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https://www.readbyqxmd.com/read/29774793/surgical-considerations-in-interrupted-aortic-arch
#1
Damien J LaPar, Christopher W Baird
Interrupted aortic arch (IAA) is a rare congenital anomaly with several anatomical variants and is often associated with other intracardiac and/or extracardiac congenital anomalies. Historically, associated with high early mortality, outcomes for this anomaly have improved in recent eras with advances in perioperative and anesthesia management and refinements in surgical technique. This review provides a description of surgical anatomy, anatomical classifications, and associated congenital lesions as well as an examination of the perioperative and surgical management of IAA in the contemporary surgical era...
May 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#2
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29771695/scheduling-the-nonoperating-room-anesthesia-suite
#3
Mary E Warner, David P Martin
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed. RECENT FINDINGS: Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29770311/-super-active-surveillance-mri-ultrasound-fusion-biopsy-and-ablation-for-less-invasive-management-of-prostate-cancer
#4
REVIEW
Jonathan B Bloom, Samuel A Gold, Graham R Hale, Kareem N Rayn, Vikram K Sabarwal, Ivane Bakhutashvili, Vladimir Valera, Baris Turkbey, Peter A Pinto, Bradford J Wood
Multiparametric magnetic resonance imaging (mpMRI) of the prostate has allowed clinicians to better visualize and target suspicious lesions during biopsy. Targeted prostate biopsies give a more accurate representation of the true cancer volume and stage so that appropriate treatment or active surveillance can be selected. Advances in technology have led to the development of MRI and ultrasound fusion platforms used for targeted biopsies, monitoring cancer progression, and more recently for the application of focal therapy...
April 2018: Gland Surgery
https://www.readbyqxmd.com/read/29768321/anesthetic-management-of-cesarean-delivery-for-a-parturient-with-wilson-s-disease-a-case-report
#5
Yantong Wan, Xiaoqin Jiang, Xuemei Lin
RATIONALE: Wilson's disease (WD), or hepatolenticular degeneration, is an autosomal recessive disorder with a prevalence of 1:50,000 to 1:100,000 live births. PATIENT CONCERNS: A 26-year-old primipara with WD was admitted to our hospital, due to awaiting delivery. Her main symptoms were slightly higher total bile acid (TBA) and bilateral depressed edema of lower limbs. DIAGNOSIS: She was at 38 weeks and 4 days of gestation with a 15-year history of WD, controlled with penicillamine in the past and replaced by zinc preparations from three months before pregnancy...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29765268/approach-to-the-post-mohs-patient
#6
REVIEW
James F Thornton, Jourdan A Carboy
This article discusses the often unique patient presentations and management challenges of the post Mohs resection surgical patient. This includes social, economic, and health issues. Anesthesia considerations and pre- and postoperative care are also discussed in this article.
May 2018: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/29764007/anesthetic-considerations-during-surgical-intervention-in-woake-s-syndrome-a-case-report
#7
So Ron Choi, Jeong Ho Kim, Kyoung Lin Chae, Seung Cheol Lee, Sang Yoong Park
Woake's syndrome (WS) is a recurrent nasal polyposis, accompanied by broadening of the nose, frontal sinus aplasia, dyscrinia, and bronchiectasis. There has been no previous report on anesthetic management in patients with WS. We describe a case involving a 13-year-old male patient with WS who was scheduled for septorhinoplasty for necrotic ethmoiditis. Anesthesia was induced and maintained with propofol and remifentanil using a target-controlled infusion device. The anesthetic considerations of this rare syndrome and the advantages of an intravenous infusion method over local and volatile anesthesia for these patients are discussed...
May 15, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29763977/transforming-care-to-evidence-based-practice-with-scripted-messages-an-improvement-project-for-pain-management-in-outpatient-surgical-patients
#8
Lanell M Bellury, Karen Mullinax, Judi Mozingo, Berta Dantzler, Nancy McGee
BACKGROUND: Outpatient surgeries are common and most patients experience pain postoperatively requiring nursing attention to pain management. Scripting, recommended for consistent, targeted communication to improve patient satisfaction, has limited evidence to support its use. AIMS: To explore the effect of scripted messages on self-reported pain control and patient satisfaction with care in outpatient surgical patients. METHODS: A retrospective medical record review pre- and postintervention evaluated a pain management scripted message delivered at two time points (preoperatively and postoperatively)...
May 15, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#9
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29759281/measuring-quality-for-individual-anesthesia-clinicians
#10
REVIEW
John Allyn, Craig Curry
A robust quality management system (QMS) will provide value to patients, providers, and hospitals or systems by focusing on system performance. The QMS must remain independent of provider-specific measures used for privileging. Some outcome measures may be used to assess system performance; they must not be used to assess individual provider performance. All anesthesia providers, especially leaders, must be guardians of an organization's safety culture.
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29758372/percutaneous-endoscopic-lumbar-surgery-via-transfacet-approach-for-lumbar-synovial-cyst
#11
Hsuan-Han Wu, Lei Chu, Yong-Jian Zhu, Chun-Yuan Cheng, Chien-Min Chen
BACKGROUND: There are currently no high-quality studies on the optimal therapeutic approach for juxtafacet cyst as treatment guidelines have not been developed. Herein, a novel technique in which using an endoscopic transfacet approach to treat a patient with symptomatic lumbar synovial cyst was presented. . CASE DESCRIPTION: A 87-year-old man presented with severe dull pain in the right anterior thigh had developed. Lumbar magnetic resonance imaging (MRI) revealed disc extrusion over the central canal zone at the L2-3 and L4-L5 level, and an ovoid lesion with a hyperintense center plus a hypointense rim on the T2-weighted image...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#12
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
https://www.readbyqxmd.com/read/29757779/the-perioperative-care-of-the-transgender-patient
#13
Luis Etienne Tollinche, Chasity Burrows Walters, Asa Radix, Michael Long, Larissa Galante, Zil Garner Goldstein, Yvonne Kapinos, Cindy Yeoh
An estimated 25 million people identify as transgender worldwide, approximately 1 million of whom reside in the United States. The increasing visibility and acceptance of transgender people makes it likely that they will present in general surgical settings; therefore, perioperative health care providers must develop the knowledge and skills requisite for the safe management of transgender patients in the perioperative setting. Extant guidelines, such as those published by the World Professional Association for Transgender Health and the University of California San Francisco Center of Excellence for Transgender Health, serve as critical resources to those caring for transgender patients; however, they do not address their unique perioperative needs...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#14
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29756101/a-short-term-analysis-of-surgical-management-of-umbilical-and-paraumbilical-hernia
#15
Varun Arunagiri, Ragumani Padmanabhan, Parimala Mayandi
Objective: Umbilical hernia and paraumbilical hernia are ventral herniae that occur in infants and adults. According to current evidence, mesh repair is the treatment of choice to avoid recurrence. The aim of this study is to analyze the surgical methods, the types of meshes used, and their benefits. Material and Methods: A retrospective analysis of patients diagnosed with umbilical hernia and paraumbilical hernia was performed. The patients' consent was obtained retrospectively...
2018: Turkish Journal of Surgery
https://www.readbyqxmd.com/read/29754394/anesthesia-for-subcutaneous-implantable-cardioverter-defibrillator-implantation-perspectives-from-the-clinical-experience-of-a-us-panel-of-physicians
#16
Michael K Essandoh, George E Mark, Johan D Aasbo, Charles A Joyner, Saumya Sharma, Beningo F Decena, Eric D Bolin, Raul Weiss, Martin C Burke, Timothy R McClernon, Emile G Daoud, Michael R Gold
BACKGROUND AND OBJECTIVE: Worldwide adoption of the subcutaneous implantable cardioverter-defibrillator (S-ICD) for preventing sudden cardiac death continues to increase, as longer-term evidence demonstrating the safety and efficacy of the S-ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S-ICD placement is lacking. This article presents advantages and disadvantages of different peri-procedural sedation and anesthesia options for S-ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia...
May 13, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#17
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29750688/feasibility-of-fully-automated-hypnosis-analgesia-and-fluid-management-using-2-independent-closed-loop-systems-during-major-vascular-surgery-a-pilot-study
#18
Alexandre Joosten, Vincent Jame, Brenton Alexander, Thierry Chazot, Ngai Liu, Maxime Cannesson, Joseph Rinehart, Luc Barvais
Automated titration of intravenous anesthesia and analgesia using processed electroencephalography monitoring is no longer a novel concept. Closed-loop control of fluid administration to provide goal-directed fluid therapy has also been increasingly described. However, simultaneously combining 2 independent closed-loop systems together in patients undergoing major vascular surgery has not been previously detailed. The aim of this pilot study was to evaluate the clinical performance of fully automated hypnosis, analgesia, and fluid management using 2 independent closed-loop controllers in patients undergoing major vascular surgery before implementation within a larger study evaluating true patient outcomes...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29750630/esophageal-atresia-with-tracheoesophageal-fistula-and-gastroesophageal-reflux-in-children-dental-considerations-and-case-report
#19
J Arturo Garrocho-Rangel, Juana M Arvizu-Rivera, Nadia P Campos-Lara, Miguel A Rosales-Berber, Amaury Pozos-Guillén
BACKGROUND: Esophageal Atresia (EA) is defined as the congenital interruption of the continuity of the esophagus. Pediatric patients also have other congenital conditions, such as Tracheo-Esophageal Fistula (TEF). CASE REPORT: A 7-year-old male with TEF referred by a Pediatric Cardiologist, with the principal complaint of "severe and generalized tooth wearing". Considering that the patient was systemically stable, it was decided to perform the oral procedures under local anesthesia and rubber-dam isolation with an antimicrobial prophylaxis regimen...
May 11, 2018: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/29746281/aesthetic-unit-boundary-approach-of-large-fibroadenoma-resection
#20
Chien-Wei Wang, Robyn M Hatley, Kenneth Christian Walters, Walter L Pipkin, Diane Bairas, Jack C Yu
BACKGROUND: Fibroadenomas are the most common benign breast tumors in adolescents. Surgical excision is indicated when the tumor becomes large or symptomatic. Multiple approaches have been described. However, unsightly scars, excess skin, and breast asymmetry are common challenges after tumor resection. The aims of our study were to describe a concentric circumareolar approach combining the round-block technique and geometric principles in the management of large benign breast tumors...
April 30, 2018: Annals of Plastic Surgery
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