Appalachian Heritage-A Literary Quarterly of the Southern Appalachians最新文献

{"title":"Comparison of carbetocin as a bolus or an infusion with prophylactic phenylephrine on maternal heart rate during Cesarean delivery under spinal anesthesia: a double-blinded randomized controlled trial.","authors":"Marie-Ève Boisselle, Valérie Vasiliki Zaphiratos, Annik Fortier, Philippe Richebé, Christian Loubert","doi":"10.1007/s12630-022-02227-y","DOIUrl":"10.1007/s12630-022-02227-y","url":null,"abstract":"<p><strong>Purpose: </strong>Carbetocin, an oxytocin analog, given as a postpartum hemorrhage prophylaxis in elective Cesarean deliveries, frequently causes tachycardia and hypotension. Phenylephrine infusion has been shown to prevent spinal anesthesia-induced hypotension. The goal of this study was to evaluate if a slow infusion of carbetocin would reduce maternal heart rate variation and hemodynamic disturbances compared with a rapid bolus in parturients receiving a prophylactic phenylephrine infusion during elective Cesarean delivery.</p><p><strong>Methods: </strong>In this double-blinded randomized controlled trial, 70 healthy parturients were allocated to either a bolus group or an infusion group. At cord clamping, participants in the bolus group received carbetocin 100 µg as a rapid intravenous bolus, while participants in the infusion group received carbetocin 100 µg over 10 min. The primary outcome was the variation in maternal heart rate from baseline during the 20 min following cord clamping. Secondary outcomes included blood pressure, cardiac output, and stroke volume variations during the study period, measured with the ClearSight™ hemodynamic monitor.</p><p><strong>Results: </strong>Maximum heart rate variation was not different between the groups: bolus group, mean (standard deviation) 29.8 (25.2)% vs infusion group, 27.2 (23.3)%; P = 0.67. The increase in heart rate occurred significantly earlier in the bolus group than in the infusion group (median [interquartile range] time, 105 [69-570] sec vs 485 [255-762] sec; P = 0.02; group × time interaction: two-way repeated measures ANOVA, P = 0.04). There was no significant difference in maximum variations for the other hemodynamic parameters between the groups.</p><p><strong>Conclusion: </strong>Carbetocin infused over ten minutes did not reduce the magnitude of maternal heart rate variation but delayed its occurrence. This finding could be relevant to the anesthesiologist caring for parturients in whom a slight increase in maternal heart rate is clinically undesirable.</p><p><strong>Study registration: </strong>www.</p><p><strong>Clinicaltrials: </strong>gov (NCT03404544); registered 19 January 2018.</p>","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"32 1","pages":"715-725"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88348237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 Pandemic on Patients with Rheumatic and Musculoskeletal Diseases: Disruptions in Care and Self-Reported Outcomes.","authors":"Ahmed M Fouad, Sally F Elotla, Nourhan E Elkaraly, Aly E Mohamed","doi":"10.1177/23743735221102678","DOIUrl":"10.1177/23743735221102678","url":null,"abstract":"<p><p>The COVID-19 pandemic presented a challenge to the care of patients with rheumatic and musculoskeletal diseases (RMDs). The objective of this study was to evaluate the impact of the pandemic on the care of RMDs patients and their health and well-being. This cross-sectional study involved 120 RMDs patients at the rheumatology department at Suez Canal University Hospital in Ismailia, Egypt, in July 2020. Patients were interviewed for sociodemographic and disease-related history. Further assessments were performed using Kessler 6-items, fears of COVID-19, and COV19-impact on quality of life scales. Rheumatoid arthritis and systemic lupus erythematosus represented the majority of our sample of RMDs patients (72.5% and 19.2%, respectively). About 50% of patients reported experiencing limitations in the access to rheumatologic care, and a similar percentage had changed or discontinued their medications. Disease-modifying antirheumatic drugs shortage and concerns about the increased risk of COVID-19 infection due to immunosuppressive drugs were the most frequently reported reasons for nonadherence. The percentage of patients with uncontrolled disease had significantly increased from 8.3% prior to the COVID-19 pandemic to 20% during the pandemic. About 60% of patients reported a high level of psychological distress. In conclusion, the pandemic negatively influenced mental health, quality of life, adherence to medications, access to rheumatology care, and the degree of disease control of RMDs patients.</p>","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"43 1","pages":"23743735221102678"},"PeriodicalIF":1.6,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9134452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88367425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Pattern of Opioid Users Attending an Opioid Agonist Treatment Clinic in North India.","authors":"Fazle R Bhat, Yasir H Rather, Ubaid Rasool","doi":"10.1055/s-0041-1736509","DOIUrl":"10.1055/s-0041-1736509","url":null,"abstract":"<p><p><b>Objectives</b>  Illicit opioid use is a major concern across the globe due to its adverse health consequences. Pharmacological intervention is regarded as the cornerstone of management of opioid dependence and the Opioid Agonist Treatment (OAT) is the most effective intervention for this chronic relapsing disorder. Since the pattern of use of illicit substances, like opioids, changes with the course of time, we studied the profile of patients registered in an OAT clinic of a tertiary care center in North India over last 8 years. <b>Methods</b>  Retrospective chart review of patients registered in the OAT clinic was done. Comparisons were made among two periods (2012-2015 and 2016-2019). <b>Results</b>  Total number of opioid dependent patients registered in OAT clinic has increased from 139 in 2012 to 2015 to 309 in 2016 to 2019. Mean age at the first use of opioids has reduced significantly from 20.2 (± 2.7) years in 2012 to 2015 to 18.3 (± 3.2) years in 2016 to 2019 ( <i>p</i>  = 0.02). Parenteral route continues to remain as the dominant mode of use of opioids, though it has increased from 80.6 to 99% of users. There has been increased use of heroin over these years (12.2% in 2012-2015 to 72.5% in 2016-19) with concomitant decrease of pentazocine use (69.1-17.5%), respectively. <b>Conclusion</b>  The changing demographic and opioid use pattern in the last couple of years among patients attending OAT clinic should alert the policy makers, so that an integrated approach is put into action for effective prevention and management of opioid use disorders.</p>","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"18 1","pages":"176-180"},"PeriodicalIF":0.8,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88321502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Great Distance","authors":"W. Cash","doi":"10.1353/APH.2020.0040","DOIUrl":"https://doi.org/10.1353/APH.2020.0040","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"17 - 8"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41755076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At the Center of All Beauty: Solitude and the Creative Life by Fenton Johnson (review)","authors":"Jayne Moore Waldrop","doi":"10.1353/APH.2020.0034","DOIUrl":"https://doi.org/10.1353/APH.2020.0034","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"107 - 110"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47395941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Where: Have All the Safety Pins Gone?","authors":"Angela Jackson-Brown","doi":"10.1353/APH.2020.0027","DOIUrl":"https://doi.org/10.1353/APH.2020.0027","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"68 - 74"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48951191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Appalachian Review Conversation","authors":"W. Cash","doi":"10.1353/APH.2020.0041","DOIUrl":"https://doi.org/10.1353/APH.2020.0041","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"18 - 25"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49086476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wiley Cash and the Ties that Bind","authors":"S. Shurbutt","doi":"10.1353/APH.2020.0042","DOIUrl":"https://doi.org/10.1353/APH.2020.0042","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"26 - 37"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45027541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Every Bone a Prayer by Ashley Blooms (review)","authors":"Hannah D. Markley","doi":"10.1353/APH.2020.0052","DOIUrl":"https://doi.org/10.1353/APH.2020.0052","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"101 - 104"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47062809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aria for Loray Mill","authors":"V. Flanagan","doi":"10.1353/APH.2020.0043","DOIUrl":"https://doi.org/10.1353/APH.2020.0043","url":null,"abstract":"","PeriodicalId":40234,"journal":{"name":"Appalachian Heritage-A Literary Quarterly of the Southern Appalachians","volume":"48 1","pages":"38 - 43"},"PeriodicalIF":0.0,"publicationDate":"2021-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1353/APH.2020.0043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43719032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}