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Intraoperative awareness

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https://www.readbyqxmd.com/read/28528047/sclerosing-aortic-and-coronary-arteritis-due-to-igg4-related-disease
#1
Mikael Barbu, Ulf Lindström, Claes Nordborg, Andreas Martinsson, Christian Dworeck, Anders Jeppsson
We present the case of a 55-year-old woman admitted for a coronary artery bypass operation because of three-vessel coronary artery disease based on angiographic findings and clinical symptoms. Unexpected intraoperative findings with diffuse tissue thickening of the ascending aorta and coronary arteries indicated an alternate pathogenesis rather than coronary artery atherosclerosis. Histopathologic findings and clinical evaluation could confirm IgG4-related disease (IgG4-RD). IgG4-RD is a newly recognized fibroinflammatory condition that can present in a variety of organs and is characterized by common histopathologic features...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#2
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28521354/surgical-microanatomy-of-the-posterior-condylar-emissary-vein-and-its-anatomical-variations-for-the-transcondylar-fossa-approach
#3
Nakao Ota, Rokuya Tanikawa, Tsutomu Yoshikane, Masataka Miyama, Takanori Miyazaki, Yu Kinoshita, Hidetoshi Matsukawa, Takeshi Yanagisawa, Fumihiro Sakakibara, Go Suzuki, Norihiro Saito, Shiro Miyata, Kosumo Noda, Toshiyuki Tsuboi, Rihei Takeda, Hiroyasu Kamiyama, Sadahisa Tokuda, Kyousuke Kamada
BACKGROUND: It is essential to identify and be aware of the anatomy of the posterior condylar emissary vein (PCEV) for achieving an adequate operative field for the transcondylar fossa approach (TCFA). OBJECTIVE: To describe the variations in the drainage patterns of PCEVs and the technical issues encountered in such cases. METHODS: This was a retrospective analysis of the anatomy of PCEVs in 104 sides in 52 cases treated by the TCFA. Preoperative findings of multidetector-row computed tomography (CT) and CT venography (CTV) were compared with the intraoperative findings...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28499624/acetabular-placement-accuracy-with-the-direct-anterior-approach-freehand-technique
#4
Melissa C Soderquist, Ryan Scully, Anthony S Unger
BACKGROUND: Acetabular cup placement in total hip arthroplasty (THA) has been recognized as an important factor in operative success, and accurate cup placement has been the impetus for novel medical technologies. METHODS: This article examines the cup placement in 955 THAs using a freehand Direct Anterior Approach on a standard operating table. Acetabular anteversion and inclination were determined using the circle theorem. Measurements were divided into safe zone placement determined by Callanan et al as 5°-25° for anteversion and 30°-45° for inclination, as well as by Lewinnek et al as 5°-25° for anteversion and 30°-50° for inclination...
April 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28491202/just-a-mirage-heterotopic-intrauterine-and-twin-ectopic-pregnancy-mimicked-by-mirror-imaging-on-ultrasound
#5
Rimsha Ahmed, Dejan Samardzic, Michael A Santos, Anna Mesina, Jaimie Maines
Heterotopic pregnancies are rare and are usually diagnosed by transvaginal ultrasound. Despite the routine use of sonography in early pregnancy, artifact created by mirror imaging can drastically and erroneously alter medical decision making by interfering with image interpretation. A heterotopic pregnancy with a single intrauterine gestation and twin left adnexal ectopic gestational sacs was observed on ultrasound in a woman presenting with abdominal pain. During laparoscopy, an ectopic pregnancy was not identified, and subsequent intraoperative ultrasound reproduced the heterotopic pregnancy through manipulation of bowel, confirming mirror image artifact...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28486286/practical-aspects-of-posttrauma-reconstruction-with-an-intramedullary-lengthening-nail
#6
Mitchell Bernstein
Limb equalization using the Ilizarov method has evolved and adapted the use of internal lengthening devices. One of the newest devices, termed "PRECICE," is a magnetically controlled telescoping nail. Complications such as pin site infection and skin irritation are eliminated. Despite trauma surgeons' familiarity with intramedullary nailing, the Ilizarov method requires sound knowledge of deformity analysis and awareness of specific complications associated with distraction osteogenesis. This manuscript discusses some of the practical preoperative and intraoperative components of limb lengthening...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28474122/survey-on-current-cognitive-practices-within-the-european-low-grade-glioma-network-towards-a-european-assessment-protocol
#7
Adrià Rofes, Emmanuel Mandonnet, John Godden, Marie Hélène Baron, Henry Colle, Amelie Darlix, Vânia de Aguiar, Hugues Duffau, Guillaume Herbet, Martin Klein, Vincent Lubrano, Juan Martino, Ryan Mathew, Gabriele Miceli, Sylvie Moritz-Gasser, Johan Pallud, Costanza Papagno, Fabien Rech, Erik Robert, Geert-Jan Rutten, Thomas Santarius, Djaina Satoer, Joanna Sierpowska, Anja Smits, Miran Skrap, Giannantonio Spena, Evy Visch, Elke De Witte, Maria Zetterling, Michel Wager
BACKGROUND: The European Low-Grade Glioma network indicated a need to better understand common practices regarding the managing of diffuse low-grade gliomas. This area has experienced great advances in recent years. METHOD: A general survey on the managing of diffuse low-grade gliomas was answered by 21 centres in 11 European countries. Here we focused on specific questions regarding perioperative and intraoperative cognitive assessments. RESULTS: More centres referred to the same speech and language therapist and/or neuropsychologist across all assessments; a core of assessment tools was routinely used across centres; fluency tasks were commonly used in the perioperative stages, and object naming during surgery; tasks that tapped on attention, executive functions, visuospatial awareness, calculation and emotions were sparsely administered; preoperative assessments were performed 1 month or 1 week before surgery; timing for postoperative assessments varied; finally, more centres recommended early rehabilitation, whenever needed...
May 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28472777/anesthetic-dreaming-anesthesia-awareness-and-patient-satisfaction-after-deep-sedation-with-propofol-target-controlled-infusion-a-prospective-cohort-study-of-patients-undergoing-day-case-breast-surgery
#8
Marco Cascella, Roberta Fusco, Domenico Caliendo, Vincenza Granata, Domenico Carbone, Maria Rosaria Muzio, Giuseppe Laurelli, Stefano Greggi, Francesca Falcone, Cira Antonietta Forte, Arturo Cuomo
BACKGROUND: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep...
April 19, 2017: Oncotarget
https://www.readbyqxmd.com/read/28463534/incidence-and-detection-of-meniscal-ramp-lesions-on-magnetic-resonance-imaging-in-patients-with-anterior-cruciate-ligament-reconstruction
#9
Nicholas N DePhillipo, Mark E Cinque, Jorge Chahla, Andrew G Geeslin, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Meniscal ramp lesions have been reported to be present in 9% to 17% of patients undergoing anterior cruciate ligament (ACL) reconstruction. Detection at the time of arthroscopy can be accomplished based on clinical suspicion and careful evaluation. Preoperative assessment via magnetic resonance imaging (MRI) has been reported to have a low sensitivity in identifying meniscal ramp lesions. PURPOSE: To investigate the incidence of meniscal ramp lesions in patients with ACL tears and the sensitivity of preoperative MRI for the detection of ramp lesions...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28461988/endoscopic-extraperitoneal-radical-prostatectomy-an-initial-report-following-the-first-30-cases
#10
Bartłomiej Jakóbczyk, Marek Wrona, Marta Wrona-Lis, Elżbieta Oszukowska, Piotr Lipiński, Mariusz Szewczyk, Marek Lipiński, Waldemar Różański
INTRODUCTION: To present initial observations after the first 30 cases of endoscopic extraperitoneal radical prostatectomy carried out at our department, which so far has had no experience with this surgical procedure. MATERIAL AND METHODS: In the period of 15 months a group of 30 patients with organ confined prostate cancer, underwent endoscopic extraperitoneal radical prostatectomy using Montsouris technique. All procedures were performed by the same team of two urologists and one resident...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28459719/profound-obstructive-hypotension-from-prone-positioning-documented-by-transesophageal-echocardiography-in-patient-with-scoliosis-a-case-report
#11
Arnoley S Abcejo, Juan Diaz Soto, Courtney Castoro, Sarah Armour, Timothy R Long
In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity...
April 28, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28452603/effects-of-music-therapy-under-general-anesthesia-in-patients-undergoing-abdominal-surgery
#12
Mohamed Kahloul, Salah Mhamdi, Mohamed Said Nakhli, Ahmed Nadhir Sfeyhi, Mohamed Azzaza, Ajmi Chaouch, Walid Naija
BACKGROUND: Music therapy, an innovative approach that has proven effectiveness in many medical conditions, seems beneficial also in managing surgical patients. The aim of this study is to evaluate its effects, under general anesthesia, on perioperative patient satisfaction, stress, pain, and awareness. METHODS: This is a prospective, randomized, double-blind study conducted in the operating theatre of visceral surgery at Sahloul Teaching Hospital over a period of 4 months...
December 2017: Libyan Journal of Medicine
https://www.readbyqxmd.com/read/28451496/carotid-artery-injury-in-anterior-cervical-spine-surgery-multicenter-cohort-study-and-literature-review
#13
Roger Härtl, Marjan Alimi, Mohamed Abdelatif Boukebir, Connor D Berlin, Rodrigo Navarro-Ramirez, Paul M Arnold, Michael G Fehlings, Thomas E Mroz, K Daniel Riew
STUDY DESIGN: Retrospective study and literature review. OBJECTIVE: To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. METHODS: We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17 625 patients who went through cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were analyzed...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28448323/hyperkalemia-after-laparoscopic-nephrectomy-in-patients-with-renal-insufficiency-a-case-report
#14
Frank J Penna, Hiep T Nguyen, Constance S Houck
Laparoscopic surgery is an evolving surgical modality in children, which has been applied to increasingly more complex surgeries and patients, including patients with renal insufficiency. These patients are particularly susceptible to the challenges that laparoscopy imposes on their altered physiology, leading to marked electrolyte disturbances, including metabolic acidosis and hyperkalemia. Hyperkalemia has the potential for marked impairment of cardiac conduction. We report 2 cases where significant, potentially lethal hyperkalemia developed during laparoscopic nephrectomy in adolescents with renal insufficiency...
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28441232/atriobronchial-fistula-complicated-by-septic-cerebral-air-emboli-after-pulmonary-vein-ablation
#15
David Velghe, Thomas Apers, Stefanie Devriendt, Ivo Deblier, Bart Hendriks, Rogier Nieuwendijk, Peter Rogiers
OBJECTIVE: To describe a case of an infected atriobronchial fistula as a late complication after pulmonary vein ablation, leading to septic air emboli and requiring urgent cardiac surgery. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. PubMed was searched for relevant literature. DATA SYNTHESIS: Given its high success and low complication rate, pulmonary vein isolation is expected to be increasingly performed worldwide...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422834/feasibility-and-safety-of-emergency-laparoscopic-partial-splenectomy-a-retrospective-analysis
#16
Hongyu Li, Yonggang Wei, Bing Peng, Bo Li, Fei Liu
The increased awareness of asplenia-related life-threatening complications has led to the development of parenchyma sparing splenic resections in past few years. The aim of this study is to retrospectively analyze the feasibility and safety of laparoscopic partial splenectomy (LPS) in selected emergency patients.From January 2013 to December 2015, there were 46 emergency patients, diagnosed with splenic rupture, admitted in our department. Selection criteria for LPS: (1) Preoperative CT scan revealed single pole rupture without spleen pedicle injury; (2) BP>90/60 mm Hg and heart rates <120 bpm; (3) No sigh of multiple organ injury...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28417660/anatomic-characteristics-identification-and-protection-of-the-nonrecurrent-laryngeal-nerve-during-thyroidectomy
#17
Na Qiao, Lin-Feng Wu, Wei Gao, Feng-Zhi Qu, Peng-Yu Duan, Cheng-Liang Cao, Pan-Quan Li, Bei Sun, Gang Wang
Objective We aimed to investigate the anatomical features and variation pattern of the nonrecurrent laryngeal nerve (NRLN), summarize the methods for identifying the NRLN before and during thyroidectomy, and share experiences regarding preventing and treating its injury. Study Design Retrospective case data analysis. Setting First Affiliated Hospital of Harbin Medical University. Subjects and Methods Between January 2002 and May 2016, 7392 patients underwent thyroidectomy in our hospital. Of them, 28 patients with NRLN were identified, and their clinical data were retrospectively analyzed...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416927/cataract-surgery-and-possible-complications-in-patients-with-pseudoexfoliation-syndrome
#18
Gulsum Egemen Erkayhan, Semih Dogan
OBJECTIVE: The aim of this study was to evaluate the demographic characteristics and intraoperative complications of cataract surgery in patients with pseudoexfoliation syndrome (PEX). MATERIALS AND METHODS: Cases of 225 eyes (80 eyes with pseudoexfoliation and 145 eyes without pseudoexfoliation as the control group) that underwent phacoemulsification cataract surgery and IOL implantation at the Silifke State Hospital Ophthalmology Clinic between April 2011 and April 2013 were analysed retrospectively...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28414277/waardenburg-syndrome-an-unusual-indication-of-cochlear-implantation-experienced-in-11-patients
#19
Feda Bayrak, Tolgahan Çatlı, Görkem Atsal, Taşkın Tokat, Levent Olgun
OBJECTIVE: The aim of this study was to present the surgical findings of children with Waardenburg syndrome (WS) and investigate speech development after cochlear implantation in this unique group of patients. MATERIALS AND METHODS: A retrospective chart review of the patients diagnosed with WS and implanted between 1998 and 2015 was performed. Categories of auditory performance (CAP) test were used to assess the auditory skills of these patients. CAP is a nonlinear hierarchical scale used to rate a child's developing auditory abilities...
April 17, 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28402345/mandibular-regional-anatomical-landmarks-and-clinical-implications-for-ridge-augmentation
#20
Istvan A Urban, Alberto Monje, Hom-Lay Wang, Jaime Lozada, Gabor Gerber, Gabor Baksa
Mandibular ridge augmentation via guided bone regeneration in the atrophic mandible is considered one of the most challenging scenarios for implant-supported oral rehabilitation. Uneventful wound healing has clearly demonstrated its impact on the final regenerative outcome. Soft tissue management must be precise and adequate to attain flap-free wound closure. Accordingly, it demands exhaustive insight and expertise to avoid damaging the neighboring structures. The cadaver study described herein discusses the mandibular morphologic landmarks (ie, musculature, vascularization, innervation, and salivary glands) necessary to safely perform regenerative procedures in the atrophic mandibular ridge, such as vertical ridge augmentation and dental implant surgery...
May 2017: International Journal of Periodontics & Restorative Dentistry
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