RESUMEN
Children undergoing magnetic resonance imaging (MRI) often require general anaesthesia (GA). Children under GA are at risk of decreases in body temperature. This risk may be greater during MRI due to MRI scanners requiring cool ambient temperatures. Conversely, radiofrequency radiation emitted by MRI scanners is absorbed by the patient as heat energy, creating a risk of an increase in body temperature. The aim of this study was to determine the proportion of anaesthetised children undergoing an MRI scan who develop hyperthermia or hypothermia, and the risk factors associated with temperature changes in these children. Pre-scan and post-scan tympanic temperatures were obtained from 193 children (aged three months to six years) undergoing an MRI procedure under GA. No active warming or cooling devices were used during the MRI scans. The median duration for anaesthesia was 42 minutes (35 to 57 minutes). Fifty-two percent of children were hypothermic after their scan, while no subjects were hyperthermic after their scan. The mean (± standard deviation) pre-scan temperature was 36.2°C±0.5°C, and the mean (± standard deviation) post-scan temperature was 35.9°C±0.6°C (an overall mean temperature decrease of 0.28°C was observed [95% confidence interval, -0.36°C to -0.19°C], P <0.001). In conclusion, core body temperature was found to decrease slightly during an MRI scan under GA. These results suggest that more focus is needed regarding the cooling effects of GA agents during MRI, as opposed to the heating effects of the MRI scanner.
Asunto(s)
Anestesia General/efectos adversos , Temperatura Corporal , Imagen por Resonancia Magnética/efectos adversos , Niño , Preescolar , Femenino , Humanos , Lactante , MasculinoRESUMEN
It remains unclear whether children form implicit memories during general anaesthesia. This is partly due to a lack of tests for implicit memory that are appropriate for the anaesthesia setting. The aim of this study was to assess a new implicit memory test that could be more suitable for use with children during anaesthesia. Ninety-three children aged five to 12 years who were undergoing elective surgery were studied. Patients were randomly assigned to one of two groups preoperatively and exposed to a familiar animal sound, followed by a distractor task. Two animal sounds were tested; in one group children were exposed to one animal sound preoperatively, while in the other group they were exposed to the other. After surgery the children were played degraded versions of the animal sounds that had been mixed with white noise and became increasingly clearer over the 60 second recording. Children who explicitly recalled hearing the sound preoperatively were excluded. Response times for recognition were recorded and compared. The analysis revealed evidence for a significant priming effect for one of the two animal sounds tested. The speed and simplicity of administration of this test suggest the degraded auditory stimulus test would be a promising tool to detect implicit memory during anaesthesia in children. However as we found evidence for priming with only one of the sounds, the choice of sound is important.
Asunto(s)
Estimulación Acústica/psicología , Memoria/fisiología , Vocalización Animal , Estimulación Acústica/métodos , Anestesia/efectos adversos , Animales , Gatos , Niño , Preescolar , Femenino , Humanos , Entrevista Psicológica/métodos , Periodo Intraoperatorio , Masculino , Memoria/efectos de los fármacos , Proyectos de Investigación , Ovinos , Factores de TiempoRESUMEN
Antimicrobial treatment can be effective in diabetic foot ulcers. However, choosing the appropriate regimen depends on the clinical and microbial presentation. This review describes the factors practitioners need to consider.
Asunto(s)
Antibacterianos/uso terapéutico , Pie Diabético/complicaciones , Infección de Heridas/tratamiento farmacológico , Infección de Heridas/etiología , Biopsia , Celulitis (Flemón)/microbiología , Desbridamiento , Esquema de Medicación , Gangrena/microbiología , Humanos , Tamizaje Masivo , Necrosis , Evaluación en Enfermería , Osteomielitis/microbiología , Selección de Paciente , Proyectos de Investigación/normas , Índice de Severidad de la Enfermedad , Cuidados de la Piel , Supuración , Factores de Tiempo , Resultado del Tratamiento , Infección de Heridas/diagnósticoRESUMEN
Twenty-five serum chemistry values were determined on 18 female sheep. These average values were obtained using current semiautomated analytical techniques, with all enzyme measurements reported in international units. Where possible, these results were compared with those of 4 other investigators. This compilation will provide a set of reference values which can be used for comparison with results obtained from current commercial clinical laboratories.