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Postoperative pain management in hip preservation surgeriesAyisi, Jake 27 January 2023 (has links)
BACKGROUND: Hip preservations surgeries are a type of surgical intervention used to often delay or prevent arthritis in patients before damage has occurred. A hip arthroscopy, a type of hip preservation surgery, allows for a minimally invasive method by using an arthroscope, a small fiber-optic tube with a camera attached, and surgical tools to perform the surgery. Hip preservation surgeries are often linked with moderate to severe postoperative pain, often leading to the use of substantial anesthesia. Nerve blocks have become increasingly popular for certain procedures as there may be advantages with postoperative pain and other same-day recovery advantages. Nerve blocks continue to be investigated in their role in lowering postoperative pain, postoperative opioid consumption, length of stay/time in postoperative anesthesia care unit, and patient satisfaction of pain control.
OBJECTIVE: The objective of this systematic review was to determine the efficacy of nerve blocks for postoperative pain management in hip arthroscopies.
METHODS: Two reviewers (J.A., E.B.) independently conducted a literature search in January 2022 with adjudication by a third reviewer using the databases Pubmed, EMBASE, and Medline. The included studies were systematically screened and reviewed, and data was analyzed.
RESULTS: With a quadratus lumborum block, a study showed a significant difference in postoperative VAS pain scores in the study group with a block compared to the control from admission into the PACU through 24 hours after the operation (P<.001). In postoperative opioid consumption, another significant difference was reported in the group with a lumbar plexus block compared to control from the PACU all the way to 24 hours post operation (P<.001). When comparing a fascia iliaca block versus a local infiltration analgesia, a study found that 1 hour post operation the patients reported a significantly lower mean pain level. However, it was found that a fascia iliaca block may be less effective in reducing the number of opioids consumed in the PACU compared to a lumbar plexus block (P=.020). With a femoral nerve block, reports show a significant reduction in postoperative pain using VAS at 30 minutes (P=.009), 1 hour (P=.004), 2 hours(P=.003), 4 hours(P=.006) and 6 hours (P=.0002). Patients who receive a femoral nerve block consumed a mean amount of 47.6 milligrams of morphine equivalents compared to 59.2 milligrams of morphine equivalents in the control group which is significantly less (P=.006). Patients with a lumbar plexus block reported a lower mean pain score compared to a combined spinal epidural (P=.048) at 48 hours (YaDeau et al., 2012). There was no difference observed in pain scores when a lumbar plexus block was compared to a pericapsular injection. The lumbar plexus block had no differences in opioid consumption when compared to both combined spinal epidural and pericapsular injection.
CONCLUSION: The use of nerve blocks provides sufficient pain management in hip arthroscopies. The effectiveness of these blocks may be more than other types of analgesic methods in lowering postoperative pain and postoperative opioid consumption.
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ListahúsiðSigurþórsson, Elías Beck January 2022 (has links)
Located in Laugarnes, Reykjavík there is an industrial building, just over 10.000m2, originally built as a slaughterhouse for the institution SS. The construction started in 1985 but due to financial setback the company never moved its function into the building. After standing empty for few years, the Iceland University of the Arts moved into a part of the building in 1991 whereas the rest is being used as a storage. The university is set to move out of the building in upcoming years, leaving no future plans for the site. My ambition is to open the building up to the public as a centre for culture and arts and create a new meeting place with a gallery, a restaurant, a library, an auditorium and more. The goal was to create a system where the building can work as a single unit with the flexibility of being able to open and close individual spaces depending on events and activities between different days. Daylight and visual connections became important design tools in creating attractive spaces and a pleasant experience moving through the building. The new layout also allows for further development and change in function through the years.
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An Analysis of the Unit Package for the Preservation of Military Supplies and Equipment with RecommendationsBloker, Wayne H. January 1956 (has links)
No description available.
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Spatial distribution and preservation of carbon isotope biosignatures in freshwater microbialite carbonateBelan, Mark A. 11 1900 (has links)
Modern microbialites provide the opportunity to explore the influences of biology on microbialite formation and understand how biosignatures can be preserved in these structures. In this study, we compared δ13Ccarb values from nodule and surface biofilm carbonates on microbialite structures across depths and locations throughout Pavilion Lake to evaluate whether variable light exposure produced limitations to biosignature formation. At depths below 21 m, vertical profiling of δ13Ccarb across colour transitions of surface biofilm on microbialite structures was performed to identify spatial arrangement of autotrophic and heterotrophic biosignatures. Finally, preservation of the photosynthetic biosignature over time was investigated by collecting carbonates beneath the microbialite surface. These investigations were performed in order to better characterize the factors controlling biosignature formation, distribution, and preservation within Pavilion Lake.Decreasing trends of δ13Ccarb with depth across study sites indicated that attenuated sunlight in the water column is likely the primary control on biosignature formation. Below 21 m, photosynthetic enrichments representing biosignatures on microbialite surfaces were reduced and recorded δ13Ccarb values that fell within the predicted equilibrium range. Biosignature loss is suggested to result from the relative proportions of autotrophic and heterotrophic processes changing at depths and producing average δ13Ccarb values. Variability of where biosignatures are lost on the microbialite surface indicated that the spatial extent of photosynthetic communities producing enrichments is potentially influenced by variable incidences of light at these depths. Although no definitive biosignatures of heterotrophy were identified, several interfaces were identified where the balancing proportions of autotrophic and heterotrophic processes influenced by light variability potentially mediate biosignature loss. Decreasing trends of δ13Ccarb beneath the microbialite surface and estimates of past microbialite growth rates indicated that surface biosignatures are lost within 100 – 400 years. It is suggested that infilling processes overprint enrichments and deplete δ13Ccarb values due to heterotrophic abundance below the microbialite surface. This is supported by an isotopic mass balance that predicts smaller inputs of heterotrophically-depleted DIC are required to sufficiently overprint δ13Ccarb enrichments. These results concluded that the photosynthetic biosignature identified in Pavilion Lake is short-lived and mitigated by biological processes. / Thesis / Master of Science (MSc)
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QUANTITATIVE ASSESSMENT OF COASTAL RESPONSE AT POINT PELEE ON LAKE ERIE 1974-75Shaw, John 06 1900 (has links)
<p> The concern about the preservation of a valuable natural
resource such as Point Pelee is readily apparent, yet
along with this concern is the need for raw materials
such as aggregates dredged from submarine sand and gravel
deposits. This could involve a conflict in resource management,
therefore the question of how significant
commercial dredging is as a process element in the local
coastal dynamics needs to be resolved. To provide a basis
for this assessment, offshore and onshore surveys, bottom
sediment analyses, wind-wave analyses, and current measurements
have bee·n taken over the last two years to derive a
sediment budget for the Point Pelee spit and shoal system. </p> <p> The magnitude of response was measured by the morphologic
and volumetric variation between successive profiles at
18 sites throughout Point Pelee. The beach zone of the
east shore evidenced the most dramatic morphologic and
volumetric changes to its profile, with an average loss
of 17.5 m3/m from fall to spring of 1975. </p> <p> Maximum material restored to the east beach in 197-5 was
4.5 m3/m. In terms of annual.quantitative changes to
the beach budget, the westward migration of the Point is
five times greater for the east shore than for the west.
The sediment budget for 1974-75 shows a net deposition
to the south of Point Pelee on the order of 440,000 m3. </p> / Thesis / Bachelor of Arts (BA)
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MismemoryUlitina, Ekaterina January 2020 (has links)
This project tries to understand how we alter existing architecture. The research leads to a proposal that attempts to answer the question: Should a death of a building be a part of its envisaged timeline? It is difficult to preempt a building being dead, but it might be possible to preempt a building being refurbished, renovated and especially replicated. I will try to incorporate the dimension of time in the new buildings and embrace the inevitable change, as well as explore the friction between originality and copying that the process of alteration generates. The site chosen for this architectural experiment is a ski jump erected at Norra Djurgården, and the proposal is its morphed copy hosting a visitors centre and an urban sports centre. The ambition is to establish guidelines or principles of mimicking and copying the elements of an existing edifice in the new one.
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Shelf-life extension studies on pita breadEl-Khoury, Anis Adib. January 1999 (has links)
No description available.
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The combined effect of modified atmosphere packaging (MAP) and chitosan on the growth of Lysteria monocytogenes in model systems and in fresh pork loinMorris, Jennifer E. (Jennifer Elizabeth) January 1995 (has links)
No description available.
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Methods to extend the mold free shelf life of pizza crustsḤasan, Ṣalāḥ, 1964- January 1997 (has links)
No description available.
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The Densification of Historic Districts: Applying Metabolism to the Cast IronCornedi, Drew 06 June 2014 (has links)
No description available.
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