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https://www.readbyqxmd.com/read/29342431/comparison-of-access-type-on-perioperative-outcomes-after-endovascular-aortic-aneurysm-repair
#1
Jeffrey J Siracuse, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Gheorghe Doros, Salvatore T Scali, Marc L Schermerhorn
OBJECTIVE: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access. Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting. METHODS: The Vascular Quality Initiative (VQI) database was queried for EVAR. Univariable analysis and multivariable analysis were used to determine the independent effect of access type. RESULTS: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions)...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29342262/preliminary-study-of-1940-nm-thulium-laser-usage-in-peroral-endoscopic-myotomy-for-achalasia
#2
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Esophageal achalasia is a type of motility disorder characterized by incomplete relaxation of lower esophageal sphincter (LES) and absence of esophageal peristalsis. Peroral endoscopic myotomy (POEM) is a new treatment option for achalasia that is less invasive, more effective, and safe as compared to surgery. High-frequency electrotome is commonly used in POEM, but takes longer time to make the tunnel in the esophagus and causes many complications. The thulium laser decreases the risk of bleeding and perforation in endoscopy but has not been reported in digestive diseases, especially in POEM...
January 9, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29342008/the-r2c2-model-in-residency-education-how-does-it-foster-coaching-and-promote-feedback-use
#3
Joan Sargeant, Jocelyn M Lockyer, Karen Mann, Heather Armson, Andrew Warren, Marygrace Zetkulic, Sophie Soklaridis, Karen D Könings, Kathryn Ross, Ivan Silver, Eric Holmboe, Cindy Shearer, Michelle Boudreau
PURPOSE: The authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: relationship building, exploring reactions, exploring content, and coaching. This research studied the use and effectiveness of the model across different residency programs and the factors that influenced its effectiveness and use. METHOD: From July 2014-October 2016, case study methodology was used to study R2C2 model use and the influence of context on use within and across five cases...
January 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29341401/the-prediction-probabilities-for-emergence-from-sevoflurane-anesthesia-in-children-a-comparison-of-the-perfusion-index-and-the-bispectral-index
#4
Pei-Pei Liu, Chi Wu, Jun-Zheng Wu, Ma-Zhong Zhang, Ji-Jian Zheng, Yang Shen, Pan He, Ying Sun
BACKGROUND: Predicting recovery of consciousness is one of the most essential functions of anesthesia depth monitors in anesthesia practice. Perfusion index and bispectral index are 2 indicators of the anesthesia depth monitoring with different working principles. The progression of the anesthesia emergence stages reflected by those monitors has not been well understood, especially in pediatric patients. The goals of this study were to compare the prediction probabilities of perfusion index and bispectral index in predicting awakening and in differentiating the different levels of arousal during emergence after sevoflurane anesthesia in children undergoing open inguinal hernia repairs...
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29341379/erector-spinae-plane-block-for-inguinal-hernia-repair-in-preterm-infants
#5
Maria A Hernandez, Lucio Palazzi, Julio Lapalma, Joseph Cravero
Neuro-axial anesthesia has been the preferred technique for inguinal hernia repair when attempting to avoid general anesthesia in neonates and preterm infants. We present a case where an erector spinae plane block was used successfully for this surgery. Hemodynamic stability, minimal anesthetic requirements, and excellent pain control were documented. This block promises to be a valuable and safe alternative for inguinal hernia repair, accompanying the path of neuroprotective anesthesia.
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29340812/partial-amniotic-carbon-dioxide-insufflation-paci-during-minimally-invasive-fetoscopic-interventions-on-fetuses-with-spina-bifida-aperta
#6
Miriam Ziemann, Rolf Fimmers, Anastasiia Khaleeva, Rainer Schürg, Markus A Weigand, Thomas Kohl
BACKGROUND: Percutaneous partial amniotic carbon dioxide insufflation (PACI) is one of the most important means for improving visualization during minimally invasive fetoscopic surgery of fetal spina bifida. The purpose of the present study was to analyze maternal and fetal safety aspects of PACI in a recent patient cohort and to present management improvements. METHODS: PACI under general materno-fetal anesthesia was performed during 65 interventions for fetoscopic patch coverage of fetal spina bifida aperta between 21 + 0 and 29 + 1 weeks of gestation...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#7
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29340574/effect-of-general-anesthesia-and-conscious-sedation-during-endovascular-therapy-on-infarct-growth-and-clinical-outcomes-in-acute-ischemic-stroke-a-randomized-clinical-trial
#8
Claus Z Simonsen, Albert J Yoo, Leif H Sørensen, Niels Juul, Søren P Johnsen, Grethe Andersen, Mads Rasmussen
Importance: Endovascular therapy (EVT) is the standard of care for select patients who had a stroke caused by a large vessel occlusion in the anterior circulation, but there is uncertainty regarding the optimal anesthetic approach during EVT. Observational studies suggest that general anesthesia (GA) is associated with worse outcomes compared with conscious sedation (CS). Objective: To examine the effect of type of anesthesia during EVT on infarct growth and clinical outcome...
January 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29339237/assessing-the-outcomes-risks-and-costs-of-local-vs-general-anesthesia-a-review-with-implications-for-cutaneous-surgery
#9
Maren C Locke, Jeremy C Davis, Ross Joseph Brothers, W Elliot Love
BACKGROUND: There is a paucity of data providing direct comparison of outcomes, complications and costs between general and local anesthesia in cutaneous surgery. OBJECTIVE: Analyze the literature from dermatologic and other specialties to compare outcomes, risks and costs of general and local anesthesia. METHODS: A retrospective analysis of case comparison studies from other specialties comparing outcomes, risks, and/or costs in local vs...
January 12, 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29339139/improved-coronary-magnetic-resonance-angiography-using-gadobenate-dimeglumine-in-pediatric-congenital-heart-disease
#10
Miguel Silva Vieira, Markus Henningsson, Nathalie Dedieu, Vassilios S Vassiliou, Aaron Bell, Sujeev Mathur, Kuberan Pushparajah, Carlos Alberto Figueroa, Tarique Hussain, René Botnar, Gerald F Greil
BACKGROUND: CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients...
January 12, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29338998/general-anesthesia-versus-conscious-sedation-for-transcatheter-aortic-valve-replacement-an-analysis-of-current-outcome-data
#11
REVIEW
Yasdet Maldonado, Joshua Baisden, Pedro A Villablanca, Menachem M Weiner, Harish Ramakrishna
No abstract text is available yet for this article.
August 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29338821/factors-influencing-regional-cerebral-oxygen-saturation-during-one-lung-ventilation-in-thoracic-surgery
#12
Ya Hong Gong, Wei Jia Wang, Wei Wei, Yu Guang Huang
Objective To identify factors influencing regional cerebral oxygen saturation (rScO2) during one-lung ventilation (OLV) in thoracic surgery. Methods Totally 33 patients with an ASA physical status of 1-3 scheduled for elective thoracic surgery with one-lung ventilation under general anesthesia were recruited. After anesthesia was induced with propofol,fentanyl/sufentanil,and rocuronium. All patients received balanced anesthesia using sevoflurane. During OLV,volume-controlled ventilation was used with a tidal volume of 6-7 ml/kg and an inspiration:expiration ratio of 1:1...
December 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29338493/challenges-of-peroral-endoscopic-myotomy-in-the-treatment-of-distal-esophageal-spasm
#13
Fraukje Anna-Marie Ponds, André J P M Smout, Paul Fockens, Albert J Bredenoord
OBJECTIVE: Distal esophageal spasm (DES) is a rare motility disorder characterized by premature and rapidly propagated contractions of the distal esophagus. Treatment options are limited and often poorly effective. Peroral endoscopic myotomy (POEM) seems an effective and attractive new treatment option for DES. In this case report we describe some of the difficulties that could arise. MATERIALS AND METHODS: A 84-year old man with therapy-refractory DES and complaints of severe dysphagia and chest pain underwent a POEM procedure under general anesthesia...
January 17, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29337746/lord-of-the-ring-general-metz-and-local-anesthesia
#14
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Anesthesiology
https://www.readbyqxmd.com/read/29337743/impact-of-a-novel-multiparameter-decision-support-system-on-intraoperative-processes-of-care-and-postoperative-outcomes
#15
Sachin Kheterpal, Amy Shanks, Kevin K Tremper
BACKGROUND: The authors hypothesized that a multiparameter intraoperative decision support system with real-time visualizations may improve processes of care and outcomes. METHODS: Electronic health record data were retrospectively compared over a 6-yr period across three groups: experimental cases, in which the decision support system was used for 75% or more of the case at sole discretion of the providers; parallel controls (system used 74% or less); and historical controls before system implementation...
February 2018: Anesthesiology
https://www.readbyqxmd.com/read/29336972/general-anesthesia-for-transcatheter-aortic-valve-replacement-total-intravenous-anesthesia-is-associated-with-less-delirium-as-compared-to-volatile-agent-technique
#16
Allie E Goins, Alan Smeltz, Cassandra Ramm, Paula D Strassle, Emily G Teeter, John P Vavalle, Lavinia Kolarczyk
OBJECTIVE: Investigate the effect of volatile anesthesia versus total intravenous anesthesia on the incidence of postoperative delirium and length of stay in patients undergoing transcatheter aortic valve replacement under general anesthesia. DESIGN: Retrospective study. SETTING: Single institution, academic medical center. PARTICIPANTS: Adult patients who underwent transcatheter aortic valve replacement under general anesthesia between November 2014 and February 2017...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29336966/conversion-from-monitored-anesthesia-care-to-general-anesthesia-for-transcatheter-aortic-valve-replacement
#17
Joseph Kimmel, Ryan Potosky, Mathew R Williams, Matthew Glading, Peter J Neuburger, J Devin Roberts, Andrew Feider
No abstract text is available yet for this article.
May 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29336287/endoscopically-assisted-crawford-tube-placement-results-in-shorter-general-anesthesia-times-in-pediatric-patients
#18
Mitchell R Dobberpuhl, Peter J Timoney, Brett T Comer
BACKGROUND: Crawford tube placement is commonly used to achieve patency of nasolacrimal ducts for epiphora secondary to nasolacrimal duct obstruction. The nasal passages of pediatric patients are narrower than adults, and the result is a relatively higher risk of intranasal complications (e.g., synechiae, bleeding) with Crawford tube placement. There is evidence that general anesthesia may negatively affect the neurocognitive function and behavioral development of children, which prompts efforts to decrease operation times for potential health benefits and also potentially to reduce health care costs...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29336085/endotracheal-tube-placement-during-computed-tomography-of-brachycephalic-dogs-alters-upper-airway-dimensional-measurements
#19
Nai-Chieh Liu, Eileen L Troconis, Matthew McMillan, Marie-Aude Genain, Lajos Kalmar, David J Price, David R Sargan, Jane F Ladlow
Computed tomography (CT) is used to document upper airway lesions in dogs with brachycephalic obstructive airway syndrome. The presence of an endotracheal tube during CT scanning is often required for general anesthesia. We hypothesized that the endotracheal tube placement would change the soft tissue dimensions of the upper airway. The aims of this prospective, method comparison study were to evaluate the reliability of the previously reported upper airway CT measurements with endotracheal tube placement, and to propose measurements that are minimally affected by the endotracheal tube...
January 15, 2018: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/29335893/neurological-prognosis-of-6-cases-after-chest-compression-during-general-anesthesia
#20
Akiko Hirotsu, Yu Suizu, Tsutomu Shichino
INTRODUCTION: Data on the outcomes after chest compression (CC) of patients who are under general anesthesia (GA) are limited. The present study aimed to evaluate the neurological outcomes in patients who received CC while under GA. METHODS: The patients who received CC while under GA, between 2010 and 2015, in Kyoto Medical Center were surveyed retrospectively. The primary outcome was poor neurologic function or death, as defined by a cerebral performance category score (CPC) score of 3-5 on day 28...
January 15, 2018: Journal of Anesthesia
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