Dexmedetomidine vs. propofol sedation reduces the duration of mechanical ventilation after cardiac surgery - a randomized controlled trial.

OBJECTIVE: The aim of our study was to compare the clinical effects of sedation with dexmedetomidine vs. propofol in patients undergoing cardiac surgery and analyze their effects on the duration of mechanical ventilation (MV), length of stay in the intensive care unit (ICU), and total hospital stay. PATIENTS AND METHODS: The study included 120 patients who were randomized in a 1:1 ratio into two groups of 60 patients. The first group was sedated with continuous dexmedetomidine in doses 0.2-0.7 mcg/kg/h. The second group was sedated with propofol in doses 1-2 mg/kg/h. RESULTS: Patients sedated with dexmedetomidine required 2.2 hours less time on MV (p<0.001). There was a positive correlation between the duration of MV and the ICU length of stay (r=0.368; p<0.001), as well as between the duration of MV and the total hospital stay (r=0.204; p=0.025). Delirium occurred in the postoperative period in 25% of patients sedated with propofol, while in the dexmedetomidine group it was only 11.7% (p=0.059). Patients who developed delirium had a significantly longer duration of MV (12.6±5.4 vs. 9.3±2.5 hours, p=0.010). CONCLUSIONS: Postoperative sedation with dexmedetomidine, compared to propofol, reduces the duration of MV, but does not influence the length of stay in the ICU and length of hospitalization after open heart surgery.

Analysis of gender differences on pyriform aperture of human skulls using geometric morphometric method.

BACKGROUND: Piriform aperture is anterior opening of the nasal cavity formed by bones of the viscerocranium and knowledge about differences between genders is important for forensic scientists, anthropologists, orthopaedists, neurosurgeons and vascular surgeons. The aim of this study was to examine gender differences of piriform aperture on three-dimensional (3D) models of human skulls originating from Bosnian population using the geometric morphometric method. MATERIALS AND METHODS: The study was conducted on 211 3D models of human skulls of known gender. 3D models were obtained by laser scanning. We analysed the gender differences of piriform aperture using geometric morphometrics method. On 3D models we marked four landmarks on piriform aperture in the Landmark Editor programme, after which we analysed its gender differences in MorphoJ programme. RESULTS: The first principal component analysis axis described 40.398% of total variability of piriform aperture. The greatest gender variability was present in the position of the landmark rhinion. Discriminant functional analysis of the shape and size of the piriform aperture allowed the gender determination with 64.03% accuracy for male and 70.83% accuracy for female gender. The size of the piriform aperture showed a statistically significant difference between genders. Discriminant functional analysis of the shape of the piriform aperture without affecting size enabled gender determination with 59.71% accuracy for male and 62.5% accuracy for female. CONCLUSIONS: Analysis showed statistically significant differences in the shape and size of piriform aperture between genders. The accuracy for gender determination based on piriform aperture was higher in females.