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https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#1
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28815834/innervation-of-the-human-posterior-cricoarytenoid-muscle-by-the-external-branch-of-the-superior-laryngeal-nerve
#2
Mehmet Uludag, Nurcihan Aygun, Kinyas Kartal, Evren Besler, Adnan Isgor
BACKGROUND: The posterior cricoarytenoid muscle is the abductor muscle for the vocal cords and is innerved by the recurrent laryngeal nerve (RLN). The purpose of this study was to present our determination if the external branch of the superior laryngeal nerve (SLN) contributes to the motor innervation of the posterior cricoarytenoid muscle. METHODS: We performed electromyographies (EMGs) via needle electrodes on 47 posterior cricoarytenoid muscles from 28 patients during thyroidectomy (9 lobectomies and 19 total thyroidectomies) with intraoperative neural monitoring...
August 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/28806222/transient-receptor-potential-vanilloid-1-antagonists-prevent-anesthesia-induced-hypothermia-and-decrease-postincisional-opioid-dose-requirements-in-rodents
#3
Andras Garami, Mohab Ibrahim, Kerry Gilbraith, Rajesh Khanna, Eszter Pakai, Alexandra Miko, Erika Pinter, Andrej A Romanovsky, Frank Porreca, Amol M Patwardhan
BACKGROUND: Intraoperative hypothermia and postoperative pain control are two important clinical challenges in anesthesiology. Transient receptor potential vanilloid 1 has been implicated both in thermoregulation and pain. Transient receptor potential vanilloid 1 antagonists were not advanced as analgesics in humans in part due to a side effect of hyperthermia. This study tested the hypothesis that a single, preincision injection of a transient receptor potential vanilloid 1 antagonist could prevent anesthesia-induced hypothermia and decrease the opioid requirement for postsurgical hypersensitivity...
August 14, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28805756/-an-experience-of-neurophysiological-monitoring-in-neurosurgery
#4
A G Vasyatkina, E A Levin, K Yu Orlov, V V Kobozev
AIM: To evaluate the efficacy of neuromonitoring methods in prevention of postoperative neurological complications and estimation of predictive power of intraoperative changes in monitored characteristics. MATERIAL AND METHODS: Retrospective study examined 240 patients, operated in the years 2014-2015 using intraoperative neurophysiological monitoring. One hundred and seventy-three patients suffered from hemispheric lesions and 67 had lesions located in or near the brainstem...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28803174/intraoperative-vascular-neuromonitoring-in-patients-with-subarachnoid-hemorrhage-a-pilot-study-using-combined-laser-doppler-spectrophotometry
#5
Emilija Schmitz, Barbara Bischoff, Dennis Wolf, Hubert Schmitt, Ilker Y Eyupoglu, Karl Roessler, Michael Buchfelder, Björn Sommer
OBJECTIVE: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurological outcome. In this pilot study, we examined the value of a novel non-invasive real-time measurement technique to detect changes in local microcirculation. METHODS: We used the laser-Doppler spectrophotometry system "Oxygen-to-see(O2C)" in 14 patients with SAH Hunt & Hess grade 2 to 5, who underwent microsurgical clipping of cerebral aneurysms...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28802148/inattentional-blindness-in-anesthesiology-a-simulation-study
#6
Anthony M-H Ho, Joseph Y C Leung, Glenio B Mizubuti, Leeanne H Contardi, Matthew T V Chan, Thomas S F Lo, Alex K T Lee
STUDY OBJECTIVES: Inattentional blindness is the psychological phenomenon of inability to see the unexpected even if it is in plain view. We hypothesized that anesthesiologists may overlook unexpected intraoperative events whereas medical students, lacking in intraoperative monitoring experience and knowledge, may be more likely to notice such events. DESIGN: A simulation study using a video of a simulated septic patient undergoing abdominal surgery. SETTING: A large academic center...
August 9, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28800981/near-infrared-spectroscopy-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#7
Matthew J Chan, Tricia Chung, Neil J Glassford, Rinaldo Bellomo
OBJECTIVES: To identify the normal baseline preoperative range of cerebral tissue oxygen saturation (SctO2) derived using near-infrared spectroscopy (NIRS) and the efficacy of perioperative interventions designed to modulate SctO2 in cardiac surgical patients. DESIGN: Systematic review and meta-analysis of relevant randomized controlled trials (RCTs) extracted from the Medline, Embase, and Cochrane Central Register of Controlled Trials databases. SETTING: Hospitals performing cardiac surgery...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800778/effects-of-intraoperative-peep-optimization-on-postoperative-pulmonary-complications-and-the-inflammatory-response-study-protocol-for-a-randomized-controlled-trial
#8
Zoltán Ruszkai, Erika Kiss, Ildikó László, Fanni Gyura, Erika Surány, Péter Töhötöm Bartha, Gergely Péter Bokrétás, Edit Rácz, István Buzogány, Zoltán Bajory, Erzsébet Hajdú, Zsolt Molnár
BACKGROUND: Patients undergoing general anesthesia and mechanical ventilation during major abdominal surgery commonly develop pulmonary atelectasis and/or hyperdistention of the lungs. Recent studies show benefits of lung-protective mechanical ventilation with the use of low tidal volumes, a moderate level of positive end-expiratory pressure (PEEP) and regular alveolar recruitment maneuvers during general anesthesia, even in patients with healthy lungs. The purpose of this clinical trial is to evaluate the effects of intraoperative lung-protective mechanical ventilation, using individualized PEEP values, on postoperative pulmonary complications and the inflammatory response...
August 11, 2017: Trials
https://www.readbyqxmd.com/read/28800725/a-novel-thermal-compression-device-for-perioperative-warming-a-randomized-trial-for-feasibility-and-efficacy
#9
Peter Luke Santa Maria, Chloe Santa Maria, Andreas Eisenried, Nathalia Velasquez, Brian Thomas Kannard, Abhinav Ramani, David Mark Kahn, Amanda Jane Wheeler, John Gerhard Brock-Utne
BACKGROUND: Inadvertent perioperative hypothermia (IPH) leads to surgical complications and increases length of stay. IPH rates are high with the current standard of care, forced air warming (FAW). Our hypothesis is that a prototype thermal compression device that heats the popliteal fossa and soles of the feet, with lower leg compression, increases perioperative temperatures and reduces IPH compared to the current standard of care. METHODS: Thirty six female breast surgery patients, at a tertiary academic hospital, were randomized to the device or intraoperative FAW (stage I) with a further 18 patients randomized to the device with a single heating area only (stage II, popliteal fossa or sole of the feet)...
August 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28795523/a-limited-evaluation-of-the-association-of-race-and-anesthetic-medication-administration-a-single-center-experience-with-appendectomies
#10
Julia M Rosenbloom, Kumaran Senthil, Alexander S Long, Whitney R Robinson, Kenneth N Peeples, John E Fiadjoe, Ronald S Litman
BACKGROUND: Although it is known that a patient's race may influence their medical care, racial patterns of medication administration in pediatric anesthesia have not been well-studied. The aim of this study was to determine if differences exist between Black and White children with regard to administration of anesthetic and analgesic medications for a single procedure at our institution. METHODS: We conducted a retrospective review of medications administered to patients for emergency appendectomies at a large academic children's hospital from 2010 to 2015...
August 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28794587/predictive-factors-for-fever-and-sepsis-following-percutaneous-nephrolithotomy-a-review-of-580-patients
#11
Sumit Suresh Bansal, Prakash Wamanrao Pawar, Ajit S Sawant, Ashwin Sunil Tamhankar, Sunil Raghunath Patil, Gaurav Vinod Kasat
AIMS: There has been much speculation and discussion about the infective complications of percutaneous nephrolithotomy (PCNL). While fever is common after PCNL, the incidence of it progressing to urosepsis is fortunately less. Which patient undergoing PCNL is at risk of developing urosepsis and in whom aggressive treatment of fever postoperatively may prevent the progression to severe sepsis becomes a very important question. This study aims to answer these vital questions. SETTINGS AND DESIGN: This is a single institutional, retrospective study over a period of 3 years...
July 2017: Urology Annals
https://www.readbyqxmd.com/read/28794525/utility-of-non-invasive-haemoglobin-monitoring-in-oncosurgery-patients
#12
Namrata Gupta, Anita Kulkarni, A K Bhargava, Aditya Prakash, Nitika Gupta
BACKGROUND AND AIMS: Oncosurgeries may incur massive blood loss demanding frequent blood sampling to assess blood loss and the need for intraoperative blood transfusions. Accuracy of non-invasive spectrophotometric haemoglobin (hereafter to be referred as SpHb) monitoring has been studied in various perioperative settings. The intraoperative use of Radical-7(®), Masimo Corp., (Radical-7(®)) for SpHb monitoring may be useful during cancer surgery. The aim of this study is to evaluate the intraoperative utility of SpHb monitoring by the Radical-7(®) to guide intraoperative transfusion in oncosurgeries...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28790271/-chronic-kidney-disease-tips-and-pitfall-of-perioperative-management
#13
Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi
Chronic kidney disease(CKD) is an important risk factor of open heart surgery. In addition, worsening of kidney function after the surgery leads to poor prognosis long-term. It is therefore crucial to protect the kidney function by intensive perioperative management in open heart surgery. In the patients having stage 3-4 CKD, mean arterial pressure needs to be higher than 70 mmHg and cardiac index needs to be greater than 2.4 intraoperatively and postoperatively. Continuous right heart monitoring by Swan-Ganz catheter is useful for this purpose...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28790251/-resection-of-a-posterior-mediastinal-tumor-using-intraoperative-motor-evoked-potential-monitoring-report-of-a-case
#14
Motoaki Yasukawa, Tsunenori Takatani, Masahiko Kawaguchi, Takeshi Kawaguchi, Norikazu Kawai, Takashi Tojo, Shigeki Taniguchi
A 20-year-old man with a posterior mediastinal tumor incidentally found on a chest X-ray was referred to our hospital. Chest computed tomography showed a 3 cm nodule located on the left side of the 10-11th thoracic vertebra, where the artery of Adamkiewicz is presumed to arise. He underwent left thoracotomy to remove the lesion. The tumor was safely resected with the assistance of intraoperative motor evoked potential(MEP) monitoring. The postoperative diagnosis was a benign schwannoma. In thoracic surgery for posterior mediastinal tumors, intraoperative MEP monitoring is useful for preventing paraplegia...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28789661/reference-free-determination-of-tissue-absorption-coefficient-by-modulation-transfer-function-characterization-in-spatial-frequency-domain
#15
Weiting Chen, Huijuan Zhao, Tongxin Li, Panpan Yan, Kuanxin Zhao, Caixia Qi, Feng Gao
BACKGROUND: Spatial frequency domain (SFD) measurement allows rapid and non-contact wide-field imaging of the tissue optical properties, thus has become a potential tool for assessing physiological parameters and therapeutic responses during photodynamic therapy of skin diseases. The conventional SFD measurement requires a reference measurement within the same experimental scenario as that for a test one to calibrate mismatch between the real measurements and the model predictions. Due to the individual physical and geometrical differences among different tissues, organs and patients, an ideal reference measurement might be unavailable in clinical trials...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28782747/laparoscopic-surgery-for-solitary-insulinoma-in-the-absence-of-ious
#16
Abhay Narendra Dalvi, Mahadeo Namdeo Garale, Yogesh Prabhakar Takalkar, Sameer Ashok Rege, Pinky Manoharlal Thapar, Lila Anurag, Nalini Samir Shah
BACKGROUND: Insulinomas are the most common pancreatic neuroendocrine neoplasms. In spite of adequate pre-operative localisation, conventional surgical methods rely on intraoperative palpation. Intraoperative ultrasonography (IOUS) is said to aid in accurate localisation, decreases morbidity. Laparoscopic removal of pancreatic endocrine neoplasms is beneficial due to magnification and minimal invasion; however, in the absence of IOUS, error of judgement may lead to conversion to open surgery, thereby relying on 'palpation method' to localise the tumour...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28781205/psoas-compartment-and-sacral-plexus-block-via-electrostimulation-for-pelvic-limb-amputation-in-dogs
#17
Jonathon M Congdon, Pedro Boscan, Clara S S Goh, Marlis Rezende
OBJECTIVE: To assess the efficacy of psoas compartment and sacral plexus block for pelvic limb amputation in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 16 dogs aged 8±3 years and weighing 35±14 kg (mean±standard deviation). METHODS: Dogs were administered morphine (0.5 mg kg(-1)) and atropine (0.02 mg kg(-1)); anesthesia was induced with propofol and maintained with isoflurane. Regional blocks were performed before surgery in eight dogs with bupivacaine (2...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28781015/incidence-and-risk-factors-for-postoperative-urinary-retention-in-total-hip-arthroplasty-performed-under-spinal-anesthesia
#18
Charles M Lawrie, Alvin C Ong, Victor H Hernandez, Samuel Rosas, Zachary D Post, Fabio R Orozco
BACKGROUND: The objective of this study is to determine the risk factors for postoperative urinary retention (POUR) following total hip arthroplasty (THA) under spinal anesthesia. METHODS: Consecutive patients who underwent a primary THA without preoperative catheterization under spinal anesthesia were identified in a prospectively collected institutional patient database. All patients were monitored postoperatively for urinary retention on the basis of symptoms and the use of bladder ultrasound scans performed by a hospital technician...
July 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28776686/contralateral-r1-and-r2-components-of-the-laryngeal-adductor-reflex-in-humans-under-general-anesthesia
#19
Catherine F Sinclair, Maria J Téllez, Oscar R Tapia, Sedat Ulkatan
OBJECTIVES: To demonstrate that under total intravenous general anesthesia (TIVA), the contralateral R1 (cRI) and contralateral R2 (cR2) components of the laryngeal adductor reflex (LAR) can be reliably elicited; to determine effects of topical anesthesia and inhalational anesthesia on the LAR; and to discuss how this technique may be utilized to continuously monitor the vagus nerve reflex arc. STUDY DESIGN: Case series. METHODS: Vocal fold mucosa was electrically stimulated via endotracheal tube surface-based electrodes to elicit a LAR...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28767471/high-flow-nasal-oxygen-in-patient-with-obstructive-sleep-apnea-undergoing-awake-craniotomy-a-case-report
#20
Jaclyn W M Wong, Amy H S Kong, Sau Yee Lam, Peter Y M Woo
Patients with obstructive sleep apnea are frequently considered unsuitable candidates for awake craniotomy due to anticipated problems with oxygenation, ventilation, and a potentially difficult airway. At present, only a handful of such accounts exist in the literature. Our report describes the novel use of high-flow nasal oxygen therapy for a patient with moderate obstructive sleep apnea who underwent an awake craniotomy under deep sedation. The intraoperative application of high-flow nasal oxygen therapy achieved satisfactory oxygenation, maintained the partial carbon dioxide pressure within a reasonable range even during periods of deep sedation, permitted responsive patient monitoring during mapping, and provided excellent patient and surgeon satisfaction...
August 1, 2017: A & A Case Reports
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