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Intra Operative Monitoring

Rob J M Groen, Jertske N M Lukassen, Gert Jan Boer, Rob A Vergeer, Maarten H Coppes, Gea Drost, Berrie Middel
BACKGROUND: Anterior thoracic spinal cord herniation (ATSCH) is a rare cause of progressive myelopathy. Early surgery is essential, but there is no agreement about the best surgical approach. OBJECTIVE: To identify factors that determine surgical results, and to find evidence for the most favorable technique to correct ATSCH. METHODS: To find relevant literature, computerized databases of PubMed, EMBASE, and ISI Web of Science were searched...
December 7, 2018: World Neurosurgery
Luis M Jara, Magaly Rodriguez, Faride Altamirano, Antonio Herrera, Manuela Verastegui, Luis G Gimenez-Lirola, Robert H Gilman, Cesar M Gavidia
Cystic echinococcosis (CE) is a parasitic zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus . Detection of the adult stage in the canine definitive host is essential for estimating infection rates, surveillance and monitoring of CE control programs. This study sought to develop and validate a coproantigen sandwich enzyme-linked immunosorbent assay (copro-ELISA), based on antibodies against E. granulosus -soluble membrane antigens (EGMA), that is capable of distinguishing infected and noninfected dogs...
December 10, 2018: American Journal of Tropical Medicine and Hygiene
Kurt Ruetzler, Huseyin O Yilmaz, Alparslan Turan, Nicole M Zimmerman, Guangmei Mao, Ming-Hui Hung, Andrea Kurz, Daniel I Sessler
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) is a major contributor to peri-operative morbidity and mortality with a reported incidence of about 8%. Tachycardia increases myocardial oxygen demand, and decreases oxygen supply, and is therefore a potential cause of MINS. OBJECTIVE: We tested the hypothesis that there is an association between intra-operative area above a heart rate (HR) of 90 bpm and a composite of MINS and in-hospital all-cause mortality...
November 30, 2018: European Journal of Anaesthesiology
Jitender Chaturvedi, Malla Bhaskara Rao, A Arivazhagan, Sanjib Sinha, Anita Mahadevan, M Ravindranadh Chowdary, K Raghavendra, A S Shreedhara, Nupur Pruthi, Jitender Saini, Rose Dawn Bharath, Jamuna Rajeswaran, P Satishchandra
Aim: Surgery for drug resistant epilepsy (DRE) with focal cortical dysplasia (FCD) often requires multiple non-invasive as well as invasive pre-surgical evaluations and innovative surgical strategies. There is limited data regarding surgical management of people with FCD as the underlying substrate for DRE among the low and middle-income countries (LAMIC) including India. Methodology: The presurgical evaluation, surgical strategy and outcome of 52 people who underwent resective surgery for DRE with FCD between January 2008 and December 2016 were analyzed...
November 2018: Neurology India
Mathias Unberath, Javad Fotouhi, Jonas Hajek, Andreas Maier, Greg Osgood, Russell Taylor, Mehran Armand, Nassir Navab
Interventional C-arm imaging is crucial to percutaneous orthopedic procedures as it enables the surgeon to monitor the progress of surgery on the anatomy level. Minimally invasive interventions require repeated acquisition of X-ray images from different anatomical views to verify tool placement. Achieving and reproducing these views often comes at the cost of increased surgical time and radiation. We propose a marker-free 'technician-in-the-loop' Augmented Reality (AR) solution for C-arm repositioning. The X-ray technician operating the C-arm interventionally is equipped with a head-mounted display system capable of recording desired C-arm poses in 3D via an integrated infrared sensor...
October 2018: Healthcare Technology Letters
Lin Rui, Guomei Xu, Xiaofan Lv, Zhengliang Ma
PURPOSE: This article describes a comprehensive protocol to protect the brachial plexus when performing pedicle subtraction osteotomy for ankylosing spondylitis patients with thoracolumbar kyphosis. DESIGN: A descriptive study was conducted. METHODS: Records of 101 cases from October 2013 to December 2016 were retrospectively audited. The protocol included five items: (1) preoperative assessment of motion range and nerve function of limbs and trunks; (2) preoperative positioning according to the assessment results; (3) intra-operative somatosensory evoked potential and blood pressure monitoring; (4) intra-operative repositioning according to the monitoring alarm signals; and (5) postoperative neurological function check...
December 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Hesham Soliman, Jared Fridley, Albert Telfeian, David B Choi, Michael Galgano, Thomas Kosztowski, Ziya L Gokaslan, Adetokunbo A Oyelese
BACKGROUND: Patients with far lateral disc herniations (FLDH) experience more severe pain and sensory symptoms than paracentral disc herniations, and by comparison, surgical intervention is both more challenging and results in poorer outcomes. METHODS: We report our experience with intraoperative CT (iCT) navigation assisted minimally invasive tubular microdiscectomy via a paramedian approach with electrophysiological monitoring for precise three-dimensional anatomical localization and early electrophysiological identification of the exiting nerve...
November 14, 2018: World Neurosurgery
Mitchell T Foster, Lalgudi Srinivasan Harishchandra, Conor Mallucci
Pediatric neuro-oncology surgery continues to progress in sophistication, largely driven by advances in technology used to aid the following aspects of surgery: operative planning (advanced MRI techniques including fMRI and DTI), intraoperative navigation [preoperative MRI, intra-operative MRI (ioMRI) and intra-operative ultrasound (ioUS)], tumor visualization (microscopy, endoscopy, fluorescence), tumor resection techniques (ultrasonic aspirator, micro-instruments, micro-endoscopic instruments), delineation of the resection extent (ioMRI, ioUS, and fluorescence), and intraoperative safety (neurophysiological monitoring, ioMRI)...
2018: Frontiers in Pediatrics
Vikas Singh, Ashwin Borkar, Aliasgar Moiyadi, Prakash Shetty
BACKGROUND: Central neurocytomas are benign tumors accounting for < 0.5% of all intracranial tumours. They are usually intraventricular, the commonest site being the lateral ventricles and are associated with good prognosis if they are completely resected surgically. CASE AND DESCRIPTION: We report a case of middle aged lady who was evaluated for recent onset headache and Magnetic resonance imaging (MRI) brain was suggestive of solid-cystic intraventricular mass spanning all the ventricles...
November 12, 2018: World Neurosurgery
Jae-Jun Kim, Alex Watras, Hewei Liu, Zhanpeng Zeng, Jacob A Greenberg, Charles P Heise, Yu Hen Hu, Hongrui Jiang
The quality and the extent of intra-abdominal visualization are critical to a laparoscopic procedure. Currently, a single laparoscope is inserted into one of the laparoscopic ports to provide intra-abdominal visualization. The extent of this field of view (FoV) is rather restricted and may limit efficiency and the range of operations. Here we report a trocar-camera assembly (TCA) that promises a large FoV, and improved efficiency and range of operations. A video stitching program processes video data from multiple miniature cameras and combines these videos in real-time...
August 25, 2018: Micromachines
Charlie Bouthors, Ahmed Benzakour, Charles Court
BACKGROUND: Surgical treatment of thoracic disc herniation (TDH) is technically demanding due to its proximity to the spinal cord. METHODS: Literature review. RESULTS: Symptomatic TDH is a rare condition predominantly localized between T8 and L1. Surgical indications include intractable back or radicular pain, neurological deficits, and myelopathy signs. Giant calcified TDH (> 40% spinal canal occupation) are frequently associated with myelopathy, intradural extension, and post-operative complications...
November 8, 2018: International Orthopaedics
Olivier Mairesse, Eoin Macdonald-Nethercott, Daniel Neu, Helio Fernandez Tellez, Emilie Dessy, Xavier Neyt, Romain Meeusen, Nathalie Pattyn
Study Objectives: Manned spaceflights from Earth to Mars will likely become reality within the next decades. Humans will be exposed to prolonged isolation, confinement, and altered photoperiods in artificial atmospheric conditions, with potential adverse effects on sleep and performance. On Earth, polar environments serve as space-analogues to study human adaptation, yet few studies include polysomnography due to operational constraints. Methods: Polysomnography, subjective sleepiness and fatigue and psychomotor performance were measured every six weeks in 13 males ("Hivernauts") during a 13-month winter-over campaign at Concordia (Antarctica)...
November 7, 2018: Sleep
Bong Eun Lee, Gwang Ha Kim, Geun Am Song, Jong Hun Seo, Hye Kyung Jeon, Dong Hoon Baek, Dong Uk Kim
Background/Aims: Proton pump inhibitors are widely used to prevent gastric endoscopic submucosal dissection (ESD)-related bleeding, but no standard administration regimens have been established. We aimed to prospectively compare the effects of continuous infusion and intermittent dosing with pantoprazole on preventing gastric ESD-related bleeding. Additionally, we analyzed the risk factors for bleeding. Methods: From April 2012 to May 2013, patients with a gastric epithelial neoplasm scheduled for ESD in the Pusan National University Hospital were randomly assigned to one of two groups according to the pantoprazole administration regimen (continuous infusion or intermittent dosing)...
October 18, 2018: Gut and Liver
Binod Gautam, Bikash Baral
Parkinson's disease, a neurodegenerative disorder, presents with resting tremor, muscle rigidity and bradykinesia. Affecting multiple organ-systems, it's an important cause of peri-operative morbidity. General anaesthesia may deteriorate cardio-pulmonary and neuro-cognitive functions; moreover, medications used may interact with anti-parkinsonian agents. Spinal anaesthesia is usually avoided in Parkinson's disease. However, it offers neurologic monitoring and less surgical stress response and avoids complications of general anaesthesia...
March 2018: JNMA; Journal of the Nepal Medical Association
Yoo Jin Choi, Young-Ki Lee, Hayne Cho Park, Eun Yi Kim, Ajin Cho, Chaehoon Han, Sun Ryoung Choi, Hanmyun Kim, Eun-Jung Kim, Jong-Woo Yoon, Jung-Woo Noh
BACKGROUND: The Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend intra-access flow (Qa) measurement as the preferred vascular access surveillance method over static intra-access pressure ratio (SIAPR). Recently, it has become possible to perform Qa measurement during hemodialysis using thermodilution method called blood temperature monitoring (BTM) with the Twister device. The aim of this study was to investigate the correlation between Qa by BTM and SIAPR and to compare the performance of two tests in prediction of vascular access stenosis...
2018: PloS One
I P Tang, X N Ling, N Prepageran
OBJECTIVES: To investigate the surgical and audiological outcome of Bonebridge (BB) at tertiary centres in Malaysia. STUDY DESIGN: Prospective, intra-subject repeated measurements of which each subject is his/her own control, from year 2012 to 2016 at two tertiary referral centres. METHODS: Twenty patients with hearing loss who fulfilled criteria for BB and showed good response to bone conduction hearing aid trial were included. Implantations of BB were carried out under general anaesthesia with preoperative computed tomography (CT) planning...
October 2018: Medical Journal of Malaysia
David C Newitt, Zheng Zhang, Jessica E Gibbs, Savannah C Partridge, Thomas L Chenevert, Mark A Rosen, Patrick J Bolan, Helga S Marques, Sheye Aliu, Wen Li, Lisa Cimino, Bonnie N Joe, Heidi Umphrey, Haydee Ojeda-Fournier, Basak Dogan, Karen Oh, Hiroyuki Abe, Jennifer Drukteinis, Laura J Esserman, Nola M Hylton
BACKGROUND: Quantitative diffusion-weighted imaging (DWI) MRI is a promising technique for cancer characterization and treatment monitoring. Knowledge of the reproducibility of DWI metrics in breast tumors is necessary to apply DWI as a clinical biomarker. PURPOSE: To evaluate the repeatability and reproducibility of breast tumor apparent diffusion coefficient (ADC) in a multi-institution clinical trial setting, using standardized DWI protocols and quality assurance (QA) procedures...
October 22, 2018: Journal of Magnetic Resonance Imaging: JMRI
Gabrielle C Musk, Helen Kershaw, Bulang He
Fifty-four pigs ( Sus scrofa, Large White cross) from a commercial pig farm were anaesthetised over a six-year period from October 2011. The procedural stages included initial instrumentation for intra-operative monitoring, laparoscopic nephrectomy, preparation of the kidney graft, orthotopic auto-transplantation by either a laparoscopic approach or an open surgical approach, and ligation of the contralateral ureter. During the evolution and establishment of this pig model multiple refinements were introduced: (1) a heat pad was changed to a circulating warm air blanket; (2) routine administration of anticholinesterase and antimuscarinic drugs for reversal of neuromuscular blockade; (3) a technique for urethral catheterisation was developed; (4) ultrasound guidance for placement of a central venous line was learned; (5) intravenous infusions of morphine and ketamine were instituted for a more stable and balanced anaesthetic protocol; and (6) post-operative monitoring was performed by two technical staff for at least the first six hours after extubation of the trachea...
October 22, 2018: Laboratory Animals
A E Pamuk, S Özer, A E Süslü, A Akgöz, M Önerci
OBJECTIVE: This study aimed to present the clinical features and surgical outcomes of juvenile nasopharyngeal angiofibroma patients who were surgically treated. METHODS: The medical records of 48 male patients histologically confirmed as having juvenile nasopharyngeal angiofibroma, who underwent transnasal endoscopic surgery between 2005 and 2016, were retrospectively reviewed. RESULTS: The overall recurrence rate was 20.8 per cent; however, the recurrence rate differed significantly between patients diagnosed aged less than 14 years (34...
October 22, 2018: Journal of Laryngology and Otology
Graeme Ethan Hancock, Tracey Hepworth, Kevin Wembridge
BACKGROUND: Measuring knee range of motion is important in examination and as a post-operative outcome. It is therefore important that measurements are accurate. Knee angles can be measured by traditional goniometers, smartphone apps are readily available and there are also purpose made digital devices. Establishing the minimum difference between methods is essential to monitor change. The purpose of this study was to assess reliability and minimum significant difference of visual estimation, short and long arm goniometers, a smartphone application and a digital inclinometer...
October 19, 2018: Journal of Experimental Orthopaedics
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