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https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#1
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
January 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28047720/su-f-t-633-cyberknife-boost-versus-conventional-tandem-and-ovoid-treatment-for-cervical-cancer
#2
J Santoro, M Witten, J Haas
PURPOSE: Brachytherapy has been the standard of care for cervical cancer for 100 years. The treatment can be administered using an HDR (high dose rate) remote afterloader with a (192) Ir source in an outpatient setting, a PDR afterloader with a (192) Ir source, or with LDR manually loaded or a remote afterloader utilizing (192) Ir or (137) Cs sources in an inpatient setting. The procedure involves the placement of a tandem and ovoid, tandem and ring, or tandem and cylinder applicator in an operating room setting with the patient under general anesthesia...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031981/drug-delivery-biomaterials-and-nanomedicine-an-interview-with-daniel-s-kohane
#3
Daniel S Kohane
Daniel Kohane speaks to Francesca Lake, Managing Editor: Obtaining his MD and PhD in Physiology from Boston University (MA, USA), Dan Kohane went on to complete residencies in Pediatrics at Boston Children's Hospital (MA, USA) and Anesthesiology at Massachusetts General Hospital (USA), followed by a fellowship in Pediatric Critical Care at Boston Children's Hospital. He is currently a Professor of Anesthesia at Harvard Medical School (MA, USA) and a Senior Associate in Pediatric Critical Care at Boston Children's Hospital, where he directs the Laboratory for Biomaterials and Drug Delivery...
September 2016: Future Science OA
https://www.readbyqxmd.com/read/28011033/cost-savings-and-patient-experiences-of-a-clinic-based-wide-awake-hand-surgery-program-at-a-military-medical-center-a-critical-analysis-of-the-first-100-procedures
#4
Peter C Rhee, Michelle M Fischer, Laura S Rhee, Ha McMillan, Anthony E Johnson
PURPOSE: Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. METHODS: A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28004329/validation-of-the-glycemic-stress-index-in-pediatric-neurosurgical-intensive-care
#5
Marco Piastra, Alessandro Pizza, Federica Tosi, Sonia Mensi, Luca Massimi, Andrea De Bellis, Daniele G Biasucci, Ersilia Luca, Giorgio Conti, Daniele De Luca
BACKGROUND: Studies have suggested that both the degree and the duration of hyperglycemia are independent risk factors for adverse outcome both in pediatric anesthesia and in critically ill children. In a recent paper, we combined intraoperative glycemic variations and length of surgery creating a metabolic glucose-related stress index called "Glycemic Stress Index" (GSI). AIM: To validate GSI for predicting PICU stay in a population of children undergoing different major neurosurgical procedures...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28002714/hypothermia-for-neuroprotection-in-convulsive-status-epilepticus
#6
RANDOMIZED CONTROLLED TRIAL
Stephane Legriel, Virginie Lemiale, Maleka Schenck, Jonathan Chelly, Virginie Laurent, Fabrice Daviaud, Mohamed Srairi, Aicha Hamdi, Guillaume Geri, Thomas Rossignol, Julia Hilly-Ginoux, Julie Boisramé-Helms, Benjamin Louart, Isabelle Malissin, Nicolas Mongardon, Benjamin Planquette, Marina Thirion, Sybille Merceron, Emmanuel Canet, Fernando Pico, Yves-Roger Tran-Dinh, Jean-Pierre Bedos, Elie Azoulay, Matthieu Resche-Rigon, Alain Cariou
Background Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. Methods In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit)...
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27989360/complications-in-neonatal-surgery
#7
Mauricio A Escobar, Michael G Caty
Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options...
December 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27984246/the-hypothalamic-pituitary-adrenal-axis-and-anesthetics-a-review
#8
Emmanuel Besnier, Thomas Clavier, Vincent Compere
The hypothalamic-pituitary-adrenal (HPA) axis is essential for human adaptation to stress. However, many anesthetic agents may interfere with the activity of this axis. Although etomidate is known for its suppressive effect on HPA axis function, in vitro evidence suggests that many other drugs used in anesthesia care may also interfere with HPA activity. In this review, we discuss the mechanisms by which all HPA axis activity may be altered during anesthesia and critical care and focus on the impact of hypnotic and analgesic drugs...
December 14, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27975008/successful-treatment-of-pyoderma-gangrenosum-after-augmentation-mastopexy-using-vacuum-therapy
#9
Julio Alberto Soncini, Alessandra Grassi Salles, Juvenal Antonio Frizzo Neto, Rolf Gemperli
BACKGROUND: Pyoderma gangrenosum (PG) is a rare, severe, destructive neutrophilic dermatosis characterized by a progressive, necrotizing process after skin injury. Its cause is still unknown, and diagnosis represents a challenge when ulcers are seen after surgery. Bacterial infection is not found in the wounds. Patients exhibit "pathergy" with the appearance of new lesions after local trauma such as surgical procedures, debridements, and wound care, suggesting altered inflammatory response...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27966337/the-incidence-of-pressure-ulcer-in-patients-on-mechanical-ventilation-andeffects-of-selected-risk-factors-on-pressure-ulcer-development
#10
Özgül Karayurt, Özay Akyol, Necmiye Kılıçaslan, Nuray Akgün, Ümran Sargın, Melike Kondakçı, Hanım Ekinci, Neslihan Sarı
BACKGROUND/AIM: This study aimed to determine the incidence of pressure ulcers in patients on mechanical ventilation and selected risk factors likely to play a role in pressure ulcer development. MATERIALS AND METHODS: The study included 110 patients recruited from an anesthesia critical care unit of a university hospital. Data were collected with a demographic and clinical characteristics form. The form was composed of questions about demographic characteristics and clinical features including diagnosis, duration of mechanical ventilation, general well-being, oxygenation, perfusion, and skin condition...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27965560/ketamine-50-years-of-modulating-the-mind
#11
REVIEW
Linda Li, Phillip E Vlisides
Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine's effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal ("top down") distribution...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27902826/association-of-a-frailty-screening-initiative-with-postoperative-survival-at-30-180-and-365-days
#12
Daniel E Hall, Shipra Arya, Kendra K Schmid, Mark A Carlson, Pierre Lavedan, Travis L Bailey, Georgia Purviance, Tammy Bockman, Thomas G Lynch, Jason M Johanning
Importance: As the US population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and morbidity more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and improve their outcomes. Objective: To examine the effect of the Frailty Screening Initiative (FSI) on mortality and complications by comparing the surgical outcomes of a cohort of surgical patients treated before and after implementation of the FSI...
November 30, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27901299/first-steps-in-validating-the-pediatric-anesthesia-parent-satisfaction-paps-survey
#13
Sarah J Milliken-Glabe, Jeannie Zuk, Sonja I Ziniel, Kara A Bjur, Monica Alvarez, Judit M Szolnoki, Norah R Janosy
BACKGROUND: In the last few decades, patient satisfaction has become a critical component of quality assessment and is being incorporated into payment for performance plans. However, assessment of satisfaction with anesthesia services is problematic and few validated satisfaction tools have been published. Assessing parent satisfaction with pediatric anesthesia services is even more challenging. OBJECTIVE: Our aim was to develop, implement, and start validating a set of survey questions that evaluate parental satisfaction with the pediatric anesthesia services in order to identify strengths and potential areas for improvement...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27829714/seizures-just-the-tip-of-the-iceberg-critical-care-management-of-super-refractory-status-epilepticus
#14
REVIEW
Karen Ruby Lionel, Ajay Prasad Hrishi
Super-refractory status epilepticus (SRSE) is defined as status epilepticus (SE) that continues or recurs 24 h or more after the onset of anesthetic therapy, including those cases where SE recurs on the reduction or withdrawal of anesthesia. Although SRSE is a rare clinical problem, it is associated with high mortality and morbidity rates. This article reviews the treatment approaches and the systemic complications commonly encountered in patients with SRSE. As evident in our search of literature, therapy for SRSE and its complications have been based on clinical reports and expert opinions since there is a lack of controlled and randomized trials...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27828796/perioperative-anesthesia-care-and-tumor-progression
#15
Mir W Sekandarzad, André A J van Zundert, Philipp B Lirk, Chris W Doornebal, Markus W Hollmann
This narrative review discusses the most recent up-to-date findings focused on the currently available "best clinical practice" regarding perioperative anesthesia care bundle factors and their effect on tumor progression. The main objective is to critically appraise the current literature on local anesthetics, regional outcome studies, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs) and their ability to decrease recurrence in patients undergoing cancer surgery. A brief discussion of additional topical perioperative factors relevant to the anesthesiologist including volatile and intravenous anesthetics, perioperative stress and anxiety, nutrition, and immune stimulation is included...
November 8, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27795775/-prioperative-adverse-events-critical-reading-of-the-data-registry-used-in-the-surgery-department-of-military-hospital-moulay-ismail-meknes
#16
Hicham Kechna, Omar Ouzzad, Khalid Chkoura, Jaouad Loutid, Moulay Ahmed Hachimi, Sidi Mohamed Hanafi
INTRODUCTION: Despite significant progress made in the field of safety in anesthesia, morbidity (serious or not, completely or partially related to anesthesia) remains common and no health practitioner is immune from accidents. In the current context where priority is given to training programmes, to quality and safety improvement in health care, the occurrence of an anesthesia-related accident in the surgery department is an extremely traumatic event. The fear of prosecution, the emotional context make it difficult to manage...
2016: Pan African Medical Journal
https://www.readbyqxmd.com/read/27759743/perioperative-and-periprocedural-airway-management-and-respiratory-safety-for-the-obese-patient-2016-siaarti-consensus
#17
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose Body Mass Index (BMI) is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
December 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27716076/smartphone-use-habits-of-anesthesia-providers-during-anesthetized-patient-care-a-survey-from-turkey
#18
Hüseyin Ulaş Pınar, Omer Karaca, Rafi Doğan, Ümmü Mine Konuk
BACKGROUND: Smartphones are used in many areas of anesthesia practice. However, recent editorial articles have expressed concerns about smartphone uses in the operating room for non-medical purposes. We performed a survey to learn about the smartphone use habits and views of Turkish anesthesia providers. METHODS: A questionnaire consisting of 14 questions about smartphone use habits during anesthesia care was sent anesthesia providers. RESULTS: In November-December 2015, a total of 955 participants answered our survey with 93...
October 6, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27687409/evaluating-sepsis-training-for-medical-students-and-nonphysicians-in-malawi
#19
P Marshall-Brown, F Namboya, G Pollach
STUDY OBJECTIVE: This study aimed to evaluate whether (regarding the Surviving Sepsis Campaign [SSC] guidelines) the training of Malawis scarce medical staff is adequate. Hospitals in Malawi have a severe shortage of human resources and therefore rely heavily on junior staff. Sepsis is a leading cause of admission to hospitals particularly in resource poor countries. It is associated with a high mortality rate. The SSC guidelines have been developed to help frontline staff diagnose and treat patients with sepsis...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27648000/impact-of-diabetes-mellitus-on-radial-and-ulnar-arterial-vasoreactivity-after-radial-artery-cannulation-a-randomized-controlled-trial
#20
Eun Jung Kim, Sarah Soh, So Yeon Kim, Hae Keum Kil, Jae Hoon Lee, Jeong Min Kim, Tae Whan Kim, Bon-Nyeo Koo
BACKGROUND: Endothelial dysfunction associated with diabetes mellitus (DM) may influence arterial vasoreactivity after arterial stimulus, such as cannulation, and cause changes in diameter and blood flow. Despite the frequent use of arterial cannulation during anesthesia and critical care, little information is available regarding vasoreactivity of the radial and ulnar arteries and its influence on underlying DM. METHODS: Forty non-DM and 40 DM patients, who required arterial cannulation during general anesthesia, were enrolled...
2016: International Journal of Medical Sciences
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