Overnight fasting is routine before elective surgery. This may not be the optimal way to prepare for surgical stress, however, because intravenous carbohydrate supplementation instead of fasting has ...recently been shown to reduce postoperative insulin resistance. In the current study, gastric emptying of a carbohydrate-rich drink was investigated before elective surgery and in a control situation.
Twelve patients scheduled for elective surgery were randomly given 400 mL of either a carbohydrate-rich drink (285 mOsm/kg, 12.0% carbohydrates, n = 6) or water 4 hours before being anesthetized. Gastric emptying was measured (gamma camera, 99Tcm). Each patient repeated the protocol postoperatively as a control. All values were presented as the mean +/- SEM by means of a nonparametric statistical evaluation.
Despite the increased anxiety experienced by patients before surgery (p < 0.005), gastric emptying did not differ between the experimental and control situations. Initially, water emptied more rapidly than carbohydrate. However, after 90 minutes, the stomach was emptied regardless of the solution administered (3.2 +/- 1.1% mean +/- SEM remaining in the stomach in the carbohydrate group versus 2.3 +/- 1.2% remaining in the stomach in the water group).
Preoperative anxiety does not prolong gastric emptying. The stomach had been emptied 90 minutes after ingestion of both the carbohydrate-rick drink and water, thereby indicating the possibility of allowing an intake of iso-osmolar carbohydrate-rich fluids before surgery.
Background
Basal cell carcinoma (BCC) is the most common cancer in the world and has a rising incidence. Current guidelines for low‐risk BCC including superficial BCC (sBCC) recommend several ...treatment options including destructive treatment methods, such as cryosurgery with or without prior curettage or curettage and electrodesiccation. Curettage only (i.e. without subsequent cryosurgery or electrodesiccation) is a simple and quick destructive treatment method used for many benign skin lesions but has not been sufficiently evaluated for the treatment of sBCCs.
Objectives
The objective was to compare the effectiveness of curettage vs. cryosurgery for sBCCs in terms of overall clinical clearance rates after 1 year as well as wound healing times.
Methods
A single‐centre non‐inferiority clinical trial was conducted. Non‐facial sBCCs with a diameter of 5–20 mm were randomised to either cryosurgery using one freeze–thaw cycle or curettage. At follow‐up visits, treatment areas were evaluated regarding the presence of residual tumour after 3–6 months and recurrence after 1 year. Further, wound healing times were assessed.
Results
In total, 228 sBCCs in 97 patients were included in the analysis. At 3–6 months, no residual tumours were seen in any of the treated areas. After 1 year, the clinical clearance rates for curettage and cryosurgery were 95.7% and 100%, respectively (P = 0.060). However, the non‐inferiority analysis was inconclusive. Wound healing times were shorter for curettage (4 weeks) compared to cryosurgery (5 weeks; P < 0.0001). Overall, patient satisfaction at 1 year was high.
Conclusions
Both treatment methods showed high clinical clearance rates after 1 year, whilst curettage reduced the wound healing time.
Full text
Available for:
BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Measurements of heights at ages 2, 4 and 7 years and of flushing, early shoot elongation and lammas growth at age 7 years were made in nurseries and in a short-term trial with seedlings from ...provenances and open pollinated families of Picea abies. Fifteen of the provenances and 45 of the families were planted in a long-term field trial. At age 29 years from seed, basic wood density and its components: earlywood and latewood density and latewood percentage from increment cores were measured by X-ray analysis. The trees of the northern provenances, which were the shortest ones, had the earliest growth start and the lowest proportion of trees with lammas growth, and had also the highest wood density and proportion of latewood. Moderate to strong negative relationships were found between the wood density traits and early height growth and growth rhythm traits, suggesting that the latter ones could be good predictors of provenance differences in wood density. For the families, much weaker and in most cases non-significant phenotypic correlations were found between the two groups of traits. The genetic correlation coefficients were in most cases negative and had low absolute values. The possible causes of the differences in relationship patterns between provenances and families are discussed.
PDF
