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https://www.readbyqxmd.com/read/29152521/isokinetic-strength-deficit-6-months-after-adductor-canal-blockade-for-anterior-cruciate-ligament-reconstruction
#1
James E Christensen, Natalie E Taylor, Scott J Hetzel, John A Shepler, Tamara A Scerpella
Background: Recent evidence shows a delayed return to sport in children and delayed quadriceps recovery in both adults and children who have undergone anterior cruciate ligament (ACL) reconstruction with concomitant femoral nerve blockade (FNB) compared with those who had no blockade. We evaluated the use of adductor canal blockade (ACB), as an alternative to FNB, at the time of ACL reconstruction. Hypothesis: Patients who receive ACB will have greater isokinetic strength at 6 months postoperative compared with patients who receive FNB at the time of ACL reconstruction...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29145311/pulmonary-hypertension-as-a-manifestation-of-mitochondrial-disease-a-case-report-and-review-of-the-literature
#2
Shan Xu, Xiaoling Xu, Jisong Zhang, Kejing Ying, Yuquan Shao, Ruifeng Zhang
BACKGROUND: Mitochondrial diseases are a group of multisystem heterogeneous diseases caused by pathologic dysfunction of the mitochondrial respiratory chain. A wide range of clinical expression has been described. However, pulmonary hypertension has rarely been described in association with mitochondrial disease until the past decade, and there is no currently recognized treatment for the pulmonary hypertension complicated with mitochondrial disorder. PATIENT CONCERNS: We reported the case of a 15-year-old boy who presented with shortness of breath and exercise limitation after a cold, and the diagnosis of pulmonary hypertension was confirmed by right heart catheter...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137727/the-quantitative-evaluation-of-the-relationship-between-the-forces-applied-to-the-palm-and-carpal-tunnel-pressure
#3
Kazutoshi Kubo, Yu-Shiuan Cheng, Boran Zhou, Kai-Nan An, Steven L Moran, Peter C Amadio, Xiaoming Zhang, Chunfeng Zhao
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy occurring in upper limbs. The etiology, however, has not been fully understood yet. Median nerve could be compressed by either increase of carpal tunnel pressure (CTP) or direct impingement when it is forced toward to carpal ligament especially in wrist flexion leading to CTS development. Thus, the increase of carpal tunnel pressure is considered an important role in CTS development. It has been identified that forces applied to the palm would affect the CTP...
November 4, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29121291/pectoral-nerve-block1-versus-modified-pectoral-nerve-block2-for-postoperative-pain-relief-in-patients-undergoing-modified-radical-mastectomy-a-randomized-clinical-trial
#4
S Goswami, P Kundra, J Bhattacharyya
Background: Pectoral nerve block1 (PEC1) given between pectoralis major and minor, and modified pectoral nerve block2 (mPEC2) performed between pectoralis minor and serratus anterior, can provide continuous analgesia after modified radical mastectomy (MRM) when catheters are placed before skin closure. This study was designed to compare PEC1 and mPEC2 block for providing postoperative pain relief after MRM. Methods: Sixty-two physically fit patients undergoing MRM were assigned into two groups (Group PEC1, n=31 and Group mPEC2, n=31)...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29109869/postintervention-dyspnea-after-radiofrequency-catheter-ablation-think-of-a-phrenic-nerve-injury
#5
Liliana E Ramos-Villalobos, Luis Colin Lizalde, Manlio F Márquez, Pedro Iturralde, Francisco Castillo
Phrenic nerve injury (PNI) is a rare complication of catheter ablation therapy, most commonly observed in cryoablation of the right side pulmonary veins. We present a case of PNI after radiofrequency catheter ablation that developed acute dyspnea 24 hours after the intervention. Dyspnea is the main symptom of PNI, so the diagnosis should always be suspected if it appears after any type of catheter ablation involving the trajectory of the phrenic nerve. There is no specific treatment for PNI. The only maneuver that has been reported to accelerate the recovery of PNI is early stopping of the ablation therapy...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29075979/second-generation-cryoballoon-ablation-for-persistent-atrial-fibrillation-an-updated-meta-analysis
#6
Hazem Omran, Klaus-Jürgen Gutleben, Stephan Molatta, Thomas Fischbach, Birgit Wellmann, Dieter Horstkotte, Britta Körber, Georg Nölker
BACKGROUND: Catheter ablation is an established treatment option for patients with symptomatic atrial fibrillation (AF). The cornerstone of AF ablation is pulmonary vein isolation (PVI). The second-generation cryoballoon (2G-CB) has shown non-inferiority to radiofrequency (RF) ablation in paroxysmal AF in several trials. Growing evidence suggests that 2G-CB is also effective in patients with persistent AF (perAF). The aim of this study was to summarize and analyze available data on safety and mid-term (≥ 12 months) efficacy of PVI using 2G-CB in patients with perAF...
October 26, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29070575/saphenous-nerve-stimulation-normalizes-bladder-underactivity-induced-by-tibial-nerve-stimulation-in-cats
#7
Shun Li, Xing Li, Katherine Theisen, Jeffrey Browning, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
This study in α-chloralose anesthetized cats aimed at investigating the bladder responses to saphenous nerve stimulation (SNS). A urethral catheter was used to infuse the bladder with saline and to record changes in bladder pressure. With the bladder fully distended, SNS at 1 Hz frequency and an intensity slightly below the threshold (T) for inducing an observable motor response of the hindlimb muscles induced large amplitude (40-150 cmH2O) bladder contractions. Application of SNS (1 Hz, 2-4T) during cystometrograms (CMGs), when the bladder was slowly (1-3 ml/min) infused with saline, significantly (p<0...
October 25, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29064530/epiduralkateter-med-knut-%C3%A3-r-en-ovanlig-komplikation-alltf%C3%A3-r-l%C3%A3-ng-inmatning-%C3%A3-kar-risken-%C3%A2-4%C3%A2-5-cm-rekommenderas
#8
Lovisa Baer Eriksson, Anna Borglund-Hemph, Jan Jakobsson
Knot on the epidural catheter, a rare complication: a case report A 30-year 1-grava woman received an epidural for labor pain. Insertion was uncomplicated and she had an effective analgesia. The epidural was successfully converted to epidural anaesthesia for Caesarean section. The epidural was removed 24 hours thereafter. The mother was lying and trying to curve the back during removal. It was initially easy to pull but after some centimeters it became difficult. The mother was asked to curve further and pulling continued...
October 23, 2017: Läkartidningen
https://www.readbyqxmd.com/read/29064127/second-generation-cryoballoon-ablation-for-treatment-of-persistent-atrial-fibrillation-three-year-outcome-and-predictors-of-recurrence-after-a-single-procedure
#9
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Harald Greiss, Christian W Hamm, Johannes Sperzel, Thomas Neumann, Malte Kuniss
INTRODUCTION: Data on long-term outcomes of cryoballoon (CB) ablation for treatment of persistent atrial fibrillation (AF) are sparse. Here, we report the first 3-year follow-up results and predictors of success for catheter ablation using the second-generation CB in patients with persistent AF. METHODS AND RESULTS: For this prospective observational study, we enrolled 101 patients ablated with the second-generation CB at our institution. The endpoint was the first documented recurrence (> 30 sec) of AF, atrial flutter, or atrial tachycardia after a 3-month blanking period...
October 24, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29056997/efficacy-and-safety-of-cryoballoon-ablation-versus-radiofrequency-catheter-ablation-in-atrial-fibrillation-an-updated-meta-analysis
#10
Honglan Ma, Dongdong Sun, Hui Luan, Wei Feng, Yaqiong Zhou, Jine Wu, Caiyun He, Chaofeng Sun
INTRODUCTION: Cryoballoon ablation (CBA) and irrigated radiofrequency catheter ablation (RFCA) are the main treatments for drug-refractory symptomatic atrial fibrillation (AF). AIM: To compare the efficacy and safety between CBA and RFCA for the treatment of AF. MATERIAL AND METHODS: We searched the Embase and Medline databases for clinical studies published up to December 2016. Studies that satisfied our predefined inclusion criteria were included...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29049708/two-staged-hybrid-ablation-of-non-paroxysmal-atrial-fibrillation-clinical-outcomes-and-functional-improvements-after-1%C3%A2-year
#11
Petr Budera, Pavel Osmancik, David Talavera, Anna Kraupnerova, Richard Fojt, Jana Zdarska, Tomas Vanek, Zbynek Straka
OBJECTIVES: Hybrid ablation of atrial fibrillation (AF) is a promising treatment strategy; however, data regarding its efficacy and safety are still limited. METHODS: Patients with non-paroxysmal AF were enrolled. First, a thoracoscopic, epicardial isolation of pulmonary veins and the left atrial posterior wall ('box lesion') was performed; a novel unipolar/bipolar radiofrequency device was used. Moreover, in 12 patients enrolled thereafter, the left atrial appendage was occluded...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046778/ultrasound-guided-percutaneous-cryoneurolysis-providing-postoperative-analgesia-lasting-many-weeks-following-a-single-administration-a-replacement-for-continuous-peripheral-nerve-blocks-a-case-report
#12
Brian M Ilfeld, Rodney A Gabriel, Andrea M Trescot
Cryoneurolysis entails using low temperatures to reversibly ablate nerves, with a subsequent analgesia duration measured in weeks or months. Previously, clinical applications for acute pain were limited because treatment originally required exposing the target nerve surgically. However, three developments have now made it possible to provide prolonged postoperative analgesia by cryoneurolysis: 1) new portable, hand-held cryoneurolysis devices, 2) ultrasound machine proliferation, and, 3) anesthesiologists trained in ultrasound-guided peripheral nerve block administration...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#13
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046095/surgical-placement-of-rectus-sheath-catheters-in-a-cadaveric-cystectomy-model
#14
Ecp Chedgy, G Lowe, R Tang, C Krebs, A Sawka, H Vaghadia, M E Gleave, A I So
Introduction Surgically inserted rectus sheath catheters (RSCs) are used increasingly for analgesia after cystectomy and other abdominal surgery. Currently, there is little information on the optimal positioning of RSCs to allow maximal spread of local anaesthetic. This study sought to assess the spread of dye injected via RSCs and to highlight the extent of its coverage in a fresh unembalmed cadaveric cystectomy model in order to confirm the nerve endings that are likely to be anaesthetised with RSCs. Methods Four cadavers underwent lower midline incision with limited bladder mobilisation...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29036728/a-retrospective-study-evaluating-the-effect-of-low-doses-of-perineural-dexamethasone-on-ropivacaine-brachial-plexus-peripheral-nerve-block-analgesic-duration
#15
Gregory D Schnepper, Benjamin I Kightlinger, Yunyun Jiang, Bethany J Wolf, Eric D Bolin, Sylvia H Wilson
Objective: Examination of the effectiveness of perineural dexamethasone administered in very low and low doses on ropivacaine brachial plexus block duration. Design: Retrospective evaluation of brachial plexus block duration in a large cohort of patients receiving peripheral nerve blocks with and without perineural dexamethasone in a prospectively collected quality assurance database. Setting: A single academic medical center. Methods: A total of 1,942 brachial plexus blocks placed over a 16-month period were reviewed...
September 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29035775/avoiding-the-pocket-a-case-report-of-coiling-of-distal-shunt-catheter-into-subcutaneous-pocket
#16
Richard Justin Garling, Sandeep Sood, Carolyn Anne Harris
INTRODUCTION: Hydrocephalus is one of the most common disorders of neurosurgery and ventricular shunting, the primary surgical intervention, malfunctions in 85% of patients by 10 years. PRESENTATION OF CASE: Here we present a case of a 12-year-old girl with history of a vagal nerve stimulator (VNS) and ventricular shunt, most recently revised from ventriculoatrial (VA) to ventriculoperitoneal (VP) shunt at an outside hospital. The patient presented with a new left chest bulge, nausea, emesis, and seizures...
October 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#17
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29026354/novel-regional-techniques-for-total-knee-arthroplasty-promote-reduced-hospital-length-of-stay-an-analysis-of-106-patients
#18
Salman Thobhani, Lauren Scalercio, Clint E Elliott, Bobby D Nossaman, Leslie C Thomas, Dane Yuratich, Kim Bland, Kristie Osteen, Matthew E Patterson
BACKGROUND: Novel regional techniques, including the adductor canal block (ACB) and the local anesthetic infiltration between the popliteal artery and capsule of the knee (IPACK) block, provide an alternative approach for controlling pain following total knee arthroplasty (TKA). This study compared 3 regional techniques (femoral nerve catheter [FNC] block alone, FNC block with IPACK, and ACB with IPACK) on pain scores, opioid consumption, performance during physical therapy, and hospital length of stay in patients undergoing TKA...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29016870/complications-of-pulmonary-vein-isolation-in-atrial-fibrillation-predictors-and-comparison-between-four-different-ablation-techniques-results-from-the-middelheim-pvi-registry
#19
Yves De Greef, Edwin Ströker, Bruno Schwagten, Kaspars Kupics, Jeroen De Cocker, Gian-Battista Chierchia, Carlo de Asmundis, Dirk Stockman, Ian Buysschaert
Aims: To define predictors of complications of pulmonary vein isolation (PVI) and compare safety between different ablation techniques. Methods and results: One thousand patients with atrial fibrillation (AF) (age 60 ± 10, 72% males, CHA2DS2-VASc score 1 ± 1) underwent PVI using various techniques: conventional PVI (CPVI) using mapping with irrigated point-per-point RF ablation (n = 576), multi-electrode RF ablation with the pulmonary vein ablation catheter (PVAC) (n = 272) or high density mesh ablator (HDMA) (n = 59) and cryoballoon (CB) ablation (n = 93)...
August 3, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28993165/motor-sparing-continuous-median-nerve-block-for-hand-surgery-a%C3%A2-pediatric-case
#20
Takeshi Murouchi
Here is described a successful perioperative pain control with continuous median nerve block after flexor tendon repair surgery on 2nd finger of a child. A 9-year-old patient was admitted for reconstruction surgery. The combination of median nerve block and lateral/medial antecubital cutaneous nerve blocks were performed before the surgery to cover all the surgical incision including the 2nd finger, palm, the graft site proximal to the wrist, and Kleinert traction at the nail bed. At the end of the surgery, the infusion catheter was inserted at the distal one-third to spare the muscle strength of flexor digitorum muscles...
September 22, 2017: Asian J Anesthesiol
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