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https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#1
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28079812/the-efficacy-of-elastomeric-patient-control-module-when-connected-to-a-balloon-pump-for-postoperative-epidural-analgesia-a-randomized-noninferiority-trial
#2
Myung Hwa Kim, Yon Hee Shim, Min-Soo Kim, Yang-Sik Shin, Hyun Joo Lee, Jeong Soo Lee
When considering the principles of a pain control strategy by patients, reliable administration of additional bolus doses is important for providing the adequate analgesia and improving patient satisfaction. We compared the efficacy of elastomeric patient-control module (PCM) with conventional PCM providing epidural analgesia postoperatively.A noninferiority comparison was used. Eighty-six patients scheduled for open upper abdominal surgery were randomized to use either an elastomeric or conventional PCM connected to balloon pump...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28074028/assessment-of-postoperative-pain-control-with-an-elastomeric-pain-pump-following-cardiothoracic-surgery
#3
Anuvrat Chopra, Jeff Hurren, Susan Szpunar, Stephanie B Edwin
OBJECTIVE: To assess the effectiveness of local anesthesia, delivered via elastomeric pump to manage pain in patients undergoing cardiothoracic surgery. METHODS: A retrospective, comparative analysis evaluating adult cardiothoracic surgery patients (by median sternotomy) who received continuous infusion bupivacaine + traditional methods of pain control (N = 100) or traditional pain control alone (N = 100) from July 2011-October 2013. The primary efficacy end point was total postoperative opioid requirements for 96 hours following surgery...
January 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28059937/laparoscopic-adhesiolysis-in-chronic-abdominal-pain-15-year-follow-up-study
#4
Paavo Paajanen, Anne Fagerström, Hannu Paajanen
BACKGROUND/GOAL: Intra-abdominal adhesions are probably underdiagnosed cause for chronic abdominal pain. Our aim was to evaluate late (>10 y) effect of laparoscopic adhesiolysis on chronic abdominal pain. STUDY: This was a nonrandomized follow-up study of 68 patients (9 males, 59 females) who suffered chronic abdominal pain. The index operation (laparoscopy and adhesiolysis; n=72 patients) was performed during 1997 to 2001. A quality-of-life questionnaire was asked after the mean follow-up time of 15 years...
January 5, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28025375/intrathecal-therapy-for-cancer-related-pain
#5
REVIEW
Brian M Bruel, Allen W Burton
OBJECTIVE: The increasing incidence of cancer survivorship has shifted treatment of cancer-related pain from short-term analgesia to long-term chronic pain management. As a result, alternatives to oral analgesics, such as intrathecal therapy, may be beneficial for patients with cancer-related pain. The authors review the use of intrathecal therapy in the management of cancer-related pain. METHODS: The Medline database was searched for English-language articles that included "ziconotide" or "morphine" AND ("cancer" OR "malignant") AND "intrathecal" in title or abstract...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28009710/subxiphoid-exchange-of-heartmate-ii-left-ventricular-assist-device
#6
Vakhtang Tchantchaleishvili, Jessica G Y Luc, Joshua Haswell, William Hallian, H Todd Massey
With increasing use of left ventricular assist devices (LVAD) for long-term circulatory support comes a growing need for device exchange. The conventional surgical approach for device exchanges has been a reoperative median resternotomy. Less invasive HeartMate II LVAD exchange via a non-muscle-dividing subxiphoid incision as an alternative to a left subcostal incision may reduce pain burden and facilitate recovery. From November 2006 through June 2015, 292 patients underwent HeartMate II LVAD placement, of which 30 (10...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28007291/-complex-regional-pain-syndrome-a-review
#7
Berenice Carolina Hernández-Porras, Ricardo Plancarte-Sánchez, Silvia Alarcón-Barrios, Marcela Sámano-García
BACKGROUND: Complex regional pain syndrome is characterized by spontaneous or induced pain disproportionate in relation to the initial event and is accompanied by a variety of regional and motor disturbances, leading to a variety of clinical presentations. It is often associated with surgery and minor trauma. PATHOPHYSIOLOGY: Three mechanisms are postulated: changes secondary to post traumatic inflammation, peripheral vasomotor dysfunction and structural and functional changes of the central nervous system as a result of maladaptation...
December 19, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27998859/-effect-of-magnesium-sulphate-infusion-on-emergence-agitation-in-patients-undergoing-esophageal-carcinoma-with-general-anesthesia-a-randomized-double-blind-controlled-trial
#8
Min Xie, Xiang-Kui Li, Jie Chen
OBJECTIVE: To evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia. METHODS: This randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People's Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27980323/intrathecal-analgesic-drug-delivery-is-effective-for-analgesia-in-a-patient-with-post-poliomyelitis-syndrome-a-case-report
#9
Cornelis W J van Tilburg
BACKGROUND Post-poliomyelitis syndrome (PPS) is a progressive neuromuscular syndrome, with chronic pain being one of the most prevalent symptoms. We present a case report on intrathecal analgesic drug delivery to diminish chro-nic, refractory pain in a patient with PPS. CASE REPORT In a wheelchair-bound 45-year-old female patient (Caucasian, body mass index [BMI] 20.5) with severe chronic, refractory pain, a Synchromed® II pump (Medtronic, Minneapolis, Minnesota, USA) was implanted after multidisciplinary consultation and a successful trial period...
December 16, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27979389/eosinophilic-esophagitis-update-in-diagnosis-and-management-position-paper-by-the-italian-society-of-gastroenterology-and-gastrointestinal-endoscopy-sige
#10
REVIEW
Nicola de Bortoli, Roberto Penagini, Edoardo Savarino, Santino Marchi
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized by symptoms related to esophageal dysfunction, as well as significant esophageal eosinophilia. The entity exists worldwide but has been most extensively studied in Western countries. However, a wide range of symptoms has been noticed such as chest pain or gastro-esophageal reflux disease-like symptoms. Upper gastro-intestinal endoscopy and esophageal biopsies are crucial for the diagnosis. Endoscopy might be normal or reveal typical patterns such as rings, furrows, exudates, edema, and stricture...
December 2, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27941483/perioperative-management-of-a-patient-with-an-intrathecal-drug-delivery-device-infusing-ziconotide
#11
Sephalie Patel, Osama Hafez, Wade J Sexton, David A Edwards
Intrathecal ziconotide is used for the treatment of chronic pain and is delivered by an implanted drug delivery device. Anesthesiologists should be familiar with the perioperative management of the pump as well as the potential adverse events related to continued ziconotide infusion during general anesthesia. A case is presented demonstrating the perioperative management of an intrathecal drug delivery device infusing ziconotide in a patient presenting for radical cystectomy with pelvic lymphadenectomy and ileal conduit diversion...
December 9, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27939574/effect-of-perioperative-pregabalin-on-postoperative-quality-of-recovery-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting-opcabg-a-prospective-randomized-double-blind-trial
#12
Deepak Prakash Borde, Savani Sameer Futane, Balaji Asegaonkar, Pramod Apsingekar, Sujeet Khade, Bapu Khodve, Manish Puranik, Antony George, Shreedhar Joshi
OBJECTIVES: Use of pregabalin is increasing in cardiac surgical patients. However, studies using comprehensive scoring systems are lacking on the drug's impact on postoperative recovery. The authors tested the hypothesis that perioperative oral pregabalin improves the postoperative quality of recovery as assessed using the Quality of Recovery (QoR-40) questionnaire in patients undergoing off-pump coronary artery bypass grafting (OPCABG). DESIGN: This was a randomized, double-blind, placebo-controlled study...
September 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27921112/-gastroenterological-diseases-as-triggers-of-chest-pain
#13
J Labenz, C Labenz
BACKGROUND: Non-cardiac chest pain is very common and gastroenterological diseases are one of the most important causes. The frequency distribution of the underlying causes depends on the sector of the healthcare system in which it is ascertained. In individual cases it must always be taken into consideration that detection of coronary heart disease, for example, does not exclude another origin of chest pain. OBJECTIVE: This article provides a systematic review of gastroenterological diseases that can cause chest pain...
December 5, 2016: Der Internist
https://www.readbyqxmd.com/read/27916771/a-case-of-left-subphrenic-abscess-caused-by-gastric-ulcer-penetration-that-was-successfully-treated-with-endoscopic-transgastric-drainage
#14
Yuki Hanaoka, Dai Sugimoto, Hiroshi Nakamura, Hiroko Yamashita, Hiroaki Igarashi, Itsuro Ogata
A 65-year-old male visited our hospital because of fever and difficulty in walking. He was suffering from left-sided hypochondrial pain for a month. Laboratory tests performed on admission revealed a white blood cell count of 1700/μl and C-reactive protein level of 9.51mg/dl, which were suggestive of severe inflammation. Contrast-enhanced computed tomography revealed a subphrenic abscess around the spleen, which we considered to be caused by gastric penetration into the gastrosplenic ligament. Upper esophagogastroduodenoscopy revealed a gastric ulcer together with a fistula that connected to the left subphrenic abscess...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27908388/the-unknown-association-of-ppis-with-chest-pain-in-patients-with-known-treated-coronary-artery-disease-a-diagnostic-dilemma
#15
Fahad Javed, Stephen Ramee
Patients with coronary artery disease (CAD) are destined to lifelong antiplatelet therapy in form of aspirin (acetylsalicylic acid) alone, or in combination with other P2Y2 inhibitors. Proton pump inhibitors (PPIs) are the preferred agents for the treatment and prophylaxis of gastrointestinal injury associated with nonsteroidal anti-inflammatory drug or acetylsalicylic acid or both,(1) but recent data has raised questions about their association with negative cardiovascular events. We report 2 cases of patients with known CAD presented with chest pain mimicking angina pectoris that successfully resolved on discontinuation of the PPIs...
July 2016: Current Problems in Cardiology
https://www.readbyqxmd.com/read/27904830/a-rare-case-of-kissing-gastric-ulcers-caused-by-trauma
#16
Yan Zhang, Yafei Zhang, Shiyang Ma, Haitao Shi, Xiaolan Lu
We present a rare case of a 32-year-old female with gastric ulcers caused by pressure from trauma. The patient was diagnosed with stress-related acute gastritis by a local hospital and she was discharged 1 week later after her symptoms improved. She was given oral proton pump inhibitors (PPI). However, epigastric pain intensified, so the woman was seen at this Hospital 3 days later. Gastric endoscopy revealed kissing ulcers in the lower body of the stomach. A point worth mentioning is that the kissing gastric ulcers were caused by trauma due to impact with the steering wheel...
November 2016: Intractable & Rare Diseases Research
https://www.readbyqxmd.com/read/27903018/intrathecal-baclofen-therapy-for-the-treatment-of-spasticity-in-lithuania
#17
Robertas Kvascevicius, Ona Lapteva, Jurate Kesiene, Alfredas Vaitkus, Laima Mikulenaite, Ramunas Raugalas, Jurate Sipylaite, Saulius Rocka, Alvydas Juocevicius
Spasticity of cerebral or spinal origin severely impairs an individual's functional ability and quality of life. Intrathecal baclofen (ITB) therapy via an implantable pump is indicated for use in patients unresponsive to oral antispasmodics. ITB therapy improves the daily caring for and relief of painful spasms. In Lithuania, ITB therapy was introduced in clinical practice just recently. We share our experience of spasticity management with the ITB pump system in five patients at Vilnius University Hospital Santariskiu Klinikos...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27885425/intrathecal-morphine-versus-intravenous-opioid-administration-to-impact-postoperative-analgesia-in-hepato-pancreatic-surgery-a-randomized-controlled-trial
#18
Sara Dichtwald, Menahem Ben-Haim, Laila Papismedov, Shoshana Hazan, Anat Cattan, Idit Matot
PURPOSE: Inadequate analgesia following abdominal surgery may affect outcome. Data in patients undergoing liver surgery suggested that postoperative coagulopathy might delay epidural catheter removal. Thus, alternative analgesic techniques should be evaluated. METHODS: We compared the analgesic efficacy of intraoperative intrathecal morphine [single injection 4 µg/kg before skin incision (ITM group, n = 23)] to intravenous opioids [iv remifentanil infusion during surgery followed by i...
November 24, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27882659/interventions-for-women-who-have-a-caesarean-birth-to-increase-uptake-and-duration-of-breastfeeding-a-systematic-review
#19
REVIEW
Sarah Beake, Debra Bick, Cath Narracott, Yan-Shing Chang
Rates of breastfeeding uptake are lower after a caesarean birth than vaginal birth, despite caesarean rates increasing globally over the past 30 years, and many high-income countries reporting overall caesarean rates of above 25%. A number of factors are likely to be associated with women's infant feeding decisions following a caesarean birth such as limited postoperative mobility, postoperative pain, and ongoing management of medical complications that may have triggered the need for a caesarean birth. The aim of this systematic review was to evaluate evidence of interventions on the initiation and duration of any and exclusive breastfeeding among women who had a planned or unplanned caesarean birth...
November 24, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27881583/acute-oesophageal-necrosis-in-a-young-man-with-cocaine-and-alcohol-abuse
#20
Caleb Evans Pineo, Thomas Zeitler Pineo
We report a case of acute oesophageal necrosis (AEN) and non-occlusive mesenteric ischaemia in an otherwise healthy 30-year-old man with cocaine and alcohol abuse. Although cocaine might be expected more frequently to cause oesophageal necrosis through sympathomimetic vasoconstriction, this is only the second known case report of AEN in a patient with cocaine abuse. His symptoms at presentation included epigastric abdominal pain, haematemesis and generalised weakness. He developed moderate neutropenia and severe lactic acidosis...
November 23, 2016: BMJ Case Reports
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