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Karsten Wiechert
No abstract text is available yet for this article.
July 14, 2018: European Spine Journal
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
STUDY DESIGN: A retrospective cohort study of utilization patterns of epidural injections. OBJECTIVE: The aim of this study was to assess patterns of utilization and variables of in chronic spinal pain in the fee-for-service (FFS) Medicare population, with a comparative analysis of pre- and post-Affordable Care Act (ACA) data from 2000 to 2009 and 2009 to 2016. SUMMARY OF BACKGROUND DATA: Over the years, utilization of interventional pain management techniques, specifically epidural injections have increased creating concern over costs and public health policy...
July 12, 2018: Spine
Geertrui Dewinter, Steve Coppens, Marc Van de Velde, André D'Hoore, Albert Wolthuis, Eva Cuypers, Steffen Rex
OBJECTIVE: To investigate the comparative analgesic efficacy of systemic lidocaine and quadratus lumborum (QL) block in laparoscopic colorectal surgery. BACKGROUND: Although epidural analgesia is the standard to control pain in patients undergoing open colorectal surgery, optimal analgesic management in laparoscopic surgery is less well-defined. There is need for effective and efficient alternatives to epidural analgesia for pain management in patients undergoing laparoscopic colorectal surgery...
July 12, 2018: Annals of Surgery
Sam E John, Nicholas Vincent Apollo, Nicholas Lachlan Opie, Gil S Rind, Stephen M Ronayne, Clive N May, Thomas J Oxley, David Bruce Grayden
OBJECTIVE: Neural prostheses are improving the quality of life for those suffering from neurological impairments. Electrocorticography electrodes located in subdural, epidural and intravascular positions, show promise as long-term neural prostheses. However, chronic implantation affects the electrochemical environments of these arrays. METHODS: In the present work, the effect of electrode location on the electrochemical properties of the interface was compared. The impedances of the electrode arrays were measured using electrochemical impedance spectroscopy in vitro in saline and in vivo four-weeks post-implantation...
July 10, 2018: IEEE Transactions on Bio-medical Engineering
Marlina E Lovett, Zubin S Shah, Melissa Moore-Clingenpeel, Eric Sribnick, Adam Ostendorf, Melissa G Chung, Jeffrey Leonard, Nicole F O'Brien
OBJECTIVE Focal intracranial infections such as intraparenchymal abscesses or localized infections in the epidural or subdural spaces are relatively rare infections associated with both morbidity and mortality in children. Although children with these infections frequently require surgical intervention, there is a paucity of literature describing the critical care resources required to manage these cases. This retrospective chart review was performed to evaluate the resources necessary to care for critically ill children with focal intracranial infections at the authors' institution...
July 13, 2018: Journal of Neurosurgery. Pediatrics
Chia-Lin Tseng, Hany Soliman, Sten Myrehaug, Young K Lee, Mark Ruschin, Eshetu G Atenafu, Mikki Campbell, Pejman Maralani, Victor Yang, Albert Yee, Arjun Sahgal
OBJECTIVES: We report mature outcomes for a cohort of patients with no prior radiation (de novo) to the spine treated with 24 Gy in 2 daily fractions for metastases, which represents the SBRT regimen under evaluation on the current SC-24 phase 3 randomized trial (NCT02512965). METHODS: The cohort consisted of 279 de novo spinal metastases in 145 consecutive patients treated with 24 Gy in 2 SBRT fractions, identified from a prospective single-institution database...
July 9, 2018: International Journal of Radiation Oncology, Biology, Physics
Eiji Horita, Yuji Takahashi, Kojiro Takashima, Kenichiro Saito, Yoshihiro Takashima, Yoshinori Munemoto
Background: Clinical cases are often observed when patients are in need of repeated use of analgesic infusion to manage pain after colon cancer surgery. This paper investigates analgesic frequency as well as safety of postoperative intravenous (IV) acetaminophen in colon cancer surgery where epidural anesthesia is used. Methods: Among patients who received epidural anesthesia during colon cancer surgery, one group of twenty eight (28) patients received acetaminophen while another group of patients (30) did not receive it...
2018: Journal of Pharmaceutical Health Care and Sciences
Vuslat Muslu Erdem, Turgut Donmez, Sinan Uzman, Sina Ferahman, Engin Hatipoglu, Oguzhan Sunamak
Introduction: Laparoscopic appendectomy (LA) has been generally performed under general anesthesia. Laparoscopic appendectomy is rarely performed under regional anesthesia because of pneumoperitoneum-related problems. Aim: To compare spinal/epidural anesthesia (SEA) and general anesthesia (GA) during LA with respect to perioperative and postoperative adverse events and postoperative pain. Material and methods: Fifty patients, aged 18-65, who underwent LA, were randomly allocated to two groups: the GA (n = 25) and SEA (n = 25) groups...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Lidia Jureczko, Karolina Dobronska, Marcin Kolacz, Piotr Radziszewski, Piotr Dobronski
Introduction: Percutaneous nephrolithotomy (PNL) is an endoscopic treatment of renal lithiasis. It is usually two-staged: it begins in the lithotomy position for ureteral catheter placement and retrograde pyelography, and subsequently an optimal renal access is obtained in the prone position. Some patients under epidural anesthesia do not tolerate the prone position and the PNL cannot be continued. This may be related to changes occurring within the circulatory system. The aim of this prospective randomized double-blind study was to evaluate the changes of the cardiac index (CI) during PNL...
June 2018: Archives of Medical Science: AMS
Linli Li, Yiqun He, Xujun Chen, Youhai Dong
The physiological reconstruction of artificial vertebral laminae without epidural scar tissue formation or spinal cord compression has been challenging. Mechanical stimulations have been reported to play an important role in bone formation and bone remodeling. In this study, we designed a comparison study to investigate the effect of continuous cerebrospinal fluid pulsation (CSFP) stress on the remodeling of artificial vertebral laminae. Mesenchymal stem cells derived from rabbit umbilical cord Wharton's Jelly were induced for osteogenic differentiation for 3 weeks before seeding on the hydroxyapatite-collagen I scaffolds to construct the tissue-engineered laminae (TEL)...
July 12, 2018: Tissue Engineering. Part A
Semih Gungor, Jasmit Brar
RATIONALE: Evidence from cadaveric studies note that the sympathetic nerves from the second and third thoracic ganglia bypass the stellate ganglion in 20% of the population. We present a novel alternative technique for sympathetic blockade of upper extremity via thoracic epidural approach. PATIENT CONCERNS: The patient-reported anxiety about "the placement of the needle in the front of the neck" and severe pain secondary to complex regional pain syndrome...
July 2018: Medicine (Baltimore)
Ajita S Prabhu
No abstract text is available yet for this article.
July 10, 2018: Annals of Surgery
Ki Jinn Chin
PURPOSE OF REVIEW: Recent research has shed further light on the place of ultrasound imaging in neuraxial blockade in routine clinical practice, its use in thoracic epidurals, and real-time ultrasound-guided techniques. RECENT FINDINGS: Compared with the conventional technique of surface landmark palpation, preprocedural ultrasound imaging minimizes technical difficulty associated with lumbar neuraxial blockade in patients with poor-quality surface landmarks. Novice practitioners are able to learn to employ the technique effectively...
July 9, 2018: Current Opinion in Anaesthesiology
Raphael Weiss, Daniel M Pöpping
PURPOSE OF REVIEW: Although thoracic epidural analgesia (TEA) is considered often as gold standard in multimodal analgesia with regard to major abdominal surgery, there is an ongoing debate if it is still a viable option for enhanced recovery because of its potential severe complications. RECENT FINDINGS: In addition to the unsurpassed analgesic quality, a TEA offers several advantages. Studies have shown that a TEA does have a positive effect on perioperative morbidity and mortality, bowel function, the occurrence of ileus and patient mobility...
July 9, 2018: Current Opinion in Anaesthesiology
Tirtza N Spiegel Strauss, Sarah L Pachtman, Burton Rochelson
Spontaneous spinal epidural abscess (SEA) is a rare infection of the central nervous system. We report a case of a 25-year-old G3 P0020 at 36 weeks of gestational age with history of intravenous drug abuse presenting with acute-onset and severe back pain. Despite antibiotic therapy, pain worsened and she developed lower extremity weakness. Magnetic resonance imaging (MRI) revealed an SEA, and cesarean delivery was performed secondary to increasing weakness, followed by laminectomy (T9-12) and decompression of epidural abscess...
2018: Case Reports in Obstetrics and Gynecology
Alessandro Favilli, Antonio Simone Laganà, Ugo Indraccolo, Alessandra Righi, Onofrio Triolo, Maria D' Apolito, Sandro Gerli
OBJECTIVE: The aim of this study was to assess women preference about pain and duration of labour applying a standardized questionnaire. STUDY DESIGN: A prospective multicentre large cohort study was carried out in two different University Hospitals. A standardized questionnaire was proposed before active labour and the day after delivery in order to investigate whether women preferred low pain intensity for a longer labour duration or greater pain intensity for a shorter labour duration...
June 28, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Allana Munro, Ronald B George, Victoria M Allen
PURPOSE: The incidence of epidural top-ups received in the second stage of labour in nulliparous women and the obstetrical and neonatal implications associated with these boluses are explored in this retrospective observational study. We hypothesized that an epidural top-up in the second stage of labour reduces operative deliveries by resolving inadequate analgesia. METHODS: A population-based cohort analysis was performed using perinatal data from 1 January 2013 through 31 December 2014...
July 9, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Gilbert J Grant, Andrew P Agoliati, Ghislaine C Echevarria, Jerome Lax
No abstract text is available yet for this article.
July 1, 2018: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
Pei Liu, Chan Li, Nan Zheng, Xiaoying Yuan, Yutong Zhou, Pu Chun, Yanyan Chi, Campbell Gilmore, Shengbo Yu, Hongjin Sui
Recent studies have identified that the myodural bridge (MDB) is located between the suboccipital muscles and cervical dura mater in the posterior atlanto-occipital interspace within humans. The myodural bridge has been considered to have a significant role in physiological functions. However, there is little information about the myodural bridge in marine mammals; we conducted this study to investigate and examine the morphology of the myodural bridge in a sperm whale. We also aim to discuss the physiological functions of the myodural bridge...
2018: PloS One
Keyuri Popat, Kelly Ann Gracia, Alexis B Guzman, Thomas W Feeley
Pain control for patients undergoing thoracic surgery is essential for their comfort and for improving their ability to function after surgery, but it can significantly increase costs. Here, we demonstrate how time-driven activity-based costing (TDABC) can be used to assess personnel costs and create process-improvement strategies.We used TDABC to evaluate the cost of providing pain control to patients undergoing thoracic surgery and to estimate the impact of specific process improvements on cost. Retrospective healthcare utilization data, with a focus on personnel costs, were used to assess cost across the entire cycle of acute pain medicine delivery for these patients...
July 2018: Journal of Healthcare Management / American College of Healthcare Executives
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