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https://www.readbyqxmd.com/read/29772562/using-neuroimaging-to-uncover-awareness-in-brain-injured-and-anesthetized-patients
#1
Mackenzie Graham, Adrian M Owen, Charles Weijer, Lorina Naci
We cast a novel perspective on two distinct populations: patients who become accidentally intraoperatively aware after receiving general anesthesia and severely brain-injured patients who are diagnosed as being in a vegetative state. In both cases, patients are behaviorally non-responsive -and on this basis presumed to lack consciousness- yet, retain covert awareness. In both contexts, detecting consciousness is highly challenging, yet highly important for ensuring adequate patient care. Although great strides have been made in the development of depth-of-anesthesia monitors, these monitors have significant limitations...
June 1, 2018: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/29772320/predictive-factors-of-silent-brain-infarcts-after-asymptomatic-carotid-endarteriectomy
#2
Rémy Pascot, Benjamin Parat, Yann Le Teurnier, Gilles Godet, Jean-Yves Gauvrit, Yann Gouëffic, Eric Steinmetz, Alain Cardon, Adrien Kaladji
BACKGROUND: The optimization of medical treatment regularly challenges the role of carotid surgery for asymptomatic patients. Current research seeks to determine which of these patients will benefit most from surgery. The goal of this study was to identify in a multi-center study, using MRI, the risk factors for postoperative silent cerebral ischemic lesions after carotid surgery for asymptomatic stenosis METHODS: The multicenter, retrospective study included patients with asymptomatic severe carotid stenosis suitable for surgical treatment and who did not have a history of cerebral ischemia...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29771695/scheduling-the-nonoperating-room-anesthesia-suite
#3
Mary E Warner, David P Martin
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) and procedural services often are associated with dispersed geographic settings and small volumes of cases. These lead to scheduling challenges that, if not managed well, result in decreased patient and healthcare team satisfaction and reduced efficiency. This review describes recent studies and provides examples on how NORA scheduling issues have been addressed. RECENT FINDINGS: Increased use of blocked time for consolidated NORA services can lead to sufficiently large volumes of cases that allow improved scheduling and maintain patient and healthcare team satisfaction and better efficiency of care...
May 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29768341/the-plethysmographic-variability-index-does-not-predict-fluid-responsiveness-estimated-by-esophageal-doppler-during-kidney-transplantation-a-controlled-study
#4
Morgan Le Guen, Arnaud Follin, Etienne Gayat, Marc Fischler
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation.To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard.Observational study.University hospital; study from May 2011 and May 2012.Forty-eight patients with end-renal function were included and 44 analyzed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29728260/anesthesia-in-a-pediatric-patient-with-rohadd-syndrome
#5
E Esparza Isasa, M A Palomero Rodríguez, I Acebedo Bambaren, C Medrano Viñas, D Gil Mayo, F Domínguez Pérez, D Pestaña Lagunas
Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome is a rare entity that is characterised by its onset in healthy children at 2-4 years of age. It is a complex syndrome that includes, among other symptoms, rapid weight gain with hyperphagia, hypothalamic dysfunction, central hypoventilation, and autonomic dysregulation. The case is presented of a 10-year-old boy with a diagnosis of ROHHAD syndrome undergoing insertion of a port-a-cath under general anaesthesia, who developed complications during the anaesthetic procedure related to his illness...
May 1, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29722903/advanced-maxillofacial-imaging-for-temporomandibular-disorder-in-special-needs-patients
#6
Chalatip Chompunud Na Ayudhya, Eric J Granquist, Mel Mupparapu, Thomas P Sollecito, Eric T Stoopler
Temporomandibular disorder (TMD) is prevalent in special needs patients. Clinical examination of the temporomandibular joint (TMJ) complex and imaging in this patient population can be challenging due to patient disposition and cooperation. We report a case of a 29-year-old male with neurologic and behavioral special needs who required advanced maxillofacial imaging for a suspected TMD under general anesthesia, which has not been reported previously. This article intends to serve as a resource for health care providers who may encounter similar clinical situations...
May 3, 2018: Special Care in Dentistry
https://www.readbyqxmd.com/read/29694305/the-use-of-local-anesthesia-to-perform-lower-limb-revascularization-in-the-fragile-patient-with-critical-limb-ischemia
#7
N Kontopodis, A Papaioannou, E Tavlas, G Papadopoulos, S Lioudaki, K Tzirakis, C V Ioannou
Patients with critical limb ischemia are usually compromised, frequently making administration of general or regional anesthesia problematic. We treated 3 fragile patients presenting contraindications to undertake traditional anesthetic techniques for lower limb revascularization, in whom local anesthesia with conscious sedation was used to complete the operation. An axillo-bifemoral, a unilateral axillo-femoral and a femoro-femoral bypass were performed. Procedure was uneventful in all three cases despite the coexistence of specific surgical challenges (distal anastomosis at the profunda in two cases, redo surgery and scarred groin in the third)...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29678488/medicolegal-considerations-involving-iatrogenic-lingual-nerve-damage
#8
REVIEW
Roberto Pippi, Andrea Spota, Marcello Santoro
The aim of this review is to improve risk management strategies through analysis of the anatomic, semeiotic, and medicolegal aspects that characterize iatrogenic lingual nerve damage (LND) and its legal consequences in the case of legal proceedings for a claim for compensation. In dental practice, LND can be caused by local or general anesthesia or by mechanical, chemical, or thermal mechanisms. A certain postoperative identification of LND etiopathogenesis is often very challenging because it can be difficult to show at what time the damage occurred and which mechanism actually caused it...
March 27, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29669562/comfort-in-palliative-sedation-compas-a-transdisciplinary-mixed-method-study-protocol-for-linking-objective-assessments-to-subjective-experiences
#9
Stefaan Six, Steven Laureys, Jan Poelaert, Johan Bilsen, Peter Theuns, Reginald Deschepper
BACKGROUND: In case of untreatable suffering at the end of life, palliative sedation may be chosen to assure comfort by reducing the patient's level of consciousness. An important question here is whether such sedated patients are completely free of pain. Because these patients cannot communicate anymore, caregivers have to rely on observation to assess the patient's comfort. Recently however, more sophisticated techniques from the neurosciences have shown that sometimes consciousness and pain are undetectable with these traditional behavioral methods...
April 18, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29666797/development-and-implementation-of-a-perianesthetic-safety-checklist-in-a-veterinary-university-small-animal-teaching-hospital
#10
Gwennaëlle Menoud, Shannon Axiak Flammer, Claudia Spadavecchia, Mathieu Raillard
Introduction: The use of a surgical safety checklist is recommended by the World Health Organization and is associated with advantages: improved communication and reduced complications and mortality. Adapting checklists to the environment in which they are used improves their efficiency, but their implementation can be challenging. The aim of this study was to develop and implement a perianesthetic safety checklist for a small animal hospital. Materials and methods: A panel of eight anesthesia diplomates and seven residents and doctoral students were gathered...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29622313/the-american-association-of-oral-and-maxillofacial-surgeons-simulation-program
#11
REVIEW
David W Todd, John J Schaefer
Patient safety in dental anesthesia has been called into question in recent years. Simulation training has been proposed and developed as one possibility for increasing preparedness and training in cases of adverse events in dental anesthesia. This article presents an overview of the challenges of patient safety in dental anesthesia and how to address them with simulation training. The American Association of Oral and Maxillofacial Surgeons simulation program is unique in its potential to become a standardized, validated competency course with objective grading criteria, mastery-based cooperative learning model, and low facilitator-to-participant ratio, leading to a practical delivery cost structure...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29608321/management-of-pregnancy-sensitized-with-anti-inb-with-monocyte-monolayer-assay-and-maternal-blood-donation
#12
Raj Shree, Kimberly K Ma, Lay S Er, Meghan Delaney
Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory medicine workup of a patient who presented for obstetrical care in the United States in the third trimester and had a rare antibody (anti-Inb)...
January 2018: Immunohematology
https://www.readbyqxmd.com/read/29600206/a-unique-case-of-cervical-myelopathy-in-an-adult-patient-with-scheie-syndrome
#13
Farzam Vazifehdan, Vasilios G Karantzoulis, Robert Ebner, Vasilios G Igoumenou
Introduction: Scheie syndrome is an extremely rare systematic disease that represents the most attenuated form of mucopolysaccharidosis Type I disorder. Although associated with a variety of manifestations, Scheie syndrome leading to the development of cervical myelopathyis yet to be reported. Our purpose was to present a unique case of a Scheie syndrome patient, who underwent surgery due to cervical myelopathy, and to discuss the clinical and imaging findings, as well as the challenges and outcomes of surgical treatment...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29576786/malignant-hyperthermia-report-of-two-cases-with-a-neglected-complication-in-cardiac-surgery
#14
Mahdi Neshati, Manizheh Azadeh, Parinaz Neshati, Tyrone Burnett, Ryan Saenz, Bahman Karbasi, Ghader Shahmohammadi, Eskandar Nourizadeh, Mohsen Rostamzadeh
Malignant hyperthermia (MH) can develop after contact with volatile anesthetics (halothane, enflurane, isoflurane, sevoflurane, and desflurane) as well as succinylcholine and cause hypermetabolism during anesthesia, which is associated with high mortality when untreated. Early diagnosis and treatment could be life-saving. During cardiac surgery, hypothermia and cardiopulmonary bypass make the diagnosis of MH extremely challenging compared with other settings such as general surgery. We herein report 2 cases of MH, graded as "very likely" or "almost certain" based on the MH clinical grading scale...
October 2017: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/29560763/pre-and-peripartal-management-of-a-woman-with-mcardle-disease-a-case-report
#15
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/29552368/primary-diffuse-large-b-cell-lymphoma-mimicking-hyperplastic-reactive-lesion-lymphoma-of-the-oral-cavity
#16
Liziane Cattelan Donaduzzi, Angélica Reinheimer, Maria Augusta Ramires da Silva, Lucia de Noronha, Aline Cristina Batista Rodrigues Johann, Ademir Franco, Soraya de Azambuja Berti Couto, Paulo Henrique Couto Souza
Objective: To report a case of a challenging oral diagnosis involving a primary diffuse large B cell lymphoma of the oral cavity mimicking a hyperplastic reactive lesion. Case Report: A 72-year-old male patient was referred to the Department of Stomatology presenting a proliferative nodular lesion in the anterior region of the mandible involving the anterior teeth. The clinical examination revealed anterior teeth affected by periodontal disease, suggesting the nodular cession hyperplastic reaction...
2018: Case Reports in Pathology
https://www.readbyqxmd.com/read/29545513/intraoperative-acute-respiratory-failure-in-an-immunocompromised-patient-with-human-metapneumovirus
#17
Justin S Merkow, Erik J Nelson
BACKGROUND Providing anesthesia to immunocompromised patients introduces unique challenges, including difficulty in detecting respiratory infections. Detailed preoperative evaluation and preparation for perioperative complications is crucial. Human metapneumovirus is a common but lesser known respiratory virus that can lead to pneumonia and respiratory compromise and is challenging to detect in the immunocompromised patient. CASE REPORT We present a case of an immunocompromised individual scheduled for umbilical hernia repair who developed severe bronchospasm and intraoperative respiratory failure after induction of general anesthesia...
March 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29544752/management-of-an-internal-carotid-artery-injury-caused-by-a-displaced-titanium-plate-with-a-combination-of-interventional-vascular-radiology-and-surgery
#18
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29535558/aplastic-anemia-during-pregnancy-a-review-of-obstetric-and-anesthetic-considerations
#19
REVIEW
Efrain Riveros-Perez, Amy C Hermesch, Linda A Barbour, Joy L Hawkins
Aplastic anemia is a hematologic condition occasionally presenting during pregnancy. This pathological process is associated with significant maternal and neonatal morbidity and mortality. Obstetric and anesthetic management is challenging, and treatment requires a coordinated effort by an interdisciplinary team, in order to provide safe care to these patients. In this review, we describe the current state of the literature as it applies to the complexity of aplastic anemia in pregnancy, focusing on pathophysiologic aspects of the disease in pregnancy, as well as relevant obstetric and anesthetic considerations necessary to treat this challenging problem...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29523485/risk-stratification-resource-availability-and-choice-of-surgical-location-for-the-management-of-parturients-with-abnormal-placentation-a-survey-of-united-states-based-obstetric-anesthesiologists
#20
T R Grant, E H Ellinas, A O Kula, M Y Muravyeva
BACKGROUND: Parturients with abnormally adherent placentas present anesthetic challenges that include risk-stratification, management planning and resource utilization. The labor and delivery unit may be remote from the main operating room services. METHODS: Division chiefs of North American obstetric anesthesiology services were surveyed about their practices and management of parturients with an abnormally adherent placenta. RESULTS: Eighty-four of 122 chiefs, representing 103 hospital sites, responded to the survey (response rate 69%)...
May 2018: International Journal of Obstetric Anesthesia
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