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https://www.readbyqxmd.com/read/30390374/general-anesthesia-sedation-requirement-influences-the-way-mri-brain-scans-are-ordered-in-a-tertiary-pediatric-hospital
#1
Min Yi Sum, Kathy Low, Phua Hwee Tang
BACKGROUND: MRI guidelines have been created to help clinicians order scans appropriately. Some scans in children are carried out under general anesthesia (GA) / sedation. PURPOSE: To evaluate if the requirement for GA/sedation influences the way MRI brain scans are ordered. STUDY TYPE: Retrospective. POPULATION: Children with MRI brain scans in 2015 to 2017. FIELD STRENGTH: 3T, 1.5T. ASSESSMENT: Institutional Review Board approval for waiver of consent was obtained...
November 3, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/30343464/acute-hemiparesis-and-status-epilepticus-following-endoscopic-esophageal-balloon-dilation-is-it-really-a-stroke
#2
Nicholas Di Mascio, Padraic MacMathuna, Sean Murphy, Eoin Carl Kavanagh
A 68-year-old gentleman was referred for elective upper gastrointestinal endoscopy on a background of dysphagia and esophageal candidiasis. A benign peptic stricture was noted, managed with balloon dilation without apparent immediate complication. At completion, however, the patient became confused and agitated, with no improvement despite the reversal of sedation. Two hours later, with all investigations for suspected complications including perforation, negative, he developed acute left-sided hemiparesis...
October 20, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/30325117/comparison-between-high-flow-nasal-oxygen-cannula-and-conventional-oxygen-therapy-after-extubation-in-pediatric-intensive-care-unit
#3
Başak Akyıldız, Sedat Öztürk, Nazan Ülgen-Tekerek, Selim Doğanay, Süreyya Burcu Görkem
Akyıldız B, Öztürk S, Ülgen-Tekerek N, Doğanay S, Görkem SB. Comparison between high-flow nasal oxygen cannula and conventional oxygen therapy after extubation in pediatric intensive care unit. Turk J Pediatr 2018; 60: 126-133. The aim of this study was to compare the efficiency, safety, and outcomes of the high-flow nasal oxygen cannula (HFNC) and conventional oxygen therapy (COT) after extubation in children. A randomized controlled trial was conducted in a 13 bed pediatric intensive care unit. One-hundred children who underwent extubation were eligible for the study...
2018: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/30315440/neurotoxicity-of-anesthesia-in-children-prevention-and-treatment
#4
REVIEW
Amy E Vinson, Constance S Houck
PURPOSE OF REVIEW: The purpose of this review is to summarize the current evidence regarding the impact of the exposure to anesthetic and sedative agents on neurodevelopment during the period of rapid brain growth in the first 3 years of life. Though much of the definitive data demonstrating anesthesia-induced neurotoxicity has come from studies in young animals, the focus of this review is on emerging human data. RECENT FINDINGS: In 2016, the first prospective trials investigating the neurodevelopmental impact of early anesthetic exposure (GAS and PANDA studies) were published, both showing no significant impact on IQ from a single brief anesthetic...
October 13, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/30295410/randomized-and-controlled-study-comparing-patient-controlled-and-radiologist-controlled-intra-procedural-conscious-sedation-using-midazolam-and-fentanyl-for-patients-undergoing-insertion-of-a-central-venous-line
#5
Warren Clements, David Sneddon, Helen Kavnoudias, Tim Joseph, Gerard S Goh, Jim Koukounaras, Thomas Snow
INTRODUCTION: Interventional Radiology procedures can provoke anxiety and may be painful. Current practice, Radiologist Controlled Sedation (RCS), involves titrating aliquots of midazolam and fentanyl to patient response but underdosing and overdosing may occur. This study tests a new method of titrating sedation/analgesia during the procedure, Patient Controlled Sedation (PCS), in which a combination of fentanyl and midazolam are administered using a patient-controlled analgesia pump...
October 8, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/30276091/readmissions-after-outpatient-transforaminal-decompression-for-lumbar-foraminal-and-lateral-recess-stenosis
#6
Kai-Uwe Lewandrowski
Background: The objective of this study was to analyze readmission rates after outpatient transforaminal endoscopic decompression surgery for lumbar foraminal and lateral recess stenosis done in an ambulatory surgery center. Endoscopic lumbar spinal surgery is gaining popularity for the treatment of lumbar disc herniations. Recent advances in surgical techniques allow for percutaneous endoscopically assisted bony decompression for neurogenic claudication symptoms due to spinal stenosis...
June 2018: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/30188259/factors-that-may-contribute-to-poor-outcome-despite-good-reperfusion-after-acute-endovascular-stroke-therapy
#7
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
https://www.readbyqxmd.com/read/30159593/gauging-potential-risk-for-patients-in-pediatric-radiology-by-review-of-over-2-000-incident-reports
#8
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
https://www.readbyqxmd.com/read/30119164/methodology-of-a-new-inflammatory-arthritis-registry-treasure
#9
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
https://www.readbyqxmd.com/read/30115675/feasibility-safety-and-periprocedural-complications-associated-with-endovascular-treatment-of-ruptured-intracranial-aneurysms-according-to-the-depth-of-anesthesia
#10
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
https://www.readbyqxmd.com/read/30066171/pain-in-percutaneous-liver-core-needle-biopsy-a-randomized-trial-comparing-the-intercostal-and-subcostal-approaches
#11
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
https://www.readbyqxmd.com/read/30064956/characteristics-of-reported-adverse-events-during-moderate-procedural-sedation-an-update
#12
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
https://www.readbyqxmd.com/read/30064904/endobronchial-brachytherapy-in-the-management-of-lung-malignancies-20-years-of-experience-in-an-australian-center
#13
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
https://www.readbyqxmd.com/read/30063371/challenges-and-opportunities-for-continued-success-and-growth-of-pediatric-interventional-radiology-a-communiqu%C3%A3-from-the-society-for-pediatric-interventional-radiology
#14
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
https://www.readbyqxmd.com/read/30002051/ultrafast-brain-mri-can-be-used-for-indications-beyond-shunted-hydrocephalus-in-pediatric-patients
#15
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
https://www.readbyqxmd.com/read/29990604/factors-of-delayed-hyperperfusion-and-the-importance-of-repeated-cerebral-blood-flow-evaluation-for-hyperperfusion-after-direct-bypass-for-moyamoya-disease
#16
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...
October 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29988098/cost-and-efficacy-comparison-of-five-prostate-biopsy-modalities-a-platform-for-integrating-cost-into-novel-platform-comparative-research
#17
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
https://www.readbyqxmd.com/read/29901282/evaluation-of-the-agreement-between-focused-assessment-with-sonography-for-trauma-afast-tfast-and-computed-tomography-in-dogs-and-cats-with-recent-trauma
#18
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
https://www.readbyqxmd.com/read/29894993/transbronchial-lung-cryobiopsy-in-interstitial-lung-diseases-best-practice
#19
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
https://www.readbyqxmd.com/read/29725913/is-mri-imaging-in-pediatric-age-totally-safe-a-critical-reprisal
#20
REVIEW
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
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