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Anesthesia and consciousness

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https://www.readbyqxmd.com/read/28639240/approach-to-thyroid-carcinoma-in-pregnancy
#1
Cristina Modesti, Paola Aceto, Lucia Masini, Celestino Pio Lombardi, Rocco Bellantone, Liliana Sollazzi
Thyroid carcinoma is the first cancer found in general population and the second diagnosed during pregnancy following the breast one. Diagnostic and therapeutic approaches to thyroid malignancy in pregnant women pose several and serious issues to the physicians. Even if there is no consensus about the surgical treatment of thyroid carcinomas during pregnancy, a large number of women undergo surgery over the world. The best surgical and anesthesiological treatment should be chosen after reaching a consensus between surgeons, anesthesiologists, obstetrics, and the patients...
June 22, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28638328/protocol-for-the-reconstructing-consciousness-and-cognition-reccognition-study
#2
Kaitlyn L Maier, Andrew R McKinstry-Wu, Ben Julian A Palanca, Vijay Tarnal, Stefanie Blain-Moraes, Mathias Basner, Michael S Avidan, George A Mashour, Max B Kelz
Important scientific and clinical questions persist about general anesthesia despite the ubiquitous clinical use of anesthetic drugs in humans since their discovery. For example, it is not known how the brain reconstitutes consciousness and cognition after the profound functional perturbation of the anesthetized state, nor has a specific pattern of functional recovery been characterized. To date, there has been a lack of detailed investigation into rates of recovery and the potential orderly return of attention, sensorimotor function, memory, reasoning and logic, abstract thinking, and processing speed...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28615244/stimulation-of-the-pelvic-nerve-increases-bladder-capacity-in-the-prostaglandin-e2-rat-model-of-overactive-bladder
#3
Christopher L Langdale, James A Hokanson, Arun Sridhar, Warren M Grill
Overactive bladder (OAB) syndrome is a highly prevalent condition that may lead to medical complications and decreased quality of life. Emerging therapies focusing on selective electrical stimulation of peripheral nerves associated with lower urinary tract (LUT) function may provide improved efficacy and reduced side effects compared to sacral neuromodulation for the treatment of OAB symptoms. Prior studies investigating the effects of pelvic nerve (PelN) stimulation on LUT function were focused on promoting bladder contractions, and it is unclear if selective stimulation of the PelN would be beneficial for the treatment of OAB...
June 14, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28614221/correlation-of-mdr1-gene-polymorphisms-with-anesthetic-effect-of-sevoflurane-remifentanil-following-pediatric-tonsillectomy
#4
Nian-Jun Shi, Wei-Xia Zhang, Ning Zhang, Li-Na Zhong, Ling-Ping Wang
BACKGROUND: The motive of this study was to investigate the collaboration between MDR1 gene polymorphisms and anesthetic effects following pediatric tonsillectomy. METHODS: All together 178 children undergoing tonsillectomy with preoperative sevoflurane-remifentanil anesthesia were selected. In order to determine MDR1 gene polymorphisms of 3435C > T, 1236C > T, and 2677G > T/A, polymerase chain reaction-restriction fragment length polymorphism was used...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28601160/sperm-collection-by-transrectal-ultrasound-guided-massage-of-the-accessory-sex-glands-is-less-stressful-than-electroejaculation-without-altering-sperm-characteristics-in-conscious-goat-bucks
#5
Silvia Abril-Sánchez, Aline Freitas-de-Melo, Florencia Beracochea, Juan Pablo Damián, Julia Giriboni, Julián Santiago-Moreno, Rodolfo Ungerfeld
In anesthetized non-domestic ruminants transrectal ultrasound-guided massage of the accessory sex glands (TUMASG) is an alternative method to collect semen slightly less stressful than electroejaculation (EE). However, some sperm characteristics are better when semen is collected with EE than with TUMASG. As anesthesia reduces the response to stressors, the advantages of TUMASG may be reduced in anesthetized animals, and thus, TUMASG may be even more advantageous in conscious animals. Therefore, the aim of the present study was to compare the stress response and the characteristics of the sperm collected with TUMASG and EE in conscious goat bucks...
August 2017: Theriogenology
https://www.readbyqxmd.com/read/28596192/the-impact-of-conscious-sedation-versus-general-anesthesia-for-stroke-thrombectomy-on-the-predictive-value-of-collateral-status-a-post-hoc-analysis-of-the-siesta-trial
#6
S Schönenberger, J Pfaff, L Uhlmann, C Klose, S Nagel, P A Ringleb, W Hacke, M Kieser, M Bendszus, M A Möhlenbruch, J Bösel
BACKGROUND AND PURPOSE: Radiologic selection criteria to identify patients likely to benefit from endovascular stroke treatment are still controversial. In this post hoc analysis of the recent randomized Sedation versus Intubation for Endovascular Stroke TreAtment (SIESTA) trial, we aimed to investigate the impact of sedation mode (conscious sedation versus general anesthesia) on the predictive value of collateral status. MATERIALS AND METHODS: Using imaging data from SIESTA, we assessed collateral status with the collateral score of Tan et al and graded it from absent to good collaterals (0-3)...
June 8, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28592064/-clinical-analysis-on-monitoring-and-comprehensive-treatment-after-carotid-endarterectomy
#7
X Y Wang, Z H Sun, L Liu, C Wu, Z Ji
Objective: To discuss the therapeutic effect of management of carotid endarterectomy in care unit. Methods: A total of 315 patients with carotid atherosclerotic stenosis were enrolled. All of the patients were taken into care unit under tracheal intubation anesthesia after carotid endarterectomy. Then the patients were managed with a breathing machine, continuous sedation, strict monitoring of hemodynamics and pupil change, strict control of heart rate and blood pressure, atomization inhalation therapy, treatment of anticoagulation and antiplatelet therapy and classification management of airway...
May 30, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28586493/a-randomized-clinical-trial-of-conscious-sedation-vs-general-anesthesia-on-outcomes-in-patients-receiving-thrombectomy-for-ischemic-stroke
#8
Robert M Starke, Eric C Peterson, Ricardo J Komotar, E Sander Connolly
No abstract text is available yet for this article.
May 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28585495/tympanostomy-tube-placement-in-children-using-a-single-pass-tool-with-moderate-sedation
#9
Shelagh Cofer, Abby Meyer, Daniel Yoon, David Beebe, Chandra Castro, Frank Rimell, Kumar Belani
Insertion of tympanostomy tubes is a common elective pediatric surgical procedure and is typically performed under general anesthesia. The potential to reduce general anesthetic requirements for young children has led to increased interest in alternatives for tympanostomy tube placement. A tympanostomy tube system, developed to enable tympanostomy tube placement in a single pass on conscious patients under moderate sedation, was evaluated. A prospective study on 128 children and 253 tympanostomy tube placements conducted at 4 centers in the United States demonstrated an 88...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28583731/risk-factors-for-postoperative-delirium-in-patients-undergoing-vascular-surgery
#10
REVIEW
George C Galyfos, Georgios E Geropapas, Argiri Sianou, Fragiska Sigala, Konstantinos Filis
OBJECTIVE: Postoperative delirium (PODE) remains a common complication after vascular surgery procedures although the exact pathogenesis remains unclear, mainly because of its multifactorial character. The aim of this systematic review was to evaluate pooled data on potential risk factors for PODE in patients undergoing vascular surgery procedures. METHODS: A systematic literature review was conducted conforming to established criteria to identify eligible articles published from 1990 to 2016...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28573153/optical-imaging-of-the-rat-brain-suggests-a-previously-missing-link-between-top-down-and-bottom-up-nervous-system-function
#11
Susan A Greenfield, Antoine-Scott Badin, Giovanni Ferrati, Ian M Devonshire
Optical imaging with voltage-sensitive dyes enables the visualization of extensive yet highly transient coalitions of neurons (assemblies) operating throughout the brain on a subsecond time scale. We suggest that operating at the mesoscale level of brain organization, neuronal assemblies may provide a functional link between "bottom-up" cellular mechanisms and "top-down" cognitive ones within anatomically defined regions. We demonstrate in ex vivo rat brain slices how varying spatiotemporal dynamics of assemblies reveal differences not previously appreciated between: different stages of development in cortical versus subcortical brain areas, different sensory modalities (hearing versus vision), different classes of psychoactive drugs (anesthetics versus analgesics), different effects of anesthesia linked to hyperbaric conditions and, in vivo, depths of anesthesia...
July 2017: Neurophotonics
https://www.readbyqxmd.com/read/28571040/videolaryngoscopy-during-conscious-sedation-in-patients-not-suitable-for-phonosurgery-by-microlaryngoscopy-a-pilot-study
#12
Vincenzo Saita, Eugenia Allegra, Nicolò Marino, Serena Trapasso, Maria Concetta Monea
BACKGROUND: Microlaryngoscopy is the preferred and most widely used technique in phonosurgery for the treatment of benign and early malignant glottic lesions. However, the procedure may be technically difficult or impossible due to alterations of the cervical spine that may not allow hyperextension of the head or may present general anesthesia contraindications. The aim of this study is to evaluate the efficacy and safety of our surgical approach for lesions of the vocal folds in patients who are not suitable for phonosurgery by microlaryngoscopy...
June 2, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28570661/breakdown-of-local-information-processing-may-underlie-isoflurane-anesthesia-effects
#13
Patricia Wollstadt, Kristin K Sellers, Lucas Rudelt, Viola Priesemann, Axel Hutt, Flavio Fröhlich, Michael Wibral
The disruption of coupling between brain areas has been suggested as the mechanism underlying loss of consciousness in anesthesia. This hypothesis has been tested previously by measuring the information transfer between brain areas, and by taking reduced information transfer as a proxy for decoupling. Yet, information transfer is a function of the amount of information available in the information source-such that transfer decreases even for unchanged coupling when less source information is available. Therefore, we reconsidered past interpretations of reduced information transfer as a sign of decoupling, and asked whether impaired local information processing leads to a loss of information transfer...
June 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28540741/fine-grained-parcellation-of-brain-connectivity-improves-differentiation-of-states-of-consciousness-during-graded-propofol-sedation
#14
Xiaolin Liu, Kathryn K Lauer, Doug Ward, Christopher Roberts, Suyan Liu, Gollapudy Suneeta, Robert Rohloff, William Gross, Zhan Xu, Guangyu Chen, Jeff Binder, Shi-Jiang Li, Anthony G Hudetz
Conscious perception relies on interactions between spatially and functionally distinct modules of the brain at various spatiotemporal scales. These interactions are altered by anesthesia - an intervention that leads to fading consciousness. Relatively little is known about brain functional connectivity and its anesthetic modulation at a fine spatial scale. Here, we used functional imaging to examine propofol-induced changes in functional connectivity in brain networks defined at a fine-grained parcellation based on a combination of anatomical and functional features...
May 25, 2017: Brain Connectivity
https://www.readbyqxmd.com/read/28524130/-creation-of-extracranial-intracranial-microvascular-anastomosis-under-regional-anesthesia-a-case-report-and-a-review-of-the-literature
#15
D Yu Usachev, V A Lukshin, A V Shmigel'skiy, A D Akhmedov, A D Sosnin, K A Kozlova
The article describes a case of successful surgical treatment of an 81-year-old male patient with symptomatic occlusion of the internal carotid artery that led to severe impairment of cerebral hemodynamics and was accompanied by severe gait and equilibrium disorders. Given the patient's age and his positive medical history, he underwent surgery for the creation of an extracranial-intracranial microvascular anastomosis under regional anesthesia, with spontaneous breathing and a baseline level of consciousness being maintained...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28522637/general-anesthesia-versus-conscious-sedation-for-endovascular-treatment-of-acute-ischemic-stroke-the-anstroke-trial-anesthesia-during-stroke
#16
Pia Löwhagen Hendén, Alexandros Rentzos, Jan-Erik Karlsson, Lars Rosengren, Birgitta Leiram, Henrik Sundeman, Dennis Dunker, Kunigunde Schnabel, Gunnar Wikholm, Mikael Hellström, Sven-Erik Ricksten
BACKGROUND AND PURPOSE: Retrospective studies have found that patients receiving general anesthesia for endovascular treatment in acute ischemic stroke have worse neurological outcome compared with patients receiving conscious sedation. In this prospective randomized single-center study, we investigated the impact of anesthesia technique on neurological outcome in acute ischemic stroke patients. METHODS: Ninety patients receiving endovascular treatment for acute ischemic stroke in 2013 to 2016 were included and randomized to general anesthesia or conscious sedation...
June 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28520577/the-effects-of-remifentanil-on-hemodynamic-response-attenuation-after-electroconvulsive-therapy-under-sevoflurane-anesthesia
#17
Feray Erdil, Ulku Ozgul, Mukadder Şanli, Gülay Kayhan, Cemil Çolak, Mahmut Durmuş
PURPOSE: We evaluated the effects of a single loading dose of remifentanil (1 μg/kg) administered as an adjunct to sevoflurane, on the duration of seizure activity, recovery times, and hemodynamic profiles, during electroconvulsive therapy. METHODS: The patients were randomly allocated to receive sevoflurane-saline (Group SS) or sevoflurane-remifentanil (Group SR). Sevoflurane (8%) was initiated for anesthesia induction in both groups until loss of consciousness was achieved...
May 18, 2017: Journal of ECT
https://www.readbyqxmd.com/read/28499653/customized-hinged-covered-metallic-stents%C3%A2-for-the-treatment-of-benign-main-bronchial-stenosis
#18
Xinwei Han, Quazi Al-Tariq, Yanle Zhao, Lei Li, Zhe Cheng, Huaqi Wang, Chao Liu, Dechao Jiao, Gang Wu
BACKGROUND: To address the limitations of silicone stents, we designed a hinged self-expandable covered metallic stent. The aim of this study was to evaluate the safety and efficacy of the customized stents in clinical applications. METHODS: This was a retrospective analysis. Under conscious sedation and local anesthesia, the stents were implanted or removed by interventional radiologists, with fluoroscopic guidance. RESULTS: Of 24 patients with benign main bronchial stenosis, stents were successfully placed in 21 (87...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28486269/neurophysiologic-correlates-of-ketamine-sedation-and-anesthesia-a-high-density-electroencephalography-study-in-healthy-volunteers
#19
Phillip E Vlisides, Tarik Bel-Bahar, UnCheol Lee, Duan Li, Hyoungkyu Kim, Ellen Janke, Vijay Tarnal, Adrian B Pichurko, Amy M McKinney, Bryan S Kunkler, Paul Picton, George A Mashour
BACKGROUND: Previous studies have demonstrated inconsistent neurophysiologic effects of ketamine, although discrepant findings might relate to differences in doses studied, brain regions analyzed, coadministration of other anesthetic medications, and resolution of the electroencephalograph. The objective of this study was to characterize the dose-dependent effects of ketamine on cortical oscillations and functional connectivity. METHODS: Ten healthy human volunteers were recruited for study participation...
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28476663/a-probabilistic-template-of-human-mesopontine-tegmental-nuclei-from-in-vivo-7-t-mri
#20
REVIEW
Marta Bianciardi, Christian Strong, Nicola Toschi, Brian L Edlow, Bruce Fischl, Emery N Brown, Bruce R Rosen, Lawrence L Wald
Mesopontine tegmental nuclei such as the cuneiform, pedunculotegmental, oral pontine reticular, paramedian raphe and caudal linear raphe nuclei, are deep brain structures involved in arousal and motor function. Dysfunction of these nuclei is implicated in the pathogenesis of disorders of consciousness and sleep, as well as in neurodegenerative diseases. However, their localization in conventional neuroimages of living humans is difficult due to limited image sensitivity and contrast, and a stereotaxic probabilistic neuroimaging template of these nuclei in humans does not exist...
May 2, 2017: NeuroImage
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