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Ana Lilia Ponce Ponce De Leon - One of the best experts on this subject based on the ideXlab platform.
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Color Doppler Flowmetry values in fetuses with nuchal cord encirclement
Ginecología y obstetricia de México, 2000Co-Authors: Gustavo Romero Gutierrez, Santiago Estrada Razo, Adelita Chavez Curiel, Ana Lilia Ponce Ponce De LeonAbstract:In order to evaluate the presence of nuchal cord entanglement and to measure resistance index with Doppler Color ultrasonography, a prospective, observational, cross-sectional study was carried out, 132 low risk term pregnant women were included, 50 of them had umbilical cord encirclement (37%), the sensitivity, specificity, positive predictive and negative predictive values were 92%, 87%, 81% and 95%, respectively. McNemar'test for discordance had a p = 0.121 in comparing ultrasonography result with the gold standard. Patients with nuchal cord entanglement had higher frequency of cesarean section (70%, p < 0.05) than those without it. On the other hand, normal vaginal delivery was more common (46%, p < 0.05) in patients without nuchal coiling of the umbilical cord. There were no significant difference in evaluating acute fetal distress, meconium stained amniotic fluid, newborn Apgar scores at one and five minutes, birth weight, neonatal intensive care unit admissions and intrapartum stillbirths. In our patients with nuchal cord entanglement the resistance index average values were 0.59 and those without nuchal cord were 0.60 (p = 0.712). We concluded that Color flow Doppler ultrasonography is a reliable tool to detect nuchal coiling of the umbilical cord, and therefore Doppler Color waveforms assessment in nuchal cord entanglements might helpful for clinicians to decide a closer surveillance in labor by using intrapartum cardiotocography.
Μανωλόπουλος Σωτήριος - One of the best experts on this subject based on the ideXlab platform.
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Contribution of Doppler Flowmetry in the study of local changes caused by the influence of local dental anesthetic solutions in the blood flow
'National Documentation Centre (EKT)', 2012Co-Authors: Μανωλόπουλος ΣωτήριοςAbstract:By definition an operative specialty dentistry lies amongst the medical specialties whose development was closely interrelated with that of locally administered anaesthetic solutions. Numerous modern operative dental procedures which otherwise could not be performed due to the strain of pain are now considered as routine procedures as a result of the development of local anaesthetics. Today’ s range of available, effective and safe local anaesthetic solutions is wide nugh, othat clinicians may choose with ease, the optimal one at a time. The current thesis, examines two of the most effective and safe, locally administered anaesthetic solutions, presenting significant difference in formulation with regards to their total pharmacokinetic activity on blood vessels, during the course of a routine dental anaesthesia. The first one; comprises a 2% Lidocaine solution with added epinephrine 1/80000 as a vasoconstriction agent (Lignospan Special, Septodont registered trademark), whereas the second one, is a 3% Mepivacaine solution only (Scandonest 3%; Septodont registered trademark). In order to answer if the aforementioned solutions present the same or a different effect in local blood kinetics after in vivo administration a research protocol was conducted, further to fulfilment of the current medical and ethical approval code in our university. The local anaesthesia technique chosen was that of mandibular nerve block. Our material was comprised of twenty (20) young and healthy volunteers, who received local anaesthesia with the two solutions in different appointments. The diagnostic method of monitoring blood kinetics, was ultrasonic colour Doppler Flowmetry. A double blind trial protocol was in use, while extra care was taken in order to exclude any negative Hawthorn effects. Statistical analysis of the results followed. The first solution (Lignospan Special) presented with a clear-cut vasoconstrictive action, resulting in a reduction of the blood flow in the examined blood vessel for at least 30 minutes. Thus, the blood flow levels showed significant, progressive, reduction at 5 and 10 minutes (climax) further to local anaesthesia. The blood flow levels at 20 minutes were increased (compared to the 10 minute ones), though still not reaching the initial levels, until the lapse of 30 minutes after the conduct of local anaesthesia (non significant differences). The second solution (Scandonest 3%) presented a very mild, short-lived vasodilative action resulting in a small blood flow increase in the examined blood vessel (statistically significant, but close to the level of statistic error) at 5 minutes following the administration of local anaesthesia. At 10, 20 and 30 minutes respectively a lack of statistically significant measurements compared to the initial ones was monitored. In conclusion the monitoring method of Color Doppler Flowmetry has been proven very sensitive, trustworthy and patient friendly.Ειδικότητα από τη φύση της επεμβατική, η οδοντιατρική ήταν από εκείνες τις ιατρικές ειδικότητες που η ανάπτυξή τους συνδέθηκε στενά με την ανακάλυψη και εξέλιξη των τοπικών αναισθητικών. Εκατοντάδες είναι οι σύγχρονες οδοντιατρικές επεμβατικές τεχνικές οι οποίες υπό την αίρεση του πόνου δεν θα μπορούσαν να εφαρμοστούν αν δεν υπήρχαν τα τοπικά αναισθητικά. Η πληθώρα των προσφερόμενων σήμερα τοπικών αναισθητικών είναι αρκετά μεγάλη, ώστε κάθε φορά ο κλινικός να έχει στη διάθεσή του ένα αποτελεσματικό και ασφαλές αναισθητικό σκεύασμα. Από τα πλέον αποτελεσματικά και ασφαλή, όταν τηρούνται οι προϋποθέσεις ορθής χρήσης τους, τα δύο εξεταζόμενα αναισθητικά διαλύματα διαφοροποιούνται σημαντικά μεταξύ τους ως προς τη σύνθεσή τους. Το πρώτο από αυτά είναι διάλυμα λιδοκαΐνης 2% στο οποίο έχει προστεθεί η αγγειοσυσπαστική ουσία επινεφρίνη σε συγκέντρωση 1/80.000 (Lignospan special, Septodont), ενώ το δεύτερο είναι διάλυμα μεπιβακαΐνης 3% χωρίς την παρουσία αγγειοσυσπαστικού παράγοντα (Scandonest 3%, της ίδιας εταιρίας). Το ερώτημα που αποτέλεσε την αφορμή για την εκπόνηση της παρούσας διατριβής συνίσταται στο αν και κατά πόσο η διαφορετική σύσταση των δύο αναισθητικών διαλυμάτων είναι καθοριστική της συνολικής αγγειοκινητικής συμπεριφοράς που αυτά εκδηλώνουν κατά τη διάρκεια μιας συνηθισμένης οδοντιατρικής αναισθησίας. Το ερώτημα, θα μπορούσε να διατυπωθεί και ως εξής: Όταν τα δύο αναισθητικά διαλύματα εγχέονται στους ιστούς κατά τη διάρκεια μιας τοπικής αναισθησίας για οδοντιατρικούς λόγους, επηρεάζουν με παρόμοιο ή με διαφορετικό τρόπο την αιμάτωση των ιστών πλησίον της περιοχής έγχυσης; Τα αποτελέσματα που προέκυψαν καταγράφηκαν και ακολούθησε στατιστική επεξεργασία. Η αξιολόγηση των αποτελεσμάτων, όπως αποτυπώνεται στα συμπεράσματα της έρευνας, έδειξε σημαντικές διαφορές στην αγγειοκινητική συμπεριφορά των δύο σκευασμάτων. Το πρώτο σκεύασμα (Lignospan special) παρουσίασε μία σαφή αγγειοσυσπαστική συμπεριφορά, που επηρέασε (μείωσε) την αιματική ροή στο εξεταζόμενο αγγείο για τουλάχιστον τριάντα λεπτά. Οι τιμές της αιματικής ροής ήταν σημαντικά μειωμένες στα πέντε λεπτά μετά την εφαρμογή της αναισθησίας και συνέχιζαν να μειώνονται μέχρι τα δέκα λεπτά, οπότε και καταγράφηκαν οι ελάχιστες τιμές. Στα είκοσι λεπτά οι τιμές της ροής ήταν μεγαλύτερες από αυτές της καταγραφής των δέκα λεπτών, αλλά ακόμη σημαντικά μικρότερες των αρχικών καταγραφών. Οι τιμές της ροής συνέχισαν να εμφανίζουν άνοδο μέχρι και την πάροδο τριάντα λεπτών από την αναισθησία, οπότε και έτειναν να εξισωθούν με τις αρχικές καταγραφές (οι διαφορές τους ήταν στατιστικά ασήμαντες). Το δεύτερο σκεύασμα (Scandonest 3%) παρουσίασε μία χρονικά περιορισμένη και εξαιρετικά ήπια αγγειοδιασταλτική συμπεριφορά. Αναλυτικότερα, στην περίπτωση του δευτέρου σκευάσματος η αιματική ροή του εξεταζόμενου αγγείου παρουσίαζε μικρή αύξηση στην τιμή της (στατιστικά σημαντική, αλλά κοντά στο όριο του στατιστικού σφάλματος) μόνο στη μέτρηση πέντε λεπτά μετά την εφαρμογή της αναισθησίας. Στη συνέχεια των μετρήσεων εξομαλυνόταν πλήρως ως προς τις αρχικές καταγραφές (στατιστικά ασήμαντες διαφορές από τις αρχικές τιμές), χωρίς σημαντικές διαφορές μεταξύ των μετρήσεων, στα δέκα, είκοσι και τριάντα λεπτά μετά την αναισθησία. Ολοκληρώνοντας με τα συμπεράσματα, αξίζει να σημειωθεί πως η υπερηχητική αιματοταχυμετρία αποδείχτηκε κατά την έρευνα μέθοδος φιλική στον ασθενή κι, ακόμη, μέθοδος ακριβής και αξιόπιστη όσον αφορά την αξιολόγηση των αγγειοκινητικών ιδιοτήτων των δύο σκευασμάτων
Gustavo Romero Gutierrez - One of the best experts on this subject based on the ideXlab platform.
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Color Doppler Flowmetry values in fetuses with nuchal cord encirclement
Ginecología y obstetricia de México, 2000Co-Authors: Gustavo Romero Gutierrez, Santiago Estrada Razo, Adelita Chavez Curiel, Ana Lilia Ponce Ponce De LeonAbstract:In order to evaluate the presence of nuchal cord entanglement and to measure resistance index with Doppler Color ultrasonography, a prospective, observational, cross-sectional study was carried out, 132 low risk term pregnant women were included, 50 of them had umbilical cord encirclement (37%), the sensitivity, specificity, positive predictive and negative predictive values were 92%, 87%, 81% and 95%, respectively. McNemar'test for discordance had a p = 0.121 in comparing ultrasonography result with the gold standard. Patients with nuchal cord entanglement had higher frequency of cesarean section (70%, p < 0.05) than those without it. On the other hand, normal vaginal delivery was more common (46%, p < 0.05) in patients without nuchal coiling of the umbilical cord. There were no significant difference in evaluating acute fetal distress, meconium stained amniotic fluid, newborn Apgar scores at one and five minutes, birth weight, neonatal intensive care unit admissions and intrapartum stillbirths. In our patients with nuchal cord entanglement the resistance index average values were 0.59 and those without nuchal cord were 0.60 (p = 0.712). We concluded that Color flow Doppler ultrasonography is a reliable tool to detect nuchal coiling of the umbilical cord, and therefore Doppler Color waveforms assessment in nuchal cord entanglements might helpful for clinicians to decide a closer surveillance in labor by using intrapartum cardiotocography.
Adelita Chavez Curiel - One of the best experts on this subject based on the ideXlab platform.
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Color Doppler Flowmetry values in fetuses with nuchal cord encirclement
Ginecología y obstetricia de México, 2000Co-Authors: Gustavo Romero Gutierrez, Santiago Estrada Razo, Adelita Chavez Curiel, Ana Lilia Ponce Ponce De LeonAbstract:In order to evaluate the presence of nuchal cord entanglement and to measure resistance index with Doppler Color ultrasonography, a prospective, observational, cross-sectional study was carried out, 132 low risk term pregnant women were included, 50 of them had umbilical cord encirclement (37%), the sensitivity, specificity, positive predictive and negative predictive values were 92%, 87%, 81% and 95%, respectively. McNemar'test for discordance had a p = 0.121 in comparing ultrasonography result with the gold standard. Patients with nuchal cord entanglement had higher frequency of cesarean section (70%, p < 0.05) than those without it. On the other hand, normal vaginal delivery was more common (46%, p < 0.05) in patients without nuchal coiling of the umbilical cord. There were no significant difference in evaluating acute fetal distress, meconium stained amniotic fluid, newborn Apgar scores at one and five minutes, birth weight, neonatal intensive care unit admissions and intrapartum stillbirths. In our patients with nuchal cord entanglement the resistance index average values were 0.59 and those without nuchal cord were 0.60 (p = 0.712). We concluded that Color flow Doppler ultrasonography is a reliable tool to detect nuchal coiling of the umbilical cord, and therefore Doppler Color waveforms assessment in nuchal cord entanglements might helpful for clinicians to decide a closer surveillance in labor by using intrapartum cardiotocography.
Santiago Estrada Razo - One of the best experts on this subject based on the ideXlab platform.
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Color Doppler Flowmetry values in fetuses with nuchal cord encirclement
Ginecología y obstetricia de México, 2000Co-Authors: Gustavo Romero Gutierrez, Santiago Estrada Razo, Adelita Chavez Curiel, Ana Lilia Ponce Ponce De LeonAbstract:In order to evaluate the presence of nuchal cord entanglement and to measure resistance index with Doppler Color ultrasonography, a prospective, observational, cross-sectional study was carried out, 132 low risk term pregnant women were included, 50 of them had umbilical cord encirclement (37%), the sensitivity, specificity, positive predictive and negative predictive values were 92%, 87%, 81% and 95%, respectively. McNemar'test for discordance had a p = 0.121 in comparing ultrasonography result with the gold standard. Patients with nuchal cord entanglement had higher frequency of cesarean section (70%, p < 0.05) than those without it. On the other hand, normal vaginal delivery was more common (46%, p < 0.05) in patients without nuchal coiling of the umbilical cord. There were no significant difference in evaluating acute fetal distress, meconium stained amniotic fluid, newborn Apgar scores at one and five minutes, birth weight, neonatal intensive care unit admissions and intrapartum stillbirths. In our patients with nuchal cord entanglement the resistance index average values were 0.59 and those without nuchal cord were 0.60 (p = 0.712). We concluded that Color flow Doppler ultrasonography is a reliable tool to detect nuchal coiling of the umbilical cord, and therefore Doppler Color waveforms assessment in nuchal cord entanglements might helpful for clinicians to decide a closer surveillance in labor by using intrapartum cardiotocography.