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Intra Operative Monitoring

Yunfei Hua, Xuping Yang, Ruiting Li, Peifang Liu, Peijia Liu, Linrui Li, Xia Yuan, Xiaoyi Hua, Yuan Tian, Zunjian Zhang, Yin Huang
Glutaminolysis is the metabolic pathway that lyses glutamine to glutamate, alanine, citrate, aspartate, and so on. As partially recruiting reaction steps from the tricarboxylic acid (TCA) cycle and the malate-aspartate shuttle, glutaminolysis takes essential place in physiological and pathological situations. We herein developed a sensitive, rapid, and reproducible liquid chromatography-tandem mass spectrometry method to determine the perturbation of glutaminolysis in human plasma by quantifying 13 involved metabolites in a single 20-min run...
February 9, 2019: Analytical and Bioanalytical Chemistry
Zhaokun Wang, Xia Wang, Shuang Li, Zhen Jiang, Xingjie Guo
In this work, a carbon nanosphere decorated by Fe3 O4 nanoparticles was prepared, characterized and used as the magnetic adsorbent. Eight commonly used chiral triazole fungicides, including penconazole, uniconazole, paclobutrazol, triazolone, tebuconazole, hexaconazole, triticonazole and epoxiconazole were extracted from two environmental water samples (river water and lake water) by magnetic solid-phase extraction, followed by the enantiomeric analysis on a Chiralpark IC column coupled with a triple quadrupole mass spectrometry to evaluate their possible stereoselective degradation occurring in the water samples...
February 6, 2019: Electrophoresis
Robert Sowerby, Andrea Gail Lantz, Daniela Ghiculete, Aaron Hong, Monica Farcas, Keith Barrett, Jason Y Lee, Michael Ordon, Kenneth Pace, John D'A Honey
INTRODUCTION Routine pre-operative electrocardiogram (ECG) before shockwave lithotripsy (SWL) is frequently performed despite recommendations against its use in asymptomatic patients undergoing low risk surgical procedures. This study assesses if routine pre-operative ECG prior to SWL is useful in patients at low risk for cardiac complications. MATERIALS AND METHODS A retrospective study of SWL at our centre (2003-2013) reviewed all cardiac-related pre-operative cancellations, intra-operative complications, post-operative admissions, and emergency department presentations in patients at low risk for cardiac complications...
February 6, 2019: Journal of Endourology
Haimin Chen, Qingsong Wu, Hongcai Fang, Bo Liang, Lu Fang
BACKGROUND: Hepatic portal vein gas (HPVG) is a rare acute abdomen, which is not an independent disease. Meanwhile, HPVG combined with appendicitis has been rarely reported. We found only a similar report by looking for literature, but no intestinal necrosis occurred. We report a patient with HPVG, appendicitis and intestinal necrosis was reported in the current study. The patient was given frequent monitoring and had been conducted operation in time. CASE PRESENTATION: An 86-year-old female with appendicitis complicated by HPVG was reported in the present study...
February 4, 2019: BMC Surgery
Alejandro Pita, Brian Nguyen, Daisy Rios, Nicolas Maalouf, Mary Lo, Yuri Genyk, Linda Sher, J Perren Cobb
PURPOSE: Recovery after liver transplant (LT) requires extensive resources, including prolonged intensive care unit stays. The objective of this study was to use an assessment tool to determine if LT recipients remain in ICU beyond designated indications. METHODS: Records from 100 consecutive LTs performed in a single institution were retrospectively reviewed. An admission, discharge, and triage screening (ADT) tool was utilized to assess the indications for each ICU day...
January 9, 2019: Journal of Critical Care
Heleen J Blussé van Oud-Alblas, Margreke J E Brill, Mariska Y M Peeters, Dick Tibboel, Meindert Danhof, Catherijne A J Knibbe
BACKGROUND: In adolescents limited data are available on the pharmacokinetics (PK) and pharmacodynamics (PD) of propofol. In this study we derived a PK-PD model for propofol in adolescents undergoing idiopathic scoliosis surgery with an intraoperative wake-up test with reinduction of anesthesia using both Bispectral Index (BIS) and composite A-line ARX index (cAAI) as endpoints. METHODS: Fourteen adolescents (9.8-20.1 years) were evaluated during standardized propofol-remifentanil anesthesia for idiopathic scoliosis surgery with an intraoperative wake-up test with reinduction of anesthesia...
January 22, 2019: BMC Anesthesiology
Alfonso Vaquero-Picado, Gaspar González-Morán, Luis Moraleda
Supracondylar fractures of the humerus are the most frequent fractures of the paediatric elbow, with a peak incidence at the ages of five to eight years.Extension-type fractures represent 97% to 99% of cases. Posteromedial displacement of the distal fragment is the most frequent; however, the radial and median nerves are equally affected. Flexion-type fractures are more commonly associated with ulnar nerve injuries.Concomitant upper-limb fractures should always be excluded. To manage the vascular status, distal pulse and hand perfusion should be monitored...
October 2018: EFORT Open Reviews
Koen Rijs, Markus Klimek, Marjan Scheltens-de Boer, Karla Biesheuvel, Biswadjiet S Harhangi
BACKGROUND: Intramedullary spinal cord tumors (IMSCT) comprise the least common types of spinal neoplasms; surgery is mostly conducted with intraoperative neuromonitoring (IONM). However, although IONM is widely used to prevent neurological damage and many single-center studies have been published, the added value, in terms of overall sensitivity and specificity, of different monitoring techniques used in IMSCT surgery, remains to be clearly defined. OBJECT: Summarize and review the published evidence on the use of IONM in IMSCT surgery, including our own case series (n=75 patients)...
January 16, 2019: World Neurosurgery
Aditya Nagori, Lovedeep Singh Dhingra, Ambika Bhatnagar, Rakesh Lodha, Tavpritesh Sethi
Proactive detection of hemodynamic shock can prevent organ failure and save lives. Thermal imaging is a non-invasive, non-contact modality to capture body surface temperature with the potential to reveal underlying perfusion disturbance in shock. In this study, we automate early detection and prediction of shock using machine learning upon thermal images obtained in a pediatric intensive care unit of a tertiary care hospital. 539 images were recorded out of which 253 had concomitant measurement of continuous intra-arterial blood pressure, the gold standard for shock monitoring...
January 14, 2019: Scientific Reports
Sara Casati, Alessandro Ravelli, Ilaria Angeli, Renato Durello, Mauro Minoli, Marica Orioli
BACKGROUND: Phosphatidylethanols (PEths) are currently under investigation as highly sensitive and specific direct biomarkers of long-term alcohol abuse. PEths belong to a group of aberrant phospholipids formed in erythrocyte membranes in presence of ethanol by the catalytic action of the enzyme phospholipase D on phosphatidylcholine. Compared to other alcohol biomarkers, a higher sensitivity (94.5-100%) and specificity (100%) characterizes PEth species. METHOD: Prior to detection, an important practical aspect in the work-flow of PEths analysis is the sample preparation step...
December 21, 2018: Journal of Chromatography. A
Anita Dittrich, Mathias Møller Thygesen, Henrik Lauridsen
Cardiac malfunction as a result of ischemic heart disease is a major challenge, and regenerative therapies to the heart are in high demand. A few model species such as zebrafish and salamanders that are capable of intrinsic heart regeneration hold promise for future regenerative therapies for human patients. To evaluate the outcome of cardioregenerative experiments it is imperative that heart function can be monitored. The axolotl salamander (A. mexicanum) represents a well-established model species in regenerative biology attaining sizes that allows for evaluation of cardiac function...
November 29, 2018: Journal of Visualized Experiments: JoVE
Kin Pan Au, Kenneth Siu Ho Chok
A large number of liver transplants have been performed for hepatocellular carcinoma (HCC), and recurrence is increasingly encountered. The recurrence of HCC after liver transplantation is notoriously difficult to manage. We hereby propose multi-disciplinary management with a systematic approach. The patient is jointly managed by the transplant surgeon, physician, oncologist and radiologist. Immunosuppressants should be tapered to the lowest effective dose to protect against rejection. The combination of a mammalian target of rapamycin inhibitor with a reduced calcineurin inhibitor could be considered with close monitoring of graft function and toxicity...
December 7, 2018: World Journal of Gastroenterology: WJG
Luca Koechlin, Urs Zenklusen, Thomas Doebele, Bejtush Rrahmani, Brigitta Gahl, Denis Berdajs, Martin T R Grapow, Friedrich S Eckstein, Oliver Reuthebuch
INTRODUCTION: The aim of this study was to report the clinical implementation of the joint use of the Myocardial Protection System (MPS® ) and the minimal extracorporeal circulation system (MiECC), in conjunction with an institutionally refined dose/volume-dependent microplegia in coronary artery bypass grafting (CABG). METHODS: Patients with isolated CABG surgery were included. The final protocol to achieve cardioplegic arrest consisted of warm blood cardioplegia with 20 mmol potassium (K), 1...
December 19, 2018: Perfusion
Rob J M Groen, Jertske N M Lukassen, Gert Jan Boer, Rob A Vergeer, Maarten H Coppes, Gea Drost, Berrie Middel
BACKGROUND: Anterior thoracic spinal cord herniation (ATSCH) is a rare cause of progressive myelopathy. Early surgery is essential, but there is no agreement about the best surgical approach. OBJECTIVE: To identify factors that determine surgical results, and to find evidence for the most favorable technique to correct ATSCH. METHODS: To find relevant literature, computerized databases of PubMed, EMBASE, and ISI Web of Science were searched...
December 7, 2018: World Neurosurgery
Luis M Jara, Magaly Rodriguez, Faride Altamirano, Antonio Herrera, Manuela Verastegui, Luis G Gimenez-Lirola, Robert H Gilman, Cesar M Gavidia
Cystic echinococcosis (CE) is a parasitic zoonosis caused by the larval stage of the tapeworm Echinococcus granulosus . Detection of the adult stage in the canine definitive host is essential for estimating infection rates, surveillance and monitoring of CE control programs. This study sought to develop and validate a coproantigen sandwich enzyme-linked immunosorbent assay (copro-ELISA), based on antibodies against E. granulosus -soluble membrane antigens (EGMA), that is capable of distinguishing infected and noninfected dogs...
December 10, 2018: American Journal of Tropical Medicine and Hygiene
Kurt Ruetzler, Huseyin O Yilmaz, Alparslan Turan, Nicole M Zimmerman, Guangmei Mao, Ming-Hui Hung, Andrea Kurz, Daniel I Sessler
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) is a major contributor to peri-operative morbidity and mortality with a reported incidence of about 8%. Tachycardia increases myocardial oxygen demand, and decreases oxygen supply, and is therefore a potential cause of MINS. OBJECTIVE: We tested the hypothesis that there is an association between intra-operative area above a heart rate (HR) of 90 bpm and a composite of MINS and in-hospital all-cause mortality...
November 30, 2018: European Journal of Anaesthesiology
Jitender Chaturvedi, Malla Bhaskara Rao, A Arivazhagan, Sanjib Sinha, Anita Mahadevan, M Ravindranadh Chowdary, K Raghavendra, A S Shreedhara, Nupur Pruthi, Jitender Saini, Rose Dawn Bharath, Jamuna Rajeswaran, P Satishchandra
Aim: Surgery for drug resistant epilepsy (DRE) with focal cortical dysplasia (FCD) often requires multiple non-invasive as well as invasive pre-surgical evaluations and innovative surgical strategies. There is limited data regarding surgical management of people with FCD as the underlying substrate for DRE among the low and middle-income countries (LAMIC) including India. Methodology: The presurgical evaluation, surgical strategy and outcome of 52 people who underwent resective surgery for DRE with FCD between January 2008 and December 2016 were analyzed...
November 2018: Neurology India
Mathias Unberath, Javad Fotouhi, Jonas Hajek, Andreas Maier, Greg Osgood, Russell Taylor, Mehran Armand, Nassir Navab
Interventional C-arm imaging is crucial to percutaneous orthopedic procedures as it enables the surgeon to monitor the progress of surgery on the anatomy level. Minimally invasive interventions require repeated acquisition of X-ray images from different anatomical views to verify tool placement. Achieving and reproducing these views often comes at the cost of increased surgical time and radiation. We propose a marker-free 'technician-in-the-loop' Augmented Reality (AR) solution for C-arm repositioning. The X-ray technician operating the C-arm interventionally is equipped with a head-mounted display system capable of recording desired C-arm poses in 3D via an integrated infrared sensor...
October 2018: Healthcare Technology Letters
Lin Rui, Guomei Xu, Xiaofan Lv, Zhengliang Ma
PURPOSE: This article describes a comprehensive protocol to protect the brachial plexus when performing pedicle subtraction osteotomy for ankylosing spondylitis patients with thoracolumbar kyphosis. DESIGN: A descriptive study was conducted. METHODS: Records of 101 cases from October 2013 to December 2016 were retrospectively audited. The protocol included five items: (1) preoperative assessment of motion range and nerve function of limbs and trunks; (2) preoperative positioning according to the assessment results; (3) intra-operative somatosensory evoked potential and blood pressure monitoring; (4) intra-operative repositioning according to the monitoring alarm signals; and (5) postoperative neurological function check...
December 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Hesham Soliman, Jared Fridley, Albert Telfeian, David B Choi, Michael Galgano, Thomas Kosztowski, Ziya L Gokaslan, Adetokunbo A Oyelese
BACKGROUND: Patients with far lateral disc herniation (FLDH) experience more severe pain and sensory symptoms compared with those with paracentral disc herniation. In addition, surgical intervention has both been more challenging and resulted in poorer outcomes. METHODS: We report our experience with intraoperative computed tomography (iCT) navigation-assisted minimally invasive tubular microdiscectomy via a paramedian approach with electrophysiological monitoring for precise 3-dimensional anatomical localization and early electrophysiological identification of the exiting nerve...
November 14, 2018: World Neurosurgery
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