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Necrotizing pancreatitis is a severe form of acute pancreatitis characterized by necrosis in and around the pancreas.
Although acute pancreatitis should not be treated at home initially, there are steps that can help prevent or reduce symptoms.
Surgical treatment of pancreatitis may be used to remove gallstones and the gallbladder or abnormalities in the pancreas. About 90%-95% of patients treated for acute pancreatitis may completely recover if the underlying cause such as alcohol or infection is appropriately treated. Alcohol problems vary in severity from mild to life threatening and affect the individual, the person's family, and society in numerous adverse ways. The pancreas is an elongated organ located toward the back of the abdomen behind the stomach. Read What Your Physician is Reading on Medscape Pancreatitis, Acute »The pancreas is a gland located in the upper, posterior abdomen and is responsible for insulin production (endocrine pancreas) and the manufacture and secretion of digestive enzymes (exocrine pancreas) leading to carbohydrate, fat, and protein metabolism.
MRSA infection is the abbreviated form of Methyicillin Resistant Staphylococcus Aureus infection.
Another category of MRSA infection occurs in healthy people also and it usually starts on those who have a skin puncture or boil. People infected with staph infection will have red bumps or lesions that looks like boils or insect bites. Actually antibiotics are taken for every disease and hence many of the viral infections do not respond to these medicines. People who are wounded, who are hospitalized and those who are in medical tubing or Intravenous drip are more prone to MRSA than others. Doctors will study the intensity of infection and drain the pus making incision for removing the abscess.
People who are hospitalized should be alert and follow hygienic procedures like washing hands, keeping the wounds covered and should not share personal items like soaps and towels.
A rash is the abnormal change in the skin and this change affects the texture, color and appearance of the skin. Itching is an unpleasant feeling in the human body that causes the reflex or desire to scratch.  Research has proved that itching has a number of similarities to pain but their behavioral response patterns are different. Rashes can be of two types, they could either induce an itching sensation or they might be non itchy rashes. Infants often suffer from itchy rash due to infection, dry skin or as a result of overactive glands in the infant.  Itchy rashes in infants can be petechial rash which are serious and require immediate medical attention or they can be erythematous rash which are usually not as serious as the petechial rashes.
Certain childhood diseases cause red itchy spots in children and this condition is known as Exanthem.
Itchy rashes are a common cause of worry during the last five weeks of pregnancy when the stretching of the skin is the greatest; however this condition clears with delivery.
Many a times itchy rashes also appears s itchy red bumps and this could be due to various causes such as insect bites, acne, razor bumps, presence of a foreign object in the skin, side effects of various drugs, infection, immune deficiency or as a reaction to external stimuli. Itchy nevuses is another type of itchy rash that is a chronic condition where in the delimited rash appears on the mole or macule of the affected individual. Itchy rashes also appear as itchy scaling patches in case of fungal infections and genetic disorder.
In severe cases itchy rashes are characterized by itchy red patches that have blisters, crusts or are scaling.  Some of these conditions are severe sunburn, photosensitivity, sever cellulitis, shingles, cold sore, eczema, impetigo, paronychia, scabies, paget disease, pompholys and more.
Other than the above mentioned conditions, itchy rashes could also be an indicator of other internal diseases. Science, Technology and Medicine open access publisher.Publish, read and share novel research.
Cybertherapy in Medicine – Experience at the Universidad Panamericana, IMSS and ISSSTE MexicoJose Luis Mosso1, Brenda Wiederhold2, Mark Wiederhold2, Gregorio T Obrador1, Veronica Lara4 and Amador Santander5[1] School of Medicine, Universidad Panamericana, Mexico[2] Virtual Reality Medical Center President, Interactive Media Institute, Mexico[3] Regional Hospital No.
The Brown Recluse spider is known as the most deadly spider in North America, and due to global warming its population is spreading to a town near you.
Ms Perez was waiting at Amarillo airport with her boyfriend Eric and his mother on September 20 and suddenly, while inside, Perez felt something stinging the back of her neck. She had to wear a helmet after she was discharged, and a protective headband for three weeks after that. My gastroenterologist put me on Dexilant (or Kapidex) after I started having a€?break througha€? reflux with my once daily dose of 20 mg Prilosec (or Omeprazole). If I took Vyvanse, Asacol, Prednisone, and Dexilant at the same time would I have any problems?
Well, obviously, you should have discussed this with the second doctor before you stated taking the fourth drug.
Now, since you didn't, you should go back and discuss it with her, and also go back and discuss it with the first doctor. Drugs aren't like clothes, you can' just mix and match them, and blow off the combos you don't like. Dexlansoprazole is used to treat certain conditions in which there is too much acid in the stomach. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do.
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Appropriate studies have not been performed on the relationship of age to the effects of dexlansoprazole in the pediatric population.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of dexlansoprazole in the elderly.
My doctor prescribed the proton pump blocker Dexilant (60mg) to see if I have acid reflux, but now I'm starting to get heartburn. I just started taking Dexilant for Acid Reflex that caused abdomen pain and I don't know if its related or not but I am now having pressure and chest pain and my abdomen pain is still pretty bad.. Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of stomach acid to the esophagus.[1] A typical symptom is heartburn. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach.
A different type of acid reflux which produces respiratory and laryngeal manifestations is laryngopharyngeal reflux (LPR), also called extraesophageal reflux disease (EERD). Antacids based on calcium carbonate (but not aluminum hydroxide) were found to actually increase the acidity of the stomach.
Foods high in fats and smoking reduce lower esophageal sphincter competence, so avoiding these may help. Milk and milk-based products containing calcium[citation needed] and fat, within 2 hours of bedtime. A meta-analysis suggested that elevating the head of the bed is an effective therapy, although this conclusion was only supported by nonrandomized studies.[20] The head of the bed can be elevated by plastic or wooden bed risers that support bed posts or legs, a therapeutic bed wedge pillow, a wedge or an inflatable mattress lifter that fits in between mattress and box spring or a hospital bed with an elevate feature.
A number of drugs are approved to treat GERD, and are among the most-often-prescribed forms of medication in most Western countries.
Proton pump inhibitors (such as omeprazole, esomeprazole, pantoprazole, lansoprazole, and rabeprazole) are the most effective in reducing gastric acid secretion.
Gastric H2 receptor blockers (such as ranitidine, famotidine and cimetidine) can reduce gastric secretion of acid. Antacids before meals or symptomatically after symptoms begin can reduce gastric acidity (increase pH). In more severe cases, an open wound is the result of the lining of the stomach, the tissue underneath and sometimes the muscle being eroded. The stomach is lined with a mucous that protects it from the acid but some do not have the protective mucous lining, or the acid is too strong and burns through it.
The following information does not constitute a prescription or recommended dose— studies have been conducted using the dosages stated and are included for your information only.
BANANA POWDER Ayurvedic doctors have used dried banana powder for years in the treatment of ulcers, as studies have shown it protects the lining of the stomach in animals, leading us to believe that it could be of benefit to humans12.
VITAMIN A helps heal mucosal tissue; the tissue that lines the stomach and the intestines and when used in very high dosages it was found to be very effective in the treatment of stomach ulcers14. ZINC (combined with acexamic acid was found to be of great benefit to those with peptic ulcers. Take 1 to 2 chewable tablets 15 minutes before meals and 1 to 2 hours before bedtime take another 1 to 2.
The herbs mentioned here have historically been considered beneficial in the treatment of various conditions including peptic ulcer.
Both MARSHMALLOW root and SLIPPERY ELM herbs soothe irritated mucous membranes, so too does CHAMOMILE tea.
Some patients may require oral pancreatic enzymes in pill form to help digest food and others may require insulin. This infection is caused by bacteria and strangely it occurs only in people who are in health care centers and hospitals. Similarly, people who live in unhygienic environment and those who have sex with same gender have risk of getting this infection. While conditions such as goose bumps, roseola, skin tags and warts are non itchy, conditions such as bumpy hives, folliculitis and acne are itchy in nature. Petechial itchy rashes may be caused by meningococcal infection, enterovirus infection, or due to tight clothing or even due to forceful coughing or vomiting. Exanthem is often coupled with headaches, high fever and malaise and is caused by bacteria or virus infection or as reaction to the toxin of these viruses or bacteria or as an immune reaction.


Irritation caused due to alkaline saliva is one of the most common causes for itchy rashes around the mouth.
During the last three months of pregnancy, pregnant women will notice itchy bumpy reddish rashes on the stretch marks on the abdomen and this condition is known as Polymorphic eruption or Polymorphous Eruption of Pregnancy.
These itchy red bumps may or may not be painful depending on the conditions and each condition has to be treated separately depending on the cause of the itchy rashes.
Some of these conditions are Nodular prurigo where in a number of itchy red nodules that has a warty surface appears on the limbs, Erythema nodosum which affects the lower legs, forearms or thighs and is characterized by raised red patches on the skin caused due to Tuberculosis or as a side effect to certain drugs.
Some of these conditions are mild sunburn, hives, Angioedema, Scombroid fish poisoning, Pityriasis rosea, Amyloidosis, Granuloma annulare and Dermatomyositis. Fungal infections are associated with scaly areas and they can infect the feet, groin, body or scalp and are mostly caused due to ringworm infection. At times contact with certain plants such as chrysanthemum or even nettle can sure itchy rashes with blisters.
In the case of skin cancers which could be squamous or basal cell carcinoma and melanoma tend to appear as ulcers on the skin. These conditions are mostly caused due to fungal infections, sexually transmitted diseases, clogging of sweat glands, cyst, lice and more.
This condition is called as Onychomycosis which causes the ends of the nail to turn white or yellow and causes the nail to become fragile. Some of the diseases that have itchy rashes as one of their symptoms are liver diseases, Chron’s disease, kidney disease, Celicac disease, Chemochromatosis, Schistosomiasis, Lymphomatoid granulomatosis, drug induced jaundice and more.
25 of the Instituto Mexicano del Seguro Social, IMSS, MexicoClinica Alberto Pisanty Ovadia ISSSTE, Mexico[4] Centro Medico Nacional 20 de Noviembre ISSSTE, Hospital de Ginecologia y Obstetricia Luis Castelazo Ayala No.
But nothing can demonstrate the danger of the notorious Loxosceles reclusa than the story of Texas Christian University student Nikki Perez, who was bitten by one such spider in September 2011 - with horrendous results.a€?I thought Ia€™d caught myself with my fingernail or something,a€™ recalls Ms Perez, 21, a fashion-merchandising student from Texas. On the drive towards the local clinic, Ms Pereza€™s neck had started to burn, an early warning sign of the terrible symptoms to follow.
I was lucky that there was a spider bite expert on duty, and he took one look at the spider and said, a€?Thata€™s an immature female Brown Recluse spidera€?,a€™ recalls Perez.Agonisingly, the doctor told Perez and her family there was nothing he could do, other than wait patiently to see if necrosis set in, which could take up to two weeks later.
I know Asacol, Prednisone, and Dexilant are fine together but I was prescribed Vyvanse by a different doctor and need to know if I can start taking it again.
It is used to treat erosive esophagitis or "heartburn" caused by gastroesophageal reflux disease (GERD), a condition where the acid in the stomach washes back up into the esophagus.
Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals.
Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
To prevent erosive esophagitis from coming back, your doctor may want you to take 30 mg once a day for up to 6 months.
I went to the doctor two weeks ago and got a prescription for Dexilant (formerly Kapidex) and he said this would help within one or two weeks but it hasnt helped by voice at all. This can be due to incompetence of the lower esophageal sphincter, transient lower esophageal sphincter relaxation, impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. Unlike GERD, LPR is unlikely to produce heartburn, and is thus sometimes called silent reflux. Having smaller, more frequent meals reduces GERD risk, as it means there is less food in the stomach at any one time. The height of the elevation is critical and must be at least 6 to 8 inches (15 to 20 cm) to be at least minimally effective to prevent the backflow of gastric fluids. Cisapride, a member of this class, was withdrawn from the market for causing long QT syndrome. Foods high in vitamin K like white rice, cottage cheese, goat’s milk, and any dark, green leafy vegetables should also be included in your diet. Therefore, these, and previously mentioned herbs are often recommended by Health-Care practitioners. Inflammation of the pancreas is termed pancreatitis and its inflammation has various causes. When there is any cut or injury on the skin, they invade the skin and penetrate inside the bloodstream. Some of the diseases that cause red itchy spots are chicken pox, which causes rashes over the face and the trunk, Measles, which casus itchy rashes on the trunk, face, limbs and mouth accompanied with cough. Scalp ringworm infection is also responsible for itchy rashes coupled with scaly skin and hair loss. This condition is also known as PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy) and is often noticed during the first pregnancy as the abdomen is the tightest at this stage.
Some of these itchy red bumps are even gender specific such as Perioral dermatitis, which causes scaly rashes around the eyes and mouth in women and Grover’s disease which almost always appears only in men who are unwell and over 50 and is characterized by the pimple like red bumps appearing on the back and chest. Psoriasis causes itchy rashes due to genetic disorder and it affects the knees, elbows, genital area, scalp and other parts of the body.
Gravitational eczema often appears on the lower legs of a person suffering from thrombosis or venous diseases.
While dandruff and scalp ringworm are the main culprits for itchy rashes on the scalp, ringworm infection of the beard and fungal infection of the groin and inner thighs causes itchy rashes on beard and groin. In such cases, itchy rashes often disappear, when the treatment for the internal diseases are successful.
Comparative measure of mean pain before, during and after each procedure in 3 representative groups. Interfaces and VR scenarios used in each group as well as the total patients participants in the groups studied and controls. I saw my family doctor today and she wanted me to stop taking the Dexilant because there's a 4 % chance stomach pain can occur with it. Some innerspring mattresses do not work well when inclined and may cause back pain; some prefer foam mattresses. Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine. Once the gland becomes inflamed, the condition can progress to swelling of the gland and surrounding blood vessels, bleeding, infection, and damage to the gland. The other part of the pancreas, the endocrine pancreas, secretes hormones called insulin and glucagon. The bacteria is potentially dangerous since they can penetrate deep into the skin infecting bones, joints and bloodstream.
For example, a person suffering from severe psoriasis will suffer from itchy rash condition where as an individual suffering from mild psoriasis may not feel the urge to itch. Erythematous itchy rashes could be caused due to eczema, viral skin rash, diaper rash, thrush, measles and  heat rash. Some of the other diseases that cause this red itchy spots condition are Fifth disease, hand foot and mouth disease, Hepatitis B, Roseola infantum, scarlet fever and more. While most of these conditions are associated with certain infections, allergic reaction or other internal diseases, the casues of some of these conditions remains unknown. Fox-Fordyce disease is another disease that causes itchy rashes in the armpits or groins due to the clogging of sweat glands in young women between the age of 13 to 35 years. IntroductionThere are many reports of Virtual Reality analysis and clinical applications in Medicine since the end of the last century for many authors.
I yelled for Eric to help me, and when he saw the spider crawling over my face, he swatted it to the floor, and stamped on it.a€™But when Erica€™s mother, a nurse, inspected Ms Pereza€™s neck, she knew something was seriously wrong.
At one stage her eye closed as the entire right side of her head swelled up to nearly twice ita€™s normal size.
Later, Perez needed a skin graft to repair the part of her ear that had rotted away with necrosis.
Is there some other prescription that helps laryngitis or something i can do on my own that will help my voice be less hoarse and louder? Some practitioners use higher degrees of incline than provided by the commonly suggested 6 to 8 inches (15 to 20 cm) and claim greater success. In trauma head injuries [1], during chemotherapy in children [2], in burn wound care [3,4,5], lumbar puncture [6,], breast cancer [7], vein puncture [8], pain distraction [9,10,11,12], dental pain control [13], leg ulcer relief [14], night vision technology with robot control to treat bourn injuries using robot-like arm mounted VR goggles [15]. Amid the health scare, Ms Perez braved through the pain and only missed a week of school.Experts fear that spider bites like these could be on the rise, as the Brown Recluse spider continues its population spread. I am doing better on this medication but however was woke up during my sleep again with the acid reflux - so again I really want to take it first thing after a bad night. The first case reports related with VR and medical invasive procedures and surgery in hospitals was in 2004 with our group, beginning with upper gastrointestinal endoscopies and so on, until introduce VR in postoperative care unit of cardiac surgery [16,17]. Kansas University researcher Erin Saupe predicts a possible migration of the Brown Recluse by 2020, predicting that the spiders could move further north toward portions of Wisconsin, Michigan, Pennsylvania and even New York.
Either type can have serious complications.Acute pancreatitis usually begins soon after the damage to the pancreas begins. Patients in; in-rooms, operating rooms and another different places, get treatments with medical and surgical procedures, and pain and anxiety are the meanly symptom. In this project we try to demonstrate that virtual reality is a complementary tool to reduce pain and anxiety in hospitals during medical procedures including surgical procedures.
An attack lasts for a short time and usually resolves completely as the pancreas returns to its normal state. Some people have only one attack, whereas other people have more than one attack, but the pancreas always returns to its normal state unless necrotizing pancreatitis develops and becomes life-threatening.Chronic pancreatitis begins as acute pancreatitis. Neonatology (0-28 days old), there are newborns staying in unit cares since few days, weeks even months, growing without contact with the external world.


If the pancreas becomes scarred during the attack of acute pancreatitis, it cannot return to its normal state. The psychological impact in growth and development in childhood is so hard, where neuro stimulation in a closed environment is a good alternative.
In Infants (lower and higher infants) VR have been a good resource to reduce pain and anxiety in oncology.
Hunter Hoffman has demonstrated in the benefits of VR during medical rehabilitation in burned childhood. Pancreatitis occurs in men and women, although chronic pancreatitis is more common in men than in women. In postoperative cardiac surgery unit care, patients stay 3 days in different critical care units depending of their progress. In these units they stay under the influence of sedative drugs receiving treatments by vein catheters, gastric tube, etc.
Their recovery is on beds with different degrees of limited position and the breathing relief is on bed also. In ambulatory surgery (General surgery, endoscopic surgery, urology, dermatology, Orthopedic, angiology, pediatric surgery, obstetrics), patients are awake, minutes, even hours awake during surgical procedures doing nothing in a same position on a surgical table. Special group of ambulatory surgery, surgeon used night vision technology while patients navigate in VR environment. At the school of medicine from Universidad Panamericana we used night vision on animal models before the application on humans.
Women during colposcopy are awake while gynecologist applies local anesthesia into the cervix to perform cervical conization with diathermal loop. Under local anesthesia, neurovegative response is present during and after each upper gastrointestinal exploration of esophagus, stomach and duodenum.
Pregnant patients without complications expected hours to complete cervical dilation in labor room to go into delivery room or operating room. This is a relative fast procedure compared with the previous groups where patient in the fetal position they expect catheter installation in their back, place where they can?t see anything and anxiety is present despite local infiltration.
Patients were afiliate at Instituto Mexicano del Seguro Social (IMSS) and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, (ISSSTE). Before each procedure, nurse measured blood pressure, heart rate, breath rate (In the case of patients in unit cares, we considered arterial blood gases). Physician asks patients about his-her feelings (Anxiety) in a scale of 0 to 10 (where 0 is no pain and 10 is high pain).
Physician installed the following equipment also: Laptop with 3 virtual scenarios (Enchanted forest, cliff final, icy city see figure 2) and connected to a vision goggles eMagin. When we used smart phones (Nokia N95 and iPhone G3) and PSP2 we used a mp3 video with a green valley scenario connected to goggles.
Physician begins the procedure and in the middle of the procedure, nurse measured vital signs again and physician repeats the same question about the feelings (Anxiety and pain).
Head Mounted display is removed of the head?s patient at the end of each procedure and 15 minutes after, nurse made the third measure of vital signs and physician asks the feelings of the patient again.
In the case of Night Vision Goggles (NV) for ambulatory surgery for total darkness was necessary to perform open surgery on rabbits at the school of Medicine at the Universidad Panamericana in 9 rabbits under general anesthesia before to make ambulatory surgeries on humans. NV equipment needs a scrub nurse to hold all equipment on the head of surgeon and first assistant after dressing with sterile clothing.
Diagnosis of surgery group: big lipomas on head, arms, legs or abdomen, non complicated inguinal and umbilical hernias. With night vision technology group: big lipomas on arms, legs and non complicated inguinal hernia.
Diagnosis for postoperative care unit of cardiac surgery: aortic and mitral valves rechange and coronary revascularization. Neonatology group: premature newborns in recovery with more than 5 days to 2 months of hospitalizations with multiple diagnosis such as necrotizing enterocolitis, sepsis, respiratory disorders.
In obstetrics, patients with 48 weeks of pregnant with 5 to 10 of cervical dilation participate with normal fetus in labor room where epidural or spinal block were installed and we follow the same patients to the delivery room and to the operating rooms. In the group of endoscopy, diagnosis was hiatal hernia, peptic disease and colon disorder.3. ResultsThe comparative measure of pain were made before, during and after each procedure in all groups using Virtual Reality and the control group, except in patients without any medical procedure such as the group of care unit of cardiac surgery and neonatology. The statistical method to measure pain used was the mean into the scale of 0 to 10 (Cero is no pain and 10 is high level of pain). We present statistical results in the 3 representative groups where pain and anxiety are high such as colposcopy (see table 3), ambulatory surgery (see table 4) and postoperative care unit of cardiac surgery (See table 5). With the results of these groups we can appreciate the possibilities to use this technique in another groups into the hospitals because we have been tested VR in a group seriously ills in critical care units in cardiac surgery and manipulations of tissues including abdominal cavity in ambulatory surgery group. In table 1 we measured mean pain (see figure 1) between before to during the procedure and between before to after (see table 1). In all groups we demonstrated an important reduction of pain using VR during medical or surgical procedures (see table 2). With these results we can appreciate the impact of distraction of VR to reduce anxiety and subsequently visceral and somatic pain in the case of surgery with regional anesthesia well placed. Group with VR (left) and control group (right)Table 5.Postoperative Care Unit of cardiac surgeryMedical complications. 2 patients of 22 in care unit of cardiac surgery group presented cardiac arrhythmias during the virtual navigation due to the slow effort on the bed, the treatment was the immediately disruption of VR exposure with total recovery. In ambulatory surgery group with local anesthesia, 2 patients presented nausea and vertigoes using VR and after 30 minutes patients become tired to carry goggles on their heads in the same position, for this reason we used a projector to display a screen in the roof of the operating room.
In the subgroup of endoscopic surgery under regional anesthesia, 3 patients of 5, presented chest pain secondary of neumoperitoneum and it was necessary convert regional anesthesia to general (For this reason we don?t suggest VR for endoscopic surgery under regional anesthesia). In ambulatory surgery, patients need to move their hands to get more distraction; but they hands tied to the table to avoid contamination and in the other hand they become tired with the goggles on their heads and after 45 minutes they prefer change the projection of the scenario to the roof of the operating room. With NV we found limitation for surgeon’s motions for the cables connected to the wall beside the table one meter away. It was difficult to evaluate the benefits of this technology, this is the reason we don?t present statistical results. We suggest using another kind of device of VR to interact with these patients who have limited vision. ConclusionsWe found differences results according with age, gender, procedures, culture, origin of regions, diagnosis, prognosis, but in all groups we found reduction of pain and anxiety, one more than others, except the subgroup of endoscopic surgery, the only one we don?t suggest use VR.. The group that enjoyed better the virtual scenarios was patients between 5 to 14 years of age in pediatric group. There where patients exposed with Virtual Reality in different conditions like age, sex, medical procedures and different physicians but all results show us reduction of anxiety and pain.
The answers were different in each group because pathways of pain involved are two, somatic and visceral. Tissues and organs manipulated were different, for instance: Skin, fat, muscles, fascias, peritoneum, cervix, uterus, peritoneum, spine?s dura, ligaments, small and medium vessels, gallbladder, omentum, visceral peritoneum, parietal peritoneum, esophagus, stomach and colon?s mucous. All patients required medications for local and regional anesthesia such as analgesics, sedatives, in different dosages.
The high level of pain we saw in all groups of patients was those who underwent endoscopic surgery.In the beginning of our experience, we used a Spider HMD game to distract patients under upper GI endoscopy in 2004.
Thanks of these results we improved the devices introducing Virtual reality scenarios and a HMD developed by Brenda and Mark Wiederhold from the Virtual Reality Medical center from San Diego CA. There were big and small groups because the results from critical care unit of cardiac surgery and ambulatory surgery allow us to conclude the usefulness of virtual reality to reduce pain and anxiety in inpatients without minimal complications and permit us to limit virtual applications in all areas of Medicine.
If patients in critical care unit presented no more than 2 complications and in surgery we consider absolutely contraindicated in endoscopic surgery is obvious to use virtual reality without major risk in the rest of areas of medicine if we follow the absolute indications.
Virtual reality is a not invasive method, easy to use, easy to install and easy to carry and each day new generations of technology are lighter, smaller such as smartphones, PSP 2, iPADs that permit more interaction with users using friendly feedbacks such as tracking (Kinect), 3D images permit more immersion with Interactive screens that could be considered in future works because U screens, virtual cubes and cave could be an option for patients because these screens have demonstrated the utility in rehabilitation for the big space for body motions and for the stereoscopic immersion. The best advantage for the healthcare institutions we found in the group for ambulatory surgery was to reduce the half of dosage of medication of fentanyl, and midazolam, and in many cases we avoid totally these medications in the intraoperative. This advantage represent an important saving for institutions always considering and appropriate selection of patients with absence of cardiovascular and respiratory disease that could permit physician works without concerns during procedures. With these results we can give the following advantages as: reduction of medication (Analgesic and in several cases, drugs to reduce anxiety as fentanyl and mydazolam), bed days and specially increase the wellbeing of patients. There were small groups of one or two patients that should increase the number of cases to get reliable results, however theirs results are a clear indicator of benefits of virtual reality. We didn’t consider more areas of medicine, but we involve representative as surgical and clinical areas and both sex, males and females and different ages, newborns and adults. Technology developments permit use small device such as mobile phones to connect to head mounted display instead of laptops; they facilitate the handling of the virtual scenarios. Display scenario on the wall is an option for navigations instead to use HMD which can be tiring for patients in prolonged time.
Virtual reality is useful in hospital and we consider that in the future, virtual rooms could be integrated inside services, operating rooms, and waiting rooms.



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