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Anesthetic considerations in hyperparathyroid crisis: A case report
Introduction: Hyperparathyroid crisis is a rare and potentially life-threatening complication of severe calcium intoxication. Parathyroidectomy is the only curative method for hyperparathyroid crisis. Several case reports and case series have been published on the medical and surgical treatments for hyperparathyroid crisis, however, few reports have focused on the associated perioperative anesthetic management. Patient concerns: A 48-year-old Chinese woman presented with a 2-week history of nausea and vomiting and complained of mental status alteration including confusion and agitation in the 24 hours prior to...
Source: Medicine - January 8, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Adipose tissue derived stromal vascular fraction as an adjuvant therapy in stroke rehabilitation: Case reports
Introduction: Stroke often causes residual hemiparesis, and upper extremity motor impairment is usually more disabling than lower extremity in those who are suffering from post-stroke hemiparesis. Cell therapy is one of the promising therapies to reduce post-stroke disability. Patient concerns: Three male participants were included in the study to investigate the feasibility and tolerability of autologous adipose tissue derived stromal vascular fraction. Diagnosis: All participants had hemiparesis after 1st-ever stroke longer than 6 months previously. Interventions: Under general anesthesia, liposuction of abdom...
Source: Medicine - August 21, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Role of injection laryngoplasty in preventing post-stroke aspiration pneumonia, case series report
Conclusion: Injection laryngoplasty proved to be both successful and safe in improving glottic closure with immediate results in those who had failed to show a positive response after long-term swallowing rehabilitation. The positive and dramatic clinical outcomes were observed through changes in the coughing force. Our case series support the use of injection larygnoplasty as a powerful adjunctive treatment method to prevent aspiration pneumonia in post-stroke patients with vocal fold insufficiency. Pre- and post-injection peak cough flow changes may reflect improvement in glottic closure and indicate the safety of swal...
Source: Medicine - February 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Comparison of the effect of propofol and desflurane on S-100β and GFAP levels during controlled hypotension for functional endoscopic sinus surgery: A randomized controlled trial
Conclusion: On comparing the effects of propofol and desflurane anesthesia for controlled hypotension on the levels of S-100β and GFAP, we noted that there was no significant difference in S-100β and GFAP levels between the 2 study groups. Clinical trial registration: Available at: http://cris.nih.go.kr, KCT0002698.
Source: Medicine - November 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

The safety and efficacy of dexmedetomidine versus propofol for patients undergoing endovascular therapy for acute stroke: A prospective randomized control trial
Background: It is uncertain if dexmedetomidine has more favorable pharmacokinetic profile than the traditional sedative drug propofol in patients who undergo endovascular therapy for acute stroke. We conducted a prospective randomized control trial to compare the safety and efficacy of dexmedetomidine with propofol for patients undergoing endovascular therapy for acute stroke. Methods: A total of 80 patients who met study inclusion criteria were received either propofol (n = 45) or dexmedetomidine (n = 35) between January 2016 and August 2018. We recorded the favorable neurologic outcome (modified Rankin score...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

The predictability of dynamic preload indices depends on the volume of fluid challenge: A prospective observational study in the operating theater
This study was designed to assess the association between volume of fluid challenge (FC) and predictability of respiratory variation of stroke volume (ΔrespSV) in the operating theater. Patients undergoing intermediate/high-risk surgery and monitored by esophageal Doppler monitoring (EDM) were prospectively included. All patients were under general anesthesia and mechanically ventilated. Exclusion criteria were frequent ectopic beats or preoperative arrhythmia, right ventricular failure, and spontaneous breathing. Hemodynamic parameters and esophageal Doppler indices (SV, cardiac output, ΔrespSV) were collected before, ...
Source: Medicine - October 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The plethysmographic variability index does not predict fluid responsiveness estimated by esophageal Doppler during kidney transplantation: A controlled study
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation. To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard. Observational study. University hospital; study from May 2011 and May 2012. Forty-eight patients with end-renal function were included and 44 analyzed. Patients with cardiac failure were not eligible. Fluid challen...
Source: Medicine - May 1, 2018 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Bilateral visual loss and cerebral infarction after spleen embolization in a trauma patient with idiopathic thrombocytopenic purpura: A case report
We report a case of acute ischemic stroke following orthopedic surgery in a patient with post-SAE reactive thrombocytosis. Patient concerns: A 37-year-old woman with idiopathic thrombocytopenic purpura (ITP) suffered from multiple trauma scheduled for open reduction and internal fixation for right tibial and left radius fracture five days after SAE. The patient did not have any thromboembolic complications, although the platelet counts increased from 43 × 109/L to 568 × 109/L within two days after SAE. Surgery was completed under general anesthesia with tracheal intubation without complications. The patient co...
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Anesthetic management of off-pump simultaneous coronary artery bypass grafting and lobectomy: Case report and literature review
Rationale: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. Patient concerns: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine. Diagnoses: All five patients were di...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Comparison of hemodynamic effects of sevoflurane and ketamine as basal anesthesia by a new and direct monitoring during induction in children with ventricular septal defect: A prospective, randomized research
Background: Sevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction. Methods: Forty-four children with ventricular septal defect (2.2 ± 1.2 years) were enrolled and randomized to receive sevoflurane (Group S) or intramuscular ketamine (Group K) for sedation, followed by intravenous mid...
Source: Medicine - December 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

Comparison of a curved forceps with a conventional straight forceps for nasogastric tube insertion under videolaryngoscopic guidance: A randomized, crossover manikin study
Background: Nasogastric tube (NGT) insertion is an easy procedure that can be routinely performed under general anesthesia. However, for difficult cases, there are limited insertion techniques available in routine clinical practice, considering the flexibility of NGTs. The SUZY curved forceps are designed for the removal of pharyngolaryngeal foreign bodies under guidance of the McGRATH MAC (McG) videolaryngoscope. Because McG enables clear visualization of the esophageal inlet, we hypothesized that the SUZY forceps can facilitate easier NGT insertion compared with the conventional Magill forceps under McG guidance and desi...
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research

The Effect of Anesthetic Type on Outcomes of Hip Fracture Surgery: A Nationwide Population-Based Study
Abstract: Hip fractures are a global public health problem. During surgery following hip fractures, both general and regional anesthesia are used, but which type of anesthesia offers a better outcome remains controversial. There has been little research evaluating different anesthetic types on mortality and readmission rates for hip fracture surgery using nationwide population-based data. We used nationwide population-based data to examine the effect of anesthetic type on mortality and readmission rates for hip fracture surgery. Retrospective observational study. General acute care hospitals throughout Taiwan. A total ...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research