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https://www.readbyqxmd.com/read/28108832/beat-by-beat-assessment-of-cardiac-afterload-using-descending-aortic-velocity-pressure-loop-during-general-anesthesia-a-pilot-study
#1
Fabrice Vallée, Arthur Le Gall, Jona Joachim, Olivier Passouant, Joaquim Matéo, Arnaud Mari, Sandrine Millasseau, Alexandre Mebazaa, Etienne Gayat
Continuous cardiac afterload evaluation could represent a useful tool during general anesthesia (GA) to titrate vasopressor effect. Using beat to beat descending aortic pressure(P)/flow velocity(U) loop obtained from esophageal Doppler and femoral pressure signals might allow to track afterload changes. Methods We defined three angles characterizing the PU loop (alpha, beta and Global After-Load Angle (GALA)). Augmentation index (AIx) and total arterial compliance (Ctot) were measured via radial tonometry. Peripheral Vascular Resistances (PVR) were also calculated...
January 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28092321/dexmedetomidine-disrupts-the-local-and-global-efficiencies-of-large-scale-brain-networks
#2
Javeria A Hashmi, Marco L Loggia, Sheraz Khan, Lei Gao, Jieun Kim, Vitaly Napadow, Emery N Brown, Oluwaseun Akeju
BACKGROUND: A clear understanding of the neural basis of consciousness is fundamental to research in clinical and basic neuroscience disciplines and anesthesia. Recently, decreased efficiency of information integration was suggested as a core network feature of propofol-induced unconsciousness. However, it is unclear whether this finding can be generalized to dexmedetomidine, which has a different molecular target. METHODS: Dexmedetomidine was administered as a 1-μg/kg bolus over 10 min, followed by a 0...
January 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28081349/chrysin-prevents-brain-damage-caused-by-global-cerebralischemia-reperfusion-in-a-c57bl-j6-mouse-model
#3
Mehmet Akif Durak, Mustafa Namık Öztanır, Neşe Başak Türkmen, Osman Çiftçi, Aslı Taşlıdere, Mehmet Tecellioğlu, Arif Önder
BACKGROUND/AIM: The present study investigated the neuroprotective effects of chrysin (CRS) following global cerebral ischemia and reperfusion (I/R) in a C57BL/J6 mouse model. MATERIALS AND METHODS: A total of 40 mice were equally divided into four groups: (1) sham-operated (SH = control), (2) global cerebral I/R (I/R), (3) CRS, and (4) CRS + I/R. In the I/R group, the bilateral carotid arteries were clipped for 15 min and the mice were treated with vehicle (corn oil) for 10 days...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28069540/multi-modal-analysis-of-functional-connectivity-and-cerebral-blood-flow-reveals-shared-and-unique-effects-of-propofol-in-large-scale-brain-networks
#4
Maolin Qiu, Dustin Scheinost, Ramachandran Ramani, R Todd Constable
Anesthesia-induced changes in functional connectivity and cerebral blow flow (CBF) in large-scale brain networks have emerged as key markers of reduced consciousness. However, studies of functional connectivity disagree on which large-scale networks are altered or preserved during anesthesia, making it difficult to find a consensus amount studies. Additionally, pharmacological alterations in CBF could amplify or occlude changes in connectivity due to the shared variance between CBF and connectivity. Here, we used data-driven connectivity methods and multi-modal imaging to investigate shared and unique neural correlates of reduced consciousness for connectivity in large-scale brain networks...
January 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28054245/the-war-on-drugs-you-did-not-hear-about-the-global-crisis-of-access-to-essential-anesthesia-medications
#5
EDITORIAL
M Dylan Bould, Angela Enright
No abstract text is available yet for this article.
January 4, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28050803/access-to-controlled-medicines-for-anesthesia-and-surgical-care-in-low-income-countries-a-narrative-review-of-international-drug-control-systems-and-policies
#6
Jason W Nickerson, Katherine Pettus, Kathleen E Wheeler, Christopher Hallam, David R Bewley-Taylor, Amir Attaran, Adrian W Gelb
PURPOSE: This article describes the functioning of the international drug control system, its integration into national legislation and policy, and the collective impact on access to medicines. SOURCE: We conducted a review of the three international drug control conventions, peer-reviewed articles, and grey literature known to the authors that describes national and international drug control systems and their impact on access to controlled medicines. This review was supplemented with literature derived from a structured search of MEDLINE(®) for articles relating to medical uses of ketamine in low- and middle-income countries conducted to strengthen an advocacy campaign...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28009677/effectiveness-of-temporary-deafferentation-of-the-arm-on-somatosensory-and-motor-functions-following-stroke-a-systematic-review
#7
Emmanuelle Opsommer, Camille Zwissig, Natalya Korogod, Thomas Weiss
BACKGROUND: After stroke, regaining functional use of the upper limb can be challenging. Temporary deafferentation (TD) is a novel approach used in neurorehabilitation to voluntarily reduce the somatosensory input in a body part by temporary anesthesia; which has been shown to improve sensorimotor functions in the affected limb. OBJECTIVES: The primary objective of this systematic review was to present the best available evidence related to the effects of TD of the affected arm on the recovery of motor function and activity of the upper limb (arm and hand) following stroke...
December 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27989917/minimally-invasive-surgery-for-the-treatment-of-pilonidal-disease-the-gips-procedure-on-2347-patients
#8
Angelo Di Castro, Francesco Guerra, Giovanni Battista Levi Sandri, Giuseppe Maria Ettorre
BACKGROUND: Pilonidal disease is a quite common chronic inflammatory disease that causes discomfort, embarrassment and absence from work or school. In line with its acquired pathogenesis, a number of surgical alternatives to conventional en bloc excision have been proposed over the last decades, yielding encouraging results. We reviewed our experience with minimally invasive sinusectomy to evaluate its safety and efficacy. METHODS: this study was a review of a prospectively maintained database of consecutive patients over a 7-year period...
October 28, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27986235/building-a-sustainable-global-surgery-nonprofit-organization-at-an-academic-institution
#9
Margaret M Frisella
BACKGROUND: Surgical Outreach for the Americas is a 501(c)3 nonprofit organization providing surgical care to those in need in developing countries of the Western Hemisphere. Every year since its inception in 2008, teams of surgeons, nurses, and allied health professionals have traveled to areas of need and performed primarily hernia repair surgeries for those without access to affordable health care. METHODS: Surgical Outreach for the Americas (SOfA) began as a general concept based on World Health Organization statistics claiming that 11% of the global burden of disease can be resolved via surgery...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27918334/challenges-of-anesthesia-in-low-and-middle-income-countries-a-cross-sectional-survey-of-access-to-safe-obstetric-anesthesia-in-east-africa
#10
Isabella Epiu, Jossy Verel Bahe Tindimwebwa, Cephas Mijumbi, Thomas M Chokwe, Edwin Lugazia, Francois Ndarugirire, Theogene Twagirumugabe, Gerald Dubowitz
BACKGROUND: The United Nations 2015 Millennium Development Goals targeted a 75% reduction in maternal mortality. However, in spite of this goal, the number of maternal deaths per 100,000 live births remains unacceptably high across Sub-Saharan Africa. Because many of these deaths could likely be averted with access to safe surgery, including cesarean delivery, we set out to assess the capacity to provide safe anesthetic care for mothers in the main referral hospitals in East Africa. METHODS: A cross-sectional survey was conducted at 5 main referral hospitals in East Africa: Uganda, Kenya, Tanzania, Rwanda, and Burundi...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27905017/an-evaluation-of-preparedness-delivery-and-impact-of-surgical-and-anesthesia-care-in-madagascar-a-framework-for-a-national-surgical-plan
#11
Emily Bruno, Michelle C White, Linden S Baxter, Vaonandianina Agnès Ravelojaona, Hasiniaina Narindria Rakotoarison, Hery Harimanitra Andriamanjato, Kristin L Close, Alison Herbert, Nakul Raykar, Saurabh Saluja, Mark G Shrime
BACKGROUND: The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. METHOD: Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27883975/evaluation-of-current-practices-in-transcatheter-aortic-valve-implantation-the-written-worldwide-tavi-experience-survey
#12
Enrico Cerrato, Luis Nombela-Franco, Tamim M Nazif, Helene Eltchaninoff, Lars Søndergaard, Henrique B Ribeiro, Marco Barbanti, Fabian Nietlispach, Peter De Jaegere, Pierfrancesco Agostoni, Ramiro Trillo, Pilar Jimenez-Quevedo, Fabrizio D'Ascenzo, Olaf Wendler, Gabriel Maluenda, Mao Chen, Corrado Tamburino, Carlos Macaya, Martin B Leon, Josep Rodes-Cabau
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been adopted worldwide as the standard treatment for severe aortic stenosis in symptomatic patients at prohibitive or high surgical risk, but there are still several areas where consensus and evidence are lacking. The purpose was to obtain a global view of current practice related to TAVI with the potential to identify the main areas of consensus and divergence between centers. METHODS: An online questionnaire was distributed in centers performing TAVI including a total of 59 questions concerning pre-procedural evaluation, procedural practices and post-procedural management...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27883901/tapping-the-brakes-cellular-and-synaptic-mechanisms-that-regulate-thalamic-oscillations
#13
REVIEW
P Michelle Fogerson, John R Huguenard
Thalamic oscillators contribute to both normal rhythms associated with sleep and anesthesia and abnormal, hypersynchronous oscillations that manifest behaviorally as absence seizures. In this review, we highlight new findings that refine thalamic contributions to cortical rhythms and suggest that thalamic oscillators may be subject to both local and global control. We describe endogenous thalamic mechanisms that limit network synchrony and discuss how these protective brakes might be restored to prevent absence seizures...
November 23, 2016: Neuron
https://www.readbyqxmd.com/read/27867480/xenon-protects-left-ventricular-diastolic-function-during-acute-ischemia-less-than-ischemic-preconditioning
#14
Jan-H Baumert, Anna B Roehl, Sandra Funcke, Marc Hein
Anesthetics modify regional left ventricular (LV) dysfunction following ischemia/reperfusion but their effects on global function in this setting are less clear. Aim of this study was to test the hypothesis that xenon would limit global LV dysfunction as caused by acute anterior wall ischemia, comparable to ischemic preconditioning. In an open-chest model under thiopental anesthesia, 30 pigs underwent 60-minute left anterior descending coronary artery occlusion, followed by 120 minutes of reperfusion. A xenon group (constant inhalation from previous to ischemia through end of reperfusion) was compared to control and ischemic preconditioning...
July 2016: Medical Gas Research
https://www.readbyqxmd.com/read/27858963/resting-state-functional-connectivity-and-cognition-after-major-cardiac-surgery-in-older-adults-without-preoperative-cognitive-impairment-preliminary-findings
#15
Jeffrey N Browndyke, Miles Berger, Todd B Harshbarger, Patrick J Smith, William White, Tiffany L Bisanar, John H Alexander, Jeffrey G Gaca, Kathleen Welsh-Bohmer, Mark F Newman, Joseph P Mathew
OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging. DESIGN: Objective cognitive testing and functional brain imaging were prospectively performed at preoperative baseline and 6 weeks after surgery and at the same time intervals in nonsurgical controls. SETTING: Academic medical center...
November 17, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#16
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27828927/effect-of-low-dose-of-ketamine-on-learning-memory-function-in-patients-undergoing-electroconvulsive-therapy-a-randomized-double-blind-controlled-clinical-study
#17
Qibin Chen, Su Min, Xuechao Hao, Lihua Peng, Huaqing Meng, Qinghua Luo, Jianmei Chen, Xiao Li
OBJECTIVES: Converging evidence suggests that low doses of ketamine have antidepressant effects. The feasibility and safety of administering low doses of ketamine as adjunctive medication during electroconvulsive therapy (ECT) to enhance ECT efficacy and mitigate cognitive impairment has attracted much attention. This study investigated the effects of low doses of ketamine on learning and memory in patients undergoing ECT under propofol anesthesia. METHODS: This randomized, placebo-controlled, double-blind study recruited patients with moderate to severe depressive disorders who failed to respond to antidepressants and were scheduled to receive ECT...
November 3, 2016: Journal of ECT
https://www.readbyqxmd.com/read/27781372/sufentanil-sublingual-tablet-30-mcg-for-the-management-of-pain-following-abdominal-surgery-a-randomized-placebo-controlled-phase-3-study
#18
Harold S Minkowitz, David Leiman, Timothy Melson, Neil Singla, Karen DiDonato, Pamela P Palmer
BACKGROUND: Results from a phase-3, prospective, randomized, double-blind, placebo-controlled trial evaluating sufentanil sublingual tablet 30 mcg (SST) for the management of pain after ambulatory abdominal surgery are presented. METHODS: Adults with American Society of Anesthesiologists status 1 - 3 scheduled to undergo abdominoplasty, open tension-free inguinal hernioplasty, or laparoscopic abdominal surgery under general or spinal anesthesia that did not include intrathecal opioids during the operation were eligible...
October 26, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27756140/in-response-to-the-editorial-sedation-in-endoscopy-in-2016-is-it-safe-sedation-with-propofol-led-by-the-endoscopist-in-complex-situations
#19
Manuel de la Matta
It is universally accepted that deep sedation involves more risks than light-to-moderate sedation. Deep sedation for endoscopic explorations is normally provided by anesthesiologists in Spain and in most countries of the European Unión. The present debate about deep sedation-anesthesia states goes beyond the topic of cardiovascular and respiratory adverse events, and targets the cognitive consequences and global increased mortality of uncontrolled sedation states, especially in specific fragile populations...
October 19, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27737853/brain-network-architecture-and-global-intelligence-in-children-with-focal-epilepsy
#20
M J Paldino, F Golriz, M L Chapieski, W Zhang, Z D Chu
BACKGROUND AND PURPOSE: The biologic basis for intelligence rests to a large degree on the capacity for efficient integration of information across the cerebral network. We aimed to measure the relationship between network architecture and intelligence in the pediatric, epileptic brain. MATERIALS AND METHODS: Patients were retrospectively identified with the following: 1) focal epilepsy; 2) brain MR imaging at 3T, including resting-state functional MR imaging; and 3) full-scale intelligence quotient measured by a pediatric neuropsychologist...
October 13, 2016: AJNR. American Journal of Neuroradiology
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