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https://www.readbyqxmd.com/read/28433385/perioperative-risks-of-narcolepsy-in-patients-undergoing-general-anesthesia-a-case-control-study
#1
Alexandre N Cavalcante, Ryan E Hofer, Maja Tippmann-Peikert, Juraj Sprung, Toby N Weingarten
STUDY OBJECTIVE: To compare the perioperative outcomes between patients with narcolepsy and matched controls undergoing anesthetic management. DESIGN: Retrospective 2:1 matched study design. SETTING: Large tertiary medical center. PATIENTS: Narcoleptic patients who underwent general anesthesia from January 1, 2011, through September 30, 2015, were matched with controls by age, sex, and type and year of surgery. MEASUREMENTS: Medical records were reviewed for episodes of respiratory depression during phase I recovery and for other meaningful perioperative outcomes...
April 19, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28431424/sleep-disordered-breathing-postoperative-delirium-and-cognitive-impairment
#2
Enoch W K Lam, Frances Chung, Jean Wong
Sleep-disordered breathing (SDB) is highly prevalent in the general population and has been associated with cognitive impairment in older individuals. Delirium is an acute decline in cognitive function and attention that often occurs after surgery, especially in older individuals. Several recent studies suggest an association between SDB and postoperative delirium. The aim of this systematic review is to examine the current literature on SDB, postoperative delirium, and cognitive impairment and to discuss the pathophysiology and perioperative considerations...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28429620/physician-perspectives-on-decision-making-for-treatment-of-pediatric-sleep-disordered-breathing
#3
Emily F Boss, Anne R Links, Ron Saxton, Tina L Cheng, Mary Catherine Beach
Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents. Interviews were analyzed using directed qualitative content analysis...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28429199/gastric-bypass-and-influence-on-improvement-of-nafld
#4
REVIEW
Vamsi Alli, Ann M Rogers
PURPOSE OF REVIEW: Obesity is recognized as a chronic and recurring disease, often accompanied by other weight-related comorbid conditions such as obstructive sleep apnea, hypertension, type 2 diabetes, and non-alcoholic fatty liver disease (NAFLD). This chapter will seek to focus on the effect of weight loss surgery (WLS), in particular Roux-en-Y gastric bypass (RYGB), on NAFLD. RECENT FINDINGS: Among several modalities available to treat NAFLD, the one most likely to achieve rapid, significant, and sustained improvement of liver disease is WLS...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28425577/postoperative-hemorrhage-and-hospital-revisit-after-transoral-robotic-surgery
#5
Joseph Zenga, Jasmina Suko, Dorina Kallogjeri, Patrik Pipkorn, Brian Nussenbaum, Ryan S Jackson
OBJECTIVES/HYPOTHESIS: To investigate the incidence and complications related to postoperative hemorrhage (POH) after transoral robotic surgery (TORS). STUDY DESIGN: Retrospective review of the State Inpatient Database (SID), the State Ambulatory Surgery Database (SASD), and the State Emergency Department Database (SEDD) from the Healthcare Cost and Utilization Project. METHODS: Patients were identified from the SID, SASD, and SEDD for the states of Florida, New York, and California from 2005 to 2013 who had an International Classification of Diseases, Ninth Edition code for a surgical procedure on the upper aerodigestive tract associated with a code for robotic-assisted surgery...
April 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#6
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28417891/outpatient-anesthetic-safety-considerations-for-obstructive-sleep-apnea
#7
REVIEW
Kevin J Butterfield
Most patients with obstructive sleep apnea (OSA) are not diagnosed preoperatively. The STOP-Bang questionnaire may identify patients at risk of OSA, especially those with severe OSA. Patients with mild to moderate OSA, with optimized comorbidities, can usually safely undergo outpatient surgery. Patients with severe OSA, who are not optimized medically, should avoid outpatient surgery.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417661/corrective-nasal-surgery-after-maxillomandibular-advancement-for-obstructive-sleep-apnea-experience-from-379-cases
#8
Stanley Yung-Chuan Liu, Pi-Jung Lee, Michael Awad, Robert W Riley, Soroush Zaghi
Objective Efficacy of maxillomandibular advancement (MMA) in the treatment of obstructive sleep apnea (OSA) is associated with degree of maxillary advancement. Large maxillary advancement leads to profound changes of the nasolabial region. We present the incidence and indications of post-MMA corrective nasal surgery in a large cohort. Study Design Case series with chart review. Setting University medical center. Subjects and Methods A total of 379 subjects with OSA underwent MMA at Stanford Hospital (surgeons: S...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28414687/disseminated-cryptococcal-disease-with-diffuse-pulmonary-infiltrates-in-a-non-hiv-host
#9
M Hughes, K Trivedi, M Rudrappa
INTRODUCTION: We present a case of disseminated Cryptococcus in a non-HIV host, where the primary manifestation was pulmonary with diffuse pulmonary infiltrates. This patient was on high dose corticosteroids for autoimmune hemolytic anemia. CASE: A 79 year old Caucasian man with a history of autoimmune hemolytic anemia on 100 mg of prednisone daily, coronary artery disease s/p bypass surgery, ischemic cardiomyopathy, chronic obstructive pulmonary disease, sleep apnea, chronic kidney disease, and history of bilateral pulmonary emboli presented to Hematology/Oncology clinic with symptoms of productive cough, worsening shortness of breath, hemoptysis...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412559/interictal-ripples-nested-in-epileptiform-discharge-help-to-identify-the-epileptogenic-zone-in-neocortical-epilepsy
#10
Shuang Wang, Norman K So, Bo Jin, Irene Z Wang, Juan C Bulacio, Rei Enatsu, Shenyi Dai, Zhong Chen, Jorge Gonzalez-Martinez, Imad M Najm
OBJECTIVE: This study aimed to identify the subtype of interictal ripples that help delineate the epileptogenic zone in neocortical epilepsy. METHODS: Totally 25 patients with focal neocortical epilepsy who had invasive electroencephalography (EEG) evaluation and subsequent surgery were included. They were followed up for at least 2years. Interictal ripples (80-250Hz) and fast ripples (250-500Hz) during slow-wave sleep were identified. Neocortical ripples were defined as type I ripples when they were superimposed on epileptiform discharges, and as type II ripples when they occurred independently...
March 25, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/28412180/computational-fluid-dynamics-study-of-the-pharyngeal-airway-space-before-and-after-mandibular-setback-surgery-in-patients-with-mandibular-prognathism
#11
Y Yajima, M Oshima, T Iwai, H Kitajima, S Omura, I Tohnai
The purpose of this study was to investigate the relationship between the pressure drop in the pharyngeal airway space (ΔPPAS) and the minimum cross-sectional area (minCSA) of the pharyngeal airway before and after mandibular setback surgery using computational fluid dynamics, in order to prevent iatrogenic obstructive sleep apnoea. Eleven patients with mandibular prognathism underwent bilateral sagittal split osteotomy for mandibular setback. Three-dimensional models of the upper airway were reconstructed from preoperative and postoperative computed tomography images, and simulations were performed using computational fluid dynamics...
April 12, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28411960/age-and-gender-influences-on-the-needs-concerns-and-strategies-of-cabg-caregivers
#12
Margo A Halm
BACKGROUND: Caring for coronary artery bypass (CABG) surgery patients can be challenging. No studies have explored caregiver burden by age and gender. OBJECTIVE: To describe age and gender-specific concerns, needs and strategies during the first 3 months. METHODS: Themes for burden concerns, needs and strategies were derived from interviews of 32 CABG caregivers using constant comparative analysis. RESULTS: Age-specific themes related to motivating exercise (<70), applying support hose, and self-reliance (>70)...
April 12, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28403009/obstructive-sleep-apnea-in-adults-the-role-of-upper-airway-and-facial-skeletal-surgery
#13
Valentina Pinto, Giovanni Sorrenti, Paolo Giovanni Morselli, Ottavio Piccin
No abstract text is available yet for this article.
February 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28399908/using-cone-beam-ct-to-assess-the-upper-airway-after-surgery-in-children-with-sleep-disordered-breathing-symptoms-and-maxillary-mandibular-disproportions-a-clinical-pilot
#14
Noura A Alsufyani, Michelle L Noga, Manisha Witmans, Irene Cheng, Hamdy El-Hakim, Paul W Major
BACKGROUND: The surgical excision of anatomic obstructions such as adenoids, palatine or lingual tonsils are commonly performed in children with sleep disordered breathing (SDB). Imaging studies measuring airway changes post-surgery in the SDB pediatric population are scarce, rarely addresses the nasal cavity, and are based on global measures (e.g. volume) that do not represent the complexity of the upper airway anatomy. The purpose of this pilot is to test the feasibility in using cone beam CT (CBCT) to analyze the nasal and pharyngeal airway space post-surgery using meaningful methods of analyses, and correlating imaging findings with clinical outcomes in children with SDB symptoms and maxillary-mandibular disproportion...
April 11, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28397553/preoperative-drug-induced-sleep-endoscopy-improves-the-surgical-approach-to-treatment-of-obstructive-sleep-apnea
#15
Colin Huntley, David Chou, Karl Doghramji, Maurits Boon
OBJECTIVE: Drug induced sleep endoscopy (DISE) allows for preoperative evaluation of the specific site and character of upper airway obstruction in obstructive sleep apnea (OSA). We aim to assess the impact DISE has on customizing the surgical plan and evaluate its role in surgical success. METHODS: We retrospectively reviewed patients undergoing surgery for OSA. We compared those patients undergoing preoperative DISE to those that did not to assess procedures performed and surgical outcomes...
April 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28396972/prevalence-and-associated-factors-of-obstructive-sleep-apnea-in-morbidly-obese-patients-undergoing-bariatric-surgery
#16
Weerapat Kositanurit, Dittapol Muntham, Suthep Udomsawaengsup, Naricha Chirakalwasan
PURPOSE: Our goal in this study is to determine the prevalence and associated factors of obstructive sleep apnea (OSA) in morbidly obese patients undergoing bariatric surgery. METHODS: This descriptive study was conducted at King Chulalongkorn Memorial Hospital from 2007 to 2015. Data of morbidly obese patients who underwent bariatric surgery were included using ICD-10 code for principle diagnosis "morbid obesity" (E668) and ICD-9 code for "bariatric surgery" (4389, 4438, 4439)...
April 11, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28395291/undiagnosed-obstructive-sleep-apnea-and-postoperative-outcomes-a-prospective-observational-study
#17
Uma Devaraj, Srinivas Rajagopala, Ajay Kumar, Priya Ramachandran, Philip J Devereaux, George A D'Souza
BACKGROUND: The prevalence of undiagnosed obstructive sleep apnea (OSA) during preoperative evaluation and the best method to screen OSA and its association with postoperative complications remain unclear. OBJECTIVES: To determine the prevalence of undiagnosed OSA in preoperative Indian patients undergoing noncardiac surgery, to compare the diagnostic accuracy of the STOP-BANG questionnaire to a preoperative level III sleep study, and to assess the association of OSA with postoperative complications...
April 11, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28393339/-the-status-change-and-health-issues-of-inpatients-sixth-vital-sign-in-a-medical-center
#18
Li-Ying Lin, Ya-Hui Huang, Chung-Lung Hung, Ya-Mei Chen, Ching-Ju Kuo, Yan-Chiou Ku
BACKGROUND: Hospitalized patients generally have elevated levels of emotional distress. Gaining a better under-standing of the problem of emotional distress among hospitalized patients is conducive to providing appropriate emotional care and promoting their recovery. PURPOSE: To analyze the scores for the "sixth vital sign" (i.e., emotional distress), diversification, and the health-related problems of hospitalized patients at a medical center in Taiwan. The results may offer an important reference for providing effective emotional care to hospitalized patients...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28391439/one-anastomosis-gastric-bypass-first-407-patients-in-1%C3%A2-year
#19
Yonatan Lessing, Niv Pencovich, Marian Khatib, Shai Meron-Eldar, Joseph Koriansky, Subhi Abu-Abeid
BACKGROUND: One-anastomosis gastric bypass (OAGB) is a promising laparoscopic procedure with various benefits including shorter operating times and less operative complications. That said, it is yet to gain widespread acceptance. Here, we describe our first-year experience with OAGB in our department, in particular the safety and efficacy of this procedure. METHODS: This study is a retrospective analysis of all patients who underwent OAGB between March 2015 and March 2016 by our bariatric surgery unit...
April 8, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28390613/self-reported-postoperative-recovery-in-children-after-tonsillectomy-compared-to-tonsillotomy
#20
Mats Eriksson, Ulrica Nilsson, Ann-Cathrine Bramhagen, Ewa Idvall, Elisabeth Ericsson
OBJECTIVES: Tonsil surgery is associated with significant morbidity during recovery. Patient-reported outcome measures (PROM) are the golden standard for the planning and follow-up of delivered care, which should also be an axiom for children. The current aims were to describe self-reported postoperative recovery in children after tonsil surgery, and to compare tonsillotomy and tonsillectomy in this respect. METHODS: In total, 238 children (4-12 years old) with a history of obstructive problems and/or recurrent tonsillitis, and undergoing tonsil surgery were included...
May 2017: International Journal of Pediatric Otorhinolaryngology
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