bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Relationship Between the Pain Experience and Emotion Regulation in Older Adults
Authors: Ghandehari Omeed , Gallant Natasha L , Hadjistavropoulos Thomas , Williams Jaime , Clark David A 
Published: May 2020

Abstract

Objective
To investigate the relationship of emotion regulation strategies (i.e., emotional suppression and reappraisal) with pain catastrophizing, fear of pain, pain intensity, worry, and depression as function of age in samples of older and younger adults.

Design
Cross-sectional design using validated questionnaires.

Setting
Participants resided in the community. They completed validated measures using online questionnaires.

Subjects
Two-hundred fifty-seven older adults and 254 younger adults with chronic pain participated.

Methods
Participants completed validated questionnaires of emotion regulation strategies, pain-related functioning and mental health.

Results
Emotion regulation varied as a function of age and gender. Among our chronic pain sample, older adult males reported lower use of reappraisal and suppression than younger adult males, while older adult females reported higher use of reappraisal than younger adult females. Emotional suppression was positively related to pain catastrophizing, pain intensity, worry, and depression. Reappraisal was negatively related to depression and worry. Interestingly, age showed a positive relationship with fear of pain, pain catastrophizing, worry, depression, and pain intensity, while gender was related to fear of pain and worry. Finally, emotional reappraisal partially mediated the relationship between the affective dimensions of pain intensity and pain catastrophizing among older adults.

Conclusions
Our results indicate that reappraisal strategies are important for older and younger adults with chronic pain, pointing to the necessity of considering these strategies when working clinically with such populations. However, given our findings as well as those in the literature, gender should also be considered.
Who Governs Immigrant Labor? Status, Residency, and Rights in Federal and State Law
Authors: Newton Lina 
Published: May 2020

AbstractThis article examines a collection of 244 state bills selected from the National Conference of State Legislatures (NCSL) Immigrant Policy Project between 2006 and 2018 covering three areas of immigrant work and worksite regulations. Even though employment regulation is an area where states claim statutory and court-backed authority and therefore where states might have been expected to act independently of the federal government, state employment, and workplace laws are in many cases aligned with federal policy. The significant degree of alignment of state and federal law in this area reveals how states face downward pressures from federal efforts to regulate and crack down on immigration broadly, and unauthorized immigrants specifically. This, in turn, suggests that immigration federalism scholarship, which has generally highlighted state–federal conflict in the area of policing and enforcement, needs to account for different types of intergovernmental relationships that accompany distinctive immigrant policy areas, and researchers should consider the different spheres where enforcement occurs.
Relation between fluid balance and incidence of morbidity and mortality rates in critically ill patients prospective observational study
Authors: Gerges M G A , Elazzazi H M M , Elsersi M H S A , Mustafa S A R , Saeed M A 
Published: May 2020

Abstract

Background
While administration of fluid can be lifesaving, it has been suggested that the fluid accumulation after initial resuscitation and hemodynamic stabilization can contribute to potentially avoidable adverse effects and less favorable outcomes.

Objective
The aim of this study is to assess whether positive fluid balance in comparison with negative or even fluid balance is associated with increased morbidity and mortality rates in critically ill patients.

Patients and Methods
This prospective observational study was performed on 145 Patients older than 18 years admitted to intensive care units at Helwan university hospitals and Ain shams university hospitals during the period from November 2017 till May 2018.

Results
A total of 145 patients with an ICU mortality rate of 14.5% were enrolled. The median cumulative fluid balance of the 124 patients who survive was -110 ml (IQR -2.1-2.2 L) after the fourth day following randomization while the median cumulative fluid balance of the 21 patients who not survive was 3800 ml (IQR 1.7-5.2 L) after the fourth day in ICU. In our study critically ill patients with fluid balance more than 1.2 litres per day had higher ICU complications: increased risk of AKI, longer ICU and hospital stays, and mechanical ventilation, and fluid balance was independently associated with mortality.

Conclusion
In the view of this study, we concluded that:Zero fluid balance and negative fluid balance independently associated with decrease mortality and morbidity rates in critically ill patients after 4 days from admission in ICU.There was higher cumulative fluid balance in non survivors compared to survivors. Cumulative fluid balance after 4 days from admission was independently predictive of mortality in a heterogeneous group of critically ill patients.96 hour negative fluid balance in critically ill patients was associated with less length of stay at ICU and less mechanical ventilation duration.Positive fluid balance, mechanical ventilation, vasopressors, and high admission SAPS II, SOFA, APACHE II and KIDGO were significantly associated with high mortality.
Ultrasound Guided Transversus Abdominis Plane (TAP) Block versus Caudal Block in Pediatrics Undergoing Inguinal Hernia Repair
Authors: Fahmy N M A , Hazem A M , Tolba M A A , Mostafa S A 
Published: May 2020

Abstract

Background
Inguinal hernia repair is one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provides safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most commonly used techniques in pediatrics are caudal block and TAP block.

Objective
This study was to compare the effectiveness and safety of US guided TAP block versus caudal block as a part of multimodal analgesia in pediatric patients undergoing inguinal hernia repair.

Patients and Methods
The study was conducted on 90 randomly chosen patients in Ain Shams University Hospitals after approval of the Medical Ethical Committee. Patients were divided randomly into two groups, each group consisted of 45 patients. After preoperative assessment and obtaining baseline vital data, all patients received general anesthesia.

Results
The results of the study revealed that US guided TAP block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents’ satisfaction as compared with caudal block in pediatric patients undergoing inguinal hernia. Both analgesic techniques are safe.

Conclusion
The current study revealed that US guided TAP block provided significantly prolonged postoperative analgesia, reduced the postoperative analgesic requirements and better parents’ satisfaction as compared with caudal block in pediatric patients undergoing inguinal hernia. Both analgesic techniques are safe.
Preoperative Pregabalin Prolongs Duration of Spinal Anesthesia and Reduces Early Postoperative Pain
Authors: Elkady G A A , Ghaly S I , Elansary A M , Ismail A M 
Published: May 2020

Abstract

Background
Various adjuvants have been used to prolong spinal anesthesia, with the additional advantages of delaying the onset of postoperative pain and reducing postoperative analgesic requirements. Pregabalin is an R-aminobutyric acid analog that binds to the α2-δ subunit of presynaptic voltage-gated calcium channels.

Objective
The aim of this work is to evaluate the efficacy of a single dose of pregabalin in terms of spinal blockade duration and its potential opioid-sparing effect during the first 24 hours postoperatively

Patients and Methods
There were limitations to the present study. First, since only 1 dosage of pregabalin was evaluated, we could not determine the most effective dosage. Second, clinically meaningful improvements in recovery were not assessed. Adequate postoperative pain control provides early postsurgical mobilization, shortened hospitalization, and increased patient satisfaction. Third, preoperative pain and anxiety scores were not recorded. Pregabalin might affect the preoperative pain, mood, and anxiety scores, and these factors can be related to the postoperative pain score.

Results
The mechanisms by which pregabalin premedication prolongs motor and sensory blocks using local anesthetics in spinal anesthesia are not fully understood. There may be several reasons for the prolongation of spinal anesthesia. Gabapentinoids are an r-aminobutyric acid analog that binds to α2-δ subunit of presynaptic voltage-gated calcium channels, and this inhibition decreases postsynaptic excitability by reducing potassium-evoked excitatory transmitter release. These medications provide antiepileptic, anxiolytic, and analgesic features by modulating both GABAergic neurotransmission and calcium influx. Gabapentinoid compounds produce a significant and clinically important improvement in preoperative anxiety scores. Since patients may be anxious in the perioperative period, the anxiolytic effects and euphorigenic effects of pregabalin may be beneficial.
Comparison between Intravenous and Perineural Dexamethasone in Prolonging the Analgesic Effect of Supraclavicular Plexus Nerve Block
Authors: Elzahaby H M M , Kamal K Y , Emam D F , Saad M Y 
Published: May 2020

Abstract

Background
poor controlled acute pain post-surgery is accompanied with several unwanted postoperative consequences, including patient agony, distress, myocardial ischemia, increased hospital stays and an increased possibility of post-operative chronic pain.

Aim of the Work
to study the effect of dexamethasone as a supplementary to bupivacaine in supraclavicular brachial plexus block. The comparison included the onset and the duration of the motor and sensory blocks, the duration of analgesia of the block and their effect on the postoperative analgesic needs. The effect of the drugs on hemodynamics and monitoring for the occurrence of any complication.

Patients and Methods
in our study, 50 patients were randomly divided into 2 equal groups. Perineural group received bupivacaine (0.5%) assosciated with 8 mg dexamethasone and Systemic group in which 8 mg of dexamethasone was injected systemically. All patients received equal volumes of 20 milliliters.

Results
our study revealed that adding 8 milligram of dexamethasone to bupivacaine in ultrasound-guided supraclavicular nerve block decreased the onset times of motor and sensory blocks and significantly increased their durations. In addition, dexamethasone prolonged the time of analgesia of the plexus block markedly, as shown by the time of request of first analgesia. Moreover, in perineural dexamethasone group, postoperative analgesic needs were much lesser than that of bupivacaine groups. Addition of dexamethasone perineural also did not affect the hemodynamics to a significant level. This makes perineural dexamethasone with bupivacaine more superior than the use of bupivacaine with addition of intravenous dexamethasone.

Conclusion
addition of Dexamethasone to bupivacaine in supraclavicular nerve block shortened the onset times of both sensory and motor blocks than injecting dexamethasone intravenously. Addition of Dexamethasone to bupivacaine significantly prolongs both sensory and motor block durations than injecting dexamethasone intravenously.
Effect of Oral Gabapentin Premedication on Post-Operative Pain in Pediatric Patient Undergoing Adenotonsillectomy
Authors: Bassiony M A , Elserwi H B , Abdelnaiem M A , Elrazzaz M H S M 
Published: May 2020

Abstract

Background
Tonsillectomy is one of the most common surgical procedures performed in otorhinolaryngology. Postoperative pain following tonsillectomy, which is especially aggravated by swallowing, can lead to various complications, such as impairment of food intake, possible dehydration, sleep disturbance and increased risk of secondary hemorrhage.

Objectives
The current study aims to evaluate the effectiveness of oral Gabapentin in decreasing the postoperative pain in pediatric patient undergoing tonsillectomy in the first 0,2,12 24 hours post-operative.

Patients and Methods: Type of study
Prospective randomized control study, study setting: Ain Shams university hospitals, Study period: 3 months from December 2018 to February 2019, Patients were divided randomly into two groups, each group consists of 25 patients:

Group A
Patients in this group received oral Gabapentin dose according to body weight (20mg/kg) at 0,2,12,24hrs post operative,

Group B
Patients in this group received oral paracetamol as analgesics (10-15 mg/kg every 12hours).

Results
The mean age of our study population was around7.2in group A and 7.08 in group B years. This study showed no statisticaly significance differance between group A and B regarding age. The mean body weight of the study was around27.79 for group A and 28.68 for group B.This study showed no statisticaly significance differance between group A and B regarding body weight. The mean HR of group A was lower than group B mean HR. The study shows statistically highly significant reduction of group A post operative heart rate compared to group B. The mean blood pressure of group A was lower than group B mean blood pressure. The study shows statistically highly significant reduction of group A postoperative blood pressure compared to group B. The median VAS score of group A was lower then group B. This study showed statisticaly significance reduction of VAS pain score post operative in group A compared to group B. The median analgesic rescue doses of group A was 2 and for group B was 3.5 so there was a statisticaly significance increase in rescue analgesia use in group B compared with group A.
A Comparative Study between Multimodal Analgesia and Single Mode Analgesia in Lumber Vertebral Surgery
Authors: Abdelhamid H S , Mahmoud D S , Ali A E , Ali H M N N 
Published: May 2020

Abstract

Background
Postoperative pain after spine surgeries is a major concern for the patients, anesthesiologists and surgeons. Nociceptive signals have the capacity to initiate prolonged changes in both the peripheral and central nervous system that will lead to the amplification and prolongation of postoperative pain.

Objective
This study aims to compare between the effect of MMA and single mode analgesia in lumbar spine surgery on intraoperative and early postoperative analgesia, the consumption of morphine in both types and incidence of side effects.

Patients and Methods
In our study a number of 70 patients were scheduled to undergo single or double lumber vertebral discectomy or fixation under general anesthesia and were randomly assigned to one of two groups: Group A: (35 patients) The multimodal group that received preoperative analgesia in the form of paracetamol 1 gm I.V, ketorolac 30 mg and morphine 3 mg I.V. 20-30 min before surgery and intraoperative maintenance of analgesia for this group was done by morphine I.V. infusion in a rate of 1 mg/hour. Group B: (35 patients) The single mode group that received preoperative analgesia in the form of morphine 3 mg I.V 20-30 min before surgery only. Intraoperative maintenance of analgesia for this group was done by morphine I.V. infusion in a rate of 1 mg/hour.

Results
Regarding systolic and diastolic blood pressures and heart rate, there was a significant decrease in intraoperative and early postoperative values in the multimodal group than morphine group. Regarding narcotic consumption there was significant lower consumption in the multimodal group and also significant longer interval time for requesting analgesia.

Conclusion
We concluded that the use of MMA prolonged the duration of postoperative analgesia and decrease the intensity of pain, with stable hemodynamics and without any respiratory burden, furthermore it decreases the consumption of narcotics by decreasing the frequent requesting of analgesia.
Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill
Authors: Fahmy N A , Alfawal S M , Abdelsamie H S , Hassan A M 
Published: May 2020

Abstract

Background
Atrial fibrillation (AF) is the most common sustained arrhythmia affecting humans. It is an electrical disturbance that leads to rapid, disorganized, and asynchronous contraction of the atrial muscle. In clinical practice, it accounts for approximately one-third of hospitalizations for cardiac rhythm disturbances. The incidence of AF increases from less than 0.1% per year in those under 40 years old to exceed 1.5% per year in women and 2% per year in men older than 80 years. Aim of the Work: to discuss the effect of variation in amiodarone use (including dosage and duration) on dysrhythmia recurrence in patients with new-onset AF in ICU.

Patients and Methods
This was a prospective observational study conducted over 6 months, 60 patients who fulfilled inclusion criteria were included in the study divided in two groups according to amiodarone dosage, each group is 30 patients: Group (A): received a loading dose of amiodarone followed by an infusion (1200mg amiodarone). Group (B): received a loading dose of amiodarone not followed by an infusion (300mg amiodarone).

Results
a significant positive correlation was observed between level of C-reactive protein (CRP) and the rate of AF recurrence. As regard effect of CRP on AF recurrence; in AF recurrent patients, mean is (191±77.3) with range from 15 to 352 which significantly differed from Non-recurrent AF patients, mean is (89±63) with range from 20 to 223 (p value &lt;0.001). AF recurrence was higher in group (B) than group (A),. In group (A) 8 patients had recurrent AF representing 26.7 % and in group (B) 19 patients had AF recurrence representing 63.3% (p value =0.004).

Conclusion
Patients with new-onset AF in (ICU) who are treated with amiodarone should receive a loading dose, immediately followed by an infusion.
Efficacy of Dexmedetomidine as an Adjuvant to Bupivacaine in Peripheral Nerve Block - Three Prospective Randomized Controlled Studies
Authors: Nassif G M , Noreldin B M E , Elazzazi H M M , Abdelmalek F A , Maarouf M M 
Published: May 2020

Abstract

Introduction
Peripheral nerve blocks are frequently used as the sole anesthetic technique or as an adjuvant to general anesthesia, However, the duration of sensory nerve block after single doses of long-acting local anesthetics is not consistent enough to avoid the use of postoperative opioids. Many adjuvants have been added to prolong the duration of nerve block, It was recently suggested that, based on current evidence, perineural dexmedetomidine is the most promising adjuvant to extend the duration of long-acting local anesthetics

Aim
The aim of this work is to study the effects of dexmedetomidine as an adjuvant to bupivacaine in various peripheral nerve blocks. The study will include: supraclavicular brachial plexus block, paravertebral block and femoral nerve block.

Patients
Adult patients of either sex aged 25 – 60 years, ASA physical status I and II, Elective surgeries appropriate for the nerve block.

Methods
patients received bupivacaine 0.5% alone in (group I) or bupivacaine 0.5% combined with 100 dexmedetomidine (group II) in peripheral nerve blocks. Motor and sensory block onset times; durations of blockades and analgesia were recorded

Results
Sensory and motor block onset times were shorter in group II than in group I. Sensory and motor blockade durations were longer in group II than in group I. Duration of analgesia was longer in group II than in group I. Systolic, diastolic arterial blood pressure levels, and heart rate were less in group II.

Conclusion
In the current study, it was obvious that:(Addition of dexmedetomidine to bupivacaine in supraclavicular nerve block, paravertebral nerve block and femoral nerve block has shortened the onset times of both sensory and motor blocks and significantly prolonged their durations, Dexmedetomidine had also the added effect of sedation with minimal side effects, which makes it a beneficial adjuvant to local anesthetics in peripheral nerve blocks, Addition of dexmedetomidine to bupivacaine prolonged the postoperative analgesia with subsequent consumption of less amount of analgesics and The use of ultrasonography in performing nerve blocks significantly reduced the incidence of complications such as pneumothorax or intra-arterial injection and hence, lowered the incidence of systemic toxicity of local anesthetics).
Vasopressors in Septic Shock (A Systematic Review / Meta-Analysis)
Authors: Elkady G A M , Elshafei M M N , Mostafa A N S , Awoad A T A 
Published: May 2020

Abstract

Background
sepsis is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Septic shock occurs in a subset of patients with sepsis and comprises of an underlying circulatory and cellular/metabolic abnormality that is associated with increased mortality. Septic shock is defined by persisting hypotension requiring vasopressors to maintain a mean arterial pressure of 65 mm Hg or higher and a serum lactate level greater than 2 mmol/L (18 mg/dL) despite adequate volume resuscitation.

Purpose
to assess the role of Vasopressors in septic shock and compare the effects among different types of vasopressor drugs.

Patients and Methods
this meta-analysis study was done on 18 studies randomized controlled studies on adult patients ( at least 18 years of age ) with septic shock and had reported mortality outcome. The study compared five vasopressors EN, DA, VP, TP and PE with norepinephrine (NE) (the control drug) in efficacy and safety.

Results
with comparison of the five vasopressors to NE, Vasopressin and its long acting analogue Terlipressin proved to be the competiting agents to NE but not the replacement choices due to many limitations to the study.

Conclusion
norepinephrine remains the first choice vasopressor to treat patients with septic shock. The use of vasopressin or terlipressin as a first line vasopressor for the support of MAP is not recommended.