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https://www.readbyqxmd.com/read/29471158/road-traffic-injuries-cross-sectional-cluster-randomized-countrywide-population-data-from-4-low-income-countries
#1
Syed Nabeel Zafar, Joseph K Canner, Neeraja Nagarajan, Adam L Kushner
INTRODUCTION: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income countries using nationally representative survey data. METHODS: The Surgeons Overseas Assessment of Surgical Needs (SOSAS) survey tool was administered in four countries: Sierra Leone, Rwanda, Nepal and Uganda. We performed nationally representative cross-sectional, cluster randomized surveys in each country...
February 19, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29470436/neurobiology-of-propofol-addiction-and-supportive-evidence-what-is-the-new-development
#2
REVIEW
Ming Xiong, Nimisha Shiwalkar, Kavya Reddy, Peter Shin, Alex Bekker
Propofol is a short-acting intravenous anesthetic agent suitable for induction and maintenance of general anesthesia as well as for procedural and intensive care unit sedation. As such it has become an unparalleled anesthetic agent of choice in many institutional and office practices. However, in addition to its idealistic properties as an anesthetic agent, there is accumulating evidence suggesting its potential for abuse. Clinical and experimental evidence has revealed that not only does propofol have the potential to be abused, but also that addiction to propofol shows a high mortality rate...
February 22, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29468091/surgical-technical-evidence-review-for-elective-total-joint-replacement-conducted-for-the-ahrq-safety-program-for-improving-surgical-care-and-recovery
#3
REVIEW
Christopher P Childers, Anaar E Siletz, Emily S Singer, Claire Faltermeier, Q Lina Hu, Clifford Y Ko, Gregory J Golladay, Stephen L Kates, Elizabeth C Wick, Melinda Maggard-Gibbons
Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29467148/controlling-postoperative-use-of-i-v-acetaminophen-at-an-academic-medical-center
#4
William R Vincent, Paul Huiras, Jennifer Empfield, Kevin J Horbowicz, Keith Lewis, David McAneny, David Twitchell
PURPOSE: Results of an interprofessional formulary initiative to decrease postoperative prescribing of i.v. acetaminophen are reported. SUMMARY: After a medical center added i.v. acetaminophen to its formulary, increased prescribing of the i.v. formulation and a 3-fold price increase resulted in monthly spending of more than $40,000, prompting an organizationwide effort to curtail that cost while maintaining effective pain management. The surgery, anesthesia, and pharmacy departments applied the Institute for Healthcare Improvement's Model for Improvement to implement (1) pharmacist-led enforcement of prescribing restrictions, (2) retrospective evaluation of i...
February 21, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29465538/enhanced-recovery-after-surgery-eras-programs-for-esophagectomy-protocol-for-a-systematic-review-and-meta-analysis
#5
Feiyu Liu, Wei Wang, Chengde Wang, Xiaonu Peng
BACKGROUND: Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Esophagectomy plays an important role and offers a potential curable chance to these patients. However, esophagectomy with radical lymphadenectomy is known as one of the most invasive digestive surgeries which are associated with high morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition, and psychology, which is designed for reducing complications, promoting recovery, and improving treatment outcomes...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29464385/prevention-of-emergence-agitation-with-ketamine-in-rhinoplasty
#6
Canser Yilmaz Demir, Nureddin Yuzkat
BACKGROUND: Emergence agitation (EA), defined as restlessness, disorientation, excitation, and/or inconsolable crying, is a common phenomenon during early recovery from general anesthesia. In this study, we aimed to determine the (1) EA incidence after rhinoplasty operations in adults; (2) the effects of ketamine administered at sub-anesthetic doses just 20 min before the end of the surgery in rhinoplasty operations on agitation level, postoperative pain, side effects, and complications; and (3) to determine the risk factors for EA in adults after rhinoplasty...
February 20, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29464293/-kirschner-wire-osteosynthesis-for-fractures-in-childhood-bury-wires-or-not-results-of-a-survey-on-care-reality-in-germany
#7
D Schneidmueller, M Kertai, V Bühren, C von Rüden
INTRODUCTION: Kirschner wire osteosynthesis is considered to be the standard technique for surgical fixation of displaced supracondylar humeral and distal radial fractures in children. The Kirschner wires can be left exposed or buried under the skin. Advantages of the epicutaneous technique are, e. g. the efficiency (cost, effort) and the possibility for wire removal without the necessity of a second anesthesia. On the other hand, there is a concern about higher infection rates as well as traumatization of the children due to externally visible wires...
February 20, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29462828/computer-aided-surgical-simulation-in-head-and-neck-reconstruction-a-cost-comparison-among-traditional-in-house-and-commercial-options
#8
Sean S Li, Libby R Copeland-Halperin, Alexander J Kaminsky, Jihui Li, Fahad K Lodhi, Reza Miraliakbari
BACKGROUND: Computer-aided surgical simulation (CASS) has redefined surgery, improved precision and reduced the reliance on intraoperative trial-and-error manipulations. CASS is provided by third-party services; however, it may be cost-effective for some hospitals to develop in-house programs. This study provides the first cost analysis comparison among traditional (no CASS), commercial CASS, and in-house CASS for head and neck reconstruction. METHODS: The costs of three-dimensional (3D) pre-operative planning for mandibular and maxillary reconstructions were obtained from an in-house CASS program at our large tertiary care hospital in Northern Virginia, as well as a commercial provider (Synthes, Paoli, PA)...
February 20, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29461445/impact-of-anesthesia-on-hospital-mortality-and-morbidities-in-geriatric-patients-following-emergency-hip-fracture-surgery
#9
Chunyuan Qiu, Priscilla H Chan, Gary L Zohman, Heather A Prentice, Jessica J Hunt, Diana C LaPlace, Vu T Nguyen, Glenn R Diekmann, Gregory B Maletis, Vimal Desai
OBJECTIVES: To determine the impact of anesthesia type on in-hospital mortality and morbidity for geriatric fragility hip fracture surgery. DESIGN: Retrospective cohort study. SETTING: Integrates health care delivery system across 38 facilities in the United States. PATIENTS/PARTICIPANTS: We identified 16,695 patients 65 years of age and older who underwent emergent hip fracture repairs between 2009 and 2014 through the Kaiser Permanente hip fracture registry and excluded pathologic or bilateral fractures...
March 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29461406/interventional-procedures-outside-of-the-operating-room-results-from-the-national-anesthesia-clinical-outcomes-registry
#10
Beverly Chang, Alan D Kaye, James H Diaz, Benjamin Westlake, Richard P Dutton, Richard D Urman
OBJECTIVES: This study examines the impact of procedural locations and types of anesthetics on patient outcomes in non-operating room anesthesia (NORA) locations. The National Anesthesia Clinical Outcomes Registry database was examined to compare OR to NORA anesthetic complications and patient demographics. METHODS: The National Anesthesia Clinical Outcomes Registry database was examined for all patient procedures from 2010 to 2013. A total of 12,252,846 cases were analyzed, with 205 practices contributing information, representing 1494 facilities and 7767 physician providers...
March 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29457122/a-case-of-spinal-anesthesia-in-a-patient-with-progressive-supranuclear-palsy
#11
Momoka Tonan, Moritoki Egi, Nana Furushima, Satoshi Mizobuchi
Progressive supranuclear palsy (PSP) is one of the rare diseases. PSP is characterized by oculomotor dysfunction, postural instability, akinesia, dysarthria, and dysphagia. The major cause of death in patients with PSP is aspiration pneumonia. Considering these complications, spinal anesthesia is useful in patients with PSP. However, the potential harmful effects of spinal anesthesia including neurotoxicity of local anesthetics and neurologic complications for patients with PSP are unclear, because there has been no report...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457121/anesthesia-for-patients-with-ptrf-mutations-a-case-report
#12
Atsuko Hirano, Tomohiko Takada, Mariko Senda, Hidemasa Takahashi, Takeo Suzuki
Background: Polymeraze I and transcript release factor ( PTRF ) mutations are a newly recognized disease, which cause congenital generalized lipodystrophy associated with myopathy. Case presentation: A 29-year-old man (height 126 cm; weight 22 kg) with a PTRF mutation was scheduled for mandibular dentigerous cystectomy. His primary symptoms were lipodystrophy, myopathy, long QT syndrome, refractory nephrosis, and abnormal lipid metabolism. Defibrillator pads were applied soon after the patient entered the operating room...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457113/pulmonary-embolism-caused-by-ovarian-vein-thrombosis-during-cesarean-section-a-case-report
#13
Yutaka Oda, Michie Fujita, Chika Motohisa, Shinichi Nakata, Motoko Shimada, Ryushi Komatsu
Background: Ovarian vein thrombosis is a rare complication of pregnancy. The representative complaints of patients with ovarian vein thrombosis are abdominal pain and fever. In some cases, however, fatal pulmonary embolism may develop. We report a case of pulmonary embolism presenting with severe hypotension and loss of consciousness during cesarean section possibly caused by ovarian vein thrombosis. Case presentation: A 25-year-old woman at 38 weeks 4 days of gestation was scheduled for repeat cesarean section...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29457112/anesthetic-management-during-a-cesarean-section-in-a-patient-with-cleidocranial-dysplasia-a-case-report
#14
Yumiko Nishio, Teruyuki Hiraki, Hiroko Taniguchi, Kazuo Ushijima
Background: Cleidocranial dysplasia is a type of skeletal dysplasia, which is primarily characterized by delayed ossification of skeletal structures. It causes facial and oral abnormalities, resulting in difficult airway management and neuraxial anesthesia. Case presentation: The patient was a 24-year-old primipara (height 138 cm, weight 42 kg) with a hypoplastic right clavicle, patent fontanelles, dental malalignment, and a high palate. She was diagnosed with cleidocranial dysplasia at birth, although gene examination has not been performed...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29456901/awake-craniotomy-for-the-treatment-of-a-cortical-pseudoaneurysm-in-a-pregnant-patient
#15
Hirad Hedayat, Daniel R Felbaum, John E Reynolds, Rashid M Janjua
Neurosurgical pathologies presenting during pregnancy are uncommon. If present, the situation creates a unique diagnostic, observational, and therapeutic challenge as both lives are placed at potential risk. Surgical procedures during pregnancy are approached carefully as physiological stressors associated with surgery and anesthesia may cause fetal or maternal compromise. We present the only known case of a pseudoaneurysm treated with an awake craniotomy, allowing us to abate the risks associated with general anesthesia in pregnancy...
December 7, 2017: Curēus
https://www.readbyqxmd.com/read/29456348/efficacy-of-dexmedetomidine-as-an-adjuvant-to-local-anesthetic-agent-in-scalp-block-and-scalp-infiltration-to-control-postcraniotomy-pain-a-double-blind-randomized-trial
#16
Shankar Vallapu, Nidhi Bidyut Panda, Navneh Samagh, Neerja Bharti
Context: Scalp infiltration and scalp block are being used to manage postcraniotomy pain. Dexmedetomidine has been successfully used as an adjuvant in regional anesthesia. The study was intended to compare whether addition of dexmedetomidine prolonged the duration of analgesia as well as to compare the two techniques. Aims: The primary objective was to assess whether addition of dexmedetomidine to bupivacaine prolonged the duration of analgesia. The secondary objective was to compare between scalp nerve block and scalp infiltration as techniques for pain relief...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29450028/implementation-of-a-novel-synchronous-multi-site-all-day-high-fidelity-simulation
#17
Paul Abraham, Franck Verdonk, Clement Buleon, Antoine Tesniere, Marc Lilot
Integration of simulation in educational curricula for anesthesia and intensive care residents is a hot topic. There is a great interest for simulation centers to share their experiences through multi-site synchronous simulation sessions. The present study results from an experience conducted at three sites in France (Paris, Lyon, and Caen), which involved 16 instructors and 25 residents facing the same scenario across 1 day. Synchronous simulations were performed at each site with local and shared debriefing via teleconference...
2018: Advances in Simulation
https://www.readbyqxmd.com/read/29449944/dexmedetomidine-use-during-epiduroscopy-reduces-fentanyl-use-and-postoperative-nausea-and-vomiting-a-single-center-retrospective-study
#18
Takashi Suzuki, Ryota Inokuchi, Kazuo Hanaoka, Machi Suka, Hiroyuki Yanagisawa
Objectives: Minimally invasive epiduroscopy has recently been reported as an effective treatment procedure for chronic and intractable low back pain. However, no study has determined safe anesthetics for monitored anesthesia care during epiduroscopy. We aimed to compare and evaluate conventional monitored anesthesia care drugs with dexmedetomidine. Methods: A retrospective study including all patients who underwent epiduroscopy at the JR Tokyo General Hospital from April 2011 to March 2016 was designed...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29449769/translational-manipulation-under-anesthesia-for-patients-with-frozen-shoulder-a-case-series-study-with-five-year-health-care-utilization-and-post-manipulative-arthroscopic-findings
#19
Ben R Hando, Daniel I Rhon, Robert E Boyles, Julie M Whitman, Jenny L English
Study Design: Case series study. Objectives: Although there have been no reported complications from translational manipulation under anesthesia (tMUA) for individuals with adhesive capsulitis (AC) there are no cases reporting surgical findings post tMUA. Also, there are no studies evaluating health care utilization following tMUA. The purpose of this study was to: (1) report clinical outcomes following tMUA, (2) describe relevant health care costs and utilization following tMUA, and (3) summarize findings from two cases receiving joint arthroscopy following tMUA...
December 2017: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/29447402/intraoperative-endotracheal-cuff-pressure-study-how-education-and-availability-of-manometers-help-guide-safer-pressures
#20
Gregory J Stevens, Joel W Warfel, James K Aden, Scott D Blackwell
Introduction: Endotracheal intubation is a medical procedure that is often indicated in both the perioperative and critical care environments. Cuffed endotracheal tubes (ETT) allow for safer and more efficient delivery of positive pressure ventilation, as well as create a barrier to reduce the risk of micro-aspiration and anesthetic pollution in the operating room environment. Over-inflation of the endotracheal cuff can lead to serious and harmful sequelae. This study aimed to assess if departmental education paired with ready access to a manometer to assess cuff pressure would result in an improvement in the proportion of ETT cuff pressures in the goal range...
February 13, 2018: Military Medicine
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