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https://www.readbyqxmd.com/read/28093358/mapping-the-functional-connectome-traits-of-levels-of-consciousness
#1
Enrico Amico, Daniele Marinazzo, Carol Di Perri, Lizette Heine, Jitka Annen, Charlotte Martial, Mario Dzemidzic, Murielle Kirsch, Vincent Bonhomme, Steven Laureys, Joaquín Goñi
Examining task-free functional connectivity (FC) in the human brain offers insights on how spontaneous integration and segregation of information relate to human cognition, and how this organization may be altered in different conditions, and neurological disorders. This is particularly relevant for patients in disorders of consciousness (DOC) following severe acquired brain damage and coma, one of the most devastating conditions in modern medical care. We present a novel data-driven methodology, connICA, which implements Independent Component Analysis (ICA) for the extraction of robust independent FC patterns (FC-traits) from a set of individual functional connectomes, without imposing any a priori data stratification into groups...
January 13, 2017: NeuroImage
https://www.readbyqxmd.com/read/28073653/rare-lateral-dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-review-of-the-literature
#2
Amir Reza Vosoughi, Pascal F Rippstein
Traumatic lateral dislocations of the first metatarsophalangeal (MTP) joint are very rare. A 44-year-old male was referred after a motorcycle to car accident because of an exposed head of the left first metatarsal through a laceration on the medial aspect of the first MTP joint. Radiographs showed a lateral dislocation of the first MTP joint, with concomitant fractures of the neck of the second metatarsal and the base of the third and fourth metatarsal bones. The dislocation was reduced in the emergency department with the patient under conscious sedation after thorough irrigation...
January 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28072745/safety-and-efficacy-of-chloral-hydrate-for-conscious-sedation-of-infants-in-the-pediatric-cardiovascular-intensive-care-unit
#3
Mei-Lian Chen, Qiang Chen, Fan Xu, Jia-Xin Zhang, Xiao-Ying Su, Xiao-Zhen Tu
This study evaluates the safety and efficacy of chloral hydrate administration for the conscious sedation of infants in the pediatric cardiovascular intensive care unit (PCICU).We conducted a retrospective review of the charts of 165 infants with congenital heart disease who received chloral hydrate in our PCICU between January 2014 and December 2014. Chloral hydrate was administered orally or rectally to infants using doses of 50 mg/kg. We collected and analyzed relevant clinical parameters.The overall length of time to achieve sedation was ranged from 5 to 35 min (10...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28070000/anesthesia-technique-and-outcomes-of-mechanical-thrombectomy-in-patients-with-acute-ischemic-stroke
#4
Kimon Bekelis, Symeon Missios, Todd A MacKenzie, Stavropoula Tjoumakaris, Pascal Jabbour
BACKGROUND AND PURPOSE: The impact of anesthesia technique on the outcomes of mechanical thrombectomy for acute ischemic stroke remains an issue of debate. We investigated the association of general anesthesia with outcomes in patients undergoing mechanical thrombectomy for ischemic stroke. METHODS: We performed a cohort study involving patients undergoing mechanical thrombectomy for ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database...
January 9, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28069540/multi-modal-analysis-of-functional-connectivity-and-cerebral-blood-flow-reveals-shared-and-unique-effects-of-propofol-in-large-scale-brain-networks
#5
Maolin Qiu, Dustin Scheinost, Ramachandran Ramani, R Todd Constable
Anesthesia-induced changes in functional connectivity and cerebral blow flow (CBF) in large-scale brain networks have emerged as key markers of reduced consciousness. However, studies of functional connectivity disagree on which large-scale networks are altered or preserved during anesthesia, making it difficult to find a consensus amount studies. Additionally, pharmacological alterations in CBF could amplify or occlude changes in connectivity due to the shared variance between CBF and connectivity. Here, we used data-driven connectivity methods and multi-modal imaging to investigate shared and unique neural correlates of reduced consciousness for connectivity in large-scale brain networks...
January 6, 2017: NeuroImage
https://www.readbyqxmd.com/read/28068834/design-considerations-of-a-randomized-controlled-trial-of-sedation-level-during-hip-fracture-repair-surgery-a-strategy-to-reduce-the-incidence-of-postoperative-delirium-in-elderly-patients
#6
Tianjing Li, L Susan Wieland, Esther Oh, Karin J Neufeld, Nae-Yuh Wang, Kay Dickersin, Frederick E Sieber
Background Delirium is an acute change in mental status characterized by sudden onset, fluctuating course, inattention, disorganized thinking, and abnormal level of consciousness. The objective of the randomized controlled trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" (STRIDE) is to assess the effectiveness of light versus heavy sedation on delirium and other outcomes in elderly patients undergoing hip fracture repair surgery. Our goal is to describe the design considerations and lessons learned in planning and implementing the STRIDE trial...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28066556/does-the-combination-use-of-two-pain-assessment-tools-have-a-synergistic-effect
#7
EDITORIAL
Takeshi Suzuki
Pain management is a very important aspect in the intensive care unit (ICU), as adequate pain control has been shown to be associated with better clinical outcomes in critically ill patients. A Numerical Rating Scale (NRS) ranging from 0 to 10 (0, no pain; 10, maximum pain), which is based on a patient's self-report, is the gold standard for pain evaluation in patients who can communicate their pain intensity. On the other hand, it is very difficult to evaluate the degree of pain in critically ill patients owing to decreased consciousness level, delirium, and the effect of sedation for mechanical ventilation management...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28060257/drug-induced-sleep-endoscopy-dise-with-target-controlled-infusion-tci-and-bispectral-analysis-in-obstructive-sleep-apnea
#8
Maximilian Traxdorf, Klaus Tschaikowsky, Claudia Scherl, Judith Bauer, Heinrich Iro, Florian Angerer
The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative propofol was combined with real-time monitoring of the depth of sedation using bispectral analysis. In an observational study 57 patients (mean age 44.8 years, ± SD 10.5; mean apnea hypopnea Index (AHI) 30.8/hr, ± SD 21.6, mean BMI 28.2 kg/m(2), ± SD 5.3) underwent cardiorespiratory polysomnography followed by DISE with TCI and bispectral analysis...
December 6, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28024853/inferior-vena-cava-compression-as-a-novel-maneuver-to-detect-patent-foramen-ovale-a%C3%A2-transesophageal-echocardiographic-study
#9
Eiji Yamashita, Tomoyuki Murata, Eri Goto, Takeshi Fujiwara, Takehito Sasaki, Kentaro Minami, Kohki Nakamura, Koji Kumagai, Shigeto Naito, Kazuomi Kario, Shigeru Oshima
BACKGROUND: The Valsalva maneuver, the most sensitive test for patent foramen ovale (PFO) detection, is difficult during transesophageal echocardiography (TEE), especially after sedation. The aim of this study was to compare PFO detection effectiveness between inferior vena cava (IVC) compression and the Valsalva maneuver. METHODS: A total of 293 patients with paroxysmal atrial fibrillation undergoing TEE before initial atrial fibrillation ablation were prospectively enrolled...
December 23, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27993673/propofol-attenuates-low-frequency-fluctuations-of-resting-state-fmri-bold-signal-in-the-anterior-frontal-cortex-upon-loss-of-consciousness
#10
Xiaolin Liu, Kathryn K Lauer, B Douglas Ward, Christopher Roberts, Suyan Liu, Suneeta Gollapudy, Robert Rohloff, William Gross, Guangyu Chen, Zhan Xu, Jeffrey R Binder, Shi-Jiang Li, Anthony G Hudetz
Recent studies indicate that spontaneous low-frequency fluctuations (LFFs) of resting-state functional magnetic resonance imaging (rs-fMRI) blood oxygen level-dependent (BOLD) signals are driven by the slow (<0.1Hz) modulation of ongoing neuronal activity synchronized locally and across remote brain regions. How regional LFFs of the BOLD fMRI signal are altered during anesthetic-induced alteration of consciousness is not well understood. Using rs-fMRI in 15 healthy participants, we show that during administration of propofol to achieve loss of behavioral responsiveness indexing unconsciousness, the fractional amplitude of LFF (fALFF index) was reduced in comparison to wakeful baseline in the anterior frontal regions, temporal pole, hippocampus, parahippocampal gyrus, and amygdala...
December 16, 2016: NeuroImage
https://www.readbyqxmd.com/read/27992862/endobronchial-valves-for-endoscopic-lung-volume-reduction-best-practice-recommendations-from-expert-panel-on-endoscopic-lung-volume-reduction
#11
Dirk-Jan Slebos, Pallav L Shah, Felix J F Herth, Arschang Valipour
Endoscopic lung volume reduction (ELVR) is being adopted as a treatment option for carefully selected patients suffering from severe emphysema. ELVR with the one-way endobronchial Zephyr valves (EBV) has been demonstrated to improve pulmonary function, exercise capacity, and quality of life in patients with both heterogeneous and homogenous emphysema without collateral ventilation. In this "expert best practices" review, we will highlight the practical aspects of this therapy. Key selection criteria for ELVR are hyperinflation with a residual volume >175% of predicted, forced expiratory volume <50% of predicted, and a 6-min walking distance >100 m...
December 20, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27990312/ultra-extended-euthermic-pulsed-radiofrequency-for-the-treatment-of-ophthalmic-neuralgia-a-case-report-with-elaboration-of-a-new-technique
#12
Mohinish G Bhatjiwale, Mrudul M Bhatjiwale, Ami Bhagat
BACKGROUND: Pulsed radiofrequency although present for many years has been used little compared to ablative procedures for pain relief. Its use in trigeminal neuralgia is sparse and unreported in the ophthalmic division, where the possibility of sensory loss can lead to high morbidity. We wished to explore the potential of this reportedly safe modality for a prolonged duration in a highly sensitive anatomic neural location, however, in a very secure, structured, and staged manner. CASE DESCRIPTION: A patient suffering from ophthalmic division (V1) medically uncontrolled neuralgia with a preoperative visual analog scale (VAS) score of 9/10 was subjected to a percutaneous pain relief procedure...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27989710/death-related-to-dental-treatment-a-systematic-review
#13
Nathan G Reuter, Philip M Westgate, Mark Ingram, Craig S Miller
OBJECTIVE: The aim of this study was to identify factors associated with death in relation to dental care. STUDY DESIGN: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Dental and Oral Sciences Source, Web of Science, and the Cochrane database were searched, and the references of all retrieved articles were analyzed. Studies were included if death had occurred within 90 days of the dental appointment, and if the patient's age, procedure, and information regarding cause or time of death were provided...
November 2, 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/27989078/intravenous-recombinant-tissue-plasminogen-activator-therapy-for-acute-basilar-artery-ischemic-stroke-following-transfemoral-transcatheter-aortic-valve-implantation
#14
Nicholas J Montarello, Adam J Nelson, Samuel L Sidharta, Stephen G Worthley
Transcatheter aortic valve implantation (TAVI) can now be considered a standard of care for inoperable and high-risk surgical patients with severe aortic stenosis, and its uptake worldwide is rapidly increasing. Indeed, many centers performing the procedure have now moved towards treating intermediate-risk patients with TAVI rather than referring them for surgical aortic valve replacement. Although the incidence of peri-procedural acute and subacute stroke following TAVI has fallen to 2-5%, its occurrence can be life-threatening and life-changing, and every effort must be made to improve patient outcome should stroke occur...
January 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27984382/diagnostic-yield-and-complications-of-ebus-tbna-performed-under-bronchoscopist-directed-conscious-sedation-single-center-experience-of-1004-subjects
#15
Sahajal Dhooria, Inderpaul S Sehgal, Nalini Gupta, Ashutosh N Aggarwal, Digambar Behera, Ritesh Agarwal
BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can be performed under either conscious sedation or general anesthesia. Herein, we describe the diagnostic yield and complications of EBUS-TBNA performed under bronchoscopist-directed conscious sedation. METHODS: This is a retrospective analysis of data collected in the bronchoscopy suite of this center on EBUS-TBNA or endoscopic ultrasound with a bronchoscope-guided fine needle aspiration (EUS-B-FNA) procedures performed between July 2011 and January 2016...
January 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/27981972/what-preventive-care-do-sedated-children-with-caries-referred-to-specialist-services-need
#16
M Sipahi Ogretme, D AbualSaoud, M T Hosey
Introduction Few studies have assessed the preventive needs of children treated under conscious sedation or their parents'/guardians' views regarding oral health education.Aim To report on the profile of children who required treatment under conscious sedation. Also to obtain the views of the parents or guardians of these children on their experiences of oral health preventive services and the support they would like in order to improve their child's oral health.Method A researcher-administered questionnaire was used to collect quantitative and qualitative responses from a consecutive sample of 123 parents/guardians during their child's sedation appointment at King's College Hospital...
December 16, 2016: British Dental Journal
https://www.readbyqxmd.com/read/27974588/trends-in-the-screening-and-treatment-of-retinopathy-of-prematurity
#17
Rebecca J Vartanian, Cagri G Besirli, John D Barks, Chris A Andrews, David C Musch
OBJECTIVES: To determine the current practice patterns of retinopathy of prematurity (ROP) screening and treatment and the attitudes toward new screening and treatment modalities in level III and level IV NICUs, as reported by medical directors. METHODS: Surveys were mailed to the medical directors of 847 level III NICUs identified in the 2011 American Academy of Pediatrics directory in April 2015. In September 2015, responses were compared with American Academy of Pediatrics guidelines and previous reports...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27970106/tct-725-general-anaesthesia-or-conscious-sedation-for-transfemoral-aortic-valve-replacement-with-the-sapien-3-transcatheter-heart-valve-in-1681-patients
#18
Franz-Josef Neumann, Simon Redwood, Mohamed Abdel-Wahab, Thierry Lefevre, Derk Frank, Helene Eltchaninoff, Christophe Caussin, Peter Boekstegers, Pieter Stella, Hendrik Treede
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27960131/prognosis-of-status-epilepticus-in-patients-requiring-intravenous-anesthetic-drugs-a-single-center-experience
#19
Estevo Santamarina, Gloria M González-Cuevas, Anna Sanchez, Rosa M Gracia, Isabel Porta, Manuel Toledo, Manuel Quintana, María Sueiras, Lorena Guzmán, Javier Salas-Puig
PURPOSE: There is concern about the safety of anesthetic drugs (IVADs) in the management of status epilepticus (SE). To clarify this aspect, we aimed to assess the factors associated with a poor prognosis in SE requiring anesthetics. METHOD: We analyzed all SE requiring IVADs between October 2011 and December 2015. Demographics, clinical data, etiology, SE duration, indications for sedation, electroencephalography features, complications and the prognosis at discharge were collected...
December 7, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27956448/delirium-a-guide-for-the-general-physician
#20
Oliver M Todd, Elizabeth A Teale
Delirium describes a sudden onset change in mental status of fluctuating course. This is a state of altered consciousness characterised chiefly by inattention or lack of arousal, but can also include new impairment of language, perception and behaviour. Certain predisposing factors can make an individual more susceptible to delirium in the face of a stressor. Stressors include direct insults to the brain, insults peripheral to the brain or external changes in the environment of an individual. Delirium is varied in its presentation, and can be categorised by the psychomotor profile as: hyperactive type (overly vigilant, agitated, often wandersome), hypoactive type (sedate or withdrawn) or mixed types...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
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