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Anesthesia and

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https://www.readbyqxmd.com/read/28346253/a-retrospective-case-matched-cost-comparison-of-surgical-treatment-of-melanoma-and-nonmelanoma-skin-cancer-in-the-outpatient-versus-operating-room-setting
#1
Ryan P Johnson, Niraj Butala, Murad Alam, Naomi Lawrence
BACKGROUND: To date, no study has used authentic billing data in a case-control matched fashion to examine the cost of treating skin cancer in different settings. OBJECTIVE: To compare the cost of surgical treatment of skin cancer in the outpatient versus operating room setting using matched cases based on patient and skin cancer characteristics. METHODS: ICD-9 diagnosis codes for skin cancers were used to find patients who had a malignant excision current procedural terminology code in the operating room setting during 2010 to 2014...
March 23, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28346035/one-needle-is-better-than-two-the-philosophy-surrounding-use-of-local-anesthesia-in-northern-india
#2
Maria Story
The author, an internal medicine resident in the United States, participated in an international elective through her postgraduate training program in a rural hospital in northern India. While performing a thoracentesis, she notes that local anesthesia has not been administered, which is seemingly the standard of care at this hospital. Several questionnaire studies about pain services and pain management in India are reviewed, and they reveal insights and severe limitations to effective management of hospitalized patients' pain...
March 27, 2017: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/28345802/the-association-between-caudal-anesthesia-and-increased-risk-of-postoperative-surgical-complications-in-boys-undergoing-hypospadias-repair
#3
Brad M Taicher, Jonathan C Routh, John B Eck, Sherry S Ross, John S Wiener, Allison K Ross
INTRODUCTION: Recent reports have suggested that caudal anesthesia may be associated with an increased risk of postoperative surgical complications. We examined our experience with caudal anesthesia in hypospadias repair to evaluate for increased risk of urethrocutaneous fistula or glanular dehiscence. METHODS: All hypospadias repairs performed by a single surgeon in 2001-2014 were reviewed. Staged or revision surgeries were excluded. Patient age, weight, hypospadias severity, surgery duration, month and year of surgery, caudal anesthesia use, and postoperative complications were recorded...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28345782/red-cell-distribution-width-as-a-novel-predictor-of-postoperative-respiratory-adverse-events-after-adenotonsillectomy
#4
Betul Kozanhan, Mehmet S Iyisoy
BACKGROUND: Respiratory adverse events are commonly observed after adenotonsillectomy in children with sleep-disordered breathing. Preoperative prediction of these events enhances quality of care and resource management in facilities while encouraging precautions against them. Red cell distribution width, a measure of erythrocyte size variability, has recently been linked to adverse outcomes in a variety of disorders. Red cell distribution width has also been found to be associated with severity of obstructive sleep apnea in adults due to hypoxia-mediated inflammation...
March 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28345743/opioids-and-nonopioids-for-postoperative-pain-control-in-patients-with-chronic-kidney-disease
#5
Michele Binhas, Julia Egbeola-Martial, Michael D Kluger, Francoise Roudot-Thoraval, Philippe Grimbert
OBJECTIVES: To evaluate postoperative pain management (POPM) practices by anesthesiologists caring for patients with chronic kidney disease (CKD). DESIGN: Prospective one-time survey endorsed by the French Society of Anesthesia and Intensive Care (SFAR). SETTING: A self-administered online questionnaire was distributed to members of SFAR nationally. PARTICIPANTS: Three hundred seven SFAR members participated in the study...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345549/sub-anesthesia-dose-of-isoflurane-in-60-oxygen-reduces-inflammatory-responses-in-experimental-sepsis-models
#6
Yi Huang, Xiao-Xia Wang, Dong-Dong Sun, Ze-Xin Zhang, Wan-Wan Yang, Tian Shao, Han Han, Er-Fei Zhang, Zhong-Shu Pu, Zuo-Xu Hou, Hai-Long Dong, Li-Ze Xiong, Li-Chao Hou
BACKGROUND: Sepsis is a major cause of mortality in Intensive Care Units. Anesthetic dose isoflurane and 100% oxygen were proved to be beneficial in sepsis; however, their application in septic patients is limited because long-term hyperoxia may induce oxygen toxicity and anesthetic dose isoflurane has potential adverse consequences. This study was scheduled to find the optimal combination of isoflurane and oxygen in protecting experimental sepsis and its mechanisms. METHODS: The effects of combined therapy with isoflurane and oxygen on lung injury and sepsis were determined in animal models of sepsis induced by cecal ligation and puncture (CLP) or intraperitoneal injection of lipopolysaccharide (LPS) or zymosan...
April 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28345075/ultrasonographic-detection-of-airway-obstruction-in-a-model-of-obstructive-sleep-apnea
#7
Amal Isaiah, Reuben Mezrich, Jeffrey Wolf
Purpose Obstructive sleep apnea (OSA) is a common clinical disorder characterized by repetitive airway obstruction during sleep. The gold standard for diagnosis of OSA, polysomnogram (PSG), cannot anatomically localize obstruction. Precise identification of obstruction has potential to improve outcomes following surgery. Current diagnostic modalities that provide this information require anesthesia, involve ionizing radiation or disrupt sleep. To mitigate these problems, we conceived that ultrasound (US) technology may be adapted (i) to detect, quantify and localize airway obstruction and (ii) for translational application to home-based testing for OSA...
February 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28344959/surgical-technique-for-single-port-laparoscopy-in-huge-ovarian-tumors-sw-kim-s-technique-and-comparison-to-laparotomy
#8
Jeong Sook Kim, In Ok Lee, Kyung Jin Eoh, Young Shin Chung, Inha Lee, Jung-Yun Lee, Eun Ji Nam, Sunghoon Kim, Young Tae Kim, Sang Wun Kim
OBJECTIVE: This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim's technique and to compare the surgical outcomes with those of laparotomy. METHODS: Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim's technique using a specially designed 30×30-cm(2)-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28344949/the-effect-of-anesthesia-on-the-ventilatory-functions-of-patients-with-maxillo-mandibular-fixation
#9
B I Akhiwu, H O Akhiwu, B D Saheeb, M M Habeeb
BACKGROUND: Maxillo-mandibular fixation (MMF) is a procedure still routinely practiced in developing countries. AIM: To determine the variations in pulmonary functions readings between cases treated under general anesthesia (GA) and those treated under local anesthesia (LA). METHODOLOGY: A descriptive hospital-based study of 106 patients was carried out from January 2011- December 2012. Information was obtained using a questionnaire and all study subjects had their baseline lung functions and their post-operative daily lung function parameters measured for the first week and then weekly for the next five weeks...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28344528/surgical-approach-and-anesthetic-modality-for-carpal-tunnel-release-a-nationwide-database-study-with-health-care-cost-implications
#10
Brock D Foster, Lakshmanan Sivasundaram, Nathanael Heckmann, Jeremiah R Cohen, William C Pannell, Jeffrey C Wang, Alidad Ghiassi
Background: Carpal tunnel release (CTR) is commonly performed for carpal tunnel syndrome once conservative treatment has failed. Operative technique and anesthetic modality vary by surgeon preference and patient factors. However, CTR practices and anesthetic trends have, to date, not been described on a nationwide scale in the United States. Methods: The PearlDiver Patient Records Database was used to search Current Procedural Terminology codes for elective CTR from 2007 to 2011. Anesthetic modality (eg, general and regional anesthesia vs local anesthesia) and surgical approach (eg, endoscopic vs open) were recorded for this patient population...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28344180/benefit-and-complications-of-frame-based-stereotactic-biopsy-in-old-and-very-old-patients
#11
Johanna Quick-Weller, Julia Tichy, Nazife Dinc, Stephanie Tritt, Sae-Yeon Won, Bedjan Behmanesh, Markus Bruder, Volker Seifert, Lutz Weise, Gerhard Marquardt
OBJECTIVE: Stereotactic biopsy is an everyday procedure implemented in numerous neurosurgical departments. The procedure is performed in order to obtain tumor tissue of unclear diagnosis. Going in hand with low complication rates and high diagnostic yield, stereotactic biopsies can be performed in adults and children likewise for histopathological evaluation of lesions in eloquent localizations. Little is known, however, whether aged patients do benefit from stereotactic biopsy or rather the therapy that is derived from histopathological results...
March 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28343821/use-of-chronic-methadone-before-total-knee-arthroplasty
#12
Ferdinand J Chan, Andrew M Schwartz, Jason Wong, Cynthia Chen, Bharat Tiwari, Sun Jin Kim
BACKGROUND: A subset of patients who undergo total knee arthroplasty (TKA) are on methadone maintenance. They require more and often unpredictable quantities of opioids to function as effective painkillers. This study aims to compare the opioid requirements and the immediate postoperative course for patients on methadone maintenance with those who are not, after a TKA. METHODS: A retrospective, case-control study was performed. From 2005 to 2010, 36 patients, who underwent a unilateral TKA, on chronic methadone maintenance were identified...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28343807/dial-test-unrecognized-predictor-of-anterior-cruciate-ligament-deficiency
#13
Brian Forsythe, Bryan M Saltzman, Gregory L Cvetanovich, Michael J Collins, Thomas A Arns, Nikhil N Verma, Brian J Cole, Bernard R Bach
PURPOSE: To evaluate the effect of isolated anterior cruciate ligament (ACL) injury on tibial external rotation as measured by the dial test. METHODS: Twenty-seven consecutive patients scheduled to undergo a primary ACL reconstruction were prospectively evaluated. Physical examination and magnetic resonance imaging findings were analyzed to exclude multiligamentous injury. The dial test was performed with the patient under anesthesia with a goniometer on both the affected and unaffected knees at 30° and 90°...
March 23, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28343806/ultrasonographic-evaluation-of-anterolateral-ligament-injuries-correlation-with-magnetic-resonance-imaging-and-pivot-shift-testing
#14
Etienne Cavaignac, Marie Faruch, Karine Wytrykowski, Olivia Constant, Jérôme Murgier, Emilie Berard, Philippe Chiron
PURPOSE: (1) To compare the diagnostic ability of ultrasonography (US) and magnetic resonance imaging (MRI) to detect anterolateral ligament (ALL) injuries in anterior cruciate ligament (ACL)-deficient patients, and (2) to evaluate the correlation between ALL injury status (as determined by US and MRI) and the knee's rotational stability. METHODS: Thirty patients with an isolated ACL injury were included prospectively over a 3-month period. The condition of the ALL was evaluated by 2 experienced radiologists using both US and MRI...
March 23, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28343804/evaluation-of-the-grafted-fascia-in-the-vocal-fold-of-dogs-a-histologic-study
#15
Eduardo G B Carvalho, Henrique F Pauna, Almiro J Machado, Ester M D Nicola, Albina M A M Altemani, Agrício N Crespo
INTRODUCTION: There is no consensus on the ideal graft for medialization surgery of the vocal folds in the literature. One of the most favorable proposals is the use of autologous fascia, which seems limited by the lack of information regarding the integration of grafted tissue. Our study aims to evaluate the degree of fully engrafted fascia integration in the vocal fold lamina propria of dogs. MATERIALS AND METHODS: Fourteen adult mongrel dogs that underwent intravenous general anesthesia were selected and kept under spontaneous ventilation...
March 23, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28343639/the-benefits-of-a-preoperative-mrsa-swabbing-protocol
#16
Hope Herd
Infection control practices pose a challenge to nursing care in general, but can have a huge negative impact on the perioperative process. Prior to July of 2012, our institution did not perform routine methacillin resistant staphylococcus aureus (MRSA) screening on preoperative patients with a prior history of MRSA. This resulted in patients remaining in isolation throughout their entire perioperative course. Screening for MRSA was delayed until the patient arrived in the medical surgical unit. Many of these patients were later found to have negative nasal swabs...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28343637/investigation-of-preoperative-fasting-times-in-children
#17
Eda Dolgun, Meryem Yavuz, Birsen Eroğlu, Ayşe Islamoğlu
PURPOSE: The aim of this study was to investigate preoperative fasting times of children. DESIGN: A prospective and descriptive design was used. METHODS: The study was carried out in the pediatric surgery departments of a University Faculty of Medicine Hospital, between January 1 and May 31, 2012. The sample included 332 pediatric patients having surgery with general anesthesia and their family. Data were collected via patient and family interview using a 28-item questionnaire developed by the researchers...
April 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28343597/national-trends-and-in-hospital-outcomes-in-pregnant-women-with-heart-disease-in-the-united-states
#18
Fabio V Lima, Jie Yang, Jianjin Xu, Kathleen Stergiopoulos
Investigation of trends and outcomes in heart disease (HD) and pregnancy has been limited. We chose to identify the prevalence, trends, and outcomes of pregnant women with different forms of HD in the United States. Healthcare Cost and Utilization Project's National Inpatient Sample was screened for hospital admissions for delivery in pregnant women with HD from 2003 to 2012. Maternal clinical characteristics and outcomes were identified in women with and without HD, and in HD subtypes: congenital (CHD), valvular HD, cardiomyopathy, and pulmonary hypertension (PH)...
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28343236/effects-of-restricting-perioperative-use-of-intravenous-chloride-on-kidney-injury-in-patients-undergoing-cardiac-surgery-the-licra-pragmatic-controlled-clinical-trial
#19
David McIlroy, Deirdre Murphy, Jessica Kasza, Dhiraj Bhatia, Lisa Wutzlhofer, Silvana Marasco
PURPOSE: The administration of chloride-rich intravenous (IV) fluid and hyperchloraemia have been associated with perioperative renal injury. The aim of this study was to determine whether a comprehensive perioperative protocol for the administration of chloride-limited IV fluid would reduce perioperative renal injury in adults undergoing cardiac surgery. METHODS: From February 2014 through to December 2015, all adult patients undergoing cardiac surgery within a single academic medical center received IV fluid according to the study protocol...
March 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28342771/the-area-postrema-ap-and-the-parabrachial-nucleus-pbn-are-important-sites-for-salmon-calcitonin-sct-to-decrease-evoked-phasic-dopamine-release-in-the-nucleus-accumbens-nac
#20
Lynda Whiting, James E McCutcheon, Christina N Neuner-Boyle, Mitchell F Roitman, Thomas A Lutz
The pancreatic hormone amylin and its agonist salmon calcitonin (sCT) act via the area postrema (AP) and the lateral parabrachial nucleus (PBN) to reduce food intake. Investigations of amylin and sCT signaling in the ventral tegmental area (VTA) and nucleus accumbens (NAc) suggest that the eating inhibitory effect of amylin is, in part, mediated through the mesolimbic 'reward' pathway. Indeed, administration of the sCT directly to the VTA decreased phasic dopamine release (DA) in the NAc. However, it is not known if peripheral amylin modulates the mesolimbic system directly or whether this occurs via the AP and PBN...
March 22, 2017: Physiology & Behavior
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