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https://www.readbyqxmd.com/read/29177107/treatment-of-morbidly-adherent-placentation-utilizing-a-standardized-multidisciplinary-approach-in-the-community-hospital-private-practice-setting
#1
Mahsa Mansouri, Kim DeStefano, Brian Monks, Jasbir Singh, Mollie McDonnold, Jamison Morgan, Richard Hale, Jasvant Adusumalli, Amanda Horton, Sina Haeri
Objective  Morbidly adherent placentation is associated with increased maternal morbidity and mortality. Recently, there has been mounting evidence supporting the benefits of a standardized multidisciplinary approach at tertiary teaching hospitals. Our objective was to estimate the impact of the implementation of a similar program at a high-volume private community hospital. Study Design  In this retrospective cohort study, we evaluated maternal outcomes in all cases of histopathologically confirmed morbidly adherent placentation since the initiation of our multidisciplinary program (2012-2016)...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29174123/intraoperative-anesthetic-management-of-lung-transplantation-center-specific-practices-and-geographic-and-centers-size-differences
#2
Roland Tomasi, David Betz, Sophie Schlager, Tobias Kammerer, Dominik J Hoechter, Thomas Weig, Peter Slinger, Laura V Klotz, Bernhard Zwißler, Nandor Marczin, Vera von Dossow
OBJECTIVE: Although increasing evidence in lung transplantation (LTx) suggests that intraoperative management could influence outcomes, there are no guidelines available regarding intraoperative management of LTx. The overall goal of the study was to assess geographic and center volume-specific clinical practices in perioperative management. DESIGN: Prospective data analysis. SETTING: Online survey from a single-center university hospital...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#3
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29073928/safety-of-tubal-ligation-by-minilaparotomy-provided-by-clinical-officers-versus-assistant-medical-officers-study-protocol-for-a-noninferiority-randomized-controlled-trial-in-tanzanian-women
#4
Mark A Barone, Zuhura Mbuguni, Japhet Ominde Achola, Carmela Cordero, Joseph Kanama, Projestine S Muganyizi, Jamilla Mwanga, Caitlin Shannon, Leopold Tibyehabwa
BACKGROUND: Female sterilization by tubal ligation is a safe, extremely effective, and permanent way to limit childbearing. It is the most popular modern contraceptive method worldwide. The simplest way to provide tubal ligation is by a procedure called minilaparotomy, generally performed with the client under local anesthesia with systemic sedation and analgesia. In Tanzania, unmet need for family planning is high and has declined little in the past decade. Access to tubal ligation is limited throughout the country, in large part because of a lack of trained providers...
October 26, 2017: Trials
https://www.readbyqxmd.com/read/29067599/legislative-enforcement-of-nonconsensual-determination-of-neurological-brain-death-in-muslim-patients-a-violation-of-religious-rights
#5
Mohamed Y Rady, Joseph L Verheijde
Death is defined in the Quran with a single criterion of irreversible separation of the ruh (soul) from the body. The Quran is a revelation from God to man, and the primary source of Islamic knowledge. The secular concept of death by neurological criteria, or brain death, is at odds with the Quranic definition of death. The validity of this secular concept has been contested scientifically and philosophically. To legitimize brain death for the purpose of organ donation and transplantation in Muslim communities, Chamsi-Pasha and Albar (concurring with the US President's Council on Bioethics) have argued that irreversible loss of capacity for consciousness and breathing (apneic coma) in brain death defines true death in accordance with Islamic sources...
October 24, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/29029588/society-for-the-advancement-of-transplant-anesthesia-liver-transplant-anesthesia-fellowship-white-paper-advocating-measurable-proficiency-in-transplant-specialties-training
#6
Ryan M Chadha, Cara Crouch, Jeron Zerillo, Ernesto A Pretto, Raymond Planinsic, Sang Kim, Ramona Nicolau-Raducu, Dieter Adelmann, Elia Elia, Christopher L Wray, Coimbatore Srinivas, M Susan Mandell
The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers...
December 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28993991/pocus-in-perioperative-medicine-a-north-american-perspective
#7
Lorenzo De Marchi, Massimiliano Meineri
Ultrasound (US) performed at the point of care has found fertile ground in perioperative medicine. In the hands of anesthesiologists, transesophageal echocardiography (TEE) has become established as a powerful diagnostic and monitoring tool in the perioperative care of cardiac and non-cardiac patients. A number of point-of-care US (POCUS) applications are relevant to perioperative care, including airway, cardiac, lung and gastric US. Although guidelines exist to define the scope of practice for basic and advanced TEE, there remains a lack of such guidelines for perioperative point-of-care ultrasound (POCUS), despite a number of recent calls for action in the academic anesthesia community...
October 9, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28982970/cold-block-of-in-vitro-eyeblink-reflexes-evidence-supporting-the-use-of-hypothermia-as-an-anesthetic-in-pond-turtles
#8
Joyce Keifer, Zhaoqing Zheng
Use of hypothermia as a means of anesthesia for amphibians and reptiles is prohibited by agencies that establish veterinary guidelines. This has recently been called into question by members of the scientific community based on reviews of published literature. Using pond turtles (Trachemys scripta elegans), hypothermia as a method for anesthesia to precede euthanasia by decapitation was assessed. Turtles were subjected to hypothermia using a cooling followed by freezing protocol. Body temperature measurements ranged between -1 to -2°C while core body temperature was -1°C...
October 5, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28891855/patient-satisfaction-with-propofol-for-outpatient-colonoscopy-a-prospective-randomized-double-blind-study
#9
RANDOMIZED CONTROLLED TRIAL
Anantha Padmanabhan, Christoforos Frangopoulos, Lynn E T Shaffer
BACKGROUND: Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. OBJECTIVE: The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28874259/outcomes-from-a-university-based-low-cost-in%C3%A2-vitro-fertilization-program-providing-access-to-care-for-a-low-resource-socioculturally-diverse-urban-community
#10
Christopher N Herndon, Yanett Anaya, Martha Noel, Hakan Cakmak, Marcelle I Cedars
OBJECTIVE: To report on outcomes from a university-based low-cost and low-complexity IVF program using mild stimulation approaches and simplified protocols to provide basic access to ART to a socioculturally diverse low-income urban population. DESIGN: Retrospective cohort study. SETTING: Academic infertility center. PATIENT(S): Sixty-five infertile couples were enrolled from a county hospital serving a low-resource largely immigrant population...
October 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28873104/management-of-trauma-and-burn-scars-the-dermatologist-s-role-in-expanding-patient-access-to-care
#11
Nathanial R Miletta, Matthias B Donelan, Chad M Hivnor
Recent advances in laser surgery and our understanding of wound healing have ushered in a new era of trauma and burn scar management. Traditional therapy has centered around scar excision followed by primary closure or tissue replacement with flaps and grafts. This approach represents a perpetuation of the common fallacy that extensive scar improvement requires extensive surgical intervention. Laser surgery in conjunction with pharmacotherapy and minor tissue-conserving surgery produces well-healed and remodeled existing tissue that provides the most natural appearance and function of the skin...
July 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28777716/research-priorities-in-subspecialty-palliative-care-policy-initiatives
#12
Lynn F Reinke, Diane E Meier
Palliative care demonstrably improves quality of life for the seriously ill in a manner that averts preventable health crises and their associated costs. Because of these outcomes, palliative care is now broadening its reach beyond hospitals, and hospice care for those near death, to patients and their families living in the community with chronic multimorbidities that have uncertain or long expected survival. In this article, we address research needed to enable policies supportive of palliative care access and quality, including changes in regulatory, accreditation, financing, and training approaches in the purview of policy makers...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28749265/emergency-anesthesia-and-exploratory-laparotomy-in-a-compromised-pacific-white-sided-dolphin-lagenorhynchus-obliquidens
#13
Justin F Rosenberg, Martin Haulena, James E Bailey, Dean A Hendrickson, Marina Ivančić, Stephen A Raverty
Anesthesia and surgery in cetaceans have inherent risks and have rarely been utilized as viable treatment options. This report represents the first known multidisciplinary team approach to emergency laparotomy in a compromised, 22-yr-old, female Pacific white-sided dolphin ( Lagenorhynchus obliquidens ). The inciting clinical signs and ancillary diagnostics were consistent with a mechanical ileus. Although no torsion or obstruction was apparent during surgery, severe enteritis and peritonitis were noted. Postoperatively, the animal was maintained on aggressive medical management with continuous supportive care until succumbing 3 days later with clinical pathology indicative of terminal sepsis and profound inflammation...
June 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28727995/physician-perceptions-about-living-organ-donation-in-patients-with-amyotrophic-lateral-sclerosis
#14
S Ansari, M B Bromberg, S B Gibson
OBJECTIVES: Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. PATIENTS AND METHODS: An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure...
September 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#15
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28718700/use-of-single-dose-oral-gabapentin-to-attenuate-fear-responses-in-cage-trap-confined-community-cats-a-double-blind-placebo-controlled-field-trial
#16
Katherine E Pankratz, Kelli K Ferris, Emily H Griffith, Barbara L Sherman
Objectives This double-blind, placebo-controlled study evaluated the safety and efficacy of single-dose oral gabapentin administered for the attenuation of fear responses in cage-trap confined community cats. Methods Community cats presented in cage traps for trap-neuter-return (TNR) were recruited and screened for inclusion. Each enrolled cat was randomly assigned and administered one of three equal-volume, single-dose treatments: placebo, low-dose gabapentin (50 mg) or high-dose gabapentin (100 mg). At baseline, 1, 2, 3 and 12 h post-administration, a single, blinded observer scored each cat for signs of fear and sedation using published paradigms, calculated the respiratory rate and documented any observable facial injuries...
July 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28694167/minimally-invasive-surgery-survey-a-survey-of-surgical-team-members-perceptions-for-successful-minimally-invasive-surgery
#17
Ladin A Yurteri-Kaplan, Leslie Andriani, Anagha Kumar, Pamela A Saunders, Mihriye M Mete, Andrew I Sokol
STUDY OBJECTIVE: To develop a valid and reliable survey to measure surgical team members' perceptions regarding their institution's requirements for successful minimally invasive surgery (MIS). DESIGN: Questionnaire development and validation study (Canadian Task Force classification II-2). SETTING: Three hospital types: rural, urban/academic, and community/academic. PARTICIPANTS: Minimally invasive staff (team members)...
November 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28652630/-sici-gise-community-campania-survey-donna-tavi-incanta-perioperative-and-short-term-outcome-of-transcatheter-aortic-valve-implantation-in-women
#18
MULTICENTER STUDY
Tiziana Attisano, Angelo Silverio, Emilio Di Lorenzo, Tullio Tesorio, Domenico Di Girolamo, Paolo Golino, Arturo Giordano, Giuseppe Valva, Giovanni Esposito, Maurizio Cappelli Bigazzi, Carlo Briguori, Ida Monteforte, Giovanni Dialetto, Paolo Rubino, Francesco Vigorito, Pietro Giudice, Ciro Mauro
BACKGROUND: Nowadays the prognostic role of gender as a relevant factor after transcatheter aortic valve implantation (TAVI) is still unfair, since available data in the literature are few and uneven. The aim of this survey was to collect acute and 30-day safety and efficacy clinical data in high- and intermediate-risk women, who underwent TAVI with new-generation devices, in the Campania Region. METHODS: All medium and high-volume TAVI centers in Campania have been invited to fulfill an online, ad-hoc questionnaire, collecting pre-, peri- and post-procedural data concerning female patients, treated between January and December 2016...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28520566/essential-thrombocytosis-and-labor-epidural-placement-while-on-aspirin-assessing-hemorrhagic-risks-a-case-report
#19
Paul Martin Kempen
Essential thrombocytosis (ET) is a rare disease with known thrombotic and bleeding complications. We encountered a patient with a diagnosis of longstanding Janus kinase-2 gene-negative ET on aspirin therapy presenting for labor epidural. Evaluation of platelet function with point-of-care analysis using Plateletworks in a community hospital setting allowed confirmation of adequate numbers of functional platelets to support safe epidural placement. The relevant issues of ET for anesthesia management with labor epidurals are discussed...
September 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28504991/tablet-e-logbooks-four-thousand-clinical-cases-and-complications-e-logged-by-14-nondoctor-anesthesia-providers-in-nepal
#20
Shristi Shah, Oliver Ross, Stephen Pickering, Stephen Knoble, Indra Rai
BACKGROUND: To meet the need for essential surgery across rural Nepal, anesthesia at district level is delivered by nondoctor anesthetists. They require support to maintain confidence and competence, and upgraded professional registration to secure their status. To meet these needs, a distance-blended learning course was pioneered and delivered. A core course requirement was to log all clinical cases; these were logged on a new e-logbook. METHODS: Fourteen nondoctor anesthesia providers working in 12 different districts across Nepal were enrolled in the 1-year course...
October 2017: Anesthesia and Analgesia
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