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https://www.readbyqxmd.com/read/29352577/erector-spinae-plane-block-for-analgesia-after-lower-segment-caesarean-section-case-report
#1
E Yamak Altinpulluk, D García Simón, M Fajardo-Pérez
Effective postoperative analgesia after emergency caesarean section is important because it provides early recovery, ambulation and breast-feeding. The ultrasound-guided erector spinae plane block has been orginally described for providing thoracic analgesia at the T5 transverse process by Forero et al. We performed post-operative bilateral erector spinae plane blocks with 20ml bupivacaine 0.25% at the level of the T9 transverse process in a pregnant woman after caesarean section. In this report, we described that bilateral erector spinae plane block at T9 level provides effective and long-lasting postoperative analgesia for lower abdominal surgery...
January 15, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29349955/-clinical-application-of-percutaneous-iliosacral-screws-combined-with-pubic-ramus-screws-in-tile-b-pelvic-fracture
#2
Qi-Fei Xu, Kui-Ran Lin, Dai-Jie Zhao, Song-Qin Zhang, Sheng-Kai Feng, Chen Li
OBJECTIVE: To investigate the application and effect of minimally invasive percutaneous anterior pelvic pubic ramus screw fixation in Tile B fractures. METHODS: A retrospective review was conducted on 56 patients with posterior pelvic ring injury combined with fractures of anterior pubic and ischiadic ramus treated between May 2010 and August 2015, including 31 males and 25 females with an average age of 36.8 years old ranging from 35 to 65 years old. Based on the Tile classification, there were 13 cases of Tile B1 type, 28 cases of Tile B2 type and 15 cases of Tile B3 type...
March 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#3
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29326820/a-case-of-intra-arterial-thrombolysis-with-alteplase-in-a-patient-with-hypothenar-hammer-syndrome-but-without-underlying-aneurysm
#4
Harshal Shukla, Vicken Yaghdjian, Issam Koleilat
Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29315468/when-do-trauma-patients-lose-temperature-a-prospective-observational-study
#5
S C Eidstuen, O Uleberg, G Vangberg, E Skogvoll
BACKGROUND: The prevalence of hypothermia in trauma patients is high and rapid recognition is important to prevent further heat loss. Hypothermia is associated with poor patient outcomes and is an independent predictor of increased mortality. The aim of this study was to analyze the changes in core body temperature of trauma patients during different treatment phases in the pre-hospital and early in-hospital settings. METHODS: A prospective observational cohort study in severely injured patients...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29314642/venous-access-closure-from-a-to-z
#6
EDITORIAL
Ashok Seth, Ranjan Modi
Points to increasing need for achieving safe and secure closure of femoral venous access site after large caliber venous sheath for after structural interventions. Emphasizes the role of a simple, easy to learn "Z-stitch" for achieving femoral vein hemostasis leading to early ambulation. Cautions and advocates the use of multiple complimentary techniques for venous access closure after extreme large bore devices.
January 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29313712/energy-efficiency-in-children-with-myelomeningocele-during-acute-use-of-assistive-devices-a-pilot-study
#7
Jennifer K Sansom, Beverly D Ulrich
Due to increased metabolic demands during walking, ∼50% of children with myelomeningocele transition to wheelchair use during adolescence/early adulthood. The purpose of our pilot study involving children with myelomeningocele was to determine: (a) energy expenditure needs during acute use of common assistive devices and (b) if walking poles are a feasible assistive device. Oxygen uptake was recorded for eight (5-12 years old) children in four conditions: independent, walker, crutches, and poles. Acute pole use did not significantly differ from independent walking net energy consumption or cost...
January 9, 2018: Adapted Physical Activity Quarterly: APAQ
https://www.readbyqxmd.com/read/29305133/phenotypic-stratification-and-genotype-phenotype-correlation-in-a-heterogeneous-international-cohort-of-gne-myopathy-patients-first-report-from-the-gne-myopathy-disease-monitoring-program-registry-portion
#8
Oksana Pogoryelova, Phillip Cammish, Hank Mansbach, Zohar Argov, Ichizo Nishino, Alison Skrinar, Yiumo Chan, Shahriar Nafissi, Hosein Shamshiri, Emil Kakkis, Hanns Lochmüller
GNE myopathy is a rare distal myopathy, caused by mutations in the GNE gene, affecting sialic acid synthesis. Clinical presentation varies from asymptomatic early stage patients to severely debilitating forms. This first report describes clinical presentations and severity of the disease, using data of 150 patients collected via the on-line, patient-reported registry component of the GNE Myopathy Disease Monitoring Program (GNEM-DMP). Disease progression was prospectively analysed, over a 2-year period, using the GNE myopathy functional activity scale (GNEM-FAS)...
November 14, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/29301177/iatrogenic-spinal-subarachnoid-hematoma-after-diagnostic-lumbar-puncture
#9
Jung Hyun Park, Jong Yeol Kim
Spinal subarachnoid hematoma (SSH) following diagnostic lumbar puncture is very rare. Generally, SSH is more likely to occur when the patient has coagulopathy or is undergoing anticoagulant therapy. Unlike the usual complications, such as headache, dizziness, and back pain at the needle puncture site, SSH may result in permanent neurologic deficits if not properly treated within a short period of time. An otherwise healthy 43-year-old female with no predisposing factors presented with fever and headache. Diagnostic lumbar puncture was performed under suspicion of acute meningitis...
December 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/29285665/total-hip-arthroplasty-performed-with-a-tissue-preserving-technique-using-superior-capsulotomy
#10
Nicola Capuano, Guido Grillo, Flavio Carbone, Angelo Del Buono
PURPOSE: We present a minimally invasive tissue-sparing posterior superior (TSPS) approach that intends to protect the abductor muscles during total hip arthroplasty, prevents the release of the short rotator muscles, and provides the surgeon with the option to repair the posterior capsule. We hypothesized that the TSPS technique would produce a better clinical outcome, faster recovery, and lower complication rates, and that it would not jeopardize acetabular component position. METHODS: A retrospective, observational study was conducted in a consecutive series of patients...
December 28, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29279561/prompt-procedures-have-a-great-impact-on-the-consequences-of-asiatic-black-bear-mauling
#11
Goh Akiyama, Hiroaki Kuwahara, Rintaro Asahi, Ryoichi Tosa, Hiroyuki Yokota
INTRODUCTION: Although bear-inflicted human injuries are rare and the mortality rate of the injuries is usually not high, the chances of bear-human interactions have been increasing, with fatal cases being reported in Japan every year. The aim of this study was to report a series of bear-inflicted injuries and discuss their management and severity. MATERIALS AND METHODS: A retrospective study was performed at the emergency and critical care center of Aizu Chuo Hospital, a tertiary care center in Japan, from May 2013 to September 2015...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29278605/erector-spinae-plane-block-for-surgery-of-the-posterior-thoracic-wall-in-a-pediatric-patient
#12
Maria Alejandra Hernandez, Lucio Palazzi, Julio Lapalma, Mauricio Forero, Ki Jinn Chin
OBJECTIVE: Historically, regional anesthesia for surgery on the posterior thoracic wall has been limited to neuraxial and paravertebral nerve blocks. The erector spinae plane (ESP) block is a novel technique that anesthetizes the dorsal rami of the spinal nerves innervating the posterior thoracic wall. We report the use of the ESP block for this clinical application in a pediatric patient. CASE REPORT: A healthy 3-year-old girl was scheduled for resection of a giant paraspinal lipoma extending over the T4-T7 dermatomes...
December 22, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29251207/perioperative-outcomes-from-the-prospective-multicenter-least-invasive-fast-track-evar-life-registry
#13
Zvonimir Krajcer, Venkatesh G Ramaiah, Esteban A Henao, D Chris Metzger, Wayne K Nelson, Mohammed M Moursi, Hiranya A Rajasinghe, Raed Al-Dallow, Larry E Miller
PURPOSE: To determine the feasibility, perioperative resource utilization, and safety of a fast-track endovascular aneurysm repair (EVAR) protocol in well-selected patients. METHODS: Between October 2014 and May 2016, the LIFE (Least Invasive Fast-track EVAR) registry ( ClinicalTrials.gov identifier NCT02224794) enrolled 250 patients (mean age 73±8 years; 208 men) in a fast-track EVAR protocol comprised of bilateral percutaneous access using the 14-F Ovation stent-graft, no general anesthesia, no intensive care unit (ICU) admission, and next-day discharge...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29245216/magnetic-resonance-imaging-of-the-spinal-cord-in-the-evaluation-of-3-patients-with-sensory-neuronopathies-diagnostic-assessment-indications-of-treatment-response-and-impact-of-autoimmunity-a-case-report
#14
Julius Birnbaum, Aliya Lalji, Ezequiel A Piccione, Izlem Izbudak
RATIONALE: Sensory neuronopathy can be a devastating peripheral nervous system disorder. Profound loss in joint position is associated with sensory ataxia, and reflects degeneration of large-sized dorsal root ganglia. Prompt recognition of sensory neuronopathies may constitute a therapeutic window to intervene before there are irreversible deficits. However, nerve-conduction studies may be unrevealing early in the disease course. In such cases, the appearance of dorsal column lesions on spinal-cord MRI can help in the diagnosis...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29240741/a-retrospective-audit-of-the-characteristics-and-treatment-outcomes-in-patients-with-diabetes-related-charcot-neuropathic-osteoarthropathy
#15
Joanne Dixon, Joshua Coulter, Michele Garrett, Rick Cutfield
AIMS: To review the characteristics, management and outcomes one year after diagnosis in patients with diabetes related charcot neuropathic osteoarthropathy (CN) treated at the Diabetes Podiatry service, Waitemata District Health Board (WDHB) between 2000-2014. METHODS: Patients with diabetes and recorded diagnosis of CN were identified from the podiatry service records. Clinical details were retrospectively obtained from WDHB databases and patient medical records...
December 15, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29232299/the-axillary-intra-aortic-balloon-pump-as-a-bridge-to-recovery-allows-early-ambulation-in-long-term-use-case-series-and-literature-review
#16
Nnamdi Nwaejike, Andre Y Son, Chetan B Patel, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29227440/what-is-the-safety-and-efficacy-of-chemical-venous-thromboembolism-prophylaxis-following-vestibular-schwannoma-surgery
#17
Geoffrey C Casazza, Christian A Bowers, Joel D MacDonald, William T Couldwell, Clough Shelton, Richard K Gurgel
OBJECTIVE: The benefit of routine chemical prophylaxis use for venous thromboembolism (VTE) prevention in skull base surgery is controversial. Chemical prophylaxis can prevent undue morbidity and mortality, however there are risks for hemorrhagic complications. STUDY DESIGN: Retrospective case-control. METHODS: A retrospective chart review of patients who underwent surgery for vestibular schwannoma from 2011 to 2016 was performed. Patients were divided by receipt of chemical VTE prophylaxis...
December 7, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29225903/early-clinical-outcomes-as-a-function-of-use-of-newer-oral-p2y12-inhibitors-versus-clopidogrel-in-the-euromax-trial
#18
Kurt Huber, Gregory Ducrocq, Christian W Hamm, Arnoud van 't Hof, Frédéric Lapostolle, Pierre Coste, Giovanni Gordini, Jacob Steinmetz, Freek W A Verheugt, Jennifer Adgey, Lutz Nibbe, Vojko Kaniĉ, Peter Clemmensen, Uwe Zeymer, Debra Bernstein, Jayne Prats, Efthymios N Deliargyris, Ph Gabriel Steg
Objective: To ascertain whether different oral P2Y12 inhibitors might affect rates of acute stent thrombosis and 30-day outcomes after primary percutaneous coronary intervention (pPCI). Methods: The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) randomised trial compared prehospital bivalirudin with heparin with optional glycoprotein IIb/IIIa inhibitor treatment in patients with ST-segment elevation myocardial infarction triaged to pPCI. Choice of P2Y12 inhibitor was at the investigator's discretion...
2017: Open Heart
https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#19
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29217856/adductor-canal-block-for-post-operative-analgesia-after-simultaneous-bilateral-total-knee-replacement-a-randomised-controlled-trial-to-study-the-effect-of-addition-of-dexmedetomidine-to-ropivacaine
#20
Rakhee Goyal, Gaurav Mittal, Arun Kumar Yadav, Rishab Sethi, Animesh Chattopadhyay
Background and Aims: Knee replacement surgery causes tremendous post-operative pain and adductor canal block (ACB) is used for post-operative analgesia. This is a randomised, controlled, three-arm parallel group study using different doses of dexmedetomidine added to ropiavcaine for ACB. Methods: A total of 150 patients aged 18-75 years, scheduled for simultaneous bilateral total knee replacement, received ultrasound-guided ACB. They were randomised into three groups -Group A received ACB with plain ropivacaine; Groups B and C received ACB with ropivacaine and addition of dexmedetomidine 0...
November 2017: Indian Journal of Anaesthesia
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