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https://www.readbyqxmd.com/read/29688930/the-erector-spinae-plane-block-provides-complete-surgical-anesthesia-in-breast-surgery-a-case-report
#1
Pedro Paulo Kimachi, Elaine Gomes Martins, Philip Peng, Mauricio Forero
We described the first ultrasound-guided erector spinae plane block that provided complete surgical anesthesia for a right-sided mastectomy and axillary dissection in a patient with high cardiovascular risk. The block targeted at T5, and 20 mL of 0.5% ropivacaine with epinephrine 1:200,000 and dexamethasone 8 mg was administered. Complete anesthesia was accomplished in 20 minutes, and the patient received propofol infusion for sedation. The patient reported no pain and remained hemodynamically stable throughout the 2...
April 23, 2018: A&A practice
https://www.readbyqxmd.com/read/29688407/mental-stress-test-a-rapid-simple-and-efficient-test-to-unmask-long-qt-syndrome
#2
Pauline Etienne, François Huchet, Nathalie Gaborit, Julien Barc, Aurélie Thollet, Florence Kyndt, Béatrice Guyomarch, Hervé Le Marec, Flavien Charpentier, Jean-Jacques Schott, Richard Redon, Vincent Probst, Jean-Baptiste Gourraud
Aims: QT prolongation during mental stress test (MST) has been associated with familial idiopathic ventricular fibrillation. In long QT syndrome (LQTS), up to 30% of mutation carriers have normal QT duration. Our aim was to assess the QT response during MST, and its accuracy in the diagnosis of concealed LQTS. Methods and results: All patients who are carrier of a KCNQ1 or KCNH2 mutations without QT prolongation were enrolled. A control group was constituted of patients with negative exercise and epinephrine tests...
April 20, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29686759/improvement-of-immediate-performance-in-neonatal-resuscitation-through-rapid-cycle-deliberate-practice-training
#3
Maclain J Magee, Christiana Farkouh-Karoleski, Tove S Rosen
Background : Simulation training is an effective method to teach neonatal resuscitation (NR), yet many pediatrics residents do not feel comfortable with NR. Rapid cycle deliberate practice (RCDP) allows the facilitator to provide debriefing throughout the session. In RCDP, participants work through the scenario multiple times, eventually reaching more complex tasks once basic elements have been mastered. Objective : We determined if pediatrics residents have improved observed abilities, confidence level, and recall in NR after receiving RCDP training compared to the traditional simulation debriefing method...
April 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29686538/hymenoptera-sting-reactions-in-southern-italy-forestry-workers-our-experience-compared-to-reported-data
#4
Luisa Ricciardi, Francesco Papia, Giuseppe Cataldo, Mario Giorgianni, Giovanna Spatari, Sebastiano Gangemi
Background: Hymenoptera sting reactions are among life-threatening causes of allergy. Several epidemiology studies have assessed the risk of these kind of reactions, among the general population, around 3% of adults. This incidence increases among highly at risk populations such as outdoor workers. Hymenoptera stings among forestry workers (FW) are occupational triggers but it has not yet been well defined which is the real incidence of anaphylaxis in these workers, not even in Italy...
2018: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/29686017/neurotransmitter-switching-coupled-to-%C3%AE-adrenergic-signaling-in-sympathetic-neurons-in-prehypertensive-states
#5
Emma N Bardsley, Harvey Davis, Keith J Buckler, David J Paterson
Single or combinatorial administration of β-blockers is a mainstay treatment strategy for conditions caused by sympathetic overactivity. Conventional wisdom suggests that the main beneficial effect of β-blockers includes resensitization and restoration of β1-adrenergic signaling pathways in the myocardium, improvements in cardiomyocyte contractility, and reversal of ventricular sensitization. However, emerging evidence indicates that another beneficial effect of β-blockers in disease may reside in sympathetic neurons...
April 23, 2018: Hypertension
https://www.readbyqxmd.com/read/29685512/causes-and-outcomes-of-finger-ischemia-in-hospitalized-patients-in-the-intensive-care-unit
#6
Gregory J Landry, Courtney J Mostul, Daniel S Ahn, Bryant J McLafferty, Timothy K Liem, Erica L Mitchell, Enjae Jung, Cherrie Z Abraham, Amir F Azarbal, Robert B McLafferty, Gregory L Moneta
OBJECTIVE: Vascular surgeons may be consulted to evaluate hospitalized patients with finger ischemia. We sought to characterize causes and outcomes of finger ischemia in intensive care unit (ICU) patients. METHODS: All ICU patients who underwent evaluation for finger ischemia from 2008 to 2015 were reviewed. All were evaluated with finger photoplethysmography. The patients' demographics, comorbidities, ICU care (ventilator status, arterial lines, use of vasoactive medications), finger amputations, and survival were also recorded...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29684568/current-trends-in-food-allergy-induced-anaphylaxis-management-at-school
#7
REVIEW
Matthew Greenhawt, Dana Wallace, Wesley Sublet, Erin Maughan, Andrea Tanner, Kevin Kelly, Stanley Fineman, Martha White, Gene Cash, Charmayne Anderson, Sally Schoessler, Ruchi Gupta, Michael Pistiner
OBJECTIVE: To review the evidence and current policies regarding the use of epinephrine at schools and child care centers Data Sources and Study Selection: A narrative review was performed based on the result of conference proceedings of a group of inter-professional stakeholders who attended the USAnaphylaxis Summit 2017 presented by Allergy & Asthma Network. RESULTS: Anaphylaxis is a well-recognized medical emergency requiring prompt treatment with intramuscular epinephrine...
April 20, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29679123/-wide-awake-hand-surgery-based-on-application-examples
#8
P Kaiser, M Keller, J Dörler, G Schmidle
OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...
April 20, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29676439/oral-and-sublingual-immunotherapy-for-egg-allergy
#9
REVIEW
Olga Romantsik, Maria Angela Tosca, Simona Zappettini, Maria Grazia Calevo
BACKGROUND: Clinical egg allergy is a common food allergy. Current management relies upon strict allergen avoidance. Oral immunotherapy might be an optional treatment, through desensitization to egg allergen. OBJECTIVES: To determine the efficacy and safety of oral and sublingual immunotherapy in children and adults with immunoglobulin E (IgE)-mediated egg allergy as compared to a placebo treatment or an avoidance strategy. SEARCH METHODS: We searched 13 databases for journal articles, conference proceedings, theses and trials registers using a combination of subject headings and text words (last search 31 March 2017)...
April 20, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29675711/%C3%AE-2-adrenoceptor-signaling-reduction-is-involved-in-the-inflammatory-response-of-fibroblast-like-synoviocytes-from-adjuvant-induced-arthritic-rats
#10
Huaxun Wu, Jingyu Chen, Chun Wang, Lihua Liu, Yujing Wu, Yunfang Zhang, Aiwu Zhou, Lingling Zhang, Wei Wei
OBJECTIVE: To investigate the effects of β-AR signaling on fibroblast-like synoviocytes (FLS) from adjuvant-induced arthritis (AA) rats and the partial mechanisms focused on β-AR desensitization mediated by GRK2 and β-arrestin2. METHODS: Animals were divided into a control group and an AA model group, and FLSs were cultured. Arthritis index, histopathology of joints, epinephrine (Epi) and norepinephrine (NE) were detected in vivo. The effect of the β-AR agonist isoprenaline (ISO) and the β2 -AR agonist salbutamol on FLS cell viability were detected by CCK8...
April 19, 2018: Inflammopharmacology
https://www.readbyqxmd.com/read/29670762/rolling-refresher-simulation-improves-performance-and-retention-of-paediatric-intensive-care-unit-nurse-code-cart-management
#11
Marcy N Singleton, Kimberly F Allen, Zhongze Li, Kevin McNerney, Urs H Naber, Matthew S Braga
Introduction: Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. Methods: An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency...
April 2018: BMJ simulation & technology enhanced learning
https://www.readbyqxmd.com/read/29670504/clozapine-induced-cardiovascular-side-effects-and-autonomic-dysfunction-a-systematic-review
#12
Jessica W Y Yuen, David D Kim, Ric M Procyshyn, Randall F White, William G Honer, Alasdair M Barr
Background: Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and has minimal risk for extrapyramidal symptoms. Therapeutic benefits, however, are accompanied by a myriad of cardiometabolic side-effects. The specific reasons for clozapine's high propensity to cause adverse cardiometabolic events remain unknown, but it is believed that autonomic dysfunction may play a role in many of these. Objective: This systematic review summarizes the literature on autonomic dysfunction and related cardiovascular side effects associated with clozapine treatment...
2018: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/29669327/effects-of-baicalin-on-diabetic-cardiac-autonomic-neuropathy-mediated-by-the-p2y12-receptor-in-rat-stellate-ganglia
#13
Xuan Sheng, Jiayue Wang, Jingjing Guo, Yurong Xu, Huaide Jiang, Chaoran Zheng, Zixi Xu, Yuanruohan Zhang, Hongyu Che, Shangdong Liang, Gaochun Zhu, Guilin Li
BACKGROUND/AIMS: Chronic diabetic hyperglycemia can damage various of organ systems and cause serious complications. Although diabetic cardiac autonomic neuropathy (DCAN) is the primary cause of death in diabetic patients, its pathogenesis remains to be fully elucidated. Baicalin is a flavonoid extracted from Scutellaria baicalensis root and has antibacterial, diuretic, anti-inflammatory, anti- metamorphotic, and antispasmodic effects. Our study explored the effects of baicalin on enhancing sympathoexcitatory response induced by DCAN via the P2Y12 receptor...
April 13, 2018: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/29668843/effects-of-catecholamines-on-secretion-of-interferon-tau-and-expression-of-genes-for-synthesis-of-polyamines-and-apoptosis-by-ovine-trophectoderm
#14
Mohammed A Elmetwally, Yasser Lenis, Wanjin Tang, Guoyao Wu, Fuller W Bazer
Ovine trophectoderm (oTr1) cells were used to investigate effects of epinephrine (EP), norepinephrine (NE) and dopamine (DA) on their proliferation, migration and adhesion, secretion of interferon tau (IFNT), and expression of genes for synthesis of polyamines and apoptosis. Expression of mRNAs for agmatinase (AGMAT), arginine decarboxylase (ADC), ornithine decarboxylase (ODC1) and solute carrier family 7 (SLC7A1) cationic amino acid transporter, Y + system), member 1 increased (P < 0.05) in oTr1 cells in response to EP and DA...
April 12, 2018: Biology of Reproduction
https://www.readbyqxmd.com/read/29668082/altered-stress-hormone-response-following-acute-exercise-during-prostate-cancer-treatment
#15
Erik D Hanson, Samy Sakkal, William S Evans, John A Violet, Claudio L Battaglini, Glenn K McConell, Alan Hayes
Exercise training reduces the side effects of cancer treatments, however, the stress hormone response to acute exercise during prostate cancer (PCa) treatment is unclear. PURPOSE: To examine the effects of acute exercise on circulating cortisol, epinephrine (Epi), and norepinephrine (NE) concentrations during PCa treatment with and without androgen deprivation therapy (ADT). METHODS: Men with PCa (n=11), with PCa on ADT (n=11) and non-cancer controls (n=8) had blood samples for stress hormones collected before and immediately (0h), 2h, and 24h after 45 minutes of intermittent cycling at 60% of peak wattage...
April 18, 2018: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29667940/the-importance-of-the-saphenous-nerve-block-for-analgesia-following-major-ankle-surgery-a-randomized-controlled-double-blind-study
#16
Siska Bjørn, Wan Yi Wong, Jørgen Baas, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery. METHODS: Eighteen patients were enrolled and received a popliteal sciatic nerve block...
March 26, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29663492/efficacy-of-epinephrine-free-articaine-compared-to-articaine-with-epinephrine-1-100-000-for-maxillary-infiltration-a-randomized-clinical-trial
#17
Konstantinos Paterakis, Marc Schmitter, Sareh Said Yekta-Michael
OBJECTIVE: The selection of local anesthetic in dental practice is essential to the patient's comfort and the success of the treatment. Many patients prefer anesthesia even for short treatments. Articaine is a local anesthetic commonly used for dental practice. The duration of the effect of articaine on the nerve fibers is not yet precisely reported. This study was aimed to evaluate the clinical efficacy of 4% articaine with and without epinephrine in treatment of occlusal caries. MATERIALS AND METHODS: Thirty healthy patients were included in this randomized double-blind study...
April 16, 2018: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/29663283/eeg-artifact-versus-subclinical-status-epilepticus-in-a-patient-following-cardiac-arrest
#18
Jean E Cibula, Daniel S Demos, Brenda G Fahy
BACKGROUND: A challenge in ICU EEG interpretation is identifying subclinical status epilepticus versus patterns on the ictal-interictal continuum versus other repetitive patterns. In the electrically noisy intensive care unit, identifying and eliminating interference and artifact allow accurate diagnoses from the EEG, avoiding unnecessary treatment or sedation. METHODS: We present a case during Impella (Abiomed Inc, Danvers, MA) continuous flow left ventricular assist device use where the EEG artifact was initially misinterpreted as seizure by the resident and treated as status epilepticus because of the "focal" sharply contoured repetitive pattern...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29660429/summary-and-simulation-of-reported-adverse-events-from-epinephrine-autoinjectors-and-a-review-of-the-literature
#19
Marcus Shaker, Dana Toy, Christopher Lindholm, Jeffrey Low, Erin Reigh, Matthew Greenhawt
No abstract text is available yet for this article.
April 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29657376/smoke-inhalation-injury-etiopathogenesis-diagnosis-and-management
#20
REVIEW
Kapil Gupta, Mayank Mehrotra, Parul Kumar, Anoop Raj Gogia, Arun Prasad, Joseph Arnold Fisher
Smoke inhalation injury is a major determinant of morbidity and mortality in fire victims. It is a complex multifaceted injury affecting initially the airway; however, in short time, it can become a complex life-threatening systemic disease affecting every organ in the body. In this review, we provide a summary of the underlying pathophysiology of organ dysfunction and provide an up-to-date survey of the various critical care modalities that have been found beneficial in caring for these patients. Major pathophysiological change is development of edema in the respiratory tract...
March 2018: Indian Journal of Critical Care Medicine
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