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https://www.readbyqxmd.com/read/29331574/a-medicare-cost-analysis-of-mri-versus-ct-based-high-dose-rate-brachytherapy-of-the-cervix-can-mri-based-planning-be-less-costly
#1
Amishi Bajaj, Grant Harmon, John Weaver, Brendan Martin, Michael Mysz, Murat Surucu, John C Roeske, Andre A Konski, William Small, Matthew M Harkenrider
PURPOSE: While some institutions deliver multiple fractions per implant for MRI-based planning, it is common for only one fraction to be delivered per implant with CT-based cervical brachytherapy. The purpose of this study was to compare physician costs, hospital costs, and overall costs for cervical cancer patients treated with either CT-based or MRI-based high-dose-rate (HDR) cervical brachytherapy to determine if MRI-based brachytherapy as described can be financially feasible. METHODS AND MATERIALS: We identified 40 consecutive patients treated with curative intent cervical brachytherapy...
January 10, 2018: Brachytherapy
https://www.readbyqxmd.com/read/29325840/early-comparative-outcomes-of-unicompartmental-and-total-knee-arthroplasty-in-severely-obese-patients
#2
Zachary C Lum, David A Crawford, Adolph V Lombardi, Jason M Hurst, Michael J Morris, Joanne B Adams, Keith R Berend
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) may have advantages over total knee arthroplasty (TKA) in the setting of obesity. There has been no direct comparison between the two cohorts. This study compares outcomes and complications of severely obese patients undergoing medial UKA versus TKA. METHODS: Six hundred and fifty medial UKA and 1300 TKA were performed in patients with BMI >35kg/m2 (mean 41kg/m2) between 2007 and 2012. Pre- and postoperative ROM, Knee Society scores, perioperative factors, complications and reoperations were compared...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29314783/controlling-the-error-on-target-motion-through-real-time-mesh-adaptation-applications-to-deep-brain-stimulation
#3
Huu Phuoc Bui, Satyendra Tomar, Hadrien Courtecuisse, Michel Audette, Stéphane Cotin, Stéphane P A Bordas
An error-controlled mesh refinement procedure for needle insertion simulations is presented. As an example, the procedure is applied for simulations of electrode implantation for Deep Brain Stimulation. We take into account the brain shift phenomena occurring when a craniotomy is performed. We observe that the error in the computation of the displacement and stress fields is localised around the needle tip and the needle shaft during needle insertion simulation. By suitably and adaptively refining the mesh in this region, our approach enables to control, and thus to reduce, the error whilst maintaining a coarser mesh in other parts of the domain...
January 5, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29307097/robotic-inguinal-lymph-node-dissection-for-melanoma-a-novel-approach-to-a-complicated-problem
#4
G Alan Hyde, Nathan L Jung, Alvaro A Valle, Syamal D Bhattacharya, Christopher E Keel
BACKGROUND: Indications for superficial inguinal lymph node (ILN) dissection in melanoma include fine needle aspiration or clinically positive ILN and sentinel lymph nodes (SLN). Open inguinal lymphadenectomy may be complicated by poor wound healing, deep vein thrombosis, and lymphedema. Technical considerations and case series of a novel surgical approach, robotic inguinal lymphadenectomy, are presented. METHODS: This is a case series of four robotic ILN dissections for melanoma at a tertiary care facility...
January 6, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29303138/is-age-a-determinant-for-nausea-and-vomiting-in-disabled-patients-after-dental-treatment-under-sedation
#5
Hüseyin Cihad Turgut, Metin Alkan, Gülay Kip, Mustafa Sancar Ataç, Sevil Kahraman Altundağ, Süleyman Bozkaya, Berrin Işik, Mustafa Arslan
BACKGROUND AND AIM: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. MATERIALS AND METHODS: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents...
November 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29300715/intraoperative-somatosensory-evoked-potential-monitoring-decreases-eeg-burst-suppression-ratio-during-deep-general-anesthesia-erratum
#6
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29300003/effects-of-inhalation-anesthesia-vs-total-intravenous-anesthesia-tiva-vs-spinal-epidural-anesthesia-on-deep-vein-thrombosis-after-total-knee-arthroplasty
#7
Lu-Yang Zhou, Wei Gu, Yun Liu, Zheng-Liang Ma
BACKGROUND The objective of the present study was to evaluate the varying efficacy of general anesthesia (GA), combined spinal-epidural anesthesia (CSEA), and total intravenous anesthesia (TIVA) on the occurrence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). MATERIAL AND METHODS From July 2013 to May 2015, a total of 197 cases of patients who had undergone TKA treatment at either the Drum Tower Hospital or Nanjing General Hospital of Nanjing Military Command were recruited to participate in the study...
January 4, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#8
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29285414/deep-brain-stimulation-for-obsessive-compulsive-disorder-knowledge-and-concerns-among-psychiatrists-psychotherapists-and-patients
#9
Matilda Naesström, Patric Blomstedt, Marwan Hariz, Owe Bodlund
Background: Deep brain stimulation (DBS) is under investigation for severe obsessive-compulsive disorder (OCD) resistant to other therapies. The number of implants worldwide is slowly increasing. Therefore, it is of importance to explore knowledge and concerns of this novel treatment among patients and their psychiatric healthcare contacts. This information is relevant for scientific professionals working with clinical studies for DBS for this indication. Especially, for future study designs and the creation of information targeting healthcare professionals and patients...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29282084/r-100-improves-pulmonary-function-and-systemic-fluid-balance-in-sheep-with-combined-smoke-inhalation-injury-and-pseudomonas-aeruginosa-sepsis
#10
Hiroshi Ito, Erik Malgerud, Sven Asmussen, Ernesto Lopez, Andrew L Salzman, Perenlei Enkhbaatar
BACKGROUND: Septic shock is a major cause of death in intensive care units around the world . The aim of the study was to investigate whether the novel drug R-100 (a superoxide degradation catalyst and nitric oxide donor) improves pulmonary function in a sheep model of septic shock caused by Pseudomonas aeruginosa and smoke inhalation. METHODS: Eleven female sheep were prepared surgically and randomly assigned to a treatment group (n = 5) or a control group (n = 6) after inhalation of cooled cotton smoke and airway instillation of live P...
December 28, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29276137/ketamine-inhibits-ultrasound-stimulation-induced-neuromodulation-by-blocking-cortical-neuron-activity
#11
Sungmin Han, Minkyung Kim, Hyungmin Kim, Hyunjoon Shin, Inchan Youn
Ultrasound (US) can be used to noninvasively stimulate brain activity. However, reproducible motor responses evoked by US are only elicited when the animal is in a light state of anesthesia. The present study investigated the effects of ketamine on US-induced motor responses and cortical neuronal activity. US was applied to the motor cortex of mice, and motor responses were evaluated based on robustness scores. Cortical neuronal activity was observed by fluorescence calcium imaging. US-induced motor responses were inhibited more than 20 min after ketamine injection, and US-triggered Ca2+ transients in cortical neurons were effectively blocked by ketamine...
December 21, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29275235/endovascular-treatment-of-renal-arterial-perforation-after-blunt-trauma-case-report
#12
Kyoung Hoon Lim, Hun Kyu Ryeom, Jinyoung Park
INTRODUCTION: Isolated renal arterial perforation is a rare consequence of blunt abdominal trauma. Meticulous surgical control of retroperitoneal active bleeding is difficult due to oozing of soft connective tissue, the deep position of operative field, and the presence of friable vascular tissue. Therefore, endovascular treatment is often preferred. PRESENTATION OF CASE: An 83-year-old man was transferred to our trauma center due to retroperitoneal active bleeding after a car accident, in which his right upper abdomen struck the steering wheel...
December 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29243470/update-on-current-care-guideline-venous-insufficiency-of-the-lower-limb
#13
(no author information available yet)
Venous insufficiency of the lower limb is a common disease. Diagnosis is based on symptoms, clinical findings and duplex ultrasound. Consideration and planning of invasive treatment cannot be performed without ultrasound. Vast majority of invasive treatments in superficial venous insufficiency can be done by ultrasound-guided endovenous methods with local anesthesia. Thermoablation (laser of radiofrequency) is the first-line treatment. There are promisisng endovenous methods for treatment of deep venous obstruction in selected cases...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29239148/effects-of-closed-loop-intravenous-anesthesia-guided-by-the-bispectral-index-in-adult-patients-on-emergence-delirium-a-randomized-controlled-study
#14
Antonella Cotoia, Lucia Mirabella, Renata Beck, Pompeo Matrella, Valentina Assenzo, Thierry Chazot, Gilda Cinnella, Ngai Liu, Michele Dambrosio
BACKGROUND: Emergence delirium (ED) is an acute change in cognition after general anesthesia (GA) occurring in operative room, recovery room or in postanesthesia care. The automated propofolremifentanil titration by Bispectral index (BIS) (AutoTIVA) avoids period of deep (BIS<40) anesthesia and could potentially decrease the ED. The aim of this study was to evaluate ED in surgical patients under AutoTIVA, manual titration of propofol-remifentanil (ManualTIVA) or volatile BIS-guided GA...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29229347/post-operative-stridor-and-acute-respiratory-failure-after-parkinson-s-disease-deep-brain-stimulator-placement-a-case-report-and-review-of-literature
#15
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson's disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech.. Acute upper airway obstruction is a very rare finding in PD, especially in the perioperative settings...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29206787/outpatient-total-knee-arthroplasty-is-associated-with-higher-risk-of-perioperative-complications
#16
Armin Arshi, Natalie L Leong, Anthony D'Oro, Christopher Wang, Zorica Buser, Jeffrey C Wang, Kristofer J Jones, Frank A Petrigliano, Nelson F SooHoo
BACKGROUND: As concerns regarding health-care expenditure in the U.S. remain at the national forefront, outpatient arthroplasty is an appealing option for carefully selected patient populations. The purpose of this study was to determine the nationwide trends and complication rates associated with outpatient total knee arthroplasty (TKA) in comparison with standard inpatient TKA. METHODS: We performed a retrospective review of the Humana subset of the PearlDiver Patient Record Database to identify patients who had undergone TKA (Current Procedural Terminology [CPT] code 27447) as either outpatients or inpatients from 2007 to 2015...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#17
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29205669/prospective-analysis-of-serious-cardiorespiratory-events-in-children-during-ophthalmic-artery-chemotherapy-for-retinoblastoma-under-a-deep-standardized-anesthesia
#18
Marie-Claire Nghe, Anne Godier, Anoushée Shaffii, Isabelle Leblanc, Hervé Picard, Raphaël Blanc, Livia Lumbroso-Le Rouic, Jean-Michel Devys
BACKGROUND AND OBJECTIVE: Serious adverse cardiorespiratory events complicate super selective ophthalmic artery chemotherapy for retinoblastoma in anesthetized children. Their mechanism remains unclear but may be attributed to an autonomic nervous reflex induced by the catheter close to the ophthalmic artery. Inadequate depth of anesthesia during catheter stimulation might be an aggravating factor. Thus, we tested whether deep general anesthesia reduced the incidence of serious cardiorespiratory events...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29197832/comparison-of-deep-sedation-with-general-anesthesia-in-patients-undergoing-percutaneous-mitral-valve-repair
#19
Johannes Patzelt, Miriam Ulrich, Harry Magunia, Reinhard Sauter, Michal Droppa, Rezo Jorbenadze, Annika S Becker, Tobias Walker, Ralph Stephan von Bardeleben, Christian Grasshoff, Peter Rosenberger, Meinrad Gawaz, Peter Seizer, Harald F Langer
BACKGROUND: Percutaneous edge-to-edge mitral valve repair (PMVR) has become an established treatment option for mitral regurgitation in patients not eligible for surgical repair. Currently, most procedures are performed under general anesthesia (GA). An increasing number of centers, however, are performing the procedure under deep sedation (DS). Here, we compared patients undergoing PMVR with GA or DS. METHODS AND RESULTS: A total of 271 consecutive patients underwent PMVR at our institution between May 2014 and December 2016...
December 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29190336/slow-waves-in-cortical-slices-how-spontaneous-activity-is-shaped-by-laminar-structure
#20
Cristiano Capone, Beatriz Rebollo, Alberto Muñoz, Xavi Illa, Paolo Del Giudice, Maria V Sanchez-Vives, Maurizio Mattia
Cortical slow oscillations (SO) of neural activity spontaneously emerge and propagate during deep sleep and anesthesia and are also expressed in isolated brain slices and cortical slabs. We lack full understanding of how SO integrate the different structural levels underlying local excitability of cell assemblies and their mutual interaction. Here, we focus on ongoing slow waves (SWs) in cortical slices reconstructed from a 16-electrode array designed to probe the neuronal activity at multiple spatial scales...
November 28, 2017: Cerebral Cortex
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