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Clara Elisa Frare de Avelar Teixeira, Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Vanessa Henriques Carvalho, Rafael Miranda da Costa, Giselle Ioná Teixeira Brighenti
INTRODUCTION: Klippel-Trenaunay syndrome is a rare congenital vascular disease characterized by cutaneous hemangiomas, varicosities, and limb asymmetry, which may evolve with coagulation disorders and hemorrhage as more frequent complications in pregnant patients. Pregnancy is not advised in women with this syndrome due to increased obstetric risk. CASE REPORT: Female patient, 29 years old, 99kg, 167cm, BMI 35.4kg.m-2 , physical status ASA III, with 27 weeks of gestational age and diagnosis of Klippel-Trenaunay syndrome...
March 2, 2018: Revista Brasileira de Anestesiologia
J C Gutiérrez, S Merino, P de la Calle, C Perrino, M Represa, P Moral
OBJECTIVES: To establish a correlation between 4 measurements made on preoperative computed axial tomography and the presence of difficult airway, as well as its clinical prediction in patients undergoing otorhinolaryngological surgery. MATERIAL AND METHODS: A retrospective, observational study was carried out using the information gathered from the clinical notes of 104 patients undergoing general anaesthesia and endotracheal intubation for oncological otorhinolaryngological surgery over a period of 36 months...
March 1, 2018: Revista Española de Anestesiología y Reanimación
Sarah Rudasill, Jonathan R Dattilo, Jiabin Liu, Ari Clements, Charles L Nelson, Atul F Kamath
Purpose: Total knee arthroplasty (TKA) is increasing in frequency and cost. Optimization of discharge location may reduce total expenditure while maximizing patient outcomes. Although preoperative illness rating systems-including the American Society for Anesthesiologists Physical Classification System (ASA), severity of illness scoring system (SOI), and Mallampati rating scale (MP)-are associated with patient morbidity and mortality, their predictive value for discharge location, length of stay (LOS), and total costs remains unclear...
March 1, 2018: Knee Surgery & related Research
John C Markley, Michaela K Farber, Nicola C Perlman, Daniela A Carusi
BACKGROUND: General anesthesia (GA) is often selected for cesarean deliveries (CD) with placenta previa and suspected morbidly adherent placenta (MAP) due to increased risk of hemorrhage and hysterectomy. We reviewed maternal outcomes and risk factors for conversion to GA in a cohort of patients undergoing CD and hysterectomy under neuraxial anesthesia (NA). METHODS: We performed a single-center, retrospective cohort study of parturients undergoing nonemergent CD for placenta previa with suspected MAP from 1997 to 2015...
February 23, 2018: Anesthesia and Analgesia
M G Gómez-Prieto, M R Míguez-Crespo, J R Jiménez-Del-Valle, M D González-Caro, I Marmesat-Ríos, J Garnacho-Montero
OBJECTIVE: To know organization, management and training in airway (AW) in Spanish Intensive Care Units (ICUs), with special interest in difficult airway (DAW). DESIGN: Descriptive cross-sectional study and χ2 subanalysis, conducted through a national survey from november 1th to december 15th, 2016. With the SEMICYUC's support, an online questionnaire of 27 items was sent to 179 ICUs. SETTING: ICUs of public, private centers, and consortia...
February 18, 2018: Medicina Intensiva
Waleed Riad, Tarek Ansari, Nanda Shetty
Background: Failed intubation in obstetrics remains the most common cause of death directly related to anesthesia. Neck circumference has been shown to be a predictor for difficult intubation in morbidly obese patients. The aim of this study was to determine an optimal cutoff point of neck circumference for prediction of difficult intubation in obstetric patients. Methods: Ninety-four parturients scheduled for cesarean section under general anesthesia were included in the study...
January 2018: Saudi Journal of Anaesthesia
Y Z Han, Y Tian, H Zhang, Y Q Zhao, M Xu, X Y Guo
BACKGROUND: We identified the most useful variables for prediction of difficult laryngoscopy in patients with cervical spondylosis according to physical indicators and preoperative skeletal X-ray and soft tissue MRI measurements. We hypothesized that there was a closer association between difficult laryngoscopy and radiologic indicators. METHODS: We randomly enroled 315 patients undergoing elective cervical spine surgery and analysed the radiological and physical data in predicting difficult laryngoscopy...
January 31, 2018: Acta Anaesthesiologica Scandinavica
Elizabeth A Hall, Ibrahim Showaihi, Frances S Shofer, Nova L Panebianco, Anthony J Dean
BACKGROUND: Recognition of the difficult airway is a critical element of emergency practice. Mallampati score and body mass index (BMI) are not always predictive and they may be unavailable in critically ill patients. Ultrasonography provides high-resolution images that are rapidly obtainable, mobile, and non-invasive. Studies have shown correlation of ultrasound measurements with difficult laryngoscopy; however, none have been performed in the Emergency Department (ED) using a consistent scanning protocol...
January 18, 2018: Critical Ultrasound Journal
Isabelle Fini Storchi, Steven Parker, Francesca Bovis, Stefano Benedicenti, Andrea Amaroli
Snoring is a sleep phenomenon due to the partial upper airway obstruction during sleep which causes vibration of the tissues of the rhino-oro-hypopharynx and less frequently the larynx. This study evaluated the use and effectiveness of the erbium:YAG 2940-nm laser as an adjunctive in providing treatment for patients suffering from chronic snoring-related sleep disorders. A prospective study of 40 consecutive patients with snoring and sleep disorders was performed, assessing data before and after three Er:YAG laser treatment sessions...
January 15, 2018: Lasers in Medical Science
Chao Ji, Qiang Ni, Wurong Chen
OBJECTIVE: The aim of this study was to evaluate the overall accuracy of radiological measurements in prediction of difficult airway and compare the diagnostic value between the radiological measurements and the modified Mallampati score through a meta-analysis of published studies. METHODS: A comprehensive electronic search of related literature was performed in PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure. Meta-DiSc 1.4 and STATA 12...
January 3, 2018: Journal of Clinical Anesthesia
M Hobzova, K Sonka, M Pretl, J Vaclavik, E Kriegova, M Radvansky, J Zapletalova, M Plackova, V Kolek
Sleep apnoea (SA) is common in patients with hypertension. Nowadays, limited data on the prevalence of SA in nocturnal hypertension (NH) exist. We, therefore, studied the occurrence of SA in Czech patients and its association with 24-hour ambulatory blood pressure monitoring (ABPM), breathing disturbances in sleep, anthropometric data, Mallampati score and Epworth sleepiness scale (ESS) using the Apnea Link device. Undiagnosed SA was found in 72.9% patients (29.3% mild, 26.6% moderate, 17.0% severe) of 188 patients with NH measured by ABPM...
January 5, 2018: Physiological Research
Ayse Cigdem Tutuncu, Emre Erbabacan, Serkan Teksoz, Birsel Ekici, Guniz Koksal, Fatis Altintas, Guner Kaya, Murat Ozcan
OBJECTIVES: We aimed to assess possible risk factors related to difficult intubation in patients undergoing thyroid surgery. METHODS: We prospectively collected data of 200 patients scheduled for thyroid surgery. Clinical risk factors were defined as: Mallampati score, interincisor gap, thyromental distance, sternomental distance, range of neck motion, body mass index, neck circumference, goiter, the presence of radiological findings suggesting compression and thyroid weight...
December 12, 2017: World Journal of Surgery
P Ahuja, D Jain, N Bhardwaj, K Jain, S Gainder, M Kang
BACKGROUND: Preeclampsia is associated with greater narrowing of the airway than normal pregnancy, but it is not known if these changes worsen during labor and delivery. The aim of the study was to evaluate the airway during and after labor in women with or without preeclampsia. METHODS: Twenty-five normal and 25 severely preeclamptic pregnant women in early labor were recruited in this single-center, prospective, case-control study. Airway assessment was performed (a) before active labor (b) within one hour of delivery and (c) 24-48 h postpartum...
February 2018: International Journal of Obstetric Anesthesia
Phillip Good, Ross Pinkerton, Simon Bowler, Justin Craig, Janet Hardy
CONTEXT: In advanced cancer, abnormal sleep patterns may contribute to poor quality of life, but the impact of opioid-related sleep disorders has not been explored in detail in these patients. OBJECTIVE: To document sleep and respiratory patterns in patients with cancer, receiving a range of opioids, determine factors that contribute to severity of central or obstructive apnea, and to what extent these contribute to sleep disturbance. METHODS: Adults with advanced cancer admitted to a palliative care service underwent a sleep analysis by an unattended polysomnography...
March 2018: Journal of Pain and Symptom Management
Erin Payne, Jacqueline Ragheb, Elizabeth S Jewell, Betsy P Huang, Angela M Bailey, Laura M Fritsch, Milo Engoren
Background: Airway management remains one of the most important responsibilities of anesthesiologists. Prediction of difficult airway allows time for proper selection of equipment, technique, and personnel experienced in managing patients with difficult airway. Face to face preoperative anesthesia interviews are difficult to conduct as they necessitate patients traveling to the clinics, and, in practice, are usually conducted in the morning of the procedure by the anesthesiologist, when identification of predictors of difficult intubation may lead to schedule delays or case cancelations...
2017: Perioperative Medicine
H C Turgut, M Alkan, M S Ataç, S K Altundağ, S Bozkaya, B Şimşek, B Işik, M Arslan
BACKGROUND AND AIM: Postoperative pain is well known and usually disturbing complication of surgery. Inflammation plays an important role in the development and progression of postoperative pain. We aimed to investigate possible relationship between preoperatively measured neutrophil-lymphocyte ratio (NLR) - as an inflammation marker - and postoperative analgesic demand in patients underwent orthognathic surgery. MATERIALS AND METHODS: We retrospectively investigated medical and anesthesia records of 177 patients underwent orthognathic surgery...
October 2017: Nigerian Journal of Clinical Practice
Rebeca Gonelli Albanez da Cunha Andrade, Bruno Luís Soares Lima, Douglas Kaíque de Oliveira Lopes, Roberto Oliveira Couceiro Filho, Luciana Cavalcanti Lima, Tania Cursino de Menezes Couceiro
INTRODUCTION: Since anesthesia complications associated with unexpected difficult airway are potentially catastrophic, they should be avoided. The modified Mallampati test and jaw-thrust maneuver enable the identification of difficult airway. The aim of this study was to associate the modified Mallampati test and the jaw-thrust maneuver with laryngoscopy (Cormack-Lehane) in an attempt to identify a better predictor of difficult airway in an adult population undergoing elective surgery...
March 2018: Revista Brasileira de Anestesiologia
Lorna Dunning, Jordan A Francke, Divya Mallampati, Rachel L MacLean, Martina Penazzato, Taige Hou, Landon Myer, Elaine J Abrams, Rochelle P Walensky, Valériane Leroy, Kenneth A Freedberg, Andrea Ciaranello
BACKGROUND: The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa...
November 2017: PLoS Medicine
Hesameddin Modir, Esmail Moshiri, Bita Malekianzadeh, Gholamreza Noori, Abolfazl Mohammadbeigi
Airway management is essential for safe anesthesia and endotracheal intubation is the most important procedure by which critically ill patients can be better managed, especially if done quickly and successfully. This study aimed to compare the techniques of intubation through laryngeal mask airway (LMA) using a bougie versus video laryngoscopy (VL) regarding to intubation success and the quality of intubation indices in patients with difficult airways. This randomized clinical trial was performed on 96 patients aged 16-76 years with Mallampati class 3 or 4 who underwent elective surgery...
July 2017: Medical Gas Research
Paolo Strati, Guilin Tang, Dzifa Y Duose, Saradhi Mallampati, Rajyalakshmi Luthra, Keyur P Patel, Mohammad Hussaini, Abu-Sayeef Mirza, Rami S Komrokji, Stephen Oh, John Mascarenhas, Vesna Najfeld, Vivek Subbiah, Hagop Kantarjian, Guillermo Garcia-Manero, Srdan Verstovsek, Naval Daver
Myeloid/lymphoid neoplasms with FGFR1 rearrangement are a rare entity. We present a multicenter experience of 17 patients with FISH-confirmed FGFR1 rearrangement. The clinical presentation at diagnosis included myeloproliferative neoplasm (MPN) in 4 (24%) patients, acute leukemia (AL) in 7 (41%), and concomitant MPN with AL in 6 (35%). The two most frequently observed cytogenetic abnormalities were t(8;13)(p11.2;q12)(partner gene ZMYM2) and t(8;22)(p11.2; q11.2)(BCR). Seventy-eight percent of tested patients had a RUNX1 mutation, of whom all had AL...
November 9, 2017: Leukemia & Lymphoma
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