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Deep anesthesia

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https://www.readbyqxmd.com/read/28230150/an-experimental-study-on-the-impacts-of-inspiratory-and-expiratory-muscles-activities-during-mechanical-ventilation-in-ards-animal-model
#1
Xianming Zhang, Juan Du, Weiliang Wu, Yongcheng Zhu, Ying Jiang, Rongchang Chen
In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs' ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically...
February 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28228109/fms-like-tyrosine-kinase-3-ligand-increases-resistance-to-burn-wound-infection-through-effects-on-plasmacytoid-dendritic-cells
#2
Leon Bae, Julia K Bohannon, Weihua Cui, Monika Vinish, Tracy Toliver-Kinsky
BACKGROUND: Patients experiencing large thermal injuries are susceptible to opportunistic infections that can delay recovery and lead to sepsis. Dendritic cells (DC) are important for the detection of pathogens and activation of the innate and acquired immune responses. DCs are significantly decreased in burn patients early after injury, and the development of sepsis is associated with persistent DC depletion. In a murine model of burn wound infection, the enhancement of DCs after injury by treatment with the DC growth factor Fms-like tyrosine kinase-3 ligand (FL) enhances neutrophil migration to infection, improves bacterial clearance, and increases survival in a DC-dependent manner...
February 22, 2017: BMC Immunology
https://www.readbyqxmd.com/read/28227981/assessment-of-sedation-analgesia-by-means-of-poincare%C3%AC-analysis-of-the-electroencephalogram
#3
Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia, Jose D Bolanos, Montserrat Vallverdu, Pere Caminal, Daniel F Valencia, Xavi Borrat, Pedro L Gambus, Jose F Valencia, Jose D Bolanos, Xavi Borrat, Jose F Valencia, Montserrat Vallverdu, Pere Caminal, Pedro L Gambus, Daniel F Valencia
Monitoring the levels of sedation-analgesia may be helpful for managing patient stress on minimally invasive medical procedures. Monitors based on EEG analysis and designed to assess general anesthesia cannot distinguish reliably between a light and deep sedation. In this work, the Poincaré plot is used as a nonlinear technique applied to EEG signals in order to characterize the levels of sedation-analgesia, according to observed categorical responses that were evaluated by means of Ramsay Sedation Scale (RSS)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#4
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#5
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#6
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205108/water-assisted-colonoscopy
#7
REVIEW
Sergio Cadoni, Felix W Leung
The current review will attempt to describe the important lessons learned from published randomized controlled trials (RCT) comparing water immersion (WI) or water exchange (WE) techniques with gas insufflation colonoscopy. Air insufflation (AI) to distend the colon to permit visualization and passage through the lumen was developed for diagnostic colonoscopy. When screening colonoscopy was adopted, the same AI method was used. Interval cancers, diagnosed within 3 to 5 years after an index screening colonoscopy, appeared to be linked to low adenoma detection rate (ADR)...
February 15, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28203021/-comparision-for-clinical-efficiency-of-continuous-adductor-canal-block-and-femoral-nerve-block-in-total-knee-arthroplasty
#8
M W Zhao, N Wang, L Zeng, M Li, Z K Zhao, H Zhang, H Tian
OBJECTIVE: To compare the pain control efficiency of continuous adductor canal block (ACB) and femoral nerve block (FNB) in total knee arthroplasty. METHODS: From April to September 2016, patients with severe knee osteoarthritis undergoing primary unilateral total knee arthroplasty (TKA) were prospectively observed, and all the patients were randomized received ultrasound-guided continuous ACB or FNB after surgery. Numeric pain rating scales(NPRS)pain scores in rest and activity 2, 6, 12, 24 and 48 h after surgery were collected, and the preoperative and postoperative quadriceps strength at 24 and 48 h were analyzed...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28197775/individual-indicators-of-appropriate-hypnotic-level-during-propofol-anesthesia-highest-alpha-power-and-effect-site-concentrations-of-propofol-at-loss-of-response
#9
Hongling Kang, Hassan Mamdouh Hassan Mohamed, Masaki Takashina, Takahiko Mori, Yuji Fujino, Satoshi Hagihira
BACKGROUND: Electroencephalogram (EEG) waveforms vary widely among individuals, this decreases the usefulness of BIS™ monitors for assessing the effects of propofol. Practically, anesthesia is only seen as too deep when evidence of burst-suppression is seen. We designed an experiment to help towards better assessment of individual anesthetic needs. First, to mark the Ce (effect-site concentration) of propofol at loss of response to calling name and gently shaking shoulders (LOR), we defined Ce-LOR...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28196488/application-of-fluorescein-sodium-in-the-resection-of-vermis-pilocytic-astrocytomas
#10
Ji Zhang, Fuad Al-Nahari, Zi-Feng Wang, Fu-Hua Lin, Yi-Yin Zhao, Shi-Yin Xiao, Jian-Min Liu, Chao Ke, Zheng-He Chen, Yu Jiang, Men Yang, Ke Sai, Jian Wang, Yong-Gao Mou
BACKGROUND: Pilocytic astrocytomas (PAs) are slow growing neoplasms and usually located at the cerebellum. There has been certainty regarding the truthful benefit of surgical resection for patients with PA. Gross total resection (GTR) of PAs, especially those being situated in deep regions, remains a surgical challenge. Generally, they are considered as benign and usually develop in young patients. PAs, belonging to WHO I can be cured by radical resection. The patients with PA have excellent prognosis if complete resection can be conducted...
February 14, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28190371/occupational-radiation-exposure-of-anesthesia-providers
#11
Rachel R Wang, Amanda H Kumar, Pedro Tanaka, Alex Macario
Anesthesia providers are frequently exposed to radiation during routine patient care in the operating room and remote anesthetizing locations. Eighty-two percent of anesthesiology residents (n = 57 responders) at our institution had a "high" or "very high" concern about the level of ionizing radiation exposure, and 94% indicated interest in educational materials about radiation safety. This article highlights key learning points related to basic physical principles, effects of ionizing radiation, radiation exposure measurement, occupational dose limits, considerations during pregnancy, sources of exposure, factors affecting occupational exposure such as positioning and shielding, and monitoring...
February 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#12
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28177176/electroencephalographic-discontinuity-during-sevoflurane-anesthesia-in-infants-and-children
#13
Laura Cornelissen, Ann M Bergin, Kimberly Lobo, Carolina Donado, Janet S Soul, Charles B Berde
BACKGROUND: Deep anesthesia in adults may be associated with electroencephalographic (EEG) suppression and higher rates of postoperative complications. Little is known about the impact of anesthetic depth on short- or long-term outcomes in pediatrics. Brain activity monitoring may complement clinical signs of anesthetic depth. This prospective observational study aimed to assess the frequency and degree of profound EEG suppression using multichannel EEG in children during sevoflurane general anesthesia...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28175443/135%C3%A2-a-comparison-of-outcomes-between-deep-brain-stimulation-under-general-anesthesia-versus-conscious-sedation-with-awake-evaluation
#14
François Alesch, Roshini Jain, Lilly Chen, Thomas Brucke, Fernando Seijo, Esther Suarez San Martin, Claire Haegelen, Marc Verin, Mohammed Maarouf, Michael T Barbe, Steven Gill, Alan Whone, Mauro Porta, Domenico Servello, Lars Timmermann
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
https://www.readbyqxmd.com/read/28151995/increased-hepatic-th2-and-treg-subsets-are-associated-with-biliary-fibrosis-in-different-strains-of-mice-caused-by-clonorchis-sinensis
#15
Bei-Bei Zhang, Chao Yan, Fan Fang, Ying Du, Rui Ma, Xiang-Yang Li, Qian Yu, Di Meng, Ren-Xian Tang, Kui-Yang Zheng
Previous studies showed that CD4+T cells responses might be involved in the process of biliary fibrosis. However, the underlying mechanism resulting in biliary fibrosis caused by Clonorchis sinensis remains not yet fully elucidated. The objectives of the present study were to investigate the different profiles of hepatic CD4+T cell subsets (Th1, Th2, Th17 and Treg cells) and their possible roles in the biliary fibrosis of different strains of mice (C57BL/6, BALB/c and FVB mice) induced by C. sinensis infection...
2017: PloS One
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#16
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149139/can-we-perform-distal-nerve-block-instead-of-brachial-plexus-nerve-block-under-ultrasound-guidance-for-hand-surgery
#17
Ilker Ince, Mehmet Aksoy, Mine Celik
OBJECTIVE: Distal nerve blocks are used in the event of unsuccessful blocks as rescue techniques. The primary purpose of this study was to determine the sufficiency for anesthesia of distal nerve block without the need for deep sedation or general anesthesia. The secondary purpose was to compare block performance times, block onset times, and patient and surgeon satisfaction. MATERIALS AND METHODS: Patients who underwent hand surgery associated with the innervation area of the radial and median nerves were included in the study...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28135163/optimal-anesthetic-regime-for-motionless-three-dimensional-image-acquisition-during-longitudinal-studies-of-adult-nonpigmented-zebrafish
#18
Nicola Lockwood, Jennifer Parker, Carole Wilson, Paul Frankel
With many live imaging techniques, it is crucial that a deep level of anesthesia is reached and maintained throughout image acquisition without reducing zebrafish viability. This is particularly true for three-dimensional tomographic imaging modalities. Currently, the most commonly used anesthetic in the zebrafish community, MS-222 (tricaine methanesulfonate), does not allow this. We show, using a combination of both MS-222 and isoflurane, that we can significantly improve the anesthetic regime required for motionless image acquisition of live adult zebrafish...
January 30, 2017: Zebrafish
https://www.readbyqxmd.com/read/28130066/timing-affects-measurement-of-portal-pressure-gradient-after-placement-of-transjugular-intrahepatic-porto-systemic-shunts-in-patients-with-portal-hypertension
#19
Gilberto Silva-Junior, Fanny Turon, Anna Baiges, Eira Cerda, Ángeles García-Criado, Annabel Blasi, Ferran Torres, Virginia Hernandez-Gea, Jaume Bosch, Juan Carlos Garcia-Pagan
BACKGROUND & AIMS: A reduction in portal pressure gradient (PPG) to below 12 mmHg after placement of a transjugular intrahepatic porto-systemic shunt (TIPS) correlates with the absence of further bleeding or ascites at follow-up examinations of patients with cirrhosis. The PPG is usually measured immediately after placement of the TIPS, when different circumstances can affect PPG values - this could affect determination of risk for decompensation. We investigated variations in PPG measurements collected at different time points after TIPS, aiming to identify a time point after which PPG values were best maintained...
January 24, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28128087/direct-insertion-of-muscle-fibers-is-not-restricted-to-facial-skin
#20
Uwe Wollina
Facial musculature is divided into masticatory muscles, i.e. M. masseter and M. buccalis, with bony insertions and smaller facial muscles involved in facial expression, which insert into bone and skin. There are four fixed osteocutaneous points of the face, i.e. zygomatic (Mac Gregor), mandibular (Furnas), orbital (Psillakis), and masseteric with an antigravitational effect and functional role in facial expression (1,2). In other body parts, the direct insertion of muscle fibers into skin has not been reported...
December 2016: Acta Dermatovenerologica Croatica: ADC
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