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https://www.readbyqxmd.com/read/28520566/essential-thrombocytosis-and-labor-epidural-placement-while-on-aspirin-assessing-hemorrhagic-risks-a-case-report
#1
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 pointof-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...
May 17, 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
#2
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...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28491126/developing-obstetric-medicine-training-in-latin-america
#3
José Rojas-Suarez, Niza Suarez, Oier Ateka-Barrutia
Maternal mortality is an important indicator of health in populations around the world. The distribution of maternal mortality ratio globally shows that middle- and low-income countries have ∼99% of the mortality burden. Most countries of Latin America are considered to be middle- or low-income countries, as well as areas of major inequities among the different social classes. Medical problems in pregnancy remain an important cause of morbidity and mortality in this region. Previous data indicate the need for a call to action for adequate diagnosis and care of medical diseases in obstetric care...
March 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/28448331/a-nurse-directed-model-for-nitrous-oxide-use-during-labor
#4
Toni Pinyan, Kelly Curlee, Mellanie Keever, Kathleen M Baldwin
BACKGROUND: Nitrous oxide has a long history of use and has been well documented in the literature as a safe, effective, and inexpensive option for pain management in labor in other countries, but it is underused in the United States. LOCAL PROBLEM: Pain relief options for laboring women in rural community hospitals with a small perinatal service are limited due to lack of availability of in-house anesthesia coverage. METHOD: This quality improvement project involved development and implementation of a nurse-driven, self-administered, demand-flow nitrous oxide program as an option for pain relief for laboring women in a rural community hospital...
May 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28439744/change-in-cost-after-5%C3%A2-years-of-experience-with-robotic-assisted-hysterectomy-for-the-treatment-of-endometrial-cancer
#5
Andrea M Avondstondt, Michelle Wallenstein, Christopher R D'Adamo, Robert M Ehsanipoor
Health care costs are an important consideration in the decision of hysterectomy routes and robotic surgery is often critiqued for its high cost. We sought to compare the cost of robotic-assisted hysterectomies performed after initial acquisition of the robotic surgical system to cases performed after 5 years of experience. The first 20 patients at a community teaching hospital who underwent robotic-assisted hysterectomy for endometrial cancer by a single gynecologic oncology surgeon were designated Group 1 and 20 patients undergoing robotic hysterectomies 5 years later for the same indication were designated Group 2...
April 24, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28419979/clinical-profile-of-persistent-genito-pelvic-postpartum-pain
#6
Jaclyn Cappell, Caroline F Pukall
OBJECTIVE*: the primary aim was to describe the pain characteristics of persistent genito-pelvic postpartum pain (PPP) and compare these characteristics by mode of delivery. The secondary aim was to incorporate psychosocial variables into the conceptualization of PPP by exploring the relationship among postpartum depressive symptoms, fatigue, and PPP. DESIGN: cross-sectional study design. SETTING: online survey. PARTICIPANTS: 106 women recruited from the community who gave birth within twelve months prior to completing the survey...
April 8, 2017: Midwifery
https://www.readbyqxmd.com/read/28315642/comparison-of-atipamezole-with-yohimbine-for-antagonism-of-xylazine-in-mice-anesthetized-with-ketamine-and-xylazine
#7
Christopher F Janssen, Pauline Maiello, M Jerry Wright, Kara B Kracinovsky, Joseph T Newsome
The α2 adrenergic agonist xylazine produces a sedative effect and is typically combined with ketamine and used for anesthesia or chemical restraint of laboratory mice. Xylazine's sedative effect-and its undesirable side effects of bradycardia, hypotension, and poor tissue perfusion-can be reversed by administration of α2 antagonists, such as atipamezole or yohimbine. Although atipamezole and yohimbine dosing guidelines are available for mice, no controlled comparison has been performed to guide the lab animal community in the selection of one over the other...
March 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28298801/stellate-ganglion-block-as-rescue-therapy-in-refractory-ventricular-tachycardia
#8
M C Rajesh, K V Deepa, E K Ramdas
Pain physicians and anesthesiologists routinely perform stellate ganglion block for the treatment of painful upper extremity sympathetic dystrophy. Close proximity of ganglion to vascular structures warrants some expertise and training in the procedure. Off late, successful use of the technique in intractable ventricular tachyarrhythmias has come in literature. We have few cases wherein we could successfully ablate intractable ventricular tachycardia with stellate block which was refractory to repeated shocks...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28291658/how-do-they-get-here-does-the-method-of-transportation-impact-salvage-for-patients-with-testicular-torsion
#9
D A Weiss, N Tsarouhas, M C Carr, A Kalmus, S A Zderic
INTRODUCTION: A growing number of patients are arriving at our tertiary care center for evaluation of possible testicular torsion using ambulance or helicopter transport. In many cases the parents arrive by car before the patient arrives. Are these advanced methods of medical transport worth the expense and risk in the case of suspected testicular torsion? OBJECTIVE: We evaluated the total number of patients presenting to our emergency room for suspected testicular torsion to see if the means of transport affected testicular survival...
January 23, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28288059/effects-of-intraoperative-fluid-management-on-postoperative-outcomes-a-hospital-registry-study
#10
Christina H Shin, Dustin R Long, Duncan McLean, Stephanie D Grabitz, Karim Ladha, Fanny P Timm, Tharusan Thevathasan, Alberto Pieretti, Cristina Ferrone, Andreas Hoeft, Thomas W L Scheeren, Boyd Taylor Thompson, Tobias Kurth, Matthias Eikermann
OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols driven by such measures are limited in their ability to define the optimal fluid state during surgery. METHODS: This analysis of data on file included 92,094 adult patients undergoing noncardiac surgery with endotracheal intubation between 2007 and 2014 at an academic tertiary care hospital and two affiliated community hospitals...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28235534/case-reports-should-we-do-away-with-them
#11
Aynur Camkiran Firat, Coskun Araz, Zeynep Kayhan
STUDY OBJECTIVE: There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports? DESIGN: Observational study...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28224104/exertional-rhabdomyolysis-and-heat-stroke-beware-of-volatile-anesthetic-sedation
#12
REVIEW
Karel Heytens, Jan De Bleecker, Walter Verbrugghe, Jonathan Baets, Luc Heytens
In view of the enormous popularity of mass sporting events such as half-marathons, the number of patients with exertional rhabdomyolysis or exercise-induced heat stroke admitted to intensive care units (ICUs) has increased over the last decade. Because these patients have been reported to be at risk for malignant hyperthermia during general anesthesia, the intensive care community should bear in mind that the same risk of life-threatening rhabdomyolysis is present when these patients are admitted to an ICU, and volatile anesthetic sedation is chosen as the sedative technique...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28216931/predictors-of-radiation-exposure-to-providers-during-percutaneous-nephrolithotomy
#13
David L Wenzler, Joel E Abbott, Jeannie J Su, William Shi, Richard Slater, Daniel Miller, Michelle J Siemens, Roger L Sur
BACKGROUND: Limited studies have reported on radiation risks of increased ionizing radiation exposure to medical personnel in the urologic community. Fluoroscopy is readily used in many urologic surgical procedures. The aim of this study was to determine radiation exposure to all operating room personnel during percutaneous nephrolithotomy (PNL), commonly performed for large renal or complex stones. MATERIALS AND METHODS: We prospectively collected personnel exposure data for all PNL cases at two academic institutions...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28212172/cognitive-decline-associated-with-anesthesia-and-surgery-in-the-elderly-does-this-contribute-to-dementia-prevalence
#14
Lisbeth Evered, David A Scott, Brendan Silbert
PURPOSE OF REVIEW: To provide an update on the current state of research investigating the effects of anesthesia and surgery on cognition in the elderly, including consideration of overlap with cognitive disorders in the community. RECENT FINDINGS: The studies reviewed here identify detrimental effects of anesthesia and surgery on cognition in a proportion of elderly individuals. Animal models demonstrate an association between anesthetic agents and Alzheimer's disease pathology...
May 2017: Current Opinion in Psychiatry
https://www.readbyqxmd.com/read/28188706/comparison-of-atipamezole-with-yohimbine-for-antagonism-of-xylazine-in-mice-anesthetized-with-ketamine-and-xylazine
#15
Christopher Janssen, Pauline Maiello, M Wright, Kara Kracinovsky, Joseph Newsome
The α2 adrenergic agonist xylazine produces a sedative effect and is typically combined with ketamine and used for anesthesia or chemical restraint of laboratory mice. Xylazine's sedative effect-and its undesirable side effects of bradycardia, hypotension, and poor tissue perfusion-can be reversed by administration of α2 antagonists, such as atipamezole or yohimbine. Although atipamezole and yohimbine dosing guidelines are available for mice, no controlled comparison has been performed to guide the lab animal community in the selection of one over the other...
February 10, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28181199/an-examination-of-disparities-in-pediatric-pain-management-centered-on-socioeconomic-factors-and-hospital-characteristics
#16
Franklin B Chiao, Alan Wang
INTRODUCTION: Very little is known about pediatric pain management resource differences. In contrast, disparities in pain management within the adult population are known to exist. This research examined whether significant differences exist between hospitals in the state of New York and what factors impact these pain resources. METHODS: The study was approved by the institutional review board. A questionnaire was sent to the anesthesia/pediatric/pain directors of every hospital in the state of New York via SurveyMonkey...
February 8, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28135163/optimal-anesthetic-regime-for-motionless-three-dimensional-image-acquisition-during-longitudinal-studies-of-adult-nonpigmented-zebrafish
#17
Nicola Lockwood, Jennifer Parker, Carole Wilson, Paul Frankel
With many live imaging techniques, it is crucial that a deep level of anesthesia is reached and maintained throughout image acquisition without reducing zebrafish viability. This is particularly true for three-dimensional tomographic imaging modalities. Currently, the most commonly used anesthetic in the zebrafish community, MS-222 (tricaine methanesulfonate), does not allow this. We show, using a combination of both MS-222 and isoflurane, that we can significantly improve the anesthetic regime required for motionless image acquisition of live adult zebrafish...
April 2017: Zebrafish
https://www.readbyqxmd.com/read/28121757/the-perinatal-birth-environment-communication-strategies-and-processes-for-adherence-to-a-standardized-guideline-in-women-undergoing-second-stage-labor-with-epidural-anesthesia
#18
Samantha A Sommerness, Rebecca Gams, Phillip N Rauk, Ananta Bangdiwala, Daniel V Landers, Melissa D Avery, Charles Hirt, Kristi Miller, Amy Millar, Suzin Cho, Andrea Shields
Key to any perinatal safety initiative is buy-in and strong leadership from obstetric and pediatric providers, advanced practice nurses, and labor and delivery nurses in collaboration with ancillary staff. In the fall of 2007, executives of a large Midwestern hospital system created the Zero Birth Injury Initiative. This multidisciplinary group sought to eliminate birth injury using the Institute of Healthcare Improvement Perinatal Bundles. Concurrently, the team implemented a standardized second-stage labor guideline for women who choose epidural analgesia for pain management to continue the work of eliminating birth injuries in second-stage labor...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28097415/anesthesia-practices-for-interventional-radiology-in-europe
#19
Alessandra Vari, Afshin Gangi
PURPOSE: The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. METHODS: Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology...
January 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28042430/experimental-protocol-of-dental-procedures-in-patients-with-hereditary-angioedema-the-role-of-anxiety-and-the-use-of-nitrogen-oxide
#20
A Rosa, M Miranda, R Franco, M G Guarino, A Barlattani, P Bollero
Hereditary angioedema (HAE) is a rare disease, little known to the medical and dental community, but with a growing rate of hospitalization over the years. HAE is due to a deficit/dysfunction of C1 esterase inhibitor which leads to an increase in vascular permeability and the appearance of edemas widespread in all body areas. The airways are the most affected and laryngeal swelling, which can occur, it is dangerous for the patient's life, is also a sensitive spot in our daily practice, therefore, it is also important to be aware of all the signs of this disease...
April 2016: Oral & Implantology
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