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https://www.readbyqxmd.com/read/29683003/assessment-of-a-lateral-nasal-wall-block-technique-for-endoscopic-sinus-surgery-under-local-anesthesia
#1
Grace M Scott, Chris Diamond, Damian C Micomonaco
Introduction With increasingly limited operative resources and patient desires for minimally invasive procedures, there is a trend toward local endoscopic procedures being performed in the outpatient clinic setting. However, there remain limited data supporting a technique to adequately anesthetize the lateral nasal wall and provide patient comfort during these procedures. The objective of this study is to assess the efficacy of a novel lateral nasal wall block for use in office-based endoscopic sinus surgery...
January 1, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29628196/effectiveness-of-novel-adjuncts-in-pain-management-following-total-knee-arthroplasty-a-randomized-clinical-trial
#2
Juan C Suarez, Ahmed A Al-Mansoori, Sumit Kanwar, Jesus M Villa, Colin A McNamara, Preetesh D Patel
BACKGROUND: Total knee arthroplasty (TKA) can be associated with significant pain which can negatively impact outcomes. Multiple strategies have been employed to reduce pain. The aim of this study is to compare the effectiveness of 3 different pain management modalities after TKA that included (1) our standardized knee injection cocktail and oral acetaminophen, (2) liposomal bupivacaine periarticular injection and oral acetaminophen, and (3) our standardized knee injection cocktail and intravenous (IV) acetaminophen...
March 12, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29618150/a-meta-analysis-comparing-liposomal-bupivacaine-and-traditional-periarticular-injection-for-pain-control-after-total-knee-arthroplasty
#3
Hao Sun, Zhiyu Huang, Zhiqi Zhang, Weiming Liao
Liposomal bupivacaine is a novel method for pain control after total knee arthroplasty (TKA), but recent studies showed no advantage for patients undergoing TKA compared with traditional periarticular injection (PAI). The purpose of this analysis was to compare the clinical outcomes between liposomal bupivacaine treatment and traditional PAI. We retrospectively reviewed data from 16 clinical trials in published databases from their inception to June 2017. The primary outcome was postoperative Visual Analogue Scale (VAS) score and secondary outcomes included opiate usage, narcotic consumption, range of motion, and length of stay...
April 4, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29567001/battling-the-opioid-epidemic-with-prospective-pain-threshold-measurement
#4
Brian T Nickel, Mitchell R Klement, William A Byrd, David E Attarian, Thorsten M Seyler, Samuel S Wellman
BACKGROUND: Responsible analgesic prescribing is paramount in the opioid epidemic era, yet no standardized protocol exists. We aim to (1) quantify and correlate outpatient opioid need after total knee and hip arthroplasties (TKA and THA) with preoperative objective pain pressure thresholds (PPTs) and subjective pain measures and (2) report incidence of nonsurgical opioid prescriptions 6 weeks postoperatively. METHODS: Prospectively, PPTs were measured using an algometer with a maximum force of 20 pounds in 160 consecutive patients (90 TKA and 70 THA)...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29289394/laparoscopic-guided-abdominal-wall-nerve-blocks-in-the-pediatric-population-a-novel-technique-with-comparison-to-ultrasound-guided-blocks-and-local-wound-infiltration-alone
#5
Alessandra Landmann, Mihaela Visoiu, Marcus M Malek
BACKGROUND: Abdominal wall nerve blocks have been gaining popularity for the treatment of perioperative pain in children. Our aim was to compare a technique of surgeon-performed, laparoscopic abdominal wall nerve blocks to anesthesia-placed, ultrasound-guided abdominal wall nerve blocks and the current standard of local wound infiltration. METHODS: After institutional review board approval was obtained, a retrospective chart review was performed of pediatric patients treated at a single institution during a 2-year period...
March 2018: Surgery
https://www.readbyqxmd.com/read/29105821/accurate-prediction-of-acute-fish-toxicity-of-fragrance-chemicals-with-the-rtgill-w1-cell-assay
#6
Andreas Natsch, Heike Laue, Tina Haupt, Valentin von Niederhäusern, Gordon Sanders
Testing for acute fish toxicity is an integral part of the environmental safety assessment of chemicals. A true replacement of primary fish tissue was recently proposed using cell viability in a fish gill cell line (RTgill-W1) as a means of predicting acute toxicity, showing good predictivity on 35 chemicals. To promote regulatory acceptance, the predictivity and applicability domain of novel tests need to be carefully evaluated on chemicals with existing high-quality in vivo data. We applied the RTgill-W1 cell assay to 38 fragrance chemicals with a wide range of both physicochemical properties and median lethal concentration (LC50) values and representing a diverse range of chemistries...
March 2018: Environmental Toxicology and Chemistry
https://www.readbyqxmd.com/read/28852928/laparoscopic-ureteral-reimplantation-with-extracorporeal-tailoring-and-direct-nipple-ureteroneocystostomy-for-adult-obstructive-megaureter-long-term-outcomes-and-comparison-to-open-procedure
#7
Wenlong Zhong, Lin Yao, Haoran Cui, Kunlin Yang, Gang Wang, Tao Xu, Xiongjun Ye, Xuesong Li, Liqun Zhou
PURPOSE: To evaluate the long-term outcomes of laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy for adult obstructive megaureter and compare the results with the open procedure. METHODS: From January 2007 to July 2013, 22 patients underwent laparoscopic and 28 patients underwent open ureteral reimplantation for adult obstructive megaureter. For laparoscopic group, the dilated ureter was delivered out of through a 12-mm port and the distal end was tailored and formed into an antireflux nipple extracorporeally...
November 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28735156/adaptive-periodic-paralysis-allows-weaning-deep-sedation-overcoming-the-drowning-syndrome-in-ecmo-patients-bridged-for-lung-transplantation-a-case-series
#8
Irina Timofte, Michael Terrin, Erik Barr, June Kim, Joseph Rinaldi, Nicholas Ladikos, Jay Menaker, Ali Tabatabai, Zachary Kon, Bartley Griffith, Richard Pierson, Si Pham, Aldo Iacono, Daniel Herr
PURPOSE: Sedation in extracorporeal membrane oxygenation (ECMO) is challenging. Patients require deep sedation because of extremely high respiratory rates and increased work of breathing ("Drowning Syndrome") resulting in altered intra-thoracic pressure and reduced pump flow associated with hemodynamic compromise and decreased oxygenation. However, deep sedation impedes essential active rehabilitation with physical therapy. METHODS: We reviewed data on 3 ECMO patients for whom we used a novel approach to replace continuous drips with periodic sedation/paralysis...
December 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#9
Marcia Irene Canto, Julian A Abrams, Hannah T Künzli, Bas Weusten, Yoshihiro Komatsu, Blair A Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by EMR, endoscopic submucosal dissection (ESD), or radiofrequency ablation. A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system [CbFAS]) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
February 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28713291/an-expanding-world-of-novel-psychoactive-substances-opioids
#10
REVIEW
Jolanta B Zawilska
The abuse of novel psychoactive substances (NPS) has been increasing dramatically worldwide since late 2000s. By the end of 2015, more than 560 NPS had been reported to the European Monitoring Centre for Drugs and Drug Addiction. Although the most popular compounds are synthetic cannabinoids and psychostimulatory derivatives of cathinone (so-called β-keto-amphetamines), novel synthetic opioids have recently emerged on the recreational drug market. They include fentanyl (a potent narcotic analgesic) and its analogs (e...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28635020/fentanyl-novel-derivative-related-deaths
#11
Arianna Giorgetti, Carmela Centola, Raffaele Giorgetti
OBJECTIVE: Fentanyl (FEN) is a potent, synthetic narcotic used as an anaesthetic and a pain reliever, but also illegally manufactured. For diversion purpose, it is being steadily modified to produce new analogous compounds and derivatives (FENS), categorised as novel psychoactive substances. While potential FEN abuse is already known, even in the absence of a clear lethal dosage, there is still a shortage of data on its derivatives. METHODS: A literature review of FENS-related deaths was performed, to better understand potential damage and future perspectives of FEN congeners...
May 2017: Human Psychopharmacology
https://www.readbyqxmd.com/read/28632547/a-less-invasive-retroperitoneal-lumbar-approach-animal-feasibility-study-and-primary-clinical-study
#12
Yu Qian, Zhen Lin, Cong Jin, Xing Zhao, Minghao Zheng
STUDY DESIGN: Surgical approach development in an animal model, and a prospective study comparing clinical outcomes between novel and conventional approaches in thoracolumbar burst fracture fixation. OBJECTIVE: To investigate the feasibility of a less-invasive retroperitoneal approach to the lumbar spine in a sheep model and to compare the clinical outcomes of anterior reconstruction in the treatment of thoracolumbar burst fractures using novel and conventional approaches...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28529168/opioids-in-gastroenterology-treating-adverse-effects-and-creating-therapeutic-benefits
#13
Michael Camilleri, Anthony Lembo, David A Katzka
The use of opioid medications on both an acute and chronic basis is ubiquitous in the United States. As opioid receptors densely populate the gastrointestinal tract, symptoms and side effects can be expected in these patients. In the esophagus, dysmotility may result, manifesting with dysphagia and a syndrome indistinguishable from primary achalasia. In the stomach, a marked delay in gastric emptying may occur with postprandial nausea and early satiety. Postoperatively, particularly with abdominal surgery, opioid-induced ileus may ensue...
September 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28528402/impact-of-brown-rice-specific-%C3%AE-oryzanol-on-epigenetic-modulation-of-dopamine-d2-receptors-in-brain-striatum-in-high-fat-diet-induced-obesity-in-mice
#14
Chisayo Kozuka, Tadashi Kaname, Chigusa Shimizu-Okabe, Chitoshi Takayama, Masato Tsutsui, Masayuki Matsushita, Keiko Abe, Hiroaki Masuzaki
AIMS/HYPOTHESIS: Overeating of dietary fats causes obesity in humans and rodents. Recent studies in humans and rodents have demonstrated that addiction to fats shares a common mechanism with addiction to alcohol, nicotine and narcotics in terms of a dysfunction of brain reward systems. It has been highlighted that a high-fat diet (HFD) attenuates dopamine D2 receptor (D2R) signalling in the striatum, a pivotal regulator of the brain reward system, resulting in hedonic overeating. We previously reported that the brown rice-specific bioactive constituent γ-oryzanol attenuated the preference for an HFD via hypothalamic control...
August 2017: Diabetologia
https://www.readbyqxmd.com/read/27975037/abdominal-wall-reconstruction-using-retrorectus-self-adhering-mesh-a-novel-approach
#15
Ibrahim Khansa, Jeffrey E Janis
BACKGROUND: In abdominal wall reconstruction, the retrorectus plane offers an ideal location for mesh placement. Mesh fixation in this plane is often achieved using transfascial sutures, which risks entrapping intercostal nerves and causing significant pain, and takes time to place. A novel alternative is the use of sutureless self-adhering mesh. Although the use of this mesh in inguinal hernias has been well described, studies on its use in abdominal wall reconstruction are lacking. METHODS: Consecutive patients who underwent ventral hernia repair with retrorectus mesh were reviewed...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27871332/the-prevalence-of-novel-psychoactive-substances-nps-use-in-non-clinical-populations-a-systematic-review-protocol
#16
REVIEW
Salma M Khaled, Elizabeth Hughes, Dan Bressington, Monica Zolezzi, Ahmed Radwan, Ashish Badnapurkar, Richard Gray
BACKGROUND: Novel psychoactive substances (NPS) are new narcotic or psychotropic drugs that are not controlled by the United Nations drug convention that may pose a serious public health threat due to their wide availability for purchase on the internet and in so called "head shops." Yet, the extent of their global use remains largely unknown. The aim of this study is to conduct a systematic review of the prevalence of NPS use in non-clinical populations. METHODS: This is a systematic review of observational studies...
November 21, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27810148/introduction-of-a-novel-ultrasound-guided-extrathoracic-sub-paraspinal-block-for-control-of-perioperative-pain-in-nuss-procedure-patients
#17
RANDOMIZED CONTROLLED TRIAL
Robert B Bryskin, Daniel K Robie, Frederick M Mansfield, Eugene B Freid, Siam Sukumvanich
BACKGROUND: A safe and effective method of multilevel thoracic pain control remains an elusive goal in patients undergoing the Nuss procedure. The aim of our study was to develop a nonopioid centered approach using a novel regional technique as part of a quality improvement initiative. METHODS: The proposed ultrasound-guided technique positions multi-perforated soaker catheter deep to the paraspinal muscles from T2 to T11. The project was conducted in two phases...
March 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27807793/opioids-and-gi-motility-friend-or-foe
#18
REVIEW
Allen A Lee, William L Hasler
The use of opioids for the treatment of chronic non-cancer pain is growing at an alarming rate. Opioid-induced bowel dysfunction (OBD) is a common adverse effect of long-term opioid treatment manifesting as constipation, nausea, and vomiting. These effects are primarily mediated by peripheral μ-opioid receptors with resultant altered GI motility and function. As a result, patients may present with opioid-induced constipation (OIC), opioid-induced nausea and vomiting (OINV), and/or narcotic bowel syndrome (NBS)...
December 2016: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/27766526/implementation-of-a-novel-postoperative-monitoring-system-using-automated-modified-early-warning-scores-mews-incorporating-end-tidal-capnography
#19
Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2 ), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27735948/transactivation-of-trkb-by-sigma-1-receptor-mediates-cocaine-induced-changes-in-dendritic-spine-density-and-morphology-in-hippocampal-and-cortical-neurons
#20
Minhan Ka, Yeon-Hee Kook, Ke Liao, Shilpa Buch, Woo-Yang Kim
Cocaine is a highly addictive narcotic associated with dendritic spine plasticity in the striatum. However, it remains elusive whether cocaine modifies spines in a cell type-specific or region-specific manner or whether it alters different types of synapses in the brain. In addition, there is a paucity of data on the regulatory mechanism(s) involved in cocaine-induced modification of spine density. In the current study, we report that cocaine exposure differentially alters spine density, spine morphology, and the types of synapses in hippocampal and cortical neurons...
October 13, 2016: Cell Death & Disease
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