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https://www.readbyqxmd.com/read/28213055/electrophysiological-measurements-that-can-explain-and-guide-temporary-accelerated-pacing-to-avert-re-occurrence-of-torsade-de-pointes-arrhythmias-in-the-canine-chronic-atrioventricular-block-model
#1
Sofieke C Wijers, Alexandre Bossu, Albert Dunnink, Jet D M Beekman, Rosanne Varkevisser, Alfonso Aranda Hernández, Mathias Meine, Marc A Vos
BACKGROUND: Pacing at higher rates is known to suppress Torsade de Pointes (TdP) arrhythmias. Nevertheless, exact application and mechanism need further clarification. In the anesthetized, canine, chronic atrioventricular block model, ventricular remodeling is responsible for a high and reproducible incidence of TdP upon a challenge with dofetilide. OBJECTIVE: We used this model to investigate by what mechanism accelerated pacing averts TdP and what repolarization parameter could be used to guide temporary applied accelerated pacing (TAP)...
February 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28211248/anesthetic-considerations-for-pediatric-electroconvulsive-therapy
#2
REVIEW
Andrew D Franklin, Jenna H Sobey, Eric T Stickles
Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28211128/staged-intraperitoneal-brachytherapy-and-hyperthermic-intraperitoneal-chemotherapy-in-an-adolescent-novel-anesthetic-challenges-for-pediatric-anesthetists
#3
Andrew D Weatherall, Tristan R Bennett, Mark Lovell, Winnie Fung, Jonathan de Lima
Newer techniques that have found a place in cancer management in adults are offered far less commonly in pediatric patients. We present a case of a patient with recurrent Wilms' tumor managed with a novel combination of cytoreductive surgery, intraperitoneal brachytherapy, and subsequent hyperthermic intraperitoneal chemotherapy. Each stage presents challenges that the pediatric anesthetist is unlikely to have faced before. Such cases require flexibility and thorough planning to manage the combination of major surgery, remote anesthesia with brachytherapy and hyperthermic chemotherapy with its potential for metabolic derangement, significant fluid shifts, analgesic care, and potential exposure of staff to cytotoxic agents...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28207594/using-high-technology-simulators-to-prepare-anesthesia-providers-before-implementation-of-a-new-electronic-health-record-module-a-technical-report
#4
Ari Y Weintraub, Ellen S Deutsch, Roberta L Hales, Newton A Buchanan, Whitney L Rock, Mohamed A Rehman
Learning to use a new electronic anesthesia information management system can be challenging. Documenting anesthetic events, medication administration, and airway management in an unfamiliar system while simultaneously caring for a patient with the vigilance required for safe anesthesia can be distracting and risky. This technical report describes a vendor-agnostic approach to training using a high-technology manikin in a simulated clinical scenario. Training was feasible and valued by participants but required a combination of electronic and manual components...
February 15, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28207390/fast-and-accurate-rat-head-motion-tracking-with-point-sources-for-awake-brain-pet
#5
Alan Miranda, Steven Staelens, Sigrid Stroobants, Jeroen Verhaeghe
To avoid the confounding effects of anesthesia and immobilization stress in rat brain positron emission tomography (PET), motion tracking based unrestrained awake rat brain imaging is being developed. In this work we propose a fast and accurate rat head motion tracking method based on small PET point sources. PET point sources (3-4) attached to the rat's head are tracked in image space using 15-32 ms time frames. Our point source tracking (PST) method was validated using a manually moved microDerenzo phantom that was simultaneously tracked with an optical tracker (OT) for comparison...
February 13, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28202356/bladder-capacity-is-a-biomarker-for-a-bladder-centric-versus-systemic-manifestation-in-interstitial-cystitis-bladder-pain-syndrome
#6
Stephen J Walker, Joao Zambon, Karl-Erik Andersson, Carl Langefeld, Catherine A Matthews, Gopal Badlani, Heather Bowman, Robert J Evans
PURPOSE: Interstitial cystitis/bladder pain syndrome (IC/BPS) presents a significant clinical challenge due to symptom heterogeneity and the myriad associated comorbid medical conditions. We recently reported that diminished bladder capacity (BC) may represent a specific IC/BPS sub-phenotype. The objective of this study is to investigate the relationship between anesthetic bladder capacity and clinical findings (urologic and non-urologic) in a cohort of IC/BPS patients who had undergone therapeutic urinary bladder hydrodistention...
February 12, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28202311/anesthetic-considerations-for-labor-and-delivery-in-women-with-cerebrospinal-fluid-shunts
#7
S Rajagopalan, S Gopinath, V T Trinh, S Chandrasekhar
BACKGROUND: The anesthetic management of labor and delivery in pregnant women with cerebrospinal fluid shunts can be challenging. We conducted a literature review to understand the anesthetic implications in pregnant women with cerebrospinal fluid shunts. METHODS: We searched PubMed, EMBASE, and Medline databases to identify reports of pregnant women with cerebrospinal fluid shunts during the 30-year period from 1985 to 2015. Twenty-four studies reporting anesthetic techniques for labor and delivery were included in the analyses...
January 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#8
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28187022/carotid-body-paraganglioma-a-rare-tumor-with-serious-anesthetic-challenges
#9
Angela T Truong, Sudip Thakar, Dam-Thuy Truong
No abstract text is available yet for this article.
February 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28186626/ultrasound-guided-dorsal-penile-nerve-block-performed-in-a-case-of-zipper-entrapment-injury
#10
Gabriel Rose, Vincent Costa, Aaran Drake, Sebastian D Siadecki, Turandot Saul
Injury to the penis resulting from zipper entrapment is a painful condition that presents a unique anesthetic challenge to the emergency physician and may even require procedural sedation for removal. In this case report, we describe successful removal of zipper entrapment from the penis of a 34-year-old patient after the application of an ultrasound-guided dorsal penile nerve block. We discuss the anatomy, sonographic features, and steps required for the nerve block procedure. © 2017 Wiley Periodicals, Inc...
February 10, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28181351/sedation-methods-for-transthoracic-echocardiography-in-children-with-trisomy-21-a-retrospective-study
#11
Jeff Miller, Lili Ding, James Spaeth, Jennifer Lam, Joanna Paquin, Erica Lin, Allison Divanovic, Bi Lian Li, Shankar Baskar, Andreas W Loepke
BACKGROUND: Many children with Trisomy 21 have neurologic or behavioral problems that make it difficult for them to remain still during noninvasive imaging studies, such as transthoracic echocardiograms (TTEcho). Recently, intranasal dexmedetomidine sedation has been introduced for this purpose. However, dexmedetomidine has been associated with bradycardia. Children with Trisomy 21 have been reported to have a higher risk of bradycardia and airway obstruction with sedation or anesthesia compared to children without Trisomy 21...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28166107/challenges-in-the-anesthetic-management-for-a-robotic-thymectomy-in-a-patient-with-myasthenia-gravis-a-case-report
#12
Susan M Martinelli, Bilal D Lateef, Jason M Long, David Y Huang, Ameeta Karmarkar, Brian P Barrick
We describe the case of a patient with myasthenia gravis undergoing a robotic-assisted thymectomy complicated by postoperative myasthenic crisis, with a focus on the anesthetic considerations specific to this case. Because myasthenia gravis is an autoimmune disease affecting acetylcholine receptors, caution must be taken with the use of neuromuscular blockade and reversal. Utilizing a robotic-assisted surgical approach makes anesthetic management challenging given the dangers of patient movement while the robot is docked, lung isolation, extubation criteria, and postoperative disposition...
February 3, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28151904/comparison-between-ultrasound-guided-interfascial-pulsed-radiofrequency-and-ultrasound-guided-interfascial-block-with-local-anesthetic-in-myofascial-pain-syndrome-of-trapezius-muscle
#13
Ik Tae Cho, Yun Woo Cho, Sang Gyu Kwak, Min Cheol Chang
Myofascial pain syndrome (MPS) of the trapezius muscle (TM) is a frequently occurring musculoskeletal disorder. However, the treatment of MPS of the TM remains a challenge. We investigated the effects of ultrasound (US)-guided pulsed radiofrequency (PRF) stimulation on the interfascial area of the TM. In addition, we compared its effect with that of interfascial block (IFB) with 10 mL of 0.6% lidocaine on the interfascial area of the TM. Thirty-six patients with MPS of the TM were included and randomly assigned into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128656/anesthetic-management-of-a-child-with-unspecified-mitochondrial-disease-in-an-outpatient-dental-setting
#14
Taylor R Gordon, Richard J Montandon
Mitochondrial disease (MD) represents a category of metabolic disorders with a wide range of symptoms across a variety of organ systems. It occurs with an incidence of greater than 1:5000 and can be difficult to specifically diagnose because of the variety of clinical presentations and multiple genomic origins. Although phenotypically variable, MD symptoms often include hypotonia, cardiac defects, dysautonomia, and metabolic dysfunction. Mitochondrial disease presents a unique challenge in terms of anesthetic management, as many anesthetic drugs suppress mitochondrial function...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28123711/gaseous-nitric-oxide-for-the-local-treatment-of-bacterial-keratitis-in-mice
#15
Mona Deichelbohrer, Ming-Feng Wu, Berthold Seitz, Stefan Wagenpfeil, Carola Meier, Markus Bischoff, Thomas Tschernig
The successful treatment of severe bacterial keratitis continues to be a challenge in animals and humans. In the present study the aim was to assess gaseous therapy using gaseous nitric oxide (gNO) in a murine model of Pseudomonas aeruginosa keratitis. The cornea of anesthetized mice was mechanically scratched and covered with a bacterial suspension of P. aeruginosa. One day later, the infected eyes were exposed to 200 ppm NO for 30 min. Three to seven days later the mice were sacrificed and the bulbi were obtained and processed for light microscopy...
January 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28118212/delayed-anaphylaxis-to-mammalian-meat-following-tick-exposure-and-its-impact-on-anesthetic-management-for-cardiac-surgery-a-case-report
#16
Amanda M Kleiman, Keith E Littlewood, Danja S Groves
Hypersensitivity reactions to mammalian meat following tick exposure are increasing in prevalence and provide a unique challenge to anesthesiologists. The reactions, including anaphylaxis, are delayed and therefore may not be easily recognized and treated. The risk is especially high in cardiac surgery, where several potential triggers, including biological valves as well as heparin, are used frequently. In the presence of such hypersensitivity, prophylactic measures including preoperative testing and pharmacologic prophylaxis may be useful in modulating the immune response such that triggering agents may be used relatively safely...
January 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28117818/a-robust-pneumonia-model-in-immunocompetent-rodents-to-evaluate-antibacterial-efficacy-against-s-pneumoniae-h-influenzae-k-pneumoniae-p-aeruginosa-or-a-baumannii
#17
Jennifer L Hoover, Thomas F Lewandowski, Cindy L Mininger, Christine M Singley, Scott Sucoloski, Stephen Rittenhouse
Efficacy of candidate antibacterial treatments must be demonstrated in animal models of infection as part of the discovery and development process, preferably in models which mimic the intended clinical indication. A method for inducing robust lung infections in immunocompetent rats and mice is described which allows for the assessment of treatments in a model of serious pneumonia caused by S. pneumoniae, H. influenzae, P. aeruginosa, K. pneumoniae or A. baumannii. Animals are anesthetized, and an agar-based inoculum is deposited deep into the lung via nonsurgical intratracheal intubation...
January 2, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28111187/functional-and-oxygen-metabolic-photoacoustic-microscopy-of-the-awake-mouse-brain
#18
Rui Cao, Jun Li, Bo Ning, Naidi Sun, Tianxiong Wang, Zhiyi Zuo, Song Hu
A long-standing challenge in optical neuroimaging has been the assessment of hemodynamics and oxygen metabolism in the awake rodent brain at the microscopic level. Here, we report first-of-a-kind head-restrained photoacoustic microscopy (PAM), which enables simultaneous imaging of the cerebrovascular anatomy, total concentration and oxygen saturation of hemoglobin, and blood flow in awake mice. Combining these hemodynamic measurements allows us to derive two key metabolic parameters-oxygen extraction fraction (OEF) and the cerebral metabolic rate of oxygen (CMRO2)...
January 19, 2017: NeuroImage
https://www.readbyqxmd.com/read/28101752/the-impact-of-hydrocortisone-treatment-on-neutrophil-gelatinase-associated-lipocalin-release-in-porcine-endotoxemic-shock
#19
E Söderberg, M Eriksson, A Larsson, M Lipcsey
BACKGROUND: A key feature of sepsis is systemic inflammatory activation that could be counteracted by steroids. In this experimental model of systemic inflammation, we sought to investigate whether septic neutrophil activation, evaluated by the plasma levels of neutrophil gelatinase-associated protein (NGAL), is modulated by the timing of hydrocortisone treatment. METHODS: Sixteen anesthetized pigs were allocated to one of four equally sized groups. Three of these groups received endotoxin at 2 μg × kg(-1) × h(-1) for 6 h so as to induce endotoxemic shock...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28100967/anesthetic-management-in-radiofrequency-catheter-ablation-of-ventricular-tachycardia
#20
REVIEW
Yi Deng, Payam S Naeini, Mehdi Razavi, Charles D Collard, Daniel A Tolpin, James M Anton
Radiofrequency catheter ablation is increasingly being used to treat patients who have ventricular tachycardia, and anesthesiologists frequently manage their perioperative care. This narrative review is intended to familiarize anesthesiologists with preprocedural, intraprocedural, and postprocedural implications of this ablation. Ventricular tachycardia typically arises from structural heart disease, most often from scar tissue after myocardial infarction. Many patients thus affected will benefit from radiofrequency catheter ablation in the electrophysiology laboratory to ablate the foci of arrhythmogenesis...
December 2016: Texas Heart Institute Journal
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