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https://www.readbyqxmd.com/read/28726791/implementation-of-a-multidisciplinary-guideline-improves-preterm-infant-admission-temperatures
#1
M W Harer, B Vergales, T Cady, A Early, C Chisholm, J R Swanson
BACKGROUND: Hypothermia is a common problem in preterm infants immediately following delivery.Local problem:The rate of admission hypothermia in our neonatal intensive care unit (NICU) was above the rate of comparable NICUs in the Vermont Oxford Network. METHODS: To reduce the rate of preterm admission hypothermia, a quality improvement (QI) project was implemented, utilizing the plan-do-study-act (PDSA) methodology. A guideline for delivery room thermoregulation management in <35-week infants at the University of Virginia was created and put into practice by a multidisciplinary team...
July 20, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#2
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719431/bispectral-index-measurements-are-not-degraded-during-aeromedical-evacuations
#3
Nicolas Donat, Audrey Cirodde, Clément Hoffmann, Jean-Vivien Schaal, Yannick Masson, Antoine Nau, Paul Vincent Martin, Samuel Madec, Thomas Leclerc
For a decade, depth of anesthesia monitoring has become a reality in the operating room. It provides valuable help for managing anesthesia, especially for unstable patients. This might be particularly relevant during aeromedical evacuation. In this study, we aimed to assess the validity of the bispectral index (BIS) during long-range patient transportation aboard fixed-wing aircraft. BIS was recorded in 30 patients, 25 under anesthesia and 5 awake, during aeromedical evacuations performed by the French Air Force...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28719425/organizational-contributors-to-the-variation-in-red-blood-cell-transfusion-practices-in-cardiac-surgery-survey-results-from-the-state-of-michigan
#4
Anton Camaj, Darin B Zahuranec, Gaetano Paone, Barbara R Benedetti, Warren D Behr, Marc A Zimmerman, Min Zhang, Robert S Kramer, Jason Penn, Patricia F Theurer, Theron A Paugh, Milo Engoren, Alphonse DeLucia, Richard L Prager, Donald S Likosky
BACKGROUND: While large volumes of red blood cell transfusions are given to preserve life for cardiac surgical patients, indications for lower volume transfusions (1-2 units) are less well understood. We evaluated the relationship between center-level organizational blood management practices and center-level variability in low volume transfusion rates. METHODS: All 33 nonfederal, Michigan cardiac surgical programs were surveyed about their blood management practices for isolated, nonemergent coronary bypass procedures, including: (1) presence and structure of a patient blood management program, (2) policies and procedures, and (3) audit and feedback practices...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28709556/intussusception-among-children-less-than-2years-of-age-findings-from-pre-vaccine-introduction-surveillance-in-pakistan
#5
Mohammad Tahir Yousafzai, Rozina Thobani, Saqib Hamid Qazi, Nasir Saddal, Catherine Yen, Negar Aliabadi, Syed Asad Ali
BACKGROUND: Rotavirus vaccination introduction in routine immunization is under consideration in Pakistan. Data on the baseline epidemiology of intussusception will inform surveillance strategies for intussusception after rotavirus vaccine introduction in Pakistan. We describe the epidemiology of intussusception-associated hospitalizations among children <2years of age in Karachi, Pakistan. METHODS: We conducted a retrospective chart review for July 01, 2012 through June 30, 2015 at the National Institute of Child Health (NICH) and Aga Khan University Hospital (AKUH) Karachi...
July 11, 2017: Vaccine
https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#6
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28707420/transthoracic-intracardiac-catheters-in-pediatric-cardiac-patients-a-single-center-experience
#7
Kristoffer Beham, Hitendu Dave, Janet Kelly, Bernhard Frey, Maja I Hug, Barbara Brotschi
BACKGROUND: Transthoracic intracardiac catheters are frequently inserted in children during congenital heart surgery for monitoring and vascular access purposes. Their use entails a small potential risk. AIM: We aimed to evaluate both catheter-associated morbidities related to maintenance and removal of transthoracic intracardiac catheters in pediatric cardiac patients, and predictors for catheter-associated adverse events. METHODS: Single-center retrospective cohort study of prospectively collected data of children aged 0-14 years receiving a transthoracic intracardiac catheter inserted in the operating room during 7 consecutive years at the University Children's Hospital Zurich...
July 14, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28704248/low-end-tidal-carbon-dioxide-at-the-onset-of-emergent-trauma-surgery-is-associated-with-nonsurvival-a-case-series
#8
Roman Dudaryk, Danielle K Bodzin, Juliet J Ray, Craig S Jabaley, Richard R McNeer, Richard H Epstein
BACKGROUND: End-tidal carbon dioxide (EtCO2) is a valuable marker of the return of adequate circulation following cardiac arrest due to medical causes. Previously, the prognostic value of capnography in trauma has been studied among limited populations in prehospital and emergency department settings. We aimed to investigate the relationship between early intraoperative EtCO2 and nonsurvival of patients undergoing emergency surgery at a level 1 academic trauma center as a case series...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28700811/probing-for-congenital-nasolacrimal-duct-obstruction
#9
REVIEW
Carisa Petris, Don Liu
BACKGROUND: Congenital nasolacrimal duct obstruction (NLDO) is a common condition causing excessive tearing in the first year of life. Infants present with excessive tearing or mucoid discharge from the eyes due to blockage of the nasolacrimal duct system, which can result in maceration of the skin of the eyelids and local infections, such as conjunctivitis, that may require antibiotics. The incidence of nasolacrimal duct obstruction in early childhood ranges from 5% to 20% and often resolves without surgery...
July 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28697533/predictors-of-operative-time-during-radical-retropubic-prostatectomy-and-robot-assisted-laparoscopic-prostatectomy
#10
Ross M Simon, Lauren E Howard, Daniel M Moreira, Martha K Terris, Christopher J Kane, William J Aronson, Christopher L Amling, Matthew R Cooperberg, Stephen J Freedland
OBJECTIVES: To better predict operative time using patient/surgical characteristics among men undergoing radical retropubic prostatectomy or robot-assisted laparoscopic prostatectomy in order to achieve more efficient operative scheduling and potentially decrease costs in the Veterans Health System. METHODS: We analyzed 2619 men treated with radical retropubic prostatectomy (n = 2005) or robot-assisted laparoscopic prostatectomy (n = 614) from 1993 to 2013 from six Veterans Affairs Hospitals in the Shared Equal Access Regional Cancer Hospital database...
July 11, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28687917/the-application-of-surgical-procedure-manager-spm-first-experience-with-fess
#11
Katharina Feige, Iris Gollnick, Pia Schmitz, Gero Strauss
In our hypothesis, the newly developed program SPM (surgical procedure manager) will ensure successful standardization and efficiency of the FESS (functional endoscopic sinus surgery) and therefore make a decisive contribution in terms of economization and improvement of intraoperative quality. Between 27th March 2015 and 8th October 2015, data from 259 FESS procedures were collected using the SPM. The study took place at the surgical desk, an operating room in the ACQUA clinic in Leipzig, Germany. 233 FESS (90%) of the total FESS (n = 259, 100%) were conducted entirely with SPM...
July 7, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28681208/surgical-considerations-in-the-optimal-management-of-patients-with-malignant-brain-tumors
#12
REVIEW
Jaclyn J Renfrow, Roy E Strowd, Adrian W Laxton, Stephen B Tatter, Carol P Geer, Glenn J Lesser
Advances in technology are revolutionizing medicine and the limits of what we can offer to our patients. In neurosurgery, technology continues to reduce morbidity, increase surgical accuracy, facilitate tissue acquisition, and promote novel techniques for prolonging survival in patients with neuro-oncologic disease. Surgery has been the backbone of glioma diagnosis and treatment by providing adequate, high quality material for precise histologic diagnosis, and genomic characterization in the setting of significant intratumoral heterogeneity, thus allowing personalized treatment selection in the clinic...
August 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28678089/children-receiving-hematopoietic-stem-cell-transplantation-are-at-increased-risk-of-onychocryptosis-requiring-surgical-management
#13
Brian Ezekian, Brian R Englum, Brian F Gilmore, Jina Kim, Harold J Leraas, Timothy A Driscoll, Elisabeth T Tracy, Henry E Rice
PURPOSE: At our institution, a high proportion of children with onychocryptosis (ingrown toenail) requiring surgical intervention were noted to have a history of hematopoietic stem cell transplantation (HSCT). We analyzed the characteristics of patients who underwent surgical intervention for onychocryptosis and examined our institutional HSCT database to determine if an association exists between onychocryptosis and HSCT. MATERIALS AND METHODS: Surgical cases for onychocryptosis performed from 2000 to 2012 were identified...
July 3, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28674675/the-role-of-central-neck-lymph-node-dissection-in-the-management-of-papillary-thyroid-cancer
#14
REVIEW
Lawrence A Shirley, Natalie B Jones, John E Phay
Papillary thyroid cancer (PTC) is the most common thyroid malignancy, and cervical nodal metastases are frequent at presentation. The most common site for nodal metastases from PTC is the central compartment of the ipsilateral neck in the paratracheal and pretracheal regions. The decision to resect these lymph nodes at the time of thyroidectomy often depends on if nodes with suspected malignancy can be identified preoperatively. If nodal spread to the central neck nodes is known, then the consensus is to remove all nodes in this area...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28671886/effect-of-drain-placement-on-infection-seroma-and-return-to-operating-room-in-expander-based-breast-reconstruction
#15
Caleb J Ollech, Lisa M Block, Ahmed M Afifi, Samuel O Poore
INTRODUCTION: There is significant variability in the location and management of drains in breast reconstruction, with most surgeons attempting to shorten the duration of drains while preventing complications possibly related to early removal. The aim of this work was to compare our experiences with placement of 1 versus 2 drains in tissue expander breast reconstruction. METHODS: This is a retrospective cohort study comparing 2 groups of patients after breast tissue expander placement in a complete submuscular pocket and without the use of acellular dermal matrix...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28670155/ruptured-corpus-luteal-cyst-prediction-of-clinical-outcomes-with-ct
#16
Myoung Seok Lee, Min Hoan Moon, Hyunsik Woo, Chang Kyu Sung, Hye Won Jeon, Taek Sang Lee
OBJECTIVE: To evaluate the determinant pretreatment CT findings that can predict surgical intervention for patients suffering from corpus luteal cyst rupture with hemoperitoneum. MATERIALS AND METHODS: From January 2009 to December 2014, a total of 106 female patients (mean age, 26.1 years; range, 17-44 years) who visited the emergency room of our institute for acute abdominal pain and were subsequently diagnosed with ruptured corpus luteal cyst with hemoperitoneum were included in the retrospective study...
July 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28668291/comparison-of-simulation-based-assessments-and-faculty-ratings-for-general-surgery-resident-milestone-evaluation-are-they-telling-the-same-story
#17
Aimee K Gardner, Kareem AbdelFattah
BACKGROUND: The goal of this article is to examine the role of simulation in documenting resident nontechnical competencies outlined by the general surgery milestones, and compare those assessments to faculty ratings. METHODS: Trainees completed a multiphasic simulation scenario to assess ability to obtain informed consent, lead a preoperative time out, crisis management, communication, and delivering bad news. Assessments from this scenario were compared with ratings of these same competencies collected from clinical rotations...
August 16, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#18
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
June 30, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28662195/the-relationship-between-minute-ventilation-and-end-tidal-co2-in-intubated-and-spontaneously-breathing-patients-undergoing-procedural-sedation
#19
Jaideep H Mehta, George W Williams, Brian C Harvey, Navneet K Grewal, Edward E George
BACKGROUND: Monitoring respiratory status using end tidal CO2 (EtCO2), which reliably reflects arterial PaCO2 in intubated patients under general anesthesia, has often proven both inaccurate and inadequate when monitoring non-intubated and spontaneously breathing patients. This is particularly important in patients undergoing procedural sedation (e.g., endoscopy, colonoscopy). This can be undertaken in the operating theater, but is also often delivered outside the operating room by non-anesthesia providers...
2017: PloS One
https://www.readbyqxmd.com/read/28657992/ready-or-not-obstetrics-and-gynecology-resident-preparedness-for-female-pelvic-medicine-and-reconstructive-surgery-training
#20
Tanaka J Dune, Robert H Blackwell, Arianna Griffin, Susanne Taege, Juliana Sung, Elizabeth R Mueller, Linda Brubaker
OBJECTIVE: The aim of this study was to assess the perception of female pelvic medicine and reconstructive surgery (FPMRS) program directors (PDs) and obstetrics and gynecology (OG) FMPRS fellows regarding the adequacy of OG residency as preparation for FPMRS fellowship. METHODS: Electronic invitations to complete a modified version of a validated survey were extended to FPMRS PDs and their second- and third-year OG FPMRS fellows who had just completed their first or second year of FPMRS fellowship, respectively...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
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