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https://www.readbyqxmd.com/read/29329881/defining-and-mitigating-the-challenges-of-an-older-and-obese-population-in-minimally-invasive-gynecologic-cancer-surgery
#1
Andrea R Hagemann, Carolyn K McCourt, Swarup S Varaday, Kathleen N Moore
The incidence of endometrial cancer (EC) is steadily increasing due in large part to an aging world population and rise in rates of obesity. Patients with obesity and advancing age can be seen as vulnerable populations, as they are both often subject to physician bias regarding surgical choices and assumptions regarding long-term outcomes. As we operate on an older and/or obese patient population, it is increasingly important that we adopt peri-operative management strategies and surgical techniques to best serve this complex patient population...
January 9, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29329321/impact-of-lipopolysaccharide-induced-acute-inflammation-on-baroreflex-controlled-sympathetic-arterial-pressure-regulation
#2
Takeshi Tohyama, Keita Saku, Toru Kawada, Takuya Kishi, Keimei Yoshida, Takuya Nishikawa, Hiroshi Mannoji, Kazuhiro Kamada, Kenji Sunagawa, Hiroyuki Tsutsui
BACKGROUND: Lipopolysaccharide (LPS) induces acute inflammation, activates sympathetic nerve activity (SNA) and alters hemodynamics. Since the arterial baroreflex is a negative feedback system to stabilize arterial pressure (AP), examining the arterial baroreflex function is a prerequisite to understanding complex hemodynamics under LPS challenge. We investigated the impact of LPS-induced acute inflammation on SNA and AP regulation by performing baroreflex open-loop analysis. METHODS: Ten anesthetized Sprague-Dawley rats were used...
2018: PloS One
https://www.readbyqxmd.com/read/29324792/critical-evaluation-of-colon-submucosal-microdialysis-in-awake-mobile-rats
#3
Norbert Cibicek, Jiri Ehrmann, Jitka Proskova, Rostislav Vecera
Sensors able to record large bowel physiology and biochemistry in situ in awake rodents are lacking. Microdialysis is a mini-invasive technique that may be utilized to continuously deliver or recover low-molecular substances from various tissues. In this experiment we evaluated the feasibility of in vivo microdialysis to monitor extracellular fluid chemistry in the descending colon submucosa of conscious, freely moving rodents. Following surgical implantation of a microdialysis probe, male Wistar rats were housed in metabolic cages where they were analgized and clinically followed for four days with free access to standard diet and water...
2018: PloS One
https://www.readbyqxmd.com/read/29284889/anaesthetic-implications-of-severe-hyperthyroidism-secondary-to-molar-pregnancy-a-case-report-and-review-of-literature
#4
Srinivasan Swaminathan, Roshin Ann James, Rashmi Chandran, Reesha Joshi
Pregnant women with gestational trophoblastic disease have an increased likelihood to develop hyperthyroidism secondary to increased secretion of human chorionic gonadotropin. Most of these cases of hyperthyroidism remain undiagnosed and may present as a thyrotoxic crisis during the perioperative period. Pregnant patients with gestational trophoblastic disease should be always evaluated for hyperthyroidism, and in cases of severe hyperthyroidism, antithyroid treatment should be initiated before evacuation of the mole...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284885/anesthetic-management-for-prolonged-incidental-surgery-in-advanced-liver-disease
#5
Riddhi Kundu, Rajeshwari Subramaniam, Arijit Sardar
In spite of advances in perioperative management, operative procedures in patients with chronic liver disease pose a significant challenge for the anesthesiologist due to multisystem involvement, high risk of postoperative hepatic decompensation, and mortality. We describe the anesthetic management of an elderly patient with advanced liver disease (model for end-stage liver disease 16) for prolonged abdominal surgery. The use of invasive hemodynamic monitoring, point-of-care biochemical, and hematological surveillance coupled with prompt correction of all abnormalities was responsible for good outcome...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284883/anesthetic-issues-and-difficult-airway-management-in-a-case-of-grisel-s-syndrome
#6
Ajit Gupta, Jay Prakash, Pawan Kumar, Niraj Narain Singh
Grisel's syndrome is a nontraumatic subluxation of atlanto-axial joint which is associated with inflammatory conditions of head and neck and occurs primarily in children. Anesthetic management is such cases constitute a multitude of challenges, especially related to the airway management. We presented here a case of 16-year-old male child weighing 23 kg, came to our hospital for the treatment of torticollis who was previously treated with intravenous antibiotics for rhinopharyngitis and diagnosed as a case of Grisel's syndrome...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284872/effects-of-dexmedetomidine-on-intraoperative-hemodynamics-and-propofol-requirement-in-patients-undergoing-laparoscopic-cholecystectomy
#7
Avneesh Khare, Satya Prakash Sharma, Mangi Lal Deganwa, Mamta Sharma, Nitesh Gill
Background: Despite multiple benefits, laparoscopic surgery always poses anesthetic challenge due to significant alteration of hemodynamics. Various pharmacological agents have been used for the same with variable response. Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics and propofol requirement using bispectral index (BIS) in laparoscopic cholecystectomy...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284831/anesthesiologist-in-cardiac-catheterization-laboratories-the-roles-and-goals-a-postgraduate-educational-review
#8
REVIEW
Akshaya N Shetti, Shivanand L Karigar, Rachita G Mustilwar, D Roshan Singh, Kusha Nag
It is not uncommon to see in developing and underdeveloped countries, where the anesthesiologist who is untrained in cardiac specialty takes care of cardiac catheterization centers. The service in cardiac catheterization laboratories (CCL) in developed countries and some of the developing countries is mainly provided by the cardiac anesthesiologists. The scenario is not same in some part of developing countries or in underdeveloped countries which are mainly due to increase in number of CCL (catheterization laboratory) when compared to the number of cardiac anesthesiologists working outside the operation theater...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29276090/anesthesia-for-lung-transplantation-in-cystic-fibrosis-retrospective-review-from-the-irish-national-transplantation-centre
#9
Martin Lenihan, Darren Mullane, Donal Buggy, Georgina Flood, Michael Griffin
Cystic fibrosis (CF) is an autosomal recessive disorder affecting approximately 1 in 2,500 live births worldwide, with double this estimated frequency in Ireland. CF is characterized by a genetic defect of the CF transmembrane regulator protein, causing impairment of chloride ion transportation. This has multisystem consequences, particularly in the lungs, where it results in intensely mucoid secretions, which increases susceptibility to infection. Lung transplantation is indicated in CF when there is progressive decline in a patient's functional reserve...
November 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29275805/from-dental-to-mental-institutions-did-hypoxic-anesthetics-by-dental-associations-add-more-brain-injured-patients-to-america-s-insane-asylums
#10
Matthew L Edwards, George S Bause
Though most patients survived the hypoxic challenge, some patients likely suffered asphyxial brain damage from GQ Colton's nitrous-oxide techniques and were admitted to insane or lunatic asylums.
October 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/29275265/anesthetic-and-pharmacologic-considerations-in-perioperative-care-of-obese-children
#11
REVIEW
Vidya Chidambaran, Anurag Tewari, Mohamed Mahmoud
PURPOSE: Anesthetic management of obese pediatric patients is challenging. With increasing prevalence of childhood obesity, more severely obese children with comorbidities present for surgery every day. The purpose of this review is to provide an up-to-date comprehensive narrative review on the impact of pathophysiological changes imposed by pediatric obesity on the perioperative management of obese children, especially drug dosing. This knowledge is necessary to provide safe delivery of anesthesia for severely obese children...
December 21, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29239909/pediatric-high-flow-pial-arteriovenous-fistula-avf-for-glue-embolization-an-anesthetic-challenge
#12
Kiranbharath Venkatesulu, Amar Nandhakumar, Mathew Cherian, Pankaj Mehta, Nithiyanandhan Palanisamy
No abstract text is available yet for this article.
December 12, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29239156/do-patients-require-escorts-or-carers-for-discharge-following-day-surgery-and-office-based-anesthesia-both-sides-of-the-debate-explored
#13
Keira P Mason, Christopher M Burkle
Over the past few years, there has been a rapid rise in office-based procedures, out of hospital and day surgery procedures, particularly as an effort to combat the escalating costs of hospital- based services. Coincident with this burgeoning demand for office based anesthesia, is the accompanying increased risk of anesthesia and sedation-related complications. In the 1990's and 2000's, the risk of mortality was higher for anesthetics and sedations performed outside of the operating theater setting. Although guidelines exist for ambulatory and office based anesthesia, they are being continuously reviewed and reconsidered...
December 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29225749/humble-foley-s-catheter-to-the-rescue-in-a-case-of-t-tube-insertion-a-case-report
#14
Upasana Goswami, Praneet Singh
The Montgomery T-tube poses a challenge to anesthesiologists because of loss of anesthetic gases through the open proximal end of the vertical limb and lack of standard anesthesia circuit connectors. Here, we present a case of a 25-year-old woman with a reported history of accidental strangulation 18 months previously. The patient had a metallic tracheostomy tube in situ due to the development of tracheal stenosis. Computed tomography showed significant narrowing in a 7-8-mm segment, 2 cm proximal to the tracheostomy tube in situ...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29225741/what-is-the-proper-ventilation-strategy-during-laparoscopic-surgery
#15
REVIEW
Youn Yi Jo, Hyun-Jeong Kwak
The main stream of intraabdominal surgery has changed from laparotomy to laparoscopy, but anesthetic care for laparoscopic surgery is challenging for clinicians, because pneumoperitoneum might aggravate respiratory mechanics and arterial oxygenation. The authors reviewed the literature regarding ventilation strategies that reduce deleterious pulmonary physiologic changes during pneumoperitoneum for laparoscopic surgery under general anesthesia and make appropriate recommendations.
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29210721/technique-utilizing-a-modified-oral-ring-adair-elwyn-tube-to-provide-continuous-oxygen-and-sevoflurane-delivery-during-nasotracheal-intubation-in-an-infant-with-a-difficult-airway-a-case-report
#16
Janice Y Man, John E Fiadjoe, Grace Hsu
Managing the airway of an infant with Pierre Robin sequence (PRS) is particularly challenging for anesthesiologists. Patients with PRS have the triad of micrognathia, glossoptosis, and airway obstruction that potentially and frequently leads to difficulty with both ventilation and intubation. Thus continuous oxygenation and spontaneous ventilation during intubation are essential. We describe a new method to deliver continuous oxygen and volatile anesthetic during nasotracheal intubation in an infant with PRS...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29207307/systemic-sclerosis-clinical-manifestations-anesthetic-and-orthopedic-considerations-in-a-patient
#17
Obada Hasan, Muneeba Jessar, Muhammad Ashar, Shahryar Noordin, Tashfeen Ahmad
INTRODUCTION: Systemic sclerosis is a rare and progressive multisystem autoimmune disorder that is characterized pathologically by vascular abnormalities, connective tissue sclerosis and atrophy of skin and various internal organs (e.g., alimentary tract, lungs, heart, kidney, CNS), and autoantibodies. With an unknown etiology, Scleroderma is a complex polygenetic disease. A recent Genome Wide Association Study (GWAS) confirmed a strong association with the Major Histocompatibility Complex (MHC) and autoimmunity...
December 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29206569/application-of-miniature-heart-rate-data-loggers-for-use-in-large-free-moving-decapod-crustaceans-method-development-and-validation
#18
Iain J McGaw, S Clay Steell, Travis E Van Leeuwen, Erika J Eliason, Steven J Cooke
Cardiovascular responses of decapod crustaceans to environmental challenges have received extensive attention. However, nearly all of these studies have been restricted to lab-based experiments; here we describe a methodology that will enable measurement of heart rate (HR) in free-moving decapods in the field. Data storage tag heart rate and temperature loggers (DST micro-HRT; Star-Oddi) were used to record electrocardiograms (ECG) and HR in large decapod crustaceans. These loggers were originally designed for use in vertebrates and must be surgically implanted in the body cavity near the heart in order to function...
January 2018: Physiological and Biochemical Zoology: PBZ
https://www.readbyqxmd.com/read/29205678/perioperative-management-of-gastrostomy-tube-placement-in-duchenne-muscular-dystrophy-adolescent-and-young-adult-patients-a-role-for-a-perioperative-surgical-home
#19
Ariane Boivin, Richard Antonelli, Navil F Sethna
BACKGROUND: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. AIMS: The aim of this study was to review our experience with perioperative care of adolescent and young adults with Duchenne muscular dystrophy undergoing gastrostomy by various surgical approaches in order to identify challenges and improve future perioperative care coordination to reduce morbidity...
December 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29203336/spontaneous-recovery-of-traumatic-brain-injury-induced-functional-deficits-is-not-hindered-by-daily-administration-of-lorazepam
#20
Jeffrey P Cheng, Jacob B Leary, Darik A O'Neil, Elizabeth A Meyer, Kristin E Free, Corina O Bondi, Anthony E Kline
Agitation and aggression are common sequelae of traumatic brain injury (TBI) and pose a challenge to physicians and other health providers during acute patient care and subsequent neurorehabilitation. Antipsychotic drugs (APDs) are routinely administered to manage TBI patients displaying such maladaptive behaviors despite several clinical and preclinical studies demonstrating that they hinder recovery. A potentially viable alternative to APDs may be the benzodiazepines, which have differing mechanisms of action...
February 26, 2018: Behavioural Brain Research
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