1.Changes in Salivary Immunoglobulin A (IgA) following Match-play and Training among English Premiership Footballers
Salim Fredericks ; Lynn Fitzgerald ; Graham Shaw ; David W Holt
The Medical Journal of Malaysia 2012;67(2):155-158
Decreased salivary immunoglobulin A (sIgA), a component of
mucosal immunity, is associated with intensive physical
activity: suggesting that sIgA may be used for the
monitoring of mucosal immunity with footballers. We
investigated changes in sIgA in elite footballers, in response
to training and match-play. There was a decrease in sIgA
following training, with a return to pre-training levels after
18 hours of rest. This return to resting levels was not
observed following competitive match-play. Overnight rest
was sufficient for mucosal IgA recovery following training
but not following two successive matches, suggesting that
sIgA may be used to monitor training in multi-sprint sports.
2.Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice
Douglas LOBB ; Masoud MIRIMOGHADDAM ; Don MACALISTER ; David CHRISP ; Graham SHAW ; Hollis LAI
Journal of Dental Anesthesia and Pain Medicine 2023;23(1):19-28
Background:
Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings.
Methods:
A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness.
Results:
Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased.
Conclusion
According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.