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https://www.readbyqxmd.com/read/29329881/defining-and-mitigating-the-challenges-of-an-older-and-obese-population-in-minimally-invasive-gynecologic-cancer-surgery
#1
Andrea R Hagemann, Carolyn K McCourt, Swarup S Varaday, Kathleen N Moore
The incidence of endometrial cancer (EC) is steadily increasing due in large part to an aging world population and rise in rates of obesity. Patients with obesity and advancing age can be seen as vulnerable populations, as they are both often subject to physician bias regarding surgical choices and assumptions regarding long-term outcomes. As we operate on an older and/or obese patient population, it is increasingly important that we adopt peri-operative management strategies and surgical techniques to best serve this complex patient population...
January 9, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29325034/ghrelin-preserves-ischemia-induced-vasodilation-of-male-rat-coronary-vessels-following-beta-adrenergic-receptor-blockade
#2
James T Pearson, Nicola Collie, Regis R Lamberts, Tadakatsu Inagaki, Misa Yoshimoto, Keiji Umetani, Philip Davis, Gerard Wilkins, Pete P Jones, Mikiyasu Shirai, Daryl O Schwenke
Acute myocardial infarction (MI) triggers an adverse increase in cardiac sympathetic nerve activity (SNA). While β-adrenergic receptor (β-AR)-blockers are routinely used for the management of MI, they may also counter β-AR-mediated vasodilation of coronary vessels. We have reported that ghrelin prevents sympathetic activation following MI. Whether ghrelin modulates coronary vascular tone following MI, either through the modulation of SNA, or directly as a vasoactive mediator, has never been addressed.We utilized synchrotron microangiography to image coronary perfusion and vessel internal diameter (ID) in anesthetized Sprague Dawley rats before, and then again 30 mins after induction of an MI (left coronary artery ligation)...
January 9, 2018: Endocrinology
https://www.readbyqxmd.com/read/29322987/complications-related-to-sitting-position-during-pediatric-neurosurgery-an-institutional-experience-and-review-of-literature
#3
Priyanka Gupta, Girija P Rath, Hemanshu Prabhakar, Parmod K Bithal
BACKGROUND: Sitting position is preferred during posterior fossa surgeries as it provides better anatomical orientation and a clear surgical field. However, its use has been declining due to its propensity to cause life-threatening complications. This study was carried out to analyze the perioperative complications and postoperative course of children who underwent neurosurgery in sitting position. MATERIALS AND METHODS: Medical records of 97 children (<18 years) who underwent neurosurgery in sitting position over a period of 12 years, were retrospectively analyzed...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29318091/nerve-blocks-in-the-geriatric-patient-with-hip-fracture-a-review-of-the-current-literature-and-relevant-neuroanatomy
#4
REVIEW
Nirav H Amin, Jacob A West, Travis Farmer, Hrayr G Basmajian
Introduction: Hip fracture is a common occurrence in the elderly population with high morbidity and mortality due to postoperative pain and opioid use. The goal of this article is to review the current literature on the neuroanatomy of the hip and the use of localized nerve block in controlling hip fracture pain. Methods: A thorough search of MEDLINE/PubMed, Embase, and the Cochrane Database of Systematic Reviews was conducted using the search terms "hip fracture" and "fascia iliaca block (FICB)...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29317965/perioperative-anesthetic-management-of-a-case-of-rare-ectopic-pheochromocytoma
#5
Aihua Jiang, Haiqiao Zhang, Xiaofei Liu, Huishan Zhao
We report an unusual case of pheochromacytoma and investigate the perioperative anesthetic management methods for giant abdominal aortic pheochromocytoma. We analyzed and summarized the recent clinical anesthetic management and experience in the hospital for a giant abdominal aortic pheochromocytoma, with the size of 20 × 14 × 5 cm. Under general anesthesia combined with TAPB, the resection of the giant abdominal aorta pheochromocytoma was successfully completed, and the patient was cured and discharged. Well planned and careful management resulted in patient with stable blood pressure, blood volume and cardiac functions, free from complications...
December 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29316010/volatile-anesthesia-for-a-pediatric-patient-with-very-long-chain-acyl-coenzyme-a-dehydrogenase-deficiency-a-case-report
#6
Aaron S Hess, Gregory M Rice, John D Jochman, Bridget L Muldowney
We report the case of a 3-year-old boy with very long-chain acyl-coenzyme A dehydrogenase deficiency presenting for adenotonsillectomy who was successfully and safely managed with a balanced anesthetic including sevoflurane. The anesthetic management is described, and the controversy surrounding volatile anesthetics in these patients is discussed.
January 9, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29311012/anesthetic-management-of-mosaic-turner-s-syndrome-posted-for-elective-cesarean-delivery-after-spontaneous-pregnancy
#7
K Kalopita, L Michala, C Theofanakis, D Valsamidis
Turner's syndrome, one of the most common sex chromosome abnormalities in females, is caused by loss of part or all of an X chromosome. We report a case of mosaic Turner's syndrome, posted for elective cesarean delivery under low-dose sequential combined spinal epidural anesthesia. The unique features of this case were the combination of an anticipated difficult airway and both short stature and scoliosis in the lumbar region. A titrated combined spinal-epidural technique was performed in order to avoid hemodynamic instability, which could have been exacerbated in the presence of cardiovascular deformities that accompany this syndrome in many cases...
November 26, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#8
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29309455/total-knee-arthroplasty-performed-with-long-acting-liposomal-bupivacaine-versus-femoral-nerve-catheter
#9
Erick G Torres, Ashley B Anderson, Brandon Broome, Stephen P Geary, Brian Burnikel
Inadequate pain management after total knee arthroplasty (TKA) can interfere with participation in and progression of physical rehabilitation, and thereby prolong hospital stay, and increase costs and overall dissatisfaction with the procedure. At our institution, TKA traditionally has been performed with femoral nerve catheters (FNCs) for postoperative pain control. We conducted a retrospective, longitudinal, repeated -measures study to compare FNC and long-acting liposomal bupivacaine (LALB) with respect to pain control, range of motion, ability to ambulate, and hospital length of stay...
November 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29307662/moringa-oleifera-phytochemicals-protect-the-brain-against-experimental-nicotine-induced-neurobehavioral-disturbances-and-cerebellar-degeneration
#10
Gabriel Olaiya Omotoso, Ismail Temitayo Gbadamosi, Olayemi Joseph Olajide, Shakirat Opeyemi Dada-Habeeb, Tolulope Timothy Arogundade, Emmanuel Olusola Yawson
Nicotine is a neuro-stimulant that has been implicated in the pathophysiology of many brain diseases. The need to prevent or alleviate the resulting dysfunction is therefore paramount, which has also given way to the use of medicinal plants in the management of brain conditions. This study was designed to determine the histomorphological and neurobehavioural changes in the cerebellum of Wistar rats following nicotine insult and how such injuries respond to Moringa intervention. Twenty-four adult male Wistar rats were divided into 4 groups...
January 4, 2018: Pathophysiology: the Official Journal of the International Society for Pathophysiology
https://www.readbyqxmd.com/read/29307147/internist-anesthesiologist-and-surgeon-use-of-ketogenic-diet
#11
Lorenzo Cenci, Antonio Paoli, Hesham R Omar, Prachiti Dalvi, Enrico M Camporesi, Devanand Mangar, Silvia Quartesan, Alberto Fiorito, Gerardo Bosco
Ketogenic diet is being increasingly utilized in recent decades because of its success as an effective tool for short and intermediate-term weight loss. Promoting physiological ketosis from a drastically low carbohydrate diet is the fundamental basis for this diet regime. Though debated, these diets have been demonstrated to be effective, at least in the short- to medium terms, to manage excess weight, hyperlipidemia, and other cardiovascular risk factors. We reviewed the cardiovascular, metabolic, anesthetic, and postsurgical profiles in the literature and summarized technical issues of anesthesia and surgery along with long-term changes from published papers...
March 2018: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/29306620/anesthetic-management-of-patients-with-continuous-flow-left-ventricular-assist-devices-undergoing-noncardiac-surgery-an-update-for-anesthesiologists
#12
REVIEW
Adam A Dalia, Brett Cronin, Marc E Stone, Katja Turner, Jennifer Hargrave, Marcos F Vidal Melo, Michael Essandoh
No abstract text is available yet for this article.
November 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29303925/local-anesthetic-systemic-toxicity-a-review-of-recent-case-reports-and-registries
#13
Marina Gitman, Michael J Barrington
This review summarizes presenting features, management, and outcomes of local anesthetic systemic toxicity (LAST) from published cases and those submitted to online registries capturing use of intravenous lipid emulsion (ILE) therapy. The results of single-center and multicenter registries and epidemiologic studies complement this information. Between March 2014 and November 2016, 47 separate cases of LAST were described in 35 peer-reviewed articles. Local anesthetic systemic toxicity events occurred as a result of penile blocks (23%), local infiltration (17%), and upper/lower extremity, torso, and neuraxial blockade...
January 5, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29299490/osteoporosis-and-the-management-of-spinal-degenerative-disease-ii
#14
REVIEW
Félix Tomé-Bermejo, Angel R Piñera, Luis Alvarez
Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been considered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequate procedures in order to avoid concomitant instrumentation...
November 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29298372/multidisciplinary-perioperative-management-of-pulmonary-arterial-hypertension-in-patients-undergoing-noncardiac-surgery
#15
José L Díaz-Gómez, Juan G Ripoll, Isabel Mira-Avendano, John E Moss, Gavin D Divertie, Ryan D Frank, Charles D Burger
OBJECTIVES: To describe the effect of implementing a contemporary perioperative pulmonary hypertension (PH)-targeted protocol in patients with pulmonary arterial hypertension (PAH) undergoing noncardiac surgery (NCS). METHODS: The data of consecutive patients with PAH diagnosed by right heart catheterization who underwent NCS between January 1, 2006 and February 9, 2016 were reviewed. Patient demographics, etiology of PAH, clinical features, diagnostic data, utilization of PH-specific medications, and trend of perioperative complications rate were recorded during the study period...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29297808/captive-management-of-wild-impala-aepyceros-melampus-during-intensive-immobilization-and-general-anesthesia-study-trials
#16
Gareth E Zeiler, Leith C R Meyer
Immobilization and anesthesia of impala ( Aepyceros melampus) has become a popular research theme. This demand is brought about by the increased need to immobilize and anesthetize impala and other medium-sized wild ungulates because of their increased value in game ranching and zoological collections. To improve our understanding of immobilization and general anesthesia in these species, it is paramount to be able to study them in a practical, safe research environment that does not cause harm or unnecessary stress to the animals...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29284893/anesthetic-management-of-a-parturient-with-hemolysis-elevated-liver-enzyme-levels-and-low-platelet-syndrome-complicated-by-renal-insufficiency-and-coagulopathy
#17
Jinguo Wang, Na Wang, Wei Han, Zhanyang Han
The objective of this study is to describe the anesthetic management of a parturient with hemolysis, elevated liver enzyme levels, and low platelet (HELLP) syndrome and renal insufficiency. A 28-year-old female patient, gestational age of 35 weeks, with hypertensive crisis (blood pressure 190/110 mmHg), was admitted for an emergency cesarean section after diagnosis of HELLP syndrome and renal insufficiency. We performed total intravenous general anesthesia with rapid sequence induction. During the surgical procedure, reduced urine output and coagulopathy were detected...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284891/anesthetic-management-of-a-patient-with-dilated-cardiomyopathy-and-end-stage-renal-disease-for-emergency-strangulated-hernia-repair-surgery
#18
Gaurav Sindwani, Aditi Suri, Amit Rastogi
Dilated cardiomyopathy (DCMP) is a myocardial disease associated with dilatation of one or both the ventricles, impaired myocardial contractility, decreased cardiac output, and increased ventricular filling pressures. Patients with end-stage renal disease are dependent on renal replacement therapy to survive and often manifest with a variety of pathological organ dysfunction. We present a case of DCMP and chronic kidney disease posted for emergency reduction of strangulated umbilical hernia under general plus epidural anesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284889/anaesthetic-implications-of-severe-hyperthyroidism-secondary-to-molar-pregnancy-a-case-report-and-review-of-literature
#19
Srinivasan Swaminathan, Roshin Ann James, Rashmi Chandran, Reesha Joshi
Pregnant women with gestational trophoblastic disease have an increased likelihood to develop hyperthyroidism secondary to increased secretion of human chorionic gonadotropin. Most of these cases of hyperthyroidism remain undiagnosed and may present as a thyrotoxic crisis during the perioperative period. Pregnant patients with gestational trophoblastic disease should be always evaluated for hyperthyroidism, and in cases of severe hyperthyroidism, antithyroid treatment should be initiated before evacuation of the mole...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284886/monitored-anesthesia-care-for-the-acute-ischemic-stroke-patient-with-end-stage-pulmonary-disease
#20
Kevin C Lee, Brian C Lee, Steven E Miller
The majority of patients who suffer acute ischemic stroke (AIS) from large vessel occlusion are at a significant risk for disability or death. Because patients on veno-arterial extracorporeal membrane oxygenation (VA ECMO) are therapeutically anticoagulated, intravenous recombinant tissue plasminogen activator is contraindicated. For AIS management, these patients must undergo emergent intra-arterial therapy. Presented is a patient on VA ECMO who subsequently suffered a large vessel embolic stroke requiring emergent surgical intervention...
October 2017: Anesthesia, Essays and Researches
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