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Anesthesiology critical care

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https://www.readbyqxmd.com/read/27919596/chimeric-anterolateral-thigh-free-flap-for-reconstruction-of-complex-cranio-orbito-facial-defects-after-skull-base-cancers-resection
#1
Mario Cherubino, Mario Turri-Zanoni, Paolo Battaglia, Marco Giudice, Igor Pellegatta, Federico Tamborini, Francesca Maggiulli, Luca Guzzetti, Danilo Di Giovanna, Maurizio Bignami, Carolina Calati, Paolo Castelnuovo, Luigi Valdatta
Complex cranio-orbito-facial defects after skull base cancers resection entail a functional and esthetic reconstruction. The introduction of endoscopic assisted techniques for excision surgery with the advances in reconstructive surgery and anesthesiology allowed to improve the management of such critical patients. We report a series of chimeric anterolateral thigh (ALT) flaps used to reconstruct complex cranio-orbital-facial defects after skull base surgery. A retrospective review of patients that underwent cranio-orbito-facial reconstruction using a chimeric ALT flap from March 2013 to October 2015 at a single tertiary care referral Institute was performed...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27785341/sex-and-gender-medicine-in-physician-clinical-training-results-of-a-large-single-center-survey
#2
Shivani Dhawan, May Bakir, Erika Jones, Sarah Kilpatrick, C Noel Bairey Merz
BACKGROUND: "Sex and Gender Medicine" is a novel medical discipline that takes into account the effects of sex and gender on the health of women and men. The Institute of Medicine in the USA declared in its 2001 and 2010 statements that being a woman or a man significantly impacts the course of diseases, and therefore, this fact must be considered in diagnosis and therapy. We evaluated the representation of Sex and Gender Medicine in clinical training at Cedars-Sinai Medical Center, a large, tertiary, non-profit, academic medical training center in the Western United States...
2016: Biology of Sex Differences
https://www.readbyqxmd.com/read/27662227/appropriateness-of-language-used-in-patient-educational-materials-from-24-national-anesthesiology-associations
#3
Denira Govender, Alexander Villafranca, Colin Hamlin, Brett Hiebert, Divya Parveen, Eric Jacobsohn
BACKGROUND: Patient education materials produced by national anesthesiology associations could be used to facilitate patient informed consent and promote the discipline of anesthesiology. To achieve these goals, materials must use language that most adults can understand. Health organizations recommend that materials be written at the grade 8 level or less to ensure that they are understood by laypersons. The authors, therefore, investigated the language of educational materials produced by anesthesiology associations...
September 22, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27637823/value-based-care-and-bundled-payments-anesthesia-care-costs-for-outpatient-oncology-surgery-using-time-driven-activity-based-costing
#4
Katy E French, Alexis B Guzman, Augustin C Rubio, John C Frenzel, Thomas W Feeley
BACKGROUND: With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. METHODS: Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27564559/use-of-anesthesia-for-imaging-studies-and-interventional-procedures-in-children
#5
Yolanda Y Huang, Lucy Li, Matthew Monteleone, Lynne Ferrari, Lisa J States, James J Riviello, Steven G Kernie, Ali A Mencin, Sumit Gupta, Lena S Sun
Ongoing investigation from the Pediatric Anesthesia NeuroDevelopment Assessment (PANDA) study hopes to examine the long-term effect on cognitive and language development of a single anesthetic exposure in children undergoing inguinal hernia repair. The fifth PANDA Symposium, held in April 2016, continued the mission of previous symposia to examine evidence from basic science and clinical studies on potential neurotoxic effects of anesthetics on developing brain. At the 2016 Symposium, a panel of specialists from nonsurgical pediatric disciplines including anesthesiology, radiology, neurology, gastroenterology, oncology, cardiology, and critical care reviewed use of anesthesia in their practices, including how concern over possible neurodevelopmental effects of early childhood anesthetic exposure has changed discussion with patients and families regarding risks and benefits of imaging studies and interventional procedures involving sedation or anesthesia...
August 25, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27555314/the-virtual-obstetrical-intensive-care-unit-providing%C3%A2-critical-care-for-contemporary-obstetrics-in%C3%A2-nontraditional%C3%A2-locations
#6
Michael P Leovic, Hailey N Robbins, Michael R Foley, Roman S Starikov
Management of the critically ill pregnant patient presents a clinical dilemma in which there are sparse objective data to determine the optimal setting for provision of high-quality care to these patients. This clinical scenario will continue to present a challenge for providers as the chronic illness and comorbid conditions continue to become more commonly encountered in the obstetric population. Various care models exist across a broad spectrum of facilities that are characterized by differing levels of resources; however, no studies have identified which model provides the highest level of care and patient safety while maintaining a reasonable degree of cost-effectiveness...
December 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27533913/pain-management-for-blunt-thoracic-trauma-a-joint-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-and-trauma-anesthesiology-society
#7
Samuel Michael Galvagno, Charles E Smith, Albert J Varon, Erik A Hasenboehler, Shahnaz Sultan, Gregory Shaefer, Kathleen B To, Adam D Fox, Darrell E R Alley, Michael Ditillo, Bellal A Joseph, Bryce R H Robinson, Elliot R Haut
INTRODUCTION: Thoracic trauma is the second most prevalent nonintentional injury in the United States and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma. As a result, updated guidelines for this topic using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework recently adopted by EAST are presented...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27495817/academic-productivity-of-accreditation-council-for-graduate-medical-education-accredited-critical-care-fellowship-program-directors
#8
Brenda G Fahy, Terrie Vasilopoulos, Peggy White, Deborah J Culley
OBJECTIVES: Academic productivity is an expectation for program directors of Accreditation Council for Graduate Medical Education-accredited subspecialty programs in critical care medicine. Within the adult critical care Accreditation Council for Graduate Medical Education-accredited programs, we hypothesized that program director length of time from subspecialty critical care certification would correlate positively with academic productivity, and primary field would impact academic productivity...
August 5, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27472989/point-of-care-ultrasound-a-wfumb-position-paper
#9
REVIEW
Christoph F Dietrich, Adrian Goudie, Liliana Chiorean, Xin Wu Cui, Odd Helge Gilja, Yi Dong, Jacques S Abramowicz, Sudhir Vinayak, Susan Campbell Westerway, Christian Pállson Nolsøe, Yi-Hong Chou, Michael Blaivas
Over the last decade, the use of portable ultrasound scanners has enhanced the concept of point of care ultrasound (PoC-US), namely, "ultrasound performed at the bedside and interpreted directly by the treating clinician." PoC-US is not a replacement for comprehensive ultrasound, but rather allows physicians immediate access to clinical imaging for rapid and direct solutions. PoC-US has already revolutionized everyday clinical practice, and it is believed that it will dramatically change how ultrasound is applied in daily practice...
January 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/27435067/cytomegalovirus-and-epstein-barr-virus-reactivation-in-the-intensive-care-unit
#10
O Coşkun, E Yazici, F Şahiner, A Karakaş, S Kiliç, M Tekin, C Artuk, L Yamanel, B A Beşirbellioğlu
AIM: The purpose of this work was to evaluate the reactivation of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in immunocompetent patients in the intensive care unit (ICU) and to identify risk factors associated with reactivation. MATERIALS AND METHODS: In this observational prospective study, 60 adult immunocompetent patients who stayed at least 7 days in an ICU were evaluated. During hospitalization, the viral load was monitored at admission and on day 7 with polymerase chain reaction to detect viral reactivation and weekly thereafter on days 14, 21, and 28 if hospitalization continued...
July 19, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27400757/update-in-perioperative-medicine-practice-changing-evidence-published-in-2015
#11
Karna K Sundsted, Arya B Mohabbat, Dennis W Regan, Bradley R Salonen, Paul R Daniels, Karen F Mauck
Evidence in perioperative medicine is published in a wide variety of journals, given the multidisciplinary nature of its practice which spans medicine and its subspecialties, as well as surgery and anesthesiology. It can be difficult to identify new and important evidence, as perioperative practice continues to evolve in multiple areas such as medication management, anticoagulation and cardiac risk stratification, among others. New, high-quality evidence is published each year, and must be placed into the context of not only existing literature, but also practical real-world patient care...
August 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27379593/the-association-of-shelter-veterinarians-2016-veterinary-medical-care-guidelines-for-spay-neuter-programs
#12
Brenda Griffin, Philip A Bushby, Emily McCobb, Sara C White, Y Karla Rigdon-Brestle, Leslie D Appel, Kathleen V Makolinski, Christine L Wilford, Mark W Bohling, Susan M Eddlestone, Kelly A Farrell, Nancy Ferguson, Kelly Harrison, Lisa M Howe, Natalie M Isaza, Julie K Levy, Andrea Looney, Michael R Moyer, Sheilah Ann Robertson, Kathy Tyson
As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners...
July 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27314597/the-link-between-anesthesiology-and-neurology-a-mindful-cooperation-to-improve-brain-protection
#13
Anna T Mazzeo, Iacopo Battaglini, Luca Brazzi, Luciana Mascia
Preventing neurological injury is mandatory during the perioperative period of any kind of surgery and in the care of critically ill patients in the intensive care unit. During daily practice, both anaesthesiologists and neurologists focus on brain protection as an integral part of systemic homeostasis maintenance. This article highlights the intriguing overlap between anaesthesiology and neurology in clinical practice along with its potential implications for outcome. Moreover, it focuses on the importance of the complementary expertise of both specialists in maintaining cerebral homeostasis, with the aim of improving outcome...
June 17, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27233473/the-first-ten-years-of-the-department-of-neurosciences-spanish-journal-of-anesthesiology-and-critical-care
#14
F Iturri Clavero, L Valencia Sola
No abstract text is available yet for this article.
May 24, 2016: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/27185704/a-peer-designed-selective-in-anesthesiology-critical-care-and-perioperative-medicine-for-first-and-second-year-medical-students
#15
Michael Tien, Christopher M Aiudi, Hans P Sviggum, Timothy R Long
STUDY OBJECTIVE: The objective of this study was to design and implement a preclinical elective (termed selective) in anesthesiology, critical care, and perioperative medicine and to report survey results assessing the impact of the selective on first- and second-year medical students' understanding of basic concepts, comfort with procedural skills, and interest in the specialty. DESIGN: Preinvention and postintervention survey evaluation was used as the design of this study...
June 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27028470/a-1966-anesthetic-administered-by-robert-d-dripps-m-d-demonstrated-his-experimental-style-of-clinical-care
#16
Robert E Johnstone, Lee A Fleisher
Robert D. Dripps, M.D. (1911 to 1973), helped found academic anesthesiology. Newly reviewed teaching slides from the University of Pennsylvania (Philadelphia, Pennsylvania) contain six anesthesia records from 1965 to 1967 that involved Dripps. They illustrate the clinical philosophy he taught-to consider administration of each anesthetic a research study. Intense public criticism in 1967 for improper experimentation on patients during anesthesia changed his clinical and research philosophies and teaching.
June 2016: Anesthesiology
https://www.readbyqxmd.com/read/27008299/analgesic-effects-and-neuropathology-changes-of-electroacupuncture-on-curing-a-rat-model-of-brachial-plexus-neuralgia-induced-by-cobra-venom
#17
Hui Liu, Xiao-Yan Qian, Jian-Xiong An, Cai-Cai Liu, Yi-De Jiang, Doris K Cope, John P Williams
BACKGROUND: Electroacupuncture (EA) is widely applied to treat neuropathic pain. Brachial plexus neuralgia (BPN) is a common form of chronic persistent pain. Few studies have evaluated the analgesic effects and mechanism of EA using the novel animal model of BPN. OBJECTIVE: To observe the curative effects of repeated EA on curing BPN induced by administration of cobra venom to the lower trunk of the right brachial plexus. STUDY DESIGN: Controlled animal study...
March 2016: Pain Physician
https://www.readbyqxmd.com/read/26994615/hemodynamically-significant-congenital-cardiac-lesions-in-pregnancy
#18
REVIEW
Malavika Prabhu, Allison Bryant
The incidence of congenital cardiac disease among reproductive-aged women is increasing. Understanding the unique physiology of pregnancy and the postpartum period is critical to helping women achieve successful pregnancy outcomes. Risk assessment models estimate the cardiac, obstetric, and neonatal risks a woman may face and influence the conversations regarding pregnancy and contraception management. This review focuses on some of the most common congenital cardiac lesion encountered during pregnancy, as well as key aspects of antepartum, intrapartum, and postpartum care for these women...
May 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/26992643/pediatric-transport-medicine-and-the-dawn-of-the-pediatric-anesthesiology-and-critical-care-medicine-subspecialty-an-interview-with-pioneer-dr-alvin-hackel
#19
Christine L Mai, Zulfiqar Ahmed, Aubrey Maze, Fatima Noorulla, Myron Yaster
Dr. Alvin 'Al' Hackel (1932-) Professor Emeritus of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics at the Stanford University School of Medicine, has been an influential pioneer in shaping the scope and practice of pediatric anesthesia. His leadership helped to formally define the subspecialty of pediatric anesthesiology ('who is a pediatric anesthesiologist?') and the importance of specialization and regionalization of expertise in both patient transport and perioperative care. His enduring impact on pediatric anesthesia and critical care practice was recognized in 2006 by the American Academy of Pediatrics when it bestowed upon him the profession's highest lifetime achievement award, the Robert M...
May 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26967948/simulation-testing-for-selection-of-critical-care-medicine-trainees-a-pilot-feasibility-study
#20
Adriano G Cocciante, Martin N Nguyen, Candida F Marane, Anita E Panayiotou, Amalia Karahalios, Janet A Beer, Navroop Johal, John Morris, Stacy Turner, Elizabeth C Hessian
RATIONALE: Selection of physicians into anesthesiology, intensive care, and emergency medicine training has traditionally relied on evaluation of curriculum vitae, letters of recommendation, and interviews, despite these methods being poor predictors of subsequent workplace performance. OBJECTIVES: In this study, we evaluated the feasibility and face validity of incorporating assessment of nontechnical skills in simulation and personality traits into an existing junior doctor selection framework...
April 2016: Annals of the American Thoracic Society
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