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https://www.readbyqxmd.com/read/29451037/esophageal-hiatal-hernia-risk-diagnosis-and-management
#1
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
February 16, 2018: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29446060/effect-of-adding-midazolam-to-bupivacaine-during-rectus-sheath-block-a-randomised-controlled-trial
#2
A Ammar, K Mahmoud, Z Kasemy
BACKGROUND: Various adjuvants have been tried to improve quality and increase duration of local anaesthetics during various nerve blocks. We aimed to evaluate the effect of adding midazolam to bupivacaine on rectus sheath (RS) block in patients undergoing umbilical or epigastric hernia repair. METHODS: In all, 60 adult patients were divided into two equal groups, each group included 30 patients. Group I received 20 ml of bupivacaine hydrochloride 0.25% + midazolam 50 μg/kg in 2 ml saline 0...
February 14, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29430677/cutaneous-refractile-foreign-body-microemboli-with-intravascular-injection-of-oral-medication
#3
Nicholas Bercovici, Kristen Russomanno, Frank Santoro, Christopher Scola, Michael Murphy, Zendee Elaba
Injection drug abuse (IDA) is known to cause a spectrum of systemic and cutaneous complications. Despite the increasing incidence of IDA around the world, there is a paucity of literature discussing cutaneous complications from a dermatopathologic perspective. We present a case of a 35-year-old male with a complex medical history of Von Willebrand disease, Behcet's disease and diverticular disease. Following a sigmoidectomy/colostomy for diverticular perforation, he presented with fever and an indurated right arm displaying livedoid purpura...
February 12, 2018: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/29425633/electronic-medical-records-as-a-replacement-for-prospective-research-data-collection-in-postoperative-pain-and-opioid-response-studies
#4
Todd Lingren, Senthilkumar Sadhasivam, Xue Zhang, Keith Marsolo
BACKGROUND AND AIM: Many clinical research studies claim to collect data that are also captured in the electronic medical record (EMR). We evaluate the potential for EMR data to replace prospective research data collection. METHODS: Using a dataset of 358 surgical patients enrolled in a prospective study, we examined the completeness and agreement of EMR and study entries for several variables, including the patient's stay in the post-operative care unit (PACU), surgical pain relief and pain medication side effects...
March 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29416861/prevalence-and-management-of-intrathecal-morphine-induced-pruritus-in-new-zealand-m%C3%A4-ori-healthcare-recipients
#5
Jennifer M Woods, Anecita Gigi Lim
Aims and objectives: The aim of this article was to determine whether the incidence of intrathecal morphine-induced pruritus (ITMI) was influenced by ethnicity, age or gender in relation to orthopaedic versus caesarean surgeries. Background: The use of intrathecal morphine for patients undergoing total hip and knee joint replacements and for lower segment caesarean sections (LSCS) has gained popularity worldwide since its introduction over 30 years ago. Several international studies show that morphine delivered via the intrathecal route is an effective and safe method of pain relief...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29416859/applying-realistic-medicine-to-intrathecal-opioid-utilisation-in-scotland-do-we-have-a-standardised-approach
#6
Robert Hart, Gordon Burns, Susan Smith
Intrathecal opioids (ITOs) are commonly administered as part of a multimodal anaesthetic strategy for a variety of surgical procedures. The evolution of laparoscopic surgical techniques has seen the popularity of ITOs increase as they are effective, well tolerated and lack the cardiovascular side effects associated with epidural infusions. The risk of delayed respiratory depression remains a concern; therefore, high-quality post-operative monitoring is vital. The evidence regarding the practicalities of ITO administration such as opioid dose, type, side effect prevalence and ideal post-operative care arrangements are sparse...
February 2018: British Journal of Pain
https://www.readbyqxmd.com/read/29398993/pregabalin-did-not-improve-pain-management-after-spinal-fusions
#7
Michael K Urban, Kristy M Labib, Shane C Reid, Amanda K Goon, Valeria Rotundo, Frank P Cammisa, Federico P Girardi
Background: The treatment of postoperative pain is a challenge after posterior spinal fusions. Pain management using predominantly opioids is often associated with multiple adverse effects, while multimodal postoperative analgesia may provide adequate pain relief with fewer opioid side effects. Questions/Purposes: The purpose of this review is to determine whether addition of 150 mg pregabalin daily would reduce narcotic requirements and improve outcomes after posterior lumbar fusion (PLF)...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29396996/intranasal-ketamine-and-its-potential-role-in-cancer-related-pain
#8
Vinita Singh, Theresa W Gillespie, R Donald Harvey
Cancer-related pain continues to be a significant therapeutic challenge, made more difficult by contemporary opioid use and diversion concerns. Conventional treatment utilizing a tiered approach of non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant agents is limited; and alternatives are needed for patients with rapidly progressing pain and those who develop hyperalgesia and tolerance to opioids. Ketamine, an N-methyl-D-aspartate (NMDA) selective antagonist, has historically been used for anesthesia in adult and pediatric populations, but has also been investigated for depression, bipolar disorder, and general and post-operative pain management...
February 3, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29382993/-c-omparative-evaluation-of-the-intranasal-spray-formulation-of-midazolam-and-dexmedetomidine-in-patients-undergoing-surgical-removal-of-impacted-mandibular-third-molars-a-split-mouth-prospective-study
#9
Shashank Hiwarkar, Rajesh Kshirsagar, Vikram Singh, Amod Patankar, Sanjay Chandan, Mukund Rathod, Ajay Mohite
Purpose: The purpose of this prospective randomized single blinded split mouth study was to conduct a comparative evaluation of the efficacy of intranasal atomised spray formulation of Dexmedetomidine with Midazolam in patients undergoing surgical removal of bilaterally impacted mandibular third molars. Methods: This prospective study was conducted in twenty volunteers. Each volunteer underwent the surgical removal of an impacted mandibular third molar at two separate appointments at an interval of two weeks...
March 2018: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/29376441/spontaneous-haemorrhage-into-a-large-abducens-nerve-schwannoma-a-case-report
#10
Daniel Brown, Nicolas McConnell, Richard List, Farouk Olubajo, Robin Highley, Mathew Storey, Gueorgui Kounin
PURPOSE: Abducens schwannomas are rare tumors that are not known to present with acute haemorrhage. We present a case of a 59 year-old female on warfarin who presented acutely with a sudden onset headache, nausea and photophobia. Neuroimaging revealed an acute haemorrhage into a lesion that entered Dorello's canal and was consistent with an abducens nerve schwannoma. MATERIALS AND METHODS: The patient's case notes, imaging, histology and operative recording were reviewed retrospectively to compile this case report...
January 29, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29373141/-the-influence-of-the-menstrual-cycle-on-acute-and-persistent-pain-after-laparoscopic-cholecystectomy
#11
Sinem Sari, Betul Kozanhan, Ayse Ilksen Egilmez, Aykut Soyder, Osman Nuri Aydin, Fabrizio Galimberti, Daniel Sessler, Alparslan Turan
BACKGROUND AND OBJECTIVES: Fluctuations of female sex hormones during menstrual cycle influence pain perception. Endogenous pain inhibition is impaired in follicular phase of menstrual cycle. We tested the primary hypothesis that the women having surgery during their follicular phase have more acute pain and require higher opioids than those in the luteal phase, and secondarily we tested that women who have surgery during their follicular phase have more incisional pain at 3 month postoperatively...
January 16, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29372567/review-article-the-physiological-effects-and-safety-of-peppermint-oil-and-its-efficacy-in-irritable-bowel-syndrome-and-other-functional-disorders
#12
REVIEW
B P Chumpitazi, G L Kearns, R J Shulman
BACKGROUND: Peppermint oil has been used for centuries as a treatment for gastrointestinal ailments. It has been shown to have several effects on gastrointestinal physiology relevant to clinical care and management. AIM: To review the literature on peppermint oil regarding its metabolism, effects on gastrointestinal physiology, clinical use and efficacy, and safety. METHODS: We performed a PubMed literature search using the following terms individually or in combination: peppermint, peppermint oil, pharmacokinetics, menthol, oesophagus, stomach, small intestine, gallbladder, colon, transit, dyspepsia, nausea, abdominal pain, and irritable bowel syndrome...
January 26, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29363821/daily-assessment-of-stressful-events-and-coping-in-early-post-operative-recovery-after-colorectal-cancer-surgery
#13
F Smith, J Öhlén, L-O Persson, E Carlsson
This study describes the most stressful events and coping strategies used by patients with colorectal cancer 4-6 weeks after surgery and whether the coping strategies were considered helpful or not. For the investigation of situational coping, an exploratory design was used. One hundred and five patients from three Swedish hospitals were included to fill in the Daily Coping Assessment. Most stressful event, number and types of pre-defined coping strategies used, and if the coping strategy used was considered helpful or not, were measured for 5 days...
January 24, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29338151/oral-prolonged-release-oxycodone-naloxone-offers-equivalent-analgesia-to-intravenous-morphine-patient-controlled-analgesia-after-total-knee-replacement-a-randomized-controlled-trial
#14
Alberto Manassero, Andrea Fanelli, Susanna Ugues, Cristian Bailo, Stefano Dalmasso
BACKGROUND: The purpose of this study was to determine whether oral prolonged- release oxycodone-naloxone combination (OXN) could provide equivalent analgesia and a side-effect profile similar to intravenous morphine patient-controlled analgesia (IVPCA) for the control of pain in the immediate postoperative period after total knee replacement (TKR). METHODS: All patients received a sciatic nerve block with 0.3% ropivacaine 15ml, femoral nerve block with 0.5% ropivacaine 20 ml, spinal anesthesia and postoperative continuous femoral nerve infusion (ropivacaine 0...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29324374/ileal-gist-presenting-with-bacteremia-and-liver-abscess-a-case-report-and-review-of-literature
#15
Marina Gorelik, Braulio Sabates, Adel Elkbuli, Tony Dunne
INTRODUCTION: Small intestine gastrointestinal stromal tumors can infrequently present with intra-abdominal abscess, perforation, obstruction or fistula. Tumor-small intestine fistula is a rare phenomenon and occurs as a result of GISTs' propensity to cause mucosal ulceration. This allows bacteria from the gut to gain access to the systemic circulation and predisposes the patient to bacteremia and pyogenic liver abscess. PRESENTATION OF CASE: We present a case of a 63-year-old female whose initial symptoms included fever, nausea, vomiting and right upper quadrant pain...
December 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29316474/spinal-versus-general-anesthesia-for-lumbar-spine-surgery-in-high-risk-patients-perioperative-hemodynamic-stability-complications-and-costs
#16
Michael Finsterwald, Marco Muster, Mazda Farshad, Andrea Saporito, Muriel Brada, José A Aguirre
OBJECTIVE: More stable perioperative hemodynamic conditions, lower costs and a lower perioperative complication rate were reported in young healthy patients undergoing lumbar spine surgery in spinal anesthesia (SA) compared to general anesthesia (GA). However, the benefits of SA in high risk patients (ASA≥II suffering from cardiovascular and/or pulmonary pathologies) undergoing this surgery are unclear. Our objective was to analyze whether SA leads to an improved perioperative hemodynamic stability and to a more cost-effective management compared to GA in high risk patients undergoing this surgery...
January 6, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29315462/aprepitant-as-a-fourth-antiemetic-prophylactic-strategy-in-high-risk-patients-a-double-blind-randomized-trial
#17
L C de Morais, A M Sousa, G F Flora, T R Grigio, G M N Guimarães, H A Ashmawi
BACKGROUND: Post-operative nausea and vomiting (PONV) is one of the most important causes of patient discomfort after laparoscopic surgeries despite the use of a multimodal pharmacological approach. This study assessed whether the addition of aprepitant to a multimodal regimen would further decrease the incidence of PONV in high-risk patients. METHODS: Apfel-score three or four patients, scheduled for laparoscopic procedures to treat abdominal or pelvic cancer, were randomized to receive oral starch (control group) or 80 mg of oral aprepitant (treatment group) before induction of anaesthesia in a double-blind study...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29284861/a-comparison-of-intrathecal-dexmedetomidine-and-neostigmine-as-adjuvant-to-ropivacaine-for-lower-limb-surgeries-a-double-blind-randomized-controlled-study
#18
Ashutosh Kumar Singh, Abhyuday Kumar, Ashok Kumar, Braj Kishore Prasad, Pradeep Kumar Tiwary, Ranjeet Kumar
Objective: The primary objective of this study was to compare the analgesic effects of intrathecal ropivacaine with or without neostigmine or dexmedetomidine in lower limb surgeries. Secondary objectives were to study the characteristics of block, duration of analgesia, postoperative analgesic requirement, and associated side effects. Materials and Methods: Seventy-five patients posted for elective orthopedic lower limb surgeries under spinal anesthesia were randomly divided into three equal groups to receive intrathecal ropivacaine 0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284851/comparison-of-i-gel-versus-endotracheal-tube-in-patients-undergoing-elective-cesarean-section-a-prospective-randomized-control-study
#19
Manohar Panneer, Saravana Babu, Prakash Murugaiyan
Background and Aim: Physiological changes during pregnancy and the sympatho adrenalstimulation during larynoscopy and intubation leads to evaluation of safe devices to secure airway during cesarean section under general anesthesia. I-gel, recently emerging effective supra glottic device found safe during general anesthesia in cesarean section. Aim of the study is to compare the hemodynamic disturbances and airway related complications of I-gel and Endotracheal tube in patients undergoing cesarean section under general anesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284769/few-gender-differences-in-attitudes-and-experiences-after-live-kidney-donation-with-minor-changes-over-time
#20
Bengt von Zur-Mühlen, Shinji Yamamoto, Jonas Wadström
BACKGROUND We sought to study gender differences and differences over time with respect to demographics, relation to recipient, donor motives, and experiences of live kidney donation. MATERIAL AND METHODS In all, 455 consecutive live kidney donors, representing all of the donors at our center between 1974 and 2008 were considered for this study. There were 28 deceased donors and 14 donors who had moved abroad, leaving 413 donors; 387 (94%) agreed to participate in this study. A questionnaire was sent and the answers was analyzed for gender differences and, where relevant, for changes over time...
December 29, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
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