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Anaesthesia

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https://www.readbyqxmd.com/read/28819468/paediatric-fractures-in-a-sub-saharan-tertiary-care-center-a-cohort-analysis-of-demographic-characteristics-clinical-presentation-therapeutic-patterns-and-outcomes
#1
Marc Leroy Guifo, Joel Noutakdie Tochie, Blondel Nana Oumarou, Jean Roger Moulion Tapouh, Aristide Guy Bang, Aurelien Ndoumbe, Bonaventure Jemea, Maurice Aurelien Sosso
INTRODUCTION: Paediatric fractures are often of good prognosis due to auto-correction of insufficient fracture reduction by bone remodeling. In sub-Saharan Africa, traditional healers are renowned for managing fractures and there is a neglect for specialized pediatric fracture care. We aimed to determine the demographic characteristics, clinical presentation, treatment patterns and outcomes of paediatric fractures in a tertiary health care centre in Yaoundé. METHODS: We conducted a prospective cohort study of all consenting consecutive cases of fractures in patients younger than 16 years managed between January 2011 and June 2015 at the University Teaching Hospital, Cameroon...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28818873/modulation-of-the-membrane-dipole-potential-a-prospective-mechanism-to-differentiate-anaesthetic-non-anaesthetic-activity-and-a-tool-to-assess-susceptibility
#2
Benjamin Michael Davis, Jonathan Brenton, Sterenn Davis, Ehtesham Shamsher, Claudia Sisa, Ljuban Grgic, M Francesca Cordeiro
There is great individual variation in response to general anaesthetics leading to difficulties in optimal dosing and sometimes even accidental awareness during general anaesthesia (AAGA). AAGA is a rare but potentially devastating complication affecting between 0.1% and 2% of patients undergoing surgery. The development of novel, personalised screening techniques to accurately predict a patient's response to GA and the risk of AAGA remains an unmet clinical need. In the present study we demonstrate the principle of using a fluorescent reporter of the membrane dipole potential, di-8-ANEPPs, as a novel method to monitor anaesthetic activity using a well-described inducer/non-inducer pair...
August 17, 2017: Journal of Lipid Research
https://www.readbyqxmd.com/read/28818287/application-of-flexible-endoscopy-based-biopsy-in-the-diagnosis-of-tumour-pathologies-in-otorhinolaryngology
#3
Carlos Saga, Manuel Olalde, Ekhiñe Larruskain, Leire Álvarez, Xabier Altuna
INTRODUCTION AND OBJECTIVES: Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. SUBJECTS AND METHODS: Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications...
August 14, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28815823/ten-years-of-simulation-based-training-in-pediatric-anesthesia-the-inception-evolution-and-dissemination-of-the-managing-emergencies-in-paediatric-anaesthesia-mepa-course
#4
Tobias C Everett, Ralph MacKinnon, David de Beer, Matthew Taylor, Matthew Dylan Bould
2016 marked the 10-year anniversary of the inception of the Managing Emergencies in Paediatric Anaesthesia (MEPA) course. This simulation-based program was originally created to allow trainees in pediatric anesthesia to experience operating room emergencies which although infrequent, would be considered key competencies for any practicing anesthetist with responsibility for providing care to children. Since its original manifestation, the course has evolved in content, scope, and worldwide availability, such that it is now available at over 60 locations on five continents...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28815066/anaesthesia-during-oesophagectomy
#5
REVIEW
Denise P Veelo, Bart F Geerts
In this review, we will provide an overview of the current state of the art of perioperative practices for open and laparoscopic oesophagus surgery from the anaesthetist's perspective. Morbidity and mortality after oesophagectomy is still high despite multidisciplinary and enhanced recovery pathways showing promising results. The anaesthetist has an important role in the complex care of the oesophageal cancer patient. Minimizing unnecessary fluid administration, adequate pain management, hypotension, and protective lung ventilation are examples of proven strategies that can improve outcome after this high-risk surgery...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28814306/blood-acid-base-status-in-impala-aepyceros-melampus-immobilised-and-maintained-under-total-intravenous-anaesthesia-using-two-different-drug-protocols
#6
Gareth E Zeiler, Leith C R Meyer
BACKGROUND: In mammals, homeostasis and survival are dependent on effective trans-membrane movement of ions and enzyme function, which are labile to extreme acid-base changes, but operate efficiently within a narrow regulated pH range. Research in patients demonstrating a pH shifts outside the narrow regulated range decreased the cardiac output and systemic vascular resistance and altered the oxygen binding to haemoglobin. These cardiopulmonary observations may be applicable to the risks associated with anaesthesia and performance of wildlife ungulates on game farms...
August 16, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28814087/effects-of-sevoflurane-on-apoptosis-bdnf-and-cognitive-functions-in-neonatal-rats
#7
A B Ozer, S Ceribasi, A O Ceribasi, I Demirel, M K Bayar, B Ustundag, A Ileri, O L Erhan
OBJECTIVE: To evaluate the early and late effects of sevoflurane on the neonatal brain. BACKGROUND: Sevoflurane is the most used anaesthetics in neonatal subjects. METHODS: The study included 7-day-old male Wistar-Albino rats (n = 30), which were divided into the two groups according to the anaesthetic received: sevoflurane (S) and control group (C). Half of each group was sacrificed six hours after anaesthesia (early, E) while the remaining subjects were sacrificed six weeks later (late, L)...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28812959/periocular-manifestations-of-trigeminal-trophic-syndrome-a-case-series-and-literature-review
#8
Katherine A McVeigh, Morag Adams, Richard Harrad, Rebecca Ford
Trigeminal trophic syndrome (TTS) is a condition whereby persistent facial ulceration presents consequent to central or peripheral insult to the trigeminal nerve. Lesions are created by repetitive self-inflicted manipulation and trauma of dysaesthetic skin within the trigeminal dermatome. We discuss four cases with aetiologies varied from presumed microvascular compromise to resection of cerebral meningioma, cerebrovascular accident, and herpes zoster ophthalmicus. We discuss the management of the under-recognised associated periocular skin ulcerations that result from physical manipulation of dysesthic skin and prove to be persistent and challenging to treat...
August 16, 2017: Orbit
https://www.readbyqxmd.com/read/28807061/the-incidence-of-hyperthermia-during-cochlear-implant-surgery-in-children
#9
A Schwartz, D Kaplan, V Rosenzweig, M Klein, B F Gruenbaum, S E Gruenbaum, M Boyko, A Zlotnik, E Brotfain
BACKGROUND: Inadvertent hyperthermia during anaesthesia is a rare but life-threatening complication. We have encountered several cases of severe hyperthermia in paediatric patients undergoing anaesthesia for cochlear implantation. METHODS: This study aimed to describe the clinical characteristics of children who developed hyperthermia while undergoing cochlear implantation, and to explore possible mechanisms and predisposing factors. The anaesthetic charts of all patients aged under 18 years who underwent cochlear implantation, or mastoid or ophthalmic surgery, between 1 January 2006 and 31 December 2009, at Soroka Medical Center in Beer Sheva, Israel, were reviewed...
August 15, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28805238/ultrasound-assessment-of-gastric-contents-in-children-undergoing-elective-ear-nose-and-throat-surgery-a-prospective-cohort-study
#10
F-P Desgranges, A-C Gagey Riegel, C Aubergy, M de Queiroz Siqueira, D Chassard, L Bouvet
Ultrasound examination of the gastric antrum allows reliable assessment of gastric contents and volume. Postoperative assessment of gastric contents before recovery from anaesthesia could help the physician to choose the most appropriate extubation technique after surgery in children. In this prospective observational study, we assessed whether significant changes occurred in gastric contents during the intra-operative period in children undergoing elective ear, nose and throat (ENT) surgery. Children aged between six months and 16 years were recruited consecutively...
August 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28805235/how-do-singapore-patients-view-post-anaesthesia-adverse-outcomes-a-single-centre-willingness-to-pay-study
#11
Xinqi Look, May Un Sam Mok, Yan Sheng Tay, Hairil Rizal Abdullah
INTRODUCTION: Knowing how patients value quality of anaesthesia helps anaesthesiologists to customise their service. However, generalising findings from Western population-based willingness-to-pay (WTP) studies across different cultures and societies might overlook several important contextualised understandings of anaesthesia experience for Singapore patients. This study aimed to capture the Singapore perspective of undesired post-anaesthesia outcomes. METHODS: 132 patients recruited in the pre-anaesthetic evaluation clinic were given questionnaires describing ten possible post-anaesthetic outcomes to rank for undesirability and assign relative value through proportioning hypothetical SGD 100 to avoid their occurrence...
August 14, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28803717/noninvasive-stroke-volume-variation-using-electrical-velocimetry-for-predicting-fluid-responsiveness-in-dogs-undergoing-cardiac-surgery
#12
Kazumasu Sasaki, Tatsushi Mutoh, Tomoko Mutoh, Yasuyuki Taki, Ryuta Kawashima
OBJECTIVE: To evaluate the ability of a noninvasive cardiac output monitoring system with electrical velocimetry (EV) for predicting fluid responsiveness in dogs undergoing cardiac surgery. STUDY DESIGN: Prospective experimental trial. ANIMALS: A total of 30 adult Beagle dogs. METHODS: Stroke volume (SV), stroke volume variation (SVV) and cardiac index were measured using the EV device in sevoflurane-anaesthetized, mechanically ventilated dogs undergoing thoracotomies for experimental creation of right ventricular failure...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28803651/using-national-hip-fracture-registries-and-audit-databases-to-develop-an-international-perspective
#13
Antony Johansen, David Golding, Louise Brent, Jacqueline Close, Jan-Erik Gjertsen, Graeme Holt, Ami Hommel, Alma B Pedersen, Niels Dieter Röck, Karl-Göran Thorngren
Hip fracture is the commonest reason for older people to need emergency anaesthesia and surgery, and leads to prolonged dependence for many of those who survive. People with this injury are usually identified very early in their hospital care, so hip fracture is an ideal marker condition with which to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries...
August 2, 2017: Injury
https://www.readbyqxmd.com/read/28803262/topic-anaesthesia-with-a-eutectic-mixture-of-lidocaine-prilocaine-cream-after-elective-caesarean-section-a-randomised-placebo-controlled-trial
#14
Thomas Grosse-Steffen, Malin Krämer, Benjamin Tuschy, Christel Weiss, Marc Sütterlin, Sebastian Berlit
PURPOSE: Aim of the study was to investigate the topical application of a eutectic mixture of lidocaine/prilocaine (EMLA(®)) cream after caesarean section (CS) and its effect on postoperative pain, time to mobilisation, and time to discharge. MATERIALS AND METHODS: A total of 189 pregnant women were enrolled; full data sets were available for 139 of them, who were prospectively randomised to receive either placebo (control group) or EMLA(®) cream (study group) on the CS lesion directly as well as 24 h after surgery...
August 12, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28803177/clusterin-a-new-cerebrospinal-fluid-biomarker-in-severe-subarachnoid-haemorrhage-a-pilot-study
#15
Norbert Wąsik, Bartosz Sokół, Marcin Hołysz, Witold Mańko, Robert Juszkat, Piotr Paweł Jagodziński, Roman Jankowski
BACKGROUND: Inflammation following subarachnoid haemorrhage (SAH) employs numerous mediators with biomarker properties. Preliminary studies indicated that clusterin, a multifunctional chaperon protein, was a potential biomarker in SAH. We aim to clarify the status of clusterin in SAH. METHOD: 47 CSF samples were collected on post-SAH days 0-3, 5-7, and 10-14 from 27 patients with severe SAH. Control CSF was collected from 25 age- and sex- matched healthy patients undergoing spinal anaesthesia for minor surgery...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28802606/comparison-of-lma-supreme%C3%A2-with-i-gel%C3%A2-and-lma-proseal%C3%A2-in-children-for-airway-management-during-general-anaesthesia-a-meta-analysis-of-randomized-controlled-trials
#16
Sulagna Bhattacharjee, Anirban Som, Souvik Maitra
STUDY OBJECTIVE: A few randomized trials have compared LMA Supreme™ with LMA ProSeal™ and i-gel™ in children but their conclusions varied widely. This systematic review and meta analysis has compared the former device with the latter two devices. DESIGN: Meta-analysis and systematic review using the Mantel-Haenszel method and pooled mean difference using inverse variance method. SETTING: Meta-analysis of published prospective randomized controlled trials...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801924/foramen-epiploicum-mesh-closure-femc-through-a-ventral-midline-laparotomy
#17
T van Bergen, A Rötting, P Wiemer, S Schauvliege, K Vanderperren, F Ugahary, A Martens
BACKGROUND: Preventive laparoscopic closure of the epiploic foramen (EF) has previously been described, but methods for EF closure during laparotomy for treatment of colic are lacking. OBJECTIVES: To describe the Foramen Epiploicum Mesh Closure (FEMC) technique through a ventral midline laparotomy in horses under general anaesthesia and its outcome. STUDY DESIGN: Terminal surgical experiment and in vivo study. METHODS: In a pilot study a standard ventral midline laparotomy was performed under general anaesthesia in 10 experimental horses and a three-dimensional expandable diabolo-shaped mesh construct was manually introduced through the EF into the omental vestibule...
August 12, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28801323/transvaginal-postpartum-manual-removal-of-a-prolapsed-submucous-leiomyoma-initially-diagnosed-hybrid-predominantly-intramural
#18
Wael Elgonaid, Reem Belkhir, Vincent Boama
We present a rare case of a large infarcted submucous fibroid removed manually after a normal vaginal delivery. This patient was known to have a large postero-fundal hybrid predominantly intramural uterine fibroid, measuring 11 x 10 cm in diameter and diagnosed 2 years prior to last conception. Thirty-five days postpartum, she presented with severe lower abdominal pain and foul smell per vaginum. Abdominal examination revealed a very tender bulky uterus at 24 weeks size, and vaginal examination revealed a big fleshy smelly mass with friable surface just bulging from a dilated cervix...
August 11, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28801130/prospective-implementation-of-enhanced-recovery-after-surgery-protocols-to-radical-cystectomy
#19
Karl H Pang, Ruth Groves, Suresh Venugopal, Aidan P Noon, James W F Catto
BACKGROUND: Multimodal enhanced recovery after surgery (ERAS) regimens have improved outcomes from colorectal surgery. OBJECTIVE: We report the application of ERAS to patients undergoing radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: Prospective collection of outcomes from consecutive patients undergoing RC at a single institution. INTERVENTION: Twenty-six components including prehabilitation exercise, same day admission, carbohydrate fluid loading, targeted intraoperative fluid resuscitation, regional local anaesthesia, cessation of nasogastric tubes, omitting oral bowel preparation, avoiding drain use, early mobilisation, chewing gum use, and audit...
August 8, 2017: European Urology
https://www.readbyqxmd.com/read/28797141/butterfly-cartilage-tympanoplasty-long-term-results-excellent-treatment-method-in-small-and-medium-sized-perforations
#20
Isa Kaya, Murat Benzer, Mustafa Uslu, Cem Bilgen, Tayfun Kirazli
Objectives: The aim of this study was to evaluate and report the long-term results of the butterfly cartilage tympanoplasty. Short-term and long-term hearing outcomes were compared according to age and perforation location as well. Methods: Ninety-three patients who were diagnosed with noncomplicated chronic otitis media and underwent microscopic transcanal butterfly cartilage tympanoplasty due to anterior, posterior, and central tympanic membrane perforation were included...
August 12, 2017: Clinical and Experimental Otorhinolaryngology
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