Search PubMed⌕ Search

Biomedical subjects

A Asada

Publications and source records attributed to A Asada.

95 records · Page 6Linked to original sources
PubMedDate not supplied

Frequency of anesthetic cardiac arrest and death in the operating room at a single general hospital over a 30-year period.

STUDY OBJECTIVES: To determine the anesthetic cardiac arrest (CA) and death rates in the operating room (OR) and to determine whether anesthetic CA and death are preventable. DESIGN: Prospective study. SETTING: OR suite of a general teaching hospital. PATIENTS: 85,708 patients undergoing surgery over a 30-year period. MEASUREMENTS AND MAIN RESULTS: Anesthetic CAs and deaths were identified, their causes and preventability were determined on the day of occurrence, and they were recorded over the years 1962 to 1992. Four anesthetic CAs (0.5 arrest per 10,000 anesthetics) and 1 death (0.1 death per 10,000 anesthetics) occurred during the 30-year study period. CONCLUSIONS: The results of 30 years' experience do not support the hypothesis that all anesthetic CAs and deaths are preventable. However, careful clinical management can reduce their frequency to a level lower than those reported in the referenced literature.

Adolescent↗
PubMedDate not supplied

A retrospective pilot study of indocyanine green enhanced diode laser photocoagulation for subfoveal choroidal neovascularization associated with age-related macular degeneration.

PURPOSE: The effectiveness and limitations of indocyanine green (ICG) enhanced diode laser photocoagulation in treating subfoveal choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD) were investigated retrospectively. METHODS: Thirty-eight eyes of 37 patients with subfoveal CNV received ICG enhanced diode laser (wavelength, 805 nm) photocoagulation in our preliminary series. Nineteen eyes had classic CNV and the others had occult CNV, which was well-delineated on ICG angiography. The rate of anatomical success and functional outcomes were investigated. Factors prognostic of a final visual acuity of 0.1 or better were analyzed. The follow-up period ranged from 6 to 51 months (mean +/- SD = 26.5 +/- 14.4 months). RESULTS: Occlusion of CNV was achieved in 35 of 38 eyes (92%), and 7 eyes (18%) showed recurrence, which was occluded by retreatment in all but 1 eye. Ten eyes (26.3%) showed improvement of visual acuity; 16 (42.1%) showed no change; and in 12 eyes (31.6%) visual acuity deteriorated. Factors prognostic of a final visual acuity of 0.1 or better were good preoperative visual acuity (Mann-Whitney U-test, P =.0028), and a relatively short distance between the edge of laser burns and the center of the foveal avascular zone (unpaired t-test, P =.0285). CONCLUSION: Indocyanine green enhanced photocoagulation achieved a higher anatomical success rate but functional outcomes equal to those with argon or krypton laser photocoagulation. A controlled prospective study is necessary to prove the efficacy of this treatment.

Aged↗
PubMedDate not supplied

Pain evaluation in the intensive care unit: observer-reported faces scale compared with self-reported visual analog scale.

BACKGROUND AND OBJECTIVES: The visual analog scale (VAS) is a simple and sensitive mean of pain assessment. The faces scale is also a simple, self-reporting method for children. Facial signs of pain have not been used to assess pain in postoperative adult patients in the intensive care unit (ICU). METHODS: Fifty patients undergoing esophageal cancer surgery by a thoracoabdominal procedure were studied. Epidural opioids, such as morphine or buprenorphine, combined with bupivacaine were administered during and after surgery. Pain measurement was performed by a physician in the ICU using the self-reported VAS 0.5, 1, 2, 4, and 6 hours after tracheal extubation and thereafter every 4 hours during the stay in the ICU. A nurse who was unaware of the patients' VAS scores assessed facial expression as a measure of pain intensity using a five-grade faces scale immediately before pain evaluation by VAS. The VAS was rescaled into five discrete units that would match the five faces scale scores. Weighted kappa statistics were used to establish a relative level of agreement between the five-grade VAS and faces scale. RESULTS: Good agreement was found between the five-grade VAS and the faces scale 30 minutes and 1 hour after tracheal extubation (weighted kappa values .67 and .62, respectively). The VAS and faces scales were measured 7-13 times per patient during the stay in the ICU, and 518 observations were collected. Although moderate agreement was found between the five-graded VAS and faces scale for all pairs of observation (weighted kappa values .54), less agreement was found between them in patients with moderate pain. In addition, the calculated mean differences between the five-graded VAS and faces scale differed significantly between patients. CONCLUSION: The faces scale may be useful for pain evaluation in the ICU.

Adult↗