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https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#1
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650757/management-considerations-for-a-retained-plantar-knife-injury
#2
Devon Rayasa, Garrett Sessions, Maciej Witkos
A 13-year-old girl presented to the emergency department in stable condition with a retained penetrating knife wound injury in her right foot. Routine radiographs taken of the foot revealed deep tissue penetration by the knife without frank bony involvement. It was decided to remove the object in the operating room. Simple removal was performed, followed by wound exploration. The patient was admitted to the hospital for one night of observation and then was discharged without further complications.
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28650410/identification-of-risk-factors-in-lymphatic-surgeries-for-melanoma-a-national-surgical-quality-improvement-program-review
#3
Mona Ascha, Mustafa S Ascha, Brian Gastman
INTRODUCTION: Sentinel lymph node biopsy (SLNB) and lymphadenectomy (LAD) are commonly performed in the staging and care of patients with malignant melanoma. These procedures are accompanied by complications that may result in hospital readmission, negatively affecting patient outcomes and potentially affecting surgical procedure reimbursement. The National Surgical Quality Improvement Program (NSQIP) database offers a large data set allowing physicians to evaluate 30-day readmission for surgical complications...
June 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#4
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649480/the-role-of-organizational-culture-in-operating-room-turnaround-time
#5
David Ninan, Janet Zhu, Amanda Kore, Elizabeth Wasson, Tricia Fullerton, Barbara Ninan
This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital's operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization's culture...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28647928/pre-procedural-ultrasonography-for-tracheostomy-in-critically-ill-patients-a-prospective-study
#6
Ella Even-Tov, Itzhak Koifman, Vladimir Rozentsvaig, Leonid Livshits, Peter Gilbey
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) has become a standard technique for critically ill patients who require long-term ventilation. The most common early post-operative complication is bleeding related to anatomical variation in vasculature. The procedure is performed at the patient's bedside unless this is deemed unsafe and then the accepted alternative is open tracheostomy in the operating room. OBJECTIVES: To evaluate the use of pre-procedural ultrasound to aid in the decision of whether PDT in critical care patients should be performed at the patient's bedside or by open surgical tracheostomy...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28647716/bilateral-recurrent-pyosalpinx-in-a-sexually-inactive-12-year-old-girl-secondary-to-rare-variant-of-mullerian-duct-anomaly
#7
Tareq Maraqa, Mohamed Mohamed, Daniel Coffey, Gul R Sachwani-Daswani, Crystal Alvarez, Leo Mercer
Pyosalpinx is a severe sequel of chronic pelvic inflammatory disease, whereby the fallopian tubes become filled with pus.(1 2) Pyosalpinx often affects sexually active women and rarely is seen in celibate adolescent girls.(3) We report a case of a 12-year-old girl with no prior sexual history who presented to our emergency department with complaints of severe right lower quadrant pain of 1-day duration. Ultrasonography and CT scan of the abdomen and pelvis revealed free fluid collections in the pelvis without visualisation of the appendix...
June 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28647048/-resident-as-teacher-in-pediatric-surgery-innovation-is-overdue-in-central-europe
#8
REVIEW
S Zundel, M Stocker, P Szavay
PURPOSE: We set out to evaluate how residents in pediatric surgery learn and how they teach. We hypnotized that European residents learn as much from their peers and teach as much as their fellows worldwide, but that they receive comparably less educational training. METHODS: An online questionnaire was distributed to the participants of the combined annual meeting for German, Swiss and Austrian residents in pediatric surgery. Participants were asked whom they learn from in different workplace environments (ward, operating room, emergency department), how, when and why they adopt the role of teacher and how they were prepared for this role...
June 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28646333/feeding-jejunostomy-associated-small-bowel-necrosis-after-elective-esophago-gastric-resection
#9
Omer S Al-Taan, Robert N Williams, James A Stephenson, Melanie Baker, S Murthy Nyasavajjala, David J Bowrey
BACKGROUND: Feeding jejunostomy has increasingly become a standard adjunctive procedure during major esophago-gastric resections. They provide nutritional support during the post-operative period as required. However, significant early complications have been reported, most notably small bowel necrosis. Literature reports have been restricted to case reports or series. This study aims to determine the frequency of this complication in a cohort of patients undergoing esophago-gastric resection, and identify any difference in the risk of this complication between patients undergoing esophagectomy and gastrectomy...
June 23, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28645904/intra-articular-lipoma-of-the-hip
#10
Anthony J Mells, G Max Gosey, Michael P Muldoon
Intra-articular lipoma of the hip is a rare entity, with only two reports published in the English-language literature. We present a case of successful arthroscopic resection of an intra-articular peripheral compartment lipoma in a 69-year-old woman with a coincident labral tear. This woman presented with left hip pain that developed gradually over 2 years and increased over 2 months. MRI showed a fat-intense mass in the anterior aspect of the hip joint, convincing for intra-articular lipoma. Physical examination in the operating room reproduced decreased range of motion and evidence of impingement but with a soft endpoint...
June 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28645599/biplanar-fluoroscopy-guided-percutaneous-lead-implantation-for-spinal-cord-stimulation-a-technical-note
#11
Aaron Lawson McLean, Susanne Frank, Daniel Staribacher, Rolf Kalff, Rupert Reichart
INTRODUCTION: The correct positioning of spinal cord stimulator leads is assessed radiographically during their percutaneous implantation for trial stimulation. Usually the C-arm is repositioned several times to allow imaging in different planes, which may extend the total duration of surgery. The study aimed to evaluate whether the concurrent intraoperative use of two C-arms could safely reduce the duration of surgery. MATERIALS: This retrospective study included cases of percutaneous implantation of an SCS lead for trial neurostimulation between 2006 and 2011...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#12
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644668/strong-light-matter-interactions-in-single-open-plasmonic-nanocavities-at-the-quantum-optics-limit
#13
Renming Liu, Zhang-Kai Zhou, Yi-Cong Yu, Tengwei Zhang, Hao Wang, Guanghui Liu, Yuming Wei, Huanjun Chen, Xue-Hua Wang
Reaching the quantum optics limit of strong light-matter interactions between a single exciton and a plasmon mode is highly desirable, because it opens up possibilities to explore room-temperature quantum devices operating at the single-photon level. However, two challenges severely hinder the realization of this limit: the integration of single-exciton emitters with plasmonic nanostructures and making the coupling strength at the single-exciton level overcome the large damping of the plasmon mode. Here, we demonstrate that these two hindrances can be overcome by attaching individual J aggregates to single cuboid Au@Ag nanorods...
June 9, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28644097/thirty-day-postoperative-morbidity-and-mortality-after-temporal-lobectomy-for-medically-refractory-epilepsy
#14
Panagiotis Kerezoudis, Brandon McCutcheon, Meghan E Murphy, Kenan R Rajjoub, Daniel Ubl, Elizabeth B Habermann, Gregory Worrell, Mohamad Bydon, Jamie J Van Gompel
OBJECTIVE Temporal lobectomy is a well-established treatment modality for the management of medically refractory epilepsy in appropriately selected patients. The aim of this study was to assess 30-day morbidity and mortality after temporal lobectomy in cases registered in a national database. METHODS A retrospective cohort analysis was conducted using a multiinstitutional surgical registry compiled between 2006 and 2014. The authors identified patients who underwent anterior temporal lobectomy and/or amygdalohippocampectomy for a primary diagnosis of intractable epilepsy...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28643066/solving-the-surgeon-ergonomic-crisis-with-surgical-exosuit
#15
Shanglei Liu, Daniel Hemming, Ran B Luo, Jessica Reynolds, Jonathan C Delong, Bryan J Sandler, Garth R Jacobsen, Santiago Horgan
INTRODUCTION: The widespread adoption of laparoscopic surgery has put new physical demands on the surgeon leading to increased musculoskeletal disorders and injuries. Shoulder, back, and neck pains are among the most common complaints experienced by laparoscopic surgeons. Here, we evaluate the feasibility and efficacy of a non-intrusive progressive arm support exosuit worn by surgeons under the sterile gown to reduce pain and fatigue during surgery. METHODS AND PROCEDURES: This is a prospective randomized crossover study approved by the Internal Review Board (IRB)...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28643060/sages-technology-and-value-assessment-committee-safety-and-effectiveness-analysis-on-immunofluorescence-in-the-operating-room-for-biliary-visualization-and-perfusion-assessment
#16
Bryan J Sandler, Danny Sherwinter, Lucian Panait, Richard Parent, Jennifer Schwartz, David Renton
No abstract text is available yet for this article.
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642910/influence-of-abutment-design-on-retention-of-metal-copings-cemented-to-implants
#17
Albano Porto da Cunha, Glauco Pereira Moysés, Ana Christina Claro Neves, Rafael Pino Vitti, Flávia Cardoso da Rosa Goulart, Laís Regiane da Siva-Concílio
Objective The study evaluated the influence of abutment design on the retention of implant-cemented metal copings. Material and methods Two abutments of the same system with the same indications, height and the total occlusal convergence, but of different designs were evaluated. Ten RN synOcta abutments (Straumann, Waltham, MA) and ten RN titanium solid abutments (Straumann, Waltham, MA) were tightened to 35 Ncm on 20 implant analogs previously placed in resin blocks. Twenty plastic burnout copings were waxed, included, cast and machined by a single operator...
December 2016: Acta Biomaterialia Odontologica Scandinavica
https://www.readbyqxmd.com/read/28642091/a-see-and-treat-office-procedure-for-retained-products-of-conception-removal-after-normal-vaginal-delivery-using-manual-vacuum-aspiration-preliminary-efficacy-and-reproductive-outcomes
#18
Karavani Gilad, Bahar Raz, Herzberg Shmuel, Yanai Nili
STUDY OBJECTIVES: To compare efficacy and reproductive outcomes of an ultrasound guided manual vacuum aspiration (MVA) procedure to the widely accepted operative hysteroscopy (OH) procedure in removal of retained products of conception (RPOC) after normal vaginal delivery. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2) SETTING: University-affiliated tertiary medical center PATIENTS: Eighty-six patients after normal vaginal delivery diagnosed with RPOC from 2005 through 2015...
June 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28641657/-affected-factors-of-separating-erythrocytes-by-discontinuous-of-density-gradient-centrifugation
#19
Meng-Xia Lin, Shuai Yu, Chao Zhu, Ya Huang, Hai-Bao Wang, Yang Yu
OBJECTIVE: To study the affected factors of the separation of red blood cells by discontinuous density gradient method, and to establish the optimal operating conditions of percoll for the separation of erythrocytes. METHODS: The osmolality of different ratio of Percoll and 1.5 mol/L NaCl were 9:1, 10:1, 11:1, 12:1, 13:1 ratio, was detected respectively. The isotonic osmolality ratio was selected as optimum stock isotonic Percoll solution(SIP). Evaluation criteria: All the different density cells were separated sufficiently by centrifugation, there is little red cell retention and entrainment phenomena...
June 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28640785/physiologic-considerations-in-trauma-patients-undergoing-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#20
Zaffer A Qasim, Robert A Sikorski
Resuscitative endovascular balloon occlusion of the aorta is a new procedure for adjunctive management of critically injured patients with noncompressible torso or pelvic hemorrhage who are in refractory hemorrhagic shock, ie, bleeding to death. The anesthesiologist plays a critical role in management of these patients, from initial evaluation in the trauma bay to definitive care in the operating room and the critical care unit. A comprehensive understanding of the effects of resuscitative endovascular balloon occlusion of the aorta is essential to making it an effective component of hemostatic resuscitation...
June 20, 2017: Anesthesia and Analgesia
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