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https://www.readbyqxmd.com/read/28644939/an-economic-analysis-of-mac-versus-walant-a-trigger-finger-release-surgery-case-study
#1
Jason L Codding, Suneel B Bhat, Asif M Ilyas
BACKGROUND: There has been recent interest in wide awake hand surgery, also referred to as "wide awake local anesthesia with no tourniquet" (WALANT) surgery. Using a model of single trigger finger release (TFR) surgery, a hypothesis was made that WALANT would result in decreased hospital time and cost than patients receiving sedation with monitored anesthetic care (MAC). METHODS: Consecutive cases of single TFR surgery with MAC were compared with WALANT. All surgeries were performed in the same manner, at the same facility, and by the same surgeon...
July 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28644314/prone-or-left-for-colonoscopy-a-randomized-controlled-trial-of-prone-versus-left-sided-starting-position-for-colonoscopy
#2
Nikhil Vergis, Alexander J Scarborough, James A Morris, Jonathan M Hoare
BACKGROUND AND AIMS: Data have emerged supporting the right-lateral starting position in reducing time to cecum and improving patient comfort for minimally sedated colonoscopy. We aimed to test whether prone starting position results in similar advantages in procedure time and patient tolerability in comparison to traditional left-sided starting position. MATERIALS AND METHODS: We conducted a randomized controlled trial in which patients were randomized to begin in either the prone or left-lateral (LL) position...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28644052/a-little-dab-will-do-ya-in-a-case-report-of-neuro-and-cardiotoxicity-following-use-of-cannabis-concentrates
#3
Shannon S Rickner, Dazhe Cao, Kurt Kleinschmidt, Steven Fleming
CONTEXT: The use of marijuana and cannabis concentrates is increasing, especially following decriminalization in several states. Psychosis and cardiotoxicity have been reported following cannabis use; however, myocardial injury from "dabbing" has not yet been reported. We report a case of hyperthermia, tachycardia, hypertension, severe agitation, neuro-, and cardiotoxicity following the use of "dabs" where there is concomitant confirmatory biological and sample testing. CASE DETAILS: A 17-year-old athletic man developed agitation requiring sedation and intubation for safety, with peak systolic blood pressures in the 190s and hyperthermia (to 102 °F)...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#4
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28642966/procedural-sedation-and-analgesia-for-pediatric-shock-wave-lithotripsy-a-10-year-experience-of-single-institution
#5
Banu Cevik, Murat Tuncer, Kutlu Hakan Erkal, Bilal Eryildirim, Kemal Sarica
The aim of this study was to evaluate anesthesia practice for pediatric extracorporeal shock wave lithotripsy (ESWL) according to the age groups and discuss the anesthetic management of these patients. Pediatric patients treated with ESWL because of urolithiasis under anesthesia in our department between December 2007 and January 2017 were evaluated retrospectively. A total of 251 patients were divided into two groups as Group PS: preschool children (<6 years) and Group S: school children (≥6 years)...
June 22, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28642088/effect-of-pre-emptive-pregabalin-on-pain-management-in-patients-undergoing-laparoscopic-cholecystectomy-a-systematic-review-and-meta-analysis
#6
REVIEW
Yi Zhang, Yu Wang, Xi Zhang
BACKGROUND: Pre-emptive pregabalin might be beneficial to the patients undergoing laparoscopic cholecystectomy. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of pregabalin on pain management of patients undergoing laparoscopic cholecystectomy. METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of pregabalin versus placebo on laparoscopic cholecystectomy were included...
June 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28640784/a-limitation-of-intensive-care-unit-sedation-using-volatile-anesthetics
#7
Hilary P Grocott
No abstract text is available yet for this article.
June 20, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28640084/effect-of-dexmedetomidine-and-midazolam-for-flexible-fiberoptic-bronchoscopy-in-intensive-care-unit-patients-a-retrospective-study
#8
Yang Gao, Kai Kang, Haitao Liu, Liu Jia, Rong Tang, Xing Zhang, Hongliang Wang, Kaijiang Yu
This study aimed to investigate the clinical effectiveness of dexmedetomidine and midazolam for sedation of intensive care unit (ICU) patients requiring flexible fiberoptic bronchoscopy (FFB).This retrospective cohort study included 148 patients from the third ICU ward of the Second Affiliated Hospital of Harbin Medical University (Harbin, China) who received simultaneous invasive mechanical ventilation and FFB between March 2012 and December 2014. Patients were divided into dexmedetomidine (n  =  72) and midazolam (n  =  76) groups according to sedative mode...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639827/the-effects-of-alcohol-expectancy-and-intake-on-slot-machine-gambling-behavior
#9
Dominic Sagoe, Rune Aune Mentzoni, Tony Leino, Helge Molde, Sondre Haga, Mikjel Fredericson Gjernes, Daniel Hanss, Ståle Pallesen
Background and aims Although alcohol intake and gambling often co-occur in related venues, there is conflicting evidence regarding the effects of alcohol expectancy and intake on gambling behavior. We therefore conducted an experimental investigation of the effects of alcohol expectancy and intake on slot machine gambling behavior. Methods Participants were 184 (females = 94) individuals [age range: 18-40 (mean = 21.9) years] randomized to four independent conditions differing in information/expectancy about beverage (told they received either alcohol or placebo) and beverage intake [actually ingesting low (target blood alcohol concentration [BAC] < 0...
June 22, 2017: Journal of Behavioral Addictions
https://www.readbyqxmd.com/read/28639240/approach-to-thyroid-carcinoma-in-pregnancy
#10
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/28639236/the-effects-of-intranasal-dexmedetomidine-premedication-in-children-a-systematic-review-and-meta-analysis
#11
Jong Hun Jun, Kyu Nam Kim, Ji Yoon Kim, Shin Me Song
PURPOSE: Intranasal dexmedetomidine premedication is a newly introduced method for reducing stress and anxiety before general anesthesia in children. We performed a meta-analysis to identify the effects of intranasal dexmedetomidine premedication in children. SOURCE: We conducted a systematic review to find published randomized-controlled trials using intranasal dexmedetomidine as premedication. We searched databases in EMBASE™, MEDLINE®, and the Cochrane Controlled Trials Register using the Ovid platform...
June 21, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28638826/anxiolytics-sedatives-and-hypnotics-prescribed-by-dentists-in-brazil-in-2010
#12
Patrícia Azevedo Lino, Maria Auxiliadora Parreiras Martins, Maria Elisa de Souza E Silva, Mauro Henrique Nogueira Guimarães de Abreu
OBJECTIVE: To describe dental prescriptions for anxiolytics, sedatives, and hypnotics for Brazilian outpatients in 2010. METHODS: A cross-sectional study was conducted using data on the use of anxiolytics, sedatives, and hypnotics from the Brazilian Health Surveillance Agency, Brazil, 2010. For each prescription, prescribed drugs and the prescribed amount were identified. Prescribed medications were classified according to Anatomical Therapeutic Chemical code. We calculated the number of Defined Daily Doses (DDD) for anxiolytics, sedatives, and hypnotics by code, their mean DDD, and DDD per inhabitant per year...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28638303/the-use-of-gabapentin-for-pain-and-agitation-in-neonates-and-infants-in-a-neonatal-icu
#13
Gretchen L Sacha, Maria G Foreman, Kay Kyllonen, Ricardo J Rodriguez
OBJECTIVES: Limited data support how to safely and effectively treat refractory pain and agitation in neonates and infants. Gabapentin has been used in this patient population and has shown promising results, yet there is still a paucity of data about its clinical efficacy. There is a need for a larger evaluation to determine its effectiveness. This study describes one institution's experience with gabapentin for the treatment of refractory pain and agitation in the neonatal intensive care unit (NICU)...
May 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28637741/the-closed-trial-clonidine-compared-with-midazolam-for-sedation-of-paediatric-patients-in-the-intensive-care-unit-study-protocol-for-a-multicentre-randomised-controlled-trial
#14
Antje Neubert, Manuel Alberto Baarslag, Monique van Dijk, Joost van Rosmalen, Joseph F Standing, Yucheng Sheng, Wolfgang Rascher, Deborah Roberts, Jackie Winslade, Louise Rawcliffe, Sara M Hanning, Tuuli Metsvaht, Viviana Giannuzzi, Peter Larsson, Pavla Pokorná, Alessandra Simonetti, Dick Tibboel
INTRODUCTION: Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label for this indication, as many drugs in paediatrics are. Therefore, the CLOSED trial aims to provide data on the pharmacokinetics, safety and efficacy of clonidine for the sedation of mechanically ventilated patients in order to obtain a paediatric-use marketing authorisation...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28637064/safety-and-efficacy-of-glycopyrrolate-as-a-premedication-for-endoscopic-submucosal-dissection-a-randomized-double-blind-placebo-controlled-study
#15
Eui Joo Kim, Min Young Um, Kyoung Oh Kim, Jung Ho Kim, Su Young Kim, Dong Kyun Park, Kwang An Kwon, Jun Won Chung, Yoon Jae Kim
Background and study aims Anticholinergic premedication has not been validated for endoscopic submucosal dissection (ESD). In this randomized, double-blind, placebo-controlled trial, we investigated the efficacy and safety of glycopyrrolate as a premedication for ESD. Methods A total of 196 patients undergoing ESD at a single tertiary medical center between December 2014 and February 2016 were randomly allocated to receive one of the following two premedications: glycopyrrolate (0.004 mg/kg intramuscularly [IM]) or placebo (2...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28637050/ultrasonography-for-the-diagnosis-of-pneumothorax-after-transbronchial-lung-cryobiopsy-in-diffuse-parenchymal-lung-diseases
#16
Luca Viglietta, Riccardo Inchingolo, Cristina Pavano, Sara Tomassetti, Sara Piciucchi, Andrea Smargiassi, Claudia Ravaglia, Alessandra Dubini, Christian Gurioli, Carlo Gurioli, Venerino Poletti
BACKGROUND: Transbronchial lung cryobiopsy (TBLC) can be indicated in diffuse parenchymal lung diseases (DPLDs) when a confident noninvasive diagnosis cannot be made. The 2 most relevant complications of TBLC are bleeding and pneumothorax (PTX). The accuracy of chest ultrasonography (US) for the detection of PTX is higher when compared to chest X-ray (CXR) with reference to computed tomography (CT) scan as a gold standard. OBJECTIVE: We evaluated the accuracy of chest US in detecting PTX after TBLC in patients with DPLDs...
June 22, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28635195/a-study-to-estimate-prevalence-and-risk-factors-of-obstructive-sleep-apnoea-syndrome-in-a-semi-urban-indian-population
#17
Abhijeet Singh, Rajendra Prasad, Rajiv Garg, Surya Kant, Giridhar B Hosmane, Abhisek Dubey, Abhisek Agarwal, Ram Kishun Verma
Obstructive Sleep Apnea Syndrome (OSAS) has been recognised as a major cause of morbidity and mortality in developing countries like India. There is still a paucity of Indian studies regarding the prevalence of OSAS. The current single centre prospective cross-sectional study was undertaken to know prevalence estimates for key symptoms and features that can indicate the presence of OSAS in an Indian population. A survey was conducted on subjects with age groups ≥ 25 years at King George's Medical University, Lucknow, Uttar Pradesh, India from August 2009 to July 2011...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634504/the-reemergence-of-eeg-reactivity-after-cardiac-arrest
#18
Joseph Zachariah, Alejandro A Rabinstein
Electroencephalogram (EEG) reactivity has been increasingly utilized in prognostication after cardiac arrest. Recent studies have demonstrated a false-positive rate of 0% in predicting poor outcome with a nonreactive EEG. The reemergence of reactivity after an initial nonreactive EEG has been noted in cases of drug intoxication, rewarming after hypothermia, and after discontinuing sedation. This is the first case describing the reemergence of EEG reactivity without the confounding factors listed above. We describe a case of resuscitated cardiac arrest with initial EEG demonstrating a lack of reactivity...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634025/impaired-cerebral-autoregulation-in-preoperative-newborn-infants-with-congenital-heart-disease
#19
Jodie K Votava-Smith, Christopher J Statile, Michael D Taylor, Eileen C King, Jesse M Pratt, David P Nelson, Erik C Michelfelder
OBJECTIVES: To characterize cerebral autoregulation (CA) in preoperative newborn infants with congenital heart disease (CHD). METHODS: This was a prospective, pilot study of term newborns with CHD who required intensive care. Continuous mean arterial blood pressure (MAP), cerebral tissue oxygen saturation (SCTO2) via near-infrared spectroscopy, and arterial oxygen saturation (SaO2) were collected. Significant low-frequency coherence between MAP and SCTO2 was used to define impaired CA in 20-minute epochs...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28633798/case-report-irreducible-ankle-fracture-with-posterior-tibialis-tendon-and-retinaculum-deltoid-ligament-and-anteromedial-joint-capsule-entrapment
#20
Nicole M Stevens, Amy S Wasterlain, Sanjit R Konda
Irreducible ankle fractures are a relatively rare phenomenon. We present a case of a pronation abduction-type ankle fracture that was irreducible in the emergency room despite sedation. The patient was taken to the operating room, where the posterior tibialis tendon and retinaculum, deltoid ligament, and anteromedial capsule were found to be trapped within the joint. After removal of the tissue, alignment was restored. The patient did well clinically and was advanced to full weightbearing at 6 weeks. This is, to the best of our knowledge, the first report of entrapment of all 4 anatomic structures, preventing closed reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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