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Administration order of midazolam/fentanyl for moderate dental sedation
Lobb, Douglas,Clarke, Alix,Lai, Hollis The Korean Dental Society of Anesthsiology 2018 Journal of Dental Anesthesia and Pain Medicine Vol.18 No.1
Background: The purpose of this study is to investigate the effects of administration order when a sedative drug (midazolam) and an opioid analgesic drug (fentanyl) is applied for moderate intravenous (IV) sedation in dentistry. Methods: A retrospective chart review was conducted in one dental clinic during its transition from a midazolam-first to a fentanyl-first protocol for dental procedures requiring moderate IV sedation. Physiological parameters, drug administration times, patient recovery times, drug dosages, and patient recall and satisfaction were investigated for differences. Results: A total of 76 charts (40 midazolam-first and 36 fentanyl-first administrations), were used in the analysis. Administering midazolam first resulted in an average 4.38 min (52%) decrease in administration times (P < 0.001), and a decrease in procedural recollection immediately following the procedure (P = 0.03), and 24 to 48 hours later (P = 0.009). Administering fentanyl first required an average of 2.43 mg (29%) less midazolam (P < 0.001). No significant differences were found for change in vital signs, minimum oxygen saturation levels, recovery times, and patient satisfaction (P > 0.05). Oxygen saturation levels did not drop below 90% for either group; however, 5 cases in the fentanyl-first group fell to between 90% and 92%, compared with 0 cases in the midazolam-first group. Conclusions: The administration order of fentanyl and midazolam may have different effects on patients and the sedation procedure. Findings from this study should be used to facilitate discussion among dental practitioners and to guide additional research investigating this topic.
Shawn W. Gibson,Alix J. Conway,Zhifu Zheng,Tina M. Uchacz,Janet L. Taylor,Christopher D.Todd 한국식물학회 2012 Journal of Plant Biology Vol.55 No.5
In the plant cytoplasm signals from multiple sources interact to control development. Lateral root proliferation is controlled by the antagonistic action of the hormones auxin and abscisic acid (ABA). Auxin stimulates the separation of pericycle initials and cell expansion. ABA is required for lateral root initiation and elongation and acts as an antagonist through auxin-dependent pathways. These hormones also mediate reactive oxygen species (ROS)accumulation in growing roots and promote cell expansion. We describe the isolation and characterization of a copperand auxin-induced gene, COPPER INDUCED in LEAVES (CIL1), from Brassica carinata. Transgenic B. carinata seedlings expressing antisense CIL1 were used to determine the biological function of this gene. Lines with reduced CIL1expression showed a decrease in lateral root development, as well as reduced sensitivity to auxin and ABA. Steady-state analysis of redox components showed a decrease in NADPH oxidase, superoxide dismutase, and catalase activity,accompanied by an increase in hydrogen peroxide concentration. GFP-tagged CIL1 accumulated at the plasma membrane and in the apoplast indicating CIL1 is likely extracellular. From these data we propose that CIL1 is an extracellular protein involved in ROS cycling mediating auxin and ABA signals.
The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis
June Sang Chun,Alix Har,Hyun-Pil Lim,Hoi-Jeong Lim 대한치과보철학회 2016 The Journal of Advanced Prosthodontics Vol.8 No.1
PURPOSE This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. MATERIALS AND METHODS The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. RESULTS When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at 10th year after the treatment, and more cost-effective regardless of the WTP from 20th year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the 10th year after the prosthodontic treatment, more than 35,000 won at the 20th year after prosthodontic treatment. CONCLUSION The CFDP was more cost-effective unless the WTP was more than 75,000 won at the 10th year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.
The analysis of cost-effectiveness of implant and conventional fixed dental prosthesis
Chun, June Sang,Har, Alix,Lim, Hyun-Pil,Lim, Hoi-Jeong The Korean Academy of Prosthodonitics 2016 The Journal of Advanced Prosthodontics Vol.8 No.1
PURPOSE. This study conducted an analysis of cost-effectiveness of the implant and conventional fixed dental prosthesis (CFDP) from a single treatment perspective. MATERIALS AND METHODS. The Markov model for cost-effectiveness analysis of the implant and CFDP was carried out over maximum 50 years. The probabilistic sensitivity analysis was performed by the 10,000 Monte-Carlo simulations, and cost-effectiveness acceptability curves (CEAC) were also presented. The results from meta-analysis studies were used to determine the survival rates and complication rates of the implant and CFDP. Data regarding the cost of each treatment method were collected from University Dental Hospital and Statistics Korea for 2013. Using the results of the patient satisfaction survey study, quality-adjusted prosthesis year (QAPY) of the implant and CFDP strategy was evaluated with annual discount rate. RESULTS. When only the direct cost was considered, implants were more cost-effective when the willingness to pay (WTP) was more than 10,000 won at $10^{th}$ year after the treatment, and more cost-effective regardless of the WTP from $20^{th}$ year after the prosthodontic treatment. When the indirect cost was added to the direct cost, implants were more cost-effective only when the WTP was more than 75,000 won at the $10^{th}$ year after the prosthodontic treatment, more than 35,000 won at the $20^{th}$ year after prosthodontic treatment. CONCLUSION. The CFDP was more cost-effective unless the WTP was more than 75,000 won at the $10^{th}$ year after prosthodontic treatment. But the cost-effectivenss tendency changed from CFDP to implant as time passed.