Postoperativ halssmärta (POST) är en mycket vanlig komplikation hos patienter som genomgått generell anestesi med intubation.  POST anses av anestesipersonal vara en relativt lindrig komplikation. Patienter upplever det dock som ett stort problem och därför bör det undvikas. Syftet med denna litteraturstudie var att undersöka vad anestesisjuksköterskor kan göra för att förebygga POST som komplikation hos patienter som genomgått generell anestesi med intubation. Examensarbetet är en integrativ litteraturstudie som innefattar tolv globala studier. Litteraturstudiens resultat visar att det finns flera farmakologiska och icke farmakologiska metoder som kan förebygga POST. Lokal behandling med kortikosteroider och NSAID-preparat har förebyggande effekt på POST. Icke farmakologiska interventioner som konformad kuff, substanser som lakritslösning, magnesium och zink lindrar. Vissa studier finner att kortikosteroider och lidokain kan öka förekomsten av POST. I nuläget kan resultatet inte tillämpas av anestesisjuksköterskor då resultaten är tvetydiga och inte kan utföras utan ordination av anestesiolog. Vidare forskning inom området med inriktning på omvårdnad är av yttersta vikt.

No description available.

<p>Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal.</p>

<p>Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal.</p>

Magister Chirurgiae Dentium - MChD / Post-operative sore throat is a common minor complication following general anaesthesia via endotracheal intubation. Pharyngeal packing has often been implicated in this minor anaesthetic complication. In maxillo-facial and oral surgery, two types of throat packs are commonly used namely ribbon gauze and tampons. In order to establish the efficacy of these two types of throat packs a prospective, randomised, clinical study was conducted. The objectives of the study were threefold: to investigate the effect of the two different types of throat packs on the incidence of post-operative sore throat, to determine the quality of seal provided by the two different types of throat packs and finally, to formulate a faculty protocol. The study consisted of 70 patients undergoing third molar surgery. All the patients were intubated via endotracheal intubation and had a throat pack placed. Patients were also randomly selected and allocated to two groups. One group had ribbon gauze while the other group had a tampon as a throat pack. The study reflected no statistically significant difference in the incidence of postoperative sore throat between the two groups. It was interesting to note that the symptoms of sore throat resolved quicker with the use of tampons. On the other hand, the ribbon gauze provided a better pharyngeal seal. / South Africa

Selection operates when the variability among individuals in heritable traits translates to differences in the number of offspring that survive to breed, which is a close estimate of fitness. Consequently, the outcome of sexual-selection should be higher reproductive success for individuals with a greater expression of the selected traits. In this thesis, the relationship between some male spotless starling (Sturnus unicolor) traits and reproductive success was assessed. A particular focus was given to the role of throat feathers (TF) as sexually selected trait. The study was conducted in a wild population using a correlative approach in 2004, while in 2005 and 2006 the TF of males were experimentally shortened. The genetic parentage of the offspring was required for determining the reproductive success of males. Nine highly polymorphic microsatellites (with 11.7± 3.2 alleles per locus) were developed and optimised for this species. Parentage analyses were conducted in NEWPAT XL and CERVUS 3.0.3 and confirmed using observational data. Eighty-five percent of the offspring had at least one parent assigned. The levels of intra-specific brood parasitism, extra-pair paternity and quasi-parasitism were 7%, 7% and 1% of the offspring, respectively. Polygamy levels decreased with year, as the study population matured. The correlative study showed that males with longer TF and with better condition had a higher probability of reproducing and sired more offspring, but their offspring were not of higher quality as measured by their weight and immune response to phytohaemagglutinin. Polygynous males were also in better condition. In the experimental study, males in better condition had a higher chance of reproducing and sired more fledglings. Conversely, males with reduced TF sired significantly fewer eggs and lighter fledglings than control males. Body condition and TF length are shown to be good predictors of reproductive success and TF length is shown to be under sexual selection.

This thesis provides analysis of the networks of power and authority, which interconnect commonly referenced sources of knowledge about Tuvan throat singing. These sources–books, websites, performances, a documentary film, CD liner notes, and the individuals involved in their production–comprise a substantial portion of contemporary public discourse that represents Tuva and its musical practices to the English speaking world and serve to produce “experts” and “expert knowledge” of throat singing. This work also shows how public discourse of Tuva forms an “authentic”, homogenous, romanticized and spiritualized pan-Asian identity centered on the practices of throat singing, shamanism, and nomadism. The conclusion offers an explanation as to why the public discourse focused on Tuvan throat singing locates the “authentic” in rural Tuva, why throat singing is so often aligned with the spiritual, the healing, and the eternal, and why such conceptions serve to benefit the careers of those involved with the production of such an image. This chapter also explores whether or not representing Tuva with an idealized and romanticized image places Tuvans and related ethnic groups at a disadvantage socially, politically, and economically. / text

Class of 2012 Abstract / Specific Aims: To evaluate the in vitro throat deposition and respirable mass of the QVAR® pressurized metered-dose inhaler (pMDI) alone or coupled to an accessory device, such as the AeroChamber Valved Holding ChamberTM or various nonconventional accessory devices. Methods: The performance of the AeroChamber and nonconventional accessory devices, including a toilet paper roll, paper towel roll, rolled paper, plastic bottle spacer, plastic bottle reverse-flow holding chamber, and nebulizer reservoir tubing, were compared to no accessory device. Throat deposition and respirable mass were evaluated using a United States Pharmacopeia (USP) inlet ("throat") coupled to instrumentation for particle size analysis. Each configuration was tested with three actuations and repeated in quadruplicate. The amount of drug deposition was quantified using high-performance liquid chromatography. The data were analyzed using multiple independent t-tests assuming unequal variances. An a priori α-threshold of 0.05 was used with a Bonferroni corrected α of 0.007. Main Results: Compared to the pMDI alone, all of the accessory devices had significantly lower throat deposition (p < 0.001) and significantly higher respirable fraction (p < 0.001). Differences in respirable mass were not significant for any accessory device (p ≥ 0.049), except the paper towel roll and the nebulizer reservoir tubing (p < 0.001). Conclusions: Under these testing circumstances, nonconventional accessory devices, such as the toilet paper roll, rolled paper, plastic bottle spacer, and plastic bottle reverse-flow holding chamber, effectively reduce throat deposition and maintain respirable mass compared to a QVAR pMDI alone. Therefore, they may be suitable alternatives to commercial spacers.

Electrostatic properties of formulation component materials and blends play an important role in dry powder inhalation (DPI) products, and that valid measurement of charge distribution will lead to more precise control of powder behavior in DPI manufacturing processes. Ultra-fine powders are known to be bipolarly charged, have non-spherical shapes and tend to be highly cohesive. Real time, non-invasive techniques need to be developed to obtain a precise and accurate time-history characteristic of electrically charged powders as they aerosolize from a DPI product, and how this measure relates to materials behavior throughout the various steps of a manufacturing process i.e. from drug micronisation, blending with lactose, through to filling dose units. A novel non-invasive technique for simultaneous measurement of size and charge of pharmaceutical powders is considered which employs the Phase Doppler Anemometry (PDA) system. Previous research demonstrated the advantages of this technique in measuring the bipolar charge distribution on a population of particles. These findings led to significant improvements in understanding performance of dry powder formulations, manufacturing processes and development of new platforms for inhaled drug delivery. The main aim of this research is to perform an investigation of electrostatic propertiesof pharmaceutical dry aerosols using the PDA system. The PDA technique was used to track the motion of charged particles in the presence of an electric field. The magnitude as well as the polarity of the particle charge can be obtained by solving the equation of particle motion in DC and AC fields combined with the simultaneous measurement of its size and velocity. The results show the capability of the technique to allow real-time size and charge distribution in the control of dry powder attributes that are critical to fully understanding manufacturing design space. The data obtained from initial investigations of electrical properties of pharmaceutical powders and bipolar charge measurements was used to perform an in-depth study of electrostatic properties of pharmaceutical aerosols dispensed by dry powder inhaler (DPI) devices. The delivery of a drug to the lungs can only be achieved by a combination of inhaler device and drug formulation which is capable of producing an aerosol of an aerodynamic diameter smaller than 5 μm and of appropriate charge. The aerosols generated by these devices are often bipolarly charged and can influence specific site deposition in human lung. By controlling the electrostatic charge generated by tribielectrification, it may be possible to achieve the desired drug deposition in the airways. Bipolary charged dispensed ultrafine particles are inhaled through the extrathoracic and tracheobronchial airways down into the alveolar region. Anatomically realistic respiratory airways and computation fluid dynamics (CFD) models have been created to study airflow structures and predict aerosol deposition within the human respiratory system using visible human data sets, human casts and morphometric data. Many theoretical studies of charged aerosol deposition in human respiratory systems have been developed, however getting real time, non-intrusive data of bipolar charge levels on aerosols dispensed from DPI’s within the human respiratory system represents a challenging issue. This research project presents a simplified human upper airway model which combined with the modified Phase Doppler Anemometry (PDA) system is able to provide real time bipolar charge distributions of aerosols delivered from several commercially available DPI devices. A three dimensional (3D) reconstruction of the upper respiratory system was performed from two dimensional (2D) images obtained from computerized tomography (CT), magnetic resonance imaging (MRI) and cryosectioned images available from Visible Human Server data set (Ecole Polytechnique Fédérale de Lausanne). The resulting dimensions of the model were consistent with morphometric data from the literature from which the simplified upper airway model consisting of two connected segments, i.e., the oral airways from the mouth to trachea (Generation G0), was created. The findings of this study provided a better understanding of the interaction between specific active ingredients and DPI devices. These results may be used in designing future generation DPI devices and a better understanding of aerosol transport and deposition efficiency within the human airways.

In CO2 storage sites, seal has a vital role in inhibiting migration of the supercritical CO2 to other geological strata. The major difficulties in studying seals include two aspects: lack of available samples (especially for saline aquifers), and the difficulty to study over geological time and spatial scales. The analysis of natural analogue has been chosen to overcome these difficulties. Hydrocarbon fields are used to investigate the pore throat radii, which is the major factor for capillary sealing of caprocks, using newly established statistics model. Natural CO2 springs at Green River, Utah are used to study how the long-term CO2 charge triggers chemical reactions and migration in shales. One of the major sealing mechanism of caprocks is capillary sealing. Pore throat radius, as the main factor to decide the capillary sealing, has been investigated in this study. As an alternative to the traditional method of mercury injection porosimetry, a statistical model for effective pore throat radii determination has been established. The cumulative percentage and the probability distribution of the effective pore throat radii of the shale caprocks in the UK North Sea oil fields are obtained, which would be used as a reference for the saline aquifers in CO2 storage siting in the future work. Monte Carlo simulation is utilised to get the distribution of the effective pore throat radii. The cumulative distribution from this study has been compared with the distribution by Yang and Aplin (1998). The distribution by the statistical model enables to narrow down the range of effective pore throat radii to 37nm~1700nm, and help to make a better prediction on the pore throat radii. The correlation between the controlling factors of faulting, burial depth, caprock thickness and the pore throat radii have been examined. Good correlation between the depth less than 3000m and the effective pore throat radii indicates clay diagenesis should be the major factor for shallowly buried caprocks. Faulting and caprock thickness present no significant correlation with the effective pore throat radii. Crystal Geyser is used as an ideal natural analogue to study the Mancos Shale alteration. The interacted fluid that deposited travertine is important for the study. Hence, carbonate veins and reduction zones that associated with the activity of the main fault are used as records of the geochemistry of the paleo-fluid, the features of which are compared to the present spring water. The result shows the paleo-fluid was much more saline than the present fluid, with greater flow-rate. The decreased flow-rate might be owing to the self-healing of the fault during the time. Mancos shales outcropped in the hanging wall of the Little Grand Wash fault were sampled to investigate on the alterations triggered by the CO2-charged fluid from the fault and fractures. The result shows the alteration radius of the Mancos has limited within the distance of 20m away from the fault. CO2-rich fluid could interact with deformed shale (both dissolution and precipitation might happen), but no evidence shows the intact Mancos has been altered. The calcite cements in Mancos derived from CO2 sequestration could reach up to 27% (%weight of the whole rock) at 15m away from the fault. The conclusion facilitates the carbon storage siting criteria by Chadwick et al., (2009), who proposed the cautionary thickness of the caprock to be 20m.