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Alessia Pedoto, Dawn P Desiderio, David Amar, Robert J Downey
BACKGROUND: Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. METHODS: A retrospective review of a single institution experience with intraoperative and postoperative hemodynamic complications associated with SCT was performed...
November 2016: Anesthesia and Analgesia
Zachary N London
Discomfort is an unavoidable part of electrodiagnostic (EDX) studies. The most readily modifiable mediator of electromyography (EMG)-associated pain is muscle selection. Interventions that may reduce pain include vapocoolant spray, ibuprofen, and techniques such as slapping or stretching the skin. Needlestick injuries to health care workers carry the risk of transmitting bloodborne illnesses, but other Infectious complications of EDX studies are very rare. EMG probably contributes to asymptomatic hemorrhage in about 1% of patients, but clinically significant bleeding has only been reported a few times...
September 28, 2016: Muscle & Nerve
Dirk Rüsch, Tilo Koch, Florian Seel, Leopold Eberhart
OBJECTIVES: Local infiltration with lidocaine is a frequently used measure to prevent pain during arterial cannulation. Its administration is associated with pain. Vapocoolants like ethyl chloride or alkanes also affect rapid-onset anesthesia. However, their administration causes less discomfort compared with administration of lidocaine. The effectiveness of vapocoolants in mitigating discomfort associated with arterial cannulation never has been studied. The authors therefore compared vapocoolant with lidocaine for reducing discomfort caused by arterial cannulation...
June 8, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Papiroon Noitasaeng, Phongthara Vichitvejpaisal, Uaypom Kaosombatwattana, Jaiyen Tassanee, Siriwongsa Suwannee
OBJECTIVE: Esophago-gastro-duodenoscopy (EGD) was performed under the topical anesthesia of the pharynx. However spraying lidocaine was found to be an annoying maneuver to patients, while nebulized lidocaine appeared to efficiently suppress gags and cough reflexes in airway anesthesia. This study aimed to compare the effectiveness of spraying and nebulized lidocaine for patients undergoing EGD. MATERIAL AND METHOD: A total of 110 patients undergoing elective EGD, with a history of neither lidocaine intolerance nor irritable airways due to smoking, chronic obstructive pulmonary disease (COPD), upper respiratory infection, asthma, cardiac and pulmonary diseases and allergy to lidocaine were included...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Hemindermeet Singh, Faraz Khan Luni, Bharat Marwaha, Syed Sohail Ali, Mohammed Alo
Pyrethroids are the major components of various commercially used insect repellants. These are less toxic to humans due to their slow absorption and rapid metabolism. However, cases of suicidal and accidental poisoning with household insecticides are not uncommon. We report a case of a 59-year-old female who presented with syncope after an accidental exposure to bed bug repellant spray at home. She was found to be in complete heart block and was treated conservatively. There was complete resolution of symptoms and atrioventricular conduction abnormality on day 2 of hospitalization...
June 25, 2016: Cardiology
Jeremy L C Smelt, Simon Phillips, Colin Hamilton, Paul Fricker, Dominic Spray, Justin L Nowell, Marjan Jahangiri
OBJECTIVE: Complications of cardiopulmonary bypass (CPB) are rare, but life-threatening events that need prompt and rehearsed actions involving a team. This is not adequately taught to cardiothoracic surgical trainees. The objective of this study was to assess the knowledge of cardiothoracic trainees required to manage these events after simulation-based vs. lecture-based teaching. PARTICIPANTS AND DESIGN: Totally, 17 cardiac surgical trainees with no formal teaching in intraoperative complications of CPB management were randomly assigned by computer to either a study group receiving simulation-based complications of CPB teaching via the Orpheus simulator (n = 9) or a control group receiving complications of CPB teaching via a lecture (n = 8)...
June 16, 2016: Journal of Surgical Education
Laura K Diaz, J William Gaynor, Shannon J Koh, Richard F Ittenbach, Marsha Gerdes, Judy C Bernbaum, Elaine H Zackai, Robert R Clancy, Mohamed A Rehman, Jeffrey W Pennington, Nancy Burnham, Thomas L Spray, Susan C Nicolson
OBJECTIVES: Despite improved survival in children with hypoplastic left heart syndrome (HLHS), significant concern persists regarding their neurodevelopmental (ND) outcomes. Previous studies have identified patient factors, such as prematurity and genetic syndromes, to be associated with worse ND outcomes. However, no consistent relationships have been identified among modifiable management factors, including cardiopulmonary bypass strategies, and ND outcomes after cardiac surgery in infancy...
August 2016: Journal of Thoracic and Cardiovascular Surgery
Stine Spray, Lars Edvinsson
Mouse models of global cerebral ischemia (GCI) allow experimental examination of cerebral pathophysiology in genetically modified mice and fast screening of new treatment strategies. Various surgical protocols of GCI-induction in mice have been published; however, many of these studies are hindered by limited neurological assessment protocols and present insufficient reporting of the cumulative survival rate. Therefore, we aim at developing a reproducible and easily implementable model of transient GCI in mice with minimal impact on normal mouse behavior...
July 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Zaid H Maayah, Hassan N Althurwi, Ghada Abdelhamid, Gabriela Lesyk, Paul Jurasz, Ayman O S El-Kadi
Doxorubicin (DOX) has been reported to be a very potent and effective anticancer agent. However, clinical treatment with DOX has been greatly limited due to its cardiotoxicity. Furthermore, several studies have suggested a role for cytochrome P450 1B1 (CYP1B1) and mid-chain hydroxyeicosatetraenoic acids (mid-chain HETEs) in DOX-induced cardiac toxicity. Therefore, we hypothesized that DOX induced cardiotoxicity is mediated through the induction of CYP1B1 and its associated mid-chain HETEs metabolite. To test our hypothesis, Sprague-Dawley rats and RL-14 cells were treated with DOX in the presence and absence of 2,3',4,5'-tetramethoxystilbene (TMS), a selective CYP1B1 inhibitor...
March 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Hiroshi Osawa, Shinpei Yoshii, Samuel J K Abraham, Yuki Okamoto, Shigeru Hosaka, Shoji Fukuda, Koji Tsuchiya, Masato Nakajima, Yoshihiro Honda, Kouki Takizawa
OBJECTIVE: The use of topical antimicrobials applied to the sternum during cardiac procedures in combination with intravenous agents to prevent mediastinitis has been reported to yield good results. The objective of this study is to provide optimal method of topical antimicrobials for the prevention of sternal wound infection after cardiac surgery. METHODS: We retrospectively evaluated the patients undergoing adult cardiac surgery at five institutions between January 1994 and August 2013 for the incidence of deep sternal wound infection (DSWI)...
April 2016: General Thoracic and Cardiovascular Surgery
T Novais, M Bourdelin, O Le Vavasseur, H Bontemps
INTRODUCTION: Vasoconstrictors, widely prescribed in the congestive states during acute rhinitis, are responsible for many cases of drug-related iatrogenic disease. CASE REPORT: We report the case of a 40-year-old man, who presented with an episode of malignant hypertensive crisis associated with life-threatening congestive heart decompensation. The patient interview revealed consumption to supra-therapeutic dosage of an association of naphazoline and prednisolone nasal sprays...
June 2016: La Revue de Médecine Interne
Vaidehi Nayar, Andrea Kennedy, Janine Pappas, Krista D Atchley, Cynthia Field, Sarah Smathers, Eva E Teszner, Julia S Sammons, Susan E Coffin, Jeffrey S Gerber, Thomas L Spray, James M Steven, Louis M Bell, Joan Forrer, Fernando Gonzalez, Albert Chi, William J Nieczpiel, John N Martin, J William Gaynor
BACKGROUND: The use of administrative data for surgical site infection (SSI) surveillance leads to inaccurate reporting of SSI rates [1]. A quality improvement (QI) initiative was conducted linking clinical registry and administrative databases to improve reporting and reduce the incidence of SSI [2]. METHODS: At our institution, The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) and infection surveillance database (ISD) were linked to the enterprise data warehouse containing electronic health record (EHR) billing data...
January 2016: Annals of Thoracic Surgery
Fabio Vaiano, Giovanni Serpelloni, Martina Focardi, Alessia Fioravanti, Francesco Mari, Elisabetta Bertol
Propofol is a short-acting hypnotic agent that is commonly used to induce and maintain anesthesia. Propofol abuse and its involvement in suicide deaths have increased in recent years, especially among healthcare personnel. An example is the suicide of a 61-year-old nurse found with a propofol drip in his left arm. We describe the postmortem concentration of propofol in various tissues (femoral and cardiac blood, bile, urine, brain, and liver) and in the drip. The toxicological analyses were performed through two analytical methods, differing in derivatization reaction and in instrumentation: silylation for gas chromatograph-mass spectrometer (GC-MS), as routinely performed in our laboratory for this kind of analyses (lower limits of quantification-LLOQ-in urine and blood: 0...
November 2015: Forensic Science International
William Wang, Yun Qing Mei, Xin Hiu Yuan, Xiao Dong Feng
OBJECTIVE: Postoperative atrial fibrillation is the most frequent complication arising after cardiac surgery, occurring in 40% of cases. The treatment of postoperative atrial fibrillation with epicardial amiodarone/corticosteroid hydrogel delivery can increase efficacy and reduce side effects. To further evaluate whether amiodarone hydrogel is superior to corticosteroid hydrogel or placebo, we performed a randomized prospective study in 150 patients with coronary artery bypass grafting to compare the effectiveness with different epicardial drug approaches in the postoperative period...
January 2016: Journal of Thoracic and Cardiovascular Surgery
Mohammed Ishaq Ruknuddeen, Rajaram Ramadoss, V Rajajee, Luke E Grzeskowiak, Ram E Rajagopalan
BACKGROUND: Therapeutic hypothermia (TH) may improve neurological outcome in comatose patients following out of hospital cardiac arrest (OHCA). The reliability of clinical prediction of neurological outcome following TH remains unclear. In particular, there is very limited data on survival and predictors of neurological outcome following TH for OHCA from resource-constrained settings in general and South Asia in specific. OBJECTIVE: The objective was to identify factors predicting unfavorable neurological outcome at hospital discharge in comatose survivors of OHCA treated with hypothermia...
June 2015: Indian Journal of Critical Care Medicine
Mehmet Besir Akpinar, Atakan Atalay, Hakan Atalay, Omer Faruk Dogan
BACKGROUND: The risk of reoperation due to bleeding after open heart surgery is 2.2%-4.2%. Patients who undergo reoperation have a two to six times greater mortality rate. Risk factors for reoperation include: older age, low body mass index, time on extracorporeal circulation, and emergency operations. In coronary artery bypass graft (CABG) patients who are treated preoperatively with antiplatelets, including clopidogrel, the source of postoperative bleeding may be difficult to detect...
2015: Heart Surgery Forum
Mark A Fogel, Christine Li, Felice Wilson, Tom Pawlowski, Susan C Nicolson, Lisa M Montenegro, Laura Diaz Berenstein, Thomas L Spray, J William Gaynor, Stephanie Fuller, Marc S Keller, Matthew A Harris, Kevin K Whitehead, Robert Clancy, Okan Elci, Jim Bethel, Arastoo Vossough, Daniel J Licht
OBJECTIVE: Patients with single ventricle can develop aortic-to-pulmonary collaterals (APCs). Along with systemic-to-pulmonary artery shunts, these structures represent a direct pathway from systemic to pulmonary circulations, and may limit cerebral blood flow (CBF). This study investigated the relationship between CBF and APC flow on room air and in hypercarbia, which increases CBF in patients with single ventricle. METHODS: 106 consecutive patients with single ventricle underwent 118 cardiac magnetic resonance (CMR) scans in this cross-sectional study; 34 prior to bidirectional Glenn (BDG) (0...
August 2015: Heart: Official Journal of the British Cardiac Society
Maryam Y Naim, J William Gaynor, Jodi Chen, Susan C Nicolson, Stephanie Fuller, Thomas L Spray, Dennis J Dlugos, Robert R Clancy, Livia Vianez Costa, Daniel J Licht, Rui Xiao, Heather Meldrum, Nicholas S Abend
OBJECTIVES: The American Clinical Neurophysiology Society recommends continuous electroencephalographic monitoring after neonatal cardiac surgery because seizures are common, often subclinical, and associated with worse neurocognitive outcomes. We performed a quality improvement project to monitor for postoperative seizures in neonates with congenital heart disease after surgery with cardiopulmonary bypass. METHODS: We implemented routine continuous electroencephalographic monitoring and reviewed the results for an 18-month period...
July 2015: Journal of Thoracic and Cardiovascular Surgery
Yecheng Deng, Yongmei Liao, Jingjing Li, Linlin Yang, Hui Zhong, Qiuyan Zhou, Zhen Qing
Cerbera manghas is a mangrove plant which possesses comprehensive biological activities. A great deal of research has been undertaken on the chemical constituents and medical functions of C. manghas; insecticidal and antifungal activities have also been reported, but the acaricidal activity has not been studied. In our study, the acaricidal activity and active substances of C. manghas were investigated using a spray method, which showed that the methanol extracts of the fruit, twigs and leaves exhibited contact activity against female adults of Panonychus citri, with LC50 values at 24 h of 3...
September 2014: Natural Product Communications
Bélin Poletto Mezzomo, Ana Luisa Miranda-Vilela, Lilian Carla Pereira Barbosa, Vanessa Lima Albernaz, Cesar Koppe Grisolia
Bacillus thuringiensis (Bt) has been widely used in foliar sprays as part of integrated pest management strategies against insect pests of agricultural crops. Since the advent of genetically modified plants expressing Bt δ-endotoxins, the bioavailability of Cry proteins has increased, and therefore for biosafety reasons their adverse effects should be studied, mainly for nontarget organisms. We evaluated, in Swiss mice, the hematotoxicity and genotoxicity of the genetically modified strains of Bt spore crystals Cry1Aa, 1Ab, 1Ac, or 2Aa at 27 mg/kg, and Cry1Aa, 1Ab and 2Aa also at 136 and 270 mg/kg, administered with a single intraperitoneal injection 24 h before euthanasia...
August 2016: Environmental Toxicology
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