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https://www.readbyqxmd.com/read/28735132/asleep-robot-assisted-surgery-for-the-implantation-of-subthalamic-electrodes-provides-the-same-clinical-improvement-and-therapeutic-window-as-awake-surgery
#1
Michel Lefranc, Yassine Zouitina, Mélissa Tir, Philippe Merle, Martial Ouendo, Jean-Marc Constans, Olivier Godefroy, Johann Peltier, Pierre Krystkowiak
OBJECTIVE: To study the impact of not performing an awake clinical evaluation during the robot-assisted implantation subthalamic nucleus deep brain stimulation (STN-DBS) electrodes on the stimulation parameters and clinical outcome in patients with Parkinson's disease (PD). METHODS: A total of 23 PD patients underwent robot-assisted surgery for the bilateral implantation of STN-DBS electrodes. Thirteen patients received general anesthesia (GA) and a limited intraoperative evaluation (side effects only), whereas 10 received local anesthesia and a full evaluation...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735131/mini-craniotomy-under-local-anesthesia-for-chronic-subdural-hematoma-an-effective-choice-for-elderly-and-for-patients-in-a-resource-strained-environment
#2
Shaikh Danish Mahmood, Muhammad Waqas, Mirza Z Baig, Aneela Darbar
BACKGROUND: Mini craniotomy for chronic subdural hematoma (CSDH) is associated with lower recurrence rates. However, the procedure is mostly performed under general anesthesia (GA) and therefore frequently requires intensive care unit (ICU) facility, especially in the elderly population. Due to unavailability of ICU beds, and to avoid GA, we started to perform this procedure under local anesthesia (LA). MATERIALS AND METHODS: This was a retrospective medical chart review conducted in the section of Neurosurgery at the Aga Khan Hospital in Karachi, Pakistan...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28734974/the-effects-of-pneumoperitoneum-and-the-steep-trendelenburg-position-on-heart-rate-variability-and-cerebral-oxygenation-during-robotic-sacrocolpopexy
#3
Emad Matanes, Amir Weissman, Aleksandr Rivlin, Roy Lauterbach, Amnon Amit, Zeev Wiener, Lior Lowenstein
STUDY OBJECTIVE: The aim of the current study was to investigate how steep Trendelenburg positioning with pneumoperitoneum modifies brain oxygenation and autonomic nervous system modulation of heart rate variability during robotic sacrocolpopexy. DESIGN: A 5-minute computerized ECG, cerebral O2 saturation (cSO2), systemic O2 saturation (sSO2), heart rate (HR), diastolic blood pressure (BP), systolic BP and end tidal CO2 tension were recorded immediately after anesthesia induction (baseline phase) and after alterations in positioning and in intra-abdominal pressure...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28734773/epico-4-0-total-quality-in-the-management-of-invasive-candidiasis-in-critically-ill-patients-by-analysing-the-integrated-process
#4
Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Emilio Maseda, Alejandro Rodríguez, Santiago Grau, Guillermo Quindós
BACKGROUND: A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. AIMS: To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis...
July 19, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28733939/comparison-of-endotracheal-tube-cuff-pressure-values-before-and-after-training-seminar
#5
Ayça Tuba Dumanlı Özcan, Cihan Döğer, Abdülkadir But, Işık Kutlu, Şemsi Mustafa Aksoy
It is recommended that endotracheal cuff (ETTc) pressure be between 20 and 30 cm H2O. In this present study, we intend to observe average cuff pressure values in our clinic and the change in these values after the training seminar. The cuff pressure values of 200 patients intubated following general anesthesia induction in the operating theatre were measured following intubation. One hundred patients whose values were measured before the training seminar held for all physician assistants, and 100 patients whose values were measured after the training seminar were regarded as Group 1 and Group 2, respectively...
July 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28733841/analgosedation-of-adult-patients-with-elevated-intracranial-pressure-survey-of-current-clinical-practice-in-austria
#6
Guenther Herzer, Claudia Mirth, Udo M Illievich, Wolfgang G Voelckel, Helmut Trimmel
BACKGROUND: Analgesia and sedation are key items in intensive care. Recently published S3 guidelines specifically address treatment of patients with elevated intracranial pressure. METHODS: The Austrian Society of Anesthesiology, Resuscitation and Intensive Care Medicine carried out an online survey of neurointensive care units in Austria in order to evaluate the current state of practice in the areas of analgosedation and delirium management in this high-risk patient group...
July 21, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#7
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
July 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28730256/advanced-metastatic-breast-cancer-in-pregnancy-the-imperative-of-physical-breast-examination-in-pregnancy
#8
Anca Angela Simionescu, Claudia Valentina Georgescu, Mirela Corina Ghiluşi, Sabrina Ioana Stoica, Mircea Dragoş Median
Breast cancer is the most frequent cancer diagnosed among women; its association with pregnancy is not encountered. As childbearing age is increasing, the diagnosis of breast cancer associated pregnancy tends to be more often than years ago. Here we report a case of a 37-year-old patient, gravida 7, para 7, diagnosed at 30 weeks gestation with metastatic breast cancer. The patient presented to hospital due to an altered performance status. Obstetrical evaluation was within normal range. A metastatic infiltrating breast cancer poorly differentiated (G3) with satellite skin lesions (T4b), ipsilateral axillary and supraclavicular lymph nodes (N3), lung metastasis bilateral with pleural effusion and hepatic metastasis (M1), were diagnosed...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/28729940/propofol-induced-downregulation-of-nr2b-membrane-translocation-in-hippocampus-and-spatial-memory-deficits-of-neonatal-mice
#9
Yuzhu Wang, Song Han, Ruquan Han, Yue Su, Junfa Li
BACKGROUND: Thousands of infants and children are undergoing anesthesia around the world every day. But impacts of anesthetics on the developing neural system remain unclear yet. Previous evidence showed that anesthesia might affect the developing neural system. Thus, early-life anesthesia becomes a critical issue in clinical pediatric practice. Hence, propofol, a short-acting and widely applied intravenous anesthetic, has been gaining focus upon neonatal anesthesia. METHODS: Fifty-four male C57BL/6J mice were randomly divided into following three groups: group D6 intraperitoneally (i...
July 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28728988/survey-of-hip-fractures-in-japan-recent-trends-in-prevalence-and-treatment
#10
Hiroshi Hagino, Naoto Endo, Atsushi Harada, Jun Iwamoto, Tasuku Mashiba, Satoshi Mori, Seiji Ohtori, Akinori Sakai, Junichi Takada, Tetsuji Yamamoto
BACKGROUND: A nationwide survey of hip fractures by the Japanese Orthopaedic Association (JOA) from 1998 to 2008 found a drastic increase in incidence. The aims of this study were to elucidate the status of hip fractures from 2009 to 2014 and to survey the causes for delayed surgery. METHODS: A tally of all hip fractures that occurred in patients from 2009 to 2014 was conducted in hospitals authorized by the JOA or in clinics with inpatient facilities of the Japanese Clinical Orthopaedic Association (JCOA)...
July 17, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28728750/trigeminocardiac-reflex-during-non-surgical-root-canal-treatment-of-teeth-with-irreversible-pulpitis
#11
James I-Sheng Huang, Hao-Hueng Chang, Chun-Pei Lin, Wan-Chuen Liao, Chia-Tze Kao, Tsui-Hsien Huang
BACKGROUND/PURPOSE: Trigeminocardiac reflex (TCR) is a unique clinical incident of acute change in hemodynamic balance, which may lead to hypotension, bradycardia, and even clinical crisis. Up to date, no study so far considers the impact of non-surgical root canal treatment (NSRCT) of irreversible pulpitis teeth under either local infiltration or block anesthesia on hemodynamic change possibly related to TCR. METHODS: This study enrolled 111 patients with 138 irreversible pulpitis teeth that were treated by two sessions of NSRCT...
July 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28728144/retinal-penetration-of-intravitreally-injected-tissue-plasminogen-activator-a-rat-model-study
#12
Kfir Tal, Assaf Dotan, Yael Nisgav, Mor Dachbash, Orly Gal-Or, Rita Ehrlich, Dan D Gaton, Dov Weinberger, Tami Livnat
PURPOSE: To determine whether intravitreal unconjugated tissue plasminogen activator (tPA) (alteplase) can penetrate the intact neural retina and reach the subretinal space in an experimental model. METHODS: This study was performed in 24 Sprague-Dawley rats aged 12 weeks. Under general anesthesia, the right eye was injected with either 0.75 μg of 3 μL tPA (14 rats; study group) or saline (10 rats, control group) into the vitreous. Animals were euthanized at 3, 24, and 48 h...
July 20, 2017: Ophthalmic Research
https://www.readbyqxmd.com/read/28727995/physician-perceptions-about-living-organ-donation-in-patients-with-amyotrophic-lateral-sclerosis
#13
S Ansari, M B Bromberg, S B Gibson
OBJECTIVES: Patients with Amyotrophic Lateral Sclerosis (ALS) have expressed desire to become living organ donors but are unable to do so with current organ donation policies. Our objective is to assess ALS patient's interest in organ donation, and perceived concerns of this practice by ALS neurologists. PATIENTS AND METHODS: An electronic survey was administered to ALS neurologists across the United States regarding living organ donation in ALS patients prior to respiratory failure...
July 5, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28727581/perioperative-gabapentin-does-not-reduce-postoperative-delirium-in-older-surgical-patients-a-randomized-clinical-trial
#14
Jacqueline M Leung, Laura P Sands, Ningning Chen, Christopher Ames, Sigurd Berven, Kevin Bozic, Shane Burch, Dean Chou, Kenneth Covinsky, Vedat Deviren, Sakura Kinjo, Joel H Kramer, Michael Ries, Bobby Tay, Thomas Vail, Philip Weinstein, Stacey Chang, Gabriela Meckler, Stacey Newman, Tiffany Tsai, Vanessa Voss, Emily Youngblom
BACKGROUND: Postoperative pain and opioid use are associated with postoperative delirium. We designed a single-center, randomized, placebo-controlled, parallel-arm, double-blinded trial to determine whether perioperative administration of gabapentin reduced postoperative delirium after noncardiac surgery. METHODS: Patients were randomly assigned to receive placebo (N = 347) or gabapentin 900 mg (N = 350) administered preoperatively and for the first 3 postoperative days...
July 20, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28725244/optimal-perioperative-anesthesia-management-for-gynecologic-interstitial-brachytherapy
#15
Alison A Nielsen, Tehani A Liyanage, Gary S Leiserowitz, Jyoti Mayadev
PURPOSE: To propose an optimal perioperative pain management clinical care pathway for interstitial brachytherapy for gynecologic cancer based on our interdepartmental experience. MATERIAL AND METHODS: We conducted a retrospective review of 23 women who underwent 32 interstitial brachytherapy procedures for gynecological cancers, analyzing patient demographics, type of anesthetic, medications, postoperative pain scores, adverse events, and delays in discharge. We measured the association of postoperative nausea and/or vomiting (PONV) with hydromorphone use, and postoperative pain scores and total narcotic administration with type of anesthesia...
June 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28724492/evaluation-of-pain-assessment-techniques-and-analgesia-efficacy-in-a-female-guinea-pig-cavia-porcellus-model-of-surgical-pain
#16
Vanessa L Oliver, Stephanie Athavale, Katherine E Simon, Lon V Kendall, Jean A Nemzek, Jennifer L Lofgren
Guinea pigs (Cavia porcellus) are a frequently used species in research, often involving potentially painful procedures. Therefore, evidence-based recommendations regarding analgesia are critically needed to optimize their wellbeing. Our laboratory examined the efficacy of carprofen and extended-release (ER) buprenorphine, alone and as a multimodal combination, for relieving postsurgical pain in guinea pigs. Animals were assessed by using evoked (mechanical hypersensitivity), nonevoked (video ethogram, cageside ethogram, time-to-consumption test), and clinical (weight loss) measurements for 96 h during baseline, anesthesia-analgesia, and hysterectomy conditions...
July 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28723837/minimum-effective-volume-of-lidocaine-for-ultrasound-guided-costoclavicular-block
#17
Thitipan Sotthisopha, Maria Francisca Elgueta, Artid Samerchua, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Aida Gordon, Roderick J Finlayson, De Q Tran
BACKGROUND AND OBJECTIVES: This dose-finding study aimed to determine the minimum effective volume in 90% of patients (MEV90) of lidocaine 1.5% with epinephrine 5 μg/mL for ultrasound-guided costoclavicular block. METHODS: Using an in-plane technique and a lateral-to-medial direction, the block needle was positioned in the middle of the 3 cords of the brachial plexus in the costoclavicular space. The entire volume of lidocaine was deposited in this location. Dose assignment was carried out using a biased-coin-design up-and-down sequential method, where the total volume of local anesthetic administered to each patient depended on the response of the previous one...
July 19, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28723831/effect-of-intrathecal-bupivacaine-dose-on-the-success-of-external-cephalic-version-for-breech-presentation-a-prospective-randomized-blinded-clinical-trial
#18
Laurie A Chalifoux, Jeanette R Bauchat, Nicole Higgins, Paloma Toledo, Feyce M Peralta, Jason Farrer, Susan E Gerber, Robert J McCarthy, John T Sullivan
BACKGROUND: Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose-response effect. We hypothesized that increasing the intrathecal bupivacaine dose would be associated with increased external cephalic version success...
July 19, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#19
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723732/role-of-anesthesia-in-endovascular-stroke-therapy
#20
Arthur Wang, Apolonia E Abramowicz
PURPOSE OF REVIEW: Recent randomized clinical trials have demonstrated strong efficacy of endovascular therapy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions; in the USA alone, tens of thousands of patients annually may benefit. The impact of the type of anesthesia used during mechanical thrombectomy on patient outcomes remains controversial. This review discusses the current literature on the effects of anesthesia type on patient outcome following endovascular stroke therapy...
July 18, 2017: Current Opinion in Anaesthesiology
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