...

  7. Local Infiltration Analgesia Compared With Epidural and Intravenous PCA After Surgical Hip Dislocation for the Treatment of Femoroacetabular Impingement in Adolescents.

    Science.gov (United States)

    Novais, Eduardo N; Kestel, Lauryn; Carry, Patrick M; Sink, Ernest; Strupp, Kim

    2018-01-01

    Open treatment of femoroacetabular impingement (FAI) through a surgical hip dislocation (SHD) approach has been reported to allow for improvement in pain and function. However, the approach require a trochanteric osteotomy and may be associated with high level of pain after surgery. Currently, there is no systematic approach for pain management after SHD for treatment of FAI. A retrospective chart review was used to collect data from 121 subjects (12 to 21 y and below) who received periarticular local infiltration analgesia (LIA, n=20), epidural analgesia (n=72), or intravenous patient-controlled analgesia (PCA, n=29) after SHD from January 2003 to June 2014. Verbal pain scores, opioid consumption, incidence of side effects/complications, and length of hospital stay (LOS) were recorded. All nonopioid medications with analgesic potential were included in the statistical models as potential confounding variables RESULTS:: Twelve hours after surgery, the odds of moderate/severe pain were higher in the PCA group (odds ratio, 20.5; 95% confidence interval (CI), 1.7-243.8; P=0.0166] and epidural group (odds ratio, 5.2; 95% CI, 0.7-92.0; P=0.3218) compared with the LIA group. There was no difference in pain scores across all groups 1 hour (P=0.0675) or 24 hours (P=0.3473) postoperatively. Total opioid consumption in the LIA group was 59.8% (95% CI, 15.0%-81.0%; P=0.0175) lower than the total opioid consumption in the epidural group and 60.7% (95% CI, 17.3-81.3; P=0.0144) lower than the total opioid consumption in the PCA group. LOS was increased in the epidural (mean difference, 22.1; 95% CI, 6.8-37.4 h; P=0.0051) and PCA (mean difference, 16 h; 95% CI, 1-31.5 h; P=0.0367) groups relative to the LIA group. There was 0 (0%) complication in the LIA group compared with 11 (15.3%) in the epidural group. LIA was more effective at controlling pain 12 hours after surgery in comparison with PCA with similar pain control to epidural. LIA was associated with significantly lower

  8. Intravenous sufentanil and morphine for post-cardiac surgery pain relief using patient-controlled analgesia (pca) device: a randomized double-blind clinical trial

    International Nuclear Information System (INIS)

    Alavi, S.M.; Kish, R.F.; Farsad, F.; Imani, F.; Sheikhvatan, M.

    2010-01-01

    Selection of the best analgesic technique in patients undergoing major surgeries can result in lower morbidity and satisfactory postoperative pain relief. In the present study, we tried to compare the effect of morphine and sufentanil on postoperative pain severity and hemodynamic changes by using patient-controlled analgesia (PCA) device in patients who were candidate for coronary artery bypass surgery (CABG). It was a randomized double-blinded clinical trial in which 120 patients aged 30-65 years, ASA physical status I-III, candidate for CABG in Shahid Rajaee hospital in Tehran were included. Before anesthesia, patients were randomly assigned to one of three groups to receive sufentanil (n=40), morphine (n=40) or normal saline (n=40). After tracheal extubation at intensive care unit, PCA was started by, sufentanil 4mg for the first group, morphine 2mg for the second group and normal saline, at same volume for the third group, intravenously with 10 minute lockout interval. Postoperative pain was evaluated by VAS scale, 1, 6, 12, 18 and 24 hours after extubation and systolic blood pressure, arterial oxygen saturation, PCO2 and PO2 were recorded 24 hours after extubation. VAS scores at rest revealed significantly less pain for patients in sufentanil and morphine groups than normal saline group, throughout the twenty-four hours after operation (P<0.001). However, there were no significant differences in the means of VAS scores between sufentanil and morphine groups. Among studied hemodynamic parameters, only systolic blood pressure was reduced more in morphine than sufentanil group (P<0.001). After CABG surgery, administration of intravenous sufentanil and morphine using PCA can lead to similar reduction of postoperative pain severity. (author)

  9. Meta-Analysis of the Ease of Care From the Nurses' Perspective Comparing Fentanyl Iontophoretic Transdermal System (ITS) Vs Morphine Intravenous Patient-Controlled Analgesia (IV PCA) in Postoperative Pain Management.

    Science.gov (United States)

    Pestano, Cecile R; Lindley, Pam; Ding, Li; Danesi, Hassan; Jones, James B

    2017-08-01

    The aim of this meta-analysis was to compare the ease of care (EOC) of fentanyl iontophoretic transdermal system (ITS) vs the morphine intravenous patient-controlled analgesia (IV PCA) as assessed by the nurse. Meta-analysis of three phase 3B randomized active-comparator trials. This meta-analysis according to Cochrane's approach assessed EOC using a validated nurse questionnaire (22 items grouped into three subscales, which include time efficiency, convenience, and satisfaction) in adult patients treated with fentanyl ITS or morphine IV PCA for postoperative pain management. The weighted mean difference (WMD) between treatments was calculated. EOC analyses were based on responses to questionnaires from 848 (fentanyl ITS) and 761 (morphine IV PCA) nurses. Fentanyl ITS was reported to provide significant advantages compared with morphine IV PCA in terms of nurses' overall EOC (WMD = -0.57, P PCA. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  10. Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery Estudo comparativo de duas diferentes modalidades de analgesia controlada pelo paciente após cirurgia cardíaca

    Directory of Open Access Journals (Sweden)

    Fabiane Almeida Mota

    2010-03-01

    ção e efeitos colaterais. MÉTODOS: Ensaio clínico randomizado em que foram estudados pacientes submetidos a cirurgias cardíacas, que utilizaram PCA com e sem infusão intravenosa de morfina. No pós-operatório, ao se extubar os pacientes, foi instalada PCA nas duas modalidades, conforme o sorteio. Intensidade dolorosa, consumo analgésico, número de solicitações analgésicas, satisfação e efeitos colaterais foram avaliados no momento da extubação e nas 6, 12, 18, 24 e 30 horas seguintes. RESULTADOS: Foram avaliados 100 pacientes, sendo 50 no grupo (A que recebeu PCA sem infusão contínua de morfina, e 50 no grupo (B que utilizou PCA com infusão contínua de morfina. Pacientes do grupo (B consumiram mais morfina, solicitaram menos vezes, e ficaram mais satisfeitos com a analgesia. Não se observaram diferenças significantes entre os grupos quanto à intensidade da dor e aos efeitos colaterais. CONCLUSÕES: O controle da dor foi eficiente e similar em ambos os grupos estudados. A mesma eficácia de analgesia e o menor consumo de morfina sugerem que PCA sem infusão contínua de morfina seja a melhor opção no controle da dor no pós-operatório de cirurgia cardíaca.

  11. Labor analgesia in preeclampsia: remifentanil patient controlled intravenous analgesia versus epidural analgesia.

    Science.gov (United States)

    El-Kerdawy, Hala; Farouk, Adel

    2010-02-01

    Epidural analgesia is considered to be the preferred method of labor analgesia in preeclamptic patients. Systemic opioids are another good effective, easy to administer alternative but may cause maternal and fetal respiratory depression. Remifentanil's rapid onset and offset of effects, should make it an ideal drug for the intermittent painful contraction during labor. Method. 30 preeclamptic patients were randomly assigned to one of two equal groups; Epidural Group: received epidural analgesia according to a standardized protocol using bupivacaine plus fentanyl. REMIFENTANIL GROUP: PCA was set up to deliver remlfentanil 0.5 microg/kg as a loading bolus infused over 20 seconds, lockout time of 5 minutes, PCA bolus of 0.25 microg/kg, continuous background infusion of 0.05 microg/kg/min, and maximum dose is 3 mg in 4 hours. Women were advised to start the PCA bolus when they feel the signs of a coming uterine contraction. All women demonstrated a significant decrease in VAS score in the first hour after administration of analgesia (P 0.05). PCA remifentanil infusion until time of delivery produce no observable maternal, fetal or neonatal side effects (P < 0.05). PCA intravenous remifentanil is an effective option for pain relief with minimal maternal and neonatal side effects in labor for preeclamptic patients with contraindications to epidural analgesia or requesting opioid analgesia.

  12. Comparação de morfina administrada por via intravenosa e via epidural com/sem bupivacaína ou ropivacaína no tratamento da dor pós-toracotomia com a técnica de analgesia controlada pelo paciente Comparación de la morfina administrada por vía intravenosa y vía epidural con /sin bupivacaína o ropivacaína en el tratamiento del dolor pos toracotomía con la técnica de analgesia controlada por el paciente Comparison of intravenous morphine, epidural morphine with/without bupivacaine or ropivacaine in postthoracotomy pain management with patient controlled analgesia technique

    Directory of Open Access Journals (Sweden)

    Esra Mercanoğlu

    2013-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O objetivo deste estudo randomizado, duplo-cego e prospectivo foi determinar a eficácia e os efeitos colaterais da administração por via intravenosa ou epidural de morfina, bupivacaína ou ropivacaína no tratamento da dor pós-toracotomia. MÉTODOS: Sessenta pacientes submetidos a procedimentos de toracotomia eletiva foram randomicamente alocados em quatro grupos com o uso da técnica de envelopes lacrados. Os grupos MIV, ME, MEB e MER receberam morfina controlada pelo paciente por via intravenosa, e morfina, morfina-bupivacaína e morfina- ropivacaína epidural, respectivamente. Frequência cardíaca, pressão arterial e saturação de oxigênio perioperatórias e dor pós-operatória em repouso e durante a tosse, efeitos colaterais e necessidade de analgésicos de resgate foram registrados aos 30 e 60 minutos e em duas, quatro, seis, 12, 24, 36, 48 e 72 horas. RESULTADOS: A necessidade de sódio diclofenaco durante o estudo foi menor no grupo ME. A área sob a curva de tempo na VAS foi menor no grupo ME em comparação com o Grupo MIV, mas similar aos Grupos MEB e MER. Os escores de dor em repouso foram maiores nos tempos 12, 24, 36 e 48 horas no Grupo MIV em comparação com o Grupo ME. Os escores de dor em repouso foram maiores aos 30 e 60 minutos nos Grupos ME e MIV em comparação com o Grupo MEB. Os escores de dor durante a tosse aos 30 minutos foram maiores no grupo ME em comparação com o Grupo MEB. Não houve diferença entre os Grupos MIV e MER. CONCLUSÕES: Morfina administrada por via epidural foi mais eficaz do que por via intravenosa. A eficácia foi maior no grupo EM no período pós-operatório tardio e no Grupo MEB no período pós-operatório inicial. Concluímos que morfina administrada por via epidural foi a mais eficaz e preferida.JUSTIFICATIVA Y OBJETIVOS: El objetivo de este estudio aleatorio, doble ciego y prospectivo fue determinar la eficacia y los efectos colaterales de la administraci

  13. Preventive analgesia

    DEFF Research Database (Denmark)

    Dahl, Jørgen B; Kehlet, Henrik

    2011-01-01

    This paper will discuss the concepts of pre-emptive and preventive analgesia in acute and persistent postsurgical pain, based on the most recent experimental and clinical literature, with a special focus on injury-induced central sensitization and the development from acute to chronic pain. Recent...... of preventive analgesia for persistent postoperative pain are promising. However, clinicians must be aware of the demands for improved design of their clinical studies in order to get more conclusive answers regarding the different avenues for intervention. Summary: The concept of preventive analgesia is still...

  14. Parent-controlled PCA for pain management in pediatric oncology: is it safe?

    Science.gov (United States)

    Anghelescu, Doralina L; Faughnan, Lane G; Oakes, Linda L; Windsor, Kelley B; Pei, Deqing; Burgoyne, Laura L

    2012-08-01

    Patient-controlled analgesia offers safe and effective pain control for children who can self-administer medication. Some children may not be candidates for patient-controlled analgesia (PCA) unless a proxy can administer doses. The safety of proxy-administered PCA has been studied, but the safety of parent-administered PCA in children with cancer has not been reported. In this study, we compare the rate of complications in PCA by parent proxy versus PCA by clinician (nurse) proxy and self-administered PCA. Our pediatric institution's quality improvement database was reviewed for adverse events associated with PCA from 2004 through 2010. Each PCA day was categorized according to patient or proxy authorization. Data from 6151 PCA observation days were included; 61.3% of these days were standard PCA, 23.5% were parent-proxy PCA, and 15.2% were clinician-proxy PCA days. The mean duration of PCA use was 12.1 days, and the mean patient age was 12.3 years. The mean patient age was lower in the clinician-proxy (9.4 y) and parent-proxy (5.1 y) groups, respectively. The complication rate was lowest in the parent-proxy group (0.62%). We found that proxy administration of PCA by authorized parents is as safe as clinician administered and standard PCA at our pediatric institution.

  15. Parent-Controlled PCA for Pain Management in Pediatric Oncology: Is it Safe?

    OpenAIRE

    Anghelescu, Doralina L.; Faughnan, Lane G.; Oakes, Linda L.; Windsor, Kelley B.; Pei, Deqing; Burgoyne, Laura L.

    2012-01-01

    Patient-controlled analgesia offers safe and effective pain control for children who can self-administer medication. Some children may not be candidates for PCA unless a proxy can administer doses. The safety of proxy-administered PCA has been studied, but the safety of parent-administered PCA in children with cancer has not been reported. In this study we compare the rate of complications in PCA by parent proxy versus PCA by clinician (nurse) proxy and self-administered PCA. Our pediatric in...

  16. Obstetric Analgesia

    OpenAIRE

    Thistlewood, John M.

    1988-01-01

    This article deals with current knowledge about labour pain; the effects of labour pain on the parturient, the fetus, and uterine activity; the benefits and risks of the various labour-pain options; and the parturient's right to exercise informed choice of analgesia options.

  17. Acciones inmunofarmacológicas de las inmunoglobulinas intravenosas

    Directory of Open Access Journals (Sweden)

    Amaury Noda

    2001-03-01

    Full Text Available Se ha recorrido un largo camino en la comprensión de los mecanismos de acción relativos a la infusión de preparados de inmunoglobulinas intravenosas desde los días donde un crudo de fracción II de Cohn obtenido de plasma humano fue administrado intramuscularmente a pacientes aquejados de agammaglobulinemia de Brutton, hasta nuestros días. Debemos hacer una distinción entre los mecanismos de acción al nivel del patógeno que provoca la enfermedad, de aquellos al nivel de una enfermedad dada provocada por la reacción del huésped contra el patógeno. El efecto de supresión de las inmunoglobulinas intravenosas en las respuestas autoinmunes abre nuevas perspectivas terapéuticas y permite un nuevo acercamiento a la comprensión de los mecanismos básicos que explican la autoinmunidad patológica.

  18. Bloqueio 3-em-1 prolongado versus analgesia sistêmica no tratamento da dor pós-operatória após a reconstrução do ligamento cruzado anterior do joelho Bloqueo 3 en 1 prolongado versus analgesia sistemica en el tratamiento del dolor postoperatorio después de la reconstrucción del ligamento cruzado anterior de la rodilla Extended three-in-one block versus intravenous analgesia for postoperative pain management after reconstruction of anterior cruciate ligament of the knee

    Directory of Open Access Journals (Sweden)

    Víctor A. Contreras-Domínguez

    2007-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio femoral contínuo (3-em-1 é usado para a analgesia pós-operatória de artroplastia de quadril e joelho com bons resultados, apresentando vantagens sobre outras técnicas de analgesia locorregional ou sistêmica e com baixa incidência de complicações. O objetivo deste estudo foi avaliar clinicamente a utilidade do bloqueio femoral contínuo em comparação com a analgesia por via venosa na reconstrução do ligamento cruzado anterior. MÉTODO: Foi realizado um estudo prospectivo, controlado, com 60 pacientes com estado físico ASA I. Os paciente foram divididos em dois grupos: Grupo 1 (n = 30: bloqueio femoral contínuo com infusão de bupivacaína e clonidina; Grupo 2 (n = 30: infusão por via venosa de cetoprofeno. A intervenção cirúrgica foi realizada sob raquianestesia e sedação. O tratamento da dor pós-operatória foi feito com analgesia controlada pelo paciente (PCA usando morfina. A dor pós-operatória foi registrada 2, 4, 6, 24 e 36 horas após a intervenção cirúrgica usando a Escala Visual Analógica (VAS. O consumo de morfina, a satisfação dos pacientes e as complicações também foram registradas. RESULTADOS: No Grupo 1, o VAS pós-operatório entre 4 e 48 horas após a intervenção cirúrgica foi de 21 mm ± 2 e no Grupo 2 foi de 45 mm ± 4 (p JUSTIFICATIVA Y OBJETIVOS: El bloqueo femoral continuo (tres-en-uno se usa para la analgesia postoperatoria de artroplastia de cadera y rodilla con buenos resultados, presentando ventajas sobre otras técnicas de analgesia loco regional o sistemica y con baja incidencia de complicaciones. El objetivo de este estudio fue el de evaluar clínicamente la utilidad del bloqueo femoral continuo en comparación con la analgesia intravenosa en la reconstrucción del ligamento cruzado anterior. MÉTODOS: Se realizó un estudio prospectivo controlado con 60 pacientes de estado físico ASA I. Los pacientes fueron divididos en dos grupos: Grupo 1 (n

  19. The PCa Tumor Microenvironment.

    Science.gov (United States)

    Sottnik, Joseph L; Zhang, Jian; Macoska, Jill A; Keller, Evan T

    2011-12-01

    The tumor microenvironment (TME) is a very complex niche that consists of multiple cell types, supportive matrix and soluble factors. Cells in the TME consist of both host cells that are present at tumor site at the onset of tumor growth and cells that are recruited in either response to tumor- or host-derived factors. PCa (PCa) thrives on crosstalk between tumor cells and the TME. Crosstalk results in an orchestrated evolution of both the tumor and microenvironment as the tumor progresses. The TME reacts to PCa-produced soluble factors as well as direct interaction with PCa cells. In return, the TME produces soluble factors, structural support and direct contact interactions that influence the establishment and progression of PCa. In this review, we focus on the host side of the equation to provide a foundation for understanding how different aspects of the TME contribute to PCa progression. We discuss immune effector cells, specialized niches, such as the vascular and bone marrow, and several key protein factors that mediate host effects on PCa. This discussion highlights the concept that the TME offers a potentially very fertile target for PCa therapy.

  20. PCA safety data review after clinical decision support and smart pump technology implementation.

    Science.gov (United States)

    Prewitt, Judy; Schneider, Susan; Horvath, Monica; Hammond, Julia; Jackson, Jason; Ginsberg, Brian

    2013-06-01

    Medication errors account for 20% of medical errors in the United States with the largest risk at prescribing and administration. Analgesics or opioids are frequently used medications that can be associated with patient harm when prescribed or administered improperly. In an effort to decrease medication errors, Duke University Hospital implemented clinical decision support via computer provider order entry (CPOE) and "smart pump" technology, 2/2008, with the goal to decrease patient-controlled analgesia (PCA) adverse events. This project evaluated PCA safety events, reviewing voluntary report system and adverse drug events via surveillance (ADE-S), on intermediate and step-down units preimplementation and postimplementation of clinical decision support via CPOE and PCA smart pumps for the prescribing and administration of opioids therapy in the adult patient requiring analgesia for acute pain. Voluntary report system and ADE-S PCA events decreased based upon 1000 PCA days; ADE-S PCA events per 1000 PCA days decreased 22%, from 5.3 (pre) to 4.2 (post) (P = 0.09). Voluntary report system events decreased 72%, from 2.4/1000 PCA days (pre) to 0.66/1000 PCA days (post) and was statistically significant (P PCA events between time periods in both the ADE-S and voluntary report system data, thus supporting the recommendation of clinical decision support via CPOE and PCA smart pump technology.

  1. No morphine sparing effect of ketamine added to morphine for patient-controlled intravenous analgesia after uterine artery embolization

    DEFF Research Database (Denmark)

    Jensen, Luana Leonora; Handberg, Gitte; Helbo-Hansen, H S

    2008-01-01

    group, n=26) by i.v. patient-controlled analgesia (IV-PCA). Pump settings were bolus dose 1 ml, lockout 10 min, no background infusion. In addition, all patients received diclofenac and acetaminophen for pain relief. Pain scores, morphine consumption and adverse events like nausea, vomiting, itching...... conditions of basal analgesia with acetaminophen and diclofenac, we failed to demonstrate any morphine-sparing effect of IV-PCA ketamine and morphine compared with IV-PCA morphine alone....

  2. Patient-controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour

    DEFF Research Database (Denmark)

    Weibel, Stephanie; Jelting, Yvonne; Afshari, Arash

    2017-01-01

    of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials.gov, the WHO International Clinical Trials...... opioid (PCA), or with epidural analgesia, or with remifentanil (continuous IV), or with remifentanil (PCA, different regimen), or with inhalational analgesia, or with placebo/no treatment in all women in labour including high-risk groups with planned vaginal delivery. DATA COLLECTION AND ANALYSIS: Two...... of effect that remifentanil (PCA) was associated with an increased risk for maternal respiratory depression when compared to epidural analgesia (RR 0.91, 95% CI 0.51 to 1.62, ccc 0.01, three trials, low-quality evidence) and no reliable conclusion might be reached compared to remifentanil (continuous IV...

  3. Metoclopramide improves the quality of tramadol PCA indistinguishable to morphine PCA: a prospective, randomized, double blind clinical comparison.

    Science.gov (United States)

    Pang, Weiwu; Liu, Yu-Cheng; Maboudou, Edgard; Chen, Tom Xianxiu; Chois, John M; Liao, Cheng-Chun; Wu, Rick Sai-Chuen

    2013-09-01

    Multimodal analgesia has been effectively used in postoperative pain control. Tramadol can be considered "multimodal" because it has two main mechanisms of action, an opioid agonist and a reuptake inhibitor of norepinephrine and serotonin. Tramadol is not as commonly used as morphine due to the increased incidence of postoperative nausea and vomiting (PONV). As metoclopramide is an antiemetic and an analgesic, it was hypothesized that when added to reduce PONV, metoclopromide may enhance the multimodal feature of tramadol by the analgesic property of metoclopramide. Therefore, the effectiveness of postoperative patient-controlled analgesia (PCA) with morphine was compared against PCA with combination of tramadol and metoclopramide. A prospective, randomized, double blind clinical trial. Academic pain service of a university hospital. Sixty patients undergoing elective total knee arthroplasty with general anesthesia. Sixty patients were randomly divided into Group M and Group T. In a double-blinded fashion, Group M received intraoperative 0.2 mg/kg morphine and postoperative PCA with 1 mg morphine per bolus, whereas Group T received intraoperative tramadol 2.5 mg/kg and postoperative PCA with 20 mg tramadol plus 1 mg metoclopramide per bolus. Lockout interval was 5 minutes in both groups. Pain scale, satisfaction rate, analgesic consumption, PCA demand, and side effects were recorded by a blind investigator. These two groups displayed no statistically significant difference between the items and variables evaluated. This combination provides analgesia equivalent to that of morphine and can be used as an alternative to morphine PCA. Wiley Periodicals, Inc.

  4. Choice of a Perioperative Analgesia Mode during Hip Joint Replacement

    Directory of Open Access Journals (Sweden)

    D. B. Borisov

    2010-01-01

    Full Text Available Objective: to evaluate the efficiency and safety of various perioperative analgesia modes during total hip joint replacement (THR. Subjects and methods. A randomized controlled trial enrolled 90 patients who were divided into 3 groups according to the choice of a perioperative analgesia mode on day 1: general sevofluorane anesthesia, by switching to intravenous patient-controlled analgesia with fentanyl (PCA, GA group, a combination of general and spinal bupiva-caine anesthesia, by switching to PCA with fentanyl (SA group, a combination of general and epidural ropivacaine anesthesia with continuous postoperative epidural ropivacaine infusion (EA group. All the patients received non-opi-oid analgesics after surgery. Results. Prolonged epidural block ensures better postoperative analgesia at rest and during mobilization and a less need for opioids than other analgesia modes (p<0.05. With neuroaxial block, the preoperative need for sympatomimetics is much higher than that in the GA group (p<0.05. There is also a trend toward a higher incidence of cardiac arrhythmias and postoperative nausea and vomiting in the SA and EA groups. There are no differences in the frequency of hemotransfusion and postoperative complications and the length of hospital stay. Conclusion. Prolonged epidural block provides excellent perioperative analgesia during THR, but the risk-benefit ratio needs to be carefully assessed when an analgesia mode is chosen.

  5. Patient controlled analgesia for extracorporeal shock wave lithotripsy of gallstones.

    Science.gov (United States)

    Schelling, G; Mendl, G; Weber, W; Pauletzki, J; Sackmann, M; Pöppel, E; Peter, K

    1992-03-01

    Sixty patients undergoing shock wave lithotripsy of gallbladder stones (ESWL) were randomly assigned to receive alfentanil either by infusion controlled by the attending anesthesiologist (standard treatment group, n = 31) or by analgesia controlled by the patient (PCA group, n = 29). Patients using PCA were allowed to self-administer 0.25 mg of alfentanil i.v. every minute as required. Data collected during treatment included the total dose of drug required, transcutaneous pCO2 values, verbal pain and sedation scores, visual analogue scale (VAS) patient satisfaction scores, and the incidence of nausea or vomiting. PCA patients used less alfentanil than the standard treatment group (PCA group: 12.8 micrograms/kg; standard treatment group: 44.3 micrograms/kg; mean values, P = 0.0001), tolerated significantly higher pain intensities and self-administered the narcotic only to moderate levels of pain but not to pronounced analgesia. Standard treatment patients reported lower levels of pain, were more sedated (P less than 0.05) and showed significantly higher transcutaneous pCO2 values. There was a trend towards a lower incidence of nausea or vomiting in PCA patients without reaching statistical significance. No significant difference with regard to patient satisfaction with pain relief could be demonstrated. Self-administered alfentanil during ESWL of gallbladder stones provided adequate analgesia with minimal side effects and high patient satisfaction. ESWL may represent a new and useful indication for PCA.

  6. Uso de kits desechables para optimizar tiempos, movimientos y apego a protocolos de la terapia intravenosa

    OpenAIRE

    José Juan Escamilla Zamudio; Gretta Itzel Ramírez Chávez

    2017-01-01

    Introducción: En México un 95% de los pacientes hospitalizados requerirán un acceso vascular y terapia intravenosa; sin embargo, el uso de intervenciones estandarizadas favorece a la prevención y reducción de infecciones asociadas a catéter vascular. El objetivo es demostrar el beneficio al implementar el uso de kits desechables en procedimientos de terapia intravenosa en comparación con el método tradicional en instituciones de salud en México. Materiales y Métodos: Estudio prospectivo cuasi...

  7. Epidural Analgesia Versus Patient-Controlled Analgesia for Pain Relief in Uterine Artery Embolization for Uterine Fibroids: A Decision Analysis

    International Nuclear Information System (INIS)

    Kooij, Sanne M. van der; Moolenaar, Lobke M.; Ankum, Willem M.; Reekers, Jim A.; Mol, Ben Willem J.; Hehenkamp, Wouter J. K.

    2013-01-01

    Purpose: This study was designed to compare the costs and effects of epidural analgesia (EDA) to those of patient-controlled intravenous analgesia (PCA) for postintervention pain relief in women having uterine artery embolization (UAE) for systematic uterine fibroids. Methods: Cost-effectiveness analysis (CEA) based on data from the literature by constructing a decision tree to model the clinical pathways for estimating the effects and costs of treatment with EDA and PCA. Literature on EDA for pain-relief after UAE was missing, and therefore, data on EDA for abdominal surgery were used. Outcome measures were compared costs to reduce one point in visual analogue score (VAS) or numeric rating scale (NRS) for pain 6 and 24 h after UAE and risk for complications. Results: Six hours after the intervention, the VAS was 3.56 when using PCA and 2.0 when using EDA. The costs for pain relief in women undergoing UAE with PCA and EDA were €191 and €355, respectively. The costs for EDA to reduce the VAS score 6 h after the intervention with one point compared with PCA were €105 and €179 after 24 h. The risk of having a complication was 2.45 times higher when using EDA. Conclusions: The results of this indirect comparison of EDA for abdominal surgery with PCA for UAE show that EDA would provide superior analgesia for post UAE pain at 6 and 24 h but with higher costs and an increased risk of complications

  8. Comparação de ibuprofeno via oral e indometacina intravenosa no tratamento da persistência do canal arterial em neonatos com extremo baixo peso ao nascer

    Directory of Open Access Journals (Sweden)

    Eun Mi Yang

    2013-02-01

    Full Text Available OBJETIVO: Existem poucos relatórios publicados com relação à eficácia do ibuprofeno via oral no tratamento da persistência do canal arterial (PCA em neonatos com extremo baixo peso ao nascer (EBPN. Comparamos o ibuprofeno via oral à indometacina intravenosa no que diz respeito à eficácia e segurança no tratamento de PCA em neonatos com peso inferior a 1.000 g ao nascer. MÉTODO: Este foi um estudo retrospectivo em um único centro. Coletamos dados de neonatos com EBPN que tiveram PCA ecocardiograficamente confirmada. Os neonatos foram tratados tanto com indometacina intravenosa quanto com ibuprofeno via oral. A taxa de fechamento do canal, a necessidade de tratamentos adicionais, os efeitos colaterais ou as complicações relacionadas ao medicamento e a mortalidade foram comparados entre os dois grupos de tratamento. RESULTADO: Examinamos 26 neonatos que receberam indometacina e 22 que receberam ibuprofeno. A taxa geral de fechamento do canal foi semelhante nos dois tratamentos: o fechamento do canal ocorreu em 23 dos 26 neonatos (88,5% no grupo indometacina, e em 18 dos 22 neonatos (81,8% no grupo ibuprofeno (p = 0,40. A taxa de ligadura cirúrgica (11,5% em comparação a 18,2%; p = 0,40 não diferiu de forma significativa entre os dois grupos de tratamento. Após o tratamento, não foi encontrada nenhuma diferença significativa nas concentrações de creatinina sérica entre os dois grupos. Não houve diferenças significativas com relação a efeitos colaterais ou complicações adicionais. CONCLUSÃO: Em neonatos com EBPN, o ibuprofeno via oral é tão eficaz quanto a indometacina intravenosa no tratamento da PCA. Não há diferenças entre os medicamentos no que diz respeito à segurança. O ibuprofeno via oral poderia ser usado como um agente alternativo no tratamento da PCA em neonatos com EBPN.

  9. Uso de kits desechables para optimizar tiempos, movimientos y apego a protocolos de la terapia intravenosa

    Directory of Open Access Journals (Sweden)

    José Juan Escamilla Zamudio

    2017-09-01

    Cómo citar este artículo: Escamilla JJ, Ramírez GI. Uso de kits desechables para optimizar tiempos, movimientos y apego a protocolos de la terapia intravenosa. Rev Cuid. 2017; 8(3: 1749-57. http://dx.doi.org/10.15649/cuidarte.v8i3.412

  10. Postoperative analgesia for supratentorial craniotomy.

    Science.gov (United States)

    Dilmen, Ozlem Korkmaz; Akcil, Eren Fatma; Tunali, Yusuf; Karabulut, Esra Sultan; Bahar, Mois; Altindas, Fatis; Vehid, Hayriye; Yentur, Ercument

    2016-07-01

    The prevalence of moderate to severe pain is high in patients following craniotomy. Although optimal analgesic therapy is mandatory, there is no consensus regarding analgesic regimen for post-craniotomy pain exists. This study aimed to investigate the effects of morphine and non-opioid analgesics on postcraniotomy pain. This prospective, randomized, double blind, placebo controlled study included eighty three patients (ASA 1, II, and III) scheduled for elective supratentorial craniotomy. Intravenous dexketoprofen, paracetamol and metamizol were investigated for their effects on pain intensity, morphine consumption and morphine related side effects during the first 24h following supratentorial craniotomy. Patients were treated with morphine based patient controlled analgesia (PCA) for 24h following surgery and randomized to receive supplemental IV dexketoprofen 50mg, paracetamol 1g, metamizol 1g or placebo. The primary endpoint was pain intensity, secondary endpoint was the effects on morphine consumption and related side effects. When the whole study period was analyzed with repeated measures of ANOVA, the pain intensity, cumulative morphine consumption and related side effects were not different among the groups (p>0.05). This study showed that the use of morphine based PCA prevented moderate to severe postoperative pain without causing any life threatening side effects in patients undergoing supratentorial craniotomy with a vigilant follow up during postoperative 24h. Although we could not demonstrate statistically significant effect of supplemental analgesics on morphine consumption, it was lower in dexketoprofen and metamizol groups than control group. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Petrology of Antarctic Eucrites PCA 91078 and PCA 91245

    Science.gov (United States)

    Howard, L. M.; Domanik, K. J.; Drake, M. J.; Mittlefehldt, D. W.

    2002-01-01

    Antarctic eucrites PCA 91078 and PCA 91245, are petrographically characterized and found to be unpaired, type 6, basaltic eucrites. Observed textures that provide insight into the petrogenesis of these meteorites are also discussed. Additional information is contained in the original extended abstract.

  12. SISTEMA COMPUTARIZADO EN LAZO CERRADO PARA EL SUMINISTRO DE LA ANESTESIA INTRAVENOSA

    Directory of Open Access Journals (Sweden)

    Alberto Vanegas-Saavedra

    2014-12-01

    Full Text Available El sistema de suministro de la anestesia total intravenosa en lazo cerrado es una técnica reciente que ofrece ventajas sobre las técnicas actuales como la estabilidad intraoperatoria y la menor y más segura dosificación. OBJETIVO: El objetivo general de este artículo es el de resumir los hallazgos sobre un nuevo método computarizado sencillo, en lazo cerrado, para suministrar la anestesia total intravenosa de forma automatizada y segura bajo la supervisión permanente del Anestesiólogo. Este sistema se ha desarrollado para la administración de anestesia intravenosa implementando varios subsistemas. Un modelo multicompartimental de distribución de fármacos en el paciente, un algoritmo para determinar la curva de velocidades del hipnótico (propofol a infundir, un protocolo de comunicación para establecer las velocidades de infusión y un lazo de realimentación para controlar la profundidad hipnótica mediante el índice biespectral. RESULTADO: El resultado final ha sido el desarrollo de un instrumento de fácil uso, con una interfaz interactiva, que facilita la operación anestésica por parte del anestesiólogo valiéndose de un computador convencional y un monitor de profundidad hipnótica. CONCLUSIÓN: Se ha implementado una herramienta informática dotada de un modelo farmacocinético multicompartimental de gran interés académico y clínico, que tal y como se ha demostrado de forma cuantitativa, proporciona idénticos resultados a los ofrecidos por equipos comerciales; con importantes ventajas adicionales como una interfaz de usuario interactiva y la posibilidad de administrar anestesia total intravenosa.

  13. Usefulness of modified intravenous analgesia: initial experience in uterine artery embolization for leiomyomata

    International Nuclear Information System (INIS)

    Yang, Seung Boo; Jung, Young Jin; Goo, Dong Erk; Jang, Yun Woo

    2006-01-01

    We wanted to evaluate the usefulness of modified intravenous analgesia for the management of pain during uterine artery embolization for leiomyomata. Between April 2004 and July 2004, 15 patients with symptomatic fibroids underwent uterine artery embolization and pain management. Except the three patients for whom the Visual Analogue Scale (VAS) score was not obtained, twelve patients were included in this study. For pain management, epidural PCA (Patient Controlled Analgesia) was used in two patients, intravenous PCA was used in two patients and modified intravenous analgesia injection was used in eight patients. For all the patients, we used the 2.8 Fr coaxial microcatheter and 500-710 μ m PVA particles for the embolic materials. The protocol of the modified intravenous analgesia injection was as follow, 1) prior to femoral artery puncture, 30 mg of ketorolac tromethamine (Tarasyn)was injected via an intravenous route. 2) At the time that the one side uterine artery embolization was finished, normal saline mixed 150 mg meperidine (Demerol) was administered through the side port of the intravenous line that was used for hydration. 3) Additional ketorolac tromethamine 30 mg was injected after 6 hour. The VAS score and side effects were then checked. After 12 hours, the VAS score was rechecked. If the VAS score was above 4, this was considered as failure of pain management. The VAS scores, complications and side effects for the modified intravenous analgesia injection were compared with that of IV PCA and epidural PCA. The average VAS score of the modified intravenous analgesia injection, intravenous PCA and epidural PCA was 1.4, 1 and 0, respectively; the number of additional intramuscular injections of analgesia was 0.5, 0.5 and 0, respectively. All the patients who underwent epidural PCA had back pain at the puncture site and 1 patient who underwent modified intravenous analgesia injection experienced mild dyspnea, but they easily recovered with such

  14. Inserting epidural patient controlled analgesia into a peripheral venous line.

    Science.gov (United States)

    2016-01-01

    A case is reported from the Safety Reporting System in Anaesthesia and Resuscitation database. The event occurred in a patient undergoing abdominal surgery in whom an epidural catheter was inserted for analgesia. After the intervention, the patient was transferred to the recovery unit where the patient controlled analgesia (PCA) is programmed. Due to an error, the PCA was connected to a peripheral venous line, which was detected early without harm to the patient. Communication and analysis of this incident served to introduce a new drug delivery protocol through PCA pumps, including the obligation to prescribe the PCA in the electronic system, a dual computerised check immediately before connecting PCA, labelling the medication bag as well as the proximal and distal lines, standardisation of daily visits to patients, and monthly monitoring of results. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Safety and Efficacy of a Pharmacist-Managed Patient-Controlled Analgesia Service in Postsurgical Patients.

    Science.gov (United States)

    McGonigal, Katrina H; Giuliano, Christopher A; Hurren, Jeff

    2017-09-01

    To compare the safety and efficacy of a pharmacist-managed patient-controlled analgesia (PCA) service with physician/midlevel provider-managed (standard) PCA services in postsurgical patients. This was a multicenter, retrospective cohort study performed at 3 major hospitals in the Detroit, Michigan, metropolitan area. Postsurgical patients from October 2012 to December 2013 were included. The primary outcome compared the pain area under the curve adjusted for time on PCA (AUC/T) of patients receiving pharmacist-managed PCA services vs. standard care, up to 72 hours after initiation of PCA. Secondary outcomes included initial opioid selection, programmed PCA settings, duration of PCA use, frequency of adjunct analgesia utilization, and frequency of breakthrough analgesia utilization. Safety outcomes were assessed as a composite safety endpoint and individually. Total pain AUC/T scores did not differ between the pharmacist-managed and standard-managed groups (3.25 vs. 3.25, respectively; P = 0.98). Adjunct pain medications were given with similar frequency in the 2 groups; however, significantly fewer patients required breakthrough pain medication in the pharmacist-managed group (11% vs. 36%, respectively; P patients requiring antiemetic use (46% vs. 32%; P = 0.04). A pharmacist-managed PCA service provided no difference in pain control compared to standard management. The requirement for breakthrough analgesia was decreased in the pharmacist group, while the need for antiemetic use was increased. Further research should be conducted to evaluate different PCA management strategies. © 2016 World Institute of Pain.

  16. Circle of Willis Variants: Fetal PCA

    Directory of Open Access Journals (Sweden)

    Amir Shaban

    2013-01-01

    Full Text Available We sought to determine the prevalence of fetal posterior cerebral artery (fPCA and if fPCA was associated with specific stroke etiology and vessel territory affected. This paper is a retrospective review of prospectively identified patients with acute ischemic stroke from July 2008 to December 2010. We defined complete fPCA as absence of a P1 segment linking the basilar with the PCA and partial fPCA as small segment linking the basilar with the PCA. Patients without intracranial vascular imaging were excluded. We compared patients with complete fPCA, partial fPCA, and without fPCA in terms of demographics, stroke severity, distribution, and etiology and factored in whether the stroke was ipsilateral to the fPCA. Of the 536 included patients, 9.5% ( had complete fPCA and 15.1% ( had partial fPCA. Patients with complete fPCA were older and more often female than partial fPCA and no fPCA patients, and significant variation in TOAST classification was detected across groups (. Patients with complete fPCA had less small vessel and more large vessel strokes than patients with no fPCA and partial fPCA. Fetal PCA may predispose to stroke mechanism, but is not associated with vascular distribution, stroke severity, or early outcome.

  17. PCA-derived factors that may be predictive of postoperative pain in pediatric patients: a possible role for the PCA ratio.

    Science.gov (United States)

    McDonnell, Conor; Pehora, Carolyne; Crawford, Mark W

    2012-01-01

    No method exists to reliably predict which patients will develop severe postoperative pain. The authors hypothesized that data derived from patient-controlled analgesia (PCA) pumps (specifically the ratio of patient demands to pump deliveries) may predict which patients would develop severe pain after scoliosis repair. Quaternary, university-affiliated, pediatric hospital. Forty American Society of Anesthesiologists I-Il pediatric patients who had undergone elective scoliosis repair and had consented to recruitment to a randomized clinical trial investigating the effects of early morphine administration on remifentanil-induced hyperalgesia. To test the hypothesis of the current study, the authors calculated the PCA ratio of demand to delivery at every 4 hours throughout the first 24 hours after surgery for all the patients recruited to the original study. The authors compared calculated PCA ratios, numeric rating scale pain scores, and cumulative morphine consumption for those patients who developed severe postoperative pain and met the criteria for opioid rotation versus those patients who did not. Seven patients required opioid rotation from PCA morphine to PCA hydromorphone. Eight hours after surgery, the median PCA ratio for those seven patients (2.5[range, 1.8-4.3]) was significantly greater than that for all other recruited patients (1.3 [range, 0-2.7]; p PCA ratios of demand to delivery as early as 8 hours after surgery.

  18. Patient-controlled versus nurse-controlled post-operative analgesia after caesarean section

    Directory of Open Access Journals (Sweden)

    Amin Ebneshahidi

    2012-01-01

    Full Text Available Background:The aim of this study was to compare the differences in the quality of analgesia by patient-controlled analgesia (PCA and nurse-controlled analgesia (NCA for post-caesarean section analgesia. Materials and Methods:350 women who undertake elective cesarean section were assigned to the three groups. Group I (n=200, IV-PCA morphine; group II (n=100, IV-PCA methadone; group III (n=50 NCA morphine. Data collected during the 24 h observation period included visual analog scale (VAS pain and patient satisfaction scores, the incidence of nausea and vomiting, severe sedation and pruritis. Results: VAS pain scores for each time at which it was evaluated were higher for NCA group than other groups. Also patient satisfaction was significantly increased in the IV-PCA Group as compared with group III. The prevalence of pruritis was higher for NCA group than other groups. Conclusion:In post caesarean section, PCA morphine or methadone improves 24-h VAS compared with NCA.

  19. PCaPAC 2006 Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    Pavel Chevtsov; Matthew Bickley (Eds.)

    2007-03-30

    The 6-th international PCaPAC (Personal Computers and Particle Accelerator Controls) workshop was held at Jefferson Lab, Newport News, Virginia, from October 24-27, 2006. The main objectives of the conference were to discuss the most important issues of the use of PCs and modern IT technologies for controls of accelerators and to give scientists, engineers, and technicians a forum to exchange the ideas on control problems and their solutions. The workshop consisted of plenary sessions and poster sessions. No parallel sessions were held.Totally, more than seventy oral and poster presentations as well as tutorials were made during the conference, on the basis of which about fifty papers were submitted by the authors and included in this publication. This printed version of the PCaPAC 2006 Proceedings is published at Jefferson Lab according to the decision of the PCaPAC International Program Committee of October 26, 2006.

  20. [Acupuncture direction and analgesia].

    Science.gov (United States)

    Sun, Lu; Kou, Renzhong; Liu, Lanqing; Fan, Gangqi

    2017-03-12

    The acupuncture direction is closely related with the efficacy of acupuncture analgesia. In this article, the relationship between efficacy of acupuncture analgesia and factors, such as whether the needle towards disease location, whether the needle towards meridian direction, whether the needle following spinal cord direction and whether the needle following muscle direction, were analyzed. The previous clinical and literature research indicated that the needle towards disease location was superior to reverse direction, however, the efficacy of analgesia between needle following and reversing meridian, needle towards and at disease location, needles following and reversing spinal cord direction, needles following and reversing muscle direction was controversial. Therefore, the solutions to these problems will benefit the optimized acupuncture treatment plan for pain disorders.

  1. Current status of patient-controlled analgesia in cancer patients.

    Science.gov (United States)

    Ripamonti, C; Bruera, E

    1997-03-01

    Patient-controlled analgesia (PCA) is a relatively new technique in which patients are able to self-administer small doses of opioid analgesics when needed. Many different devices are available for opioid infusion, including a syringe pump, disposable plastic cylinder, and battery-operated computer-driven pump. These devices allow patients to choose an intermittent (demand) bolus, continuous infusion, or both modes of administration. Parameters, such as route, drug concentration dose, frequency, and maximum daily or hourly dose, are programmed by the physician. The patient decides whether or not to take a dose. Devices can be used to deliver the drug into a running intravenous infusion, the epidural space, or subcutaneously. Controlled trials indicate that PCA is probably superior to regular opioid administration in postoperative pain. Reported advantages include greater patient satisfaction, decreased sedation and anxiety, and reduced nursing time and hospitalization. Preliminary experience suggests that PCA is also useful and safe for cancer pain, but further research is greatly needed.

  2. Speeding up PCA in R

    DEFF Research Database (Denmark)

    Kucheryavskiy, Sergey V.

    and computational issues if standard algorithms for estima- tion of principal components are employed. In the present work author is going to share his experience of creating an in- teractive tool for exploratory analysis of relatively large hyperspectral images with PCA using R and JavaScript based user interface...

  3. analgesia in small children

    African Journals Online (AJOL)

    36:20 26. 6. Prince DD, Man J, Lu J. Effects of the combined oral administration of NSAIDS and dextromethorphan on behavioral symptoms indicative of arthritic pain in rat. Pain 1996; 68: 119 127. 7. Tonussi CR, Ferreira SH. Mechanism of diclofenac analgesia: direct blockade of. inflammatory sensitization Eur J Pharmacol.

  4. Analgesia for acute pain

    African Journals Online (AJOL)

    ailment known to man, and acute pain is an experience familiar to all. Pain is defined as an unpleasant sensation associated with ... of the pathways involved in pain perception, and how these pathways can be targeted with various modalities is required to obtain adequate analgesia. This article provides an overview of the ...

  5. EVALUACIÓN DE LA ANALGESIA PERIOPERATORIA DEL FENTANILO, LIDOCAINA, KETAMINA, DEXMEDETOMIDINA O LA COMBINACIÓN LIDOCAINA-KETAMINA-DEXMEDETOMIDINA EN PERRAS SOMETIDAS A OVARIOHISTERECTOMIA

    OpenAIRE

    GUTIÉRREZ BLANCO, EDUARDO

    2013-01-01

    Las técnicas de anestesia equilibrada proveen una mejor estabilidad cardiovascular al reducir los requerimientos de los anestésicos inhalatorios, mejorando la analgesia durante la anestesia general y en el postoperatorio. El objetivo de este estudio fue evaluar los efectos sobre el requerimiento de isoflurano y analgésicos postquirúrgicos durante la infusión continua (IC) intravenosa (IV) de fentanilo (FENT), lidocaina (LIDO), ketamina (KET), dexmedetomidina (DEX), o la combinación lidocaína-...

  6. PCA

    African Journals Online (AJOL)

    2012-08-01

    ISOMAP) are dimensionality reduction techniques employed to transform a high- dimensional data ... Aircrafts, Electrical power generation Systems, Trains, Marine .... GTE data is nonlinear and the distribution of the data is not ...

  7. Introducing a patient-controlled analgesia-based acute pain relief ...

    African Journals Online (AJOL)

    The 10 months after the introduction of the first acute pain relief service (APRS) in southern Africa is described. Seven hundred patients were treated with morphine by means of patient-controlled analgesia (PCA), administered to patients after major surgery or extensive burns via the intravenous (IV) or subcutaneous (SC) ...

  8. ANALGESIA TRANSOPERATÓRIA INDUZIDA PELA MORFINA OU MEPERIDINA EM GATOS SUBMETIDOS A OSTEOSSÍNTESE

    OpenAIRE

    Cunha, João Marcelo Caldeira Cardoso Pinto da; Cortopassi, Silvia Renata Gaido; Machado, Aline

    2002-01-01

    O objetivo do presente estudo foi avaliar a qualidade da analgesia proporcionada pela morfina e meperidina em gatos acometidos por processos traumáticos e submetidos a osteossíntese. Para tanto, foram utilizados 18 animais distribuídos em dois grupos: o grupo I recebeu acepromazina (0,2mg/kg) e meperidina (4,0mg/kg), ambos pela via intramuscular; a indução anestésica foi realizada através da administração de quetamina (3,0mg/kg) e midazolam (0,3mg/kg) ambos pela via intravenosa, e a manutençã...

  9. Circle of Willis Variants: Fetal PCA

    OpenAIRE

    Amir Shaban; Karen C. Albright; Amelia K. Boehme; Sheryl Martin-Schild

    2013-01-01

    We sought to determine the prevalence of fetal posterior cerebral artery (fPCA) and if fPCA was associated with specific stroke etiology and vessel territory affected. This paper is a retrospective review of prospectively identified patients with acute ischemic stroke from July 2008 to December 2010. We defined complete fPCA as absence of a P1 segment linking the basilar with the PCA and partial fPCA as small segment linking the basilar with the PCA. Patients without intracranial vascular ima...

  10. Peripheral Opioid Analgesia

    Science.gov (United States)

    1999-07-16

    well. Morphine was isolated in 1806 and as early as 1850 it was used medicinally in conjunction with anesthesia , and it continues to be used for pain...and morphine stimulate POMC expression which is probably mediated through CRH. In the periphery of humans, rats and cows the POMC mRNA is 200-300 base...use of any copyrighted material in the dissenation entitled: "Peripheral Opioid Analgesia" beyond brief excerpts is with the pennission of the

  11. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain

    DEFF Research Database (Denmark)

    Carstensen, M.; Møller, Ann

    2010-01-01

    In experimental trials, ketamine has been shown to reduce hyperalgesia, prevent opioid tolerance, and lower morphine consumption. Clinical trials have found contradictory results. We performed a review of randomized, double-blinded clinical trials of ketamine added to opioid in i.v. patient......-controlled analgesia (PCA) for postoperative pain in order to clarify this controversy. Our primary aim was to compare the effectiveness and safety of postoperative administered ketamine in addition to opioid for i.v. PCA compared with i.v. PCA with opioid alone. Studies were identified from the Cochrane Library 2003...... of 4.5. Pain was assessed using visual analogue scales or verbal rating scales. Six studies showed significant improved postoperative analgesia with the addition of ketamine to opioids. Five studies showed no significant clinical improvement. For thoracic surgery, the addition of ketamine to opioid...

  12. Tensile properties of unirradiated path A PCA

    International Nuclear Information System (INIS)

    Braski, D.N.; Maziasz, P.J.

    1983-01-01

    The tensile properties of PCA in the Al (solution annealed), A3 (25%-cold worked), and B2 (aged, cold worked, and reaged) conditions were determined from room temperature to 600 0 C. The tensile behavior of PCA-A1 and -A3 was generally similar to that of titanium-modified type 316 stainless steel with similar microstructures. The PCA-B2 was weaker than PCA-A3, especially above 500 0 C, but demonstrated slightly better ducility

  13. Remifentanil for labour analgesia: a double-blinded, randomised controlled trial of maternal and neonatal effects of patient-controlled analgesia versus continuous infusion.

    Science.gov (United States)

    Shen, M K; Wu, Z F; Zhu, A B; He, L L; Shen, X F; Yang, J J; Feng, S W

    2013-03-01

    This trial aimed to compare the maternal and neonatal effects of remifentanil given by patient-controlled analgesia (PCA) or continuous infusion for labour analgesia. Patient controlled analgesia was administered using increasing stepwise boluses from 0.1 to 0.4 μg.kg(-1) (0.1 μg.kg(-1) increment, 2 min lockout, n = 30). Continuous infusion used rates from 0.05 to 0.2 μg.kg(-1) .min(-1) (0.05 μg.kg(-1) .min(-1) increment, n = 30). Dose increments were given on request. Women reported lowest pain scores (median (IQR [range]) of 3 (2-4 [2-5]) for PCA and 4 (3-5.25 [3-7]) for continuous infusion (p = 0.004) at 60 min after the beginning of analgesia. The mean (SD) remifentanil umbilical vein/maternal artery ratio in the PCA and infusion groups were 0.74 (0.45) vs 0.70 (0.52), respectively (p = 0.776). The mean (SD) umbilical artery/umbilical vein ratios were 0.31 (0.12) vs 0.26 (0.07), respectively (p = 0.088). Maternal and neonatal adverse reactions of remifentanil were similar between the two groups. The total remifentanil consumption (median (IQR [range]) during PCA administration was lower than continuous infusion, 1.34 (1.22-1.48 [0.89-1.69]) mg vs 1.49 (1.35-1.61 [1.12-1.70] mg; p = 0.011). The results suggest that remifentanil PCA provides better pain relief and similar placental transfer compared with continuous infusion. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  14. Epidural analgesia during labor vs no analgesia: A comparative study

    Directory of Open Access Journals (Sweden)

    Wesam Farid Mousa

    2012-01-01

    Full Text Available Background: Epidural analgesia is claimed to result in prolonged labor. Previous studies have assessed epidural analgesia vs systemic opioids rather than to parturients receiving no analgesia. This study aimed to evaluate the effect of epidural analgesia on labor duration compared with parturients devoid of analgesia. Methods: One hundred sixty nulliparous women in spontaneous labor at full term with a singleton vertex presentation were assigned to the study. Parturients who request epidural analgesia were allocated in the epidural group, whereas those not enthusiastic to labor analgesia were allocated in the control group. Epidural analgesia was provided with 20 mL bolus 0.5% epidural lidocaine plus fentanyl and maintained at 10 mL for 1 h. Duration of the first and second stages of labor, number of parturients receiving oxytocin, maximal oxytocin dose required for each parturient, numbers of instrumental vaginal, vacuum-assisted, and cesarean deliveries and neonatal Apgar score were recorded. Results: There was no statistical difference in the duration of the active-first and the second stages of labor, instrumental delivery, vacuum-assisted or cesarean delivery rates, the number of newborns with 1-min and 5-min Apgar scores less than 7 between both groups and number of parturients receiving oxytocin, however, the maximal oxytocin dose was significantly higher in the epidural group. Conclusion: Epidural analgesia by lidocaine (0.5% and fentanyl does not prolong labor compared with parturients without analgesia; however, significant oxytocin augmentation is required during the epidural analgesia to keep up the aforementioned average labor duration.

  15. Epidural analgesia during labor vs no analgesia: A comparative study

    Science.gov (United States)

    Mousa, Wesam Farid; Al-Metwalli, Roshdi; Mostafa, Manal

    2012-01-01

    Background: Epidural analgesia is claimed to result in prolonged labor. Previous studies have assessed epidural analgesia vs systemic opioids rather than to parturients receiving no analgesia. This study aimed to evaluate the effect of epidural analgesia on labor duration compared with parturients devoid of analgesia. Methods: One hundred sixty nulliparous women in spontaneous labor at full term with a singleton vertex presentation were assigned to the study. Parturients who request epidural analgesia were allocated in the epidural group, whereas those not enthusiastic to labor analgesia were allocated in the control group. Epidural analgesia was provided with 20 mL bolus 0.5% epidural lidocaine plus fentanyl and maintained at 10 mL for 1 h. Duration of the first and second stages of labor, number of parturients receiving oxytocin, maximal oxytocin dose required for each parturient, numbers of instrumental vaginal, vacuum-assisted, and cesarean deliveries and neonatal Apgar score were recorded. Results: There was no statistical difference in the duration of the active-first and the second stages of labor, instrumental delivery, vacuum-assisted or cesarean delivery rates, the number of newborns with 1-min and 5-min Apgar scores less than 7 between both groups and number of parturients receiving oxytocin, however, the maximal oxytocin dose was significantly higher in the epidural group. Conclusion: Epidural analgesia by lidocaine (0.5%) and fentanyl does not prolong labor compared with parturients without analgesia; however, significant oxytocin augmentation is required during the epidural analgesia to keep up the aforementioned average labor duration. PMID:22412775

  16. Semi-Supervised Kernel PCA

    DEFF Research Database (Denmark)

    Walder, Christian; Henao, Ricardo; Mørup, Morten

    We present three generalisations of Kernel Principal Components Analysis (KPCA) which incorporate knowledge of the class labels of a subset of the data points. The first, MV-KPCA, penalises within class variances similar to Fisher discriminant analysis. The second, LSKPCA is a hybrid of least squ...... squares regression and kernel PCA. The final LR-KPCA is an iteratively reweighted version of the previous which achieves a sigmoid loss function on the labeled points. We provide a theoretical risk bound as well as illustrative experiments on real and toy data sets....

  17. International assessment of PCA codes

    International Nuclear Information System (INIS)

    Neymotin, L.; Lui, C.; Glynn, J.; Archarya, S.

    1993-11-01

    Over the past three years (1991-1993), an extensive international exercise for intercomparison of a group of six Probabilistic Consequence Assessment (PCA) codes was undertaken. The exercise was jointly sponsored by the Commission of European Communities (CEC) and OECD Nuclear Energy Agency. This exercise was a logical continuation of a similar effort undertaken by OECD/NEA/CSNI in 1979-1981. The PCA codes are currently used by different countries for predicting radiological health and economic consequences of severe accidents at nuclear power plants (and certain types of non-reactor nuclear facilities) resulting in releases of radioactive materials into the atmosphere. The codes participating in the exercise were: ARANO (Finland), CONDOR (UK), COSYMA (CEC), LENA (Sweden), MACCS (USA), and OSCAAR (Japan). In parallel with this inter-code comparison effort, two separate groups performed a similar set of calculations using two of the participating codes, MACCS and COSYMA. Results of the intercode and inter-MACCS comparisons are presented in this paper. The MACCS group included four participants: GREECE: Institute of Nuclear Technology and Radiation Protection, NCSR Demokritos; ITALY: ENEL, ENEA/DISP, and ENEA/NUC-RIN; SPAIN: Universidad Politecnica de Madrid (UPM) and Consejo de Seguridad Nuclear; USA: Brookhaven National Laboratory, US NRC and DOE

  18. Parallel GPU implementation of iterative PCA algorithms.

    Science.gov (United States)

    Andrecut, M

    2009-11-01

    Principal component analysis (PCA) is a key statistical technique for multivariate data analysis. For large data sets, the common approach to PCA computation is based on the standard NIPALS-PCA algorithm, which unfortunately suffers from loss of orthogonality, and therefore its applicability is usually limited to the estimation of the first few components. Here we present an algorithm based on Gram-Schmidt orthogonalization (called GS-PCA), which eliminates this shortcoming of NIPALS-PCA. Also, we discuss the GPU (Graphics Processing Unit) parallel implementation of both NIPALS-PCA and GS-PCA algorithms. The numerical results show that the GPU parallel optimized versions, based on CUBLAS (NVIDIA), are substantially faster (up to 12 times) than the CPU optimized versions based on CBLAS (GNU Scientific Library).

  19. Uso de la gammaglobulina intravenosa y sus efectos en la mortalidad por sepsis en niños

    Directory of Open Access Journals (Sweden)

    Izaida Montero López

    2014-08-01

    Full Text Available Se realizó una revisión sistemática sobre el uso de inmunoglobulina intravenosa y su efecto sobre la mortalidad en el niño menor de un año. Se analizaron artículos originales y revisiones sistemáticas realizadas en los últimos años acerca del tema; se incluyeron artículos originales publicados en los años 2002 al 2011 y las revisiones sistemáticas publicadas en los años 2007 al 2011, que resultaron en total siete. Se concluye que no existe un consenso en la prescripción de inmunoglobulina intravenosa en el tratamiento de la sepsis y aunque no existe reducción significativa de la mortalidad, se evidencia un mayor número de vidas salvadas en el grupo de pacientes con este tratamiento

  20. Pain relief and clinical outcome: from opioids to balanced analgesia

    DEFF Research Database (Denmark)

    Kehlet, H

    1996-01-01

    If it is generally accepted that adequate postoperative pain relief will improve outcome from surgery, several controlled trials demonstrated this only for lower body surgical procedures with epidural and spinal anesthetics. Important effects on outcome were not shown when postoperative opioids...... were administered with patient controlled (PCA) or epidural techniques. However, the most optimal pain relief seems to be best achieved with balanced analgesia techniques using combinations of epidural opioids and local anesthetics and systemic non-steroidal antiinflammatory drugs. Future efforts...... should aim at including physical rehabilitation programs in the pain treatment regimen....

  1. CENTRAL MECHANISMS OF ACUPUNCTURE ANALGESIA

    Directory of Open Access Journals (Sweden)

    Eman S. Mansour

    2015-12-01

    Full Text Available Background: Acupuncture is an component of traditional Chinese medicine (TCM that has been used for three thousand years to treat diseases and relieve pain. Pain is found to be the most common reason for people to use acupuncture. Due to recent scientific findings, acupuncture treatment has been accepted worldwide. Numerous trials have been conducted especially in analgesia. The mechanisms of acupuncture analgesia has been widely investigated, however, the underlying mechanism still not clear. This article summarizes the central mechanisms of acupuncture analgesia and reviews recent studies on the topic. Method: We have focused on examining the recent literature on acupuncture analgesia. The central mechanisms of acupuncture analgesia and reviews recent studies on the topic. We focused on the studies related to central mechanisms of acupuncture analgesia from these aspects: (neurophysiology, neurochemistry and neuroanatomy. Result: The result revealed that acupuncture act on various parts of the central nervous system, including the spinal cord, brain stem, cerebral ganglia and cerebral cortex to alleviate pain. The central mechanisms underlying the effects of acupuncture include neurohumors and neurotransmitters, which are involved in analgesia. At spinal level, Spinal opioids, glutamate, norepinephrine and serotonin are the key elements acupuncture-induced analgesia. At brain level, Endogenous opioid peptides, limbic system play essential roles in mediating the analgesia. Conclusion: Acupuncture is an effective approach to pain management. There is good evidence in both experimental and clinical research that supports acupuncture efficacy in management of chronic pain through central nervous system. Acupuncture should be strongly used as a part of pain management plans. This work helps in improving our understanding of the scientific basis underlying acupuncture analgesia.

  2. MD-11 PCA - Research flight team photo

    Science.gov (United States)

    1995-01-01

    On Aug. 30, 1995, a the McDonnell Douglas MD-11 transport aircraft landed equipped with a computer-assisted engine control system that has the potential to increase flight safety. In landings at NASA Dryden Flight Research Center, Edwards, California, on August 29 and 30, the aircraft demonstrated software used in the aircraft's flight control computer that essentially landed the MD-11 without a need for the pilot to manipulate the flight controls significantly. In partnership with McDonnell Douglas Aerospace (MDA), with Pratt & Whitney and Honeywell helping to design the software, NASA developed this propulsion-controlled aircraft (PCA) system following a series of incidents in which hydraulic failures resulted in the loss of flight controls. This new system enables a pilot to operate and land the aircraft safely when its normal, hydraulically-activated control surfaces are disabled. This August 29, 1995, photo shows the MD-11 team. Back row, left to right: Tim Dingen, MDA pilot; John Miller, MD-11 Chief pilot (MDA); Wayne Anselmo, MD-11 Flight Test Engineer (MDA); Gordon Fullerton, PCA Project pilot; Bill Burcham, PCA Chief Engineer; Rudey Duran, PCA Controls Engineer (MDA); John Feather, PCA Controls Engineer (MDA); Daryl Townsend, Crew Chief; Henry Hernandez, aircraft mechanic; Bob Baron, PCA Project Manager; Don Hermann, aircraft mechanic; Jerry Cousins, aircraft mechanic; Eric Petersen, PCA Manager (Honeywell); Trindel Maine, PCA Data Engineer; Jeff Kahler, PCA Software Engineer (Honeywell); Steve Goldthorpe, PCA Controls Engineer (MDA). Front row, left to right: Teresa Hass, Senior Project Management Analyst; Hollie Allingham (Aguilera), Senior Project Management Analyst; Taher Zeglum, PCA Data Engineer (MDA); Drew Pappas, PCA Project Manager (MDA); John Burken, PCA Control Engineer.

  3. Algoritmo assistencial de enfermagem para infusão de amiodarona intravenosa

    Directory of Open Access Journals (Sweden)

    Francimar Tinoco de Oliveira

    2014-01-01

    Full Text Available Los objetivos fueron identificar publicaciones científicas sobre flebitis causado por amiodarona y proponer un algoritmo de atención de enfermería para intervenciones en la administración intravenosa de amiodarona, basada en la Infusion Nursing Society y Center for Disease Control and Prevention . Estudio descriptivo, llevado a cabo por revisión integradora en bases MedLine, LILACS, IBECS, BDENF, Biblioteca Cochrane y Scielo, publicados de 2006 a 2013. La muestra consistió de nueve artículos. Las evidencias señalaron incidencia de flebitis debido a la infusión de amiodarona y la necesidad de su control. El algoritmo propuesto nortea los materiales que deben ser utilizados y el procedimiento de administración del medicamento, objetivando minimizar agravios. Esto algoritmo, además de subsidiar el desarrollo de futuros estudios, también promueve la incorporación de mejores recomendaciones para la práctica clínica de forma intervencionista y legítima.

  4. An efficient algorithm for weighted PCA

    NARCIS (Netherlands)

    Krijnen, W.P.; Kiers, H.A.L.

    1995-01-01

    The method for analyzing three-way data where one of the three components matrices in TUCKALS3 is chosen to have one column is called Replicated PCA. The corresponding algorithm is relatively inefficient. This is shown by offering an alternative algorithm called Weighted PCA. Specifically it is

  5. Pain management in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion: combined intrathecal morphine and continuous epidural versus PCA.

    Science.gov (United States)

    Ravish, Matthew; Muldowney, Bridget; Becker, Aimee; Hetzel, Scott; McCarthy, James J; Nemeth, Blaise A; Noonan, Kenneth J

    2012-12-01

    A retrospective case-comparison study. Compare efficacy and safety of combined intrathecal morphine (ITM) and epidural analgesia (EPI) to that of conventional intravenous patient-controlled analgesia (IV-PCA) after posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Pain control after PSF in AIS has been managed traditionally with IV-PCA. More recently studies have shown improvement in pain control with the use of continuous EPI or intraoperative ITM. No studies to our knowledge have compared the use of both ITM and EPI analgesia to that of IV-PCA. An Institutional Review Board-approved retrospective case-comparison study was performed from 1989 to 2009 of all patients undergoing PSF for AIS. Patients received either IV-PCA or ITM/EPI. Daily pain scores were recorded along with total opioid and benzodiazepine use. Adverse events were recorded for all the patients. A total of 146 patients were initially included in the study; 95 patients received ITM/EPI and 51 received IV-PCA as a historical control. Eight patients from the ITM/EPI group were excluded from the pain comparison portion of the study. There were no statistical differences in age, sex, weight, or hospital stay between the 2 groups. The ITM/EPI group had, on average, 1 additional level of fusion (P = 0.001). Daily average pain scores were lower in the ITM/EPI group on all hospital days, and statistically lower in days 1 and 3 to 5. Total opioid requirement was significantly lower in the ITM/EPI patients, although oral opioid use was higher among this group. Total benzodiazepine use was lower among the IV-PCA group. A total of 15.7% of the IV-PCA patients had bladder hypotonia, compared with 1.1% of the ITM/EPI group (P = 0.002). The rate of illeus was 15.7% in the IV-PCA patients and 5.7% in the ITM/EPI (P = 0.071). Respiratory depression was reported in 4 ITM/EPI patients, 0 in our PCA group. Technical catheter malfunction was reported in 8.5% of the EPI group. The use of ITM

  6. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain: a qualitative review of randomized trials

    DEFF Research Database (Denmark)

    Carstensen, M; Møller, A M

    2010-01-01

    In experimental trials, ketamine has been shown to reduce hyperalgesia, prevent opioid tolerance, and lower morphine consumption. Clinical trials have found contradictory results. We performed a review of randomized, double-blinded clinical trials of ketamine added to opioid in i.v. patient......-controlled analgesia (PCA) for postoperative pain in order to clarify this controversy. Our primary aim was to compare the effectiveness and safety of postoperative administered ketamine in addition to opioid for i.v. PCA compared with i.v. PCA with opioid alone. Studies were identified from the Cochrane Library 2003...... of 4.5. Pain was assessed using visual analogue scales or verbal rating scales. Six studies showed significant improved postoperative analgesia with the addition of ketamine to opioids. Five studies showed no significant clinical improvement. For thoracic surgery, the addition of ketamine to opioid...

  7. Complicações decorrentes da terapia intravenosa em pacientes cirúrgicos Complicaciones causadas por la terapia intravenosa en pacientes quirúrgicos Complications due to intravenous therapy in surgical patients

    Directory of Open Access Journals (Sweden)

    Renata Cristina de Campos Pereira

    2000-10-01

    Full Text Available A enfermagem desempenha papel primordial na prevenção e redução das complicações relacionadas ao acesso venoso. O estudo teve como objetivo o levantamento das complicações decorrentes da terapia intravenosa. Os dados de maior expressividade obtidos foram: 77,3% das punções foram realizadas pelo auxiliar de enfermagem; 68% não usaram luvas durante o procedimento; 60% das punções tiveram cuidado de enfermagem insatisfatório; 47% dos dispositivos permaneceram "in situ" de 24 a 72 horas; dentre as complicações, 20% relacionaram-se com infiltração, 5,4% infiltração e hematoma e 5,3% obstrução. Os dados sugerem a necessidade de um aprimoramento da equipe de enfermagem relacionado a terapia intravenosa.Enfermería desempeña un papel primordial en la prevención y reducción de complicaciones relacionadas con el acceso venoso. El estudio tiene como objetivo la identificación de complicaciones ocurridas en la terapia intravenosa. Los datos más relevantes que fueron obtenidos son: 77,3% de las punciones fueron realizadas por auxiliares de enfermería; 68% no usaron guantes durante el procedimiento; 60% de las punciones tuvieron cuidado de enfermería insatisfactorio; 20% relacionados con infiltraciones; 5,4% con infiltraciones y hematomas y, 5,3% con obstrucciones. Los datos sugieren la necesidad de capacitar al equipo de enfermería con respecto a la terapia intravenosa.Nursing plays an important role in prevention and reduction of complications related to venous access. This study had the purpose to find complications derived from intravenous therapy. Major data were: 77.3% of the venous accesses were performed by auxiliary nursing; 68% of the procedures were performed without gloves; 60% of the accesses were not satisfactorily performed by nurses; 47% of the cannulae were "in situ" between 24 and 72 hours; among the complications, 20% were related to infiltration, 5.4% to infiltration and hematoma and 5.3% to obstruction. Data

  8. Tratamento das formas severas de miastenia pelo ACTH por via intravenosa

    Directory of Open Access Journals (Sweden)

    José Lamartine de Assis

    1960-12-01

    Full Text Available O autor inicia o trabalho referindo as bases bioquímicas, fisiopatológicas e anátomo-patológicas do tratamento da miastenia pelo ACTH. Na miastenia grave há diminuição da síntese da acetilcolina no organismo, atuando o ACTH no sentido de aumentar esta síntese seja diretamente, por ativação da colinacetilase, seja indiretamente, mediante a redução da massa dos tecidos linfóides, em particular do timo, responsáveis pela elaboração de substâncias que diminuem a síntese da acetilcolina. O autor empregou o ACTH "Armour" e a Cortrofina "Organon", nas doses de 2,5 a 25 mg, sempre pela via intravenosa, diluídos em 250 a 1.000 ml de soluto glicosado a 5%, administrado gota a gôta, na velocidade média de 20 gôtas por minuto, durante 8 horas. Como medicação associada foi administrada a Prostigmina a todos os pacientes, substituída, depois, em alguns casos, pelo Mestinon ou pela Mytelaze. Como adjuvantes foram empregados o cloreto de potássio (2 a 8 g por dia e o sulfato de efedrina (25 mg 3 vêzes ao dia. Os pacientes foram mantidos em regime hiperprotéico e acloretado, sendo tomados todos os cuidados inerentes ao uso do ACTH. Foram estudados 10 pacientes portadores de miastenia com sintomatologia acentuada (8 casos e média (2 casos. Todos os doentes vinham sendo tratados com drogas anticolinesterásicas em doses adequadas (Prostigmina, Mestinon, Mytelaze e a sua sintomatologia respondia cada vez menos a esta terapêutica. Em alguns casos haviam sido tentados outros tratamentos (timectomia, denervação do seio carotídeo, irradiação da região tímica sem resultado. É de notar que as remissões espontâneas neste grupo de enfermos foram excepcionais e de curta duração. A evolução foi acompanhada do ponto de vista clínico, com a sintomatologia classificada como muito acentuada, acentuada, média e leve. Em todos os casos houve remissão completa ou quase completa da sintomatologia após dosagens variáveis de ACTH; no

  9. O eletrencefalograma nas hemorragias uterinas disfuncionais: ação dos estrogênios por via intravenosa

    Directory of Open Access Journals (Sweden)

    C. De Guarnieri Netto

    1961-01-01

    Full Text Available Em 10 pacientes do sexo feminino, portadoras de hemorragia uterina disfuncional, foi investigada a existência de manifestações epilépticas (clínicas e eletrencefalográficas : dos 10 casos, 7 apresentavam antecedentes e/ou sintomas de natureza provável ou certamente epilépticos: o eletrencefalograma foi anormal em 5 casos. Foi estudada a ação do Premarin por via intravenosa, na dose de 20 mg, durante registro eletrencefalográfico. Não houve piora do traçado durante ou após a injeção.

  10. Model selection for Gaussian kernel PCA denoising

    DEFF Research Database (Denmark)

    Jørgensen, Kasper Winther; Hansen, Lars Kai

    2012-01-01

    We propose kernel Parallel Analysis (kPA) for automatic kernel scale and model order selection in Gaussian kernel PCA. Parallel Analysis [1] is based on a permutation test for covariance and has previously been applied for model order selection in linear PCA, we here augment the procedure to also...... tune the Gaussian kernel scale of radial basis function based kernel PCA.We evaluate kPA for denoising of simulated data and the US Postal data set of handwritten digits. We find that kPA outperforms other heuristics to choose the model order and kernel scale in terms of signal-to-noise ratio (SNR...

  11. Patient-controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour.

    Science.gov (United States)

    Weibel, Stephanie; Jelting, Yvonne; Afshari, Arash; Pace, Nathan Leon; Eberhart, Leopold Hj; Jokinen, Johanna; Artmann, Thorsten; Kranke, Peter

    2017-04-13

    Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP), handsearched congress abstracts (November 2015), and reference lists of retrieved studies. Randomised controlled trials (RCTs) and cluster-randomised trials comparing remifentanil (PCA) with another opioid (intravenous (IV)/intramuscular (IM)), or with another opioid (PCA), or with epidural analgesia, or with remifentanil (continuous IV), or with remifentanil (PCA, different regimen), or with inhalational analgesia, or with placebo/no treatment in all women in labour including high-risk groups with planned vaginal delivery. Two review authors independently assessed trials for inclusion, extracted data, and appraised study quality.We contacted study authors for additional information other than incomplete outcome data. We performed random-effects meta-analysis.To reduce the risk of random error in meta-analysis we performed trial sequential analysis. We included total zero event trials and used a constant continuity correction of 0.01 (ccc 0.01) for meta-analysis. We applied the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach to assess the quality of evidence. Twenty RCTs with 3569 women were included. Of those, 10 trials (2983 participants) compared remifentanil (PCA) to an epidural, four trials (216 participants) to another opioid (IV/IM), three trials (215 participants) to another opioid (PCA), two trials (135 participants) to remifentanil (continuous IV

  12. PcaO Positively Regulates pcaHG of the β-Ketoadipate Pathway in Corynebacterium glutamicum▿

    OpenAIRE

    Zhao, Ke-Xin; Huang, Yan; Chen, Xi; Wang, Nan-Xi; Liu, Shuang-Jiang

    2010-01-01

    We identified a new regulator, PcaO, which is involved in regulation of the protocatechuate (PCA) branch of the β-ketoadipate pathway in Corynebacterium glutamicum. PcaO is an atypical large ATP-binding LuxR family (LAL)-type regulator and does not have a Walker A motif. A mutant of C. glutamicum in which pcaO was disrupted (RES167ΔpcaO) was unable to grow on PCA, and growth on PCA was restored by complementation with pcaO. Both an enzymatic assay of PCA 3,4-dioxygenase activity (encoded by p...

  13. Comparação de ibuprofeno via oral e indometacina intravenosa no tratamento da persistência do canal arterial em neonatos com extremo baixo peso ao nascer Comparison of oral ibuprofen and intravenous indomethacin for the treatment of patent ductus arteriosus in extremely low birth weight infants

    Directory of Open Access Journals (Sweden)

    Eun Mi Yang

    2013-02-01

    Full Text Available OBJETIVO: Existem poucos relatórios publicados com relação à eficácia do ibuprofeno via oral no tratamento da persistência do canal arterial (PCA em neonatos com extremo baixo peso ao nascer (EBPN. Comparamos o ibuprofeno via oral à indometacina intravenosa no que diz respeito à eficácia e segurança no tratamento de PCA em neonatos com peso inferior a 1.000 g ao nascer. MÉTODO: Este foi um estudo retrospectivo em um único centro. Coletamos dados de neonatos com EBPN que tiveram PCA ecocardiograficamente confirmada. Os neonatos foram tratados tanto com indometacina intravenosa quanto com ibuprofeno via oral. A taxa de fechamento do canal, a necessidade de tratamentos adicionais, os efeitos colaterais ou as complicações relacionadas ao medicamento e a mortalidade foram comparados entre os dois grupos de tratamento. RESULTADO: Examinamos 26 neonatos que receberam indometacina e 22 que receberam ibuprofeno. A taxa geral de fechamento do canal foi semelhante nos dois tratamentos: o fechamento do canal ocorreu em 23 dos 26 neonatos (88,5% no grupo indometacina, e em 18 dos 22 neonatos (81,8% no grupo ibuprofeno (p = 0,40. A taxa de ligadura cirúrgica (11,5% em comparação a 18,2%; p = 0,40 não diferiu de forma significativa entre os dois grupos de tratamento. Após o tratamento, não foi encontrada nenhuma diferença significativa nas concentrações de creatinina sérica entre os dois grupos. Não houve diferenças significativas com relação a efeitos colaterais ou complicações adicionais. CONCLUSÃO: Em neonatos com EBPN, o ibuprofeno via oral é tão eficaz quanto a indometacina intravenosa no tratamento da PCA. Não há diferenças entre os medicamentos no que diz respeito à segurança. O ibuprofeno via oral poderia ser usado como um agente alternativo no tratamento da PCA em neonatos com EBPN.OBJECTIVE: There are few published reports concerning the efficacy of oral ibuprofen for the treatment of patent ductus arteriosus

  14. Simultaneous Estimation of Hydrochlorothiazide, Hydralazine Hydrochloride, and Reserpine Using PCA, NAS, and NAS-PCA.

    Science.gov (United States)

    Sharma, Chetan; Badyal, Pragya Nand; Rawal, Ravindra K

    2015-01-01

    In this study, new and feasible UV-visible spectrophotometric and multivariate spectrophotometric methods were described for the simultaneous determination of hydrochlorothiazide (HCTZ), hydralazine hydrochloride (H.HCl), and reserpine (RES) in combined pharmaceutical tablets. Methanol was used as a solvent for analysis and the whole UV region was scanned from 200-400 nm. The resolution was obtained by using multivariate methods such as the net analyte signal method (NAS), principal component analysis (PCA), and net analyte signal-principal component analysis (NAS-PCA) applied to the UV spectra of the mixture. The results obtained from all of the three methods were compared. NAS-PCA showed a lot of resolved data as compared to NAS and PCA. Thus, the NAS-PCA technique is a combination of NAS and PCA methods which is advantageous to obtain the information from overlapping results.

  15. The experience of labour with epidural analgesia

    DEFF Research Database (Denmark)

    Jepsen, Ingrid; Keller, Kurt Dauer

    2014-01-01

    of the epidural analgesia as high, in general, their satisfaction with labour is unchanged or even lower when epidural analgesia is used. Question: How do women experience being in labour with epidural analgesia, and what kind of midwifery care do they, consequently, need? Methods: A field study and semi...

  16. Pain Levels Within 24 Hours After UFE: A Comparison of Morphine and Fentanyl Patient-Controlled Analgesia

    International Nuclear Information System (INIS)

    Kim, Hyun S.; Czuczman, Gregory J.; Nicholson, Wanda K.; Pham, Luu D.; Richman, Jeffrey M.

    2008-01-01

    The purpose of this study was to assess the presence and severity of pain levels during 24 h after uterine fibroid embolization (UFE) for symptomatic leiomyomata and compare the effectiveness and adverse effects of morphine patient-controlled analgesia (PCA) versus fentanyl PCA. We carried out a prospective, nonrandomized study of 200 consecutive women who received UFE and morphine or fentanyl PCA after UFE. Pain perception levels were obtained on a 0-10 scale for the 24-h period after UFE. Linear regression methods were used to determine pain trends and differences in pain trends between two groups and the association between pain scores and patient covariates. One hundred eighty-five patients (92.5%) reported greater-than-baseline pain after UFE, and 198 patients (99%) required IV opioid PCA. One hundred thirty-six patients (68.0%) developed nausea during the 24-h period. Seventy-two patients (36%) received morphine PCA and 128 (64%) received fentanyl PCA, without demographic differences. The mean dose of morphine used was 33.8 ± 26.7 mg, while the mean dose of fentanyl was 698.7 ± 537.4 μg. Using this regimen, patients who received morphine PCA had significantly lower pain levels than those who received fentanyl PCA (p < 0.0001). We conclude that patients develop pain requiring IV opioid PCA within 24 h after UFE. Morphine PCA is more effective in reducing post-uterine artery embolization pain than fentanyl PCA. Nausea is a significant adverse effect from opioid PCA.

  17. PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2013-08-01

    Full Text Available While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3 test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. The PCA3 test was performed before ≥12-core initial prostate biopsy, along with standard risk factor assessment. Diagnostic performance of the PCA3 test was evaluated. The three available nomograms (Hansen’s and Chun’s nomograms, as well as the updated Prostate Cancer Prevention Trial risk calculator; PCPT were applied to the cohort, and their predictive accuracies were assessed in terms of biopsy outcome: the presence of any prostate cancer (PCa and high-grade prostate cancer (HGPCa. The PCA3 score provided significant predictive accuracy. While the PCPT risk calculator appeared less accurate; both Chun’s and Hansen’s nomograms provided good calibration and high net benefit on decision curve analyses. When applying nomogram-derived PCa probability thresholds ≤30%, ≤6% of HGPCa would have been missed, while avoiding up to 48% of unnecessary biopsies. The urinary PCA3 test and PCA3-incorporating nomograms can be considered as reliable tools to aid in the initial biopsy decision.

  18. Impact of Frequent Interruption on Nurses' Patient-Controlled Analgesia Programming Performance.

    Science.gov (United States)

    Campoe, Kristi R; Giuliano, Karen K

    2017-12-01

    The purpose was to add to the body of knowledge regarding the impact of interruption on acute care nurses' cognitive workload, total task completion times, nurse frustration, and medication administration error while programming a patient-controlled analgesia (PCA) pump. Data support that the severity of medication administration error increases with the number of interruptions, which is especially critical during the administration of high-risk medications. Bar code technology, interruption-free zones, and medication safety vests have been shown to decrease administration-related errors. However, there are few published data regarding the impact of number of interruptions on nurses' clinical performance during PCA programming. Nine acute care nurses completed three PCA pump programming tasks in a simulation laboratory. Programming tasks were completed under three conditions where the number of interruptions varied between two, four, and six. Outcome measures included cognitive workload (six NASA Task Load Index [NASA-TLX] subscales), total task completion time (seconds), nurse frustration (NASA-TLX Subscale 6), and PCA medication administration error (incorrect final programming). Increases in the number of interruptions were associated with significant increases in total task completion time ( p = .003). We also found increases in nurses' cognitive workload, nurse frustration, and PCA pump programming errors, but these increases were not statistically significant. Complex technology use permeates the acute care nursing practice environment. These results add new knowledge on nurses' clinical performance during PCA pump programming and high-risk medication administration.

  19. Patient-controlled analgesia in the pediatric population: morphine versus hydromorphone

    Science.gov (United States)

    DiGiusto, Matthew; Bhalla, Tarun; Martin, David; Foerschler, Derek; Jones, Megan J; Tobias, Joseph D

    2014-01-01

    Objective Patient controlled analgesia (PCA) is commonly used to provide analgesia following surgical procedures in the pediatric population. Morphine and hydromorphone remain the most commonly used opioids for PCA. Although both are effective, adverse effects may occur. When these adverse effects are unremitting or severe, opioid rotation may be required. In this study, we retrospectively evaluated PCA use, the adverse effect profile, and the frequency of opioid rotation. Methods This retrospective study was performed at Nationwide Children’s Hospital (Columbus, OH). The hospital’s electronic registry was queried for PCA use delivering either morphine or hydromorphone from January 1, 2008 to December 31, 2010. Results A total of 514 patients were identified, that met study entry criteria. Of the 514 cases, 298 (56.2%) were initially started on morphine and 225 (43.8%) were initially started on hydromorphone. There were a total of 26 (5.1%) opioid changes in the cohort of 514 patients. Of the 26 switches, 23 of 298 (7.7%) were from morphine to hydromorphone, and 3 of 225 (1.3%) were from hydromorphone to morphine (P=0.0008). Of the 17 morphine-to-hydromorphone switches with adverse effects, pruritus (64.7%), and inadequate pain control (47.1%) were the most common side effects. The most common side effect resulting in a hydromorphone-to-morphine switch was nausea (66.7%). Conclusion PCA switches from morphine-to-hydromorphone (88.5%) were more common than vice-versa (11.5%). The most common reasons for morphine-to-hydromorphone switch were pruritus and inadequate pain control. These data suggest that a prospective study is necessary to determine the side effect differences between morphine and hydromorphone in pediatric PCA. PMID:25152630

  20. Intrathecal morphine is superior to intravenous PCA in patients undergoing minimally invasive cardiac surgery

    Directory of Open Access Journals (Sweden)

    Chirojit Mukherjee

    2012-01-01

    Full Text Available Aim of our study was to evaluate the beneficial effect of low dose intrathecal morphine on postoperative analgesia, over the use of intravenous patient controlled anesthesia (PCA, in patients undergoing fast track anesthesia during minimally invasive cardiac surgical procedures. A randomized controlled trial was undertaken after approval from local ethical committee. Written informed consent was obtained from 61 patients receiving mitral or tricuspid or both surgical valve repair in minimal invasive technique. Patients were assigned randomly to 2 groups. Group 1 received general anesthesia and intravenous patient controlled analgesia (PCA pump with Piritramide (GA group. Group 2 received a single shot of intrathecal morphine (1.5 μg/kg body weight prior to the administration of general anesthesia (ITM group. Site of puncture was confined to lumbar (L1-2 or L2-3 intrathecal space. The amount of intravenous piritramide used in post anesthesia care unit (PACU and the first postoperative day was defined as primary end point. Secondary end points included: time for tracheal extubation, pain and sedation scores in PACU upto third postoperative day. For statistical analysis Mann-Whitney-U Test and Fishers exact test (SPSS were used. We found that the demand for intravenous opioids in PACU was significantly reduced in ITM group (P <0.001. Pain scores were significantly decreased in ITM group until second postoperative day (P <0.01. There was no time delay for tracheal extubation in ITM group, and sedation scores did not differ in either group. We conclude that low dose single shot intrathecal morphine provides adequate postoperative analgesia, reduces the intravenous opioid consumption during the early postoperative period and does not defer early extubation.

  1. Five-year experience of critical incidents associated with patient-controlled analgesia in an Irish University Hospital.

    LENUS (Irish Health Repository)

    Ahmad, I

    2012-02-01

    BACKGROUND: Patient-controlled analgesia (PCA) is a common and effective means of managing post-operative pain. We sought to identify factors that may lead to critical incidents (CIs) in patient safety when using PCA in our institution. METHODS: An observational study of prospectively collected data of patients who received PCA from 2002 to 2006 was performed. All CIs were documented and analysed by staff members of the acute pain service (APS). Cause analysis of CIs was undertaken to determine if measures can be instituted to prevent recurrence of similar events. RESULTS: Over eight thousand patients (8,240) received PCA. Twenty-seven CIs were identified. Eighteen were due to programming errors. Other CIs included co-administration of opioids and oversedation. CONCLUSION: In our institution, the largest contributory factor to CIs with PCAs was programming error. Strategies to minimize this problem include better education and surveillance.

  2. Theoretical analysis of the PCA experiment

    International Nuclear Information System (INIS)

    Minsart, G.

    1980-01-01

    A very brief description of the PCA-PVF facility is given, and the studied configurations are mentioned. The analysis of the experiment has been divided into two parts: study of the fission density distribution across the PCA core and neutronic analysis of the flux spectra and spatial distributions in the whole facility. For both parts, the procedure of calculation is explained: cross section sets, one- and two-dimensional models, group collapsing, choice of bucklings, ... . The obtained results are shortly compared with the measured values, and illustrated by a figure and several tables. The computations of the fission map in the PCA core yield results in good agreement with the experimental ones (within a few percents for nearly all points). The discrepancies observed for relative reaction rates and spectral indices of a series of threshold detectors at the selected locations in and between steel and iron layers in the water reflector are briefly discussed

  3. PEM-PCA: A Parallel Expectation-Maximization PCA Face Recognition Architecture

    Directory of Open Access Journals (Sweden)

    Kanokmon Rujirakul

    2014-01-01

    Full Text Available Principal component analysis or PCA has been traditionally used as one of the feature extraction techniques in face recognition systems yielding high accuracy when requiring a small number of features. However, the covariance matrix and eigenvalue decomposition stages cause high computational complexity, especially for a large database. Thus, this research presents an alternative approach utilizing an Expectation-Maximization algorithm to reduce the determinant matrix manipulation resulting in the reduction of the stages’ complexity. To improve the computational time, a novel parallel architecture was employed to utilize the benefits of parallelization of matrix computation during feature extraction and classification stages including parallel preprocessing, and their combinations, so-called a Parallel Expectation-Maximization PCA architecture. Comparing to a traditional PCA and its derivatives, the results indicate lower complexity with an insignificant difference in recognition precision leading to high speed face recognition systems, that is, the speed-up over nine and three times over PCA and Parallel PCA.

  4. PEM-PCA: a parallel expectation-maximization PCA face recognition architecture.

    Science.gov (United States)

    Rujirakul, Kanokmon; So-In, Chakchai; Arnonkijpanich, Banchar

    2014-01-01

    Principal component analysis or PCA has been traditionally used as one of the feature extraction techniques in face recognition systems yielding high accuracy when requiring a small number of features. However, the covariance matrix and eigenvalue decomposition stages cause high computational complexity, especially for a large database. Thus, this research presents an alternative approach utilizing an Expectation-Maximization algorithm to reduce the determinant matrix manipulation resulting in the reduction of the stages' complexity. To improve the computational time, a novel parallel architecture was employed to utilize the benefits of parallelization of matrix computation during feature extraction and classification stages including parallel preprocessing, and their combinations, so-called a Parallel Expectation-Maximization PCA architecture. Comparing to a traditional PCA and its derivatives, the results indicate lower complexity with an insignificant difference in recognition precision leading to high speed face recognition systems, that is, the speed-up over nine and three times over PCA and Parallel PCA.

  5. [Analgesia using continuous axillary block after surgery of severe hand injuries: self-administration versus continuous injection].

    Science.gov (United States)

    Iskandar, H; Rakotondriamihary, S; Dixmérias, F; Binje, B; Maurette, P

    1998-01-01

    To compare analgesia produced after surgery for severe hand trauma, by a continuous axillary block obtained either with a continuous injection (CA) or controlled by the patient (PCA). Prospective, randomized study. Forty-two ASA physical class 1 and 2 patients were enrolled over a twelve-month period and randomly allocated either into the CA or the PCA group. After recovery from the surgical block, the axillary plexus was located using a nerve stimulator and a 20 G catheter (Contiplex B Braun) inserted over 5 centimeters into the axillary sheath. In the CA group (n = 21) patients received 0.1 mL.kg-1.h-1 of 0.25% bupivacaine and in the PCA group (n = 21) patients received 0.1 mL.kg-1 boluses of 0.25% bupivacaine with a one hour lock-out period. Data collected were pain intensity rated according to he visual analog scale (VAS), the total volume of bupivacaine injected, the quantity of nalbuphine administered as 10 mg boluses when VAS was = 5, and the patient's satisfaction after removal of the catheter. Statistical analysis used Student t test, ANOVA and chi 2 test. The mean duration of catheter use was 5 +/- 3 days. During this period the amount of bupivacaine was significantly reduced in the PCA group when compared to the CA group (P plexus blockade provides safe and effective postoperative analgesia. With the PCA technique results a lower quantity of bupivacaine is required and patient's satisfaction better.

  6. Gordon Fullerton in PCA (MD-11) Simulator

    Science.gov (United States)

    1998-01-01

    NASA research pilot Gordon Fullerton 'flying' in the MD-11 simulator during the Propulsion Controlled Aircraft (PCA) project. This investigation grew out of the crash of a DC-10 airliner on July 19, 1989, following an explosion in the rear engine which caused the loss of all manual flight controls. The flight crew attempted to control the airliner using only the thrust from the two remaining engines. Although the DC-10 crashed during the landing attempt, 184 of the 296 passengers and crew aboard survived. The PCA effort at the Dryden Flight Research Center grew out of the crash, and attempted to develop a means to successfully land an aircraft using only engine thrust. After more than five years of work, on August 29, 1995, Gordon Fullerton made the first PCA touchdown aboard an MD-11 airliner (a later version of the DC-10). The concept was further refined over the years that followed this first landing. Simulators were essential ingredients of the PCA development process. The feasibility of the concept was first tested with an F-15 simulator, then the results of actual flight tests in an F-15 were incorporated back into the simulator. Additional simulations were run on the Boeing 720 airliner simulator used in the Controlled Impact Demonstration project. After the MD-11 test landings, Boeing 747 and 757 simulators tested a wide range of possible situations. Simulations even helped develop a method of landing an airliner if it lost its complete hydraulic system as well as a wing engine, by transferring fuel to shift the center of gravity toward the working engine. The most extreme procedure was undertaken in a 747 simulator. The aircraft simulated the loss of the hydraulic system at 35,000 feet and rolled upside down. Then, the PCA mode was engaged, the airliner righted itself, leveled its wings, and made an approach nearly identical to that of a normal auto landing.

  7. Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, L.M.; Bloemenkamp, K.W.; Franssen, M.T.; Papatsonis, D.N.; Hajenius, P.J.; Hollmann, M.W.; Woiski, M.D.; Porath, M.; Berg, H.J. van den; Beek, E. van; Borchert, O.W.; Schuitemaker, N.; Sikkema, J.M.; Kuipers, A.H.; Logtenberg, S.L.; Salm, P.C. van der; Oude Rengerink, K.; Lopriore, E.; Akker-van Marle, M.E. van den; Cessie, S. le; Lith, J.M. van; Struys, M.M.; Mol, B.W.; Dahan, A; Middeldorp, J.M.

    2015-01-01

    OBJECTIVE: To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. DESIGN: Multicentre randomised controlled equivalence trial. SETTING: 15 hospitals in the Netherlands. PARTICIPANTS: Women with an

  8. Patient controlled analgesia with remifentanil versus epidural analgesia in labour : randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M; Bloemenkamp, Kitty W; Franssen, Maureen T; Papatsonis, Dimitri N; Hajenius, Petra J; Hollmann, Markus W; Woiski, Mallory D; Porath, Martina; van den Berg, Hans J; van Beek, Erik; Borchert, Odette W H M; Schuitemaker, Nico; Sikkema, J Marko; Kuipers, A H M; Logtenberg, Sabine L M; van der Salm, Paulien C M; Oude Rengerink, Katrien; Lopriore, Enrico; van den Akker-van Marle, M Elske; le Cessie, Saskia; van Lith, Jan M; Struys, Michel M; Mol, Ben Willem J; Dahan, Albert; Middeldorp, Johanna M; Oude Rengerink, K

    2015-01-01

    OBJECTIVE: To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. DESIGN: Multicentre randomised controlled equivalence trial. SETTING: 15 hospitals in the Netherlands. PARTICIPANTS: Women with an

  9. Patient controlled analgesia with remifentanil versus epidural analgesia in labour: randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M.; Bloemenkamp, Kitty W.; Franssen, Maureen T.; Papatsonis, Dimitri N.; Hajenius, Petra J.; Hollmann, Markus W.; Woiski, Mallory D.; Porath, Martina; van den Berg, Hans J.; van Beek, Erik; Borchert, Odette W. H. M.; Schuitemaker, Nico; Sikkema, J. Marko; Kuipers, A. H. M.; Logtenberg, Sabine L. M.; van der Salm, Paulien C. M.; Oude Rengerink, Katrien; Lopriore, Enrico; van den Akker-van Marle, M. Elske; le Cessie, Saskia; van Lith, Jan M.; Struys, Michel M.; Mol, Ben Willem J.; Dahan, Albert; Middeldorp, Johanna M.

    2015-01-01

    To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. Multicentre randomised controlled equivalence trial. 15 hospitals in the Netherlands. Women with an intermediate to high obstetric risk with an

  10. Labour pain with remifentanil patient-controlled analgesia versus epidural analgesia : a randomised equivalence trial

    NARCIS (Netherlands)

    Logtenberg, Slm; Oude Rengerink, K; Verhoeven, C J; Freeman, L M; van den Akker, Esa; Godfried, M B; van Beek, E; Borchert, Owhm; Schuitemaker, N; van Woerkens, Ecsm; Hostijn, I; Middeldorp, J M; van der Post, J A; Mol, B W

    OBJECTIVE: To distinguish satisfaction with pain relief using remifentanil patient-controlled analgesia (RPCA) compared with epidural analgesia (EA) in low-risk labouring women. DESIGN: Randomised controlled equivalence trial. SETTING: Eighteen midwifery practices and six hospitals in the

  11. Patient controlled analgesia with remifentanil versus epidural analgesia in labour : randomised multicentre equivalence trial

    NARCIS (Netherlands)

    Freeman, Liv M.; Bloemenkamp, Kitty W.; Franssen, Maureen T.; Papatsonis, Dimitri N.; Hajenius, Petra J.; Hollmann, Markus W.; Woiski, Mallory D.; Porath, Martina; van den Berg, Hans J.; van Beek, Erik; Borchert, Odette W. H. M.; Schuitemaker, Nico; Sikkema, J. Marko; Kuipers, A. H. M.; Logtenberg, Sabine L. M.; van der Salm, Paulien C. M.; Rengerink, Katrien Oude; Lopriore, Enrico; van den Akker-van Marle, M. Elske; le Cessie, Saskia; van Lith, Jan M.; Struys, Michel M.; Mol, Ben Willem J.; Dahan, Albert; Middeldorp, Johanna M.

    2015-01-01

    Objective To determine women's satisfaction with pain relief using patient controlled analgesia with remifentanil compared with epidural analgesia during labour. Design Multicentre randomised controlled equivalence trial. Setting 15 hospitals in the Netherlands. Participants Women with an

  12. Sucrose ingestion causes opioid analgesia

    Directory of Open Access Journals (Sweden)

    F.N. Segato

    1997-08-01

    Full Text Available The intake of saccharin solutions for relatively long periods of time causes analgesia in rats, as measured in the hot-plate test, an experimental procedure involving supraspinal components. In order to investigate the effects of sweet substance intake on pain modulation using a different model, male albino Wistar rats weighing 180-200 g received either tap water or sucrose solutions (250 g/l for 1 day or 14 days as their only source of liquid. Each rat consumed an average of 15.6 g sucrose/day. Their tail withdrawal latencies in the tail-flick test (probably a spinal reflex were measured immediately before and after this treatment. An analgesia index was calculated from the withdrawal latencies before and after treatment. The indexes (mean ± SEM, N = 12 for the groups receiving tap water for 1 day or 14 days, and sucrose solution for 1 day or 14 days were 0.09 ± 0.04, 0.10 ± 0.05, 0.15 ± 0.08 and 0.49 ± 0.07, respectively. One-way ANOVA indicated a significant difference (F(3,47 = 9.521, P<0.001 and the Tukey multiple comparison test (P<0.05 showed that the analgesia index of the 14-day sucrose-treated animals differed from all other groups. Naloxone-treated rats (N = 7 receiving sucrose exhibited an analgesia index of 0.20 ± 0.10 while rats receiving only sucrose (N = 7 had an index of 0.68 ± 0.11 (t = 0.254, 10 degrees of freedom, P<0.03. This result indicates that the analgesic effect of sucrose depends on the time during which the solution is consumed and extends the analgesic effects of sweet substance intake, such as saccharin, to a model other than the hot-plate test, with similar results. Endogenous opioids may be involved in the central regulation of the sweet substance-produced analgesia.

  13. Patient-controlled analgesia in the pediatric population: morphine versus hydromorphone

    Directory of Open Access Journals (Sweden)

    DiGiusto M

    2014-08-01

    Full Text Available Matthew DiGiusto,2 Tarun Bhalla,1 David Martin,1 Derek Foerschler,3 Megan J Jones,2 Joseph D Tobias1 1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital and the Ohio State University, 2The Ohio State School of Medicine, 3Department of Anesthesiology, The Ohio State University, Columbus, OH, USA Objective: Patient controlled analgesia (PCA is commonly used to provide analgesia following surgical procedures in the pediatric population. Morphine and hydromorphone remain the most commonly used opioids for PCA. Although both are effective, adverse effects may occur. When these adverse effects are unremitting or severe, opioid rotation may be required. In this study, we retrospectively evaluated PCA use, the adverse effect profile, and the frequency of opioid rotation. Methods: This retrospective study was performed at Nationwide Children’s Hospital (Columbus, OH. The hospital's electronic registry was queried for PCA use delivering either morphine or hydromorphone from January 1, 2008 to December 31, 2010. Results: A total of 514 patients were identified, that met study entry criteria. Of the 514 cases, 298 (56.2% were initially started on morphine and 225 (43.8% were initially started on hydromorphone. There were a total of 26 (5.1% opioid changes in the cohort of 514 patients. Of the 26 switches, 23 of 298 (7.7% were from morphine to hydromorphone, and 3 of 225 (1.3% were from hydromorphone to morphine (P=0.0008. Of the 17 morphine-to-hydromorphone switches with adverse effects, pruritus (64.7%, and inadequate pain control (47.1% were the most common side effects. The most common side effect resulting in a hydromorphone-to-morphine switch was nausea (66.7%. Conclusion: PCA switches from morphine-to-hydromorphone (88.5% were more common than vice-versa (11.5%. The most common reasons for morphine-to-hydromorphone switch were pruritus and inadequate pain control. These data suggest that a prospective study is necessary

  14. Efficacy of trans abdominis plane block for post cesarean delivery analgesia: A double-blind, randomized trial

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2015-01-01

    Full Text Available Background: The transverse abdominis plane (TAP block, a regional block provides effective analgesia after lower abdominal surgeries if used as part of multimodal analgesia. In this prospective, randomized double-blind study, we determined the efficacy of TAP block in patients undergoing cesarean section. Materials and Methods: Totally, 62 parturients undergoing cesarean section were randomized in a double-blind manner to receive either bilateral TAP block at the end of surgery with 20 ml of 0.25% bupivacaine or no TAP block, in addition to standard analgesic comprising 75 mg diclofenac 8 hourly and intravenous patient-controlled analgesia (PCA tramadol. Each patient was assessed at 0, 4, 8, 12, 24, 36, and 48 h after surgery by an independent observer for pain at rest and on movement using numeric rating scale of 0-10, time of 1 st demand for tramadol, total consumption of PCA tramadol, satisfaction with pain management and side effects. Results: Use of tramadol was reduced in patients given TAP block by 50% compared to patients given no block during 48 h after surgery (P < 0.001. Pain scores were lower both on rest and activity at each time point for 24 h in study group (P < 0.001, time of first analgesia was significantly longer, satisfaction was higher, and side effects were less in study group compared to control group. Conclusion: Transverse abdominis plane block was effective in providing analgesia with a substantial reduction in tramadol use during 48 h after cesarean section when used as adjunctive to standard analgesia.

  15. MD-11 PCA - First Landing at Edwards

    Science.gov (United States)

    1995-01-01

    This McDonnell Douglas MD-11 approaches the first landing ever of a transport aircraft under engine power only on Aug. 29, 1995, at NASA's Dryden Flight Research Center, Edwards, California. The milestone flight, flown by NASA research pilot and former astronaut Gordon Fullerton, was part of a NASA project to develop a computer-assisted engine control system that enables a pilot to land a plane safely when it normal control surfaces are disabled. The Propulsion-Controlled Aircraft (PCA) system uses standard autopilot controls already present in the cockpit, together with the new programming in the aircraft's flight control computers. The PCA concept is simple--for pitch control, the program increases thrust to climb and reduces thrust to descend. To turn right, the autopilot increases the left engine thrust while decreasing the right engine thrust. The initial Propulsion-Controlled Aircraft studies by NASA were carried out at Dryden with a modified twin-engine F-15 research aircraft.

  16. MD-11 PCA - Research flight team egress

    Science.gov (United States)

    1995-01-01

    This McDonnell Douglas MD-11 has parked on the flightline at NASA's Dryden Flight Research Center, Edwards, California, following its completion of the first and second landings ever performed by a transport aircraft under engine power only (on Aug. 29, 1995). The milestone flight, with NASA research pilot and former astronaut Gordon Fullerton at the controls, was part of a NASA project to develop a computer-assisted engine control system that enables a pilot to land a plane safely when its normal control surfaces are disabled. Coming down the steps from the aircraft are Gordon Fullerton (in front), followed by Bill Burcham, Propulsion Controlled Aircraft (PCA) project engineer at Dryden; NASA Dryden controls engineer John Burken; John Feather of McDonnell Douglas; and Drew Pappas, McDonnell Douglas' project manager for PCA.

  17. Improvements to the RXTE/PCA Calibration

    Science.gov (United States)

    Jahoda, K.

    2009-01-01

    The author presents the current status of the RXTE/PCA Calibration, with emphasis on recent updates to the energy scale and the background subtraction. A new treatment of the Xenon K-escape line removes the largest remaining residual in the previously distributed matrices. Observations of Sco X-1 made simultaneously with Swift XRT, expressly for the purpose of cross calibrating the response to bright sources, are presented.

  18. Analgesia adjuvante e alternativa Analgesia adyuvante y alternativa Adjuvant and alternative analgesia

    Directory of Open Access Journals (Sweden)

    Nilton Bezerra do Vale

    2006-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Embora a dor aguda e a crônica sejam habitualmente controladas com intervenções farmacológicas, 14 métodos complementares de analgesia adjuvante e alternativa (AAA podem reduzir o uso e abuso na prescrição de analgésicos e diminuir os efeitos colaterais que eventualmente comprometem o estado fisiológico do paciente. CONTEÚDO: Todos os mecanismos antiálgicos atuam através da via espinal de controle da comporta de Melzack e Wall e/ou através da transdução do sinal nos sistemas de neurotransmissão e neuromodulação central relacionados com analgesia, relaxamento e humor: peptidérgico, monaminérgico, gabaérgico, colinérgico e canabinóide. A analgesia adjuvante complementar é habitualmente utilizada nos tratamentos fisiátricos, ortopédicos, reumatológicos, obstétricos e com acupuntura. A analgesia alternativa complementar pode potencializar os métodos analgésicos convencionais, a exposição à luz do sol matutino, luz e cores sob luz artificial, o tempo (T - anestésicos gerais mais potentes à noite, opióides de manhã e anestésicos locais à tarde, dieta, bom humor e riso, espiritualidade, religião, meditação, musicoterapia, hipnose e efeito placebo. CONCLUSÕES: Se a dor aguda é um mecanismo de defesa, a dor crônica é um estado patológico desagradável relacionado com a depressão endógena e a uma baixa qualidade de vida. É importante estabelecer relações interdisciplinares entre a Medicina adjuvante e alternativa nas terapias analgésicas e antiinflamatórias clássicas.JUSTIFICACIÓN Y OBJETIVOS: Aunque el dolor agudo y el crónico sean habitualmente controlados con intervenciones farmacológicas, 14 métodos complementarios de analgesia adyuvante y alternativa (AAA pueden reducir el uso y el abuso en la prescripción de analgésicos y disminuir los efectos colaterales que eventualmente comprometen el estado fisiológico del paciente. CONTENIDO: Todos los mecanismos anti

  19. Cost of opioid intravenous patient-controlled analgesia: results from a hospital database analysis and literature assessment

    Directory of Open Access Journals (Sweden)

    Palmer P

    2014-06-01

    Full Text Available Pamela Palmer,1 Xiang Ji,2 Jennifer Stephens21AcelRx Pharmaceuticals, Inc., Redwood City, CA, 2Pharmerit International, Bethesda, MD, USABackground: Intravenous patient-controlled analgesia (PCA equipment and opioid cost analyses on specific procedures are lacking. This study estimates the intravenous PCA hospital cost for the first 48 postoperative hours for three inpatient surgeries.Methods: Descriptive analyses using the Premier database (2010–2012 of more than 500 US hospitals were conducted on cost (direct acquisition and indirect cost for the hospital, such as overhead, labor, pharmacy services of intravenous PCA after total knee/hip arthroplasty (TKA/THA or open abdominal surgery. Weighted average cost of equipment and opioid drug and the literature-based cost of adverse events and complications were aggregated for total costs.Results: Of 11,805,513 patients, 272,443 (2.3%, 139,275 (1.2%, and 195,062 (1.7% had TKA, THA, and abdominal surgery, respectively, with approximately 20% of orthopedic and 29% of abdominal patients having specific intravenous PCA database cost entries. Morphine (57% and hydromorphone (44% were the most frequently used PCA drugs, with a mean cost per 30 cc syringe of $16 (30 mg and $21 (6 mg, respectively. The mean number of syringes used for morphine and hydromorphone in the first 48 hours were 1.9 and 3.2 (TKA, 2.0 and 4.2 (THA, and 2.5 and 3.9 (abdominal surgery, respectively. Average costs of PCA pump, intravenous tubing set, and drug ranged from $46 to $48, from $20 to $22, and from $33 to $46, respectively. Pump, tubing, and saline required to maintain patency of the intravenous PCA catheter over 48 hours ranged from $9 to $13, from $8 to $9, and from $20 to $22, respectively. Supplemental non-PCA opioid use ranged from $56 for THA to $87 for abdominal surgery. Aggregated mean intravenous PCA equipment and opioid cost per patient were $196 (THA, $204 (TKA, and $243 (abdominal surgery. Total costs, including

  20. Sequential combination of k-t principle component analysis (PCA) and partial parallel imaging: k-t PCA GROWL.

    Science.gov (United States)

    Qi, Haikun; Huang, Feng; Zhou, Hongmei; Chen, Huijun

    2017-03-01

    k-t principle component analysis (k-t PCA) is a distinguished method for high spatiotemporal resolution dynamic MRI. To further improve the accuracy of k-t PCA, a combination with partial parallel imaging (PPI), k-t PCA/SENSE, has been tested. However, k-t PCA/SENSE suffers from long reconstruction time and limited improvement. This study aims to improve the combination of k-t PCA and PPI on both reconstruction speed and accuracy. A sequential combination scheme called k-t PCA GROWL (GRAPPA operator for wider readout line) was proposed. The GRAPPA operator was performed before k-t PCA to extend each readout line into a wider band, which improved the condition of the encoding matrix in the following k-t PCA reconstruction. k-t PCA GROWL was tested and compared with k-t PCA and k-t PCA/SENSE on cardiac imaging. k-t PCA GROWL consistently resulted in better image quality compared with k-t PCA/SENSE at high acceleration factors for both retrospectively and prospectively undersampled cardiac imaging, with a much lower computation cost. The improvement in image quality became greater with the increase of acceleration factor. By sequentially combining the GRAPPA operator and k-t PCA, the proposed k-t PCA GROWL method outperformed k-t PCA/SENSE in both reconstruction speed and accuracy, suggesting that k-t PCA GROWL is a better combination scheme than k-t PCA/SENSE. Magn Reson Med 77:1058-1067, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  1. Ketamina en analgesia multimodal postcesarea

    OpenAIRE

    Monzón Rubio, Eva María

    2011-01-01

    Mediante la analgesia multimodal influimos en las diferentes vías del dolor a la vez que minimizamos los potenciales efectos adversos de los diferentes fármacos administrados. En el caso del dolor postcesárea esto adquiere un importante matiz debido a la necesidad de disminuir el uso de opioides que pasan a la leche materna en caso de lactancia natural. El uso de dosis subanestésicas de Ketamina ha demostrado en diferentes estudios la disminución de requerimientos de opioides en las primer...

  2. Labor epidural analgesia: Past, present and future

    Directory of Open Access Journals (Sweden)

    Reena

    2014-01-01

    Full Text Available One of the most severe pains experienced by a woman is that of childbirth. Providing analgesia for labor has always been a challenge more so because of the myths and controversies surrounding labor. It is imperative to understand the pain transmission during various stages of labor in order to select a proper technique for providing labor analgesia. The adverse effects of labor pain are numerous and affect both the mother as well as the fetus. Currently lumbar epidural is considered to be the gold standard technique for labor analgesia. Local anaesthetics like bupivacaine and ropivacaine are commonly used and adjuvants like clonidine, fentanyl and neostigmine have been extensively studied. However, despite being so popular, epidural analgesia is not without complications, with hypotension being the most common. Other complications include accidental dural puncture, infection, intravascular placement, high block and epidural hematoma. Other neuraxial techniques include continuous caudal analgesia, and combined spinal epidural analgesia. The numerous studies investigating the various aspects of this method have also served to dispel various myths surrounding epidural analgesia like increased incidence of cesarean section and instrumental delivery, prolongation of labor and future back pain. The future of labor analgesia lies in the incorporation of ultrasound in identifying the epidural space helping in proper catheter placement. The keywords "labor epidural" in the PUBMED revealed a total of 5018 articles with 574 review articles and 969 clinical trials. The relevant articles along with their references were extensively studied.

  3. 24 CFR 401.451 - PAE Physical Condition Analysis (PCA).

    Science.gov (United States)

    2010-04-01

    ... (PCA). 401.451 Section 401.451 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.451 PAE Physical Condition Analysis (PCA). (a) Review... of the project by means of a PCA. If the PAE finds any immediate threats to health and safety, the...

  4. Multimodal analgesia and regional anaesthesia.

    Science.gov (United States)

    Tornero Tornero, C; Fernández Rodríguez, L E; Orduña Valls, J

    Multimodal analgesia provides quality analgesia, with fewer side effects due to the use of combined analgesics or analgesic techniques. Regional anaesthesia plays a fundamental role in achieving this goal. The different techniques of regional anaesthesia that include both peripheral and central blocks in either a single dose or in continuous infusion help to modulate the nociceptive stimuli that access the central level. The emergence of the ultrasound as an effective system to perform regional anaesthesia techniques has allowed the development of new regional anaesthesia techniques that formerly could not be carried out since only neurostimulation or skin references were used. It is essential to take into account that even with effective blocking it is advisable to associate other drugs by other routes, in this way we will be able to reduce the required doses individually and attempt to achieve a synergistic, not purely additive, effect. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Postoperative pain and patient-controlled epidural analgesia-related adverse effects in young and elderly patients: a retrospective analysis of 2,435 patients

    Directory of Open Access Journals (Sweden)

    Koh JC

    2017-04-01

    Full Text Available Jae Chul Koh, Young Song, So Yeon Kim, Sooyeun Park, Seo Hee Ko, Dong Woo Han Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea Abstract: In this retrospective study, data of 2,435 patients who received fentanyl and ropivacaine-based patient-controlled epidural analgesia (PCEA for pain relief after elective surgery under general or spinal anesthesia were reviewed. Differences in postoperative pain, incidence of patient-controlled analgesia (PCA-related adverse effects, and risk factors for the need for rescue analgesics for 48 hours postsurgery in young (age 20–39 years and elderly (age ≥70 years patients were evaluated. Although there were no significant differences in postoperative pain intensity between the two groups until 6 hours postsurgery, younger patients experienced greater postoperative pain intensity compared with older patients 6–48 hours postsurgery. While younger patients exhibited greater incidence of numbness, motor weakness, and discontinuation of PCA postsurgery, elderly patients exhibited greater incidence of hypotension, nausea/vomiting, rescue analgesia, and antiemetic administration. Upon multivariate analysis, low fentanyl dosage and history of smoking were found to be associated with an increased need for rescue analgesia among younger patients, while physical status classification III/IV and thoracic surgery were associated with a decreased need for rescue analgesia among the elderly. Discontinuation of PCA was more frequent among younger patients than the elderly (18.5% vs 13.5%, P=0.001. Reasons for discontinuation of PCA among young and elderly patients, respectively, were nausea and vomiting (6.8% vs 26.6%, numbness or motor weakness (67.8% vs 11.5%, urinary retention (7.4% vs 8.7%, dizziness (2.2% vs 5.2%, and hypotension (3.1% vs 20.3%. In conclusion, PCEA was more frequently associated with numbness, motor

  6. Considerações sobre analgesia controlada pelo paciente em hospital universitário Consideraciones sobre analgesia controlada por el paciente en hospital universitario Patient controlled analgesia in a university hospital

    Directory of Open Access Journals (Sweden)

    Guilherme Antônio Moreira de Barros

    2003-02-01

    ás utilizado (54,2%, siendo la vía peridural la que tiene preferencia (49,5%. La escala numérica verbal media fue de 0,8 (0-10. Los efectos colaterales ocurrieron en 22,4% de los enfermos tratados. CONCLUSIONES: Los resultados fueron considerados excelentes en lo que se refiere a la calidad de la analgesia, no obstante con ocurrencia de efectos colaterales indeseables, siendo que hubo buena aceptación de la técnica de analgesia por las clínicas atendidas.BACKGROUND AND OBJECTIVES: The rapid development seen in recent years in surgical and anesthetic techniques allowed for an increased indication of invasive procedures. At the same time, with the aging of the population, the postoperative recovery period became the focus of major concern for the healthcare team. For such, new analgesic techniques were developed, among them, Patient Controlled Analgesia (PCA. In Brazil, the Acute Pain Service (SEDA of the Anesthesiology Department, Botucatu Medical School - UNESP, has been using PCA for many years. Aiming at verifying the quality of the service provided, this research has evaluated the efficacy and safety of the technique, in addition to identifying and characterizing patients submitted to PCA. METHODS: Participated in this retrospective study 679 patients treated by SEDA with the PCA method only, during a 3-year period. Patients were randomly included in the study with no restrictions concerning age, gender and type of surgery, considering only the possibility of PCA. The following parameters were evaluated: gender, age, type of surgery, pain score, treatment duration, analgesic drugs used, administration route, side effects and complications. RESULTS: The PCA technique was used in 3.96% of patients submitted to surgical procedures and in 1.64% of all hospitalized patients. Thoracic surgeries were the most frequent procedures and accounted for 25% of patients. Morphine was the most commonly used analgesics (54.2% and the epidural route was the most frequent route of

  7. The evaluation of efficacy and safety of paravertebral block for perioperative analgesia in patients undergoing laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2012-01-01

    Full Text Available Background: Paravertebral block is a popular regional anesthetic technique used for perioperative analgesia in multiple surgical procedures. There are very few randomized trials of its use in laparoscopic cholecystectomy in medical literature. This study was aimed at assessing its efficacy and opioid-sparing potential in this surgery. Methods: Fifty patients were included in this prospective randomized study and allocated to two groups: Group A (25 patients receiving general anesthesia alone and Group B (25 patients receiving nerve-stimulator-guided bilateral thoracic Paravertebral Block (PVB at T6 level with 0.3 ml/kg of 0.25% bupivacaine prior to induction of general anesthesia. Intraoperative analgesia was supplemented with fentanyl (0.5 μg/kg based on hemodynamic and clinical parameters. Postoperatively, patients in both the groups received Patient-Controlled Analgesia (PCA morphine for the first 24 hours. The efficacy of PVB was assessed by comparing intraoperative fentanyl requirements, postoperative VAS scores at rest, and on coughing and PCA morphine consumption between the two groups. Results: Intraoperative supplemental fentanyl was significantly less in Group B compared to Group A (17.6 μg and 38.6 μg, respectively, P =0.001. PCA morphine requirement was significantly low in the PVB group at 2, 6, 12, and 24 hours postoperatively compared to that in Group A (4.4 mg vs 6.9 mg, 7.6 mg vs 14.2 mg, 11.6 mg vs 20.0 mg, 16.8 mg vs 27.2 mg, respectively; P <0.0001 at all intervals. Conclusion: Pre-induction PVB resulted in improved analgesia for 24 hours following laparoscopic cholecystectomy in this study, along with a significant reduction in perioperative opioid consumption and opioid-related side effects.

  8. Paediatric analgesia in an Emergency Department.

    LENUS (Irish Health Repository)

    Hawkes, C

    2012-02-03

    Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. An audit including 145 patients followed this. 55.6% of patients with major fractures received analgesia after a median time of 54 minutes, which improved to 61.1% (p = 0.735) after 7 minutes (p = 0.004). Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.

  9. Efeitos hemodinâmicos da anestesia em plano profundo com infusão intravenosa contínua de propofol ou propofol associado à lidocaína em cães

    Directory of Open Access Journals (Sweden)

    Rodrigo Mannarino

    2014-02-01

    Full Text Available Os efeitos hemodinâmicos da anestesia total intravenosa com propofol ou propofol associado à lidocaína foram estudados em 12 cães. No grupo P (n=6, os animais receberam bolus de 6mg kg-1 de propofol e infusão contínua de 1,25mg kg-1 min-1. No grupo PL (n=6, os animais receberam bolus de 6mg kg-1 de propofol e 1,5mg kg-1 de lidocaína, seguido de infusão de 1,0mg kg-1 min-1 e 0,25mg kg-1 min-1, dos mesmos fármacos, respectivamente. Os animais foram instrumentados para mensuração das variáveis hemodinâmicas e do índice bispectral (BIS, aos 75, 90, 105 e 120 minutos de anestesia. Foram observados valores menores de índice cardíaco, índice sistólico, pressões arteriais sistólica, diastólica e média no grupo P do que no grupo PL (P<0,05. Não foram observadas diferenças entre os grupos na frequência cardíaca, índice de resistência vascular sistêmica e BIS. As concentrações plasmáticas de propofol foram menores no grupo PL do que no grupo P (medianas de 5,7 a 6,1µg mL-1 no grupo P versus 3,1 a 3,7µg mL-1 no grupo PL. As concentrações plasmáticas de lidocaína (medianas de 2,27 a 2,51µg mL-1 mensuradas encontram-se na faixa que resulta em analgesia e abaixo de valores que resultam em toxicidade em cães. Os valores de BIS obtidos nos dois grupos foram compatíveis com plano profundo de anestesia (médias de 43 a 46 e 45 a 49 nos grupos P e PL, respectivamente. A manutenção da anestesia em plano profundo com lidocaína-propofol causa menor depressão cardiovascular do que a anestesia com dose equipotente de propofol isoladamente.

  10. Sensorial saturation for neonatal analgesia.

    Science.gov (United States)

    Bellieni, Carlo V; Cordelli, Duccio M; Marchi, Simonetta; Ceccarelli, Simona; Perrone, Serafina; Maffei, Marianna; Buonocore, Giuseppe

    2007-01-01

    Sensorial saturation (SS) is a procedure in which touch, massage, taste, voice, smell, and sight compete with pain, producing almost complete analgesia during heel prick in neonates. SS is an apparently complex maneuvre, but when correctly explained it is easily learnt. In the present paper, we studied its feasibility, assessing whether a long training is really needed to achieve good results. We enrolled 66 consecutive babies and divided them randomly into 3 groups which received the following forms of analgesia: glucose plus sucking (A), SS performed by nurses (B), SS performed by mothers (C). We did not use perfume on the caregivers' hands, so that babies could smell the natural scent of the hands. We assessed pain level by the ABC scale. Median scores of groups A, B, and C were: 1 (0 to 6), 0 (0 to 4), and 0 (0 to 6), respectively. Mean scores were: 0.6, 0.6, and 1.7 and standard errors were 0.38, 0.22, and 0.32, respectively. Scores of groups B and C were significantly lower than that of A (P=0.03 and 0.006, respectively). No significant difference was found between values of scores of groups B and C. Even without the use of perfume on the hands, SS was effective as an analgesic maneuvre. It made no difference whether SS was performed by mothers who applied it for the first time or experienced nurses. SS is rapid to learn and any caregiver (mother, pediatrician or nurse) can effectively use it.

  11. Does counterpain imagery mediate hypnotic analgesia?

    Science.gov (United States)

    Hargadon, R; Bowers, K S; Woody, E Z

    1995-08-01

    Sixty-six high hypnotizable individuals received a baseline exposure to pain and 2 counterbalanced hypnotic analgesia conditions. Standard analgesia invoked counterpain imagery, whereas imageless analgesia proscribed imagery. The mean level of pain reduction in these 2 conditions was virtually identical and significantly less than the pain rated in the baseline condition. Furthermore, cognitions experienced as active efforts to cope with the pain occurred far less often and were associated with less pain reduction than cognitions experienced as passive concomitants of pain reduction. The results cast considerable doubt on the widespread assumption that imaginative involvement mediates hypnotic responding.

  12. PCA: Principal Component Analysis for spectra modeling

    Science.gov (United States)

    Hurley, Peter D.; Oliver, Seb; Farrah, Duncan; Wang, Lingyu; Efstathiou, Andreas

    2012-07-01

    The mid-infrared spectra of ultraluminous infrared galaxies (ULIRGs) contain a variety of spectral features that can be used as diagnostics to characterize the spectra. However, such diagnostics are biased by our prior prejudices on the origin of the features. Moreover, by using only part of the spectrum they do not utilize the full information content of the spectra. Blind statistical techniques such as principal component analysis (PCA) consider the whole spectrum, find correlated features and separate them out into distinct components. This code, written in IDL, classifies principal components of IRS spectra to define a new classification scheme using 5D Gaussian mixtures modelling. The five PCs and average spectra for the four classifications to classify objects are made available with the code.

  13. Nonlinear peculiar-velocity analysis and PCA

    Energy Technology Data Exchange (ETDEWEB)

    Dekel, A. [and others

    2001-02-20

    We allow for nonlinear effects in the likelihood analysis of peculiar velocities, and obtain {approximately}35%-lower values for the cosmological density parameter and for the amplitude of mass-density fluctuations. The power spectrum in the linear regime is assumed to be of the flat {Lambda}CDM model (h = 0:65, n = 1) with only {Omega}{sub m} free. Since the likelihood is driven by the nonlinear regime, we break the power spectrum at k{sub b} {approximately} 0.2 (h{sup {minus}1} Mpc){sup {minus}1} and fit a two-parameter power-law at k > k{sub b} . This allows for an unbiased fit in the linear regime. Tests using improved mock catalogs demonstrate a reduced bias and a better fit. We find for the Mark III and SFI data {Omega}{sub m} = 0.35 {+-} 0.09 with {sigma}{sub 8}{Omega}P{sub m}{sup 0.6} = 0.55 {+-} 0.10 (90% errors). When allowing deviations from {Lambda}CDM, we find an indication for a wiggle in the power spectrum in the form of an excess near k {approximately} 0.05 and a deficiency at k {approximately} 0.1 (h{sup {minus}1} Mpc){sup {minus}1}--a cold flow which may be related to a feature indicated from redshift surveys and the second peak in the CMB anisotropy. A {chi}{sup 2} test applied to principal modes demonstrates that the nonlinear procedure improves the goodness of fit. The Principal Component Analysis (PCA) helps identifying spatial features of the data and fine-tuning the theoretical and error models. We address the potential for optimal data compression using PCA.

  14. Intranasal sufentanil/ketamine analgesia in children

    DEFF Research Database (Denmark)

    Nielsen, Bettina Nygaard; Friis, Susanne M; Rømsing, Janne

    2014-01-01

    The management of procedural pain in children ranges from physical restraint to pharmacological interventions. Pediatric formulations that permit accurate dosing, are accepted by children and a have a rapid onset of analgesia are lacking....

  15. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    OpenAIRE

    Stolik-Dollberg, Orit C; Dollberg, Shaul

    2005-01-01

    Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivac...

  16. Use of fetal analgesia during prenatal surgery.

    Science.gov (United States)

    Bellieni, Carlo V; Tei, M; Stazzoni, G; Bertrando, S; Cornacchione, S; Buonocore, G

    2013-01-01

    Recent progresses in fetal surgery have raised concern on fetal pain, its long-term consequences and the risks of sudden fetal movements induced by pain. In several studies, surgeons have directly administered opioids to the fetus, while others have considered sufficient the maternally administered analgesics. We performed a review of the literature to assess the state of the art. We performed a PubMed search to retrieve the papers that in the last 10 years reported studies of human fetal surgery and that described whether any fetal analgesia was administered. We retrieved 34 papers. In three papers, the procedure did not hurt the fetus, being performed on fetal annexes, in two papers, it was performed in the first half of pregnancy, when pain perception is unlikely. In 10 of the 29 remaining papers, fetal surgery was performed using direct fetal analgesia, while in 19, analgesia was administered only to the mother. In most cases, fetal direct analgesia was obtained using i.m. opioids, and muscle relaxant. Rare drawbacks on either fetuses or mothers due to fetal analgesia were reported. Fetal direct analgesia is performed only in a minority of cases and no study gives details about fetal reactions to pain. More research is needed to assess or exclude its possible long-term drawbacks, as well as the actual consequences of pain during surgery.

  17. Beyond textbook neuroanatomy: The syndrome of malignant PCA infarction.

    Science.gov (United States)

    Gogela, Steven L; Gozal, Yair M; Rahme, Ralph; Zuccarello, Mario; Ringer, Andrew J

    2015-01-01

    Given its limited vascular territory, occlusion of the posterior cerebral artery (PCA) usually does not result in malignant infarction. Challenging this concept, we present 3 cases of unilateral PCA infarction with secondary malignant progression, resulting from extension into what would classically be considered the posterior middle cerebral artery (MCA) territory. Interestingly, these were true PCA infarctions, not "MCA plus" strokes, since the underlying occlusive lesion was in the PCA. We hypothesize that congenital and/or acquired variability in the distribution and extent of territory supplied by the PCA may underlie this rare clinical entity. Patients with a PCA infarction should thus be followed closely and offered early surgical decompression in the event of malignant progression.

  18. Effect of Sucrose Analgesia, for Repeated Painful Procedures, on Short-term Neurobehavioral Outcome of Preterm Neonates: A Randomized Controlled Trial.

    Science.gov (United States)

    Banga, Shreshtha; Datta, Vikram; Rehan, Harmeet Singh; Bhakhri, Bhanu Kiran

    2016-04-01

    Safety of oral sucrose, commonly used procedural analgesic in neonates, is questioned. To evaluate the effect of sucrose analgesia, for repeated painful procedures, on short-term neurobehavioral outcome of preterm neonates. Stable preterm neonates were randomized to receive either sucrose or distilled water orally, for every potentially painful procedure during the first 7 days after enrollment. Neurodevelopmental status at 40 weeks postconceptional age (PCA) measured using the domains of Neurobehavioral Assessment of Preterm Infants scale. A total of 93 newborns were analyzed. The baseline characteristics of the groups were comparable. No statistically significant difference was observed in the assessment at 40 weeks PCA, among the groups. Use of sucrose analgesia, for repeated painful procedures on newborns, does not lead to any significant difference in the short-term neurobehavioral outcome. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. Ilioinguinal-iliohypogastric nerve block with intravenous dexketoprofen improves postoperative analgesia in abdominal hysterectomies.

    Science.gov (United States)

    Yucel, Evren; Kol, Iclal Ozdemir; Duger, Cevdet; Kaygusuz, Kenan; Gursoy, Sinan; Mimaroglu, Caner

    2013-01-01

    In this study, our aim was to evaluate the effects of intravenous dexketoprofen trometamol with ilioinguinal and iliohypogastric nerve block on analgesic quality and morphine consumption after total abdominal hysterectomy operations. We conducted this randomized controlled clinical study on 61 patients. The study was conducted in the operation room, post-anesthesia care unit, and inpatient clinic. We randomly grouped the 61 patients into control group (group C), block group (group B) and dexketoprofen-block group (group DB). Before the skin incision performed after anesthesia induction, we performed ilioinguinal iliohypogastric block (group C given saline and group P and DB given levobupivacaine). In contrast to group C and B, group DB was given dexketoprofen. We administered morphine analgesia to all patients by patient-controlled analgesia (PCA) during the postoperative 24 hours. We recorded Visual Analogue Scale (VAS), satisfaction scores, morphine consumption and side effects during postoperative 24 hours. We found the DB group's VAS scores to be lower than the control group and block group's (p dexketoprofen increases patient satisfaction by decreasing opioid consumption, increasing patient satisfaction, which suggests that dexketoprofen trometamol is an effective non-steroidal anti-inflammatory analgesic in postoperative analgesia. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  20. The Comparison of Intrathecal Morphine and IV Morphine PCA on Pain Control, Patient Satisfaction, Morphine Consumption, and Adverse Effects in Patients Undergoing Reduction Mammoplasty.

    Science.gov (United States)

    Karamese, Mehtap; Akdağ, Osman; Kara, İnci; Yıldıran, Gokce Unal; Tosun, Zekeriya

    2015-01-01

    Following breast reduction procedures, the level of postoperative pain can be severe, and sufficient pain control influences a patient's physiological, immunological, and psychological status. The aim of this study was to examine the use of intrathecal morphine (ITM) in breast reduction surgery with patient-controlled analgesia (PCA). Sixty-two female patients who underwent breast reductions with the same technique participated in this study. The study group (ITM + PCA) included 32 patients; a single shot (0.2 mg) of ITM and intravenous morphine with PCA were administered. In the control group, morphine PCA alone was intravenously administered to 30 patients. Comparisons between the groups of cumulative morphine consumption, visual analog scale scores, and patient satisfaction scores, which were the primary outcome measures, and adverse effects, which were the secondary outcome measures, were conducted. The patients in the 2 groups had similar degrees of pain and satisfaction scores. The study group had lower cumulative morphine consumption (P = .001) than the PCA-only control group; there was no statistically significant difference in adverse effects between the 2 groups. Intrathecal morphine may effectively control pain with lower total morphine consumption following breast reduction surgery.

  1. Principal Component Analysis (Pca) Dan Aplikasinya Dengan Spss

    OpenAIRE

    Bus Umar, Hermita

    2009-01-01

    PCA (Principal Component Analysis ) are statistical techniques applied to a single set of variables when the researcher is interested in discovering which variables in the setform coherent subset that are relativity independent of one another.Variables that are correlated with one another but largely independent of other subset of variables are combined into factors. The Coals of PCA to which each variables is explained by each dimension. Step in PCA include selecting and mean measuring a set...

  2. Preliminary Design Review: PCA Integrated Radar-Tracker Application

    National Research Council Canada - National Science Library

    Lebak, J

    2002-01-01

    The DARPA Polymorphous Computing Architecture (PCA) program is building advanced computer architectures that can reorganize their computation and communication structure to achieve better overall application performance...

  3. [THE CHOICE OF PERIOPERATIVE MULTIMODAL ANALGESIA IN PATIENTS WITH LUMBAR HERNIATED DISC: THE PRELIMINARY RESULTS.

    Science.gov (United States)

    Genov, P G; Timerbaev, V H; Grin, A A; Rebrova, O Yu

    2017-09-01

    129 patients scheduled for elective lumbar discectomy in 2010-2013 were enrolled in prospective study. Group K (n=20) underwent general anaesthesia and postoperative analgesia on-demand. Group PMA+SA (n=23) got subarachnoid block and preventive multimodal analgesia (PMA) including ketoprofen, paracetamol and nalbuphine. At PMA group (n=21) general anaesthesia and PMA were used; at PMA+I (n=21) also bupivacaine wound infiltration was administrated; at PlvL4+S (n=20) - depo-corticosteroid was applied locally on affected spinal nerve root; at PMA+IS (n=24) wound infiltration and local corticosteroids were combined. Patients could use i.v. nalbuphine on-demand by PCA device in addition to PMA post-operatively. 7 days post-operatively, the pain scores using 10 cm VAS at rest and during movement were also recorded. Group K patients had not adequate pain relief during 4 postoperative days. At PMA group the postoperative analgesia was adequate during the whole assessment time, PMA group patients had significant less pain scores than at K group during 4 postoperative days. Patients at PM +SA had better than PMA group pain relief only during 2 hours postoperatively. Groups PMA+I and PMA+IS did not demand nalbuphine at al. Their pain scores were signifcant less than at PMA group during 2 postoperative days. Postoperative analgesia on-demand is not adequate but the PMA is. Subarachnoid block results in decreasing severity of pain only during first hours postoperatively. The additional bupivacaine wound infiltration in pa- tients with lumbar herniated disc follows avoiding of opioids and significant pain relief during 2 postoperative days.

  4. OUR EXPERIENCE WITH EPIDURAL LABOUR ANALGESIA

    Directory of Open Access Journals (Sweden)

    Uršula Reš Muravec

    2003-12-01

    Full Text Available Background. To evaluate the effects of regional labour analgesia used at the Hospital for Gynecology and Obstetrics in Postojna, Slovenia, in the year 2002.Patients and methods. In this retrospective study we enrolled 294 parturients who delivered in the year 2002 in the Postojna Maternity Hospital: in group 1 there were 147 parturients in whom three different regional analgesic techniques (study group were used at labour; in group 2 there were 147 parturients in whom regional analgesia was not used (control group. In the first step the two groups were compared in terms of maternal demographic data, duration and outcome of labour and 1' and 5' Apgar scores. In the second step the three regional analgesic groups were compared in terms of the course and outcome of labour, fetal condition, side and adverse effects of regional analgesic techniques, and patient satisfaction with a particular analgesic technique.Results. Regional labour analgesia was used in 147 (14% of the 1048 women who delivered in 2002: epidural analgesia (EPI was performed in 51.0%, combined spinal-epidural (CSE in 42.2% and spinal analgesia (SA in 6.8% of cases. The women in the regional analgesia group were significantly older, more educated, more often nulliparous and accompanied by their partner at labour than the women in the control group. Further, the duration of labour was significantly longer, oxytocin more frequently administered than in the control group. In terms of labour outcome there were no differences in the Cesarean section rates and 1- and 5-min Apgar scores minutes, but and the vacuum extraction rate was significantly higher in the regional analgesia group. Among the three regional analgesia techniques used, there were no statistically significant differences observed in terms of labour duration and outcome, and Apgar scores. The patient satisfaction was greatest with CSE. Adverse side effects such as weak muscles, reduced motion abilities, itching, nausea

  5. Denoising by semi-supervised kernel PCA preimaging

    DEFF Research Database (Denmark)

    Hansen, Toke Jansen; Abrahamsen, Trine Julie; Hansen, Lars Kai

    2014-01-01

    Kernel Principal Component Analysis (PCA) has proven a powerful tool for nonlinear feature extraction, and is often applied as a pre-processing step for classification algorithms. In denoising applications Kernel PCA provides the basis for dimensionality reduction, prior to the so-called pre-imag...

  6. Gas-Chromatographic Determination Of Water In Freon PCA

    Science.gov (United States)

    Melton, Donald M.

    1994-01-01

    Gas-chromatographic apparatus measures small concentrations of water in specimens of Freon PCA. Testing by use of apparatus faster and provides greater protection against accidental contamination of specimens by water in testing environment. Automated for unattended operation. Also used to measure water contents of materials, other than Freon PCA. Innovation extended to development of purgeable sampling accessory for gas chromatographs.

  7. Condition Monitoring of Sensors in a NPP Using Optimized PCA

    Directory of Open Access Journals (Sweden)

    Wei Li

    2018-01-01

    Full Text Available An optimized principal component analysis (PCA framework is proposed to implement condition monitoring for sensors in a nuclear power plant (NPP in this paper. Compared with the common PCA method in previous research, the PCA method in this paper is optimized at different modeling procedures, including data preprocessing stage, modeling parameter selection stage, and fault detection and isolation stage. Then, the model’s performance is greatly improved through these optimizations. Finally, sensor measurements from a real NPP are used to train the optimized PCA model in order to guarantee the credibility and reliability of the simulation results. Meanwhile, artificial faults are sequentially imposed to sensor measurements to estimate the fault detection and isolation ability of the proposed PCA model. Simulation results show that the optimized PCA model is capable of detecting and isolating the sensors regardless of whether they exhibit major or small failures. Meanwhile, the quantitative evaluation results also indicate that better performance can be obtained in the optimized PCA method compared with the common PCA method.

  8. Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Freeman Liv M

    2012-07-01

    Full Text Available Abstract Background Pain relief during labour is a topic of major interest in the Netherlands. Epidural analgesia is considered to be the most effective method of pain relief and recommended as first choice. However its uptake by pregnant women is limited compared to other western countries, partly as a result of non-availability due to logistic problems. Remifentanil, a synthetic opioid, is very suitable for patient controlled analgesia. Recent studies show that epidural analgesia is superior to remifentanil patient controlled analgesia in terms of pain intensity score; however there was no difference in satisfaction with pain relief between both treatments. Methods/design The proposed study is a multicentre randomized controlled study that assesses the cost-effectiveness of remifentanil patient controlled analgesia compared to epidural analgesia. We hypothesize that remifentanil patient controlled analgesia is as effective in improving pain appreciation scores as epidural analgesia, with lower costs and easier achievement of 24 hours availability of pain relief for women in labour and efficient pain relief for those with a contraindication for epidural analgesia. Eligible women will be informed about the study and randomized before active labour has started. Women will be randomly allocated to a strategy based on epidural analgesia or on remifentanil patient controlled analgesia when they request pain relief during labour. Primary outcome is the pain appreciation score, i.e. satisfaction with pain relief. Secondary outcome parameters are costs, patient satisfaction, pain scores (pain-intensity, mode of delivery and maternal and neonatal side effects. The economic analysis will be performed from a short-term healthcare perspective. For both strategies the cost of perinatal care for mother and child, starting at the onset of labour and ending ten days after delivery, will be registered and compared. Discussion This study, considering cost

  9. Epidural analgesia, neonatal care and breastfeeding.

    Science.gov (United States)

    Zuppa, Antonio Alberto; Alighieri, Giovanni; Riccardi, Riccardo; Cavani, Maria; Iafisco, Alma; Cota, Francesco; Romagnoli, Costantino

    2014-11-29

    The objective of our study is to evaluate the correlation between epidural analgesia during labor, start of breastfeeding and type of maternal-neonatal care.Two different assistance models were considered: Partial and Full Rooming-in.In this cohort study, 2480 healthy infants were enrolled, 1519 in the Partial Rooming-in group and 1321 in the Full Rooming-in group; 1223 were born to women subjected to epidural analgesia in labor.In case of Partial Rooming-in the rate of exclusive or prevailing breastfeeding is significant more frequent in newborns born to mothers who didn't receive analgesia. Instead, in case of Full Rooming-in the rate of exclusive or prevailing breastfeeding is almost the same and there's no correlation between the use or not of epidural analgesia.The good start of lactation and the success of breastfeeding seems to be guaranteed by the type of care offered to the couple mother-infant, that reverses any possible adverse effects of the use of epidural analgesia in labor.

  10. Toxicidad hepática recurrente secundaria a metilprednisolona intravenosa Recurrent acute liver toxicity from intravenous methyprednisolone

    Directory of Open Access Journals (Sweden)

    M. Rivero Fernández

    2008-11-01

    Full Text Available Las reacciones adversas hepáticas relacionadas con la administración de fármacos (hepatotoxicidad son cuadros relativamente frecuentes que presentan una amplia variabilidad clínica e histológica. La identificación precoz de estos cuadros es fundamental en la práctica clínica debido a su potencial gravedad. En la mayoría de los casos la suspensión del fármaco desencadenante es suficiente para la resolución del cuadro clínico. A pesar de que los esteroides son utilizados en una amplia variedad de situaciones clínicas, la notificación de cuadros de hepatotoxicidad secundaria a esteroides intravenosos es excepcional. Presentamos el caso clínico de una mujer diagnosticada de esclerosis múltiple, que recibió metilprednisolona a altas dosis en forma de "pulsos" intravenosos como tratamiento de las reagudizaciones de su enfermedad y presentó 3 brotes recurrentes de hepatitis de predominio hepatocelular con un patrón clínico, analítico e histológico compatible con toxicidad hepática aguda secundaria a metilprednisolona intravenosa. En el tercer episodio se realizó una biopsia hepática que demostró un patrón de hepatitis aguda con necrosis líticas confluentes, histología no descrita previamente en pacientes tratados con esteroides intravenosos.Adverse drug reactions (hepatotoxicity are a frequent cause of acute liver injury with a wide clinical and histological spectrum. An early recognition of drug-related liver disease has been considered essential in clinical practice due to potential risks. In most cases exposure discontinuation improves the clinical picture. Steroids are used in a variety of clinical settings. However, intravenous steroids have rarely been associated with hepatotoxicity. We report the case of a middle-aged woman with multiple sclerosis who received a bolus of methylprednisolone on three occasions for the management of relapsing disease, with the development of repeated episodes of elevated liver enzymes

  11. Avaliação da buprenorfina pelas vias intravenosa ou intramuscular em cães anestesiados pelo desfluorano

    Directory of Open Access Journals (Sweden)

    Souza Almir Pereira de

    2004-01-01

    Full Text Available Objetivou-se avaliar comparativamente os efeitos da buprenorfina, administrada pelas vias intramuscular(IM ou intravenosa (IV, sobre variáveis cardiovasculares, em cães anestesiados com desfluorano. Para tanto, foram utilizados dezesseis cães adultos, clinicamente saudáveis, distribuídos em dois grupos (n=8 denominados de GI e GII. Em ambos os grupos, a anestesia foi induzida com propofol (8 mg/kg, IV e em seguida os animais foram intubados com sonda orotraqueal de Magill, a qual foi conectada ao aparelho de anestesia volátil para administração de desfluorano (1,5 CAM. Após 30 minutos do início da anestesia inalatória, foi aplicado no GI buprenorfina na dose de 0,02 mg/kg pela via IV, enquanto no GII administrou-se o opióide na mesma dose porém pela via IM. Avaliaram-se: freqüência cardíaca (FC; pressões arteriais sistólica, diastólica e média (PAS, PAD e PAM; débito cardíaco (DC; pressão venosa central (PVC e pressão da artéria pulmonar (PAP. As colheitas foram feitas nos seguintes momentos: M1 - 30 minutos após o início da anestesia inalatória antes da aplicação do opióide; M2 - 15 minutos após a administração da buprenorfina; M3, M4 e M5 - de 15 em 15 minutos após M2. A avaliação estatística dos dados foi efetuada por meio de Análise de Perfil (p<0,05. As variáveis PAS, PAM, DC, PVC e PAP, não apresentaram alterações significativas de seus valores em ambos os grupos. Entretanto, a FC e a PAD apresentaram reduções significativas após a administração do opióide apenas no GI. Assim, pôde-se concluir que a buprenorfina administrada pelas vias IV ou IM não interferiu nos índices cardiovasculares de forma a manifestar efeitos clínicos importantes em cães anestesiados com desfluorano.

  12. Effect of postoperative epidural analgesia on surgical outcome

    DEFF Research Database (Denmark)

    Holte, K; Holte, Kathrine

    2002-01-01

    Pain relief allowing sufficient mobilization after major surgical procedures can only be achieved by continuous epidural analgesia with local anesthetics, which also reduces the stress response to surgery. However, the role of postoperative epidural analgesia on postoperative morbidity is controv...

  13. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    Directory of Open Access Journals (Sweden)

    Stolik-Dollberg Orit C

    2005-05-01

    Full Text Available Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivacaine. The outcome variable was the administration by the parents of acetaminophen during the ensuing 24 hours. Results Seventeen infants received lidocaine and 19 received bupivacaine DPNB. Ten infants in the lidocaine group (59% were given acetaminophen following circumcision compared to only 3 (16% in the bupivacaine group (P 2 = 20.6; P = 0.006. Conclusion DPNB with bupivacaine for neonatal circumcision apparently confers better analgesia than lidocaine as judged by the requirement of acetaminophen over the ensuing 24-hour period.

  14. Incidência de depressão respiratória no pós-operatório em pacientes submetidos à analgesia venosa ou peridural com opioides Incidencia de depresión respiratoria en el postoperatorio en pacientes sometidos a la analgesia venosa o epidural con opioides The incidence of postoperative respiratory depression in patients undergoing intravenous or epidural analgesia with opioids

    Directory of Open Access Journals (Sweden)

    Leonardo Teixeira Domingues Duarte

    2009-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A analgesia controlada pelo paciente (PCA, por via venosa ou peridural, é técnica segura e eficaz no tratamento da dor pós-operatória. Todavia, o uso de opioides não é isento de risco, e a depressão respiratória é a complicação mais temida. Os objetivos deste estudo foram descrever a incidência de depressão respiratória associada à analgesia pós-operatória com opioides administrados por via peridural ou venosa e as características dos pacientes que apresentaram a complicação. MÉTODO: Estudo de incidência, retrospectivo, em pacientes operados no Hospital SARAH Brasília entre dezembro de 1999 e dezembro de 2007 e tratados com PCA com opioides por via venosa ou peridural. Foram definidos como casos de depressão respiratória: frequência respiratória JUSTIFICATIVA Y OBJETIVOS: La analgesia controlada por el paciente (PCA, por vía venosa o epidural, es una técnica segura y eficaz en el tratamiento del dolor postoperatorio. Sin embargo, el uso de opioides no está exento de riesgos y la depresión respiratoria es la complicación más temida. Los objetivos de este estudio fueron describir la incidencia de depresión respiratoria asociada a la analgesia postoperatoria con opioides administrados por vía epidural o venosa, y las características de los pacientes que presentaron la complicación. MÉTODO: Estudio de incidencia retrospectiva en pacientes operados en el Hospital SARAH Brasília entre diciembre de 1999 y diciembre de 2007 y tratados con PCA con opioides por vía venosa o epidural. Se definieron como casos de depresión respiratoria, frecuencia respiratoria d" 8 irpm, necesidad del uso de naloxona, o saturación periférica de oxígeno por debajo de un 90%. RESULTADOS: Fueron evaluados 2790 pacientes, de los cuales 635 pacientes recibieron PCA venosa y 2155, analgesia epidural. Se dieron siete casos de depresión respiratoria postoperatoria (incidencia de 0,25%. De ellos, seis pacientes

  15. Memory efficient PCA methods for large group ICA

    Directory of Open Access Journals (Sweden)

    Srinivas eRachakonda

    2016-02-01

    Full Text Available Principal component analysis (PCA is widely used for data reduction in group independent component analysis (ICA of fMRI data. Commonly, group-level PCA of temporally concatenated datasets is computed prior to ICA of the group principal components. This work focuses on reducing very high dimensional temporally concatenated datasets into its group PCA space. Existing randomized PCA methods can determine the PCA subspace with minimal memory requirements and, thus, are ideal for solving large PCA problems. Since the number of dataloads is not typically optimized, we extend one of these methods to compute PCA of very large datasets with a minimal number of dataloads. This method is coined multi power iteration (MPOWIT. The key idea behind MPOWIT is to estimate a subspace larger than the desired one, while checking for convergence of only the smaller subset of interest. The number of iterations is reduced considerably (as well as the number of dataloads, accelerating convergence without loss of accuracy. More importantly, in the proposed implementation of MPOWIT, the memory required for successful recovery of the group principal components becomes independent of the number of subjects analyzed. Highly efficient subsampled eigenvalue decomposition techniques are also introduced, furnishing excellent PCA subspace approximations that can be used for intelligent initialization of randomized methods such as MPOWIT. Together, these developments enable efficient estimation of accurate principal components, as we illustrate by solving a 1600-subject group-level PCA of fMRI with standard acquisition parameters, on a regular desktop computer with only 4GB RAM, in just a few hours. MPOWIT is also highly scalable and could realistically solve group-level PCA of fMRI on thousands of subjects, or more, using standard hardware, limited only by time, not memory. Also, the MPOWIT algorithm is highly parallelizable, which would enable fast, distributed implementations

  16. Memory Efficient PCA Methods for Large Group ICA.

    Science.gov (United States)

    Rachakonda, Srinivas; Silva, Rogers F; Liu, Jingyu; Calhoun, Vince D

    2016-01-01

    Principal component analysis (PCA) is widely used for data reduction in group independent component analysis (ICA) of fMRI data. Commonly, group-level PCA of temporally concatenated datasets is computed prior to ICA of the group principal components. This work focuses on reducing very high dimensional temporally concatenated datasets into its group PCA space. Existing randomized PCA methods can determine the PCA subspace with minimal memory requirements and, thus, are ideal for solving large PCA problems. Since the number of dataloads is not typically optimized, we extend one of these methods to compute PCA of very large datasets with a minimal number of dataloads. This method is coined multi power iteration (MPOWIT). The key idea behind MPOWIT is to estimate a subspace larger than the desired one, while checking for convergence of only the smaller subset of interest. The number of iterations is reduced considerably (as well as the number of dataloads), accelerating convergence without loss of accuracy. More importantly, in the proposed implementation of MPOWIT, the memory required for successful recovery of the group principal components becomes independent of the number of subjects analyzed. Highly efficient subsampled eigenvalue decomposition techniques are also introduced, furnishing excellent PCA subspace approximations that can be used for intelligent initialization of randomized methods such as MPOWIT. Together, these developments enable efficient estimation of accurate principal components, as we illustrate by solving a 1600-subject group-level PCA of fMRI with standard acquisition parameters, on a regular desktop computer with only 4 GB RAM, in just a few hours. MPOWIT is also highly scalable and could realistically solve group-level PCA of fMRI on thousands of subjects, or more, using standard hardware, limited only by time, not memory. Also, the MPOWIT algorithm is highly parallelizable, which would enable fast, distributed implementations ideal for big

  17. A comparison of extradural tramadol and extradural morphine for postoperative analgesia in female dogs undergoing ovariohysterectomy Tramadol peridural comparativamente à morfina para analgesia pós-operatória em cadelas submetidas à ovariosalpingohisterectomia

    Directory of Open Access Journals (Sweden)

    Celso Sawaya Neves

    2012-04-01

    Full Text Available PURPOSE: To compare the postoperative analgesic effects of the extradural tramadol or morphine in female dogs undergoing ovariohysterectomy. METHODS: Sixteen female dogs were randomly assigned to two groups of eight animals each and received morphine (0.1mg kg-1 M group or tramadol (2mg kg-1 T group. The pre-anesthetic medication was intravenously (iv acepromazine (0.05mg kg-1. Anesthesia was induced with propofol (4mg kg-1iv and maintained with isoflurane. The degree of analgesia was evaluated using a numerical rating scale that included physiologic and behavior variables. Dogs were scored at one, three, six and 12 hours after surgery by one blinded observer. Dogs were treated with morphine (0.5mg kg-1 if their scores were >6. Serum cortisol was measured before the pre-anesthetic medication was administered (basal, at the time of the ovarian pedicle clamping (T0, and at 1 (T1, 6 (T6 and 12 (T12 hours postoperative. RESULTS: The pain score did not differ between morphine and tramadol treatments. Rescue analgesia was administered to one dog in the T treatment group. Serum cortisol did not differ between treatments. CONCLUSION: The extradural administration of morphine or tramadol is a safe and effective method of inducing analgesia in female dogs undergoing ovariohyterectomy.OBJETIVO: Comparar o efeito analgésico pós-operatório do tramadol em relação à morfina quando utilizados por via peridural em cadelas submetidas à ovariosalpingohisterectomia (OSH. MÉTODOS: Dezesseis cadelas foram aleatoriamente distribuídas em dois tratamentos, com oito animais em cada, tratadas com morfina (0,1mg kg-1, M e tramadol (2mg kg-1, T. A medicação pré-anestésica foi feita por via intravenosa (iv com acepromazina (0,05mg kg-1, seguindo-se indução e manutenção anestésicas com propofol (4mg kg-1 iv e isofluorano, respectivamente. O grau de analgesia foi avaliado uma, três, seis e 12 horas após o término da cirurgia, com escala descritiva num

  18. Sedation and analgesia to facilitate mechanical ventilation.

    Science.gov (United States)

    Nemergut, Michael E; Yaster, Myron; Colby, Christopher E

    2013-09-01

    Regardless of age, health care professionals have a professional and ethical obligation to provide safe and effective analgesia to patients undergoing painful procedures. Historically, newborns, particularly premature and sick infants, have been undertreated for pain. Intubation of the trachea and mechanical ventilation are ubiquitous painful procedures in the neonatal intensive care unit that are poorly assessed and treated. The authors review the use of sedation and analgesia to facilitate endotracheal tube placement and mechanical ventilation. Controversies regarding possible adverse neurodevelopmental outcomes after sedative and anesthetic exposure and in the failure to treat pain is also discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Educação sem distâncias: utilização do WebCT como ferramenta de apoio para o ensino da Terapia Intravenosa na graduação em Enfermagem

    Directory of Open Access Journals (Sweden)

    Denise Costa Dias

    2003-08-01

    Full Text Available Esta investigação focalizou o ambiente de aprendizagem por meio da Internet, onde foi abordado o ensino da terapia intravenosa(TIV. Dentre os vários conteúdos que poderiam ser ministrados em um ambiente de aprendizagem via Internet foi escolhida a TIV pois trata-se de um tema complexo que abrange não apenas os procedimentos técnicos mas também aspectos conceituais que podem ser discutidos em um ambiente virtual de aprendizagem. Os objetivos da investigação foram desenvolver material educacional sobre Terapia Intravenosa, utilizando a Internet para orientar o aprendizado de conceitos relacionados a terapia intravenosa, proceder avaliação por especialistas do material educacional sobre Terapia Intravenosa produzido e avaliar a utilização do mesmo pelos alunos em termos de dificuldades e/ou facilidades, participação/interação no ambiente, usabilidade das ferramentas disponíveis no ambiente. O ambiente utilizado para disponibilizar o curso na Internet foi o WebCT.

  20. Comparative study of PCA in classification of multichannel EMG signals.

    Science.gov (United States)

    Geethanjali, P

    2015-06-01

    Electromyographic (EMG) signals are abundantly used in the field of rehabilitation engineering in controlling the prosthetic device and significantly essential to find fast and accurate EMG pattern recognition system, to avoid intrusive delay. The main objective of this paper is to study the influence of Principal component analysis (PCA), a transformation technique, in pattern recognition of six hand movements using four channel surface EMG signals from ten healthy subjects. For this reason, time domain (TD) statistical as well as auto regression (AR) coefficients are extracted from the four channel EMG signals. The extracted statistical features as well as AR coefficients are transformed using PCA to 25, 50 and 75 % of corresponding original feature vector space. The classification accuracy of PCA transformed and non-PCA transformed TD statistical features as well as AR coefficients are studied with simple logistic regression (SLR), decision tree (DT) with J48 algorithm, logistic model tree (LMT), k nearest neighbor (kNN) and neural network (NN) classifiers in the identification of six different movements. The Kruskal-Wallis (KW) statistical test shows that there is a significant reduction (P PCA transformed features compared to non-PCA transformed features. SLR with non-PCA transformed time domain (TD) statistical features performs better in accuracy and computational power compared to other features considered in this study. In addition, the motion control of three drives for six movements of the hand is implemented with SLR using TD statistical features in off-line with TMSLF2407 digital signal controller (DSC).

  1. Stability and chaos of LMSER PCA learning algorithm

    International Nuclear Information System (INIS)

    Lv Jiancheng; Y, Zhang

    2007-01-01

    LMSER PCA algorithm is a principal components analysis algorithm. It is used to extract principal components on-line from input data. The algorithm has both stability and chaotic dynamic behavior under some conditions. This paper studies the local stability of the LMSER PCA algorithm via a corresponding deterministic discrete time system. Conditions for local stability are derived. The paper also explores the chaotic behavior of this algorithm. It shows that the LMSER PCA algorithm can produce chaos. Waveform plots, Lyapunov exponents and bifurcation diagrams are presented to illustrate the existence of chaotic behavior of this algorithm

  2. Differences in maternal temperature during labour with remifentanil patient-controlled analgesia or epidural analgesia: a randomised controlled trial

    NARCIS (Netherlands)

    Douma, M.R.; Stienstra, R.; Middeldorp, J.M.; Arbous, M.S.; Dahan, A

    2015-01-01

    BACKGROUND: Epidural analgesia and remifentanil patient-controlled analgesia are two popular techniques for the treatment of labour pain, each with its own efficacy and toxicity. METHODS: Parturients requesting analgesia were randomly assigned to either patient-controlled intravenous remifentanil or

  3. Nitrous oxide for labor analgesia: Utilization and predictors of conversion to neuraxial analgesia.

    Science.gov (United States)

    Sutton, Caitlin D; Butwick, Alexander J; Riley, Edward T; Carvalho, Brendan

    2017-08-01

    We examined the characteristics of women who choose nitrous oxide for labor analgesia and identified factors that predict conversion from nitrous oxide to labor neuraxial analgesia. Retrospective descriptive study. Labor and Delivery Ward. 146 pregnant women who used nitrous oxide for analgesia during labor and delivery between September 2014 and September 2015. Chart review only. Demographic, obstetric, and intrapartum characteristics of women using nitrous oxide were examined. Multivariable logistic regression was performed to identify factors associated with conversion from nitrous oxide to neuraxial analgesia. Data are presented as n (%), median [IQR], adjusted relative risk (aRR), and 95% confidence intervals (CI) as appropriate. During the study period, 146 women used nitrous oxide for labor analgesia (accounting for 3% of the total deliveries). The majority (71.9%) of women who used nitrous oxide were nulliparous, and over half (51.9%) had expressed an initial preference for "nonmedical birth." The conversion rate to neuraxial blockade was 63.2%, compared to a concurrent institutional rate of 85.1% in women who did not use nitrous oxide. Factors associated with conversion from nitrous oxide to neuraxial blockade were labor induction (aRR=2.0, CI 1.2-3.3) and labor augmentation (aRR=1.7, CI 1.0-2.9). Only a small number of women opted to use nitrous oxide during labor, analgesia was minimal, and most converted to neuraxial analgesia. Women with induced and augmented labors should be counseled about the increased likelihood that they will convert to neuraxial analgesia. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Neuraxial block and postoperative epidural analgesia

    DEFF Research Database (Denmark)

    Leslie, K; McIlroy, D; Kasza, J

    2016-01-01

    BACKGROUND: We assessed associations between intraoperative neuraxial block and postoperative epidural analgesia, and a composite primary outcome of death or non-fatal myocardial infarction, at 30 days post-randomization in POISE-2 Trial subjects. METHODS: 10 010 high-risk noncardiac surgical pat...

  5. Elevated YKL40 is associated with advanced prostate cancer (PCa) and positively regulates invasion and migration of PCa cells.

    Science.gov (United States)

    Jeet, Varinder; Tevz, Gregor; Lehman, Melanie; Hollier, Brett; Nelson, Colleen

    2014-10-01

    Chitinase 3-like 1 (CHI3L1 or YKL40) is a secreted glycoprotein highly expressed in tumours from patients with advanced stage cancers, including prostate cancer (PCa). The exact function of YKL40 is poorly understood, but it has been shown to play an important role in promoting tumour angiogenesis and metastasis. The therapeutic value and biological function of YKL40 are unknown in PCa. The objective of this study was to examine the expression and function of YKL40 in PCa. Gene expression analysis demonstrated that YKL40 was highly expressed in metastatic PCa cells when compared with less invasive and normal prostate epithelial cell lines. In addition, the expression was primarily limited to androgen receptor-positive cell lines. Evaluation of YKL40 tissue expression in PCa patients showed a progressive increase in patients with aggressive disease when compared with those with less aggressive cancers and normal controls. Treatment of LNCaP and C4-2B cells with androgens increased YKL40 expression, whereas treatment with an anti-androgen agent decreased the gene expression of YKL40 in androgen-sensitive LNCaP cells. Furthermore, knockdown of YKL40 significantly decreased invasion and migration of PCa cells, whereas overexpression rendered them more invasive and migratory, which was commensurate with an enhancement in the anchorage-independent growth of cells. To our knowledge, this study characterises the role of YKL40 for the first time in PCa. Together, these results suggest that YKL40 plays an important role in PCa progression and thus inhibition of YKL40 may be a potential therapeutic strategy for the treatment of PCa. © 2014 The authors.

  6. Tracking image features with PCA-SURF descriptors

    CSIR Research Space (South Africa)

    Pancham, A

    2015-05-01

    Full Text Available , Principal Component Analysis (PCA) is applied to the 64-Dimension (D) Speeded Up Robust Features (SURF) descriptor to reduce the descriptor dimensionality and computational time, and suggest the minimum number of dimensions needed for reliable tracking...

  7. EEG frequency PCA in EEG-ERP dynamics.

    Science.gov (United States)

    Barry, Robert J; De Blasio, Frances M

    2018-05-01

    Principal components analysis (PCA) has long been used to decompose the ERP into components, and these mathematical entities are increasingly accepted as meaningful and useful representatives of the electrophysiological components constituting the ERP. A similar expansion appears to be beginning in regard to decomposition of the EEG amplitude spectrum into frequency components via frequency PCA. However, to date, there has been no exploration of the brain's dynamic EEG-ERP linkages using PCA decomposition to assess components in each measure. Here, we recorded intrinsic EEG in both eyes-closed and eyes-open resting conditions, followed by an equiprobable go/no-go task. Frequency PCA of the EEG, including the nontask resting and within-task prestimulus periods, found seven frequency components within the delta to beta range. These differentially predicted PCA-derived go and no-go N1 and P3 ERP components. This demonstration suggests that it may be beneficial in future brain dynamics studies to implement PCA for the derivation of data-driven components from both the ERP and EEG. © 2017 Society for Psychophysiological Research.

  8. On the Link Between L1-PCA and ICA.

    Science.gov (United States)

    Martin-Clemente, Ruben; Zarzoso, Vicente

    2017-03-01

    Principal component analysis (PCA) based on L1-norm maximization is an emerging technique that has drawn growing interest in the signal processing and machine learning research communities, especially due to its robustness to outliers. The present work proves that L1-norm PCA can perform independent component analysis (ICA) under the whitening assumption. However, when the source probability distributions fulfil certain conditions, the L1-norm criterion needs to be minimized rather than maximized, which can be accomplished by simple modifications on existing optimal algorithms for L1-PCA. If the sources have symmetric distributions, we show in addition that L1-PCA is linked to kurtosis optimization. A number of numerical experiments illustrate the theoretical results and analyze the comparative performance of different algorithms for ICA via L1-PCA. Although our analysis is asymptotic in the sample size, this equivalence opens interesting new perspectives for performing ICA using optimal algorithms for L1-PCA with guaranteed global convergence while inheriting the increased robustness to outliers of the L1-norm criterion.

  9. A Retrospective Observational Study Examining the Effect of Thoracic Epidural and Patient Controlled Analgesia on Short-term Outcomes in Blunt Thoracic Trauma Injuries.

    Science.gov (United States)

    Baker, Edward James; Lee, Geraldine Ann

    2016-01-01

    Effective analgesia in the early stages after any major traumatic event remains pivotal to optimal trauma management. For patients with significant thoracic injuries, this is paramount to ensure ongoing efficient respiratory function. The aim of this study was to investigate the use of analgesic modes in the management of patients with a primary thoracic injury and blunt mechanism of injury. By understanding variables that influence the use of varying analgesic modes and influence the development of pulmonary complications, there should be more uniform evidence-based prescription in the future.This retrospective study considered analgesic use in patients admitted after blunt thoracic injuries at one major trauma center over a 2-year period. Pulmonary complications measured included both infective and ventilator-associated failure. Univariate and multivariate analyses were used to identify patient and injury severity characteristics and their association with respiratory complications.A total of 401 cases were reviewed and analyzed: 159 received Patient Controlled Analgesia (PCA), 32 received PCA and epidural analgesia (EA), 6 received EA alone, and 204 received interval-administered analgesia. There were no significant differences in the rates of complication when compared between analgesic modes. Patients who developed pneumonia had significantly increased number of thoracic fractures and underlying organ injury (P cardiac disease (OR 2.624, P = 0.042) and ICU length of stay (OR: 1.146, P blunt thoracic injuries. However, variables that may influence usage of different analgesic modes and high-risk groups for the development of pneumonia were identified. Further work is warranted to consider the long-term benefits of analgesia in patients post-blunt thoracic injuries.

  10. A PCA3 gene-based transcriptional amplification system targeting primary prostate cancer

    OpenAIRE

    Neveu, Bertrand; Jain, Pallavi; T?tu, Bernard; Wu, Lily; Fradet, Yves; Pouliot, Fr?d?ric

    2015-01-01

    Targeting specifically primary prostate cancer (PCa) cells for immune therapy, gene therapy or molecular imaging is of high importance. The PCA3 long non-coding RNA is a unique PCa biomarker and oncogene that has been widely studied. This gene has been mainly exploited as an accurate diagnostic urine biomarker for PCa detection. In this study, the PCA3 promoter was introduced into a new transcriptional amplification system named the 3-Step Transcriptional Amplification System (PCA3-3STA) and ...

  11. Long-Term Stability of Tramadol and Ketamine Solutions for Patient-Controlled Analgesia Delivery.

    Science.gov (United States)

    Gu, Junfeng; Qin, Wengang; Chen, Fuchao; Xia, Zhongyuan

    2015-08-26

    Subanesthetic doses of ketamine as an adjuvant to tramadol in patient-controlled analgesia (PCA) for postoperative pain have been shown to improve the quality of analgesia. However, there are no such commercially available drug mixtures, and the stability of the combination has rarely been assessed. Admixtures were assessed for periods of up to 14 days at 4°C and 25°C. Three different mixtures of tramadol and ketamine (tramadol 5.0 mg/mL + ketamine 0.5 mg/mL, tramadol 5.0 mg/mL + ketamine 1.0 mg/mL, and tramadol 5.0 mg/mL + ketamine 2.0 mg/mL) were prepared in polyolefin bags by combining these 2 drugs with 0.9% sodium chloride (normal saline [NS]). The chemical stability of the admixtures was evaluated by a validated high-performance liquid chromatography (HPLC) method and by measurement of pH values. Solution appearance and color were assessed by observing the samples against black and white backgrounds. Solutions were considered stable if they maintained 90% of the initial concentration of each drug. The percentages of initial concentration of tramadol and ketamine in the various solutions remained above 98% when stored at 4°C or 25°C over the testing period. No changes in color or turbidity were observed in any of the prepared solutions. Throughout this period, pH values remained stable. The results indicate that the drug mixtures of tramadol with ketamine in NS for PCA delivery systems were stable for 14 days when stored in polyolefin bags at 4°C or 25°C.

  12. The efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia technique in post-laparoscopic cholecystectomy pain treatment.

    Science.gov (United States)

    Ekmekçi, Perihan; Kazak Bengisun, Züleyha; Kazbek, Baturay Kansu; Öziş, Salih Erpulat; Taştan, Huri; Süer, Arif Hikmet

    2012-01-01

    Pain treatment in laparoscopic cholecystectomy, which is performed in increasing numbers as an ambulatory procedure, is an important issue.Although laparoscopic cholecystectomy is regarded as an ambulatory procedure, patients are often hospitalized due to pain and this increases opioid consumption and side effects caused by opioids. This study aims at evaluating the efficacy of adding dexketoprofen trometamol to tramadol with patient controlled analgesia (PCA) in postlaparoscopic cholecystectomy pain treatment. 40 patients in ASA I-II risk groups aged between 18-65 years were enrolled in the study and were randomized using closed envelope method. In Group TD 600 mg tramadol and 100 mg dexketoprofen trometamol, in Group T 600 mg tramadol was added to 100 ml 0.9% normal saline for PCA. 8 mg lornoxicam iv was given if VAS >40 in the postoperative period. There was no statistically significant difference in terms of adverse effects (hypotension, bradycardia, sedation) but in Group T 4 patients complained of nausea and 3 complained of vomiting. Opioid consumption was lower and patient satisfaction was higher in group TD. This study has shown that adding dexketoprofen trometamol to tramadol in patient controlled analgesia following laparoscopic cholecystectomy lowers VAS scores, increases patient satisfaction and decreases opioid consumption.

  13. Predisposing factors for peripheral intravenous puncture failure in children Factores predisponentes para fracaso de la punción intravenosa periférica en niños Fatores predisponentes para insucesso da punção intravenosa periférica em crianças

    Directory of Open Access Journals (Sweden)

    Daniela Cavalcante de Negri

    2012-12-01

    Full Text Available OBJECTIVE: To identify predisposing factors for peripheral intravenous puncture failure in children. METHODS: Cross-sectional cohort study conducted with 335 children in a pediatric ward of a university hospital after approval of the ethics committee. The Wald Chi-squared, Prevalence Ratio (PR and backward procedure (p≤0.05 tests were applied. RESULTS: Success of peripheral intravenous puncture was obtained in 300 (89.5% children and failure in 35 (10.4%. The failure rates were significantly influenced by: presence of clinical history of difficult venous access, malnourishment, previous use of peripherally inserted central venous catheter, previous use of central venous catheter, and history of phlebitis or infiltration. In the multivariate model, being malnourished and having previously been submitted to central venous catheterization were the predisposing factors for the failure. CONCLUSION: The failure rate of 10.4% is similar to that identified in analogous studies and was influenced by characteristics of the children and intravenous therapy. In association with this, malnutrition and previous use of a central venous catheter were the most important variables influencing increase in peripheral intravenous puncture failure.OBJETIVO: Verificar factores predisponentes para el fracaso de la punción intravenosa periférica realizada en niños. MÉTODO: Estudio de cohorte transversal realizado con 335 niños internados en unidad pediátrica de un hospital universitario, después de la aprobación del mérito ético. Se utilizaron testes Jue-cuadrado de Wald, Razón de Superioridad (RP y procedimiento de backward (p≤0,05. RESULTADOS: se evidenció éxito de la punción en 300 (89,5% niños e fracaso en 35 (10,4%. Influenciaron significantemente las proporciones de fracaso: presentar historia clínica para dificultad en la punción, estar desnutrido, uso previo de catéter central de inserción periférica, uso previo de catéter venoso central

  14. Nerve injury caused by mandibular block analgesia

    DEFF Research Database (Denmark)

    Hillerup, S; Jensen, Rigmor H

    2006-01-01

    Fifty-four injection injuries in 52 patients were caused by mandibular block analgesia affecting the lingual nerve (n=42) and/or the inferior alveolar nerve (n=12). All patients were examined with a standardized test of neurosensory functions. The perception of the following stimuli was assessed......: feather light touch, pinprick, sharp/dull discrimination, warm, cold, point location, brush stroke direction, 2-point discrimination and pain perception. Gustation was tested for recognition of sweet, salt, sour and bitter. Mandibular block analgesia causes lingual nerve injury more frequently than...... inferior alveolar nerve injury. All grades of loss of neurosensory and gustatory functions were found, and a range of persisting neurogenic malfunctions was reported. Subjective complaints and neurosensory function tests indicate that lingual nerve lesions are more incapacitating than inferior alveolar...

  15. Epidural Analgesia and Fever at Labor

    Directory of Open Access Journals (Sweden)

    Ye. M. Shifman

    2008-01-01

    Full Text Available Objective: to study the incidence of labor fever under epidural analgesia (EA and to evaluate its impact on the courses of puerperium and early neonatality. Subjects and methods. The paper presents the data of a prospective study of the course of labor, puerperium, and early neonatality in 397 women in whom labors occurred at the Republican Peritoneal Center in 2006. A study group included 324 parturients in whom labor pain was relieved by EA. A comparison group comprised 55 parturients in whom no analgesics were used at labor. Results. There were no significant statistical differences between the groups in the incidence of labor fever and complicated puerperium and in that of neonatal pyoseptic diseases. Key words: labor hyperthermia, epidural analgesia, labor pain relief.

  16. Decomposing ERP time-frequency energy using PCA.

    Science.gov (United States)

    Bernat, Edward M; Williams, William J; Gehring, William J

    2005-06-01

    Time-frequency transforms (TFTs) offer rich representations of event-related potential (ERP) activity, and thus add complexity. Data reduction techniques for TFTs have been slow to develop beyond time analysis of detail functions from wavelet transforms. Cohen's class of TFTs based on the reduced interference distribution (RID) offer some benefits over wavelet TFTs, but do not offer the simplicity of detail functions from wavelet decomposition. The objective of the current approach is a data reduction method to extract succinct and meaningful events from both RID and wavelet TFTs. A general energy-based principal components analysis (PCA) approach to reducing TFTs is detailed. TFT surfaces are first restructured into vectors, recasting the data as a two-dimensional matrix amenable to PCA. PCA decomposition is performed on the two-dimensional matrix, and surfaces are then reconstructed. The PCA decomposition method is conducted with RID and Morlet wavelet TFTs, as well as with PCA for time and frequency domains separately. Three simulated datasets were decomposed. These included Gabor logons and chirped signals. All simulated events were appropriately extracted from the TFTs using both wavelet and RID TFTs. Varying levels of noise were then added to the simulated data, as well as a simulated condition difference. The PCA-TFT method, particularly when used with RID TFTs, appropriately extracted the components and detected condition differences for signals where time or frequency domain analysis alone failed. Response-locked ERP data from a reaction time experiment was also decomposed. Meaningful components representing distinct neurophysiological activity were extracted from the ERP TFT data, including the error-related negativity (ERN). Effective TFT data reduction was achieved. Activity that overlapped in time, frequency, and topography were effectively separated and extracted. Methodological issues involved in the application of PCA to TFTs are detailed, and

  17. [A Quantitative Verification for Operability of Three PCA Devices Attached to the Disposable Infusion Pumps].

    Science.gov (United States)

    Tadokoro, Takahiro; Fuchibe, Makoto; Odo, Yuichiro; Kakinohana, Manabu

    2015-11-01

    In this study using 3 different PCA devices (Baxter infuser LVBB +PCM 2 ml: Pump B, Coopdech Balloonjector +PCA 3 ml: Pump C, Rakuraku fuser +PCA 3 ml: Pump S), we investigated how easily PCA devices could be handled. In this study with 42 volunteers (14 elders and 28 nurses), we compared 3 PCA ejection volume and ejection rate among three PCA devices. PCA ejection rate was defined as the ratio of actual ejection volume to the maximum ejection volume (MEV) of each PCA device. Although not only elders but also nurses failed to produce accurate PCA ejection volume in the Pump B, Pump S could provide the MEV even by elders. In the Pump C, approximately 80% of MEV could be achieved by nurses, but 60% of MEV by elders (P PCA ejection volume might be dependent on PCA device.

  18. Joint Group Sparse PCA for Compressed Hyperspectral Imaging.

    Science.gov (United States)

    Khan, Zohaib; Shafait, Faisal; Mian, Ajmal

    2015-12-01

    A sparse principal component analysis (PCA) seeks a sparse linear combination of input features (variables), so that the derived features still explain most of the variations in the data. A group sparse PCA introduces structural constraints on the features in seeking such a linear combination. Collectively, the derived principal components may still require measuring all the input features. We present a joint group sparse PCA (JGSPCA) algorithm, which forces the basic coefficients corresponding to a group of features to be jointly sparse. Joint sparsity ensures that the complete basis involves only a sparse set of input features, whereas the group sparsity ensures that the structural integrity of the features is maximally preserved. We evaluate the JGSPCA algorithm on the problems of compressed hyperspectral imaging and face recognition. Compressed sensing results show that the proposed method consistently outperforms sparse PCA and group sparse PCA in reconstructing the hyperspectral scenes of natural and man-made objects. The efficacy of the proposed compressed sensing method is further demonstrated in band selection for face recognition.

  19. Postcastration analgesia in ponies using buprenorphine hydrochloride.

    Science.gov (United States)

    Love, E J; Taylor, P M; Whay, H R; Murrell, J

    2013-06-15

    Buprenorphine has recently obtained UK Marketing Authorisation for horses. The analgesic effects are long lasting, and have considerable potential for postoperative pain relief. This observer blinded, randomised study aimed to evaluate postsurgical analgesia in ponies premedicated with buprenorphine prior to castration under intravenous anaesthesia. Ponies received either 0.01 mg/kg bodyweight (BW) buprenorphine (group B) or an equivalent volume of 5 per cent glucose (group C) given intravenously before induction of anaesthesia. Pain was assessed and recorded using dynamic interactive visual analogue scores (DIVAS 0-100) and a Simple Descriptive Scale (SDS 0-3) (high scores=most pain) before and 1, 3, 6, 9, 12 and 24 hours after anaesthesia. Rescue analgesia was given if DIVAS>40 mm. Data were analysed using the Mann-Whitney U test at PBuprenorphine did not produce any serious adverse effects. Buprenorphine at 0.01 mg/kg BW intravenously administered before anaesthesia provided near-comprehensive postoperative analgesia after surgical castration in ponies.

  20. The nature, magnitude, and reporting compliance of device-related events for intravenous patient-controlled analgesia in the FDA Manufacturer and User Facility Device Experience (MAUDE) database.

    Science.gov (United States)

    Lawal, Oluwadolapo D; Mohanty, Maitreyee; Elder, Harrison; Skeer, Margie; Erpelding, Nathalie; Lanier, Ryan; Katz, Nathaniel

    2018-04-01

    The aim of this study is to determine the characteristics, magnitude, and the quality of reporting of mandated events involving intravenous patient-controlled analgesia (IV-PCA) devices in the Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database; a postmarket surveillance system. We utilized a mixed-methods approach to systematically characterize structured data and text narratives associated with IV-PCA events submitted to MAUDE between 1 January 2011 and 12 September 2016. Of 1,430 IV-PCA events reported during the study period, 6.4% were adverse events (AEs) as identified via structured data fields in the MEDWATCH forms. Upon qualitative review of the narrative texts, 11.0% of events were associated with an unfavorable clinical outcome, which was 71% higher than the incidence of the adverse outcomes reported using the structured data fields. Device-related issues, which were mostly preventable, accounted for 86.9% of events. Of 65 reportable events submitted by manufacturers, 18.5% did not comply with reporting requirements as mandated by law. Patients on IV-PCA continue to experience serious complications as a result of preventable errors. Multi-modal interventions including educational training and the development and adoption of PCA devices with improved safety features are needed to improve safety.

  1. On a PCA-based lung motion model.

    Science.gov (United States)

    Li, Ruijiang; Lewis, John H; Jia, Xun; Zhao, Tianyu; Liu, Weifeng; Wuenschel, Sara; Lamb, James; Yang, Deshan; Low, Daniel A; Jiang, Steve B

    2011-09-21

    Respiration-induced organ motion is one of the major uncertainties in lung cancer radiotherapy and is crucial to be able to accurately model the lung motion. Most work so far has focused on the study of the motion of a single point (usually the tumor center of mass), and much less work has been done to model the motion of the entire lung. Inspired by the work of Zhang et al (2007 Med. Phys. 34 4772-81), we believe that the spatiotemporal relationship of the entire lung motion can be accurately modeled based on principle component analysis (PCA) and then a sparse subset of the entire lung, such as an implanted marker, can be used to drive the motion of the entire lung (including the tumor). The goal of this work is twofold. First, we aim to understand the underlying reason why PCA is effective for modeling lung motion and find the optimal number of PCA coefficients for accurate lung motion modeling. We attempt to address the above important problems both in a theoretical framework and in the context of real clinical data. Second, we propose a new method to derive the entire lung motion using a single internal marker based on the PCA model. The main results of this work are as follows. We derived an important property which reveals the implicit regularization imposed by the PCA model. We then studied the model using two mathematical respiratory phantoms and 11 clinical 4DCT scans for eight lung cancer patients. For the mathematical phantoms with cosine and an even power (2n) of cosine motion, we proved that 2 and 2n PCA coefficients and eigenvectors will completely represent the lung motion, respectively. Moreover, for the cosine phantom, we derived the equivalence conditions for the PCA motion model and the physiological 5D lung motion model (Low et al 2005 Int. J. Radiat. Oncol. Biol. Phys. 63 921-9). For the clinical 4DCT data, we demonstrated the modeling power and generalization performance of the PCA model. The average 3D modeling error using PCA was within 1

  2. Synthesis and antifungal evaluation of PCA amide analogues.

    Science.gov (United States)

    Qin, Chuan; Yu, Di-Ya; Zhou, Xu-Dong; Zhang, Min; Wu, Qing-Lai; Li, Jun-Kai

    2018-04-18

    To improve the physical and chemical properties of phenazine-1-carboxylic acid (PCA) and find higher antifungal compounds, a series of PCA amide analogues were designed and synthesized and their structures were confirmed by 1 H NMR, HRMS, and X-ray. Most compounds showed some antifungal activities in vitro. Particularly, compound 3d exhibited inhibition effect against Pyriculariaoryzac Cavgra with EC 50 value of 28.7 μM and compound 3q exhibited effect against Rhizoctonia solani with EC 50 value of 24.5 μM, more potently active than that of the positive control PCA with its EC 50 values of 37.3 μM (Pyriculariaoryzac Cavgra) and 33.2 μM (Rhizoctonia solani), respectively.

  3. Copenhagen uPAR prostate cancer (CuPCa) database

    DEFF Research Database (Denmark)

    Lippert, Solvej; Berg, Kasper D; Høyer-Hansen, Gunilla

    2016-01-01

    AIM: Urokinase plasminogen activator receptor (uPAR) plays a central role during cancer invasion by facilitating pericellular proteolysis. We initiated the prospective 'Copenhagen uPAR Prostate Cancer' study to investigate the significance of uPAR levels in prostate cancer (PCa) patients. METHODS......: Plasma samples and clinical data from patients with newly diagnosed PCa have been collected prospectively. The uPAR forms have been measured in plasma using time-resolved fluorescence immunoassays. RESULTS: The level of intact uPAR(I-III) did not differ. Plasma uPAR(I-III) + uPAR(II-III) levels and u......PAR(I) levels were significantly higher in hormone-naive and castrate-resistant patients compared with patients with localized disease (both: p PCa....

  4. Adaptive PCA based fault diagnosis scheme in imperial smelting process.

    Science.gov (United States)

    Hu, Zhikun; Chen, Zhiwen; Gui, Weihua; Jiang, Bin

    2014-09-01

    In this paper, an adaptive fault detection scheme based on a recursive principal component analysis (PCA) is proposed to deal with the problem of false alarm due to normal process changes in real process. Our further study is also dedicated to develop a fault isolation approach based on Generalized Likelihood Ratio (GLR) test and Singular Value Decomposition (SVD) which is one of general techniques of PCA, on which the off-set and scaling fault can be easily isolated with explicit off-set fault direction and scaling fault classification. The identification of off-set and scaling fault is also applied. The complete scheme of PCA-based fault diagnosis procedure is proposed. The proposed scheme is first applied to Imperial Smelting Process, and the results show that the proposed strategies can be able to mitigate false alarms and isolate faults efficiently. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  5. ANALGESIA TRANSOPERATÓRIA INDUZIDA PELA MORFINA OU MEPERIDINA EM GATOS SUBMETIDOS A OSTEOSSÍNTESE

    Directory of Open Access Journals (Sweden)

    Cunha João Marcelo Caldeira Cardoso Pinto da

    2002-01-01

    Full Text Available O objetivo do presente estudo foi avaliar a qualidade da analgesia proporcionada pela morfina e meperidina em gatos acometidos por processos traumáticos e submetidos a osteossíntese. Para tanto, foram utilizados 18 animais distribuídos em dois grupos: o grupo I recebeu acepromazina (0,2mg/kg e meperidina (4,0mg/kg, ambos pela via intramuscular; a indução anestésica foi realizada através da administração de quetamina (3,0mg/kg e midazolam (0,3mg/kg ambos pela via intravenosa, e a manutenção da anestesia foi efetuada com o auxílio de 100% de oxigênio e halotano. Os animais do grupo II foram pré-tratados com acepromazina (0,2mg/kg e morfina (0,2mg/kg, ambos pela via intramuscular e posteriormente foram submetidos ao mesmo tratamento proposto no grupo I. Foram avaliados: freqüência cardíaca e respiratória, pressão arterial sistólica, saturação da oxi-hemoglobina, concentração de dióxido de carbono no ar expirado, concentração inspirada e expirada do halotano, no período pré, trans, e pós-operatório. Concluiu-se que os fármacos opióides empregados apresentam propriedades adequadas para a utilização na medicação pré-anestésica de gatos que serão submetidos a procedimentos ortopédicos, uma vez que não foram observados sinais de depressão cardiovascular nem respiratória e a recuperação foi tranqüila e isenta de fenômenos excitatórios.

  6. Intrathecal analgesia and palliative care: A case study

    Directory of Open Access Journals (Sweden)

    Naveen S Salins

    2010-01-01

    Full Text Available Intrathecal analgesia is an interventional form of pain relief with definite advantages and multiple complications. Administration of intrathecal analgesia needs a good resource setting and expertise. Early complications of intrathecal analgesia can be very distressing and managing these complications will need a high degree of knowledge, technical expertise and level of experience. Pain control alone cannot be the marker of quality in palliative care. A holistic approach may need to be employed that is more person and family oriented.

  7. Combined spinal epidural labour analgesia: Complications and their management

    OpenAIRE

    YILMAZ, Nurullah; KOCAMANOGLU, Ismail Serhat; ABANOZ, Hakan

    2016-01-01

    Combined spinal-epidural analgesia (CSEA) is an effective and increasingly popular analgesia method used in vaginal delivery. CSEA provides rapid and excellent analgesia, allows mobilization, reduces drug consumption significantly and generally causes negligible maternal and fetal /neonatal adverse effects /complications not requiring treatment. The resulting adverse effects /complications are often associated with technical and /or agent/agents used and cause maternal and fetal /neonatal or,...

  8. LABOUR ANALGESIA: EPIDURAL DEXMEDITOMIDINE WITH EITHER BUPIVACAINE OR ROPIVACAINE

    OpenAIRE

    Varaprasad

    2015-01-01

    BACKGROUND: Pain relief in labour is associated with myths and controversies. Providing effective and safe analgesia has remained a challenge. AIM: The purpose of the study was to compare the effect of analgesia with epidural bupivacain or ropivacain along with dexme ditomidine. METHODS AND MATERIAL: Sixty parturients of ASA grade I and II were randomly selected for the study. Each group consisted of thirty patients. The analgesia, motor loss and level of seda...

  9. Combination of dexmedetomidine and remifentanil for labor analgesia: A double-blinded, randomized, controlled study

    Directory of Open Access Journals (Sweden)

    Waleed Abdalla

    2015-01-01

    Full Text Available Background: Satisfactory analgesia is of great importance in the labor. The clinical efficacy and side effects of remifentanil in the management of labor pain had been evaluated. Dexmedetomidine (DMET demonstrates an antinociceptive effect in visceral pain conditions. Aims of the study were to assess whether the combination of DMET with remifentanil would produce a synergistic effect that results in lower analgesic requirements. Furthermore, whether this combination would have less maternal and neonatal adverse effects. Patients and Methods: Sixty American Society of Anesthesiologists physical status I-II pregnant women had been enrolled into this study. All were full term (37-40 weeks′ gestation, singleton fetus with cephalic presentation in the first stage of spontaneous labor. They were divided into two groups group (I Patient-controlled IV remifentanil analgesia (bolus dose 0.25 μg/kg, lockout interval 2 min increased by 0.25 μg/kg to a maximum bolus dose 1 μg/kg in addition to a loading dose of DMET 1 μg/kg over 20 min, followed by infusion at 0.5 μg/kg/h group (II Patient-controlled IV remifentanil analgesia (PCA (bolus dose 0.25 μg/kg, lockout interval 2 min increased by 0.25 μg/kg to a maximum bolus dose 1 μg/kg in addition to a the same volume of normal saline as a loading dose, followed by a continuous saline infusion. Visual analog scale score, maternal, and fetal complications and patients′ satisfaction were recorded. Results: Patients receiving a combination of PCA remifentanil and DMET had a lower pain score compared with remifentanil alone in the second stage of labor (P = 0.001. The Total consumption of remifentanil was reduced by 53.3% in group I. There was an increased incidence of maternal complications and a lower patient satisfaction score in group II. Conclusion: DMET has an opioid sparing effect; a combination of DMET and remifentanil produces a synergistic effect that results in lower analgesic requirements

  10. Recent Improvements to the Calibration Models for RXTE/PCA

    Science.gov (United States)

    Jahoda, K.

    2008-01-01

    We are updating the calibration of the PCA to correct for slow variations, primarily in energy to channel relationship. We have also improved the physical model in the vicinity of the Xe K-edge, which should increase the reliability of continuum fits above 20 keV. The improvements to the matrix are especially important to simultaneous observations, where the PCA is often used to constrain the continuum while other higher resolution spectrometers are used to study the shape of lines and edges associated with Iron.

  11. Efficacy of Lysine-Specific Demethylase 1 Inhibition in PCa

    Science.gov (United States)

    2016-08-01

    new insight into the actions of both LSD1 and FOXA1 that may be relevant in a number of cancers. We further found that short-term treatment with LSD1...how PCa cells adapt to LSD1 inhibition or loss, and to determine whether effective therapies targeting LSD1 can be developed for PCa. 15. SUBJECT...chromatin (Fig. 2B). Finally, we similarly examined the effects of overexpression the wild -type LSD1 (Fig. 3A,B). Conversely to the LSD1 inhibition

  12. Selective REM Sleep Deprivation Improves Expectation-Related Placebo Analgesia.

    Science.gov (United States)

    Chouchou, Florian; Chauny, Jean-Marc; Rainville, Pierre; Lavigne, Gilles J

    2015-01-01

    The placebo effect is a neurobiological and psychophysiological process known to influence perceived pain relief. Optimization of placebo analgesia may contribute to the clinical efficacy and effectiveness of medication for acute and chronic pain management. We know that the placebo effect operates through two main mechanisms, expectations and learning, which is also influenced by sleep. Moreover, a recent study suggested that rapid eye movement (REM) sleep is associated with modulation of expectation-mediated placebo analgesia. We examined placebo analgesia following pharmacological REM sleep deprivation and we tested the hypothesis that relief expectations and placebo analgesia would be improved by experimental REM sleep deprivation in healthy volunteers. Following an adaptive night in a sleep laboratory, 26 healthy volunteers underwent classical experimental placebo analgesic conditioning in the evening combined with pharmacological REM sleep deprivation (clonidine: 13 volunteers or inert control pill: 13 volunteers). Medication was administered in a double-blind manner at bedtime, and placebo analgesia was tested in the morning. Results revealed that 1) placebo analgesia improved with REM sleep deprivation; 2) pain relief expectations did not differ between REM sleep deprivation and control groups; and 3) REM sleep moderated the relationship between pain relief expectations and placebo analgesia. These results support the putative role of REM sleep in modulating placebo analgesia. The mechanisms involved in these improvements in placebo analgesia and pain relief following selective REM sleep deprivation should be further investigated.

  13. Selective REM Sleep Deprivation Improves Expectation-Related Placebo Analgesia.

    Directory of Open Access Journals (Sweden)

    Florian Chouchou

    Full Text Available The placebo effect is a neurobiological and psychophysiological process known to influence perceived pain relief. Optimization of placebo analgesia may contribute to the clinical efficacy and effectiveness of medication for acute and chronic pain management. We know that the placebo effect operates through two main mechanisms, expectations and learning, which is also influenced by sleep. Moreover, a recent study suggested that rapid eye movement (REM sleep is associated with modulation of expectation-mediated placebo analgesia. We examined placebo analgesia following pharmacological REM sleep deprivation and we tested the hypothesis that relief expectations and placebo analgesia would be improved by experimental REM sleep deprivation in healthy volunteers. Following an adaptive night in a sleep laboratory, 26 healthy volunteers underwent classical experimental placebo analgesic conditioning in the evening combined with pharmacological REM sleep deprivation (clonidine: 13 volunteers or inert control pill: 13 volunteers. Medication was administered in a double-blind manner at bedtime, and placebo analgesia was tested in the morning. Results revealed that 1 placebo analgesia improved with REM sleep deprivation; 2 pain relief expectations did not differ between REM sleep deprivation and control groups; and 3 REM sleep moderated the relationship between pain relief expectations and placebo analgesia. These results support the putative role of REM sleep in modulating placebo analgesia. The mechanisms involved in these improvements in placebo analgesia and pain relief following selective REM sleep deprivation should be further investigated.

  14. Principal Component Analysis Based Two-Dimensional (PCA-2D) Correlation Spectroscopy: PCA Denoising for 2D Correlation Spectroscopy

    International Nuclear Information System (INIS)

    Jung, Young Mee

    2003-01-01

    Principal component analysis based two-dimensional (PCA-2D) correlation analysis is applied to FTIR spectra of polystyrene/methyl ethyl ketone/toluene solution mixture during the solvent evaporation. Substantial amount of artificial noise were added to the experimental data to demonstrate the practical noise-suppressing benefit of PCA-2D technique. 2D correlation analysis of the reconstructed data matrix from PCA loading vectors and scores successfully extracted only the most important features of synchronicity and asynchronicity without interference from noise or insignificant minor components. 2D correlation spectra constructed with only one principal component yield strictly synchronous response with no discernible a asynchronous features, while those involving at least two or more principal components generated meaningful asynchronous 2D correlation spectra. Deliberate manipulation of the rank of the reconstructed data matrix, by choosing the appropriate number and type of PCs, yields potentially more refined 2D correlation spectra

  15. Optimization of CNC end milling process parameters using PCA ...

    African Journals Online (AJOL)

    Optimization of CNC end milling process parameters using PCA-based Taguchi method. ... International Journal of Engineering, Science and Technology ... To meet the basic assumption of Taguchi method; in the present work, individual response correlations have been eliminated first by means of Principal Component ...

  16. An improved PCA method with application to boiler leak detection.

    Science.gov (United States)

    Sun, Xi; Marquez, Horacio J; Chen, Tongwen; Riaz, Muhammad

    2005-07-01

    Principal component analysis (PCA) is a popular fault detection technique. It has been widely used in process industries, especially in the chemical industry. In industrial applications, achieving a sensitive system capable of detecting incipient faults, which maintains the false alarm rate to a minimum, is a crucial issue. Although a lot of research has been focused on these issues for PCA-based fault detection and diagnosis methods, sensitivity of the fault detection scheme versus false alarm rate continues to be an important issue. In this paper, an improved PCA method is proposed to address this problem. In this method, a new data preprocessing scheme and a new fault detection scheme designed for Hotelling's T2 as well as the squared prediction error are developed. A dynamic PCA model is also developed for boiler leak detection. This new method is applied to boiler water/steam leak detection with real data from Syncrude Canada's utility plant in Fort McMurray, Canada. Our results demonstrate that the proposed method can effectively reduce false alarm rate, provide effective and correct leak alarms, and give early warning to operators.

  17. Chemical fingerprinting of petroleum biomakers using time warping and PCA

    DEFF Research Database (Denmark)

    Christensen, Jan H.; Tomasi, Giorgio; Hansen, Asger B.

    2005-01-01

    A new method for chemical fingerprinting of petroleum biomakers is described. The method consists of GC-MS analysis, preprocessing of GC-MS chromatograms, and principal component analysis (PCA) of selected regions. The preprocessing consists of baseline removal by derivatization, normalization...... compared to other fingerprinting methods....

  18. The in-reactor deformation of the PCA alloy

    International Nuclear Information System (INIS)

    Puigh, R.J.

    1986-04-01

    The swelling and in-reactor creep behaviors of the PCA alloy have been determined from the irradiation of pressurized tube specimens in the FFTF reactor. These data have been obtained to a peak neutron fluence corresponding to approximately 80 dpa in the FFTF reactor for irradiation temperatures between 400 and 750 0 C. Diametral measurements performed on the unstressed specimens indicate the possible onset of swelling in the PCA alloy for irradiation temperatures between 400 and 550 0 C and at a neutron fluence corresponding to ∼50 dpa. The creep data suggest a non-linear fluence dependence and linear stress dependence (for hoop stresses less than 100 MPa) which is consistent with the in-reactor creep behavior of many cold worked austenitic stainless steels. These PCA creep data are compared to available 316 SS in-reactor creep data. The in-reactor creep strains for PCA are significantly less than observed in 20% cold worked 316 SS over the temperature ranges and fluences investigated

  19. Neutron spectral characterization of the PCA-PV benchmark facility

    International Nuclear Information System (INIS)

    Stallmann, F.W.; Kam, F.B.K.; Fabry, A.

    1980-01-01

    The Pool Critical Assembly (PCA) at the Oak Ridge National Laboratory is being used to generate the PCA-PV benchmark neutron field. A configuration consisting of steel blocks and water gaps is used to simulate the thermal shield pressure vessel configurations in power reactors. The distances between the steel blocks can be changed so that the penetration of neutrons through water and steel can be determined and compared for many different configurations. Easy access and low flux levels make it possible to conduct extensive measurements using active and passive neutron dosimetry, which are impossible to perform in commercial reactors. The clean core and simple geometry facilitates neutron transport calculations which can be validated in detail by comparison with measurements. A facility which has the same configuration of water and steel as the PCA-PV facility but contains test specimens for materials testing, will be irradiated in the higher fluxes at the Oak Ridge Research Reactor. Using the results from the PCA-PV facility, the correlation between neutron flux-fluences and radiation damage in steel can be established. This facility is being discussed in a separate paper

  20. ECG-derived respiration methods: adapted ICA and PCA.

    Science.gov (United States)

    Tiinanen, Suvi; Noponen, Kai; Tulppo, Mikko; Kiviniemi, Antti; Seppänen, Tapio

    2015-05-01

    Respiration is an important signal in early diagnostics, prediction, and treatment of several diseases. Moreover, a growing trend toward ambulatory measurements outside laboratory environments encourages developing indirect measurement methods such as ECG derived respiration (EDR). Recently, decomposition techniques like principal component analysis (PCA), and its nonlinear version, kernel PCA (KPCA), have been used to derive a surrogate respiration signal from single-channel ECG. In this paper, we propose an adapted independent component analysis (AICA) algorithm to obtain EDR signal, and extend the normal linear PCA technique based on the best principal component (PC) selection (APCA, adapted PCA) to improve its performance further. We also demonstrate that the usage of smoothing spline resampling and bandpass-filtering improve the performance of all EDR methods. Compared with other recent EDR methods using correlation coefficient and magnitude squared coherence, the proposed AICA and APCA yield a statistically significant improvement with correlations 0.84, 0.82, 0.76 and coherences 0.90, 0.91, 0.85 between reference respiration and AICA, APCA and KPCA, respectively. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

  1. Linking PCA and time derivatives of dynamic systems

    NARCIS (Netherlands)

    Stanimirovic, Olja; Hoefsloot, Huub C. J.; de Bokx, Pieter K.; Smilde, Age K.

    2006-01-01

    Low dimensional approximate descriptions of the high dimensional phase space of dynamic processes are very useful. Principal component analysis (PCA) is the most used technique to find the low dimensional subspace of interest. Here, it will be shown that mean centering of the process data across

  2. PCA-Guided Routing Algorithm for Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Gong Chen

    2012-01-01

    Full Text Available An important performance concern for wireless sensor networks (WSNs is the total energy dissipated by all the nodes in the network over the course of network lifetime. In this paper, we propose a routing algorithm termed as PCA-guided routing algorithm (PCA-RA by exploring the principal component analysis (PCA approach. Our algorithm remarkably reduces energy consumption and prolongs network lifetime by realizing the objective of minimizing the sum of distances between the nodes and the cluster centers in a WSN network. It is demonstrated that the PCA-RA can be efficiently implemented in WSNs by forming a nearly optimal K-means-like clustering structure. In addition, it can decrease the network load while maintaining the accuracy of the sensor measurements during data aggregating process. We validate the efficacy and efficiency of the proposed algorithm by simulations. Both theoretical analyses and simulation results demonstrate that this algorithm can perform significantly with less energy consumption and thus prolong the system lifetime for the networks.

  3. A Hold-out method to correct PCA variance inflation

    DEFF Research Database (Denmark)

    Garcia-Moreno, Pablo; Artes-Rodriguez, Antonio; Hansen, Lars Kai

    2012-01-01

    In this paper we analyze the problem of variance inflation experienced by the PCA algorithm when working in an ill-posed scenario where the dimensionality of the training set is larger than its sample size. In an earlier article a correction method based on a Leave-One-Out (LOO) procedure...

  4. Chemical fingerprinting of petroleum biomakers using time warping and PCA

    DEFF Research Database (Denmark)

    Christensen, Jan H.; Tomasi, Giorgio; Hansen, Asger B.

    2005-01-01

    A new method for chemical fingerprinting of petroleum biomakers is described. The method consists of GC-MS analysis, preprocessing of GC-MS chromatograms, and principal component analysis (PCA) of selected regions. The preprocessing consists of baseline removal by derivatization, normalization...

  5. The influence of pre-emptive analgesia on postoperative analgesia and its objective evaluation

    Czech Academy of Sciences Publication Activity Database

    Fricová, J.; Vejražka, M.; Stopka, Pavel; Křížová, Jana; Běláček, J.; Rokyta, R.

    2010-01-01

    Roč. 6, č. 5 (2010), s. 764-771 ISSN 1734-1922 Institutional research plan: CEZ:AV0Z40320502 Keywords : postoperative pain * objective evaluation * preemptive analgesia * morphin * pethidin Subject RIV: FH - Neurology Impact factor: 1.199, year: 2010

  6. Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial

    NARCIS (Netherlands)

    Freeman, Liv M.; Bloemenkamp, Kitty W. M.; Franssen, Maureen T. M.; Papatsonis, Dimitri N. M.; Hajenius, Petra J.; van Huizen, Marloes E.; Bremer, Henk A.; van den Akker, Eline S. A.; Woiski, Mallory D.; Porath, Martina M.; van Beek, Erik; Schuitemaker, Nico; van der Salm, Paulien C. M.; Fong, Bianca F.; Radder, Celine; Bax, Caroline J.; Sikkema, Marko; van den Akker-van Marle, M. Elske; van Lith, Jan M. M.; Lopriore, Enrico; Uildriks, Renske J.; Struys, Michel M. R. F.; Mol, Ben Willem J.; Dahan, Albert; Middeldorp, Johanna M.

    2012-01-01

    Background: Pain relief during labour is a topic of major interest in the Netherlands. Epidural analgesia is considered to be the most effective method of pain relief and recommended as first choice. However its uptake by pregnant women is limited compared to other western countries, partly as a

  7. Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial.

    NARCIS (Netherlands)

    Freeman, L.M.; Bloemenkamp, K.W.; Franssen, M.T.; Papatsonis, D.N.; Hajenius, P.J.; Huizen, M.E. van; Bremer, H.A.; Akker, E.S. van den; Woiski, M.D.; Porath, M.M.; Beek, E. van; Schuitemaker, N.; Salm, P.C. van der; Fong, B.F.; Radder, C.; Bax, C.J.; Sikkema, M.; Akker-van Marle, M.E. van den; Lith, J.M. van; Lopriore, E.; Uildriks, R.J.; Struys, M.M.; Mol, B.W.; Dahan, A; Middeldorp, J.M.

    2012-01-01

    ABSTRACT: BACKGROUND: Pain relief during labour is a topic of major interest in the Netherlands. Epidural analgesia is considered to be the most effective method of pain relief and recommended as first choice. However its uptake by pregnant women is limited compared to other western countries,

  8. Labor analgesia: An update on the effect of epidural analgesia on labor outcome

    Directory of Open Access Journals (Sweden)

    Samina Ismail

    2013-01-01

    Full Text Available Following the introduction of epidural for labor analgesia, debate has centered on the issue of its effect on outcome of labor; in terms of length of labor and increase in the rate of instrumental vaginal delivery and cesarean section (CS. There is no ideal study on the effect of epidural analgesia (EA on the outcome of labor due to logistic problems in randomization, blinding and getting a control group; as a result these queries are partly answered. Despite these problems, it has been established that labor epidural has minimal effect on progress of established labor and maternal request should be a sufficient indication to start an epidural. Although instrumental vaginal delivery is probably increased with epidural but obstetrician practice, pain free patient and teaching opportunity are likely factors increasing the incidence. Maternal-fetal factors and obstetric management and not the use of EA are the most important determinants of the CS rate. The purpose of this review is to summarize data from controlled trials addressing the question of whether neuraxial labor analgesia causes an increased risk of CS or rate of instrumental delivery. In addition, the review discusses whether the timing of initiation of analgesia infl uences the mode of delivery.

  9. ENDOGENOUS ANALGESIA, DEPENDENCE, AND LATENT PAIN SENSITIZATION

    Science.gov (United States)

    Taylor, Bradley K; Corder, Gregory

    2015-01-01

    Endogenous activation of μ-opioid receptors (MORs) provides relief from acute pain. Recent studies have established that tissue inflammation produces latent pain sensitization (LS) that is masked by spinal MOR signaling for months, even after complete recovery from injury and re-establishment of normal pain thresholds. Disruption with MOR inverse agonists reinstates pain and precipitates cellular, somatic and aversive signs of physical withdrawal; this phenomenon requires N-methyl-D-aspartate receptor-mediated activation of calcium-sensitive adenylyl cyclase type 1 (AC1). In this review, we present a new conceptual model of the transition from acute to chronic pain, based on the delicate balance between LS and endogenous analgesia that develops after painful tissue injury. First, injury activates pain pathways. Second, the spinal cord establishes MOR constitutive activity (MORCA) as it attempts to control pain. Third, over time, the body becomes dependent on MORCA, which paradoxically sensitizes pain pathways. Stress or injury escalates opposing inhibitory and excitatory influences on nociceptive processing as a pathological consequence of increased endogenous opioid tone. Pain begets MORCA begets pain vulnerability in a vicious cycle. The final result is a silent insidious state characterized by the escalation of two opposing excitatory and inhibitory influences on pain transmission: LS mediated by AC1 (which maintains accelerator), and pain inhibition mediated by MORCA (which maintains the brake). This raises the prospect that opposing homeostatic interactions between MORCA analgesia and latent NMDAR–AC1-mediated pain sensitization create a lasting vulnerability to develop chronic pain. Thus, chronic pain syndromes may result from a failure in constitutive signaling of spinal MORs and a loss of endogenous analgesic control. An overarching long-term therapeutic goal of future research is to alleviate chronic pain by either: a) facilitating endogenous opioid

  10. Neonatal respiratory depression associated with epidural analgesia

    Directory of Open Access Journals (Sweden)

    Alberto Gálvez Toro

    2013-06-01

    Full Text Available Background: Epidural analgesia is the most effective analgesics used during childbirth but is not without its problems.In the Hospital San Juan de la Cruz of Ubeda from November 2011 we have detected 3 cases of newborn infants with signs of respiratory depression. Appeared in them: normal cardiotocographic records during childbirth, use of epidural associated with fentanyl, termination by vacuum and elevated temperature in one case.ObjectivesKnow if the neonatal adaptation to extrauterine life may be influenced by the use of epidural analgesia in childbirth. Review what role can have the rise in maternal temperature and the use of epidural fentanyl with the appearance of newborn respiratory distress.MethodsLiterature Review conducted in February of 2012 in Pubmed and the Cochrane Library, using the key words: childbirth, epidural analgesia, neonatal respiratory depression.ResultsOn the respiratory depression associated with fentanyl, a Cochrane review found indicating that newborns of mothers with an epidural, had a lower pH and were less need for administration of naloxone.On PubMed we find a review study that indicates that the respiratory depression caused by the administration of opioids via neuroaxial is rare, placing it below 1 per 1000, and a clinical case that concluded that doses of fentanyl exceeding 300 µg (approx. 5 µg/kg for 4 hours previous to childbirth, have a high risk of neonatal respiratory depression at birth.The same Cochrane review indicates that the women with epidural analgesia had increased risk of maternal fever of at least 38 ° C and a recent cohort study relates this increase in temperature with a greater likelihood of neonatal adverse events (from 37.5 ° C.ConclusionsThe studies found considered safe epidurals to the neonate and the mother, except when certain conditions are met. The literature and our clinical experience have been reports linking neonatal respiratory depression with increasing temperature (37

  11. Epidural Labor Analgesia and Maternal Fever.

    Science.gov (United States)

    Sharpe, Emily E; Arendt, Katherine W

    2017-06-01

    Women receiving an epidural for labor analgesia are at increased risk for intrapartum fever. This relationship has been supported by observational, before and after, and randomized controlled trials. The etiology is not well understood but is likely a result of noninfectious inflammation as studies have found women with fever have higher levels of inflammatory markers. Maternal pyrexia may change obstetric management and women are more likely to receive antibiotics or undergo cesarean delivery. Maternal pyrexia is associated with adverse neonatal outcomes. With these consequences, understanding and preventing maternal fever is imperative.

  12. Postoperative analgesia after major spine surgery: patient-controlled epidural analgesia versus patient-controlled intravenous analgesia.

    Science.gov (United States)

    Schenk, Michael R; Putzier, Michael; Kügler, Bjoern; Tohtz, Stephan; Voigt, Kristina; Schink, Tania; Kox, Wolfgang J; Spies, Claudia; Volk, Thomas

    2006-11-01

    Spinal fusion surgery causes severe postoperative pain, hampering reconvalescense. We investigated the efficacy of patient-controlled epidural analgesia (PCEA) in a prospective, double-blind, randomized, controlled comparison with patient-controlled IV analgesia (PCIA). After lumbar anterior-posterior fusion receiving an epidural catheter intraoperatively, 72 patients were given either PCEA (ropivacaine 0.125% and sufentanil 1.0 microg/mL at 14 mL/h; bolus: 5 mL; lockout time: 15 min) and IV placebo or PCIA (morphine 2.0 mg/mL; bolus: 3 mg; lockout time: 15 min) and epidural placebo. Pain levels (visual analog scale 0-10), functional capabilities (turning in bed, standing, and walking), analgesic consumption, and side effects were evaluated until 72 h after surgery. Fourteen patients were excluded by predetermined criteria, leaving 58 patients for data analysis. Pain levels at rest and during mobilization were significantly lower in the PCEA when compared with that in the PCIA group throughout the study period (P turn in bed was achieved earlier in the PCEA group (P Patients in the PCEA group were significantly more satisfied with pain therapy (P patient satisfaction when compared with PCIA after spinal fusion surgery.

  13. Assessment of phlebitis, infiltration and extravasation events in neonates submitted to intravenous therapy Avaliacion de la ocurrencia de flebitis, infiltración y extravasamiento en neonatos submetidos a terapia intravenosa Avaliação da ocorrência de flebite, infiltração e extravasamento em neonatos submetidos à terapia intravenosa

    Directory of Open Access Journals (Sweden)

    Ana Caroline Rodrigues Gomes

    2011-09-01

    Full Text Available This study aimed to describe phlebitis, infiltration and extravasation events in newborn infants hospitalized at the neonatal intensive care unit of a public maternity in Rio de Janeiro, Brazil. A quantitative and descriptive study was carried out, involving 36 newborns under intravenous therapy and indicated for the removal of the peripheral intravenous device. Fifty puncture sites were assessed immediately after the peripheral catheter removal, resulting in an average 1.40 punctures per infant. Complications were responsible for 48% of catheter removals before discharge from treatment, predominantly infiltration (79.2%, followed by phlebitis (16.7% and extravasation (4.2%. To avoid aggravations and enhance the security of newborns submitted to intravenous therapy, the nursing team should periodically assess the peripheral venous access and gain knowledge on interventions needed when signs of complications are detected.El objetivo de este estudio fue describir la ocurrencia de flebitis, infiltración y extravasamiento en recién nacidos internados en la unidad de terapia intensiva neonatal de una maternidad pública de Rio de Janeiro. Se trata de un estudio cuantitativo descriptivo con 36 recién nacidos en uso de terapia intravenosa y con indicación de remoción del dispositivo intravenoso periférico. Fueron evaluados 50 sitios de punción inmediatamente después de la remoción de catéteres periféricos originando una media de 1,40 punciones venosas por neonato. Las complicaciones fueron responsables por 48% de las remociones de los catéteres, antes del alta del tratamiento, con predominio de infiltraciones (79,2%, seguida por flebitis (16,7% e extravasamiento (4,2%. Con el fin de evitar los lesiones y promover la seguridad de los recién nacidos sometidos a terapia intravenosa, el equipo de enfermería debe evaluar periódicamente el acceso venoso periférico y obtener conocimiento acerca de las intervenciones necesarias cuando

  14. Analgesia after total hip replacement: epidural versus psoas ...

    African Journals Online (AJOL)

    Capdevila et al. proposed new landmarks and technical guidelines for the psoas compartment block and found it to give optimal analgesia after hip replacement surgery, with few side effects.9. Several studies concluded that surgical analgesia (requiring a more dense block) is achievable using a psoas compartment block, ...

  15. Órfãos de terapia medicamentosa: a administração de medicamentos por via intravenosa em crianças hospitalizadas

    Directory of Open Access Journals (Sweden)

    Peterlini Maria Angélica Sorgini

    2003-01-01

    Full Text Available Estudo descritivo, realizado em um hospital universitário, que verificou quantidade e tipo de medicamentos administrados por via intravenosa em crianças, além da adequação da apresentação farmacológica para uso em pediatria e custo estimado de administração de algumas drogas. Em trinta dias, foram administradas 8.245 doses de medicamentos, com média diária de 274,83 doses, e projeção anual de 98.940. Os principais medicamentos utilizados foram metilpredinosolona, vancomicina, furosemida, ranitidina, penicilina, amicacina, midazolan, fentanil, ceftriaxone e cefalotina. Nenhum dos 41 medicamentos identificados possuía apresentação pediátrica, acarretando, em alguns casos, maior manipulação durante o preparo, risco de contaminação e perda da estabilidade. Observou-se que a falta de apresentação pediátrica gerou aumento dos custos de atendimento; na prescrição de uma criança em pós-operatório, com tempo de internação estimado de cinco dias, a terapia administrada diária foi de US$ 6.71, e US$ 39.52 de medicamentos tiveram que ser desprezados, por excederem as necessidades terapêuticas da criança.

  16. Segurança do paciente: análise do preparo de medicação intravenosa em hospital da rede sentinela

    Directory of Open Access Journals (Sweden)

    Flavia Giron Camerini

    2011-01-01

    Full Text Available La investigación tubo como objetivo identificar el tipo y frecuencia de los errores en la preparación de medicamentos intravenosos. Se trata de una investigación observacional transversal, en tres unidades de un hospital. Se observaron 365 dosis de medicamentos por vía intravenosa preparados por 35 técnicos de enfermería. Los datos se recolectaron de enero a febrero de 2008. Se encontraron tasas de errores en todos los sectores, por encima de 70,00%. Los errores se agruparon en las siguientes categorías: cambio de jeringas, desinfección de las ampollas, higiene de la encimera, hora y dosis errada. Las tasas de errores fueron superiores a 50,00% en todos las categorías, excepto en la dosis errada (6,58%. Se concluye que estas tasas pueden afectar la seguridad microbiológica del procedimiento, aumentando la posibilidad de daño si ocurre la contaminación del medicamento. La preparación en el momento equivocado, antes de una hora, se produjo con tenoxicam y dipirona. La estabilidad de los medicamentos pudo haber sido comprometida, al producir cambios en el resultado terapéutico esperado, lo que puede dar lugar a consecuencias indeseables para los pacientes.

  17. Acupuncture Mechanisms: Anesthesia, Analgesia and Protection on Organ Functions

    Directory of Open Access Journals (Sweden)

    Jing Wang

    2015-01-01

    Full Text Available Acupuncture, as a healing art in traditional Chinese medicine, has been widely used to treat various diseases. In the history of acupuncture anesthesia, in the past decades, mechanisms of acupuncture analgesia has been widely investigated, and in recent years, acupuncture protection on organ functions has attracted great interest. This review summarized the research progress on mechanisms of acupuncture for analgesia and its protection against organ function injury in anesthesia, and its perspective of analgesia, immunomodulation, neuroendocrine regulation and multiple organ protection. The current evidence supports that acupuncture analgesia and its organ protection in anesthesia is associated with the integration of neuroendocrine-immune networks in the level of neurotransmitters, cytokines, hormones, neuronal ensembles, lymphocytes, and endocrine cells. Although the mechanisms of acupuncture analgesia and its organ protection are still not completely understood, basic as well as clinic researches on the mechanisms and applications of acupuncture and related techniques are being carried out.

  18. Epidural analgesia for labour: maternal knowledge, preferences and informed consent.

    LENUS (Irish Health Repository)

    2012-02-29

    Epidural analgesia has become increasingly popular as a form of labour analgesia in Ireland. However obtaining true inform consent has always been difficult. Our study recruited 100 parturients who had undergone epidural analgesia for labour, aimed to determine the information they received prior to regional analgesia, and to ascertain their preferences regarding informed consent. Only 65 (65%) of patients planned to have an epidural. Knowledge of potential complications was variable and inaccurate, with less than 30 (30%) of women aware of the most common complications. Most women 79 (79%) believed that discomfort during labour affected their ability to provide informed consent, and believe consent should be taken prior to onset of labour (96, 96%). The results of this study helps define the standards of consent Irish patients expect for epidural analgesia during labour.

  19. Bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno intravenoso melhora a analgesia após histerectomia abdominal

    Directory of Open Access Journals (Sweden)

    Evren Yucel

    2013-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVO: O objetivo deste estudo foi avaliar os efeitos da aplicação intravenosa(IV de dexcetoprofeno trometamol em bloqueio dos nervos ilioinguinal e ílio-hipogástrico na qualidade analgésica e no consumo de morfina após histerectomia abdominal total. MÉTODO: Estudo clínico controlado e randomizado conduzido com 61 pacientes. O estudo foi feito em sala de operação, sala de recuperação pós-anestésica e ambulatório. Os 61 pacientes foram randomicamente alocados em três grupos: grupo controle (Grupo C, grupo bloqueio (Grupo B e grupo bloqueio com dexcetoprofeno (Grupo BD. Antes da incisão cirúrgica feita após a indução da anestesia, fizemos o bloqueio dos nervos ilioinguinal e ilio-hipogástrico (Grupo C recebeu solução salina e grupos B e BD receberam levobupivacaína. Em contraste com os grupos C e B, o Grupo BD recebeu dexcetoprofeno. Administramos morfina a todos os pacientes para analgesia, com o uso do método de analgesia controlada pelo paciente (ACP durante o pós-operatório de 24 horas. Registramos os escores para dor pela escala visual analógica (EVA, os índices de satisfação, o consumo de morfina e os efeitos colaterais durante o pós-operatório de 24 horas. RESULTADOS: Os escores EVA do Grupo BD foram menores do que os dos grupos C e B no pós-operatório (p < 0,05 nos intervalos de 1, 2, 6 e 12 horas. Os escores EVA do Grupo C foram maiores do que os do Grupo B nas primeiras 2 horas de pós-operatório. O tempo até a primeira demanda de ACP foi mais longo, os valores de consumo de morfina mais baixos e os índices de satisfação maiores no Grupo BD do que nos outros dois grupos (p < 0,05. CONCLUSÃO: O bloqueio dos nervos ilioinguinal e ílio-hipogástrico com dexcetoprofeno IV aumenta a satisfação do paciente e diminui o consumo de opioides e sugere que dexcetoprofeno trometamol é um analgésico anti-inflamatório não esteroide eficaz em analgesia pós-operatória.

  20. Regional analgesia in postsurgical critically ill patients.

    Science.gov (United States)

    Moliner Velázquez, S; Rubio Haro, R; De Andrés Serrano, C; De Andrés Ibáñez, J

    2017-03-01

    Regional analgesia intrinsically, based on its physiological effects, is routinely used for the perioperative treatment of pain associated with surgical procedures. However, in other areas such as the non-surgical treatment of acute pain for patients in a critical condition, it has not been subjected to specific prospective studies. If we confine ourselves to the physiological effects of the nerve block, in a situation of stress, the indications for regional anaesthesia in this group of patients extend to the management of a wide variety of medical as well as postsurgical conditions, of trauma patients and of other painful procedures performed in the patient's bed. The critical patient certainly must be analyzed individually as their own primary conditions is of vital importance, as well as any associated conditions they have developed that can potentially increase the risk of systemic toxicity or morbidity, such as, coagulopathies, infection, immunosuppressive states, sedation and problems associated with mechanical ventilation. This review aims to assess the role of regional analgesia in critically ill patients, placing it within the algorithm decision tree of the professional responsible for patients in critical care units, all based on the evidence of potential benefits according to the published literature. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Effect on pain relief and inflammatory response following addition of tenoxicam to intravenous patient-controlled morphine analgesia: a double-blind, randomized, controlled study in patients undergoing spine fusion surgery.

    Science.gov (United States)

    Chang, Wen-Kuei; Wu, Hsin-Lun; Yang, Chang-Sue; Chang, Kuang-Yi; Liu, Chien-Lin; Chan, Kwok-Hon; Sung, Chun-Sung

    2013-05-01

    This study tested the hypothesis that adding tenoxicam (T) to intravenous patient-controlled analgesia (IV-PCA) with morphine (M) would improve postoperative pain relief and wound inflammatory responses compared with M alone after spine surgery. Randomized, prospective, double-blind, controlled study. Ninety-four patients eligible for elective spine surgery. Teaching hospital. Patients were randomized to one of three groups: the M group (PCA regimen with M), the TM group (PCA regimen with T and M), or the T+TM group (20 mg T administered 30 minutes before wound closure in addition to the TM regimen). The primary end point was the numeric rating scale score for pain intensity, and secondary end points pertaining to postoperative pain management included M consumption, PCA demand/delivery, use of rescue analgesics, adverse events, and levels of inflammatory mediators in wound drainages. PCA demand was reduced in both the TM and T+TM groups compared with the M group (both P ≤ 0.001). The incidence of skin itching was significantly reduced in the T+TM group compared with the other groups (both P ≤ 0.05). PGE2 and interleukin-6 levels in wound drainages were reduced in the TM and T+TM groups compared with the M group (both P ≤ 0.001). The combination of T and M for IV-PCA was not more efficacious than IV-PCA with M alone in reducing postoperative pain after spine surgery but reduced PCA demand and suppressed local inflammation at the surgical site. Administration of T before wound closure may ameliorate IV-PCA M-induced skin itching. Wiley Periodicals, Inc.

  2. F-15 PCA (Propulsion Controlled Aircraft) Simulation Cockpit

    Science.gov (United States)

    1990-01-01

    The F-15 PCA (Propulsion Controlled Aircraft) simulation was used from 1990 to 1993. It was used for the development of propulsion algorithms and piloting techniques (using throttles only) to be used for emergency flight control in the advent of a major flight control system failure on a multi-engine aircraft. Following this program with the Dryden F-15, similiar capabilities were developed for other aircraft, such as the B-720, Lear 24, B-727, C-402, and B-747.

  3. Technology Marketing using PCA , SOM, and STP Strategy Modeling

    OpenAIRE

    Sunghae Jun

    2011-01-01

    Technology marketing is a total processing about identifying and meeting the technological needs of human society. Most technology results exist in intellectual properties like patents. In our research, we consider patent document as a technology. So patent data are analyzed by Principal Component Analysis (PCA) and Self Organizing Map (SOM) for STP(Segmentation, Targeting, and Positioning) strategy modeling. STP is a popular approach for developing marketing strategies. We use STP strategy m...

  4. Imaging network level language recovery after left PCA stroke.

    Science.gov (United States)

    Sebastian, Rajani; Long, Charltien; Purcell, Jeremy J; Faria, Andreia V; Lindquist, Martin; Jarso, Samson; Race, David; Davis, Cameron; Posner, Joseph; Wright, Amy; Hillis, Argye E

    2016-05-11

    The neural mechanisms that support aphasia recovery are not yet fully understood. Our goal was to evaluate longitudinal changes in naming recovery in participants with posterior cerebral artery (PCA) stroke using a case-by-case analysis. Using task based and resting state functional magnetic resonance imaging (fMRI) and detailed language testing, we longitudinally studied the recovery of the naming network in four participants with PCA stroke with naming deficits at the acute (0 week), sub acute (3-5 weeks), and chronic time point (5-7 months) post stroke. Behavioral and imaging analyses (task related and resting state functional connectivity) were carried out to elucidate longitudinal changes in naming recovery. Behavioral and imaging analysis revealed that an improvement in naming accuracy from the acute to the chronic stage was reflected by increased connectivity within and between left and right hemisphere "language" regions. One participant who had persistent moderate naming deficit showed weak and decreasing connectivity longitudinally within and between left and right hemisphere language regions. These findings emphasize a network view of aphasia recovery, and show that the degree of inter- and intra- hemispheric balance between the language-specific regions is necessary for optimal recovery of naming, at least in participants with PCA stroke.

  5. Prostate cancer gene 3 (PCA3): development and internal validation of a novel biopsy nomogram.

    Science.gov (United States)

    Chun, Felix K; de la Taille, Alexandre; van Poppel, Hendrik; Marberger, Michael; Stenzl, Arnulf; Mulders, Peter F A; Huland, Hartwig; Abbou, Clement-Claude; Stillebroer, Alexander B; van Gils, Martijn P M Q; Schalken, Jack A; Fradet, Yves; Marks, Leonard S; Ellis, William; Partin, Alan W; Haese, Alexander

    2009-10-01

    Urinary prostate cancer gene 3 (PCA3) represents a promising novel marker of prostate cancer detection. To test whether urinary PCA3 assay improves prostate cancer (PCa) risk assessment and to construct a decision-making aid in a multi-institutional cohort with pre-prostate biopsy data. PCA3 assay cut-off threshold analyses were followed by logistic regression models which used established predictors to assess PCa-risk at biopsy in a large multi-institutional data set of 809 men at risk of harboring PCa. Regression coefficients were used to construct four sets of nomograms. Predictive accuracy (PA) estimates of biopsy outcome predictions were quantified using the area under the curve of the receiver operator characteristic analysis in models with and without PCA3. Bootstrap resamples were used for internal validation and to reduce overfit bias. The extent of overestimation or underestimation of the observed PCa rate at biopsy was explored graphically using nonparametric loss-calibration plots. Differences in PA were tested using the Mantel-Haenszel test. Finally, nomogram-derived probability cut-offs were tested to assess the ability to identify patients with or without PCa. PCA3 was identified as a statistically independent risk factor of PCa at biopsy. Addition of a PCA3 assay improved bootstrap-corrected multivariate PA of the base model between 2% and 5%. The highest increment in PA resulted from a PCA3 assay cut-off threshold of 17, where a 5% gain in PA (from 0.68 to 0.73, p=0.04) was recorded. Nomogram probability-derived risk cut-off analyses further corroborate the superiority of the PCA3 nomogram over the base model. PCA3 fulfills the criteria for a novel marker capable of increasing PA of multivariate biopsy models. This novel PCA3-based nomogram better identifies men at risk of harboring PCa and assists in deciding whether further evaluation is necessary.

  6. Developments in labour analgesia and their use in Australia.

    Science.gov (United States)

    Eley, V A; Callaway, L; van Zundert, A A

    2015-07-01

    Since the introduction of chloroform for labour analgesia in 1847, different methods and medications have been used to relieve the pain of labour. The use of heavy sedative medication in the early 1900s was encouraged by enthusiastic doctors and by women empowered by the women's suffrage movement in America. Nitrous oxide by inhalation has been used in Australia since the 1950s and improved methods of administration have made this method of analgesia safe and practical. Caudal epidural analgesia and lumbar epidural analgesia were first made popular in America and by the 1970s these techniques were more widely available in Australia. In 1847, physicians and the public were unsure whether relieving labour pains was the 'right' thing to do. However, many medical and social changes have occurred thanks to the clinical connection between Australia and the United Kingdom and those first settlers to land on Australian shores. Thanks to this historical connection, in today's Australia there is no question that women should use analgesia as a pain relief if they wish. Currently, the majority of women worldwide use some form of analgesia during labour and different methods are widely available. This paper discusses the four milestones of the development of obstetric analgesia and how they were introduced into patient care in Australia.

  7. Labour analgesia and the baby: good news is no news.

    Science.gov (United States)

    Reynolds, Felicity

    2011-01-01

    When investigating different methods of maternal pain relief in labour, neonatal outcome has not always been at the forefront, or else maternal changes, such as haemodynamics, fever, length of labour, need for oxytocin or type of delivery, are taken as surrogates for neonatal outcome. It is essential to examine the actual baby and to appreciate that labour pain itself has adverse consequences for the baby. For systemic analgesia, pethidine has been most extensively studied and compared with neuraxial analgesia. It depresses fetal muscular activity, aortic blood flow, short-term heart rate variability and oxygen saturation. In the newborn it exacerbates acidosis, depresses Apgar scores, respiration, neurobehavioural score, muscle tone and suckling. Alternatives have few advantages, remifentanil being the most promising. Neuraxial analgesia is associated with better Apgar scores and variable neurobehavioural changes. Neonatal acid-base status is not only better with epidural than with systemic opioid analgesia, it is also better than with no analgesia. The effect on breast feeding has yet to be established, though it is certainly no worse than that of systemic opioid analgesia. Variations in neuraxial technique have little impact on the newborn. Widespread ignorance of the benefit to the newborn of neuraxial labour analgesia in the UK among non-anaesthetists needs to be combated. Copyright © 2010 Elsevier Ltd. All rights reserved.

  8. King's Health Partners' Prostate Cancer Biobank (KHP PCaBB).

    Science.gov (United States)

    Saifuddin, S R; Devlies, W; Santaolalla, A; Cahill, F; George, G; Enting, D; Rudman, S; Cathcart, P; Challacombe, B; Dasgupta, P; Galustian, C; Chandra, A; Chowdhury, S; Gillett, C; Van Hemelrijck, M

    2017-11-22

    The KHP PCaBB was established in 2013 and recruits donors from the Urology or Oncology Departments at Guy's Hospital in London (UK). Prostate cancer patients may be approached to give their consent for biobanking at any point in their treatment pathway, which allows residual material from their earlier diagnosis to be transferred and used by the Biobank. Currently, patients are specifically asked to donate samples of blood and surplus prostate tissue as well as permitting access to their clinical and pathological data that continues to be added throughout the course of their disease. Between 2013 and 2015, 549 prostate cancer patients gave their consent to the biobank and, the tissue repository collected 489 blood samples, 120 frozen prostate tissue samples and 1064 formalin fixed paraffin embedded diagnostic blocks.Prostate cancer has become a chronic disease in a large proportion of men, with many men receiving multiple subsequent treatments, and their treatment trajectory often spanning over decades. Therefore, this resource aims to provide an ideal research platform to explore potential variations in treatment response as well as disease markers in the different risk categories for prostate cancer.A recent audit of the KHP PCaBB revealed that between 2013 and 2015, 1796 patients were diagnosed with prostate cancer at King's Health Partners (KHP), out of which 549 (30.6%) gave their consent to KHP PCaBB. Comparisons between demographic and clinical characteristics of patients who had consented compared to the total patient population revealed that the KHP PCaBB is demographically representative of the total prostate cancer patient population seen in Guy's and St Thomas' NHS Foundation Trust (GSTT). We observed no differences in distribution of ethnicity (p = 0.507) and socioeconomic status (p = 0.097). Some differences were observed in clinical characteristics, specifically with treatment type - which differed significantly between the patients who had

  9. Prostate cancer (PCa) risk variants and risk of fatal PCa in the National Cancer Institute Breast and Prostate Cancer Cohort Consortium.

    Science.gov (United States)

    Shui, Irene M; Lindström, Sara; Kibel, Adam S; Berndt, Sonja I; Campa, Daniele; Gerke, Travis; Penney, Kathryn L; Albanes, Demetrius; Berg, Christine; Bueno-de-Mesquita, H Bas; Chanock, Stephen; Crawford, E David; Diver, W Ryan; Gapstur, Susan M; Gaziano, J Michael; Giles, Graham G; Henderson, Brian; Hoover, Robert; Johansson, Mattias; Le Marchand, Loic; Ma, Jing; Navarro, Carmen; Overvad, Kim; Schumacher, Fredrick R; Severi, Gianluca; Siddiq, Afshan; Stampfer, Meir; Stevens, Victoria L; Travis, Ruth C; Trichopoulos, Dimitrios; Vineis, Paolo; Mucci, Lorelei A; Yeager, Meredith; Giovannucci, Edward; Kraft, Peter

    2014-06-01

    Screening and diagnosis of prostate cancer (PCa) is hampered by an inability to predict who has the potential to develop fatal disease and who has indolent cancer. Studies have identified multiple genetic risk loci for PCa incidence, but it is unknown whether they could be used as biomarkers for PCa-specific mortality (PCSM). To examine the association of 47 established PCa risk single-nucleotide polymorphisms (SNPs) with PCSM. We included 10 487 men who had PCa and 11 024 controls, with a median follow-up of 8.3 yr, during which 1053 PCa deaths occurred. The main outcome was PCSM. The risk allele was defined as the allele associated with an increased risk for PCa in the literature. We used Cox proportional hazards regression to calculate the hazard ratios of each SNP with time to progression to PCSM after diagnosis. We also used logistic regression to calculate odds ratios for each risk SNP, comparing fatal PCa cases to controls. Among the cases, we found that 8 of the 47 SNPs were significantly associated (pPCa, but most did not differentiate between fatal and nonfatal PCa. Rs11672691 and rs10993994 were associated with both fatal and nonfatal PCa, while rs6465657, rs7127900, rs2735839, and rs13385191 were associated with nonfatal PCa only. Eight established risk loci were associated with progression to PCSM after diagnosis. Twenty-two SNPs were associated with fatal PCa incidence, but most did not differentiate between fatal and nonfatal PCa. The relatively small magnitudes of the associations do not translate well into risk prediction, but these findings merit further follow-up, because they may yield important clues about the complex biology of fatal PCa. In this report, we assessed whether established PCa risk variants could predict PCSM. We found eight risk variants associated with PCSM: One predicted an increased risk of PCSM, while seven were associated with decreased risk. Larger studies that focus on fatal PCa are needed to identify more markers that

  10. Analgesia acupuntural en las extracciones dentarias

    Directory of Open Access Journals (Sweden)

    Juana María Abreu Correa

    1997-12-01

    Full Text Available Se compararon los resultados de la exodoncia con anestesia y con analgesia con acupuntura en 2 grupos de 60 pacientes cada uno, en los cuales se evaluaron los efectos de ambos tratamientos a las 24, 48 y 72 horas de realizada la extracción. Los aspectos evaluados fueron las complicaciones posextracción y la presencia de dolor, molestias o inflamación con posterioridad a ésta. En el grupo de los pacientes a los que se les aplicó la anestesia a las 24 horas, 51 tenían inflamación y a las 72 horas 31 continuaban con ligero enrojecimiento e inflamación, 3 casos presentaron alveolitis fungosa. Entre los que recibieron la acupuntura a las 24 horas, 26 tenían ligero enrojecimiento que desapareció antes de las 72 horas sin otras complicaciones.The results of exodontia with anesthesia and with acupuncture analgesia are compared in two groups of 60 patients each, in which the effects of both treatments were evaluated 24, 48 and 72 hours after the extraction. The aspects evaluated were the postextraction complications and the presence of pain, disturbance or inflammation after it. In the group of patients that received anesthesia, 51 had inflammation 24 hours after the extraction, whereas 31 still had a mild redness and inflammation 72 hours later. 3 patients presented fungous alveolitis. Among those who were treated with acupuncture, 26 showed a mild redness 24 hours after the extraction that dissapeared before the 72 hours without other complications.

  11. 40 CFR 86.1111-87 - Test procedures for PCA testing.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 19 2010-07-01 2010-07-01 false Test procedures for PCA testing. 86... Light-Duty Trucks § 86.1111-87 Test procedures for PCA testing. (a)(1) For heavy-duty engines, the prescribed test procedure for PCA testing is the Federal Test Procedure as described in subparts N, I, and P...

  12. Comparison of Dexmedetomidine and Fentanyl as an Adjuvant to Ropivacaine for Postoperative Epidural Analgesia in Pediatric Orthopedic Surgery.

    Science.gov (United States)

    Park, Sang Jun; Shin, Seokyung; Kim, Shin Hyung; Kim, Hyun Woo; Kim, Seung Hyun; Do, Hae Yoon; Choi, Yong Seon

    2017-05-01

    Opioids are commonly used as an epidural adjuvant to local anesthetics, but are associated with potentially serious side effects, such as respiratory depression. The aim of this study was to compare the efficacy and safety of dexmedetomidine with that of fentanyl as an adjuvant to epidural ropivacaine in pediatric orthopedic surgery. This study enrolled 60 children (3-12 years old) scheduled for orthopedic surgery of the lower extremities and lumbar epidural patient-controlled analgesia (PCA). Children received either dexmedetomidine (1 μg/kg) or fentanyl (1 μg/kg) along with 0.2% ropivacaine (0.2 mL/kg) via an epidural catheter at 30 minutes before the end of surgery. Postoperatively, the children were observed for ropivacaine consumption via epidural PCA, postoperative pain intensity, need for rescue analgesics, emergence agitation, and other adverse effects. The mean dose of bolus epidural ropivacaine was significantly lower within the first 6 h after surgery in the dexmedetomidine group, compared with the fentanyl group (0.029±0.030 mg/kg/h vs. 0.053±0.039 mg/kg/h, p=0.012). The median pain score at postoperative 6 h was also lower in the dexmedetomidine group, compared to the fentanyl group [0 (0-1.0) vs. 1.0 (0-3.0), p=0.039]. However, there was no difference in the need for rescue analgesia throughout the study period between groups. The use of dexmedetomidine as an epidural adjuvant had a significantly greater analgesic and local anesthetic-sparing effect, compared to fentanyl, in the early postoperative period in children undergoing major orthopedic lower extremity surgery. © Copyright: Yonsei University College of Medicine 2017

  13. Low-dose spinal anaesthesia provides effective labour analgesia ...

    African Journals Online (AJOL)

    Low-dose spinal anaesthesia provides effective labour analgesia and does not limit ambulation. T Anabaha*, A Olufolabia,b,d, J Boydc and R Georgec,d. aSchool of Medicine and ... limits ambulation more than epidural analgesia in non-pregnant patients.16,17 However, ..... ft/weo/2012/01/pdf/text.pdf. 25. The World Bank ...

  14. Innovative Comparison of Transient Ignition Temperature at the Booster Interface, New Stainless Steel Pyrovalve Primer Chamber Assembly "V" (PCA) Design Versus the Current Aluminum "Y" PCA Design

    Science.gov (United States)

    Saulsberry, Regor L.; McDougle, Stephen H.; Garcia,Roberto; Johnson, Kenneth L.; Sipes, William; Rickman, Steven; Hosangadi, Ashvin

    2011-01-01

    An assessment of four spacecraft pyrovalve anomalies that occurred during ground testing was conducted by the NASA Engineering & Safety Center (NESC) in 2008. In all four cases, a common aluminum (Al) primer chamber assembly (PCA) was used with dual NASA Standard Initiators (NSIs) and the nearly simultaneous (separated by less than 80 microseconds) firing of both initiators failed to ignite the booster charge. The results of the assessment and associated test program were reported in AIAA Paper AIAA-2008-4798, NESC Independent Assessment of Pyrovalve Ground Test Anomalies. As a result of the four Al PCA anomalies, and the test results and findings of the NESC assessment, the Mars Science Laboratory (MSL) project team decided to make changes to the PCA. The material for the PCA body was changed from aluminum (Al) to stainless steel (SS) to avoid melting, distortion, and potential leakage of the NSI flow passages when the device functioned. The flow passages, which were interconnected in a Y-shaped configuration (Y-PCA) in the original design, were changed to a V-shaped configuration (V-PCA). The V-shape was used to more efficiently transfer energy from the NSIs to the booster. Development and qualification testing of the new design clearly demonstrated faster booster ignition times compared to the legacy AL Y-PCA design. However, the final NESC assessment report recommended that the SS V-PCA be experimentally characterized and quantitatively compared to the Al Y-PCA design. This data was deemed important for properly evaluating the design options for future NASA projects. This test program has successfully quantified the improvement of the SS V-PCA over the Al Y-PCA. A phase B of the project was also conducted and evaluated the effect of firing command skew and enlargement of flame channels to further assist spacecraft applications.

  15. EPIDURAL LABOUR ANALGESIA IN IZOLA GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Sabina Verem

    2018-02-01

    Full Text Available Background. The study presents the experience with epidural analgesia (EPA for pain relief in Izola General Hospital from 2003 to 2006, the differences of labour between epidural analgesia and without it and the parturients’ satisfaction. Methods. A retrospective observational study was performed. Data were compared between 214 parturients with EPA matched by 214 parturients without. The control parturient was the equiipara with a term birth and the cephalic presentation of fetus that delivered just before the parturient of the EPA group. Maternal age, labor length, rate of oxitocin use, instrumental deliveries and cesarean sections, Apgar scores and birthweights were compared. The questionnaire was used to estimate the pain in 62 parturients. Results. In GH Izola in 214 parturients (10 % EPA was applied for labour pain relief in the period from July 2003 till December 2006. In the EPA group there was a statistically significance compared with the control group: higher parturients’ mean age (30.5 vs 28.7 y.o.; p < 0.0005, longer labour length (278 vs 222 min; p < 0.0005, higher oxitocin use rate (93.4 % vs 72.9 %; p < 0.0001 and higher instrumental delivery rate (vacuum extraction 14 % vs 1.9 %; p < 0.0001. The cesarean section rates were equal in both groups. Despite the higher instrumental delivery rate and the longer labour length in the EPA group there were no worse perinatal outcomes, neither was statisticaly significant difference in Apgar scores compared with the control group. The mean intensity of pain was highest before the EPA application (VAS 7, lowest during the transition stage (VAS 1.5 and some higher during the second phase (VAS 2.7. Most of parturients in the EPA group were satisfied; 92 % of them evaluated the EPA as good or very good. Conclusions. EPA is a very effective method for pain control during labor. The parturients’ satisfaction with this pain control method is appropriate. Despite the higher instrumental

  16. Evaluación de una solución gluco-electrolítica isotónica e isoclorada propuesta como recurso único a emplear en la rehidratación intravenosa a ritmo genérico de las distintas deshidrataciones por pérdidas digestivas en la edad pediátrica

    OpenAIRE

    Jiménez Buselo, María Teresa

    2015-01-01

    La rehidratación intravenosa (RIV) es a menudo inevitable cuando hay impedimento absoluto para satisfacer la deseable rehidratación oral (RHO). Coexisten históricamente dos modalidades de rehidratación intravenosa (RIV) en Pediatría: la convencional (RIC), basada en los estudios de Darrow (1949), Holliday y Segar (1957), y la llamada “rápida” (RIR), fundamentada en los de Hirschhorn (1968), y Rahman (1979), bajo cuya denominación se han publicado métodos muy dispares. Cada una ofrece alguna v...

  17. Fault detection of feed water treatment process using PCA-WD with parameter optimization.

    Science.gov (United States)

    Zhang, Shirong; Tang, Qian; Lin, Yu; Tang, Yuling

    2017-05-01

    Feed water treatment process (FWTP) is an essential part of utility boilers; and fault detection is expected for its reliability improvement. Classical principal component analysis (PCA) has been applied to FWTPs in our previous work; however, the noises of T 2 and SPE statistics result in false detections and missed detections. In this paper, Wavelet denoise (WD) is combined with PCA to form a new algorithm, (PCA-WD), where WD is intentionally employed to deal with the noises. The parameter selection of PCA-WD is further formulated as an optimization problem; and PSO is employed for optimization solution. A FWTP, sustaining two 1000MW generation units in a coal-fired power plant, is taken as a study case. Its operation data is collected for following verification study. The results show that the optimized WD is effective to restrain the noises of T 2 and SPE statistics, so as to improve the performance of PCA-WD algorithm. And, the parameter optimization enables PCA-WD to get its optimal parameters in an automatic way rather than on individual experience. The optimized PCA-WD is further compared with classical PCA and sliding window PCA (SWPCA), in terms of four cases as bias fault, drift fault, broken line fault and normal condition, respectively. The advantages of the optimized PCA-WD, against classical PCA and SWPCA, is finally convinced with the results. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  18. Posterior cerebral artery involvement in moyamoya disease: initial infarction and angle between PCA and basilar artery.

    Science.gov (United States)

    Lee, Ji Yeoun; Kim, Seung-Ki; Cheon, Jung-Eun; Choi, Jung Won; Phi, Ji Hoon; Kim, In-One; Cho, Byung-Kyu; Wang, Kyu-Chang

    2013-12-01

    Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease, and progressive involvement of the posterior cerebral artery (PCA) has been reported. However, majority of MMD articles are presenting classic anterior circulation related issues. This study investigates the preoperative factors related to the long-term outcome of posterior circulation in MMD. Retrospective review of 88 MMD patients (166 PCAs in either hemisphere) without symptomatic disease involvement of PCA at initial diagnosis was done. Data at initial diagnosis regarding age, presence of infarction, status of the PCA, type of posterior communicating artery, and the angle between PCA and basilar artery were reviewed. Progressive stenosis of PCA was evaluated by symptom or radiological imaging during follow up. During an average follow up of 8.3 years, 29 out of 166 (18 %) evaluated PCAs showed progressive disease involvement. The average time of progression from the initial operation was 4.9 years, with the latest onset at 10.8 years. The patients who showed progressive stenosis of the PCA tended to be younger, present with infarction, have smaller angle between PCA and basilar artery, and have asymptomatic stenosis of the PCA at initial presentation. However, multivariate analysis confirmed only the presence of initial infarction and a smaller angle between PCA and basilar artery to be significantly associated with progressive stenosis of PCA. Involvement of PCA in MMD may occur in a delayed fashion, years after the completion of revascularization of anterior circulation. Persistent long-term follow-up regarding the posterior circulation is recommended.

  19. Pattern Recognition by Dinamic Feature Analysis Based on PCA

    Directory of Open Access Journals (Sweden)

    Juliana Valencia-Aguirre

    2009-06-01

    Full Text Available Usually, in pattern recognition problems we represent the observations by mean of measures on appropriate variables of data set, these measures can be categorized as Static and Dynamic Features. Static features are not always an accurate representation of data. In these sense, many phenomena are better modeled by dynamic changes on their measures. The advantage of using an extended form (dynamic features is the inclusion of new information that allows us to get a better representation of the object. Nevertheless, sometimes it is difficult in a classification stage to deal with dynamic features, because the associated computational cost often can be higher than we deal with static features. For analyzing such representations, we use Principal Component Analysis (PCA, arranging dynamic data in such a way we can consider variations related to the intrinsic dynamic of observations. Therefore, the method made possible to evaluate the dynamic information about of the observations on a lower dimensionality feature space without decreasing the accuracy performance. Algorithms were tested on real data to classify pathological speech from normal voices, and using PCA for dynamic feature selection, as well.

  20. MD-11 PCA - View of aircraft on ramp

    Science.gov (United States)

    1995-01-01

    This McDonnell Douglas MD-11 is taxiing to a position on the flightline at NASA's Dryden Flight Research Center, Edwards, California, following its completion of the first and second landings ever performed by a transport aircraft under engine power only (on Aug. 29, 1995). The milestone flight, with NASA research pilot and former astronaut Gordon Fullerton at the controls, was part of a NASA project to develop a computer-assisted engine control system that enables a pilot to land a plane safely when its normal control surfaces are disabled. The Propulsion-Controlled Aircraft (PCA) system uses standard autopilot controls already present in the cockpit, together with the new programming in the aircraft's flight control computers. The PCA concept is simple. For pitch control, the program increases thrust to climb and reduces thrust to descend. To turn right, the autopilot increases the left engine thrust while decreasing the right engine thrust. The initial Propulsion-Controlled Aircraft studies by NASA were carried out at Dryden with a modified twin-engine F-15 research aircraft.

  1. MD-11 PCA - Closeup view of aircraft on ramp

    Science.gov (United States)

    1995-01-01

    This McDonnell Douglas MD-11 has taxied to a position on the flightline at NASA's Dryden Flight Research Center, Edwards, California, following its completion of the first and second landings ever performed by a transport aircraft under engine power only (on Aug. 29, 1995). The milestone flight, with NASA research pilot and former astronaut Gordon Fullerton at the controls, was part of a NASA project to develop a computer-assisted engine control system that enables a pilot to land a plane safely when its normal control surfaces are disabled. The Propulsion-Controlled Aircraft (PCA) system uses standard autopilot controls already present in the cockpit, together with the new programming in the aircraft's flight control computers. The PCA concept is simple. For pitch control, the program increases thrust to climb and reduces thrust to descend. To turn right, the autopilot increases the left engine thrust while decreasing the right engine thrust. The initial Propulsion-Controlled Aircraft studies by NASA were carried out at Dryden with a modified twin-engine F-15 research aircraft.

  2. Ultrasound-guided rectus sheath and transversus abdominis plane blocks for perioperative analgesia in upper abdominal surgery: A randomized controlled study

    Directory of Open Access Journals (Sweden)

    Khaled Abdelsalam

    2016-01-01

    Full Text Available Background: Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US-guided rectus sheath (RS and transversus abdominis plane (TAP blocks for better perioperative analgesia. Patients and Methods: It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included. All patients received a standardized anesthetic technique. Group 1 (n = 20 received preincisional US-guided bilateral RS and TAP blocks using 20 ml volume of bupivacaine 0.25% for each, and group 2 (n = 20 received local wound infiltration at end of surgery with 40 ml of bupivacaine 0.25%. A standardized postoperative analgesic regimen composed of intravenous paracetamol and a morphine patient-controlled analgesia (PCA. The use of intraoperative fentanyl and recovery room morphine boluses, PCA-administered morphine, pain scores as well as number of patients′ experienced postoperative nausea and vomiting in the ward at 6 and 24 h were recorded. Results: Group 1 patients received a significantly lower cumulative intraoperative fentanyl, significantly lesser boluses of morphine in postanesthesia care unit, as well, significantly lower cumulative 24 h postoperative morphine dosage than the group 2 patients. Pain visual analog scale scores were significantly lower at both 6 and 24 h postoperatively in TAP group when compared with the no-TAP group. There were no complications related to the TAP block procedures. No signs or symptoms of local anesthetic systemic toxicity were detected. Conclusion: The combination of bilateral US-guided RS and TAP blocks provides excellent perioperative analgesia for major upper abdominal surgery.

  3. Multimodal analgesia versus traditional opiate based analgesia after cardiac surgery, a randomized controlled trial

    DEFF Research Database (Denmark)

    Rafiq, Sulman; Steinbrüchel, Daniel Andreas; Wanscher, Michael Jaeger

    2014-01-01

    significantly lower average pain scores from the day of surgery throughout the third postoperative day. Extensive nausea and vomiting, was found in no patient in the multimodal group but in 13 patients in the morphine group, p levels demonstrated a non....... 1, p = 0.31). 30-day mortality was 1 vs. 2, p = 0.54. CONCLUSIONS: In patients undergoing cardiac surgery, a multimodal regimen offered significantly better analgesia than a traditional opiate regimen. Nausea and vomiting complaints were significantly reduced. No safety issues were observed...

  4. Identification of an IL-1-induced gene expression pattern in AR+ PCa cells that mimics the molecular phenotype of AR- PCa cells.

    Science.gov (United States)

    Thomas-Jardin, Shayna E; Kanchwala, Mohammed S; Jacob, Joan; Merchant, Sana; Meade, Rachel K; Gahnim, Nagham M; Nawas, Afshan F; Xing, Chao; Delk, Nikki A

    2018-06-01

    In immunosurveillance, bone-derived immune cells infiltrate the tumor and secrete inflammatory cytokines to destroy cancer cells. However, cancer cells have evolved mechanisms to usurp inflammatory cytokines to promote tumor progression. In particular, the inflammatory cytokine, interleukin-1 (IL-1), is elevated in prostate cancer (PCa) patient tissue and serum, and promotes PCa bone metastasis. IL-1 also represses androgen receptor (AR) accumulation and activity in PCa cells, yet the cells remain viable and tumorigenic; suggesting that IL-1 may also contribute to AR-targeted therapy resistance. Furthermore, IL-1 and AR protein levels negatively correlate in PCa tumor cells. Taken together, we hypothesize that IL-1 reprograms AR positive (AR + ) PCa cells into AR negative (AR - ) PCa cells that co-opt IL-1 signaling to ensure AR-independent survival and tumor progression in the inflammatory tumor microenvironment. LNCaP and PC3 PCa cells were treated with IL-1β or HS-5 bone marrow stromal cell (BMSC) conditioned medium and analyzed by RNA sequencing and RT-QPCR. To verify genes identified by RNA sequencing, LNCaP, MDA-PCa-2b, PC3, and DU145 PCa cell lines were treated with the IL-1 family members, IL-1α or IL-1β, or exposed to HS-5 BMSC in the presence or absence of Interleukin-1 Receptor Antagonist (IL-1RA). Treated cells were analyzed by western blot and/or RT-QPCR. Comparative analysis of sequencing data from the AR + LNCaP PCa cell line versus the AR - PC3 PCa cell line reveals an IL-1-conferred gene suite in LNCaP cells that is constitutive in PC3 cells. Bioinformatics analysis of the IL-1 regulated gene suite revealed that inflammatory and immune response pathways are primarily elicited; likely facilitating PCa cell survival and tumorigenicity in an inflammatory tumor microenvironment. Our data supports that IL-1 reprograms AR + PCa cells to mimic AR - PCa gene expression patterns that favor AR-targeted treatment resistance and cell survival. © 2018 Wiley

  5. Methadone analgesia in the critically ill.

    Science.gov (United States)

    Elefritz, Jessica L; Murphy, Claire V; Papadimos, Thomas J; Lyaker, Michael R

    2016-08-01

    Methadone is increasingly used as an analgesic or a bridge to weaning other analgesics and sedatives in critically ill patients. This review discusses the pharmacology of methadone, summarizes available evidence for its use in the intensive care unit setting, and makes suggestions for appropriate use and monitoring. Articles evaluating the efficacy, safety, and pharmacology of methadone were identified from a PubMed search through June 2015. References from selected articles were reviewed for additional material. Experimental and observational English-language studies that focused on the efficacy, safety, and pharmacology of methadone in critically-ill adults and children were selected. Methadone is a synthetic opioid analgesic with potential advantages over other commonly used opioids. Limited evidence from critically ill pediatric, adult, and burn populations suggests that methadone protocols may expedite weaning opiate infusions, decrease the length of mechanical ventilation, and reduce the incidence of negative outcomes such as opiate withdrawal, delirium, and over-sedation. Data from current literature supports a role for methadone analgesia in weaning opiates and potentially reducing the duration of mechanical ventilation in critically ill patients. More studies are needed to confirm these benefits and determine criteria for patient selection. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Newborn Analgesia Mediated by Oxytocin during Delivery

    Science.gov (United States)

    Mazzuca, Michel; Minlebaev, Marat; Shakirzyanova, Anastasia; Tyzio, Roman; Taccola, Giuliano; Janackova, Sona; Gataullina, Svetlana; Ben-Ari, Yehezkel; Giniatullin, Rashid; Khazipov, Rustem

    2011-01-01

    The mechanisms controlling pain in newborns during delivery are poorly understood. We explored the hypothesis that oxytocin, an essential hormone for labor and a powerful neuromodulator, exerts analgesic actions on newborns during delivery. Using a thermal tail-flick assay, we report that pain sensitivity is two-fold lower in rat pups immediately after birth than 2 days later. Oxytocin receptor antagonists strongly enhanced pain sensitivity in newborn, but not in 2-day-old rats, whereas oxytocin reduced pain at both ages suggesting an endogenous analgesia by oxytocin during delivery. Similar analgesic effects of oxytocin, measured as attenuation of pain-vocalization induced by electrical whisker pad stimulation, were also observed in decerebrated newborns. Oxytocin reduced GABA-evoked calcium responses and depolarizing GABA driving force in isolated neonatal trigeminal neurons suggesting that oxytocin effects are mediated by alterations of intracellular chloride. Unlike GABA signaling, oxytocin did not affect responses mediated by P2X3 and TRPV1 receptors. In keeping with a GABAergic mechanism, reduction of intracellular chloride by the diuretic NKCC1 chloride co-transporter antagonist bumetanide mimicked the analgesic actions of oxytocin and its effects on GABA responses in nociceptive neurons. Therefore, endogenous oxytocin exerts an analgesic action in newborn pups that involves a reduction of the depolarizing action of GABA on nociceptive neurons. Therefore, the same hormone that triggers delivery also acts as a natural pain killer revealing a novel facet of the protective actions of oxytocin in the fetus at birth. PMID:21519396

  7. Analgesia, sedation, and memory of intensive care.

    Science.gov (United States)

    Capuzzo, M; Pinamonti, A; Cingolani, E; Grassi, L; Bianconi, M; Contu, P; Gritti, G; Alvisi, R

    2001-09-01

    The purpose of this article was to investigate the relationship between analgesia, sedation, and memory of intensive care. One hundred fifty-two adult, cooperative intensive care unit (ICU) patients were interviewed 6 months after hospital discharge about their memory of intensive care. The patient was considered to be cooperative when he/she was aware of self and environment at the interview. The patients were grouped as follows: A (45 patients) substantially no sedation, B (85) morphine, and C (22) morphine and other sedatives. The patients having no memory of intensive care were 38%, 34%, and 23% respectively, in the three groups. They were less ill, according to SAPS II (P memories was not different among the three groups. Females reported at least one emotional memory more frequently than males (odds ratio 4.17; 95% CI 10.97-1.59). The patients receiving sedatives in the ICU are not comparable with those receiving only opiates or nothing, due to the different clinical condition. The lack of memory of intensive care is present in one third of patients and is influenced more by length of stay in ICU than by the sedation received. Sedation does not influence the incidence of factual, sensation, and emotional memories of ICU admitted patients. Females have higher incidences of emotional memories than males. Copyright 2001 by W.B. Saunders Company

  8. Tramadol Versus Low Dose Tramadol-paracetamol for Patient Controlled Analgesia During Spinal Vertebral Surgery

    Directory of Open Access Journals (Sweden)

    Esad Emir

    2010-06-01

    Full Text Available Pain intensity may be high in the postoperative period after spinal vertebral surgery. The aim of the study was to compare the effectiveness and cost of patient controlled analgesia (PCA with tramadol versus low dose tramadol-paracetamol on postoperative pain. A total of 60 patients were randomly divided into two groups. One group received 1.5 mg/kg tramadol (Group T while the other group received 0.75 mg/kg tramadol plus 1 g of paracetamol (Group P intravenously via a PCA device immediately after surgery and the patients were transferred to a recovery room, Tramadol was continuously infused at a rate of 0.5 mL/h in both groups, at a dose of 10 mg/mL in Group T and 5 mg/mL in Group P. The bolus and infusion programs were adjusted to administer a 1 mL bolus dose of tramadol with a lock time of 10 minutes. In Group P, 1 g of paracetamol was injected intravenously every 6 hours. The four-point nausea scale, numeric rating scale for pain assessment, Ramsey sedation scale, blood pressure, heart rate, respiration rate, peripheral oxygen saturation values and side effects were recorded at 0, 15 and 30 minutes, and at 1, 2, 4, 6, 12, 18 and 24 hours. The time to reach an Aldrete score of 9 was also recorded. A cost analysis for both groups was performed. In Group P, the numeric rating scale scores were significantly lower than that in Group T at 0 and 15 minutes. The number of side effects, additional analgesic requirement and the total dose of tramadol were lower in Group P than in Group T. However, the total cost of postoperative analgesics was significantly higher in Group P than in Group T (p < 0.001. We conclude that PCA using tramadol-paracetamol could be used safely for postoperative pain relief after spinal vertebral surgery, although at a higher cost than with tramadol alone.

  9. [The effects of intravenous dexketoprofen on postoperative analgesia and morphine consumption in patients undergoing abdominal hysterectomy].

    Science.gov (United States)

    Tuncer, Sema; Reisli, Ruhiye; Keçecioğlu, Melahat; Erol, Atilla

    2010-07-01

    Dexketoprofen trometamol is a water-soluble salt of the dextrorotatory enantiomer of the nonsteroidal anti-inflammatory drug ketoprofen. The aim of this study was to investigate the effect of intravenous dexketoprofen on postoperative pain. This study was performed on 50 (ASA I-II) patients scheduled for abdominal hysterectomy. Fifty patients were randomized into two equal groups. Patients received saline solution (Group I) or 50 mg intravenous dexketoprofen (Group II) 1 hour (h) before surgery and 8-16 h after surgery. All patients received a standard anesthetic protocol. At the end of surgery, all patients received intravenous (IV) morphine via a PCA (patient- controlled analgesia) device. Pain scores were assessed at 2, 6, 12 and 24 h after surgery. Morphine consumption and adverse effects were noted during the first 24 h after the surgery. The pain scores were significantly lower in the dexketoprofen group compared with the control group (pdexketoprofen group than the control group (p0.05). We conclude that the administration of IV dexketoprofen provided a significant analgesic benefit and decreased the morphine requirements in patients undergoing abdominal hysterectomy.

  10. [Epidural obstetric analgesia, maternal fever and neonatal wellness parameters].

    Science.gov (United States)

    Fernández-Guisasola, J; Delgado Arnáiz, C; Rodríguez Caravaca, G; Serrano Rodríguez, M L; García del Valle, S; Gómez-Arnau, J I

    2005-04-01

    To study the relation between epidural analgesia and the development of maternal fever during labor and childbirth, and to determine the possible relation between that association and neonatal welfare and in the performance of tests to rule out sepsis in newborns. Prospective study of all women who gave birth at Fundación Hospital Alcorcón over a period of 3 years. All the women were offered epidural analgesia based on infusion of 0.0625% bupivacaine and 2 microg x mL(-1). Data collected were age, nulliparity, epidural analgesia infusion, induction of labor, uterine stimulation with oxytocin, type of birth, fetal weight, duration of dilation and expulsion, Apgar score (at 1 and 5 minutes), umbilical artery pH, and maternal temperature. Data for 4364 women were analyzed. Fever developed during labor in 5.7%; 93.7% of the fevers occurred in women receiving epidural analgesia (P<0.05). Logistic regression analysis revealed that independent risk factors for the development of fever were epidural analgesia (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.05-3.04), nulliparity (OR, 2,929; 95% CI, 2.005-4.279), fetal weight (OR, 1.484; 95% CI, 1.102-2.001), and duration of labor (OR, 1.003; 95% CI, 1.003-1.004). No significant differences in Apgar score at 5 minutes or umbilical artery pH were found between the women with and without fever. Tests to rule out sepsis were ordered for 85.1% of the infants of mothers with fever after epidural analgesia. Epidural analgesia was associated with greater risk of developing fever in mothers giving birth, but that association had no repercussion on the neonatal wellness parameters studied.

  11. Cost effectiveness analysis of screening in the early diagnosis of prostate cancer (PCA)

    International Nuclear Information System (INIS)

    Mueller-Lisse, U.G.; Mueller-Lisse, U.L.

    2002-01-01

    Purpose. The authors attempted to provide an overview of current concepts and the status of research in the field of cost effectiveness analysis (CEA) of screening for prostate cancer (PCA).Material and methods. Basic concepts and methods of CEA were reviewed. Examples of CEA-related studies of PCA were obtained from pertinent literature through medical databases.Results. Screening for PCA has so far been restricted to limited groups of health care recipients, usually within the framework of clinical trials. In those trials, screening for PCA usually results in higher numbers of PCAs being detected at lower average stages in a given population. As a consequence of screening, the rate of potentially curable PCAs increases. However, it has not yet been demonstrated that screening for PCA decreases PCA-related mortality or morbidity from metastatic PCA. On the other hand, additional costs are associated with the screening measure and with increased use of resources for diagnosis and treatment of the additional PCAs detected through screening.Conclusions. Throughout the European Union and North America, mass screening for PCA has not been implemented. This may chiefly be due to the current lack of information on long term benefits of PCA screening, particularly disease-specific survival. Currently, major studies are underway to assess the effects of PCA screening and its cost effectiveness. These studies include the US-American prostate, lung, colon and ovary trials (PLCO) and the European randomised study of Screening for Prostate Cancer (ERSPC). (orig.) [de

  12. Prostate-Specific Antigen (PSA) Screening and New Biomarkers for Prostate Cancer (PCa).

    Science.gov (United States)

    Stephan, Carsten; Rittenhouse, Harry; Hu, Xinhai; Cammann, Henning; Jung, Klaus

    2014-04-01

    PSA screening reduces PCa-mortality but the disadvantages overdiagnosis and overtreatment require multivariable risk-prediction tools to select appropriate treatment or active surveillance. This review explains the differences between the two largest screening trials and discusses the drawbacks of screening and its meta-analysisxs. The current American and European screening strategies are described. Nonetheless, PSA is one of the most widely used tumor markers and strongly correlates with the risk of harboring PCa. However, while PSA has limitations for PCa detection with its low specificity there are several potential biomarkers presented in this review with utility for PCa currently being studied. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved prostate health index (phi) shows improved specificity over percent free and total PSA. Another kallikrein panel, 4K, which includes KLK2 has recently shown promise in clinical research studies but has not yet undergone formal validation studies. In urine, prostate cancer gene 3 (PCA3) has also been validated and approved by the FDA for its utility to detect PCa. The potential correlation of PCA3 with cancer aggressiveness requires more clinical studies. The detection of the fusion of androgen-regulated genes with genes of the regulatory transcription factors in tissue of (~)50% of all PCa-patients is a milestone in PCa research. A combination of the urinary assays for TMPRSS2:ERG gene fusion and PCA3 shows an improved accuracy for PCa detection. Overall, the field of PCa biomarker discovery is very exciting and prospective.

  13. Prostate-Specific Antigen (PSA) Screening and New Biomarkers for Prostate Cancer (PCa)

    Science.gov (United States)

    Rittenhouse, Harry; Hu, Xinhai; Cammann, Henning; Jung, Klaus

    2014-01-01

    Abstract PSA screening reduces PCa-mortality but the disadvantages overdiagnosis and overtreatment require multivariable risk-prediction tools to select appropriate treatment or active surveillance. This review explains the differences between the two largest screening trials and discusses the drawbacks of screening and its meta-analysisxs. The current American and European screening strategies are described. Nonetheless, PSA is one of the most widely used tumor markers and strongly correlates with the risk of harboring PCa. However, while PSA has limitations for PCa detection with its low specificity there are several potential biomarkers presented in this review with utility for PCa currently being studied. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved prostate health index (phi) shows improved specificity over percent free and total PSA. Another kallikrein panel, 4K, which includes KLK2 has recently shown promise in clinical research studies but has not yet undergone formal validation studies. In urine, prostate cancer gene 3 (PCA3) has also been validated and approved by the FDA for its utility to detect PCa. The potential correlation of PCA3 with cancer aggressiveness requires more clinical studies. The detection of the fusion of androgen-regulated genes with genes of the regulatory transcription factors in tissue of ~50% of all PCa-patients is a milestone in PCa research. A combination of the urinary assays for TMPRSS2:ERG gene fusion and PCA3 shows an improved accuracy for PCa detection. Overall, the field of PCa biomarker discovery is very exciting and prospective. PMID:27683457

  14. PCA method for automated detection of mispronounced words

    Science.gov (United States)

    Ge, Zhenhao; Sharma, Sudhendu R.; Smith, Mark J. T.

    2011-06-01

    This paper presents a method for detecting mispronunciations with the aim of improving Computer Assisted Language Learning (CALL) tools used by foreign language learners. The algorithm is based on Principle Component Analysis (PCA). It is hierarchical with each successive step refining the estimate to classify the test word as being either mispronounced or correct. Preprocessing before detection, like normalization and time-scale modification, is implemented to guarantee uniformity of the feature vectors input to the detection system. The performance using various features including spectrograms and Mel-Frequency Cepstral Coefficients (MFCCs) are compared and evaluated. Best results were obtained using MFCCs, achieving up to 99% accuracy in word verification and 93% in native/non-native classification. Compared with Hidden Markov Models (HMMs) which are used pervasively in recognition application, this particular approach is computational efficient and effective when training data is limited.

  15. Measuring the Indonesian provinces competitiveness by using PCA technique

    Science.gov (United States)

    Runita, Ditha; Fajriyah, Rohmatul

    2017-12-01

    Indonesia is a country which has vast teritoty. It has 34 provinces. Building local competitiveness is critical to enhance the long-term national competitiveness especially for a country as diverse as Indonesia. A competitive local government can attract and maintain successful firms and increase living standards for its inhabitants, because investment and skilled workers gravitate from uncompetitive regions to more competitive ones. Altough there are other methods to measuring competitiveness, but here we have demonstrated a simple method using principal component analysis (PCA). It can directly be applied to correlated, multivariate data. The analysis on Indonesian provinces provides 3 clusters based on the competitiveness measurement and the clusters are Bad, Good and Best perform provinces.

  16. Preemptive analgesia I: physiological pathways and pharmacological modalities.

    LENUS (Irish Health Repository)

    Kelly, D J

    2012-02-03

    PURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included: analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; pathways, nociception; anesthetic techniques; analgesics, agents. Principal findings: The physiological basis of preemptive analgesia is complex and involves modification of the pain pathways. The pharmacological modalities available may modify the physiological responses at various levels. Effective preemptive analgesic techniques require multi-modal interception of nociceptive input, increasing threshold for nociception, and blocking or decreasing nociceptor receptor activation. Although the literature is controversial regarding the effectiveness of preemptive analgesia, some general recommendations can be helpful in guiding clinical care. Regional anesthesia induced prior to surgical trauma and continued well into the postoperative period is effective in attenuating peripheral and central sensitization. Pharmacologic agents such as NSAIDs (non-steroidal anti-inflammatory drugs) opioids, and NMDA (N-methyl-D-aspartate) - and alpha-2-receptor antagonists, especially when used in combination, act synergistically to decrease postoperative pain. CONCLUSION: The variable patient characteristics and timing of preemptive analgesia in relation to surgical noxious input requires individualization of the technique(s) chosen. Multi-modal analgesic techniques appear most effective.

  17. Preemptive analgesia II: recent advances and current trends.

    LENUS (Irish Health Repository)

    Kelly, D J

    2012-02-03

    PURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; pathways, nociception; anesthetic techniques; analgesics, agents. Principal findings: In Part I of this review article, techniques and agents that attenuate or prevent central and peripheral sensitization were reviewed. In Part II, the conditions required for effective preemptive techniques are evaluated. Specifically, preemptive analgesia may be defined as an antinociceptive treatment that prevents establishment of altered central processing of afferent input from sites of injury. The most important conditions for establishment of effective preemptive analgesia are the establishment of an effective level of antinociception before injury, and the continuation of this effective analgesic level well into the post-injury period to prevent central sensitization during the inflammatory phase. Although single-agent therapy may attenuate the central nociceptive processing, multi-modal therapy is more effective, and may be associated with fewer side effects compared with the high-dose, single-agent therapy. CONCLUSION: The variable patient characteristics and timing of preemptive analgesia in relation to surgical noxious input require individualization of the technique(s) chosen. Multi-modal analgesic techniques appear more effective.

  18. Analgesia for patients undergoing shockwave lithotripsy for urinary stones – a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Omar M. Aboumarzouk

    Full Text Available ABSTRACT Background Shock wave lithotripsy (SWL is the first line treatment modality for a significant proportion of patients with upper urinary tracts stones. Simple analgesics, opioids and non-steroidal anti-inflammatory drugs (NSAIDs are all suitable agents but the relative efficacy and tolerability of these agents is uncertain. Objectives To determine the efficacy of the different types of analgesics used for the control of pain during SWL for urinary stones. Materials and Methods We searched the Cochrane Renal Group’s Specialised Register, MEDLINE, EMBASE and also hand-searched reference lists of relevant articles (Figure-1. Randomised controlled trials (RCT’s comparing the use of any opioid, simple analgesic or NSAID during SWL were included. These were compared with themselves, each-other or placebo. We included any route or form of administration (bolus, PCA. We excluded agents that were used for their sedative qualities. Data were extracted and assessed for quality independently by three reviewers. Meta-analyses have been performed where possible. When not possible, descriptive analyses of variables were performed. Dichotomous outcomes are reported as relative risk (RR and measurements on continuous scales are reported as weighted mean differences (WMD with 95% confidence intervals. Results Overall, we included 9 RCTs (539 participants from 6 countries. Trial agents included 7 types of NSAIDs, 1 simple analgesic and 4 types of opioids. There were no significant differences in clinical efficacy or tolerability between a simple analgesic (paracetamol and an NSAID (lornoxicam. When comparing the same simple analgesic with an opioid (tramadol, both agents provided safe and effective analgesia for the purpose of SWL with no significant differences. There were no significant differences in pain scores between NSAIDs or opioids in three studies. Adequate analgesia could be achieved more often for opioids than for NSAIDs (RR 0.358; 95% CI

  19. Shallow-Land Buriable PCA-type austenitic stainless steel for fusion application

    International Nuclear Information System (INIS)

    Zucchetti, M.

    1991-01-01

    Neutron-induced activity in the PCA (Primary Candidate Alloy) austenitic stainless steel is examined, when used for first-wall components in a DEMO fusion reactor. Some low-activity definitions, based on different waste management and disposal concepts, are introduced. Activity in the PCA is so high that any recycling of the irradiated material can be excluded. Disposal of PCA radioactive wastes in Shallow-Land Buriable (SLB) is prevented as well. Mo, Nb and some impurity elements have to be removed or limited, in order to reduce the radioactivity of the PCA. Possible low-activity versions of the PCA are introduced (PCA-la); they meet the requirements for SLB and may also be recycled under certain conditions. (author)

  20. Improved k-t PCA Algorithm Using Artificial Sparsity in Dynamic MRI.

    Science.gov (United States)

    Wang, Yiran; Chen, Zhifeng; Wang, Jing; Yuan, Lixia; Xia, Ling; Liu, Feng

    2017-01-01

    The k - t principal component analysis ( k - t PCA) is an effective approach for high spatiotemporal resolution dynamic magnetic resonance (MR) imaging. However, it suffers from larger residual aliasing artifacts and noise amplification when the reduction factor goes higher. To further enhance the performance of this technique, we propose a new method called sparse k - t PCA that combines the k - t PCA algorithm with an artificial sparsity constraint. It is a self-calibrated procedure that is based on the traditional k - t PCA method by further eliminating the reconstruction error derived from complex subtraction of the sampled k - t space from the original reconstructed k - t space. The proposed method is tested through both simulations and in vivo datasets with different reduction factors. Compared to the standard k - t PCA algorithm, the sparse k - t PCA can improve the normalized root-mean-square error performance and the accuracy of temporal resolution. It is thus useful for rapid dynamic MR imaging.

  1. Comparative analysis of prostate cancer specific biomarkers PCA3 and ERG in whole urine, urinary sediments and exosomes

    NARCIS (Netherlands)

    Hendriks, R.J.; Dijkstra, S.; Jannink, S.A.; Steffens, M.G.; Oort, I.M. van; Mulders, P.F.A.; Schalken, J.A.

    2016-01-01

    BACKGROUND: PCA3 and ERG are mRNA-based prostate cancer (PCa) specific biomarkers that can be detected in urine. However, urine is a complex substrate that can be separated in several fractions. In this study we compared the levels of PCa-specific biomarkers (PCA3 and ERG) and KLK3 as

  2. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Karen V; Bak, Marie; Christensen, Birgitte V

    2010-01-01

    There have been few studies describing wound infiltration with additional intraarticular administration of multimodal analgesia for total knee arthroplasty (TKA). In this study, we assessed the efficacy of wound infiltration combined with intraarticular regional analgesia with epidural infusion...

  3. Classical conditioning and pain: conditioned analgesia and hyperalgesia.

    Science.gov (United States)

    Miguez, Gonzalo; Laborda, Mario A; Miller, Ralph R

    2014-01-01

    This article reviews situations in which stimuli produce an increase or a decrease in nociceptive responses through basic associative processes and provides an associative account of such changes. Specifically, the literature suggests that cues associated with stress can produce conditioned analgesia or conditioned hyperalgesia, depending on the properties of the conditioned stimulus (e.g., contextual cues and audiovisual cues vs. gustatory and olfactory cues, respectively) and the proprieties of the unconditioned stimulus (e.g., appetitive, aversive, or analgesic, respectively). When such cues are associated with reducers of exogenous pain (e.g., opiates), they typically increase sensitivity to pain. Overall, the evidence concerning conditioned stress-induced analgesia, conditioned hyperalagesia, conditioned tolerance to morphine, and conditioned reduction of morphine analgesia suggests that selective associations between stimuli underlie changes in pain sensitivity. © 2013 Elsevier B.V. All rights reserved.

  4. Effect of pain and analgesia on compensatory reserve.

    Science.gov (United States)

    Hinojosa-Laborde, Carmen; Fernandez, Jessie Renee D; Muniz, Gary W; Nawn, Corinne D; Burns, Rebecca K; Le, Thuan H; Porter, Kathy B; Hardy, John T; Convertino, Victor A

    2017-07-01

    The measurement of the body's capacity to compensate for reduced blood volume can be assessed with a compensatory reserve measurement (CRM). The CRM, which is calculated from changes in features of the arterial waveform, represents the integration of compensatory mechanisms during states of low tissue perfusion and oxygenation, such as hemorrhage. This study was designed to test the hypothesis that pain which activates compensatory mechanisms and analgesia that result in reduced blood pressure are associated with lower compensatory reserve. This study evaluated CRM in obstetric patients during labor as pain intensity increased from no pain to severe pain and compared CRM before and after epidural anesthesia. CRM was calculated from a finger pulse oximeter placed on the patient's index finger and connected to the DataOx monitor in healthy pregnant women (n = 20) before and during the active labor phase of childbirth. As pain intensity, based on an 11-point scale (0, no pain; 10, worst pain), increased from 0 to 8.4 ± 0.9 (mean ± SD), CRM was not affected (81 ± 10% to 82 ± 13%). Before analgesia, CRM was 84 ± 10%. CRM at 10 minutes, 20 minutes, 30 minutes, 40 minutes, 50 minutes, and 60 minutes after analgesia was 82 ± 11%, 83 ± 14%, 83 ± 15%, 86 ± 12%, 89 ± 9%, and 87 ± 10%, respectively. There was a transient 2% reduction followed by a 5% increase in CRM from before to after epidural anesthesia (p = 0.048). Pain scores before and after analgesia were 7 ± 2 and 1 ± 1, respectively (p < 0.001). These results indicate that pain and analgesia contribute minimally, but independently to the reduction in compensatory reserve associated with trauma and hemorrhage. As such, our findings suggest that analgesia can be safely administered on the battlefield while maintaining the maximal capacity of mechanisms to compensate for blood loss. Diagnostic study, level II.

  5. Neonatal morphine enhances nociception and decreases analgesia in young rats.

    Science.gov (United States)

    Zhang, Guo Hua; Sweitzer, Sarah M

    2008-03-14

    The recognition of the impact of neonatal pain experience on subsequent sensory processing has led to the increased advocacy for the use of opioids for pain relief in infants. However, following long-term opioid exposure in intensive care units more than 48% of infants exhibited behaviors indicative of opioid abstinence syndrome, a developmentally equivalent set of behaviors to opioid withdrawal as seen in adults. Little is known about the long-term influence of repeated neonatal morphine exposure on nociception and analgesia. To investigate this, we examined mechanical and thermal nociception on postnatal days 11, 13, 15, 19, 24, 29, 39 and 48 following subcutaneous administration of morphine (3 mg/kg) once daily on postnatal days 1-9. The cumulative morphine dose-response was assessed on postnatal days 20 and 49, and stress-induced analgesia was assessed on postnatal days 29 and 49. Both basal mechanical and thermal nociception in neonatal, morphine-exposed rats were significantly lower than those in saline-exposed, handled-control rats and naive rats until P29. A rightward-shift of cumulative dose-response curves for morphine analgesia upon chronic neonatal morphine was observed both on P20 and P49. The swim stress-induced analgesia was significantly decreased in neonatal morphine-exposed rats on P29, but not on P49. These data indicate that morphine exposure equivalent to the third trimester of gestation produced prolonged pain hypersensitivity, decreased morphine antinociception, and decreased stress-induced analgesia. The present study illustrates the need to examine the long-term influence of prenatal morphine exposure on pain and analgesia in the human pediatric population.

  6. Quality of Life and Sexual Health in the Aging of PCa Survivors

    Directory of Open Access Journals (Sweden)

    Mauro Gacci

    2014-01-01

    Full Text Available Prostate cancer (PCa is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.

  7. A Multi-Time Scale Morphable Software Milieu for Polymorphous Computing Architectures (PCA) - Composable, Scalable Systems

    National Research Council Canada - National Science Library

    Skjellum, Anthony

    2004-01-01

    Polymorphous Computing Architectures (PCA) rapidly "morph" (reorganize) software and hardware configurations in order to achieve high performance on computation styles ranging from specialized streaming to general threaded applications...

  8. PCA-1/ALKBH3 contributes to pancreatic cancer by supporting apoptotic resistance and angiogenesis.

    Science.gov (United States)

    Yamato, Ichiro; Sho, Masayuki; Shimada, Keiji; Hotta, Kiyohiko; Ueda, Yuko; Yasuda, Satoshi; Shigi, Naoko; Konishi, Noboru; Tsujikawa, Kazutake; Nakajima, Yoshiyuki

    2012-09-15

    The PCA-1/ALKBH3 gene implicated in DNA repair is expressed in several human malignancies but its precise contributions to cancer remain mainly unknown. In this study, we have determined its functions and clinical importance in pancreatic cancer. PCA-1/ALKBH3 functions in proliferation, apoptosis and angiogenesis were evaluated in human pancreatic cancer cells in vitro and in vivo. Further, PCA-1/ALKBH3 expression in 116 patients with pancreatic cancer was evaluated by immunohistochemistry. siRNA-mediated silencing of PCA-1/ALKBH3 expression induced apoptosis and suppressed cell proliferation. Conversely, overexpression of PCA-1/ALKBH3 increased anchorage-independent growth and invasiveness. In addition, PCA-1/ALKBH3 silencing downregulated VEGF expression and inhibited angiogenesis in vivo. Furthermore, immunohistochemical analysis showed that PCA-1/ALKBH3 expression was abundant in pancreatic cancer tissues, where it correlated with advanced tumor status, pathological stage and VEGF intensity. Importantly, patients with low positivity of PCA-1/ALKBH3 expression had improved postoperative prognosis compared with those with high positivity. Our results establish PCA-1/ALKBH3 as important gene in pancreatic cancer with potential utility as a therapeutic target in this fatal disease.

  9. Tensile properties of unirradiated PCA from room temperature to 7000C

    International Nuclear Information System (INIS)

    Braski, D.N.; Maziasz, P.J.

    1983-01-01

    The tensile properties of Prime Candidate Alloy (PCA) austenitic stainless steel after three different thermomechanical treatments were determined from room temperature to 700 0 C. The solution-annealed PCA had the lowest strength and highest ductility, while the reverse was true for the 25%-cold-worked material. The PCA containing titanium-rich MC particles fell between the other two heats. The cold-worked PCA had nearly the same tensile properties as cold-worked type 316 stainless steel. Both alloys showed ductility minima at 300 0 C

  10. Quality of Life and Sexual Health in the Aging of PCa Survivors.

    Science.gov (United States)

    Gacci, Mauro; Baldi, Elisabetta; Tamburrino, Lara; Detti, Beatrice; Livi, Lorenzo; De Nunzio, Cosimo; Tubaro, Andrea; Gravas, Stavros; Carini, Marco; Serni, Sergio

    2014-01-01

    Prostate cancer (PCa) is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.

  11. Polymorphous Computing Architecture (PCA) Application Benchmark 1: Three-Dimensional Radar Data Processing

    National Research Council Canada - National Science Library

    Lebak, J

    2001-01-01

    The DARPA Polymorphous Computing Architecture (PCA) program is building advanced computer architectures that can reorganize their computation and communication structures to achieve better overall application performance...

  12. [Horner's syndrome and paresthesia in the trigeminal nerve territory secondary to epidural analgesia for labor].

    Science.gov (United States)

    Ferreira, Céline; Macedo, Ana Luísa; Almeida, Valentina

    2018-03-01

    Currently, epidural analgesia is a common procedure for labor analgesia. Although it is considered a safe technique, it is not without complications. Horner's syndrome and paresthesia within the trigeminal nerve distribution are rare complications of epidural analgesia. We report a case of a pregnant woman who developed Horner's syndrome and paresthesia within the distribution of the trigeminal nerve following epidural analgesia for the relief of labor pain. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. Analgesia in Amphibians: Preclinical Studies and Clinical Applications

    Science.gov (United States)

    Stevens, Craig W.

    2010-01-01

    SYNOPSIS Preclinical studies of analgesia in amphibians or recommendations for clinical use of analgesics in amphibian species are extremely limited. This article briefly reviews the issues surrounding the use of analgesics in amphibians starting with common definitions of pain and analgesia when applied to non-human animals. Nociceptive and endogenous opioid systems in amphibians are reviewed and results of preclinical research on opioid and non-opioid analgesics summarized. Recommended opioid and non-opioid analgesics are summarized and practical recommendations made for their clinical use. PMID:21074701

  14. Continuous cervical epidural analgesia for Isshiki type - I thyroplasty

    Science.gov (United States)

    Trivedi, Vandana

    2010-01-01

    Thyroplasty is an operation on the upper airway to improve voice quality in patients with unilateral vocal cord paralysis. It is a difficult anaesthetic procedure that requires sharing the airway with the surgeon. We describe a good anaesthetic technique, which provides a safe airway with excellent operating conditions, using continuous cervical epidural anaesthesia and postoperative analgesia in three patients. The use of a regional anaesthetic technique provides excellent anaesthesia and analgesia while allowing the patient to phonate at the request of the surgeon intraoperatively. PMID:20532074

  15. Stellate ganglion blockade for analgesia following upper limb surgery.

    LENUS (Irish Health Repository)

    McDonnell, J G

    2012-01-31

    We report the successful use of a stellate ganglion block as part of a multi-modal postoperative analgesic regimen. Four patients scheduled for orthopaedic surgery following upper limb trauma underwent blockade of the stellate ganglion pre-operatively under ultrasound guidance. Patients reported excellent postoperative analgesia, with postoperative VAS pain scores between 0 and 2, and consumption of morphine in the first 24 h ranging from 0 to 14 mg. While these are preliminary findings, and must be confirmed in a clinical trial, they highlight the potential for stellate ganglion blockade to provide analgesia following major upper limb surgery.

  16. Effect of sufentanil combined with different concentrations of ropivacaine for labor analgesia on maternal

    Directory of Open Access Journals (Sweden)

    Han-He Wang

    2016-12-01

    Full Text Available Objective: To study the effect of sufentanil combined with different concentration of ropivacaine for stepped analgesia on stage of labor, stress indexes and blood coagulation function. Methods: A total of 178 cases of full-term singleton primiparas who awaited delivery and received epidural labor analgesia in our hospital from January 2015 to June 2016 were selected and randomly divided into stepped analgesia group and routine analgesia group, and the stage of labor, levels of stress hormones and pain mediators during childbirth and blood coagulation function indexes after childbirth were observed between two groups. Results: The duration of latent phase of labor of stepped analgesia group was shorter than that of routine analgesia group while the duration of active phase of labor, the duration of second stage of labor and the duration of third stage of labor were not significantly different from those of routine analgesia group; serum PRL level of stepped analgesia group was significantly higher than that of routine analgesia group while PA, NE, E, DYN, β-EP, SP, PGE2, 5-HT, TF, TFPI, FPA, AT-III and DD levels were not significantly different from those of routine analgesia group. Conclusions: Sufentanil combined with different concentration of ropivacaine for stepped analgesia is with equivalent effect to routine analgesia, and can shorten the latent phase of labor and reduce the inhibitory effect of pain on prolactin without affecting the degree of stress during childbirth and the blood coagulation function after childbirth.

  17. Comparison of Continuous Femoral Nerve Block versus Local Infiltration Analgesia as a Postoperative Analgesia in Unilateral Total Knee Arthroplasty.

    Science.gov (United States)

    Chaubey, Deepika; Mahajan, Hari Krishan; Chauhan, Parshu Ram; Govind, Preeti S; Singh, Pushpinder; Dhanevar, Ravinder; Gupta, Abhinav

    2017-07-01

    Local infiltration of knee joint in arthroplasty, provide postoperative analgesia and preserves motor power of quadriceps, which helps in early mobilisation, as compared to femoral nerve block which paralyses vastus medialis. To compare the quality of postoperative analgesia provided by femoral nerve block and local infiltration in unilateral Total Knee Arthroplasty (TKA). A prospective study was conducted on 60 patients (25-65 years) of ASA I and II, which were randomly(using random number table) divided into two groups - Group 1-femoral nerve block (FNB) and Group 2-Local Infiltration Analgesia (LIA). Patients with chronic pain and on opioids were excluded. Numeric rating scale (primary objective), sedation score, nausea vomiting score and motor power were analysed. The results were analysed by parametric and nonparametric tests using SPSS software version 22. ppower grading (<0.001). FNB has better pain relief than LIA Group but range of motion was reduced in FNB Group grossly, effect on mobilisation remained comparable in both group.

  18. PCA/HEXTE Observations of Coma and A2319

    Science.gov (United States)

    Rephaeli, Yoel

    1998-01-01

    The Coma cluster was observed in 1996 for 90 ks by the PCA and HEXTE instruments aboard the RXTE satellite, the first simultaneous, pointing measurement of Coma in the broad, 2-250 keV, energy band. The high sensitivity achieved during this long observation allows precise determination of the spectrum. Our analysis of the measurements clearly indicates that in addition to the main thermal emission from hot intracluster gas at kT=7.5 keV, a second spectral component is required to best-fit the data. If thermal, it can be described with a temperature of 4.7 keV contributing about 20% of the total flux. The additional spectral component can also be described by a power-law, possibly due to Compton scattering of relativistic electrons by the CMB. This interpretation is based on the diffuse radio synchrotron emission, which has a spectral index of 2.34, within the range allowed by fits to the RXTE spectral data. A Compton origin of the measured nonthermal component would imply that the volume-averaged magnetic field in the central region of Coma is B =0.2 micro-Gauss, a value deduced directly from the radio and X-ray measurements (and thus free of the usual assumption of energy equipartition). Barring the presence of unknown systematic errors in the RXTE source or background measurements, our spectral analysis yields considerable evidence for Compton X-ray emission in the Coma cluster.

  19. Sunspot Pattern Classification using PCA and Neural Networks (Poster)

    Science.gov (United States)

    Rajkumar, T.; Thompson, D. E.; Slater, G. L.

    2005-01-01

    The sunspot classification scheme presented in this paper is considered as a 2-D classification problem on archived datasets, and is not a real-time system. As a first step, it mirrors the Zuerich/McIntosh historical classification system and reproduces classification of sunspot patterns based on preprocessing and neural net training datasets. Ultimately, the project intends to move from more rudimentary schemes, to develop spatial-temporal-spectral classes derived by correlating spatial and temporal variations in various wavelengths to the brightness fluctuation spectrum of the sun in those wavelengths. Once the approach is generalized, then the focus will naturally move from a 2-D to an n-D classification, where "n" includes time and frequency. Here, the 2-D perspective refers both to the actual SOH0 Michelson Doppler Imager (MDI) images that are processed, but also refers to the fact that a 2-D matrix is created from each image during preprocessing. The 2-D matrix is the result of running Principal Component Analysis (PCA) over the selected dataset images, and the resulting matrices and their eigenvalues are the objects that are stored in a database, classified, and compared. These matrices are indexed according to the standard McIntosh classification scheme.

  20. Caudal analgesia for herniotomy: Comparative evaluation of two ...

    African Journals Online (AJOL)

    Objective: There is currently a wide range of volume schemes for bupivacaine caudal anesthesia. This study evaluated the quality of caudal analgesia achieved with a dosing scheme of 0.75 ml/kg compared with 0.5 ml/kg of 0.25% plain bupivacaine for herniotomy. Methods: After the institutional approval, American Society ...

  1. High-volume infiltration analgesia in bilateral hip arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Lasse Ø; Otte, Niels Kristian Stahl; Husted, Henrik

    2011-01-01

    Background and purpose High-volume infiltration analgesia may be effective in postoperative pain management after hip arthroplasty but methodological problems prevent exact interpretation of previous studies. Methods In a randomized, double-blind placebo-controlled trial in 12 patients undergoing...

  2. Overdose of opioid from patient-controlled analgesia pumps.

    Science.gov (United States)

    Notcutt, W G; Knowles, P; Kaldas, R

    1992-07-01

    Two incidence have occurred in our hospital when a patient-controlled analgesia pump has accidentally delivered the whole contents of the syringe of diamorphine (60 mg) over a period of approximately 1 h. Electrical corruption of the pumps' program has been identified as the probable cause. All pumps of this type have been modified to prevent such occurrences.

  3. Safety and efficacy of procedural sedation and analgesia (PSA ...

    African Journals Online (AJOL)

    Safety and efficacy of procedural sedation and analgesia (PSA) conducted by medical officers in a level 1 hospital in Cape Town. ... Respiratory complications were treated with simple airway manoeuvres; no patient required intubation or experienced respiratory problems after waking up. There was no significant difference ...

  4. Information Models of Acupuncture Analgesia and Meridian Channels

    Directory of Open Access Journals (Sweden)

    Chang Hua Zou

    2010-12-01

    Full Text Available Acupuncture and meridian channels have been major components of Chinese and Eastern Asian medicine—especially for analgesia—for over 2000 years. In recent decades, electroacupuncture (EA analgesia has been applied clinically and experimentally. However, there were controversial results between different treatment frequencies, or between the active and the placebo treatments; and the mechanisms of the treatments and the related meridian channels are still unknown. In this study, we propose a new term of infophysics therapy and develop information models of acupuncture (or EA analgesia and meridian channels, to understand the mechanisms and to explain the controversial results, based on Western theories of information, trigonometry and Fourier series, and physics, as well as published biomedical data. We are trying to build a bridge between Chinese medicine and Western medicine by investigating the Eastern acupuncture analgesia and meridian channels with Western sciences; we model the meridians as a physiological system that is mostly constructed with interstices in or between other physiological systems; we consider frequencies, amplitudes and wave numbers of electric field intensity (EFI as information data. Our modeling results demonstrate that information regulated with acupuncture (or EA is different from pain information, we provide answers to explain the controversial published results, and suggest that mechanisms of acupuncture (or EA analgesia could be mostly involved in information regulation of frequencies and amplitudes of EFI as well as neuronal transmitters such as endorphins.

  5. Effect of irradiation on analgesia induced by morphine and endorphin

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Kyu; Lee, Byoung Hun; Hyun, Soung Hee; Chung, Ki Myung [KAERI, Daejeon (Korea, Republic of)

    2003-07-01

    Morphine and endorphin administered intracerebroventricularly (i.c.v.) produce analgesia by activating different descending pain inhibitory systems. Gamma irradiation attenuates the acute analgesic action of i.c.v. injected morphine in mice. This study was done to investigate the effect of-irradiation on the analgesia produced by i.c.v. injected morphine and endorphin in male ICR mice. In one group, mice were exposed to whole-body irradiation at a dose of 5 Gy from a {sup 60}Co source and the analgesic effects were tested 5, 30, 60, 90 and 180 min after irradiation using the acetic acid-induced writhing test. The analgesic effect was produced time-dependently and reached its maximum at 90 min after irradiation. Thus, time was fixed in the following studies. In another group, mice were irradiated with 5 Gy and tested 90 minutes later for analgesia produced by i.c.v. administration of morphine or endorphin. Irradiation significantly potentiated the analgesia produced by endorphin. However, the antinociception produced by morphine was not affected by irradiation. These results support the hypothesis that morphine and endorphin administered supraspinally produce antinocieception by different neuronal mechanisms.

  6. Side effects of pain and analgesia in animal experimentation.

    Science.gov (United States)

    Jirkof, Paulin

    2017-03-22

    This review highlights selected effects of untreated pain and of widely used analgesics such as opioids, non-steroid anti-inflammatory drugs and antipyretics, to illustrate the relevance of carefully planned, appropriate and controlled analgesia for greater reproducibility in animal experiments involving laboratory rodents.

  7. Survey of Current Practice of Labour Analgesia Among Obstetricians ...

    African Journals Online (AJOL)

    Labour pain has been described as the worst possible pain known to mankind. It is more excruciating than cancer pain, phantom pain or toothache. Failure to relieve pain of any cause has been regarded as a violation of fundamental human rights. This study aimed to evaluate the current obstetrics analgesia practice ...

  8. Effect of irradiation on analgesia induced by morphine and endorphin

    International Nuclear Information System (INIS)

    Kim, Jin Kyu; Lee, Byoung Hun; Hyun, Soung Hee; Chung, Ki Myung

    2003-01-01

    Morphine and endorphin administered intracerebroventricularly (i.c.v.) produce analgesia by activating different descending pain inhibitory systems. Gamma irradiation attenuates the acute analgesic action of i.c.v. injected morphine in mice. This study was done to investigate the effect of-irradiation on the analgesia produced by i.c.v. injected morphine and endorphin in male ICR mice. In one group, mice were exposed to whole-body irradiation at a dose of 5 Gy from a 60 Co source and the analgesic effects were tested 5, 30, 60, 90 and 180 min after irradiation using the acetic acid-induced writhing test. The analgesic effect was produced time-dependently and reached its maximum at 90 min after irradiation. Thus, time was fixed in the following studies. In another group, mice were irradiated with 5 Gy and tested 90 minutes later for analgesia produced by i.c.v. administration of morphine or endorphin. Irradiation significantly potentiated the analgesia produced by endorphin. However, the antinociception produced by morphine was not affected by irradiation. These results support the hypothesis that morphine and endorphin administered supraspinally produce antinocieception by different neuronal mechanisms

  9. How Classical Conditioning Shapes Placebo Analgesia: Hidden versus Open Conditioning.

    Science.gov (United States)

    Babel, Przemyslaw; Adamczyk, Waclaw; Swider, Karolina; Bajcar, Elzbieta A; Kicman, Pawel; Lisinska, Natalia

    2017-07-22

    To investigate the influence of expectancy of pain intensity, fear of pain (trait), and fear (state) on the effectiveness of hidden and open conditioning to produce placebo analgesia. A total of 90 healthy female volunteers were randomly assigned to three groups (hidden conditioning, open conditioning, and control) that received electrical stimuli preceded by either orange or blue lights. One color was paired with painful stimuli (control stimuli) and the other color was paired with nonpainful stimuli (conditioned stimuli) in both the hidden and open conditioning groups. Only participants in the open conditioning group were informed about this association. In the control group, both color lights were followed by control stimuli. In the testing phase, both colored lights were followed by identical control stimuli. Participants rated pain intensity, expectancy of pain intensity, fear, and fear of pain. A significant analgesic effect was found only in the hidden conditioning group, where no explicit verbal suggestions were provided. Hidden conditioning had an effect on expectancy and fear-participants in the hidden conditioning group expected less pain and experienced less fear in relation to conditioned stimuli. Fear was the only predictor of placebo analgesia in the hidden conditioning group. Neither expectancy of pain intensity nor fear of pain predicted placebo analgesia. Fear seems to be a more important factor than expectancy in producing placebo analgesia induced by hidden conditioning. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. ambulation during labor with combined spinal-epidural analgesia

    African Journals Online (AJOL)

    Adele

    risk of epidural catheter migration through the dural puncture hole; 2) the potential risk of increased drug leakage through the dural puncture hole; 3) the possibility of ... by Morgan at Queen Charlotte's Hospital in London, England. Use of the CSEA technique without the test dose for ambu- latory labor analgesia leaves the ...

  11. Southern African Journal of Anaesthesia and Analgesia - Vol 19, No ...

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia. ... Regional anaesthesia in children: an update · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT ... outcomes in anaesthesia. The relevant As: allergy, asthma airway and anaphylaxis · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  12. Analgesia and anesthesia for neonates : Study design and ethical issues

    NARCIS (Netherlands)

    Anand, KJS; Aranda, JV; Berde, CB; Buckman, S; Capparelli, EV; Carlo, WA; Hummel, P; Lantos, P; Johnston, CC; Lehr, VT; Lynn, AM; Oberlander, TF; Raju, TNK; Soriano, SG; Taddio, A; Walco, GA; Maxwell, L.G.

    Objective: The purpose of this article is to summarize the clinical, methodologic, and ethical considerations for researchers interested in designing future trials in neonatal analgesia and anesthesia, hopefully stimulating additional research in this field. Methods: The MEDLINE, PubMed, EMBASE, and

  13. Developing and Evaluating Creativity Gamification Rehabilitation System: The Application of PCA-ANFIS Based Emotions Model

    Science.gov (United States)

    Su, Chung-Ho; Cheng, Ching-Hsue

    2016-01-01

    This study aims to explore the factors in a patient's rehabilitation achievement after a total knee replacement (TKR) patient exercises, using a PCA-ANFIS emotion model-based game rehabilitation system, which combines virtual reality (VR) and motion capture technology. The researchers combine a principal component analysis (PCA) and an adaptive…

  14. The role of PCA3 in the diagnosis of prostate cancer.

    NARCIS (Netherlands)

    Hessels, D.

    2010-01-01

    Serum PSA has shown to be the most valuable tool in the detection, staging and monitoring of prostate cancer (PCa). However, the substantial overlap in serum PSA values between men with non-malignant prostatic diseases and PCa is the limitation of PSA as a prostate tumor marker. In patients with

  15. Protocatechuic acid (PCA) induced a better antiviral effect by immune enhancement in SPF chickens.

    Science.gov (United States)

    Guo, Yongxia; Zhang, Qiang; Zuo, Zonghui; Chu, Jun; Xiao, Hongzhi; Javed, M Tariq; He, Cheng

    2018-01-01

    Protocatechuic acid (PCA) is an antiviral agent against Avian Influenza virus (AIV) and Infectious Bursal Disease (IBD) virus, but its antiviral mechanism is unknown. In this study, we evaluated the humoral and cellular responses to PCA in specific pathogen-free (SPF) chickens. One hundred forty 35-day-old SPF chickens were randomly divided into 7 groups. The birds were inoculated with the commercial, attenuated Newcastle Disease Virus (NDV) vaccine and then received orally with 10, 20 or 40 mg/kg body weight of PCA for 30 days. Immune organ indexes, anti-Newcastle Disease Virus (NDV) antibodies and lymphocyte proliferation, but not body weight, were significantly increased in chicken treated with 40 mg/kg PCA, compared to the control birds treated with Astragalus polysaccharide (ASP). Survival rate was 70% and 60%, respectively, in the chickens with 40 mg/kg PCA, 20 mg/kg PCA while 50% survival was found in the birds treated with 125 mg/kg ASP. PCA treatment resulted in significantly lower viral load and reduced shedding. These results indicate that PCA may improve poultry health by enhancing both the humoral and cellular immune response. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. GO-PCA: An Unsupervised Method to Explore Gene Expression Data Using Prior Knowledge.

    Science.gov (United States)

    Wagner, Florian

    2015-01-01

    Genome-wide expression profiling is a widely used approach for characterizing heterogeneous populations of cells, tissues, biopsies, or other biological specimen. The exploratory analysis of such data typically relies on generic unsupervised methods, e.g. principal component analysis (PCA) or hierarchical clustering. However, generic methods fail to exploit prior knowledge about the molecular functions of genes. Here, I introduce GO-PCA, an unsupervised method that combines PCA with nonparametric GO enrichment analysis, in order to systematically search for sets of genes that are both strongly correlated and closely functionally related. These gene sets are then used to automatically generate expression signatures with functional labels, which collectively aim to provide a readily interpretable representation of biologically relevant similarities and differences. The robustness of the results obtained can be assessed by bootstrapping. I first applied GO-PCA to datasets containing diverse hematopoietic cell types from human and mouse, respectively. In both cases, GO-PCA generated a small number of signatures that represented the majority of lineages present, and whose labels reflected their respective biological characteristics. I then applied GO-PCA to human glioblastoma (GBM) data, and recovered signatures associated with four out of five previously defined GBM subtypes. My results demonstrate that GO-PCA is a powerful and versatile exploratory method that reduces an expression matrix containing thousands of genes to a much smaller set of interpretable signatures. In this way, GO-PCA aims to facilitate hypothesis generation, design of further analyses, and functional comparisons across datasets.

  17. k-t PCA: temporally constrained k-t BLAST reconstruction using principal component analysis

    DEFF Research Database (Denmark)

    Pedersen, Henrik; Kozerke, Sebastian; Ringgaard, Steffen

    2009-01-01

    in applications exhibiting a broad range of temporal frequencies such as free-breathing myocardial perfusion imaging. We show that temporal basis functions calculated by subjecting the training data to principal component analysis (PCA) can be used to constrain the reconstruction such that the temporal resolution...... is improved. The presented method is called k-t PCA....

  18. The relationship between Prostate CAncer gene 3 (PCA3) and prostate cancer significance

    NARCIS (Netherlands)

    van Poppel, Hein; Haese, Alexander; Graefen, Markus; de la Taille, Alexandre; Irani, Jacques; de Reijke, Theo; Remzi, Mesut; Marberger, Michael

    2012-01-01

    OBJECTIVE To evaluate the relationship between Prostate CAncer gene 3 (PCA3) and prostate cancer significance. PATIENTS AND METHODS Clinical data from two multi-centre European open-label, prospective studies evaluating the clinical utility of the PCA3 assay in guiding initial and repeat biopsy

  19. EPIDURAL ANALGESIA DURING LABOR Analgesia epidural para el trabajo de parto

    Directory of Open Access Journals (Sweden)

    Juan Carlos Zafra Pedone

    2008-12-01

    Full Text Available Introduction: The labor pain affect to all pregnant woman and it has biochemical and physiological changes that affect to mother and fetus and interact with your normal evolution. Currently there are analgesic techniques to less effectively labor pain, to provide a high satisfaction level and supply clinical and laboratory beneficial outcomes. In own context these techniques are very low used. Objective: To describe the use of epidural analgesic procedures in a pregnancy woman group during labor at the Universitarian Hospital San Jose – Popayan, Colombia. Materials and methods: Case series design. We recollected information of patients from Obstetric service during two months of 2006. The patient’s information was recollected from medical history with an instrument that content variables related with the analgesic technique and labor. The analyses were performed using descriptive statistics Results: 41 pregnant woman with a mean age of 23,4 were included. 65,9% were nulliparous and 85,4% were term pregnancy. At the moment of dural puncture the dilation and EVA pain scale mode was 6 and 8 respectively. The latency mean was 14,1 minutes. 95,1% were require a booster applied in a mean of 80 minutes and 61% were required a second booster applied in a mean of 49 min after that. The way of termination of pregnancy was vaginal predominantly. Conclusions: The results of this study are congruent to reporting in the world literature. These conclusions support the effectiveness of epidural analgesia and its favorable benefit/risk relation to the control of labor pain. Introducción: El dolor asociado con el trabajo de parto afecta a todas las pacientes e involucra alteraciones que afectan a la madre y al feto e interactúan interfiriendo con su evolución normal. Actualmente disponemos de alternativas analgésicas peridurales que han demostrado controlar en forma efectiva el dolor, proporcionar un alto grado de satisfacción de las pacientes y proveer

  20. The biological knowledge discovery by PCCF measure and PCA-F projection.

    Science.gov (United States)

    Jia, Xingang; Zhu, Guanqun; Han, Qiuhong; Lu, Zuhong

    2017-01-01

    In the process of biological knowledge discovery, PCA is commonly used to complement the clustering analysis, but PCA typically gives the poor visualizations for most gene expression data sets. Here, we propose a PCCF measure, and use PCA-F to display clusters of PCCF, where PCCF and PCA-F are modeled from the modified cumulative probabilities of genes. From the analysis of simulated and experimental data sets, we demonstrate that PCCF is more appropriate and reliable for analyzing gene expression data compared to other commonly used distances or similarity measures, and PCA-F is a good visualization technique for identifying clusters of PCCF, where we aim at such data sets that the expression values of genes are collected at different time points.

  1. Effect of epidural analgesia on labor and its outcomes

    International Nuclear Information System (INIS)

    Fawad, A.; Naz, H.; Nelofar, T.; Abbasi, A.U.N.

    2015-01-01

    Epidural analgesia is an effective and popular way to relieve labour pain but it may interfere with normal mechanism of labour. The objective of this study was to evaluate the outcome of labour in women with effective epidural analgesia in terms of duration of labour, mode of delivery and neonatal outcome. Methods: This was a quasi-experimental study conducted in the Department of Obstetrics and Gynaecology, Shaikh Zayed Federal Postgraduate Medical Institute and Hospital, Lahore. One hundred pregnant women were selected by non-probability convenient sampling method. Subjects were divided into two groups of 50 each as per convenience. Patients of any gravidity at term from 37-41 weeks were included in the sample. Epidural analgesia was applied to group B and distilled water to group A at the lumber region and the progress of labour, mode of delivery and effects on Apgar scores of neonates were evaluated. Out of hundred patients, 77 had normal duration of second stage while 23 had prolonged second stage. Among them, 18 patients (36%) were in epidural group and 5 patients (10%) in non-epidural group, while 4 patients (8%) in epidural group developed intra-partum complications; whereas among non-epidural group had such complications. 65 patients had spontaneous vaginal delivery while 35 patients had instrumental delivery. Among them 29 patients (58%) were in epidural group while only 6 patients (12%) were in non-epidural group. Babies born had Apgar score 5/10 (21.8%), 6/10 (59.4%) and 7/10 (17.8%) at 1 minute and 8/10 (74.3%) and 9/10 (24.8%) at 5 minutes in both groups and none of them needed bag and mask resuscitation. Conclusion: Epidural analgesia does prolong the duration of second stage of labour and increases the instrumental delivery rate. Neonatal outcome is satisfactory while only a few intra-partum complications are found with epidural analgesia. (author)

  2. EFFECT OF EPIDURAL ANALGESIA ON LABOR AND ITS OUTCOMES.

    Science.gov (United States)

    Anwar, Sadia; Anwar, Muhannad Waseem; Ahmad, Sajjad

    2015-01-01

    Epidural analgesia is an effective and popular way to relieve labour pain but it may interfere with normal mechanism of labour. The objective of this study was to evaluate the outcome of labour in women with effective epidural analgesia in terms of duration of labour, mode of delivery and neonatal outcome. This was a quasi-experimental study conducted in the Department of Obstetrics and Gynaecology, Shaikh Zayed Federal Postgraduate Medical Institute and Hospital, Lahore. One hundred pregnant women were selected by non-probability convenient sampling method. Subjects were divided into two groups of. 50 each as per convenience. Patients of any gravidity at term from 37-41 weeks were included in the sample. Epidural analgesia was applied to group B and distilled water to group A at the lumber region and the progress of labour, mode of delivery and effects on Apgar scores of neonates were evaluated. Out of hundred patients, 77 had normal duration of second stage while 23 had prolonged second stage. Among them, 18 patients (36%) were in epidural group and 5 patients (10%) in non-epidural group, while 4 patients (8%) in epidural group developed intra-partum complications; whereas among non-epidural group had such complications. 65 patients had spontaneous vaginal delivery while 35 patients had instrumental delivery. Among them 29 patients (58%) were in epidural group while only 6 patients (12%) were in non-epidural group. Babies born had Apgar score 5/10 (21.8%), 6/10 (59.4%) and 7/10 (17.8%) at 1 minute and 8/10 (74.3%) and 9/10 (24.8%) at 5 minutes in both groups and none of them needed bag and mask resuscitation. Epidural analgesia does prolong the duration of second stage of labour and increases the instrumental delivery rate. Neonatal outcome is satisfactory while only a few intra-partum complications are found with epidural analgesia.

  3. Effects of maternal epidural analgesia on the neonate--a prospective cohort study.

    Science.gov (United States)

    Shrestha, Bikash; Devgan, Amit; Sharma, Mukti

    2014-12-10

    Epidural analgesia is one of the most popular modes of analgesia for child birth. There are controversies regarding adverse effects and safety of epidural analgesia. This study was conducted to study the immediate effects of the maternal epidural analgesia on the neonate during early neonatal phase. A prospective cohort study of 100 neonates born to mothers administered epidural analgesia were compared with 100 neonates born to mothers not administered epidural analgesia in terms of passage of urine, initiation of breast feeding, birth asphyxia and incidence of instrumentation. There was significant difference among the two groups in the passage of urine (P value 0.002) and incidence of instrumentation (P value 0.010) but there was no significant difference in regards to initiation of breast feeding and birth asphyxia. Epidural analgesia does not have any effect on the newborns in regards to breast feeding and birth asphyxia but did have effects like delayed passage of urine and increased incidence of instrumentation.

  4. Intraoperative local infiltration analgesia for early analgesia after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Lunn, Troels H; Husted, Henrik; Solgaard, Søren

    2011-01-01

    : High-volume local infiltration analgesia (LIA) is widely applied as part of a multimodal pain management strategy in total hip arthroplasty (THA). However, methodological problems hinder the exact interpretation of previous trials, and the evidence for LIA in THA remains to be clarified. Theref...

  5. Epidural analgesia practices for labour: results of a 2005 national survey in Ireland.

    LENUS (Irish Health Repository)

    Fanning, Rebecca A

    2012-02-01

    BACKGROUND AND OBJECTIVE: The last 25 years have seen changes in the management of epidural analgesia for labour, including the advent of low-dose epidural analgesia, the development of new local anaesthetic agents, various regimes for maintaining epidural analgesia and the practice of combined spinal-epidural analgesia. We conducted a survey of Irish obstetric anaesthetists to obtain information regarding the conduct and management of obstetric epidural analgesia in Ireland in 2005. The specific objective of this survey was to discover whether new developments in obstetric anaesthesia have been incorporated into clinical practice. METHODS: A postal survey was sent to all anaesthetists with a clinical commitment for obstetric anaesthesia in the sites approved for training by the College of Anaesthetists, Ireland. RESULTS: Fifty-three per cent of anaesthetists surveyed responded. The majority of anaesthetists (98%) use low-dose epidural analgesia for the maintenance of analgesia. Only 11% use it for test-dosing and 32% for the induction of analgesia. The combined spinal-epidural analgesia method is used by 49%, but two-thirds of those who use it perform fewer than five per month. Patient-controlled epidural analgesia was in use at only one site. CONCLUSION: It appears that Irish obstetric anaesthetists have adopted the low-dose epidural analgesia trend for the maintenance of labour analgesia. This practice is not as widespread, however, for test dosing, the induction of analgesia dose or in the administration of intermittent epidural boluses to maintain analgesia when higher concentrations are used. Since its introduction in 2000, levobupivacaine has become the most popular local anaesthetic agent.

  6. [Randomized study comparing piroxicam analgesia and tramadol analgesia during outpatient electromagnetic extracorporeal lithotripsy].

    Science.gov (United States)

    Andréou, Andréas; Sibert, Louis; Montes, Ricardo; Hacpille, Lucie; Pfister, Christian; Grise, Philippe

    2006-04-01

    To analyse the efficacy of two types of analgesia protocols during outpatient electromagnetic extracorporeal lithotripsy (ESWL) with a STORZ Modulith SLX second generation lithotriptor. One hundred and seventy one patients were prospectively randomized to 2 groups. Group 1 (n-82) received 40 mg of Piroxicam IM, and group 2 (n=89) received 100 mg Tramadol IV Lithotripsy was performed in 2 sequences, T1 and T2, during which quantitative evaluation of pain (VE) was performed according to a VAS scale and qualitative evaluation of pain (QE) was performed according to the McGill questionnaire. Endpoints included the mean VE and QE pain scores at T1 and T2, the maximum power tolerated at T2, the postoperative pain at the 6th, 12th and 24th hours after ESWL, the pain score according to the power and according to the frequency and adverse effects. Comparisons were performed by analyses of variance (significant for p 0.05) and significant difference was observedfor pain with the two drugs used. Pain was more severe as frequency and power increased. Only one intervention was stopped because of pain. Data analysis suggests that tramadol induces more adverse effects. Piroxicam and tramadol are two analgesics commonly used in clinical practice and both are suitable for the treatment of pain during outpatient extracorporeal lithotripsy.

  7. Continuous versus patient-controlled epidural analgesia for labour analgesia and their effects on maternal motor function and ambulation.

    Science.gov (United States)

    Lovach-Chepujnoska, Margarita; Nojkov, Jordan; Joshevska-Jovanovska, Slagjana; Domazetov, Robert

    2014-01-01

    The advantages of patient-controlled epidural analgesia (PCEA) for delivery compared with continuous epidural analgesia (CEA) have been a point of interest in research obstetric anaesthesia for more than two decades. The aim of this single blind randomized controlled study was to evaluate the incidence of motor block and ability to perform partial knee flexion in women who received CEA or PCEA. Fifty-one healthy nulliparous women were included in this study. After an initial dose and established sensory block at Th 10, parturients were randomized into two groups: group CEA (10 ml/h), and group PCEA (bolus - 5 ml, lockout interval - 15 minutes, basal rate - 0 ml) with bupivacaine 0.08% and fentanyl 2 µg/ml. The motor function of the lower limbs was evaluated by modified Bromage scale at regular hourly intervals until full cervical dilatation. The quality of analgesia was assessed using a visual analogue pain scale (VAPS) and maternal satisfaction. Mode of delivery, the total number of additional rescue boluses, foetal and neonatal outcomes were recorded. Motor block was significantly lower in the third (33.3% vs. 4.35%; p = 0.008), fourth (57.9% vs. 6.3%; p = 0.003) and fifth hour (75.0% vs. 18.2%; p = 0.001) in the PCEA group. Ambulation occurred in 18% in the CEA and 46% in the PCEA group (p = 0.036). VAPS was with borderline significance in the second (p = 0.076) and significantly lower in the fourth hour (p = 0.034). Compared with CEA, PCEA provided less motor block and better first-stage analgesia, which leads to the conclusion that patient-controlled analgesia techniques are the preferred model in obstetric anesthesia.

  8. Effect of the CYP2D6 gene polymorphism on postoperative analgesia of tramadol in Han nationality nephrectomy patients.

    Science.gov (United States)

    Dong, Hong; Lu, Shu-Jun; Zhang, Rui; Liu, Dong-Dong; Zhang, Yan-Zhuo; Song, Chun-Yu

    2015-06-01

    Tramadol is a synthetic opioid which has analgesic efficacy in the postoperative pain. It is metabolized by polymorphic enzyme cytochrome P450 (CYP2D6). Patients with different CYP2D6 genotypes would have different responses to tramadol in pain relief. The CYP2D6*10 allele is the most common allele in a Chinese population. The aim of this study was to evaluate whether the different CYP2D6*10 genotypes have an effect on the postoperative tramadol analgesia in the Chinese population after elective nephrectomy. One hundred and twenty patients after performed elective nephrectomy were enrolled in this study after being approved by the local Ethics Committee. The patients were given patient-controlled analgesia (PCA) which included 10 mg/ml tramadol after receiving a loading dose of 100 mg tramadol and 1 mg granisetron intravenously. Blood samples were collected after induction of anesthesia. The CYP2D6*10 polymorphism was analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). According to the results, the patients were divided into three groups (CYP2D6*1/*1, n = 33; CYP2D6*1/*10, n = 28; CYP2D6*10/*10, n = 50). The total consumption of tramadol, visual analogue scale (VAS) score, and PCA control times among the three genotype groups for 2, 4, 24, 48, and 72 h after operation were compared. Nine out of 120 patients were dropped out of the study; 111 patients completed the study. The frequency of CYP2D6*10 allele was 57.7%. The demographic data among the three groups were comparable. The consumption of tramadol, patient self-control times of pump, and VAS score in CYP2D6*10/*10 group were significantly higher than that in CYP2D6*1/*1 or CYP2D6*1/*10 group at 2 and 4 h (P 0.05). There was no difference in the incidence of nausea and vomiting among the three groups (P > 0.05). No sever apnea was recorded in these groups. Different CYP2D6*10 genotypes have an influence on the analgesic effect of tramadol in Han nationality patients after

  9. GND-PCA-based statistical modeling of diaphragm motion extracted from 4D MRI.

    Science.gov (United States)

    Swastika, Windra; Masuda, Yoshitada; Xu, Rui; Kido, Shoji; Chen, Yen-Wei; Haneishi, Hideaki

    2013-01-01

    We analyzed a statistical model of diaphragm motion using regular principal component analysis (PCA) and generalized N-dimensional PCA (GND-PCA). First, we generate 4D MRI of respiratory motion from 2D MRI using an intersection profile method. We then extract semiautomatically the diaphragm boundary from the 4D-MRI to get subject-specific diaphragm motion. In order to build a general statistical model of diaphragm motion, we normalize the diaphragm motion in time and spatial domains and evaluate the diaphragm motion model of 10 healthy subjects by applying regular PCA and GND-PCA. We also validate the results using the leave-one-out method. The results show that the first three principal components of regular PCA contain more than 98% of the total variation of diaphragm motion. However, validation using leave-one-out method gives up to 5.0 mm mean of error for right diaphragm motion and 3.8 mm mean of error for left diaphragm motion. Model analysis using GND-PCA provides about 1 mm margin of error and is able to reconstruct the diaphragm model by fewer samples.

  10. The applications of PCA in QSAR studies: A case study on CCR5 antagonists.

    Science.gov (United States)

    Yoo, ChangKyoo; Shahlaei, Mohsen

    2018-01-01

    Principal component analysis (PCA), as a well-known multivariate data analysis and data reduction technique, is an important and useful algebraic tool in drug design and discovery. PCA, in a typical quantitative structure-activity relationship (QSAR) study, analyzes an original data matrix in which molecules are described by several intercorrelated quantitative dependent variables (molecular descriptors). Although extensively applied, there is disparity in the literature with respect to the applications of PCA in the QSAR studies. This study investigates the different applications of PCA in QSAR studies using a dataset including CCR5 inhibitors. The different types of preprocessing are used to compare the PCA performances. The use of PC plots in the exploratory investigation of matrix of descriptors is described. This work is also proved PCA analysis to be a powerful technique for exploring complex datasets in QSAR studies for identification of outliers. This study shows that PCA is able to easily apply to the pool of calculated structural descriptors and also the extracted information can be used to help decide upon an appropriate harder model for further analysis. © 2017 John Wiley & Sons A/S.

  11. Differential research of inflammatory and related mediators in BPH, histological prostatitis and PCa.

    Science.gov (United States)

    Huang, T R; Wang, G C; Zhang, H M; Peng, B

    2018-02-14

    Prostate cancer (PCa) is one of the most common male malignancies in the world. It was aimed to investigate differential expression of inflammatory and related factors in benign prostatic hyperplasia (BPH), prostate cancer (PCa), histological prostatitis (HP) and explore the role of Inducible nitric oxide synthase (iNOS), (VEGF) Vascular endothelial growth factor, androgen receptor (AR) and IL-2, IL-8 and TNF-α in the occurrence and development of prostate cancer. RT-PCR was used to detect the mRNA expression level of iNOS, VEGF, AR and IL-2, IL-8 and TNF-α in BPH, PCa and BPH+HP. Western blotting and immunohistochemical staining were used to detect the protein levels of various proteins in three diseases. The results showed the mRNA and protein levels of iNOS, VEGF and IL-2, IL-8 and TNF-α were significantly increased in PCa and BPH+HP groups compared with BPH group (p PCa and BPH+HP groups (p PCa and BPH+HP groups (p > .05). iNOS, VEGF, AR and IL-2, IL-8 and TNF-α are involved in the malignant transformation of prostate tissue and play an important role in the development and progression of Prostate cancer (PCa). © 2018 Blackwell Verlag GmbH.

  12. An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery

    Directory of Open Access Journals (Sweden)

    Chuang CC

    2017-04-01

    Full Text Available Chia-Chun Chuang,1 Chien-Ching Lee,1,2 Li-Kai Wang,1 Bor-Shyh Lin,2 Wen-Ju Wu,1 Chung-Han Ho,3 Jen-Yin Chen1,4 1Department of Anesthesiology, Chi Mei Medical Center, 2Department of Imaging and Biomedical Photonics, National Chiao Tung University, 3Department of Medical Research, Chi Mei Medical Center, 4Department of the Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, Republic of China Purpose: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit into standard operating procedure (SOP in acute pain service (APS improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA.Patients and methods: This was a nonrandomized before–after study. Adult patients (aged between 20 and 80 years who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients’ characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0–10. A score of NRS ≥4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent. Patients were separated into “before” and “after” CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA.Results: The response rate was 55.3%, with 187 usable questionnaires. CICARE

  13. Distinct clinical and metabolic deficits in PCA and AD are not related to amyloid distribution.

    Science.gov (United States)

    Rosenbloom, M H; Alkalay, A; Agarwal, N; Baker, S L; O'Neil, J P; Janabi, M; Yen, I V; Growdon, M; Jang, J; Madison, C; Mormino, E C; Rosen, H J; Gorno-Tempini, M L; Weiner, M W; Miller, B L; Jagust, W J; Rabinovici, G D

    2011-05-24

    Patients with posterior cortical atrophy (PCA) often have Alzheimer disease (AD) at autopsy, yet are cognitively and anatomically distinct from patients with clinical AD. We sought to compare the distribution of β-amyloid and glucose metabolism in PCA and AD in vivo using Pittsburgh compound B (PiB) and FDG-PET. Patients with PCA (n = 12, age 57.5 ± 7.4, Mini-Mental State Examination [MMSE] 22.2 ± 5.1), AD (n = 14, age 58.8 ± 9.6, MMSE 23.8 ± 6.7), and cognitively normal controls (NC, n = 30, age 73.6 ± 6.4) underwent PiB and FDG-PET. Group differences in PiB distribution volume ratios (DVR, cerebellar reference) and FDG uptake (pons-averaged) were assessed on a voxel-wise basis and by comparing binding in regions of interest (ROIs). Compared to NC, both patients with AD and patients with PCA showed diffuse PiB uptake throughout frontal, temporoparietal, and occipital cortex (p PCA and AD even after correcting for atrophy. FDG patterns in PCA and AD were distinct: while both groups showed hypometabolism compared to NC in temporoparietal cortex and precuneus/posterior cingulate, patients with PCA further showed hypometabolism in inferior occipitotemporal cortex compared to both NC and patients with AD (p PCA. Fibrillar amyloid deposition in PCA is diffuse and similar to AD, while glucose hypometabolism extends more posteriorly into occipital cortex. Further studies are needed to determine the mechanisms of selective network degeneration in focal variants of AD.

  14. Can we use PCA to detect small signals in noisy data?

    Science.gov (United States)

    Spiegelberg, Jakob; Rusz, Ján

    2017-01-01

    Principal component analysis (PCA) is among the most commonly applied dimension reduction techniques suitable to denoise data. Focusing on its limitations to detect low variance signals in noisy data, we discuss how statistical and systematical errors occur in PCA reconstructed data as a function of the size of the data set, which extends the work of Lichtert and Verbeeck, (2013) [16]. Particular attention is directed towards the estimation of bias introduced by PCA and its influence on experiment design. Aiming at the denoising of large matrices, nullspace based denoising (NBD) is introduced. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Improved swelling resistance for PCA austenitic stainless steel under HFIR irradiation through microstructural control

    International Nuclear Information System (INIS)

    Maziasz, P.J.; Braski, D.N.

    1984-01-01

    Swelling evaluation of PCA variants and 20%-cold-worked (N-Lot) type 316 stainless steel (CW 316) at 300 to 600 0 C was extended to 44 dpa. Swelling was negligible in all the steels at 300 0 C after approx. 44 dpa. At 500 to 600 0 C 25%-cold-worked PCA showed better void swelling resistance than type 316 at approx. 44 dpa. There was less swelling variation among alloys at 400 0 C, but again 25%-cold-worked PCA was the best

  16. Effects of epidural analgesia on labor length, instrumental delivery, and neonatal short-term outcome.

    Science.gov (United States)

    Hasegawa, Junichi; Farina, Antonio; Turchi, Giovanni; Hasegawa, Yuko; Zanello, Margherita; Baroncini, Simonetta

    2013-02-01

    We aimed to clarify whether the short-term adverse neonatal outcomes associated with epidural analgesia are due to the epidural analgesia itself or to the instrumental delivery. A retrospective case-control study was conducted to evaluate the relationship between epidural analgesia, labor length, and perinatal outcomes. A total of 350 pregnant women at term who delivered under epidural analgesia (cases) were compared with 1400 patients without epidural analgesia (controls). Vacuum extraction (6.5 vs. 2.9 %) and cesarean section (19.9 vs. 11.1 %) were more frequently performed in the cases than controls (p neonatal variables stratified by mode of delivery were not different in cases and controls, except for a slightly lower umbilical arterial pH in spontaneous delivery for the cases group. However, the Apgar scores and umbilical arterial pH were significantly lower in the neonates delivered by vacuum extraction compared with those in the neonates delivered by spontaneous delivery or cesarean section, regardless of whether epidural analgesia was performed. A multivariable analysis showed that vacuum extraction much more consistently affected the arterial pH than the analgesia itself (the β coefficients were -0.036 for epidural analgesia vs. -0.050 for vacuum extraction). Epidural analgesia was associated with slowly progressing labor, thus resulting in an increased rate of instrumental delivery. This instrumental delivery appears to adversely affect the neonatal outcomes more strongly than the analgesia itself.

  17. Fatores relacionados ao uso de analgesia sistêmica em neonatologia Factors related to use of systemic analgesia in neonatology

    Directory of Open Access Journals (Sweden)

    Carmen Lúcia Guimarães de Aymar

    2008-12-01

    Full Text Available O objetivo desse trabalho foi realizar uma revisão da literatura sobre o histórico e o estágio atual de conhecimento sobre a analgesia sistêmica em neonatologia e os fatores que influenciam a sua utilização. Foi realizada busca de artigos científicos através das bases dados do MEDLINE, SciELO e LILACS com as palavras chave: analgesia, analgésicos sistêmicos, dor, neonatologia, recém-nascido, unidade de terapia intensiva e unidade de terapia intensiva neonatal, além de pesquisa adicional em bancos de dados de dissertações, teses e livros texto. A literatura consultada revela que a analgesia não é uma prática rotineira nas unidades de terapia intensiva neonatal, de uma forma geral, apesar dos inúmeros estudos demonstrando a importância do tema. Apesar de ser o alívio da dor um dos princípios básicos da medicina, de envolver questões éticas e humanitárias, e de estarem disponíveis atualmente vários guias práticos e consensos a respeito do manejo da dor no neonato de risco, os resultados encontrados no presente estudo estão muito aquém das recomendações atuais, tornando-se necessária uma intervenção urgente para reverter a situação observada.The purpose of this paper was to carry out a review of literature on the history and current stage of the knowledge of systemic analgesia in neonatology and the factors influencing its use. A search for scientific articles was made in the MEDLINE, SciELO and LILACS databases using the keywords: analgesia, systemic analgesics, pain, neonatology, newborn, intensive care units and neonatal intensive care units. Additional research was made on dissertations and thesis databanks as well as text books. Literature consulted disclosed that, in general, analgesia is not a routine practice in neonatal intensive care units, despite the numerous studies demonstrating its importance. Although pain relief is a basic principle of medicine, involving ethic and humanitarian issues and despite

  18. Ropivacaine pharmacokinetics after local infiltration analgesia in hip arthroplasty.

    Science.gov (United States)

    Affas, Fatin; Eksborg, Staffan; Wretenberg, Per; Olofsson, Christina; Stiller, Carl-Olav

    2014-10-01

    In this study, we determined the plasma concentration of ropivacaine by liquid chromatography-mass spectrometry for 30 hours after local infiltration analgesia in 15 patients with elective hip arthroplasty. The 95% upper prediction bound of maximal unbound plasma concentration of ropivacaine was 0.032 mg/L. Side effects sufficient to stop an IV infusion have been reported at arterial concentrations of 0.34 to 0.85 mg/L. Alpha-1-acid glycoprotein did not correlate with the fraction of unbound ropivacaine during the first 24 hours after local infiltration analgesia. No signs or symptoms of systemic local anesthetic toxicity were observed. The Clopper-Pearson 95% upper confidence limit for adverse signs was 0.218.

  19. How first time mothers experience the use of epidural analgesia

    DEFF Research Database (Denmark)

    Jepsen, Ingrid

    2010-01-01

    How first time mothers experience the use of epidural analgesia during birth Ingrid Jepsen, Midwife, SD, MPH, Kurt Dauer Keller cand.psych, PhD Contact email irj@ucn.dk Aim: to investigate the experiences of epidural analgesia as to the choice of epidurals, the changes in pain, the period from....... The analyses are also judged to be reliable. The women in the study are not representative of all women who use epidurals, but it was possible to draw out several common experiences. The possibility of generalizing the results is depending on the context, including the contents of the medication and how...... midwives handle the epidurals. Conclusion: In particular, the use of an epidural does not diminish the need for an individual approach. The woman’s level of consciousness and the entire situation makes her very sensitive to the midwives care....

  20. Acupuncture Anesthesia and Analgesia for Clinical Acute Pain in Japan

    Directory of Open Access Journals (Sweden)

    Reina Taguchi

    2008-01-01

    Full Text Available Acupuncture anesthesia has been practiced in China since about 1960. In Japan, Hyodo reported 30 cases of acupuncture anesthesia in 1972. However, from around 1980, the direction of acupuncture investigations turned from anesthesia to analgesia. Acupuncture analgesia is presently considered a way to activate the body's endogenous analgesic system. Recently, with the rise of acupuncture as one of the most well known CAM therapies, acupuncture or moxibustion treatment has been reported for both acute and chronic pain. Even so, few clinical reports and original articles have been reported in Japan. This review illustrates how acupuncture is being used in Japan for acute pain such as surgical operations, post- operative pain (POP, neuropathic pain, pain associated with teeth extractions and after the extraction of impacted wisdom teeth.

  1. [Obstetric analgesia and anesthesia in Switzerland in 1999].

    Science.gov (United States)

    Zwetsch-Rast, G; Schneider, M C; Siegemund, M

    2002-02-01

    This survey investigated the common practice of obstetric analgesia and anaesthesia in Swiss hospitals and evaluated the influence of the Swiss interest group for obstetric anaesthesia. In March 1999 we submitted 145 questionnaires to all Swiss hospitals providing an obstetric service. The rate of epidural analgesia (EA) was higher in large hospitals (> 1,000 births/year) than in small services. EA was maintained by continuous infusion techniques in 53% of the responding hospitals. For elective caesarean section, spinal anaesthesia (SA) and EA were performed in 77% and 16% of the patients, respectively. General anaesthesia (5%) was only used in small hospitals (interest group for obstetric anaesthesia, as well as the expectations of pregnant women, increased the numbers of regional anaesthesia compared with the first survey in 1992.

  2. Endorphin release: a possible mechanism of acupuncture analgesia.

    Science.gov (United States)

    Peng, C H; Yang, M M; Kok, S H; Woo, Y K

    1978-01-01

    The action of acupuncture stimulation on analgesia has been investigated. The brain and serum extracts of acupunctured rabbits injected into rabbits produced a marked analgesic effect on the recipient, as shown by a great increase of their pain threshold. This effect is counteracted by a specific opiate anatagonist, naloxone. The data suggest that the release of the endogenous substances with morphine-like biological properties, endorphins, is increased by acupuncture stimulation, thus inhibiting pain perception.

  3. Analgesia in Patients with Trauma in Emergency Medicine.

    Science.gov (United States)

    Häske, David; Böttiger, Bernd W; Bouillon, Bertil; Fischer, Matthias; Gaier, Gernot; Gliwitzky, Bernhard; Helm, Matthias; Hilbert-Carius, Peter; Hossfeld, Björn; Meisner, Christoph; Schempf, Benjamin; Wafaisade, Arasch; Bernhard, Michael

    2017-11-17

    Suitable analgesic drugs and techniques are needed for the acute care of the approximately 18 200-18 400 seriously injured patients in Germany each year. This systematic review and meta-analysis of analgesia in trauma patients was carried out on the basis of randomized, controlled trials and observational studies. A systematic search of the literature over the 10-year period ending in February 2016 was carried out in the PubMed, Google Scholar, and Springer Link Library databases. Some of the considered trials and studies were included in a meta-analysis. Mean differences (MD) of pain reduction or pain outcome as measured on the Numeric Rating Scale were taken as a summarizing measure of treatment efficacy. Out of 685 studies, 41 studies were considered and 10 studies were included in the meta-analysis. Among the drugs and drug combinations studied, none was clearly superior to another with respect to pain relief. Neither fentanyl versus morphine (MD -0.10 with a 95% confidence interval of [-0.58; 0.39], p = 0.70) nor ketamine versus morphine (MD -1.27 [-3.71; 1.16], p = 0.31), or the combination of ketamine and morphine versus morphine alone (MD -1.23 [-2.29; -0.18], p = 0.02) showed clear superiority regarding analgesia. Ketamine, fentanyl, and morphine are suitable for analgesia in spontaneously breathing trauma patients. Fentanyl and ketamine have a rapid onset of action and a strong analgesic effect. Our quantitative meta-analysis revealed no evidence for the superiority of any of the three substances over the others. Suitable monitoring equipment, and expertise in emergency procedures are prerequisites for safe and effective analgesia by healthcare professionals..

  4. Diclofenac and metamizol in postoperative analgesia in plastic surgery.

    Science.gov (United States)

    Saray, A; Büyükkocak, U; Cinel, I; Tellioglu, A T; Oral, U

    2001-01-01

    Postoperative pain relief after major surgery cannot be achieved with opioids alone in all patients without respiratory depression or other significant drawbacks. Modern medical practice, therefore, dictates the use of alternative analgesic agents as an adjunct or substitute to minimize the deleterious effects and to facilitate an earlier return to work and daily activities. Diclofenac and metamizol inhibit prostaglandin synthesis, thus attenuate the peripheral nociceptive sensitization caused by the surgical trauma. This investigation was conducted to determine the potency of diclofenac compared with metamizol in the control of postoperative pain after various plastic surgical operations under general anesthesia. A multiple-dose, randomized, double-blind clinical trial composed of one hundred and sixty-six patients was conducted. Group M patients received 1 g intramuscular metamizol (every 8 hours) and Group D patients received 75 mg intramuscular diclofenac (every 12 hours). Additional analgesia requirements were recorded and meperidine was used as the complementary analgesic when needed. Pain was assessed by visual analogue scores. Platelet count and bleeding time analyses were performed preoperatively and on the first postoperative day. Metamizol decreased the additional analgesia requirement during the 18 hours following surgery. This was also associated with significantly lower pain scores. There was no significant difference between the patients receiving either metamizol or diclofenac in terms of pain scores, additional request for analgesia and frequency of side effects from the 18th until the 48th hour postoperatively. However, the use of diclofenac was associated with reduced side effects, though a reduction in platelet number and prolongation of bleeding time was noted in the majority of the patients receiving diclofenac. Metamizol is significantly superior to diclofenac for the reduction of postoperative pain after plastic surgery in the first 18 hours

  5. Intrapartum analgesia as a condition of human satisfaction at hospital

    Directory of Open Access Journals (Sweden)

    Concetta Polizzi

    2013-06-01

    Full Text Available The study investigates parturients’ satisfaction with intrapartum analgesia. It aims to assess their opinions about hospital and health staff involved in delivery, besides investigating emotional control, locus control and bond between mothers and their newborn infants. A multidimensional approach has been used to investigate the variable of woman as a person, the variable of context and the variable of bond with the newborn infant. The study was conducted according to a quasi-experimental design, with a control group. The study was performed within the Analgesia and Intensive Care Operational Unit of the Maternal-Infant Department of the P. Giaccone University General Hospital of Palermo. It involved 60 women subdivided into two groups of 30 women each, the experimental group (women who requested intrapartum analgesia called the A group, and the control group (women who refused it called the B group. The following tools were administered: the STAI-Y (State-Trait Anxiety Inventory, form Y scale; the Depression Questionnaire of CBA (Cognitive Behavioural Assessment scale; the Locus of Control questionnaire; and an interview designed for the purpose. The experimental A group women exhibited lower levels of state anxiety and depression post-partum than those of the control B group; moreover, the women in the A group exhibited higher levels of external locus of control and evaluated delivery more positively than those of the B group. There were no significant differences with regard to the relationship with their newborn infants. The study shows that intrapartum analgesia provides hospitals with the possibility to satisfy women’s needs for safety and well-being.

  6. Using a cross-model loadings plot to identify protein spots causing 2-DE gels to become outliers in PCA

    DEFF Research Database (Denmark)

    Kristiansen, Luise Cederkvist; Jacobsen, Susanne; Jessen, Flemming

    2010-01-01

    The multivariate method PCA is an exploratory tool often used to get an overview of multivariate data, such as the quantified spot volumes of digitized 2-DE gels. PCA can reveal hidden structures present in the data, and thus enables identification of potential outliers and clustering. Based on PCA...

  7. Intrapartum epidural analgesia and breastfeeding: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Simpson Judy M

    2006-12-01

    Full Text Available Abstract Background Anecdotal reports suggest that the addition of fentanyl (an opioid to epidural analgesia for women during childbirth results in difficulty establishing breastfeeding. The aim of this paper is to determine any association between epidural analgesia and 1 breastfeeding in the first week postpartum and 2 breastfeeding cessation during the first 24 weeks postpartum. Methods A prospective cohort study of 1280 women aged ≥ 16 years, who gave birth to a single live infant in the Australian Capital Territory in 1997 was conducted. Women completed questionnaires at weeks 1, 8, 16 and 24 postpartum. Breastfeeding information was collected in each of the four surveys and women were categorised as either fully breastfeeding, partially breastfeeding or not breastfeeding at all. Women who had stopped breastfeeding since the previous survey were asked when they stopped. Results In the first week postpartum, 93% of women were either fully or partially breastfeeding their baby and 60% were continuing to breastfeed at 24 weeks. Intrapartum analgesia and type of birth were associated with partial breastfeeding and breastfeeding difficulties in the first postpartum week (p Conclusion Women in this cohort who had epidurals were less likely to fully breastfeed their infant in the few days after birth and more likely to stop breastfeeding in the first 24 weeks. Although this relationship may not be causal, it is important that women at higher risk of breastfeeding cessation are provided with adequate breastfeeding assistance and support.

  8. [Sedation and analgesia practices among Spanish neonatal intensive care units].

    Science.gov (United States)

    Avila-Alvarez, A; Carbajal, R; Courtois, E; Pertega-Diaz, S; Muñiz-Garcia, J; Anand, K J S

    2015-08-01

    Pain management and sedation is a priority in neonatal intensive care units. A study was designed with the aim of determining current clinical practice as regards sedation and analgesia in neonatal intensive care units in Spain, as well as to identify factors associated with the use of sedative and analgesic drugs. A multicenter, observational, longitudinal and prospective study. Thirty neonatal units participated and included 468 neonates. Of these, 198 (42,3%) received sedatives or analgesics. A total of 19 different drugs were used during the study period, and the most used was fentanyl. Only fentanyl, midazolam, morphine and paracetamol were used in at least 20% of the neonates who received sedatives and/or analgesics. In infusions, 14 different drug prescriptions were used, with the most frequent being fentanyl and the combination of fentanyl and midazolam. The variables associated with receiving sedation and/or analgesia were, to have required invasive ventilation (P3 (P=.023; OR=2.26), the existence of pain evaluation guides in the unit (Pneonates admitted to intensive care units receive sedatives or analgesics. There is significant variation between Spanish neonatal units as regards sedation and analgesia prescribing. Our results provide evidence on the "state of the art", and could serve as the basis of preparing clinical practice guidelines at a national level. Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  9. Perinatal and neonatal use of sedation and analgesia.

    Science.gov (United States)

    McPherson, Christopher; Inder, Terrie

    2017-10-01

    Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus. Although experimental data raise concerns, human data are reassuring and future research may focus on neuroprotective adjuncts in the setting of repeated or prolonged anesthetic exposures. Opioid analgesia is standard of care for preterm infants undergoing major procedures including invasive surgery and endotracheal intubation. The use of opioids for agitation resulting from mechanical ventilation is controversial, but prevalent. Randomized and retrospective studies detect short-term toxicity with inconclusive long-term impact, suggesting the need to explore alternative therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Lactate Oxidation Coupled to Iron or Electrode Reduction by Geobacter sulfurreducens PCA

    KAUST Repository

    Call, D. F.

    2011-10-14

    Geobacter sulfurreducens PCA completely oxidized lactate and reduced iron or an electrode, producing pyruvate and acetate intermediates. Compared to the current produced by Shewanella oneidensis MR-1, G. sulfurreducens PCA produced 10-times-higher current levels in lactate-fed microbial electrolysis cells. The kinetic and comparative analyses reported here suggest a prominent role of G. sulfurreducens strains in metaland electrode-reducing communities supplied with lactate. © 2011, American Society for Microbiology.

  11. Faults detection approach using PCA and SOM algorithm in PMSG-WT system

    Directory of Open Access Journals (Sweden)

    Mohamed Lamine FADDA

    2016-07-01

    Full Text Available In this paper, a new approach for faults detection in observable data system wind turbine - permanent magnet synchronous generator (WT-PMSG, the studying objective, illustrate the combination (SOM-PCA to build Multi-local-PCA models faults detection in system (WT-PMSG, the performance of the method suggested to faults detection in system data, finding good results in simulation experiment.

  12. Is urinary drainage necessary during continuous epidural analgesia after colonic resection?

    DEFF Research Database (Denmark)

    Basse, L; Werner, M; Kehlet, H

    2000-01-01

    . METHODS: This is a prospective, uncontrolled study with well-defined general anesthesia, postoperative analgesia, and nursing care programs in patients with a planned 2-day hospital stay, urinary catheter removal on the first postoperative morning, and epidural catheter removal on the second postoperative......BACKGROUND AND OBJECTIVES: Postoperative urinary retention may occur in between 10% and 60% of patients after major surgery. Continuous lumbar epidural analgesia, in contrast to thoracic epidural analgesia, may inhibit urinary bladder function. Postoperative urinary drainage has been common...... in patients with continuous epidural analgesia, despite the lack of scientific evidence for its indication after thoracic epidural analgesia. This study describes 100 patients who underwent elective colonic resection with 48 hours of continuous thoracic epidural analgesia and only 24 hours of urinary drainage...

  13. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia

    DEFF Research Database (Denmark)

    Joshi, G.P.; Bonnet, F.; Shah, R.

    2008-01-01

    BACKGROUND: Thoracotomy induces severe postoperative pain and impairment of pulmonary function, and therefore regional analgesia has been intensively studied in this procedure. Thoracic epidural analgesia is commonly considered the "gold standard" in this setting; however, evaluation...... techniques, compared to each other and to systemic opioid analgesia, in adult thoracotomy. Postoperative pain, analgesic use, and complications were analyzed. RESULTS: Continuous paravertebral block was as effective as thoracic epidural analgesia with local anesthetic (LA) but was associated with a reduced......; interpleural analgesia was inadequate. CONCLUSIONS: Either thoracic epidural analgesia with LA plus opioid or continuous paravertebral block with LA can be recommended. Where these techniques are not possible, or are contraindicated, intrathecal opioid or intercostal nerve block are recommended despite...

  14. A systematic review of randomized trials evaluating regional techniques for postthoracotomy analgesia

    DEFF Research Database (Denmark)

    Joshi, G.P.; Bonnet, F.; Shah, R.

    2008-01-01

    of the evidence is needed to assess the comparative benefits of alternative techniques, guide clinical practice and identify areas requiring further research. METHODS: In this systematic review of randomized trials we evaluated thoracic epidural, paravertebral, intrathecal, intercostal, and interpleural analgesic...... techniques, compared to each other and to systemic opioid analgesia, in adult thoracotomy. Postoperative pain, analgesic use, and complications were analyzed. RESULTS: Continuous paravertebral block was as effective as thoracic epidural analgesia with local anesthetic (LA) but was associated with a reduced...... incidence of hypotension. Paravertebral block reduced the incidence of pulmonary complications compared with systemic analgesia, whereas thoracic epidural analgesia did not. Thoracic epidural analgesia was superior to intrathecal and intercostal techniques, although these were superior to systemic analgesia...

  15. "Perdeu a veia": significados da prática da terapia intravenosa na unidade de terapia intensiva neonatal "The vein is missed": meanings of intravenous therapy practice in Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Elisa da Conceição Rodrigues

    2012-04-01

    Full Text Available A terapia intravenosa (TIV destaca-se entre as tecnologias imprescindíveis para garantir a sobrevivência dos recém-nascidos de risco. Contudo, é fonte de dor, estresse e complicações graves. O objeto de estudo foram os significados da prática da terapia intravenosa na unidade de terapia intensiva neonatal (UTIN, mais especificamente: analisar os significados atribuídos à prática da TIV pela equipe e discutir como esses significados refletem no cuidado do recém-nascido. Trata-se de um estudo de caso etnográfico com referencial teórico da antropologia cultural, realizado em uma UTIN pública do município do Rio de Janeiro. Os sujeitos foram nove enfermeiros, quatro médicos, três técnicos e quatro auxiliares de enfermagem. Os dados foram coletados através de entrevista semiestruturada e observação participante. A análise qualitativa das entrevistas foi realizada utilizando-se o método da interpretação dos sentidos. Os significados, quando entrelaçados na "teia cultural", revelaram que a prática da TIV é reduzida a técnicas de punção venosa periférica, acarretando sérios agravos para os recém-nascidos e desgaste emocional para a equipe e a família. A ressignificação da prática da terapia intravenosa será possível a partir da reflexão crítica dos padrões culturais nos quais ela se estrutura.Intravenous Therapy (IVT is an important item among the necessary technologies for the survival of high-risk new-born babies. However, it is also a source of pain, stress and risk of serious complications. This article aims to assess the meanings of IVT as ascribed by care teams and to discuss the reflection of such meanings on the attention to new-born babies. The article, with a theoretical referential in Cultural Anthropology, presents an ethnographic case study carried out in a Neonatal Intensive Care Unit of municipal administration in Rio de Janeiro. Subjects were nine nurses, four doctors, and three nurse assistants

  16. Patient Controlled Epidural Analgesia during Labour: Effect of Addition of Background Infusion on Quality of Analgesia & Maternal Satisfaction

    Directory of Open Access Journals (Sweden)

    Uma Srivastava

    2009-01-01

    Full Text Available Patient controlled epidural analgesia (PCEA is a well established technique for pain relief during labor. But the inclusion of continuous background infusion to PCEA is controversial. The aim of this study was to assess whether the use of continuous infusion along with PCEA was beneficial for laboring women with regards to quality of analgesia, maternal satisfaction and neonatal outcome in comparison to PCEA alone. Fifty five parturients received epidural bolus of 10ml solution containing 0.125% bupivacaine +2 ìg.ml-1 of fentanyl. For maintenance of analgesia the patients of Group PCEA self administered 8 ml bolus with lockout interval of 20 minutes of above solution on demand with no basal infusion. While the patients of Group PCEA + CI received continuous epidural infusion at the rate of 10 ml.hr-1 along with self administered boluses of 3 ml with lockout interval of 10 minutes of similar epidural solution. Patients of both groups were given rescue boluses by the anaesthetists for distressing pain. Verbal analogue pain scores, incidence of distressing pain, need of supplementary/rescue boluses, dose of bupivacaine consumed, maternal satisfaction and neonatal Apgar scores were recorded. No significant difference was observed between mean VAS pain scores during labor, maternal satisfaction, mode of delivery or neonatal Apgar scores. But more patients (n=8 required rescue boluses in PCEA group for distressing pain. The total volume consumed of bupivacaine and opioid was slightly more in PCEA + CI group. In both the techniques the highest sensory level, degree of motor block were comparable& prolongation of labor was not seen. It was concluded that both the techniques provided equivalent labor analgesia, maternal satisfaction and neonatal Apgar scores. PCEA along with continuous infusion at the rate of 10 ml/ hr resulted in lesser incidence of distressing pain and need for rescue analgesic. Although this group consumed higher dose of bupivacaine

  17. Lateral supraorbital approach to ipsilateral PCA-P1 and ICA-PCoA aneurysms.

    Science.gov (United States)

    Goehre, Felix; Jahromi, Behnam Rezai; Elsharkawy, Ahmed; Lehto, Hanna; Shekhtman, Oleg; Andrade-Barazarte, Hugo; Munoz, Francisco; Hijazy, Ferzat; Makhkamov, Makhkam; Hernesniemi, Juha

    2015-01-01

    Aneurysms of the posterior cerebral artery (PCA) are rare and often associated with anterior circulation aneurysms. The lateral supraorbital approach allows for a very fast and safe approach to the ipsilateral lesions Circle of Willis. A technical note on the successful clip occlusion of two aneurysms in the anterior and posterior Circle of Willis via this less invasive approach has not been published before. The objective of this technical note is to describe the simultaneous microsurgical clip occlusion of an ipsilateral PCA-P1 and an internal carotid artery - posterior communicating artery (ICA-PCoA) aneurysm via the lateral supraorbital approach. The authors present a technical report of successful clip occlusions of ipsilateral located PCA-P1 and ICA-PCoA aneurysms. A 59-year-old female patient was diagnosed with a PCA-P1 and an ipsilateral ICA-PCoA aneurysm by computed tomography angiography (CTA) after an ischemic stroke secondary to a contralateral ICA dissection. The patient underwent microsurgical clipping after a lateral supraorbital craniotomy. The intraoperative indocyanine green (ICG) videoangiography and the postoperative CTA showed a complete occlusion of both aneurysms; the parent vessels (ICA and PCA) were patent. The patient presents postoperative no new neurologic deficit. The lateral supraorbital approach is suitable for the simultaneous microsurgical treatment of proximal anterior circulation and ipsilateral proximal PCA aneurysms. Compared to endovascular treatment, direct visual control of brainstem perforators is possible.

  18. Optimization Methods to Minimize Emergence Time While Maintaining Adequate Post-Operative Analgesia

    OpenAIRE

    Tams, Carl; Syroid, Noah; Johnson, Ken B.; Egan, Talmage D.; Westenskow, Dwayne

    2011-01-01

    A rapid emergence from anesthesia combined with an extended duration of adequate analgesia is desired. Difficulties arise when trying to achieve a rapid emergence and provide adequate analgesia for procedures associated with moderate post operative pain. We propose to use pharmacokinetic (PK) and pharmacodynamic (PD) models with optimization techniques to determine anesthetic drugs ratios to improve post-anesthetic outcomes of emergence and analgesia. We hypothesize that optimized propofol, r...

  19. Stereotactic core biopsy of an impalpable screen-detected breast lesion using acupuncture-analgesia

    OpenAIRE

    English, R E; Chen, J H

    2010-01-01

    Chinese acupuncture-analgesia is used for pain management during various surgical procedures. Over the past 40 years this approach has been introduced in many countries and has been particularly helpful in the investigation and treatment of patients who are unable to tolerate conventional analgesia. We report here the case of a woman with a 17-year history of myalgic encephalitis who underwent a stereotactic core biopsy of the breast under acupuncture-analgesia. A planning session was needed ...

  20. Bilateral Heel Numbness due to External Compression during Obstetric Epidural Analgesia

    Directory of Open Access Journals (Sweden)

    Vivian P. Kamphuis

    2015-01-01

    Full Text Available We describe the case of a 32-year-old woman who developed bilateral heel numbness after obstetric epidural analgesia. We diagnosed her with bilateral neuropathy of the medial calcaneal nerve, most likely due to longstanding pressure on both heels. Risk factors for the development of this neuropathy were prolonged labour with spinal analgesia and a continuation of analgesia during episiotomy. Padded footrests decrease pressure and can possibly prevent this neuropathy.

  1. Os níveis plasmáticos, farmacocinética e regime de dosagem de gatifloxacina administrado por via intravenosa em bezerros búfalos (Bubalus bubalis na administração concomitante com meloxicam

    Directory of Open Access Journals (Sweden)

    Vinod Kumar Dumka

    2010-12-01

    Full Text Available Investigou-se a farmacocinética da gatifloxacina, administrada por via intravenosa, concomitante à aplicação de meloxicam em bezerros búfalos. O meloxicam foi administrado por via subcutânea (0,5 mg.kg-1, imediatamente seguido pela administração intravenosa de gatifloxacina (4 mg.kg-1. A concentração plasmática de gatifloxacina foi estimada por ensaio microbiológico. Os parâmetros farmacocinéticos foram calculados e a posologia adequada foi computada. A concentração plasmática do fármaco-terapêutico foi mantida por 12 h. A gatifloxacina foi rapidamente distribuída a partir de sangue para o compartimento de tecido, o que ficou evidente a partir dos valores elevados da taxa constante de distribuição, α1 (11.9 ± 0.52 h-1 e a proporção de velocidade constante de transferência de droga a partir de centrais para os compartimentos periféricos e vice-versa, K12/K21 (3.05 ± 0.36 e K13/K31 (2.04 ± 0.12. A área sob a curva plasmática de concentração-tempo da droga e o volume aparente de distribuição foi de 12.0 ± 0.68 µg.ml-1.h e 2.69 ± 0.14 L.kg-1, respectivamente. A meia-vida (t1/2β, a depuração corporal total (ClB e relação da droga presente no sangue periférico para o compartimento central (P/C foram 5.59 ± 0.40 h, 337.6 ± 19.9 ml.kg-1.h-1 e 8.04 ± 0.50, respectivamente. O presente estudo revelou que o regime de dosagem mais adequado de gatifloxacina quando administrada concomitantemente com meloxicam em bezerros búfalos seria 2,5 mg.kg-1 seguida de 2,0 mg.kg-1 em intervalos de 12 h.

  2. Administração de clonidina intravenosa e sua capacidade de reduzir a pressão da artéria pulmonar em pacientes submetidos a cirurgia cardíaca

    Directory of Open Access Journals (Sweden)

    Benedito Barbosa João

    2014-01-01

    Full Text Available Objetivo: Avaliar a capacidade da clonidina de reduzir a pressão arterial pulmonar de pacientes com hipertensão pulmonar, submetidos a cirurgia cardíaca, seja pela diminuição dos valores pressóricos a partir da aferição direta da pressão de artéria pulmonar, seja pela redução ouabolição da necessidade de dobutamina e nitroprussiato de sódio no intraoperatório. Método: Trata-se de estudo controlado, comparativo, randomizado e duplamente encoberto feito com 30 pacientes portadores de hipertensão arterial pulmonar tipo 2, submetidos a cirurgia cardíaca. Avaliaram-se a pressão média de artéria pulmonar e a posologia de dobutaminae nitroprussiato de sódio em quatro momentos: (M0 antes da administração de 2 µg/kg declonidina intravenosa ou placebo; (M1 decorridos 30 minutos do tratamento testado e antes da circulação extracorpórea; (M2 imediatamente após a circulação extracorpórea; e (M310 minutos após a injeção de protamina. Resultados: Não houve diferenças significativas em relação à pressão média de artéria pulmonarem nenhum dos momentos estudados. Entre os grupos não houve também diferença significativa entre as demais variáveis estudadas, como pressão arterial sistêmica média, frequência cardíaca, dosagem total de dobutamina, dosagem total de nitroprussiato de sódio e necessidade do hipnoanalgésico fentanil. Conclusão: A análise dos dados obtidos dos pacientes incluídos neste estudo permite concluir que a clonidina, na dose de 2 µg/kg administrada via intravenosa, não foi capaz de reduzir a pressão média de artéria pulmonar de pacientes com hipertensão pulmonar do grupo 2 (hipertensão venosa pulmonar, submetidos a cirurgia cardíaca, e nem reduzir ou abolir a necessidade da administração de dobutamina e nitroprussiato de sódio no intraoperatório.

  3. PCA as a practical indicator of OPLS-DA model reliability.

    Science.gov (United States)

    Worley, Bradley; Powers, Robert

    Principal Component Analysis (PCA) and Orthogonal Projections to Latent Structures Discriminant Analysis (OPLS-DA) are powerful statistical modeling tools that provide insights into separations between experimental groups based on high-dimensional spectral measurements from NMR, MS or other analytical instrumentation. However, when used without validation, these tools may lead investigators to statistically unreliable conclusions. This danger is especially real for Partial Least Squares (PLS) and OPLS, which aggressively force separations between experimental groups. As a result, OPLS-DA is often used as an alternative method when PCA fails to expose group separation, but this practice is highly dangerous. Without rigorous validation, OPLS-DA can easily yield statistically unreliable group separation. A Monte Carlo analysis of PCA group separations and OPLS-DA cross-validation metrics was performed on NMR datasets with statistically significant separations in scores-space. A linearly increasing amount of Gaussian noise was added to each data matrix followed by the construction and validation of PCA and OPLS-DA models. With increasing added noise, the PCA scores-space distance between groups rapidly decreased and the OPLS-DA cross-validation statistics simultaneously deteriorated. A decrease in correlation between the estimated loadings (added noise) and the true (original) loadings was also observed. While the validity of the OPLS-DA model diminished with increasing added noise, the group separation in scores-space remained basically unaffected. Supported by the results of Monte Carlo analyses of PCA group separations and OPLS-DA cross-validation metrics, we provide practical guidelines and cross-validatory recommendations for reliable inference from PCA and OPLS-DA models.

  4. PCA based clustering for brain tumor segmentation of T1w MRI images.

    Science.gov (United States)

    Kaya, Irem Ersöz; Pehlivanlı, Ayça Çakmak; Sekizkardeş, Emine Gezmez; Ibrikci, Turgay

    2017-03-01

    Medical images are huge collections of information that are difficult to store and process consuming extensive computing time. Therefore, the reduction techniques are commonly used as a data pre-processing step to make the image data less complex so that a high-dimensional data can be identified by an appropriate low-dimensional representation. PCA is one of the most popular multivariate methods for data reduction. This paper is focused on T1-weighted MRI images clustering for brain tumor segmentation with dimension reduction by different common Principle Component Analysis (PCA) algorithms. Our primary aim is to present a comparison between different variations of PCA algorithms on MRIs for two cluster methods. Five most common PCA algorithms; namely the conventional PCA, Probabilistic Principal Component Analysis (PPCA), Expectation Maximization Based Principal Component Analysis (EM-PCA), Generalize Hebbian Algorithm (GHA), and Adaptive Principal Component Extraction (APEX) were applied to reduce dimensionality in advance of two clustering algorithms, K-Means and Fuzzy C-Means. In the study, the T1-weighted MRI images of the human brain with brain tumor were used for clustering. In addition to the original size of 512 lines and 512 pixels per line, three more different sizes, 256 × 256, 128 × 128 and 64 × 64, were included in the study to examine their effect on the methods. The obtained results were compared in terms of both the reconstruction errors and the Euclidean distance errors among the clustered images containing the same number of principle components. According to the findings, the PPCA obtained the best results among all others. Furthermore, the EM-PCA and the PPCA assisted K-Means algorithm to accomplish the best clustering performance in the majority as well as achieving significant results with both clustering algorithms for all size of T1w MRI images. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Impact of Analgesia on the Course of Spontaneous Labor in Women with Diabetes Mellitus

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    M. I. Neimark

    2013-01-01

    Full Text Available Objective: to improve the results of spontaneous labor in female patients with diabetes mellitus (DM. Subjects and methods. The results of physiological labor analgesia were analyzed in 140 patients. The parturients were divided into 3 groups: 1 40 parturients in whom analgesia was performed by the intravenous administration of promedol; 2 40 parturients in whom analgesia was done by the fractional administration of 0.2% ropivacaine hydrochloride into the epidural space; 3 40 parturients in whom analgesia was carried out with intravenous paracetamol 2000—3000 mg. In all the patients, the investigators estimated central hemodynamic parameters by echocardiography, the efficiency of labor analgesia according to the scale described by N. N. Rasstrigina and B. V. Shnaider, as well as blood glucose levels, fetal status by a cardiotocographic technique, and neonatal status by Apgar scores at 1 and 5 minutes of life. Results. Analgesia quality assessment established that the best analgesic effect was achieved in the patients in Group 2 where 75.0% of the parturients had 8—10 scores. A comparative analysis of carbohydrate metabolic parameters also ascertained that the most steady-state and physiological glycemic level was recorded in Group 2 patients throughout the study. In addition, epidural analgesia versus other analgesic techniques provides the most steady-state hemodynamic parameters during labor, which promotes improved labor and has a beneficial effect on fetal and neonatal states. Conclusion. Glycemic levels during labor and delivery can be optimized in patients with DM only if adequate analgesia is achieved. By ensuring adequate labor analgesia, epidural analgesia normalizes glycemic and central hemodynamic parameters, favors elimination of delivery abnormalities, and has a beneficial effect on fetal and neonatal states. Key words: epidural analgesia, diabetes mellitus, spontaneous labor.

  6. Peripheral nerve catheters and local anesthetic infiltration in perioperative analgesia.

    Science.gov (United States)

    Merritt, Christopher K; Mariano, Edward R; Kaye, Alan David; Lissauer, Jonathan; Mancuso, Kenneth; Prabhakar, Amit; Urman, Richard D

    2014-03-01

    Peripheral nerve catheters (PNCs) and local infiltration analgesia (LIA) represent valuable options for controlling perioperative pain. PNCs have been increasingly utilized to provide both surgical anesthesia and prolonged postoperative analgesia for a wide variety of procedures. PNCs can be more technically challenging to place than typical single-injection nerve blocks (SINB), and familiarity with the indications, contraindications, relevant anatomy, and appropriate technical skills is a prerequisite for the placement of any PNC. PNCs include risks of peripheral nerve injury, damage to adjacent anatomic structures, local anesthetic toxicity, intravascular injection, risks associated with motor block, risks of unnoticed injury to the insensate limb, and risks of sedation associated with PNC placement. In addition to these common risks, there are specific risks unique to each PNC insertion site. LIA strategies have emerged that seek to provide the benefit of targeted local anesthesia while minimizing collateral motor block and increasing the applicability of durable local anesthesia beyond the extremities. LIA involves the injection and/or infusion of a local anesthetic near the site of surgical incision to provide targeted analgesia. A wide variety of techniques have been described, including single-injection intraoperative wound infiltration, indwelling wound infusion catheters, and the recent high-volume LIA technique associated with joint replacement surgery. The efficacy of these techniques varies depending on specific procedures and anatomic locations. The recent incorporation of ultra-long-acting liposomal bupivacaine preparations has the potential to dramatically increase the utility of single-injection LIA. LIA represents a promising yet under-investigated method of postoperative pain control. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Postoperative analgesia using diclofenac and acetaminophen in children.

    Science.gov (United States)

    Hannam, Jacqueline A; Anderson, Brian J; Mahadevan, Murali; Holford, Nick H G

    2014-09-01

    Diclofenac dosing in children for analgesia is currently extrapolated from adult data. Oral diclofenac 1.0 mg·kg(-1) is recommended for children aged 1-12 years. Analgesic effect from combination diclofenac/acetaminophen is unknown. Children (n = 151) undergoing tonsillectomy (c. 1995) were randomized to receive acetaminophen elixir 40 mg·kg(-1) before surgery and 20 mg·kg(-1) rectally at the end of surgery with diclofenac suspension 0.1 mg·kg(-1) , 0.5 mg·kg(-1) , or 2.0 mg·kg(-1) before surgery or placebo. A further 93 children were randomized to receive diclofenac 0.1 mg·kg(-1) , 0.5 mg·kg(-1) , or 2.0 mg·kg(-1) only. Postoperative pain was assessed (visual analogue score, VAS 0-10) at half-hourly intervals from waking until discharge. Data were pooled with those from a further 222 children and 30 adults. One-compartment models with first-order absorption and elimination described the pharmacokinetics of both medicines. Combined drug effects were described using a modified EMAX model with an interaction term. An interval-censored model described the hazard of study dropout. Analgesia onset had an equilibration half-time of 0.496 h for acetaminophen and 0.23 h for diclofenac. The maximum effect (EMAX ) was 4.9. The concentration resulting in 50% of EMAX (C50 ) was 1.23 mg·l(-1) for diclofenac and 13.3 mg·l(-1) for acetaminophen. A peak placebo effect of 6.8 occurred at 4 h. Drug effects were additive. The hazard of dropping out was related to pain (hazard ratio of 1.35 per unit change in pain). Diclofenac 1.0 mg·kg(-1) with acetaminophen 15 mg·kg(-1) achieves equivalent analgesia to acetaminophen 30 mg·kg(-1) . Combination therapy can be used to achieve similar analgesia with lower doses of both drugs. © 2014 John Wiley & Sons Ltd.

  8. 2D-3D Face Recognition Method Basedon a Modified CCA-PCA Algorithm

    Directory of Open Access Journals (Sweden)

    Patrik Kamencay

    2014-03-01

    Full Text Available This paper presents a proposed methodology for face recognition based on an information theory approach to coding and decoding face images. In this paper, we propose a 2D-3D face-matching method based on a principal component analysis (PCA algorithm using canonical correlation analysis (CCA to learn the mapping between a 2D face image and 3D face data. This method makes it possible to match a 2D face image with enrolled 3D face data. Our proposed fusion algorithm is based on the PCA method, which is applied to extract base features. PCA feature-level fusion requires the extraction of different features from the source data before features are merged together. Experimental results on the TEXAS face image database have shown that the classification and recognition results based on the modified CCA-PCA method are superior to those based on the CCA method. Testing the 2D-3D face match results gave a recognition rate for the CCA method of a quite poor 55% while the modified CCA method based on PCA-level fusion achieved a very good recognition score of 85%.

  9. PCA criterion for SVM (MLP) classifier for flavivirus biomarker from salivary SERS spectra at febrile stage.

    Science.gov (United States)

    Radzol, A R M; Lee, Khuan Y; Mansor, W; Omar, I S

    2016-08-01

    Non-structural protein (NS1) has been conceded as one of the biomarkers for flavivirus that causes diseases with life threatening consequences. NS1 is an antigen that allows detection of the illness at febrile stage, mostly from blood samples currently. Our work here intends to define an optimum model for PCA-SVM with MLP kernel for classification of flavivirus biomarker, NS1 molecule, from SERS spectra of saliva, which to the best of our knowledge has never been explored. Since performance of the model depends on the PCA criterion and MLP parameters, both are examined in tandem. Input vector to classifier determined by each PCA criterion is subjected to brute force tuning of MLP parameters for entirety. Its performance is also compared to our previous works where a Linear and RBF kernel are used. It is found that the best PCA-SVM (MLP) model can be defined by 5 PCs from Cattel's Scree test for PCA, together with P1 and P2 values of 0.1 and -0.2 respectively, with a classification performance of [96.9%, 93.8%, 100.0%].

  10. Avoiding Optimal Mean ℓ2,1-Norm Maximization-Based Robust PCA for Reconstruction.

    Science.gov (United States)

    Luo, Minnan; Nie, Feiping; Chang, Xiaojun; Yang, Yi; Hauptmann, Alexander G; Zheng, Qinghua

    2017-04-01

    Robust principal component analysis (PCA) is one of the most important dimension-reduction techniques for handling high-dimensional data with outliers. However, most of the existing robust PCA presupposes that the mean of the data is zero and incorrectly utilizes the average of data as the optimal mean of robust PCA. In fact, this assumption holds only for the squared [Formula: see text]-norm-based traditional PCA. In this letter, we equivalently reformulate the objective of conventional PCA and learn the optimal projection directions by maximizing the sum of projected difference between each pair of instances based on [Formula: see text]-norm. The proposed method is robust to outliers and also invariant to rotation. More important, the reformulated objective not only automatically avoids the calculation of optimal mean and makes the assumption of centered data unnecessary, but also theoretically connects to the minimization of reconstruction error. To solve the proposed nonsmooth problem, we exploit an efficient optimization algorithm to soften the contributions from outliers by reweighting each data point iteratively. We theoretically analyze the convergence and computational complexity of the proposed algorithm. Extensive experimental results on several benchmark data sets illustrate the effectiveness and superiority of the proposed method.

  11. A comparative study of two different doses of epidural neostigmine coadministered with lignocaine for post operative analgesia and sedation

    Directory of Open Access Journals (Sweden)

    Mamta Harjai

    2010-01-01

    Conclusion: Co administration of epidural neostigmine and lignocaine appears to be a useful technique for postoperative analgesia as it increases the duration of analgesia and provides desirable sedation at the same time.

  12. A comparison of intrathecal dexmedetomidine verses intrathecal fentanyl with epidural bupivacaine for combined spinal epidural labor analgesia

    Directory of Open Access Journals (Sweden)

    P K Dilesh

    2014-01-01

    Conclusion: 10 μg dexmedetomidine intrathecally provides a longer duration of analgesia with lesser incidence of pruritus compared to 20 μg fentanyl intrathecally for CSE labor analgesia with comparable neonatal side-effects.

  13. Prospective, randomized, controlled trial of thoracic epidural or patient-controlled opiate analgesia on perioperative quality of life.

    LENUS (Irish Health Repository)

    Ali, M

    2010-03-01

    Perioperative epidural analgesia provides continuous pain control and may have advantages over parenteral opiate administration. This study assessed the impact of epidural analgesia on quality of life (QOL) of patients undergoing major surgery.

  14. 21 CFR 868.5160 - Gas machine for anesthesia or analgesia.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gas machine for anesthesia or analgesia. 868.5160... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5160 Gas machine for anesthesia or analgesia. (a) Gas machine for anesthesia—(1) Identification. A gas machine for anesthesia is a...

  15. Unpredictability of regression of analgesia during the continuous postoperative extradural infusion of bupivacaine

    DEFF Research Database (Denmark)

    Mogensen, T; Hjortsø, N C; Bigler, D

    1988-01-01

    Twenty-four otherwise healthy patients scheduled for elective major abdominal surgery received general anaesthesia plus lumbar extradural analgesia. A loading dose of 0.5% plain bupivacaine was given to produce sensory analgesia (pin prick) from T4 to S5 and followed by a continuous infusion of 0...

  16. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Karen Vestergaard; Bak, Marie; Christensen, Birgitte Viebæk

    2010-01-01

    There have been few studies describing wound infiltration with additional intraarticular administration of multimodal analgesia for total knee arthroplasty (TKA). In this study, we assessed the efficacy of wound infiltration combined with intraarticular regional analgesia with epidural infusion...... on analgesic requirements and postoperative pain after TKA....

  17. Mode of delivery after epidural analgesia in a cohort of low-risk nulliparas

    DEFF Research Database (Denmark)

    Eriksen, Lena Mariann; Nøhr, Ellen Aagaard; Kjaergaard, Hanne

    2011-01-01

    Although epidural analgesia is widespread and very effective for alleviating labor pain, its use is still controversial, as the literature is inconsistent about the risk of adverse birth outcome after administration of epidural analgesia. The aim of this study was to explore associations between ...

  18. Intravenous Remifentanil versus Epidural Ropivacaine with Sufentanil for Labour Analgesia: A Retrospective Study

    Science.gov (United States)

    Xu, Zhendong; Su, Jing; Liu, Zhiqiang

    2014-01-01

    Remifentanil with appropriate pharmacological properties seems to be an ideal alternative to epidural analgesia during labour. A retrospective cohort study was undertaken to assess the efficacy and safety of remifentanil intravenous patient-controlled analgesia (IVPCA) compared with epidural analgesia. Medical records of 370 primiparas who received remifentanil IVPCA or epidural analgesia were reviewed. Pain and sedation scores, overall satisfaction, the extent of pain control, maternal side effects and neonatal outcome as primary observational indicators were collected. There was a significant decline of pain scores in both groups. Pain reduction was greater in the epidural group throughout the whole study period (0∼180 min) (Panalgesia. And logistic regression analysis demonstrated that nausea, vomiting were associated with oxytocin usage and instrumental delivery, and dizziness was associated to the type and duration of analgesia. Neonatal outcomes such as Apgar scores and umbilical-cord blood gas analysis were within the normal range, but umbilical pH and base excess of neonatus in the remifentanil group were significantly lower. Remifentanil IVPCA provides poorer efficacy on labor analgesia than epidural analgesia, with more sedation on parturients and a trend of newborn acidosis. Despite these adverse effects, remifentanil IVPCA can still be an alternative option for labor analgesia under the condition of one-to-one bedside care, continuous monitoring, oxygen supply and preparation for neonatal resuscitation. PMID:25386749

  19. Sedation and analgesia practices in neonatal intensive care units (EUROPAIN): results from a prospective cohort study

    NARCIS (Netherlands)

    Carbajal, Ricardo; Eriksson, Mats; Courtois, Emilie; Boyle, Elaine; Avila-Alvarez, Alejandro; Andersen, Randi Dovland; Sarafidis, Kosmas; Polkki, Tarja; Matos, Cristina; Lago, Paola; Papadouri, Thalia; Montalto, Simon Attard; Ilmoja, Mari-Liis; Simons, Sinno; Tameliene, Rasa; van Overmeire, Bart; Berger, Angelika; Dobrzanska, Anna; Schroth, Michael; Bergqvist, Lena; Lagercrantz, Hugo; Anand, Kanwaljeet J. S.; Kiechl-Kohlendorfer, Ursula; Trinkl, Anna; Deindl, Philipp; Wald, Martin; Rigo, Vincent; Dussart, Anneliese; Dierckx, Elke; Coppens, Sophie; Kiilsapaa, Birgit; Metsvaht, Tuuli; Metsäranta, Marjo; Nikolajev, Kari; Saarela, Timo; Peltoniemi, Outi; Tammela, Outi; Lehtonen, Liisa; Savagner, Christophe; Sevestre, Anna; Alexandre, Cénéric; Bouchon-Guedj, Nathalie; Saumureau, Simone; Grosse, Camille; Jouvencel, Philippe; Ramful, Duksha; Clamadieu, Catherine; Mourdie, Julien; Montcho, Yannis; Cambonie, Gilles; Di Maio, Massimo; Patural, Hugues; Asrtuc, Dominique; Norbert, Karine; Bouchera, Kassis; Lang, Mathieu; Galene Gromez, Sophie; Hamon, Isabelle; Nolent, Paul; Ntwari, René-Christian; Lallemant, Carine; Chary Tardy, Anne Cécile; Pelluau, Sonia; Roue, Jean Michel; Picaud, Jean Charles; Camelio, Aurélie; Tourneux, Pierre; Saint-Faust, Marie; Morville, Patrice; David, Alexandra; Theret, Bernard; Frédérique, Martin; Topf, Georg; Menendez-Castro, Ricardo; Fujiwara-Pichler, Erhard; Deeg, Karl Heinz; Anatolitou, Fani; Baroutis, George; Papazafeiratou, Chrissoulan; Giannakopoulou, Christine; Baltogianni, Maria; Delivoria, Varvara; Sterpi, Magdalena; Saklamaki-Kontou, Melpomeni; Dimitriou, Gabriel; Charitou, Antonia; Thomaidou, Agathi; Chatziioannidis, Ilias; Salvanos, Iraklis; Pirelli, Anna; Poggiani, Carlo; Fasolato, Valeria; Cristofori, Gloria; Gomirato, Serena; Allegro, Antonella; Alfiero, Michela; Biban, Paolo; Bertolini, Alessandra; Golin, Rosanna; Franco, Elena; Molinaro, Grazia; Federica, Visintini; Rossini, Roberto; Garetti, Elisabetta; Faraoni, Maddalena; Dani, Carlo; Germini, Cristina; Braguglia, Annabella; Benigni, Gina; Azzali, Adriano; Santa, Barresi; Romoli, Raffaella; Carrera, Giuseppe; Miria, Natile; Savant, Patrizia; Cossu, Maria Antonia; Giancarlo, Gargano; Cassar, Robert; Bos, Annelis; van Kaam, Anton; Brouwer, Mieke; van Lingen, Richard; Bambang Oetomo, Sidarto; Sivertsen, Wiebke; Nakstad, Britt; Solhjell, Kari; Flagstad, Gro; Salvesen, Bodil; Nessestrand, Ingunn A. M.; Nordhov, Marianne; Anderssen, Sven-Harald; Wasland, Kristin; Danielsen, Kåre; Kristoffersen, Laila Marie; Ytterdahl Bergland, Unni; Borghild Stornes, Randi; Andresen, Jannicke; Solberg, Rønnaug; Hochnowski, Kristoffer; Terpinska, Ewa; Kociszewska-Najman, Bozena; Melka, Andrzej; Głuszczak, Ewa; Niezgoda, Anna; Borszewska-Kornacka, Maria Katarzyna; Witwicki, Jacek M.; Korbal, Piotr; Ramos, Helena; Garcia, Pedro; Machado, Cidália; Clemente, Fátima; Costa, Miguel; Trindade, Cristina; Salazar, Anabela; Martins Barroso, Laura; Resende, Cristine; Afonso, Maria Eulàlia; Torres, Jacinto; Maciel, Paula; Nunes, José Luis; Neve Dos Santos, Vera Alexandra; Melgar Bonis, Ana; Euba Lopez, Aintzane; Tapia Collados, Caridad; Jesus Ripalda, María; Solis Sanchez, Gonzalo; Martin Parra, Belén; Botet, Francesc; Fernandez Trisac, Jose Luis; Elorza Fernandez, María Dolores; Arriaga Redondo, María; Bargallo Ailagas, Eva; Saenz, Pilar; Lopez Ortego, Paloma; Ventura, Purificación; Galve, Zenaida; Perez Ocon, Amaya; Crespo Suarez, Pilar; Dianez Vega, Gloria; San Feliciano, Laura; Herranz Carillo, Gloria; Esteban Diez, Inés; Reyné, Mar; Garcia Borau, María José; de Las Cuevas, Isabel; Couce, María L.; González Carrasco, Ersilia; Montoro Exposito, Aurora; Concheiro Guisan, Ana; Luna Lagares, Salud; Sanchez Redondo, Maria Dolores; Hellström Westas, Lena; Moren, Stefan; Norman, Elisabeth; Olsson, Emma; Åberg, Emma; Printz, Gordana; Turner, Mark; McBride, Tim; Bomont, Robert; Webb, Delyth; Saladi, Murthy; Thirumurugan, Arumugavelu; Brooke, Nigel; Skene, Caryl; Bilolikar, Harsha; Noble, Vibert; Vora, Amish; Thompson, Fiona; Deorukhkar, Anjum; El-Refee, Sherif; McIntyre, John; Millman, Guy; Reed, Joanne; Babirecki, Matthew; Kumar, Dev; Yadav, Mahesh; O'Brien, Margaret; Gasiorowski, Edward Robert; Rawlingson, Chris; Shastri, Aravind; Tibby, Shane; Walsh, Sandra; Azzopardi, Denis; Soe, Aung; MaCrae, Duncan; Eyre, Elizabeth; Menon, Gopi; Gupta, Samir; James, Anitha; Surana, Pinki; Adams, Eleri; Wolf, Andrew; Maxwell, Nicola; Wagstaff, Miles; Mann, Rebecca; Kumar, Yadlapalli; Quinn, Michael; Jones Dyson, Steve; Mannix, Paul; Morris, Kevin; Ewer, Andrew; Gurusamy, Kalyana; Deshpande, Sanjeev; Alexander, John; Blake, Kathryn; Kumar, Siva; Oddie, Sam; Ohadike, Pamela; McKechnie, Liz; Gibson, David; Shirsalkar, Anand; Suryanarayanan, Balaji; Hubbard, Marie; Lal, Mithilesh; Ali, Imdad; Shah, Divyen; Sketchley, Suzanne; Gupta, Richa; Schofield, Joanne; Ezzat, Medhat; Mupanemunda, Richard; Gallagher, Andrew; Kronsberg, Shari

    2015-01-01

    Background Neonates who are in pain or are stressed during care in the intensive care unit (ICU) are often given sedation or analgesia. We investigated the current use of sedation or analgesia in neonatal ICUs (NICUs) in European countries. Methods EUROPAIN (EUROpean Pain Audit In Neonates) was a

  20. Retrospective Assessment Of Postoperative Pain Control With Intravenous Or Epidural Patient-Controlled Analgesia After Orthopedic, General And Plastic Surgery

    OpenAIRE

    Çakir E; Doğan G; Akdur F; Kılıç I; Örnek D; Gökçinar D; Gökçinar D

    2017-01-01

    Aim: Patient-controlled analgesia methods are more effective than conventional analgesia methods for the management of postoperative pain. Patient-controlled analgesia is often preferred as it has less sedative effect, minimum complications, high patient satisfaction and has positive effects on the healing process of patients. The aim of this study was to research patientcontrolled analgesia methods that were used for postoperative pain control in a training and research hospital. Material An...

  1. FlashPCA2: principal component analysis of Biobank-scale genotype datasets.

    Science.gov (United States)

    Abraham, Gad; Qiu, Yixuan; Inouye, Michael

    2017-09-01

    Principal component analysis (PCA) is a crucial step in quality control of genomic data and a common approach for understanding population genetic structure. With the advent of large genotyping studies involving hundreds of thousands of individuals, standard approaches are no longer feasible. However, when the full decomposition is not required, substantial computational savings can be made. We present FlashPCA2, a tool that can perform partial PCA on 1 million individuals faster than competing approaches, while requiring substantially less memory. https://github.com/gabraham/flashpca . gad.abraham@unimelb.edu.au. Supplementary data are available at Bioinformatics online. © The Author (2017). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  2. A MEDICAL MULTI-MODALITY IMAGE FUSION OF CT/PET WITH PCA, DWT METHODS

    Directory of Open Access Journals (Sweden)

    S. Guruprasad

    2013-11-01

    Full Text Available This paper gives a view on the fusion of different modality images like PET and CT (Positron Emission Tomography & Computed Tomography by two domain methods PCA and DWT methods. The spatial domain is PCA method, and another transformation domain method (DWT. In dwt decomposed coefficients of DWT (discrete wavelet transformation are applied with the IDWT to get fused image information. Before that, choose a detailed part of decomposed coefficients by maximum selection and averaging the approximated part of DWT coefficients. In applying the PCA using eigen values and eigen vector of larger values as principal components and after to reconstruct using addition to these to get the fussed image of two modalities CT & PET. So that adds complimentary features of both anatomic, physiological and metabolic information in one image, provides better visual information in single image of patients in medical field. The analytic parameters like, MSE, PSNR, ENTROPY results are better enough to prove the methods each other.

  3. Enhancement of noisy EDX HRSTEM spectrum-images by combination of filtering and PCA.

    Science.gov (United States)

    Potapov, Pavel; Longo, Paolo; Okunishi, Eiji

    2017-05-01

    STEM spectrum-imaging with collecting EDX signal is considered in view of the extraction of maximum information from very noisy data. It is emphasized that spectrum-images with weak EDX signal often suffer from information loss in the course of PCA treatment. The loss occurs when the level of random noise exceeds a certain threshold. Weighted PCA, though potentially helpful in isolation of meaningful variations from noise, might provoke the complete loss of information in the situation of weak EDX signal. Filtering datasets prior PCA can improve the situation and recover the lost information. In particular, Gaussian kernel filters are found to be efficient. A new filter useful in the case of sparse atomic-resolution EDX spectrum-images is suggested. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Fundamental flow and fracture analysis of prime candidate alloy (PCA) for path a (austenitics)

    International Nuclear Information System (INIS)

    Lucas, G.E.; Jayakumar, M.; Maziasz, P.J.

    1982-01-01

    Room temperature microhardness tests have been performed on samples of Prime Candidate Alloy (PCA) for the austenitics (Path A) subjected to various thermomechanical treatments (TMT). The TMTs have effected various microstructures, which have been well characterized by optical metallography and TEM. For comparison, microhardness tests have been performed on samples of N-lot, DO heat and MFE 316 stainless steel with similar TMTs. The results indicate that the TMTs investigated can significantly alter the microhardness of the PCA in a manner which is consistent with microstructural changes. Moreover, while PCA had the lowest microhardness of the four alloys types after cold working, its microhardness increased while the others decreased to comparable values after aging for 2 h at 750 0 C

  5. COMBINING PCA ANALYSIS AND ARTIFICIAL NEURAL NETWORKS IN MODELLING ENTREPRENEURIAL INTENTIONS OF STUDENTS

    Directory of Open Access Journals (Sweden)

    Marijana Zekić-Sušac

    2013-02-01

    Full Text Available Despite increased interest in the entrepreneurial intentions and career choices of young adults, reliable prediction models are yet to be developed. Two nonparametric methods were used in this paper to model entrepreneurial intentions: principal component analysis (PCA and artificial neural networks (ANNs. PCA was used to perform feature extraction in the first stage of modelling, while artificial neural networks were used to classify students according to their entrepreneurial intentions in the second stage. Four modelling strategies were tested in order to find the most efficient model. Dataset was collected in an international survey on entrepreneurship self-efficacy and identity. Variables describe students’ demographics, education, attitudes, social and cultural norms, self-efficacy and other characteristics. The research reveals benefits from the combination of the PCA and ANNs in modeling entrepreneurial intentions, and provides some ideas for further research.

  6. Improved swelling resistance for PCA austenitic stainless steel under HFIR irradiation through microstructural control

    International Nuclear Information System (INIS)

    Maziasz, P.J.; Braski, D.N.

    1983-01-01

    Six microstructural variants of Prime Candidate Alloy (PCA) were evaluated for swelling resistance during HFIR irradiation, together with several heats of type 316 stainless steel (316). Swelling was negligible in all the steels at 300 0 C after approx. 44 dpa. At 500 to 600 0 C 25%-cold-worked PCA showed better void swelling resistance than type 316 at approx. 44 dpa. There was less swelling variability among alloys at 400 0 C, but again 25%-cold-worked PCA was the best. Microstructurally, swelling resistance correlated with development of fine, stable bubbles whereas high swelling was due to coarser distributions of bubbles becoming unstable and converting to voids (bias-driven cavities)

  7. Ovariohysterectomy requires more post-operative analgesia than orchiectomy in dogs and cats.

    Science.gov (United States)

    Quarterone, Carolina; Luna, Stelio Pacca Loureiro; Crosignani, Nadia; de Oliveira, Flávia Augusta; Lopes, Carlize; da Maia Lima, Alfredo Feio; de Araújo Aguiar, Antonio Jose

    2017-11-01

    The requirement for post-operative analgesia after ovariohysterectomy (OH) versus orchiectomy in dogs and cats was compared. Twelve male and 12 female cats and 12 male and 12 female dogs received meloxicam, 0.1 mg/kg body weight, PO, 2 h before surgery. Eleven female cats and 3 female dogs received rescue analgesia ( P = 0.002). No male of either species required rescue analgesia. The number of cats receiving rescue analgesia was greater in females than in males ( P dogs or cats. Postoperative pain after OH should be assessed for at least 2 h for cats and 4 h for dogs, using species-specific validated tools, to ensure proper postoperative pain diagnosis and management. Male dogs and cats subjected to orchiectomy required less postoperative analgesia intervention than female dogs and cats submitted to OH.

  8. A comparative study of PCA, SIMCA and Cole model for classification of bioimpedance spectroscopy measurements.

    Science.gov (United States)

    Nejadgholi, Isar; Bolic, Miodrag

    2015-08-01

    Due to safety and low cost of bioimpedance spectroscopy (BIS), classification of BIS can be potentially a preferred way of detecting changes in living tissues. However, for longitudinal datasets linear classifiers fail to classify conventional Cole parameters extracted from BIS measurements because of their high variability. In some applications, linear classification based on Principal Component Analysis (PCA) has shown more accurate results. Yet, these methods have not been established for BIS classification, since PCA features have neither been investigated in combination with other classifiers nor have been compared to conventional Cole features in benchmark classification tasks. In this work, PCA and Cole features are compared in three synthesized benchmark classification tasks which are expected to be detected by BIS. These three tasks are classification of before and after geometry change, relative composition change and blood perfusion in a cylindrical organ. Our results show that in all tasks the features extracted by PCA are more discriminant than Cole parameters. Moreover, a pilot study was done on a longitudinal arm BIS dataset including eight subjects and three arm positions. The goal of the study was to compare different methods in arm position classification which includes all three synthesized changes mentioned above. Our comparative study on various classification methods shows that the best classification accuracy is obtained when PCA features are classified by a K-Nearest Neighbors (KNN) classifier. The results of this work suggest that PCA+KNN is a promising method to be considered for classification of BIS datasets that deal with subject and time variability. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. [Mechanisms and applications of transcutaneous electrical nerve stimulation in analgesia].

    Science.gov (United States)

    Tang, Zheng-Yu; Wang, Hui-Quan; Xia, Xiao-Lei; Tang, Yi; Peng, Wei-Wei; Hu, Li

    2017-06-25

    Transcutaneous electrical nerve stimulation (TENS), as a non-pharmacological and non-invasive analgesic therapy with low-cost, has been widely used to relieve pain in various clinical applications, by delivering current pulses to the skin area to activate the peripheral nerve fibers. Nevertheless, analgesia induced by TENS varied in the clinical practice, which could be caused by the fact that TENS with different stimulus parameters has different biological mechanisms in relieving pain. Therefore, to advance our understanding of TENS in various basic and clinical studies, we discussed (1) neurophysiological and biochemical mechanisms of TENS-induced analgesia; (2) relevant factors that may influence analgesic effects of TENS from the perspectives of stimulus parameters, including stimulated position, pulse parameters (current intensity, frequency, and pulse width), stimulus duration and used times in each day; and (3) applications of TENS in relieving clinical pain, including post-operative pain, chronic low back pain and labor pain. Finally, we propose that TENS may involve multiple and complex psychological neurophysiological mechanisms, and suggest that different analgesic effects of TENS with different stimulus parameters should be taken into consideration in clinical applications. In addition, to optimize analgesic effect, we recommend that individual-based TENS stimulation parameters should be designed by considering individual differences among patients, e.g., adaptively adjusting the stimulation parameters based on the dynamic ratings of patients' pain.

  10. Specifying the non-specific components of acupuncture analgesia

    Science.gov (United States)

    Vase, Lene; Baram, Sara; Takakura, Nobuari; Yajima, Hiroyoshi; Takayama, Miho; Kaptchuk, Ted J.; Schou, Søren; Jensen, Troels Staehelin; Zachariae, Robert; Svensson, Peter

    2014-01-01

    It is well known that acupuncture has pain-relieving effects, but the contribution of specific and especially non-specific factors to acupuncture analgesia is less clear. One hundred and one patients who developed pain ≥ 3 on a visual analog scale (VAS, 0-10) following third molar surgery were randomized to receive active acupuncture, placebo acupuncture, or no treatment for 30 min with acupuncture needles with potential for double-blinding. Patients’ perception of the treatment (active or placebo), and expected pain levels (VAS) were assessed prior to and halfway through the treatment. Looking at actual treatment allocation, there was no specific effect of active acupuncture (P = 0.240), but a large and significant non-specific effect of placebo acupuncture (P acupuncture (P acupuncture had significantly lower pain levels than those who believed they received placebo acupuncture. Expected pain levels accounted for significant and progressively larger amounts of the variance in pain ratings following both active and placebo acupuncture (up to 69.8%), This is the first study to show that under optimized blinding conditions non-specific factors such as patients’ perception of and expectations toward treatment are central to the efficacy of acupuncture analgesia and that these factors may contribute to self-reinforcing effects in acupuncture treatment To obtain an effect of acupuncture in clinical practice it may, therefore, be important to incorporate and optimize these factors. PMID:23707680

  11. RESULTS OF THE MEGAVEREBRATE ANALGESIA SURVEY: GIRAFFE AND HIPPOPOTAMUS.

    Science.gov (United States)

    Boothe, Matthew; Kottwitz, Jack; Harmon, Roy; Citino, Scott B; Zuba, Jeffery R; Boothe, Dawn M

    2016-12-01

    Results of an online survey posted on the American Association of Zoo Veterinarians listserv examined the patterns of analgesic medication and pain management modalities used for captive giraffe and hippopotami. Compiled data included signalment, drugs administered, dosing regimens, subjective efficacy scores, ease of administration, and adverse events. Nineteen institutions exhibiting hippopotami ( Hippopotamus amphibious ) and pygmy hippopotami (Choeropsis liberiensis) and 45 exhibiting giraffe ( Giraffa camelopardalis spp.) responded. Phenylbutazone was the most-commonly administered nonsteroidal anti-inflammatory drug (NSAID), followed by flunixin meglumine, but doses varied widely. Eight institutions reported adverse events from NSAID administration. Tramadol was the most-commonly administered opioid followed by butorphanol. Only one adverse event was reported for opioids. Twenty-three of 45 institutions exhibiting giraffe utilized alternative analgesia methods including gabapentin, glucosamine-chondroitin, local anesthetics, and low level laser therapy. Six of 19 institutions exhibiting hippopotami administered omega 3-6 fatty acids, gabapentin, glucosamine-chondroitin, and α-2 adrenergics to provide analgesia. While all reporting zoological institutions administered similar drugs, there was substantial variation and diversity in both dosing regimens and frequencies, indicating the need for both preclinical and clinical studies supporting dosing regimens.

  12. Sedation and analgesia for procedures in the pediatric emergency room.

    Science.gov (United States)

    Ramalho, Carlos Eduardo; Bretas, Pedro Messeder Caldeira; Schvartsman, Claudio; Reis, Amélia Gorete

    Children and adolescents often require sedation and analgesia in emergency situations. With the emergence of new therapeutic options, the obsolescence of others, and recent discoveries regarding already known drugs, it became necessary to review the literature in this area. Non-systematic review in the PubMed database of studies published up to December 2016, including original articles, review articles, systematic reviews, and meta-analyses. References from textbooks, publications from regulatory agencies, and articles cited in reviews and meta-analyses through active search were also included. Based on current literature, the concepts of sedation and analgesia, the necessary care with the patient before, during, and after sedoanalgesia, and indications related to the appropriate choice of drugs according to the procedure to be performed and their safety profiles are presented. The use of sedoanalgesia protocols in procedures in the pediatric emergency room should guide the professional in the choice of medication, the appropriate material, and in the evaluation of discharge criteria, thus assuring quality in care. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. Pharmacological therapy for analgesia and sedation in the newborn.

    Science.gov (United States)

    Anand, K J S; Hall, R W

    2006-11-01

    Rapid advances have been made in the use of pharmacological analgesia and sedation for newborns requiring neonatal intensive care. Practical considerations for the use of systemic analgesics (opioids, non-steroidal anti-inflammatory agents, other drugs), local and topical anaesthetics, and sedative or anaesthetic agents (benzodiazepines, barbiturates, other drugs) are summarised using an evidence-based medicine approach, while avoiding mention of the underlying basic physiology or pharmacology. These developments have inspired more humane approaches to neonatal intensive care. Despite these advances, little is known about the clinical effectiveness, immediate toxicity, effects on special patient populations, or long-term effects after neonatal exposure to analgesics or sedatives. The desired or adverse effects of drug combinations, interactions with non-pharmacological interventions or use for specific conditions also remain unknown. Despite the huge gaps in our knowledge, preliminary evidence for the use of neonatal analgesia and sedation is available, but must be combined with a clear definition of clinical goals, continuous physiological monitoring, evaluation of side effects or tolerance, and consideration of long-term clinical outcomes.

  14. [Benefits of epidural analgesia in major neonatal surgery].

    Science.gov (United States)

    Gómez-Chacón, J; Encarnación, J; Couselo, M; Mangas, L; Domenech, A; Gutiérrez, C; García Sala, C

    2012-07-01

    The aim of this paper is to describe and evaluate the benefits of epidural anesthesia in major surgery neonatal. We have performed a matched case-control (2:1) study of patients undergoing neonatal major surgery (NMSs) who received intra-and postoperative epidural anesthesia (EA) and controls with conventional general anesthesia. The matching criteria were age, weight and baseline pathology. EA was administered by caudal puncture and epidural catheter placed with ultrasound support. Levobupivacaine was selected as anesthetic drug. The time to extubation, intestinal transit time, type of analgesia and complications were studied. This study is based on 11 cases (2 esophageal atresia, 2 diaphragmatic hernias, 1 necrotizing enterocolitis, 3 intestinal atresia, 2 anorectal malformation and 1 bladder exstrophy) and 22 controls. We observed statistically significant differences in time to extubation (95% CI OR 12 1.99 to 72.35; Chi2 p = 0.004, Mann U Whytney p = 0.013) and intestinal transit time (Mann Whitney U p analgesia. Therefore we believe that the intra-and postoperative EA helps improve postoperative management in neonates and should be preferred in centers where this technique is available.

  15. Fentanyl versus tramadol with levobupivacaine for combined spinal-epidural analgesia in labor

    Directory of Open Access Journals (Sweden)

    Veena Chatrath

    2015-01-01

    Full Text Available Background: Neuraxial labor analgesia using new local anesthetics such as levobupivacaine has become very popular by virtue of the safety and lesser motor blockade caused by these agents. Combined spinal-epidural analgesia (CSEA has become the preferred method for labor analgesia as it combines benefits of both spinal analgesia and flexibility of the epidural catheter. Adding opioids to local anesthetic drugs provide rapid onset and prolonged analgesia but may be associated with several maternal and fetal adverse effects. The purpose of this study is to compare fentanyl and tramadol used in CSEA in terms of duration of analgesia and frequency of the adverse fetomaternal outcome. Materials and Methods: A total of 60 primiparas with a singleton pregnancy in active labor were given CSEA after randomly allocating them in two groups of 30 each. Group I received intrathecal 2.5 mg levobupivacaine + 25 μg fentanyl followed by epidural top ups of 20 ml 0.125% solution of the same combination. Group II received 25 mg tramadol instead of fentanyl. Epidural top ups were given when parturient complained of two painful contractions (visual analogue scale ≥ 4. Data collected were demographic profile of the patients, analgesic qualities, side- effects and the fetomaternal outcome. Results: Patients in Group II had significantly prolonged analgesia (145 ± 9 minutes than in Group I (95 ± 7 minutes. Patients receiving fentanyl showed rapid onset of analgesia, but there were more incidence of side-effects like shivering, pruritus, transient fetal bradycardia, hypotension, nausea and vomiting. Only side-effect in the tramadol group was nausea and vomiting. During labor, maternal satisfaction was excellent. Conclusions: Adding tramadol to local anesthetic provides prolonged analgesia with minimal side effects. Fentanyl, when used as adjuvant to local anesthetic, has a rapid onset of analgesia but has certain fetomaternal side-effects.

  16. Variational group-PCA for intrinsic dimensionality determination in fMRI data

    DEFF Research Database (Denmark)

    Hinrich, Jesper Løve; Nielsen, Søren Føns Vind; Madsen, Kristoffer Hougaard

    2016-01-01

    Functional Magnetic Resonance Imaging (fMRI) is widely used to gain a better understanding of the human brain's functional organization. As fMRI data are high dimensional it is challenging to analyse using conventional methods thus low-rank approximations such as principal component analysis (PCA...... implementation using a graphical processing unit (GPU). We test the model on fMRI data from 29 healthy subjects performing a block-design fingertapping experiment. The model identified 10 active components. Neither variational Bayesian PCA on temporally concatenated data nor Group-BPCA, where uncertainties...

  17. Acupuncture analgesia: The complementary pain management in dentistry

    Directory of Open Access Journals (Sweden)

    Abdurachman Abdurachman

    2011-03-01

    Full Text Available Background: Pain is the most common reason for medical consultation in the United States. Pain is a major symptom in many medical conditions, and can significantly interfere with a person’s quality of life and general functioning. One of the very unpleasant pain is toothache. Conventional treatments for toothache are improving oral hygiene, prescribing analgesics, anti-inflammatory, and also antibiotics if there are infection even extractions are performed if necessary. Another way to conventional approaches, patients may consider acupuncture method. Acupuncture involves the insertion of needles with the width of a human hair along the precise points throughout the body. This process triggers body’s energy normal flow through extra anatomy pathway called meridian. Purpose: This case report is aimed to emphasize the existence of teeth-organ relationships through communication channels outside the lines of communication that has been known in anatomy. Case: Two patients with toothache complaints in the lower right molars came to an acupuncturist who was a medical practitioner. In these cases pain were relieved by acupuncture analgesia. Case management: Two patients were subjected to acupuncture analgesia with different acupuncture points that were customized to the affected tooth, case 1 with the large intestine-4 (Li-4 which located in the hand and case 2 with bladder-25 (Bl-25 which located in the back of the body. Ninety percent of pain was relieved in 40 seconds. Conclusion: Pain in toothache can be relieved using acupuncture analgesia technique, using meridian as an extra anatomy pathway. Nevertheless, treating the source of pain by dental practitioner is mandatory.Latar belakang: Nyeri adalah alasan paling umum yang menyebabkan orang datang berkonsultasi kepada profesional medis di Amerika Serikat. Nyeri merupakan gejala utama dalam kasus medis, dan dapat mengganggu kualitas hidup dan kegiatan umum seseorang secara signifikan. Salah satu

  18. Analgesia controlada pelo paciente reduz consumo de bupivacaína no bloqueio femoral no tratamento da dor pós-operatória após reconstrução do ligamento cruzado anterior do joelho Analgesia controlada por el paciente reduce consumo de bupivacaína en bloqueo femoral para manejo de dolor postoperatorio en reconstrucción de ligamento cruzado anterior de rodilla Patient controlled analgesia reduces the consumption of bupivacaine in femoral nerve block for the treatment of postoperative pain after reconstruction of anterior cruciate ligament of the knee

    Directory of Open Access Journals (Sweden)

    Victor A. Contreras-Domínguez

    2007-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O bloqueio femoral contínuo (BFC é utilizado na analgesia pós-operatória das substituições articulares de quadril e joelho com bom resultado. O objetivo deste estudo foi avaliar a utilidade do BFC, comparando três esquemas de administração de bupivacaína após reconstrução do ligamento cruzado anterior (LCA do joelho por artroscopia. MÉTODO: Estudo prospectivo controlado de 90 pacientes estado físico ASA I e II. Os pacientes foram divididos em três grupos: Grupo 1 (n = 30: 10 mL.h-1 em infusão contínua (IC de bupivacaína 0,125% + clonidina 1µg.mL-1 (B + C; Grupo 2 (n = 30: 5 mL.h-1 em IC + 2,5 mL de B + C em PCA a cada 30 min; Grupo 3 (n = 30: 5 mL.h-1 de B + C em PCA cada 30 min. A anestesia foi por via subaracnóidea. A dor pós-operatório foi registrada às 2, 4, 6, 24 e 48 horas após a operação avaliada pela Escala Analógica Visual (VAS. Anotou-se também consumo de bupivacaína e morfina. RESULTADOS: Não foram registradas diferenças nas variáveis demográficas entre ambos os grupos. O VAS pós-operatório entre 2 e 48 horas não mostrou diferenças. O consumo de morfina entre 4 e 48 horas foi similar nos três grupos (p = 0,07. No grupo em que só foi utilizado o modo PCA, o consumo de bupivacaína foi significativamente menor (p JUSTIFICATIVA Y OBJETIVOS: El bloqueo femoral continuo (BFC se utiliza en la analgesia postoperatoria de los reemplazos articulares de cadera y rodilla con buen resultado. El objetivo es evaluar la utilidad del BFC, comparando 3 esquemas de administración de bupivacaína en reconstrucción de ligamento cruzado anterior (LCA de rodilla asistida por artroscopía. MÉTODO: Estudio prospectivo controlado de 90 pacientes estado físico ASA I y II estables. Los pacientes fueron divididos en tres grupos. El Grupo 1 (n = 30: 10 mL.h-1 en infusión continua (IC de bupivacaína 0,125% + clonidina 1µg.mL-1 (B + C; Grupo 2 (n = 30: 5 mL.h-1 en IC + 2,5 mL de B + C en PCA

  19. Modification of the grain boundary microstructure of the austenitic PCA stainless steel to improve helium embrittlement resistance

    International Nuclear Information System (INIS)

    Maziasz, P.J.; Braski, D.N.

    1986-01-01

    Grain boundary MC precipitation was produced by a modified thermal-mechanical pretreatment in 25% cold worked (CW) austenitic prime candidate alloy (PCA) stainless steel prior to HFIR irradiation. Postirradiation tensile results and fracture analysis showed that the modified material (B3) resisted helium embrittlement better than either solution annealed (SA) or 25% CW PCA irradiated at 500 to 600 0 C to approx.21 dpa and 1370 at. ppM He. PCA SA and 25% CW were not embrittled at 300 to 400 0 C. Grain boundary MC survives in PCA-B3 during HFIR irradiation at 500 0 C but dissolves at 600 0 C; it does not form in either SA or 25% CW PCA during similar irradiation. The grain boundary MC appears to play an important role in the helium embrittlement resistance of PCA-B3

  20. Biopsy and treatment decisions in the initial management of prostate cancer and the role of PCA3; a systematic analysis of expert opinion

    NARCIS (Netherlands)

    Tombal, Bertrand; Ameye, Filip; de la Taille, Alexandre; de Reijke, Theo; Gontero, Paolo; Haese, Alexander; Kil, Paul; Perrin, Paul; Remzi, Mesut; Schröder, Jörg; Speakman, Mark; Volpe, Alessandro; Meesen, Bianca; Stoevelaar, Herman

    2012-01-01

    The Prostate CAncer gene 3 (PCA3) assay may guide prostate biopsy decisions and predict prostate cancer (PCa) aggressiveness. This study explored the appropriateness of (1) PCA3 testing; (2) biopsy; (3) active surveillance (AS) and the value of the PCA3 Score for biopsy and AS decisions. Using the

  1. PCA3 noncoding RNA is involved in the control of prostate-cancer cell survival and modulates androgen receptor signaling

    International Nuclear Information System (INIS)

    Ferreira, Luciana Bueno; Gimba, Etel Rodrigues Pereira; Palumbo, Antonio; Mello, Kivvi Duarte de; Sternberg, Cinthya; Caetano, Mauricio S; Oliveira, Felipe Leite de; Neves, Adriana Freitas; Nasciutti, Luiz Eurico; Goulart, Luiz Ricardo

    2012-01-01

    PCA3 is a non-coding RNA (ncRNA) that is highly expressed in prostate cancer (PCa) cells, but its functional role is unknown. To investigate its putative function in PCa biology, we used gene expression knockdown by small interference RNA, and also analyzed its involvement in androgen receptor (AR) signaling. LNCaP and PC3 cells were used as in vitro models for these functional assays, and three different siRNA sequences were specifically designed to target PCA3 exon 4. Transfected cells were analyzed by real-time qRT-PCR and cell growth, viability, and apoptosis assays. Associations between PCA3 and the androgen-receptor (AR) signaling pathway were investigated by treating LNCaP cells with 100 nM dihydrotestosterone (DHT) and with its antagonist (flutamide), and analyzing the expression of some AR-modulated genes (TMPRSS2, NDRG1, GREB1, PSA, AR, FGF8, CdK1, CdK2 and PMEPA1). PCA3 expression levels were investigated in different cell compartments by using differential centrifugation and qRT-PCR. LNCaP siPCA3-transfected cells significantly inhibited cell growth and viability, and increased the proportion of cells in the sub G0/G1 phase of the cell cycle and the percentage of pyknotic nuclei, compared to those transfected with scramble siRNA (siSCr)-transfected cells. DHT-treated LNCaP cells induced a significant upregulation of PCA3 expression, which was reversed by flutamide. In siPCA3/LNCaP-transfected cells, the expression of AR target genes was downregulated compared to siSCr-transfected cells. The siPCA3 transfection also counteracted DHT stimulatory effects on the AR signaling cascade, significantly downregulating expression of the AR target gene. Analysis of PCA3 expression in different cell compartments provided evidence that the main functional roles of PCA3 occur in the nuclei and microsomal cell fractions. Our findings suggest that the ncRNA PCA3 is involved in the control of PCa cell survival, in part through modulating AR signaling, which may raise new

  2. PCA3-based nomogram for predicting prostate cancer and high grade cancer on initial transrectal guided biopsy.

    Science.gov (United States)

    Elshafei, Ahmed; Chevli, K Kent; Moussa, Ayman S; Kara, Onder; Chueh, Shih-Chieh; Walter, Peter; Hatem, Asmaa; Gao, Tianming; Jones, J Stephen; Duff, Michael

    2015-12-01

    To develop a validated prostate cancer antigen 3 (PCA3) based nomogram that predicts likelihood of overall prostate cancer (PCa) and intermediate/high grade prostate cancer (HGPCa) in men pursuing initial transrectal prostate biopsy (TRUS-PBx). Data were collected on 3,675 men with serum prostate specific antigen level (PSA) ≤ 20 ng/ml who underwent initial prostate biopsy with at least 10 cores sampling at time of the biopsy. Two logistic regression models were constructed to predict overall PCa and HGPCa incorporating age, race, family history (FH) of PCa, PSA at diagnosis, PCA3, total prostate volume (TPV), and digital rectal exam (DRE). One thousand six hundred twenty (44%) patients had biopsy confirmed PCa with 701 men (19.1%) showing HGPCa. Statistically significant predictors of overall PCa were age (P time of initial biopsy with a concordance index of 0.742 (Fig. 1), and HGPCa with a concordance index of 0.768 (Fig. 2). Our internally validated initial biopsy PCA3 based nomogram is reconstructed based on a large dataset. The c-index indicates high predictive accuracy, especially for high grade PCa and improves the ability to predict biopsy outcomes. © 2015 Wiley Periodicals, Inc.

  3. Evaluation of prolonged epidural chloroprocaine for postoperative analgesia in infants.

    Science.gov (United States)

    Ross, Emma L; Reiter, Pamela D; Murphy, Michael E; Bielsky, Alan R

    2015-09-01

    To describe the use and adverse effects of chloroprocaine for epidural analgesia in young infants for infusion durations greater than 3.5 hours. A retrospective cohort review of the electronic medical record over a 14-month period. The level IV neonatal intensive care unit of a 414-bed free-standing children's hospital. Eighteen infants (mean age, 1.7 ± 1.8 months [0.03-6.3]; mean weight, 3.8 ± 1.3 kg [1.56-6.9]; n = 10 [55%] males) received 1% chloroprocaine for epidural analgesia postoperatively for up to 96-hour duration and met criteria for inclusion. Dosing requirements, placement of epidural catheter, supplementary analgesic therapy, respiratory support, vital signs, and incidence of adverse events associated with local anesthetics were collected. Epidural catheter placement was caudal (n = 8), lumbar (n = 6), or thoracic (n = 4). Mean operative time was 2.48 ± 1 hour (1-5). Initial chloroprocaine dose was 1.3 ± 0.5 mL/h (0.4-2.5) (3.5 ± 1 mg/kg per hour [1.4-5]) with a maximum dose of 1.5 ± 0.6 mL/h (0.4-3) (4.2 ± 1.1 mg/kg per hour [2.2-6.1]). Duration of epidural analgesia was 48.3 ± 21.5 hours (10-96). Duration of epidural infusion did not influence dosing requirement, suggesting the absence of drug tachyphylaxis. All patients received intermittent doses of opioid and nonopioid pain medications while receiving chloroprocaine. Two mechanically ventilated patients required continuous infusion of opioids. No adverse events were directly attributed to chloroprocaine use. Epidural 1% chloroprocaine, in doses of 0.4-3 mL/h (1.5-6.1 mg/kg per hour), was well tolerated in both mechanically ventilated and spontaneously breathing infants for up to 96 hours with no identified adverse effects or tachyphylaxis. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Investigation of domain walls in PPLN by confocal raman microscopy and PCA analysis

    Science.gov (United States)

    Shur, Vladimir Ya.; Zelenovskiy, Pavel; Bourson, Patrice

    2017-07-01

    Confocal Raman microscopy (CRM) is a powerful tool for investigation of ferroelectric domains. Mechanical stresses and electric fields existed in the vicinity of neutral and charged domain walls modify frequency, intensity and width of spectral lines [1], thus allowing to visualize micro- and nanodomain structures both at the surface and in the bulk of the crystal [2,3]. Stresses and fields are naturally coupled in ferroelectrics due to inverse piezoelectric effect and hardly can be separated in Raman spectra. PCA is a powerful statistical method for analysis of large data matrix providing a set of orthogonal variables, called principal components (PCs). PCA is widely used for classification of experimental data, for example, in crystallization experiments, for detection of small amounts of components in solid mixtures etc. [4,5]. In Raman spectroscopy PCA was applied for analysis of phase transitions and provided critical pressure with good accuracy [6]. In the present work we for the first time applied Principal Component Analysis (PCA) method for analysis of Raman spectra measured in periodically poled lithium niobate (PPLN). We found that principal components demonstrate different sensitivity to mechanical stresses and electric fields in the vicinity of the domain walls. This allowed us to separately visualize spatial distribution of fields and electric fields at the surface and in the bulk of PPLN.

  5. External validation of urinary PCA3-based nomograms to individually predict prostate biopsy outcome

    NARCIS (Netherlands)

    Auprich, Marco; Haese, Alexander; Walz, Jochen; Pummer, Karl; de la Taille, Alexandre; Graefen, Markus; de Reijke, Theo; Fisch, Margit; Kil, Paul; Gontero, Paolo; Irani, Jacques; Chun, Felix K.-H.

    2010-01-01

    Prior to safely adopting risk stratification tools, their performance must be tested in an external patient cohort. To assess accuracy and generalizability of previously reported, internally validated, prebiopsy prostate cancer antigen 3 (PCA3) gene-based nomograms when applied to a large, external,

  6. PCA-MLP SVM distinction of salivary Raman spectra of dengue fever infection.

    Science.gov (United States)

    Radzol, A R M; Lee, Khuan Y; Mansor, W; Wong, P S; Looi, I

    2017-07-01

    Dengue fever (DF) is a disease of major concern caused by flavivirus infection. Delayed diagnosis leads to severe stages, which could be deadly. Of recent, non-structural protein (NS1) has been acknowledged as a biomarker, alternative to immunoglobulins for early detection of dengue in blood. Further, non-invasive detection of NS1 in saliva makes the approach more appealing. However, since its concentration in saliva is less than blood, a sensitive and specific technique, Surface Enhanced Raman Spectroscopy (SERS), is employed. Our work here intends to define an optimal PCA-SVM (Principal Component Analysis-Support Vector Machine) with Multilayer Layer Perceptron (MLP) kernel model to distinct between positive and negative NS1 infected samples from salivary SERS spectra, which, to the best of our knowledge, has never been explored. Salivary samples of DF positive and negative subjects were collected, pre-processed and analyzed. PCA and SVM classifier were then used to differentiate the SERS analyzed spectra. Since performance of the model depends on the PCA criterion and MLP parameters, both are examined in tandem. Its performance is also compared to our previous works on simulated NS1 salivary samples. It is found that the best PCA-SVM (MLP) model can be defined by 95 PCs from CPV criterion with P1 and P2 values of 0.01 and -0.2 respectively. A classification performance of [76.88%, 85.92%, 67.83%] is achieved.

  7. AlleleCoder: a PERL script for coding codominant polymorphism data for PCA analysis

    Science.gov (United States)

    A useful biological interpretation of diploid heterozygotes is in terms of the dose of the common allele (0, 1 or 2 copies). We have developed a PERL script that converts FASTA files into coded spreadsheets suitable for Principal Component Analysis (PCA). In combination with R and R Commander, two- ...

  8. Statistical Significance of the Contribution of Variables to the PCA Solution: An Alternative Permutation Strategy

    Science.gov (United States)

    Linting, Marielle; van Os, Bart Jan; Meulman, Jacqueline J.

    2011-01-01

    In this paper, the statistical significance of the contribution of variables to the principal components in principal components analysis (PCA) is assessed nonparametrically by the use of permutation tests. We compare a new strategy to a strategy used in previous research consisting of permuting the columns (variables) of a data matrix…

  9. Regularized Pre-image Estimation for Kernel PCA De-noising

    DEFF Research Database (Denmark)

    Abrahamsen, Trine Julie; Hansen, Lars Kai

    2011-01-01

    The main challenge in de-noising by kernel Principal Component Analysis (PCA) is the mapping of de-noised feature space points back into input space, also referred to as “the pre-image problem”. Since the feature space mapping is typically not bijective, pre-image estimation is inherently illposed...

  10. Effect of Spatial Alignment Transformations in PCA and ICA of Functional Neuroimages

    DEFF Research Database (Denmark)

    Lukic, Ana S.; Wernick, Miles N.; Yang, Yongui

    2007-01-01

    this observation is true, not only for spatial ICA, but also for temporal ICA and for principal component analysis (PCA). In each case we find conditions that the spatial alignment operator must satisfy to ensure invariance of the results. We illustrate our findings using functional magnetic-resonance imaging (f...

  11. Evaluation of PCA dimensionality reduction techniques in imaging spectroscopy for foreign object detection

    Science.gov (United States)

    Conde, Olga M.; Amado, Marta; García-Allende, Pilar B.; Cobo, Adolfo; López-Higuera, José Miguel

    2007-04-01

    Foreign object detection processes are improving thanks to imaging spectroscopy techniques through the employment of hyperspectral systems such as prism-grating-prism spectrographs. These devices offer a valuable but sometimes huge and redundant amount of spectral and spatial information that facilitates and speed up the classification and sorting procedures of materials in industrial production chains. In this work, different algorithms of supervised and non-supervised Principal Components Analysis (PCA) are thoroughly applied on the experimentally acquired hyperspectral images. The evaluated PCA versions implement different statistical mechanisms to maximize the class separability. PCA alternatives (traditional "m-method", "J-measure", SEPCOR and "Supervised PCA") are compared taking into account how the achieved spectral compression affects the classification performance in terms of accuracy and execution time. During the whole process, the classification stage is fixed and performed by an Artificial Neural Network (ANN). The developed techniques have been probed and successfully checked in tobacco industry where detection of plastics, cords, cardboards, papers, textile threads, etc. must be done in order to enter only tobacco leaves in the industrial chain.

  12. Characteristics and Validation Techniques for PCA-Based Gene-Expression Signatures

    Directory of Open Access Journals (Sweden)

    Anders E. Berglund

    2017-01-01

    Full Text Available Background. Many gene-expression signatures exist for describing the biological state of profiled tumors. Principal Component Analysis (PCA can be used to summarize a gene signature into a single score. Our hypothesis is that gene signatures can be validated when applied to new datasets, using inherent properties of PCA. Results. This validation is based on four key concepts. Coherence: elements of a gene signature should be correlated beyond chance. Uniqueness: the general direction of the data being examined can drive most of the observed signal. Robustness: if a gene signature is designed to measure a single biological effect, then this signal should be sufficiently strong and distinct compared to other signals within the signature. Transferability: the derived PCA gene signature score should describe the same biology in the target dataset as it does in the training dataset. Conclusions. The proposed validation procedure ensures that PCA-based gene signatures perform as expected when applied to datasets other than those that the signatures were trained upon. Complex signatures, describing multiple independent biological components, are also easily identified.

  13. Global Clustering Quality Coefficient Assessing the Efficiency of PCA Class Assignment

    Directory of Open Access Journals (Sweden)

    Mirela Praisler

    2014-01-01

    Full Text Available An essential factor influencing the efficiency of the predictive models built with principal component analysis (PCA is the quality of the data clustering revealed by the score plots. The sensitivity and selectivity of the class assignment are strongly influenced by the relative position of the clusters and by their dispersion. We are proposing a set of indicators inspired from analytical geometry that may be used for an objective quantitative assessment of the data clustering quality as well as a global clustering quality coefficient (GCQC that is a measure of the overall predictive power of the PCA models. The use of these indicators for evaluating the efficiency of the PCA class assignment is illustrated by a comparative study performed for the identification of the preprocessing function that is generating the most efficient PCA system screening for amphetamines based on their GC-FTIR spectra. The GCQC ranking of the tested feature weights is explained based on estimated density distributions and validated by using quadratic discriminant analysis (QDA.

  14. Naltrexone-sensitive analgesia following exposure of mice to 2450-MHz radiofrequency radiation (RFR)

    Energy Technology Data Exchange (ETDEWEB)

    Maillefer, R.H.; Quock, R.M. (Univ. of Illinois, Rockford (United States))

    1991-03-11

    This study was conducted to determine whether exposure to RFR might induce sufficient thermal stress to activate endogenous opioid mechanisms and induce analgesia. Male Swiss Webster mice, 20-25 g, were exposed to 10, 15 or 20 mV/cm{sup 2} RFR in a 2,450-MHz waveguide system for 10 min, then tested in the abdominal constriction paradigm. Specific absorption rates (SAR) were 23.7 W/kg at 10 mW/cm{sup 2}, 34.6 W/kg at 15 mW/cm{sup 2} and 45.5 W/kg at 20 mW/cm{sup 2}. Confinement in the exposure chamber alone did not appreciably alter body temperature but did appear to induce a stress-associated analgesia that was insensitive to the opioid receptor blocker naltrexone. Exposure of confined mice to RFR elevated body temperature and further increased analgesia in SAR-dependent manner. The high-SAR RFR-induced analgesia, but not the hyperthermia, was reduced by naltrexone. These findings suggest that (1) RFR produces SAR-dependent hyperthermia and analgesia and (2) RFR-induced analgesia is mediated by opioid mechanisms while confinement-induced analgesia involves non-opioid mechanisms.

  15. Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

    Science.gov (United States)

    Rossen, Janne; Klungsøyr, Kari; Albrechtsen, Susanne; Løkkegård, Ellen; Rasmussen, Steen; Bergholt, Thomas; Skjeldestad, Finn E

    2018-03-07

    Maternal age is an established risk factor for cesarean section; epidural analgesia and oxytocin augmentation may modify this association. We investigated the effects and interactions of oxytocin augmentation, epidural analgesia and maternal age on the risk of cesarean section. In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1]. In this case-control study the main exposure was maternal age; epidural analgesia, oxytocin augmentation, birthweight and time period were explanatory variables. Chi-square test and logistic regression were used to estimate associations and interactions. The cesarean section rate increased consistently with advancing maternal age, both overall and in strata of epidural analgesia and oxytocin augmentation. We observed strong interactions between maternal age, oxytocin augmentation and epidural analgesia for the risk of cesarean section. Women with epidural analgesia generally had a reduced adjusted odds ratio when oxytocin was used compared with when it was not used. In Norway, this applied to all maternal age groups but in Denmark only for women ≥30 years. Among women without epidural, oxytocin augmentation was associated with an increased odds ratio for cesarean section in Denmark, whereas no difference was observed in Norway. Oxytocin augmentation in nulliparous women with epidural analgesia is associated with a reduced risk of cesarean section in labor with spontaneous onset. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

  16. Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet

    Directory of Open Access Journals (Sweden)

    Torvaldsen Siranda

    2010-04-01

    Full Text Available Abstract Background Most women use some method of pain relief during labour. There is extensive research evidence available of pharmacological pain relief during labour; however this evidence is not readily available to pregnant women. Decision aids are tools that present evidence based information and allow preference elicitation. Methods We developed a labour analgesia decision aid. Using a RCT design women either received a decision aid or a pamphlet. Eligible women were primiparous, ≥ 37 weeks, planning a vaginal birth of a single infant and had sufficient English to complete the trial materials. We used a combination of affective (anxiety, satisfaction and participation in decision-making and behavioural outcomes (intention and analgesia use to assess the impact of the decision aid, which were assessed before labour. Results 596 women were randomised (395 decision aid group, 201 pamphlet group. There were significant differences in knowledge scores between the decision aid group and the pamphlet group (mean difference 8.6, 95% CI 3.70, 13.40. There were no differences between decisional conflict scores (mean difference -0.99 (95% CI -3.07, 1.07, or anxiety (mean difference 0.3, 95% CI -2.15, 1.50. The decision aid group were significantly more likely to consider their care providers opinion (RR 1.28 95%CI 0.64, 0.95. There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use. Conclusions This decision aid improves women's labour analgesia knowledge without increasing anxiety. Significantly, the decision aid group were more informed of labour analgesia options, and considered the opinion of their care providers more often when making their analgesia decisions, thus improving informed decision making. Trial Registration Trial registration no: ISRCTN52287533

  17. Desarrollo tecnológico de sulfato de cinc 5 mg/mL infusión intravenosa Technological development of zinc sulphate 5 mg/mL intravenous infusion

    Directory of Open Access Journals (Sweden)

    Armando Gato del Monte

    2005-08-01

    Full Text Available Se desarrolló una formulación de sulfato de cinc 5 mg/mL para infusión intravenosa que cumplió con las especificaciones de calidad de la USP 26, así como con el estudio de la estabilidad física, química, microbiológica y biológica de la solución, almacenada en envases de vidrio neutro de 5 mL de calidad hidrolítica I. El producto se expuso al calor por 90 días, y al calor y acción de la luz durante un período de 180 días, así como a vida de estante en condiciones normales de temperatura ambiente. Se comprobó la efectividad de los preservativos antimicrobianos presentes en la formulación. De los estudios realizados se determinó que la solución es estable por un período de más de 18 meses, almacenada a temperatura ambiente.A formulation of zinc sulphate 5 mg/mL for intravenous infusion was developed. It met the quality specifications of the USP 26, and it underwent the study of physical, chemical, microbiological and biological stability of the solution stored in neutral glass flasks of 5 ml of hydrolitic quality I. The product was exposed to heat for 90 days and to heat and the action of light for a period of 180 days, as well as to a shelf life under normal conditions of room temperature. It was proved the effectivity of the antimicrobial preservatives present in the formulation. According to the conducted studies, it was determined that the solution is stable for more than 18 months stored at room temperature.

  18. Long noncoding RNA PCA3 gene promoter region is related to the risk of prostate cancer on Chinese males.

    Science.gov (United States)

    Zhou, Wu; Tao, Zhihua; Wang, Zhongyong; Hu, Wangqiang; Shen, Mo; Zhou, Lianlian; Wen, Zhiliang; Yu, Zhixian; Wu, Xiuling; Huang, Kate; Hu, Yuanping; Lin, Xiangyang

    2014-12-01

    Long noncoding RNA prostate cancer gene antigen 3 (PCA3) is one of the most prostate cancer-specific genes at present. Consequently, the prostate-specific expression and the sharp up-regulation of PCA3 RNA in prostate cancer suggest a unique transcriptional regulation, which possibly can be attributed to promoter polymorphism. In this study, we investigated a short tandem repeat (STR) polymorphism of TAAA in the promoter region of PCA3 gene found in our previous study in prostate cancer (PCa) patients and benign prostatic hypertrophy (BPH) patients, aiming to evaluate the association between the STR and increased risk for PCa. 120 PCa cases and 120 benign prostatic hypertrophy (BPH) cases were identified among participants. The region encompassing the TAAA repeat was amplified with a specific primer set we designed and screened by PCR-based cloning and sequencing in paired peripheral blood leukocytes and prostate tissues. Genotype-specific risks were estimated as odds ratios (ORs) associated with 95% confidence intervals (CIs) and adjusted for age by means of unconditional logistic regression. 5 PCA3 TAAA STR polymorphisms and 8 genotypes were found in both peripheral blood leukocytes and prostate tissues, the carriers with more TAAA repeats were associated with increased risk for PCa than individuals having less TAAA repeats. Interestingly, 18 (15.0%) of 120 PCa patients had more (TAAA)n repeats in prostate tissues than that in peripheral blood leukocytes, and 3 (2.5%) of 120 had less (TAAA)n repeats in prostate tissues. The results of this study suggest that short tandem repeat polymorphism of TAAA in the promoter region of PCA3 gene is a risk-increasing factor for prostate cancer in the Chinese population. In addition to the hereditary factor, the insertion mutation of (TAAA)n in a local tissue maybe another mechanism of the onset of PCa. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Prolonged gabapentin analgesia in an experimental mouse model of fibromyalgia

    Directory of Open Access Journals (Sweden)

    Ueda Hiroshi

    2008-11-01

    Full Text Available Abstract In a new mouse model for generalized pain syndrome, including fibromyalgia, which used intermittent cold stress (ICS, bilateral allodynia in the hindpaw was observed that lasted more than 12 days; thermal hyperalgesia lasted 15 days. During constant cold stress (CCS, mice showed only a transient allodynia. A female prevalence in ICS-induced allodynia was observed in gonadectomized but not in gonad intact mice. Systemic gabapentin showed complete anti-allodynic effects in the ICS model at the one-tenth dose for injury-induced neuropathic pain model, and central gabapentin showed long-lasting analgesia for 4 days in ICS, but not the injury model. These results suggest that the ICS model is useful for the study of generalized pain syndrome.

  20. Morphine versus oxycodone analgesia after percutaneous kidney stone surgery

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Olesen, Anne Estrup; Drewes, Asbjørn Mohr

    2013-01-01

    According to previous studies oxycodone might have some advantages over morphine in the treatment of visceral pain. This study investigated the opioid consumption (primary outcome), pain relief and side effects (secondary outcomes) of morphine versus oxycodone after percutaneous nephrolithotomy...... using a method where the somatic pain component was minimized. Forty-four adult patients were studied. The patients were randomised to receive either morphine or oxycodone intravenously as postoperative pain treatment. During the first 4 h after surgery the opioid consumption, pain scores and side...... was significantly less frequent with morphine (P = 0.03). In this study morphine and oxycodone produced similar analgesia the first 4 h after surgery but the frequency of nausea was significantly less patient-reported with morphine. The hypothesis that oxycodone would be superior in the treatment of visceral pain...

  1. Imaging-guided hyperstimulation analgesia in low back pain

    Directory of Open Access Journals (Sweden)

    Gorenberg M

    2013-06-01

    Full Text Available Miguel Gorenberg,1,2 Kobi Schwartz31Department of Nuclear Medicine, B'nai Zion Medical Center, Haifa, Israel; 2The Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; 3Department of Physical Therapy, B'nai Zion Medical Center, Haifa, IsraelAbstract: Low back pain in patients with myofascial pain syndrome is characterized by painful active myofascial trigger points (ATPs in muscles. This article reviews a novel, noninvasive modality that combines simultaneous imaging and treatment, thus taking advantage of the electrodermal information available from imaged ATPs to deliver localized neurostimulation, to stimulate peripheral nerve endings (Aδ fibers and in turn, to release endogenous endorphins. "Hyperstimulation analgesia" with localized, intense, low-rate electrical pulses applied to painful ATPs was found to be effective in 95% patients with chronic nonspecific low back pain, in a clinical validation study.Keywords: myofascial, noninvasive, electrical, impedance

  2. Thoracic epidural analgesia reduces gastric microcirculation in the pig

    DEFF Research Database (Denmark)

    Ambrus, Rikard; Strandby, Rune B; Secher, Niels H.

    2016-01-01

    BACKGROUND: Thoracic epidural analgesia (TEA) is used for pain relief during and after abdominal surgery, but the effect of TEA on the splanchnic microcirculation remains debated. We evaluated whether TEA affects splanchnic microcirculation in the pig. METHODS: Splanchnic microcirculation...... was assessed in nine pigs prior to and 15 and 30 min after induction of TEA. Regional blood flow was assessed by neutron activated microspheres and changes in microcirculation by laser speckle contrast imaging (LSCI). RESULTS: As assessed by LSCI 15 min following TEA, gastric arteriolar flow decreased by 22...... regional blood flow 30 min following induction of TEA (p = 0.048). These manifestations took place along with a drop in systolic blood pressure (p = 0.030), but with no significant change in mean arterial pressure, cardiac output, or heart rate. CONCLUSION: The results indicate that TEA may have an adverse...

  3. Clonidine for sedation and analgesia for neonates receiving mechanical ventilation.

    Science.gov (United States)

    Romantsik, Olga; Calevo, Maria Grazia; Norman, Elisabeth; Bruschettini, Matteo

    2017-05-10

    Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates. To compare the intervention versus placebo, no treatment, and dexmedetomidine; and to assess the safety of clonidine infusion for potential harms.To perform subgroup analyses according to gestational age; birth weight; administration method (infusion or bolus therapy); dose, duration, and route of clonidine administration; and pharmacologic sedation as a co-intervention. We used the standard search strategy of the Cochrane Neonatal Review Group to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 12) in the Cochrane Library, MEDLINE via PubMed (1966 to January 10, 2017), Embase (1980 to January 10, 2017), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL; 1982 to January 10, 2017). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomized controlled trials and quasi-randomized trials. We searched for randomized controlled trials, quasi-randomized controlled trials, and cluster trials comparing clonidine versus placebo, no treatment, or dexmedetomidine administered to term and preterm newborns receiving mechanical ventilation via an endotracheal tube. For the included trial, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, all-cause death during initial hospitalization, duration of respiratory support, sedation

  4. Comparison of Lidocaine and Lidocaine-Meperidine Combination for Caudal Epidural Analgesia in Mares

    OpenAIRE

    BİRİCİK, Halil Selçuk

    2014-01-01

    The objectives of this study were to compare some haemodynamic and clinical parameters and the analgesic, sedative effects of lidocaine and a lidocaine-meperidine combination for caudal epidural analgesia in mares. This study was performed on 12 thoroughbred mares aged 13-24 years. Time to onset of analgesia in the combination group (6.67 ± 0.42 min) was significantly (P < 0.01) lower than in the lidocaine group (12.17 ± 1.05 min). However, duration of analgesia was significantly (P &a...

  5. Morphine- and buprenorphine-induced analgesia and antihyperalgesia in a human inflammatory pain model

    DEFF Research Database (Denmark)

    Ravn, Pernille; Secher, EL; Skram, U

    2013-01-01

    Opioid therapy is associated with the development of tolerance and paradoxically increased sensitivity to pain. It has been suggested that buprenorphine is associated with a higher antihyperalgesia/analgesia ratio than μ-opioid receptor agonists. The primary outcome of this study was therefore...... to investigate relative differences in antihyperalgesia and analgesia effects between morphine and buprenorphine in an inflammatory pain model in volunteers. The secondary outcome was to examine the relationship between pain sensitivity and opioid-induced effects on analgesia, antihyperalgesia, and descending...

  6. Randomized comparison of effectiveness of unimodal opioid analgesia with multimodal analgesia in post–cesarean section pain management

    Directory of Open Access Journals (Sweden)

    Adeniji AO

    2013-05-01

    Full Text Available Adetunji Oladeni Adeniji,1 Oluseyi Olaboyede A Atanda21Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology, Ogbomoso, Nigeria; 2Department of Obstetrics and Gynaecology, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, NigeriaBackground: Postoperative pain leads to patient discomfort, decreased level of satisfaction, prolonged recovery, and higher health costs. Acute pain control therefore improves the overall quality of life in patients undergoing cesarean section. Pain relief is a fundamental human right, but there is no gold standard for post–cesarean section pain management.Objective: To compare the efficacy of pentazocine and tramadol used in unimodal and multimodal (in combination with piroxicam approach, in the management of post–cesarean section pain.Materials and methods: This study employed a random allocation design to compare the effectiveness of intramuscular pentazocine (60 mg or tramadol (100 mg as single analgesic agent and in combination with daily intramuscular piroxicam 20 mg, for the management of post–cesarean section pain during the immediate 12 hours after surgery. The primary outcome measure was control of postoperative pain, while the secondary outcome measures were the analgesic agent onset of action, duration of action, patient satisfaction, and maternal and neonatal adverse outcomes. Data obtained were entered into a predesigned sheet and analyzed with the Statistical Package for Social Sciences version 17. Means ± standard deviation (SD were calculated for the quantitative variables, and the difference between two independent groups was compared using unpaired Student's t-test. The level of significance was set at 0.05.Results: A total of 120 patients were equally and randomly allocated to four study groups – two that received unimodal analgesia (the pentazocine group and the tramadol group and two that received multimodal analgesia (the pentazocine

  7. The programmed cell death GLuc PCA library – a powerful tool for pathway discovery and drug screening

    Science.gov (United States)

    Gilad, Yuval; Kimchi, Adi

    2014-01-01

    A programmed cell death library based on the Gaussia luciferase protein-fragment complementation assay (GLuc PCA) enables detection of protein–protein interactions (PPI) within the cell death network and quantitative assessments of these interactions. Among future applications for the GLuc PCA cell death library is its potential use as a platform for PPI-targeted drug screening. PMID:27308378

  8. Effect of process control agent (PCA) on the characteristics of mechanically alloyed Ti-Mg powders [Conference paper

    CSIR Research Space (South Africa)

    Machio, Christopher N

    2010-10-01

    Full Text Available This article reports results of a study to determine the effect of process control agent (PCA) on the characteristics of Ti-Mg powders during milling. It has been shown that a 2% increase in PCA content leads to up to a 40% increase in yield...

  9. RXTE PCA and Swift BAT detects the millisecond pulsar Swift J1756.9-2508 in outburst

    NARCIS (Netherlands)

    Patruno, A.; Markwardt, C.B.; Strohmayer, T.E.; Swank, J.H.; Smith, S.E.; Pereira, D.

    2009-01-01

    We report a detection of increased activity of the accreting millisecond X-ray pulsar Swift J1756.9-2508 observed with the RXTE-PCA monitoring on July 8, 9hr UTC. Increased flux is detected simultaneously on the Swift-BAT camera. RXTE-PCA follow up observations starting on July 13, 23hr UTC,

  10. Feasibility of ANFIS towards multiclass event classification in PFBR considering dimensionality reduction using PCA

    International Nuclear Information System (INIS)

    Prusty, Manas Ranjan; Jayanthi, T.; Chakraborty, Jaideep; Velusamy, K.

    2017-01-01

    Highlights: • A dimensionality reduction using principal component analysis (PCA) is achievable in nuclear power plant. • PCA reduces the complexity of any classifier used for event classification. • Adaptive neuro fuzzy inference system (ANFIS) works in acceptable range for such classification. • PCA along with ANFIS improves the overall performance of ANFIS for event classification. • Multiple ANFIS gives better performance over single ANFIS when the number of classes is more. - Abstract: Nuclear power plant (NPP) such as Prototype Fast Breeder Reactor (PFBR), is a paradigm of complex engineering which is safety critical in nature. It sends copious plant signals to the main control room. An amalgamation of plenty of such plant signals escorts an operator to make appropriate decision during catastrophic circumstances. This decision must be quick and unambiguous in order to overcome any adverse situation. The concept of dimensionality reduction aids the purpose as it reduces the number of inputs to any system or model or classifier which ultimately makes the decision process faster. The fundamental aspect which should be taken paramount care is that there should not be any loss of information due to dimensionality reduction, as in a NPP, safety is the foremost goal. One of the most prevalently used dimensionality reduction algorithms is principal component analysis (PCA). This is achieved by dumping the principal components which has less variability. In this paper, the feasibility of dimensionality reduction is studied for classification of some of the events in PFBR. Two cases are considered in this paper out of which in first one, the event is divided into two sub events such as primary and secondary part of the event based on the importance of classification. The event data is fed to two separate classifiers which classify both the parts of the event separately. Finally, the event is classified as the concatenation of the outputs of both the

  11. Comparison of ropivacaine (0.2%) with or without clonidine 1 μg/kg for epidural labor analgesia: A randomized controlled study

    OpenAIRE

    Indira Kumari; Kapil Sharma; Vikram Bedi; Madhan Mohan; Hemraj Tungaria; Manish Kumar Modi

    2018-01-01

    Background and Aims: The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. Material and Methods: A total of 60 term parturients of the American Society of Anesthesiologists Grade I and II with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labor analgesia after informed consent were divided in two groups. Group ...

  12. Use of principal components analysis (PCA) on estuarine sediment datasets: The effect of data pre-treatment

    International Nuclear Information System (INIS)

    Reid, M.K.; Spencer, K.L.

    2009-01-01

    Principal components analysis (PCA) is a multivariate statistical technique capable of discerning patterns in large environmental datasets. Although widely used, there is disparity in the literature with respect to data pre-treatment prior to PCA. This research examines the influence of commonly reported data pre-treatment methods on PCA outputs, and hence data interpretation, using a typical environmental dataset comprising sediment geochemical data from an estuary in SE England. This study demonstrated that applying the routinely used log (x + 1) transformation skewed the data and masked important trends. Removing outlying samples and correcting for the influence of grain size had the most significant effect on PCA outputs and data interpretation. Reducing the influence of grain size using granulometric normalisation meant that other factors affecting metal variability, including mineralogy, anthropogenic sources and distance along the salinity transect could be identified and interpreted more clearly. - Data pre-treatment can have a significant influence on the outcome of PCA.

  13. Antineoplastic and immunomodulatory effect of polyphenolic components of Achyranthes aspera (PCA) extract on urethane induced lung cancer in vivo.

    Science.gov (United States)

    Narayan, Chandradeo; Kumar, Arvind

    2014-01-01

    Polyphenolic compounds of Achyranthes aspera (PCA) extract is evaluated for anti-cancerous and cytokine based immunomodulatory effects. The PCA extract contains known components of phenolic acid and flavonoids such as mixture of quinic acid, chlorogenic acid, kaempferol, quercetin and chrysin along with many unknown components. PCA has been orally feed to urethane (ethyl carbamate) primed lung cancerous mice at a dosage of 100 mg/kg body weight for 30 consecutive days. 100 mg powder of A. aspera contains 2.4 mg phenolic acid and 1.1 mg flavonoid (2:1 ratio). Enhanced activities and expression of antioxidant enzymes GST, GR, CAT, SOD, while down regulated expression and activation of LDH enzymes in PCA feed urethane primed lung cancerous tissues as compared to PCA non-feed urethane primed lung cancerous tissues were observed. PCA feed urethane primed lung tissues showed down regulated expression of pro-inflammatory cytokines IL-1β, IL-6 and TNF-α along with TFs, NF-κB and Stat3 while the expression of pro-apoptotic proteins Bax and p53 were enhanced in PCA feed urethane primed lung tissues. FTIR and CD spectroscopy data revealed that PCA resisted the urethane mediated conformational changes of DNA which is evident by the shift in guanine and thymine bands in FTIR from 1,708 to 1,711 cm(-1) and 1,675 to 1,671 cm(-1), respectively in PCA feed urethane primed lung cancerous tissues DNA in comparison to urethane primed lung cancerous tissues DNA. The present study suggests that PCA components have synergistic anti-cancerous and cytokine based immunomodulatory role and DNA conformation restoring effects. However, more research is required to show the effects of each component separately and in combination for effective therapeutic use to cure and prevent lung cancer including other cancers.

  14. Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy

    Directory of Open Access Journals (Sweden)

    Hala Saad Abdel-Ghaffar

    2017-01-01

    Conclusion: Wound instillation of bupivacaine/ketamine is a simple, noninvasive, and effective technique that could be a safe alternative to CK for postoperative analgesia in children undergoing inguinal hernia repair.

  15. Dexamethasone prolongs local analgesia after subcutaneous infiltration of bupivacaine microcapsules in human volunteers

    DEFF Research Database (Denmark)

    Holte, Kathrine; Werner, Mads U; Lacouture, Peter G

    2002-01-01

    BACKGROUND: The addition of small amounts of dexamethasone to extended-release formulations of bupivacaine in microcapsules has been found to prolong local analgesia in experimental studies, but no clinical data are available. METHODS: In a double-blinded study, 12 healthy male volunteers were...... randomized to receive simultaneous subcutaneous injections of bupivacaine microcapsules with dexamethasone and bupivacaine microcapsules without dexamethasone in each calf. Local analgesia was assessed with a validated human pain model; main parameters evaluated were thermal, mechanical, and pain detection...... curve [AUC]) were considered best estimate of analgesia. Safety evaluations were performed daily for the first week and at 2 weeks, 6 weeks, and 6 months after injection. RESULTS: The addition of dexamethasone significantly prolonged local analgesia of bupivacaine microcapsules without influence...

  16. Labor analgesia in parturients of fetal growth restriction having raised umbilical Doppler vascular indices

    Directory of Open Access Journals (Sweden)

    Sukhen Samanta

    2018-01-01

    Conclusions: Continuous epidural ropivacaine causes improved fetoplacental circulation in parturients with growth-restricted fetuses having raised Doppler indices during labor analgesia. We also found better neonatal outcome with continuous infusion of epidural ropivacaine as compared to IM tramadol.

  17. Sedação e analgesia em neonatologia Sedación y analgesia en neonatología Sedation and analgesia in neonatology

    Directory of Open Access Journals (Sweden)

    Yerkes Pereira e Silva

    2007-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A importância do estudo da dor em Neonatologia se deve ao fato de que a sensação de dor e estresse significa sofrimento e desconforto para os recém-nascidos e, apesar desse conhecimento, pouco tem sido feito para minimizá-los. Nessa revisão foram discutidas: a prevenção da dor, as medidas não-farmacológicas e farmacológicas para o seu tratamento e a sedação em recém-nascidos. CONTEÚDO: Várias são as medidas não-farmacológicas que podem ser tomadas com intuito de prevenir a dor nas Unidades de Terapia Intensiva Neonatal e também para tornar o ambiente mais humanizado e menos estressante para os pacientes e seus familiares. O tratamento da dor no recém-nascido consiste em medidas não-farmacológicas (sucção não-nutritiva, glicose e farmacológicas (analgésicos não-opióides, opióides e anestésicos locais. A sedação em recém-nascidos é produzida por fármacos que agem diminuindo a atividade, a ansiedade e a agitação do paciente, podendo levar à amnésia de eventos dolorosos ou não-dolorosos. A sedação pode ser feita pela administração de hidrato de cloral, barbitúricos, propofol e benzodiazepínicos. CONCLUSÕES: A prevenção da dor e a indicação de analgesia devem ser individualizadas e sempre consideradas em todos os recém-nascidos portadores de doenças potencialmente dolorosas e/ou submetidos a procedimentos invasivos, cirúrgicos ou não.JUSTIFICATIVA Y OBJETIVOS: La importancia del estudio del dolor en neonatología se debe al hecho de que la sensación de dolor y de estrés significa sufrimiento e incomodidad para los recién nacidos y, a pesar de ese conocimiento poco se ha hecho para reducirlo. Dentro de esa revisión se discutieron: la prevención del dolor, las medidas no farmacológicas ye farmacológicas para su tratamiento y la sedación en recién nacidos. CONTENIDO: Varias son las medidas no-farmacológicas que pueden ser tomadas con el objetivo de prevenir el

  18. [Labor epidural analgesia for a woman with a pityriasis versicolor in the lumbar region].

    Science.gov (United States)

    Dubar, G; Omarjee, M; Viguié, C; Barbarot, S; Mignon, A

    2011-01-01

    Epidural analgesia is usually contraindicated in case of infection at the site of needle insertion. Tinea versicolor is a benign superficial cutaneous fungal infection caused by the proliferation of a skin commensal yeast of low pathogenicity. We report the case of a pregnant woman with a tinea versicolor in the lumbar region, who benefited from a labor epidural analgesia, realised with reinforced antiseptic measures. No neurological or infectious complication occurred. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  19. Analgesia for pain control during extracorporeal shock wave lithotripsy: Current status

    Directory of Open Access Journals (Sweden)

    Narmada P Gupta

    2008-01-01

    Conclusion: The ideal analgesic, offering optimal pain control, minimal side effects, and cost-effectiveness is still elusive. Opioids administered using various techniques, provide effective analgesia, but require active monitoring of patient for potential adverse effects. Combination therapy (oral NSAID and occlusive dressing of EMLA, DMSO with lidocaine offers an effective alternative mode for achieving analgesia with minimal morbidity. This therapy avoids the need for general anesthesia, injectable analgesics, and opioids along with their side effects.

  20. Mediation of buprenorphine analgesia by a combination of traditional and truncated mu opioid receptor splice variants.

    Science.gov (United States)

    Grinnell, Steven G; Ansonoff, Michael; Marrone, Gina F; Lu, Zhigang; Narayan, Ankita; Xu, Jin; Rossi, Grace; Majumdar, Susruta; Pan, Ying-Xian; Bassoni, Daniel L; Pintar, John; Pasternak, Gavril W

    2016-10-01

    Buprenorphine has long been classified as a mu analgesic, although its high affinity for other opioid receptor classes and the orphanin FQ/nociceptin ORL1 receptor may contribute to its other actions. The current studies confirmed a mu mechanism for buprenorphine analgesia, implicating several subsets of mu receptor splice variants. Buprenorphine analgesia depended on the expression of both exon 1-associated traditional full length 7 transmembrane (7TM) and exon 11-associated truncated 6 transmembrane (6TM) MOR-1 variants. In genetic models, disruption of delta, kappa1 or ORL1 receptors had no impact on buprenorphine analgesia, while loss of the traditional 7TM MOR-1 variants in an exon 1 knockout (KO) mouse markedly lowered buprenorphine analgesia. Loss of the truncated 6TM variants in an exon 11 KO mouse totally eliminated buprenorphine analgesia. In distinction to analgesia, the inhibition of gastrointestinal transit and stimulation of locomotor activity were independent of truncated 6TM variants. Restoring expression of a 6TM variant with a lentivirus rescued buprenorphine analgesia in an exon 11 KO mouse that still expressed the 7TM variants. Despite a potent and robust stimulation of (35) S-GTPγS binding in MOR-1 expressing CHO cells, buprenorphine failed to recruit β-arrestin-2 binding at doses as high as 10 µM. Buprenorphine was an antagonist in DOR-1 expressing cells and an inverse agonist in KOR-1 cells. Buprenorphine analgesia is complex and requires multiple mu receptor splice variant classes but other actions may involve alternative receptors. © 2016 Wiley Periodicals, Inc.

  1. An Update on Drugs Used for Lumbosacral Epidural Anesthesia and Analgesia in Dogs

    OpenAIRE

    Steagall, Paulo V. M.; Simon, Bradley T.; Teixeira Neto, Francisco J.; Luna, Stelio P. L.

    2017-01-01

    This review aims to report an update on drugs administered into the epidural space for anesthesia and analgesia in dogs, describing their potential advantages and disadvantages in the clinical setting. Databases searched include Pubmed, Google scholar, and CAB abstracts. Benefits of administering local anesthetics, opioids, and alpha2 agonists into the epidural space include the use of lower doses of general anesthetics (anesthetic “sparing” effect), perioperative analgesia, and reduced side ...

  2. Thermal balance during transurethral resection of the prostate. A comparison of general anaesthesia and epidural analgesia

    DEFF Research Database (Denmark)

    Stjernström, H; Henneberg, S; Eklund, A

    1985-01-01

    anaesthesia (G.A.) or epidural analgesia (E.A.). Oxygen uptake, catecholamines, peripheral and central temperatures were followed in the per- and postoperative period. Heat production and total body heat were calculated from oxygen uptake and temperature measurements, respectively. Transurethral resection...... increased, while no such changes could be detected using epidural analgesia. The ability to increase mean body temperature by increasing heat production was negatively correlated to age....

  3. Short-term PV/T module temperature prediction based on PCA-RBF neural network

    Science.gov (United States)

    Li, Jiyong; Zhao, Zhendong; Li, Yisheng; Xiao, Jing; Tang, Yunfeng

    2018-02-01

    Aiming at the non-linearity and large inertia of temperature control in PV/T system, short-term temperature prediction of PV/T module is proposed, to make the PV/T system controller run forward according to the short-term forecasting situation to optimize control effect. Based on the analysis of the correlation between PV/T module temperature and meteorological factors, and the temperature of adjacent time series, the principal component analysis (PCA) method is used to pre-process the original input sample data. Combined with the RBF neural network theory, the simulation results show that the PCA method makes the prediction accuracy of the network model higher and the generalization performance stronger than that of the RBF neural network without the main component extraction.

  4. Microstructural design of PCA austenitic stainless steel for improved resistance to helium embrittlement under HFIR irradiation

    International Nuclear Information System (INIS)

    Maziasz, P.J.; Braski, D.N.

    1983-01-01

    Several variants of Prime Candidate Alloy (PCA) with different preirradiation thermal-mechanical treatments were irradiated in HFIR and were evaluated for embrittlement resistance via disk-bend tensile testing. Comparison tests were made on two heats of 20%-cold-worked type 316 stainless steel. None of the alloys were brittle after irradiation at 300 to 400 0 C to approx. 44 dpa and helium levels of 3000 to approx.3600 at. ppm. However, all were quite brittle after similar exposure at 600 0 C. Embrittlement varied with alloy and pretreatment for irradiation to 44 dpa at 500 0 C and to 22 dpa at 600 0 C. Better relative embrittlement resistance among PCA variants was found in alloys which contained prior grain boundary MC carbide particles that remained stable under irradiation

  5. Extraction of prostatic lumina and automated recognition for prostatic calculus image using PCA-SVM.

    Science.gov (United States)

    Wang, Zhuocai; Xu, Xiangmin; Ding, Xiaojun; Xiao, Hui; Huang, Yusheng; Liu, Jian; Xing, Xiaofen; Wang, Hua; Liao, D Joshua

    2011-01-01

    Identification of prostatic calculi is an important basis for determining the tissue origin. Computation-assistant diagnosis of prostatic calculi may have promising potential but is currently still less studied. We studied the extraction of prostatic lumina and automated recognition for calculus images. Extraction of lumina from prostate histology images was based on local entropy and Otsu threshold recognition using PCA-SVM and based on the texture features of prostatic calculus. The SVM classifier showed an average time 0.1432 second, an average training accuracy of 100%, an average test accuracy of 93.12%, a sensitivity of 87.74%, and a specificity of 94.82%. We concluded that the algorithm, based on texture features and PCA-SVM, can recognize the concentric structure and visualized features easily. Therefore, this method is effective for the automated recognition of prostatic calculi.

  6. Power line identification of millimeter wave radar based on PCA-GS-SVM

    Science.gov (United States)

    Fang, Fang; Zhang, Guifeng; Cheng, Yansheng

    2017-12-01

    Aiming at the problem that the existing detection method can not effectively solve the security of UAV's ultra low altitude flight caused by power line, a power line recognition method based on grid search (GS) and the principal component analysis and support vector machine (PCA-SVM) is proposed. Firstly, the candidate line of Hough transform is reduced by PCA, and the main feature of candidate line is extracted. Then, upport vector machine (SVM is) optimized by grid search method (GS). Finally, using support vector machine classifier optimized parameters to classify the candidate line. MATLAB simulation results show that this method can effectively identify the power line and noise, and has high recognition accuracy and algorithm efficiency.

  7. A Study of Wind Turbine Comprehensive Operational Assessment Model Based on EM-PCA Algorithm

    Science.gov (United States)

    Zhou, Minqiang; Xu, Bin; Zhan, Yangyan; Ren, Danyuan; Liu, Dexing

    2018-01-01

    To assess wind turbine performance accurately and provide theoretical basis for wind farm management, a hybrid assessment model based on Entropy Method and Principle Component Analysis (EM-PCA) was established, which took most factors of operational performance into consideration and reach to a comprehensive result. To verify the model, six wind turbines were chosen as the research objects, the ranking obtained by the method proposed in the paper were 4#>6#>1#>5#>2#>3#, which are completely in conformity with the theoretical ranking, which indicates that the reliability and effectiveness of the EM-PCA method are high. The method could give guidance for processing unit state comparison among different units and launching wind farm operational assessment.

  8. Extraction of Prostatic Lumina and Automated Recognition for Prostatic Calculus Image Using PCA-SVM

    Science.gov (United States)

    Wang, Zhuocai; Xu, Xiangmin; Ding, Xiaojun; Xiao, Hui; Huang, Yusheng; Liu, Jian; Xing, Xiaofen; Wang, Hua; Liao, D. Joshua

    2011-01-01

    Identification of prostatic calculi is an important basis for determining the tissue origin. Computation-assistant diagnosis of prostatic calculi may have promising potential but is currently still less studied. We studied the extraction of prostatic lumina and automated recognition for calculus images. Extraction of lumina from prostate histology images was based on local entropy and Otsu threshold recognition using PCA-SVM and based on the texture features of prostatic calculus. The SVM classifier showed an average time 0.1432 second, an average training accuracy of 100%, an average test accuracy of 93.12%, a sensitivity of 87.74%, and a specificity of 94.82%. We concluded that the algorithm, based on texture features and PCA-SVM, can recognize the concentric structure and visualized features easily. Therefore, this method is effective for the automated recognition of prostatic calculi. PMID:21461364

  9. In Vivo Imaging of Experimental Melanoma Tumors using the Novel Radiotracer 68Ga-NODAGA-Procainamide (PCA).

    Science.gov (United States)

    Kertész, István; Vida, András; Nagy, Gábor; Emri, Miklós; Farkas, Antal; Kis, Adrienn; Angyal, János; Dénes, Noémi; Szabó, Judit P; Kovács, Tünde; Bai, Péter; Trencsényi, György

    2017-01-01

    The most aggressive form of skin cancer is the malignant melanoma. Because of its high metastatic potential the early detection of primary melanoma tumors and metastases using non-invasive PET imaging determines the outcome of the disease. Previous studies have already shown that benzamide derivatives, such as procainamide (PCA) specifically bind to melanin pigment. The aim of this study was to synthesize and investigate the melanin specificity of the novel 68 Ga-labeled NODAGA-PCA molecule in vitro and in vivo using PET techniques. Procainamide (PCA) was conjugated with NODAGA chelator and was labeled with Ga-68 ( 68 Ga-NODAGA-PCA). The melanin specificity of 68 Ga-NODAGA-PCA was tested in vitro , ex vivo and in vivo using melanotic B16-F10 and amelanotic Melur melanoma cell lines. By subcutaneous and intravenous injection of melanoma cells tumor-bearing mice were prepared, on which biodistribution studies and small animal PET/CT scans were performed for 68 Ga-NODAGA-PCA and 18 FDG tracers. 68 Ga-NODAGA-PCA was produced with high specific activity (14.9±3.9 GBq/µmol) and with excellent radiochemical purity (98%PCA uptake of B16-F10 cells was significantly ( p ≤0.01) higher than Melur cells. Ex vivo biodistribution and in vivo PET/CT studies using subcutaneous and metastatic tumor models showed significantly ( p ≤0.01) higher 68 Ga-NODAGA-PCA uptake in B16-F10 primary tumors and lung metastases in comparison with amelanotic Melur tumors. In experiments where 18 FDG and 68 Ga-NODAGA-PCA uptake of B16-F10 tumors was compared, we found that the tumor-to-muscle (T/M) and tumor-to-lung (T/L) ratios were significantly ( p ≤0.05 and p ≤0.01) higher using 68 Ga-NODAGA-PCA than the 18 FDG accumulation. Our novel radiotracer 68 Ga-NODAGA-PCA showed specific binding to the melanin producing experimental melanoma tumors. Therefore, 68 Ga-NODAGA-PCA is a suitable diagnostic radiotracer for the detection of melanoma tumors and metastases in vivo .

  10. SU-C-BRF-03: PCA Modeling of Anatomical Changes During Head and Neck Radiation Therapy

    International Nuclear Information System (INIS)

    Chetvertkov, M; Kim, J; Siddiqui, F; Kumarasiri, A; Chetty, I; Gordon, J

    2014-01-01

    Purpose: To develop principal component analysis (PCA) models from daily cone beam CTs (CBCTs) of head and neck (H and N) patients that could be used prospectively in adaptive radiation therapy (ART). Methods: : For 7 H and N patients, Pinnacle Treatment Planning System (Philips Healthcare) was used to retrospectively deformably register daily CBCTs to the planning CT. The number N of CBCTs per treatment course ranged from 14 to 22. For each patient a PCA model was built from the deformation vector fields (DVFs), after first subtracting the mean DVF, producing N eigen-DVFs (EDVFs). It was hypothesized that EDVFs with large eigenvalues represent the major anatomical deformations during the course of treatment, and that it is feasible to relate each EDVF to a clinically meaningful systematic or random change in anatomy, such as weight loss, neck flexion, etc. Results: DVFs contained on the order of 3×87×87×58=1.3 million scalar values (3 times the number of voxels in the registered volume). The top 3 eigenvalues accounted for ∼90% of variance. Anatomical changes corresponding to an EDVF were evaluated by generating a synthetic DVF, and applying that DVF to the CT to produce a synthetic CBCT. For all patients, the EDVF for the largest eigenvalue was interpreted to model weight loss. The EDVF for other eigenvalues appeared to represented quasi-random fraction-to-fraction changes. Conclusion: The leading EDVFs from single-patient PCA models have tentatively been identified with weight loss changes during treatment. Other EDVFs are tentatively identified as quasi-random inter-fraction changes. Clean separation of systematic and random components may require further work. This work is expected to facilitate development of population-based PCA models that can be used to prospectively identify significant anatomical changes, such as weight loss, early in treatment, triggering replanning where beneficial

  11. Improved medical image fusion based on cascaded PCA and shift invariant wavelet transforms.

    Science.gov (United States)

    Reena Benjamin, J; Jayasree, T

    2018-02-01

    In the medical field, radiologists need more informative and high-quality medical images to diagnose diseases. Image fusion plays a vital role in the field of biomedical image analysis. It aims to integrate the complementary information from multimodal images, producing a new composite image which is expected to be more informative for visual perception than any of the individual input images. The main objective of this paper is to improve the information, to preserve the edges and to enhance the quality of the fused image using cascaded principal component analysis (PCA) and shift invariant wavelet transforms. A novel image fusion technique based on cascaded PCA and shift invariant wavelet transforms is proposed in this paper. PCA in spatial domain extracts relevant information from the large dataset based on eigenvalue decomposition, and the wavelet transform operating in the complex domain with shift invariant properties brings out more directional and phase details of the image. The significance of maximum fusion rule applied in dual-tree complex wavelet transform domain enhances the average information and morphological details. The input images of the human brain of two different modalities (MRI and CT) are collected from whole brain atlas data distributed by Harvard University. Both MRI and CT images are fused using cascaded PCA and shift invariant wavelet transform method. The proposed method is evaluated based on three main key factors, namely structure preservation, edge preservation, contrast preservation. The experimental results and comparison with other existing fusion methods show the superior performance of the proposed image fusion framework in terms of visual and quantitative evaluations. In this paper, a complex wavelet-based image fusion has been discussed. The experimental results demonstrate that the proposed method enhances the directional features as well as fine edge details. Also, it reduces the redundant details, artifacts, distortions.

  12. [Identification of varieties of cashmere by Vis/NIR spectroscopy technology based on PCA-SVM].

    Science.gov (United States)

    Wu, Gui-Fang; He, Yong

    2009-06-01

    One mixed algorithm was presented to discriminate cashmere varieties with principal component analysis (PCA) and support vector machine (SVM). Cashmere fiber has such characteristics as threadlike, softness, glossiness and high tensile strength. The quality characters and economic value of each breed of cashmere are very different. In order to safeguard the consumer's rights and guarantee the quality of cashmere product, quickly, efficiently and correctly identifying cashmere has significant meaning to the production and transaction of cashmere material. The present research adopts Vis/NIRS spectroscopy diffuse techniques to collect the spectral data of cashmere. The near infrared fingerprint of cashmere was acquired by principal component analysis (PCA), and support vector machine (SVM) methods were used to further identify the cashmere material. The result of PCA indicated that the score map made by the scores of PC1, PC2 and PC3 was used, and 10 principal components (PCs) were selected as the input of support vector machine (SVM) based on the reliabilities of PCs of 99.99%. One hundred cashmere samples were used for calibration and the remaining 75 cashmere samples were used for validation. A one-against-all multi-class SVM model was built, the capabilities of SVM with different kernel function were comparatively analyzed, and the result showed that SVM possessing with the Gaussian kernel function has the best identification capabilities with the accuracy of 100%. This research indicated that the data mining method of PCA-SVM has a good identification effect, and can work as a new method for rapid identification of cashmere material varieties.

  13. Maximizing genetic differentiation in core collections by PCA-based clustering of molecular marker data.

    Science.gov (United States)

    van Heerwaarden, Joost; Odong, T L; van Eeuwijk, F A

    2013-03-01

    Developing genetically diverse core sets is key to the effective management and use of crop genetic resources. Core selection increasingly uses molecular marker-based dissimilarity and clustering methods, under the implicit assumption that markers and genes of interest are genetically correlated. In practice, low marker densities mean that genome-wide correlations are mainly caused by genetic differentiation, rather than by physical linkage. Although of central concern, genetic differentiation per se is not specifically targeted by most commonly employed dissimilarity and clustering methods. Principal component analysis (PCA) on genotypic data is known to effectively describe the inter-locus correlations caused by differentiation, but to date there has been no evaluation of its application to core selection. Here, we explore PCA-based clustering of marker data as a basis for core selection, with the aim of demonstrating its use in capturing genetic differentiation in the data. Using simulated datasets, we show that replacing full-rank genotypic data by the subset of genetically significant PCs leads to better description of differentiation and improves assignment of genotypes to their population of origin. We test the effectiveness of differentiation as a criterion for the formation of core sets by applying a simple new PCA-based core selection method to simulated and actual data and comparing its performance to one of the best existing selection algorithms. We find that although gains in genetic diversity are generally modest, PCA-based core selection is equally effective at maximizing diversity at non-marker loci, while providing better representation of genetically differentiated groups.

  14. Wavelet Compressed PCA Models for Real-Time Image Registration in Augmented Reality Applications

    OpenAIRE

    Christopher Cooper; Kent Wise; John Cooper; Makarand Deo

    2015-01-01

    The use of augmented reality (AR) has shown great promise in enhancing medical training and diagnostics via interactive simulations. This paper presents a novel method to perform accurate and inexpensive image registration (IR) utilizing a pre-constructed database of reference objects in conjunction with a principal component analysis (PCA) model. In addition, a wavelet compression algorithm is utilized to enhance the speed of the registration process. The proposed method is used to perform r...

  15. Evaluation of PCA and Gamma test techniques on ANN operation for weekly solid waste prediction.

    Science.gov (United States)

    Noori, Roohollah; Karbassi, Abdulreza; Salman Sabahi, Mohammad

    2010-01-01

    Artificial neural networks (ANNs) are suitable for modeling solid waste generation. In the present study, four training functions, including resilient backpropagation (RP), scale conjugate gradient (SCG), one step secant (OSS), and Levenberg-Marquardt (LM) algorithms have been used. The main goal of this research is to develop an ANN model with a simple structure and ample accuracy. In the first step, an appropriate ANN model with 13 input variables is developed using the afore-mentioned algorithms to optimize the network parameters for weekly solid waste prediction in Mashhad, Iran. Subsequently, principal component analysis (PCA) and Gamma test (GT) techniques are used to reduce the number of input variables. Finally, comparison amongst the operation of ANN, PCA-ANN, and GT-ANN models is made. Findings indicated that the PCA-ANN and GT-ANN models have more effective results than the ANN model. These two models decrease the number of input variables from 13 to 7 and 5, respectively. 2009 Elsevier Ltd. All rights reserved.

  16. Fusion of PCA-Based and LDA-Based Similarity Measures for Face Verification

    Directory of Open Access Journals (Sweden)

    Kittler Josef

    2010-01-01

    Full Text Available The problem of fusing similarity measure-based classifiers is considered in the context of face verification. The performance of face verification systems using different similarity measures in two well-known appearance-based representation spaces, namely Principle Component Analysis (PCA and Linear Discriminant Analysis (LDA is experimentally studied. The study is performed for both manually and automatically registered face images. The experimental results confirm that our optimised Gradient Direction (GD metric within the LDA feature space outperforms the other adopted metrics. Different methods of selection and fusion of the similarity measure-based classifiers are then examined. The experimental results demonstrate that the combined classifiers outperform any individual verification algorithm. In our studies, the Support Vector Machines (SVMs and Weighted Averaging of similarity measures appear to be the best fusion rules. Another interesting achievement of the work is that although features derived from the LDA approach lead to better results than those of the PCA algorithm for all the adopted scoring functions, fusing the PCA- and LDA-based scores improves the performance of the system.

  17. A Novel Algorithm for Satellite Images Fusion Based on Compressed Sensing and PCA

    Directory of Open Access Journals (Sweden)

    Wenkao Yang

    2013-01-01

    Full Text Available This paper studies the image fusion of high-resolution panchromatic image and low-resolution multispectral image. Based on the classic fusion algorithms on remote sensing image fusion, the PCA (principal component analysis transform, and discrete wavelet transform, we carry out in-depth research. The compressed sensing (CS abandons the full sample and shifts the sampling of the signal to sampling information that greatly reduces the potential consumption of traditional signal acquisition and processing. We combine compressed sensing with satellite remote sensing image fusion algorithm and propose an innovative fusion algorithm (CS-FWT-PCA, in which the symmetric fractional B-spline wavelet acts as the sparse base. In the algorithm we use Hama Da matrix as the measurement matrix and SAMP as the reconstruction algorithm and adopt an improved fusion rule based on the local variance. The simulation results show that the CS-FWT-PCA fusion algorithm achieves better fusion effect than the traditional fusion method.

  18. Automatic detection of optic disc based on PCA and mathematical morphology.

    Science.gov (United States)

    Morales, Sandra; Naranjo, Valery; Angulo, Us; Alcaniz, Mariano

    2013-04-01

    The algorithm proposed in this paper allows to automatically segment the optic disc from a fundus image. The goal is to facilitate the early detection of certain pathologies and to fully automate the process so as to avoid specialist intervention. The method proposed for the extraction of the optic disc contour is mainly based on mathematical morphology along with principal component analysis (PCA). It makes use of different operations such as generalized distance function (GDF), a variant of the watershed transformation, the stochastic watershed, and geodesic transformations. The input of the segmentation method is obtained through PCA. The purpose of using PCA is to achieve the grey-scale image that better represents the original RGB image. The implemented algorithm has been validated on five public databases obtaining promising results. The average values obtained (a Jaccard's and Dice's coefficients of 0.8200 and 0.8932, respectively, an accuracy of 0.9947, and a true positive and false positive fractions of 0.9275 and 0.0036) demonstrate that this method is a robust tool for the automatic segmentation of the optic disc. Moreover, it is fairly reliable since it works properly on databases with a large degree of variability and improves the results of other state-of-the-art methods.

  19. EEG channels reduction using PCA to increase XGBoost's accuracy for stroke detection

    Science.gov (United States)

    Fitriah, N.; Wijaya, S. K.; Fanany, M. I.; Badri, C.; Rezal, M.

    2017-07-01

    In Indonesia, based on the result of Basic Health Research 2013, the number of stroke patients had increased from 8.3 ‰ (2007) to 12.1 ‰ (2013). These days, some researchers are using electroencephalography (EEG) result as another option to detect the stroke disease besides CT Scan image as the gold standard. A previous study on the data of stroke and healthy patients in National Brain Center Hospital (RS PON) used Brain Symmetry Index (BSI), Delta-Alpha Ratio (DAR), and Delta-Theta-Alpha-Beta Ratio (DTABR) as the features for classification by an Extreme Learning Machine (ELM). The study got 85% accuracy with sensitivity above 86 % for acute ischemic stroke detection. Using EEG data means dealing with many data dimensions, and it can reduce the accuracy of classifier (the curse of dimensionality). Principal Component Analysis (PCA) could reduce dimensionality and computation cost without decreasing classification accuracy. XGBoost, as the scalable tree boosting classifier, can solve real-world scale problems (Higgs Boson and Allstate dataset) with using a minimal amount of resources. This paper reuses the same data from RS PON and features from previous research, preprocessed with PCA and classified with XGBoost, to increase the accuracy with fewer electrodes. The specific fewer electrodes improved the accuracy of stroke detection. Our future work will examine the other algorithm besides PCA to get higher accuracy with less number of channels.

  20. [Research on spectra recognition method for cabbages and weeds based on PCA and SIMCA].

    Science.gov (United States)

    Zu, Qin; Deng, Wei; Wang, Xiu; Zhao, Chun-Jiang

    2013-10-01

    In order to improve the accuracy and efficiency of weed identification, the difference of spectral reflectance was employed to distinguish between crops and weeds. Firstly, the different combinations of Savitzky-Golay (SG) convolutional derivation and multiplicative scattering correction (MSC) method were applied to preprocess the raw spectral data. Then the clustering analysis of various types of plants was completed by using principal component analysis (PCA) method, and the feature wavelengths which were sensitive for classifying various types of plants were extracted according to the corresponding loading plots of the optimal principal components in PCA results. Finally, setting the feature wavelengths as the input variables, the soft independent modeling of class analogy (SIMCA) classification method was used to identify the various types of plants. The experimental results of classifying cabbages and weeds showed that on the basis of the optimal pretreatment by a synthetic application of MSC and SG convolutional derivation with SG's parameters set as 1rd order derivation, 3th degree polynomial and 51 smoothing points, 23 feature wavelengths were extracted in accordance with the top three principal components in PCA results. When SIMCA method was used for classification while the previously selected 23 feature wavelengths were set as the input variables, the classification rates of the modeling set and the prediction set were respectively up to 98.6% and 100%.

  1. Synthesis and bioactivities of Phenazine-1-carboxylic acid derivatives based on the modification of PCA carboxyl group.

    Science.gov (United States)

    Xiong, Zhipeng; Niu, Junfan; Liu, Hao; Xu, Zhihong; Li, Junkai; Wu, Qinglai

    2017-05-01

    Phenazine-1-carboxylic acid (PCA) as a natural product widely exists in microbial metabolites of Pseudomonads and Streptomycetes and has been registered for the fungicide against rice sheath blight in China. To find higher fungicidal activities compounds and study the effects on fungicidal activities after changing the carboxyl group of PCA, we synthesized a series of PCA derivatives by modifying the carboxyl group of PCA and their structures were confirmed by 1 H NMR and HRMS. Most compounds exhibited significant fungicidal activities in vitro. In particular, compound 6 exhibited inhibition effect against Rhizoctonia solani with EC 50 values of 4.35mg/L and compound 3b exhibited effect against Fusarium graminearum with EC 50 values of 8.30mg/L, compared to the positive control PCA with its EC 50 values of 7.88mg/L (Rhizoctonia solani) and 127.28mg/L (Fusarium graminearum), respectively. The results indicated that the carboxyl group of PCA could be modified to be amide group, acylhydrazine group, ester group, methyl, hydroxymethyl, chloromethyl and ether group etc. And appropriate modifications on carboxyl group of PCA were useful to extend the fungicidal scope. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Treatment of a patient with posterior cortical atrophy (PCA) with chiropractic manipulation and Dynamic Neuromuscular Stabilization (DNS): A case report.

    Science.gov (United States)

    Francio, Vinicius T; Boesch, Ron; Tunning, Michael

    2015-03-01

    Posterior cortical atrophy (PCA) is a rare progressive neurodegenerative syndrome which unusual symptoms include deficits of balance, bodily orientation, chronic pain syndrome and dysfunctional motor patterns. Current research provides minimal guidance on support, education and recommended evidence-based patient care. This case reports the utilization of chiropractic spinal manipulation, dynamic neuromuscular stabilization (DNS), and other adjunctive procedures along with medical treatment of PCA. A 54-year-old male presented to a chiropractic clinic with non-specific back pain associated with visual disturbances, slight memory loss, and inappropriate cognitive motor control. After physical examination, brain MRI and PET scan, the diagnosis of PCA was recognized. Chiropractic spinal manipulation and dynamic neuromuscular stabilization were utilized as adjunctive care to conservative pharmacological treatment of PCA. Outcome measurements showed a 60% improvement in the patient's perception of health with restored functional neuromuscular pattern, improvements in locomotion, posture, pain control, mood, tolerance to activities of daily living (ADLs) and overall satisfactory progress in quality of life. Yet, no changes on memory loss progression, visual space orientation, and speech were observed. PCA is a progressive and debilitating condition. Because of poor awareness of PCA by physicians, patients usually receive incomplete care. Additional efforts must be centered on the musculoskeletal features of PCA, aiming enhancement in quality of life and functional improvements (FI). Adjunctive rehabilitative treatment is considered essential for individuals with cognitive and motor disturbances, and manual medicine procedures may be consider a viable option.

  3. Efeito alcalinizante de soluções eletrolíticas intravenosas com concentrações elevadas de lactato de sódio infundidas em bezerros sadios

    Directory of Open Access Journals (Sweden)

    J.R.C. Junqueira

    2015-02-01

    Full Text Available Com o objetivo de investigar o potencial alcalinizante de soluções eletrolíticas com concentrações elevadas de lactato de sódio em bezerros sadios, foram idealizadas seis soluções contendo 28, 56 e 84mEq/L de lactato (L28, L56 e L84 ou de bicarbonato (B28, B56 e B84, com concentrações de sódio, de potássio e de cálcio semelhantes às da solução de Ringer com lactato (SRL. As soluções contendo bicarbonato de sódio foram utilizadas como padrão para comparação. Seis bezerros receberam, por via intravenosa, todas as seis soluções, uma a cada vez, com intervalo de quatro a cinco dias entre as infusões, em volume correspondente a 10% do peso corporal, durante cinco horas (20mL/kg/h. Amostras de sangue venoso e de urina foram coletadas antes de iniciar a infusão, na metade do volume, ao término e duas horas e meia após o término da infusão. Determinaram-se concentração de proteína plasmática total, pH sanguíneo e urinário, pCO2, HCO3 -, BE, concentração plasmática e urinária de lactato L e concentrações séricas e urinárias de Na+, K+, Cl- e creatinina. A solução L28, idêntica à SRL, provocou discreto incremento da reserva alcalina e, consequentemente, produziu efeito alcalinizante insuficiente para a correção de estados de acidose metabólica. A solução L84, além de provar-se segura, provocou o maior aumento da reserva alcalina, equivalente à B84, e, assim, produziu efeito capaz de corrigir o grau moderado de acidose metabólica.

  4. Prostate cancer detection rate at repeat saturation biopsy: PCPT risk calculator versus PCA3 score versus case-finding protocol.

    Science.gov (United States)

    Pepe, Pietro; Aragona, Francesco

    2013-02-01

    To evaluate Prostate Cancer Prevention Trial (PCPT) risk calculator versus prostate cancer gene 3 (PCA3) score versus case-finding protocol accuracy in prostate cancer diagnosis in patients with prostate-specific antigen (PSA) below 10 ng/mL submitted to repeat saturation biopsy (SPBx). From December 2010 to December 2011, 100 patients (median 66 years) underwent a SPBx (median 30 cores); the indications for repeat biopsy were those of a case-finding protocol: PSA values between 4.1 ng/mL-10 ng/mL or 2.6 ng/mL-4 ng/mL with F/T PSA ≤ 25% and ≤ 20%, respectively. All patients had negative digital rectal examination (DRE) and median PSA was 7.9 ng/mL. The performance of PCPT risk calculator (alone, combined with PSA free/total ( F/T) or PCA3 score) and PCA3 score in comparison with the case-finding protocol results (alone or combined with PCA3 score) was retrospectively evaluated in terms of detection rate for cancer and number of avoided biopsies. Prostate cancer was found in 28 (28%) patients; in the presence and absence of prostate cancer median PCA3 score was 57 versus 35 (p 20 missed 7.2% of cancer; the case-finding protocol combined with PCA3 score > 35 would save 22% of avoidable biopsies, missing no cancer if all patients with PSA F/T ≤ 15% would undergo prostate biopsy irrespective of PCA3 values. PCA3 score improves PCPT risk calculator accuracy in prostate cancer diagnosis; moreover, PCA3 score combined with PSA F/T reduce number of unnecessary biopsies (about 20%).

  5. Transversus abdominis plane block: A multimodal analgesia technique – Our experience

    Directory of Open Access Journals (Sweden)

    Deepak Dwivedi

    2017-01-01

    Full Text Available Context: A retrospective observational study conducted to assess transversus abdominis plane (TAP block as a tool for providing multimodal analgesia postoperatively for abdominal surgeries. Aims: The aim is to compare the visual analog scale (VAS of pain and the requirement of rescue analgesia postoperatively in patients undergoing various abdominal surgeries (open and laparoscopic where TAP block was given for postoperative analgesia and was compared with patients who received pain relief according to the institutional protocol. Settings and Design: Retrospective observational study conducted in a tertiary care hospital. Subjects and Methods: Retrospective data from anesthesia records of patients, who underwent abdominal surgeries from January 2016 to December 2016, were analyzed and were divided into two groups. Group A (n = 250 consisted of patients who received the conventional standard postoperative analgesia protocol of the department of anesthesia. Group B (n = 136 consisted of patients who were administered TAP block postsurgery for the postoperative analgesia by the trained anesthesiologist. Primary outcome considered was (i average VAS at 02, 06, 12, and 24 h and (ii average opioid/nonsteroidal anti-inflammatory drug consumption at 24 h postoperatively. Secondary outcome considered was time to first rescue analgesia. Statistical Analysis: All parametric data were analyzed using unpaired t-test. Data are expressed as the mean ± standard deviation. A SPSS version 17 (SPSS Inc., Chicago, IL, USA was used for statistical analysis. Results: Average pain scores (VAS were lower in Group B as compared to Group A in all subcategories of surgery postoperatively. Patients given TAP block (Group B required less rescue analgesia in the postoperative period with time to first rescue analgesia being prolonged. Conclusions: On the basis of our retrospective study, we suggest that TAP block can be utilized as a part of multimodal analgesia regimen for

  6. 2L-PCA: a two-level principal component analyzer for quantitative drug design and its applications.

    Science.gov (United States)

    Du, Qi-Shi; Wang, Shu-Qing; Xie, Neng-Zhong; Wang, Qing-Yan; Huang, Ri-Bo; Chou, Kuo-Chen

    2017-09-19

    A two-level principal component predictor (2L-PCA) was proposed based on the principal component analysis (PCA) approach. It can be used to quantitatively analyze various compounds and peptides about their functions or potentials to become useful drugs. One level is for dealing with the physicochemical properties of drug molecules, while the other level is for dealing with their structural fragments. The predictor has the self-learning and feedback features to automatically improve its accuracy. It is anticipated that 2L-PCA will become a very useful tool for timely providing various useful clues during the process of drug development.

  7. Postarthroscopy analgesia using intraarticular levobupivacaine and intravenous dexketoprofen trometamol.

    Science.gov (United States)

    Sahin, Sevtap Hekimoglu; Memiş, Dilek; Celik, Erkan; Sut, Necdet

    2015-12-01

    The aim of this prospective study was to determine the efficacy of intraarticular levobupivacaine with and without intravenous dexketoprofen trometamol for postarthroscopy analgesia. Sixty patients who underwent arthroscopic knee surgery were randomly assigned to three treatment groups. When the surgical procedure was completed, patients received the following treatments: group I (n = 20) patients received 20 mL intraarticular normal saline and 2 mL intravenous dexketoprofen trometamol (50 mg); group II (n = 20) patients received 20 mL intraarticular 0.5 % levobupivacaine (100 mg) and 2 mL intravenous normal saline; and group III (n = 20) patients received 20 mL intraarticular 0.5 % levobupivacaine (100 mg) and 2 mL intravenous dexketoprofen trometamol (50 mg). The visual analogue scale (VAS) was used, and the total analgesic consumption was assessed at 1, 2, 4, 6, 12, and 24 h post-operatively. The VAS scores at 1, 2, 4, 6, 12, and 24 h post-operatively were significantly increased in group I and group II compared with group III (p dexketoprofen trometamol administration provided better pain relief and less analgesic requirement after arthroscopic knee surgery during the first 24 h than that induced by dexketoprofen alone or levobupivacaine intraarticular alone. II.

  8. Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage

    Energy Technology Data Exchange (ETDEWEB)

    Hatzidakis, A.A.; Charonitakis, E.; Athanasiou, A.; Tsetis, D.; Chlouverakis, G.; Papamastorakis, G.; Roussopoulou, G.; Gourtsoyiannis, N.C

    2003-02-01

    AIM: To present our experience using intravenous sedoanalgesia for percutaneous biliary drainage. MATERIALS AND METHODS: This study comprised 100 patients, all of whom were continuously monitored [electrocardiogram (ECG), blood pressure, pulse oxymetry] and received an initial dose of 2 mg midazolam followed by 0.02 mg fentanyl. Before every anticipated painful procedure, a maintenance dose of 0.01 mg fentanyl was administered. If the procedure continued and the patient became aware, another 1 mg midazolam was given. This was repeated if patients felt pain. A total dose of 0.08 mg fentanyl and 7 mg midazolam was never exceeded. Immediately after the procedure, the nurse was asked to evaluate patients' pain score. The patients were asked 3 h later to complete a visual 10-degree pain score scale. RESULTS: The average dose of fentanyl and midazolam was 0.042 mg (0.03-0.08 mg) and 4.28 mg (2-7 mg), respectively. Only one patient recorded the procedure as painful. The scores given by the attending nurse (1-7 points, mean 2.9) correlated well with those given by the patients (1-6 points, mean 2.72). No complications were noted. CONCLUSION: According to our experience, interventional radiologists practising biliary procedures can administer low doses of midazolam and minimize the doses of fentanyl, without loss of adequate sedation and analgesia. Hatzidakis, A. A. et al. (2003). Clinical Radiology58, 121-127.

  9. Sedations and analgesia in patients undergoing percutaneous transhepatic biliary drainage

    International Nuclear Information System (INIS)

    Hatzidakis, A.A.; Charonitakis, E.; Athanasiou, A.; Tsetis, D.; Chlouverakis, G.; Papamastorakis, G.; Roussopoulou, G.; Gourtsoyiannis, N.C.

    2003-01-01

    AIM: To present our experience using intravenous sedoanalgesia for percutaneous biliary drainage. MATERIALS AND METHODS: This study comprised 100 patients, all of whom were continuously monitored [electrocardiogram (ECG), blood pressure, pulse oxymetry] and received an initial dose of 2 mg midazolam followed by 0.02 mg fentanyl. Before every anticipated painful procedure, a maintenance dose of 0.01 mg fentanyl was administered. If the procedure continued and the patient became aware, another 1 mg midazolam was given. This was repeated if patients felt pain. A total dose of 0.08 mg fentanyl and 7 mg midazolam was never exceeded. Immediately after the procedure, the nurse was asked to evaluate patients' pain score. The patients were asked 3 h later to complete a visual 10-degree pain score scale. RESULTS: The average dose of fentanyl and midazolam was 0.042 mg (0.03-0.08 mg) and 4.28 mg (2-7 mg), respectively. Only one patient recorded the procedure as painful. The scores given by the attending nurse (1-7 points, mean 2.9) correlated well with those given by the patients (1-6 points, mean 2.72). No complications were noted. CONCLUSION: According to our experience, interventional radiologists practising biliary procedures can administer low doses of midazolam and minimize the doses of fentanyl, without loss of adequate sedation and analgesia. Hatzidakis, A. A. et al. (2003). Clinical Radiology58, 121-127

  10. RESULTS OF THE MEGAVERTEBRATE ANALGESIA SURVEY: ELEPHANTS AND RHINO.

    Science.gov (United States)

    Kottwitz, Jack; Boothe, Matthew; Harmon, Roy; Citino, Scott B; Zuba, Jeffery R; Boothe, Dawn M

    2016-03-01

    An online survey utilizing Survey Monkey linked through the American Association of Zoo Veterinarians listserve examined current practices in megavertebrate analgesia. Data collected included drugs administered, dosing regimens, ease of administration, efficacy, and adverse events. Fifty-nine facilities (38 housing elephants, 33 housing rhinoceroses) responded. All facilities administered nonsteroidal anti-inflammatory drugs (NSAIDs), with phenylbutazone (0.25-10 mg/kg) and flunixin meglumine (0.2-4 mg/kg) being most common. Efficacy was reported as "good" to "excellent" for these medications. Opioids were administered to elephants (11 of 38) and rhinoceroses (7 of 33), with tramadol (0.5-3.0 mg/kg) and butorphanol (0.05-1.0 mg/kg) being most common. Tramadol efficacy scores were highly variable in both elephants and rhinoceroses. While drug choices were similar among institutions, substantial variability in dosing regimens and reported efficacy between and within facilities indicates the need for pharmacokinetic studies and standardized methods of analyzing response to treatment to establish dosing regimens and clinical trials to establish efficacy and safety.

  11. Effects on the infant of obstetric regional analgesia.

    Science.gov (United States)

    Bratteby, L E

    1981-01-01

    We found no differences between the analgesia and control groups in the Apgar score, blood gases, acid-base status or lactate, nor in the neonatal neurology or psychomotor development at 18 months. On the other hand certain deviations in blood chemistry and some physiological variables were noted. These deviations in certain infants whose mothers had received nerve blockade during labour were most likely not caused by toxic effects of the anaesthetic drug but secondary to changes in the course of labour due to the nerve blockade. These effects have not been found to be associated with harmful longterm consequences to the infants of our study, but the findings illustrate how sensitive the foetus and the newborn infant are to altered environmental conditions. The observed effects must of course be confirmed by other investigations, and the mechanisms must be clarified in greater detail. Special attention should be paid to the increased incidence of hypo- and hyperglycemia. The fact that we did not observe any deviations in the psychomotor development at 18 months' does not, of course, mean that teses might not be found in a material with a different composition from ours.

  12. Preventive analgesia in hip or knee arthroplasty: a systematic review.

    Science.gov (United States)

    Díaz-Heredia, J; Loza, E; Cebreiro, I; Ruiz Iban, M Á

    2015-01-01

    To analyze the efficacy and safety of preventive analgesia in patients undergoing hip or knee arthroplasty due to osteoarthritis. A systematic literature review was performed, using a defined a sensitive strategy on Medline, Embase and Cochrane Library up to May 2013. The inclusion criteria were: patients undergoing knee and/or hip arthroplasty, adults with moderate or severe pain (≥4 on a Visual Analog Scale). The intervention, the use (efficacy and safety) of pharmacological treatment (preventive) close to surgery was recorded. Oral, topical and skin patch drugs were included. Systematic reviews, meta-analysis, controlled trials and observational studies were selected. A total of 36 articles, of moderate quality, were selected. The patients included were representative of those undergoing knee and/or hip arthroplasty in Spain. They had a mean age >50 years, higher number of women, and reporting moderate to severe pain (≥4 on a Visual Analog Scale). Possurgical pain was mainly evaluated with a Visual Analog Scale. A wide variation was found as regards the drugs used in the preventive protocols, including acetaminophen, classic NSAID, Cox-2, opioids, corticosteroids, antidepressants, analgesics for neuropathic pain, as well as others, such as magnesium, ketamine, nimodipine or clonidine. In general, all of them decreased post-surgical pain without severe adverse events. The use or one or more pre-surgical analgesics decreases the use of post-surgical drugs, at least for short term pain. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  13. The effect of Hegu acupoint stimulation in dental acupuncture analgesia

    Directory of Open Access Journals (Sweden)

    Fransiskus Andrianto

    2007-03-01

    Full Text Available In daily life, dental treatments are often related with oral pain sensation which needs anesthesia procedures. Sometimes local anesthetics can not be used because patients have hypersensitive reaction or systemic diseases which may lead to complications. Stimulating acupoint, such as Hegu activates hypothalamus and pituitary gland to release endogenous opioid peptide substances that reduce pain sensitivity. The aim of the study was to determine Hegu acupoint stimulation effect on the pain sensitivity reduction in maxillary central incisor gingiva. The laboratory experimental research was conducted on 12 healthy male Wistar rats (3 months old, weights 150–200 grams. All rat samples received the same treatments and adapted within 1 month. The research was done in pre and post test control group design. 40-Volt electro-stimulation was done once on the maxillary central incisor gingiva prior to the bilateral Hegu acupoint stimulation, then followed by 3 times electro-stimulation with 3 minutes intervals. The pain scores were obtained based on the samples’ contraction in each electro-stimulation. The responses were categorized into 5 pain scores and statistically analyzed using Wilcoxon Test. The results showed that Hegu acupoint stimulation lowered the pain scores significantly (p < 0.05. Hegu acupoint stimulation could reduce the pain sensitivity in maxillary central incisor gingiva. Therefore, the use of acupuncture analgesia in dental pain management can be considered in the future.

  14. Labor epidural analgesia is independent risk factor for neonatal pyrexia.

    Science.gov (United States)

    Agakidis, Charalampos; Agakidou, Eleni; Philip Thomas, Sumesh; Murthy, Prashanth; John Lloyd, David

    2011-09-01

    To explore whether epidural analgesia (EA) in labor is independent risk factor for neonatal pyrexia after controlling for intrapartum pyrexia. Retrospective observational study of 480 consecutive term singleton infants born to mothers who received EA in labor (EA group) and 480 term infants delivered to mothers who did not receive EA (NEA group). Mothers in the EA group had significantly higher incidence of intrapartum pyrexia [54/480 (11%) vs. 4/480 (0.8%), OR = 15.1, p neonatal pyrexia [68/480 (14.2%) vs. 15/480 (3.1%), OR = 5.1, p Neonates in the EA group had a median duration of pyrexia of 1 h (maximum 5 h) with a peak temperature within 1 h. Stepwise logistic regression analysis showed that maternal EA was independent risk factor for neonatal pyrexia (>37.5°C) after controlling for intrapartum pyrexia (>37.9°C) and other confounders (OR = 3.44, CI = 1.9-6.3, p neonates. It is unnecessary to investigate febrile offspring of mothers who have had epidurals unless pyrexia persists for longer than 5 h or other signs or risk factors for neonatal sepsis are present.

  15. Disruption of glial function enhances electroacupuncture analgesia in arthritic rats.

    Science.gov (United States)

    Sun, Shan; Chen, Wen-Ling; Wang, Pei-Fen; Zhao, Zhi-Qi; Zhang, Yu-Qiu

    2006-04-01

    Activated glia play a major role in mediating behavioral hypersensitive state following peripheral inflammation. Electroacupuncture is well known to relieve persistent inflammatory pain. The present study was undertaken to examine whether fluorocitrate, a glial metabolic inhibitor, could synergize electroacupuncture antagonizing thermal hyperalgesia and mechanical allodynia evoked by ankle joint inflammation. Monoarthritis of rat ankle joint was induced by an intra-articular injection of Complete Freund's Adjuvant (CFA). The paw withdrawal latency (PWL) from a thermal stimulus and paw withdrawal threshold (PWT) from von Frey hairs were measured in awake rats. Intrathecal (i.t.) injection of 1 nmol fluorocitrate markedly suppressed monoarthritis-induced thermal hyperalgesia and mechanical allodynia. Unilateral electroacupuncture stimulation of "Huantiao" (GB30) and "Yanglingquan" (GB34) acupuncture points (100/2 Hz alternation, 1-2-3 mA) significantly elevated the PWLs and PWTs for 45 min after cessation of electroacupuncture in monoarthritic rats. Co-application of 0.1 or 1 nmol fluorocitrate with electroacupuncture significantly potentiated electroacupuncture analgesia, although 0.1 nmol fluorocitrate alone had no effect on PWLs and PWTs in monoarthritic rats. These results suggested that electroacupuncture and disrupting glial function could synergistically antagonize inflammatory pain, which might provide a potential strategy for the treatment of arthritic pain.

  16. Anesthesia and analgesia for caesaren section in dog

    Directory of Open Access Journals (Sweden)

    Vasiljević Maja

    2014-01-01

    Full Text Available This work presents a case of a pregnant female dog, of English bulldog breed, three years old, which was brought to Belgrade Faculty of Veterinary Medicine because of inability for normal parturition. Cesarean section is an urgent intervention both in human and in veterinary medicine. Anesthesia of a pregnant dog should be carried out very carefully, because of all the physiological changes that appear during pregnancy, as well as the impact of anesthetics on embryos themselves. Anesthetics, analgesics and sedatives pass through blood brain barrier, but also their transport goes through placenta to embryo, so for that reason it is not possible to anesthetize only mother and to avoid anesthesia effects on the embryo. Therefore, anesthetics with short time of action which metabolize quickly and have minimal negative effect on embryos are recommended. When choosing the right analgesics and anesthetics, there should be known that female dogs in which it is necessary to do Cesarean section belong to the group of high risk patients. Pregnant female dogs are exposed to hypoventilation, hypoxia, hypercapnia, intense heart work, vomiting and regurgitation as well. Reversible anesthetics are recommended to provide shorter duration time of anesthesia, and in accordance, inhalation anesthetics doses are minimal. Application of α2- agonist in premedication, propophol in induction, as well as maintaining general inhalation anesthesia with sevofluran, along with local analgesia, proved to be the ideal combination in this case of cesarean section.

  17. A comparison of intrathecal dexmedetomidine verses intrathecal fentanyl with epidural bupivacaine for combined spinal epidural labor analgesia

    OpenAIRE

    P K Dilesh; S Eapen; S Kiran; Vivek Chopra

    2014-01-01

    Context: Combined spinal epidural (CSE) analgesia technique is effective for labor analgesia and various concentrations of bupivacaine and lipophilic opioids like fentanyl have been studied. Dexmedetomidine is a highly selective alpha 2 adrenoreceptor agonist with analgesic properties and has been used intrathecally with bupivacaine for prolonged postoperative analgesia. Recent reviews have shown that it is highly lipophilic and does not cross placenta significantly. Aim: The aim of this s...

  18. IMPROVE trial: a randomized controlled trial of patient-controlled analgesia for sickle cell painful episodes: rationale, design challenges, initial experience, and recommendations for future studies.

    Science.gov (United States)

    Dampier, Carlton D; Smith, Wally R; Wager, Carrie G; Kim, Hae-Young; Bell, Margaret C; Miller, Scott T; Weiner, Debra L; Minniti, Caterina P; Krishnamurti, Lakshmanan; Ataga, Kenneth I; Eckman, James R; Hsu, Lewis L; McClish, Donna; McKinlay, Sonja M; Molokie, Robert; Osunkwo, Ifeyinwa; Smith-Whitley, Kim; Telen, Marilyn J

    2013-04-01

    The hallmark of sickle cell disease (SCD) is pain from a vaso-occlusive crisis. Although ambulatory pain accounts for most days in pain, pain is also the most common cause of hospitalization and is typically treated with parenteral opioids. The evidence base is lacking for most analgesic practice in SCD, particularly for the optimal opioid dosing for patient-controlled analgesia (PCA), in part because of the challenges of the trial design and conduct for this rare disease. The purpose of this report is to describe our Network's experiences with protocol development, implementation, and analysis, including overall study design, the value of pain assessments rather than 'crisis' resolution as trial endpoints, and alternative statistical analysis strategies. The Improving Pain Management and Outcomes with Various Strategies (IMPROVE) PCA trial was a multisite inpatient randomized controlled trial comparing two PCA-dosing strategies in adults and children with SCD and acute pain conducted by the SCD Clinical Research Network. The specified primary endpoint was a 25-mm change in a daily average pain intensity using a Visual Analogue Scale, and a number of related pain intensity and pain interference measures were selected as secondary efficacy outcomes. A time-to-event analysis strategy was planned for the primary endpoint. Of 1116 individuals admitted for pain at 31 participating sites over a 6-month period, 38 were randomized and 4 withdrawn. The trial was closed early due to poor accrual, reflecting a substantial number of challenges encountered during trial implementation. While some of the design issues were unique to SCD or analgesic studies, many of the trial implementation challenges reflected the increasing complexity of conducting clinical trials in the inpatient setting with multiple care providers and evolving electronic medical record systems, particularly in the context of large urban academic medical centers. Complicated clinical organization of many

  19. Prostatic adenocarcinoma (PCa metastasizing to renal cell carcinoma (RCC with periureteral tumor deposit: A case of tumor-to-tumor metastasis (TTM

    Directory of Open Access Journals (Sweden)

    Jenissa Amor Dionisio Arceño, MD

    2017-06-01

    Full Text Available Renal cell carcinoma (RCC and prostatic adenocarcinoma (PCa, occurring as a double primary is uncommon, but well documented. However, metastatic PCa in a RCC is quite rare. We report a case of an 81-year old male chemical engineer with history of hematuria and prostatomegaly suspicious for carcinoma, who underwent left radical nephrectomy for a renal mass. Histopathology revealed RCC that harbored an undiagnosed PCa. Periureteral tumor deposit likewise showed combined metastasis of RCC and PCa.

  20. Primary Spoken Language and Neuraxial Labor Analgesia Use Among Hispanic Medicaid Recipients.

    Science.gov (United States)

    Toledo, Paloma; Eosakul, Stanley T; Grobman, William A; Feinglass, Joe; Hasnain-Wynia, Romana

    2016-01-01

    Hispanic women are less likely than non-Hispanic Caucasian women to use neuraxial labor analgesia. It is unknown whether there is a disparity in anticipated or actual use of neuraxial labor analgesia among Hispanic women based on primary language (English versus Spanish). In this 3-year retrospective, single-institution, cross-sectional study, we extracted electronic medical record data on Hispanic nulliparous with vaginal deliveries who were insured by Medicaid. On admission, patients self-identified their primary language and anticipated analgesic use for labor. Extracted data included age, marital status, labor type, delivery provider (obstetrician or midwife), and anticipated and actual analgesic use. Household income was estimated from census data geocoded by zip code. Multivariable logistic regression models were estimated for anticipated and actual neuraxial analgesia use. Among 932 Hispanic women, 182 were self-identified as primary Spanish speakers. Spanish-speaking Hispanic women were less likely to anticipate and use neuraxial anesthesia than English-speaking women. After controlling for confounders, there was an association between primary language and anticipated neuraxial analgesia use (adjusted relative risk: Spanish- versus English-speaking women, 0.70; 97.5% confidence interval, 0.53-0.92). Similarly, there was an association between language and neuraxial analgesia use (adjusted relative risk: Spanish- versus English-speaking women 0.88; 97.5% confidence interval, 0.78-0.99). The use of a midwife compared with an obstetrician also decreased the likelihood of both anticipating and using neuraxial analgesia. A language-based disparity was found in neuraxial labor analgesia use. It is possible that there are communication barriers in knowledge or understanding of analgesic options. Further research is necessary to determine the cause of this association.

  1. Differential effects of experimental central sensitization on the time-course and magnitude of offset analgesia.

    Science.gov (United States)

    Martucci, Katherine T; Yelle, Marc D; Coghill, Robert C

    2012-02-01

    Pain perception is temporally altered during states of chronic pain and acute central sensitization; however, the mechanisms contributing to temporal processing of nociceptive information remain poorly understood. Offset analgesia is a phenomenon that reflects the presence of temporal contrast mechanisms for nociceptive information and can provide an end point to study temporal aspects of pain processing. In order to investigate whether offset analgesia is disrupted during sensitized states, 23 healthy volunteers provided real-time continuous visual analogue scale responses to noxious heat stimuli that evoke offset analgesia. Responses to these stimuli were evaluated during capsaicin-heat sensitization (45°C stimulus, capsaicin cream 0.1%) and heat-only sensitization (40°C stimulus, placebo cream). Capsaicin-heat sensitization produced significantly larger regions of secondary mechanical allodynia compared to heat-only sensitization. Although areas of mechanical allodynia were positively related to individual differences in heat pain sensitivity, this relationship was altered at later time points after capsaicin-heat sensitization. Heat hyperalgesia was observed in the secondary region following both capsaicin-heat and heat-only sensitization. Increased latencies to maximal offset analgesia and prolonged aftersensations were observed only in the primary regions directly treated by capsaicin-heat or heat alone. However, contrary to the hypothesis that offset analgesia would be reduced following capsaicin-heat sensitization, the magnitude of offset analgesia remained remarkably intact after both capsaicin-heat and heat-only sensitization in zones of both primary and secondary mechanical allodynia. These data indicate that offset analgesia is a robust phenomenon and engages mechanisms that interact minimally with those supporting acute central sensitization. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights

  2. Case report: bilateral tunneled epidural catheters to prevent unilateral analgesia for cancer-related pain

    Directory of Open Access Journals (Sweden)

    Padalia RB

    2017-07-01

    Full Text Available Raj B Padalia,1 Corey J Reeves,2 Neal Shah,1 Ankur A Patel,3 Devang M Padalia4 1Pain Medicine, University of South Florida, Tampa, FL, USA; 2Physical Medicine and Rehabilitation, University of South Florida, Tampa, FL, USA; 3Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA; 4Interventional Pain, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA Objective: Unilateral analgesia often occurs with epidural analgesia. Traditional methods of troubleshooting this problem can be insufficient in obtaining adequate pain relief in a timely manner for terminal cancer patients. This case report demonstrates a safe and effective solution which can be utilized in these circumstances.Case report: A 55-year-old female with stage IV pancreatic cancer and life expectancy of a few weeks presented to the interventional pain clinic with intractable sacral pain. The decision to place an epidural catheter and external pump for analgesia was made. An epidural catheter placed at the L5-S1 level showed contrast spread only along the right nerve roots and a test dose produced only right-sided analgesia. Suspecting compartmentalization of the epidural space, a second left-sided epidural catheter was placed and bilateral analgesia was achieved by using both catheters. This dual catheter technique gave the patient effective bilateral analgesia until she passed away several weeks later. Conclusion: The bilateral epidural catheter technique is safe and effective in patients who present with persistent unilateral epidural analgesia despite exhausting traditional solutions. Keywords: pain management, palliative care, cancer, regional techniques

  3. Swelling and microstructural development in path A PCA and type 316 stainless steel irradiated in HFIR to about 22 dpa

    International Nuclear Information System (INIS)

    Maziasz, P.J.; Braski, D.N.

    1983-01-01

    Irradiation of several microstructural variants of PCA and 20%-cold-worked N-lot type 316 stainess steel (CW 316) in HFIR to about 10 dpa produced no visible cavities at 300 0 C, bubbles at 400 0 C, and varying distributions of bubbles and voids at 500 and 600 0 C. The PCA-B1 swells the most and CW 316 (N-lot) the least at 600 0 C. Irradiations have been extended to about 22 dpa. The PCA-Al swells 0.06%/dpa at 600 0 C but at a much lower rate at 500 0 C. The PCA-A3 shows the lowest swelling at 600 0 C, about the half the swelling rate of type 316 stainless steel

  4. Evaluation of significant sources influencing the variation of water quality of Kandla creek, Gulf of Katchchh, using PCA

    Digital Repository Service at National Institute of Oceanography (India)

    Dalal, S.G.; Shirodkar, P.V.; Jagtap, T.G.; Naik, B.G.; Rao, G.S.

    To evaluate the significant sources contributing to water quality parameters, we used principal component analysis (PCA) for the interpretation of a large complex data matrix obtained from the Kandla creek environmental monitoring program. The data...

  5. Testing a Modified PCA-Based Sharpening Approach for Image Fusion

    Directory of Open Access Journals (Sweden)

    Jan Jelének

    2016-09-01

    Full Text Available Image data sharpening is a challenging field of remote sensing science, which has become more relevant as high spatial-resolution satellites and superspectral sensors have emerged. Although the spectral property is crucial for mineral mapping, spatial resolution is also important as it allows targeted minerals/rocks to be identified/interpreted in a spatial context. Therefore, improving the spatial context, while keeping the spectral property provided by the superspectral sensor, would bring great benefits for geological/mineralogical mapping especially in arid environments. In this paper, a new concept was tested using superspectral data (ASTER and high spatial-resolution panchromatic data (WorldView-2 for image fusion. A modified Principal Component Analysis (PCA-based sharpening method, which implements a histogram matching workflow that takes into account the real distribution of values, was employed to test whether the substitution of Principal Components (PC1–PC4 can bring a fused image which is spectrally more accurate. The new approach was compared to those most widely used—PCA sharpening and Gram–Schmidt sharpening (GS, both available in ENVI software (Version 5.2 and lower as well as to the standard approach—sharpening Landsat 8 multispectral bands (MUL using its own panchromatic (PAN band. The visual assessment and the spectral quality indicators proved that the spectral performance of the proposed sharpening approach employing PC1 and PC2 improve the performance of the PCA algorithm, moreover, comparable or better results are achieved compared to the GS method. It was shown that, when using the PC1, the visible-near infrared (VNIR part of the spectrum was preserved better, however, if the PC2 was used, the short-wave infrared (SWIR part was preserved better. Furthermore, this approach improved the output spectral quality when fusing image data from different sensors (e.g., ASTER and WorldView-2 while keeping the proper albedo

  6. Intravenous remifentanil versus epidural ropivacaine with sufentanil for labour analgesia: a retrospective study.

    Directory of Open Access Journals (Sweden)

    Rong Lin

    Full Text Available Remifentanil with appropriate pharmacological properties seems to be an ideal alternative to epidural analgesia during labour. A retrospective cohort study was undertaken to assess the efficacy and safety of remifentanil intravenous patient-controlled analgesia (IVPCA compared with epidural analgesia. Medical records of 370 primiparas who received remifentanil IVPCA or epidural analgesia were reviewed. Pain and sedation scores, overall satisfaction, the extent of pain control, maternal side effects and neonatal outcome as primary observational indicators were collected. There was a significant decline of pain scores in both groups. Pain reduction was greater in the epidural group throughout the whole study period (0 ∼ 180 min (P < 0.0001, and pain scores in the remifentanil group showed an increasing trend one hour later. The remifentanil group had a lower SpO2 (P < 0.0001 and a higher sedation score (P < 0.0001 within 30 min after treatment. The epidural group had a higher overall satisfaction score (3.8 ± 0.4 vs. 3.7 ± 0.6, P = 0.007 and pain relief score (2.9 ± 0.3 vs. 2.8 ± 0.4, P < 0.0001 compared with the remifentanil group. There was no significant difference on side effects between the two groups, except that a higher rate of dizziness (1% vs. 21.8%, P < 0.0001 was observed during remifentanil analgesia. And logistic regression analysis demonstrated that nausea, vomiting were associated with oxytocin usage and instrumental delivery, and dizziness was associated to the type and duration of analgesia. Neonatal outcomes such as Apgar scores and umbilical-cord blood gas analysis were within the normal range, but umbilical pH and base excess of neonatus in the remifentanil group were significantly lower. Remifentanil IVPCA provides poorer efficacy on labor analgesia than epidural analgesia, with more sedation on parturients and a trend of newborn acidosis. Despite these adverse effects, remifentanil IVPCA can still be an alternative

  7. PCA-based algorithm for calibration of spectrophotometric analysers of food

    International Nuclear Information System (INIS)

    Morawski, Roman Z; Miekina, Andrzej

    2013-01-01

    Spectrophotometric analysers of food, being instruments for determination of the composition of food products and ingredients, are today of growing importance for food industry, as well as for food distributors and consumers. Their metrological performance significantly depends of the numerical performance of available means for spectrophotometric data processing; in particular – the means for calibration of analysers. In this paper, a new algorithm for this purpose is proposed, viz. the algorithm using principal components analysis (PCA). It is almost as efficient as PLS-based algorithms of calibration, but much simpler

  8. Convergence analysis of Chauvin's PCA learning algorithm with a constant learning rate

    International Nuclear Information System (INIS)

    Lv Jiancheng; Yi Zhang

    2007-01-01

    The convergence of Chauvin's PCA learning algorithm with a constant learning rate is studied in this paper by using a DDT method (deterministic discrete-time system method). Different from the DCT method (deterministic continuous-time system method), the DDT method does not require that the learning rate converges to zero. An invariant set of Chauvin's algorithm with a constant learning rate is obtained so that the non-divergence of this algorithm can be guaranteed. Rigorous mathematic proofs are provided to prove the local convergence of this algorithm

  9. PMSVM: An Optimized Support Vector Machine Classification Algorithm Based on PCA and Multilevel Grid Search Methods

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    Yukai Yao

    2015-01-01

    Full Text Available We propose an optimized Support Vector Machine classifier, named PMSVM, in which System Normalization, PCA, and Multilevel Grid Search methods are comprehensively considered for data preprocessing and parameters optimization, respectively. The main goals of this study are to improve the classification efficiency and accuracy of SVM. Sensitivity, Specificity, Precision, and ROC curve, and so forth, are adopted to appraise the performances of PMSVM. Experimental results show that PMSVM has relatively better accuracy and remarkable higher efficiency compared with traditional SVM algorithms.

  10. A g-factor metric for k-t SENSE and k-t PCA based parallel imaging.

    Science.gov (United States)

    Binter, Christian; Ramb, Rebecca; Jung, Bernd; Kozerke, Sebastian

    2016-02-01

    To propose and validate a g-factor formalism for k-t SENSE, k-t PCA and related k-t methods for assessing SNR and temporal fidelity. An analytical gxf -factor formulation in the spatiotemporal frequency domain is derived, enabling assessment of noise and depiction fidelity in both the spatial and frequency domain. Using pseudoreplica analysis of cardiac cine data the gxf -factor description is validated and example data are used to analyze the performance of k-t methods for various parameter settings. Analytical gxf -factor maps were found to agree well with pseudoreplica analysis for 3x, 5x, and 7x k-t SENSE and k-t PCA. While k-t SENSE resulted in lower average gxf values (gx (avg) ) in static regions when compared with k-t PCA, k-t PCA yielded lower gx (avg) values in dynamic regions. Temporal transfer was better preserved with k-t PCA for increasing undersampling factors. The proposed gxf -factor and temporal transfer formalism allows assessing noise performance and temporal depiction fidelity of k-t methods including k-t SENSE and k-t PCA. The framework enables quantitative comparison of different k-t methods relative to frame-by-frame parallel imaging reconstruction. © 2015 Wiley Periodicals, Inc.

  11. Cadmium and Secondary Structure-dependent Function of a Degron in the Pca1p Cadmium Exporter*

    Science.gov (United States)

    Smith, Nathan; Wei, Wenzhong; Zhao, Miaoyun; Qin, Xiaojuan; Seravalli, Javier; Kim, Heejeong; Lee, Jaekwon

    2016-01-01

    Protein turnover is a critical cellular process regulating biochemical pathways and destroying terminally misfolded or damaged proteins. Pca1p, a cadmium exporter in the yeast Saccharomyces cerevisiae, is rapidly degraded by the endoplasmic reticulum-associated degradation (ERAD) system via a cis-acting degron that exists at the 250–350 amino acid region of Pca1p and is transferable to other proteins to serve as a degradation signal. Cadmium stabilizes Pca1p in a manner dependent on the degron. This suggested that cadmium-mediated masking of the degron impedes its interaction with the molecular factors involved in the ERAD. The characteristics and mechanisms of action of the degron in Pca1p and most of those in other proteins however remain to be determined. The results presented here indicate that specific cysteine residues in a degron of Pca1p sense cadmium. An unbiased approach selecting non-functional degrons indicated a critical role of hydrophobic amino acids in the degron for its function. A secondary structure modeling predicted the formation of an amphipathic helix. Site-directed mutagenesis confirmed the functional significance of the hydrophobic patch. Last, hydrophobic amino acids in the degron- and cadmium-binding region affected the interaction of Pca1p with the Ssa1p molecular chaperone, which is involved in ERAD. These results reveal the mechanism of action of the degron, which might be useful for the identification and characterization of other degrons. PMID:27059957

  12. COMPARATIVE STUDY OF NALBUPHINE VS. PENTAZOCINE FOR POSTOPERATIVE ANALGESIA

    Directory of Open Access Journals (Sweden)

    Naresh Ganpatrao Tirpude

    2016-10-01

    Full Text Available BACKGROUND To provide postoperative pain relief is a prime duty of health care providers. Failure to relieve pain is morally and ethically unacceptable. Post-operative pain may results in adverse effects such as: a Physiological Changes: Reduced pulmonary functions, e.g. vital capacity, tidal volume, functional residual capacity; sympathetic stimulation; reduced the physical activity of patients; thereby increasing the risk of venous thrombosis. b Psychological disturbances: Anger, Resentment, Depression, Adversarial Relationship with Doctors, Insomnia. Aim of this study was 1. To investigate whether “Postoperative analgesia with Nalbuphine is longer than Pentazocine”. 2. To investigate whether “Side effects/complications are less with Nalbuphine as compared to Pentazocine”. MATERIALS AND METHODS It was a prospective randomized double blind observational study. Eighty patients of hydrocoele & inguinal hernia were operated under spinal anaesthesia of age group 20-70 years, ASA grade I & II & patients with controlled co-morbid conditions. In postoperative period, Group N- Inj. Nalbuphine (0.3 mg/kg IM or Group P- Inj. Pentazocine (0.5 mg/kg IM was administered to provide postoperative pain relief & to know the duration of pain relief & its side effects. RESULTS On statistical analysis, demographic data i.e. age, sex had no influence on outcome of study. Mean VAS score in group N was highly significant (p-value in Inj. Pentazocine group. 2. Side Effects - Incidence of sedation was more in Nalbuphine group as compared to Pentazocine group. Nausea & Vomiting were more so in Pentazocine group as compared to Nalbuphine group. Limitation of the present study was that sample size was very small.

  13. Efficacy of tramadol versus fentanyl for postoperative analgesia in neonates.

    Science.gov (United States)

    Alencar, Ana Julia Couto; Sanudo, Adriana; Sampaio, Virginia Maria Ramos; Góis, Rôsicler Pereira; Benevides, Fernando Antônio Barbosa; Guinsburg, Ruth

    2012-01-01

    To assess, in newborn infants submitted to surgical procedures, the efficacy of two opioids-fentanyl and tramadol-regarding time to extubate, time to achieve 100 ml/kg of enteral feeding and pain in the first 72 h after surgery. Controlled, blind, randomised clinical trial. Neonatal intensive care unit. 160 newborn infants up to 28 days of life requiring major or minor surgeries. Patients were randomised to receive analgesia with fentanyl (1-2 μg/kg/h intravenously) or tramadol (0.1-0.2 mg/kg/h intravenously) in the first 72 h of the postoperative period, stratified by surgical size and by patient's gender. Pain assessed by validated neonatal scales (Crying, Requires oxygen, Increased vital signs, Expression and Sleepless Scale and the Neonatal Facial Coding System), time until extubation and time to reach 100 ml/kg enteral feeding. Statistical analysis included repeated measures analysis of variance adjusted for confounding variables and Kaplan-Meier curve adjusted by a Cox model of proportional risks. Neonatal characteristics were (mean±SD) birth weight of 2924±702 g, gestational age of 37.6±2.2 weeks and age at surgery of 199±63 h. The main indication of surgery was gastrointestinal malformation (85 newborns; 53%). Neonates who received fentanyl or tramadol were similar regarding time until extubation, time to reach 100 ml/kg of enteral feeding and pain scores in the first 72 h after surgery. Tramadol was as effective as fentanyl for postoperative pain relief in neonates but does not appear to offer advantages over fentanyl regarding the duration of mechanical ventilation and time to reach full enteral feeding. Trial registration NCT00713726.

  14. Combination Analgesia for Neonatal Circumcision: A Randomized Controlled Trial.

    Science.gov (United States)

    Sharara-Chami, Rana; Lakissian, Zavi; Charafeddine, Lama; Milad, Nadine; El-Hout, Yaser

    2017-12-01

    There is no consensus on the most effective pain management for neonatal circumcision. We sought to compare different modalities. This is a double-blinded randomized controlled trial comparing 3 combination analgesics used during circumcision (EMLA + sucrose; EMLA + sucrose + dorsal penile nerve block [DPNB]; EMLA + sucrose + ring block [RB]) with the traditional topical analgesic cream EMLA alone. The trial was set in the normal nursery of a teaching hospital. The sample included 70 healthy male newborns, randomly assigned to intervention and control groups at a 2:1 ratio. Infants were videotaped (face and torso) during the procedure for assessment of pain by 2 blinded, independent reviewers. The primary outcome measure is the Neonatal Infant Pain Scale score. Secondary outcomes include heart rate, oxygen saturation, and crying time. Neonatal Infant Pain Scale scores were significantly lower in the intervention groups (EMLA + sucrose, mean [SD]: 3.1 [1.33]; EMLA + sucrose + DPNB: 3 [1.33]; EMLA + sucrose + RB: 2.45 [1.27]) compared with the control (5.5 [0.53]). Between-group analyses showed RB + EMLA + sucrose to be significantly more effective than EMLA + sucrose; EMLA + sucrose + DPNB ( P = .009 and P = .002, respectively). Interrater reliability was κ = 0.843. Significant increase in heart rate (139.27 [9.63] to 163 [13.23] beats per minute) and crying time (5.78 [6.4] to 45.37 [12.39] seconds) were noted in the EMLA group. During neonatal circumcision in boys, the most effective analgesia is RB combined with oral sucrose and EMLA cream. Copyright © 2017 by the American Academy of Pediatrics.

  15. Combined spinal-epidural analgesia in labour: its effects on delivery outcome

    Directory of Open Access Journals (Sweden)

    Suneet Kaur Sra Charanjit Singh

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n = 55 or Non-CSE (n = 55 group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%. The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5 min was similar in both groups. CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

  16. Autoradiographic visualization on the role of central 3H-5-hydroxytryptamine in acupuncture analgesia

    International Nuclear Information System (INIS)

    Zhu Shoupeng; Shi Fuxi; Liu Zhonghao; Jiang Ji

    1990-10-01

    The role played by central 5-hydroxytryptamine (5-HT) in electroacupuncture analgesia has been studied in rats by means of autoradiography with isotopic tracers 3 H-5-HT. The purpose of the study is to determine the localization of 3 H-5-HT in the midbrain raphe nuclei and in the mesencephalon aquaeduct as well as periaquaeductal gray matter. Parallel experiments were studied by freezing microautoradiographic method and histo-fixative microautoradiographic method. The analgesic effect of acupuncture can be enhanced or lowered by the increment or the decrement of the 5-HT level in the midbrain raphe nuclei and in the mesencephalon aquaeduct as well as periaquaeductal gray matter. The results show that when the rats were subjected to electro-acupuncture analgesia, the microautoradiographic intensities of 3 H-5-HT both in the midbrain raphe nuclei and in the areas of mesencephalon aqueduct were significantly increased. It may be observed that the release of 5-HT in these regions of the brain is accelerated during acupuncture analgesia. From this it can be concluded that the midbrain raphe nuclei and the mesencephalon aquaeduct as well as the periaquaeductal gray matter are closely related to acupuncture analgesia. The results imply that 5-HT in these areas may be one of the most important neurochemical agents mediating acupuncture analgesia

  17. Retrospective study of the association between epidural analgesia during labour and complications for the newborn.

    Science.gov (United States)

    Herrera-Gómez, A; García-Martínez, O; Ramos-Torrecillas, J; De Luna-Bertos, E; Ruiz, C; Ocaña-Peinado, F M

    2015-06-01

    our objective was to determine the association between epidural analgesia and different variables. the effect on newborns of epidural analgesia administered to the mother during labour remains under debate. this association was retrospectively investigated in a cohort of 2399 children born in a Spanish public hospital. Only full-term (>37 weeks of gestation) deliveries were included. Other exclusion criteria were: induced delivery (medical or obstetric indication), elective caesarean section, or the presence of an important pregnancy risk factors (hypertension, diabetes, severe disease, toxaemia, retarded intrauterine growth, chronologically prolonged pregnancy, prolonged membrane rupture (>24 hours), oligoamnios, or polyhydramnios). The Mann-Whitney U test and Fisher׳s exact test were applied to determine the relationship between variables. Apgar index values at one minute and five minutes were slightly but significantly lower in neonates whose mothers had received epidural analgesia. Neonatal intensive care unit admission was significantly more frequent in the epidural versus non-epidural group. Resuscitation was significantly more frequent in the epidural versus non-epidural group. Early breast feeding onset was more frequent in the non-epidural group. The adverse effect of epidural analgesia on early lactation remained significant after adjusting for NICU admission and the need for resuscitation in a logistic regression analysis. Epidural analgesia may have adverse effects on newborns, although the risks are low, and further research is required to elucidate the causal nature of this relationship. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Obstetrical and perinatal outcomes in patients with or without obstetric analgesia during labor

    Directory of Open Access Journals (Sweden)

    Piedrahíta-Gutiérrez, Dany Leandro

    2016-07-01

    Full Text Available Objective: To describe and compare the obstetric and perinatal outcomes in patients with or without obstetric analgesia during labor, and to determine whether such analgesia is associated with adverse maternal or perinatal outcomes. Methodology: Comparative, retrospective, descriptive study, between January and November 2014, that included 502 healthy patients with normal pregnancies, out of which 250 received obstetric analgesia. The groups were compared as to maternal and perinatal outcomes. Results: Young, single and nulliparous mothers predominated; delivery was vaginal in 86 % of the cases, and by caesarean section in 14 %. Obstetric analgesia was associated with longer duration of the second stage of labor, instrumental delivery and cesarean section due to arrest of dilatation or fetal bradycardia; however, it was not related with higher incidence of postpartum hemorrhage or adverse perinatal outcomes such as meconium-stained amniotic fluid, Apgar under 5 at one minute or under 7 at 5 minutes, the need for neonatal resuscitation or for admission to NICU. Conclusion: Obstetric analgesia increases the duration of the second stage of labor and can increase the rate of caesarean sections and instrumental delivery, but it is not associated with adverse maternal or perinatal outcomes. Therefore, its use in labor is justified.

  19. Comparison of dural puncture epidural technique versus conventional epidural technique for labor analgesia in primigravida

    Directory of Open Access Journals (Sweden)

    Pritam Yadav

    2018-01-01

    Full Text Available >Background: Dural puncture epidural (DPE is a method in which a dural hole is created prior to epidural injection. This study was planned to evaluate whether dural puncture improves onset and duration of labor analgesia when compared to conventional epidural technique.Methods and Materials: Sixty term primigravida parturients of ASA grade I and II were randomly assigned to two groups of 30 each (Group E for conventional epidural and Group DE for dural puncture epidural. In group E, epidural space was identified and 18-gauge multi-orifice catheter was threaded 5 cm into the epidural space. In group DE, dura was punctured using the combines spinal epidural (CSE spinal needle and epidural catheter threaded as in group E followed by 10 ml of injection of Ropivacaine (0.2% with 20 mcg of Fentanyl (2 mcg/ml in fractions of 2.5 ml. Later, Ropivacaine 10 ml was given as a top-up on patient request. Onset, visual analouge scale (VAS, sensory and motor block, haemodynamic variables, duration of analgesia of initial dose were noted along with mode of delivery and the neonatal outcome.Results: Six parturients in group DE achieved adequate analgesia in 5 minutes while none of those in group E (P 0.05.Conclusions: Both techniques of labor analgesia are efficacious; dural puncture epidural has the potential to fasten onset and improve quality of labor analgesia when compared with conventional epidural technique.

  20. Adding ketamine to morphine for intravenous patient-controlled analgesia for acute postoperative pain

    DEFF Research Database (Denmark)

    Carstensen, M.; Møller, Ann

    2010-01-01

    In experimental trials, ketamine has been shown to reduce hyperalgesia, prevent opioid tolerance, and lower morphine consumption. Clinical trials have found contradictory results. We performed a review of randomized, double-blinded clinical trials of ketamine added to opioid in i.v. patient...... for i.v. PCA was superior to i.v. PCA opioid alone. The combination allows a significant reduction in pain score, cumulative morphine consumption, and postoperative desaturation. The benefit of adding ketamine to morphine in i.v. PCA for orthopaedic or abdominal surgery remains unclear. Owing to huge...

  1. Intravenous sodium fluorescein enhances the visibility of vitreous during vitrectomy surgery for diabetic retinopathy Fluoresceína sódica intravenosa aumenta a visibilidade do vítreo durante a cirurgia de vitrectomia para retinopatia diabética

    Directory of Open Access Journals (Sweden)

    Rubens Camargo Siqueira

    2008-08-01

    Full Text Available OBJECTIVE: To observe the effectiveness of intravenous sodium fluorescein visibility in the vitreous during vitrectomy surgery in patients with diabetic retinopathy. METHODS: Fourteen consecutive cases of vitreoretinal surgery for vitreous hemorrhage and tractional retinal detachment secondary to diabetic retinopathy underwent intravenous injection of sodium fluorescein to 20% 1 hour before the surgery. The images of the steps of the surgeries were recorded. RESULTS: The sodium fluorescein stained green from the vitreous peripheral, vitreous base, posterior hyaloid, further improving visibility to a complete and more secure vitrectomy. The sodium fluorescein also stained fibrous points (sites of neovascularization with high intensity making it easier its visibility. No complications associated with the dye injection were observed in all cases. CONCLUSION: Intravenous sodium fluorescein can be used safely for facilitating the observation of the vitreous, vitreous base, posterior hyaloid and sites of neovascularization. This technique can facilitate the process of vitrectomy in patients with diabetic retinopathy.OBJETIVO: Observar a eficácia da fluoresceína sódica intravenosa, na visibilidade do vítreo, durante a cirurgia de vitrectomia nos pacientes com retinopatia diabética. MÉTODOS: Quatorze casos consecutivos de cirurgia vitreorretiniana para hemorragia vítrea e descolamento tracional da retina secundário à retinopatia diabética, foram submetidos à injeção de fluoresceína intravenosa a 20%, 1 hora antes da cirurgia.As imagens de todos os passos das cirurgias foram gravadas. RESULTADOS: A fluoresceína corou de verde o vítreo periférico, base vítrea, hialóide posterior melhorando a visibilidade para uma vitrectomia completa e mais segura. A fluoresceína também corou pontos fibrosos (sítios de neovascularização com alta intensidade tornando mais fácil sua observação. Nenhuma complicação associada com a injeção do

  2. External validation of a PCA-3-based nomogram for predicting prostate cancer and high-grade cancer on initial prostate biopsy.

    Science.gov (United States)

    Greene, Daniel J; Elshafei, Ahmed; Nyame, Yaw A; Kara, Onder; Malkoc, Ercan; Gao, Tianming; Jones, J Stephen

    2016-08-01

    The aim of this study was to externally validate a previously developed PCA3-based nomogram for the prediction of prostate cancer (PCa) and high-grade (intermediate and/or high-grade) prostate cancer (HGPCa) at the time of initial prostate biopsy. A retrospective review was performed on a cohort of 336 men from a large urban academic medical center. All men had serum PSA PCa, PSA at diagnosis, PCA3, total prostate volume (TPV), and abnormal finding on digital rectal exam (DRE). These variables were used to test the accuracy (concordance index) and calibration of a previously published PCA3 nomogram. Biopsy confirms PCa and HGPCa in 51.0% and 30.4% of validation patients, respectively. This differed from the original cohort in that it had significantly more PCa and HGPCA (51% vs. 44%, P = 0.019; and 30.4% vs. 19.1%, P PCa detection the concordance index was 75% and 77% for overall PCa and HGPCa, respectively. Calibration for overall PCa was good. This represents the first external validation of a PCA3-based prostate cancer predictive nomogram in a North American population. Prostate 76:1019-1023, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. From the ocean to a salt marsh: towards understanding iron reduction processes with FORC-PCA.

    Science.gov (United States)

    Muraszko, J. R.; Lascu, I.; Collins, S. M.; Harrison, R. J.

    2017-12-01

    Biogenic magnetic minerals are a high fidelity recorder of climate change. Their sensitivity to sedimentary redox conditions and bottom water ventilation have the potential to provide useful insights into past diagenetic conditions. However, the mechanisms controlling preservation and dissolution of magnetosomes are not fully understood, thus undermining the reliability of the paleomagnetic records in marine environments. Recovering information about the diagenetic past of the sediment is a crucial challenge; specifically, the biogenic components need to be identified and unmixed from the bulk magnetic signal. We address the issue in this study by applying Principal Component Analysis on First Order Reversal Curve diagrams (FORC-PCA) in case studies of cores obtained from the Iberian Margin and the sedimentologically active coastal salt marshes of Norfolk. We demonstrate the applicability of FORC-PCA as a new environmental proxy, yielding a high resolution temporal marine record of environmental changes reflected in magnetic composition over the last 194 kyr. The strongest variations are observed in the microbially derived components, the bulk properties of the sediment being controlled by a low coercivity SP-SD component which is generally anticorrelated with the magnetosome signal. Supported by TEM studies, we suggest the prevalence of clusters of nano-particles of magnetite associated with iron reduction. To further investigate the mechanisms controlling these processes, the active sedimentary environment of Norfolk was chosen as a case study of early diagenesis controlled by strong vertical geochemical gradients.

  4. Combining ANOVA-PCA with POCHEMON to analyse micro-organism development in a polymicrobial environment.

    Science.gov (United States)

    Geurts, Brigitte P; Neerincx, Anne H; Bertrand, Samuel; Leemans, Manja A A P; Postma, Geert J; Wolfender, Jean-Luc; Cristescu, Simona M; Buydens, Lutgarde M C; Jansen, Jeroen J

    2017-04-22

    Revealing the biochemistry associated to micro-organismal interspecies interactions is highly relevant for many purposes. Each pathogen has a characteristic metabolic fingerprint that allows identification based on their unique multivariate biochemistry. When pathogen species come into mutual contact, their co-culture will display a chemistry that may be attributed both to mixing of the characteristic chemistries of the mono-cultures and to competition between the pathogens. Therefore, investigating pathogen development in a polymicrobial environment requires dedicated chemometric methods to untangle and focus upon these sources of variation. The multivariate data analysis method Projected Orthogonalised Chemical Encounter Monitoring (POCHEMON) is dedicated to highlight metabolites characteristic for the interaction of two micro-organisms in co-culture. However, this approach is currently limited to a single time-point, while development of polymicrobial interactions may be highly dynamic. A well-known multivariate implementation of Analysis of Variance (ANOVA) uses Principal Component Analysis (ANOVA-PCA). This allows the overall dynamics to be separated from the pathogen-specific chemistry to analyse the contributions of both aspects separately. For this reason, we propose to integrate ANOVA-PCA with the POCHEMON approach to disentangle the pathogen dynamics and the specific biochemistry in interspecies interactions. Two complementary case studies show great potential for both liquid and gas chromatography - mass spectrometry to reveal novel information on chemistry specific to interspecies interaction during pathogen development. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  5. Low-light level image de-noising algorithm based on PCA

    Science.gov (United States)

    Miao, Zhuang; Wang, Xiuqin; Yin, Panqiang; Lu, Dongming

    2014-11-01

    A de-noising method based on PCA (Principal Component Analysis) is proposed to suppress the noise of LLL (Low-Light Level) image. At first, the feasibility of de-noising with the algorithm of PCA is analyzed in detail. Since the image data is correlated in time and space, it is retained as principal component, while the noise is considered to be uncorrelated in both time and space and be removed as minor component. Then some LLL images is used in the experiment to confirm the proposed method. The sampling number of LLL image which can lead to the best de-noising effects is given. Some performance parameters are calculated and the results are analyzed in detail. To compare with the proposed method, some traditional de-noising algorithm are utilized to suppress noise of LLL images. Judging from the results, the proposed method has more significant effects of de-noising than the traditional algorithm. Theoretical analysis and experimental results show that the proposed method is reasonable and efficient.

  6. Location optimization of solar plants by an integrated hierarchical DEA PCA approach

    International Nuclear Information System (INIS)

    Azadeh, A.; Ghaderi, S.F.; Maghsoudi, A.

    2008-01-01

    Unique features of renewable energies such as solar energy has caused increasing demands for such resources. In order to use solar energy as a natural resource, environmental circumstances and geographical location related to solar intensity must be considered. Different factors may affect on the selection of a suitable location for solar plants. These factors must be considered concurrently for optimum location identification of solar plants. This article presents an integrated hierarchical approach for location of solar plants by data envelopment analysis (DEA), principal component analysis (PCA) and numerical taxonomy (NT). Furthermore, an integrated hierarchical DEA approach incorporating the most relevant parameters of solar plants is introduced. Moreover, 2 multivariable methods namely, PCA and NT are used to validate the results of DEA model. The prescribed approach is tested for 25 different cities in Iran with 6 different regions within each city. This is the first study that considers an integrated hierarchical DEA approach for geographical location optimization of solar plants. Implementation of the proposed approach would enable the energy policy makers to select the best-possible location for construction of a solar power plant with lowest possible costs

  7. Learning binary code via PCA of angle projection for image retrieval

    Science.gov (United States)

    Yang, Fumeng; Ye, Zhiqiang; Wei, Xueqi; Wu, Congzhong

    2018-01-01

    With benefits of low storage costs and high query speeds, binary code representation methods are widely researched for efficiently retrieving large-scale data. In image hashing method, learning hashing function to embed highdimensions feature to Hamming space is a key step for accuracy retrieval. Principal component analysis (PCA) technical is widely used in compact hashing methods, and most these hashing methods adopt PCA projection functions to project the original data into several dimensions of real values, and then each of these projected dimensions is quantized into one bit by thresholding. The variances of different projected dimensions are different, and with real-valued projection produced more quantization error. To avoid the real-valued projection with large quantization error, in this paper we proposed to use Cosine similarity projection for each dimensions, the angle projection can keep the original structure and more compact with the Cosine-valued. We used our method combined the ITQ hashing algorithm, and the extensive experiments on the public CIFAR-10 and Caltech-256 datasets validate the effectiveness of the proposed method.

  8. Improvements in Alzheimer's disease diagnosis using principle components analysis (PCA) in combination with Raman spectroscopy

    Science.gov (United States)

    Archer, John K. J.; Sudworth, Caroline D.; Williams, Rachel; How, Thien; Stone, Nicholas; Mann, David; Black, Richard A.

    2007-07-01

    The significant achievements of medical science over the last century are evident in the increasing age of the global population, however this now brings new problems, the most prominent being the growth in the number of people suffering from dementia. Over half the people with dementia in the UK are sufferers of Alzheimer's disease, a condition in which intraneuronal neurofibrillary tangles and extraneuronal senile tangles take over neurons prompting their death. A definitive diagnosis is still only currently available post-mortem, whilst current symptom based processes of elimination are far from perfect, especially when the only treatments available are symptom inhibiting drugs. Principal component analysis (PCA) of the Raman spectra taken from brain tissue has proved to be a potential tool in the diagnosis. However, this work now has to be refined in order to progress to tissue less associated with the symptoms of Alzheimer's disease. The first step of this has already been taken in progressing from frontal tissue to occipital tissue point spectra taken at random positions from bulk tissue. Now we present initial work into acquiring Raman spectral maps from across a tissue area, in pursuit of identifying unique plaque and tangle spectra. These spectra are presented alongside synthetic β-Amyloid spectra, in a study of the role that the peptide plays in the biomarker spectra, and how this information can aid the PCA of bulk tissue, and point towards a Raman spectroscopic test on less sensitive tissue, such as blood.

  9. Spike sorting of heterogeneous neuron types by multimodality-weighted PCA and explicit robust variational Bayes

    Directory of Open Access Journals (Sweden)

    Takashi eTakekawa

    2012-03-01

    Full Text Available This study introduces a new spike sorting method that classifies spike waveforms from multiunit recordings into spike trains of individual neurons. In particular, we develop a method to sort a spike mixture generated by a heterogeneous neural population. Such a spike sorting has a significant practical value, but was previously difficult. The method combines a feature extraction method, which we may term multimodality-weighted principal component analysis (mPCA, and a clustering method by variational Bayes for Student’s t mixture model (SVB. The performance of the proposed method was compared with that of other conventional methods for simulated and experimental data sets. We found that the mPCA efficiently extracts highly informative features as clusters clearly separable in a relatively low-dimensional feature space. The SVB was implemented explicitly without relying on Maximum-A-Posterior (MAP inference for the degree of freedom parameters. The explicit SVB is faster than the conventional SVB derived with MAP inference and works more reliably over various data sets that include spiking patterns difficult to sort. For instance, spikes of a single bursting neuron may be separated incorrectly into multiple clusters, whereas those of a sparsely firing neuron tend to be merged into clusters for other neurons. Our method showed significantly improved performance in spike sorting of these difficult neurons. A parallelized implementation of the proposed algorithm (EToS version 3 is available as open-source code at http://etos.sourceforge.net/.

  10. PCA-based ANN approach to leak classification in the main pipes of VVER-1000

    International Nuclear Information System (INIS)

    Hadad, Kamal; Jabbari, Masoud; Tabadar, Z.; Hashemi-Tilehnoee, Mehdi

    2012-01-01

    This paper presents a neural network based fault diagnosing approach which allows dynamic crack and leaks fault identification. The method utilizes the Principal Component Analysis (PCA) technique to reduce the problem dimension. Such a dimension reduction approach leads to faster diagnosing and allows a better graphic presentation of the results. To show the effectiveness of the proposed approach, two methodologies are used to train the neural network (NN). At first, a training matrix composed of 14 variables is used to train a Multilayer Perceptron neural network (MLP) with Resilient Backpropagation (RBP) algorithm. Employing the proposed method, a more accurate and simpler network is designed where the input size is reduced from 14 to 6 variables for training the NN. In short, the application of PCA highly reduces the network topology and allows employing more efficient training algorithms. The accuracy, generalization ability, and reliability of the designed networks are verified using 10 simulated events data from a VVER-1000 simulation using DINAMIKA-97 code. Noise is added to the data to evaluate the robustness of the method and the method again shows to be effective and powerful. (orig.)

  11. Semi-supervised classification for hyperspectral remote sensing image based on PCA and kernel FCM algorithm

    Science.gov (United States)

    Liu, Xiaofang; He, Binbin; Li, Xiaowen

    2008-10-01

    Hyperspectral remote sensing image classification is a challenging task in remote sensing applications because this image always has some information redundancy and is easy to be affected by noise or lack of the separability. A semi-supervised classification method based on principal component analysis (PCA) method and kernel fuzzy C-means (KFCM) algorithm for hyperspectral remote sensing image is proposed in this paper. First the PCA method finds an effective representation of spectral signature in a reduced dimensional feature space. Then a semi-supervised kernel-based FCM algorithm, called SSKFCM algorithm by introducing semi-supervised learning technique and the kernel trick simultaneously into conventional fuzzy C-means algorithm, is introduced to classify the feature vectors. Finally numerical experiments are conducted on a hyperspectral remote sensing image that provides digital images of 80 spectral bands with wavelength rang from 455 nm to 1642 nm. Classification performance is estimated by classification accuracy and kappa coefficient. The simulation results show that the proposed approach can be effectively applied to hyperspectral remote sensing image classification.

  12. A new LPV modeling approach using PCA-based parameter set mapping to design a PSS

    Directory of Open Access Journals (Sweden)

    Mohammad B. Abolhasani Jabali

    2017-01-01

    Full Text Available This paper presents a new methodology for the modeling and control of power systems based on an uncertain polytopic linear parameter-varying (LPV approach using parameter set mapping with principle component analysis (PCA. An LPV representation of the power system dynamics is generated by linearization of its differential-algebraic equations about the transient operating points for some given specific faults containing the system nonlinear properties. The time response of the output signal in the transient state plays the role of the scheduling signal that is used to construct the LPV model. A set of sample points of the dynamic response is formed to generate an initial LPV model. PCA-based parameter set mapping is used to reduce the number of models and generate a reduced LPV model. This model is used to design a robust pole placement controller to assign the poles of the power system in a linear matrix inequality (LMI region, such that the response of the power system has a proper damping ratio for all of the different oscillation modes. The proposed scheme is applied to controller synthesis of a power system stabilizer, and its performance is compared with a tuned standard conventional PSS using nonlinear simulation of a multi-machine power network. The results under various conditions show the robust performance of the proposed controller.

  13. A new LPV modeling approach using PCA-based parameter set mapping to design a PSS.

    Science.gov (United States)

    Jabali, Mohammad B Abolhasani; Kazemi, Mohammad H

    2017-01-01

    This paper presents a new methodology for the modeling and control of power systems based on an uncertain polytopic linear parameter-varying (LPV) approach using parameter set mapping with principle component analysis (PCA). An LPV representation of the power system dynamics is generated by linearization of its differential-algebraic equations about the transient operating points for some given specific faults containing the system nonlinear properties. The time response of the output signal in the transient state plays the role of the scheduling signal that is used to construct the LPV model. A set of sample points of the dynamic response is formed to generate an initial LPV model. PCA-based parameter set mapping is used to reduce the number of models and generate a reduced LPV model. This model is used to design a robust pole placement controller to assign the poles of the power system in a linear matrix inequality (LMI) region, such that the response of the power system has a proper damping ratio for all of the different oscillation modes. The proposed scheme is applied to controller synthesis of a power system stabilizer, and its performance is compared with a tuned standard conventional PSS using nonlinear simulation of a multi-machine power network. The results under various conditions show the robust performance of the proposed controller.

  14. A Method for Aileron Actuator Fault Diagnosis Based on PCA and PGC-SVM

    Directory of Open Access Journals (Sweden)

    Wei-Li Qin

    2016-01-01

    Full Text Available Aileron actuators are pivotal components for aircraft flight control system. Thus, the fault diagnosis of aileron actuators is vital in the enhancement of the reliability and fault tolerant capability. This paper presents an aileron actuator fault diagnosis approach combining principal component analysis (PCA, grid search (GS, 10-fold cross validation (CV, and one-versus-one support vector machine (SVM. This method is referred to as PGC-SVM and utilizes the direct drive valve input, force motor current, and displacement feedback signal to realize fault detection and location. First, several common faults of aileron actuators, which include force motor coil break, sensor coil break, cylinder leakage, and amplifier gain reduction, are extracted from the fault quadrantal diagram; the corresponding fault mechanisms are analyzed. Second, the data feature extraction is performed with dimension reduction using PCA. Finally, the GS and CV algorithms are employed to train a one-versus-one SVM for fault classification, thus obtaining the optimal model parameters and assuring the generalization of the trained SVM, respectively. To verify the effectiveness of the proposed approach, four types of faults are introduced into the simulation model established by AMESim and Simulink. The results demonstrate its desirable diagnostic performance which outperforms that of the traditional SVM by comparison.

  15. The PCA learning effect: An emerging correlate of face memory during childhood.

    Science.gov (United States)

    Gao, Xiaoqing; Maurer, Daphne; Wilson, Hugh R

    2015-10-01

    Human adults implicitly learn the prototype and the principal components of the variability distinguishing faces (Gao & Wilson, 2014). Here we measured the implicit learning effect in adults and 9-year-olds, and with a modified child-friendly procedure, in 7-year-olds. All age groups showed the implicit learning effect by falsely recognizing the average (the prototype effect) and the principal component faces as having been seen (the PCA learning effect). The PCA learning effect, but not the prototype effect increased between 9years of age and adulthood and at both ages was the better predictor of memory for the actually studied faces. In contrast, for the 7-year-olds, the better predictor of face memory was the prototype effect. The pattern suggests that there may be a developmental change between ages 7 and 9 in the mechanism underlying memory for faces. We provide the first evidence that children as young as age 7 can extract the most important dimensions of variation represented by principal components among individual faces, a key ability that grows stronger with age and comes to underlie memory for faces. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Modeling of the ORNL PCA Benchmark Using SCALE6.0 Hybrid Deterministic-Stochastic Methodology

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    Mario Matijević

    2013-01-01

    Full Text Available Revised guidelines with the support of computational benchmarks are needed for the regulation of the allowed neutron irradiation to reactor structures during power plant lifetime. Currently, US NRC Regulatory Guide 1.190 is the effective guideline for reactor dosimetry calculations. A well known international shielding database SINBAD contains large selection of models for benchmarking neutron transport methods. In this paper a PCA benchmark has been chosen from SINBAD for qualification of our methodology for pressure vessel neutron fluence calculations, as required by the Regulatory Guide 1.190. The SCALE6.0 code package, developed at Oak Ridge National Laboratory, was used for modeling of the PCA benchmark. The CSAS6 criticality sequence of the SCALE6.0 code package, which includes KENO-VI Monte Carlo code, as well as MAVRIC/Monaco hybrid shielding sequence, was utilized for calculation of equivalent fission fluxes. The shielding analysis was performed using multigroup shielding library v7_200n47g derived from general purpose ENDF/B-VII.0 library. As a source of response functions for reaction rate calculations with MAVRIC we used international reactor dosimetry libraries (IRDF-2002 and IRDF-90.v2 and appropriate cross-sections from transport library v7_200n47g. The comparison of calculational results and benchmark data showed a good agreement of the calculated and measured equivalent fission fluxes.

  17. The study of patient controlled analgesia undergoing interventional therapy for gynecology and obstetrics ailment

    International Nuclear Information System (INIS)

    She Shouzhang

    2006-01-01

    Uterine artery embolism is widely used for interventional therapy of gynecology and obstetrics ailment, but immediate incidence of pain occurs in 90% to 100% after uterine artery embolism and postoperative incidence of pain takes place from 80% to 90%. Patient controlled epidural analgesia (PCEA) could be adopted to treat pain with obviously outweighed effects over the traditional drug regimen or patient intravenous analgesia during the period of interventional therapy of uterine artery embolization. PCEA possesses good effect of analgesia and less adverse reaction and furthermore could eliminate or lessen the sufferings of patient and thus improve rehabilitation quality. Adding droperidol (0.005%) into the preparation of PCEA could decrease adverse effect incidence of nausea and vomiting; so it deserves recommendation for extending application in clinical interventional therapy. (authors)

  18. Postoperative Paraplegia as a Result of Undiagnosed Primitive Neuroectodermal Tumor, Not Epidural Analgesia

    Directory of Open Access Journals (Sweden)

    Pei-Ching Hung

    2007-10-01

    Full Text Available Postoperative paraplegia is a rare complication after epidural analgesia and often occurs with spinal hematoma or cord injury. We present the case of a 16-year-old girl who suffered from a tumor mass in the neck and abdomen who underwent gynecologic operation. Preoperatively, liver metastasis was found by computed tomography. Pathologic findings revealed that the abdominal mass was an ovarian dermoid cyst. After the operation, the patient complained of paraplegia while receiving epidural analgesia for postoperative pain control. A peripheral primitive neuroectodermal tumor in the thoracic and lumbar spines with spinal cord compression was later detected using magnetic resonance imaging. Learning from this case, we suggest that when a patient is preoperatively diagnosed with tumor metastasis, back pain and soreness, spinal cord compression from tumor metastasis should be excluded before epidural analgesia is implemented.

  19. Obstetric regional analgesia in the Jesenice General hospital in year 2006

    Directory of Open Access Journals (Sweden)

    Aleksandra Kern

    2007-11-01

    Full Text Available Background: The aim of this retrospective analysis of the obstetric regional analgesia (ORA in Jesenice General Hospital in year 2006 was to evaluate our work and present results. We analysed workload, quality of the analgesia and patients’ satisfaction. We also estimated the OR for vacuum extraction (VE in nulliparous labouring women having ORA. We compared quality of analgesia and total local analgesic consumption in nulliparous women having VE or spontaneous delivery.Methods: We performed retrospective analysis of labours with ORA in year 2006. All women received epiduraly mixture of 0.1 % bupivacaine with 2 µg of fentanyl per ml in intermittent boluses.The labour pain was assessed using visual analogue scale (VAS. We used median and interquartile range to describe distribution of these values and mean with standard deviation to describe distribution of other data (local anaesthetic consumption. We considered patient with pain VAS 3 or less adequately treated, VAS 4 and 5 sufficiently and VAS 6 and more insufficiently treated. We used odds ratio as measurement of risk for VE, t-test for differences in local anaesthetic consumption and Mann-Whitney test to evaluate differences in pain between tested groups.Results: 225 labouring women opted for ORA or 38 % of all labouring women in year 2006. We performed 224 ORA, 59 % during regular work, 41 % during turn of duty. 18 % of ORA were performed between 10 p.m. and 7.00 a.m. In 98 % of cases epidural analgesia was used. Anaesthesiologic work took 16 minutes in average (SD 6.06. Analgesia was started at VAS median 5 (IQR 4–6.5 and at average cervical dilatation 4.1 cm (SD 1.4. Average consumption of bupivacaine was 55 mg (SD 23.7 and fentanyl 91.7 µg (SD 46.5. Most common complications were inadequate analgesia, and misplacement of epidural catheter (10/222, dural tap (6/222, and unilateral analgesia (2/222. 70 labours were ended with VE (13 %; n = 532. There were 27 (8.7 %; n = 309 VE in

  20. Influence on number of top-ups after implementing patient controlled epidural analgesia: A cohort study.

    Science.gov (United States)

    van Samkar, Ganapathy; Hermanns, Henning; Lirk, Philipp; Hollmann, Markus W; Stevens, Markus F

    2017-01-01

    Postoperative epidural analgesia often needs rate readjustment using top-ups. Patient-controlled epidural analgesia (PCEA) is said to reduce the requirement of epidural top-ups when compared to continuous epidural analgesia (CEA). We compared CEA and PCEA in major thoracic and abdominal surgery, in a cohort study. The primary endpoint was the required number of epidural top-ups. Secondary endpoints were pain scores, side effects and workload differences. We analysed 199 patients with CEA and 187 with PCEA. Both groups had similar pain scores. The total number of top-ups was 75 in 57 patients (CEA) versus 20 top-ups in 18 patients (PCEA). (p = 0.0001) Sedation tended to occur more frequently in patients with CEA versus PCEA, 5.5% vs 1.6% (p = 0.05). Implementation of PCEA led to a decreased number of top-ups, fewer side-effects and decreased use of the postoperative care unit.

  1. Essential Elements of Multimodal Analgesia in Enhanced Recovery After Surgery (ERAS) Guidelines.

    Science.gov (United States)

    Beverly, Anair; Kaye, Alan D; Ljungqvist, Olle; Urman, Richard D

    2017-06-01

    Perioperative multimodal analgesia uses combinations of analgesic medications that act on different sites and pathways in an additive or synergistic manner to achieve pain relief with minimal or no opiate consumption. Although all medications have side effects, opiates have particularly concerning, multisystemic, long-term, and short-term side effects, which increase morbidity and prolong admissions. Enhanced recovery is a systematic process addressing each aspect affecting recovery. This article outlines the evidence base forming the current multimodal analgesia recommendations made by the Enhanced Recovery After Surgery Society (ERAS). We describe current evidence and important future directions for effective perioperative multimodal analgesia in enhanced recovery pathways. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. An Update on Drugs Used for Lumbosacral Epidural Anesthesia and Analgesia in Dogs

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    Paulo V. M. Steagall

    2017-05-01

    Full Text Available This review aims to report an update on drugs administered into the epidural space for anesthesia and analgesia in dogs, describing their potential advantages and disadvantages in the clinical setting. Databases searched include Pubmed, Google scholar, and CAB abstracts. Benefits of administering local anesthetics, opioids, and alpha2 agonists into the epidural space include the use of lower doses of general anesthetics (anesthetic “sparing” effect, perioperative analgesia, and reduced side effects associated with systemic administration of drugs. However, the potential for cardiorespiratory compromise, neurotoxicity, and other adverse effects should be considered when using the epidural route of administration. When these variables are considered, the epidural technique is useful as a complementary method of anesthesia for preventive and postoperative analgesia and/or as part of a balanced anesthesia technique.

  3. An Update on Drugs Used for Lumbosacral Epidural Anesthesia and Analgesia in Dogs

    Science.gov (United States)

    Steagall, Paulo V. M.; Simon, Bradley T.; Teixeira Neto, Francisco J.; Luna, Stelio P. L.

    2017-01-01

    This review aims to report an update on drugs administered into the epidural space for anesthesia and analgesia in dogs, describing their potential advantages and disadvantages in the clinical setting. Databases searched include Pubmed, Google scholar, and CAB abstracts. Benefits of administering local anesthetics, opioids, and alpha2 agonists into the epidural space include the use of lower doses of general anesthetics (anesthetic “sparing” effect), perioperative analgesia, and reduced side effects associated with systemic administration of drugs. However, the potential for cardiorespiratory compromise, neurotoxicity, and other adverse effects should be considered when using the epidural route of administration. When these variables are considered, the epidural technique is useful as a complementary method of anesthesia for preventive and postoperative analgesia and/or as part of a balanced anesthesia technique. PMID:28553642

  4. Fluoroscopically guided tunneled trans-caudal epidural catheter technique for opioid-free neonatal epidural analgesia.

    Science.gov (United States)

    Franklin, Andrew D; Hughes, Elisabeth M

    2016-06-01

    Epidural analgesia confers significant perioperative advantages to neonates undergoing surgical procedures but may be very technically challenging to place using a standard interlaminar loss-of-resistance to saline technique given the shallow depth of the epidural space. Thoracic epidural catheters placed via the caudal route may reduce the risk of direct neural injury from needle placement, but often pose higher risks of infection and/or improper positioning if placed without radiographic guidance. We present a detailed method of placing a fluoroscopically guided, tunneled transcaudal epidural catheter, which may reduce both of these risks. The accuracy and precision of this technique often provides adequate analgesia to allow for opioid-free epidural infusions as well as significant reductions in systemic opioids through the perioperative period. Opioid-free analgesia using a regional anesthetic technique allows for earlier extubation and reduced perioperative sedation, which may have a less deleterious neurocognitive effect on the developing brain of the neonate.

  5. Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review

    Directory of Open Access Journals (Sweden)

    Jiang-Ti Kong

    2013-01-01

    Full Text Available We discuss the emerging translational tools for the study of acupuncture analgesia with a focus on psychophysical methods. The gap between animal mechanistic studies and human clinical trials of acupuncture analgesia calls for effective translational tools that bridge neurophysiological data with meaningful clinical outcomes. Temporal summation (TS and conditioned pain modulation (CPM are two promising tools yet to be widely utilized. These psychophysical measures capture the state of the ascending facilitation and the descending inhibition of nociceptive transmission, respectively. We review the basic concepts and current methodologies underlying these measures in clinical pain research, and illustrate their application to research on acupuncture analgesia. Finally, we highlight the strengths and limitations of these research methods and make recommendations on future directions. The appropriate addition of TS and CPM to our current research armamentarium will facilitate our efforts to elucidate the central analgesic mechanisms of acupuncture in clinical populations.

  6. Efficacy of clonidine as an adjuvant to bupivacaine for caudal analgesia in children undergoing sub-umbilical surgery

    Directory of Open Access Journals (Sweden)

    Aruna Parameswari

    2010-01-01

    Full Text Available Caudal epidural analgesia with bupivacaine is very popular in paediatric anaesthesia for providing intra- and postoperative analgesia. Several adjuvants have been used to prolong the action of bupivacaine. We evaluated the efficacy of clonidine added to bupivacaine in prolonging the analgesia produced by caudal bupivacaine in children undergoing sub-umbilical surgery. One hundred children, age one to three years, undergoing sub-umbilical surgery, were prospectively randomized to one of two groups: caudal analgesia with 1 ml/kg of 0.25% bupivacaine in normal saline (Group A or caudal analgesia with 1 ml/kg of 0.25% bupivacaine with 1 μg/kg of clonidine in normal saline (Group B. Post-operative pain was assessed for 24 hours using the FLACC scale. The mean duration of analgesia was significantly longer in Group B (593.4 ± 423.3 min than in Group A (288.7 ± 259.1 min; P < 0.05. The pain score assessed using FLACC scale was compared between the two groups, and children in Group B had lower pain scores, which was statistically significant. The requirement of rescue medicine was lesser in Group B. Clonidine in a dose of 1 μg/kg added to 0.25% bupivacaine for caudal analgesia, during sub-umbilical surgeries, prolongs the duration of analgesia of bupivacaine, without any side effects.

  7. Modafinil reduces patient-reported tiredness after sedation/analgesia but does not improve patient psychomotor skills.

    NARCIS (Netherlands)

    Galvin, E.; Boesjes, H.; Hol, J.; Ubben, J.F.; Klein-Nulend, J.; Verbrugge, S.J.

    2010-01-01

    BACKGROUND: Early recovery of patients following sedation/analgesia and anesthesia is important in ambulatory practice. The aim of this study was to assess whether modafinil, used for the treatment of narcolepsy, improves recovery following sedation/analgesia. METHODS: Patients scheduled for

  8. Local infiltration analgesia in urogenital prolapse surgery: a prospective randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Kristensen, Billy B; Rasmussen, Yvonne H; Agerlin, Marianne

    2011-01-01

    To evaluate the analgesic effect of high-volume infiltration analgesia in urogenital prolapse surgery and provide a detailed description of the infiltration technique.......To evaluate the analgesic effect of high-volume infiltration analgesia in urogenital prolapse surgery and provide a detailed description of the infiltration technique....

  9. Effects of subtle cognitive manipulations on placebo analgesia - An implicit priming study.

    Science.gov (United States)

    Rosén, A; Yi, J; Kirsch, I; Kaptchuk, T J; Ingvar, M; Jensen, K B

    2017-04-01

    Expectancy is widely accepted as a key contributor to placebo effects. However, it is not known whether non-conscious expectancies achieved through semantic priming may contribute to placebo analgesia. In this study, we investigated if an implicit priming procedure, where participants were unaware of the intended priming influence, affected placebo analgesia. In a double-blind experiment, healthy participants (n = 36) were randomized to different implicit priming types; one aimed at increasing positive expectations and one neutral control condition. First, pain calibration (thermal) and a credibility demonstration of the placebo analgesic device were performed. In a second step, an independent experimenter administered the priming task; Scrambled Sentence Test. Then, pain sensitivity was assessed while telling participants that the analgesic device was either turned on (placebo) or turned off (baseline). Pain responses were recorded on a 0-100 Numeric Response Scale. Overall, there was a significant placebo effect (p priming conditions (positive/neutral) did not lead to differences in placebo outcome. Prior experience of pain relief (during initial pain testing) correlated significantly with placebo analgesia (p Priming is one of many ways to influence behaviour, and non-conscious activation of positive expectations could theoretically affect placebo analgesia. Yet, we found no SST priming effect on placebo analgesia. Instead, our data point to the significance of prior experience of pain relief, trait neuroticism and social interaction with the treating clinician. Our findings challenge the role of semantic priming as a behavioural modifier that may shape expectations of pain relief, and affect placebo analgesia. © 2016 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

  10. Epidural analgesia in labour and neonatal respiratory distress: a case-control study.

    Science.gov (United States)

    Kumar, Manoj; Chandra, Sue; Ijaz, Zainab; Senthilselvan, Ambikaipakan

    2014-03-01

    Epidural analgesia is the commonest mode for providing pain relief in labour, with a combination of bupivacaine and fentanyl most often used in practice. To test whether late-preterm and term neonates exposed to opioids in epidural analgesia in labour are more likely to develop respiratory distress in the immediate neonatal period. A case-control study was conducted of singleton infants born during January 2006 to December 2010. Cases were neonates ≥34 weeks gestation, who developed respiratory distress within 24 h of life requiring supplemental oxygen ≥2 h and/or positive pressure ventilation in the neonatal intensive care unit. Controls were gestation and site-matched neonates who did not develop any respiratory distress within the same period. The information on exposure to epidural analgesia and on potential confounding variables was obtained from the standardised delivery record, routinely filled out on all women admitted to the labour wards. In our study, 206 cases and 206 matched controls were enrolled. Exposure to epidural analgesia was present in 146 (70.9%) cases as compared with 131 (63.6%) of the controls. The association between exposure to epidural analgesia and respiratory distress in neonates was statistically significant upon adjustment for all potential confounders (adjusted OR: 1.75, 95% CI 1.03 to 2.99; p = 0.04). When data was separately analysed for term and late-preterm infants, the results were consistent across these subpopulations, showing no interaction effect. Late-preterm and term infants exposed to maternal epidural analgesia in labour are more likely to develop respiratory distress in the immediate neonatal period.

  11. Evaluating emergency nurse practitioner service effectiveness on achieving timely analgesia: a pragmatic randomized controlled trial.

    Science.gov (United States)

    Jennings, Natasha; Gardner, Glenn; O'Reilly, Gerard; Mitra, Biswadev

    2015-06-01

    The rapid uptake of nurse practitioner (NP) services in Australia has outpaced evaluation of this service model. A randomized controlled trial was conducted to compare the effectiveness of NP service versus standard medical care in the emergency department (ED) of a major referral hospital in Australia. Patients presenting with pain were randomly assigned to receive either standard ED medical care or NP care. Primary investigators were blinded to treatment allocation for data analyses. The primary outcome measure was the proportion of patients receiving analgesia within 30 minutes from being seen by care group. Secondary outcome measures were time to analgesia from presentation and documentation of and changes in pain scores. There were 260 patients randomized; 128 received standard care (medical practitioner led), and 130 received NP care. Two patients needed to be excluded due to incomplete consent forms. The proportion of patients who received analgesia within 30 minutes from being seen was 49.2% (n = 64) in the NP group and 29.7% (n = 38) in the standard group, a difference of 19.5% (95% confidence interval [CI] = 7.9% to 31.2%; p = 0.001). Of 165 patients who received analgesia, 64 (84.2%) received analgesia within 30 minutes in the NP group compared to 38 (42.7%) in the standard care group, a difference in proportions of 41.5% (95% CI = 28.3% to 54.7%; p Nurse practitioner service effectiveness was demonstrated through superior performance in achieving timely analgesia for ED patients. © 2015 by the Society for Academic Emergency Medicine.

  12. Tolerance to Morphine Analgesia: Influence of Pain and Method of Morphine Delivery

    Directory of Open Access Journals (Sweden)

    Scott A Chen

    2000-01-01

    Full Text Available Whether some kinds of pain can modify the development of tolerance to morphine analgesia is a controversial issue. Clinically, the development of tolerance is often difficult to establish because many factors can contribute to a decline in analgesic coverage, including disease progression. Basic animal research designed to examine tolerance provides the experimental control necessary to differentiate 'real' tolerance from other variables that can influence morphine analgesia. The present study examines the effects of inflammation induced by complete Freund's adjuvant (CFA on the development of tolerance to morphine analgesia produced by two different methods of morphine delivery - repeated bolus injections and continuous infusion. Male Long-Evans hooded rats were injected with CFA (0.2 mL into the right hind paw under sodium pentobarbital anesthesia or were given anesthesia alone. Starting 24 h later, rats either received an injection of morphine (20 mg/kg, intraperitoneal on four consecutive days or were implanted with a 72 h osmotic minipump that delivered 80 mg/kg morphine over a similar time period. Control animals received saline injections or were implanted with empty minipumps. After 24 h, sensitivity to morphine-induced analgesia was measured by the tail-immersion test (water maintained at 52°C using a cumulative dosing procedure. It was found that CFA attenuated tolerance to the morphine analgesia that was induced by intraperitoneal injections of morphine. In contrast, when morphine was delivered via osmotic minipumps, significant analgesic tolerance was observed in animals that received morphine in the presence of CFA but not in those that received morphine in the absence of CFA. These results show the importance of the method used to deliver morphine in determining the effects of pain on the development of tolerance to morphine analgesia.

  13. Projecting Benefits and Harms of Novel Cancer Screening Biomarkers: A Study of PCA3 and Prostate Cancer

    Science.gov (United States)

    Birnbaum, Jeanette K.; Feng, Ziding; Gulati, Roman; Fan, Jing; Lotan, Yair; Wei, John T.; Etzioni, Ruth

    2015-01-01

    Background New biomarkers for early detection of cancer must pass through several phases of development. Early phases provide information on diagnostic properties but not on population benefits and harms. Prostate cancer antigen 3 (PCA3) is a promising prostate cancer biomarker still in early development. We use simulation modeling to project the impact of adding PCA3 to prostate-specific antigen (PSA) screening on prostate cancer detection and mortality in the United States. Methods We used data from a recent study of PCA3 in men referred for prostate biopsy to extend an existing simulation model of PSA growth, disease progression and survival. We specified several PSA-PCA3 strategies designed to improve specificity and reduce overdiagnosis. Using these strategies to screen a cohort of men biennially between ages 50 and 74, we projected true and false positive tests, overdiagnoses, and lives saved relative to a PSA-based strategy with a cutoff of 4.0 ng/ml for biopsy referral. Results We identified several PSA-PCA3 strategies that substantially reduced false positive tests and overdiagnoses while preserving the majority of lives saved. PCA3>35 for biopsy referral in men with PSA between 4.0 and 10.0 ng/ml retained 85% of lives saved while approximately halving false positives and reducing overdiagnoses by 25%. Conclusions Adding PCA3 to PSA screening can significantly reduce adverse screening outcomes. Strategies can be identified that preserve most of the lives saved relative to PSA-based screening. Impact Simulation modeling provides advance projections of population outcomes of new screening biomarkers and may help guide early detection research. PMID:25613117

  14. Combined epidural-spinal opioid-free anaesthesia and analgesia for hysterectomy

    DEFF Research Database (Denmark)

    Callesen, T; Schouenborg, Lars Øland; Nielsen, D

    1999-01-01

    Postoperative nausea and vomiting (PONV) are major problems after gynaecological surgery. We studied 40 patients undergoing total abdominal hysterectomy, allocated randomly to receive opioid-free epidural-spinal anaesthesia or general anaesthesia with continuous epidural bupivacaine 15 mg h-1...... or continuous bupivacaine 10 mg h-1 with epidural morphine 0.2 mg h-1, respectively, for postoperative analgesia. Nausea, vomiting, pain and bowel function were scored on 4-point scales for 3 days. Patients undergoing general anaesthesia had significantly higher nausea and vomiting scores (P ... for hysterectomy caused less PONV, but with less effective analgesia compared with general anaesthesia with postoperative continuous epidural morphine and bupivacaine....

  15. Comparison of bupivacaine, xylazine and buprenorphine with ketamine combination for spinal analgesia in buffalo calves

    Directory of Open Access Journals (Sweden)

    Rekha Pathak

    Full Text Available Aim: The study was undertaken to compare the clinical efficacy of lumbosacral spinal analgesia produced using bupivacaine, xylazine and buprenorphine with ketamine combination in buffalo calves. Materials and Methods: 36 male buffalo calves of seven to eight months of age and weighing 60 to 75 kg were used to evaluate the efficacy and safety of lumbosacral spinal analgesia produced by bupivacaine 0.25mg/kg, xylazine 0.05 mg/kg and buprenorphine 20 μg/kg in combination with ketamine 2.5mg/ kg and divided into groups A, B and C, respectively with 12 animals in each group. Results: The onset of analgesia in animals of group A (bupivacaine + ketamine was 3.0±0.3 min, group B (xylazine + ketamine was recorded as 2.6±0.4 min and group C (buprenorphine + ketamine 4.0±0.4 min. Ketamine-bupivacaine in animals of group A produced complete analgesia of almost all the dermatomes for varying lengths of time. So also the group B except that it produced only moderate analgesia of thorax, abdomen and flank. Animals of group C produced only mild analgesia of thorax, abdomen and flank and moderate analgesia of digits , perineum, inguinal, himd limbs and tail region. The longest (>180 min. duration of complete analgesia was recorded in animals of group A. The heart rate and respiration rate significantly decreased in group A and B than group C, so also the rectal temperature. Sedation recorded was maximum in group B fallowed by group A and least sedation scores were given by group C animals. Similiarly the scores of motor incordination was higher in group B and group A than group C. Conclusion: It was concluded that the combinations viz. Bupivacaine+ Ketamine and Xylazine + ketamine when given intraspinally at the lumbosacral space have similar analgesic potency on spinal administration in buffaloes. The synergism is more pronounced in xylazine-ketamine combination,whereas Buprenorphine +ketamine combination in the above said dose is a poor analgesic agent

  16. Preemptive ketamine during general anesthesia for postoperative analgesia in patients undergoing laparoscopic cholecystectomy.

    Science.gov (United States)

    Launo, C; Bassi, C; Spagnolo, L; Badano, S; Ricci, C; Lizzi, A; Molinino, M

    2004-10-01

    Preemptive analgesia is currently in use in the management of postoperative pain and no more under search. The administration of ketamine as intraoperative analgesic agent is well-known since a long time; the analgesic properties of this drug are related to its actions as a non-competitive N-methyl-D-aspartate receptors antagonist; these receptors present an excitatory function on pain transmission and this binding seems to prevent or reverse the central sensitisation of every kind of pain, including postoperative pain. In literature, the use of this anesthetic for the preemptive analgesia in the management of postoperative pain is controversial; for this reason the aim of our study was the clinical evaluation of preemptive perioperative analgesia with low-doses ketamine. This trial involved 40 patients undergoing laparoscopic cholecystectomy, with the same surgical operator; postoperative analgesia was performed with the intraoperative administration of ketamine (0.7 mg/kg) or tramadol (15 mg/kg). A randomized, double-blind study was performed; after an inhalatory/analgesic general anesthesia (sevofluorane + remifentanyl) the postoperative-pain control was clinically evaluated through algometric measurements (Visual Analog Scale, Verbal Rating Scale, Pain Intensity Difference); supplemental doses of tramadol were administered if required, also to quantify the adequacy of analgesia, and adverse effects were evaluated. The results show that preemptive intraoperative analgesia with ketamine produces a good analgesia at the awakening, despite low duration (approximately 1 hour), and upgrades the analgesic effect of tramadol in the postoperative period. Among the adverse effects, some (for example nausea) were related to the administration of both analgesics and to the kind of surgery, others (hallucinosis, nystagmus, photophobia, psychomotor excitation, psychotic symptoms) were due to ketamine, and others (respiratory depression and hypotension) could be related to

  17. Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Axelsen, Solveig Forberg

    of an antenatal education program in small classes on use of epidural analgesia. Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according...... on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future. Main messages (max 200 anslag): 1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour...

  18. Intraoperative haloperidol does not improve quality of recovery and postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Amin Ebneshahidi

    2013-01-01

    Conclusion: Intraoperative small-dose IV haloperidol is effective against post-operative nausea and vomiting with no significant effect on overall QoR. It may also attenuate the analgesic effects of morphine PCA.

  19. Estudos clínico, laboratorial e eletrocardiográfico dos efeitos da solução hipertônica de cloreto de sódio a 7,5%, intravenosa, em cães clinicamente sadios

    OpenAIRE

    Nogueira, Fábio dos Santos [UNESP

    2003-01-01

    A solução hipertônica de cloreto de sódio a 7,5% é uma solução hiperosmolar (2566mOsm/L) que promove aumento da tonicidade e da osmolaridade sérica e, consequentemente, a troca de líquidos entre os compartimentos extracelular e intracelular. Quando administrada por via intravenosa, apresenta efeitos de expansão plasmática ou seja: aumento do débito cardíaco, vasodilatações pulmonar e sistêmica, redução do edema das células endoteliais e, proporcionando, melhora do fluxo sangüíneo capilar, dim...

  20. Acupuntura e analgesia: aplicações clínicas e principais acupontos Acupuncture and analgesia: clinical applications and main acupoints

    Directory of Open Access Journals (Sweden)

    Marilda Onghero Taffarel

    2009-12-01

    Full Text Available A dor é uma resposta protetora do organismo a estímulos nocivos, que resulta em efeitos indesejáveis quando não controlada. A analgesia pode ser promovida mediante a utilização de vários tipos de fármacos. No entanto, estes podem causar efeitos adversos de acordo com a espécie e condição física do paciente. A acupuntura tem se mostrado eficaz como coanalgésico pela capacidade de diminuir a quantidade de fármacos utilizados para o controle da dor e raramente ser contraindicada. Objetivou-se com este trabalho fazer uma breve revisão sobre as aplicações clínicas e os efeitos fisiológicos da acupuntura nos mecanismos da dor, bem como demonstrar os principais pontos de acupuntura utilizados para analgesia em animais. A pesquisa foi realizada em bases de dados eletrônicas por palavra-chave, durante o período de março a dezembro de 2008.Pain is a protective response of the body to harmful stimulus, which results in undesirable effects if not controlled. Analgesia can be achieved with the use of different types of drugs. However, these drugs can cause adverse effects according to species and patient physical condition. Acupuncture has been proved to be an effective analgesic adjuvant, by the capacity to decrease the amount of drug used for pain control, rarely contra-indicated. The aim of this paper was to review the physiological effects of acupuncture on pain mechanisms, and demonstrate the main acupoints used for animal analgesia. The search was done in electronic search database using key words, in 2008.