Salma M Bakr, Ajay Patel, Mohamed A Zaazoue, Kathryn Wagner, Sandi K Lam, Daniel J Curry, Jeffrey S Raskin
OBJECTIVE: The grid-based orthogonal placement of depth electrodes (DEs), initially defined by Jean Talairach and Jean Bancaud, is known as stereo-electroencephalography (sEEG). Although acceptance in the United States was initially slow, advances in imaging and technology have spawned a proliferation of North American epilepsy centers offering sEEG. Despite publications highlighting minimal access techniques and varied indications, standard work for phase I targeted DE has not been defined...
January 22, 2021: Journal of Neurosurgery. Pediatrics
Giovambattista Caruso, Chiara Toscano, Giuseppe Evola, Salvatore Antonio Maria Benfatto, Martina Reina, Giuseppe Angelo Reina
INTRODUCTION AND IMPORTANCE: Amyand hernia is a rare disease seen in approximatively 1% of all hernias, complications of it, like acute appendicitis, or perforated appendicitis are even more rare, about 0.1%. Its diagnosis is very difficult in the preoperative period: it is usually an incidental finding. CASE PRESENTATION: We report an unusual case of perforated gangrenous appendicitis with peri-appendicular abscess occurring in an irreducible Amyand's hernia. An 80-year-old male, with chronic obstructive disease and pulmonary emphysema, atrial fibrillation, acute myocardial infarction, underwent urgent surgery, under local anesthesia, for right incarcerated inguinoscrotal hernia...
January 16, 2021: International Journal of Surgery Case Reports
Masaki Hashimoto, Fumihiro Arizumi, Aya Yamamoto, Kazuki Kusuyama, Akifumi Nakamura, Toshiya Tachibana, Seiki Hasegawa
A 67-year-old female presented with a thoracic dumbbell-shaped tumor at the left T3-4 level. One-staged surgical resection via the spinal and robotic-assisted thoracic approach without repositioning was planned. The patient was placed in the prone position under general anesthesia. First, the tumor was dissected from the dura after T3 left hemilaminectomy and T3/4 left facetectomy. Then, posterior spinal fixation was performed. Second, three ports were placed in her left thoracic cavity without repositioning and the tumor was resected via robotic-assisted thoracic approach...
January 19, 2021: Annals of Thoracic Surgery
Walid Alrayashi, Stephen Kelleher, James DiNardo, Pete Kovatsis, William Clarke, Paul Hickey, Raymond Park
Point of care ultrasonography (POCUS) is a rapidly evolving diagnostic modality. Equipment to scan various parts of the body with compact handheld devices is readily available. Surface cardiac ultrasound (US) can be used to rapidly assess volume status, cardiac function, and the detection of pericardial fluid. In the case presented here, we describe the use of a novel, hands-free, biplane, transthoracic echocardiography (TTE) probe with a design that provided continuous acquisition of cardiac US images during an operative procedure...
January 22, 2021: Paediatric Anaesthesia
Maliwan Oofuvong, Jutarat Tanasansuttiporn, Wirat Wasinwong, Voravit Chittithavorn, Pongsanae Duangpakdee, Jirayut Jarutach, Qistina Yunuswangsa
OBJECTIVE: To determine risk factors affecting time-to-death ≤90 and >90 days in children who underwent a modified Blalock-Taussig shunt (MBTS). METHODS: Data from a retrospective cohort study were obtained from children aged 0-3 years who experienced MBTS between 2005 and 2016. Time-to-death (prior to Glenn/repair), time-to-alive up until December 2017 without repair, and time-to-progression to Glenn/repair following MBTS were presented using competing risks survival analysis...
2021: PloS One
Kaouther Dimassi, Ahmed Halouani, Amine Kammoun, Olivier Ami, Benedicte Simon, Luka Velemir, Denis Fauck, Amel Triki
OBJECTIVE: To determine whether the French AmbUlatory Cesarean Section (FAUCS) technique reduces postoperative pain and promotes maternal autonomy compared with the Misgav Ladach cesarean section (MLCS) technique in elective conditions. STUDY DESIGN: One hundred pregnant women were randomly, but in a non-blinded manner, assigned to undergo FAUCS or MLCS. The primary outcome was a postoperative mean pain score (PMPS), and secondary outcomes were a combined pain/medication score, time to regain autonomy, surgical duration, calculated blood loss, surgical complications, and neonatal outcome...
2021: PloS One
Oded Ohana, Juan Ayala-Haedo, Apostolos Anagnostopolous, Wendy W Lee
BACKGROUND: Perceived pain during local anesthesia injections can be effected by the injection sequence. OBJECTIVE: We sought to compare pain levels during local anesthesia injections during upper lid blepharoplasty (ULB) using 2 surgical sequences. MATERIALS AND METHODS: We conducted a prospective, randomized clinical trial. Patients with ULB were randomized to either have local anesthesia injection followed by ULB in the right eyelid and then in the left (Group A) or to have local anesthesia injection to both eyelids followed by ULB on both eyelids (Group B)...
December 29, 2020: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Silvia Coppola, Davide Chiumello
No abstract text is available yet for this article.
January 18, 2021: Anesthesia and Analgesia
Ting Wang, Huaping Sun, Yan Zhou, Dandan Chen, Ann E Harman, Robert S Isaak, Cathleen Peterson-Layne, Alex Macario, Brenda G Fahy, David O Warner
BACKGROUND: The American Board of Anesthesiology administers the APPLIED Examination as a part of initial certification, which as of 2018 includes 2 components-the Standardized Oral Examination (SOE) and the Objective Structured Clinical Examination (OSCE). The goal of this study is to investigate the measurement construct(s) of the APPLIED Examination to assess whether the SOE and the OSCE measure distinct constructs (ie, factors). METHODS: Exploratory item factor analysis of candidates' performance ratings was used to determine the number of constructs, and confirmatory item factor analysis to estimate factor loadings within each construct and correlation(s) between the constructs...
January 18, 2021: Anesthesia and Analgesia
Senthilkumar Sadhasivam, Blessed W Aruldhas, Senthil Packiasabapathy, Brian R Overholser, Pengyue Zhang, Yong Zang, Janelle S Renschler, Ryan E Fitzgerald, Sara K Quinney
BACKGROUND: Intraoperative methadone, a long-acting opioid, is increasingly used for postoperative analgesia, although the optimal methadone dosing strategy in children is still unknown. The use of a single large dose of intraoperative methadone is controversial due to inconsistent reductions in total opioid use in children and adverse effects. We recently demonstrated that small, repeated doses of methadone intraoperatively and postoperatively provided sustained analgesia and reduced opioid use without respiratory depression...
January 21, 2021: Anesthesia and Analgesia
Stephanie Lam, Helena Qu, Margaret Hannum, Kay See Tan, Anoushka Afonso, Hanae K Tokita, Patrick J McCormick
BACKGROUND: Compared to general anesthesia, regional anesthesia confers several benefits including improved pain control and decreased postoperative opioid consumption. While the benefits of peripheral nerve blocks (PNB) have been well studied, there are little epidemiological data on PNB usage in mastectomy and lumpectomy procedures. The primary objective of our study was to assess national trends of the annual proportion of PNB use in breast surgery from 2010 to 2018. We also identified factors associated with PNB use for breast surgery...
January 21, 2021: Anesthesia and Analgesia
Jie Hu, Emanuele Rezoagli, Francesco Zadek, Edward A Bittner, Chong Lei, Lorenzo Berra
BACKGROUND: Cardiac surgery with cardiopulmonary bypass (CPB) is associated with a high risk of postoperative acute kidney injury (AKI). Due to limitations of current diagnostic strategies, we sought to determine whether free hemoglobin (fHb) ratio (ie, levels of fHb at the end of CPB divided by baseline fHb) could predict AKI after on-pump cardiac surgery. METHODS: This is a secondary analysis of a randomized controlled trial comparing the effect of nitric oxide (intervention) versus nitrogen (control) on AKI after cardiac surgery (NCT01802619)...
January 21, 2021: Anesthesia and Analgesia
Thomas D Bernier, Michael J Schontz, Saef Izzy, David Y Chung, Sarah E Nelson, Thabele M Leslie-Mazwi, Galen V Henderson, Hormuzdiyar Dasenbrock, Nirav Patel, Mohammad A Aziz-Sultan, Steven Feske, Rose Du, Yasser B Abulhasan, Mark R Angle
Delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage continues to be associated with high levels of morbidity and mortality. This complication had long been thought to occur secondary to severe cerebral vasospasm, but expert opinion now favors a multifactorial etiology, opening the possibility of new therapies. To date, no definitive treatment option for DCI has been recommended as standard of care, highlighting a need for further research into potential therapies. Milrinone has been identified as a promising therapeutic agent for DCI, possessing a mechanism of action for the reversal of cerebral vasospasm as well as potentially anti-inflammatory effects to treat the underlying etiology of DCI...
January 20, 2021: Journal of Neurosurgical Anesthesiology
Jeffrey J Pasternak
This review summarizes the literature published in 2020 that is relevant to the perioperative care of neurosurgical patients and patients with neurological diseases as well as critically ill patients with neurological diseases. Broad topics include general perioperative neuroscientific considerations, stroke, traumatic brain injury, monitoring, anesthetic neurotoxicity, and perioperative disorders of cognitive function.
January 20, 2021: Journal of Neurosurgical Anesthesiology
Jennifer Russell, Nicholas Jeffery, James Bailey, Steven Osborn, Carolina Le-Bert, Heidi Whitehead, Hendrik Nollens
Brucella ceti, associated with neurobrucellosis, has been isolated from cerebrospinal fluid (CSF) of postmortem cetaceans. A 106-kg, stranded female bottlenose dolphin ( Tursiops truncatus ) presented with serum antibodies to Brucella spp. via competitive enzyme-linked immunosorbent assay and fluorescence polarization assay. Polymerase chain reaction (PCR) and culture of whole blood, bronchoalveolar fluid, and rectal, nasal, and genital swabs for Brucella spp. were consistently negative. Serial computed tomography revealed mild focal dilatation of brain ventricles...
January 2021: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Benjamin Lamglait, Marion Jalenques, Noémie Summa, Wahiba Ait Youcef, Claire Vergneau-Grosset
Reference intervals of intraocular pressure (IOP) are poorly described in piscine species as the factors that may influence it. Rebound tonometry was used to measure IOP in 28 adult brook trout ( Salvelinus fontinalis ) anesthetized in a buffered solution of 60 mg/L tricaine methanesulfonate ( n = 16) or restrained with electronarcosis ( n = 12) at 16 mA. There was no significant effect of the eye side, sex, fish origin, and body weight, but IOP values were significantly higher with electronarcosis (mean ± SD: 16...
January 2021: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Lindsey A Schneider, Isabel A Jimenez, Esther E V Crouch, Gerald E Duhamel, Nadine Fiani, George V Kollias, Santiago Peralta
Dental and oral diseases are prevalent in many mammalian species including wild felids. Determining the dental and oral health status of captive animal populations can help establish preventive and therapeutic strategies, leading to improved welfare and conservation efforts. The aim of this study was to assess the prevalence of periodontal disease, endodontic disease, tooth resorption, and other clinically relevant dental and maxillofacial abnormalities in a population of captive jaguars ( Panthera onca ) using clinical, radiographic, and histopathological findings...
January 2021: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Evan S Emmel, Samuel Rivera, Freddy Cabrera, Stephen Blake, Sharon L Deem
Evaluation of sex ratios is a critical component of chelonian captive breeding programs and may become increasingly useful to assess the demographics of free-living populations. In many reptile species, the sex of immature animals cannot be determined based on external features. Endoscopic sex identification is an accurate and safe method to identify the sex of immature individuals of some chelonian species. A number of studies describe this technique in controlled, hospital settings and report significant interspecies variations in gonad morphology; however, there are few reports describing this technique in field conditions...
January 2021: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Lauren M Mulreany, Andrew C Cushing, Anthony L Ashley, Christopher K Smith
The electroencephalogram (EEG) waveform can predictably change with depth of anesthesia, and algorithms such as the Patient State index (PSi) have been developed to convert the waveform into a user-friendly objective reading of anesthetic depth. In this study, PSi values were measured in 10 captive chimpanzees ( Pan troglodytes ) during three phases of an anesthetic event. Phase 1 included sedation with dexmedetomidine, midazolam, and ketamine. Phase 2 started with administration of an α-2 antagonist and isoflurane...
November 2020: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Ellie L Milnes, Thalita Calvi, Yedra Feltrer, Aimee L Drane, Glyn Howatson, Rob E Shave, Bryony A Curry, Joshua C Tremblay, David L Williams
Measurements of intraocular pressure (IOP) and tear production are key components of ophthalmic examination. Chimpanzees ( Pan troglodytes ) were anesthetized using either tiletamine-zolazepam (TZ; 2 mg/kg) combined with medetomidine (TZM; 0.02 mg/kg), or, TZ alone (6mg/kg). Tear production was lower ( P = 0.03) with TZM (5.63 ± 6.22 mm/min; n = 16) than with TZ (11.13 ± 4.63 mm/min; n = 8). Mean IOP, measured using rebound tonometry in an upright body position ( n = 8) was 18.74 ± 3.01 mm Hg, with no differences between right and left eyes...
November 2020: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
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