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Current status of extracorporeal shock wave lithotripsy in urinary lithiasis.

[Current status of extracorporeal shock wave lithotripsy in urinary lithiasis.] Arch Esp Urol. 2017 Mar;70(2):263-287 Authors: Pereira-Arias JG, Gamarra-Quintanilla M, Urdaneta-Salegui LF, Mora-Christian JA, Sánchez-Vazquez A, Astobieta-Odriozola A, Ibarluzea-González G Abstract Over the last decade, urinary lithiasis' prevalence has dramatically increased due to diet and lifestyle changes, growing 10.6% and 7.1% in men and women respectively. Extracorporeal shock wave lithotripsy has lost relevance in current practice due to endoscopic device development and unpredictability of results. Instrument miniaturization is leading to an increase of the percutaneous approach of increasingly smaller stones, while most flexible ureteroscopes durability and digitalization has allowed urologists to address larger stones. So that, decision algorithm is now impossible to define, but what is clear is that ESWL has declined worldwide. Can it disappear as a urinary lithiasis treatment modality? If we don't improve appropriate candidate selection and optimize disintegration efficiency, guidelines are going to replace the more "boring" ESWL by popular and more attractive endoscopes. Shock wave technology has evolved in the last two decades, however lithotripsy fundamental principle has not changed. ESWL has passed the test of time and centers dedicated to stone treatment should have a lithotripter in order to offer an appropriate balance in differen...
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research

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Conclusion Further studies incorporating head-to-toe bedside ultrasound by trained clinicians will need to be validated but are likely to demonstrate the significant advantages of incorporating bedside ultrasound in the practice of anesthesiology and critical care.
Source: Colombian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
Conclusion: Unilateral 3-level TPVB was superior to 2-level TPVB and LA infiltration for anesthetic adequacy for patients undergoing medical thoracoscopy. Moreover, US-guided TPVB was followed by higher FEV1 values and lower pain scores during the next 12 h postthoracoscopy in comparison to local infiltration, so 3-level TPVB is an effective and relatively safe anesthetic technique for adult patients undergoing medical thoracoscopy which may replace local anesthesia.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Conclusion: In conclusion, the ultrasound assessment of local anesthetic spread after a caudal block showed that cranial spread of the block is dependent on the volume injected into the caudal space. Since there was no difference between 1 ml/kg and 1.25 ml/kg, to achieve a dermatomal blockade up to thoracic level, we might have to increase the dose beyond 1.25 ml/kg, keeping the toxic dose in mind.
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
Amer Majeed, Iftikhar Ahmed, Ghadah Jamaan Alkahtani, Nasser Abdullah AltahtamSaudi Journal of Anaesthesia 2017 11(4):479-482 With rapid improvement in healthcare in Saudi Arabia, increasing number of women with surgically corrected kyphoscoliosis are likely to present for cesarean section (CS) or vaginal delivery requiring anesthesia or analgesia. Despite the surgical correction, these patients have poor cardiopulmonary reserves which increase the risks associated with general anesthesia. Whereas altered vertebral anatomy from previous surgery and the presence of metal work in spine make performing of regional anesthesia...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
ConclusionsUltrasound-guided tracheal intubation showed a lower first attempt success rate in patients with cervical spine immobilization compared to fiberscope-guided tracheal intubation but the overall success rates were comparable. Ultrasound can be an alternative technique for guiding tracheal intubation in patients with cervical spine immobilization.Registry numberPACTR201602001476292.
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
  Clarius Mobile Health, a Canadian firm, is a pioneering company specializing in portable solutions for ultrasound diagnostics. Since its debut, it has surprised and impressed us with its tiny portable ultrasounds. Clarius offers the only app-based, wireless ultrasound scanner that can be taken to the point of care even in the most rugged conditions. The multi-purpose Clarius C3 scanner comes with transducer clip-ons, transforming the convex scanner that can image heart, lungs, and deep structures, into a linear or virtual phased array scanner. Although these clip-ons are not meant to replace the dedicated Clar...
Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Cardiology Critical Care Emergency Medicine Exclusive Ob/Gyn Pediatrics Surgery Source Type: blogs
Conclusions: Propofol anesthesia with postoperative ketorolac analgesia demonstrated a favorable impact on immune function by preserving NKCC compared with sevoflurane anesthesia and postoperative fentanyl analgesia in patients undergoing breast cancer surgery. PMID: 28924368 [PubMed - in process]
Source: International Journal of Medical Sciences - Category: Biomedical Science Tags: Int J Med Sci Source Type: research
Conclusions The decision to attempt extubation could be significantly assisted by an integrative, dynamic, and fully bedside ultrasonographic assessment of cardiac, lung, and diaphragm functions.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
We present ultrasound images of a basic perioperative transthoracic echocardiogram examination performed during the resuscitation of a 16- month-old girl who presented for an open hip reduction and experienced an acute decrease in her end-tidal carbon dioxide, heart rate, and blood pressure shortly after standard induction, intubation, and caudal block. The images are a subcostal, four-chamber view of the heart obtained shortly after the initiation of resuscitation. There are copious air bubbles giving a snowstorm appearance to the right ventricle (RV) (panel A). The mitral valve, left atrium (LA), and right atrium (RA) ar...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
We describe an approach to the supraclavicular region through the costoclavicular space.2,3Figure 1 shows a reconstructed image of a catheter placed using this technique with its entry point (blue arrow) and tip position (yellow arrow) marked.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
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