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radiology sedation

Alejandro A Rabinstein, Gregory W Albers, Waleed Brinjikji, Sebastian Koch
Endovascular therapy with mechanical thrombectomy is a formidable treatment for severe acute ischemic stroke caused by occlusion of a proximal intracranial artery. Its strong beneficial effect is explained by the high rates of very good and excellent reperfusion achieved with current endovascular techniques. However, there is a sizable proportion of patients who do not experience clinical improvement despite successful recanalization of the occluded artery and reperfusion of the ischemic territory. Factors such as baseline reserve, collateral flow, anesthesia and systemic factors have been identified as potential culprits for lack of improvement in the setting of timely and successful revascularization...
September 6, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Elizabeth J Snyder, Wei Zhang, Kimberly Chua Jasmin, Sam Thankachan, Lane F Donnelly
BACKGROUND: Incident reporting can be used to inform imaging departments about adverse events and near misses. OBJECTIVE: To study incident reports submitted during a 5-year period at a large pediatric imaging system to evaluate which imaging modalities and other factors were associated with a greater rate of filed incident reports. MATERIALS AND METHODS: All incident reports filed between 2013 and 2017 were reviewed and categorized by modality, patient type (inpatient, outpatient or emergency center) and use of sedation/anesthesia...
August 29, 2018: Pediatric Radiology
Umut Kalyoncu, Etem Koray Taşcılar, Ali İhsan Ertenli, Hüseyin Ediz Dalkılıç, Cemal Bes, Orhan Küçükşahin, Timuçin Kaşifoğlu, Nilüfer Alpay Kanıtez, Hakan Emmungil, Gezmis Kimyon, Nazife Şule Yaşar Bilge, Servet Akar, Mehmet Pamir Atagündüz, Süleyman Serdar Koca, Aşkın Ateş, Veli Yazısız, Ender Terzioğlu, Emine Duygu Ersözlü, Müge Aydın Tufan, Muhammet Çınar, Rıdvan Mercan, Ali Şahin, Şükran Erten, Yavuz Pehlivan, Sedat Yılmaz, Ayşe Bahar Keleşoğlu Dinçer, Önay Gerçik, Belkıs Nihan Coşkun, Burcu Yağız, Sema Kaymaz Tahra, Aysun Aksoy, Ömer Karadağ, Levent Kılıç, Sedat Kiraz
Background/aim: The TReasure registry, created in 2017, is an observational multicenter cohort that includes inflammatory arthritis patients. This article reviews the methodology and objectives of the TReasure registry established to collect data from rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients. Methodology: Fifteen rheumatology centers in Turkey will contribute data to the TReasure database. The actual proprietor of the database is the Hacettepe Rheumatology Association (HRD) and Hacettepe Financial Enterprises...
August 16, 2018: Turkish Journal of Medical Sciences
J Song, C-Y Lee, H-W Kim
BACKGROUND AND PURPOSE: The aim of the present study was to report the feasibility, safety, and periprocedural complications associated with EVT of ruptured intracranial aneurysms according to the depth of anesthesia. In most centers, endovascular treatment of intracranial aneurysm is performed under general anesthesia. MATERIALS AND METHODS: Between March 2011 and December 2016, a total of 183 consecutive patients with 183 aneurysms were treated endovascularly at the authors' center...
September 2018: AJNR. American Journal of Neuroradiology
Masoud Pezeshki Rad, Bita Abbasi, Negar Morovatdar, Masoomeh Sadeghi, Khaled Hashemi
PURPOSE: Effective pain control during and after percutaneous core needle liver biopsy is important with regard to ethical considerations and patient comfort. In this randomized double-blind study, we compared post-biopsy pain in the patients undergoing liver core-needle biopsy using either subcostal or intercostal approaches. METHODS: All patients referred for ultrasound-guided CNLB between July 2017 and January 2018 to our interventional radiology department were randomized into two groups...
July 31, 2018: Abdominal Radiology
Mark R Jones, Sergey Karamnov, Richard D Urman
BACKGROUND: Many interventional procedures are performed under moderate procedural sedation (MPS). It is important to understand the nature of and factors contributing to adverse events (AEs). Little data exist examining reportable AEs during MPS across specialties. A study was conducted to investigate adverse events during MPS and to compare associated patient and provider characteristics. METHODS: In a retrospective review, 83 MPS cases in which safety incidents were reported (out of approximately 20,000 annual cases during a 12-year period at a tertiary medical center) were analyzed...
July 27, 2018: Joint Commission Journal on Quality and Patient Safety
Matthew C Knox, Andrej Bece, Joseph Bucci, John Moses, Peter H Graham
OBJECTIVES: Management of end-stage lung cancers focuses on symptom control, requiring multimodality management. Endobronchial brachytherapy (EBB) is an evidence-based approach allowing safe delivery of clinically meaningful radiation doses. We provide a summary of treatment characteristics and clinical outcomes of EBB in a single center. METHODS AND MATERIALS: Our retrospective study examined all EBB procedures performed at St George Hospital, NSW, Australia, between 1997 and 2016...
July 29, 2018: Brachytherapy
Roger K Harned, Manraj K S Heran, Manish Patel, Alex Barnacle, Anne Marie Cahill, Leah Braswell, G Peter Feola, Sergio Sierre, Francis Marshalleck
OBJECTIVE: Pediatric interventional radiology (PIR) is a dynamic and growing subspecialty. We will detail our need to evolve like the emerging therapies and innovative imaging options that we provide to children. CONCLUSION: New interventional radiology training pathways, maintaining competency with small volumes of complex procedures, limited availability of pediatric-specific equipment, questions about the safety of sedation in the developing brain, and the dearth of PIR opportunities outside of North America provide challenges and opportunities for the vibrant community of PIR practitioners...
October 2018: AJR. American Journal of Roentgenology
A Tekes, S S Senglaub, E S Ahn, T A G M Huisman, E M Jackson
BACKGROUND AND PURPOSE: Evaluation of shunted hydrocephalus is the most common indication for ultrafast brain MRI. Radiation-/sedation-free imaging capabilities make this protocol more desirable over CT and standard brain MRI. We hypothesized that ultrafast brain MRI can be used for selected indications beyond shunted hydrocephalus without adverse outcomes. MATERIALS AND METHODS: Ultrafast brain MRI was performed with axial, sagittal, and coronal HASTE. The radiology information system was used to identify pediatric patients (0-18 years of age) who underwent ultrafast brain MRI between March 2014 and May 2016...
August 2018: AJNR. American Journal of Neuroradiology
Shunsuke Nomura, Koji Yamaguchi, Tatsuya Ishikawa, Akitsugu Kawashima, Yoshikazu Okada, Takakazu Kawamata
OBJECTIVE: Postoperative hyperperfusion is an important complication after direct bypass for moyamoya disease, which sometimes occurs late after initial postoperative cerebral blood flow (CBF) measurement. This study aimed to clarify the incidence of hyperperfusion with management using postoperative continuous sedation and repeated postoperative CBF measurement and to identify factors associated with delayed hyperperfusion. METHODS: This retrospective study evaluated 72 consecutive hemispheres in 56 adult Japanese patients with moyamoya disease who underwent direct bypass...
July 7, 2018: World Neurosurgery
Muammer Altok, Bumyang Kim, Bina B Patel, Ya-Chen Tina Shih, John F Ward, Stephen E McRae, Brian F Chapin, Louis L Pisters, Curtis A Pettaway, Jeri Kim, Huseyin C Demirel, John W Davis
BACKGROUND: The cornerstone of prostate cancer diagnosis remains the transrectal ultrasound-guided biopsy (TRUS-BX), which most frequently occurs in the office setting under local anesthesia. However, there are now other techniques of prostate biopsy aimed at improving outcomes such as patient comfort, significant cancer detection, and infectious complications. The purpose of the present study is to compare the cost and efficacy outcomes of five different approaches. METHODS: We compared the comprehensive costs of a random sample size of 20-30 cases from each of the following: (1) local anesthesia TRUS-BX (reference), (2) sedation TRUS-BX, (3) general anesthesia transperineal template biopsy (TP), (4) sedation MRI-TRUS fusion biopsy (FB), and (5) sedation in-bore MRI biopsy (IB-MRI)...
July 9, 2018: Prostate Cancer and Prostatic Diseases
Andrea M Walters, Mauria A O'Brien, Laura E Selmic, Sue Hartman, Maureen McMichael, Robert T O'Brien
OBJECTIVE: To determine the agreement between focused assessment with sonography for trauma (FAST) exams and computed tomography (CT) for the detection of pleural and peritoneal fluid and pneumothorax in animals that have sustained recent trauma. DESIGN: Prospective study. SETTING: University Teaching Hospital. ANIMALS: Thirteen dogs and 2 cats were enrolled into the study, with 10 having sustained blunt force trauma and 5 penetrating trauma...
September 2018: Journal of Veterinary Emergency and Critical Care
Sara Colella, Maik Haentschel, Pallav Shah, Venerino Poletti, Jürgen Hetzel
The lung biopsy in interstitial lung disease (ILD) represents an important diagnostic step when the clinical and radiological data are insufficient for a firm diagnosis. A growing body of evidence suggests the utility of transbronchial lung cryobiopsy (TBLC) in the diagnostic algorithm of ILD as it allows, compared to transbronchial lung biopsy with conventional forceps, a better identification of complex histological patterns - such as usual interstitial pneumonia - and can provide information which has a clinical impact on the multidisciplinary discussion similar to that provided by surgical lung biopsy...
2018: Respiration; International Review of Thoracic Diseases
Sergio Salerno, Claudio Granata, Marco Trapenese, Vittorio Cannata, Davide Curione, Maria Camilla Rossi Espagnet, Andrea Magistrelli, Paolo Tomà
Current radiological literature is strongly focussed on radiation imaging risks. Indeed, given there is a small but actual augment in cancer risk from exposure to ionizing radiation in children, it is important to understand what the risk of alternative techniques could be. We retrospectively review literature data concerning possible MR imaging risks, focussing on the biological effects of MR, sedation and gadolinium compound risks when dealing with infant patients. The main concerns can be summarized in: (1) Biological effects of non-ionizing electromagnetic fields (EMF) employed-whose mechanisms of interaction with human tissues are polarization, induced current, and thermal heating, respectively...
September 2018: La Radiologia Medica
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
July 2018: American Journal of Emergency Medicine
Adam McCulloch, Ovishek Roy, Dunecan Massey, Rachel Hedges, Serena Skerratt, Nicola Wilson, Jeremy Woodward
Objective: Percutaneous endoscopic gastrostomy (PEG) tube placement is associated with a high risk of cardiorespiratory complications in patients with significant respiratory compromise. This study reports a case series of high-risk patients undergoing PEG placement using a modified technique-nasal unsedated seated PEG (nuPEG) placement. Design: Retrospective review of 67 patients at high risk of complications undergoing PEG placement between September 2012 and December 2016...
April 2018: Frontline Gastroenterology
Richard B Parad
On Dec. 16, 2016, the U.S. Food and Drug Administration (FDA) released a warning regarding the potential neurotoxicity of anesthesia and sedation agents on the developing brain in children younger than 3 years and in women during their 3rd trimester of pregnancy. These concerns have relevance to the pediatric radiologist who must take into consideration how the child's state might impact image quality. In this review the author provides background on the special concerns in the potentially highest-risk group, pre-term and term neonates, and provides guidance and rationale for the avoidance of sedation in procedural imaging of the newborn...
April 2018: Pediatric Radiology
Mustafa M Almuqbel, Gareth Leeper, David N Palmer, Nadia L Mitchell, Katharina N Russell, Ross J Keenan, Tracy R Melzer
OBJECTIVE: To highlight specific instances when radial k-space acquisitions in MRI result in image artifacts and how to ameliorate such artifacts. METHODS: We acquired axial T2  weighted MR images on (1) the American College of Radiology (ACR) phantom and (2) a sedated sheep with rectilinear and multiblade radial k-space filling acquisitions. Images were acquired on four (2 × 1.5T and 2 × 3T) different MRI scanners. For the radial k-space acquisitions, we acquired images with and without motion correction...
July 2018: British Journal of Radiology
Ebru H Ayvazoglu Soy, Aydincan Akdur, Sedat Yildirim, Hande Arslan, Mehmet Haberal
OBJECTIVES: Despite surgical advances and effective prophylactic strategies in liver transplant, infection is still a major cause of morbidity and mortality. Up to 80% of liver recipients will develop at least 1 infection during the first year after liver transplant. The spectrum and manifestations of these infections are broad and variable. Their diagnosis and treatment are often delayed because immunosuppressive therapy diminishes inflammatory responses. However, if an infection is not identified early enough and treated properly, it can have devastating consequences...
March 2018: Experimental and Clinical Transplantation
Asad A Khawaja, Dmitry Tumin, Ralph J Beltran, Joseph D Tobias, Joshua C Uffman
OBJECTIVES: General anesthesia or sedation can facilitate the completion of diagnostic radiological studies in children. We evaluated the incidence, predictors, and causes of adverse events (AEs) when general anesthesia is provided for diagnostic radiological imaging. METHODS: Deidentified data from 24 pediatric tertiary care hospitals participating in the Wake-Up Safe registry during 2010-2015 were obtained for analysis. Children 18 years or younger receiving general anesthesia for radiological procedures were identified using Current Procedural Terminology codes, and reported AEs were analyzed if they were associated with anesthetic care at magnetic resonance imaging or computed tomography locations...
March 8, 2018: Journal of Patient Safety
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