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https://www.readbyqxmd.com/read/28631129/optimizing-the-deep-brain-stimulation-care-pathway-in-patients-with-parkinson-s-disease
#1
N J Thomas, P Mertens, T Danaila, G Polo, H Klinger, E Broussolle, S Thobois
Management of Parkinson's disease (PD) using deep brain stimulation (DBS) requires complex care in specialized, multidisciplinary centers. A well-organized, efficient patient flow is crucial to ensure that eligible patients can quickly access DBS. Delays or inefficiencies in patient care may impact a center's ability to meet demand, creating a capacity bottleneck. Analysis of the current practices within a center may help identify areas for improvement. After external audit of the DBS workflow of the Lyon Neurological Hospital and comparison with other European centers, manageable steps were suggested to restructure the care pathway...
June 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28630662/sex-differences-in-endogenous-cortical-network-activity-spontaneously-recurring-up-down-states
#2
Charalambos Sigalas, Eleni Konsolaki, Irini Skaliora
BACKGROUND: Several molecular and cellular processes in the vertebrate brain exhibit differences between males and females, leading to sexual dimorphism in the formation of neural circuits and brain organization. While studies on large-scale brain networks provide ample evidence for both structural and functional sex differences, smaller-scale local networks have remained largely unexplored. In the current study, we investigate sexual dimorphism in cortical dynamics by means of spontaneous Up/Down states, a type of network activity that is exhibited during slow-wave sleep, quiet wakefulness, and anesthesia and is thought to represent the default activity of the cortex...
2017: Biology of Sex Differences
https://www.readbyqxmd.com/read/28625750/postoperative-delirium-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting-according-to-the-anesthetic-agent-a-retrospective-study
#3
Chung-Sik Oh, Sewon Park, Seung Wan Hong, Woon-Seok Kang, Tae-Gyoon Yoon, Seong-Hyop Kim
OBJECTIVE: To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG). DESIGN: Retrospective observational design. SETTING: University hospital. PARTICIPANTS: Two hundred ninety-two patients undergoing off-pump CABG who were anesthetized with sevoflurane or propofol. METHODS: Incidence of POD, laboratory data, and pre-, intra-, and 24-hour postoperative clinical variables were reviewed retrospectively...
February 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28625438/efficacy-of-prophylactic-doses-of-intravenous-nitroglycerin-in-preventing-myocardial-ischemia-under-general-anesthesia-a-systematic-review-and-meta-analysis-with-trial-sequential-analysis
#4
REVIEW
Hiroshi Hoshijima, Yohei Denawa, Takahiro Mihara, Risa Takeuchi, Norifumi Kuratani, Tsutomu Mieda, Yoshinori Iwase, Toshiya Shiga, Zen'ichiro Wajima, Hiroshi Nagasaka
STUDY OBJECTIVE: To evaluate the efficacy of intravenous nitroglycerin (TNG) in preventing intraoperative myocardial ischemia (MI) under general anesthesia. Moreover, we analyzed the hemodynamic changes in heart rate (HR), mean blood pressure (MBP), and pulmonary capillary wedge pressure (PCWP) associated with TNG administration both before and after the induction of anesthesia. DESIGN: Meta-analysis. SETTING: Operating room, cardiac surgery or non-cardiac surgery, all surgeries were elective measurements...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625424/scheduling-non-operating-room-anesthesia-cases-in-endoscopy-using-the-sandbox-analogy
#5
Mitchell H Tsai, Leah A Cipri, Stephen E O'Donnell, J Matthew Fisher, Dimitrios A Andritsos
STUDY OBJECTIVE: For many hospitals, the non-operating room anesthesia (NORA) workload continues to expand. We developed a new NORA scheduling process with shared block time - a sandbox - amongst all of the gastroenterology groups and measured the efficacy of the intervention using basic operating room management metrics. DESIGN: Prospective analysis, statistical process control. SETTING: Academic, rural hospital; endoscopy suite; postoperative recovery area...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#6
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#7
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28618198/effect-of-intravenous-paracetamol-as-pre-emptive-compared-to-preventive-analgesia-in-a-pediatric-dental-setting-a-prospective-randomized-study
#8
Johny Kharouba, Nasir Hawash, Benjamin Peretz, Sigalit Blumer, Yara Srour, Marry Nassar, Mulham Sabbah, Anan Safadi, Alexey Khorev, Mostafa Somri
BACKGROUND: Efficacy of pre-emptive analgesia compared to preventive regimen, managing postoperative pain is still controversial. AIM: Evaluating the efficacy of intravenous (IV) paracetamol as pre-emptive analgesia compared to preventive post-treatment administration in pediatric dental setting. DESIGN: In a prospective trial, 60 noncooperative children of ASA I, II aged 3-10 years who underwent dental rehabilitation under general anesthesia were randomly divided into two groups...
June 15, 2017: International Journal of Paediatric Dentistry
https://www.readbyqxmd.com/read/28616796/comparison-of-surgeon-comfort-assessment-during-phacoemulsification-using-bilateral-topical-anesthesia-versus-ipsilateral-topical-anesthesia-a-randomized-controlled-study
#9
Rashim Mannan, Archna Pruthi, Sumeet Khanduja
AIM: To evaluate the effectiveness of bilateral use of topical anesthetic eye drops during phacoemulsification procedure as compared to use in one eye only. METHODS: This is a prospective double-blind randomized case study of 180 cases undergoing phacoemulsification under topical anesthesia using 0.5% proparacaine: Group 1 consisting of patients who had topical anesthetic eye drop instilled into the operating eye only and Group 2 consisting of patients who had both their eyes anesthetized using topical anesthetic eye drops...
June 14, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28613203/-renal-tumors-percutaneous-ablation-by-microwave-initial-experience
#10
Juan Sebastian Toro-Gutierrez, Juan Jose Espejo-Herrero, Maria Sagrario Lombardo-Galera, Maria Eugenia Pérez-Montilla, Miguel Canis-López, Luis Zurera-Tendero, Juan Manuel Rubio
OBJECTIVE: To analyze retrospectively the safety and effectiveness of percutaneous microwave ablation of solid renal tumors, and also review different approach techniques. METHODS: It is a retrospective study approved by the ethics committee of both hospitals. 14 tumors with a mean size of 37 mm (12-50 mm) were treated in a single session, under general anesthesia and with CT guidance, in 14 patients (9 men) with a mean age of 66 years, using the ablation system AMICA by different approaches (trans pulmonary, trans peritoneal and retroperitoneal)...
June 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28608275/robert-mathys-finger-prosthesis-of-the-proximal-interphalangeal-joint-a-retrospective-case-series-of-19-joints-in-17-patients
#11
J P Rijnja, P P G M Kouwenberg, S Ray, E T Walbeehm
INTRODUCTION: The Robert Mathys (RM) Finger is a hinged type of arthroplasty for the metacarpophalangeal and proximal interphalangeal (PIP) joint that compensates ligament instability. The aim of this study is to evaluate the outcomes and complications of RM Finger arthroplasty of the PIP joint. MATERIALS AND METHODS: A retrospective case series of 19 RM Finger arthroplasties of the PIP joint in 17 patients was performed with a median follow-up of 36 months. The active range of motion (AROM) was measured pre-operatively, at the 6-week follow-up, at the termination of hand therapy, and at the final follow-up...
June 12, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28594746/enhanced-recovery-after-surgery-eras-eliminates-racial-disparities-in-postoperative-length-of-stay-after-colorectal-surgery
#12
Tyler S Wahl, Lauren E Goss, Melanie S Morris, Allison A Gullick, Joshua S Richman, Gregory D Kennedy, Jamie A Cannon, Selwyn M Vickers, Sara J Knight, Jeffrey W Simmons, Daniel I Chu
OBJECTIVE: To investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. BACKGROUND: Racial disparities in surgical outcomes exist. We hypothesized that ERAS would reduce disparities in pLOS between black and white patients. METHODS: Patients undergoing ERAS in 2015 were 1:1 matched by race/ethnicity, age, sex, and procedure to a pre-ERAS group from 2010 to 2014...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28591008/plasma-resuscitation-improved-survival-in-a-cecal-ligation-and-puncture-rat-model-of-sepsis
#13
Ronald Chang, John B Holcomb, Par I Johansson, Shibani Pati, Martin A Schreiber, Charles E Wade
BACKGROUND: The paradigm shift from crystalloid to plasma resuscitation of traumatic hemorrhagic shock has improved patient outcomes due in part to plasma-mediated reversal of catecholamine and inflammation-induced endothelial injury, decreasing vascular permeability and attenuating organ injury. Since sepsis induces a similar endothelial injury as seen in hemorrhage, we hypothesized that plasma resuscitation would increase 48-hour survival in a rat sepsis model. METHODS: Adult male Sprague-Dawley rats (375-425 g) were subjected to 35% cecal ligation and puncture (CLP) (t = 0 h)...
June 6, 2017: Shock
https://www.readbyqxmd.com/read/28583486/ototoxicity-associated-with-topical-administration-of-diclofenac-sodium-as-an-otic-drop-an-experimental-animal-study
#14
Engin Acioglu, Ozgur Yigit, Firat Onur, Ahmet Atas, Ela Araz Server, Eyup Kara
OBJECTIVES: The aim of the study is to evaluate the ototoxicity of topical diclofenac sodium in comparison to positive and negative controls prior to the investigation of analgesic and anti-inflammatory efficacy of the agent in otic administration. METHODS: Twenty four ears of 12 guinea pigs were included in the study. Wide myringotomy was performed on all tympanic membranes under general anesthesia and auditory brainstem responses (ABR) were evaluated. The subjects were separated into four groups, two groups received diclofenac sodium at low and high doses, positive controls received gentamicin and negative controls received isotonic sodium chloride topically for 14 days and ABRs were reevaluated...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28570524/comparing-the-effects-of-electronic-cigarette-vapor-and-cigarette-smoke-in-a-novel-in-vivo-exposure-system
#15
Anthony N Hage, Will Krause, Angela Mathues, Luke Krasner, Seth Kasten, Jonathan L Eliason, Abhijit Ghosh
Electronic cigarettes (E-cigarettes) are being widely used, and growing in popularity. It is estimated that more than 9 million adults use them regularly. The potential adverse health effects of electronic cigarette vapor (E-vapor) exposure are poorly defined. While several animal models of E-vapor exposure have been developed, few models expose rodents to clinically relevant quantities of nicotine and make direct comparisons to cigarette smoke within the same exposure system. Here, we present a method for constructing and operating an E-vapor chamber and cigarette smoke chamber...
May 24, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28559097/von-willebrand-disease-type-2-in-pregnancy-a-critical-clinical-association
#16
REVIEW
Anca A Simionescu, Natalia F Buinoiu, Nicoleta Berbec
Von Willebrand disease (vWD) is the most common inherited bleeding disorder. Its association with pregnancy is infrequent. Here we report three cases of vWD associated with pregnancy. The clinical features of this combination are very suggestive. However, difficulties are still encountered during the diagnosis process. The first case was diagnosed for the first time during the patient's second pregnancy despite several episodes of vaginal bleeding and suggestive clinical symptomatology. The second case was diagnosed during childhood and the patient was properly managed during this pregnancy...
May 18, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28557798/thermal-ablation-of-a-confluent-lesion-in-the-porcine-kidney-with-a-clinically-available-mr-hifu-system
#17
J M M van Breugel, M de Greef, J W Wijlemans, G Schubert, M A A J van den Bosch, C T W Moonen, M G Ries
The incidence of small renal masses (SRMs) sized  <4 cm has increased over the decades (as co-findings/or due to introduction of cross sectional imaging). Currently, partial nephrectomy (PN) or watchful waiting is advised in these patients. Ultimately, 80-90% of these SRMs require surgical treatment and PN is associated with a 15% complication rate. In this aging population, with possible comorbidities and poor health condition, both PN and watchful waiting are non-ideal treatment options. This resulted in an increased need for early, non-invasive treatment strategies such as MR-guided high intensity focused ultrasound (MR-HIFU)...
July 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28549895/needle-free-jet-lidocaine-administration-for-preinjection-anesthesia-in-trigger-finger-injection-a%C3%A2-randomized-controlled-trial
#18
Brandon E Earp, Spencer J Stanbury, Ariana N Mora, Philip E Blazar
PURPOSE: To evaluate the efficacy of needle-free jet lidocaine (J-tip) administration for pain reduction in trigger finger corticosteroid injection compared with simultaneous lidocaine injection with corticosteroid. METHODS: A prospective randomized clinical trial was performed in which patients received either 0.25 mL of 2% lidocaine administered by J-tip just prior to 0.5 mL of corticosteroid injection by needle or 0.5 mL of 1% lidocaine and 0.5 mL of corticosteroid administered simultaneously through a needle for the treatment of trigger finger...
May 24, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#19
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28537661/effect-of-urinary-trypsin-inhibitor-on-inflammatory-cytokines-and-organ-function-in-patients-with-cardiopulmonary-bypass
#20
H-Y Xu, X-S Rong, D-P Wang, S-Y Jiang, Z-D Zang, W Xia, F Zhang, J Yan
OBJECTIVE: This research is to study the effect of urinary trypsin inhibitor (UTI) on inflammatory cytokines and organ function in patients with cardiopulmonary bypass. PATIENTS AND METHODS: From February 2015 to February 2016, 40 patients that had undergone cardiopulmonary bypass surgery in our hospital were selected and randomly divided into the observation group and the control group with 20 patients in each group. Patients in the control group were intravenously injected with 5000 U/kg normal saline during the operation and 5000 U/kg•d-1 at 1-3 days postoperatively, while the patients in the observation group received intravenous injection of the same amount of UTI at pre-operation (T0), post-anesthesia (T1), after aortic opening (T2), after cardiopulmonary bypass 4h (T3), 8h (T4), 24h (T5), 48h (T6), and 72h (T7)...
May 2017: European Review for Medical and Pharmacological Sciences
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