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https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#1
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28319552/evaluation-of-lung-function-and-clinical-features-of-the-ultrasound-guided-stellate-ganglion-block-with-2-different-concentrations-of-a-local-anesthetic-a-randomized-controlled-trial
#2
Won-Joong Kim, Hahck Soo Park, Myung Sub Yi, Gill-Hoi Koo, Hwa-Yong Shin
BACKGROUND: One possible complication of stellate ganglion block (SGB) is respiratory compromise. No study has yet addressed the comparison of its effect on lung function and clinical features, including Horner's syndrome, changes in temperature, sensory and motor functions, and adverse events of lower versus higher concentrations (LC and HC, respectively) of local anesthetics in an ultrasound-guided SGB. METHODS: Fifty patients were randomized into 1 of 2 groups: the LC group (5 mL of 0...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28317398/cardiac-transplantation-towards-a-new-noninvasive-approach-of-cardiac-allograft-rejection
#3
Sophie I Mavrogeni, George Athanasopoulos, Aggeliki Gouziouta, Evangelos Leontiadis, Stamatis Adamopoulos, Genovefa Kolovou
Cardiac allograft rejection (CAR) may occur after transplantation and remains silent, until hemodynamic deterioration takes place. Endomyocardial biopsy (EMB) is applied to early detect CAR. Although, flexible bioptoms have decreased the incidence of lethal complications, EMB remains an invasive procedure carrying risk of tamponade and permanent heart block. Therefore, a new non-invasive approach is needed. Areas covered: AlloMap molecular expression testing and graft-derived cell-free DNA (GcfDNA) test can be used as blood indices of acute and chronic CAR, respectively...
March 20, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28314439/reversing-the-atypical-valuation-of-drug-and-nondrug-rewards-in-smokers-using-multimodal-neuroimaging
#4
Travis E Baker, Paul Lesperance, Alan Tucholka, Stephane Potvin, Kevin Larcher, Yu Zhang, Didier Jutras-Aswad, Patricia Conrod
BACKGROUND: Chronic substance use can disrupt the reward function of the anterior cingulate cortex (ACC), biasing the ACC to favor goal-directed behaviors that converge on drug use. Here we used multimodal neuroimaging methods to ask whether modulating reward-related signaling in the ACC can reverse the atypical valuation of nondrug and drug rewards in abstinent smokers. METHODS: We first recorded functional magnetic resonance imaging data from 20 moderately dependent cigarette smokers (mean age = 25 years; no history of neuropsychiatric disorders), following an overnight period of abstinence, to identify regions of the left dorsal lateral prefrontal cortex associated with the anticipation of drug-related rewards (cigarette puff)...
January 27, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/28303639/covered-stent-implantation-through-a-single-8-french-guide-catheter-for-the-management-of-a-distal-coronary-perforation
#5
Yader Sandoval, Angie S Lobo, Emmanouil S Brilakis
Distal coronary perforation can cause early or late tamponade and is usually treated with fat or coil embolization. An alternative treatment strategy is occlusion of the ostium of the perforated vessel via implantation of a covered stent in the main vessel, which is typically achieved using the ping-pong guide catheter technique. In this technique, a balloon is inflated over one guide catheter to stop pericardial bleeding and a covered stent is delivered through a second guide catheter due to inability to fit both a balloon and a covered stent through a single guide catheter...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28301062/metabolomic-guided-discovery-of-alzheimer-s-disease-biomarkers-from-body-fluid
#6
REVIEW
Che Nor Adlia Enche Ady, Siong Meng Lim, Lay Kek Teh, Mohd Zaki Salleh, Ai-Vyrn Chin, Maw Pin Tan, Philip Jun Hua Poi, Shahrul Bahyah Kamaruzzaman, Abu Bakar Abdul Majeed, Kalavathy Ramasamy
The rapid increase in the older population has made age-related diseases like Alzheimer's disease (AD) a global concern. Given that there is still no cure for this neurodegenerative disease, the drastic growth in the number of susceptible individuals represents a major emerging threat to public health. The poor understanding of the mechanisms underlying AD is deemed the greatest stumbling block against progress in definitive diagnosis and management of this disease. There is a dire need for biomarkers that can facilitate early diagnosis, classification, prognosis, and treatment response...
March 16, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28299433/mri-guided-cryoablation-of-the-posterior-femoral-cutaneous-nerve-for-the-treatment-of-neuropathy-mediated-sitting-pain
#7
Dharmdev H Joshi, Gaurav K Thawait, Filippo Del Grande, Jan Fritz
Neuropathy of the posterior femoral cutaneous nerve may manifest as pain and paresthesia in the skin over the inferior buttocks, posterior thigh, and popliteal region. Current treatment options include physical and oral pain therapy, perineural injections, and surgical neurectomy. Perineural steroid injections may provide short-term pain relief; however, to our knowledge, there is currently no minimally invasive denervation procedure for sustained pain relief that could serve as an alternative to surgical neurectomy...
March 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28298785/the-effect-of-intravenous-dexmedetomidine-compared-to-propofol-on-patients-hemodynamics-as-a-sedative-in-brachial-plexus-block-a-comparative-study
#8
Amarjeet Kumar, Chandni Sinha, Ajeet Kumar, Poonam Kumari
BACKGROUND: The quest for an ideal sedative during regional anesthesia is on. Although propofol has been accepted as a sedative intraoperatively, it can be associated with troublesome hemodynamic changes. Dexmedetomidine is a new alpha 2 agonist used widely for sedation. AIMS: In this study, we tried to compare equivalent doses of dexmedetomidine infusion with propofol with emphasis on their effect on the hemodynamics. SETTINGS AND DESIGN: Prospective, single-blinded randomized controlled trial...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298781/analgesic-efficacy-of-transverse-abdominal-plane-block-after-elective-cesarean-delivery-bupivacaine-with-fentanyl-versus-bupivacaine-alone-a-randomized-double-blind-controlled-clinical-trial
#9
Roshan John, R V Ranjan, T R Ramachandran, Sagiev Koshy George
BACKGROUND: The analgesic benefit of transversus abdominis plane (TAP) blocks for cesarean delivery remains controversial. In our study, we compared the analgesic efficacy of TAP block using local anesthetic bupivacaine and adjunct fentanyl with bupivacaine alone in patients undergoing elective cesarean section. METHODS: Our study was a randomized, double-blind, controlled clinical trial where sixty patients undergoing elective cesarean delivery under subarachanoid block (2 ml of 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298773/comparison-of-nerve-stimulation-guided-axillary-brachial-plexus-block-single-injection-versus-four-injections-a-prospective-randomized-double-blind-study
#10
Santoshi V Badiger, Sameer N Desai
BACKGROUND: A variety of techniques have been described for the axillary block using nerve stimulator, either with single injection, two, three, or four separate injections. Identification of all the four nerves is more difficult and time-consuming than other methods. AIMS: Aim of the present study is to compare success rate, onset, and duration of sensory and motor anesthesia of axillary block using nerve stimulator, either with single injection after identification of any one of the four nerves or four separate injections following identification of each of nerve...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298747/benefits-and-pitfalls-of-cadavers-as-learning-tool-for-ultrasound-guided-regional-anesthesia
#11
REVIEW
Chhavi Sawhney, Sanjeev Lalwani, Bikash Ranjan Ray, Sumit Sinha, Abhyuday Kumar
Ultrasound-guided regional anesthesia (UGRA), like other basic skills, should be learnt in a simulation laboratory before performing on the patient. Cadavers provide an ideal tool for learning sonoanatomy and skills required for performing UGRA. On the basis of preservation technique used, the cadavers can be formalin embalmed cadavers, Thiel cadavers (soft cadavers), and fresh frozen cadavers. We compared three types of cadavers for performing ultrasound-guided upper and lower limb blocks. We observed that fresh frozen and Thiel cadavers were less smelling and had more realistic appearance as compared to formalin embalmed cadavers...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28297795/-the-potential-use-of-serum-hbv-rna-to-guide-the-functional-cure-of-chronic-hepatitis-b
#12
F M Lu, J Wang, X M Chen, J N Jiang, W H Zhang, J M Zhao, H Ren, J L Hou, N S Xia
Hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) in infected hepatocytes is the main cause of off-therapy viral rebound. The half-life of cccDNA is only 33-50 days, so the conversion of newly synthesized rcDNA to cccDNA in the nucleus is essential for the maintenance of cccDNA pool in infected hepatocytes. Though not directly targeting the existing cccDNA, current nucleos(t)ide analogues (NAs) may exhaust the cccDNA reservoir by blocking the rcDNA formation. Indeed, a prolonged consolidation therapy post loss of serum HBV DNA can achieve sustained remission and thus safe drug discontinuation in a small proportion of chronic hepatitis B (CHB) patients...
February 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28297352/improved-setup-and-positioning-accuracy-using-a-three-point-customized-cushion-mask-bite-block-immobilization-system-for-stereotactic-reirradiation-of-head-and-neck-cancer
#13
He Wang, Congjun Wang, Samuel Tung, Andrew Wilson Dimmitt, Pei Fong Wong, Mark A Edson, Adam S Garden, David I Rosenthal, Clifton D Fuller, Gary B Gunn, Vinita Takiar, Xin A Wang, Dershan Luo, James N Yang, Jennifer Wong, Jack Phan
The purpose of this study was to investigate the setup and positioning uncertainty of a custom cushion/mask/bite-block (CMB) immobilization system and determine PTV margin for image-guided head and neck stereotactic ablative radiotherapy (HN-SABR). We analyzed 105 treatment sessions among 21 patients treated with HN-SABR for recurrent head and neck cancers using a custom CMB immobilization system. Initial patient setup was performed using the ExacTrac infrared (IR) tracking system and initial setup errors were based on comparison of ExacTrac IR tracking system to corrected online ExacTrac X-rays images registered to treatment plans...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28294274/discovery-of-hierarchical-superstructures-in-block-copolymers-by-integrating-different-liquid-crystalline-interactions
#14
Wei Wei, Zhichao Wu, Mingjun Huang, Chih-Hao Hsu, Yu Liu, Xinlin Zhang, Huiming Xiong
Hierarchically assembled superstructures of block copolymers are discovered by introduction of the competition of anisotropy attributed from liquid crystalline ordering and nano-phase separation. When the two prototypical fields of liquid crystals (LCs), smectics (S) and nematics (N), are adjoined within the framework of diblock copolymers (S-N) in a variety of precisely tuned compositions, a novel class of superlattices with an interdigitated array of smectic layers between the nearest lamellae or cylinders are observed...
March 15, 2017: Soft Matter
https://www.readbyqxmd.com/read/28291849/vertical-ridge-augmentation-in-the-atrophic-mandible-a-systematic-review-and-meta-analysis
#15
Basel Elnayef, Alberto Monje, Jordi Gargallo-Albiol, Pablo Galindo-Moreno, Hom-Lay Wang, Federico Hernández-Alfaro
PURPOSE: To systematically appraise the effectiveness/reliability of vertical ridge augmentation (VRA) in the atrophic mandible. Articles that addressed any one of the following four areas were included in this study: amount of VRA, implant survival (ISR) and success rates (SSR) in the area of newly regenerated bone, complication rate during the bone augmentation procedure, and bone resorption. MATERIALS AND METHODS: An electronic literature search was conducted by two independent reviewers in several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register databases for articles reporting VRA in the atrophic mandible via distraction osteogenesis (DO), inlay block grafting (IBG), onlay block grafting (OBG), and guided bone regeneration (GBR)...
March 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28291128/the-use-of-ultrasound-in-obstetric-anesthesia
#16
Carolyn F Weiniger, Limor Sharoni
PURPOSE OF REVIEW: The current review considers an array of recent applications for point-of-care ultrasound in clinical practice including diagnostic and therapeutic procedures that may be relevant for the obstetric anesthesiologist. The rapid advancement of technology and clinical applications for bedside ultrasound in obstetric anesthesiology requires an appraisal of the limitations and uses. RECENT FINDINGS: The review presents the most recent literature describing ultrasound-guided airway assessments, airway management, cricothyroidotomy, transthoracic echocardiography, gastric volume assessments, point-of-care lung ultrasound diagnoses, intracranial pressure assessments, vascular access, neuraxial blocks, and transversus abdominis plane blocks...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28289637/ultrasonography-evaluation-of-vulnerable-vessels-around-cervical-nerve-roots-during-selective-cervical-nerve-root-block
#17
Hoon Hoon Lee, Donghwi Park, Yoongul Oh, Ju Seok Ryu
OBJECTIVE: To evaluate the prevalence of vulnerable blood vessels around cervical nerve roots before cervical nerve root block in the clinical setting. METHODS: This retrospective study included 74 patients with cervical radiculopathy who received an ultrasonography-guided nerve block at an outpatient clinic from July 2012 to July 2014. Before actual injection of the steroid was performed, we evaluated the vulnerable blood vessels around each C5, C6, and C7 nerve root of each patient's painful side, with Doppler ultrasound...
February 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28288650/analysis-of-an-international-collaboration-for-capacity-building-of-human-resources-for-eye-care-case-study-of-the-college-college-vision-2020-link
#18
Nyawira Mwangi, Marcia Zondervan, Covadonga Bascaran
BACKGROUND: There is an extreme health workforce shortage in Eastern, Central, and Southern Africa. Shortage of eye care workers impedes effective implementation of prevention of blindness programs. The World Health Organization has identified education, partnership, leadership, financing, and policy as intertwined interventions that are critical to resolving this crisis on the long term. CASE PRESENTATION: The VISION 2020 LINK between the College of Ophthalmology of Eastern, Central, and Southern Africa and the Royal College of Ophthalmologists in the United Kingdom aims to increase the quantity and quality of eye care training in East, Central, and Southern Africa through a focus on five strategic areas: fellowship examination for ophthalmologists, training the trainers, curriculum development for residents in ophthalmology and ophthalmic clinical officers, continuous professional development (CPD), and mentoring program for young ophthalmologists...
March 14, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28287264/prospective-evaluation-of-free-energy-calculations-for-the-prioritization-of-cathepsin-l-inhibitors
#19
Bernd Kuhn, Michal Tichý, Lingle Wang, Shaughnessy Robinson, Rainer E Martin, Andreas Kuglstatter, Jörg Benz, Maude Giroud, Tanja Schirmeister, Robert Abel, François Diederich, Jérôme Hert
Improving the binding affinity of a chemical series by systematically probing one of its exit vectors is a medicinal chemistry activity that can benefit from molecular modeling input. Herein, we compare the effectiveness of four approaches in prioritizing building blocks with better potency: selection by a medicinal chemist, manual modeling, docking followed by manual filtering, and free energy calculations (FEP). Our study focused on identifying novel substituents for the apolar S2 pocket of cathepsin L and was conducted entirely in a prospective manner with synthesis and activity determination of 36 novel compounds...
March 13, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28286861/nerve-stimulator-versus-ultrasound-guided-femoral-nerve-block-a-randomized-clinical-trial
#20
Arash Forouzan, Kambiz Masoumi, Hasan Motamed, Mohammad Reza Gousheh, Akram Rohani
INTRODUCTION: Pain control is the most important issue in emergency department management of patients with femoral bone fractures. The present study aimed to compare the procedural features of ultrasonography and nerve stimulator guided femoral nerve block in this regard. METHOD: In this randomized clinical trial, patients with proximal femoral fractures presenting to emergency department were randomly divided into two groups of ultrasonography or nerve stimulator guided femoral block and compared regarding success rate, procedural time, block time, and need for rescue doses of morphine sulfate, using SPSS 20...
2017: Emergency (Tehran, Iran)
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