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Sepsis And Anesthesia

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https://www.readbyqxmd.com/read/27897974/delayed-coloanal-anastomosis-for-rectovaginal-fistula-after-colorectal-resection-for-deep-endometriosis
#1
Gaetano Gallo, Alberto Realis Luc, Roberta Tutino, Giuseppe Clerico, Mario Trompetto
AIM: The deep infiltrating endometriosis, defined as a subperitoneal infiltration of endometrial implants of ≥ 5 mm involving not only the colorectal tract but also rectovaginal septum, vagina and bladder often requires a challenging surgery. Endometriosis nodes of the rectovaginal septum, if symptomatic, need a resection of the involved colorectal tract with colorectal or coloanal anastomosis. Unfortunately in these cases is not uncommon the possibility of a postoperative rectovaginal fistula (RVF), caused by the weakness of the septum that must be skeletonized to completely remove the endometriosis nodes...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27889458/transcatheter-device-closure-of-postmyocardial-infarction-ventricular-septal-defect
#2
You-Lin Nie, Ming-Chih Lin, Wei-Wen Lin, Chung-Chi Wang, Ching-Pei Chen, Chia-Hsun Lin, Tsung-Cheng Shyu, Yeak-Wun Quek, Sheng-Ling Jan, Yun-Ching Fu
BACKGROUND: Transcatheter device closure of postmyocardial infarction ventricular septal defect (PMIVSD) is less invasive than surgical repair. However, its feasibility, timing, outcome, and prognostic factors remain unclear. METHODS: This was a multicenter, retrospective cohort study. Between February 2012 and July 2015, a total of 10 (8 male and 2 female) patients with PMIVSD undergoing attempted device closure were enrolled retrospectively. The procedures were performed under general anesthesia with fluoroscopic and transesophageal echocardiographic guidance...
November 23, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/27884349/endotoxemia-accelerates-diaphragm-dysfunction-in-ventilated-rabbits
#3
Yi Yang, Tao Yu, Chun Pan, Federico Longhini, Ling Liu, Yingzi Huang, Fengmei Guo, Haibo Qiu
BACKGROUND: Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27882755/prague-1337-the-first-successful-caesarean-section-in-which-both-mother-and-child-survived-may-have-occurred-in-the-court-of-john-of-luxembourg-king-of-bohemia
#4
A Pařízek, V Drška, M Říhová
OBJECTIVE: An interdisciplinary historical-medical study, analysis of historical sources, and critical interpretation of the indirect evidence surrounding the childbirth of Beatrice of Bourbon, the second wife of the Bohemian King John of Luxembourg. STUDY TYPE: A material-based study founded on a comparative analysis of available private and public sources, particularly surviving letters, and narrative sources. The conclusions are reached based on a textual interpretation according to historical methods...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27878281/etomidate-inhibits-nuclear-factor-%C3%AE%C2%BAb-through-decreased-expression-of-glucocorticoid-receptor-in-septic-rats
#5
Yu Zhang, Ruo-Meng Li, Chun Wang, Na Liu, Shen Lv, Jun-Yu Xiong
The present study aimed to investigate the effect of etomidate administered prior to or following cecal ligation and puncture (CLP) on the expression of glucocorticoid receptor (GR) and lymphocyte apoptosis in septic rats. Right jugular vein catheterization was performed on female Sprague‑Dawley rats under isoflurane anesthesia, and CLP surgery was performed to induce sepsis 3 days following catheterization. The rats were randomly divided into five groups. All groups were infused with 2 ml of either etomidate or 5‰ dimethyl sulfoxide (DMSO) at 1 ml/h for 2 h from 6 h post‑surgery...
November 16, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27849320/management-of-perforation-after-endoscopic-retrograde-cholangiopancreatography
#6
Cengiz Tavusbay, Emrah Alper, Melek Gökova, Erdinç Kamer, Haldun Kar, Kemal Atahan, Oğuzhan Özşay, Özlem Gür, Necat Cin, Emir Çapkınoğlu, Evren Durak
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation is an infrequent complication. It is associated with significant morbidity and mortality. The present study is an evaluation of experience with management and outcomes of ERCP-related perforations and a review of relevant literature. METHODS: Between January 2008 and January 2015, a total of 9383 ERCPs were performed in endoscopy unit. A total of 29 perforations (0.33%) were identified and retrospectively reviewed...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27829181/effect-of-thoracic-epidural-block-on-infection-induced-inflammatory-response-a-randomized-controlled-trial
#7
Asha Tyagi, Anuradha Bansal, Shukla Das, Ashok Kumar Sethi, Aanchal Kakkar
PURPOSE: Epidural block decreases inflammation and oxidative stress in experimental models of sepsis as well as after surgery. There is, however, no clinical evidence evaluating its effect on infection-induced inflammatory process. The present trial evaluated the effect of thoracic epidural block (TEB) on systemic inflammatory response in patients with small intestinal perforation peritonitis. Outcome measures included systemic levels of interleukin (IL)-6, IL-10, procalcitonin, and C-reactive protein and postoperative Sepsis-Related Organ Failure Assessment scores...
October 18, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27816133/anesthesia-for-patients-with-concomitant-sepsis-and-cardiac-dysfunction
#8
REVIEW
Abed Abubaih, Charles Weissman
Anesthesiologists faced with a patient with sepsis and concurrent cardiac dysfunction must be cognizant of the patient's cardiac status and cause of the cardiac problem to appropriately adapt physiologic and metabolic monitoring and anesthetic management. Anesthesia in such patients is challenging because the interaction of sepsis and cardiac dysfunction greatly complicates management. Intraoperative anesthesia management requires careful induction and maintenance of anesthesia; optimizing intravascular volume status; avoiding lung injury during mechanical ventilation; and close monitoring of arterial blood gases, serum lactate concentrations, and hematology renal and electrolyte parameters...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27704184/mini-percutaneous-nephrolithotomy-for-stones-in-anomalous-kidneys-a-prospective-study
#9
Sanjay Khadgi, Babu Shrestha, Hamdy Ibrahim, Sunil Shrestha, Mohammed S ElSheemy, Ahmed M Al-Kandari
To evaluate safety and efficacy of minipercutaneous nephrolithotomy (Mini-PNL) in management of stones in different types of renal anomalies. Patients with stones ≥2 cm or SWL-resistant stones in anomalous-kidneys treated by Mini-PNL between March 2010 and September 2012 were included prospectively. Mini-PNL was done under regional anesthesia in prone position with fluoroscopic guidance through 18 Fr sheath using semirigid ureteroscope (8.5/11.5 Fr) and pneumatic lithotripter. All patients were followed-up for 2-3 years...
October 4, 2016: Urolithiasis
https://www.readbyqxmd.com/read/27687409/evaluating-sepsis-training-for-medical-students-and-nonphysicians-in-malawi
#10
P Marshall-Brown, F Namboya, G Pollach
STUDY OBJECTIVE: This study aimed to evaluate whether (regarding the Surviving Sepsis Campaign [SSC] guidelines) the training of Malawis scarce medical staff is adequate. Hospitals in Malawi have a severe shortage of human resources and therefore rely heavily on junior staff. Sepsis is a leading cause of admission to hospitals particularly in resource poor countries. It is associated with a high mortality rate. The SSC guidelines have been developed to help frontline staff diagnose and treat patients with sepsis...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27645688/hypoxic-pulmonary-vasoconstriction-from-molecular-mechanisms-to-medicine
#11
Kimberly J Dunham-Snary, Danchen Wu, Edward A Sykes, Amar Thakrar, Leah Rg Parlow, Jeffrey D Mewburn, Joel L Parlow, Stephen L Archer
Hypoxic pulmonary vasoconstriction (HPV) is a homeostatic mechanism that is intrinsic to the pulmonary vasculature. Intrapulmonary arteries constrict in response to alveolar hypoxia, diverting blood to better-oxygenated lung segments, thereby optimizing ventilation-perfusion matching and systemic oxygen delivery. In response to alveolar hypoxia, a mitochondrial sensor dynamically changes reactive oxygen species and redox couples in PASMC. This inhibits potassium channels, depolarizes PASMC, activates voltage-gated calcium channels, and increases cytosolic calcium, causing vasoconstriction...
September 16, 2016: Chest
https://www.readbyqxmd.com/read/27613897/protective-effect-of-nicotine-on-sepsis-induced-oxidative-multi-organ-damage-role-of-neutrophils
#12
Zarife Nigâr Özdemir-Kumral, Dilek Özbeyli, Ahmet Faruk Özdemir, M Buğra Karaaslan, Kübra Kaytaz, Mustafa F Kara, Olgu Enis Tok, Feriha Ercan, Berrak Ç Yeğen
INTRODUCTION: Despite its adverse health consequences, tobacco smoking is associated with lower incidence of several neurodegenerative and inflammatory diseases. The present study is aimed to show the effects of nicotine, major tobacco constituent, on five organs targeted by sepsis. METHODS: Male Wistar albino rats received tap water with (5 mg/kg) or without nicotine for 14 days. Under ketamine anesthesia, sepsis (n=50) was induced by ligation and punction of the cecum, while sham group (n=8) had only laparotomy...
August 3, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/27525399/-determination-of-candida-colonization-and-candida-score-in-patients-in-anesthesia-intensive-care-unit
#13
Günhan Gökahmetoğlu, Fatma Mutlu Sarıgüzel, Ayşe Nedret Koç, Orhan Behret, Selma Gökahmetoğlu, Mustafa Altay Atalay, Ferhan Elmalı, Kamil Darçın
The colonization rate of Candida spp. reaches up to 80% in patients who reside in intensive care units (ICUs) more than a week, and the mean rate of development of invasive disease is 10% in colonized patients. Since invasive candidiasis (IC) in ICU patients presents with septic shock and high mortality rate, rapid diagnosis and treatment are crucial. The aim of this study was to assess the relationship between invasive infection and the determination of Candida colonization index (CI) and Candida score (CS) in patients admitted to ICU who are at high risk for IC and likely to benefit from early antifungal therapy...
July 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/27420728/severe-perioperative-bleeding-in-renal-cell-carcinoma-after-elective-pericardiocentesis-associated-left-ventricular-puncture-case-report
#14
Javier Lasala, Miguel Alejandro Patino, Gabriel Mena, Shital Vachhani, Teresa Moon, Thao Bui, January Tsai
In the United States during the year 2015, approximately 61,560 patients are expected to be diagnosed with kidney cancer and 14,080 to die from the disease. We present the case of a patient with renal cell carcinoma who suffered severe perioperative bleeding and coagulopathy after emergency sternotomy. We also engage in relevant aspects of perioperative anesthesia care including the considerations and management of coagulopathy, liver failure and renal failure in the oncologic patient. The case is a 49-year-old man with vena cava tumor thrombus who underwent radiologic tumor embolization, left radical nephrectomy, and inferior vena cava (IVC) thrombectomy...
2016: Medwave
https://www.readbyqxmd.com/read/27387839/the-validity-of-discharge-billing-codes-reflecting-severe-maternal-morbidity
#15
Matthew J G Sigakis, Lisa R Leffert, Hooman Mirzakhani, Nadir Sharawi, Baskar Rajala, William M Callaghan, Elena V Kuklina, Andreea A Creanga, Jill M Mhyre, Brian T Bateman
BACKGROUND: Discharge diagnoses are used to track national trends and patterns of maternal morbidity. There are few data regarding the validity of the International Classification of Diseases (ICD) codes used for this purpose. The goal of our study was to try to better understand the validity of administrative data being used to monitor and assess trends in morbidity. METHODS: Hospital stay billing records were queried to identify all delivery admissions at the Massachusetts General Hospital for the time period 2001 to 2011 and the University of Michigan Health System for the time period 2005 to 2011...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27382438/the-effect-of-prophylactic-antibiotics-on-post-laparoscopic-cholecystectomy-infectious-complications-a-double-blinded-clinical-trial
#16
Ali Asghar Darzi, Alieh Nikmanesh, Farhad Bagherian
BACKGROUND: Laparoscopic cholecystectomy (LC) is one of the most common surgeries in laparoscopic surgery. Although, it is believed that LC has low-risk for post-operative infectious complications, the use of a prophylactic antibiotic is still controversial in elective LC. OBJECTIVE: To determine the impact of prophylactic antibiotics on postoperative infection complications in elective laparoscopic cholecystectomy. METHODS: In this double-blind, placebo-controlled, randomized, clinical trial, patients who were candidates for elective LC, from March 2012 to 2015, in four hospitals in Babol, Iran, were studied...
May 2016: Electronic Physician
https://www.readbyqxmd.com/read/27130262/pathology-and-quality-of-life-outcomes-following-office-based-transperineal-prostate-biopsy
#17
Gregory S Merrick, Sarah Irvin, Ryan Fiano, Richard Anderson, Wayne M Butler, Edward Adamovich
OBJECTIVE: To report the incidence of prostate cancer diagnosis and quality of life outcomes following transperineal prostate biopsy. METHODS: Forty-six consecutive patients underwent office-based transperineal prostate biopsy for an elevated prostate-specific antigen and a normal digital rectal examination without prior prostate biopsy. Prior to biopsy, a repeat prostate-specific antigen was obtained to ensure persistent elevation. Silodosin (8 mg daily) was initiated the day prior to biopsy and continued for 1 week...
August 2016: Urology
https://www.readbyqxmd.com/read/27074053/dexmedetomidine-attenuates-inflammatory-reaction-in-the-lung-tissues-of-septic-mice-by-activating-cholinergic-anti-inflammatory-pathway
#18
Zhaoguo Liu, Yueping Wang, Yaoqi Wang, Qiaoqing Ning, Yong Zhang, Chunzhi Gong, Wenxiang Zhao, Guangjian Jing, Qianqian Wang
Dexmedetomidine (Dex) is a highly selective α2-adrenergic receptor agonist that is widely used for sedation in intensive care units and in clinical anesthesia. Dex has also been shown to possess anti-inflammatory benefits. However, the underlying mechanism by which Dex relieves the inflammatory reaction in the lung tissues of septic mice has not been fully elucidated. In this study, we aimed to evaluate the protective effects and possible mechanism of Dex on the sepsis-induced lung inflammatory response in mice...
June 2016: International Immunopharmacology
https://www.readbyqxmd.com/read/27057897/the-effect-of-anesthetic-type-on-outcomes-of-hip-fracture-surgery-a-nationwide-population-based-study
#19
COMPARATIVE STUDY
Yu-Chi Tung, Ya-Hui Hsu, Guann-Ming Chang
Hip fractures are a global public health problem. During surgery following hip fractures, both general and regional anesthesia are used, but which type of anesthesia offers a better outcome remains controversial. There has been little research evaluating different anesthetic types on mortality and readmission rates for hip fracture surgery using nationwide population-based data.We used nationwide population-based data to examine the effect of anesthetic type on mortality and readmission rates for hip fracture surgery...
April 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27051378/caudal-anesthesia-in-a-patient-with-peritonitis-is-it-safe
#20
H Kako, M Hakim, A Kundu, T D Tobias
Neuraxial anesthesia combined with general anesthesia has become a widely accepted method of providing effective postoperative analgesia and decreasing intraoperative anesthetic needs in the pediatric population. In clinical practice, there still appears to be hesitancy for the use of a neuraxial technique (spinal or epidural) in patients at risk for bacteremia or with an on-going systemic infection. However, evidence-based medicine lacks any data to support an increase in the risk of infectious complications following neuraxial anesthesia...
April 2016: Saudi Journal of Anaesthesia
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