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https://www.readbyqxmd.com/read/28725244/optimal-perioperative-anesthesia-management-for-gynecologic-interstitial-brachytherapy
#1
Alison A Nielsen, Tehani A Liyanage, Gary S Leiserowitz, Jyoti Mayadev
PURPOSE: To propose an optimal perioperative pain management clinical care pathway for interstitial brachytherapy for gynecologic cancer based on our interdepartmental experience. MATERIAL AND METHODS: We conducted a retrospective review of 23 women who underwent 32 interstitial brachytherapy procedures for gynecological cancers, analyzing patient demographics, type of anesthetic, medications, postoperative pain scores, adverse events, and delays in discharge. We measured the association of postoperative nausea and/or vomiting (PONV) with hydromorphone use, and postoperative pain scores and total narcotic administration with type of anesthesia...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28721538/-methamphetamine-epidemiology-clinical-importance-and-sequelae-of-abuse
#2
N Arnaud, T Thomasius
Methamphetamine (also known as meth and crystal meth) is a highly psychoactive synthetic amphetamine type stimulant, which falls under the German Federal Narcotics Law. The substance is similar to other stimulants but has distinct features with respect to psychoactive effects, clinical symptoms, user characteristics and short and long-term consequences including substance-induced problems and comorbidities. The consumption and misuse of crystal meth is still limited to certain regions in Germany; however, the substance causes significant clinical and public health concerns in the affected regions and beyond due to the associated high potential for misuse and dependence, neurotoxic and neurodegenerative effects as well as many other severe health risks...
July 18, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#3
Marcia Irene Canto, Julian Abrams, Hannah Kunzli, Bas Weusten, Yoshihiro Komatsu, Blair Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or radiofrequency ablation (RFA). A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system (CbFAS) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 15, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28719390/total-pancreatectomy-with-islet-autotransplantation-recent-updates-and-outcomes
#4
Yoshitaro Shindo, Mazhar A Kanak
PURPOSE OF REVIEW: Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indications to include benign and malignant pancreatic disease has been suggested. Improved methods for evaluating the functional quality of islets and predicting transplant outcome have been discussed...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#5
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28717587/closed-incision-negative-pressure-therapy-in-obese-patients-undergoing-cesarean-delivery-a-randomized-controlled-trial
#6
Ravindu P Gunatilake, Geeta K Swamy, Leo R Brancazio, Michael P Smrtka, Jennifer L Thompson, Jennifer B Gilner, Beverly A Gray, Robert Phillips Heine
Background  Postcesarean wound morbidity is a costly complication of cesarean delivery for which preventative strategies remain understudied. Objective  We compared surgical site occurrences (SSOs) in cesarean patients receiving closed-incision negative-pressure therapy (ciNPT) or standard-of-care (SOC) dressing. Study Design  A single-center randomized controlled trial compared ciNPT (5-7 days) to SOC dressing (1-2 days) in obese women (body mass index [BMI] ≥ 35), undergoing cesarean delivery between 2012 and 2014...
July 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28716296/clinical-and-radiologic-predictive-factors-of-rib-fractures-in-outpatients-with-chest-pain
#7
REVIEW
Liang Zhang, Colm J McMahon, Samir Shah, Jim S Wu, Ronald L Eisenberg, Justin W Kung
PURPOSE: To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. METHOD AND MATERIALS: Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting...
May 30, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28715206/high-throughput-screening-and-quantitation-of-target-compounds-in-biofluids-by-coated-blade-spray-mass-spectrometry
#8
Marcos Tascon, German Augusto Gómez-Ríos, Nathaly Reyes-Garcés, Justen J Poole, Ezel Boyaci, Janusz Pawliszyn
Most contemporary methods of screening and quantitating controlled substances and therapeutic drugs in biofluids typically require laborious, time-consuming, and expensive analytical workflows. In recent years, our group has worked towards developing microextraction (µe)-mass spectrometry (MS) technologies that merge all of the tedious steps of the classical methods into a simple, efficient, and low-cost methodology. Unquestionably, the automation of these technologies allows for faster sample throughput, greater reproducibility, and radically reduced analysis times...
July 17, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28713291/an-expanding-world-of-novel-psychoactive-substances-opioids
#9
REVIEW
Jolanta B Zawilska
The abuse of novel psychoactive substances (NPS) has been increasing dramatically worldwide since late 2000s. By the end of 2015, more than 560 NPS had been reported to the European Monitoring Centre for Drugs and Drug Addiction. Although the most popular compounds are synthetic cannabinoids and psychostimulatory derivatives of cathinone (so-called β-keto-amphetamines), novel synthetic opioids have recently emerged on the recreational drug market. They include fentanyl (a potent narcotic analgesic) and its analogs (e...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28707149/long-term-quality-of-life-and-outcomes-following-robotic-assisted-tapp-inguinal-hernia-repair
#10
Andrew Iraniha, Joshua Peloquin
Laparoscopic TAPP inguinal hernia repair is an established alternative to open hernia repair, which offers equivalent outcomes with less postoperative pain and faster recovery. Unfortunately, it remains technically challenging, requiring advanced laparoscopic skills which have limited its popularity among surgeons. The robotic platform has the potential to overcome these challenges. The objective of this study was to examine the long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair, since these data have not been reported up to now...
July 13, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28705485/trainees-as-agents-of-change-in-the-opioid-epidemic-optimizing-the-opioid-prescription-practices-of-surgical-residents
#11
Alexander S Chiu, James M Healy, Michael P DeWane, Walter E Longo, Peter S Yoo
OBJECTIVE: Opioid abuse has become an epidemic in the United States, causing nearly 50,000 deaths a year. Postoperative pain is an unavoidable consequence of most surgery, and surgeons must balance the need for sufficient analgesia with the risks of overprescribing. Prescribing narcotics is often the responsibility of surgical residents, yet little is known about their opioid-prescribing habits, influences, and training experience. DESIGN: Anonymous online survey that assessed the amounts of postoperative opioid prescribed by residents, including type of analgesia, dosage, and number of pills, for a series of common general surgery procedures...
July 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28699562/which-green-way-description-of-the-intervention-for-mobilising-against-aedes-aegypti-under-difficult-security-conditions-in-southern-mexico
#12
REVIEW
Arcadio Morales-Perez, Elizabeth Nava-Aguilera, José Legorreta-Soberanis, Sergio Paredes-Solís, Alejandro Balanzar-Martínez, Felipe René Serrano-de Los Santos, Claudia Erika Ríos-Rivera, Jaime García-Leyva, Robert J Ledogar, Anne Cockcroft, Neil Andersson
BACKGROUND: Community mobilisation for prevention requires engagement with and buy in from those communities. In the Mexico state of Guerrero, unprecedented social violence related to the narcotics trade has eroded most community structures. A recent randomised controlled trial in 90 coastal communities achieved sufficient mobilisation to reduce conventional vector density indicators, self-reported dengue illness and serologically proved dengue virus infection. METHODS: The Camino Verde intervention was a participatory research protocol promoting local discussion of baseline evidence and co-design of vector control solutions...
May 30, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28699497/quantitative-structure-activity-relationships-of-aquatic-narcosis-a-review
#13
Chandana Adhikari, Bijay Kumar Mishra
BACKGROUND: Prior estimation of toxicity of each and every, existing and yet to be synthesized chemicals is a must to elude their adverse effect on the environment. Experimental determination of such parameters is time consuming, cost effective and above all it demands the sacrifice of many vertebrates. At this end the REACH regulations advocate for the use of non-testing predictive methods such as read-across, weight-of-evidence and QSAR (quantitative structure-activity relationship) techniques...
July 11, 2017: Current Computer-aided Drug Design
https://www.readbyqxmd.com/read/28699380/addressing-the-barriers-related-with-opioid-therapy-for-management-of-chronic-pain-in-india
#14
Gur Prasad Dureja, Paramanand N Jain, Muralidhar Joshi, Ashok Saxena, Gautam Das, Jaishid Ahdal, Prashant Narang
India has a high prevalence of chronic disorders which may be associated with persistent pain. Despite the availability of multiple treatment options, chronic pain is largely untreated and contributes to disability and mortality. Medical consumption of opioids remains low due to various barriers that prevent access to opioids for patients and healthcare practitioners. Stringent regulatory provisions outlined in the Narcotic Drugs and Psychotropic Substances Act (1985) have been major deterrents to adequate opioid use...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28697049/wide-variation-and-overprescription-of-opioids-after-elective-surgery
#15
Cornelius A Thiels, Stephanie S Anderson, Daniel S Ubl, Kristine T Hanson, Whitney J Bergquist, Richard J Gray, Halena M Gazelka, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: We aimed to identify opioid prescribing practices across surgical specialties and institutions. BACKGROUND: In an effort to minimize the contribution of prescription narcotics to the nationwide opioid epidemic, reductions in postoperative opioid prescribing have been proposed. It has been suggested that a maximum of 7 days, or 200 mg oral morphine equivalents (OME), should be prescribed at discharge in opioid-naïve patients. METHODS: Adults undergoing 25 common elective procedures from 2013 to 2015 were identified from American College of Surgeons National Surgical Quality Improvement Program data from 3 academic centers in Minnesota, Arizona, and Florida...
July 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28694151/liposomal-bupivacaine-decreases-pain-following-retropubic-sling-placement-a-randomized-placebo-controlled-trial
#16
Donna Mazloomdoost, Rachel N Pauls, Erin N Hennen, Jennifer Y Yeung, Benjamin C Smith, Steven D Kleeman, Catrina C Crisp
BACKGROUND: Midurethral slings are commonly used to treat stress urinary incontinence. Pain control, however, may be a concern. Liposomal bupivacaine is a local anesthetic with slow release over 72 hours, demonstrated to lower pain scores and decrease narcotic use postoperatively. OBJECTIVES: The objectives were to examine the impact of liposomal bupivacaine on pain scores and narcotic consumption following retropubic midurethral sling placement. STUDY DESIGN: This randomized, placebo-controlled trial enrolled women undergoing retropubic midurethral slings with or without concomitant anterior or urethrocele repair...
July 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28691766/detection-of-metabolites-of-the-new-synthetic-cannabinoid-cumyl-4cn-binaca-in-authentic-urine-samples-and-human-liver-microsomes-using-high-resolution-mass-spectrometry
#17
Yeter Erol Ozturk, Oya Yeter, Serkan Ozturk, Goksun Karakus, Ismail Ates, Yalçın Buyuk, Turkan Yurdun
CUMYL-4CN-BINACA(1-(4-cyanobutyl)-N-(2-phenylpropan-2-yl)-1H-indazole-3-carboxamide) is a recently introduced indazole-3-carboxamide type synthetic cannabinoid (SC) that was detected in herbal incense seized by of the Council of Forensic Medicine Istanbul Narcotics Department in May 2016 in Turkey. Recently introduced SCs are not detected in routine toxicological analysis; therefore, analytical methods to measure these compounds are in demand. The present study aims to identify urinary marker metabolites of CUMYL-4CN-BINACA by investigating its metabolism in human liver microsomes and to confirm the results in authentic urine samples (n=80)...
July 10, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28688994/comparison-of-30-day-emergency-department-bouncebacks-after-pediatric-versus-adult-urologic-surgery
#18
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
June 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28688514/pain-control-with-continuous-infusion-preperitoneal-wound-catheters-versus-continuous-epidural-analgesia-in-colon-and-rectal-surgery-a-randomized-controlled-trial
#19
Nicolas J Mouawad, Stefan W Leichtle, Christodoulos Kaoutzanis, Kathleen Welch, Suzanne Winter, Richard Lampman, Matt McCord, Kimberly A Hoskins, Robert K Cleary
OBJECTIVE: To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery. METHODS: An open-label equivalence trial randomizing patients to CPA or CEA. Primary outcomes were postoperative pain as determined by numeric pain scores and supplemental narcotic analgesia requirements. Secondary outcomes included incidence of complications and patient health status measured with the SF-36 Health Survey (Acute Form)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28686547/incidence-of-naloxone-redosing-in-the-age-of-the-new-opioid-epidemic
#20
Ronald Klebacher, Matthew I Harris, Navin Ariyaprakai, Ammundeep Tagore, Vince Robbins, Larissa Sophia Dudley, Robert Bauter, Susmith Koneru, Ryan D Hill, Eric Wasserman, Andrew Shanes, Mark A Merlin
STUDY OBJECTIVE: Naloxone, an opioid-antagonist deliverable by an intra-nasal route, has become widely available and utilized by law enforcement officers as well as basic life support (BLS) providers in the prehospital setting. This study aimed to determine the frequency of repeat naloxone dosing in suspected narcotic overdose (OD) patients and identify patient characteristics. METHODS: A retrospective chart review of patients over 17 years of age with suspected opioid overdose, treated with an initial intranasal (IN) dose of naloxone and subsequently managed by paramedics, was performed from April 2014 to June 2016...
July 7, 2017: Prehospital Emergency Care
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