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https://www.readbyqxmd.com/read/28426446/providing-anesthesia-in-resource-limited-settings
#1
Lena E Dohlman
PURPOSE OF REVIEW: The article reviews the reality of anesthetic resource constraints in low and middle-income countries (LMICs). Understanding these limitations is important to volunteers from high-income countries who desire to teach or safely provide anesthesia services in these countries. RECENT FINDINGS: Recently published information on the state of anesthetic resources in LMICs is helping to guide humanitarian outreach efforts from high-income countries. The importance of using context-appropriate anesthesia standards and equipment is now emphasized...
April 19, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28424861/s-ketamine-compared-to-etomidate-during-electroconvulsive-therapy-in-major-depression
#2
Maxim Zavorotnyy, Ina Kluge, Kathrin Ahrens, Thomas Wohltmann, Benjamin Köhnlein, Patricia Dietsche, Udo Dannlowski, Tilo Kircher, Carsten Konrad
Objective of the study was to compare two commonly used anesthetic drugs, S-ketamine and etomidate, regarding their influence on seizure characteristics, safety aspects, and outcome of electroconvulsive therapy (ECT) in major depression. Treatment data of 60 patients who underwent a total number of 13 ECTs (median) because of the severe or treatment-resistant major depressive disorder (DSM-IV) were analyzed. Etomidate, mean dosage (SD) = 0.25 (0.04) mg/kg, was used for anesthesia in 29 participants; 31 patients received S-ketamine, mean dosage (SD) = 0...
April 19, 2017: European Archives of Psychiatry and Clinical Neuroscience
https://www.readbyqxmd.com/read/28400499/the-coherence-of-macrocirculation-microcirculation-and-tissue-metabolic-response-during-nontraumatic-hemorrhagic-shock-in-swine
#3
Halvor Langeland, Oddveig Lyng, Petter Aadahl, Nils-Kristian Skjærvold
Hemorrhagic shock is clinically observed as changes in macrocirculatory indices, while its main pathological constituent is cellular asphyxia due to microcirculatory alterations. The coherence between macro- and microcirculatory changes in different shock states has been questioned. This also applies to the hemorrhagic shock. Most studies, as well as clinical situations, of hemorrhagic shock include a "second hit" by tissue trauma. It is therefore unclear to what extent the hemorrhage itself contributes to this lack of circulatory coherence...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28400498/effect-of-thoracic-epidural-anesthesia-on-heart-rate-variability-in-a-porcine-model
#4
Arjun Mahajan, Tatsuo Takamiya, Peyman Benharash, Wei Zhou
Heart rate variability (HRV) is increasingly recognized as a means of evaluating autonomic tone. Thoracic epidural anesthesia (TEA) has been previously demonstrated to suppress the electrical storms in patients. However, the effect of TEA on HRV during sympathoexcitation remains unknown. In this study, we aimed to determine the effects of TEA on HRV response to left stellate ganglion stimulation (LSS) in a porcine model. In 12 anesthetized pigs after insertion of an epidural catheter to T1 level, a median sternotomy was performed to expose the heart and the left stellate ganglion...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28377845/time-dependent-decline-in-multifocal-electroretinogram-requires-faster-recording-procedures-in-anesthetized-pigs
#5
Nina Buus Sørensen, Anders Tolstrup Christiansen, Troels Wesenberg Kjær, Kristian Klemp, Morten la Cour, Jens Folke Kiilgaard
PURPOSE: The time-dependent effect of anesthetics on the retinal function is debated. We hypothesize that in anesthetized animals there is a time-dependent decline that requires optimized multifocal electroretinogram (mfERG) recording procedures. METHODS: Conventional and four-frame global-flash mfERG recordings were obtained approximately 15, 60, and 150 minutes after the induction of propofol anesthesia (20 pigs) and isoflurane anesthesia (nine pigs). In six of the propofol-anesthetized pigs, the mfERG recordings were split in 3-minute segments...
March 2017: Translational Vision Science & Technology
https://www.readbyqxmd.com/read/28377836/scientific-publication-performance-of-turkish-anaesthesia-clinics-in-high-impact-factor-international-journals-between-2005-and-2014-a-bibliometric-analysis
#6
Hüseyin Oğuz Yılmaz, Rovnat Babazade, Oğuz Alp Turan, Betül Babazade, Onur Koyuncu, Alparslan Turan
OBJECTIVE: International scientific publication productivity is a tangible indicator for the accuracy of scientific policies. The quality of scientific publications is not increasing despite the fast increase in the publication count in Turkey. The international publication activities of Turkish anaesthesia clinics have not been previously explored. Thus, we aimed to evaluate the high quality scientific productivity of Turkish anesthesia clinics within the last 10 years. METHODS: We searched for studies conducted by anaesthesiologists in Turkey within the last 10 years and published in journals listed under the medical subject categories of anaesthesiology and critical care using 'Thomson Reuters InCites' and PubMed databases...
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28372658/a-case-of-paradoxical-presentation-of-a-postural-postdural-puncture-headache-after-combined-spinal-epidural-anesthesia
#7
John W Bordlee, Burton D Beakley, Rayomond Mody, Anne P McConville, Jonathan T Weed, Brian P McClure, Peter J Foldes, Jonathan G Ma, Alan D Kaye, Jonathan P Eskander
We report a case of paradoxical presentation of a postural postdural puncture headache secondary to dural puncture with a 25-gauge Whitacre needle for combined spinal-epidural anesthesia. This 27-year-old female patient presented to the emergency department with elevated blood pressure and a global headache 9 days after administration of epidural anesthesia for a spontaneous vaginal delivery after an uncomplicated pregnancy. The patient reported that the headache was more intense when lying down and immediately improved when she sat or stood up from a recumbent position...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28358748/effect-of-thoracic-epidural-anesthesia-on-ventricular-excitability-in-a-porcine-model
#8
Kimberly Howard-Quijano, Tatsuo Takamiya, Erica A Dale, Kentaro Yamakawa, Wei Zhou, Una Buckley, Aman Mahajan
BACKGROUND: Imbalances in the autonomic nervous system, namely, excessive sympathoexcitation, contribute to ventricular tachyarrhythmias. While thoracic epidural anesthesia clinically suppresses ventricular tachyarrhythmias, its effects on global and regional ventricular electrophysiology and electrical wave stability have not been fully characterized. The authors hypothesized that thoracic epidural anesthesia attenuates myocardial excitability and the proarrhythmic effects of sympathetic hyperactivity...
March 30, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28323561/immobilization-of-asiatic-black-bears-ursus-thibetanus-with-medetomidine-zolazepam-tiletamine-in-south-korea
#9
Dong-Hyuk Jeong, Jeong-Jin Yang, Seong-Hoon Seok, Byeung-Cheul Song, Seong-Chan Yeon
The Asiatic black bear ( Ursus thibetanus ; ABB) is a globally endangered species for which a restoration program has been ongoing in South Korea since 2001. However, there is little information on immobilization protocols for ABBs. We evaluated the use of medetomidine-zolazepam-tiletamine for their immobilization. During 2005-2013, we anesthetized 60 ABBs (32 males, 28 females; 7 mo to 12 yr old) with medetomidine 0.03-0.045 mg/kg and zolazepam-tiletamine 1.54-2.3 mg/kg; reversal of anesthesia was done with atipamezole 0...
March 21, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28314284/altered-levels-of-serum-ceramide-sphingosine-and-sphingomyelin-are-associated-with-colorectal-cancer-a-retrospective-pilot-study
#10
Duska Separovic, Anthony F Shields, Philip A Philip, Jacek Bielawski, Alicja Bielawska, Jason S Pierce, Adi L Tarca
BACKGROUND/AIM: Because patients with cancer of apparently equivalent stage often have different outcomes, it is necessary to gather additional information to complement cancer staging. Dysregulated sphingolipid metabolism contributes to carcinogenesis. In this retrospective pilot study, we tested the hypothesis that changes in serum levels of sphingolipids are associated with stage IV colorectal cancer (CRC). PATIENTS AND METHODS: We used commercially available serum samples from healthy males and patients with CRC (adenocarcinoma of the large intestine, stage IV with metastases)...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28306682/training-future-anesthesiologists-in-obstetric-care
#11
Mauricio Vasco Ramírez
PURPOSE OF REVIEW: In order for the obstetric anesthesiologist to become a true perioperative / peripartum physician, a change in formative programs and certification process in anesthesia are needed. RECENT FINDINGS: Anesthesia training programs are migrating to competency based medical education (CBME) worldwide. The traditional model of attending lectures, grand rounds, reading textbooks and journal papers should be complemented by virtual modalities such as massive open online courses or online teaching tools...
April 10, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#12
Torsten Baehner, Richard K Ellerkmann
PURPOSE OF REVIEW: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. RECENT FINDINGS: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28293478/disrupted-brain-network-functional-dynamics-and-hyper-correlation-of-structural-and-functional-connectome-topology-in-patients-with-breast-cancer-prior-to-treatment
#13
Shelli R Kesler, Marjorie Adams, Melissa Packer, Vikram Rao, Ashley M Henneghan, Douglas W Blayney, Oxana Palesh
INTRODUCTION: Several previous studies have demonstrated that cancer chemotherapy is associated with brain injury and cognitive dysfunction. However, evidence suggests that cancer pathogenesis alone may play a role, even in non-CNS cancers. METHODS: Using a multimodal neuroimaging approach, we measured structural and functional connectome topology as well as functional network dynamics in newly diagnosed patients with breast cancer. Our study involved a novel, pretreatment assessment that occurred prior to the initiation of any cancer therapies, including surgery with anesthesia...
March 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28282987/lateral-pressure-profile-and-free-volume-properties-in-phospholipid-membranes-containing-anesthetics
#14
Balázs Fábián, Marcello Sega, Vladimir P Voloshin, Nikolai N Medvedev, Pál Jedlovszky
The effect of four general anesthetics, namely chloroform, halothane, diethyl ether, and enflurane on the free volume fraction and lateral pressure profiles in a fully hydrated dipalmitoylphosphatidylcholime (DPPC) membrane is investigated by means of computer simulation. In order to find changes that can be related to the molecular mechanism of anesthesia as well as its pressure reversal, the simulations are performed both at atmospheric and high (1000 bar) pressures. The obtained results show that the additional free volume occurring in the membrane is localized around the anesthetic molecules themselves...
March 27, 2017: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/28270098/the-effects-of-y-27632-on-pial-microvessels-during-global-brain-ischemia-and-reperfusion-in-rabbits
#15
Noriyuki Shintani, Tadahiko Ishiyama, Masakazu Kotoda, Nobumasa Asano, Daniel I Sessler, Takashi Matsukawa
BACKGROUND: Global brain ischemia-reperfusion during propofol anesthesia provokes persistent cerebral pial constriction. Constriction is likely mediated by Rho-kinase. Cerebral vasoconstriction possibly exacerbates ischemic brain injury. Because Y-27632 is a potent Rho-kinase inhibitor, it should be necessary to evaluate its effects on cerebral pial vessels during ischemia-reperfusion period. We therefore tested the hypotheses that Y-27632 dilates cerebral pial arterioles after the ischemia-reperfusion injury, and evaluated the time-course of cerebral pial arteriolar status after the ischemia-reperfusion...
March 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28253549/the-immune-response-of-the-human-brain-to-abdominal-surgery
#16
Anton Forsberg, Simon Cervenka, Malin Jonsson Fagerlund, Lars S Rasmussen, Henrik Zetterberg, Helena Erlandsson Harris, Pernilla Stridh, Eva Christensson, Anna Granström, Anna Schening, Karin Dymmel, Nina Knave, Niccolò Terrando, Mervyn Maze, Jacqueline Borg, Andrea Varrone, Christer Halldin, Kaj Blennow, Lars Farde, Lars I Eriksson
OBJECTIVE: Surgery launches a systemic inflammatory reaction that reaches the brain and associates with immune activation and cognitive decline. Although preclinical studies have in part described this systemic-to-brain signaling pathway, we lack information on how these changes appear in humans. This study examines the short- and long-term impact of abdominal surgery on the human brain immune system by positron emission tomography (PET) in relation to blood immune reactivity, plasma inflammatory biomarkers, and cognitive function...
April 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28207530/can-quality-of-recovery-be-enhanced-by-premedication-with-midazolam-a-prospective-randomized-double-blind-study-in-females-undergoing-breast-surgery
#17
RANDOMIZED CONTROLLED TRIAL
Myoung Hwa Kim, Min Soo Kim, Jae Hoon Lee, Jae Hi Seo, Jeong-Rim Lee
BACKGROUND: Preoperative anxiety is known to be related with the postoperative outcomes, although it remains unclear whether pharmacologic anxiolysis preoperatively leads to better postanesthesia recovery. Hence, the purpose of this study was to assess whether midazolam premedication would result in improved Quality of Recovery-40 survey scores, as a postoperative recovery parameter, in female patients undergoing mastectomy. METHODS: This randomized double-blind study was performed at Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28169844/standard-setting-for-clinical-performance-of-basic-perioperative-transesophageal-echocardiography-moving-beyond-the-written-test
#18
Julian S Bick, Jonathan P Wanderer, Conrad S Myler, Andrew D Shaw, Matthew D McEvoy
BACKGROUND: Credible methods for assessing competency in basic perioperative transesophageal echocardiography examinations have not been reported. The authors' objective was to demonstrate the collection of real-world basic perioperative transesophageal examination performance data and establish passing scores for each component of the basic perioperative transesophageal examination, as well as a global passing score for clinical performance of the basic perioperative transesophageal examination using the Angoff method...
April 2017: Anesthesiology
https://www.readbyqxmd.com/read/28160988/continuous-monitoring-in-global-health-taking-principles-of-anesthesia-care-abroad-the-lifebox-model
#19
EDITORIAL
Luca Anna Koritsanszky
No abstract text is available yet for this article.
January 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/28160985/two-japanese-pioneers-in-anesthesiology-seish%C3%A5-hanaoka-and-gendai-kamada
#20
REVIEW
Kentaro Dote, Keizo Ikemune, Yoko Desaki, Hideyuki Nandate, Amane Konisi, Tosihiro Yorozuya, Hiroshi Makino
Seishū Hanaoka and Gendai Kamada are two Japanese pioneers in anesthesiology. Seishū Hanaoka was the world's first surgeon on record to successfully perform surgery under general anesthesia in 1804. Seishū discovered that six medicinal herbs containing Datura, stramonium, and Aconitum had anesthetic properties. From these, he developed Mafutsusan. His fame spread across Japan, and he was inundated with requests from patients and prospective students. He founded a private medical school (Shunrinken) and trained more than 1000 students...
January 2017: Journal of Anesthesia History
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