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The secrets of anesthesia

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https://www.readbyqxmd.com/read/28938866/the-interpretation-of-hair-analysis-for-drugs-and-drug-metabolites
#1
Eva Cuypers, Robert J Flanagan
INTRODUCTION: Head hair analysis for drugs and drug metabolites has been used widely with the aim of detecting exposure in the weeks or months prior to sample collection. However, inappropriate interpretation of results has likely led to serious miscarriages of justice, especially in child custody cases. OBJECTIVE: The aim of this review is to assess critically what can, and perhaps more importantly, what cannot be claimed as regards the interpretation of hair test results in a given set of circumstances in order to inform future testing...
September 22, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28842149/the-history-of-japanese-anesthesiology
#2
REVIEW
Shigeru Saito, Hirosato Kikuchi, Akitomo Matsuki
Anesthesia in Japan has a 200-year history, beginning when Seishū Hanaoka first conducted surgery successfully under general anesthesia in 1804. Despite common belief, Hanaoka was not secretive about his technique using Mafutsusan, and he spawned a generation of Japanese anesthetists, including Gendai Kamada, author of several influential texts. Japanese anesthetists adopted inhalational techniques as they became available. In 1954, the Japanese Society of Anesthesiologists was established; in 1960, "Anesthesiology" was accredited by Japanese government as an officially approved medical specialty; and in 1963, board examinations were established to be an instructor of anesthesia...
July 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/28810998/delayed-diagnosis-of-acromegaly-in-the-context-of-post-traumatic-stress-disorder-due-to-symptoms-mimicking-known-psychotropic-medication-side-effects
#3
Ray-Bernard Portier, Afshin Afarin, Sara Pope
BACKGROUND: Acromegaly is caused by elevated secretion of human growth hormone, which is frequently because of intracranial tumors. This diagnosis is fairly uncommon with an incidence of 3 to 4 cases per million patients per year. We are presenting a case of acromegaly diagnosed in an active duty Chief Petty Officer. MATERIALS AND METHODS: A 38-year-old male Chief Petty Officer with no previous mental health diagnosis experienced post-traumatic stress disorder (PTSD)-like symptoms in early 2012 after deploying to Iraq and Afghanistan from 2010 to 2011...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28759404/upper-respiratory-infections-and-airway-adverse-events-in-pediatric-procedural-sedation
#4
Michael D Mallory, Curtis Travers, Courtney E McCracken, James Hertzog, Joseph P Cravero
BACKGROUND: Upper respiratory infections (URIs) are associated with airway adverse events (AAEs) during general anesthesia. There have been no large studies examining the relationship between URIs and AAEs during pediatric procedural sedation. We hypothesized that there would be a relationship between URI status and AAEs in pediatric procedural sedation. METHODS: We examined prospectively collected data from the Pediatric Sedation Research Consortium database. Specific questions regarding URI status were added to the database to facilitate our analysis...
July 2017: Pediatrics
https://www.readbyqxmd.com/read/28750664/harvesting-multipotent-progenitor-cells-from-a-small-sample-of-tonsillar-biopsy-for-clinical-applications
#5
Raju Khatri, Michal Arad, Timothy Ortlip, Benjamin A Portney, W Alex Meltzer, Silviu Diaconu, Lorna E Silipino, Ying Wang, David M Kaetzel, Rodney J Taylor, Michal Zalzman
BACKGROUND: Human adult stem cells hold the potential for the cure of numerous conditions and degenerative diseases. They possess major advantages over pluripotent stem cells as they can be derived from donors at any age, and therefore pose no ethical concerns or risk of teratoma tumor formation in vivo. Furthermore, they have a natural ability to differentiate and secrete factors that promote tissue healing without genetic manipulation. However, at present, clinical applications of adult stem cells are limited by a shortage of a reliable, standardized, and easily accessible tissue source which does not rely on specimens discarded from unrelated surgical procedures...
July 27, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28669540/successful-management-of-primary-atrophic-rhinitis-by-turbinate-reconstruction-using-autologous-costal-cartilage
#6
Marn Joon Park, Yong Ju Jang
Initial management of primary atrophic rhinitis is conservative, with nasal ointments, saline irrigation, and antibiotics prescribed to relieve symptoms. However, in cases that show no improvement, a surgical approach is considered. Recently, many studies have reported successful surgical outcomes using various nasal implants. However, no study has reported implantation of autologous costal cartilage in PAR patients. We report here the case of a 63-year-old woman diagnosed with PAR that was intractable to medical therapy...
June 29, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#7
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28630662/sex-differences-in-endogenous-cortical-network-activity-spontaneously-recurring-up-down-states
#8
Charalambos Sigalas, Eleni Konsolaki, Irini Skaliora
BACKGROUND: Several molecular and cellular processes in the vertebrate brain exhibit differences between males and females, leading to sexual dimorphism in the formation of neural circuits and brain organization. While studies on large-scale brain networks provide ample evidence for both structural and functional sex differences, smaller-scale local networks have remained largely unexplored. In the current study, we investigate sexual dimorphism in cortical dynamics by means of spontaneous Up/Down states, a type of network activity that is exhibited during slow-wave sleep, quiet wakefulness, and anesthesia and is thought to represent the default activity of the cortex...
2017: Biology of Sex Differences
https://www.readbyqxmd.com/read/28628505/central-connections-of-the-lacrimal-functional-unit
#9
Catherine Willshire, Roger J Buckley, Anthony J Bron
PURPOSE: To study the contribution of each eye to the reflex tear response, after unilateral and bilateral topical anesthesia. METHOD: A closed-eye, modified Schirmer test was performed bilaterally in 8 normal subjects, in a controlled environment chamber set to 23°C, 45% relative humidity, and 0.08 m/s airflow. Eye drops were instilled into each eye 10 minutes before the Schirmer test. Experiments were as follows: 1) bilateral saline (control), 2) unilateral anesthesia (ipsilateral anesthetic; contralateral saline), and 3) bilateral anesthesia...
August 2017: Cornea
https://www.readbyqxmd.com/read/28622174/insufficient-astrocyte-derived-brain-derived-neurotrophic-factor-contributes-to-propofol-induced-neuron-death-through-akt-glycogen-synthase-kinase-3%C3%AE-mitochondrial-fission-pathway
#10
Yanan Liu, Yasheng Yan, Yasuyoshi Inagaki, Sarah Logan, Zeljko J Bosnjak, Xiaowen Bai
BACKGROUND: Growing animal evidence demonstrates that prolonged exposure to propofol during brain development induces widespread neuronal cell death, but there is little information on the role of astrocytes. Astrocytes can release neurotrophic growth factors such as brain-derived neurotrophic factor (BDNF), which can exert the protective effect on neurons in paracrine fashion. We hypothesize that during propofol anesthesia, BDNF released from developing astrocytes may not be sufficient to prevent propofol-induced neurotoxicity...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28621297/endoscopic-ultrasound-with-or-without-fine-needle-aspiration-has-a-meaningful-impact-on-clinical-care-in-the-pediatric-population
#11
Amit Raina, Maire A Conrad, Benjamin Sahn, Alireza Sedarat, Gregory G Ginsberg, Nuzhat A Ahmad, Vinay Chandrasekhara, Petar Mamula, Michael L Kochman
BACKGROUND AND OBJECTIVES: The safety and utility of endoscopic ultrasound (EUS) for the evaluation and management of gastrointestinal (GI) tract disorders among adults has been established. The literature on safety and efficacy in a pediatric referral population (under 21 years of age) is limited. We hypothesized that EUS is safe and useful in the pediatric population. We reviewed the pediatric EUS experience at a single tertiary-care system. We describe the indications, findings, safety, technical success rate, and impact on clinical outcomes...
May 2017: Endoscopic Ultrasound
https://www.readbyqxmd.com/read/28543309/adenovirus-vector-expressing-keratinocyte-growth-factor-using-cag-promoter-impairs-pulmonary-function-of-mice-with-elastase-induced-emphysema
#12
Hiroshi Oki, Takuya Yazawa, Yasuko Baba, Yumi Kanegae, Hanako Sato, Seiko Sakamoto, Takahisa Goto, Izumu Saito, Kiyoyasu Kurahashi
Pulmonary emphysema impairs quality of life and increases mortality. It has previously been shown that administration of adenovirus vector expressing murine keratinocyte growth factor (KGF) before elastase instillation prevents pulmonary emphysema in mice. We therefore hypothesized that therapeutic administration of KGF would restore damage to lungs caused by elastase instillation and thus improve pulmonary function in an animal model. KGF expressing adenovirus vector, which prevented bleomycin-induced pulmonary fibrosis in a previous study, was constructed...
July 2017: Microbiology and Immunology
https://www.readbyqxmd.com/read/28480814/application-of-platelet-derived-growth-factor-bb-and-diabetic-wound-healing-the-relationship-with-oxidative-events
#13
Sibel Gökşen, Barbaros Balabanlı, Şule Coşkun Cevher
The reasons that cause delay in wound healing in diabetes are a decrease in the level of growth factors secretion, an increase in the destruction of growth factors and in oxidative stress. Platelet derived growth factor (PDGF) is one of the important growth factors that play a role in all phases of wound healing. This study investigates time-dependent effects of topically PDGF-BB administration on oxidative events on the healing of dorsolateral-excisional wounds in diabetic rats. Forty-two female Wistar-albino rats with streptozotocin (STZ)-induced diabetes were divided into four groups: control group, untreated group, chitosan-treated group, chitosan+PDGF-BB-treated group...
May 7, 2017: Free Radical Research
https://www.readbyqxmd.com/read/28445291/efficacy-of-sevoflurane-as-an-adjuvant-to-propofol-based-total-intravenous-anesthesia-for-attenuating-secretions-in-ocular-surgery
#14
RANDOMIZED CONTROLLED TRIAL
Hou-Chuan Lai, Yun-Hsiang Chang, Ren-Chih Huang, Nan-Kai Hung, Chueng-He Lu, Jou-Hsiu Chen, Zhi-Fu Wu
BACKGROUND: The incidence of nasal secretions into the operative field is as high as 5% in ophthalmic surgery under general anesthesia. It may induce postoperative endophthalmitis. Secretions under propofol-based total intravanous anesthesia (TIVA) are greater than sevoflurane anesthesia during surgery. Postoperative nausea and vomiting (PONV) after inhalational anesthesia is higher than TIVA and may increase intraocluar pressure. We investigated the effect of sevoflurane combination with propofol-based TIVA on nasopharyngeal secretions and PONV in ocular surgery...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28390062/outcome-of-laparoscopic-adrenalectomy-for-resection-of-unilateral-noninvasive-adrenocortical-tumors-in-11-cats
#15
Jeffrey W Mitchell, Philipp D Mayhew, William T N Culp, J Brad Case, Ameet Singh, Mark C Fuller, Ann Della Maggiore
OBJECTIVE: To describe the technique and outcomes of laparoscopic adrenalectomy (LA) in cats with adrenocortical neoplasia. STUDY DESIGN: Retrospective case series. ANIMALS: Eleven client-owned cats with unilateral adrenal tumors. METHODS: Medical records of cats that underwent LA for unilateral functional adrenal tumors at 3 veterinary teaching hospitals were reviewed. Data collected included signalment, clinical signs, physical examination findings, diagnostic imaging results, preoperative laboratory tests, laparoscopic port placement and techniques, duration of anesthesia and surgery, complications, concomitant procedures, need for conversion to an open celiotomy, histopathological diagnosis, and postoperative survival...
July 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/28387890/effects-of-propofol-and-dexmedetomidine-anesthesia-on-th1-th2-of-rat-spinal-cord-injury
#16
F-Y He, W-Z Feng, J Zhong, W Xu, H-Y Shao, Y-R Zhang
OBJECTIVE: Spinal cord injury (SCI) patients had major trauma during surgery, which thus necessitates optimal choice of anesthesia drugs. The specific selection of anesthesia agents may affect body immune system. Therefore, this study aims to investigate the anesthesia effect of propofol and dexmedetomidine on the rat SCI and their effects of Th1/Th2. MATERIALS AND METHODS: Improved ALLEN's pouching method was used to generate rat SCI model. The SCI rat models were further divided into propofol and dexmedetomidine group for analyzing anesthesia time, duration, post-op analgesia time, SCI sensory function Reuter score...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28341956/improvement-on-the-neo-umbilicoplasty-technique-and-review-of-the-literature
#17
Valderi Vieira da Silva Júnior, Francis Régis Soares de Sousa
INTRODUCTION: The umbilicus is an important component of body esthetics, and its absence or dysmorphia may give rise to psychological discomfort, making it a common concern in surgical planning. Many techniques of umbilicus reconstruction have been proposed, each with its own limitations in terms of esthetics, risk of stenosis or final positioning. Reconstruction techniques may involve skin grafting, cartilage, purse-string suture and flaps. One of the most promising approaches is scarless neo-umbilicoplasty...
June 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28328861/relationship-between-anesthesia-and-postoperative-endophthalmitis-a-retrospective-study
#18
Hou-Chuan Lai, Wei-Cheng Tseng, Shu-I Pao, Chih-Shung Wong, Ren-Chih Huang, Wei-Hung Chan, Zhi-Fu Wu
Previous study showed that patients under general anesthesia (GA) had nasopharyngeal secretions on the face at the end of ocular surgery, especially in propofol-based total intravenous anesthesia (TIVA), it might induce postoperative endophthalmitis. Therefore, we conducted a retrospective study to compare the incidence of endophthalmitis after ocular surgery under topical, inhalation anesthesia, and propofol-based TIVA in our medical center from 2011 to 2015.A total of 21,032 patients were included, and we evaluated epidemiologic factors, systemic diseases, other ocular pathologic characteristics, complications during the surgery, technique of ocular surgery, method of antibiotic prophylaxis, vitreous culture, and vision outcome in these patients...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28259132/alterations-in-tear-biochemistry-associated-with-postanesthetic-chronic-dry-eye-syndrome
#19
E Yu Zernii, M O Golovastova, V E Baksheeva, E I Kabanova, I E Ishutina, O S Gancharova, A E Gusev, M S Savchenko, A P Loboda, L F Sotnikova, A A Zamyatnin, P P Philippov, I I Senin
Perioperative dry eye syndrome (DES) is a common ocular complication of long-term general anesthesia. Chronic DES can lead to permanent damage to the cornea and disturbance of visual function, up to total loss of vision. Here, a relationship between the duration of general anesthesia and the risk of chronic DES in patients was demonstrated. Using an experimental model of perioperative corneal abrasions in rabbits, it was found that introduction of animals to 3-h general anesthesia resulted in clinically significant chronic damage to the cornea in 50% of cases...
December 2016: Biochemistry. Biokhimii︠a︡
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#20
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
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