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https://www.readbyqxmd.com/read/29461406/interventional-procedures-outside-of-the-operating-room-results-from-the-national-anesthesia-clinical-outcomes-registry
#1
Beverly Chang, Alan D Kaye, James H Diaz, Benjamin Westlake, Richard P Dutton, Richard D Urman
OBJECTIVES: This study examines the impact of procedural locations and types of anesthetics on patient outcomes in non-operating room anesthesia (NORA) locations. The National Anesthesia Clinical Outcomes Registry database was examined to compare OR to NORA anesthetic complications and patient demographics. METHODS: The National Anesthesia Clinical Outcomes Registry database was examined for all patient procedures from 2010 to 2013. A total of 12,252,846 cases were analyzed, with 205 practices contributing information, representing 1494 facilities and 7767 physician providers...
March 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29452811/effects-on-adult-cognitive-function-after-neonatal-exposure-to-clinically-relevant-doses-of-ionising-radiation-and-ketamine-in-mice
#2
S Buratovic, B Stenerlöw, S Sundell-Bergman, A Fredriksson, H Viberg, T Gordh, P Eriksson
BACKGROUND: Radiological methods for screening, diagnostics and therapy are frequently used in healthcare. In infants and children, anaesthesia/sedation is often used in these situations to relieve the patients' perception of stress or pain. Both ionising radiation (IR) and ketamine have been shown to induce developmental neurotoxic effects and this study aimed to identify the combined effects of these in a murine model. METHODS: Male mice were exposed to a single dose of ketamine (7...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29443785/can-endotracheal-intubation-be-the-first-step-in-management-of-nonconvulsive-status-epilepticus-a-case-report
#3
Saad Warraich, Abbas Ali, Atif Nizami, Moiz Bakhiet
RATIONALE: Nonconvulsive status epilepticus (NCSE) is prolonged seizure activity without motor manifestations. Clinically, there are certain examination findings, in addition to elements of history, that help differentiate it from other encephalopathies. When diagnosing NCSE, the physician faces significant difficulties due to inconsistent clinical presentation and somewhat nonspecific electroencephalogram (EEG) criteria. PATIENT CONCERNS: To highlight the problems faced when dealing with such a patient, a case of a 29-year-old male who presented with an altered state of consciousness is put forth for the reader...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29417268/retrospective-single-arm-cohort-study-of-patients-with-hepatocellular-adenomas-treated-with-percutaneous-thermal-ablation
#4
Oleg Mironov, Arash Jaberi, Robert Beecroft, John R Kachura
PURPOSE: To assess the safety and efficacy of percutaneous thermal ablation for the treatment of hepatocellular adenomas. MATERIALS AND METHODS: This is an ethics board-approved, single-arm, retrospective, cohort study of patients with pathologically proven hepatocellular adenomas treated with percutaneous thermal ablation at a tertiary referral center from 1999 to 2016. Demographic, procedural, and outcome data were collected and summarized with appropriate measures of central tendency and dispersion...
February 7, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29363517/use-of-intranasal-dexmedetomidine-as-a-solo-sedative-for-mri-of-infants
#5
Gokhan Olgun, Mir Hyder Ali
BACKGROUND: Dexmedetomidine, a selective α-2 receptor agonist, can be delivered via the intranasal (IN) route and be used for procedural sedation. The drug's favorable hemodynamic profile and relative ease of application make it a promising agent for sedation during radiologic procedures, although there are few studies on its efficacy for MRI studies. METHODS: A retrospective chart review was performed between June 2014 and December 2016. Outpatients between 1 and 12 months of age who received 4 μg/kg of IN dexmedetomidine for MRI were included in the analysis...
January 23, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29334501/practice-guidelines-for-moderate-procedural-sedation-and-analgesia-2018-a-report-by-the-american-society-of-anesthesiologists-task-force-on-moderate-procedural-sedation-and-analgesia-the-american-association-of-oral-and-maxillofacial-surgeons-american-college
#6
https://www.readbyqxmd.com/read/29314070/diagnostic-reliability-of-pretreatment-biopsy-in-malignant-nasoethmoidal-tumors-a-retrospective-study-of-77-cases
#7
Alberto Schreiber, Vittorio Rampinelli, Marco Ferrari, Davide Mattavelli, Davide Farina, Simonetta Battocchio, Piero Nicolai
OBJECTIVES/HYPOTHESIS: Pretreatment biopsy is crucial in histology-based management of malignant nasoethmoidal tumors, because misdiagnosis can lead to inadequate therapeutic planning. Factors influencing the reliability of biopsy were retrospectively investigated in a tertiary referral center. STUDY DESIGN: Retrospective case series. METHODS: All patients who underwent biopsy, staging magnetic resonance, surgery, and histologic diagnosis for nasoethmoidal tumors in our hospital were retrospectively evaluated...
January 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29234838/clinical-characteristics-and-prognosis-of-traumatic-head-injury-following-road-traffic-accidents-admitted-in-icu-analysis-of-694-cases
#8
Hedi Chelly, Mabrouk Bahloul, Rania Ammar, Ahmed Dhouib, Khaireddine Ben Mahfoudh, Mohamed Zaher Boudawara, Olfa Chakroun, Imen Chabchoub, Anis Chaari, Mounir Bouaziz
BACKGROUND: The aim of the present study is to analyze the clinical and epidemiological characteristics of Traumatic Brain Injury (TBI) following Road Traffic Accidents (RTAs). Moreover, we aim to evaluate the outcome of the TBI victims referred to our medico-surgical Intensive Care Unit (ICU), and to define predictive factors associated with poor prognosis. METHODS: A retrospective study over a 4-year period (2009 to 2012) of 694 patients with head injuries, incurred during road traffic accidents, admitted to the Intensive Care Unit (ICU) of a university hospital (Sfax-Tunisia)...
December 12, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29230889/use-of-personal-protective-equipment-in-a-radiology-room-at-a-veterinary-teaching-hospital
#9
Monique N Mayer, Niels K Koehncke, Alexandra F Belotta, Isaac T Cheveldae, Cheryl L Waldner
The use of personal protective equipment by veterinary workers during radiographic imaging is inconsistent. While the self-reported use of leaded aprons and thyroid shields approaches 100% in some studies, the use of leaded gloves and eyeglasses is much lower. Previous studies describing personal protective equipment use are based on self-reporting. Objectives of this prospective, observational study were to describe use of leaded personal protective equipment during radiographic imaging by veterinary workers, and to compare observed use with self-reported use...
December 11, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#10
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29187664/-clinical-characteristics-of-hemichorea-associated-with-non-ketotic-hyperglycemia-in-3-patients-case-report-and-literature-review
#11
Yacen Hu, Yafang Zhou, Fang Yi, Lingyan Yao, Hongwei Xu, Lin Zhou
To investigate the pathophysiology, clinical manifestation and neuroimaging characteristics and therapeutic experiences for hemichore associated with non-ketotic hyperglycemia (HC-NH).
 Methods: Clinical data of three patients with HC-NH from Xiangya Hospital, Central South University were analyzed retrospectively, and the related literature was reviewed.
 Results: The core clinical features of HC-NH were characterized by acute/subacute onset of hemichorea with non-ketotic hyperglycemia in the elderly females...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29170353/56%C3%A2-manipulation-and-reduction-of-paediatric-forearm-fractures-using-es-ketamine-in-a-paediatric-emergency-department-a-5-year-study
#12
Shirley Mulvaney
BACKGROUND: Forearm fractures are the most common paediatric injury presenting to A+E.1,2 Literature supports safe and effective treatment of these injuries in A+E using a variety of sedation methods, including ketamine.3,4 The Paediatric Orthopaedic Trauma Snapshot (POTS) study showed that only 35% of A+Es nationally allow manipulation of these injuries in the department. METHODS: A retrospective analysis was undertaken of all patients presenting with fractures of the forearm between January 2012 to December 2016 who were treated with reduction and manipulation in the Alder Hey A+E department using Es-ketamine...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29142969/elucidation-of-renal-scars-in-children-with%C3%A2-vesicoureteral-reflux-using-contrast-enhanced-ultrasound-a-pilot%C3%A2-study
#13
David S Hains, Harris L Cohen, M Beth McCarville, Ellen E Ellison, Amy Huffman, Stacey Glass, Aslam H Qureshi, Keith R Pierce, Ashlyn L Cahill, Ashley Dixon, Noel Delos Santos
Introduction: Vesicoureteral reflux is a common disorder in children but can result in kidney scarring following acute pyelonephritis. The gold standard diagnostic to detect renal scars in children is (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy. DMSA has a number of limitations including radiation exposure, need for sedation, and radiotracer supply shortages. Contrast-enhanced ultrasound (CEUS) is a technique whereby biocompatible microspheres of inert gas are administered i.v...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29125398/the-management-of-peri-and-postprocedural-pain-in-interventional-radiology-a-narrative-review
#14
Jeremy N Cashman, Lenny Ng
Interventional radiology encompasses a wide range of procedures and the degree of associated pain depends predominantly on the procedure being undertaken. Procedures may be painful during but not after the procedure, relatively painless during but painful after the procedure, or relatively painless during and after the procedure. However, there is a lack of good quality publications in interventional radiology that specifically address the subject of peri- and postprocedural pain management. Nevertheless, a variety of more or less complex protocols exist for intraprocedural sedation and for peri- and postprocedural analgesia...
November 2017: Pain Management
https://www.readbyqxmd.com/read/29083986/effect-of-general-anesthesia-versus-conscious-sedation-for-stroke-thrombectomy-on-angiographic-workflow-in-a-randomized-trial-a-post-hoc-analysis-of-the-siesta-trial
#15
Johannes A R Pfaff, Silvia Schönenberger, Simon Nagel, Peter A Ringleb, Werner Hacke, Martin Bendszus, Julian Bösel, Markus Alfred Möhlenbruch
Purpose To investigate whether the sedation mode (ie, conscious sedation [CS] vs general anesthesia [GA]) affects the angiographic workflow applied for treatment of endovascular stroke in a post hoc analysis of a recent randomized controlled trial, Sedation versus Intubation for Endovascular Stroke Treatment (SIESTA). Materials and Methods SIESTA was an institutional review board-approved, single-center, prospective, randomized, parallel-group, open-label treatment trial with a blinded end-point evaluation to compare GA with CS for treatment of endovascular stroke in 73 and 77 patients, respectively...
October 30, 2017: Radiology
https://www.readbyqxmd.com/read/29080097/hydromorphone-hydrochloride-use-during-various-interventional-radiology-procedures-pain-control-and-adverse-events-a-case-series-audit-analysis
#16
Thea Moran, Amit Prabhakar, James H Diaz, Alan David Kaye
INTRODUCTION: This project studied pain control and the development of adverse events before, during, and after the administration of hydromorphone hydrochloride for various interventional radiology (IR) procedures. METHODS: We performed a retrospective analysis of 100 patients (men = 58; women = 42) sedated with peri-procedural intravenous (IV) hydromorphone in association with various IR procedures. We stratified the procedures as follows: abscess drainages (M = 8; F = 8), arteriograms (M = 1; F = 0), biliary interventions (M = 3; F = 2), bone biopsies (M = 2; F = 2), non-bone biopsies (M = 26; F = 19), non-tunneled venous catheters (M = 1; F = 1), tunneled venous catheters (M = 7; F = 5), embolization (M = 4; F = 0), IVC filter placement (M = 1; F = 1), nephrostomy tube placement (M = 1; F = 4), and percutaneous nephrolithotomy tube placements (M = 4; F = 0)...
December 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29078663/endoscopic-treatment-with-fibrin-glue-of-post-intubation-tracheal-laceration
#17
Alfonso Fiorelli, Roberto Cascone, Davide Di Natale, Matteo Pierdiluca, Rossella Mastromarino, Giovanni Natale, Emanuele De Ruberto, Gaetana Messina, Giovanni Vicidomini, Mario Santini
Post-intubation tracheal laceration (PITL) is a rare and potential life-threatening condition requiring prompt diagnosis and treatment. A conservative treatment is indicated in patients with laceration <2 cm in length while surgery is the treatment of choice for laceration >4 cm. For laceration between 2-4 cm, the best treatment is debate; some authors recommend surgery while others do not definitely exclude endoscopic treatment. Herein, we reported the endoscopic treatment with fibrin glue of PITL. The procedure is performed using a standard video-bronchoscopy in operating room; the patient is in spontaneous breathing and deep sedation...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29051964/identification-of-quality-improvement-areas-in-pediatric-mri-from-analysis-of-patient-safety-reports
#18
Camilo Jaimes, Diana J Murcia, Karen Miguel, Cathryn DeFuria, Pallavi Sagar, Michael S Gee
BACKGROUND: Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. OBJECTIVE: To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. MATERIALS AND METHODS: In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015...
October 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28978605/cognitive-aids-a-must-for-procedures-performed-by-multidisciplinary-sedation-teams-outside-the-operation-room
#19
Susanne Eberl, Lena Koers, Maartje Van Haperen, Benedikt Preckel
The human brain might not perform optimally during stressful situations. Cognitive aids can help in such situations to carry out all necessary treatment steps in a correct order. We present the case of a severe anaphylactic reaction during a percutaneous radiological intervention to drain an echinococcosis cyst on the radiology suite outside the operation room (OR), in which cognitive aids were successfully used to optimise patient care by a multidisciplinary team. Cognitive aids do not replace experience and skills of the individual caregivers, but can be invaluable tools for multidisciplinary teams dealing with crisis situations outside the OR...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28933333/-canine-elbow-humeroulnar-incongruity-measurements-using-computed-tomography
#20
R Snášil, P Proks, A Nečasová, K Michalčáková, A Nečas
PURPOSE OF THE STUDY The purpose of the study is to compare the repeatability and reproducibility of quantitative and subjective evaluation of elbow humeroulnar incongruity (HUI) using computed tomography (CT) on an in vivo canine model. MATERIAL AND METHODS HUI was evaluated on canine (n = 50) elbow joints (n = 100). The computed tomography of elbow joints was performed under intravenous sedation. Multiplanar reconstructions (MPR) were produced. HUI was evaluated on sagittal MPR images subjectively and by measuring the subluxation index (SI)...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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