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Reduction Group (reduction + group)
Selected AbstractsWard reduction of gastroschisis in a single stage without general anaesthesia may increase the risk of short-term morbidities: Results of a retrospective auditJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 6 2009Shripada C Rao Background: Ward reduction of gastroschisis in a single stage without the need for general inhalational anaesthesia (ward reduction) has been reported by some authors to be effective and safe. We introduced this practice to our neonatal unit 2 years ago. Aim: To compare the short-term outcomes of this new practice with the standard procedure of reduction under general anaesthesia (GA). Methods: Retrospective case series of all infants with gastroschisis between January 2004 and January 2008. Results: Twenty-seven infants were managed with the traditional approach and 11 infants underwent ward reduction without GA. Infants in the ward reduction group had an increased frequency for all the three major adverse events (ischemic necrosis of bowel: 27.3% vs. 3.7%, odds ratio (OR) 10.72, 95% confidence interval (CI): 0.72, 159.6; need for total parenteral nutrition (TPN) more than 60 days: 18% vs. 3.7%, OR 4.13, 95% CI: 0.28, 61.55; and unplanned return to theatre: 27.3% vs. 7.4%, OR 3.88, 95% CI: 0.44, 34.08), although none of these events reached statistical significance. There were no significant differences between the groups for the outcomes of time to reach full feeds, duration of hospital stay and number of days on antibiotics. Conclusions: These results raise concerns over the role of ward reduction of gastroschisis in a single sitting without the use of GA. Randomised trials with appropriate design and sample size are needed before embracing this method as a standard practice. [source] Depressed humoral immunity after weight reduction in competitive judoistsLUMINESCENCE: THE JOURNAL OF BIOLOGICAL AND CHEMICAL LUMINESCENCE, Issue 3 2002Seikou Ohta Abstract We studied changes in serum opsonic activity (SOA) in male judoists who were engaged in active weight reduction. Serum immunoglobulins, complements and SOA, measured by neutrophil-associated chemiluminescence responses, were investigated 20 days, 7 days and 1 day before a competition and 5 days after the competition. In addition, muscle strength and anaerobic work capacity, as well as body composition, were also determined. A dietary survey was conducted daily during the observation period. Body weight decreased by 4.2 kg over 19 days. SOA significantly decreased 5 days after the competition, as well as the concentrations of serum immunoglobulins, complements and total proteins. These trends were noted in the marked weight reduction group (i.e. reduction weight of body fat/body fat weight before weight reduction ,25%) more than the slight reduction group (<25%). Depressed SOA was closely correlated with the decreased concentrations of immunoglobulins and complements. These results suggest that the decrease in immunoglobulins and complements following weight reduction is associated with reduced SOA, which might cause susceptibility to infections. This study demonstrated that such immunosuppression appeared in the recovery period after the competition rather than immediately before the competition. Copyright © 2002 John Wiley & Sons, Ltd. [source] Patient satisfaction with polypharmacy reduction in chronic epilepticsPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 2 2000Masato Matsuura MD Abstract The effects of polypharmacy reduction on patient satisfaction and subjective seizure severity were assessed prospectively in adult out-patients with chronic epilepsy using Japanese versions of the Side effects and Life Satisfaction (SEALS) and the Seizure Severity Questionnaires (SSQ). Antiepileptic drugs (AED) were withdrawn using a 1-year reduction schedule. The SSQ score was not aggravated and total SEALS score improved significantly. Moreover, temper subscore was also improved in the sedative AED reduction group. Similar to previous studies from the physician's viewpoint, the present study confirms that from the perspective of the patient, polypharmacy reduction, especially withdrawal of sedative AED, has a favorable effect on patient satisfaction. [source] Analysis of the cardiovascular risk profile in stable kidney transplant recipients after 50% cyclosporine reduction,CLINICAL TRANSPLANTATION, Issue 4 2004Waichi Wong Abstract:, Background:, Long-term use of cyclosporine (CsA) contributes to post-transplant cardiovascular disease (CVD). Hence, a reduction in CsA dosage in kidney transplant recipients (KTR) may improve long-term outcomes. We analyzed the effects of 50% CsA dose reduction on the CVD risk profile in stable KTR. Method:, Thirty-one KTR on a regimen of CsA, prednisone and mycophenolate mofetil (MMF) were studied. Patients were randomized to either a) continue their previously determined CsA dose (control group, n = 15) or b) lower their CsA dose by 50% (CsA reduction group, n = 16). Renal function, blood pressure, lipid profile, plasma homocysteine (HCY), C-reactive protein (CRP), fibrinogen, and uric acid were compared at baseline and at 6 months. Results:, At 6 months, there was a significant improvement in allograft function, systolic blood pressure, number of anti-hypertensive medications and serum uric acid levels in the CsA reduction group. No significant decrease in plasma HCY, CRP, fibrinogen or improvement in lipid profile was found. In contrast, in the Control group, there was a significant increase in HCY, uric acid, and triglycerides. No acute rejection occurred in either group. Conclusions:, A greater reduction in CsA dose could further improve CVD risk profiles, although this may increase the risk of acute or subclinical rejection. [source] |