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Anesthesiology 2016

Mohammad Irfan Akhtar, Karima Karam, Fauzia Anis Khan
Context: The South Asian region is comprised of eight countries, i.e., Pakistan, India, Bangladesh, Sri Lanka, Afghanistan, Bhutan, Nepal, and Maldives. There is dearth of literature documenting anesthesia research in this region. Aim: The aim of this audit was to look at research productivity in the region by examining the volume and the type of anesthesia publication in five high-index anesthesia journals. Settings and Design: The study design was a survey of literature in the top five high-impact anesthesiology journals carried out at a tertiary care hospital...
July 2018: Saudi Journal of Anaesthesia
Martha A Bissing, Elizabeth M S Lange, Wilmer F Davila, Cynthia A Wong, Robert J McCarthy, M Christine Stock, Paloma Toledo
BACKGROUND: Gender inequity is still prevalent in today's medical workforce. Previous studies have investigated the status of women in academic anesthesiology. The objective of this study is to provide a current update on the status of women in academic anesthesiology. We hypothesized that while the number of women in academic anesthesiology has increased in the past 10 years, major gender disparities continue to persist, most notably in leadership roles. METHODS: Medical student, resident, and faculty data were obtained from the Association of American Medical Colleges...
August 9, 2018: Anesthesia and Analgesia
Yin-Fa Zhang, Fei Xiao, Wen-Ping Xu, Lin Liu
BACKGROUND: Phenylephrine infusion to prevent spinal-induced hypotension can attenuate cephalic spread of intrathecal bupivacaine. Therefore, we suspected the intrathecal dose requirement for bupivacaine may differ when using phenylephrine infusion to prevent spinal-induced hypotension in cesarean section. We designed a prospective, randomized study to determine the ED50 of hyperbaric bupivacaine for cesarean section under combined spinal-epidural anesthesia in healthy parturients with and without prophylactic phenylephrine infusion to prevent spinal-induced hypotension...
August 2018: Medicine (Baltimore)
Samir Kendale, Prathamesh Kulkarni, Andrew D Rosenberg, Jing Wang
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Hypotension is a risk factor for adverse perioperative outcomes. Machine learning methods allow large amounts of data for development of robust predictive analytics. The authors hypothesized that machine learning methods can provide prediction for the risk of postinduction hypotension METHODS:: Data was extracted from the electronic health record of a single quaternary care center from November 2015 to May 2016 for patients over age 12 that underwent general anesthesia, without procedure exclusions...
August 1, 2018: Anesthesiology
Lena M Mayes, Cynthia A Wong, Shanta Zimmer, Ana Fernandez-Bustamante, Karsten Bartels
BACKGROUND: Although the status of women in anesthesiology has advanced by many measures, obtaining career development funding remains challenging. Here, we sought to compare the characteristics of funded career development awards from the National Institutes of Health (NIH) between the specialties of anesthesiology and surgery. We hypothesized that the two groups differ in percentage of faculty with awards, gender distribution among principal investigators, as well as the number of awards promoting diversity...
July 27, 2018: BMC Anesthesiology
Michael G Fitzsimons, Keith Baker, Rajeev Malhotra, Andrew Gottlieb, Edward Lowenstein, Warren M Zapol
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: The incidence of substance use disorders in the United States among residents in anesthesiology is between 1% and 2%. A recent study reported that the incidence of substance use disorders in U.S. anesthesiology residents has been increasing. There are no reports of effective methods to prevent substance use disorder in residents. A comprehensive drug testing program including a random component may reduce the incidence of substance use disorders...
July 17, 2018: Anesthesiology
Rachel A Lindor, Erika M McMahon, Joseph P Wood, Annie T Sadosty, Eric T Boie, Ronna L Campbell
Introduction: Anaphylaxis continues to cause significant morbidity and mortality. Healthcare providers struggle to promptly recognize and appropriately treat anaphylaxis patients. The goal of this study was to characterize anaphylaxis-related malpractice lawsuits. Methods: We collected jury verdicts, settlements, and court opinions regarding alleged medical malpractice involving anaphylaxis from May 2011 through May 2016 from an online legal database (Thomson Reuters Westlaw)...
July 2018: Western Journal of Emergency Medicine
Gunnar Lachmann, Claudia Spies, Thomas Schenk, Frank M Brunkhorst, Felix Balzer, Paul La Rosée
BACKGROUND: Hemophagocytic lymphohistiocytosis in adults (aHLH) is a rare life-threatening hyperinflammatory syndrome caused by excessive activation of macrophages and CD8+ T-cells. Due to the clinical overlap with severe sepsis, aHLH often remains undiagnosed resulting in poor outcome. Here, we present a retrospective study of incidence, clinical findings, and the outcome of aHLH in intensive care units (ICUs). METHODS: This retrospective analysis was performed at the university hospital Charité - Universitätsmedizin Berlin...
August 2018: Shock
Paul E Hilliard, Jennifer Waljee, Stephanie Moser, Lynn Metz, Michael Mathis, Jenna Goesling, David Cron, Daniel J Clauw, Michael Englesbe, Goncalo Abecasis, Chad M Brummett
Importance: Patterns of preoperative opioid use are not well characterized across different surgical services, and studies in this patient population have lacked important self-reported data of pain and affect. Objectives: To assess the prevalence of preoperative opioid use and the characteristics of these patients in a broadly representative surgical cohort. Design, Setting, and Participants: Cross-sectional, observational study of patients undergoing surgery at a tertiary care academic medical center...
July 11, 2018: JAMA Surgery
Edward R Mariano, Richard W Rosenquist
PURPOSE OF REVIEW: The purpose of this review is to provide the background and rationale for pursuing accreditation of regional anesthesiology and acute pain medicine (RAAPM) fellowships, explain specific steps and challenges in the process, and forecast the future of fellowship training. RECENT FINDINGS: In 2016, the first fellowship program in RAAPM was able to apply for accreditation from the Accreditation Council for Graduate Medical Education (ACGME). The establishment of this newly accredited subspecialty fellowship and the announcement of the first accredited programs represented a tremendous achievement in anesthesiology training and medical education in general and was the culmination of nearly 4 years of dedicated effort...
July 9, 2018: Current Opinion in Anaesthesiology
A Engelking, M Cavar, L Puljak
AIMS: New randomized clinical trials (RCTs) should be initiated if previous systematic reviews (SRs) indicate that new trials are needed. We analysed whether RCTs published in anaesthesiology journals mentioned previous SRs as a rationale for conducting trial and for discussing results. METHODS: This was a meta-epidemiological, descriptive cross-sectional study. We analysed RCTs published in the seven first-quartile anaesthesiology journals between 2014 and 2016...
July 5, 2018: European Journal of Pain: EJP
Markus Vogelsang, Katrin Rockenbauch, Hermann Wrigge, Wolfgang Heinke, Gunther Hempel
Aim: The aims of this study were to gain an overview of the web-based media used during the clinical phase of medical study at German medical schools and to identify the resources needed for web-based media use. Also examined were the influences on web-based media use, for instance, the assessment of their suitability for use in teaching. Method: An online survey of 264 teacher coordinators in internal medicine, surgery, anesthesiology, gynecology, pediatrics and psychiatry was conducted in March and April, 2016...
2018: GMS Journal for Medical Education
Stephen J Gleich, Amy C S Pearson, Kevin C Lindeen, Ryan E Hofer, George D Gilkey, Luann F Borst, Dawit T Haile, David P Martin
BACKGROUND: The use of cognitive aids, such as emergency manuals (EMs), improves team performance on critical steps during crisis events. In our large academic anesthesia practice, we sought to broadly implement an EM and subsequently evaluate team member performance on critical steps. METHODS: We observed the phases of implementing an EM at a large academic anesthesia practice from 2013 to 2016, including the formation of the EM implementation team, identification of preferred EM characteristics, consideration of institution-specific factors, selection of the preferred EM, recognition of logistical barriers, and staff education...
June 28, 2018: Anesthesia and Analgesia
U Keppler, T Schmoch, B H Siegler, M A Weigand, F Uhle
BACKGROUND: The old definition of sepsis was replaced by Sepsis-3 in February 2016. The new screening diagnostic tools sequential organ failure assessment (SOFA) score and quick SOFA (qSOFA) score were incorporated into the definition. The resulting scientific controversy led to several retrospective and prospective evaluations. In contrast no evaluation of the state of play of national implementation of Sepsis-3 has been conducted so far. OBJECTIVE: The aim of this study was to capture the current situation in German academic intensive care units 1 year after the implementation of Sepsis-3...
June 26, 2018: Der Anaesthesist
Susan M Martinelli, Fei Chen, Matthew D Mcevoy, David A Zvara, Randall M Schell
Background: Flipped classroom (FC) is an active learning (AL) technique thought to have potential benefits in anesthesiology resident education. This survey aimed to determine the frequency of FC utilization, barriers of utilization, and means to overcome these barriers. Method: A web-based questionnaire was developed to survey anesthesiology faculty on their knowledge of and experience with FC. The Society of Academic Associations of Anesthesiology and Perioperative Medicine sent the survey to all United States core program directors (PD) via their list serve with a request for the PDs to forward the survey invitation to their clinical faculty...
January 2018: Journal of Education in Perioperative Medicine: JEPM
Dirk Rüsch, Christian Arndt, Leopold Eberhart, Scarlett Tappert, Dennis Nageldick, Hinnerk Wulf
BACKGROUND: It is unknown to what extent hypotension frequently observed following administration of propofol for induction of general anesthesia is caused by overdosing propofol. Unlike clinical signs, electroencephalon-based cerebral monitoring allows to detect and quantify an overdose of hypnotics. Therefore, we tested whether the use of an electroencephalon-based cerebral monitoring will cause less hypotension following induction with propofol. METHODS: Subjects were randomly assigned to a bispectral index (BIS)-guided (target range 40-60) or to a weight-related (2 mg...
June 15, 2018: BMC Anesthesiology
Abhiraj D Bhimani, Steven Denyer, Darian R Esfahani, Jack Zakrzewski, Tania M Aguilar, Ankit I Mehta
BACKGROUND: Intradural extramedullary (IDEM) spinal cord tumors account for two-thirds of all intraspinal neoplasms. Surgery for IDEM tumors carries risks for many different complications, which to date have been poorly described and quantified. In this study, we better characterize risk factors and complications for IDEM tumors, stratifying patients by spinal cord level and malignancy. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried to determine 30-day outcomes following surgery for IDEM tumors between 2005 and 2016...
June 12, 2018: World Neurosurgery
C C Pang, W Pan, Z W Zhang, C B Zhou, Y F Li, X Zhang, F Z Han, Y X Sun, S Wang, J Zhuang
Objectives: Two cases who underwent fetal pulmonary valvuloplasty (FPV) for pulmonary atresia with intact ventricular septum (PA-IVS) or critical pulmonary stenosis with intact ventricular septum (CPS-IVS) successfully were reported. The aim of the report was to explore the criteria for case selection, the technical essentials of FPV, and the postpartum outcome of the fetus. Methods: One case with PA-IVS and the other with CPS-IVS were enrolled in September 2016 and February 2017 in Guangdong General Hospital, and both cases were diagnosed with severe right ventricular dysplasia and tricuspid regurgitation by fetal echocardiogram...
June 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Qiang Xiao, Jinlong Li, Kai Zhou, Tingxian Ling, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
Objective: To evaluate the safety and efficacy of total hip arthroplasty (THA) in patients with end stage renal disease (ESRD). Methods: Between December 2009 and May 2016, 30 THAs were performed in 28 patients with dialysis-dependent renal failure (18 patients) or renal transplantation (10 patients). A retrospective case control study was carried out to compare these 28 ESRD patients (ESRD group) with a matched cohort of 28 nonrenal patients (control group). There was no significant difference in gender, age, hip side, American Society of Anesthesiology (ASA) classification, comorbidities, and preoperative Harris score and hemoglobin (Hb) level between 2 groups ( P >0...
December 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Canfeng Li, Hongwei Xu, Bin Shen, Jing Yang, Zongke Zhou, Pengde Kang, Fuxing Pei
Objective: To compare the analgesia effect and clinical rehabilitation between continuous adductor canal block (ACB) and single shot ACB in total knee arthroplasty (TKA).. Methods: Between October 2016 and February 2017, 60 patients with severe knee osteoarthritis undergoing primary unilateral TKA were prospectively recruited in the study. All the patients were randomly allocated into 2 groups and received ultrasound-guided continuous ACB (group A, n =30) or single shot ACB (group B, n =30), respectively...
September 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
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