RESUMEN
The Universal Anaesthesia Machine has been developed as a complete anaesthesia workstation for use in low- and middle-income countries, where the provision of safe general anaesthesia is often compromised by unreliable supply of electricity and anaesthetic gases. We performed a functional and clinical assessment of this anaesthetic machine, with particular reference to novel features and functioning in the intended environment. The Universal Anaesthesia Machine was found to be reliable, safe and consistent across a range of tests during targeted functional testing.
Asunto(s)
Anestesiología/instrumentación , Adolescente , Anestesia General/instrumentación , Anestésicos por Inhalación/química , Niño , Preescolar , Países en Desarrollo , Suministros de Energía Eléctrica , Falla de Equipo , Femenino , Salud Global , Humanos , Lactante , Masculino , Oxígeno/administración & dosificación , Pobreza , Respiración ArtificialRESUMEN
A case of unexpected difficult laryngoscopy in a patient with gross hydrocephalus and generalized hypertonus is described. The 30-month-old girl had no antecedent history of such difficulty, having had two recent uneventful anaesthetics. We suggest that the reason for our inability to open the patient's mouth was a result of contracture of the temporalis muscle. The patient was managed using a laryngeal mask airway with controlled ventilation.
Asunto(s)
Hidrocefalia/cirugía , Intubación Intratraqueal/métodos , Laringoscopía/métodos , Anestesia/métodos , Preescolar , Remoción de Dispositivos , Femenino , Humanos , Hidrocefalia/complicaciones , Máscaras Laríngeas , Hipertonía Muscular/complicaciones , Hipertonía Muscular/fisiopatología , Músculo Temporal/fisiopatología , Derivación VentriculoperitonealAsunto(s)
Analgésicos Opioides/uso terapéutico , Craneosinostosis/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Piperidinas/uso terapéutico , Analgésicos Opioides/efectos adversos , Humanos , Cuidados Intraoperatorios , Procedimientos Neuroquirúrgicos/métodos , Piperidinas/efectos adversos , Remifentanilo , Proyectos de InvestigaciónRESUMEN
OBJECTIVE: The authors developed and evaluated the reliability and validity of the Brown Assessment of Beliefs Scale, a clinician-administered seven-item scale designed to assess delusions across a wide range of psychiatric disorders. METHOD: The authors developed the scale after reviewing the literature on the assessment of delusions. Four raters administered the scale to 20 patients with obsessive-compulsive disorder (OCD), 20 patients with body dysmorphic disorder, and 10 patients with mood disorder with psychotic features. Audiotaped interviews of scale administration conducted by one rater were independently scored by the other raters to evaluate interrater reliability. The scale was administered to 27 patients twice to determine test-retest reliability. Other insight instruments as well as scales that assess symptom severity were administered to assess convergent and discriminant validity. Sensitivity to change was assessed in a multicenter treatment study of sertraline for OCD. RESULTS: Interrater and test-retest reliability for the total score and individual item scores was excellent, with a high degree of internal consistency. One factor was obtained that accounted for 56% of the variance. Scores on the Brown Assessment of Beliefs Scale were not correlated with symptom severity but were correlated with other measures of insight. The scale was sensitive to change in insight in OCD but was not identical to improvement in severity. CONCLUSIONS: The Brown Assessment of Beliefs Scale is a reliable and valid instrument for assessing delusionality in a number of psychiatric disorders. This scale may help clarify whether delusional and nondelusional variants of disorders constitute the same disorder as well as whether delusionality affects treatment outcome and prognosis.
Asunto(s)
Deluciones/diagnóstico , Trastornos Mentales/psicología , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , 1-Naftilamina/análogos & derivados , 1-Naftilamina/uso terapéutico , Adulto , Trastornos Psicóticos Afectivos/diagnóstico , Trastornos Psicóticos Afectivos/psicología , Concienciación , Escalas de Valoración Psiquiátrica Breve/estadística & datos numéricos , Deluciones/psicología , Análisis Factorial , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Trastorno Obsesivo Compulsivo/diagnóstico , Trastorno Obsesivo Compulsivo/tratamiento farmacológico , Trastorno Obsesivo Compulsivo/psicología , Inventario de Personalidad/estadística & datos numéricos , Pronóstico , Psicometría , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Sertralina , Índice de Severidad de la Enfermedad , Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/psicología , Grabación en Cinta , Resultado del TratamientoRESUMEN
OBJECTIVE: The authors evaluated the frequency of DSM-III-R obsessive-compulsive disorder in patients with a primary diagnosis of schizophrenia or schizoaffective disorder. METHOD: Patients with schizophrenia (N = 52) or schizoaffective disorder (N = 25) were evaluated for the presence of obsessions and compulsions by means of the Structured Clinical Interview for DSM-III-R, the Yale-Brown Obsessive Compulsive Scale, chart review, and contact with the treating clinicians. RESULTS: Six (7.8%) of the 77 patients met the DSM-III-R criteria for both obsessive-compulsive disorder and schizophrenia or schizoaffective disorder. CONCLUSIONS: These findings suggest that obsessive-compulsive disorder occurs in a substantial percentage of patients with schizophrenia or schizoaffective disorder. The addition of medications targeted at obsessive-compulsive disorder may be beneficial to these patients but requires systematic evaluation.