MedWorm: Anesthesiology

Weighted ∂¯-Integral Representations of C1-Functions in C n

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

For C1-functions f, given in the complex space Cn, integral representations of the form f=P(f)−T(∂¯f) are obtained. Here, P is the orthogonal projector of the space L2{Cn;e−σ|z|ρ|z|γdm(z)} onto its subspace of entire functions and the integral operator T appears by means of explicitly constructed kernel Φ which is investigated in detail. (Source: Anesthesiology Research and Practice)

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Memantine as an Augmentation Therapy for Anxiety Disorders

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

Conclusion. The NMDA receptor antagonist memantine may be an effective augmentation therapy in patients with treatment-resistant anxiety. (Source: Anesthesiology Research and Practice)

Isolation of Human Islets for Autologous Islet Transplantation in Children and Adolescents with Chronic Pancreatitis

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

We present here a technical approach for the isolation and preservation of the islets proven to be efficient to obtain high numbers of islets, favoring the successful treatment of young patients. (Source: Anesthesiology Research and Practice)

Sensor Arrays and Electronic Tongue Systems

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

This paper describes recent work performed with electronic tongue systems utilizing electrochemical sensors. The electronic tongues concept is a new trend in sensors that uses arrays of sensors together with chemometric tools to unravel the complex information generated. Initial contributions and also the most used variant employ conventional ion selective electrodes, in which it is named potentiometric electronic tongue. The second important variant is the one that employs voltammetry for its operation. As chemometric processing tool, the use of artificial neural networks as the preferred data processing variant will be described. The use of the sensor arrays inserted in flow injection or sequential injection systems will exemplify attempts made to automate the operation of electronic ton...

Neurogenic Bladder

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper ...

A Dysmorphic Child with a Pericentric Inversion of Chromosome 8

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

An 8-year-old boy was referred to our institute with dysmorphic features such as mild lupus, micrognathia, low hair line, hypoplasia, hemi atrophy of left side of the face, abnormal size of ears, hypothenar, hypoplasia of chin, and tongue tie. MRI scan was found to be normal and EEG suggestive of generalized seizure disorder. Cytogenetic evaluation of the proband revealed a pericentric inversion of chromosome 8 with 46, XY, and inv 8 (p11.2; q21.2) karyotype. (Source: Anesthesiology Research and Practice)

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Post-Communist Health Transitions in Central and Eastern Europe

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

The countries of Central and Eastern Europe (CEE) have gone through immense political and socioeconomic restructuring after the collapse of communism around 1990. Such transition has affected the lives of populations in these countries in many significant respects. A key aspect of life and wellbeing in any society is that of population health. This paper traces the transitions in population health—life expectancies and mortality rates for both males and females—in seven of the CEE countries during the two decades after the fall of communism. We estimate a series of panel data models to identify some of the common factors that would explain health transitions in these countries, while allowing for country-specific variability. Our findings indicate that the health transitions ar...

Axisymmetric Stagnation Flow of a Micropolar Nanofluid in a Moving Cylinder

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

An analysis is carried out for axisymmetric stagnation flow of a micropolar nanofluid in a moving cylinder with finite radius. The coupled nonlinear partial differential equations of the problem are simplified with the help of similarity transformations and the resulting coupled nonlinear differential equations are solved analytically by homotopy analysis method (HAM). The features of the flow phenomena, inertia, heat transfer, and nanoparticles are analyzed and discussed. (Source: Anesthesiology Research and Practice)

Giant Cell Tumors of the Axial Skeleton

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

Conclusions. GCT of the axial skeleton have a high local recurrence rate. Neurological deficits are common. En-bloc spondylectomy combined with embolization is the treatment of choice. In case of inoperability, serial arterial embolization seems to be an alternative not only for sacral but also for spinal tumors. (Source: Anesthesiology Research and Practice)

Study on the Interaction between Two Hydrokinetic Savonius Turbines

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

Savonius turbine is simple in design and easy to fabricate at a lower cost. The drag is the basic driving force for Savonius turbine. Savonius turbines are mainly used for the small-scale electricity generation in remote areas. In real life, multiple Savonius turbines are to be arranged to form a farm to scale up the electricity generation. So, it is important to study the interaction among them to avoid the power loss due to negative interaction between turbines. The purpose of this investigation is to examine closely the effect of interaction between two Savonius turbines arranged in line. Experimental investigations are carried out to study the mutual interaction between turbines with water as the working medium at a Reynolds number of 1.2×105 based on the diameter of the turbine. ...

Common Errors in Digital Panoramic Radiographs of Patients with Mixed Dentition and Patients with Permanent Dentition

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

Conclusions. More errors were prevalent in panoramic radiographs of permanent dentitions. Properly positioning the patient is the most important factor in preventing a cascade of errors. (Source: Anesthesiology Research and Practice)

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Rational Generalized Offsets of Rational Surfaces

Anesthesiology Research and Practice — Wed, 08 Feb 2012 12:16:29 +0100

The rational surfaces and their offsets are commonly used in modeling and manufacturing. The purpose of this paper is to present relationships between rational surfaces and orientation-preserving similarities of the Euclidean 3-space. A notion of a similarity surface offset is introduced and applied to different constructions of rational generalized offsets of a rational surface. It is shown that every rational surface possesses a rational generalized offset. Rational generalized focal surfaces are also studied. (Source: Anesthesiology Research and Practice)

Neonatal administration with dexmedetomidine does not impair the rat hippocampal synaptic plasticity later in adulthood

Pediatric Anesthesia — Wed, 08 Feb 2012 12:08:52 +0100

Conclusion: These findings demonstrate that a single administration of DEX to rats on P7 preserves hippocampal synaptic plasticity as well as synaptic transmission later in life. In view of the some evidence that have demonstrated the permanent detrimental impact of commonly used anesthetics on neurological outcomes after neonatal exposure, our findings may suggest the relative safety of DEX administered as a sedative agent to neonatal animals with regard to the development of hippocampal synaptic functions. (Source: Pediatric Anesthesia)

Insomnia

MedicineNet Chronic Pain General — Tue, 07 Feb 2012 07:00:00 +0100

Title: InsomniaCategory: Diseases and ConditionsCreated: 6/6/2005Last Editorial Review: 2/7/2012 (Source: MedicineNet Chronic Pain General)

Efficacy and Safety of Dextromethorphan/Quinidine at Two Dosage Levels for Diabetic Neuropathic Pain: A Double‐Blind, Placebo‐Controlled, Multicenter Study

Pain Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions. Throughout a 13‐week trial, DMQ was effective, with an acceptable safety profile, for treatment of DPN pain. Other fixed‐dose combinations of DMQ should be studied to improve overall tolerability while maintaining significant efficacy. (Source: Pain Medicine)

Power and Meaninglessness

Pain Medicine — Tue, 07 Feb 2012 05:00:00 +0100

(Source: Pain Medicine)

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Beneficial Effect of Amantadine on Postoperative Pain Reduction and Consumption of Morphine in Patients Subjected to Elective Spine Surgery

Pain Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions. Pre‐ and postoperative administration of amantadine significantly reduced fentanyl use during operation, as well as reduced the postoperative pain and decreased morphine consumption in young patients undergoing orthopedic surgery. (Source: Pain Medicine)

Addressing Both Depression and Pain in Late Life: The Methodology of the ADAPT Study

Pain Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions. The results of this trial will inform the care of these complex patients and further understanding of comorbid pain and depression in late life. (Source: Pain Medicine)

Management of Neuropathic Pain with Methylprednisolone at the Site of Nerve Injury

Pain Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions. Our results suggest that peripheral nerve block with 80 mg depo‐methylprednisolone plus 0.5% lidocaine provides effective management in the treatment of neuropathic pain due to peripheral nerve damage. (Source: Pain Medicine)

A Descriptive Feasibility Study to Evaluate Scheduled Oral Analgesic Dosing at Home for the Management of Postoperative Pain in Preschool Children Following Tonsillectomy

Pain Medicine — Tue, 07 Feb 2012 05:00:00 +0100

Discussion. Study results suggest that acetaminophen with hydrocodone is effective in relieving preschool children's pain following tonsillectomy and that parental adherence to a scheduled analgesic regimen decreases over time. Time‐contingent dosing was associated with moderate to severe side effects and should be addressed in discharge teaching with parents. Findings provide insight into parents' perspective of pain management at home following tonsillectomy and methods for relieving their child's pain. (Source: Pain Medicine)

Timing of skin testing after a suspected anaphylactic reaction during anaesthesia

Acta Anaesthesiologica Scandinavica — Tue, 07 Feb 2012 05:00:00 +0100

ConclusionsOnly positive skin tests can be taken into account, and there is little safety data to provide confidence in early skin testing. A protocol of how to act if urgent surgery is necessary is suggested. (Source: Acta Anaesthesiologica Scandinavica)

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Vasopressors for the management of hypotension after spinal anesthesia for elective caesarean section. Systematic review and cumulative meta‐analysis

Acta Anaesthesiologica Scandinavica — Tue, 07 Feb 2012 05:00:00 +0100

ConclusionsOur analysis could clearly demonstrate a decreased risk of fetal acidosis associated with phenylephrine use. In addition with our findings for BE, this suggests a favorable effect of phenylephrine on fetal outcome parameters. The mechanism of pH depression is not related to pCO2. (Source: Acta Anaesthesiologica Scandinavica)

Drug‐administration sequence of target‐controlled propofol and remifentanil influences the onset of rocuronium. A double‐blind, randomized trial

Acta Anaesthesiologica Scandinavica — Tue, 07 Feb 2012 05:00:00 +0100

ConclusionThe onset time of rocuronium is prolonged significantly by early administration of remifentanil during target‐controlled infusion of propofol and remifentanil, and it may be due to the decreased CO caused by remifentanil. (Source: Acta Anaesthesiologica Scandinavica)

Comparison of forces applied to the maxillary incisors by direct and indirect laryngoscopes

Acta Anaesthesiologica Scandinavica — Tue, 07 Feb 2012 05:00:00 +0100

(Source: Acta Anaesthesiologica Scandinavica)

Science Weekly podcast: Transplants and the future of intensive care

Guardian Unlimited Science — Mon, 06 Feb 2012 14:05:00 +0100

This week, we're focusing on some pivotal stories from the history of science and medicine. First up are human-to-human transplants and intensive care medicine. These are among the greatest successes of post-war medicine, but they also raise some of the most profound ethical questions. Ahead of a discussion at the Royal Institution in London, Kevin Fong, an anaesthetist and physiology lecturer at University College London, and medical historian Richard Barnett came into the studio to discuss how these important medical interventions started and, crucially, where they are heading. The debates will be held at the Royal Institution on 28 February. "From iron lungs to intensive care", "Hearts to hearts" will be on 15 February.The Observer's science editor, Robin McKie, was on hand to delve int...

How To Boost The Power Of Pain Relief, Without Drugs

Health News from Medical News Today — Mon, 06 Feb 2012 09:00:00 +0100

Placebos reduce pain by creating an expectation of relief. Distraction - say, doing a puzzle - relieves it by keeping the brain busy. But do they use the same brain processes? Neuromaging suggests they do. When applying a placebo, scientists see activity in the dorsolateral prefrontal cortex. That's the part of the brain that controls high-level cognitive functions like working memory and attention - which is what you use to do that distracting puzzle. Now a new study challenges the theory that the placebo effect is a high-level cognitive function. The authors - Jason T. Buhle, Bradford L... (Source: Health News from Medical News Today)

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Multiple Exposure To Anesthesia Increases Risk Of ADHD In Young Children

Health News from Medical News Today — Mon, 06 Feb 2012 08:00:00 +0100

Mayo Clinic researchers have found that multiple exposures to anesthesia at a young age are associated with higher rates of attention-deficit/hyperactivity disorder (ADHD). Children exposed to two or more anesthetics before age 3 had more than double the incidence of ADHD than children who had no exposure, says David Warner, M.D., a Mayo Clinic pediatric anesthesiologist and investigator on the observational study. The findings are published in Mayo Clinic Proceedings... (Source: Health News from Medical News Today)

Map Shows Where in U.S. to Beware of Lyme Disease

MedicineNet Chronic Pain General — Mon, 06 Feb 2012 07:00:00 +0100

Title: Map Shows Where in U.S. to Beware of Lyme DiseaseCategory: Health NewsCreated: 2/3/2012 6:06:00 PMLast Editorial Review: 2/6/2012 (Source: MedicineNet Chronic Pain General)

An optimum time for intravenous cannulation after induction with sevoflurane in children

Pediatric Anesthesia — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion: We recommend an optimal time of 3.5 min for attempting intravenous cannulation after the loss of eyelash reflex with sevoflurane induction. (Source: Pediatric Anesthesia)

Smartphone applications for pediatric anesthesia

Pediatric Anesthesia — Mon, 06 Feb 2012 05:00:00 +0100

We present a review of smartphone applications (apps) available for pediatric anesthesia. (Source: Pediatric Anesthesia)

Clonidine does not improve quality of ropivacaine axillary brachial plexus block in children

Pediatric Anesthesia — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion: Ropivacaine (0.2% 0.4 ml·kg−1) for ABPB provides sufficient postoperative analgesia in children scheduled for forearm or hand surgery. The addition of clonidine to ABPB does not improve overall postoperative analgesia but may increase the time to first analgesia request. (Source: Pediatric Anesthesia)

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An intraoperative multimodal neurophysiologic approach to successful resection of precentral gyrus epileptogenic lesions

Epilepsia — Mon, 06 Feb 2012 05:00:00 +0100

We present an illustrative case of intractable epilepsy where judicious use of intraoperative neurophysiologic–techniques guided resection of precentral CD, under general anesthesia and in the absence of preoperative electrophysiologic mapping data. Ictal onset was accurately delineated using electrocorticography (ECoG). Phase reversal of the median somatosensory‐evoked potentials (MSSEPs) localized the central sulcus (CS). Motor evoked potentials (MEPs) triggered by high‐frequency monopolar anodal electrical cortical stimulation at the primary motor cortex (PMC) threshold delineated the PMC. Using this technique, PMC and the corticospinal tract (CST) were continuously monitored during resection. No changes in MEPs from the preresection baseline were seen; no residual abnormal activi...

Kids, Anesthesia, and ADHD

Medical Headlines From Ivanhoe.com — Mon, 06 Feb 2012 05:00:00 +0100

(Ivanhoe Newswire) -- Affecting three to five percent of children in the United States, attention deficit/hyperactivity disorder (ADHD) is the most diagnosed behavior disorder in childhood. (Source: Medical Headlines From Ivanhoe.com)

Anxiety and Pain as Predictors of Anesthesia Requirements Anxiety and Pain as Predictors of Anesthesia Requirements

Medscape Today Headlines — Mon, 06 Feb 2012 04:00:00 +0100

Can preoperative pain and anxiety predict anesthetic requirements and postoperative pain? British Journal of Anaesthesia (Source: Medscape Today Headlines)

What Are the Major Diseases Involving Copper Metabolism?

PediatricEducation.org — Mon, 06 Feb 2012 00:08:49 +0100

Discussion Nutritional problems can occur in all parts of the world and in all socioeconomic strata. Caloric and/or protein inadequacy unfortunately plagues too many people because of inadequate supplies or availability. Supplemental food programs around the world attempt to provide appropriate nutrition, but can be stymied because of war, political instability, economic instability and many other social factors. The most common specific nutrient deficiencies are iron and Vitamin D deficiencies. Minerals important for essential nutrition include copper, iodine, selenium and zinc. A typical mixed diet usually provides enough minerals. In the United States, mineral deficiencies are usually uncommon unless there is an underlying disease process or abnormal food restrictions or diet. Vegan an...

Factors influencing blood loss and allogeneic blood transfusion practice in craniosynostosis surgery.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:50:07 +0100

Authors: Stricker PA, Fiadjoe JE, Jobes DR PMID: 22272672 [PubMed - in process] (Source: Paediatric Anaesthesia)

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Delayed emergence from anesthesia in a child with congenital generalized lipodystrophy (Berardinelli-Seip syndrome).

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:49:56 +0100

Authors: Bennett T, Allford M PMID: 22272673 [PubMed - in process] (Source: Paediatric Anaesthesia)

Congenital tracheoesophageal fistula.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:49:45 +0100

Authors: Ho AM, Kwok WH PMID: 22272674 [PubMed - in process] (Source: Paediatric Anaesthesia)

Comment on the review article 'Anesthetic management of congenital tracheoesophageal fistula'.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:49:34 +0100

Authors: Sivaprakasam J, Guruswamy V, Bew S PMID: 22272675 [PubMed - in process] (Source: Paediatric Anaesthesia)

Tracheal stenosis masquerading as decompensated total anomalous pulmonary venous return in a neonate.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:49:25 +0100

Authors: Demasie K, Humphreys L, Dierdorf SF PMID: 22272676 [PubMed - in process] (Source: Paediatric Anaesthesia)

25 years of experience, thousands of caudal blocks, and no dural puncture. What happened today?

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:49:16 +0100

Authors: Visoiu M, Lichtenstein S PMID: 22272677 [PubMed - in process] (Source: Paediatric Anaesthesia)

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Spinal anesthesia in children - let's make it safe!

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:49:07 +0100

Authors: Goyal R, Shukla RN, Saxena V PMID: 22272678 [PubMed - in process] (Source: Paediatric Anaesthesia)

Paravertebral block for vascular ring operation in a patient with CHARGE syndrome.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:48:58 +0100

Authors: Türköz A, Can MG, Vuran C PMID: 22272679 [PubMed - in process] (Source: Paediatric Anaesthesia)

Children's seizures caused by continuous intravenous infusion of tramadol analgesia: two rare case reports.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:48:49 +0100

Authors: Li X, Zuo Y, Dai Y PMID: 22272680 [PubMed - in process] (Source: Paediatric Anaesthesia)

Two case reports of the transverse cervical artery description under and below internal jugular veins in securing pediatric central venous catheters by ultrasound echo images.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:48:40 +0100

Authors: Kayashima K, Imai K, Sozen R PMID: 22272681 [PubMed - in process] (Source: Paediatric Anaesthesia)

A case report of an accidental vertebral arterial puncture videotaped during central venous catheterization in a child undergoing a ventricular septal defect repair.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:48:31 +0100

Authors: Kayashima K, Habe K PMID: 22272682 [PubMed - in process] (Source: Paediatric Anaesthesia)

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Methemoglobinemia following prilocaine administration for bilateral tube thoracostomy in a pediatric case.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:48:21 +0100

Authors: Tunç M, Sazak H, Ulus F, Sahin S PMID: 22272683 [PubMed - in process] (Source: Paediatric Anaesthesia)

Clinical Signs of Temporomandibular Disorders and Various Pain Conditions Among Children 6 to 8 Years of Age: The PANIC Study.

Pain Physician — Sun, 05 Feb 2012 17:36:02 +0100

Conclusion: Clinical signs of TMD and pain symptoms are common in children. The relationship of back pain, neck-shoulder muscle palpation tenderness, and headache with clinical signs of TMD suggests that more attention should be paid to stomatognathic function in children with such pain problems. J Orofac Pain 2012;26:17-25. PMID: 22292136 [PubMed - in process] (Source: Pain Physician)

Pathomorphology and treatment of femoroacetabular impingement.

Pain Physician — Sun, 05 Feb 2012 17:36:02 +0100

Authors: Klenke FM, Siebenrock KA Abstract Femoroacetabular impingement is recognized as a major cause of hip pain and early hip joint osteoarthritis in young adults. The dynamic conflict between the femoral neck and the acetabular rim has been shown to result in labral tears, cartilage lesions, and early osteoarthritis. To be successful, the treatment strategy should address the underlying pathomorphology at the femoral neck, the acetabulum, or both. An overview of the various pathomorphologies leading to femoroacetabular impingement and a treatment algorithm intended to preserve the native hip joint should be helpful to the orthopaedic surgeon treating patients with this condition. PMID: 22301238 [PubMed - in process] (Source: Pain Physician)

MRI and arthroscopy correlations of the hip: a case-based approach.

Pain Physician — Sun, 05 Feb 2012 17:36:02 +0100

Authors: McCall DA, Safran MR Abstract Disorders of the hip joint can be physically disabling for the patient and a diagnostic challenge for the physician. Advances in imaging the hip with MRI can help the physician determine a more specific diagnosis for patients with acute or chronic hip pain. MRI and particularly magnetic resonance arthrography have helped raised awareness of nonarthritic hip problems and have made the diagnosis of hip problems much easier. Intra-articular and extra-articular processes can be evaluated with MRI; multiple sequences are available to increase the sensitivity and specificity for detecting specific pathology around the hip. Because the hip is a deep joint within a large soft-tissue envelope, MRI more precisely delineates the sources of hip pain by ev...

A Randomized, Double‐Blind Comparison Shows the Addition of Oxygenated Glycerol Triesters to Topical Mentholated Cream for the Treatment of Acute Musculoskeletal Pain Demonstrates Incremental Benefit Over Time

Pain Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusion: Based on this study, a MC containing OGTs is safe, effective, and provided significantly better pain relief than MC alone. The combination of oxygenated glycerol trimesters and MC provided significant pain relief and offered continued improvement in pain relief over time. (Source: Pain Practice)

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Modulation of Somatosensory Profiles by Spinal Cord Stimulation in Primary Raynaud′s Syndrome

Pain Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusion: SCS significantly modulated the somatosensory profile in a patient with primary Raynaud′s syndrome. These effects were pronounced in qualities involving Aβ, C, and A∂ nerve fibers. Further investigations may help to understand the mechanisms of action of SCS. (Source: Pain Practice)

Use and Costs of Prescription Medications and Alternative Treatments in Patients with Osteoarthritis and Chronic Low Back Pain in Community‐Based Settings

Pain Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusions: Patients with OA and CLBP used a variety of pain‐related and adjunctive medications. Although, alternative treatments are widely recommended, we found limited use of several of these in clinical practice, potentially due to the source of our data (commercial claims). Further research is needed to ascertain the extent to which such therapies contribute to the total costs of OA and CLBP management. (Source: Pain Practice)

The Long‐Term Outcome of Transcutaneous Electrical Nerve Stimulation in the Treatment for Patients with Chronic Pain: A Randomized, Placebo‐Controlled Trial

Pain Practice — Sun, 05 Feb 2012 05:00:00 +0100

Conclusions: Transcutaneous electrical nerve stimulation and sham TENS show similar effects in patients with chronic pain over a period of 1 year. We found support for a long sustained placebo effect. (Source: Pain Practice)

A Comprehensive Review of Telehealth for Pain Management: Where We Are and The Way Ahead

Pain Practice — Sun, 05 Feb 2012 05:00:00 +0100

AbstractPain is generally undertreated in the United States, owing to a number of barriers including geographic distance from specialty treatment providers; functional disability that limits mobility; treatment‐related stigma; economic limitations; and educational barriers. Pain undertreatment exacerbates pain chronicity and emotional disruption that can significantly erode a pain patient’s quality of life, and there is widespread agreement that pain care must evolve to address this significant problem. The growing field of telehealth (defined for the purposes of this paper as technology that allows for distance interaction between providers and/or patients) offers a novel opportunity to expand pain assessment, consultation, and treatment services beyond the walls of the specialty pain...

Study Looks At Reasons For Lack Of Improvement In Outcomes For Treatment Of Unruptured Brain Aneurysms

Health News from Medical News Today — Sat, 04 Feb 2012 08:00:00 +0100

Despite advances in the diagnosis and treatment of unruptured brain aneurysms, outcomes have remained stagnant over the last 10 years. This can be explained by the dramatic proliferation of minimally invasive endoscopic coiling procedures at lower-volume community hospitals, where outcomes are inferior. These findings are reported in a study by neurologists, neurosurgeons and neuro-anesthesiologists at NewYork-Presbyterian Hospital/Columbia University Medical Center and published in the journal Stroke... (Source: Health News from Medical News Today)

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Multiple anesthesias linked to ADHD

Health News - UPI.com — Sat, 04 Feb 2012 05:03:33 +0100

ROCHESTER, Minn., Feb. 4 (UPI) -- Multiple exposures to anesthesia at a young age are associated with higher rates of attention-deficit hyperactivity disorder, U.S. researchers found. (Source: Health News - UPI.com)

DIY science: should you try this at home?

Guardian Unlimited Science — Fri, 03 Feb 2012 22:59:00 +0100

When Richard Handl was arrested for attempting to split the atom on his stove, he joined a growing band of home experimenters cooking up all kinds of trouble behind the kitchen doorÄngelholm is a pretty southern Swedish town, famed for its clay cuckoo manufacturing, a clay cuckoo being a kind of ocarina, which is a kind of flute. The crime rate here is practically zero. Except one of its residents was last year arrested for trying to split the atom in his kitchen. His name is Richard Handl and he buzzes me into his first-floor flat.I wanted to meet Richard because I keep seeing reports of home science experimenters clashing with the authorities. There's been a spate of them this past year or two.I glance into Richard's kitchen and recognise his cooker from the news. It was horrendously, a...

Epidural Plus Fever in Mom May Raise Risks for Baby

The Doctors Lounge - Infections — Fri, 03 Feb 2012 20:00:00 +0100

Study found as mother's temperature rose, problems were more likely at birth (Source: The Doctors Lounge - Infections)

Anaesthetic use linked to ADHD

Telegraph Health — Fri, 03 Feb 2012 18:33:46 +0100

Children repeatedly exposed to anaesthetic early in life are more likely to develop Attention Deficit Hyperactivity Disorder (ADHD), an American study suggests. (Source: Telegraph Health)

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Talin, Vinculin and Nestin Expression in Orofacial Muscles of Dystrophin Deficient mdx Mice

Archivum Immunologiae et Therapiae Experimentalis — Fri, 03 Feb 2012 17:10:48 +0100

Abstract The activity of cytoskeletal proteins like talin, vinculin and nestin increases in muscle that regenerates. Little is known about their role or at least their expression in the process of regeneration in masticatory muscles of mdx mice, a model of Duchenne muscular dystrophy. To determine a potential role of cytoskeletal proteins in the regeneration process of mdx masticatory muscles, we examined the expression of talin 1, talin 2, vinculin and nestin in 100-day-old control and mdx mice using quantitative RT-PCR, Western blot analyses and histochemistry. The protein expression of talin 1, talin 2, nestin and vinculin in mdx muscles remained unchanged as compared with normal mice. However, in mdx masseter it was found a relative increase of nestin compared to contr...

Continuous Near-Infrared Regional Cerebral Perfusion Monitoring Shows Promise in Stroke Patients

Medgadget Anesthesiology — Fri, 03 Feb 2012 16:47:02 +0100

Researchers at Mayo Clinic in Florida have shown that cerebral optically-based near infra-red spectroscopic oximetry applied to patients who have suffered a stroke can help monitor regional cerebral perfusion in real time, and thus “may serve as a useful, noninvasive, bedside intensive care unit monitoring tool to assess brain oxygenation in a direct manner.” The study looked at the device called Fore-Sight from Casmed of Branford, CT, that measures blood oxygen, similar to a finger clip pulse oximeter. The Mayo study results have been published in Journal of Neurosurgery this month.Regional cerebral blood flow monitoring devices such as Fore-Sight are already in wide deployment in cardiac surgery, where they are thought to prevent brain ischemia in patients undergoing major s...

Children exposed to anaesthetic early in life 'have double risk of ADHD'

the Mail online | Health — Fri, 03 Feb 2012 15:57:52 +0100

Children given two or more doses of anaesthetic before they turned three had more than double the incidence of ADHD than children who had no exposure, Mayo Clinic research found. (Source: the Mail online | Health)

Study Suggests Surgical Breast Biopsy Not Overused

Health News from Medical News Today — Fri, 03 Feb 2012 08:00:00 +0100

Contrary to earlier findings, surgical breast biopsies may not be as overused as previously thought, according to a study in the February issue of the Journal of the American College of Radiology. Surgical breast biopsies are more invasive than needle biopsies, requiring an incision and the use of general anesthesia. Results from a previous study in 2011 in a surgical journal suggested that surgery is used for 30 percent of breast biopsies, an excessive number... (Source: Health News from Medical News Today)

Types and severity of operated supraclavicular brachial plexus injuries caused by traffic accidents

Acta Neurochirurgica — Fri, 03 Feb 2012 07:21:35 +0100

Conclusion Study results indicate that the most common injury was an upper plexus palsy. It was characteristic of bicycle accidents, and significantly more common in car and motorcycle accidents. The results also indicate that it is important to consider the potential of a brachial plexus injury after serious traffic accidents and to examine both upper extremities in detail even if some motor function is preserved. Content Type Journal ArticleCategory Clinical ArticlePages 1-5DOI 10.1007/s00701-012-1291-7Authors Radek Kaiser, Third Faculty of Medicine, Department of Neurosurgery, Hospital Kralovske Vinohrady, Charles University, Srobarova 50, 100 34 Prague, Czech RepublicPetr Waldauf, Third Faculty of Medicine, Department of Anesthesiology and Critical Care Medicin...

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Renal bioenergetics during early gram-negative mammalian sepsis and angiotensin II infusion

Intensive Care Medicine — Fri, 03 Feb 2012 07:21:32 +0100

Conclusions During early hypotensive experimental Gram-negative sepsis, there was no evidence of renal bioenergetic failure despite decreased RBF. In this setting, the addition of a powerful renal vasoconstrictor does not lead to deterioration in renal bioenergetics. Content Type Journal ArticleCategory ExperimentalPages 1-8DOI 10.1007/s00134-012-2487-2Authors Clive N. May, Howard Florey Institute, Florey Neurosciences Institutes, University of Melbourne, Parkville, VIC, AustraliaKen Ishikawa, Howard Florey Institute, Florey Neurosciences Institutes, University of Melbourne, Parkville, VIC, AustraliaLi Wan, Howard Florey Institute, Florey Neurosciences Institutes, University of Melbourne, Parkville, VIC, AustraliaJohn Williams, Howard Florey Institute, Florey Neurosc...

Brain Tissue Oxygenation and Cerebral Perfusion Pressure Thresholds of Ischemia in a Standardized Pig Brain Death Model

Neurocritical Care — Fri, 03 Feb 2012 07:21:15 +0100

Conclusions A severe increase of ICP leading to CPP below 30 mmHg and BtipO2 below 10 mmHg is associated with an increase of the L/P ratio, thus seems to be critical thresholds for cerebral ischemia under these conditions. Content Type Journal ArticleCategory Translational ResearchPages 1-8DOI 10.1007/s12028-012-9675-3Authors Karlis Purins, Department of Neuroscience, Section of Neurosurgery, Uppsala University, 751 85 Uppsala, SwedenPer Enblad, Department of Neuroscience, Section of Neurosurgery, Uppsala University, 751 85 Uppsala, SwedenLars Wiklund, Department of Surgical Sciences, Section of Anaesthesia and Intensive Care, Uppsala University, Uppsala, SwedenAnders Lewén, Department of Neuroscience, Section of Neurosurgery, Uppsala University, 751 85 Up...

New Heart Failure Risks: Fractures and Memory Problems

MedicineNet Chronic Pain General — Fri, 03 Feb 2012 07:00:00 +0100

Title: New Heart Failure Risks: Fractures and Memory ProblemsCategory: Health NewsCreated: 2/3/2012 11:01:00 AMLast Editorial Review: 2/3/2012 (Source: MedicineNet Chronic Pain General)

Joint immobilisation prevents murine osteoarthritis, and reveals the highly mechanosensitive nature of protease expression in vivo

Arthritis and Rheumatism — Fri, 03 Feb 2012 05:00:00 +0100

Conclusion: Gene expression in the joint following induction of OA is rapid and highly mechanosensitive. Regulated genes include the known pathogenic protease Adamts5. Targeting the mechanosensing mechanisms of joint tissues could offer new strategies for disease modification. (Source: Arthritis and Rheumatism)

Evaluation of TAPSE as a measure of right ventricular output.

Canadian Journal of Anaesthesia — Fri, 03 Feb 2012 05:00:00 +0100

CONCLUSION: Tricuspid annular plane systolic excursion by M mode and by speckle tracking correlates modestly with SV. There was no correlation between TAPSE and SV by tissue tracking at the inferior wall of the right ventricle. Tricuspid annular plane systolic excursion by M mode and by speckle tracking does not track changes in SV following either volume loading or ephedrine administration. PMID: 22302303 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

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Early versus late parenteral nutrition in the adult ICU: feeding the patient or our conscience?

Canadian Journal of Anaesthesia — Fri, 03 Feb 2012 05:00:00 +0100

Authors: Kerrie JP, Bagshaw SM, Brindley PG PMID: 22302305 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

Anesthesia in Toddlers Linked to ADHD (CME/CE)

MedPage Today Neurology — Thu, 02 Feb 2012 23:43:06 +0100

(MedPage Today) -- Children exposed to general anesthesia multiple times during the first two years of life have an increased likelihood of later developing attention deficit hyperactivity disorder, researchers found. (Source: MedPage Today Neurology)

Anesthesia Exposure Linked To ADHD In Children

Health News from Medical News Today — Thu, 02 Feb 2012 22:00:00 +0100

A study by researchers at Mayo Clinic, Rochester Minn., and published in Mayo Clinic Proceedings, reveals that children who have been under anesthesia many times when they are young have a greater risk of developing attention-deficit/hyperactivity disorder (ADHD). According to David Warner, M.D, a Mayo Clinic pediatric anesthesiologist, and researchers of this study, kids who have been exposed to anesthesia more than twice before the age of 3 are twice as likely to have ADHD than children who have not been exposed... (Source: Health News from Medical News Today)

Anesthesia in Toddlers Linked to ADHD (CME/CE, with video)

MedPage Today Psychiatry — Thu, 02 Feb 2012 20:59:54 +0100

Cardinal Health Releases Smart-Seal Surgical Mask

Medgadget Anesthesiology — Thu, 02 Feb 2012 19:11:23 +0100

Cardinal Health has made available its Smart-Seal surgical mask that improves both its fit and reduces interior fogging while providing a high level of filtration and resistance to liquids.From the announcement:Read More (Source: Medgadget Anesthesiology)

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Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis

Advances in Pharmacological Sciences — Thu, 02 Feb 2012 18:35:24 +0100

We describe the anesthetic management of a patient with severe myasthenia gravis and tracheal stenosis; the patient was scheduled for direct laryngoscopy and dilatation. The combination of myasthenia gravis and tracheal obstruction presents several difficulties for anesthetic management. The airway is shared; therefore, any complications are also shared by the anesthesiologist and bronchoscopists. The potential for respiratory compromise in patients undergoing the two procedures requires that anesthesiologists be familiar with the underlying disease state, as well as the interaction of anesthetic and nonanesthetic drugs in a case involving myasthenia gravis. We reviewed the literature and report our experience in this case. There is no strong evidence for choosing one approach to general a...

Apolipoprotein E e4 allele does not increase the risk of early postoperative delirium after major surgery

Journal of Anesthesia — Thu, 02 Feb 2012 18:14:05 +0100

Conclusions Apolipoprotein e4 carrier status was not associated with an increased risk for early postoperative delirium. Age, congestive heart failure, and emergency surgery were independent risk factors for the development of delirium after major surgery. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00540-012-1326-5Authors Fernando José Abelha, Anesthesiology and Perioperative Care Unit, Surgical Department, Faculty of Medicine, University of Porto, Porto, PortugalVera Fernandes, Department of Anesthesiology, Centro Hospitalar de São João, Porto, PortugalMiguela Botelho, Department of Anesthesiology, Centro Hospitalar de São João, Porto, PortugalPatricia Santos, Department of Anesthesiology, Centro Hospitalar de São João, Porto,...

Retrograde intubation during laryngeal cleft repair on cardiopulmonary bypass

Journal of Anesthesia — Thu, 02 Feb 2012 18:14:03 +0100

We present our experience of retrograde intubation for a 4-month-old patient who presented for laryngeal cleft repair on cardiopulmonary bypass. This case highlights the unique place for retrograde intubation in small patients in the current era. Content Type Journal ArticleCategory Clinical ReportPages 1-2DOI 10.1007/s00540-011-1310-5Authors Vincent Collard, Montreal Childrens Hospital, 2300 Tupper Street, Montreal, QC H3H 1P3, CanadaLeal G. Segura, Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, 300 Longwood Avenue, Bader 3, Boston, MA 02115, USADima G. Daaboul, Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital Boston, 300 Longwood Avenue, Bader 3, Boston, MA 02115, USAKoichi Yuki, Department of Anes...

Contrast-induced acute kidney injury: what is the prevalence of prevention protocols?

Intensive Care Medicine — Thu, 02 Feb 2012 18:13:11 +0100

Content Type Journal ArticleCategory CorrespondencePages 1-1DOI 10.1007/s00134-012-2479-2Authors Jamie M. Strachan, Intensive Care Unit, Royal Berkshire Hospital, Reading, RG1 5AN UKMichael P. J. DeVile, Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, OX3 9DU UK Journal Intensive Care MedicineOnline ISSN 1432-1238Print ISSN 0342-4642 (Source: Intensive Care Medicine)

Clinicopathological Profile, Airway Management, and Outcome in Huge Multinodular Goiters: An Institutional Experience from an Endemic Goiter Region

World Journal of Surgery — Thu, 02 Feb 2012 18:12:35 +0100

Conclusions Long-standing huge goiters are common in iodine-deficient endemic areas. The majority of patients have symptomatic or clinicoradiological evidence of airway involvement. The incidence of RSE, airway deformity, intubation difficulty, and tracheomalacia is high with huge goiters. The surgery is technically demanding with greater associated chances of injury to native structures. Malignancy influences the presentation and outcome in smaller goiters. In centers with experienced endocrine surgeons and dedicated anesthetists, huge goiters can be successfully managed with minimal short-term and long-term morbidity. Content Type Journal ArticlePages 1-6DOI 10.1007/s00268-012-1447-xAuthors Amit Agarwal, Department of Endocrine Surgery, Sanjay Gandhi Post Gradua...

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Sepsis Immunopathology: Perspectives of Monitoring and Modulation of the Immune Disturbances

Archivum Immunologiae et Therapiae Experimentalis — Thu, 02 Feb 2012 18:11:05 +0100

Abstract Septic syndromes are the main cause of death in the intensive care units and although the mortality rates is slowly decreasing, the occurrence of the disease has been increasing. The pathogenesis of sepsis includes countless disturbances of the host immune system starting with a harmful, infection-triggered exaggerated inflammatory cascade, followed by the development of an immunoparalysis state. The latter contributes to the failure in pathogen eradication and leads to secondary infections, which are often the cause of fatal complications. In this review, we consider different novel therapeutic strategies for restoration of immune function. The use of glucocorticoids, intravenous immunoglobulins, heparin, recombinant human activated protein C, granulocyte macroph...

The burden of endoscopic retrograde cholangiopancreatography (ERCP) performed with the patient under conscious sedation

Surgical Endoscopy — Thu, 02 Feb 2012 18:07:54 +0100

Conclusion One-third to one-half of patients experience pain and discomfort during and immediately after ERCP when it is performed with conscious sedation for the patient. Other sedation strategies, such as the use of general anesthesia or propofol, may well reduce the burden of ERCP, particularly for patients with a higher EQ-5D score, younger age, or therapeutic ERCP treatment. However, randomized trials are warranted. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-012-2162-2Authors S. M. Jeurnink, Department of Gastroenterology and Hepatology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The NetherlandsE. W. Steyerberg, Department of Public Health, Erasmus MC/University Medical Center, Rotterdam, The NetherlandsE. J. Kuipers, Department o...

Anti-Xa Levels 4 h After Subcutaneous Administration of 5,700 IU Nadroparin Strongly Correlate with Lean Body Weight in Morbidly Obese Patients

Obesity Surgery — Thu, 02 Feb 2012 17:58:24 +0100

Abstract Background Morbidly obese patients (BMI > 40 kg/m2) are at increased risk for venous thromboembolism, especially after surgery. Despite limited evidence, morbidly obese patients are often administered a double dose of nadroparin for thromboprophylaxis compared to non-obese patients. The aim of this study was to evaluate the influence of different body size descriptors on anti-Xa levels after a double dose of nadroparin (5,700 IU) in morbidly obese patients. Methods In 27 morbidly obese patients with a mean total body weight of 148 kg (range 107–260 kg), anti-Xa levels were determined peri-operatively until 24 h after administration of a subcutaneous dose of 5,700 IU of nadroparin. Results &nbs...

Prolonged propriospinal myoclonus following spinal anesthesia for cesarean section: case report and literature review

Archives of Gynecology and Obstetrics — Thu, 02 Feb 2012 17:57:19 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00404-012-2246-1Authors Anna Lev, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, POB 3235, 91031 Jerusalem, IsraelIsabell Korn-Lubezki, Department of Neurology, Shaare Zedek Medical Center, Jerusalem, IsraelBettina Steiner-Birmanns, Department of Neurology, Shaare Zedek Medical Center, Jerusalem, IsraelArnon Samueloff, Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, IsraelYaakov Gozal, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, POB 3235, 91031 Jerusalem, IsraelAlexander Ioscovich, Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zede...

Young Children Exposed to Anesthesia Multiple Times Show Elevated Rates of ADHD

News from Mayo Clinic — Thu, 02 Feb 2012 17:40:21 +0100

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Anesthesia in Early Childhood May Be Linked to ADHD

Pediatrics News - Doctors Lounge — Thu, 02 Feb 2012 15:00:00 +0100

Only associated with multiple surgeries; not a reason to delay needed procedures, experts say (Source: Pediatrics News - Doctors Lounge)

Young children exposed to anesthesia multiple times show elevated rates of ADHD

ScienceDaily Headlines — Thu, 02 Feb 2012 14:22:22 +0100

Researchers have found that multiple exposures to anesthesia at a young age are associated with higher rates of attention-deficit/hyperactivity disorder (ADHD). (Source: ScienceDaily Headlines)

30 Years Lost in Anesthesia Theory

Thu, 02 Feb 2012 14:05:42 +0100

(Source: Cardiovascular and Hematological Agents in Medicinal Chemistry (Formerly Current Medicinal Chemistry - Cardiovascular and Hematological Agents))

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Anesthesia in Early Childhood May be Linked to ADHD

MedlinePlus Health News — Thu, 02 Feb 2012 14:00:00 +0100

Only associated with multiple surgeries; not a reason to delay needed procedures, experts say Source: HealthDay Related MedlinePlus Pages: Anesthesia, Attention Deficit Hyperactivity Disorder, Children's Health (Source: MedlinePlus Health News)

General anesthesia in infancy linked to higher risk of ADHD

CNN.com - Health — Thu, 02 Feb 2012 12:31:58 +0100

Infants who undergo surgical procedures requiring general anesthesia in their first two years of life may be at increased risk of developing ADHD. (Source: CNN.com - Health)

Automatic electroencephalography monitor offers tight anesthesia control

MedWire News - Anesthesiology — Thu, 02 Feb 2012 12:16:26 +0100

An automatic system that monitors patients’ needs for anesthesia and analgesia during surgery outperforms manual control of anesthesia on some indices, research shows. (Source: MedWire News - Anesthesiology)

The Size 1 ProSeal™ laryngeal mask airway in infants: a randomized, noncrossover study with the Classic™ laryngeal mask airway

Pediatric Anesthesia — Thu, 02 Feb 2012 12:09:21 +0100

Conclusions: We conclude that the size 1 PLMA is a stable, safe, and efficacious airway control device during neonatal and infant anesthesia, allowing higher peak airway pressure during positive pressure ventilation, with fewer mask displacements and gastric insufflations than the cLMA. (Source: Pediatric Anesthesia)

Helping Seniors With Pain: New GSA Resources

Health News from Medical News Today — Thu, 02 Feb 2012 09:00:00 +0100

The pain suffered by older adults is the shared focus of the two newest entries in The Gerontological Society of America's (GSA) From Publication to Practice* series. Together they address both pain management and new labeling changes for one of the most popular pain medications, acetaminophen. Both issues aim to provide readers with information on how new advances in pain prevention, treatment, and management may improve care and quality of life for older adults... (Source: Health News from Medical News Today)

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Researchers Develop Novel Drug Delivery System

Health News from Medical News Today — Thu, 02 Feb 2012 08:00:00 +0100

Long duration, controllable drug delivery is of wide interest to medical researchers and clinicians, particularly those seeking to improve treatment for patients with chronic pain or to prevent cancer recurrence after surgery. Now a team of researchers led by Boston University Biomedical Engineer and Chemist Mark Grinstaff has developed a unique material and drug delivery mechanism that could pave the way for implants that release a drug at a designated rate for months... (Source: Health News from Medical News Today)

Health Tip: Help Prevent a Stress Fracture

MedicineNet Chronic Pain General — Thu, 02 Feb 2012 07:00:00 +0100

Title: Health Tip: Help Prevent a Stress FractureCategory: Health NewsCreated: 2/2/2012 8:05:00 AMLast Editorial Review: 2/2/2012 (Source: MedicineNet Chronic Pain General)

Gleevec Approval Widened to Include Rare Cancer

MedicineNet Chronic Pain General — Thu, 02 Feb 2012 07:00:00 +0100

Title: Gleevec Approval Widened to Include Rare CancerCategory: Health NewsCreated: 2/1/2012 4:06:00 PMLast Editorial Review: 2/2/2012 (Source: MedicineNet Chronic Pain General)

infliximab, Remicade

MedicineNet Chronic Pain General — Thu, 02 Feb 2012 07:00:00 +0100

Title: infliximab, RemicadeCategory: MedicationsCreated: 12/13/1999 9:40:00 PMLast Editorial Review: 2/2/2012 (Source: MedicineNet Chronic Pain General)

Anesthesia in Early Childhood May Be Linked to ADHD

MedicineNet Kids Health General — Thu, 02 Feb 2012 07:00:00 +0100

Title: Anesthesia in Early Childhood May Be Linked to ADHDCategory: Health NewsCreated: 2/2/2012 10:05:00 AMLast Editorial Review: 2/2/2012 (Source: MedicineNet Kids Health General)

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Visualization versus Neuromonitoring of Recurrent Laryngeal Nerves during Thyroidectomy: What About the Costs?

World Journal of Surgery — Thu, 02 Feb 2012 06:53:59 +0100

Conclusions The regional DRG tariff for thyroid surgery is barely sufficient to cover conventional surgery costs. Intraoperative neural monitoring accounts for 5–7% of the hospitalization costs for a thyroidectomy. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1452-0Authors Gianlorenzo Dionigi, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria Varese-Como, Via Guicciardini, 21100 Varese, ItalyAlessandro Bacuzzi, Department of Anesthesia, University of Insubria, 21100 Varese, ItalyLuigi Boni, Department of Surgical Sciences, Endocrine Surgery Research Center, University of Insubria Varese-Como, Via Guicciardini, 21100 Varese, ItalyStefano Rausei, Department of Surgical Sciences, Endocrine Surgery Research Center...

Comparison of Dexamethasone with Ondansetron or Haloperidol for Prevention of Patient-Controlled Analgesia-Related Postoperative Nausea and Vomiting: A Randomized Clinical Trial

World Journal of Surgery — Thu, 02 Feb 2012 06:53:57 +0100

Conclusions Dexamethasone 5 mg with either haloperidol 2 mg or ondansetron 4 mg provides a better antiemetic effect than dexamethasone 5 mg alone in patients receiving postoperative morphine PCA. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-012-1446-yAuthors Po-Kai Wang, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CPei-Jiuan Tsay, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CChia-Chun Huang, Department of Anesthesiology, Buddhist Tzu-Chi General Hospital, 707, Section 3, Chung-Yang Road, 970, Hualien, Taiwan, R.O.CHsien-Yong Lai, Department of Medical Education and Research, M...

Anesthesia may cause ADHD and Brain Damage

NaturalNews.com — Thu, 02 Feb 2012 06:00:00 +0100

Many within the alternative health community believe anesthetics cause brain damage. Evidence for this claim has included innumerable animal studies demonstrating a wide range of side effects from every class of anesthetics. Clinical observations of patients and in... (Source: NaturalNews.com)

[PHTLS team course: a pilot project : Structured student education in prehospital care of severely injured patients.]

Der Unfallchirurg — Thu, 02 Feb 2012 05:00:00 +0100

CONCLUSION: Especially the treatment of multiply injured patients is a challenge for young medical professionals. However, there is a high motivation to learn and train in emergency medicine. The students long for a practical trauma course compared to the advanced medical CPR course provided by the Department of Anaesthesiology of the University of Heidelberg. Those algorithm-based trauma courses do exist with PHTLS® and ATLS®. Based on these courses we developed the PHTLS® TEAM course. PMID: 22294422 [PubMed - as supplied by publisher] (Source: Der Unfallchirurg)

Do Prescription Monitoring Programs Impact State Trends in Opioid Abuse/Misuse?

Pain Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions. Two observational data sources offer preliminary support that PMPs are effective. Future efforts should evaluate what PMP characteristics are most effective and which opioids are most impacted. (Source: Pain Medicine)

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Cerebral Blood Flow Dynamics During Pain Processing Investigated by Functional Transcranial Doppler Sonography

Pain Medicine — Thu, 02 Feb 2012 05:00:00 +0100

Conclusions. The findings suggest that fTCD measurements prove sensitive both to different levels of physical intensity of painful stimuli and to interindividual differences in nociceptive responding. fTCD may be a valuable tool in clinical pain research, for instance, when it comes to quantifying the temporal dynamics of exaggerated nociceptive responses in chronic pain, or evaluating treatment effects on nociceptive processing. (Source: Pain Medicine)

Ursodeoxycholate modulates bile flow and bile salt pool independently from the cystic fibrosis transmembrane regulator (Cftr)in mice.

American Journal of Physiology. Gastrointestinal and Liver Physiology — Thu, 02 Feb 2012 05:00:00 +0100

Conclusion. Acute TUDCA infusion and chronic UDCA treatment both stimulate bile flow in CF conditions independently from Cftr function. Chronic UDCA treatment reduces the hydrophobicity of the bile salt pool in Cftr(-/-) mice. These results support a potential beneficial effect of UDCA on bile flow and bile salt metabolism in CF conditions. PMID: 22301109 [PubMed - as supplied by publisher] (Source: American Journal of Physiology. Gastrointestinal and Liver Physiology)

A recurrent variant branch of the inferior alveolar nerve: Is it unique?

Clinical Anatomy — Thu, 02 Feb 2012 05:00:00 +0100

In this study, a recurrent variant branch of the IAN arising just below the origin of the mylohyoid nerve was investigated in adult Indian cadavers allotted for dissection to the first year dental students of Government Dental College, Ahmedabad (India). The dissection was performed by the lateral approach to the infratemporal fossa. The nerve was found in 12 of 35 sides (34.3%) and 8 of 18 cadavers (44.4%). Thus, in our study it was not a rare variation of the IAN, where in most cases it innervated the lateral pterygoid muscle. In some cases, it terminated in the lateral pterygoid muscle. In others, it penetrated the muscle to join the anterior or posterior division of the mandibular nerve or its branches; thus, the variant nerve in such cases might be regarded as an additional root of th...

Tracheal occlusions evoke respiratory load compensation and neural activation in anesthetized rats

Journal of Applied Physiology — Thu, 02 Feb 2012 05:00:00 +0100

Airway obstruction in animals leads to compensation and avoidance behavior and elicits respiratory mechanosensation. The pattern of respiratory load compensation and neural activation in response to intrinsic, transient, tracheal occlusions (ITTO) via an inflatable tracheal cuff are unknown. We hypothesized that ITTO would cause increased diaphragm activity, decreased breathing frequency, and activation of neurons within the medullary and pontine respiratory centers without changing airway compliance. Obstructions were performed for 2–3 breaths followed by a minimum of 15 unobstructed breaths with an inflatable cuff sutured around the trachea in rats. The obstruction procedure was repeated for 10 min. The brains of obstructed and control animals were removed, fixed, sectioned, and st...

A toothbrush impalement injury of the floor of mouth in autism child

Dental Traumatology — Thu, 02 Feb 2012 05:00:00 +0100

We report a case of a toothbrush impalement injury of the floor of the mouth in a child with autism. A 5‐year‐old boy with autism presented with an accidentally impaled toothbrush in the oral cavity. He was taken to the operation room and examined under general anesthesia. The handle of the toothbrush was cut off using rib scissors for mask ventilation, and intra‐oral intubation was performed. The toothbrush was located approximately 2.5 cm into the floor of the mouth. The toothbrush was removed uneventfully. Intravenous antibiotic therapy was instituted during hospitalization, and discharge from the hospital occurred 4 days after the operation. (Source: Dental Traumatology)

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Young children exposed to anesthesia multiple times show elevated rates of ADHD

EurekAlert! - Medicine and Health — Thu, 02 Feb 2012 05:00:00 +0100

(Mayo Clinic) Mayo Clinic researchers have found that multiple exposures to anesthesia at a young age are associated with higher rates of attention-deficit/hyperactivity disorder. (Source: EurekAlert! - Medicine and Health)

Massages Scientifically Proven To Help Reduce Pain

Health News from Medical News Today — Wed, 01 Feb 2012 23:00:00 +0100

According to a study published online in Science Translational Medicine by researchers from the Buck Institute for Research on Aging and McMaster University in Hamilton Ontario, massages aid the growth of new mitochondria in skeletal muscle, and help to reduce inflammation. Many athletes would attest to the fact that massages help in treating pain, and speed up recovery, but now scientists have the evidence to go along with their testimonies... (Source: Health News from Medical News Today)

Alternative model of birth to reduce the risk of assisted vaginal delivery and perineal trauma

International Urogynecology Journal — Wed, 01 Feb 2012 17:14:21 +0100

Conclusion A combination of postural changes during the passive expulsive phase of labor and lateral position during active pushing time is associated with reductions in AVD and PT. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00192-012-1675-5Authors Carolina Walker, Department of Physiotherapy, European University of Madrid, c/ Villaviciosa de Odón s/n, 28260 Madrid, SpainTania Rodríguez, Department of Physiotherapy, European University of Madrid, c/ Villaviciosa de Odón s/n, 28260 Madrid, SpainAna Herranz, Department of Obstetrics and Gynecology, La Paz University Hospital, Madrid, SpainJosé A. Espinosa, Department of Obstetrics and Gynecology, Quiron University Hospital, Madrid, SpainEmília Sánchez, Blanquerna School of Health S...

Treatment of Neurocritical Care Emergencies in Pregnancy

Current Treatment Options in Neurology — Wed, 01 Feb 2012 17:14:15 +0100

Opinion statement Neurologic emergencies are a major cause of morbidity and mortality in pregnant women. In part because the patient population is young, the nihilistic approach that often accompanies neurologically devastating disorders in other contexts is largely absent. A number of studies have demonstrated improved patient outcomes in the setting of aggressive care delivered by neurointensivists in a specialty-specific environment. It stands to reason that young, pregnant women who suffer from neurologically devastating disorders and who have a wide range of prognosis may also benefit from such specialized care. Close collaboration between obstetricians and neurointensivists is critical in this context. A number of unique considerations in diagnosis and management pre...

Delay from fracture to hospital admission: a new risk factor for hip fracture mortality?

Osteoporosis International — Wed, 01 Feb 2012 17:14:09 +0100

Conclusions If the association estimated in our study is causal, our results provide evidence that some hip fracture-related deaths could be prevented by improved patient access to appropriate and timely hospital care in the context of a developing country. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00198-012-1917-xAuthors E. I. O. Vidal, Internal Medicine Department, Universidade Estadual Paulista (UNESP), Botucatu, BrazilD. C. Moreira-Filho, Preventive and Social Medicine Department, Universidade Estadual de Campinas (UNICAMP), Campinas, BrazilR. S. Pinheiro, Public Health Studies Institute, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, BrazilR. C. Souza, Health Sciences Center, Fundação Serra dos Órgãos, Teresop...

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Bilateral Single Sitting Myringoplasty Using Tragal Cartilage from One Ear

Indian Journal of Otolaryngology and Head and Neck Surgery — Wed, 01 Feb 2012 17:13:59 +0100

Abstract Though single sitting myringoplasty using temporalis fascia under general anesthesia has been documented in many studies, but ours is the first center to have started using tragal cartilage harvested from one ear to do bilateral myringoplasty in one sitting using local anesthesia with excellent results including very good graft uptake rate and audiological improvement without significant complications. Content Type Journal ArticleCategory Short CommunicationPages 1-4DOI 10.1007/s12070-012-0487-8Authors Arvinder Singh Sood, Department of ENT, SGRDIMSR, 22-A, Rajinder Nagar, Sultanwind Road, Amritsar, 143001 India Journal Indian Journal of Otolaryngology and Head & Neck SurgeryOnline ISSN 0973-7707Print ISSN 2231-3796 (Source: Indian Journal of Otolaryngo...

Toluidine blue for the intraoperative staining of the ureters. Studies on the safe administration in rats

Langenbeck's Archives of Surgery — Wed, 01 Feb 2012 17:11:57 +0100

Conclusions In rats, intravenous injection of 0.4 mg TB/kg was sufficient for the intraoperative staining of the urinary tract without the risk of severe cardiovascular and hemodynamic side effects. Provided our results are transferable to humans, the administration of low TB doses could allow its safer clinical use for the intraoperative visualization of the ureters. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00423-012-0907-yAuthors Frank Petrat, Institut für Physiologische Chemie, Universitätsklinikum, Universität Duisburg-Essen, Hufelandstr. 55, 45122 Essen, GermanyMatthias Hartmann, Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstr. 55, 45122 Essen, GermanyErnst Schmidt, Dr. F...

Re: The efficacy and safety of ureteroscopy for ureteral calculi in pregnancy: our experience in 32 patients

Urological Research — Wed, 01 Feb 2012 17:11:43 +0100

Content Type Journal ArticleCategory Letter to the EditorPages 1-1DOI 10.1007/s00240-012-0458-2Authors Abdulkadir Tepeler, Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Adnan Mendres Bulvarı, Fatih, Istanbul, TurkeyAbdullah Armağan, Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Adnan Mendres Bulvarı, Fatih, Istanbul, TurkeyZafer Doğan, Department of Anesthesiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, TurkeyMehmet Yılmaz, Department of Obstetrics and Gynecology, Faculty of Medicine, Atatürk University, Erzurum, TurkeyMesrur Selçuk Sılay, Department of Urology, Faculty of Medicine, Bezmialem Vakif University, Adnan Mendres Bulvarı, Fatih, Istanbul, Turkey Journal Urological ResearchOnline ISSN 1434...

Pseudocholinesterase in gestational diabetes: positive correlation with LDL and negative correlation with triglyceride

Archives of Gynecology and Obstetrics — Wed, 01 Feb 2012 17:10:04 +0100

Conclusion PChE activity was not significantly different between the groups. However, there was a positive correlation between PChE and LDL levels in pregnant women with GD, suggesting that LDL levels in pregnant women with GD may help to predict the risk of prolonged apnea in situations in which PChE activity cannot be measured. Content Type Journal ArticleCategory Maternal-Fetal MedicinePages 1-7DOI 10.1007/s00404-012-2241-6Authors Lütfiye Pirbudak Cocelli, Department of Anaesthesiology and Algology, Medical School, University of Gaziantep, 27310 Gaziantep, TurkeyEbru Dikensoy, Department of Obstetrics and Gynecology, Medical School, University of Gaziantep, Gaziantep, TurkeyHülya Cicek, Department of Clinical Biochemistry, Medical School, University of Gaziante...

Deep sedation during pneumatic reduction of intussusception

Pediatric Radiology — Wed, 01 Feb 2012 17:09:45 +0100

Conclusions Deep sedation with propofol did not add any complication to the pneumatic reduction. The fluoroscopic time was short. The success rate of reduction was high, raising the possibility that sedation is beneficial, possibly by smooth muscle relaxation. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00247-011-2311-0Authors Anat Ilivitzki, Department of Diagnostic Imaging, Rambam Health Care Campus, Haifa, IsraelLuda Glozman Shtark, Department of Diagnostic Imaging, Rambam Health Care Campus, Haifa, IsraelKarin Arish, Department of Anesthesiology, Western Galilee Hospital, Nahariya, IsraelAhuva Engel, Department of Diagnostic Imaging, Rambam Health Care Campus, Haifa, Israel Journal Pediatric RadiologyOnline ISSN 1432-1998Prin...

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Heartburn Drugs Linked to Hip Fractures in Women

MedicineNet Chronic Pain General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Heartburn Drugs Linked to Hip Fractures in WomenCategory: Health NewsCreated: 2/1/2012 11:01:00 AMLast Editorial Review: 2/1/2012 (Source: MedicineNet Chronic Pain General)

Pain (Acute and Chronic)

MedicineNet Chronic Pain General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Pain (Acute and Chronic)Category: Doctor's ViewsCreated: 11/30/2004Last Editorial Review: 2/1/2012 (Source: MedicineNet Chronic Pain General)

Rheumatoid Arthritis: Questions for Your Doctor

MedicineNet Chronic Pain General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Rheumatoid Arthritis: Questions for Your DoctorCategory: Doctor's ViewsCreated: 8/6/2001 4:16:00 PMLast Editorial Review: 2/1/2012 (Source: MedicineNet Chronic Pain General)

Arthritis - Whether Weather Affects Arthritis

MedicineNet Chronic Pain General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Arthritis - Whether Weather Affects ArthritisCategory: Doctor's ViewsCreated: 9/10/2000Last Editorial Review: 2/1/2012 (Source: MedicineNet Chronic Pain General)

Coping With Chronic Rheumatic Diseases

MedicineNet Chronic Pain General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Coping With Chronic Rheumatic DiseasesCategory: Doctor's ViewsCreated: 8/4/2000 3:27:00 PMLast Editorial Review: 2/1/2012 (Source: MedicineNet Chronic Pain General)

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Nonsteroidal Anti-inflammatory Drugs and Ulcers

MedicineNet Chronic Pain General — Wed, 01 Feb 2012 07:00:00 +0100

Title: Nonsteroidal Anti-inflammatory Drugs and UlcersCategory: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 2/1/2012 (Source: MedicineNet Chronic Pain General)

MCQs

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

(pp 56–58) Which of the following delay gastric emptying? (Source: Anaesthesia and intensive care medicine)

Drugs and the liver

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: The liver is a major organ with multiple functions. Many drugs are metabolized by the liver during phase 1 and 2 reactions which include complex processes involving cytochrome P450. Additionally, drugs can also modify how the liver functions and cause dysfunction or even failure of the organ both by a direct effect on the liver or by alteration in liver blood flow. It is important to recognize the signs and symptoms of liver failure in patients and identify possible causes including drug interactions. Furthermore, once a patient has been recognized to be suffering with liver dysfunction or failure drug choice and dosing regime will need to be rationalized.Paracetamol overdose can have severe and life-threatening consequences for patients due to its effect on liver function. It is...

Gastric disorders: modifications of gastric content, antacids and drugs influencing gastric secretions and motility

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: Gastric disorders have clinical implications in both anaesthesia and critical care medicine. Aspiration of acidic gastric contents in the perioperative setting is linked to pneumonitis and later development of pneumonia. Pharmacological strategies to minimize this risk include histamine-2 receptor antagonists, sucralfate, proton pump inhibitors and sodium citrate. Use of gastric acid-suppressing therapy is widespread in critical care. The aim is to reduce the incidence of stress-related mucosal bleeding. Intestinal failure is common in critical illness. Medications that decrease gastric motility and contribute to ileus, include opioid analgesics, catecholamines and α2-adrenoceptor antagonists. Current pharmacological strategies for increasing gastric motility include the use of ...

Central nervous system stimulants: basic pharmacology and relevance to anaesthesia and critical care

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: Sympathomimetic agents are commonly encountered in anaesthetic and critical care settings. Some only act on autonomic nervous system reflexes, whilst others affect higher mental function – thus these agents are used frequently in the clinical setting, as well as being drugs of abuse (e.g. the amphetamines). Competition for various metabolic and transport processes can lead to dangerous drug interactions, with sympathetic nervous system overactivity being the major consequence leading to morbidity. They are an important group of drugs and a detailed understanding of their pharmacology is vital to the safe practice of anaesthesia and critical care medicine.Respiratory stimulants also have their place in modern medical treatment. Doxapram and the methylxanthines are used clinicall...

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Digestion and absorption

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: Carbohydrates, mostly as starch, are digested by salivary and pancreatic amylases to di-, tri- and oligosaccharides, then to monosaccharides by saccharidases on the wall of the small intestine, following which they are absorbed. Proteins are absorbed as amino acids and small peptides that are broken down further, in the cell, to amino acids. Monosaccharides and amino acids pass to the liver via the portal vein. Fats are digested and absorbed as free fatty acids and glycerides and are then mostly reconstituted to triglycerides in the mucosal cells of the small intestine. They combine with phospholipids and a protein to form chylomicrons, which pass via the lymphatics and the thoracic duct into the general circulation. Fatty acids are released in the tissues and are then either re-...

Gut motility and its control

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: The gastrointestinal tract is composed of smooth muscle arranged in two layers: longitudinal and circular. Although its activity is influenced by the autonomic nervous system, it is mainly under local reflex control mediated by an enteric nervous system and local hormones. The motility of the gastrointestinal tract has several different well-defined patterns. Its function is to move the gastrointestinal contents through the various phases of homogenization (mixing), digestion, absorption and elimination. (Source: Anaesthesia and intensive care medicine)

The mouth, stomach and intestines

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: Food is divided into digestible portions in the mouth and swallowed – a complex reflex process involving several cranial nerves. The stomach homogenizes food, begins digestion and regulates the rate at which food enters the duodenum. Pancreatic juices containing powerful digesting enzymes are added and digestion is completed in the small intestine. The large bowel dehydrates the gastrointestinal contents. (Source: Anaesthesia and intensive care medicine)

Metabolic functions of the liver

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: The liver is one of the most important organs in the body and serves a variety of important functions including metabolic, vascular, immunological, secretory and excretory functions. It plays a key role in the carbohydrate, protein and fat metabolism in the human body. In this article, we outline a brief overview of the metabolic functions. (Source: Anaesthesia and intensive care medicine)

Functional anatomy and blood supply of the liver

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: The liver is the second-largest organ in the human body. Traditionally, the anatomy of the liver has been described on the basis of its external appearance/gross anatomy. However, with the increase in surgical procedures, for example resection and transplant, the need for a more functional description of the liver based on its vascular and biliary architecture evolved. Different models of functional anatomy of the liver have been described in the literature in the past, but Couinaud’s model of functional anatomy of the liver is the most popular. The liver has dual vascular supply, with most of its supply coming from the portal vein and the remainder through the hepatic artery. In this article, we outline the functional anatomy of the liver along with its blood supply. (Source:...

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Anaesthesia and minimally invasive surgery

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

This article will focus on the pathophysiological changes caused by CO2 pneumoperitoneum, the anaesthetic management for patients undergoing laparoscopy, and potential complications. (Source: Anaesthesia and intensive care medicine)

Laboratory tests in hepatic failure

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: Laboratory tests of liver function are among most commonly ordered blood tests. However, interpretation of parameters should be based not only on measuring the metabolic and synthetic function of the liver, but also parameters which reflect liver injury. Clinical and laboratory assessment of liver function help to identify causes of liver failure, monitor clinical deterioration and prognosis, and determine treatment options including liver transplantation. (Source: Anaesthesia and intensive care medicine)

Clinical aspects of hepatic disease

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

Abstract: Liver disease has a high prevalence. Patients with advanced liver disease have poor outcome after surgery. Prognostic scoring systems help to identify those at high risk. Chronic liver disease is associated with typical extra-hepatic manifestations, resulting from failure to clear endogenous vasodilators, splanchnic vasodilation, high cardiac output and decreased central blood volume. Complications include hepatorenal syndrome, hepatopulmonary syndrome and porto-pulmonary hypertension. In fulminant liver failure, cerebral oedema is a prominent feature. Without liver transplantation, prognosis is dismal. Appreciation of the multi-system sequelae of liver disease is a prerequisite to appropriate management. (Source: Anaesthesia and intensive care medicine)

Anaesthesia for gastrointestinal surgery

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

This article will discuss how to recognize these problems and try to minimize their impact on recovery. A growing body of evidence shows that adoption of a package of care known collectively as enhanced recovery significantly reduces postoperative morbidity and reduces length of hospital stay. For anaesthetists the changes involve analgesic regimens and perioperative fluid and nutrition management. This evidence has been brought together in the national Enhanced Recovery After Surgery Programme and has been introduced to many hospitals for elective bowel surgery patients. The principles of the programme will be discussed. Aspects of it can be applied to many other surgical groups. (Source: Anaesthesia and intensive care medicine)

Editorial Board

Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Anaesthesia and intensive care medicine)

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Anaesthesia and intensive care medicine — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Anaesthesia and intensive care medicine)

Bayesian enhanced meta‐analysis of post‐operative analgesic efficacy of additives for caudal analgesia in children

Acta Anaesthesiologica Scandinavica — Wed, 01 Feb 2012 05:00:00 +0100

ConclusionsNeostigmine provides the longest post‐operative analgesia. With clonidine, the duration of analgesia is shorter and sedation is increased, but the probability for PONV could be decreased. (Source: Acta Anaesthesiologica Scandinavica)

Healthcare Costs Associated with Osteoarthritis in US Patients

Pain Practice — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: Newly diagnosed osteoarthritis patients incurred higher annual costs, but lower pain‐related prescription drug costs in the year following diagnosis than patients with existing osteoarthritis. (Source: Pain Practice)

Closed Treatment of Overriding Distal Radial Fractures without Reduction in Children.

The Journal of Bone and Joint Surgery. American volume — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: This treatment protocol presents an alternative approach to overriding distal radial fractures in children and provides the orthopaedic surgeon a simple, effective, and cost and time-efficient method of treatment. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID: 22298057 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Causes of death after hip fracture in senile patients.

Chinese Journal of Traumatology — Wed, 01 Feb 2012 05:00:00 +0100

This article reviews these causes from the aspects of patient's own factors, iatrogenic factors, medical treatment and other factors and provides some clues for further clinical application according to the recent foreign and domestic researches. According to the present research, it is essential for surgeons to perform a comprehensive estimation for patients suffering from hip trauma. PMID: 22300919 [PubMed - in process] (Source: Chinese Journal of Traumatology)

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The Size 1 ProSeal™ laryngeal mask airway in infants: a randomized, noncrossover study with the Classic™ laryngeal mask airway.

Paediatric Anaesthesia — Wed, 01 Feb 2012 05:00:00 +0100

Prevalence of anatomic impediments to interlaminar lumbar epidural steroid injection.

Pain Physician — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSIONS: Anatomic impediments to interlaminar LESI were common in this community-based population, particularly at the L5-S1 spinal level. Because of the high overall prevalence of anatomic impediments, and differences in prevalence by spinal level, knowledge of the distribution and frequency of these impediments may aid in aspects of decision-making for the interventional spine physician. PMID: 22289247 [PubMed - in process] (Source: Pain Physician)

Pain and bleeding are the main determinants of unscheduled contacts after outpatient tonsillectomy.

Pain Physician — Wed, 01 Feb 2012 05:00:00 +0100

CONCLUSION: Outpatient tonsillectomy seems safe in Denmark. A minimum postoperative observation period of four hours will reduce the need for postoperative contacts. Because of the potentially life-threatening risk related to tonsillectomy, careful patient selection is mandatory and continuous monitoring of the quality of the procedure is essential. FUNDING: not relevant. TRIAL REGISTRATION: not relevant. PMID: 22293052 [PubMed - in process] (Source: Pain Physician)

Functions and Outcomes of a Clinical Medical Ethics Committee: A Review of 100 Consults.

Pain Physician — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion: PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined. PMID: 22302457 [PubMed - as supplied by publisher] (Source: Pain Physician)