381,707 results match your criteria anaesthesia

General anaesthesia in end-of-life care: extending the indications for anaesthesia beyond surgery.

Anaesthesia 2021 Apr 20. Epub 2021 Apr 20.

Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

In this article, we describe an extension of general anaesthesia - beyond facilitating surgery - to the relief of suffering during dying. Some refractory symptoms at the end of life (pain, delirium, distress, dyspnoea) might be managed by analgesia, but in high doses, adverse effects (e.g. Read More

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Local and Regional Blocks for Complex Facial Wound Repair.

Joy Obokhare

Facial Plast Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Surgery, Texas Tech University Health Sciences Center, Amarillo, Texas.

The location, severity, and associated injuries of the head and neck trauma dictate the type and treatment location needed for that particular patient. An in-depth knowledge of local and regional block options is vital to the proper management of facial wounds at the bedside, decreasing need for general anesthesia, anesthesia-related complication, length of hospital stay, and overall hospital costs. This article will discuss local and regional block options for the upper-face, midface, and lower face including dentition; complications of local and regional blocks and how to prevent them; and recent advances in local anesthesia. Read More

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Altered Fibrinolysis during and after Surgery.

Semin Thromb Hemost 2021 Apr 20. Epub 2021 Apr 20.

Anaesthesia and Critical Care Department, Bellvitge University Hospital, L'Hospitalet de LLobregat, Barcelona, Spain.

Major surgery induces hemostatic changes related to surgical stress, tissue destruction, and inflammatory reactions. These changes involve a shift of volume from extravascular space to intravascular and interstitial spaces, a "physiologic" hemodilution of coagulation proteins, and an increase of plasmatic fibrinogen concentration and platelets. Increases in fibrinogen and platelets together with a simultaneous dilution of pro- and anticoagulant factors and development of a hypofibrinolytic status result in a postoperative hypercoagulable state. Read More

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Alterations in the lipid profile associate with a dysregulated inflammatory, prothrombotic, anti-fibrinolytic state and development of severe acute kidney injury in coronavirus disease 2019 (COVID-19): A study from Cincinnati, USA.

Diabetes Metab Syndr 2021 Apr 14;15(3):863-868. Epub 2021 Apr 14.

Section of Clinical Biochemistry, University of Verona, Verona, Italy.

Background And Aims: Reduction of atherogenic lipoproteins is often the ultimate goal of nutritional interventions, however this is complicated given that hypolipidemia is frequently observed in coronavirus disease 2019 (COVID-19) patients. We aimed to explore the association of hypolipidemia with patient outcomes in terms of immunothrombosis and multiorgan injury, focusing on specialized apolipoproteins apo A1 and apo B.

Methods: Lipid profiles of 50 COVID-19 patients and 30 sick controls presenting to the Emergency Department (ED) were measured in this prospective observational study. Read More

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A case of intramandibular neurofibroma resembling a radicular cyst in a neurofibromatosis type 1 patient.

Int J Surg Case Rep 2021 Apr 10;82:105883. Epub 2021 Apr 10.

Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.

Introduction: Neurofibromatosis is a disease that causes various abnormalities such as neurofibroma, mainly in the skin and nerves. The common sites in the oral cavity are the palate, gingiva, tongue, buccal mucosa, and lips but, occurrence in the mandible is rare.

Presentation Of Case: A 26-year-old woman was referred to our clinic because of percussion pain. Read More

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Mini-open surgical management of a type-2 jersey finger under WALANT with ultrasound assistance: A case report about a new technique.

Hand Surg Rehabil 2021 Apr 17. Epub 2021 Apr 17.

Université de Picardie - Jules Verne, 1-3 rue des Louvels, 80000 Amiens, France. Electronic address:

We describe an innovative mini-open technique for reinsertion of the flexor digitorum profundus tendon under Wide Awake Local Anesthesia No Tourniquet (WALANT) with ultrasound assistance. Ultrasound-aided detection at the surgeon's practice is used to plan the surgical tendon repair procedure so that tendon reinsertion can be performed with the smallest incision possible. Passage of the tendon through the digital sheath was accomplished with the help of a compressive tendon guide to avoid a surgical approach. Read More

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Guideline No. 417: Prevention of Venous Thromboembolic Disease in Gynaecological Surgery: (En français : Prévention de la maladie thromboembolique veineuse en chirurgie gynécologique).

J Obstet Gynaecol Can 2021 Apr 17. Epub 2021 Apr 17.

Hamilton, ON.

Objective: The primary objective of this clinical practice guideline is to provide gynaecologists with an algorithm and evidence to guide the use of thromboprophylaxis in gynaecological surgery.

Target Population: All patients undergoing gynaecological surgery for benign or malignant indications.

Benefits, Harms, And Costs: The implementation of this guideline will benefit patients undergoing gynaecological surgery and provide physicians with a standard algorithm for the use of perioperative thromboprophylaxis. Read More

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The effect of pre-analytical handling on the stability of fractalkine, monocyte chemoattractant protein 1 (MCP1), interleukin 6 and interleukin 8 in samples of human cerebrospinal fluid.

J Immunol Methods 2021 Apr 17:113057. Epub 2021 Apr 17.

Pain Research Group, Pain Center, Odense University Hospital, Heden 9, Odense DK-5000, Denmark; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, Odense DK-5000, Denmark.

Cytokine networks in cerebrospinal fluid (CSF) are important to our understanding of several neuroinflammatory diseases. Knowledge about optimal handling of samples is limited but important to minimize bias and reduce costs in CSF biomarker studies. The aim of this study was to examine the effect of storage temperature and time delay from CSF sample collection until freezing on the concentration of 11 different cytokines thought to be associated with chronic pain. Read More

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Increased mortality in patients with standard EEG findings of 'diffuse slowing'.

Ann Clin Psychiatry 2021 May;33(2):93-100

Department of Psychiatry, Department of Neurosurgery, Department of Anesthesia, Iowa Neuroscience Institute, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.

Background: We aimed to confirm the association between slow brain wave activity typically described as "diffuse slowing" on standard electroencephalogram (EEG) and patient outcomes, including mortality.

Methods: This retrospective study was conducted with patient chart data from March 2015 to March 2017 at a tertiary care academic hospital in the midwestern United States. In total, 1,069 participants age ≥55 years on an inpatient floor or ICU received a standard 24-hour EEG. Read More

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Fatigue in critical care survivors: multidisciplinary and self-management strategies.

Anaesthesia 2021 Apr 20. Epub 2021 Apr 20.

Department of Anesthesiology and Critical Care Medicine, Department of Pediatrics, and Department of Physical Medicine and Rehabilitation, Outcomes After Critical Illness and Surgery Research Group Johns Hopkins University School of Medicine, Baltimore, MD, USA.

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A randomised trial of bilateral erector spinae plane block vs. no block for thoracolumbar decompressive spinal surgery.

Anaesthesia 2021 Apr 20. Epub 2021 Apr 20.

Division of Anaesthesiology and Peri-operative Medicine, Mater Misericordiae University Hospital, Dublin, Ireland.

Major spinal surgery causes significant postoperative pain. We tested the efficacy and safety of bilateral erector spinae block on quality of recovery and pain after thoracolumbar decompression. We randomly allocated 60 adults to standard care or erector spinae block. Read More

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Mid-Term Clinical Outcomes and Survivorship of a Second-Generation Modular Revision Knee System.

Surg Technol Int 2021 Apr 20;38. Epub 2021 Apr 20.

Joint Implant Surgeons, Inc., New Albany, Ohio.

Introduction: Revision knee systems have adapted to the challenges of revision knee arthroplasty with offset stems, augments, cones, and various levels of constraint. The purpose of this study is to review the mid-term outcomes of a second-generation modular knee revision system.

Materials And Methods: A retrospective review was conducted from 2011 through 2014 on all patients who underwent knee arthroplasty with the Vanguard® 360 revision knee system (Zimmer Biomet, Warsaw, Indiana). Read More

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A single intra-articular dose of vitamin D analog calcipotriol alleviates synovitis without adverse effects in rats.

PLoS One 2021 20;16(4):e0250352. Epub 2021 Apr 20.

Cancer Research and Translational Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.

1,25-dihydroxyvitamin-D3 and its derivatives have shown anti-arthritic and chondroprotective effects in experimental animal models with prophylactic dosing. The purpose of this preliminary study was to test the efficacy and safety of calcipotriol, vitamin D analog, as a treatment for a fully-developed knee arthritis in Zymosan-induced arthritis (ZIA) model. Forty 5-month-old male Sprague-Dawley rats were randomized into three arthritis groups and a non-arthritic control group with no injections (10 rats/group). Read More

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Reply: Patients' Perspective on Carpal Tunnel Release with WALANT or Intravenous Regional Anesthesia.

Egemen Ayhan

Plast Reconstr Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Orthopaedics and Traumatology University of Health Sciences Diskapi Yildirim Beyazit Training and Research Hospital Mutlukent Mh Angora Evleri, No. 2/6 Cankaya, Ankara, Turkey

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Patients' Perspective on Carpal Tunnel Release with WALANT or Intravenous Regional Anesthesia.

Plast Reconstr Surg 2021 Apr 20. Epub 2021 Apr 20.

Department of Plastic and Reconstructive Surgery Kocaeli University Faculty of Medicine Kocaeli, Turkey.

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The influence of moderate or deep neuromuscular block status on anesthetic depth monitoring system during total intravenous anesthesia using propofol and remifentanil: A randomized trial.

Sci Prog 2021 Apr-Jun;104(2):368504211010629

Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, South Korea.

The neuromuscular block state may affect the electroencephalogram-derived index representing the anesthetic depth. We applied an Anesthetic Depth Monitoring for Sedation (ADMS) to patients undergoing laparoscopic cholecystectomy under total intravenous anesthesia, and evaluated the requirement of propofol according to the different neuromuscular block state. Adult patients scheduled to undergo laparoscopic cholecystectomy were enrolled and randomly assigned to either the moderate (MB) or deep neuromuscular block (DB) group. Read More

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Pain distraction during awake low anterior resection and Cuddle Delivery initiative for inpatient: frugal procedural options to support surgery in the COVID-19 era.

Eur Rev Med Pharmacol Sci 2021 Apr;25(7):3116-3121

Department of General Surgery, Valduce Hospital, Como, Italy.

Objective: Since minimally invasive surgery and general anesthesia are both aerosol-generating procedures, their use became controversial during the outbreak of coronavirus disease 2019 (COVID-19). Moreover, social distancing resulted in serious psychological consequences for inpatients. This case report investigates pain distraction during awake laparotomy, as well as new possibilities for emotional postoperative support to inpatients. Read More

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Penetration of echinocandins into wound secretion of critically ill patients.

Infection 2021 Apr 20. Epub 2021 Apr 20.

Clinical Pharmacokinetics Unit, Division of Intensive Care and Emergency Medicine, Department of Internal Medicine I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Purpose: Wound infections caused by Candida are life-threatening and difficult to treat. Echinocandins are highly effective against Candida species and recommended for treatment of invasive candidiasis. As penetration of echinocandins into wounds is largely unknown, we measured the concentrations of the echinocandins anidulafungin (AFG), micafungin (MFG), and caspofungin (CAS) in wound secretion (WS) and in plasma of critically ill patients. Read More

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Concurrent positive skin tests to prophylactic antibiotics and rocuronium in two patients with life-threatening anaphylaxis after induction of anesthesia.

JA Clin Rep 2021 Apr 20;7(1):37. Epub 2021 Apr 20.

Department of Anesthesiology and Critical Care, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima, 734-8551, Japan.

Background: Prophylactic antibiotics and neuromuscular blocking agents (NMBA) are two of the major causative agents of anaphylaxis after induction of anesthesia.

Case Presentation: One female and one male patients (aged 29 and 69 years, respectively) had Ring and Messmer scale grade III anaphylaxis after administration of prophylactic antibiotics following induction of anesthesia. They showed typical hemodynamic and respiratory features of life-threatening anaphylaxis. Read More

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ABO blood types and sepsis mortality.

Ann Intensive Care 2021 Apr 20;11(1):61. Epub 2021 Apr 20.

CHIP / PERSIMUNE, Department of Infectious Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, The Capital Region of Denmark, Denmark.

Background: We aimed to determine if the ABO blood types carry different risks of 30-day mortality, acute kidney injury (AKI), and endothelial damage in critically ill patients with sepsis. This was a retrospective cohort study of three independent cohorts of critically ill patients from the United States and Scandinavia consisting of adults with septic shock. We compared the 30-day mortality across the blood types within each cohort and pooled the results in a meta-analysis. Read More

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Trans-isthmic pars interarticularis screw fixation under CT and fluoroscopic guidance: technical success and clinical outcome in patients with symptomatic low-grade lumbar isthmic lysis.

Eur Radiol 2021 Apr 20. Epub 2021 Apr 20.

Interventional and Diagnostic Neuroradiology Unit, Grenoble University Hospital, Boulevard du Grésivaudan, 38000, Grenoble, France.

Objectives: To assess the technical success of trans-isthmic screw fixation with simultaneous CT and fluoroscopic guidance in patients with symptomatic low-grade isthmic spondylolisthesis.

Methods: Fifty patients (28 women and 22 men; mean age ± standard deviation: 50 years ± 18.9) presenting with symptomatic low back pain with isthmic spondylolisthesis refractory to medical management were treated by means of trans-isthmic pars interarticularis percutaneous screw fixation. Read More

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[Perioperative strategies: taking care of the elderly patient with severe advanced comorbidities needing acute surgery.]

Recenti Prog Med 2021 Apr;112(4):250-261

In the common clinical practice the perioperative risk assessment of an acute surgical patient with advanced chronic comorbidities is carried out independently by surgeon and anesthesiologist, usually in two different steps. While the surgeon evaluates the risk mainly in relation to the surgical outcome, the perioperative risk assessment regarding the weight of the coexisting medical condition on the quality of recovery in the short- mid- and long-term is all about the anesthesiologist evaluation. When frailty and/or comorbidities are so serious that will make surgery seem futile, the patient's assessment on one hand, and the decisions regarding the further clinical waypoint on the other, have to be discussed firstly between surgeons and anesthesiologists before being shared with the patients and their relatives. Read More

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CellR4 Repair Replace Regen Reprogram 2013 14;1(1). Epub 2013 Jun 14.

Cell Transplant Center and Diabetes Research Institute, University of Miami, Miami, FL, USA.

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Ideal body weight calculations: fit for purpose in modern anaesthesia?

Eur J Anaesthesiol 2021 Apr 14. Epub 2021 Apr 14.

From the Division of Surgery, Department of Surgery and Cancer (NA), Helix Centre for Design in Healthcare (NA, JC), NIHR-Imperial Patient Safety Translational Research Centre (NA, JC) and EPSRC Centre for Mathematics of Precision Healthcare, Department of Mathematics, Imperial College London, London, UK (JC).

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No interactive effect of lumbar epidural blockade and target-controlled infusion of propofol on mean arterial pressure, cardiac output and bispectral index: A randomised controlled and pharmacodynamic modelling study.

Eur J Anaesthesiol 2021 Apr 14. Epub 2021 Apr 14.

From the Department of Anaesthesiology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands (ES, EO, AD, JV).

Background: It is generally accepted that a neuraxial blockade strengthens the sedative effects of propofol. Deafferentation caused by neuraxial blockade is thought to play a key role.

Objectives: The objective is to determine whether epidural blockade affects the bispectral index (BIS) of propofol and two other pharmacodynamic endpoints, mean arterial pressure (MAP) and cardiac output (CO). Read More

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4E-BP2-dependent translation in parvalbumin neurons controls epileptic seizure threshold.

Proc Natl Acad Sci U S A 2021 Apr;118(15)

Department of Anesthesia and Faculty of Dentistry, McGill University, Montreal, QC H3A 2B4, Canada;

The mechanistic/mammalian target of rapamycin complex 1 (mTORC1) integrates multiple signals to regulate critical cellular processes such as mRNA translation, lipid biogenesis, and autophagy. Germline and somatic mutations in mTOR and genes upstream of mTORC1, such as , , , , and components of GATOR1 and KICSTOR complexes, are associated with various epileptic disorders. Increased mTORC1 activity is linked to the pathophysiology of epilepsy in both humans and animal models, and mTORC1 inhibition suppresses epileptogenesis in humans with tuberous sclerosis and animal models with elevated mTORC1 activity. Read More

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Clinical and angiographical features of first episode of acute coronary syndrome in patients with human immunodeficiency virus infection.

HIV Res Clin Pract 2021 Apr 20:1-5. Epub 2021 Apr 20.

Department of Cardiovascular Disease, University of Rome "Tor Vergata", Rome, Italy.

Background: Patients affected by the human immunodeficiency virus (HIV) show an increased risk of myocardial infarction. Clinical and angiographic features of HIV positive (HIV+) patients presenting with the first episode of an acute coronary syndrome (ACS) are not well defined in previous studies.

Objective: To demonstrate that HIV + patients with acute coronary syndrome had different features than non-HIV patients. Read More

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Continuous erector spinae plane block for postoperative analgesia in robotic lung lobectomy: a case report.

Tumori 2021 Apr 20:3008916211005839. Epub 2021 Apr 20.

Department of Anesthesia and Intensive Care, AOU Città della Salute e della Scienza, Torino, Italy.

Background: Erector spinae plane block (ESPB) has been described as an effective regional anesthesia technique in thoracic parenchymal surgery. Evidence highlighting the use of this technique continuously via perifascial catheter is lacking.

Case Presentation: In this case report, we present the case of a patient scheduled for robotic-assisted thoracic surgery for a pulmonary neoformation in the lower right lobe. Read More

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Impact of structured curriculum with simulation on bronchoscopy.

Respirology 2021 Apr 19. Epub 2021 Apr 19.

Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore.

Background And Objective: Simulation enhances a physician's competency in procedural skills by accelerating ascent of the learning curve. Training programmes are moving away from the Halstedian model of 'see one, do one, teach one', also referred as medical apprenticeship. We aimed to determine if a 3-month structured bronchoscopy curriculum that incorporated simulator training could improve bronchoscopy competency among pulmonary medicine trainees. Read More

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Increased miR-21-3p and miR-487b-3p serum levels during anaphylactic reaction in food allergic children.

Pediatr Allergy Immunol 2021 Apr 19. Epub 2021 Apr 19.

Department of Allergy and Immunology, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain.

Background: Anaphylaxis is the most severe manifestation of allergic disorders. The poor knowledge of its molecular mechanisms often leads to underdiagnosis. MicroRNAs (miRNA) regulate physiological and pathological processes and they have been postulated as promising diagnostic markers. Read More

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