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https://www.readbyqxmd.com/read/28079825/the-utility-of-bispectral-index-monitoring-for-prevention-of-rocuronium-induced-withdrawal-movement-in-children-a-randomized-controlled-trial
#1
Byung Gun Lim, Il Ok Lee, Young Sung Kim, Young Ju Won, Heezoo Kim, Myoung Hoon Kong
BACKGROUND: This study was designed to determine whether a deep hypnotic state with a bispectral index (BIS) value less than 40 could alleviate withdrawal movement (WM) upon rocuronium injection during anesthesia induction in children. METHODS: Finally, 135 healthy children (3-12 years) scheduled for minor elective surgery were studied. Without premedication, anesthesia was induced with thiopental sodium 5 mg/kg. Patients were randomized into 2 groups (control vs experimental) and then by virtue of rocuronium injection time, patients in the experimental group were allocated into 2 groups, as follows: in the control group (group C; n = 45), rocuronium 0...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#2
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079536/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-severe-inherited-thrombophilia-a-series-of-33-patients
#3
Anetta Undas, Tadeusz Goralczyk
The aim of the study was to investigate whether treatment with non-vitamin K antagonist oral anticoagulants (NOACs) is effective and well tolerated in real-life patients following venous thromboembolism (VTE) associated with severe inherited thrombophilia. We evaluated 33 consecutive patients with severe inherited thrombophilia, defined as the presence of deficiencies in protein C, protein S, or anti-thrombin, homozygous factor V Leiden and prothrombin G20210A mutations, or combined defects. The patients were recruited from March 2010 to December 2015 and followed till July 2016...
January 12, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28077026/a-case-control-study-of-risk-factors-of-chronic-venous-ulceration-in-patients-with-varicose-veins
#4
Gohar Abelyan, Lusine Abrahamyan, Gayane Yenokyan
Background/objectives Venous ulcers carry psychological and high financial burden for patients, causing depression, pain, and limitation of mobility. The study aimed to identify factors associated with an increased risk of venous ulceration in patients with varicose veins in Armenia. Methods A case-control study design was utilized enrolling 80 patients in each group, who underwent varicose treatment surgery in two specialized surgical centers in Armenia during 2013-2014 years. Cases were patients with varicose veins and venous leg ulcers...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28074807/isolated-persistent-left-superior-vena-cava-a-case-report-and-its-clinical-implications
#5
Samarjit Bisoyi, Usha Jagannathan, Anjan Kumar Dash, Sabyasachi Tripathy, Raghunath Mohapatra, Naba Kumar Pattnaik, Satyajit Sahu, Debashish Nayak
The venous anomaly of a persistent left superior vena cava (PLSVC) affects 0.3%-0.5% of the general population. PLSVC with absent right superior vena cava, also termed as "isolated PLSVC," is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074802/goal-directed-therapy-improves-the-outcome-of-high-risk-cardiac-patients-undergoing-off-pump-coronary-artery-bypass
#6
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Singh Rawat, Yatin Mehta, Sameer Taneja, R Ravi, Milind P Hote
BACKGROUND: There has been a constant emphasis on developing management strategies to improve the outcome of high-risk cardiac patients undergoing surgical revascularization. The performance of coronary artery bypass surgery on an off-pump coronary artery bypass (OPCAB) avoids the risks associated with extra-corporeal circulation. The preliminary results of goal-directed therapy (GDT) for hemodynamic management of high-risk cardiac surgical patients are encouraging. The present study was conducted to study the outcome benefits with the combined use of GDT with OPCAB as compared to the conventional hemodynamic management...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072940/elective-use-of-veno-venous-extracorporeal-membrane-oxygenation-and-high-flow-nasal-oxygen-for-resection-of-subtotal-malignant-distal-airway-obstruction
#7
Rkf Fung, J Stellios, P G Bannon, A Ananda, P Forrest
We describe the use of peripheral veno-venous extracorporeal membrane oxygenation (VV ECMO) and high-flow nasal oxygen as procedural support in a patient undergoing debulking of a malignant tumour of the lower airway. Due to the significant risk of complete airway obstruction upon induction of anaesthesia, ECMO was established while the patient was awake, and was maintained without systemic anticoagulation to minimise the risk of intraoperative bleeding. This case illustrates that ECMO support with high-flow nasal oxygen can be considered as part of the algorithm for airway management during surgery for subtotal lower airway obstruction, as it may be the only viable option for maintaining adequate gas exchange...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072805/anatomical-variants-of-the-pudendal-nerve-observed-during-a-transgluteal-surgical-approach-in-a-population-of-patients-with-pudendal-neuralgia
#8
Stephane Ploteau, Marie-Aimee Perrouin-Verbe, Jean-Jacques Labat, Thibault Riant, Amelie Levesque, Roger Robert
BACKGROUND: Several studies have described the course and anatomical relations of the pudendal nerve. Several surgical nerve decompression techniques have been described, but only the transgluteal approach has been validated by a prospective randomized clinical trial. The purpose of this study was to describe the course of the nerve and its variants in a population of patients with pudendal neuralgia in order to guide the surgeon in the choice of surgical approach for pudendal nerve decompression...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28072626/acquired-coronary-artery-disease-in-adult-patients-with-congenital-heart-disease-a-true-or-a-false-problem
#9
Alessandro Giamberti, Mauro Lo Rito, Erika Conforti, Alessandro Varrica, Mario Carminati, Alessandro Frigiola, Lorenzo Menicanti, Massimo Chessa
BACKGROUND: The population of adults with congenital heart disease (ACHD) is increasing and aging, and a large percentage of this population is now over 65 years of age. For this reason, it is probable that acquired coronary artery disease (CAD) will become an important issue that needs to be addressed also in these patients. We retrospectively analyzed all ACHD patients who underwent surgery in our Institution with the aim to investigate the incidence of associated CAD and the results of surgical treatment...
January 7, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28071663/covalent-modification-of-pericardial-patches-for-sustained-rapamycin-delivery-inhibits-venous-neointimal-hyperplasia
#10
Hualong Bai, Jung Seok Lee, Elizabeth Chen, Mo Wang, Ying Xing, Tarek M Fahmy, Alan Dardik
Prosthetic grafts and patches are commonly used in cardiovascular surgery, however neointimal hyperplasia remains a significant concern, especially under low flow conditions. We hypothesized that delivery of rapamycin from nanoparticles (NP) covalently attached to patches allows sustained site-specific delivery of therapeutic agents targeted to inhibit localized neointimal hyperplasia. NP were covalently linked to pericardial patches using EDC/NHS chemistry and could deliver at least 360 ng rapamycin per patch without detectable rapamycin in serum; nanoparticles were detectable in the liver, kidney and spleen but no other sites within 24 hours...
January 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28066586/nanoparticle-mediated-arresten-gene-inhibits-neointimal-formation-of-vein-grafts-an-experimental-research
#11
Rong-Fei Wang, Qing-Yi Meng
BACKGROUND: Recently, we established a new rat model of venous arterialization by grafting the jugular vein into carotid arteries. In many respects, the morphological features of this murine vascular graft model resemble those of human venous bypass graft diseases. Using this model, we studied nanoparticles that mediated the arresten gene to inhibit the neointimal formation of vein grafts. METHODS: Thirty healthy Wistar female rats were randomly divided into three groups...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28065957/the-effect-of-educational-internships-on-medical-students-perceptions-of-plastic-surgery
#12
Andac Aykan, Engin Kurt, Sedat Avsar, Muhitdin Eski, Serdar Ozturk
OBJECTIVE: To investigate the effects of plastic, reconstructive and aesthetic surgery educational internships on medical students' perceptions of the scope of plastic surgery. METHODS: This cross-sectional study was conducted at the Gulhane Medical Faculty, Ankara, Turkey, from 2012 to 2013, and comprised 4th-, 5th- and 6th-year medical students. Students were given a questionnaire consisting of 28 questions related to maxillofacial and upper and lower extremity medical conditions, and skin, aesthetic and congenital anomalies...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28064364/significance-of-right-atrial-tension-for-the-development-of-complications-in-patients-after-atriopulmonary-connection-fontan-procedure-potential-indicator-for-fontan-conversion
#13
Gaku Izumi, Hideaki Senzaki, Atsuhito Takeda, Hirokuni Yamazawa, Kohta Takei, Takuo Furukawa, Kei Inai, Tokuko Shinohara, Toshio Nakanishi
Elevated right atrial (RA) pressure and progressive RA dilation are thought to play pivotal roles in the development of late complications after atriopulmonary connection (APC) Fontan surgery. However, no clear cut-off value for RA pressure or RA volume has been determined for stratifying the risk of developing Fontan complications. We hypothesized that RA tension, which incorporates information about both RA pressure and volume, might help predict the risk of developing complications. We retrospectively studied 51 consecutive APC Fontan patients (median postoperative period 14 years)...
January 7, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#14
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28061497/cerebellar-hemorrhage-due-to-a-direct-carotid-cavernous-fistula-after-surgery-for-maxillary-cancer
#15
Yoshinobu Kamio, Hisaya Hiramatsu, Mika Kamiya, Shuhei Yamashita, Hiroki Namba
Infratentorial cerebral hemorrhage due to a direct carotid-cavernous fistula (CCF) is very rare. To our knowledge, only four such cases have been reported. Cerebellar hemorrhage due to a direct CCF has not been reported. We describe a 63-year-old female who presented with reduced consciousness 3 days after undergoing a maxillectomy for maxillary cancer. Computed tomography showed a cerebellar hemorrhage. Magnetic resonance angiography showed a left-sided direct CCF draining into the left petrosal and cerebellar veins through the left superior petrosal sinus (SPS)...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28059946/comparative-study-of-the-difference-of-perioperative-complication-and-radiologic-results-mis-dlif-minimally-invasive-direct-lateral-lumbar-interbody-fusion-versus-mis-olif-minimally-invasive-oblique-lateral-lumbar-interbody-fusion
#16
Jie Jin, Kyeong-Sik Ryu, Jung-Woo Hur, Ji-Hoon Seong, Jin-Sung Kim, Hyun-Jin Cho
STUDY DESIGN: Retrospective observatory analysis. OBJECTIVE: The purpose of this study was to compare the incidence of perioperative complication, difference of cage location, and sagittal alignment between minimally invasive oblique lateral lumbar interbody fusion (MIS-OLIF) and MIS-direct lateral lumbar interbody fusion (DLIF) in the cases of single-level surgery at L4-L5. SUMMARY OF BACKGROUND DATA: MIS-DLIF using tubular retractor has been used for the treatment of lumbar degenerative diseases; however, blunt transpsoas dissection poses a risk of injury to the lumbar plexus...
January 4, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28059916/does-hospital-transfer-impact-outcomes-after-colorectal-surgery
#17
Christopher J Chow, Wolfgang B Gaertner, Christine C Jensen, Bradford Sklow, Robert D Madoff, Mary R Kwaan
BACKGROUND: With increasing public reporting of outcomes and bundled payments, hospitals and providers are scrutinized for morbidity and mortality. The impact of patient transfer before colorectal surgery has not been well characterized in a risk-adjusted fashion. OBJECTIVE: We hypothesized that hospital-to-hospital transfer would independently predict morbidity and mortality beyond traditional predictor variables. DESIGN: We constructed a retrospective cohort of 158,446 patients who underwent colorectal surgery using the 2009-2013 American College of Surgeons National Surgical Quality Improvement Program database...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28057352/sigmoid-sinus-cortical-plate-dehiscence-induces-pulsatile-tinnitus-through-amplifying-sigmoid-sinus-venous-sound
#18
Shan Tian, Lizhen Wang, Jiemeng Yang, Rui Mao, Zhaohui Liu, Yubo Fan
Sigmoid sinus cortical plate dehiscence (SSCPD) is common in pulsatile tinnitus (PT) patients, and is treated through SSCPD resurfacing surgery in clinic, but the bio-mechanism is not clear as so far. This study aimed to clarify the bio-mechanism of PT sensation induced by SSCPD, and quantify the relationship of cortical plate (CP) thickness and PT sensation intensity. It was hypothesized that SSCPD would induce PT through significantly amplifying sigmoid sinus (SS) venous sound in this study. Finite element (FE) analysis based on radiology data of typical patient was used to verify this hypothesis, and was validated with clinical reports...
December 16, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28056988/cytoreductive-nephrectomy-with-thrombectomy-before-targeted-therapy-improves-survival-for-metastatic-renal-cell-carcinoma-with-venous-tumor-thrombus-a-single-center-experience
#19
Nienie Qi, Pengjie Wu, Jinchao Chen, Teng Li, Xianghui Ning, Jin Wang, Kan Gong
BACKGROUND: The aim of the study is to evaluate the role of cytoreductive nephrectomy (CN) with thrombectomy before targeted molecular therapy (TMT) on survival in metastatic renal cell carcinoma (mRCC) with venous tumor thrombus. METHODS: We performed a retrospective analysis of 47 patients treated in our center from April 2008 to October 2014. In the study, 20 patients underwent CN with thrombectomy followed by targeted therapy (group 1); 15 patients received targeted therapy alone (group 2); and 12 patients underwent CN with thrombectomy alone (group 3)...
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28056702/management-of-venous-ulcers-according-to-their-anatomical-relationship-with-varicose-veins
#20
Yun-Nan Lin, Tung-Ying Hsieh, Shu-Hung Huang, Chia-Ming Liu, Kao-Ping Chang, Sin-Daw Lin
Background Adequately excising varicose and incompetent perforating veins is necessary for reducing their recurrence rate of venous ulcer. Method In total, 66 venous ulcers (C6) in 1083 legs with primary varicose veins were managed through endoscopic-assisted surgery. In an endoscopic operative view, the nonvaricose, varicose, and incompetent perforating veins were clearly visualized and precisely dissected. The varicose and incompetent perforating veins were divided and completely excised. Result The varicose veins were traced to the base or periphery of the 55 ulcers...
January 1, 2017: Phlebology
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