Anesthesia in gastrointestinal endoscopy: peroral endoscopic myotomy.

[Anesthesia in gastrointestinal endoscopy: peroral endoscopic myotomy]. Anaesthesist. 2019 Sep 13;: Authors: Löser B, Werner YB, Löser A, Rösch T, Petzoldt M Abstract Idiopathic achalasia is a motility disorder of the esophagus characterized by a dysfunction of the lower esophageal sphincter, which typically manifests as dysphagia. Peroral endoscopic myotomy (POEM) is an interventional endoscopic procedure for achalasia, which was introduced in 2010. Although results from randomized studies comparing short-term and long-term safety and efficacy are yet to be published, POEM is regarded to be less invasive than the standard treatment of achalasia (laparoscopic Heller myotomy). POEM is the first endoscopic procedure routinely performed with the patient under general anesthesia. During the preoperative assessment particular attention must be paid to the specific fasting intervals and the risk of aspiration during induction of anesthesia. For the purpose of temporary surgical access, the integrity of the esophageal wall is deliberately interrupted to create a long submucosal tunnel. As a result, unwanted fistulas can arise between the esophageal lumen, the mediastinum, the pleura or the intraperitoneal cavity. Endoscopically insufflated CO2 may escape into these surrounding compartments with subsequent systemic CO2 accumulation, capnomediastinum, tension capnoperitoneum or pneumothorax. As a result substantial cardiorespiratory ...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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We report 13 cases (11 males/2 females) of SPM. The average age was 31 ± 0.85 years. The most common precipitating factor was asthma attack. The onset symptoms were mainly chest pain (11 cases). Synchronous pneumothorax was found in 5 cases and it was bilateral in 2 patients. The evolution was marked by the spontaneous resorption. SMP is an underrecognized cause of chest pain in young adults. Chest radiography is usually sufficient for the diagnosis, and further diagnostic procedures are generally not necessary. The prognosis is often favorable.
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Birt-Hogg-Dub é syndrome (BHDS) is an autosomal dominant disease featured by lung cysts, spontaneous pneumothorax, fibrofolliculomas and renal tumors. The causative gene for BHDS is the folliculin (FLCN) gene and ...
Source: Orphanet Journal of Rare Diseases - Category: Internal Medicine Authors: Tags: Research Source Type: research
ConclusionAlthough rare in younger patients, catamenial pneumothorax should be considered as a cause for recurrent pnueumothoraces in any post-pubertal female.
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
ConclusionsExtra-pelvic endometriosis, traditionally thought to be rare, have been reported in a considerable number of cases. Heightened awareness and clinical suspicion of the disease, and multi-disciplinary approach is recommended to achieve prompt diagnosis and optimize patient outcomes. At this time, there are no comparative studies to provide recommendations regarding optimal diagnostic methods, treatment options and outcomes for endometriosis involving extra-pelvic sites.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
AbstractTuberous sclerosis complex lymphangioleiomyomatosis (TSC-LAM) is a rare disease, which may develop an intractable pneumothorax. Chemical or mechanical pleurodesis is a general management to prevent recurrence of pneumothorax, rendering it difficult to later dissect the pleura and control intraoperative bleeding. Since total pleural coverage (TPC) alternative to pleurodesis has been firstly reported by Kurihara et al. (Jpn J Thorac Cardiovasc Surg 54:274,2006), TPC was performed in case of a 46-year-old female with a secondary spontaneous pneumothorax caused by TSC-LAM and followed by lung transplantation. Final pat...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
For neonates and children requiring decompression of tension pneumothorax, specific recommendations for the choice of needle type and size are missing. The aim of this retrospective study was to determine opti...
Source: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine - Category: Emergency Medicine Authors: Tags: Original research Source Type: research
In patients with alveolar-to-pleural air leak due to recent surgery or trauma, clinicians tend to manage chest tubes with suction therapy. Non-suction therapy is associated with shorter chest tube duration but also a higher risk of pneumothorax. We sought to develop an intrapleural electrical impedance sensor for continuous, real-time monitoring of pneumothorax development in a porcine model of air leak as a means of promoting non-suction therapy. Using thoracoscopy, two chest tubes and the pleural impedance sensor were introduced into the pleural space of three pigs.
Source: Seminars in Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: THORACIC – Original Submission Source Type: research
While in the last years, sci-fi stories, experts and even some opinion-leader public figures frequently spelled the end of mankind through artificial intelligence, lately, it turned out just how easy it is to play tricks on smart algorithms and fool them into making errors. We looked around how researchers can hack A.I. and what that means for medicine and healthcare, mainly from a security perspective. Does A.I. have an Achilles heel? As the saying goes, a chain is as strong as its weakest link – and the ancient Greeks knew it. No matter that Achilles had extraordinary strength, courage, and loyalty, that he f...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Artificial Intelligence Future of Medicine Security & Privacy adversarial adversarial example AI autonomous data security digital digital health hack Healthcare self-driving technology Source Type: blogs
Title: Collapsed Lung (Pneumothorax)Category: Diseases and ConditionsCreated: 12/31/1997 12:00:00 AMLast Editorial Review: 10/10/2019 12:00:00 AM
Source: MedicineNet Lungs General - Category: Respiratory Medicine Source Type: news
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