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https://www.readbyqxmd.com/read/29411032/association-of-preoperatively-diagnosed-patent-foramen-ovale-with-perioperative-ischemic-stroke
#1
Pauline Y Ng, Andrew K-Y Ng, Balachundhar Subramaniam, Sara M Burns, Fanny Herisson, Fanny P Timm, Cand Med, Maira I Rudolph, Cand Med, Flora Scheffenbichler, Cand Med, Sabine Friedrich, Cand Med, Timothy T Houle, Deepak L Bhatt, Matthias Eikermann
Importance: Perioperative stroke is a major complication for patients undergoing surgery. Patent foramen ovale (PFO) represents a possible anatomical link between venous thrombosis and stroke. Objective: To determine whether a preoperatively diagnosed PFO is associated with increased risk of perioperative ischemic stroke. Design, Setting, and Participants: Retrospective cohort study from Massachusetts General Hospital and 2 affiliated community hospitals between January 1, 2007, and December 31, 2015...
February 6, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29398380/a-retrospective-analysis-of-the-variability-in-case-duration-for-aortic-valve-replacement-and-association-with-hospital-facility-types
#2
Rodney A Gabriel, Byron D Fergerson, Ethan Y Brovman, Richard P Dutton, Richard D Urman
OBJECTIVE: Currently, there are no large-scale studies that compare differences in case duration of aortic valve replacements (AVRs). The primary objective of this study was to determine associations of hospital facility type, geographic location, case volume per year, and time of day with duration of valve replacement surgery. DESIGN: Retrospective. SETTING: Data from the National Anesthesia Clinical Outcomes Registry. PARTICIPANTS: National data from university and non-university hospitals...
June 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29377127/dental-therapists-linked-to-improved-dental-outcomes-for-alaska-native-communities-in-the-yukon-kuskokwim-delta
#3
Donald L Chi, Dane Lenaker, Lloyd Mancl, Matthew Dunbar, Michael Babb
OBJECTIVES: Dental Health Aide Therapists (DHATs) have been part of the dental workforce in Alaska's Yukon-Kuskokwim (YK) Delta since 2006. They are trained to provide preventive and restorative care such as filling and extractions. In this study, we evaluated community-level dental outcomes associated with DHATs. METHODS: This was a secondary data analysis of Alaska Medicaid and electronic health record data for individuals in Alaska's YK Delta (2006-2015). The independent variable was the number of DHAT treatment days in each community...
January 29, 2018: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/29366746/how-cardiac-anesthesiology-can-help-stem-the-tide-of-under-representation-of-minorities-in-science-and-medicine
#4
Elliott Woodward, Yvonne Lai, Christyanna Egun, Michael G Fitzsimons
The field of medicine is built upon science, technology, engineering, and math (STEM), yet the United States is rapidly falling behind when it comes to educating the next generation in these disciplines, especially under-represented populations. The authors reflect on existing educational literature surrounding efforts to promote interest in STEM among students and under-represented populations. The authors advocate for greater efforts toward the development of youth programing. Cardiac anesthesia is uniquely positioned as a subspecialty to advance the goal of promoting interest in STEM in diverse groups of young students...
June 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29356773/the-third-american-society-of-regional-anesthesia-and-pain-medicine-practice-advisory-on-local-anesthetic-systemic-toxicity-executive-summary-2017
#5
Joseph M Neal, Michael J Barrington, Michael R Fettiplace, Marina Gitman, Stavros G Memtsoudis, Eva E Mörwald, Daniel S Rubin, Guy Weinberg
The American Society of Regional Anesthesia and Pain Medicine's Third Practice Advisory on local anesthetic systemic toxicity is an interim update from its 2010 advisory. The advisory focuses on new information regarding the mechanisms of lipid resuscitation, updated frequency estimates, the preventative role of ultrasound guidance, changes to case presentation patterns, and limited information related to local infiltration anesthesia and liposomal bupivacaine. In addition to emerging information, the advisory updates recommendations pertaining to prevention, recognition, and treatment of local anesthetic systemic toxicity...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29285834/evidence-for-increased-use-of-the-society-of-pediatric-anesthesia-critical-events-checklist-in-resource-limited-environments-a-retrospective-observational-study-of-app-data
#6
Vikas N O'Reilly-Shah, Jamie Kitzman, Craig S Jabaley, Grant C Lynde
BACKGROUND: Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. AIMS: We sought to combine demographics with usage information to elucidate important patterns in the rate of use of the Society of Pediatric Anesthesia Critical Events Checklist, as measured by in-app accesses of the checklist via the freely available anesthesia calculator app anesthesiologist...
December 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29239956/the-anesthesia-workstation-quo-vadis
#7
Jan F A Hendrickx, Andre M De Wolf
Ensuring adequate ventilation and oxygenation and delivering inhaled anesthetic agent to the patient remain core responsibilities of the anesthesia provider during general anesthesia. Because of the emphasis placed on physiology, pharmacology, clinical sciences, and administrative duties, the stellar anesthesia workstation technology may be underutilized by the anesthesia community. Target-controlled O2 and agent delivery and automated end-expired CO2 control have entered the clinical arena, with only cost, luddism, and administrative hurdles preventing their more widespread use...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29177107/treatment-of-morbidly-adherent-placentation-utilizing-a-standardized-multidisciplinary-approach-in-the-community-hospital-private-practice-setting
#8
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
#9
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%C3%A2-randomized-controlled-trial
#10
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: The aim of this study was 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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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