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Intraoperative awareness

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https://www.readbyqxmd.com/read/28810991/posterior-cruciate-ligament-injuries-associated-with-military-survival-swim-training
#1
Michael S Crowell, John S Mason, Matthew A Posner, Chad A Haley
OBJECTIVES: Posterior cruciate ligament (PCL) injuries are relatively common injuries associated with athletic activities and high-energy trauma. Posterolateral corner (PLC) injuries frequently accompany injury to the PCL. Diagnosis can be challenging and requires a comprehensive history and physical examination. Patients frequently report vague, nonspecific symptoms and the mechanism of injury is often useful in localizing injured structures. Two of the more common mechanisms for PCL injury include a direct blow to the proximal anterior tibia with the knee flexed, as well as a significant knee hyperextension injury...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28793141/factors-associated-with-discordance-between-preoperative-parathyroid-4-dimensional-computed-tomographic-scans-and-intraoperative-findings-during-parathyroidectomy
#2
Shonan Sho, Alexander D Yuen, Michael W Yeh, Masha J Livhits, Ali R Sepahdari
Importance: Parathyroid 4-dimensional computed tomographic scans (4D-CTs) have emerged as an accurate and cost-effective initial localization study for patients with primary hyperparathyroidism. However, potential limitations and factors affecting the accuracy of preoperative 4D-CTs remain poorly defined. Objectives: To characterize factors associated with missed parathyroid lesions on preoperative 4D-CTs and to investigate patterns of commonly observed errors. Design, Setting, and Participants: A prospectively accrued patient database was analyzed from September 1, 2011, through October 31, 2016...
August 9, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28777229/the-modified-rambo-transcanal-approach-for-cochlear-implantation-in-charge-syndrome
#3
Cameron C Wick, Amy M Moore, Daniel E Killeen, Brandon Isaacson
OBJECTIVE: CHARGE syndrome is associated with a variety of temporal bone anomalies and deafness. The lack of surgical landmarks and facial nerve irregularities make cochlear implantation in this population a challenging endeavor. This study aims to describe a safe and efficacious transcanal approach for cochlear implantation that obviates the need to perform a mastoidectomy and facial recess. PATIENTS: Three children with profound hearing loss secondary to CHARGE syndrome...
August 2, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28761524/selective-dorsal-rhizotomy-a-multidisciplinary-approach-to-treating-spastic-diplegia
#4
Hussam Abou Al-Shaar, Muhammad Tariq Imtiaz, Hazem Alhalabi, Shara M Alsubaie, Abdulrahman J Sabbagh
BACKGROUND: Spasticity is a motor disorder that interferes with mobility and affects the quality of life. Different approaches have been utilized to address patients with spastic diplegia, among which is selective dorsal rhizotomy (SDR). Although SDR has been shown to be efficacious in treating spastic patients, many neurologists and neurosurgeons are not well aware of the procedure, its indications, and expected outcomes due to the limited number of centers performing this procedure...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28758184/motor-evoked-potentials-and-bis-guided-anaesthesia-in-image-guided-mini-invasive-neurosurgery-of-supratentorial-tumors-nearby-the-cortico-spinal-tract
#5
Roberto Cordella, Eleonora Orena, Francesco Acerbi, Elena Beretta, Dario Caldiroli, Francesco Dimeco, Carla Carozzi
AIM: to describe and evaluate the anaesthesiological regimen used in neurophysiologically monitored image-guided mini-invasive neurosurgery. MATERIAL AND METHODS: 24 patients underwent elective surgery under general anaesthesia that was administered through Target Controlled Infusion (TCI) for effect-site concentration (Ce) of Propofol and Remifentanil, targeting Bispectral Index (BIS) in the 40-60 intervals. Stimulating intensity of transcranial motor evoked potentials (tMEP), BIS index, Propofol and Remifentanil Ce were collected at MEPs threshold (T) definition (respectively BIS@T, CeProp@T and CeRemi@T)...
June 14, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28753862/validation-of-the-clavien-dindo-grading-system-in-urology-by-the-european-association-of-urology-guidelines-ad-hoc-panel
#6
REVIEW
Dionysios Mitropoulos, Walter Artibani, Chandra Shekhar Biyani, Jørgen Bjerggaard Jensen, Morgan Rouprêt, Michael Truss
CONTEXT: Since 2012 uniformed reporting of complications after urological procedures has been advocated by the European Association of Urology (EAU) guidelines. The Clavien-Dindo grading system was recommended to report the outcomes of urologic procedures. OBJECTIVE: To validate the Clavien-Dindo grading system in urology. DESIGN, SETTING, AND PARTICIPANTS: Members of the EAU working group compiled a list of case scenarios including those with minor and major complications...
March 7, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28735464/radiation-dose-reduction-in-thoracic-and-lumbar-spine-instrumentation-using-navigation-based-on-an-intraoperative-cone-beam-ct-imaging-system-a-prospective-randomized-clinical-trial
#7
Nathalie Pireau, Virginie Cordemans, Xavier Banse, Nadia Irda, Sébastien Lichtherte, Ludovic Kaminski
PURPOSE: Spine surgery still remains a challenge for every spine surgeon, aware of the potential serious outcomes of misplaced instrumentation. Though many studies have highlighted that using intraoperative cone beam CT imaging and navigation systems provides higher accuracy than conventional freehand methods for placement of pedicle screws in spine surgery, few studies are concerned about how to reduce radiation exposure for patients with the use of such technology. One of the main focuses of this study is based on the ALARA principle (as low as reasonably achievable)...
July 22, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28734751/how-many-people-work-in-your-operating-room-an-assessment-of-factors-associated-with-instrument-recounts-within-plastic-surgery
#8
Derek D Reformat, Joshua A David, J Rodrigo Diaz-Siso, Natalie M Plana, Annie Wang, Nicholas D Brownstone, Daniel J Ceradini
BACKGROUND: Intraoperative instrument recounts are performed to avoid retained foreign surgical items. These additional counts, however, beget risks of their own, including prolonged operative times, exposure to radiation, and increased cost. Our study aimed to identify factors that increase the likelihood of instrument recounts during plastic surgery procedures, and use our findings to guide potential solutions for preventing unnecessary recounts across all surgical fields. STUDY DESIGN: This is a retrospective review of all plastic surgical cases in the main operating setting at New York University Langone Medical Center (NYULMC) between March 2014 and February 2015...
June 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28733690/do-obstetric-patients-opt-to-undergo-general-anaesthesia-to-avoid-being-conscious-despite-safer-alternatives
#9
Daryl Ja Tan, Melissa Mh Chan
There are various modes of anaesthesia available in the community today. This gives anaesthesiologists the freedom to select those that are safe, efficacious and most suitable for patients. However, patients may not always agree with their anaesthesiologist on the preferred mode of anaesthesia because they may have a different set of priorities, with many of them electing to have the lack of intraoperative awareness as the primary objective. Hence, disagreements between anaesthesiologists and patients may arise and could potentially disrupt doctor-patient relationship...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28732621/generic-trypan-blue-as-possible-cause-of%C3%A2-a%C3%A2-cluster-of-toxic-anterior-segment-syndrome-cases-after-uneventful-cataract%C3%A2-surgery
#10
Artemis Matsou, Argyrios Tzamalis, Nikolaos Chalvatzis, Asimina Mataftsi, Ioannis Tsinopoulos, Periklis Brazitikos
Five of 16 patients having uneventful cataract surgery over 2 consecutive days presented on the first postoperative day with painless, unexpected blurry vision; marked limbus-to-limbus corneal edema; and severe anterior chamber inflammation with hypopyon and fibrin formation. Review of the records showed the 5 patients had received an intracameral injection of generic trypan blue solution 0.06% to facilitate the capsulorhexis. Patients who had not received the trypan blue injection had an uneventful first-day check and subsequent course...
June 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28699067/intraoperative-clinical-testing-overestimates-the-therapeutic-window-of-the-permanent-dbs-electrode-in-the-subthalamic-nucleus
#11
Josefine Blume, J Schlaier, E Rothenfußer, J Anthofer, F Zeman, A Brawanski, U Bogdahn, M Lange
BACKGROUND: Intraoperative test stimulation is established to optimize target localization in STN DBS, but requires a time-consuming awake surgery in off-medication state. The aim of this study was to compare the thresholds of stimulation-induced effects of test stimulation and the permanent electrode. METHODS: Fifty-nine PD patients receiving bilateral STN DBS were clinically examined with stepwise increasing monopolar stimulation during surgery and DBS programming at matched stimulation depths...
July 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28696881/persistent-left-superior-vena-cava-incidence-and-management-in-patients-undergoing-repair-of-partial-anomalous-pulmonary-venous-connection
#12
Nicholas S Clarke, Raghav A Murthy, Kristine J Guleserian
INTRODUCTION: A association between partial anomalous pulmonary venous connection (PAPVC) and systemic venous anomalies has been described in the literature, but the true incidence is yet to be elucidated. At our institution, we sought to find the incidence of a persistent left superior vena cava (PLSVC) in patients undergoing an operation for PAPVC. METHODS: A retrospective review of all pediatric and adult patients with PAPVC who underwent surgical repair from February 2006 to February 2016...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#13
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28673212/awareness-during-general-anaesthesia-in-the-first-4-000-incidents-reported-to-webairs
#14
K Leslie, M D Culwick, H Reynolds, J A Hannam, A F Merry
The aim of this study was to analyse the incidents related to awareness during general anaesthesia in the first 4,000 cases reported to webAIRS-an anaesthetic incident reporting system established in Australia and New Zealand in 2009. Included incidents were those in which the reporter selected "neurological" as the main category and "awareness/dreaming/nightmares" as a subcategory, those where the narrative report included the word "awareness" and those identified by the authors as possibly relevant to awareness...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28663647/incidence-of-awareness-with-recall-under-general-anesthesia-in-rural-india-an-observational-study
#15
Deepak Singla, Mishu Mangla
CONTEXT: Awareness under anesthesia is a rare but extremely unpleasant phenomenon. There are very few studies in the developing world and none from rural areas where incidence of intraoperative awareness may be higher due to increased patient load, limited patient knowledge and lack of trained hospital staff, reliance on older, cheaper but less effective drugs, and lack of proper equipment both for providing anesthesia, as well as monitoring the patient. AIMS: To assess the incidence of intraoperative awareness during general anesthesia among patients in rural India and any factors associated with the same...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28661726/laparoscopic-findings-associated-with-bladder-endometriosis-are-correlated-with-disease-severity
#16
Jerome Bouaziz, Zohar Dotan, Michal Zajicek, Matityahu Zolti, Howard Carp, Mordechai Goldenberg, Daniel S Seidman, David Soriano
STUDY OBJECTIVE: Bladder involvement is rare in endometriosis. The prevalence is estimated to be ∼1% in patients with endometriosis. However, this figure seems to be an underestimation. The diagnosis of bladder endometriosis might be missed during laparoscopy. The aim of this study was to determine an intraoperative visual score of pelvic lesions that help the surgeon suspect bladder endometriosis. Design, Design Classification: A retrospective analysis was performed on the intraoperative photographs and videos of 69 patients with histological confirmation of bladder endometriosis...
June 29, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28657949/laparoscopic-surgery-for-adhesive-small-bowel-obstruction-is-associated-with-a-higher-risk-of-bowel-injury-a-population-based-analysis-of-8584-patients
#17
Ramy Behman, Avery B Nathens, James P Byrne, Stephanie Mason, Nicole Look Hong, Paul J Karanicolas
OBJECTIVE: We set out to compare the incidence of bowel repair and/or resection in a large cohort of patients with adhesive small bowel obstruction (SBO) managed operatively. BACKGROUND: Laparoscopic lysis of adhesions for adhesive SBO (aSBO) is becoming more common, yet might increase the risk of bowel injury given the distended and/or potentially compromised small bowel. METHODS: We used administrative discharge data derived from a large geographic region, identifying patients who underwent surgery for their first episode of aSBO during 2005 to 2014...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648840/reducing-fluid-related-complications-during-operative-hysteroscopy-use-of-a-new-mandatory-fluid-balance-form
#18
Heli Alexandroni, Raz Bahar, Henry H Chill, Gilad Karavani, Orna Ben-Yossef, Asher Shushan
STUDY OBJECTIVE: To examine whether our new reporting system and mandatory fluid-balance form could improve the communication and awareness within the surgical team and therefore the safety of hysteroscopic operations. DESIGN: A case-control study (Canadian Task Force classification II-2). SETTING: An endoscopic gynecology unit at a tertiary-care university hospital. PATIENTS: Women aged 17 to 88 years (median, 43.9) who underwent operative hysteroscopy to treat uterine pathology...
June 22, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28648410/the-great-unknown-a-systematic-literature-review-about-risk-associated-with-intraoperative-imaging-during-orthopaedic-surgeries
#19
REVIEW
Amir Matityahu, Ryan K Duffy, Sabine Goldhahn, Alexander Joeris, Peter H Richter, Florian Gebhard
INTRODUCTION: Modern techniques in orthopaedic surgery using minimally invasive procedures, and increased use of fluoroscopic imaging present a potential increased risk to surgeons due to ionizing radiation exposure. This article is a systematic review of recent literature on radiation exposure of orthopaedic surgeons. MATERIALS AND METHODS: Pubmed and Cochrane searches were performed on intraoperative radiation exposure covering English and German articles published between 1...
April 21, 2017: Injury
https://www.readbyqxmd.com/read/28647750/misdiagnosed-paranasal-gossypiboma-a-10-year-experience-with-21-cases-at-a-tertiary-center
#20
P Z Wu, W Sun, Y H Wen, R Q Ma, X L Zhu, W P Wen
BACKGROUND: Different from rhinoliths, the paranasal gossypiboma is a foreign body, such as a surgical sponge, left in the nasal cavity. It is a rare, frequently misdiagnosed disease that has rarely been reported. We summarize its clinical characteristics, management, and possible risk factors. METHODOLOGY: We reviewed medical records of confirmed paranasal gossypibomas at a tertiary medical center between 2005 and 2015. Clinical symptoms, age, sex, anatomic sites, endoscopic photography, computed tomography, intraoperative findings, and past medical history were reviewed...
June 25, 2017: Rhinology
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