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F Tosi, A Chiaretti, D Buonsenso, S Mensi, O Genovese, M Pittiruti, G Conti
We performed a systematic review of the literature starting from a real case of venous air embolism (VAE) in a young infant undergoing central catheterization during procedural sedation. Air embolism due to internal jugular vein catheterization during procedural sedation is very rare, but it is a potentially life-threatening complication of central catheterization that warrants attention. To our knowledge, this is the first case published in a similar scenario.
November 2018: European Review for Medical and Pharmacological Sciences
Sjirk J Westra
No abstract text is available yet for this article.
December 10, 2018: Pediatric Radiology
Sedat Giray Kandemirli, Feyza Kabar, Guzin Cakir Kandemirli, Nadide Basak Gulleroglu, Zeynep Yazici
Clavicle duplication is a rare entity with limited number of cases reported. Congenital origin and trauma related mechanisms are the main hypotheses to explain this anatomical variation. In skeletally immature patient, trauma may cause physeal-metaphyseal injury in the distal clavicle rather than acromioclavicular strain. The distal epiphysis remains in continuity with acromion and has an intact periosteal sleeve. The periosteal sleeve is extremely osteogenic, and may lead to new bone formation between epiphysis and displaced metaphysis...
December 8, 2018: Surgical and Radiologic Anatomy: SRA
Rosanna Vaschetto, Federico Longhini, Paolo Persona, Carlo Ori, Giulia Stefani, Songqiao Liu, Yang Yi, Weihua Lu, Tao Yu, Xiaoming Luo, Rui Tang, Maoqin Li, Jiaqiong Li, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Zhaochen Jin, Jun Yan, Ruiqiang Zheng, Jingjing Yin, Stefania Guido, Francesco Della Corte, Tiziano Fontana, Cesare Gregoretti, Andrea Cortegiani, Antonino Giarratano, Claudia Montagnini, Silvio Cavuto, Haibo Qiu, Paolo Navalesi
PURPOSE: Noninvasive ventilation (NIV) may facilitate withdrawal of invasive mechanical ventilation (i-MV) and shorten intensive care unit (ICU) length of stay (LOS) in hypercapnic patients, while data are lacking on hypoxemic patients. We aim to determine whether NIV after early extubation reduces the duration of i-MV and ICU LOS in patients recovering from hypoxemic acute respiratory failure. METHODS: Highly selected non-hypercapnic hypoxemic patients were randomly assigned to receive NIV after early or standard extubation...
December 10, 2018: Intensive Care Medicine
Daisy J M Ermers, Karin J H van Bussel, Marieke Perry, Yvonne Engels, Henk J Schers
Background: Advance care planning (ACP) is a crucial element of palliative care. It improves the quality of end-of-life care and reduces aggressive and needless life-prolonging medical interventions. However, little is known about its application in daily practice. This study aims to examine the application of ACP for patients with cancer in general practice. Methods: We performed a retrospective cohort study in 11 general practices in the Netherlands. Electronic patient records (EPRs) of deceased patients with colorectal or lung cancer were analysed...
December 10, 2018: Family Practice
Sedigheh Mozafar, Majid Bargrizan, Mojtaba Vahid Golpayegani, Shahnaz Shayeghi, Rahil Ahmadi
Background: This study compared the safety and efficacy of nitrous oxide (N2 O)/midazolam and N2 O/promethazine for dental treatment of uncooperative children. Materials and Methods: In this randomized, cross-over, clinical trial investigation Eighteen healthy uncooperative children with a pair of similar teeth requiring the same treatment were included. Combination of N2 O/midazolam was given in one visit, where N2 O/promethazine was administrated in the other appointment for each patient in a cross-over manner...
November 2018: Dental Research Journal
Houman Teymourian, Shayesteh Khorasanizadeh, Padideh Ansar, Leila Nazari, Masih Ebrahimy Dehkordy
Objectives: In this study, we aimed to compare the effects of bupivacaine alone and in combination with dexmedetomidine on postoperative analgesia, neonatal Apgar score, and bispectral index (BIS), which has been shown to correlate with increased sedation and loss of consciousness in women undergoing cesarean section under spinal anesthesia. Methods: A total of 152 term parturient women scheduled to have elective cesarean section with American Society of Anesthesiologist (ASA) physical status I or II were allocated randomly into two groups to receive either bupivacaine plus placebo (BV group) or bupivacaine plus dexmedetomidine (BVD group)...
October 2018: Anesthesiology and Pain Medicine
Soudabeh Haddadi, Reyhaneh Shahrokhirad, Malek Moien Ansar, Shideh Marzban, Mitra Akbari, Arman Parvizi
Background: Retrobulbar block is one of the chosen methods for local anesthesia in cataract surgery. Since it is a painful procedure, using analgesic and sedative drugs is recommended. Current medications have side effects and evaluating of new drugs or new uses of existing safer drugs is necessary. Objectives: The aim of this study was to compare the administration of melatonin and acetaminophen on pain and hemodynamic changes during retrobulbar block. Methods: In a double-blinded randomized trial, 180 patients undergoing cataract surgery were randomly divided into three groups: Melatonin group (received melatonin 6 mg), acetaminophen group (received acetaminophen 500 mg), and control group (received placebo)...
October 2018: Anesthesiology and Pain Medicine
Gun Min Youn, Brittany M Woodall, Nicholas Elena, Edward C Shin, Neil Pathare, Patrick J McGahan, James L Chen
Bone marrow aspirate concentrate is commonly harvested to obtain mesenchymal stem cells, progenitor cells, and growth factors. The iliac crest is the most common donor site for bone marrow harvesting and is associated with donor site morbidity of an additional incision and pain from the harvest. Iliac crest harvesting can be cumbersome because it often requires different patient positioning from the surgical procedure and additional sedation or anesthesia for the harvest prior to repositioning. The purpose of this Technical Note and accompanying video is to describe a technique to arthroscopically aspirate bone marrow from the intercondylar femoral notch, reducing the need for iliac crest harvesting...
November 2018: Arthroscopy Techniques
Armando Mansilla-Olivares, Joaquín López-Bárcena, Ricardo Plancarte-Sánchez, Fermín Valenzuela-Gómez-Gallardo, Julieta Rojo, Fernando Meneses-González, Gilberto Felipe Vázquez-De Anda, Patricio Santillán-Doherty, José Ignacio Santos-Preciado, María de Jesús Medina, Asunción Álvarez, Beatriz Vanda
There are decisions at the end of life that currently are relevant as humanistic values. Respect for human life and dignity are part of human rights. The National Academy of Medicine of Mexico declares its posture about end-of-life decisions that include treatment refusal, limitation of the therapeutic effort, advance directives and palliative sedation, among others, with the purpose to favor a peaceful death.
2018: Gaceta Médica de México
Lian Liu, Quan Yuan, Yafeng Wang, Wenwei Gao, Jiabao Hou, Yang Wu, Bo Zhao, Zhongyuan Xia
BACKGROUND This study was designed to evaluate the effects of combined usage of dexmedetomidine (DEX) and sufentanil on young patients with postoperative delirium (POD) after general anesthesia. MATERIAL AND METHODS We randomized 100 young patients with POD into 4 groups: Group D, Group S, Group DS1, and Group DS2, with loading and maintenance doses of DEX and/or sufentanil administered according to the experimental protocol. Hemodynamic variables, standard visual analogue scale (VAS) scores, sedation agitation scale (SAS) scores, stress hormones, and inflammatory biomarkers were assessed at 5 time-points: baseline (T1); 1 h (T2), 2 h (T3), 4 h (T4), and 8 h (T5) after completion of the loading dose...
December 10, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Jian Sun, Fa Liang, Youxuan Wu, Yan Zhao, Zhongrong Miao, Li Zhang, Adrian W Gelb, Matthew T V Chan, Yuming Peng, Ruquan Han
BACKGROUND: The effect of choice of anesthesia on clinical outcome for endovascular treatment (EVT) in patients with acute ischemic stroke (AIS) remains unclear. METHODS: We conducted a pilot trial of 43 patients with acute anterior circulation ischemic stroke having EVT. Patients were randomly allocated to receive general anesthesia or conscious sedation. We documented the rate of recruitment and rate of conversion from conscious sedation to general anesthesia...
December 7, 2018: Journal of Neurosurgical Anesthesiology
Lia D Ernst, Katie L Krause, Marissa A Kellogg, Ahmed M Raslan, David C Spencer
There are very few randomized controlled trials studying treatment of super refractory status epilepticus (SE), despite estimated occurrence in about 15% of SE cases and its association with high morbidity and mortality rates. Small case series and case reports have described use of neurostimulation, including vagal nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation, to treat super refractory SE when medical interventions have failed. To our knowledge, this is the first reported case of responsive neurostimulation being used to successfully treat a case of super refractory SE...
December 6, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Pil-Jong Kim, Hong-Gee Kim, Teo Jeon Shin
Integration of neural information could be considered a crucial element in maintaining consciousness. Although consciousness is usually maintained during sedation, strictly speaking, the sedative state is different from consciousness. Nitrous oxide (N2O) has been used widely to sedate patients for dental procedures. However, its mechanism remains unclear. The aim of this study was to analyze the extent of disturbance in the integration of brain activities during N2O administration on the basis of projection to the reconstructed state space...
December 7, 2018: Neuroreport
Christopher W Liu, Anuj Bhatia, Arlene Buzon-Tan, Susan Walker, Dharini Ilangomaran, Jamal Kara, Lakshmikumar Venkatraghavan, Atul J Prabhu
BACKGROUND: The recreational and medical use of cannabinoids has been increasing. While most studies and reviews have focused on the role of cannabinoids in the management of acute pain, no study has examined the postoperative outcomes of surgical candidates who are on cannabinoids preoperatively. This retrospective cohort study examined the impact of preoperative cannabinoid use on postoperative pain scores and pain-related outcomes in patients undergoing major orthopedic surgery. METHODS: Outcomes of patients who had major orthopedic surgery at our hospital between April 1, 2015 and June 30, 2017 were reviewed...
December 7, 2018: Anesthesia and Analgesia
Nathan Smischney, Rahul Kashyap, Mohamed Seisa, Darrell Schroeder, Daniel Diedrich
BACKGROUND: Endotracheal intubation can occur in up to 60% of critically ill patients. Despite the frequency with which endotracheal intubation occurs, the current practice is largely unknown. This is relevant, as advances in airway equipment (ie, video laryngoscopes) have become more prevalent, leading to possible improvement of care delivered during this process. In addition to new devices, a greater emphasis on airway plans and choices in sedation have evolved, although the influence on patient morbidity and mortality is largely unknown...
December 7, 2018: JMIR Research Protocols
Yu Horiguchi, Noriyuki Ohta, Syunsuke Yamamoto, Moe Koide, Yuji Fujino
BACKGROUND: Benzodiazepines are widely used for anesthesia and sedation and have immunomodulatory properties that may negatively influence clinical outcomes; however, the cellular targets and intermediary signaling pathways involved are unclear. We examined the immunomodulatory effects of the benzodiazepine midazolam on human macrophages and associated molecular mechanisms. METHODS: We analyzed effects of midazolam pretreatment on lipopolysaccharide (LPS)-induced upregulation of the costimulatory molecule CD80 and secretion of the pro-inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α, interleukin-10, and nitric oxide (NO) in the human monocyte-macrophage cell line THP-1 and in peripheral monocyte-derived macrophages (PMDMs)...
December 5, 2018: International Immunopharmacology
Chioma Ndubisi, Antoinette Danvers, Melanie A Gold, Lisa Morrow, Carolyn L Westhoff
OBJECTIVES: To assess pain-management using auricular acupuncture as an adjunct to ibuprofen and paracervical block during first trimester uterine aspiration, and to assess auricular acupuncture's effect on anxiety. STUDY DESIGN: This randomized, double-blinded, three-arm trial enrolled women undergoing uterine aspiration for spontaneous or induced abortion. Study participants were randomized 1:1:1 to receive auricular acupuncture, placebo, or usual care alone. Participants in all groups received ibuprofen and paracervical block (usual care)...
December 7, 2018: Contraception
Massimo Luerti, Amerigo Vitagliano, Attilio Di Spiezio Sardo, Stefano Angioni, Giancarlo Garuti, Carlo De Angelis
STUDY OBJECTIVE: To compare the effectiveness and safety of different techniques of hysteroscopic polypectomy. DESIGN: Multicenter, prospective observational trial (Canadian Task Force Classification II-2). SETTING: 19 Italian Gynecologic Departments (University-Affiliated or Public Hospitals). PATIENTS: Consecutive patients suffering from endometrial polyps (EPs). INTERVENTIONS: Hysteroscopic polypectomy, as performed through different techniques...
December 7, 2018: Journal of Minimally Invasive Gynecology
Stijn Schauvliege, Charlotte Cuypers, Anneleen Michielsen, Frank Gasthuys, Miguel Gozalo-Marcilla
OBJECTIVE: To summarize the different methods used to assess sedation and/or adjust the dose or administration rate of alpha-2 agonists in horses and to propose an algorithm to adjust the administration rate of a constant rate infusion of an alpha-2 agonist in horses. DATABASES USED: PubMed and Web of Science; search terms: horse, sedation and score. CONCLUSIONS: Most authors distinguish between sedation depth, sedation quality and degree of ataxia...
September 19, 2018: Veterinary Anaesthesia and Analgesia
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