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https://www.readbyqxmd.com/read/29051964/identification-of-quality-improvement-areas-in-pediatric-mri-from-analysis-of-patient-safety-reports
#1
Camilo Jaimes, Diana J Murcia, Karen Miguel, Cathryn DeFuria, Pallavi Sagar, Michael S Gee
BACKGROUND: Analysis of safety reports has been utilized to guide practice improvement efforts in adult magnetic resonance imaging (MRI). Data specific to pediatric MRI could help target areas of improvement in this population. OBJECTIVE: To estimate the incidence of safety reports in pediatric MRI and to determine associated risk factors. MATERIALS AND METHODS: In a retrospective HIPAA-compliant, institutional review board-approved study, a single-institution Radiology Information System was queried to identify MRI studies performed in pediatric patients (0-18 years old) from 1/1/2010 to 12/31/2015...
October 19, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29051898/accuracy-of-the-lever-sign-test-in-the-diagnosis-of-anterior-cruciate-ligament-injuries
#2
Keith A Jarbo, David E Hartigan, Kelly L Scott, Karan A Patel, Anikar Chhabra
BACKGROUND: The lever sign test is a new physical examination tool to diagnose anterior cruciate ligament (ACL) tears. Preliminary results suggest almost 100% sensitivity and specificity to diagnose acute and chronic complete ACL tears and clinically significant partial tears as compared with magnetic resonance imaging (MRI). PURPOSE: To assess the sensitivity and specificity of the lever sign test for the diagnosis of acute ACL injuries, as compared to MRI. We also aimed to determine the accuracy of the lever sign test compared with 3 other tests (anterior drawer, Lachman, and pivot shift) when performed by providers of various training levels, and with the patient awake or under anesthesia...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29050061/-perioperative-anaphylaxia-on-drugs
#3
Wolfgang Pfützner, Hinnerk Wulf
The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29050059/-ambulant-anesthesia-organization-in-medical-practices-and-hospitals
#4
Frank Vescia, Harald Hofer
Legislation, regulations and rules must be complied with when conducting ambulant surgeries and administering ambulant anesthesia. Additionally, there are social welfare legislation and regulations, as well as technical guidelines and standards that must be complied with, for instance, regarding the management of medical products or the disposal of waste and sewage in medical practices. At a country level, many of these regulatory areas are managed differently by each German state, and in some instances management differs significantly from one state to another...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29049230/goniosynechialysis-combined-with-cataract-extraction-for-iridoschisis-a-case-report
#5
Zhipeng You, Yan Qin, Guodong Li, Ke Shi
RATIONALE: Iridoschisis is a rare eye disease. In this case report, we described the examination and diagnosis of a case of iridoschisis accompanied by secondary glaucoma. We also observed the effects of treating the patient with a combination of goniosynechialysis and cataract removal. PATIENT CONCERN: A 67-year-old female patient presented with decreased vision in both eyes. An eye examination indicated that visual acuities (VAs) were 20/100 and light perception in the right and left eyes, respectively...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29049119/a-review-of-opioid-sparing-modalities-in-perioperative-pain-management-methods-to-decrease-opioid-use-postoperatively
#6
Kanupriya Kumar, Meghan A Kirksey, Silvia Duong, Christopher L Wu
There is an epidemic of opioid use, abuse, and misuse in the United States, which results in significant morbidity and mortality. It may be difficult to reduce perioperative opioid use given known acute surgical trauma and resultant pain; however, the discrete and often limited nature of postoperative pain also may make management easier in part by utilizing nonopioid modalities, such as regional anesthesia/analgesia, and multimodal analgesia, which may decrease the need for powerful opioids. This article reviews the relevant literature describing the use of adjunct medications, regional anesthesia and analgesic techniques, and regional block additives in the context of providing adequate pain control while lessening opioid use...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29045961/-effects-of-recent-upper-respiratory-tract-infections-on-incidence-of-the-perioperative-respiratory-adverse-events-in-children-a-prospective-cohort-study
#7
C Q Li, D X Wang, T Cheng, X Y Zheng
OBJECTIVE: To investigate the effects of the recent upper respiratory tract infections (URI) on the incidence of perioperative respiratory adverse events in children scheduled to undergo general anesthesia and elective surgery. METHODS: In the study, 232 children undergoing general anesthesia with laryngeal mask airway (LMA) for elective ophthalmic surgeries at Peking University First Hospital, Beijing, China, from Nov. 1, 2015 to May 10, 2016 were enrolled. On the day of the surgery, the parents of the children were preoperatively asked to fill out a questionnaire regarding the baseline characteristics and medical history of the children, including gender, age, height, weight, history of URI within the last 2 weeks before anesthesia, history of premature, long-term passive smoking exposure, habitual sleep snoring, and history of asthma...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29044014/-anaphylaxis-and-allergic-reactions-during-surgery-and-medical-procedures
#8
Blas J Larrauri, María Gabriela Torre, Eloísa Malbrán, María Cecilia Juri, Diego S Fernández Romero, Alejandro Malbrán
Anaphylaxis during anesthesia is an unpredictable, severe, and rare reaction. It has an incidence of 1/10 000 to 1/20 000 surgeries. In most series, the responsible drugs include neuromuscular blocking agents, latex, or antibiotics. The frequency and etiology of systemic allergic reactions in other medical procedures are largely unknown. The identification of responsible drugs of anaphylaxis is a complex task, requiring testing of all medications and substances used during surgery. We describe our experience in a retrospective study of 15 patients...
2017: Medicina
https://www.readbyqxmd.com/read/29042333/postoperative-intravenous-acetaminophen-for-craniotomy-patients-a-randomized-controlled-trial
#9
Steven Greenberg, Glenn S Murphy, Michael J Avram, Torin Shear, Jessica Benson, Kruti N Parikh, Aashka Patel, Rebecca Newmark, Vimal Patel, Julian Bailes, Joseph W Szokol
OBJECTIVE: To determine whether opioids during the first 24 postoperative hours were significantly altered when receiving intravenous (IV) acetaminophen during that time compared to those receiving placebo (normal saline). METHODS: One hundred forty patients undergoing any craniotomy were randomly assigned to receive either 1g of IV acetaminophen or placebo upon surgical closure, and every six hours thereafter, up to 18 hours postoperatively. Analgesic requirements for the first 24 hours postoperatively were recorded...
October 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29039154/severe-headache-following-ozone-therapy-pneumocephalus
#10
Hüseyin Toman, Uğur Özdemir, Hasan Ali Kiraz, Nurettin Lüleci
Pneumocephalus is defined as air in the cranial cavity. Pneumocephalus can result from inadvertent dural puncture during lumbar epidural anesthesia or epidural steroid injection. Presently described is case of 41-year-old woman who had undergone lumbar disc hernia operation but due to ongoing complaints, was diagnosed as having failed back surgery syndrome. Percutaneous epidural neuroplasty was performed. In the operating room, under sterile conditions and under sedoanalgesia, Racz catheter was inserted in caudal area and guided to epidural area with scope...
July 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/29035894/prevalence-of-potentially-distracting-noncare-activities-and-their-effects-on-vigilance-workload-and-nonroutine-events-during-anesthesia-care
#11
Jason M Slagle, Eric S Porterfield, Amanda N Lorinc, David Afshartous, Matthew S Shotwell, Matthew B Weinger
BACKGROUND: When workload is low, anesthesia providers may perform non-patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on anesthesia workload, vigilance, and the occurrence of nonroutine events. METHODS: In 319 qualifying cases in an academic medical center using a Web-based electronic medical chart, a trained observer recorded video and performed behavioral task analysis...
October 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29033726/ultrasound-guided-multilevel-paravertebral-block-versus-local-anesthesia-for-medical-thoracoscopy
#12
Maha A Abo-Zeid, Mohammad M Elgamal, Asem A Hewidy, Amro A Moawad, Alaa Eldin Adel Elmaddawy
BACKGROUND: Local anesthetic infiltration for medical thoracoscopy has an analgesic properties for short duration. Single injection thoracic paravertebral block (PVB) provides limited analgesia. PURPOSE: Comparison between thoracic PVB performed at two or three levels with local infiltration for anesthetic adequacy in adult medical thoracoscopy as a primary outcome and postthoracoscopic analgesia and pulmonary function as secondary outcomes for adult medical thoracoscopy...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033420/usefulness-of-bronchial-thermoplasty-for-patients-with-a-deteriorating-lung-function-a-report-of-two-cases
#13
Daisuke Minami, Chihiro Ando, Takamasa Nakasuka, Yoshitaka Iwamoto, Ken Sato, Keiichi Fujiwara, Takuo Shibayama, Toshirou Yonei, Toshio Sato
Bronchial thermoplasty is a novel procedure for patients with severe asthma showing a stable lung function. We herein report two cases with a deteriorating lung function. The lung function tended to improve in one case, while the other case discontinued mepolizumab medication after the procedure. Treatment was performed safely under general anesthesia in both cases. The use of bronchial thermoplasty may therefore be useful for the treatment of patients with a deteriorating lung function.
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29030933/technical-success-of-the-ultrasound-guided-supra-inguinal-fascia-iliaca-compartment-block-in-older-children-and-adolescents-for-hip-arthroscopy
#14
Elizabeth Eastburn, Maria A Hernandez, Karen Boretsky
BACKGROUND: Hip arthroscopic surgery is performed on older pediatric patients. Fascia iliaca compartment block has proven efficacy in providing analgesia following hip surgery and can be performed with target location of local anesthetic below or above the inguinal ligament. The reported success of ultrasound-guided infra-inguinal fascia iliaca compartment block is lower when compared to traditional landmark technique, while the reliability of supra-inguinal fascia iliaca compartment block is unreported...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29026330/parecoxib-relieves-pain-and-has-an-opioid-sparing-effect-following-major-gastrointestinal-surgery
#15
Margaret Noyes Essex, Hao Xu, Bruce Parsons, Li Xie, Chunming Li
PURPOSE: Parecoxib provides analgesia following a variety of surgeries, including minor gastrointestinal procedures. To our knowledge, there is no data on parecoxib following major gastrointestinal surgery. This study assessed the efficacy and opioid-sparing effects of parecoxib following major gastrointestinal surgeries. PATIENTS AND METHODS: Patients in this analysis were a subset from a large, randomized, double-blind, placebo-controlled trial of parecoxib following noncardiac surgeries and consisted of those undergoing a variety of major gastrointestinal surgeries via laparotomy...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29017364/can-patients-safely-be-admitted-to-a-ward-after-craniotomy-for-resection-of-intra-axial-brain-tumors
#16
Farhan A Mirza, Catherine Wang, Thomas Pittman
OBJECTIVE: We reviewed the safety of our practice of admitting patients who have undergone a craniotomy for resection of an intra-axial brain tumor to a floor bed instead of an ICU. We also tried to quantify the risk that patients electively admitted to the ICU would develop a problem that could not have been effectively managed on the ward. METHODS: A retrospective chart review was performed of both adult and pediatric patients who underwent craniotomy by the senior author for resection of an intra-axial brain tumor between January 2012 and December 2015...
October 11, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28993991/pocus-in-perioperative-medicine-a-north-american-perspective
#17
Lorenzo De Marchi, Massimiliano Meineri
Ultrasound (US) performed at the point of care has found fertile ground in perioperative medicine. In the hands of anesthesiologists, transesophageal echocardiography (TEE) has become established as a powerful diagnostic and monitoring tool in the perioperative care of cardiac and non-cardiac patients. A number of point-of-care US (POCUS) applications are relevant to perioperative care, including airway, cardiac, lung and gastric US. Although guidelines exist to define the scope of practice for basic and advanced TEE, there remains a lack of such guidelines for perioperative point-of-care ultrasound (POCUS), despite a number of recent calls for action in the academic anesthesia community...
October 9, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28993080/the-effect-of-previous-coronary-artery-revascularization-on-the-adverse-cardiac-events-ninety-days-after-total-joint-arthroplasty
#18
Bin Feng, Jin Lin, Jin Jin, Wenwei Qian, Shiliang Cao, Xisheng Weng
BACKGROUND: Although coronary artery revascularization therapies are effective for treating coronary artery disease (CAD), these patients may be more susceptible to adverse cardiac events during later non-cardiac surgeries. The purpose of this study is to evaluate post-operative 90-day complications of total joint arthroplasty (TJA) in CAD patients with a history of CAD and to study the risk factors for cardiac complications. METHODS: We performed a retrospective analysis of TJA patients between 2005 and 2015 at our institute by summarizing the history of CAD, cardiac revascularization, and cardiac complications within 90 days after the operation...
August 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28991116/incidence-and-operative-factors-associated-with-discretional-postoperative-mechanical-ventilation-after-general-surgery
#19
Juliet J Ray, Meredith Degnan, Krishnamurti A Rao, Jonathan P Meizoso, Charles A Karcutskie, Danielle B Horn, Luis Rodriguez, Richard P Dutton, Carl I Schulman, Roman Dudaryk
BACKGROUND: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28984638/the-future-of-nonoperating-room-anesthesia-in-the-21st-century-emphasis-on-quality-and-safety
#20
Steven D Boggs, Sheila R Barnett, Richard D Urman
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) has grown from an insignificant percentage of total anesthesia cases into a major percentage of anesthesia workload over the past 30 years. This trend evidences no signs of abating. RECENT FINDINGS: With the rapid development of novel interventional techniques in cardiology, radiology, gastroenterology and pulmonary medicine and other areas, the core responsibilities of the anesthesia provider will no longer be confined to delivering care in traditional operating rooms...
October 3, 2017: Current Opinion in Anaesthesiology
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