Sosasnider2165

ACWD using laryngeal ultrasound and CLT showed high sensitivity (91.7% and 92.6%, respectively), specificity (91.7% and 90.4%, respectively) and negative predictive value (99.43% and 99.42%, respectively) with low positive predictive value (44% and 37.93%, respectively) for both the diagnostic tests.

Application of laryngeal ultrasound in combination with CLT can help the anaesthesiologist in decision making with the extubation plan after thyroid surgeries.

Application of laryngeal ultrasound in combination with CLT can help the anaesthesiologist in decision making with the extubation plan after thyroid surgeries.

Monitorisation under anaesthesia is important for objective evaluation in intracranial surgery. We investigated general anaesthesia management performed by bispectral index (BIS) monitoring in patients who underwent surgery due to intracranial pathology with different Glasgow Coma Scales (GCS).

Forty-five patients who had been planned to undergo intracranial surgery under general anaesthesia were included in the study. Patients were divided into three groups according to GCS Group I (n ¼ 15) ¼ 13-15 mildly injured; Group II (n ¼ 15) ¼ 9-12 moderately damaged; Group III (n ¼ 15) ¼ 3-8 severely damaged. Heart rate (HR), mean blood pressure, and use of anaesthetic agent were recorded.

It was found that the consumption of the inhalation agent in Group III was lower than Groups I and II at all time intervals measured, and it was lower in Group II than Group I during the intervals at intraoperative 15th minute and up to 150th minute thereafter. The inhalation agent consumption rates according to the duration of anaesthesia were different between groups. The HR was significantly higher in Group III compared with Group II during the post-operative period. The mean arterial pressure was significantly lower in Group I than Group II preoperatively and at 5th, 10th, 15th, 20th, and 40th minute intra-operatively, whilst it was significantly lower in Group I than Group III preoperatively and 10th minute and 15th minute, intraoperatively.

We found that in patients whose GCS was severely damaged and underwent intracranial surgery under general anaesthesia with BIS monitoring, the consumption of inhalation anaesthetic agent decreased, but opioid consumption did not change.

We found that in patients whose GCS was severely damaged and underwent intracranial surgery under general anaesthesia with BIS monitoring, the consumption of inhalation anaesthetic agent decreased, but opioid consumption did not change.

The Internet may facilitate active participation of the patient in specifying the priorities of disease management and improve rehearsal for awaiting interventions. In this study, we sought to assess the relationship of Internet use with the anaesthesia-related variables.

A 15-question survey was formed involving questions about demographics, Internet use habits and awareness of the planned interventions. A previous online search for anaesthesia and topics of search were specifically asked. Searching for anaesthesia on the Internet was determined as the primary end-point.

One-hundred and fifty-seven patients (41.1 6 14.4 years, 63.1% female) responded to our survey. The ratio of the participants who had previous experience of anaesthesia was 62.4%. Seventy-nine percent of the subjects had an Internet access frequency of couple of times a week or more often. However, only 39.5% (n ¼ 49) of those specifically searched about anaesthesia on the Internet. Individuals who searched for anaesthesia on the Inter surgeons' ideas about anaesthesia procedure.

Amino acids attenuate hypothermia during the perioperative period by increasing thermogenesis and stimulating energy consumption. Percutaneous nephrolithotomy (PCNL) induces profound hypothermia owing to the use of large volumes of irrigating fluids. The role of amino acids in this group of surgeries for hypothermia and shivering prevention has been evaluated in this study because there is no available literature of concern.

This prospective randomised controlled trial was conducted in patients undergoing PCNL. Group A received amino acids at 60 mL h-1 an hour before surgery until the end of surgery. Group C received normal saline infusion. Perioperative nasopharyngeal temperature, haemodynamics, and postoperative shivering were recorded.

Although there was no significant difference in temperature in the intraoperative period, postoperative decrease in the temperature was less in the amino acid group. In the postoperative period, 2 patients in the amino acid group and 11 patients in the control group experienced shivering.

Intravenous administration of amino acids attenuated postoperative hypothermia and reduced shivering in patients undergoing PCNL without any adverse effects.

Intravenous administration of amino acids attenuated postoperative hypothermia and reduced shivering in patients undergoing PCNL without any adverse effects.

Video-assisted thoracoscopic surgery (VATS) techniques are commonly used for surgical procedures within the thoracic cavity with smaller incisions. There are very few regional anesthesia methods used to achieve this goal. This study aimed to investigate the effect of two fascial plane block technique rhomboid intercostal block (RIB) and serratus anterior plane block (SAPB) administered on pain scores after VATS.

A total of 90 patients who underwent VATS were included in this study. Patients were divided in three groups Group R (intravenous patient-controlled analgesia (IV. PCA) +RİB with (25 mL 0.25% bupivacaine; n=30), Group S (IV. PCA + SAPB with (25 mL 0.25% bupivacaine; n=30), and Group C (IV. PCA). The primary outcome was determined as a tramadol consumption amount (at hours 6, 12, and 24). Postoperative pain was evaluated using the VAS (at the 30th minute, 2nd, 6th, 12th, and 24th hours) scores. Secondary outcomes included the side effect profile and additional analgesic use.

VAS scores of the Group R were found to be statistically significantly lower to those of Group S and Group C (p<0.05). A comparison of Groups R and S with Group C in terms of tramadol consumption amounts, at all measurement time points, revealed statistically significantly lower values (p<0.005).

As per the results of this study, we believe that RİB and SAPB administration for pain palliation after VATS is an effective analgesia technique.

As per the results of this study, we believe that RİB and SAPB administration for pain palliation after VATS is an effective analgesia technique.In the new century, our diagnostic armamentarium has been significantly reinforced by the 'three-dimensional' volumetric haemodynamic monitoring currently available at the bedside in many perioperative and intensive care settings. The volumetric approach has improved our insight into the haemodynamic scenarios of many critical illnesses and surgical interventions, including sepsis, circulatory shock, acute respiratory distress syndrome as well as cardiothoracic and transplantation surgery. However, the influence of volumetric haemodynamic monitoring on clinical outcome is still a subject for debates. This review presents physiological background, technical details, aspects of bedside use, limitations and further perspectives of the volumetric approach to the cardiopulmonary monitoring.Scientific research has been changing medical practice at an increasing pace. To keep up with this change, physicians of the future will need to be lifelong learners with the skills to engage with emerging science and translate it into clinical care. How medical schools can best prepare students for ongoing scientific change remains unclear. Adding to the challenge is reduced time allocated to basic science in curricula and rapid expansion of relevant scientific fields. A return to science with greater depth after clinical clerkships has been suggested, although few schools have adopted such curricula and implementation can present challenges. The authors describe an innovation at Harvard Medical School, the Advanced Integrated Science Courses (AISCs), which are taken after core clerkships. Students are required to take 2 such courses, which are offered in a variety of topics. Rather than factual content, the learning objectives are a set of generalizable skills to enable students to critically evaluate emerging research and its relationship to medical practice. Making these generalizable skills the defining principle of the courses has several important advantages it allows standardization of acquired skills to be combined with diverse course topics ranging from basic to translational and population sciences; students can choose courses and projects aligned with their interests, thereby enhancing engagement, curiosity, and career relevance; schools can tailor course offerings to the interests of local faculty; and the generalizable skills delineate a unique purpose of these courses within the overall medical school curriculum. For the 3 years AISCs have been offered, students rated the courses highly and reported learning the intended skill set effectively. The AISC concept addresses the challenge of preparing students for this era of rapidly expanding science and should be readily adaptable to other medical schools.

A 79-year-old man 6 days status-post left total knee arthroplasty (TKA) presented to our institution from an outside hospital (OSH) after a suspected STEMI and ventricular fibrillation arrest. At the OSH, intraosseous (IO) access was placed in his right tibia. Orthopaedics was consulted for compartment syndrome at the IO access site. X-rays demonstrated this was secondary to the IO access abutting the cement mantle of a stemmed tibial component of a remote TKA, for which the patient required emergent fasciotomies.

Healthcare providers should be cognizant of potential orthopaedic hardware that can impede proper introduction of IO access.

Healthcare providers should be cognizant of potential orthopaedic hardware that can impede proper introduction of IO access.

A 51-year-old lady with multiple comorbidities presented with T11 spondylolysis in association with thoracic stenosis and myelopathy. Our patient underwent T11-T12 laminectomy, T10-L1 posterior instrumented stabilization, and T11-T12 transforaminal interbody fusion. She had a good neurological recovery, and the radiographs at 1-year follow-up showed good fusion and implant position.

Spondylolysis is an anatomical defect or stress fracture of the pars interarticularis and usually reported in the lumbar region. This case of T11 spondylolysis in association with thoracic stenosis, spinal instability, and myelopathy is highlighted for its rarity and to reiterate the need for high index of suspicion among surgeons for the timely diagnosis.

Spondylolysis is an anatomical defect or stress fracture of the pars interarticularis and usually reported in the lumbar region. This case of T11 spondylolysis in association with thoracic stenosis, spinal instability, and myelopathy is highlighted for its rarity and to reiterate the need for high index of suspicion among surgeons for the timely diagnosis.

Pathological complete response (pCR) of axillary lymph nodes (ALNs) is frequently achieved in patients with clinically node-positive breast cancer after neoadjuvant chemotherapy (NAC), and ALN status is an important prognostic factor for breast cancer patients. see more This study aims to develop a new predictive clinical model to assess the ALN pCR rate after NAC.

This was a retrospective series of 467 patients who had biopsy-proven positive ALNs at diagnosis and underwent ALN dissection from 2007 to 2014 at the National Cancer Center/Cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the clinicopathologic features of the patients and developed a nomogram to predict the probability of ALN pCR. A multivariable logistic regression stepwise model was used to construct a nomogram to predict ALN pCR in node-positive patients. The adjusted area under the receiver operating characteristic curve (AUC) was calculated to quantify the ability to rank patients by risk. Internal validation was performed using the 50/50 hold-out validation method.