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https://www.readbyqxmd.com/read/28944481/efficacy-of-dexmedetomidine-on-perioperative-morbidity-during-nasal-surgery-a-meta-analysis
#1
Se Hwan Hwang, Ho Seok Lee, Young Hoon Joo, Jae Hyun Seo, Jun Myung Kang
OBJECTIVES: The goal of this meta-analysis was to perform a systematic review of the literature on the effect of dexmedetomidine on perioperative morbidity following nasal surgery and on the adverse effects of dexmedetomidine. DATA SOURCES: MEDLINE, Scopus, and Cochrane Database of Systematic Reviews. REVIEW METHODS: Two authors independently searched scientific and medical databases from their inception of article collection to March 2017...
September 25, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28940686/median-effective-dose-of-intranasal-dexmedetomidine-sedation-for-transthoracic-echocardiography-in-pediatric-patients-with-noncyanotic-congenital-heart-disease-an-up-and-down-sequential-allocation-trial
#2
Qing Yu, Yang Liu, Mang Sun, Jing Zhang, Yan Zhao, Fengzhi Liu, Shangyingying Li, Shengfen Tu
BACKGROUND: Intranasal dexmedetomidine can provide adequate sedation during short procedures. However, previous literature investigating the single-dose use of intranasal dexmedetomidine for sedation during transthoracic echocardiography in younger children is scarce, and the effects of age on sedation with intranasal dexmedetomidine remain controversial. OBJECTIVE: This study was to determine the 50% effective dose and estimate the 95% effective dose of single-dose intranasal dexmedetomidine to induce sedation in pediatric patients with noncyanotic congenital heart disease, and also determine the effect of age on the dose required for sedation...
September 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28940368/cerebral-oximetry-and-postoperative-delirium-after-cardiac-surgery-a-randomised-controlled-trial
#3
L Lei, R Katznelson, L Fedorko, J Carroll, H Poonawala, M Machina, R Styra, V Rao, G Djaiani
Postoperative delirium is associated with increased morbidity and mortality. We hypothesised that restoration of regional cerebral oxygen desaturation would reduce the incidence of postoperative delirium in elderly patients after cardiac surgery. After institutional ethics review board approval and informed consent, a double-blinded, prospective, randomised, controlled trial was conducted in patients ≥ 60 years of age undergoing cardiac surgery with cardiopulmonary bypass. In the intervention group, an algorithm was commenced if regional cerebral oxygen saturation decreased below 75% of baseline value for 1 min or longer...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28939210/toward-a-blood-borne-biomarker-of-chronic-hypoxemia-red-cell-distribution-width-and-respiratory-disease
#4
Joseph W Yčas
Hypoxemia (systemic oxygen desaturation) marks the presence, risk, and progression of many diseases. Episodic or nocturnal hypoxemia can be challenging to detect and quantify. A sensitive, specific, and convenient marker of recent oxygen desaturation represents an unmet medical need. Observations of acclimatization to high altitude in humans and animals reveals several proteosomic, ventilatory, and hematological responses to low oxygen tension. Of these, increased red cell distribution width (RDW) appears to have the longest persistence...
2017: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/28937905/combined-orthodontic-and-surgical-treatment-in-a-8-years-old-patient-affected-by-severe-obstructive-sleep-apnea-a-case-report
#5
Antonio Gracco, Giovanni Bruno, Alberto de Stefani, Rosario Marchese Ragona, Sergio Mazzoleni, Edoardo Stellini
An eight-years-old girl showed a restless sleep with snoring and severe apnea episodes, a mandibular retrognathia, mouth breathing, maxillary transverse discrepancy, mandibular transverse discrepancy, moderate crowding and anterior open-bite. The CBCT showed an anterior collapse of the epiglottis. The treatment consisted in a rapid palatal expansion, an epiglottoplasty and a reduction of the tongue base. Polysomnography revealed that apnea-hypopnea index improved from 21,8 episodes/hr at the baseline to 0,6 episodes/hr, average oxygen saturation from 96,5% to 98,1%, oxygen desaturation events from 23,4 episodes/hr to 1/hr...
September 22, 2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28929400/can-polymorphisms-in-the-fatty-acid-desaturase-fads-gene-cluster-alter-the-effects-of-fish-oil-supplementation-on-plasma-and-erythrocyte-fatty-acid-profiles-an-exploratory-study
#6
Suzanne J Meldrum, Yuchun Li, Guicheng Zhang, Alexandra E M Heaton, Nina D'Vaz, Judith Manz, Eva Reischl, Berthold V Koletzko, Susan L Prescott, Karen Simmer
PURPOSE: The enzymes encoded by fatty acid desaturases (FADS) genes determine the desaturation of long-chain polyunsaturated fatty acids (LCPUFA). We investigated if haplotype and single nucleotide polymorphisms (SNPs) in FADS gene cluster can influence LCPUFA status in infants who received either fish oil or placebo supplementation. METHODS: Children enrolled in the Infant Fish Oil Supplementation Study (IFOS) were randomly allocated to receive either fish oil or placebo from birth to 6 months of age...
September 19, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28929225/prediction-of-survival-by-texture-based-automated-quantitative-assessment-of-regional-disease-patterns-on-ct-in-idiopathic-pulmonary-fibrosis
#7
Sang Min Lee, Joon Beom Seo, Sang Young Oh, Tae Hoon Kim, Jin Woo Song, Sang Min Lee, Namkug Kim
OBJECTIVES: To retrospectively investigate whether the baseline extent and 1-year change in regional disease patterns on CT can predict survival of patients with idiopathic pulmonary fibrosis (IPF). METHODS: A total of 144 IPF patients with CT scans at the time of diagnosis and 1 year later were included. The extents of five regional disease patterns were quantified using an in-house texture-based automated system. The fibrosis score was defined as the sum of the extent of honeycombing and reticular opacity...
September 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28926830/a-distinctive-ictal-amplitude-integrated-electroencephalography-pattern-in-newborns-with-neonatal-epilepsy-associated-with-kcnq2-mutations
#8
Ana Vilan, José Mendes Ribeiro, Pasquale Striano, Sarah Weckhuysen, Lauren C Weeke, Eva Brilstra, Linda S de Vries, Maria Roberta Cilio
BACKGROUND: Recurrent and prolonged seizures are harmful for the developing brain, emphasizing the importance of early seizure recognition and effective therapy. Amplitude-integrated electroencephalography (aEEG) has become a valuable tool to diagnose epileptic seizures, and, in parallel, genetic etiologies are increasingly being recognized, changing the paradigm of the workup and management of neonatal seizures. OBJECTIVE: To report the ictal aEEG pattern in neonates with KCNQ2-related epilepsy...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28922573/diastolic-blood-pressure-rises-with-the-exacerbation-of-obstructive-sleep-apnea-in-males
#9
Wei Hu, Xian Jin, Chengjun Chen, Peng Zhang, Dandan Li, Qian Su, Guizhi Yin, Yanwen Hang
OBJECTIVE: To characterize the association pattern between blood pressure (BP), metabolism changes, and obstructive sleep apnea (OSA) severity within male OSA patients. METHODS: The association between systolic BP (SBP), diastolic BP (DBP), glucose, lipids, apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and arousal index (ArI) was evaluated after adjustment for BMI and waist circumference/hip circumference ratio (WHR) in 1,370 male OSA patients. RESULTS: In the multiple linear regression models using SBP as an independent variable, SBP did not associate with the increase of any OSA indexes...
September 18, 2017: Obesity
https://www.readbyqxmd.com/read/28919734/usefulness-of-the-desaturation-distance-ratio-from-the-six-minute-walk-test-for-patients-with-copd
#10
Yukari Fujimoto, Yutaro Oki, Masahiro Kaneko, Hideki Sakai, Shogo Misu, Takumi Yamaguchi, Yuji Mitani, Hisafumi Yasuda, Akira Ishikawa
PURPOSE: A straightforward, noninvasive method is needed to assess emphysema and pulmonary hypertension (PH) in COPD patients. The desaturation-distance ratio (DDR) is an index derived from the distance traveled and level of desaturation during a six-minute walk test (6MWT); it has previously been shown to be associated with percentage of forced expiratory volume in the first second of expiration (%FEV1.0) and percentage of diffusion capacity of the lung for carbon monoxide (%DLCO). The aim of this study was to examine the associations between DDR and emphysema and PH...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28919244/does-synaesthesia-age-changes-in-the-quality-and-consistency-of-synaesthetic-associations
#11
Julia Simner, Alberta Ipser, Rebecca Smees, James Alvarez
Developmental grapheme-colour synaesthesia is a rare condition in which colours become automatically paired with letters or digits in the minds of certain individuals during childhood, and remain paired into adulthood. Although synaesthesia is well understood in younger adults almost nothing is known about synaesthesia in aging. We present the first evidence that aging desaturates synaesthetic colours in the minds of older synaesthetes, and we show for the first time that aging affects the key diagnostic measure of synaesthesia (consistency of colours over time)...
September 14, 2017: Neuropsychologia
https://www.readbyqxmd.com/read/28912057/apnoeic-oxygenation-during-intubation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#12
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Anthony Hodge, Thomas Ryan, Leigh D White
Hypoxaemia increases the risk of cardiac arrest and mortality during intubation. The reduced physiological reserve and reduced efficacy of pre-oxygenation in intensive care patients makes their intubation particularly dangerous. Apnoeic oxygenation is a promising means of preventing hypoxaemia in this setting. We sought to ascertain whether apnoeic oxygenation reduces the incidence of hypoxaemia when used during endotracheal intubation in the intensive care unit (ICU). A systematic review of five databases for all relevant studies published up to November 2016 was performed...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28910915/-assessment-of-sleep-disordered-breathing-using-hypoxia-index
#13
Y X Du, Y M Zeng, Z B Zhou, L M Huang
Objective: To analyze the clinical significance of hypoxia index (HI) in assessing the severity of hypoxemia in obstructive sleep apnoea hypopnea syndrome(OSAHS). Methods: A total of 127 patients with a complaint of snoring visiting our hospital were recruited from February 2014 to January 2016. All patients received polysomnography (PSG) test. The PSG results were analyzed by a technician and the SpO(2) data were analyzed by a pre-designed computer software. The patients were grouped according to apnea hypopnea index (AHI) and lowest oxygen saturation (LSpO(2)) respectively...
September 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28904271/frequent-oxygen-desaturation-during-sleep-on-the-day-of-bronchoscopy-evaluated-by-continuous-pulse-oximeter-monitoring
#14
Yasuo Chojin, Hiroshi Ishimoto, Shingo Noguchi, Toshinori Kawanami, Tatsuji Kato, Hiroshi Mukae, Kazuhiro Yatera
To perform a bronchoscopy safely, it is very important to make a risk assessment before and after the procedure. There have been no reports of hypoxemia during sleep on the day after a bronchoscopic examination; therefore, we evaluated the oxygen saturation status during sleep on the days before and after bronchoscopy. Thirty patients that underwent bronchoscopy were studied. Continuous pulse oximetry monitoring was performed on the day before bronchoscopy and the day when the bronchoscopy was performed. The average oxygen saturation levels and the oxygen desaturation index (ODI) were evaluated...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28899537/severity-of-individual-obstruction-events-increases-with-age-in-patients-with-obstructive-sleep-apnea
#15
Timo Leppänen, Juha Töyräs, Esa Mervaala, Thomas Penzel, Antti Kulkas
BACKGROUND: Age is a risk factor of obstructive sleep apnea (OSA). It has been shown that OSA progresses over time, although conflicting results have been reported. However, the effect of age on the severity of OSA and individual obstruction events has not been investigated within different OSA severity categories by taking the most prominent confounding factors (i.e., body mass index, gender, smoking, daytime sleepiness, snoring, hypertension, heart failure, and proportion of supine sleep) into account...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28899526/association-between-severity-of-untreated-sleep-apnoea-and-postoperative-complications-following-major-cardiac-surgery-a-prospective-observational-cohort-study
#16
Martina Mason, Jules Hernández Sánchez, Alain Vuylsteke, Ian Smith
OBJECTIVE: To examine whether untreated sleep apnoea is associated with prolonged Intensive Care Unit (ICU) stay and increased frequency of postoperative ICU complications, in patients undergoing major cardiac surgery. PATIENTS/METHODS: Adult patients, undergoing elective coronary artery bypass grafting with or without cardiac valve surgery, between March 2013 and July 2014, were considered. We excluded patients participating in other interventional studies, those who had a tracheostomy before surgery, required emergency surgery or were due to be admitted on the day of surgery...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28895149/efficacy-of-dexmedetomidine-for-perioperative-morbidities-in-pediatric-tonsillectomy-a-metaanalysis
#17
REVIEW
Hye Kyung Cho, Ho Young Yoon, Ho Jun Jin, Se Hwan Hwang
OBJECTIVES: This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children. DATA SOURCE: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017. REVIEW METHODS: Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28891836/feasibility-and-safety-of-flexible-bronchoscopy-performed-via-tracheal-tubes-in-patients-with-tracheostomies-a-retrospective-single-center-experience
#18
Gustavo Ferrer, Chi Chan Lee, Sameer Shaharyar, Osman Perez, Molly Moor, Frank Gomez, Fanny Tse, Hamid Feiz, Mauricio Danckers
BACKGROUND: Flexible bronchoscopy (FB) is commonly performed to assess, diagnose, and treat patients with respiratory disease, and is typically performed via transnasal or transoral approaches. FB can be performed via tracheal tubes in patients with tracheostomies; however, the safety and technical feasibility has not been established. The present study evaluates the safety and feasibility of performing FB via tracheal tubes. MATERIALS AND METHODS: A total of 45 patients underwent 56 procedures involving FB via tracheal tubes at a single institution from November 2013 to November 2014 and were included in this retrospective case series...
September 7, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28883203/machine-learning-models-of-post-intubation-hypoxia-during-general-anesthesia
#19
Philipp Sippl, Thomas Ganslandt, Hans-Ulrich Prokosch, Tino Muenster, Dennis Toddenroth
Fine-meshed perioperative measurements are offering enormous potential for automatically investigating clinical complications during general anesthesia. In this study, we employed multiple machine learning methods to model perioperative hypoxia and compare their respective capabilities. After exporting and visualizing 620 series of perioperative vital signs, we had ten anesthesiologists annotate the subjective presence and severity of temporary post-intubation oxygen desaturation. We then applied specific clustering and prediction methods on the acquired annotations, and evaluated their performance in comparison to the inter-rater agreement between experts...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28882741/tracheal-extubation-with-suction-vs-positive-pressure-during-emergence-from-general-anaesthesia-in-adults-a-randomised-controlled-trial
#20
Joël L'Hermite, Olivier Wira, Chritel Castelli, Jean-Emmanuel de La Coussaye, Jacques Ripart, Philippe Cuvillon
BACKGROUND: After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO2 < 92%). METHODS: Sixty-nine patients with a body mass index < 30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group. GA was standardised with propofol and remifentanil via target-controlled infusion...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
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