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https://www.readbyqxmd.com/read/29141380/-the-analysis-of-anesthetic-management-for-renal-cell-carcinoma-with-associated-inferior-vena-cava-tumor-thrombus
#1
H Zeng, X Y Rong, Y Wang, X Y Guo
Objective: To explore the key points of anesthetic management for renal cell carcinoma combined with inferior vena cava (IVC) tumor thrombus. Methods: Twenty-seven cases of renal cell carcinoma with inferior vena cava (IVC) tumor thrombus underwent radical nephrectomy and inferior caval venous thrombectomy were reviewed retrospectively during January 2014 to January 2017 in our hospital.Analyzed data includs demographics, classification of tumor, perioperative anesthetic management and monitoring approaches, IVC clamping time , vital signs during cardiopulmonary bypass(CPB), estimated blood loss (EBL), usage of blood products, hospitalization time and ICU time , as well as postoperative outcomes...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140927/clinical-trial-designs-and-models-for-analgesic-medications-for-acute-pain-in-neonates-infants-toddlers-children-and-adolescents-acttion-recommendations
#2
Gary A Walco, Ernest A Kopecky, Steven J Weisman, Jennifer Stinson, Bonnie Stevens, Paul J Desjardins, Charles B Berde, Elliot J Krane, Kanwaljeet Js Anand, Myron Yaster, Carlton D Dampier, Robert H Dworkin, Ian Gilron, Anne M Lynn, Lynne G Maxwell, Srinivasa Raja, Bernard Schachtel, Dennis C Turk
Clinical trials to test the safety and efficacy of analgesics across all pediatric age cohorts are needed to avoid inappropriate extrapolation of adult data to children. However, the selection of acute pain models and trial design attributes to maximize assay sensitivity, by pediatric age cohort, remains problematic. Acute pain models used for drug treatment trials in adults are not directly applicable to the pediatric age cohorts - neonates, infants, toddlers, children, and adolescents. Developmental maturation of metabolic enzymes in infants and children must be taken into consideration when designing trials to test analgesic treatments for acute pain...
November 13, 2017: Pain
https://www.readbyqxmd.com/read/29140384/two-bilateral-zygomatic-implants-placed-and-immediately-loaded-a-retrospective-chart-review-with-up-to-54-month-follow-up
#3
Jay Neugarten, Frank J Tuminelli, Leora Walter
PURPOSE: To report on the outcome of placement of two bilateral zygomatic implants with an immediately loaded prosthesis. MATERIALS AND METHODS: A retrospective chart review was conducted of all patients treated with zygomatic implants between August 1, 2011 and June 6, 2016. All patients had at least two zygomatic implants placed bilaterally and immediately loaded with a provisional prosthesis the same day of implant placement. The implants were Nobel Biocare TiUnite or machined surface with lengths of 30 to 52...
November 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/29138928/mechanisms-of-drug-binding-to-voltage-gated-sodium-channels
#4
M E O'Leary, M Chahine
Voltage-gated sodium (Na(+)) channels are expressed in virtually all electrically excitable tissues and are essential for muscle contraction and the conduction of impulses within the peripheral and central nervous systems. Genetic disorders that disrupt the function of these channels produce an array of Na(+) channelopathies resulting in neuronal impairment, chronic pain, neuromuscular pathologies, and cardiac arrhythmias. Because of their importance to the conduction of electrical signals, Na(+) channels are the target of a wide variety of local anesthetic, antiarrhythmic, anticonvulsant, and antidepressant drugs...
November 15, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/29135363/total-and-subtotal-laparoscopic-gastrectomy-for-the-treatment-of-advanced-gastric-cancer-morbidity-and-oncological-outcomes
#5
Stefano Olmi, Riccardo Giorgi, Stefano Piero Bernardo Cioffi, Matteo Uccelli, Roberta Villa, Francesca Ciccarese, Bruno Scotto, Giorgio Castello, Gianluca Legnani, Giovanni Cesana
BACKGROUND: A debate is still surrounding the use of laparoscopic surgery for advanced gastric cancer (AGC) related to doubts about the requirements to satisfy oncologic criteria. The aim of this study is to analyze the oncological results, the intraoperative complications, and the short- and medium-term morbidity and mortality in patients with AGC who underwent subtotal laparoscopic gastrectomy (SLG) or total laparoscopic gastrectomy (TLG) with extended lymphadenectomy. MATERIALS AND METHODS: We reviewed medical records of patients who underwent radical gastrectomy for AGC started laparoscopically with the intent of curative surgery, between July 2007 and October 2015...
November 14, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29133765/geriatric-anesthesia-related-morbidity-and-mortality-in-china-current-status-and-trend
#6
REVIEW
Yang Liu, Wei Xiao, Ling-Zhong Meng, Tian-Long Wang
OBJECTIVE: The population of elderly patients and the amount of geriatric anesthesia have been growing rapidly in China. Thus, understanding the morbidity and mortality associated with geriatric anesthesia in China is critical to the improvement of anesthesia quality and outcome. The aim of the review was to discuss the geriatric anesthesia-related morbidity and mortality in China, as well as to point out the future trend. DATA SOURCES: Articles in this review were all searched from Wanfang, China National Knowledge Infrastructure (CNKI), VIP, PubMed, and Web of Science databases, based on the reports originated in China from January 2011 to December 2016...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29133582/use-of-ketamine-for-acute-suicidal-ideation-in-a-patient-with-chronic-pain-on-prescribed-cannabinoids
#7
Daniel Bigman, Sindhura Kunaparaju, Bradford Bobrin
Ketamine is a standard anaesthetic drug that has been studied as a possible treatment for acute suicidal ideation. Aside to the potential psychotropic effects of ketamine, a Cochrane review reported that available studies suggest a modest effect of ketamine for chronic pain months to years after surgical intervention. We present a patient with acute suicidal ideation who required immediate inpatient psychiatric admission in the setting of concurrent chronic pain on cannabinoids which could not be prescribed within our inpatient hospital setting...
November 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29132808/bilateral-vocal-fold-medialization-a-treatment-for-abductor-spasmodic-dysphonia
#8
Karuna Dewan, Gerald S Berke
INTRODUCTION: Abductor spasmodic dysphonia, a difficult-to-treat laryngologic condition, is characterized by spasms causing the vocal folds to remain abducted despite efforts to adduct them during phonation. Traditional treatment for abductor spasmodic dysphonia-botulinum toxin injection into the posterior cricoarytenoid muscle-can be both technically challenging and uncomfortable. Due to the difficulty of needle placement, it is often unsuccessful. The purpose of this investigation is to present a previously undescribed treatment for abductor spasmodic dysphonia-bilateral vocal fold medialization...
November 10, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/29131754/perioperative-local-and-systemic-warming-in-surgical-site-infection-a-systematic-review-and-meta-analysis
#9
K Ousey, K-L Edward, S Lui, J Stephenson, K Walker, J Duff, D Leaper
OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs...
November 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#10
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29131366/successful-and-safe-use-of-q-switched-lasers-in-the-treatment-of-nevus-of-ota-in-children-with-phototypes-iv-vi
#11
Daniel A Belkin, Hana Jeon, Elliot Weiss, Jeremy A Brauer, Roy G Geronemus
OBJECTIVE: Nevus of Ota represents congenital dermal melanocytosis in a trigeminal distribution, most commonly occurring in Asian individuals and other individuals with skin of color. Evidence suggests early treatment is beneficial. Multiple reports have shown efficacy and safety of Q-switched laser treatment in adults. There is little data on children and in non-Asian skin types. This series was done to demonstrate safe and effective use of Q-switched laser therapy in children of multiple skin types...
November 13, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/29131086/intracranial-epidural-haematoma-following-surgical-removal-of-a-giant-lumbosacral-schwannoma-a-case-report-and-literature-review
#12
Jakob Nemir, Vjerislav Peterković, Ines Trninić, Ivan Domazet, Hrvoje Barić, Miroslav Vukić
Postoperative intracranial epidural haematoma (EDH) is an extremely rare complication following spinal surgery, with only a handful of cases described in the literature. We report the case of a 16-year-old girl who underwent a successful subtotal resection of a giant lumbosacral schwannoma (L2-S2 level). Recovery from general anaesthesia was uneventful; however, her neurological status deteriorated rapidly within 24 h after surgery. A head computed tomography scan revealed a large right frontoparietal EDH with midline shift...
November 11, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29131005/a-review-of-anesthetic-effects-on-renal-function-potential-organ-protection
#13
Negar Motayagheni, Sheshanna Phan, Crystal Eshraghi, Ala Nozari, Anthony Atala
BACKGROUND: Renal protection is a critical concept for anesthesiologists, nephrologists, and urologists, since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries, especially transplant procedures. Some experimental studies have shown that some anesthetics provide protection against renal ischemia/reperfusion (IR) injury, but there is limited clinical evidence...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130583/endoscopic-retrograde-cholangio-pancreatography-in-the-management-of-biliary-complications-after-paediatric-liver-transplantation
#14
Sivaramakrishnan Venkatesh Karthik, Seng-Hock Quak, Marion M Aw
BACKGROUND: The published paediatric experience with Endoscopic retrograde cholangio-pancreatography (ERCP) in the diagnosis and management of biliary complications following liver transplantation (LT) is limited. AIMS: We describe our experience with ERCP in the management of children following LT who presented with biliary complications, over a 20 year period (1995-2014). METHODS: The retrospectively reviewed data is summarized descriptively...
November 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#15
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29127600/a-review-of-current-and-emerging-approaches-to-pain-management-in-the-emergency-department
#16
REVIEW
Knox H Todd
INTRODUCTION: Pain is the most common symptom prompting an emergency department visit and emergency physicians are responsible for managing both acute pain and acute exacerbations of chronic pain resulting from a broad range of illnesses and injuries. The responsibility to treat must be balanced by the duty to limit harm resulting from analgesics. In recent years, opioid-related adverse effects, including overdose and deaths, have increased dramatically in the USA. In response to the US opioid crisis, emergency physicians have broadened their analgesic armamentarium to include a variety of non-opioid approaches...
November 10, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/29127294/preventing-shivering-with-adjuvant-low-dose-intrathecal-meperidine-a-meta-analysis-of-randomized-controlled-trials-with-trial-sequential-analysis
#17
Yu-Cih Lin, Chien-Yu Chen, Yuan-Mei Liao, Alan Hsi-Wen Liao, Pi-Chu Lin, Chuen-Chau Chang
The aim of this systematic review and meta-analysis is to evaluate the pros and cons of adjuvant low dose intrathecal meperidine for spinal anaesthesia. We searched electronic databases for randomized controlled trials using trial sequential analysis (TSA) to evaluate the incidence of reduced rescue analgesics, shivering, pruritus, nausea and vomiting when applying adjuvant intrathecal meperidine. Twenty-eight trials with 2216 patients were included. Adjuvant intrathecal meperidine, 0.05-0.5 mg kg(-1), significantly reduced incidence of shivering (relative risk, RR, 0...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29127018/curriculum-using-the-in-situ-operating-room-setting
#18
Raghavendra Rao, Robert C Caskey, Lily Owei, Kathleen O'Connor, Elijah Riddle, Daniel T Dempsey, Joshua Atkins, Dimitry Baranov, Gregory Motuk, Ari D Brooks, Noel Williams, Jon Morris, Kristoffel Dumon
OBJECTIVE: The American College of Surgeons/Association of Program Directors in Surgery is a comprehensive, simulation-based curriculum for General Surgery residents which exists in 3 phases. While phases 1 and 2 deal with core skills and advanced procedures respectively, phase 3 targets team-based skills. To date, the 3rd phase of this curriculum has not seen wide scale implementation. This is a pilot study to verify the feasibility of implementing the phase 3 curriculum in the in-situ setting...
November 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29126680/anesthetic-and-perioperative-considerations-for-combined-heart-kidney-transplantation
#19
Santiago Mc Loughlin, Juan C Bianco, Ricardo G Marenchino
OBJECTIVE: To describe detailed perioperative features of combined heart and kidney transplant (HKT). DESIGN: Retrospective study. SETTING: Tertiary care university hospital. PARTICIPANTS: All consecutive HKT recipients aged 18 years and older. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: After approval of the Institutional Review Board, the authors studied all consecutive adult patients who underwent HKT between January 2013 and July 2016...
September 15, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29125801/laparoscopic-versus-open-restorative-proctocolectomy-for-familial-adenomatous-polyposis
#20
Fábio Guilherme Campos, Carlos Augusto Real Martinez, Mariane Gouveia Monteiro de Camargo, Daniele Menezes Cesconetto, Sérgio Carlos Nahas, Ivan Cecconello
PURPOSE: This study compared outcomes after laparoscopic (LAP) or conventional (open) total proctocolectomy with outcomes after ileal J-pouch anal anastomosis (IPAA) at a single institution. METHODS: Charts from 133 familial adenomatous polyposis patients (1997-2013) were reviewed. Demographic data (age, sex, color, American Society of Anesthesiologists [ASA] status, previous surgery, and body mass index) and surgical outcomes (length of stay, early and late morbidity, reoperation, and mortality rates) were compared among 63 patients undergoing IPAA...
November 10, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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