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https://www.readbyqxmd.com/read/29692919/case-based-review-pediatric-medulloblastoma
#1
REVIEW
Cassie N Kline, Roger J Packer, Eugene I Hwang, David R Raleigh, Steve Braunstein, Corey Raffel, Pratiti Bandopadhayay, David A Solomon, Mariam Aboian, Soonmee Cha, Sabine Mueller
Medulloblastoma is the most common malignant brain tumor affecting children. These tumors are high grade with propensity to metastasize within the central nervous system and, less frequently, outside the neuraxis. Recent advancements in molecular subgrouping of medulloblastoma refine diagnosis and improve counseling in regards to overall prognosis. Both are predicated on the molecular drivers of each subgroup-WNT-activated, SHH-activated, group 3, and group 4. The traditional therapeutic mainstay for medulloblastoma includes a multimodal approach with surgery, radiation, and multiagent chemotherapy...
September 2017: Neuro-oncology Practice
https://www.readbyqxmd.com/read/29689399/primary-focal-intracranial-leptomeningeal-glioma-pfilg-a-case-report-and-review-of-literature
#2
Vinayak Narayan, Amey Savardekar, Nasser Mohammed, Devi Prasad Patra, Maria-Magdalena Georgescu, Anil Nanda
BACKGROUND: Primary focal intracranial leptomeningeal glioma [PFILG] is considered as a rare solitary glial tumor arising from the leptomeninges without brain attachment or evidence of primary neoplasm elsewhere within the neuraxis. We herein report a case of PFILG in left parietal location with a concise review on its clinico-radiological, histopathological and management characteristics. CASE PRESENTATION: A 75 year old lady presented with focal motor seizures involving right upper limb with associated occasional headache...
April 21, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29672828/characteristics-of-children-less-than-2-years-of-age-undergoing-anaesthesia-in-denmark-2005-2015-a-national-observational-study
#3
C Strøm, A Afshari, L H Lundstrøm, N Lohse
There are few data available that describe the current anaesthetic management of children. We have analysed anaesthetic practice and peri-operative complications for children in Denmark aged less than two years. We conducted a population-based observational cohort study using the Danish Anaesthesia Database to identify children who received anaesthesia in hospital from 1 January 2005 until 31 December 2015. Data were combined with that from the Danish National Patient Registry and the Danish Civil Registration System...
April 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29661417/postoperative-delirium-in-total-knee-and-hip-arthroplasty-patients-a-study-of-perioperative-modifiable-risk-factors
#4
S M Weinstein, L Poultsides, L R Baaklini, E E Mörwald, C Cozowicz, J N Saleh, M B Arrington, J Poeran, N Zubizarreta, S G Memtsoudis
BACKGROUND: Postoperative delirium continues to pose major clinical difficulties. While unmodifiable factors (e.g. age and comorbidity burden) are commonly studied risk factors for delirium, the role of modifiable factors, such as anaesthesia type and commonly used perioperative medications, remains understudied. This study aims to evaluate the role of modifiable factors for delirium after hip and knee arthroplasties. METHODS: We performed a retrospective study of 41 766 patients who underwent hip or knee arthroplasties between 2005 and 2014 at a single institution...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29659439/clotting-factor-concentrations-5-days-after-discontinuation-of-warfarin
#5
Honorio T Benzon, Yogen Asher, Mark C Kendall, Loyda Vida, Robert J McCarthy, David Green
BACKGROUND: The American Society of Regional Anesthesia and Pain Medicine guidelines recommend discontinuation of warfarin and an international normalized ratio (INR) of 1.2 or less before a neuraxial injection. The European and Scandinavian guidelines accept an INR of 1.4 or less. We evaluated INR and levels of clotting factors (CFs) II, VII, IX, and X 5 days after discontinuation of warfarin. METHODS: Patients who discontinued warfarin for 5 days and had an INR of 1...
April 14, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#6
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29652745/severe-perineal-lacerations-after-vaginal-delivery-are-they-an-anesthesiologist-s-problem
#7
Feyce Peralta, Joseph Bradley Bavaro
PURPOSE OF REVIEW: Perineal tears or lacerations are common occurrences after vaginal delivery. Understanding the degree of severity of these tears and the immediate and long-term complications of severe perineal lacerations can assist anesthesiologists with the management of these patients in the immediate postpartum period. RECENT FINDINGS: Severe perineal lacerations have a high degree of association with postpartum depression. The presence of neuraxial labor analgesia decreases the odds of severe perineal lacerations...
April 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29643635/regional-anesthesia-is-safe-and-effective-for-lower-limb-orthopedic-surgery-in-patient-with-renal-tubular-acidosis-and-hypokalemia
#8
Indira Gurajala, Sapna Annaji Nikhar, Kavitha Jayaram, Ramachandran Gopinath
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29628823/ultrasound-and-central-neuraxial-blocks
#9
EDITORIAL
Atul Gaur, Jatin Dedhia, Kaddour Bouazza-Marouf
No abstract text is available yet for this article.
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628563/postoperative-analgesia-with-epidural-dexmedetomidine-compared-with-clonidine-following-total-abdominal-hysterectomies-a-prospective-double-blind-randomized-trial
#10
Sunil Chiruvella, Balaji Donthu, Srinivasa Rao Nallam, Dora Babu Salla
Background and Aims: Anesthesia for total abdominal hysterectomies is not only concerned with relieving pain during intraoperative period but also during the postoperative period. We compared clonidine and dexmedetomidine as an adjuvant to levobupivacaine for epidural analgesia with respect to onset and duration of sensory block, duration of analgesia, and adverse effects. Materials and Methods: A total of 80 individuals between the age of 45 and 65 years of American Society of Anesthesiologists (ASA) physical status Classes I and II who underwent total abdominal hysterectomies were randomly allocated into two groups, comprising 40 patients in each group...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627871/autonomic-regulation-and-ventricular-arrhythmias
#11
REVIEW
Lingjin Meng, Kalyanam Shivkumar, Olujimi Ajijola
Autonomic nervous system (ANS) has a crucial role of regulating cardiac function in the physiological state and contributes to the pathogenesis of arrhythmias in the diseased state. The cardiac neuraxis consists of multiple feedback loops consisting of efferent and afferent limbs, mediating neurotransmission to and from the heart. Efferent parasympathetic neurotransmission is mediated by the vagus nerve, while paravertebral sympathetic ganglia relay efferent sympathetic neurotransmission to the heart. The association between autonomic activity and ventricular arrhythmias (VAs) has been studied extensively in both experimental models and humans...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29622413/use-of-genitofemoral-and-ilioinguinal-and-iliohypogastric-nerve-block-during-orchiectomy-in-a-post-lung-transplant-patient-a-case-report
#12
B A Rivas Rivero, A Mira Puerto, J Cuenca
The case is presented of a post-lung transplant patient, ASA III, proposed for orchiectomy due to testicular cancer. A combination of iliohypogastric (ILH), ilioinguinal (ILI) and genitofemoral (GF) nerve block together with sedation was used as anaesthetic technique. The inguinal area received sensory innervation mainly from ILI, ILH and GF nerves. The genital branch of the GF nerve supplies innervation to skin of the anterosuperior portion of the scrotum. When performing the echo-guided block of GF nerve, it is necessary to identify the spermatic cord, and administer the local anaesthetic on the inside and periphery of the cord...
April 2, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29620988/a-simple-guide-to-regional-anaesthesia
#13
E M Valsamis, S Wade, C Thornhill, C Carey, D Ricketts
Regional anaesthesia is widely used in modern anaesthetic practice for perioperative and postoperative analgesia. In the operating theatre, regional anaesthesia is used both on its own and in combination with other techniques (general anaesthesia and sedation). Regional anaesthesia is now a core skill set in anaesthetic training. This article provides a basic outline of regional anaesthesia for surgeons and other non-anaesthetic staff working with anaesthetists, reviewing preparation, consent, basic and specialist equipment, central neuraxial blocks (spinal, epidural and caudal), trunk blocks, upper limb blocks (interscalene, supraclavicular, infraclavicular and axillary) and lower limb blocks (femoral, fascia iliaca, sciatic, popliteal and ankle)...
April 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29619627/new-advances-in-acute-postoperative-pain-management
#14
REVIEW
Sukanya Mitra, Daniel Carlyle, Gopal Kodumudi, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: Postoperative pain remains one of the most common challenges following inpatient and outpatient surgeries. With our advances in modern medicine, pain following surgical procedures still remains a challenge, though significant accomplishments have been made over the past few decades. This article highlights some of the promising new advances and approaches in postoperative pain management. RECENT FINDINGS: Over the last decade, Enhanced Recovery after Surgery (ERAS) pathways and protocols are becoming the benchmark standards for enhancing postoperative recovery...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29616731/sonic-hedgehog-in-vertebrate-neural-tube-development
#15
Marysia Placzek, James Briscoe
The formation and wiring of the vertebrate nervous system involves the spatially and temporally ordered production of diverse neuronal and glial subtypes that are molecularly and functionally distinct. The chick embryo has been the experimental model of choice for many of the studies that have led to our current understanding of this process, and has presaged and informed a wide range of complementary genetic studies, in particular in the mouse. The versatility and tractability of chick embryos means that it remains an important model system for many investigators in the field...
2018: International Journal of Developmental Biology
https://www.readbyqxmd.com/read/29604982/hiv-neuropathology
#16
Susan Morgello
Primary human immunodeficiency virus (HIV) neuropathologies can affect all levels of the neuraxis and occur in all stages of natural history disease. Some, like HIV encephalitis, HIV myelitis, and diffuse infiltrative lymphocytosis of peripheral nerve, reflect productive infection of the nervous system; others, like vacuolar myelopathy, distal symmetric polyneuropathy, and central and peripheral nervous system demyelination, are not clearly related to regional viral replication, and reflect more complex cascades of dysregulated host immunity and metabolic dysfunction...
2018: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29576118/association-between-mode-of-anaesthesia-and-severe-maternal-morbidity-during-admission-for-scheduled-caesarean-delivery-a-nationwide-population-based-study-in-japan-2010-2013
#17
H Abe, M Sumitani, K Uchida, T Ikeda, H Matsui, K Fushimi, H Yasunaga, Y Yamada
BACKGROUND: Although the incidence of maternal mortality during Caesarean delivery remains very low, the rate of severe maternal morbidity is increasing. Improvements in obstetric anaesthetic practice have resulted in a dramatic reduction in the risk of maternal death from general anaesthesia. Less clear is whether the risk of severe maternal morbidity differs according to mode of anaesthesia for women undergoing Caesarean delivery. We analysed the association between the mode of anaesthesia and severe maternal morbidity during Caesarean delivery using a nationally representative inpatient database...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29576110/haematoma-and-abscess-after-neuraxial-anaesthesia-a-review-of-647-cases
#18
REVIEW
E M E Bos, J Haumann, M de Quelerij, W P Vandertop, C J Kalkman, M W Hollmann, P Lirk
Although rare, spinal haematoma and abscess after central neuraxial blocks may cause severe permanent neurological injury. Optimal treatment and outcome remain unclear. In order to identify possible predisposing patient characteristics and describe the ensuing clinical course, we searched Medline, Embase, and the Cochrane Library for reports of spinal haematomas and abscesses associated with central neuraxial blocks. Extracted data included patient characteristics, symptoms, treatment, and outcome. We analysed 409 reports, including 647 patients (387 patients with spinal haematoma and 260 patients with spinal abscess)...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29548057/ependymoma
#19
Elizabeth R Gerstner, Kristian W Pajtler
Ependymoma can arise throughout the whole neuraxis. In children, tumors predominantly occur intracranially, whereas the spine is the most prevalent location in adults. Significant variance in the grade II versus grade III distinction of ependymomas has led to the acknowledgment that the clinical utility of histopathological classification is limited. Epigenomic profiling efforts have identified molecularly distinct groups of ependymomas that adequately reflect the biological, clinical, and histopathological heterogeneities across anatomical compartments, age groups, and grades...
February 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29543614/neuraxial-labor-analgesia-a-focused-narrative-review-of-the-2017-literature
#20
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
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