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https://www.readbyqxmd.com/read/29764457/video-mediastinoscopy-assisted-fish-bone-extraction-and-superior-medistinal-abscess-debridement
#1
Jun Wang, Wei Bing Wu, Liang Chen, Quan Zhu
BACKGROUND: Mediastinum abscess caused by sharp esophageal foreign body perforation usually needs surgical treatment, and the surgical procedures vary according to size of perforation and scope of abscess, etc. For special case with small esophageal mucosal crevasse and focal abscess confined to mediastinum, minimally invasive surgery with guidance of video-mediastinoscopy would be an alternative method, however, application of video-mediastinoscopy in this life-threatening situation was rarely reported...
May 15, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29678556/heterogeneity-among-hospitals-statewide-in-percentage-shares-of-the-annual-growth-of-surgical-caseloads-of-inpatient-and-outpatient-major-therapeutic-procedures
#2
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Suppose that it were a generalizable finding, in both densely populated and rural states, that there is marked heterogeneity among hospitals in the percentage change in surgical caseload and/or in the total change in caseload. Then, individual hospitals should not simply rely on federal and state forecasts to infer their expected growth. Likewise, individual hospitals and their anesthesiology groups would best not rely on national or US regional surgical trends as causal reasons for local trends in caseload...
April 17, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29672400/enhanced-recovery-after-surgery-eras-pathway-in-esophagectomy-is-a-reasonable-prediction-of-hospital-stay-possible
#3
Paolo Parise, Carlo Ferrari, Andrea Cossu, Francesco Puccetti, Ugo Elmore, Stefano De Pascale, Leonardo Garutti, Uberto Romario Fumagalli, Mariaclelia Stefania Di Serio, Riccardo Rosati
OBJECTIVE: To assess whether perioperative variables or deviation from enhanced recovery after surgery (ERAS) items could be associated with delayed discharge after esophagectomy, and to convert them into a scoring system to predict it. SUMMARY BACKGROUND DATA: ERAS perioperative pathways have been recently applied to esophageal resections. However, low adherence to ERAS items and high rates of protocol deviations are often reported. METHODS: All patients who underwent esophagectomy between April 2012 and March 2017 were managed with a standardized perioperative pathway according to ERAS principles...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29570150/cost-effectiveness-research-in-anesthesiology
#4
Bijan J Teja, Tori N Sutherland, Sheila R Barnett, Daniel S Talmor
Perioperative interventions aimed at decreasing costs and improving outcomes have become increasingly popular in recent years. Anesthesiologists are often faced with a choice among different treatment strategies with little data available on the comparative cost-effectiveness. We performed a systematic review of the English language literature between 1980 and 2014 to identify cost-effectiveness analyses of anesthesiology and perioperative medicine interventions. We excluded interventions related to critical care or pediatric anesthesiology, and articles on interventions not normally ordered or performed by anesthesiologists...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29560763/pre-and-peripartal-management-of-a-woman-with-mcardle-disease-a-case-report
#5
Tina Stopp, Michael Feichtinger, Wolfgang Eppel, Thomas M Stulnig, Peter Husslein, Christian Göbl
McArdle disease or glycogen storage disease (GSD) type V is a rare autosomal recessive inherited disorder in skeletal muscle metabolism leading to exercise intolerance, muscle cramps and in some cases to rhabdomyolysis and acute renal failure due to elevated serum myoglobin levels. Albeit the uterine smooth muscle is not affected, pregnancy and delivery can be physically strenuous and may require specific anesthesiologic care. However, data on pregnancy progress and outcome and on special implications linked to anesthesia in women with McArdle's disease is scarce, thus posing a challenge to pre- and peripartal management...
March 21, 2018: Gynecological Endocrinology
https://www.readbyqxmd.com/read/29497708/telepain-primary-care-chronic-pain-management-through-weekly-didactic-and-case-based-telementoring
#6
Diane M Flynn, Linda H Eaton, Honor McQuinn, Ashley Alden, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Chronic pain is a significant problem among military personnel and a priority of the military health system. The U.S. Army Surgeon General's Pain Management Task Force recommends using telehealth capabilities to enhance pain management. This article describes the development and evaluation of a telehealth intervention (TelePain) designed to improve access to pain specialist consultation in the military health system. The study uses a wait-list controlled clinical trial to test: 1) effectiveness of the intervention, and 2) interviews to assess barriers and facilitators of the intervention implementation...
December 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29491752/preliminary-indications-for-the-use-of-sugammadex-after-its-addition-to-a-formulary-at-a-tertiary-care-children-s-hospital
#7
N'Diris Barry, Joshua C Uffman, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: Neuromuscular blocking agents (NMBAs) are administered to facilitate endotracheal intubation and provide skeletal muscle relaxation in surgical procedures. Sugammadex (Bridion) recently received approval by the United States Food and Drug Administration for reversal of rocuronium and vecuronium-induced neuromuscular blockade thereby providing an alternative to acetylcholinesterase inhibitors such as neostigmine. This quality improvement analysis sought to investigate the clinical reasons and common clinical perceptions for choosing sugammadex over neostigmine to reverse NMBAs...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29490011/awake-surgery-for-a-violin-player-monitoring-motor-and-music-performance-a-case-report
#8
Vitória Piai, Sandra H Vos, Reinhard Idelberger, Pauline Gans, Jonne Doorduin, Mark Ter Laan
Objective: We report the case of a professional violin player who underwent an awake craniotomy to resect a tumor in the left supplementary motor area, an area involved in motor planning. Method: A careful pre- and intraoperative monitoring plan for music performance and complex motor function was established that could be used in combination with cortical stimulation. Results: The patient suffered an epileptic seizure during cortical stimulation...
February 27, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29396626/-ablative-therapy-of-small-renal-masses
#9
REVIEW
M C Kriegmair, N Wagener, S J Diehl, N Rathmann
Renal cell cancer is nowadays predominantly diagnosed in early stages due to the widespread use of sectional imaging for unrelated symptoms. Small renal masses (<4 cm) feature a largely indolent biology with a very low risk for metastasis or even a benign biology in up to 30% of the cases. Consequently, there is a need for less invasive therapeutic alternatives to nephron-sparing surgery. Meanwhile, there is a broad portfolio of local ablation techniques to treat small renal tumors. These include the extensively studied radiofrequency ablation and cryoablation techniques as well as newer modalities like microwave ablation and irreversible electroporation as more experimental techniques...
March 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29116968/antiemetic-prophylaxis-as-a-marker-of-health-care-disparities-in-the-national-anesthesia-clinical-outcomes-registry
#10
Michael H Andreae, Jonah S Gabry, Ben Goodrich, Robert S White, Charles Hall
BACKGROUND: US health care disparities persist despite repeated countermeasures. Research identified race, ethnicity, gender, and socioeconomic status as factors, mediated through individual provider and/or systemic biases; little research exists in anesthesiology. We investigated antiemetic prophylaxis as a surrogate marker for anesthesia quality by individual providers because antiemetics are universally available, indicated contingent on patient characteristics (gender, age, etc), but independent of comorbidities and not yet impacted by regulatory or financial constraints...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29046933/-regional-anesthesia-are-the-standards-changing
#11
REVIEW
T Volk, C Kubulus
Regional anesthesia has undergone many changes over the years and the increasing use of ultrasound has certainly played an important role in this. Apart from individual case reports in the literature of very different blocking options, some new procedures seem to have become established and can be broadly applied. Among these are blockades, by which ultrasound-guided injection of local anesthetics is carried out in fascial or muscular layers rather than around target nerves (e.g. cervical plexus blocks and truncal blocks)...
December 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28967732/endobronchial-ultrasound-guided-transbronchial-needle-aspiration-under-conscious-sedation-with-meperidine-and-midazolam
#12
Lorenzo Agostini, Nicola Facciolongo, Mirco Lusuardi, Eleonora Casalini, Carla Galeone, Luciano Lasagni, Luigi Zucchi
Endobronchial Ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is usually performed under general anesthesia or deep sedation with drugs such as Propofol that, at least in Italy, can be administered only by an anesthesiologist. Aim of the study was to assess conscious sedation feasibility, safety and tolerability using Meperidine and Midazolam as administered by Pulmonologist and relevant impact on the efficiency of the sampling procedures.All patients undergoing EBUS-TBNA from February 2013 to July 2014 were examined retrospectively...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28937424/a-case-report-of-incidental-hepatic-cysts-found-on-ultrasound-imaging-implications-for-the-anesthesiologist
#13
Aysha Hasan, Walid Alrayashi, David Waisel, Karen Boretsky
Point-of-care ultrasound imaging is increasingly used by anesthesiologists to facilitate rapid clinical diagnosis and treatment in the perioperative period. With its growing popularity, inevitably, unfamiliar structures will be observed. We present a case of cystic liver lesions in a healthy model during a point-of-care workshop. We address the clinical, ethical, and legal implications of incidental findings in anesthesiology. We offer recommendations and an algorithmic approach to these occurrences.
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28870691/-burnout-in-tunisian-medical-residents-about-149-cases
#14
A Ben Zid, W Homri, I Ben Romdhane, N Bram, R Labbane
BACKGROUND: Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome. AIMS: Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences...
September 1, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28796131/beyond-ultrasound-guidance-for-regional-anesthesiology
#15
De Q Tran, André P Boezaart, Joseph M Neal
Despite its popularity, ultrasound (US)-guided regional anesthesiology is associated with significant limitations. The latter can be attributed to either the US machine (ie, decreased ability to insonate deep neural structures, as well as the thoracic spine) or the operator. Shortcomings associated with the operator can be explained by errors in perception (ie, ambiguous criteria for needle/catheter tip-to-nerve proximity and subparaneural local anesthetic injection) or interpretation. Perhaps the greatest confusion afflicting US-guided regional anesthesiology originates from an intellectual misconception pertaining to its application...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28599909/anterior-transthoracic-surgery-with-motor-evoked-potential-monitoring-for-high-risk-thoracic-disc-herniations-technique-and-results
#16
Erwin Cornips, Jeroen Habets, Vivianne van Kranen-Mastenbroek, Herman Bos, Paul Bergs, Alida Postma
OBJECTIVE: To present our experience with anterior transthoracic surgery for high-risk thoracic disc herniations (TDHs) using motor evoked potential monitoring (MEPm). METHODS: We estimated surgical risk based on clinical and radiologic characteristics, including anteroposterior (AP) spinal canal occupation (SCO), AP spinal cord compression (SCC), residual AP spinal cord diameter (RSCD), and intramedullary signal changes (ISC). We analyzed Anand, ASIA, and Nurick scores, anesthesiologic, neurophysiological, and surgical reports...
September 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28570294/blind-intubation-through-self-pressurized-disposable-supraglottic-airway-laryngeal-intubation-masks-an-international-multicenter-prospective-cohort-study
#17
MULTICENTER STUDY
Kurt Ruetzler, Sandra Esther Guzzella, David Werner Tscholl, Tanja Restin, Marco Cribari, Alparslan Turan, Jing You, Daniel I Sessler, Burkhardt Seifert, Tomasz Gaszynski, Michael T Ganter, Donat R Spahn
BACKGROUND: Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28448321/chest-pain-during-cesarean-delivery-in-relation-to-anomalous-right-coronary-artery-a-case-report
#18
Blanca Tapia Salinas, Andrea Kollmann Camaiora, Estibaliz Alsina Marcos, Fernando Gilsanz
Chest pain during labor can have many etiologies, one of which is myocardial ischemia. We report a 38-year-old woman with American Society of Anesthesiology physical status I scheduled for elective cesarean delivery who experienced chest pain and electrocardiographic signs of myocardial ischemia immediately after carbetocin administration. Subsequent investigations revealed an aberrant right coronary artery originating from the left coronary sinus coursing between the aorta and the pulmonary artery. This was considered the likely cause of the patient's chest pain...
August 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28430550/round-table-on-malignant-hyperthermia-in-physically-active-populations-meeting-proceedings
#19
Yuri Hosokawa, Douglas J Casa, Henry Rosenberg, John F Capacchione, Emmanuel Sagui, Sheila Riazi, Luke N Belval, Patricia A Deuster, John F Jardine, Stavros A Kavouras, Elaine C Lee, Kevin C Miller, Sheila M Muldoon, Francis G O'Connor, Scott R Sailor, Nyamkhishig Sambuughin, Rebecca L Stearns, William M Adams, Robert A Huggins, Lesley W Vandermark
CONTEXT:   Recent case reports on malignant hyperthermia (MH)-like syndrome in physically active populations indicate potential associations among MH, exertional heat stroke (EHS), and exertional rhabdomyolysis (ER). However, an expert consensus for clinicians working with these populations is lacking. OBJECTIVE:   To provide current expert consensus on the (1) definition of MH; (2) history, etiology, and pathophysiology of MH; (3) epidemiology of MH; (4) association of MH with EHS and ER; (5) identification of an MH-like syndrome; (6) recommendations for acute management of an MH-like syndrome; (7) special considerations for physically active populations; and (8) future directions for research...
April 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28429143/how-to-treat-lumbar-disc-herniation-in-pregnancy-a-systematic-review-on-current-standards
#20
REVIEW
Alberto Di Martino, Fabrizio Russo, Luca Denaro, Vincenzo Denaro
PURPOSE: In this systematic review, we aim to illustrate the current and safe concepts in the assessment, diagnosis and management of herniated lumbar disc (HLD) during pregnancy. METHODS: A systematic review and reporting on the diagnosis, treatment and clinical results of HLD during pregnancy is performed. RESULTS: The MRI represents the first level and safest diagnostic tool for pregnant women affected by spinal problems allowing for a noninvasive and detailed radiological examination of the spine...
October 2017: European Spine Journal
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