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Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
Torsten Loop, Johannes Spaeth
Lung separation and isolation with accomplished one-lung ventilation plays a key role in the airway management for thoracic surgery. Spectrum of indication contains thoracic surgery, procedure- and patient-dependent factors. Usually lung isolation is achieved with a double-lumen tube or a bronchial blocker. Knowledge in tracheobronchial anatomy is routinely requested for anesthesiologists just as the standard use of flexible fibreoptic bronchoscope. This review would give an overview and discussion about the airway management in patients during thoracic anesthesia with double-lumen tubes and recommendations for the clinical routine...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Xiang-Wu Yang, Shai-Hong Zhu, Peng-Zhou Li, Wei-Zheng Li, Xu-Long Sun
PURPOSE: This study aimed to compare the short- and longterm outcomes of elderly and middle-aged patients with gastric cancer who underwent laparoscopic gastrectomy. METHODS: From January 2010 to February 2017, a total of 75 patients with gastric cancer aged ≥70 years (elderly group) underwent laparoscopic gastrectomy, and their short- and long-term outcomes were compared with those of 197 patients with gastric cancer aged 60-69 years (middleaged group) who underwent also laparoscopic gastrectomy during the same period...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Guangyuan Sun, Jun Xue, Yue Zhang, Xiaobin Gao, Fei Guo
PURPOSE: This study aimed to use propensity score matching (PSM) to compare the short- and long-term outcomes of laparoscopic surgery for the treatment of rectal cancer in elderly and middle-aged patients. METHODS: Data were retrospectively obtained from 588 patients aged ≥60 years when they underwent laparoscopic surgery for rectal cancer in our hospital between January 2009 and December 2016. The patients were divided into an elderly group (≥70 years) or a middle-aged group (60-69 years), and were subsequently matched 1:1 using PSM for sex, body mass index, Charlson comorbidity index (CCI), tumor location, clinical stage, and American Society of Anesthesiologists (ASA) score...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Ze-Yu Zhao, Jian-Hui Gan, Jian-Bo Liu, Qing Cheng
Background: Dexmedetomidine is a useful sedative agent for spinal anesthesia. However, it has been reported to decreases heart rate in a dose-dependent manner. In the present study, we compared the bolus dose of midazolam and bolus loaded dexmedetomidine over 10 min to determine additional sedation methods. Methods: A total of 100 patients who were classified as American Society of Anesthesiologists physical status I-II undergoing spinal anesthesia were randomly divided into two groups...
December 2017: Saudi Journal of Biological Sciences
Xiaosong Meng, Benjamin Press, Audrey Renson, James S Wysock, Samir S Taneja, William C Huang, Marc A Bjurlin
BACKGROUND: The American Society of Anesthesiologists physical status classification system, modified Charlson Comorbidity Index (mCCI), and modified Frailty Index have been associated with complications after urologic surgery. No study has compared the predictive performance of these indexes for postoperative complications after radical cystectomy (RC) for bladder cancer. MATERIALS AND METHODS: Data from 1516 patients undergoing elective RC for bladder cancer were extracted from the 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program for a retrospective review...
February 26, 2018: Clinical Genitourinary Cancer
Helmut Trimmel, Christoph Beywinkler, Sonja Hornung, Janett Kreutziger, Wolfgang G Voelckel
BACKGROUND: Competence in emergency airway management is key in order to improve patient safety and outcome. The scope of compulsory training for emergency physicians or paramedics is quite limited, especially in Austria. The purpose of this study was to review the difficult airway management performance of an emergency medical service (EMS) in a region that has implemented a more thorough training program than current regulations require, comprising 3 months of initial training and supervised emergency practice and 3 days/month of on-going in-hospital training as previously reported...
March 16, 2018: International Journal of Emergency Medicine
Wen-Tso Huang, Ping-Shun Chen, John J Liu, Yi-Ru Chen, Yen-Hsin Chen
Scheduling approaches for conventional surgery operating rooms in a hospital treat surgeons as bottleneck resources directly, but do not deal with stochastic medical resources, leading to an uneven human resource distribution in optimizing medical resource scheduling. Thus, this research focuses on the dynamic configuration scheduling problem for stochastic medical resources. In this paper, the surgical operating room is limited, and the arriving calls (i.e., number of patients) are dynamic. When a patient arrives, the nurse anesthetist and anesthesiologist are limited, but the medical service duration per patient is random...
March 13, 2018: Journal of Biomedical Informatics
David Asuzu, Kevin Y Pei, Kimberly A Davis
BACKGROUND: Small bowel obstruction is common and often requires surgical management. Simple preoperative models are lacking to predict post-operative complications after surgical management of adhesive small bowel obstruction. METHODS: We retrospectively analyzed data from 15,036 patients who underwent open lysis of adhesions for small bowel obstruction from 2005 to 2013 using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database...
March 6, 2018: American Journal of Surgery
Emanuele Rinninella, Roberto Persiani, Domenico D'Ugo, Francesco Pennestrì, Americo Cicchetti, Eugenio Di Brino, Marco Cintoni, Giacinto Abele Donato Miggiano, Antonio Gasbarrini, Maria Cristina Mele
BACKGROUND: Postoperative complications and length of hospital stay (LOS) are major issues and affect hospital costs. Enhanced Recovery After Surgery (ERAS) protocols are effective in reducing morbidity and LOS after major surgery. We propose a nutritional protocol within ERAS programs in colorectal surgery, starting from preadmission. METHODS: We compared the ERAS + NutriCatt approach versus the ERAS standard program adopted in our center in the previous months...
February 5, 2018: Nutrition
Eugène Zoumenou, Martin Chobli, Bernard le Polain de Waroux, Philippe Louis Baele
Belgium has been collaborating for 20 years with Abomey-Calavi University in Cotonou, Republic of Benin, to train anesthesiologists for Sub-Saharan, French-speaking African countries. With 123 graduates from 15 countries and 46 residents still in training, this program has succeeded in reversing the trend of a decreasing anesthesiology workforce in those countries, thus improving the quality of anesthesia and patient safety. Belgian government sources, as well as hospitals and anesthesia teams, provided most of the financial resources...
April 2018: Anesthesia and Analgesia
Wayne W Morriss, Miodrag S Milenovic, Faye M Evans
There are inadequate numbers of anesthesia providers in many parts of the world. Good quality educational programs are needed to increase provider numbers, train leaders and teachers, and increase knowledge and skills. In some countries, considerable external support may be required to develop self-sustaining programs. There are some key themes related to educational programs in low- and middle-income countries:(1) Programs must be appropriate for the local environment-there is no "one-size-fits-all" program...
April 2018: Anesthesia and Analgesia
Ganbold Lundeg, Amanda Baric, David C Pescod, Keith Pescod
Anesthesia in Mongolia has undergone a period of major development over the past 17 years, thanks to the work of the Mongolian Society of Anesthesiologists (MSA) and the support of the World Federation of Societies of Anaesthesiologists and the Australian Society of Anaesthetists. The specialty has made major advances in training and in its standing among medical specialties in Mongolia. The MSA has produced members who are leaders in the development of anesthesia as well as emergency medicine and critical care...
April 2018: Anesthesia and Analgesia
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Mitko Kocarev, Fouzia Khalid, Fatima Khatoon, Roshan Fernando
PURPOSE OF REVIEW: Neuraxial labor analgesia remains the most effective and one of the most commonly utilized methods for pain relief during labor. This narrative review article is a summary of the literature published in 2017 on neuraxial analgesia for labor. RECENT FINDINGS: From a total of 41 identified articles, 13 were included in the review. The topics have been structured into three categories: initiation of neuraxial analgesia, maintenance of neuraxial analgesia, and neuraxial analgesia and obstetric outcomes...
March 14, 2018: Current Opinion in Anaesthesiology
Ramón E Ruiz-Curiel, Ydaly Bonilla H, Alberto Baptista, Manuel Bronstein
OBJECTIVES: propofol is a rapid acting hypnotic that is becoming the drug of choice for sedation in digestive endoscopy worldwide. There is some controversy with regard to the use of propofol by physicians who are not anesthesiologists. We present our experience of the administration of propofol by endoscopist and nursing personnel. METHODS: this was a retrospective study of sedation in endoscopy. Propofol was exclusively used and administered by the endoscopist who performed the procedure and the nursing staff...
March 15, 2018: Revista Española de Enfermedades Digestivas
Marianna Galeazzi, Paolo Mazzola, Breanna Valcarcel, Giuseppe Bellelli, Marco Dinelli, Giulio Maria Pasinetti, Giorgio Annoni
BACKGROUND: The incidence of biliary tract pathology is growing with an age-related trend, and progresses as the population ages. Endoscopic Retrograde Cholangiopancreatography (ERCP) represents the gold standard for treatment in these cases, but evidence about its safety in the elderly is still debated. METHODS: We retrospectively analyzed the clinical records of all patients aged ≥65 undergoing ERCP between July 2013 and July 2015. Of 387 ERCP cases, 363 (~ 94%) were completed entirely...
March 14, 2018: BMC Gastroenterology
Vo Truong Nhu Ngoc, Trinh Do Van Nga, Dinh-Toi Chu, Le Quynh Anh
Hemophilia-a bleeding disorder due to the lack of clotting factors-is mostly induced by genetic factors. Its most common type is hemophilia A. Hemorrhage in hemophilia A may occur in several different sites of the body, including those inside the oral cavity, such as mucous membrane and gum. However, only a few studies and case reports on dental issues of hemophilia A patients have been conducted. In clinical dentistry, treatment procedures are invasive, possibly leading to more severe bleeding, especially in hemophilia A cases...
March 14, 2018: Special Care in Dentistry
James M West
Anesthesiologists have clearly established their place in the history of medical ethics. Our involvement goes back to 1966 when Henri Beecher published his landmark paper on research and informed consent. Participation in the ethics of transplantation is no less important than our previous work. Organ transplant has been life saving for many but also has given rise to many misunderstandings not just from the public but also among our own colleagues. These include methods of allocation and donation, the role that affluence may play in receiving an organ, the definition of death and donation after circulatory death...
March 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
Wei Wang, Jie Lv, Qi Wang, Lei Yang, Wanyou Yu
Objective This study was performed compare the effectiveness of oxycodone and fentanyl in reducing the incidence and severity of etomidate-induced myoclonus. Methods In total, 162 patients with an American Society of Anesthesiologists physical status of I or II were assigned at random to three groups. Patients assigned to Group O received 0.1 mg/kg of oxycodone (n = 54), those assigned to Group F were given 1 µg/kg of fentanyl (n = 54), and those assigned to Group S were given an equal volume of saline intravenously 2 minutes prior to administration of 0...
January 1, 2018: Journal of International Medical Research
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