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https://www.readbyqxmd.com/read/29928666/a-program-director-survey-of-the-clinical-base-year-in-anesthesiology-residency-programs
#1
Agathe Streiff, Barbara Orlando, Bryan Mahoney
Background: To maintain compliance with the current shift towards competency-based milestone assessment in graduate medical education, residency training programs must reflect this emphasis in their curricula starting with the intern year of training.1 In working towards collaborative efforts in curricular development between Accreditation Council for Graduate Medical Education (ACGME) anesthesiology residency programs, understanding the structure and design of the clinical base year for anesthesiology residency programs nationwide will serve as a valuable initial step...
January 2018: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29928664/utilization-of-the-flipped-classroom-in-anesthesiology-graduate-medical-education-an-initial-survey-of-faculty-beliefs-and-practices-about-active-learning
#2
Susan M Martinelli, Fei Chen, Matthew D Mcevoy, David A Zvara, Randall M Schell
Background: Flipped classroom (FC) is an active learning (AL) technique thought to have potential benefits in anesthesiology resident education. This survey aimed to determine the frequency of FC utilization, barriers of utilization, and means to overcome these barriers. Method: A web-based questionnaire was developed to survey anesthesiology faculty on their knowledge of and experience with FC. The Society of Academic Associations of Anesthesiology and Perioperative Medicine sent the survey to all United States core program directors (PD) via their list serve with a request for the PDs to forward the survey invitation to their clinical faculty...
January 2018: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29928663/factors-influencing-immediate-post-residency-career-decisions-for-graduating-anesthesiology-residents
#3
Nafisseh S Warner, Matthew A Warner, Jason S Eldrige, Resham Datta, Susan M Moeschler, Timothy R Long
Background: Little is known regarding the factors that influence post-residency career decisions following anesthesiology residency training. The objective of this study was to assess the relationship between demographic and academic variables and immediate post-residency positions. Methods: The authors conducted a retrospective review of anesthesiology resident files from 2000 to 2014 at Mayo Clinic (Rochester, MN). Univariate and multivariable analyses were used to assess relationships between demographic and academic factors and post-residency positions...
January 2018: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29923936/multiple-micronutrient-plasma-level-changes-are-related-to-oxidative-stress-intensity-in-critically-ill-children
#4
Frédéric V Valla, Muriel Bost, Sylvain Roche, Marion Pitance, Charlotte Cuerq, Jenna Ridout, René Ecochard, Tiphanie Ginhoux, Amandine Bellon, Carole Ford-Chessel, Aurélie Portefaix, Etienne Javouhey, Emilie Blond
OBJECTIVES: Micronutrient supplementation in critically ill adults remains controversial. In the pediatric setting, the impact of oxidative stress on the overall micronutrient status has been poorly explored, due to the limited number of studies and to confounding factors (i.e., malnutrition or extra losses). In order to better understand this phenomenon, we aim to describe micronutrient status, focusing on seven micronutrients, in well-nourished critically ill children presenting with severe oxidative stress...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29916860/the-las-vegas-risk-score-for-prediction-of-postoperative-pulmonary-complications-an-observational-study
#5
Ary Serpa Neto, Luiz Guilherme V da Costa, Sabrine N T Hemmes, Jaume Canet, Göran Hedenstierna, Samir Jaber, Michael Hiesmayr, Markus W Hollmann, Gary H Mills, Marcos F Vidal Melo, Rupert Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE: We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data. DESIGN: This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study...
June 18, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29902969/bispectral-index-to-guide-induction-of-anesthesia-a-randomized-controlled-study
#6
Dirk Rüsch, Christian Arndt, Leopold Eberhart, Scarlett Tappert, Dennis Nageldick, Hinnerk Wulf
BACKGROUND: It is unknown to what extent hypotension frequently observed following administration of propofol for induction of general anesthesia is caused by overdosing propofol. Unlike clinical signs, electroencephalon-based cerebral monitoring allows to detect and quantify an overdose of hypnotics. Therefore, we tested whether the use of an electroencephalon-based cerebral monitoring will cause less hypotension following induction with propofol. METHODS: Subjects were randomly assigned to a bispectral index (BIS)-guided (target range 40-60) or to a weight-related (2 mg...
June 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29901637/extracranial-intracranial-bypass-in-medial-sphenoid-ridge-meningioma-associated-with-severe-stenosis-of-the-intracranial-segments-of-the-internal-carotid-artery-a-case-report
#7
Yabo Huang, Zhong Wang, Qingdong Han
RATIONALE: Tumor resection and extracranial-intracranial bypass concerning medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery (ICA) of intracranial segments has been rarely presented. Effective treatment as to the complex lesions may be complicated. Tumor resection and cerebrovascular protection should be both taken into consideration. PATIENT CONCERNS: We presented one case of medial sphenoid ridge meningioma associated with severe stenosis of the internal carotid artery of intracranial segments...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29878944/decision-support-tool-improves-real-and-perceived-anesthesiology-resident-relief-equity
#8
Monica Bhutiani, Patrick M Jablonski, Jesse M Ehrenfeld, Matthew D McEvoy, Leslie C Fowler, Jonathan P Wanderer
BACKGROUND: The Accreditation Council of Graduate Medical Education requires monitoring of resident clinical and educational hours but does not require tracking daily work patterns or duty hour equity. Lack of such monitoring may allow for inequity that affects resident morale. No defined system for resident relief of weekday operating room (OR) clinical duties existed at our institution, leaving on-call residents to independently decide daily relief order. We developed an automated decision support tool (DST) to improve equitable decision making for clinical relief and assessed its impact on real and perceived relief equity...
June 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29875918/serum-levels-of-selenium-and-c-reactive-protein-in-comatose-patients-with-severe-traumatic-brain-injury-during-the-first-week-of-hospitalization-case-control-study
#9
Bahia Belatar, Fatna Laidi, Abdelah El Abidi, Rachid Eljaoudi, Fouzia Mamouch, Saad Kabbaj, Wajdi Maazouzi
Introduction: Mortality and morbidity related to traumatic brain injuries still remain high in patients. Many authors reported the importance of Selenium in maintaining the integrity of brain functions. This fact is supported by clinical evidence that therapy with selenium supplementation could help patients suffering from brain disorders like neurodegenerative diseases. The aim of our study was to assess the relationship between Selenium concentration in serum and evolution of comatose patients with severe traumatic brain injury, in the first week of admission, and the correlation between selenium and C-reactive protein...
2018: Pan African Medical Journal
https://www.readbyqxmd.com/read/29874192/procalcitonin-guided-antibiotic-therapy-an-expert-consensus
#10
Michele Bartoletti, Massimo Antonelli, Francesco Arturo Bruno Blasi, Ivo Casagranda, Arturo Chieregato, Roberto Fumagalli, Massimo Girardis, Filippo Pieralli, Mario Plebani, Gian Maria Rossolini, Massimo Sartelli, Bruno Viaggi, Pierluigi Viale, Claudio Viscoli, Federico Pea
BACKGROUND: Procalcitonin (PCT) is a useful biomarker of bacterial infection and its use is associated to reduced duration of antibiotic therapy in the setting of intensive care medicine. To address the need of practical guidance for the use of PCT in various clinical settings, a group of experts was invited to participate at a consensus process with the aims of defining the rationale for appropriate use of PCT and for improving the management of critically ill patients with sepsis. METHODS: A group of 14 experts from anesthesiology and critical care, infectious diseases, internal medicine, pulmonology, clinical microbiology, laboratory medicine, clinical pharmacology and methodology provided expert opinion through a modified Delphi process, after a comprehensive literature review...
June 6, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29858588/the-association-of-lymph-node-dissection-with-30-day-perioperative-morbidity-among-men-undergoing-minimally-invasive-radical-prostatectomy-analysis-of-the-national-surgical-quality-improvement-program-nsqip
#11
Joseph Brito, Jorge Pereira, Daniel M Moreira, Gyan Pareek, Christopher Tucci, Ruiting Guo, Zheng Zhang, Ali Amin, Anthony Mega, Joseph Renzulli, Dragan Golijanin, Boris Gershman
BACKGROUND: The incremental morbidity of lymph node dissection (LND) among men undergoing radical prostatectomy remains uncertain. We therefore evaluated  the association of LND with perioperative morbidity among men undergoing minimally invasive radical prostatectomy (MIRP). METHODS: We identified 29,012 men aged 35-89 who underwent MIRP from 2010-2015 in the National Surgical Quality Improvement Program (NSQIP) database, of whom 47% underwent concomitant LND...
June 1, 2018: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/29802440/-patient-endangerment-due-to-device-diversity-discussion-of-a-risk-factor-based-on-the-results-of-two-surveys-of-german-hospitals
#12
K Lange, A Brinker, M Nowak, C Zöllner, W Lauer
BACKGROUND: The Federal Institute for Drugs and Medical Devices (BfArM) was notified of an event in which it was not possible to sufficiently ventilate a patient suffering a severe asthma attack. It turned out that the ventilation pressures used by the device for pressure-controlled ventilation were below the values set by the user, which the user was not aware of. The ventilation pressures chosen by the user exceeded the preset alarm limits of the ventilator. This pressure and alarm management significantly differed from that of other ventilators used in the hospital...
May 25, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29798560/-effect-of-continuous-and-single-shot-adductor-canal-blocks-for-postoperative-analgesia-and-early-rehabilitation-after-total-knee-arthroplasty
#13
Canfeng Li, Hongwei Xu, Bin Shen, Jing Yang, Zongke Zhou, Pengde Kang, Fuxing Pei
Objective: To compare the analgesia effect and clinical rehabilitation between continuous adductor canal block (ACB) and single shot ACB in total knee arthroplasty (TKA).. Methods: Between October 2016 and February 2017, 60 patients with severe knee osteoarthritis undergoing primary unilateral TKA were prospectively recruited in the study. All the patients were randomly allocated into 2 groups and received ultrasound-guided continuous ACB (group A, n =30) or single shot ACB (group B, n =30), respectively...
September 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29796968/recommendations-for-the-use-of-ect-in-pregnancy-literature-review-and-proposed-clinical-protocol
#14
Heather Burrell-Ward, John A Fromson, Joseph J Cooper, Gildasio De Oliveira, Marcela Almeida
Psychiatric disorders are common in pregnancy, affecting 15-29% of pregnant women. Untreated depression has negative health consequences for mother and fetus. Electroconvulsive therapy (ECT) is an effective option for the treatment of severe depression, high suicide risk, catatonia, medication-resistant illness, psychotic agitation, severe physical decline, and other life-threatening conditions. To our knowledge, however, there is no literature that consolidates all the evidence on maternal and fetal risks associated with untreated depression, medications, and ECT then translating it into one cohesive protocol that could serve as a management guide and a source of reassurance to health-care providers involved in such practice...
May 23, 2018: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/29791521/specific-questionnaire-detects-a-high-incidence-of-intra-operative-hypersensitivity-reactions
#15
Laila S Garro, Marcelo V Aun, Iracy Sílvia C Soares, Marisa R Ribeiro, Antônio A Motta, Jorge Kalil, Mariana C Castells, Maria José C Carmona, Pedro Giavina-Bianchi
OBJECTIVE: To assess the incidence of intra-operative immediate hypersensitivity reactions and anaphylaxis. METHODS: A cross-sectional observational study was conducted at the Department of Anesthesiology, University of São Paulo School of Medicine, Hospital das Clínicas, São Paulo, Brazil, from January to December 2010. We developed a specific questionnaire to be completed by anesthesiologists. This tool included questions about hypersensitivity reactions during anesthesia and provided treatments...
May 17, 2018: Clinics
https://www.readbyqxmd.com/read/29789877/-meta-analyses-on-measurement-precision-of-non-invasive-hemodynamic-monitoring-technologies-in-adults
#16
G Pestel, K Fukui, M Higashi, I Schmidtmann, C Werner
An ideal non-invasive monitoring system should provide accurate and reproducible measurements of clinically relevant variables that enables clinicians to guide therapy accordingly. The monitor should be rapid, easy to use, readily available at the bedside, operator-independent, cost-effective and should have a minimal risk and side effect profile for patients. An example is the introduction of pulse oximetry, which has become established for non-invasive monitoring of oxygenation worldwide. A corresponding non-invasive monitoring of hemodynamics and perfusion could optimize the anesthesiological treatment to the needs in individual cases...
May 22, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29782402/understanding-conflict-management-styles-in-anesthesiology-residents
#17
Terrie Vasilopoulos, Christopher R Giordano, Jack D Hagan, Brenda G Fahy
BACKGROUND: Successful conflict resolution is vital for effective teamwork and is critical for safe patient care in the operating room. Being able to appreciate the differences in training backgrounds, individual knowledge and opinions, and task interdependency necessitates skilled conflict management styles when addressing various clinical and professional scenarios. The goal of this study was to assess conflict styles in anesthesiology residents via self- and counterpart assessment during participation in simulated conflict scenarios...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29766035/using-the-teaching-perspectives-inventory-as-an-introduction-to-a-residents-as-teachers-curriculum
#18
Amy C Robertson, Leslie C Fowler, Amy Miller Juve
Objective: The Anesthesiology Milestone Project includes a milestone for assessing the teaching attributes of residents within the competency of Practice-based Learning and Improvement. We intend to develop a Residents-as-Teachers educational curriculum to assist our residents in successfully achieving this milestone. The goal of this study is to identify the specific teaching perspectives and intentions of our residents and to promote residents' comprehension of their own teaching philosophy...
October 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29759279/measuring-clinical-productivity
#19
REVIEW
Mark E Hudson, Evan E Lebovitz
Productivity measurements have been used to evaluate and compare physicians and physician practices. Anesthesiology is unique in that factors outside anesthesiologist control impact opportunity for revenue generation and make comparisons between providers and facilities challenging. This article uses data from the multicenter University of Pittsburgh Physicians Department of Anesthesiology to demonstrate factors influencing productivity opportunity by surgical facility, between department divisions and subspecialties within multispecialty divisions, and by individuals within divisions...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29754394/anesthesia-for-subcutaneous-implantable-cardioverter-defibrillator-implantation-perspectives-from-the-clinical-experience-of-a-us-panel-of-physicians
#20
Michael K Essandoh, George E Mark, Johan D Aasbo, Charles A Joyner, Saumya Sharma, Beningo F Decena, Eric D Bolin, Raul Weiss, Martin C Burke, Timothy R McClernon, Emile G Daoud, Michael R Gold
BACKGROUND AND OBJECTIVE: Worldwide adoption of the subcutaneous implantable cardioverter-defibrillator (S-ICD) for preventing sudden cardiac death continues to increase, as longer-term evidence demonstrating the safety and efficacy of the S-ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S-ICD placement is lacking. This article presents advantages and disadvantages of different peri-procedural sedation and anesthesia options for S-ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia...
May 13, 2018: Pacing and Clinical Electrophysiology: PACE
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