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case report in anesthesiology

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https://www.readbyqxmd.com/read/27919596/chimeric-anterolateral-thigh-free-flap-for-reconstruction-of-complex-cranio-orbito-facial-defects-after-skull-base-cancers-resection
#1
Mario Cherubino, Mario Turri-Zanoni, Paolo Battaglia, Marco Giudice, Igor Pellegatta, Federico Tamborini, Francesca Maggiulli, Luca Guzzetti, Danilo Di Giovanna, Maurizio Bignami, Carolina Calati, Paolo Castelnuovo, Luigi Valdatta
Complex cranio-orbito-facial defects after skull base cancers resection entail a functional and esthetic reconstruction. The introduction of endoscopic assisted techniques for excision surgery with the advances in reconstructive surgery and anesthesiology allowed to improve the management of such critical patients. We report a series of chimeric anterolateral thigh (ALT) flaps used to reconstruct complex cranio-orbital-facial defects after skull base surgery. A retrospective review of patients that underwent cranio-orbito-facial reconstruction using a chimeric ALT flap from March 2013 to October 2015 at a single tertiary care referral Institute was performed...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27918331/growth-of-nonoperating-room-anesthesia-care-in-the-united-states-a-contemporary-trends-analysis
#2
Alexander Nagrebetsky, Rodney A Gabriel, Richard P Dutton, Richard D Urman
BACKGROUND: Although previous publications suggest an increasing demand and volume of nonoperating room anesthesia (NORA) cases in the United States, there is little factual information on either volume or characteristics of NORA cases at a national level. Our goal was to assess the available data using the National Anesthesia Clinical Outcomes Registry (NACOR). METHODS: We performed a retrospective analysis of NORA volume and case characteristics using NACOR data for the period 2010-2014...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27898548/two-cardiac-arrests-because-of-venous-air-embolism-during-endoscopic-retrograde-cholangiopancreatography
#3
Joseph M Sisk, Monica D Choi, Andrew B Casabianca, Ali M Hassan
Venous air embolism is a rare but potentially catastrophic complication of endoscopic retrograde cholangiopancreatography. We report 2 cases of venous air embolism and subsequent cardiac arrests. During resuscitation efforts, a transesophageal echocardiogram was placed, which demonstrated significant air in the right heart. Although gastroenterologists seem to be more aware of this complication, it is underreported in the anesthesiology literature. As anesthesiologists continue to expand coverage to endoscopy suites, anesthesia providers must be aware of predisposing factors and maintain a high index of suspicion to recognize and treat in a timely manner to prevent serious adverse outcomes...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27882764/-acute-pancreatitis-in-pregnancy-complicated-by-rupture-of%C3%A2-aneurysm-of-artery-lienalis
#4
E Hostinská, K Huml, R Pilka
OBJECTIVE: We present a case of pregnant woman with acute pacreatitis in 38th week comlicated by acute rupture of aneurysm of artery lienalis. DESIGN: Case report. SETTING: Department of Gynaecology and Obstetrics, Faculty Hospital and Palacky University, Olomouc. CASE REPORT: 28-years-old primipara in 38th week of gestation was admitted to our department for acute pancreatitis caused by gallstones. Subsequent conservative treatment was complicated by rupture of aneurysm of lienal artery and haemorrhagic shock...
2016: Ceská Gynekologie
https://www.readbyqxmd.com/read/27852079/propofol-and-remifentanil-sedation-for-bronchial-thermoplasty-a-prospective-cohort-trial
#5
Julia N S d'Hooghe, Susanne Eberl, Jouke T Annema, Peter I Bonta
BACKGROUND: Bronchial thermoplasty (BT) is a rapidly emerging bronchoscopic treatment for patients with moderate-to-severe asthma. Different sedation strategies are currently used, ranging from mild midazolam sedation to general anesthesia requiring tracheal intubation. OBJECTIVES: The aim of this study was to assess the feasibility, safety, and both patients' and bronchoscopists' satisfaction with propofol and remifentanil sedation administered by specialized sedation anesthesiology nurses during BT in severe asthma patients...
November 17, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27659764/-when-a-patient-falls-asleep-and-can-t-get-up-conversion-disorder-paraplegia-following-general-anesthesia
#6
Chawla LaToya Mason
BACKGROUND AND OBJECTIVES: This case report describes the rare occurrence of paraplegia caused by conversion disorder in a woman who received general anesthesia for breast surgery. CASE REPORT: A 46-year-old healthy woman received general anesthesia for excision of a left breast fibroepithelial lesion. In the post-anesthesia care unit, she reported bilateral loss of both sensation and motor function below the knees. Physical signs and symptoms did not correlate with any anatomical or neurological patterns; imaging revealed no abnormalities...
September 19, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27392440/-aggression-and-subjective-risk-in-emergency-medicine-a-survey
#7
S Petersen, B Scheller, S Wutzler, K Zacharowski, S Wicker
BACKGROUND: Healthcare personnel may be faced with different degrees of violence and aggression, particularly concerning preclinical care. However, systematic data with respect to the frequency and type of violence in emergency medicine in Germany has not been researched. METHODS AND OBJECTIVES: At an anesthesiology congress, an anonymous survey was distributed about the different kinds and extent of violent acts that the participants had experienced during their work in emergency medicine...
August 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27365892/complex-regional-pain-syndrome
#8
Emily S Carr, Ashley De La Cerda, Katherine Fiala
Complex regional pain syndrome (CRPS) is a neurologic disorder that often results in debilitating chronic pain, but the diagnosis may elude providers as it is one of exclusion. A history of trauma may be elucidated. We report a case of CRPS and review the clinical findings, appropriate workup, and treatment options for the patient. The patient we describe went through an extensive workup before receiving the correct diagnosis. Delay in diagnosis leads to prolonged suffering for the patient and, at times, unnecessary invasive debridement procedures...
July 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27357590/sudden-death-after-major-head-and-neck-cancer-surgery-due-to-undetected-arrhythmogenic-right-ventricle-cardiomyopathy-arvc
#9
Ákos Bicsák, Alice Jellen, Herwig Tuppy, Wolfgang Paul Poeschl
BACKGROUND: Oral squamous cell carcinoma is the sixth most frequent malignancy in Austria. The incidence of arrhythmogenic right ventricle dysplasia (ARVC), an important cause of sudden cardiac death, is estimated at 1:5000 to 1:1000. CASE REPORT: We present a case of a 75-year-old woman who underwent major oncologic surgery for T4aN0M0 maxillary squamous cell carcinoma and reconstruction with a scapular-latissimus dorsi microvascular flap. The patient died suddenly during her postoperative care...
June 29, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27319102/-current-situation-survey-of-the-measures-to-prevent-medication-errors-in-the-operating-room-report-of-the-japan-society-of-anesthesiologists-safety-commission-working-group-for-consideration-of-recommendations-for-color-coding-of-prepared-syringe-labels-for
#10
Kyoko Shida, Toshiyasu Suzuki, Kazuhiro Sugahara, Kazuya Sobue
BACKGROUND: In the case of medication errors which are among the more frequent adverse events that occur in the hospital, there is a need for effective measures to prevent incidence. According to the Japan Society of Anesthesiologists study "Drug incident investigation 2005-2007 years", "Error of a syringe at the selection stage" was the most frequent (44.2%). The status of current measures and best practices implemented in Japanese hospitals was the focus of a subsequent investigation...
May 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/27301056/human-error-in-throat-pack-management-report-of-two-cases
#11
Violaine Baranger, Nicolas Bon Mardion, Bertrand Dureuil, Vincent Compère
Throat packs are frequently used after tracheal intubation during ear, nose, and throat surgery. We report 2 cases of complications related to throat packs retained at the end of surgery. Miscommunication between anesthesiology and surgery teams on throat pack management led to an upper gastrointestinal endoscopy examination under general anesthesia in the first case and to severe respiratory distress requiring tracheal reintubation in the second case. Our 2 case reports highlight the importance of good communication between anesthesiology and surgery teams and of standardized procedures and checklists for the management of throat packs to ensure patient safety...
June 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27209623/the-effects-of-patient-obesity-on-early-postoperative-complications-after-shoulder-arthroscopy
#12
David C Sing, David Y Ding, Thomas U Aguilar, Tammy Luan, C Benjamin Ma, Brian T Feeley, Alan L Zhang
PURPOSE: To report the prevalence of obesity in shoulder arthroscopy, determine a body mass index (BMI) threshold most predictive of complication within 30 days, and evaluate obesity as an independent risk factor for medical and surgical complications. METHODS: Using the National Surgical Quality Improvement Program database, we reviewed all patients who underwent shoulder arthroscopy during 2011 to 2013. Receiver operating characteristic and Youden coefficient were calculated to find an optimal BMI cutoff to predict complications within 30 days of surgery...
May 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27129535/donor-derived-tuberculosis-in-an-anesthetist-after-short-term-exposure-an-old-demon-transplanted-from-the-past-to-the-present
#13
I Freytag, J Bucher, M Schoenberg, M Stangl, G Schelling
We report a case of a 27-year-old anesthetist who acquired tuberculosis (TB) while performing general anesthesia in a renal transplant (RTX) patient who had donor-derived contagious TB. The anesthetist developed pleural TB 6 months after exposure. Contact investigations (CIs) did not include health care workers (HCWs) of the Department of Anesthesiology, thereby missing the opportunity for the early diagnosis and treatment of TB. Genomic fingerprinting revealed identical Mycobacterium tuberculosis (MT) isolates in the anesthetist and in the RTX patient...
May 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27069694/anesthesiological-management-of-a-patient-with-williams-syndrome-undergoing-spine-surgery
#14
Federico Boncagni, Luca Pecora, Vasco Durazzi, Francesco Ventrella
Williams Syndrome (WS) is a complex neurodevelopmental disorder associated with a mutation on chromosome 7. Patients with WS usually display dysmorphic facial and musculoskeletal features, congenital heart diseases, metabolic disturbances and cognitive impairment. Structural cardiovascular abnormalities are present in the majority of the children and may provide a substrate for perioperative Sudden Cardiac Death, as presented by several reports, something that creates a great challenge to the anesthetic conduct...
2016: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/26951450/anesthetic-management-of-the-first-pediatric-bilateral-hand-transplant
#15
Harshad G Gurnaney, John E Fiadjoe, L Scott Levin, Benjamin Chang, Heather Delvalle, Jorge Gálvez, Mohamed A Rehman
PURPOSE: The purpose of this case report is to describe the anesthetic and case management of the first vascularized composite allograft pediatric bilateral hand transplant. CLINICAL DETAILS: Our patient was an eight-year-old male with a medical history of Staphylococcus aureus sepsis at one year of age that resulted in end-stage renal disease as well as bilateral upper and lower extremity amputations. After referral for bilateral hand transplantation, the transplantation team, with expertise in all aspects of perioperative care (surgery, anesthesiology, nephrology, renal transplantation, pediatric intensive care, and therapeutic pharmacy), was consulted to help develop anesthetic and other perioperative protocols for surgery...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26948074/pediatric-anesthesiology-fellow-education-is-a-simulation-based-boot-camp-feasible-and-valuable
#16
Aditee P Ambardekar, Devika Singh, Justin L Lockman, David L Rodgers, Roberta L Hales, Harshad G Gurnaney, Aruna Nathan, Ellen S Deutsch
BACKGROUND: Pediatric anesthesiologists must manage crises in neonates and children with timely responses and limited margin for error. Teaching the range of relevant skills during a 12-month fellowship is challenging. An experiential simulation-based curriculum can augment acquisition of knowledge and skills. OBJECTIVES: To develop a simulation-based boot camp (BC) for novice pediatric anesthesiology fellows and assess learner perceptions of BC activities. We hypothesize that BC is feasible, not too basic, and well received by fellows...
May 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26908306/minimizing-stress-with-remifentanil-in-a-patient-with-takotsubo-undergoing-ophthalmic-surgery
#17
Sbaraglia Fabio, Garra Rossella, De Riso Mariella, Continolo Nicola, Sammartino Maria
Anesthesiological management of patients with Takotsubo syndrome (TTS) is a challenge of questions related to physiopathology, prognosis, and trigger causes. Relative rarity of this disease and lack of wide literature do not allow to state any negative or positive effect of the variety of drugs available for anesthesia. The authors report a case of a woman with a clear diagnosis of TTS and anxiety disorder, who underwent to cataract extractions at both eyes at two different times. Clinical management is described, from preoperative assessment until discharge of the patient...
January 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/26831501/characteristics-of-morbidity-and-mortality-conferences-associated-with-the-implementation-of-patient-safety-improvement-initiatives-an-observational-study
#18
MULTICENTER STUDY
Patrice François, Frédéric Prate, Gwenaëlle Vidal-Trecan, Jean-François Quaranta, José Labarere, Elodie Sellier
BACKGROUND: The aim of this study was to identify the characteristics of morbidity and mortality conferences (MMCs) associated with the implementation of patient health-care quality and safety improvement initiatives. METHODS: We conducted an observational study of MMCs and followed up improvement initiatives for 1 year. Data on MMC baseline characteristics were abstracted using document analysis and observation of a meeting in three university hospitals in France (Grenoble, Nice, and Cochin [Paris] hospitals)...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/26831272/outbreak-of-parvovirus-b19-infection-among-anesthesiology-and-surgical-fellows
#19
Reynaldo Lara-Medrano, Michel Fernando Martínez-Reséndez, Elvira Garza-González, Ana Gabriela Medina-Torres, Adrián Camacho-Ortiz
A human parvovirus B19 outbreak was detected in personnel assigned to a surgical area (anesthesiology fellows and an otorhinolaryngology fellow) in a university hospital. The attack rate between susceptible members was higher than previous reports. Diagnosis was determined by polymerase chain reaction for human parvovirus B19 in serum of 1 subject and immunoglobulin M/immunoglobulin G antibody titer in the remaining subjects. Medical personnel were put on leave of absence until resolution of symptoms and laboratory confirmation of health...
September 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/26829952/-or-minute-myth-guidelines-for-calculation-of-drg-revenues-per-or-minute
#20
R M Waeschle, J Hinz, F Bleeker, B Sliwa, A Popov, C E Schmidt, M Bauer
The economic situation in German Hospitals is tense and needs the implementation of differentiated controlling instruments. Accordingly, parameters of revenue development of different organizational units within a hospital are needed. This is particularly necessary in the revenue and cost-intensive operating theater field. So far there are only barely established productivity data for the control of operating room (OR) revenues during the year available. This article describes a valid method for the calculation of case-related revenues per OR minute conform to the diagnosis-related groups (DRG)...
February 2016: Der Anaesthesist
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