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https://www.readbyqxmd.com/read/29779231/specialist-perioperative-allergy-clinic-services-in-the-uk-2018-results-from-the-royal-college-of-anaesthetists-sixth-national-audit-project-nap6-investigation-of-perioperative-anaphylaxis
#1
W Egner, T M Cook, T Garcez, S Marinho, H Kemp, D N Lucas, K Floss, S Farooque, H Torevell, M Thomas, K Ferguson, S Nasser, S Karanam, K-L Kong, N McGuire, M Bellamy, A Warner, J Hitchman, L Farmer, N J N Harper
BACKGROUND: The Royal College of Anaesthetists 6th National Audit Project examined Grade 3-5 perioperative anaphylaxis for one year in the UK. OBJECTIVE: To describe the causes and investigation of anaphylaxis in the NAP6 cohort, in relation to published guidance and previous baseline survey results. METHODS: We used a secure registry to gather details of Grade 3-5 perioperative anaphylaxis. Anonymous reports were aggregated for analysis and reviewed in detail...
May 19, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29778972/hypnotic-agents-for-induction-of-general-anesthesia-in-cesarean-section-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
Kavita Houthoff Khemlani, Stephanie Weibel, Peter Kranke, Jan-Uwe Schreiber
STUDY OBJECTIVE: An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. DESIGN: A systematic review and meta-analysis, using PRISMA methodology, of randomized controlled trials (RCTs), comparing women undergoing CS using thiopentone with those undergoing CS with propofol, ketamine, or benzodiazepines as hypnotic agents...
May 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29778596/anterior-vs-posterior-approach-for-thoracic-corpectomy-an-analysis-of-risk-factors-outcomes-and-complications
#3
Ryan G Chiu, Jonathan Hobbs, Darian R Esfahani, Saavan Patel, David Rosenberg, Clayton L Rosinski, Akash S Patel, Anisse N Chaker, Ankit I Mehta
BACKGROUND: Thoracic corpectomies are performed for various reasons including spinal deformity, trauma, neoplasms, and infection. Regardless of indication, both anterior and posterior approaches are surgical options, selected based on pathology, anatomy, patient characteristics, and surgical experience. Risk profiles and outcomes for these procedures are poorly characterized, however, and the choice between the two approaches remains inconclusive. OBJECTIVE: To compare risk factors and complications for adult patients undergoing anterior and posterior thoracic corpectomies...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29778545/a-descriptive-model-for-a-multidisciplinary-unit-for-colorectal-and-pelvic-malformations
#4
Alejandra Vilanova-Sanchez, Devin R Halleran, Carlos A Reck-Burneo, Alessandra C Gasior, Laura Weaver, Meghan Fisher, Andrea Wagner, Onnalisa Nash, Kristina Booth, Kaleigh Peters, Charae Williams, Sarah Mayer Brown, Peter Lu, Molly Fuchs, Karen Diefenbach, Jeffrey R Leonard, Geri Hewitt, Kate McCracken, Carlo Di Lorenzo, Richard J Wood, Marc A Levitt
INTRODUCTION: Patients with anorectal malformations (ARM), Hirschsprung disease (HD), and colonic motility disorders often require care from specialists across a variety of fields, including colorectal surgery, urology, gynecology, and GI motility. We sought to describe the process of creating a collaborative process for the care of these complex patients. METHODS: We developed a model of a devoted center for these conditions that includes physicians, psychologists, social workers, nurses, and advanced practice nurses...
April 19, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#5
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29774793/surgical-considerations-in-interrupted-aortic-arch
#6
Damien J LaPar, Christopher W Baird
Interrupted aortic arch (IAA) is a rare congenital anomaly with several anatomical variants and is often associated with other intracardiac and/or extracardiac congenital anomalies. Historically, associated with high early mortality, outcomes for this anomaly have improved in recent eras with advances in perioperative and anesthesia management and refinements in surgical technique. This review provides a description of surgical anatomy, anatomical classifications, and associated congenital lesions as well as an examination of the perioperative and surgical management of IAA in the contemporary surgical era...
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29774222/asymmetrical-traumatic-bilateral-hip-dislocations-with-hemodynamic-instability-and-an-unstable-pelvic-ring-case-report-and-review-of-literature
#7
Kai Huang, Grey Giddins, Jian-Fang Zhang, Jian-Wei Lu, Jun-Ming Wan, Peng-Li Zhang, Shao-Yu Zhu
Simultaneous anterior and posterior traumatic dislocations of both hips are very rare. Only 33 cases have been previously reported in the English language literature. Although they were all due to high-energy injuries, they were hemodynamically stable and had a stable pelvic ring. We report a unique case of asymmetrical hip dislocations with an unstable pelvic ring and hemodynamic instability. A 40-year-old man was injured in a high-energy motor vehicle accident. He was hemodynamically unstable when he presented in the emergency department...
May 16, 2018: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/29773715/embolus-retriever-with-interlinked-cages-versus-other-stent-retrievers-in-acute-ischemic-stroke-an-observational-comparative-study
#8
Philipp Gruber, Salome Zeller, Carlos Garcia-Esperon, Jatta Berberat, Javier Anon, Michael Diepers, Krassen Nedeltchev, Fabian Flottmann, Jens Fiehler, Luca Remonda, Timo Kahles
BACKGROUND AND PURPOSE: Given the promising performance of the new Embolus Retriever with Interlinked Cages (ERIC) in smaller case series, we sought to assess the efficacy and safety of mechanical thrombectomy (MT) with ERIC compared with other stent retrievers (SRs) in acute ischemic stroke due to large vessel occlusion (LVO). METHODS: We reviewed the databases of two comprehensive stroke centers in in Germany and Switzerland for MT due to LVO in the anterior circulation with either ERIC or another SR as a first device...
May 17, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29773485/pregnancy-after-heterotopic-heart-transplant-removal
#9
S Churchill, L de Lloyd, H C Francis, H Wallis
Heterotopic heart transplants were introduced in 1974. The technique allows the patient's native heart to be preserved in situ, alongside the transplanted heterotopic donor heart (Newcomb et al., 2004). We present the case of a nulliparous woman who underwent heterotopic heart transplant in infancy, and subsequent explantation of the donor heart eleven years later, when her native heart function recovered. In adulthood the patient attended pre-pregnancy counselling and was awaiting cardiac magnetic resonance imaging when she presented pregnant at 6 weeks-of-gestation...
April 24, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29773277/-thicker-polyethylene-bearings-are-not-associated-with-higher-failure-rates-in-primary-total-knee-arthroplasty
#10
Nicholas J Greco, David A Crawford, Keith R Berend, Joanne B Adams, Adolph V Lombardi
BACKGROUND: Despite improvements in polyethylene bearing surface properties, only 1 previous study has examined the results of larger thickness bearings. The purpose of this study was to determine whether polyethylene thickness influenced patient outcomes and implant survival following modular total knee arthroplasty. METHODS: A retrospective review was performed of patients undergoing primary total knee arthroplasty from 2003 to 2014 in a single practice database...
April 23, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29772592/-cardiac-anaesthesia-anaesthesiological-management
#11
Jochen Renner, Berthold Bein, Ole Broch
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29771811/use-of-emergency-manuals-during-actual-critical-events-in-china-a-multi-institutional-study
#12
Jeffrey Huang, Jiayan Wu, Christina Dai, Xianwei Zhang, Hui Ju, Yiqi Chen, Chunyuan Zhang, Fan Ye, Yi Tan, Yongbo Zong, Telong Liu
INTRODUCTION: Emergency manuals (EMs) can help healthcare providers respond to crises more efficiently. Three anesthesia EMs have been translated into Chinese. These EMs have been made publicly available as a free document downloadable in China. A year after these Chinese versions of EMs were published, we conducted a multi-institutional survey in China to assess the progress of how well EM had been adapted and used in the setting of critical events. METHODS: Our study used a multi-institutional, anonymous electronic survey...
May 16, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29771731/effect-of-intravenous-dexmedetomidine-during-general-anesthesia-on-acute-postoperative-pain-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
Xiuqin Wang, Naifu Liu, Jinlong Chen, Zan Xu, Fumei Wang, Chuan Ding
BACKGROUND: Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies. METHODS: Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials (RCTs). The relative risk (RR) and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. RESULTS: Compared to the normal saline group, patients using dexmedetomidine showed a significantly decreased pain intensity within 6 hours (WMD=-0...
May 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#14
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771715/whole-blood-for-resuscitation-in-adult-civilian-trauma-in-2017-a-narrative-review
#15
Evan G Pivalizza, Christopher T Stephens, Srikanth Sridhar, Sam D Gumbert, Susan Rossmann, Marsha F Bertholf, Yu Bai, Bryan A Cotton
After a hiatus of several decades, the concept of cold whole blood (WB) is being reintroduced into acute clinical trauma care in the United States. Initial implementation experience and data grew from military medical applications, followed by more recent development and data acquisition in civilian institutions. Anesthesiologists, especially those who work in acute trauma facilities, are likely to be presented with patients either receiving WB from the emergency department or may have WB as a therapeutic option in massive transfusion situations...
May 15, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29771696/the-future-of-anesthesia-for-interventional-radiology
#16
Annie Amin, Jason Scott Lane
PURPOSE OF REVIEW: To review novel procedures in interventional radiology and describe anesthetic implications. RECENT FINDINGS: Noninvasive treatment options for patients who are nonsurgical candidates are on the rise. The complication rate for patients receiving anesthesia in the interventional radiology suite is higher than other nonoperating room anesthetizing locations. The investigative use of catheter-directed thrombolysis for acute submassive pulmonary embolism will likely lead to an increased demand for anesthesia assistance...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29771695/scheduling-the-nonoperating-room-anesthesia-suite
#17
Mary E Warner, David P Martin
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed. RECENT FINDINGS: Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29771394/the-effect-of-intraoperative-hypothermia-on-shoulder-arthroplasty
#18
Toufic R Jildeh, Kelechi R Okoroha, Nathan E Marshall, Chad Amato, Hunter Trafton, Stephanie J Muh, Patricia Kolowich
Limited evidence is available regarding the correlation between intraoperative hypothermia and perioperative complications in shoulder arthroplasty. The purpose of this study was to determine the incidence of intraoperative hypothermia in patients treated with shoulder arthroplasty and its effect on perioperative complications. A retrospective chart review was performed on 657 consecutive patients who underwent shoulder arthroplasty at a single institution between August 2013 and June 2016. Demographic data, surgery-specific data, postoperative complications, length of stay, and 30-day read-mission were recorded...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29770880/intraoperative-periprosthetic-femur-fracture-during-bipolar-hemiarthroplasty-for-displaced-femoral-neck-fractures
#19
Choon Chiet Hong, Nazrul Nashi, Jiong Hao Tan, Ruben Manohara, Wei Ting Lee, Diarmuid Paul Murphy
INTRODUCTION: We aim to review the incidence and risk factors for the development of intraoperative periprosthetic femur fractures while performing a bipolar hemiarthroplasty for displaced neck of femur fractures. Our secondary aim is to characterize the types of intraoperative periprosthetic fractures, the steps leading to the fractures, and the salvage treatments instituted. MATERIALS AND METHODS: 271 patients treated with bipolar hemiarthroplasty after traumatic displaced femoral neck fractures were retrospectively analyzed...
May 17, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29770432/automated-mandatory-bolus-versus-basal-infusion-for-maintenance-of-epidural-analgesia-in-labour
#20
REVIEW
Ban Leong Sng, Yanzhi Zeng, Nurun Nisa A de Souza, Wan Ling Leong, Ting Ting Oh, Fahad Javaid Siddiqui, Pryseley N Assam, Nian-Lin R Han, Edwin Sy Chan, Alex T Sia
BACKGROUND: Childbirth may cause the most severe pain some women experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour and is considered to be the reference standard. Traditionally epidural analgesia has been delivered as a continuous infusion via a catheter in the epidural space, with or without the ability for the patient to supplement the analgesia received by activating a programmable pump to deliver additional top-up doses, known as patient-controlled epidural analgesia (PCEA)...
May 17, 2018: Cochrane Database of Systematic Reviews
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