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Nipun Sodhi, Hiba K Anis, Marine Coste, Joseph O Ehiorobo, Alexander Chee, Benjamin Freund, Assem A Sultan, Joseph T Moskal, Giles R Scuderi, Michael A Mont
Compared with nonelective total knee arthroplasties (TKAs), elective procedures have more time for preoperative planning, which allows for potentially improved patient optimization, risk factor modification, and patient education. The purpose of this study was to (1) determine nationwide trends in operative times and (2) evaluate associations between surgery type, elective or nonelective, with respect to (a) operative times, (b) length of stay (LOS), (c) discharge dispositions, (d) 30-day postoperative complications, (e) reoperations, and (f) readmissions...
February 20, 2019: Journal of Knee Surgery
Richard S Cartabuke, Brian J Anderson, Charles Elmaraghy, Julie Rice, Dmitry Tumin, Joseph D Tobias
OBJECTIVES/HYPOTHESIS: Oxymetazoline is an α-adrenergic agonist that is commonly used as a topical hemostatic agent in the operating room during ear, nose, and throat surgery. There are limited data on oxymetazoline pharmacokinetics in children who undergo general anesthesia. We assessed the hemodynamic effects and systemic absorption of topically applied oxymetazoline in children undergoing various nasal procedures. STUDY DESIGN: Prospective trial. METHODS: Children ages 2 to 17 years undergoing functional endoscopic sinus surgery, turbinate resection, or adenoidectomy were enrolled...
February 20, 2019: Laryngoscope
D Merrill Dane, Cuneyt Yilmaz, Dipendra Gyawali, Roshni Iyer, Jyothi U Menon, Kytai T Nguyen, Priya Ravikumar, Aaron S Estrera, Connie C W Hsia
Paracrine erythropoietin (EPO) signaling in the lung recruits endothelial progenitor cells, promotes cell maturation and angiogenesis , and is upregulated during canine post-pneumonectomy (PNX) compensatory lung growth. To determine whether inhalational delivery of exogenous EPO augments endogenous post-PNX lung growth, adult canines underwent right PNX and received, via a permanent tracheal stoma, weekly nebulization of recombinant human EPO-containing nanoparticles or empty nanoparticles (control) for 16 weeks...
February 20, 2019: American Journal of Physiology. Lung Cellular and Molecular Physiology
Mia W Steffenssen, Issam Al-Najami, Gunnar Baatrup
OBJECTIVE: The purpose of this systematic review was to investigate the incidence and nature of minor adverse events (MAEs) after colonoscopy, and response rates to questionnaires concerning MAEs in patients undergoing colonoscopy. MATERIALS AND METHODS: A systematic literature search was conducted in the databases PubMed and Embase. Predictor variables were patient-reported MAEs after colonoscopy. The outcome was frequency and types of MAEs and the patients' response rate to questionnaires after colonoscopy...
February 20, 2019: Acta Oncologica
Fabio Spina, Laura Brizzi, Giliola Spattini, Fabio Faiola, Francesco Birettoni
BACKGROUND: Previous ultrasonographic studies of Sapajus apella to determine the normal anatomy and physiology are incomplete. The aim of this study was to determine normal ultrasonographic appearance and measurements of all abdominal organs and structures of interest. METHODS: Twelve adult monkeys were recruited considered healthy on the basis of history, physical examination, and general blood work. To avoid additional anesthesia, the ultrasonographic examinations were performed during routine screening, annually scheduled by the Unit of Cognitive Primatology & Primate Center, CNR-Rome, where the animals were housed...
February 19, 2019: Journal of Medical Primatology
Robert Chen
This module will introduce the concept of a point-of-care ultrasound (POCUS) examination for perioperative clinicians. A focused cardiac examination of ventricular filling and function is presented. An examination of the inferior vena cava is also reviewed as a tool to assess volume status. Finally, a brief examination of the lung and pleura is explored to aid the clinician in situations of patient hypoxia and difficult ventilation. Limited ultrasound cardiorespiratory examinations can be performed by non-cardiologists and non-radiologists...
February 19, 2019: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Masashi Ishikawa, Dai Namizato, Atsuhiro Sakamoto
Acoustic respiratory rate (RRa) monitoring is a non-invasive method of monitoring respiratory rate in spontaneously breathing individuals. The aim of this report is to highlight the clinical utility of this monitoring system in post-thyroidectomy patients by presenting a case of respiratory compromise due to post-thyroidectomy hematoma, in which the alarm of the respiratory rate monitor alerted the nursing staff about the complication. A 61-year-old woman who uneventfully underwent right thyroid lobectomy for adenomatous goiter under general anesthesia with endotracheal intubation was being monitored postoperatively using the RRa monitoring system...
February 19, 2019: Journal of Clinical Monitoring and Computing
C Sponholz, C Schuwirth, L Koenig, H Hoyer, S M Coldewey, C Schelenz, T Doenst, A Kortgen, M Bauer
Intraoperative vasopressor and fluid application are common strategies against hypotension. Use of processed electroencephalographic monitoring (pEEG) may reduce vasopressor application, a known risk factor for organ dysfunction, in elective cardiac surgery patients. Randomized single-centre clinical trial at Jena University Hospital. Adult patients operated on cardiopulmonary bypass or off-pump coronary artery bypass grafting were randomised to receive anesthesia with visible or blinded pEEG using Narcotrend™...
February 19, 2019: Journal of Clinical Monitoring and Computing
Roni Zelitzki, Akiva Korn, Eti Arial, Carmit Ben-Harosh, Zvi Ram, Rachel Grossman
BACKGROUND: Surgical removal of intra-axial brain tumors aims at maximal tumor resection while preserving function. The potential benefit of awake craniotomy over craniotomy under general anesthesia (GA) for motor preservation is yet unknown. OBJECTIVE: To compare the clinical outcomes of patients who underwent surgery for perirolandic tumors while either awake or under GA. METHODS: Between 2004 and 2015, 1126 patients underwent surgical resection of newly diagnosed intra-axial tumors in a single institution...
February 20, 2019: Neurosurgery
Meiru Jiang, Qiaoxia Sun, Ganggang Liu, Hua Qu, Jiahai Ma
Burn-induced acute post-operative pain and the associated stress response may result in prolonged convalescence. The present study investigated the effects of dexmedetomidine (DEX) administration on post-operative pain and the quality of recovery following surgical treatment of moderate-to-severe burn injuries. A total of 60 adult patients undergoing tangential excision skin grafting were randomized into two groups. The DEX group (Group D) received an intravenous (i.v.) single-dose bolus injection of DEX 0...
March 2019: Experimental and Therapeutic Medicine
Tjark Tassemeier, Marcel Haversath, Moritz Schutzbach, Marcus Jäger
Purpose: Osteoporotc fractures with posterior wall injury are commonly treated with a pedicle srcrew instrumentation (PSI) or a ballonkyphoplasty (BKP). A predictor for complications for these patients is the American Society of Anesthesiologists (ASA) class. Clinical results in ASA II/III patients who underwent BKP and PSI due to OF were evaluated to find the optimal treatment regimen. Materials and Methods: In a retrospective study design, ASA Class II and III patients with OF type OF 2 and OF 3 according to the German Society of Orthopedics and Trauma Surgery classification who underwent surgery between 2011 and 2016 were enrolled...
October 2018: Journal of Craniovertebral Junction and Spine
Nozomi Matsumura, Toru Suzuki, Satoshi Goto, Takeshi Fujita, Shin Yamane, Maiko Maruyama-Inoue, Kazuaki Kadonosono
OBJECTIVES: To examine the causes of congenital nasolacrimal duct obstruction (CNLDO) using dacryoendoscopy, and to evaluate the surgical outcomes of primary transcanalicular endoscopic dacryoplasty. METHODS: The subjects of this study were a total of 56 eyes of 46 Japanese children aged one to five years old (mean, 29.1 ± 14.0 months old) with clinically diagnosed CNLDO. The blockage was visualized and probed using a dacryoendoscope (MD10 with a 20 G probe, Fiber Tech Co...
February 19, 2019: Eye
Rolvix H Patterson, Alexis N Bowder, Theodule Jean-Baptiste, Daniel L Eisenson, Mallory K Wilson, Christopher M Dodgion, Luther E Ward, Michelson M N Padovany
BACKGROUND: St. Boniface Hospital (SBH) plays a critical role in providing safe, accessible surgery in rural southern Haiti. We examine the impact of SBH increasing surgical capacity on case volume, patient complexity, and inpatient mortality across three phases. MATERIALS AND METHODS: A retrospective review and geospatial analysis of all surgical cases performed at SBH between 2015 and 2017 were performed. Inpatient mortality was defined by in-hospital deaths divided by the number of procedures performed...
February 18, 2019: Journal of Surgical Research
Valentin Mocanu, Jerry Dang, Farah Ladak, Noah Switzer, Daniel W Birch, Shahzeer Karmali
BACKGROUND: Gastrointestinal leak is one of the most severe postoperative complications after Roux-en-Y gastric bypass (RYGB), occurring in up to 2% of all patients. This has led to adoption of simpler procedures, such as sleeve gastrectomy, which have improved safety profiles but potentially less effective long-term metabolic outcomes. Yet, in contrast to sleeve gastrectomy, a paucity of modern literature exists regarding predictors of leak for RYGB. OBJECTIVES: The purpose of this study was to examine gastrointestinal leak in patients undergoing RYGB using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement data registry...
January 26, 2019: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Mary Ellen McCann, Jurgen C de Graaff, Liam Dorris, Nicola Disma, Davinia Withington, Graham Bell, Anneke Grobler, Robyn Stargatt, Rodney W Hunt, Suzette J Sheppard, Jacki Marmor, Gaia Giribaldi, David C Bellinger, Penelope L Hartmann, Pollyanna Hardy, Geoff Frawley, Francesca Izzo, Britta S von Ungern Sternberg, Anne Lynn, Niall Wilton, Martin Mueller, David M Polaner, Anthony R Absalom, Peter Szmuk, Neil Morton, Charles Berde, Sulpicio Soriano, Andrew J Davidson
BACKGROUND: In laboratory animals, exposure to most general anaesthetics leads to neurotoxicity manifested by neuronal cell death and abnormal behaviour and cognition. Some large human cohort studies have shown an association between general anaesthesia at a young age and subsequent neurodevelopmental deficits, but these studies are prone to bias. Others have found no evidence for an association. We aimed to establish whether general anaesthesia in early infancy affects neurodevelopmental outcomes...
February 16, 2019: Lancet
Lily H P Nguyen, Ilana Bank, Rachel Fisher, Marco Mascarella, Meredith Young
BACKGROUND: A longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education. METHODS: Residents participated in four different simulation-based training modules using animal models, cadavers, task trainers, and crisis scenarios using high fidelity manikins. Scenarios were based on various clinical settings (i.e. emergency room, operating room) and were followed by video-assisted structured debriefings...
February 19, 2019: Journal of Otolaryngology—Head & Neck Surgery
Shengqun Xu, Yongqiang Yu, Hamdy ElHakim, Xiangguo Cui, Huaian Yang
OBJECTIVES: The treatment of hemangiomas in the hypopharynx and larynx can be challenging and stressful because of the high tumor recurrence rate. The objective of this study was to investigate the therapeutic effect of the combination of intratumor injection of bleomycin and electroresection/electrocautery on the hemangiomas in the hypopharynx and larynx through suspension laryngoscopy. METHODS: With patients under general anesthesia, the hemangiomas were fully exposed through suspension laryngoscopy...
February 19, 2019: Annals of Otology, Rhinology, and Laryngology
Harrison C Walker, Jesse Faulk, Akm Fazlur Rahman, Christopher L Gonzalez, Patrick Roush, Arie Nakhmani, Jason L Crowell, Barton L Guthrie
Despite substantial experience with deep brain stimulation for movement disorders and recent interest in electrode targeting under general anesthesia, little is known about whether awake macrostimulation during electrode targeting predicts postoperative side effects from stimulation. We hypothesized that intraoperative awake macrostimulation with the newly implanted DBS lead predicts dose-limiting side effects during device activation in clinic. We reviewed 384 electrode implants for movement disorders, characterized the presence or absence of stimulus amplitude thresholds for dose-limiting DBS side effects during surgery, and measured their predictive value for side effects during device activation in clinic with odds ratios ±95% confidence intervals...
February 18, 2019: Brain Sciences
Negin Amini, Alireza Sarkaki, Mahin Dianat, Seyyed Ali Mard, Akram Ahangarpour, Mohammad Badavi
Renal Ischemia-Reperfusion (IR) injury occurs due to circulatory shock and renal transplantation, leading to mortality and morbidity worldwide. The primary purpose of the current study was to evaluate the renoprotective effects of the naringin (NAR) and trimetazidine (TMZ) on IR injury, renal hemodynamics, antioxidant capacity, microRNA-10a, and expression of apoptosis factors. Forty rats were divided into five groups randomly: Sham, IR injury, (TMZ, 5 mg/kg), (NAR pretreatment, 100 mg/kg), and TMZ plus NAR...
February 16, 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Hussam Metwali, Mathijs Raemaekers, Katja Kniese, Amir Samii
BACKGROUND: Intraoperative assessment of the functional connectivity (FC) provides a new possibility of mapping the eloquent brain region before, during, and after tumor resection. a systematic analysis of the detectability of FC and its variation between subjects and session. METHODS: the FC was analyzed in 10 pituitary adenoma patients under propofol anesthesia before and after tumor resection. The FC of each session (totally 20 sessions) was correlated to a reference matrix of a group of healthy subjects to evaluate the variations of the overall, interhemispheric and intrahemispheric FC between sessions...
February 16, 2019: World Neurosurgery
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