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[PMID]: 29524827
[Au] Autor:Paul M; Kannaujia A; Chatterjee A; Mayilvaganan S
[Ad] Address:Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Department of Anesthesia, A Block, PIN-226014, India.
[Ti] Title:Serial fiber optic bronchoscopy (FOB) to predict the need of tracheostomy in tracheomalacia after thyroidectomy in long standing goiter.
[So] Source:J Clin Anesth;47:9-10, 2018 Mar 07.
[Is] ISSN:1873-4529
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:LETTER
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29524770
[Au] Autor:Bakonyi M; Gácsi A; Kovács A; Szucs MB; Berkó S; Csányi E
[Ad] Address:Institute of Pharmaceutical Technology and Regulatory Affairs, University of Szeged, Szeged, H-6720, Hungary.
[Ti] Title:Following-up skin penetration of lidocaine from different vehicles by Raman spectroscopic mapping.
[So] Source:J Pharm Biomed Anal;154:1-6, 2018 Mar 06.
[Is] ISSN:1873-264X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:The application of local anesthetics, usually administered by subcutaneous injection, is common in the course of diagnostic, therapeutic, and cosmetic dermatology procedures. The effective dermal delivery of lidocaine could offer a solution to many adverse effects caused by needle insertion, such as pain, local reactions or toxicity, and additionally, it avoids the disruption of anatomical landmarks. Therefore, novel dermal formulations of local anesthetics are needed to overcome the barrier function of the skin and provide sufficient and prolonged anesthesia. In our study, we aimed to investigate and compare the penetration profiles of four different lidocaine containing formulations (hydrogel, oleogel, lyotropic liquid crystal and nanostructured lipid carrier) by Raman microscopic mapping of the drug. The application of Raman spectroscopy provided information about the spatial distribution of lidocaine in the skin ex vivo. The penetration of lidocaine from lyotropic liquid crystal and nanostructured carrier reached deeper skin layers and a higher amount of the drug was diffused into the skin, compared with hydrogel and oleogel. This study confirmed that nanostructured carriers can improve skin penetration properties of lidocaine and proved the applicability of Raman spectroscopy in the research of dermatological preparations ex vivo as a nondestructive, relatively easy and fast technique.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  3 / 257478 MEDLINE  
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[PMID]: 29524643
[Au] Autor:Onishi O; Ikoma K; Oda R; Yamazaki T; Fujiwara H; Yamada S; Tanaka M; Kubo T
[Ad] Address:Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 602-8566 465, Kajiicho, Kamigyo-ku Kyoto-shi, Kyoto, Japan. Electronic address: pni_oki@yahoo.co.jp.
[Ti] Title:Sequential Variation in Brain Functional Magnetic Resonance Imaging After Peripheral Nerve Injury: A Rat Study.
[So] Source:Neurosci Lett;, 2018 Mar 07.
[Is] ISSN:1872-7972
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:Although treatment protocols are available, patients experience both acute neuropathic pain and chronic neuropathic pain, hyperalgesia, and allodynia after peripheral nerve injury. The purpose of this study was to identify the brain regions activated after peripheral nerve injury using functional magnetic resonance imaging (fMRI) sequentially and assess the relevance of the imaging results using histological findings. To model peripheral nerve injury in male Sprague-Dawley rats, the right sciatic nerve was crushed using an aneurysm clip, under general anesthesia. We used a 7.04T MRI system. T weighted image, coronal slice, repetition time, 7 ms; echo time, 3.3 ms; field of view, 30 mm × 30 mm; pixel matrix, 64 × 64 by zero-filling; slice thickness, 2 mm; numbers of slices, 9; numbers of average, 2; and flip angle, 8 degrees. fMR images were acquired during electrical stimulation to the rat's foot sole; after 90 min, c-Fos immunohistochemical staining of the brain was performed in rats with induced peripheral nerve injury for 3, 6, and 9 weeks. Data were pre-processed by realignment in the Statistical Parametric Mapping 8 software. A General Linear Model first level analysis was used to obtain T-values. One week after the injury, significant changes were detected in the cingulate cortex, insular cortex, amygdala, and basal ganglia; at 6 weeks, the brain regions with significant changes in signal density were contracted; at 9 weeks, the amygdala and hippocampus showed activation. Histological findings of the rat brain supported the fMRI findings. We detected sequential activation in the rat brain using fMRI after sciatic nerve injury. Many brain regions were activated during the acute stage of peripheral nerve injury. Conversely, during the chronic stage, activation of the amygdala and hippocampus may be related to chronic-stage hyperalgesia, allodynia, and chronic neuropathic pain.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29520391
[Au] Autor:Lee K; Chung JM; Lee SD
[Ad] Address:Department of Urology, Pusan National University School of Medicine, Yangsan, Korea.
[Ti] Title:The safety of a mixture of bupivacaine and lidocaine in children after urologic inguinal and scrotal surgery.
[So] Source:Investig Clin Urol;59(2):141-147, 2018 Mar.
[Is] ISSN:2466-054X
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Purpose: Local anesthetic agents such as bupivacaine and lidocaine are commonly used after surgery for pain control. The aim of this prospective study was to evaluate the safety of a mixture of bupivacaine and lidocaine in children who underwent urologic inguinal and scrotal surgery. Materials and Methods: Fifty-five patients who underwent pediatric urologic outpatient surgeries, were prospectively enrolled in this study. The patients were divided into three groups according to age (group I: under 2 years, group II: between 3-4 years, and group III: 5 years and above). Patients were further sub-divided into unilateral and bilateral groups. All patients were injected with a mixture of 0.5% bupivacaine and 2% lidocaine (2:1 volume ratio) at the surgical site, just before the surgery ended. Hemodynamic and electrocardiographic parameters were measured before local anesthesia, 30 minutes after administration of local anesthesia, and 60 minutes after administration. Results: The patients' mean age was 40.5±39.9 months. All patients had normal hemodynamic and electrocardiographic parameters before local anesthesia, after 30 minutes, and after 60 minutes. Also, results of all intervals were within normal values, when analyzed by age and laterality. No mixture related adverse events (nausea, vomiting, pruritus, sedation, respiratory depression) or those related to electrocardiographic parameters (arrhythmias and asystole) were reported in any patients. Conclusions: A mixture of bupivacaine and lidocaine can be safely used in children undergoing urologic inguinal and scrotal surgery. An appropriate dose has no clinically significant hemodynamic or cardiac changes and adverse effects.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.4111/icu.2018.59.2.141

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[PMID]: 29520388
[Au] Autor:Chong JT; Kan KM; Phillips CK; Greenstein A
[Ad] Address:Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
[Ti] Title:Ureteral catheters for colorectal surgery: Influence on operative times and complication outcomes: An observational study.
[So] Source:Investig Clin Urol;59(2):119-125, 2018 Mar.
[Is] ISSN:2466-054X
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:Purpose: Placement of pre-operative ureteral catheters for colorectal surgery can aid in the identification of ureteral injuries. This study investigates whether simultaneous ureteral catheterization with surgery skin preparation can minimize operating room times without increasing post-operative complications. Materials and Methods: Patients undergoing simultaneous colorectal surgery skin preparation and placement of pre-operative ureteral catheters (n=21) were compared to those who underwent these events sequentially (n=28). Operative time-points of anesthesia ready (AR), surgery procedure start (PS), dorsal lithotomy and catheter insertion (CI) times were compared to assess for differences between groups. Complications were compared between groups. Results: There were no differences in age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA), comorbidities, current procedure terminology (CPT) or International Classification of Diseases, 9th revision (ICD-9) codes between groups. Simultaneous catheterization saved 11.82 minutes of operative time between CI to PS (p=0.005, t-test). There was a significant difference in mean time between CI to PS (11.82 minutes, p=0.008) between simultaneous and sequential ureteral catheterization groups in a linear regression multivariate analysis controlling for age, BMI, CPT and ICD-9 codes. There were 4 complications in the simultaneous (19%) and 3 in the sequential group (11%) (p=0.68). Conclusions: Ureteral catheterization and colorectal surgery skin preparation in a simultaneous fashion decreases the time between CI and PS without significant increase in complications. Mean time saved with simultaneous ureteral catheterization was 11.82 minutes per case. Simultaneous ureteral catheterization may be an option in colorectal surgery and may result in cost savings without additional complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Data-Review
[do] DOI:10.4111/icu.2018.59.2.119

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[PMID]: 29515726
[Au] Autor:Kahloul M; Nakhli MS; Chouchene A; Chebbi N; Mhamdi S; Naija W
[Ad] Address:Department of Anesthesia and Intensive Care, Sahloul Teaching Hospital; Faculty of Medicine "Ibn El Jazzar", Sousse, Tunisia.
[Ti] Title:Comparison of two doses of hypobaric bupivacaine in unilateral spinal anesthesia for hip fracture surgery: 5 mg versus 7.5 mg.
[So] Source:Pan Afr Med J;28:108, 2017.
[Is] ISSN:1937-8688
[Cp] Country of publication:Uganda
[La] Language:eng
[Ab] Abstract:Introduction: Hip fracture is a frequent and severe disease. Its prognosis depends on the perioperative hemodynamic stability which can be preserved by the unilateral spinal anesthesia especially with low doses of local anesthetics. This study aims to compare the efficacy and hemodynamic stability of two doses of hypobaric bupivacaine (7.5 mg vs 5 mg) in unilateral spinal anesthesia. Methods: In this prospective, randomized, double-blind study, 108 patients scheduled for hip fracture surgery under unilateral spinal anesthesia were enrolled to receive either 5 mg (group 1) or 7.5 mg (group 2) of hypobaric bupivacaine. Spinal anesthesia was performed in lateral position. Patients' socio-demographic characteristics, hemodynamic profile, sensory and motor blocks parameters were recorded. Results: Both groups were comparable regarding to demographic data. Two cases of failure occurred in group 1 and one case in group 2 corresponding to a comparable efficiency rates (96.29% and 98.14% respectively; = 0.5). A higher mean onset and lower mean regression times of sensory block were significantly noted in group 1 (7.79±3.76 min vs 5.75±2.35 min, p < 0.001 and 91.29±31.55 min vs 112.77±18.77 min, p <0.001 respectively). Incidence of bilateralization (29.62% vs 87.03%, p < 0.001), incidence of hypotensive episodes (59.25% vs 92.59%, p < 0.001) and vascular loading (1481.48±411.65 ml vs 2111.11±596.10 ml, p < 0.001) were significantly higher in group 2. Conclusion: The dosage of 5mg of hypobaric bupivacaine in unilateral spinal anesthesia is as effective as the dosage of 7.5 mg with lower bilateralization incidence and better hemodynamic stability.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.11604/pamj.2017.28.108.11421

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[PMID]: 29506576
[Au] Autor:Söbbeler FJ; Carrera I; Pasloske K; Ranasinghe MG; Kircher P; Kästner SBR
[Ad] Address:Small Animal Clinic (Söbbeler, Kästner), University of Veterinary Medicine Hanover Foundation, Bünteweg 9, 30559, Hannover, Germany. franz.josef.soebbeler@tiho-hannover.de.
[Ti] Title:Effects of isoflurane, sevoflurane, propofol and alfaxalone on brain metabolism in dogs assessed by proton magnetic resonance spectroscopy ( H MRS).
[So] Source:BMC Vet Res;14(1):69, 2018 Mar 05.
[Is] ISSN:1746-6148
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The purpose of this study was to determine the effects of isoflurane, sevoflurane, propofol and alfaxalone on the canine brain metabolite bioprofile, measured with single voxel short echo time proton magnetic resonance spectroscopy at 3 Tesla. Ten adult healthy Beagle dogs were assigned to receive isoflurane, sevoflurane, propofol and alfaxalone at 3 different dose rates each in a randomized cross-over study design. Doses for isoflurane, sevoflurane, propofol and alfaxalone were F 'Iso 1.7 vol%, 2.1 vol%, 2.8 vol%, F 'Sevo 2.8 vol%, 3.5 vol% and 4.7 vol%, 30, 45 and 60 mg kg h and 10, 15 and 20 mg kg h respectively. A single voxel Point Resolved Spectroscopy Sequence was performed on a 3 T MRI scanner in three brain regions (basal ganglia, parietal and occipital lobes). Spectral data were analyzed with LCModel. Concentration of total N-acetylaspartate (tNAA), choline, creatine, inositol and glutamine and glutamate complex (Glx) relative to water content was obtained. Plasma concentration of lactate, glucose, triglycerides, propofol and alfaxalone were determined. Statistics were performed using repeated measures ANOVA or Wilcoxon Sign Rank test with alpha = 5%. RESULTS: Plasma glucose increased with isoflurane, sevoflurane and alfaxalone but decreased with propofol. Plasma lactate increased with all anesthetics (isoflurane > sevoflurane > propofol > alfaxalone). Cerebral lactate could not be detected. Only minor changes in cerebral metabolite concentrations of tNAA, choline, inositol, creatine and Glx occurred with anesthetic dose changes. CONCLUSION: The metabolomic profile detected with proton magnetic resonance spectroscopy at 3 Tesla of canine brain showed only minor differences between doses and anesthetics related to tNAA, choline, creatine, inositol and Glx.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[St] Status:In-Process
[do] DOI:10.1186/s12917-018-1396-1

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[PMID]: 29471158
[Au] Autor:Zafar SN; Canner JK; Nagarajan N; Kushner AL; SOSAS4 Research Group
[Ad] Address:Department of Surgery, Howard University Hospital, Washington DC, USA. Electronic address: snabeelzafar@som.umaryland.edu.
[Ti] Title:Road traffic injuries: Cross-sectional cluster randomized countrywide population data from 4 low-income countries.
[So] Source:Int J Surg;52:237-242, 2018 Feb 20.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income countries using nationally representative survey data. METHODS: The Surgeons Overseas Assessment of Surgical Needs (SOSAS) survey tool was administered in four countries: Sierra Leone, Rwanda, Nepal and Uganda. We performed nationally representative cross-sectional, cluster randomized surveys in each country. Information regarding demographics, injury characteristics, anatomic location of injury, healthcare seeking behavior, and disability from injury was collected. Data were reported with descriptive statistics and evaluated for differences between the four countries using statistical tests where appropriate. RESULTS: A total of 13,765 respondents from 7115 households in the four countries were surveyed. RTIs occurred in 2.2% (2.0-2.5%) of the population and accounted for 12.9% (11.5-14.2%) of all injuries incurred. The mean age was 34 years (standard deviation ±1years); 74% were male. Motorcycle crashes accounted for 44.7% of all RTIs. The body regions most affected included head/face/neck (36.5%) followed by extremity fractures (32.2%). Healthcare was sought by 78% road injured; 14.8% underwent a major procedure (requiring anesthesia). Major disability resulting in limitations of work or daily activity occurred in 38.5% (33.0-43.9%). CONCLUSION: RTIs account for a significant proportion of disability from injury. Younger men are most affected, raising concerns for potential detrimental consequences to local economies. Prevention initiatives are urgently needed to stem this growing burden of disease; additionally, improved access to timely emergency, trauma and surgical care may help alleviate the burden due to RTI in LMICs.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29462739
[Au] Autor:Wang Y; Liu Z; Chen S; Ye X; Xie W; Hu C; Iezzi T; Jackson T
[Ad] Address:Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China.
[Ti] Title:Pre-surgery beliefs about pain and surgery as predictors of acute and chronic post-surgical pain: A prospective cohort study.
[So] Source:Int J Surg;52:50-55, 2018 Feb 17.
[Is] ISSN:1743-9159
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Chronic pain post-surgical pain (CPSP) is common and has far-reaching negative consequences for patients, yet relatively few studies have evaluated the impact of both deficit- and resource-based beliefs about pain and surgery on subjective intensities of acute and chronic post-surgical pain. To address this issue a prospective cohort study was performed. METHOD: 259 consecutive surgery patients from general surgery, gynecology, and thoracic departments completed a self-report battery of demographics, pain experiences, and psychological factors 24 h before surgery (T1) and provided follow-up pain intensity ratings 48 h-72 h after surgery (T2), and at a 4-month follow-up (T3). RESULTS: In the hierarchical regression model for acute post-operative pain intensity, pre-surgery pain self-efficacy beliefs made a significant unique contribution independent of all other pre-surgery and surgery-related factors (i.e., age, presence of pre-surgical pain, type of anesthesia, surgery duration). In the prediction model for intensity of chronic post-surgical pain, beliefs about long-term effects of surgery had a unique impact after controlling other significant pre-surgery and surgery influences (gender, education, surgery time). CONCLUSION: Results underscored the potential utility of considering specific pre-surgery pain- and surgery-related beliefs as factors that predict patient experiences of acute and chronic post-operative pain.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

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[PMID]: 29318277
[Au] Autor:Jones PM; Cherry RA; Allen BN; Jenkyn KMB; Shariff SZ; Flier S; Vogt KN; Wijeysundera DN
[Ad] Address:Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, Ontario, Canada.
[Ti] Title:Association Between Handover of Anesthesia Care and Adverse Postoperative Outcomes Among Patients Undergoing Major Surgery.
[So] Source:JAMA;319(2):143-153, 2018 01 09.
[Is] ISSN:1538-3598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Handing over the care of a patient from one anesthesiologist to another occurs during some surgeries and might increase the risk of adverse outcomes. Objective: To assess whether complete handover of intraoperative anesthesia care is associated with higher likelihood of mortality or major complications compared with no handover of care. Design, Setting, and Participants: A retrospective population-based cohort study (April 1, 2009-March 31, 2015 set in the Canadian province of Ontario) of adult patients aged 18 years and older undergoing major surgeries expected to last at least 2 hours and requiring a hospital stay of at least 1 night. Exposure: Complete intraoperative handover of anesthesia care from one physician anesthesiologist to another compared with no handover of anesthesia care. Main Outcomes and Measures: The primary outcome was a composite of all-cause death, hospital readmission, or major postoperative complications, all within 30 postoperative days. Secondary outcomes were the individual components of the primary outcome. Inverse probability of exposure weighting based on the propensity score was used to estimate adjusted exposure effects. Results: Of the 313 066 patients in the cohort, 56% were women; the mean (SD) age was 60 (16) years; 49% of surgeries were performed in academic centers; 72% of surgeries were elective; and the median duration of surgery was 182 minutes (interquartile [IQR] range, 124-255). A total of 5941 (1.9%) patients underwent surgery with complete handover of anesthesia care. The percentage of patients undergoing surgery with a handover of anesthesiology care progressively increased each year of the study, reaching 2.9% in 2015. In the unweighted sample, the primary outcome occurred in 44% of the complete handover group compared with 29% of the no handover group. After adjustment, complete handovers were statistically significantly associated with an increased risk of the primary outcome (adjusted risk difference [aRD], 6.8% [95% CI, 4.5% to 9.1%]; P < .001), all-cause death (aRD, 1.2% [95% CI, 0.5% to 2%]; P = .002), and major complications (aRD, 5.8% [95% CI, 3.6% to 7.9%]; P < .001), but not with hospital readmission within 30 days of surgery (aRD, 1.2% [95% CI, -0.3% to 2.7%]; P = .11). Conclusions and Relevance: Among adults undergoing major surgery, complete handover of intraoperative anesthesia care compared with no handover was associated with a higher risk of adverse postoperative outcomes. These findings may support limiting complete anesthesia handovers.
[Mh] MeSH terms primary: Anesthesiology/organization & administration
Intraoperative Care/adverse effects
Patient Handoff
Postoperative Complications/etiology
[Mh] MeSH terms secundary: Adult
Aged
Female
Humans
Male
Middle Aged
Patient Readmission/statistics & numerical data
Retrospective Studies
Surgical Procedures, Operative/mortality
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1801
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180111
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20040


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