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Rapid sequence induction

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https://www.readbyqxmd.com/read/27900760/choice-of-anaesthesia-for-category-1-caesarean-section-in-women-with-anticipated-difficult-tracheal-intubation-the-use-of-decision-analysis
#1
A J Krom, Y Cohen, J P Miller, T Ezri, S H Halpern, Y Ginosar
A predicted difficult airway is sometimes considered a contra-indication to rapid sequence induction of general anaesthesia, even in an urgent case such as a category-1 caesarean section for fetal distress. However, formally assessing the risk is difficult because of the rarity and urgency of such cases. We have used decision analysis to quantify the time taken to establish anaesthesia, and probability of failure, of three possible anaesthetic methods, based on a systematic review of the literature. We considered rapid sequence induction of general anaesthesia with videolaryngoscopy, awake fibreoptic intubation and rapid spinal anaesthesia...
November 30, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27884715/improved-sustained-release-of-antigen-from-immunostimulatory-dna-hydrogel-by-electrostatic-interaction-with-chitosan
#2
Yumiko Ishii-Mizuno, Yuka Umeki, Yoshinori Onuki, Hiroshi Watanabe, Yuki Takahashi, Yoshinobu Takakura, Makiya Nishikawa
Immunostimulatory DNA hydrogel (sDNA hydrogel) containing unmethylated cytosine-phosphate-guanine (CpG) sequences has been demonstrated to be a useful antigen delivery system, which can effectively induce an antigen-specific immune response through stimulation of the innate immune system. However, relatively rapid release of antigens from the sDNA hydrogel limits its potential. To enhance the potency of the sDNA hydrogel via improvement of its sustained release property, we selected chitosan, a biocompatible cationic polymer which electrostatically interacts with DNA, and mixed it with the sDNA hydrogel...
November 21, 2016: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/27876864/identification-of-an-infectious-bronchitis-coronavirus-strain-exhibiting-a-classical-genotype-but-altered-antigenicity-pathogenicity-and-innate-immunity-profile
#3
Shu-Yi Lin, Yao-Tsun Li, You-Ting Chen, Ting-Chih Chen, Che-Ming J Hu, Hui-Wen Chen
Avian coronavirus infectious bronchitis virus (IBV) poses economic threat to the poultry industry worldwide. Pathogenic IBV 3575/08 was isolated from broilers vaccinated with the attenuated viral vaccine derived from a Taiwan strain 2575/98. In this study, extensive investigations were conducted on the genome sequences, antigenicity, pathogenicity, and host immune responses of several IBV strains in specific-pathogen-free chickens. Sequence analyses revealed that 3575/08 and 2575/98 shared high homology in their structural genes, but not in non-structural accessory proteins such as 3a, 3b and 5b...
November 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27871575/dose-requirements-of-alfentanil-to-eliminate-autonomic-responses-during-rapid-sequence-induction-with-thiopental-4-mg-kg-and-rocuronium-0-6-mg-kg
#4
Mohammad H Abou-Arab, Morten Rostrup, Tom Heier
STUDY OBJECTIVE: Opioids are integral part of anesthesia induction, but information on optimal dosing is limited. We aimed to determine doses of alfentanil needed to eliminate increases in 5 autonomic response variables (plasma concentrations of epinephrine, norepinephrine and vasopressin, arterial blood pressure [ABP], and heart rate) during rapid-sequence induction of anesthesia with thiopental 4 mg/kg and rocuronium 0.6 mg/kg. DESIGN: Prospective, randomized, observer-blinded, interventional clinical study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27833478/comparison-of-rocuronium-at-two-different-doses-and-succinylcholine-for-endotracheal-intubation-in-adult-patients-for-elective-surgeries
#5
S G Chavan, S Gangadharan, A K Gopakumar
BACKGROUND: The effects of rocuronium at two different doses, that is, 0.6 mg/kg (2 × ED95) and 0.9 mg/kg (3 × ED95), were compared with succinylcholine (2 mg/kg) when used for endotracheal intubation in adult patients for elective surgeries under general anesthesia. MATERIALS AND METHODS: Ninety patients were divided into three groups of 30 each. Groups A, B received injection rocuronium at 0.6 mg/kg, 0.9 mg/kg respectively and Group C received succinylcholine at 2 mg/kg...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27793243/anesthesia-in-pregnant-women-with-hellp-syndrome-case-report
#6
Eduardo Barbin Zuccolotto, Eugenio Pagnussatt Neto, Glínia Cavalcante Nogueira, José Roberto Nociti
BACKGROUND AND OBJECTIVES: HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency cesarean. CASE REPORT: Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27777610/infiltration-rnaseq-transcriptome-profiling-of-agrobacterium-mediated-infiltration-of-transcription-factors-to-discover-gene-function-and-expression-networks-in-plants
#7
Donna M Bond, Nick W Albert, Robyn H Lee, Gareth B Gillard, Chris M Brown, Roger P Hellens, Richard C Macknight
BACKGROUND: Transcription factors (TFs) coordinate precise gene expression patterns that give rise to distinct phenotypic outputs. The identification of genes and transcriptional networks regulated by a TF often requires stable transformation and expression changes in plant cells. However, the production of stable transformants can be slow and laborious with no guarantee of success. Furthermore, transgenic plants overexpressing a TF of interest can present pleiotropic phenotypes and/or result in a high number of indirect gene expression changes...
2016: Plant Methods
https://www.readbyqxmd.com/read/27776548/fast-type-i-interferon-response-protects-astrocytes-from-flavivirus-infection-and-virus-induced-cytopathic-effects
#8
Richard Lindqvist, Filip Mundt, Jonathan D Gilthorpe, Silke Wölfel, Nelson O Gekara, Andrea Kröger, Anna K Överby
BACKGROUND: Neurotropic flaviviruses such as tick-borne encephalitis virus (TBEV), Japanese encephalitis virus (JEV), West Nile virus (WNV), and Zika virus (ZIKV) are causative agents of severe brain-related diseases including meningitis, encephalitis, and microcephaly. We have previously shown that local type I interferon response within the central nervous system (CNS) is involved in the protection of mice against tick-borne flavivirus infection. However, the cells responsible for mounting this protective response are not defined...
October 24, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27718183/development-of-the-cpg-adjuvant-1018-a-case-study
#9
John D Campbell
The development of aluminum salts (alum) as vaccine adjuvants was an empirical process with little understanding of the mechanism of action and, with decades of use, it has become clear that there is a need for alternatives where alum-based adjuvants are suboptimal. Oligonucleotides containing unmethylated CpG sequences represent one alternative as they are potent stimulators of the vertebrate innate immune system through activation of Toll-like receptor-9. This chapter outlines the methods used by Dynavax Technologies to progress a CpG-containing oligonucleotide sequence termed 1018 through preclinical and clinical testing as an adjuvant for immunization against hepatitis B virus (HBV)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27718129/the-readiness-of-emergency-and-trauma-care-in-low-and-middle-income-countries-a-cross-sectional-descriptive-study-of-42-public-hospitals-in-albania
#10
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27703843/xa21-specific-induction-of-stress-related-genes-following-xanthomonas-infection-of-detached-rice-leaves
#11
Nicholas C Thomas, Benjamin Schwessinger, Furong Liu, Huamin Chen, Tong Wei, Yen P Nguyen, Isaac W F Shaker, Pamela C Ronald
The rice XA21 receptor kinase confers robust resistance to the bacterial pathogen Xanthomonas oryzaepv. oryzae (Xoo). We developed a detached leaf infection assay to quickly and reliably measure activation of the XA21-mediated immune response using genetic markers. We used RNA sequencing of elf18 treated EFR:XA21:GFP plants to identify candidate genes that could serve as markers for XA21 activation. From this analysis, we identified eight genes that are up-regulated in both in elf18 treated EFR:XA21:GFP rice leaves and Xoo infected XA21 rice leaves...
2016: PeerJ
https://www.readbyqxmd.com/read/27692621/use-of-king-vision-videolaryngoscope-in-an-unanticipated-difficult-airway-in-an-adult-patient-with-giant-vallecular-cyst-a-case-report
#12
L España Fuente, P de la Rica Fernández, J L González González
Laryngeal cysts are largely asymptomatic and typically described in the context of incidental discovery on routine laryngoscopy. These cysts, in adults are even rarer and can have catastrophic consequences in an anaesthetized patient if airway management is inappropriate. We describe a case of difficult endotracheal intubation and the treatment of an adult patient with an asymptomatic, giant vallecular cyst that was discovered during rapid-sequence induction of general anesthesia in urgent surgery. In conclusion, vallecular cysts can cause extreme problems in securing the airway...
September 27, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27681432/rapid-and-efficient-generation-of-regulatory-t-cells-to-commensal-antigens-in-the-periphery
#13
Katherine Nutsch, Jiani N Chai, Teresa L Ai, Emilie Russler-Germain, Taylor Feehley, Cathryn R Nagler, Chyi-Song Hsieh
Commensal bacteria shape the colonic regulatory T (Treg) cell population required for intestinal tolerance. However, little is known about this process. Here, we use the transfer of naive commensal-reactive transgenic T cells expressing colonic Treg T cell receptors (TCRs) to study peripheral Treg (pTreg) cell development in normal hosts. We found that T cells were activated primarily in the distal mesenteric lymph node. Treg cell induction was rapid, generating >40% Foxp3(+) cells 1 week after transfer...
September 27, 2016: Cell Reports
https://www.readbyqxmd.com/read/27678137/-simulation-based-training-and-or-apprenticeship-for-medical-students-a%C3%A2-prospective-randomized-single-blind-study-of-clinical-skills
#14
T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
September 27, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27646281/collective-review-of-the-status-of-rapid-sequence-intubation-drugs-of-choice-in-trauma-in-low-and-middle-income-settings-prehospital-emergency-department-and-operating-room-setting
#15
Leressè Pillay, Timothy Hardcastle
INTRODUCTION: Establishing a definitive airway in order to ensure adequate ventilation and oxygenation is an important aspect of resuscitation of the polytrauma patient . AIM: To review the relevant literature that compares the different drugs used for rapid sequence intubation (RSI) of trauma patients, specifically reviewing: premedication, induction agents and neuromuscular blocking agents across the prehospital, emergency department and operating room setting, and to present the best practices based on the reviewed evidence...
September 19, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27640666/rapid-sequence-induction-in-patients-with-acute-appendicitis-is-it-always-justified
#16
Peter Keogh, Tara Keogh
No abstract text is available yet for this article.
September 2, 2016: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/27631579/simulation-fails-to-replicate-stress-in-trainees-performing-a-technical-procedure-in-the-clinical-environment
#17
B G Baker, A Bhalla, B Doleman, E Yarnold, S Simons, J N Lund, J P Williams
INTRODUCTION: Simulation-based training (SBT) has become an increasingly important method by which doctors learn. Stress has an impact upon learning, performance, technical, and non-technical skills. However, there are currently no studies that compare stress in the clinical and simulated environment. We aimed to compare objective (heart rate variability, HRV) and subjective (state trait anxiety inventory, STAI) measures of stress theatre with a simulated environment. METHODS: HRV recordings were obtained from eight anesthetic trainees performing an uncomplicated rapid sequence induction at pre-determined procedural steps using a wireless Polar RS800CX monitor © in an emergency theatre setting...
September 15, 2016: Medical Teacher
https://www.readbyqxmd.com/read/27620818/identification-and-functional-characterization-of-tumor-necrosis-factor-receptor-1-tnfr1-of-grass-carp-ctenopharyngodon-idella
#18
Shengnan Zhang, Rui Zhang, Tengyue Ma, Xingyang Qiu, Xinyan Wang, Anying Zhang, Hong Zhou
Tumor necrosis factor-alpha (TNF-α) exerts its regulatory effects by binding one of two TNF receptors, TNF-α receptor 1 (TNFR1) or TNFR2. In this study, we isolated and identified the cDNA sequence of grass carp TNFR1 (gcTNFR1). Similar to its homologs in other fish species, the putative protein of gcTNFR1 possessed an extracellular region containing three TNF homology domains, a transmembrane region and a cytoplasmic region with a conserved death domain. Consistent with the widespread expression of mammalian TNFR1, gcTNFR1 transcripts ubiquitously expressed in spleen, thymus, liver, heart, gill, intestine, brain and head kidney with the highest expression levels in head kidney...
September 9, 2016: Fish & Shellfish Immunology
https://www.readbyqxmd.com/read/27595907/anesthesia-for-traumatic-diaphragmatic-hernia-associated-with-corneal-laceration
#19
Reza Safaeian, Valiollah Hassani, Hamid Reza Faiz
BACKGROUND Diaphragmatic rupture can be seen in up to 5% of car accidents, and 80%-100% of diaphragmatic hernias are associated with other vital organ injuries. Brain, pelvis, long bones, liver, spleen, and aorta are some other organs that can be severely damaged and need different anesthetic managements. CASE REPORT A 37-year-old male victim of a head-on collision who was suffering diaphragmatic rupture and corneal laceration was prepared for an emergency operation 11 hours after the car accident. Gastric decompression, pre-oxygenation, rapid sequence induction with succinylcholine, immediate use of non-depolarizing muscle relaxant, and mechanical ventilation with low tidal volume after intubation were used in anesthetic management of the patient...
2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27566791/systematic-review-of-the-anaesthetic-management-of-non-iatrogenic-acute-adult-airway-trauma
#20
S J Mercer, C P Jones, M Bridge, E Clitheroe, B Morton, P Groom
INTRODUCTION: Non-iatrogenic trauma to the airway is rare and presents a significant challenge to the anaesthetist. Although guidelines for the management of the unanticipated difficult airway have been published, these do not make provision for the 'anticipated' difficult airway. This systematic review aims to inform best practice and suggest management options for different injury patterns. METHODS: A literature search was conducted using Embase, Medline, and Google Scholar for papers after the year 2000 reporting on the acute airway management of adult patients who suffered airway trauma...
September 2016: British Journal of Anaesthesia
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