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https://www.readbyqxmd.com/read/29742667/total-laparoscopic-hysterectomy-under-regional-anesthesia
#1
Nash S Moawad, Estefania Santamaria Flores, Linda Le-Wendling, Martina T Sumner, F Kayser Enneking
BACKGROUND: Laparoscopic hysterectomies comprise a large proportion of all hysterectomies in the United States. Procedures completed under regional anesthesia pose a number of benefits to patients, but laparoscopic hysterectomies traditionally have been performed under general anesthesia. We describe a case of total laparoscopic hysterectomy under epidural anesthesia with the patient fully awake. CASE: A 51-year-old woman with abnormal uterine bleeding underwent an uncomplicated total laparoscopic hysterectomy, bilateral salpingectomy, and excision of endometriosis...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29734991/violent-parasomnia-with-recurrent-biting-and-surgical-interventions-case-report-and-differential-diagnosis
#2
Nilam Danish, Imran S Khawaja, Carlos H Schenck
A case is reported of recurrent, injurious self-biting during sleep, requiring surgical interventions, in a 55-year-old obese man with a 20-year history of violent complex parasomnia, with greatly increased frequency and severity of episodes induced by work stress during the preceding 3 years. After clinical evaluation and overnight, hospital-based video-polysomnography, the cause of the chronic injurious parasomnia was deemed to be a non-rapid eye movement (NREM) sleep parasomnia comorbid with severe obstructive sleep apnea...
April 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29724743/efficacy-of-bilevel-positive-airway-pressure-and-continuous-positive-airway-pressure-therapy-in-patients-with-obesity-hypoventilation-syndrome-protocol-for-systematic-review-and-meta-analysis
#3
Lili Guan, Weiliang Wu, Yating Huo, Xiaoying Li, Bingpeng Guo, Yuqiong Yang, Jiawen Xu, Fangfang Jiang, Luqian Zhou, Rongchang Chen
INTRODUCTION: Obesity hypoventilation syndrome (OHS) is a major respiratory complication caused by severe obesity, being associated with significant morbidity, negative impacts on quality of life and reduced survival if not treated appropriately. Positive airway pressure therapy is the first-line treatment for OHS although the optimal modality remains unclear. The goal of this study is to identify the efficacy of home bilevel positive airway pressure therapy by comparison to continuous positive airway pressure therapy and determine the best strategy for patients with OHS...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29669621/effect-of-environmental-enrichment-on-aggression-in-balb-cj-and-balb-cbyj-mice-monitored-by-using-an-automated-system
#4
Jareca M Giles, Julia W Whitaker, Sheryl S Moy, Craig A Fletcher
Aggression among mice remains a common undesirable problem in laboratory settings, and animal welfare and scientific outcomes may become compromised depending on the severity of aggression. This study evaluated the effect of cage enrichment comprising a bilevel, mounted 'mezzanine' compared with a cotton square or shelter on intracage male aggression over a 6-wk period. Our first study involved home-cage behavioral challenges to male mice from a high aggression substrain (BALB/cJ) and low-aggression substrain (BALB/cByJ)...
April 18, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/29590111/an-outer-approximation-method-for-the-road-network-design-problem
#5
Saeed Asadi Bagloee, Majid Sarvi
Best investment in the road infrastructure or the network design is perceived as a fundamental and benchmark problem in transportation. Given a set of candidate road projects with associated costs, finding the best subset with respect to a limited budget is known as a bilevel Discrete Network Design Problem (DNDP) of NP-hard computationally complexity. We engage with the complexity with a hybrid exact-heuristic methodology based on a two-stage relaxation as follows: (i) the bilevel feature is relaxed to a single-level problem by taking the network performance function of the upper level into the user equilibrium traffic assignment problem (UE-TAP) in the lower level as a constraint...
2018: PloS One
https://www.readbyqxmd.com/read/29578608/optimization-of-bioprocess-productivity-based-on-metabolic-genetic-network-models-with-bilevel-dynamic-programming
#6
Banafsheh Jabarivelisdeh, Steffen Waldherr
One of the main goals of metabolic engineering is to obtain high levels of a microbial product through genetic modifications. To improve the productivity of such a process, the dynamic implementation of metabolic engineering strategies has been proven to be more beneficial compared to static genetic manipulations in which the gene expression is not controlled over time, by resolving the trade-off between growth and production. In this work, a bilevel optimization framework based on constraint-based models is applied to identify an optimal strategy for dynamic genetic and process level manipulations to increase productivity...
March 26, 2018: Biotechnology and Bioengineering
https://www.readbyqxmd.com/read/29575773/non-invasive-ventilation-practices-in-children-across-europe
#7
Juan Mayordomo-Colunga, Martí Pons-Òdena, Alberto Medina, Corsino Rey, Christophe Milesi, Merja Kallio, Andrea Wolfler, Mireia García-Cuscó, Demet Demirkol, Milagros García-López, Peter Rimensberger
OBJECTIVES: To describe the diversity in practice in non-invasive ventilation (NIV) in European pediatric intensive care units (PICUs). WORKING HYPOTHESIS: No information about the use of NIV in Pediatrics across Europe is currently available, and there might be a wide variability regarding the approach. STUDY DESIGN: Cross-sectional electronic survey. METHODOLOGY: The survey was distributed to the ESPNIC mailing list and to researchers in different European centers...
March 24, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29544721/dexmedetomidine-high-flow-nasal-oxygen-and-sugammadex-reversal-of-rocuronium-overcoming-anaesthetic-challenges-in-a-parturient-with-congenital-muscular-dystrophy-presenting-for-caesarean-section
#8
M Creaney, R M Moriarty, M Milner, C Murphy
Congenital muscular dystrophies are characterised by progressive skeletal muscle weakness from birth or early infancy. Maternal respiratory compromise, joint contractures and presence of spinal instrumentation or fusion are some of the anaesthetic challenges that may be encountered in the obstetric setting. The choice of anaesthetic technique for surgical delivery needs to be considered on an individual basis. Multidisciplinary involvement is paramount to optimise peripartum care and outcomes. In this case report, we present the use of dexmedetomidine, humidified high-flow nasal oxygen, rocuronium and sugammadex in the anaesthetic management of a wheelchair-bound, non-invasive bilevel positive airway pressure ventilation-dependent parturient with congenital muscular dystrophy, who was presenting for caesarean section...
May 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29530362/the-optiflow%C3%A2-interface-for-chronic-cpap-use-in-children
#9
C Overbergh, S Installe, A Boudewyns, K Van Hoorenbeeck, S L Verhulst
Continuous positive airway pressure (CPAP) is being increasingly used in children of all age ranges. The limited number of commercially available masks especially in infants and young children may complicate its use and compliance. In this report, we describe our experience with the use of the Optiflow™ (Fisher and Paykel Healthcare) Nasal Cannula attached to a regular CPAP device in the setting of chronic CPAP use. This interface consists of a nasal cannula and was originally designed for the delivery of high-flow oxygen therapy...
April 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29527742/use-of-autobilevel-ventilation-in-patients-with-obstructive-sleep-apnea-an-observational-study
#10
Pierpaolo Baiamonte, Emilia Mazzuca, Claudia I Gruttad'Auria, Alessandra Castrogiovanni, Claudia Marino, Davide Lo Nardo, Marco Basile, Margherita Algeri, Salvatore Battaglia, Oreste Marrone, Andrea Gagliardo, Maria R Bonsignore
Continuous positive airway pressure (CPAP) is the first-choice treatment for obstructive sleep-disordered breathing. Automatic bilevel ventilation can be used to treat obstructive sleep-disordered breathing when CPAP is ineffective, but clinical experience is still limited. To assess the outcome of titration with CPAP and automatic bilevel ventilation, the charts of 356 outpatients (obstructive sleep apnea, n = 242; chronic obstructive pulmonary disease + obstructive sleep apnea overlap, n = 80; obesity hypoventilation syndrome [OHS], n = 34; 103 females) treated for obstructive sleep-disordered breathing from January 2014 to April 2017 were reviewed...
March 12, 2018: Journal of Sleep Research
https://www.readbyqxmd.com/read/29458694/persistent-high-residual-ahi-after-cpap-use
#11
Leay Kiaw Er, Shinn-Kuang Lin, Stephen Shei-Dei Yang, Chou-Chin Lan, Yao-Kuang Wu, Mei-Chen Yang
Treatment-emergent central sleep apnea has recently been noted after various treatment modalities for obstructive sleep apnea. It often remits spontaneously or can be treated with continuous positive airway pressure. However, we encountered a pediatric patient with obstructive sleep apnea who presented with severe complications, including growth failure, attention-deficit hyperactivity disorder, poor school performance, daytime sleepiness, and urinary difficulty that required permanent cystostomy. His obstructive sleep apnea resolved after adenotonsillectomy...
March 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29427294/simultaneous-multislice-refocusing-via-time-optimal-control
#12
Armin Rund, Christoph Stefan Aigner, Karl Kunisch, Rudolf Stollberger
PURPOSE: Joint design of minimum duration RF pulses and slice-selective gradient shapes for MRI via time optimal control with strict physical constraints, and its application to simultaneous multislice imaging. THEORY AND METHODS: The minimization of the pulse duration is cast as a time optimal control problem with inequality constraints describing the refocusing quality and physical constraints. It is solved with a bilevel method, where the pulse length is minimized in the upper level, and the constraints are satisfied in the lower level...
February 9, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29411336/central-sleep-apnea-with-cheyne-stokes-breathing-in-heart-failure-from-research-to-clinical-practice-and-beyond
#13
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29384883/comparison-of-the-clinical-effects-of-zero-profile-anchored-spacer-roi-c-and-conventional-cage-plate-construct-for-the-treatment-of-noncontiguous-bilevel-of-cervical-degenerative-disc-disease-cddd-a-minimum-2-year-follow-up
#14
COMPARATIVE STUDY
Yingjie Lu, Weiguo Bao, Zongyi Wang, Feng Zhou, Jun Zou, Weimin Jiang, Huilin Yang, Zhiming Zhang, Xuesong Zhu
Comparing the clinical and radiographic outcomes in anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer (ROI-C) or a conventional cage-plate construct (CPC) for treating noncontiguous bilevel of cervical degenerative disc disease (CDDD).Overall, 46 patients with 2 noncontiguous segments of CDDD, treated with ACDF from January 2011 to October 2015, were included in this study. ROI-C was used in 22 patients (group A) and CPC in 24 patients (group B). The clinical and radiographic outcomes and complications were compared pre- and postoperatively...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29358787/risk-factors-for-failure-of-continuous-positive-airway-pressure-treatment-in-patients-with-ostructive-sleep-apnoea
#15
David Slouka, Monika Honnerova, Petr Hosek, Ales Matas, Karel Slama, Jana Landsmanova, Radek Kucera
BACKGROUND AND AIMS: Obstructive sleep apnoea is a potentially serious sleep disorder associated with the risk of cardiovascular disease. It is treated with continuous airway pressure (CPAP) but this is not always successful. Unsuccessful cases should be treated by bilevel positive airway pressure (BiPAP). The aim of this study was to determine whether common respiratory parameters and/or body mass index (BMI) can be used to predict the probability CPAP failure and hence start such patients on BiPAP from the outset...
January 18, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29351818/obstructive-sleep-apnea-in-patients-with-congenital-central-hypoventilation-syndrome-ventilated-by-diaphragm-pacing-without-tracheostomy
#16
Annie Wang, Sheila Kun, Bonnie Diep, Sally L Davidson Ward, Thomas G Keens, Iris A Perez
STUDY OBJECTIVES: To determine presence of obstructive sleep apnea (OSA) in patients with congenital central hypoventilation syndrome (CCHS) ventilated by diaphragm pacing (DP) without tracheostomy, and to determine if OSA can be improved by DP setting changes. METHODS: We reviewed polysomnography (PSG) results of 15 patients with CCHS from October 2001 to April 2014, age 15.4 ± 7.8 years, body mass index 22.0 ± 6.0 kg/m2 , and 60% female. RESULTS: Of the 22 PSG results obtained for the 15 patients with CCHS, 9 were performed with tracheostomy capped, and 13 were performed after patients underwent decannulation...
February 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29305266/pre-emptive-awake-airway-management-under-dexmedetomidine-sedation-in-a-parturient-with-spinal-muscular-atrophy-type-2
#17
C A Godlewski, P F Castellanos
Historically, pregnancy in females with spinal muscular atrophy was contraindicated due to the great risk to the parturient, but with improved management and increased survival more patients are becoming pregnant. We describe the management of a pregnant patient with spinal muscular atrophy type-2, who had severe restrictive lung disease, extensive spinal fusion that precluded neuraxial anesthesia, and chronic respiratory failure on nocturnal Bilevel Positive Airway Pressure. Airway management was further complicated by limited mouth opening and cervical spine ankylosis...
February 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29297943/wrapping-newborn-infants-in-cloth-and-newspaper-after-delivery-led-to-higher-temperatures-on-arrival-at-the-neonatal-intensive-care-unit
#18
Nitika Agrawal, Kunal Das, Prachi Patwal, Neerul Pandita, Alpa Gupta
AIM: Neonatal hypothermia is a preventable cause of neonatal mortality and morbidity, and wrapping neonates in newspaper sandwiched between cotton sheets is a simple intervention. This 2017 Indian pilot study tested the heat insulating property of sandwiched sheets. METHODS: At birth, we randomised 100 neonates who were more than 32 weeks of gestation and needed neonatal intensive care unit (NICU) observation or care without a ventilator or bilevel positive airway pressure support into two groups of 50...
January 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29224641/design-of-a-bilevel-clinical-trial-targeting-adherence-in-heart-failure-patients-and-their-providers-the-congestive-heart-failure-adherence-redesign-trial-chart
#19
RANDOMIZED CONTROLLED TRIAL
Ashvarya Mangla, Rami Doukky, DeJuran Richardson, Elizabeth F Avery, Rebecca Dawar, James E Calvin, Lynda H Powell
BACKGROUND: Socioeconomically disadvantaged patients are at an increased risk for adverse heart failure (HF) outcomes based upon nonadherence to medications and diet. Physicians are also suboptimally adherent to prescribing evidence-based therapy for HF. METHODS: Congestive Heart Failure Adherence Redesign Trial (CHART) (NCT01698242) is a multicenter, bilevel, cluster randomized behavioral efficacy trial designed to assess the impact of intervening simultaneously on physicians and their socioeconomically disadvantaged patients (annual income <$30,000) having HF with reduced ejection fraction...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29200833/positive-airway-pressure-adherence-and-subthreshold-adherence-in-posttraumatic-stress-disorder-patients-with-comorbid-sleep-apnea
#20
Barry J Krakow, Jessica J Obando, Victor A Ulibarri, Natalia D McIver
Study objectives: Patients with comorbid posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) manifest low adherence to continuous positive airway pressure (CPAP) due to fixed, pressure-induced expiratory pressure intolerance (EPI), a subjective symptom and objective sign aggravated by anxiety sensitivity and somatosensory amplification. As advanced PAP therapy modes (ie, auto-bilevel PAP [ABPAP] or adaptive servo-ventilation [ASV]) may address these side effects, we hypothesized such treatment would be associated with decreased expiratory intolerance and increased adherence in posttraumatic stress patients with co-occurring OSA...
2017: Patient Preference and Adherence
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