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Global anesthesia

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https://www.readbyqxmd.com/read/28743122/utility-of-transbronchial-lung-cryobiopsy-in-non-interstitial-diseases
#1
Olivia Sánchez-Cabral, Dina Martínez-Mendoza, Sebastián Fernandez-Bussy, Berenice López-González, Carolina Perea-Talamantes, Rosa María Rivera-Rosales, César Luna-Rivero, José Arturo Martínez-Orozco, Luis Felipe Flores-Suárez, Patricio Santillán-Doherty, Gustavo Reyes-Terán
BACKGROUND: Transbronchial lung cryobiopsy (TLCB), performed with a flexible cryoprobe, is an interventional pulmonology procedure that has proved its diagnostic value for interstitial pulmonary disease. However, it has not been explored extensively as a diagnostic tool for patients with non-interstitial lung pathology, including infectious and malignant diseases. OBJECTIVE: To evaluate the diagnostic yield and safety of an interventional pulmonology approach that integrates TLCB and bronchoalveolar lavage (BAL) for the diagnosis of non-interstitial pulmonary disease...
July 26, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28719524/establishing-obstetric-anesthesiology-practice-guidelines-in-the-republic-of-armenia-a-global-health-collaboration
#2
Gordon Yuill, Ashot Amroyan, Simon Millar, Emil Vardapetyan, Ashraf S Habib, Medge D Owen
BACKGROUND: Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report's aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28713258/relationship-of-topology-multiscale-phase-synchronization-and-state-transitions-in-human-brain-networks
#3
Minkyung Kim, Seunghwan Kim, George A Mashour, UnCheol Lee
How the brain reconstitutes consciousness and cognition after a major perturbation like general anesthesia is an important question with significant neuroscientific and clinical implications. Recent empirical studies in animals and humans suggest that the recovery of consciousness after anesthesia is not random but ordered. Emergence patterns have been classified as progressive and abrupt transitions from anesthesia to consciousness, with associated differences in duration and electroencephalogram (EEG) properties...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28701933/network-efficiency-and-posterior-alpha-patterns-are-markers-of-recovery-from-general-anesthesia-a-high-density-electroencephalography-study-in-healthy-volunteers
#4
Stefanie Blain-Moraes, Vijay Tarnal, Giancarlo Vanini, Tarik Bel-Behar, Ellen Janke, Paul Picton, Goodarz Golmirzaie, Ben J A Palanca, Michael S Avidan, Max B Kelz, George A Mashour
Recent studies have investigated local oscillations, long-range connectivity, and global network patterns to identify neural changes associated with anesthetic-induced unconsciousness. These studies typically employ anesthetic protocols that either just cross the threshold of unconsciousness, or induce deep unconsciousness for a brief period of time-neither of which models general anesthesia for major surgery. To study neural patterns of unconsciousness and recovery in a clinically-relevant context, we used a realistic anesthetic regimen to induce and maintain unconsciousness in eight healthy participants for 3 h...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28700368/regional-anesthesia-and-analgesia-in-cancer-care-is-it-time-to-break-the-bad-news
#5
Mir W Sekandarzad, André A J van Zundert, Chris W Doornebal, Markus W Hollmann
PURPOSE OF REVIEW: There is ongoing controversy regarding the tumor-protective effects of regional anesthesia in patients undergoing cancer surgery. Evidence of up-to-date systematic reviews will be presented alongside recent updates on the effects of opioids and local anesthetics. RECENT FINDINGS: In recent years, the literature regarding the effects of regional anesthesia techniques on cancer recurrence has raised many unanswered questions. Ongoing randomized controlled trials may not be able to shed light on the controversial discussion regarding the tumor protective effects of regional anesthesia because the expected effect size and event rate in those studies may be overstated...
July 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28699371/minocycline-attenuates-high-mobility-group-box-1-translocation-microglial-activation-and-thalamic-neurodegeneration-after-traumatic-brain-injury-in-postnatal-day-17-rats
#6
Dennis William Simon, Rajesh K Aneja, Henry Alexander, Michael J Bell, Hulya Bayir, Patrick M Kochanek, Robert S B Clark
In response to cell injury the danger signal high mobility group box-1 (HMGB) is released, activating macrophages by binding pattern recognition receptors. We investigated the role of the anti-inflammatory drug minocycline in attenuating HMGB1 translocation, microglial activation, and neuronal injury in a rat model of pediatric traumatic brain injury (TBI). Postnatal day 17 Sprague-Dawley rats were subjected to moderate-severe controlled cortical impact (CCI). Animals were randomized to treatment with minocycline (90 mg/kg, i...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28682957/the-new-world-health-organization-recommendations-on-perioperative-administration-of-oxygen-to-prevent-surgical-site-infections-a-dangerous-reductionist-approach
#7
Manuel Wenk, Hugo Van Aken, Alexander Zarbock
In October 2016, the World Health Organization (WHO) published recommendations for preventing surgical site infections (SSIs). Among those measures is a recommendation to administer oxygen at an inspired fraction of 80% intra- and postoperatively for up to 6 hours. SSIs have been identified as a global health problem, and the WHO should be commended for their efforts. However, this recommendation focuses only on the patient's "wound," ignores other organ systems potentially affected by hyperoxia, and may ultimately worsen patient outcomes...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28682949/an-analysis-of-substandard-propofol-detected-in-use-in-zambian-anesthesia
#8
Hazel Mumphansha, Jason W Nickerson, Amir Attaran, Sean Overton, Sharon Curtis, Paul Mayer, M Dylan Bould
BACKGROUND: In early 2015, clinicians throughout Zambia noted a range of unpredictable adverse events after the administration of propofol, including urticaria, bronchospasm, profound hypotension, and most predictably an inadequate depth of anesthesia. Suspecting that the propofol itself may have been substandard, samples were procured and sent for testing. METHODS: Three vials from 2 different batches were analyzed using gas chromatography-mass spectrometry methods at the John L...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28667887/feasibility-safety-and-preliminary-efficacy-of-low-amplitude-seizure-therapy-lap-st-a-proof-of-concept-clinical-trial-in-man
#9
Nagy A Youssef, Emad Sidhom
BACKGROUND: Current pulse amplitude used in clinical ECT may be higher than needed. Reducing pulse amplitude may improve focality of the electric field and thus cognitive adverse effects. Here we examine the feasibility, safety, and whether Low Pulse Amplitude Seizure Therapy (LAP-ST, 0.5-0.6A) minimizes cognitive adverse effects while retaining efficacy. METHODS: Patients with treatment-resistant primary mood (depressive episodes) or psychotic disorders who were clinically indicated to undergo ECT were offered to be enrolled in an open-label study...
November 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28648326/the-role-for-international-outreach-in-hand-surgery
#10
REVIEW
Karen Y Chung
Internationally, surgery is making its mark as a necessary priority in Low and Middle Income Countries (LMICs). In 2013, Paul Farmer, MD, and international leaders from 14 countries founded the Lancet Commission of Global Surgery to develop and assemble the best evidence on the state of surgery worldwide, to study the economics of surgical and anesthesia care delivery, and to develop strategies for improving access. Concurrently, there is growing interest in hand surgery. The Journal of Hand Surgery (European Volume) recently called for LMIC research with the goal of using their resources to improve the end product...
June 22, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28641979/sexual-dimorphism-in-the-fetal-cardiac-response-to-maternal-nutrient-restriction
#11
Sribalasubashini Muralimanoharan, Cun Li, Ernesto S Nakayasu, Cameron P Casey, Thomas O Metz, Peter W Nathanielsz, Alina Maloyan
Poor maternal nutrition causes intrauterine growth restriction (IUGR); however, its effects on fetal cardiac development are unclear. We have developed a baboon model of moderate maternal undernutrition, leading to IUGR. We hypothesized that the IUGR affects fetal cardiac structure and metabolism. Six control pregnant baboons ate ad-libitum (CTRL)) or 70% CTRL from 0.16 of gestation (G). Fetuses were euthanized at C-section at 0.9G under general anesthesia. Male but not female IUGR fetuses showed left ventricular fibrosis inversely correlated with birth weight...
June 19, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28619774/protocol-for-a-multicentre-multistage-prospective-study-in-china-using-system-based-approaches-for-consistent-improvement-in-surgical-safety
#12
Xiaochu Yu, Jingmei Jiang, Changwei Liu, Keng Shen, Zixing Wang, Wei Han, Xingrong Liu, Guole Lin, Ye Zhang, Ying Zhang, Yufen Ma, Haixin Bo, Yupei Zhao
INTRODUCTION: Surgical safety has emerged as a crucial global health issue in the past two decades. Although several safety-enhancing tools are available, the pace of large-scale improvement remains slow, especially in developing countries such as China. The present project (Modern Surgery and Anesthesia Safety Management System Construction and Promotion) aims to develop and validate system-based integrated approaches for reducing perioperative deaths and complications using a multicentre, multistage design...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28608275/robert-mathys-finger-prosthesis-of-the-proximal-interphalangeal-joint-a-retrospective-case-series-of-19-joints-in-17-patients
#13
J P Rijnja, P P G M Kouwenberg, S Ray, E T Walbeehm
INTRODUCTION: The Robert Mathys (RM) Finger is a hinged type of arthroplasty for the metacarpophalangeal and proximal interphalangeal (PIP) joint that compensates ligament instability. The aim of this study is to evaluate the outcomes and complications of RM Finger arthroplasty of the PIP joint. MATERIALS AND METHODS: A retrospective case series of 19 RM Finger arthroplasties of the PIP joint in 17 patients was performed with a median follow-up of 36 months. The active range of motion (AROM) was measured pre-operatively, at the 6-week follow-up, at the termination of hand therapy, and at the final follow-up...
June 12, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28603012/an-improved-three-vessel-occlusion-model-of-global-cerebral-ischemia-in-rats
#14
Dmitriy N Atochin, Galina A Chernysheva, Oleg I Aliev, Vera I Smolyakova, Anton N Osipenko, Sergey V Logvinov, Anna A Zhdankina, Tatiana M Plotnikova, Mark B Plotnikov
We developed an improved three-vessel occlusion model of global cerebral ischemia in rats. This method consists in cessation of cerebral blood flow by accessing a. carotis communis sinistra through the ventral surface of the neck as well as tr. brachiocephalicus and a. subclavia sinistra through the first intercostal space, bypassing the pleural cavity and excluding pneumothorax. After the occlusion of the vessels that resulted in interruption of their blood flow, according to laser-Doppler flowmetry, there was a sharp decline in local cerebral blood flow in the visual cortex to 4±1% of the initial level...
June 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28596491/intraoperative-use-of-dexmedetomidine-promotes-postoperative-sleep-and-recovery-following-radical-mastectomy-under-general-anesthesia
#15
Cunxian Shi, Jin Jin, Qiang Pan, Shan Song, Kezhong Li, Jiahai Ma, Tao Li, Zhi Li
Postoperative sleep disturbance and fatigue following radical mastectomy were high risks for prolonged convalescence in patients with breast cancer. The present study was designed to observe the effect of intraoperative use of dexmedetomidine on postoperative sleep, fatigue and recovery following radical mastectomy under general anesthesia. Forty-seven patients were randomized into two groups that were maintained with propofol/remifentanil/Ringer's solution (Control group), or propofol/remifentanil/Dexmedetomidine (DEX group) for surgery under general anesthesia...
May 24, 2017: Oncotarget
https://www.readbyqxmd.com/read/28593682/interactive-pediatric-emergency-checklists-to-the-palm-of-your-hand-how-the-pedi-crisis-app-traveled-around-the-world
#16
Jorge A Gálvez, Justin L Lockman, Laura E Schleelein, Allan F Simpao, Luis M Ahumada, Bryan A Wolf, Maully J Shah, Eugenie Heitmiller, Mohamed Rehman
BACKGROUND: Cognitive aids help clinicians manage critical events and have been shown to improve outcomes by providing critical information at the point of care. Critical event guidelines, such as the Society of Pediatric Anesthesia's Critical Events Checklists described in this article, can be distributed globally via interactive smartphone apps. From October 1, 2013 to January 1, 2014, we performed an observational study to determine the global distribution and utilization patterns of the Pedi Crisis cognitive aid app that the Society for Pediatric Anesthesia developed...
June 7, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28576279/-atypical-reaction-to-anesthesia-in-duchenne-becker-muscular-dystrophy
#17
Helga Cristina Almeida da Silva, Marcia Hiray, Mariz Vainzof, Beny Schmidt, Acary Souza Bulle Oliveira, José Luiz Gomes do Amaral
BACKGROUND AND OBJECTIVES: Duchenne/Becker muscular dystrophy affects skeletal muscles and leads to progressive muscle weakness and risk of atypical anesthetic reactions following exposure to succinylcholine or halogenated agents. The aim of this report is to describe the investigation and diagnosis of a patient with Becker muscular dystrophy and review the care required in anesthesia. CASE REPORT: Male patient, 14 years old, referred for hyperCKemia (chronic increase of serum creatine kinase levels - CK), with CK values of 7,779-29,040IU...
May 30, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28572583/perioperative-and-anesthesia-related-cardiac-arrests-in-geriatric-patients-a-systematic-review-using-meta-regression-analysis
#18
Karen S Braghiroli, José R C Braz, Bruna Rocha, Regina El Dib, José E Corrente, Mariana G Braz, Leandro G Braz
The worldwide population is aging, and the number of surgeries performed in geriatric patients is increasing. This systematic review evaluated anesthetic procedures to assess global data on perioperative and anesthesia-related cardiac arrest (CA) rates in geriatric surgical patients. Available data on perioperative and anesthesia-related CA rates over time and by the country's Human Development Index (HDI) were evaluated by meta-regression, and a pooled analysis of proportions was used to compare perioperative and anesthesia-related CA rates by HDI and time period...
June 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28537981/development-of-education-and-research-in-anesthesia-and-intensive-care-medicine-at-the-university-teaching-hospital-in-lusaka-zambia-a-descriptive-observational-study
#19
Anna Janowicz, Tuma Kasole, Emily Measures, Meg Langley, Fastone M Goma, Feruza Ismailova, John A Kinnear, M Dylan Bould
BACKGROUND: Data from 2006 show that the practice of anesthesia at the University Teaching Hospital in Lusaka, Zambia was underdeveloped by international standards. Not only was there inadequate provision of resources related to environment, equipment, and drugs, but also a severe shortage of staff, with no local capability to train future physician anesthetic providers. There was also no research base on which to develop the specialty. This study aimed to evaluate patient care, education and research to determine whether conditions had changed a decade later...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28537976/interest-of-urinary-timp-2-%C3%A3-igfbp-7-for-predicting-the-occurrence-of-acute-kidney-injury-after-cardiac-surgery-a-gray-zone-approach
#20
Toufic Finge, Sebastien Bertran, Claire Roger, Damien Candela, Bruno Pereira, Christopher Scott, Laurent Muller, Benjamin Louart, Jean-Yves Lefrant
BACKGROUND: This study assessed the ability of 3-hour postoperative urinary tissue inhibitor of metalloproteinases-2 × insulin-like growth factor binding protein-7 ([TIMP-2] × [IGFBP-7]) to predict postoperative acute kidney injury (AKI) in patients undergoing cardiopulmonary bypass during cardiac surgery. METHODS: Patients undergoing cardiac surgery with cardiopulmonary bypass were eligible for this study. Patients with initial chronic renal insufficiency requiring renal replacement therapy, patients <18 years of age, and parturients were not included...
May 19, 2017: Anesthesia and Analgesia
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