RESUMO
BACKGROUND: Hyaline membrane disease (HMD) has remained a common neonatal problem and is a cause of morbidity in infants. The shake test can be used to assess whether surfactant is present in the infant's lungs at birth. OBJECTIVE: The goal of this study was to determine the usefulness and accuracy of gastric aspirate shake test for the diagnosis of two HMD. MATERIALS AND METHODS: This was a diagnostic accuracy study carried out on 49 preterm infant born at Shahid Sadoughi hospital in 2012 (25 newborns without pulmonary diseases and 24 newborns with HMD). Shortly after birth, the shake test was performed using gastric fluid. The results of the shake test were correlated with definitive diagnosis of HMD. RESULTS: All infants who developed HMD had negative test results. In 23 of 25 infants with no respiratory distress, the test was positive. Our findings indicated that the gastric aspirate shake test has 100% sensitivity, 92% specificity, a 92.3% predictive value for surfactant deficiency, and 100% predictive value for surfactant sufficiency. CONCLUSION: According to this study gastric shake test (GST) is a reliable test and is a simple procedure to identify those neonates who will develop respiratory distress syndrome (RDS) and therefore to decide prophylactic exogenous surfactant replacement.
RESUMO
General concept and major emphasis on off-pump coronary artery bypass surgery (OPCAB) is maintaining quality of care and patient safety while reducing cost and resource utilization. OPCAB probably avoids the potential complications of cardiopulmonary bypass. However its acceptance depends on clinical and economic outcome. The aim of this study is to compare clinical and economic outcome of off-pump and on pump coronary artery bypass surgery. This is a report of an analytic cross-sectional study on 304 patients underwent coronary artery bypass surgery that were randomized into conventional on pump and off-pump groups. Variables and costs were obtained for each group and these data were analyzed using parametric methods. There was no difference between the two groups with respect to perioperative and intraoperative patient's variables. OPCAB reduced the need for postoperative transfusion requirement (P<0.05) which was statistically significant and showed a trend towards reduction of morbidity although didn't reach statistical significance (P>0.05). There were no statistically significant differences in surgical re exploration and length of stay between the two groups. The mean cost for an on pump surgery was 8312000 ± 2859 Rials per patient that was significantly higher than an off-pump surgery. Based on the findings of this study, clinical outcome has no statistically significant difference between on pump and off-pump CABG but the costs are significantly higher in the on pump group.
