3,432 results match your criteria guide anaesthesia

Anesthesia for deep brain stimulation: an update.

Curr Opin Anaesthesiol 2021 Jul 20. Epub 2021 Jul 20.

Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.

Purpose Of Review: Deep brain stimulation (DBS) is a rapidly expanding surgical modality for the treatment of patients with movement disorders. Its ability to be adjusted, titrated, and optimized over time has given it a significant advantage over traditional more invasive surgical procedures. Therefore, the success and popularity of this procedure have led to the discovery of new indications and therapeutic targets as well as advances in surgical techniques. Read More

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Kinetics of cerebral blood flow velocities during treatment for delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage.

Neurocrit Care 2021 Jul 20. Epub 2021 Jul 20.

Neurology and Neurosurgery Department, Federal University of São Paulo, São Paulo, Brazil.

Background: In aneurysmal subarachnoid hemorrhage (aSAH), one of the main determinants of prognosis is delayed cerebral ischemia (DCI). Transcranial Doppler (TCD) is used to monitor vasospasm and DCI. We aimed to better understand cerebral hemodynamics response to hypertension induction (HI) with norepinephrine (NE) and inotropic therapy with milrinone so that TCD can be a bedside tool in helping to guide DCI therapies. Read More

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'The Laryngectomee Guide' in Malaysian Language.

Itzhak Brook

Malays J Med Sci 2021 Jun 30;28(3):160-161. Epub 2021 Jun 30.

Georgetown University School of Medicine, Washington DC, USA.

'The Laryngectomee Guide' () is available now in Malaysian language. The Guide provides information that can assist laryngectomees and their medical providers about medical, dental and psychological issues. It contains information about side effects of radiation and chemotherapy; methods of speaking; airway, stoma, and voice prosthesis care; eating and swallowing; medical, dental and psychological concerns; respiration; anesthesia; travelling and how to cope with the COVID-19 pandemic. Read More

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A Clinician-Led, Experience-Based Co-Design Approach for Developing mHealth Services to Support the Patient Self-management of Chronic Conditions: Development Study and Design Case.

JMIR Mhealth Uhealth 2021 Jul 20;9(7):e20650. Epub 2021 Jul 20.

Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.

Background: Despite the increasing use of mobile health (mHealth) services, such as mHealth apps or SMS text messaging services, that support the patient self-management of chronic conditions, many existing mHealth services lack theoretical guidance. In addition, although often the target audience for requirement acquisition at the initial mHealth app design stage, it is a common challenge for them to fully conceptualize their needs for mHealth services that help self-manage chronic conditions.

Objective: This study proposes a novel co-design approach with the initial requirements for mHealth services proposed by clinicians based on their experiences in guiding patients to self-manage chronic conditions. Read More

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Personalized Positive End-Expiratory Pressure and Tidal Volume in Acute Respiratory Distress Syndrome: Bedside Physiology-Based Approach.

Tommaso Mauri

Crit Care Explor 2021 Jul 13;3(7):e0486. Epub 2021 Jul 13.

Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda, Maggiore Policlinico Hospital, Milan, Italy.

Positive end-expiratory pressure and tidal volume may have a key role for the outcome of patients with acute respiratory distress syndrome. The variety of acute respiratory distress syndrome phenotypes implies personalization of those settings. To guide personalized positive end-expiratory pressure and tidal volume, physicians need to have an in-depth understanding of the physiologic effects and bedside methods to measure the extent of these effects. Read More

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Point-of-Care Thoracic Ultrasonography in Patients With Cirrhosis and Liver Failure.

Cureus 2021 Jun 10;13(6):e15559. Epub 2021 Jun 10.

Hepatology, Asian Institute of Gastroenterology, Hyderabad, IND.

Point-of-care ultrasonography (POCUS) helps determine liver-related pathologies like an abscess, portal vein or hepatic vein thromboses, presence of ascites, site for pleural or ascitic paracentesis, and guiding biopsies. POCUS is revolutionizing the management of critically ill patients presenting with pneumonia, acute respiratory distress syndrome, acute-on-chronic liver failure, and in the emergency. The objectives of thoracic ultrasonography (TUS) are to aid the clinician in differentiating between pneumonia, effusions, interstitial edema and collections, and in estimating the volume status of patients with liver disease using inferior vena cava dynamic indices. Read More

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A Case of Successfully Implanted Dual Chamber Pacemaker in a Young Patient with Dextrocardia and Sick Sinus Syndrome.

Clin Med Insights Case Rep 2021 2;14:11795476211017733. Epub 2021 Jul 2.

Pediatric Clinic, University Clinical Center of Kosova and Medical Faculty, University of Prishtina, Rr.Nëna Tereza pn, 10000 Pristina, Kosovo.

Dextrocardia is a rare congenital anomaly, whereas its association with sick sinus syndrome in young adults without accompanying heart abnormalities is exceptional. We report a case of a 38 year old female patient who was admitted to our hospital due to syncope as a consequence of sinus pauses up to 4.9 seconds. Read More

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Civilian walking blood bank emergency preparedness plan.

Transfusion 2021 Jul;61 Suppl 1:S313-S325

University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Background: The current global pandemic has created unprecedented challenges in the blood supply network. Given the recent shortages, there must be a civilian plan for massively bleeding patients when there are no blood products on the shelf. Recognizing that the time to death in bleeding patients is less than 2 h, timely resupply from unaffected locations is not possible. Read More

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Does Gender Matter: A Multi-Institutional Analysis of Viscoelastic Profiles for 1565 Trauma Patients With Severe Hemorrhage.

Am Surg 2021 Jul 15:31348211033542. Epub 2021 Jul 15.

Department of Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA.

Background: Viscoelastic tests including thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are being used in patients with severe hemorrhage at trauma centers to guide resuscitation. Several recent studies demonstrated hypercoagulability in female trauma patients that was associated with a survival advantage. The objective of our study was to elucidate the effects of gender differences in TEG/ROTEM values on survival in trauma patients with severe hemorrhage. Read More

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Assessment of Trauma Care Capacity in Karachi, Pakistan: Toward an Integrated Trauma Care System.

World J Surg 2021 Jul 12. Epub 2021 Jul 12.

Global Health Directorate, Indus Health Network, Plot 3 & 3-A, Sector 47, Korangi Creek Road, Korangi Creek, Karachi, Pakistan.

Background: Pakistan is a lower-middle-income country with a high burden of injuries. Karachi, its most populated city, lacks a trauma care system due to which trauma patients do not receive the required care. We conducted an assessment of the existing facilities for trauma care in Karachi. Read More

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Economic Evaluation of Transperineal versus Transrectal Devices for Local Anaesthetic Prostate Biopsies.

Pharmacoecon Open 2021 Jul 9. Epub 2021 Jul 9.

Cambridge Urology Translational Research and Clinical Trials Office, Cambridge Biomedical Campus, Cambridge, UK.

Background: Biopsy of the prostate for suspected cancer is usually performed transrectally under local anaesthesia in the outpatient clinic setting. As this involves piercing the bowel wall, the procedure is associated with a risk of infection. Recently, devices that facilitate transperineal biopsy approaches have been developed that avoid piercing the bowel and so should reduce the risk of infection. Read More

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Lived Experience of Women Who Underwent Early Removal of Long-Acting Family Planning Methods in Bedesa Town, Wolaita Zone, Southern Ethiopia: A Phenomenological Study.

Int J Womens Health 2021 2;13:645-652. Epub 2021 Jul 2.

Department of Pharmacy, Wolaita Soddo University, Wolaita Soddo, Ethiopia.

Background: Long-acting family planning method (LAFP) is a low-cost yet effective method of reducing maternal mortality, limiting and spacing childbirth. In Ethiopia, the family planning prevalence rate rises from 15% in 2005 to 36% in 2016. However, the discontinuation rate of LAFP is still high in the region. Read More

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Multimodal monitoring including early EEG improves stratification of brain injury severity after pediatric cardiac arrest.

Resuscitation 2021 Jul 5. Epub 2021 Jul 5.

Division of Neurology, Children's Hospital of Philadelphia, United States; Departments of Neurology and Pediatrics, University of Pennsylvania Perelman School of Medicine, United States.

Aims: Assessment of brain injury severity early after cardiac arrest (CA) may guide therapeutic interventions and help clinicians counsel families regarding neurologic prognosis. We aimed to determine whether adding EEG features to predictive models including clinical variables and examination signs increased the accuracy of short-term neurobehavioral outcome prediction.

Methods: This was a prospective, observational, single-center study of consecutive infants and children resuscitated from CA. Read More

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Identification of Clinical Relevant Molecular Subtypes of Pheochromocytoma.

Front Endocrinol (Lausanne) 2021 21;12:605797. Epub 2021 Jun 21.

Department of Preventive Medicine, Institute of Biomedical Informatics, Cell Signal Transduction Laboratory, Bioinformatics Center, School of Basic Medical Sciences, Henan University, Kaifeng, China.

Pheochromocytoma (PCC) is a rare neuroendocrine tumor of the adrenal gland with a high rate of mortality if diagnosed at a late stage. Common symptoms of pheochromocytoma include headache, anxiety, palpitation, and diaphoresis. Different treatments are under observation for PCC but there is still no effective treatment option. Read More

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Computer-assisted subcapital correction osteotomy in slipped capital femoral epiphysis using individualized drill templates.

3D Print Med 2021 Jul 6;7(1):18. Epub 2021 Jul 6.

Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.

Background: Subcapital osteotomy by means of surgical hip dislocation is a treatment approach offered for moderate-to-severe cases of Slipped Capital Femoral Epiphysis (SCFE). This procedure is demanding, highly dependent on the surgeon's experience, and requires considerable radiation exposure for monitoring and securing the spatial alignment of the femoral head. We propose the use of individualized drill guides as an accurate method for placing K-wires during subcapital correction osteotomies in SCFE patients. Read More

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Association of the intraoperative peripheral perfusion index with postoperative morbidity and mortality in acute surgical patients: a retrospective observational multicentre cohort study.

Br J Anaesth 2021 Jul 2. Epub 2021 Jul 2.

Department of Anaesthesiology and Intensive Care, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.

Background: We hypothesised that in acute high-risk surgical patients, a lower intraoperative peripheral perfusion index (PPI) would indicate a higher risk of postoperative complications and mortality.

Methods: This retrospective observational study included 1338 acute high-risk surgical patients from November 2017 until October 2018 at two University Hospitals in Denmark. Intraoperative PPI was the primary exposure variable and the primary outcome was severe postoperative complications defined as a Clavien-Dindo Class ≥III or death, within 30 days. Read More

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The Big Game: hunting for retained bullets and foreign bodies in Great War radiology.

Ann Ital Chir 2021 Jun 21;10. Epub 2021 Jun 21.

Objectives: Searching for retained bullets has always been crucial in war surgery. Aim of this paper is to briefly outline the history of retained bullet identification methods before X-rays discovery and describe the proliferation of the most significant methods of foreign body localization during WWI.

Methods: Coeval medical journals, reference textbooks, dedicated manuals and documents have been searched and compared in multiple archives and on the internet. Read More

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Comparison between intraoperative bleeding score and ROTEM® measurements to assess coagulopathy during major pediatric surgery.

Transfus Apher Sci 2021 Jun 19:103191. Epub 2021 Jun 19.

Children's Research Center, University Children's Hospital of Zurich, Zurich, Switzerland; Department of Anesthesia, Zurich University Children's Hospital, Zurich, Switzerland.

Purpose: Intraoperative bleeding should be regularly assessed visually to guide coagulation management. Whereas viscoelastic testing with ROTEM® measurement has been proven to be useful in detecting coagulopathies, the visual assessment is not standardized. This study therefore aims to compare a standardized visual assessment with ROTEM® results. Read More

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Effect of 0.12% Chlorhexidine Use for Oral Care on Ventilator-Associated Respiratory Infections: A Randomized Controlled Trial.

J Trauma Nurs 2021 Jul-Aug 01;28(4):228-234

Department of Nursing (Drs Kes and Aydin Yildirim), Faculty of Health Sciences, and Departments of Medical Microbiology (Dr Kuru) and Medical Pharmacology (Dr Ozdemir), Faculty of Medicine, Karabuk University, Demir-Celik Campus, Karabuk, Turkey; and Intensive Care Nursing (Ms Pazarlıoglu) and Anesthesia and Reanimation Intensive Care Unit (Dr Ciftci), Karabuk University Training and Research Hospital, Karabuk, Turkey.

Background: Evidence suggests that the effect of 0.12% chlorhexidine (CHX) use for oral care on the development of ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT) is lacking. Evidence-based approaches to the prevention of VAP and VAT are of paramount importance for improving patients' outcomes. Read More

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Role of early management of hyperornithinaemia-hyperammonaemia-homocitrullinuria syndrome in pregnancy.

BMJ Case Rep 2021 Jul 1;14(7). Epub 2021 Jul 1.

Department of Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Birmingham, UK.

Hyperornithinaemia-hyperammonaemia-homocitrullinuria (HHH) syndrome is a rare inherited metabolic disorder of the urea cycle. Few reports exist to guide practices during pregnancy and fetal delivery. Yet, with affected patients often surviving into reproductive age, appropriate management of the peripartum phase is essential to ensure positive maternal and fetal outcomes. Read More

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Applications and Limitations of Neuro-Monitoring in Paediatric Anaesthesia and Intravenous Anaesthesia: A Narrative Review.

J Clin Med 2021 Jun 15;10(12). Epub 2021 Jun 15.

Unit for Research & Innovation, Department of Paediatric Anaesthesia, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy.

Safe management of anaesthesia in children has been one of the top areas of research over the last decade. After the large volume of articles which focused on the putative neurotoxic effect of anaesthetic agents on the developing brain, the attention and research efforts shifted toward prevention and treatment of critical events and the importance of peri-anaesthetic haemodynamic stability to prevent negative neurological outcomes. Safetots. Read More

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Preoperative Routine Laboratory Markers for Predicting Postoperative Recurrence and Death in Patients with Breast Cancer.

J Clin Med 2021 Jun 13;10(12). Epub 2021 Jun 13.

Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Gangnam Severance Hospital, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea.

Simple, convenient, and reliable preoperative prognostic indicators are needed to estimate the future risk of recurrences and guide the treatment decisions associated with breast cancer. We evaluated preoperative hematological markers related to recurrence and mortality and investigated independent risk factors for recurrence and mortality in patients after breast cancer surgery. We reviewed electronic medical records of patients with invasive breast cancer diagnosed at our tertiary institution between November 2005 and December 2010 and followed them until 2015. Read More

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The Importance of Clinical Examination under General Anesthesia: Improving Parametrial Assessment in Cervical Cancer Patients.

Cancers (Basel) 2021 Jun 13;13(12). Epub 2021 Jun 13.

Department of Gynecology, Leipzig University Medical Center, D-04103 Leipzig, Germany.

Background: Parametrial tumor involvement is an important prognostic factor in cervical cancer and is used to guide management. Here, we investigate the diagnostic value of clinical examination under general anesthesia (EUA) and magnetic resonance imaging (MRI) in determining parametrial tumor spread.

Methods: Post-operative pathological findings of 400 patients with primary cervical cancer were compared to the respective MRI data and the results from EUA. Read More

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Making a business case in healthcare: the value of careful consideration.

Br J Hosp Med (Lond) 2021 Jun 9;82(6):1-9. Epub 2021 Jun 9.

Department of Anaesthesia, Hammersmith and Queen Charlotte's Hospital, Imperial College Healthcare Trust, London, UK.

A well thought-out business case offers an opportunity for clinicians to bring about evidenced-based change in clinical practice. It is a powerful tool that can have a significant impact on healthcare services and patient outcomes, while also offering desirable solutions to the NHS, which is facing growing healthcare demands on increasingly limited resources. The role of a business case is to justify the need for change, argue its value, gain support from leadership and illustrate how it can be sustainably implemented. Read More

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Do Intra-articular Corticosteroid Injections Prior to Total Knee Arthroplasty Increase Postoperative Complication Rates: A Retrospective Review.

J Knee Surg 2021 Jun 29. Epub 2021 Jun 29.

Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois.

There is conflicting literature suggesting that intra-articular corticosteroid injections before total knee arthroplasty (TKA) may lead to an increase in the rate of postoperative complications, specifically periprosthetic joint infection (PJI). Thus, this retrospective review of all TKAs performed at a large, urban hospital will add valuable evidence to help guide future patient care. After exclusion criteria, we retrospectively reviewed 417 patients who received a TKA from a group of fellowship-trained orthopaedic surgeons between 2009 and 2016 at a single academic medical center. Read More

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Health-related quality of life outcome measures for children surviving critical care: a scoping review.

Qual Life Res 2021 Jun 29. Epub 2021 Jun 29.

Division of Critical Care Medicine, Department of Anesthesia, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.

Purpose: Health-related quality of life (HRQL) has been identified as one of the core outcomes most important to assess following pediatric critical care, yet there are no data on the use of HRQL in pediatric critical care research. We aimed to determine the HRQL instruments most commonly used to assess children surviving critical care and describe study methodology, patient populations, and instrument characteristics to identify areas of deficiency and guide investigators conducting HRQL research.

Methods: We queried PubMed, EMBASE, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Registry for studies evaluating pediatric critical care survivors published 1970-2017. Read More

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An In Vivo Mouse Model of Total Intravenous Anesthesia during Cancer Resection Surgery.

J Vis Exp 2021 Jun 8(172). Epub 2021 Jun 8.

Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University; Department of Anaesthesia, Division of Cancer Surgery, Peter MacCallum Cancer Centre;

Anesthesia is a routine component of cancer care that is used for diagnostic and therapeutic procedures. The anesthetic technique has recently been implicated in impacting long-term cancer outcomes, possibly through modulation of adrenergic-inflammatory responses that impact cancer cell behavior and immune cell function. Emerging evidence suggests that propofol-based total intravenous anesthesia (TIVA) may be beneficial for long-term cancer outcomes when compared to inhaled volatile anesthesia. Read More

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Initial Results of Precision Treatment of Postoperative Cerebrospinal Fluid Leak with Ultrasound-Guided Epidural Blood Patch.

World Neurosurg 2021 Jun 25. Epub 2021 Jun 25.

Department of Anesthesiology, Mayo Clinic, Jacksonville, Florida, USA.

Background: Incidental durotomy, a known complication of spinal surgery, can lead to persistent cerebrospinal fluid leak and pseudomeningocele if unrecognized or incompletely repaired. We describe the use of ultrasound to visualize the site of durotomy, observe the aspiration of the pseudomeningocele, and guide the precise application of an ultrasound-guided epidural blood patch (US-EBP), under direct visualization in real time.

Methods: A retrospective review was performed to determine demographic, procedural, and outcome characteristics for patients who underwent US-EBP for symptomatic postoperative pseudomeningocele. Read More

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Resting state functional connectivity analysis during general anesthesia: A high-density EEG study.

IEEE/ACM Trans Comput Biol Bioinform 2021 Jun 22;PP. Epub 2021 Jun 22.

The depth of anesthesia monitoring is helpful to guide administrations of general anesthetics during surgical procedures,however, the conventional 2-4 channels electroencephalogram (EEG) derived monitors have their limitations in monitoring conscious states due to low spatial resolution and suboptimal algorithm. In this study, 256-channel high-density EEG signals in 24 subjects receiving three types of general anesthetics (propofol, sevoflurane and ketamine) respectively were recorded both before and after anesthesia.The raw EEG signals were preprocessed by EEGLAB 14. Read More

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