Normal Pressure Group Research Articles

Continuous Positive-Pressure Oxygen Supply Improves Fiberoptic Intubation Efficacy and Safety in Patients With Simulated Cervical Spinal Injury: A Prospective Double-Blind Randomized Controlled Study.

Fiberoptic intubation is an important method for tracheal intubation in patients with cervical spine injury. How to effectively and safely complete fiberoptic intubation while maintaining the stability of the cervical spine is very important. This study compared the efficiency and safety of fiberoptic intubation after anesthesia induction under different types of air pressure in patients with simulated cervical spinal injury. In total, 59 adult patients who underwent fiberoptic intubation with a cervical collar for simulated cervical spinal injury were randomly allocated to continuous positive-pressure oxygen, normal-pressure, or intermittent negative-pressure suction groups. After the induction of anesthesia and adequate 100% oxygenation, which confirmed effective neuromuscular blockade, it was deemed appropriate to begin fiberoptic intubation. In the continuous positive-pressure oxygen group, the fiberoptic device was connected through the negative-pressure suction path with 5 L/min oxygen. In the intermittent negative-pressure suction group, the fiberoptic device was connected to the negative-pressure suction device. In the normal-pressure group, the flexible fiberoptic device was not connected to either the oxygen source or the negative-pressure suction device. The intubation time was recorded as the primary outcome measure. The intubation success rate, number of attempts, minimum SpO2, objective lens contamination rate, and incidence of complications were also compared among the groups. Compared with those in the other groups, the median (range) intubation time in the continuous positive-pressure group was 59 (36-181) seconds, which was significantly shorter than that in the normal-pressure group, 167 (46-181) seconds, and the intermittent negative-pressure suction group, 132.5 (38-181) seconds (P=0.04). The success rate of nasotracheal intubation was significantly greater in the continuous positive-pressure group (94.7%, 18/19) than in the normal-pressure group (50%, 10/20) and intermittent negative-pressure suction group (50%, 10/20) (P=0.004). There was a significant difference among the three groups (P=0.043). The median (range) minimum SpO2 during fiberoptic intubation was 100% (99-100%) in the continuous positive-pressure group, 100% (90-100%) in the normal-pressure group, and 99% (88-100%) in the intermittent negative-pressure suction group (P=0.029). However, no statistically significant difference was detected among the groups with complications. The continuous use of positive-pressure oxygen via the negative-pressure suction pathway can improve the efficiency and safety of fiberoptic intubation in patients with simulated cervical spinal injury after anesthesia induction.

Measurement of oesophageal hiatus surface area by multiplanar reconstruction of MDCT: relationship with lower oesophageal sphincter pressure and acid reflux

To evaluate the relationship between oesophageal hiatus surface area (OHSA) and gastro-oesophageal reflux disease (GERD). Patients who underwent 24-h pH monitoring, oesophageal high-resolution manometry, and upper abdominal contrast-enhanced multidetector computed tomography (MDCT) during 2014-2021 were enrolled. Patients with a hiatus hernia (HH) on MDCT or who had a history of gastro-oesophageal surgery were excluded. Multiplanar reconstruction (MPR) of the MDCT image was used for the measurement of OHSA. Correlations of OHSA with acid exposure time (AET) and lower oesophageal sphincter (LOS) pressure of all patients were analysed. Seventy-eight patients were included in the study. OHSA was much less in the AET <4% group than in the AET >6% group (1.61±0.42 versus 2.09±0.55 cm2, p<0.001). Correlation analysis reveals that OHSA correlated positively with AET (correlation coefficient=0.47, p<0.001). Receiver operating characteristic (ROC) curve analysis reveals that OHSA can significantly distinguish patients in different groups divided by AET (area under the ROC curve [AUC]=0.76, 95% confidence interval [CI]: 0.63-0.90). OHSA was not related to LOS pressure (correlation coefficient=-0.268, p=0.051). There was no difference in OHSA between the low LOS pressure group and the normal LOS pressure group (1.84±0.61 versus 1.74±0.50 cm2, p=0.52). OHSA significantly correlated with AET but has no relationship with LOS pressure. It may be an independent risk factor of GERD.

Association of trabecular meshwork height with steroid-induced ocular hypertension

It is important to identify at-risk patients prior to administering steroid injections to prevent avoidable irreversible blindness inducted by steroid-induced ocular hypertension (SIOH). We aimed to investigate the association of SIOH following intravitreal dexamethasone implantation (OZURDEX) using anterior segment optical coherence tomography (AS-OCT). We conducted a retrospective case control study to assess the association between trabecular meshwork and SIOH. A total of 102 eyes that underwent both AS-OCT and intravitreal dexamethasone implant injection were divided into the post-steroid ocular hypertension and normal intraocular pressure groups. Ocular parameters that can contribute to intraocular pressure were measured using AS-OCT. Univariable logistic regression analysis was used to calculate the odds ratio of the SIOH and significant variables were further analyzed using a multivariable model. Trabecular meshwork (TM) height was significantly shorter in the ocular hypertension group (716.13 ± 80.55 μm) than that in the normal intraocular pressure group (784.27 ± 82.33 μm) (p < 0.001). The receiver operating characteristic curve technique analysis showed that the optimal cut-off of ≥ 802.13 μm for TM height specificity was 96.2%, and TM height with < 646.75 μm had a sensitivity of 94.70%. The odds ratio of the association was 0.990 (p = 0.001). TM height was identified as a newly observed association with SIOH. TM height can be assessed using AS-OCT, with acceptable sensitivity and specificity. Caution must be exercised while injecting steroids in patients with short TM height (especially < 646.75 μm) as it may cause SIOH and irreversible blindness.

Investigation of intracranial pressure in intensive care unit patients with delirium assessed by bedside ultrasound

To explore the changes of intracranial pressure in intensive care unit (ICU) patients during the occurrence and evolution of delirium by using bedside ultrasound to measure the optic nerve sheath diameter (ONSD) to evaluate intracranial pressure. A retrospective observational study was conducted. Adult patients who developed delirium during hospitalization in the general ICU of Beihai People's Hospital from October 2020 to November 2021 were enrolled, and patients who did not have ultrasonographic ONSD records within 24 hours after the diagnosis of delirium were excluded. The ONSD measured before delirium was recorded as ONSD0, the ONSD measured within 24 hours of the onset of delirium recorded as ONSD1, and the ONSD reexamined after ONSD1 recorded as ONSD2. Patients were divided into intracranial hypertension group (ONSD1 > 5 mm) and normal intracranial pressure group (ONSD1 ≤ 5 mm) according to the size of ONSD1. According to the outcome of delirium, the patients were divided into cured, improved, and non-improved groups. The reduction ratio of ONSD2 to ONSD1 in the three groups were calculated and compared. Pearson correlation test was used to analyze the correlation between fluid balance and ONSD changes after delirium. There were 43 patients, including 40 cases in the intracranial hypertension group (the incidence rate was 93.0%), 3 cases in the normal intracranial pressure group, 23 cases were cured, 13 cases were improved, and 7 cases were not improved. In the intracranial hypertension group, 11 cases had ONSD0 and ONSD1 records, and ONSD1 was significantly higher than ONSD0 [mm: 5.88±0.61 vs. 5.34±0.57, 95% confidence interval (95%CI) -0.85 to -0.23, P = 0.003]. The reduction ratio of ONSD2 to ONSD1 in the cured group was significantly higher than that in the improved group and the non-improved group [(12.04±6.20)% vs. (5.68±4.10)%, (0.17±3.96)%; 95%CI were 2.37 to 10.33, 6.41 to 17.31, P values were 0.003 and 0.000, respectively]. The correlation analysis showed that the reduction ratio of ONSD2 to ONSD1 was negatively correlated with fluid balance (r = -0.42, 95%CI was -0.66 to -0.10, P = 0.012). The incidence of intracranial hypertension in ICU delirium patients is high. A more pronounced decrease in intracranial pressure predicts a better delirium outcome. Dynamic ONSD measurement can provide valuable information for the prevention and treatment of delirium.

Cine magnetic resonance urography and Whitaker test: dynamic visualized and quantified tools in ileal ureter replacement.

BackgroundTo assess the feasibility and usefulness of cine magnetic resonance urography (MRU) and Whitaker test as postoperative evaluation tools of ileal ureter replacement.MethodsWe retrospectively collected the medical records of 42 patients who underwent ileal ureter replacement between August 2015 and August 2020. The morphology, luminal diameter, amplitude, contraction ratio, peristaltic frequency, ureteral jets and peristalsis efficiency were recorded in cine MRU. Under different perfusion loads, image and pressure changes of the reconstructed upper urinary tract were recorded in the Whitaker test. Patients were categorized into normal pressure and elevated pressure groups.ResultsA total of 42 patients underwent cine MRU, and 20 of them finished the Whitaker test successfully. The mean amplitude was 9.29±3.51 mm, and the contraction ratio was 0.607 (0.247–0.790). The median peristaltic efficiency was 0.75 (0.29–1). Three patients presented an unusual rise in renal pelvis pressure, which was 54, 26, 57 cmH2O respectively. The amplitude of the ileal graft in the elevated pressure group was larger (13.80±5.73 vs. 8.09±3.38 mm, P=0.024), the contraction ratio was higher [0.68 (0.59–0.79) vs. 0.59 (0.25–0.79), P=0.028], the peristaltic frequency was more active [7 (6–8) vs. 4 (3–8), P=0.025], but the peristaltic efficiency was lower [0.50 (0.29–0.50) vs. 0.75 (0.33–1), P=0.029] compared to the normal pressure group. There were no significant differences in the ureteral jets [3 (2–4) vs. 3 (1–7), P=0.840), creatinine (97.3±7.3 vs. 103.2±30.7 µmol/L, P=0.753), and estimated glomerular filtration rate (eGFR) (76.4±14.1 vs. 68.5±28.7 mL/min·1.73 m2, P=0.663).ConclusionsCine MRU provides morphological and peristaltic motility of the ileal graft, cine MRU after ileal ureter replacement was recommended as a routine examination. The Whitaker test represents a complementary investigation to evaluate pressure changes to reveal the ability to transport urine, and it can be used as a supplementary examination to clarify equivocal cases.

Right Atrial Pressure Is Associated with Outcomes in Patients with Heart Failure and Indeterminate Left Ventricular Filling Pressure

In a significant proportion of patients with left-sided heart failure (HF), left ventricular filling pressure (LVFP) may not be estimated using echocardiography, so filling pressure status may remain indeterminate. In these patients, mean right atrial pressure (mRAP) has been suggested as a surrogate of LVFP. The aim of this study was to determine whether high mRAP has prognostic value in patients with HF with indeterminate pressure (IP) and whether mRAP-based reclassification of patients with IP has an impact on outcomes. A cohort of 465 patients hospitalized with HF was retrospectively studied and divided into groups with normal pressure (n=102), high pressure (n=265), and IP (n=98). A composite end point of all-cause mortality and HF rehospitalization was evaluated after a median follow-up duration of 2.5years. There were 282 events in the entire population (53 in the normal pressure group, 173 in the high pressure group, and 56 in the IP group; P=.047). High mRAP was independently associated with outcome only in patients with IP (hazard ratio, 2.72; 95% CI, 1.25-5.9; P=.012). Evaluation of LVFP after mRAP-based reclassification of patients with IP resulted in higher risk stratification capability than current recommendations alone (log-rank χ2=15.057 vs 8.148). In patients with inconclusive determination of LVFP, echocardiographic estimation of mRAP is associated with outcomes. This finding corroborates previous observation of mRAP as a surrogate marker of elevated LVFP in left-sided HF and suggests its use in clinical practice.

RELATIONSHIP BETWEEN THE ALLOY FREQUENCY OF THE T102C POLYMORPHISM OF THE 5HT2A GENE WITH ANTHROPOMETRIC AND CARDIOMETABOLIC MEASURES

Obesity is a disease characterized by excessive body fat. Among the neurobiological factors associated with obesity, the serotonergic system stands out. The neurotransmitter of these circuits is serotonin (5-HT). Decreased levels of 5-HT have been linked to increased desire to ingest sweets and carbohydrates. This study aims to verify the relationship of the 5HT2A T102C gene polymorphism with obesity and anthropometric parameters. Blood samples and anthropometric data were collected from 150 volunteers, divided between the control and obese groups. The results showed that for individuals with diastolic pressure (p = 0.3681), Estimated Mean Glycemia (GMe) (p = 0.0228) and Homeostatic Model Assessment (HOMA-IR-IR) (p = 0.001) all altered, a higher frequency of C alleles was observed. For normal GMe (p = 0.0270), a higher frequency of the T allele was observed. There was no difference for the allele distribution between the normal and altered groups for the parameters of Triglycerides, HDL cholesterol, total cholesterol, glycated hemoglobin and Insulin. The distribution of the alleles between the groups, normal diastolic pressure (p = 0.3681) and HOMA-IR (p = 0.9203) groups presented no difference. From the genotypic analyzes of the T102C polymorphism of the 5HT2A gene, it was possible to demonstrate a relationship between the presence of the C allele with biochemical and anthropometric markers related to obesity and hypertension.

Study on the feasibility of optic nerve subarachnoid width in qualitative diagnosis of intracranial hypertension

Objective To evaluate the feasibility of optic nerve subarachnoid space in non-invasive qualitatively diagnosis of intracranial hypertension. Methods In this retrospective study,patients who received lumbar puncture from October 2009 to June 2015 were enrolled and divided into normal intracranial pressure group (41 cases) and intracranial hypertension group (39 cases). Optic nerve subarachnoid space width (SASW) behind ocular 3 mm (SASW-3),9 mm (SASW-9),and 15 mm (SASW-15) were measured on MRI and compared between groups. Chi-square test, t test and ROC analyses were used. Results SASW-3,SASW-9,and SASW-15 were (1.16±0.21), (0.98±0.21) and (0.92±0.17) mm in normal group and (1.46±0.20), (1.29±0.19) and (1.17±0.20) mm in intracranial hypertension group,respectively. According to independent samples t test,SASW-3,SASW-9,and SASW-15 of intracranial hypertension group was significant larger than those at the same measured site of normal group (P<0.01). According to MedCalc analysis,Receive operating characteristic (ROC) area was 0.849 in SASW-3 and when the cut-off value was fixes as 1.19 mm,the sensibility and specificity were 94.9% and 63.4%,respectively. ROC area was 0.849 in SASW-9 and when the cut-off value was fixes as 1.10 mm,the sensibility and specificity were 84.6% and 78.0%,respectively. ROC area was 0.824 in SASW-15 and when the cut-off value was fixes as 1.06 mm,the sensibility and specificity were 69.2% and 80.5%,respectively. Conclusion SASW-9 can be used to screen and monitor the intracranial hypertension as a non-invasive tool. Key words: Optic nerve; Subarachnoid space; Intracranial pressure; Magnetic resonance imaging

A randomized controlled trial comparing the long-term use of soft lumbosacral orthoses at two different pressures in patients with chronic nonspecific low back pain

BackgroundThere is concern that wearing soft lumbosacral orthoses for prolonged periods may impair motor function. Moreover, the pressure applied by lumbosacral orthoses on the abdominal wall is usually ignored when these orthoses are prescribed. MethodIn this randomized controlled trial study, 48 patients with chronic nonspecific low back pain were randomly divided into high pressure, normal pressure and control groups. All groups received medication for 4 weeks. The normal pressure and high pressure groups, in addition to medication, used soft lumbosacral orthoses at normal pressure and 50% increased pressure, respectively. Motor function outcome measures were strength, endurance, proprioception and electromyographic activity of the trunk muscles. Clinical outcome measures were pain and disability, which were evaluated in two sessions before and after a 4-week interval.Findings.Isometric strength, endurance and most of the electromyographic parameters were generally unaffected by wearing the lumbosacral orthosis. Pain improved in all groups, and disability and proprioception improved in the high pressure and normal pressure groups. Between-group differences in these three measures indicated better results in the lumbosacral orthoses groups than in the control group. The improvements in pain and proprioception were significantly greater in the high pressure group than the normal pressure group.Interpretation.Long-term use of lumbosacral orthoses had no significant adverse effects on motor function or clinical factors in patients with chronic low back pain. Increasing lumbosacral orthosis tightness may improve motor functioning and the clinical efficacy of the orthosis.Clinical Trial Registration number: Code: IRCT201708192391N38.

Pulse Pressure and Carotid Artery Doppler Velocimetry as Indicators of Maternal Volume Status: A Prospective Cohort Study.

Narrow pulse pressure has been demonstrated to indicate low central volume status. In critically ill patients, volume status can be qualitatively evaluated using Doppler velocimetry to assess hemodynamic changes in the carotid artery in response to autotransfusion with passive leg raise (PLR). Neither parameter has been prospectively evaluated in an obstetric population. The objective of this study was to determine if pulse pressure could predict the response to autotransfusion using carotid artery Doppler in healthy intrapartum women. We hypothesized that the carotid artery Doppler response to PLR would be greater in women with a narrow pulse pressure, indicating relative hypovolemia. Intrapartum women with singleton gestations ≥35 weeks without acute or chronic medical conditions were recruited to this prospective cohort study. Participants were grouped by admission pulse pressure as <45 mm Hg (narrow) or ≥50 mm Hg (normal). Maternal carotid artery Doppler assessment was then performed in all patients before and after PLR using a standard technique where carotid blood flow (mL/min) = π × (carotid artery diameter/2) × (velocity time integral) × (60 seconds). The velocity time integral was calculated from the Doppler waveform. The primary outcome was the change in the carotid Doppler parameters (carotid artery diameter, velocity time integral, and carotid blood flow) after PLR. Outcomes were compared between study groups with univariable and multivariable analyses with adjustment for potential confounding factors. Thirty-three women consented to participation, including 18 in the narrow and 15 in the normal pulse pressure groups (mean and standard deviation initial pulse pressure, 38.3 ± 4.4 vs 57.3 ± 4.1 mm Hg). The 2 groups demonstrated similar characteristics except for initial pulse pressure, systolic and diastolic blood pressure, and race. In response to PLR, the narrow pulse pressure group had a significantly greater increase in carotid artery diameter (0.08 vs 0.02 cm; standardized difference, 2.0; 95% confidence interval [CI], 1.16-2.84), carotid blood flow (79.4 vs 16.0 mL/min; standardized difference, 2.23; 95% CI, 1.36-3.10), and percent change in carotid blood flow (47.5% vs 8.7%; standardized difference, 2.52; 95% CI, 1.60-3.43) compared with the normal pulse pressure group. In multivariable analysis with adjustment for potential confounding factors, women with narrow admission pulse pressure had a significantly larger carotid diameter (0.66 vs 0.62 cm; P < .0001) and greater carotid flow (246.7 vs 219.3 cm/s; P = .001) after PLR compared to women with a normal pulse pressure. Initial pulse pressure was strongly correlated with the change in carotid flow after PLR (r = 0.60; P < .0001). The hemodynamic response of the carotid artery to autotransfusion after PLR is significantly greater in women with narrow pulse pressure. Pulse pressure correlates with the physiological response to autotransfusion and provides a qualitative indication of intravascular volume in term and near-term pregnant women.

Role of plasma asymmetric dimethyl-L-arginine levels in detection of pulmonary hypertension in children with CHD.

The objectives of this study were to evaluate the plasma levels of asymmetric dimethyl-L-arginine in children with pulmonary hypertension due to CHD before and after treatment with sildenafil and to evaluate its diagnostic and prognostic value as a biomarker in such children. A total of 60 children with CHD and 30 healthy control children matched for age and sex were recruited. Children with CHD were divided into two equal groups: the normal pulmonary pressure group (n=30) and the pulmonary hypertension group (n=30). Children with pulmonary hypertension were treated with sildenafil and were followed up for 6 months. Clinical data, haemodynamic parameters, echocardiographic examination, and asymmetric dimethyl-L-arginine levels were evaluated before and after treatment. Asymmetric dimethyl-L-arginine levels were significantly higher in patients with pulmonary hypertension than in those with CHD-only or the control group, and this increase was positively correlated with increased severity of pulmonary hypertension. Asymmetric dimethyl-L-arginine levels, mean pulmonary artery pressure, and pulmonary vascular resistance were significantly decreased after treatment with sildenafil. Moreover, asymmetric dimethyl-L-arginine level was significantly lower in patients who responded to sildenafil treatment compared with those who did not. At a cut-off point of more than 0.85 nmol/ml, asymmetric dimethyl-L-arginine has a sensitivity of 83% and a specificity of 80% to diagnose pulmonary hypertension-CHD. Asymmetric dimethyl-L-arginine has a sensitivity of 100% and a specificity of 94% to predict poor prognosis in pulmonary hypertension-CHD children at a cut-off point of 1.3 nmol/ml. Asymmetric dimethyl-L-arginine level has a good diagnostic and prognostic value as a biomarker in children with pulmonary hypertension-CHD and can be used for following up patients with pulmonary hypertension and predicting response to treatment.

Comparison of Different Cuff Pressure Use with the Supreme Laryngeal Mask Airway on Haemodynamic Response, Seal Pressure and Postoperative Adverse Events: A Prospective Randomized Study.

The Supreme™ laryngeal mask airway (SLMA) is a supra glottic airway (SGA) device that is used as an alternative to endotracheal tubes. In the present study, we aimed to compare the use of the SLMA with normal cuff pressure and low cuff pressure, primarily for haemodynamic response. In the present study, 120 patients diagnosed with hypertension and scheduled for varicose vein or inguinal hernia operation were enrolled and 99 patients finished. Using randomization, patients were divided into two groups according to cuff pressure as a low-pressure group (Group L, 45 cm H2O) and a normal-pressure group (Group N, 60 cm H2O). Demographics, Mallampati score and the type and duration of surgery, heart rate (HR), mean arterial pressure (MAP), percentage of tidal volume leakage, Ppeak, Pmean, etCO2, seal pressure, fibreoptic scores and postoperative adverse effects of all patients were recorded. MAP and HR values immediately and 2 minutes after SLMA insertion were significantly lower in Group L (p<0.001). In Group L and Group N, the seal pressures were 24.1±3.1 cm H2O and 26.2±3.9 cm H2O, respectively (p=0.003). Also, blood staining and sore throat occurred less frequently in Group L (p<0.05). The fibreoptic average score, insertion features and ventilation parameters were similar between the groups (p>0.05). SLMA use with a cuff pressure of 45 cm H2O significantly decreases haemodynamic response and post-operative side effects compared with a normal cuff pressure. Therefore, except for some specific surgeries that require higher seal pressures, we recommend the use of the SLMA with cuff pressures as low as 45 cm H2O.

Vascular Cell Glycocalyx-Mediated Vascular Remodeling Induced by Hemodynamic Environmental Alteration.

Vascular remodeling induced by hemodynamic stimuli contributes to the pathophysiology of cardiovascular diseases. The importance of vascular cells (endothelial cells and smooth muscle cells) glycocalyx in the mechanotransduction of flow-induced shear stress at the cellular and molecular levels has been demonstrated over the past decade. However, its potential mechanotransduction role in vascular remodeling has triggered little attention. In the present study, a home-made apparatus was used to expose the rat abdominal aorta to sterile, flow or no flow, normal-pressure or high-pressure conditions for 4 days. The histomophometric, cellular, and molecular analysis of vessels were performed. The results showed that after exposing the vessels in the flow and high-pressure condition, the apoptotic rate, the cell number, and the RNA level of contractile marker gene smooth muscle 22 of smooth muscle cells were significantly increased, whereas the expression of nitric oxide synthase, α-smooth muscle actin, smoothelin, and calponion showed no significant differences compared with the flow and normal-pressure groups. Moreover, the histomophometric analysis of vascular walls suggested a remodeling induced by flow and high-pressure loading consistent with the classic hypertensive aortic phenotype, which is characterized by a thicker and more rigid vascular wall as well as increased aortic diameter. However, those phenomena were totally abolished after compromising the integrity of glycocalyx by the treatment of vessels with hyaluronidase, which provided evidence of the important mechanotransduction role of the vascular cells glycocalyx in vascular remodeling induced by hemodynamic stimuli.

High-resolution transbulbar ultrasonography helping differentiate intracranial hypertension in bilateral optic disc oedema patients.

The enlargement of optic nerve sheath diameter (ONSD) has been proven to be related with raised intracranial pressure (ICP). No prospective study has been focused on utilizing retrobulbar ultrasonography in optic disc oedema patient presented to ophthalmologist. High-resolution transbulbar ultrasonography was performed in a cohort of patient presented with bilateral optic disc oedema. The subarachnoid space of optic nerve (SAS), ONSD and optic nerve diameter (OND) was measured prior to other ancillaries including lumbar puncture. Subjects were classified into increased intracranial pressure (IIP) and normal intracranial pressure (NIP) group according to the open cerebrospinal fluid pressure more than 200mm H2 0. The SAS, ONSD and OND were compared between groups and with normal control. The sensitivity of SAS or ONSD change for predicating intracranial hypertension was assessed. A total of 20 IIP, 25 NIP patients and 25 normal controls were evaluated. The mean SAS and ONSD measured in idiopathic intracranial hypertension group was significantly increased than that of NIP and controls (p<0.001), whereas the OND showed no statistic difference between each group. The sensitivities using the SAS and ONSD for differentiating increased ICP in optic disc oedema patients were 0.99 and 0.97, respectively. The enlarged SAS and ONSD measured by high-resolution transbulbar sonography are very sensitive parameters to predicate increased ICP in bilateral optic disc oedema patients.

Correlative factors on prevalence rate of dislipidemia among 1 337 coal miners in Shanxi province

Objective: To understand the prevalence rate and correlative factors of dislipidemia among Shanxi coal miners and to provide evidence for the development of programs on dislipidemia prevention. Methods: We investigated 1 337 mine workers from a Coal Group in April 2016 and collected data related to their blood biochemistry. We then classified the types in accordance with the diagnostic criteria of " Guidelines for prevention and treatment of dyslipidemia in Chinese adults (2007)" , using χ(2) test and unconditional logistic regression model for analysis. Results: The overall prevalence rate of Dislipidemia was 59.1% (790/1 337), with males as 60.4% (708/1 173) and females as 50.0%(82/164) while males appeared higher (χ(2)=6.386, P<0.05). Among the 20-34, 35-49, 50 and above year-old groups, the rates were 68.8%, 58.7%, 49.5%, respectively. Results from the χ(2) test showed that gender, age and body mass index were the influencing factors on dislipidemia (χ(2)=7.117, P<0.01; χ(2)=37.135, P<0.01; χ(2)=7.009, P<0.05), while logistic regression analysis showed that sex, age, body mass index level, systolic blood pressure were significantly associated with dislipidemia (P<0.05). Male miners appeared 1.501 times (OR=1.501, 95%CI: 1.895-2.516) higher than female miners in suffering from the risk of dyslipidemia. In different age groups, risks of dyslipidemia in the 35-49, 20-34 year-old groups were 1.672 (OR=1.672, 95%CI: 1.501-2.392) and 2.369 times (OR= 2.369, 95% CI: 1.275-3.469) higher than the 50 year-old. Group that with high BMI, the risk of dyslipidemia was 1.443 times (OR=1.443, 95%CI: 1.139-1.828) higher than the normal BMI group. Group with abnormal systolic pressure was 1.829 times (OR=1.829, 95%CI: 1.152-2.906) higher than normal systolic pressure group. However, diastolic blood pressure, blood sugar, uric acid, and electrocardiogram findings did not seem to show statistically significant meanings on dislipidemia. Conclusion: Among the coal mine workers, those who were males, aged from 20 to 34, having high blood pressure (systolic blood pressure abnormalities) or with high BMI (≥24.0 kg/m(2)) need to be taken special attention on care and prevention of dislipidemia.

Neutrophil Gelatinase-Associated Lipocalin as a Marker for Renal Dysfunction Detection in Critically Ill Patients with Increased Intraabdominal Pressure.

IntroductionElevated intraabdominal pressure (IAP) it is known to have an impact on renal function trough the pressure transmitted from the abdominal cavity to the vasculature responsible for the renal blood flow. Intraabdominal pressure is found to be frequent in intensive care patients and also to be a predictor of mortality. Intra-abdominal high pressure is an entity that can have serious impact on intensive care admitted patients, studies concluding that if this condition progresses to abdominal compartment syndrome mortality is as high as 80%.AimThe aim of this study was to observe if a link between increased intraabdominal pressure and modification in renal function exists (NGAL, creatinine clearance).Material and MethodThe study enrolled 30 critically ill patients admitted in the Intensive Care Unit of SCJU TîrguMures between November 2015 and August 2016. The study enrolled adult, hemodynamically stable patients admitted in intensive critical care - defined by a normal blood pressure maintained without any vasopressor or inotropic support, invasive monitoring using PICCO device and abdominal pressure monitoring.ResultsThe patients were divided into two groups based on the intraabdominal pressure values: normal intraabdominal pressure group= 52 values and increased intraabdominal group= 35 values. We compared the groups in the light of NGAL values, 24 hours diuresis, GFR and creatinine clearance. The groups are significantly different when compared in the light of NGAL values and GFR values. We obtained a statistically significant correlation between NGAL value and 24 hour diuresis. No other significant correlations were encountered between the studied items.ConclusionsNGAL values are increased in patients with high intraabdominal pressure which may suggest its utility as a cut off marker for patients with increased intraabdominal pressure. There is a significant decreased GFR in patient with elevated intraabdominal pressure, observation which can help in early detection of renal injury in patients due to high intraabdominal pressure. No correlation was found between creatinine clearance and increased intraabdominal pressure.

Influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge

To discuss the influence of intermittently monitoring on endotracheal tube cuff pressure using handheld pressure gauge, and to provide some reference for the clinical work. The experiment was carried out on the model of the glass tube, which was divided into three parts. Each part of the experiment was divided into normal pressure group and high pressure group according to the different inflation pressure target value. The endotracheal tube cuff pressure was determined intermittently by using the transparent tracheal models which had a static diameter of 2 cm. The target press value of normal pressure group was 32 cmH2O (1 cmH2O = 0.098 kPa) while that of high pressure group was 40 cmH2O. The handheld pressure gauge was connected with the indicated cuff through a tee joint, and the pressure in the cuff in both groups was determined. The pressure loss caused by intermittent measurement of the two groups was compared. By switching the tee joint, the pressure loss through the gauge self-structure and the pressure loss when connecting and disconnecting the indicated cuff were determined to analyze the causes of pressure loss caused by intermittent measurement of pressure gauge. The pressure loss caused by intermittent measurement of high pressure group was significantly higher than that of normal pressure group (cmH2O: 15.10±0.43 vs. 10.19±0.45) with statistical significance (t = -24.875, P = 0.000). The pressure loss through the gauge self-structure of high pressure group was also significantly higher than that of normal pressure group (cmH2O: 13.91±0.48 vs. 8.77±0.53), which showed a statistics significance (t = -22.854, P = 0.000). The pressure loss when connecting and disconnecting the indicated cuff of the normal pressure and high pressure groups were (1.33±0.49) cmH2O and (1.23±0.55) cmH2O, respectively, without statistics significance (t = 0.445, P = 0.662). It was figured that the total pressure loss caused by intermittent measurement of the endotracheal intubation cuff was approximately equal to the value of the pressure loss caused by the pressure gauge self-structure and the pressure loss when the indicated cuff was connected and disconnected [normal pressure group: (10.19±0.45) cmH2O ≍ (8.77±0.53) cmH2O + (1.33±0.49) cmH2O, high pressure group: (15.10±0.43) cmH2O ≍ (13.91±0.48) cmH2O + (1.23±0.55) cmH2O]. The intermittently monitoring on endotracheal tube cuff pressure is the main cause of the pressure loss. The total pressure loss consists of the pressure leak from the cuff to the gauge and the pressure leak when connecting and disconnecting the gauge and the indicated cuff during each test. When the pressure in the cuff is increased, it will cause more pressure loss.

大学生与高眼压者眼压与角膜厚度、角膜曲率关系

目的：研究大学生群体以及高眼压群体的中央角膜厚度(CCT)与眼压测量值(IOP)以及角膜曲率的相关性。方法：应用非接触眼压计(NCT)、A超角膜测厚仪UP-1000和验光仪分别测量广州医科大学在校大学生(31例)和广州医科大学附属第二医院眼科门诊高眼压就诊者(22例)的眼压值、角膜厚度和角膜曲率，观察眼压与各参数之间的关系。结果：将正常眼压组和高眼压组数据合并分析，眼压与角膜厚度不相关(Pearson r = 0.129, P = 0.356)；分别分析，两组各自的眼压与角膜厚度也不相关(Pearson r = 0.153, P = 0.410, Pearson r = 0.048, P = 0.832)。将正常眼压组和高眼压组数据合并分析，眼压与角膜曲率不相关(Pearson r = 0.090, P = 0.541)。分别分析，两组各自的眼压与角膜曲率也不相关(Pearson r = 0.194, P = 0.323, Pearson r = −0.01, P = 0.964)。结论：正常眼压组(大学生群体)与高眼压组的眼压与中央角膜厚度以及角膜曲率不相关。 Objective: to study the correlation between intraocular pressure (IOP) and central corneal thick-ness (CCT), corneal curvature in normal intraocular pressure group of college students and high intraocular pressure group. Method: use non-contact tonometer (NCT), a ultrasound pachymeter UP-1000 and automatic optometry instrument to measure IOP, CCT and corneal curvature of college students with normal IOP in Guangzhou Medical University (31 cases) and outpatients with high IOP of the Second Affiliated Hospital of Guangzhou Medical University (22 cases). Results: ag-gregately analysing, there is no significant correlation between IOP and CCT (Pearson, r = 0.129, P = 0.356) as well as between IOP and corneal curvature (Pearson r = 0.090, P = 0.541); separately analysing, the IOP and CCT of two groups had no significant correlation respectively (Pearson r = 0.153, P = 0.410, Pearson r = 0.048, P = 0.832); the IOP and corneal curvature of two groups had no significant correlation respectively (Pearson r = 0.194, P = 0.323 Pearson, r = −0.01, P = 0.964). Conclusions: there is no correlation between the IOP and corneal thickness, corneal curvature in normal intraocular pressure group of college students and high intraocular pressure group.

Analysis of changes of intraocular pressure and nursing for vitrectomy with silicone oil tamponade technique

Objective To explore the changes of intraocular pressure and nursing for vitrectomy with silicone oil tamponade technique. Methods Clinical data of 52 patients(52 eyes) with silicone oil tamponade after vitrectomy were retrospectively analyzed and made a summary of nursing care. Results There were 24 patients(46.2%)with high intraocular pressure,and there were 19 patients high intraocular pressure occurrence within 2 weeks. There were no significant differences in sex, age, duration, the amount of refraction and silicone oil tamponade between high and normal intraocular pressure groups(P> 0.05). Conclusion The early high intraocular pressure is common after vitrectomy with silicone oil tamponade technique.Patient's condition observation should be strengthened and prevent from post- operation complications. Key words: Vitrectomy; Silicone oil; Intraocular pressure; Post-operative nursing care

Evaluation of Right Ventricular Diastolic Function in Patients with Chronic Obstructive Pulmonary Disease Using Pulsed Doppler Tissue Imaging

Objective: To evaluate the global and segmental diastolic function of the right ventricle using pulsed tissue Doppler imaging (TDI) in patients with clinically stable chronic obstructive pulmonary disease (COPD) without pulmonary hypertension (PHT). Methods: Twenty stable patients with COPD (mean age 61.4±8.6, 16 males) with normal pulmonary artery pressure (PAP) (Group I) and 20 age-matched normal subjects (mean age Original Research Article Ugurlu et al.; JAMPS, 2(3): 107-116, 2015; Article no.JAMPS.2015.014 108 57.8±4.0, 11 males, Group II) were enrolled. All the participants underwent conventional echocardiography and TDI. TDI of the right ventricle was performed from four different segments. The early myocardial diastolic peak velocity (Em), late myocardial diastolic peak velocity (Am), systolic peak velocity (Sm), early diastolic velocity deceleration time (eDTm), duration of the S wave, isovolumetric relaxation time (IVRTm), and isovolumetric contraction time (IVCTm) were measured. Results: The conventional echocardiographic measurements of the two groups were similar, but specific TDI parameters differed between the groups. The Em of the anterior wall was lower, and the duration of the anterior S wave and IVRTm in the apical 4-chamber (A4C) view for all the right ventricular (RV) segments were longer. The eDTm measured from the apex was shorter in the COPD patients (parasternal Em, p=0.003; duration of anterior wall S wave, p=0.02; A4C apical IVRTm, p=0.02; A4C middle IVRTm, p=0.001; A4C basal IVRTm, p=0.01; A4C apical eDTm, p=0.05). Conclusion: TDI was more sensitive than conventional echocardiography in the evaluation of diastolic function in the patients with COPD. In COPD patients with an unlikely diagnosis of PHT, the diastolic functions of the right ventricle seemed to show some deterioration, but this difference failed to reach a significant level. Measurements of the basal segment of the RV free wall can be used to determine global RV diastolic function.