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331 full-text articles. Page 1 of 13.

Changes To Echocardiography-Derived Left Ventricular Filling Pressures And Cardiac Output In Response To Fluid Boluses In Elderly Patients With Left Ventricular Diastolic Dysfunction Undergoing Vascular Surgery, Sasha K. Shillcutt 2016 University of Nebraska Medical Center

Changes To Echocardiography-Derived Left Ventricular Filling Pressures And Cardiac Output In Response To Fluid Boluses In Elderly Patients With Left Ventricular Diastolic Dysfunction Undergoing Vascular Surgery, Sasha K. Shillcutt

Theses & Dissertations

Left ventricular diastolic dysfunction (LVDD) of the heart is a condition where the heart does not relax properly. This condition is important during times of stress, as LVDD is associated with significant morbidity of elderly surgical patients. LVDD is often asymptomatic and unrecognized as many of these patients have normal ejection fractions. However, LVDD may lead to heart failure in patients with preserved systolic function, with the incidence being as high as 50% in hospitalized elderly patients. The diagnosis of LVDD is an independent risk factor for postoperative major adverse cardiac events (MACE) and negatively impacts post-surgery readmission rates. Anesthesiologists ...


Point-Of-Care Electronic Prompts: An Effective Means Of Increasing Compliance, Demonstrating Quality, And Improving Outcome, Nanette M. Schwann MD, Karen A. Bretz MD, Sherrine Eid MPH, Terry L. Burger RN, BSN, MBA, Deborah Fry MT, MBA, Frederick Ackler CRNA, Paul J. Evans CRNA, David Romanchuk BS, Michelle Beck BS, MBA, Anthony J. Ardire MD, MPH, Harry Lukens BS, MS, Thomas M. McLoughlin Jr, MD 2016 Lehigh Valley Health Network

Point-Of-Care Electronic Prompts: An Effective Means Of Increasing Compliance, Demonstrating Quality, And Improving Outcome, Nanette M. Schwann Md, Karen A. Bretz Md, Sherrine Eid Mph, Terry L. Burger Rn, Bsn, Mba, Deborah Fry Mt, Mba, Frederick Ackler Crna, Paul J. Evans Crna, David Romanchuk Bs, Michelle Beck Bs, Mba, Anthony J. Ardire Md, Mph, Harry Lukens Bs, Ms, Thomas M. Mcloughlin Jr, Md

Thomas M McLoughlin Jr., MD

No abstract provided.


Commentary: Sense And Sensibility: The Role Of Specialists In Health Care Reform, Nanette M. Schwann MD, Brian A. Nester DO, Thomas M. McLoughlin Jr, MD 2016 Lehigh Valley Health Network

Commentary: Sense And Sensibility: The Role Of Specialists In Health Care Reform, Nanette M. Schwann Md, Brian A. Nester Do, Thomas M. Mcloughlin Jr, Md

Thomas M McLoughlin Jr., MD

No abstract provided.


Effects Of Diabetes Mellitus And Chronic Kidney Disease On Major Outcomes In Patients Undergoing Cardiac Surgery, Mark W. Berguson, Jordan E. Goldhammer, Hong Liu, Rohinton Morris, Jianzhong Sun 2016 Department of Anesthesiology, Thomas Jefferson University Hospital

Effects Of Diabetes Mellitus And Chronic Kidney Disease On Major Outcomes In Patients Undergoing Cardiac Surgery, Mark W. Berguson, Jordan E. Goldhammer, Hong Liu, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). CKD typically manifests in late stages of DM.

• DM and CKD are prevalent in patients with cardiovascular disease.

• The impact of concurrent DM and CKD on major adverse cardiocerebral events (MACE) in patients undergoing cardiac surgery remains unclear.1,2

Objective:

To determine the effect of DM and CKD on major outcomes in patients undergoing cardiac surgery.


Preoperative Aspirin And Major Perioperative Outcomes In Patients With Hypertension Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Rohinton Morris, Jianzhong Sun 2016 Department of Anesthesiology, Thomas Jefferson University Hospital

Preoperative Aspirin And Major Perioperative Outcomes In Patients With Hypertension Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

  • Hypertension is prevalent in patients undergoing cardiac surgery and associated with a higher incidence of cardiovascular complications.
  • Aspirin has been shown to prevent cardiovascular events in patients with a high risk of cardiovascular disease.
  • Very few studies have investigated aspirin and hypertension, particularly its effects on major outcomes in hypertensive patients undergoing cardiac surgery.1,2

Objective

To determine the effects of preoperative aspirin on postoperative outcomes for patients with hypertension undergoing cardiac surgery.

To examine the impact of chronic kidney disease and heart failure superimposed with hypertension on outcomes after cardiac surgery.


Effects Of Preoperative Aspirin On Major Outcomes In Graded High-Risk Patients Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Jordan E. Goldhammer, Jianzhong Sun 2016 Department of Anesthesiology, Thomas Jefferson University Hospital

Effects Of Preoperative Aspirin On Major Outcomes In Graded High-Risk Patients Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Jordan E. Goldhammer, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

  • Among patients with cardiovascular disease, nearly 70% take preventive aspirin.1
  • The benefits of aspirin are greater as a patient’s risk of cardiovascular events increases; patients with a lower risk of cardiovascular events derive less of a benefit from aspirin.2
  • The effect of aspirin in surgical patients has not yet been investigated, in particular if there is an optimal effect based on operative risk when undergoing cardiac surgery.

Objective:

To determine the effects of preoperative aspirin on major outcomes after cardiac surgery in patients with low, medium, and high predicted operative mortality as determined by the EuroSCORE ...


Safety Culture In Cardiac Surgical Teams: Data From Five Programs And National Surgical Comparison., Jill A Marsteller, Mei Wen, Yea-Jen Hsu, Laura C Bauer, Nanette M. Schwann M.D., Christopher J Young, Juan A Sanchez, Nicole A Errett, Ayse P Gurses, David A Thompson, Joyce A Wahr, Elizabeth A Martinez 2016 Lehigh Valley Health Network

Safety Culture In Cardiac Surgical Teams: Data From Five Programs And National Surgical Comparison., Jill A Marsteller, Mei Wen, Yea-Jen Hsu, Laura C Bauer, Nanette M. Schwann M.D., Christopher J Young, Juan A Sanchez, Nicole A Errett, Ayse P Gurses, David A Thompson, Joyce A Wahr, Elizabeth A Martinez

Nanette M Schwann MD

BACKGROUND: Little is known about safety culture in the area of cardiac surgery as compared with other types of surgery. The unique features of cardiac surgical teams may result in different perceptions of patient safety and patient safety culture.

METHODS: We measured and described safety culture in five cardiovascular surgical centers using the Hospital Survey on Patient Safety Culture, and compared the data with the Agency for Healthcare Research and Quality (AHRQ) 2010 comparative database in surgery and anesthesiology (all types). We reported mean scores, standard deviations, and percent positive responses for the two single-item measures and 12 patient safety ...


Effectiveness Of A New Method For Endotracheal Tube Pilot Balloon Repair, Amir C. Dayan, MD, Richard H. Epstein, MD 2016 Thomas Jefferson University Hospital, Philadelphia, PA

Effectiveness Of A New Method For Endotracheal Tube Pilot Balloon Repair, Amir C. Dayan, Md, Richard H. Epstein, Md

Department of Anesthesiology Posters

Introduction:

  • An intact pilot balloon is crucial to proper function of a cuffed endotracheal tube (ETT).
  • Failure of the pilot balloon or disruption of the inflation tubing results in cuff deflation which may lead to inadequate ventilation and aspiration of oropharyngeal secretions.
  • We describe a method that we employed using readily available components to repair a pilot balloon and inflation tubing, and report on the effectiveness of the repair method, as tested in vitro.


Sciatic Peripheral Nerve Blockade For Pain Control Following Hamstring Autograft Harvest In Adolescents: A Comparison Of Two Techniques, James Furstein 2016 Virginia Commonwealth University

Sciatic Peripheral Nerve Blockade For Pain Control Following Hamstring Autograft Harvest In Adolescents: A Comparison Of Two Techniques, James Furstein

Theses and Dissertations

Anterior cruciate ligament reconstruction utilizing a hamstring autograft is a surgical technique that has gained popularity among orthopedic surgeons caring for adolescent patients. While utilization of a hamstring autograft is a revered technique, harvest of the hamstring yields significant pain. Sciatic peripheral nerve blockade has proven to reliably provide analgesia at the hamstring donor site. Single-injection sciatic peripheral nerve blockade is considered a basic and effective technique, making its use following anterior cruciate ligament reconstruction standard practice in many institutions. The duration of action of a single-injection sciatic peripheral nerve blockade may fail to outlast the pain arising from the ...


Where Is Pain In The Brain?, Marshall Devor 2016 The Hebrew University of Jerusalem

Where Is Pain In The Brain?, Marshall Devor

Animal Sentience: An Interdisciplinary Journal on Animal Feeling

Key argues that fish cannot experience pain based on (1) brain imaging in humans, (2) consequences of lesions and (3) direct brain stimulation. Imaging indeed shows that pain-relevant signals reach the cortex, but not that they underlie the subjective experience of pain. Lesions and stimulation data are more to the point, but Key paints an idiosyncratic and misleading picture of their effects. S1 and S2 ablation does not eliminate evoked or spontaneous pain, although there may be up- or down-modulation. Likewise, stimulation of pain-associated cortical areas rarely induces pain, and pain almost never occurs at the onset of epileptic seizures ...


The Incidence Of Early Stage Postoperative Nausea And Vomiting Following The Use Of Nitrous Oxide And Prophylactic Antiemetic Therapy: Implications For Clinical Practice, James Sullivan 2015 University of Southern Mississippi

The Incidence Of Early Stage Postoperative Nausea And Vomiting Following The Use Of Nitrous Oxide And Prophylactic Antiemetic Therapy: Implications For Clinical Practice, James Sullivan

Doctoral Nursing Capstone Projects

Nitrous oxide (N2O) is a volatile agent currently used during the induction and maintenance of general anesthesia. Since it’s discovery in 1786 by Dr. Priestly, it is the oldest volatile agent to find continued use in current practice (Kossick, 2014). In conjunction with its extensive history is the debate regarding its emetic properties. Numerous studies have investigated the effect of nitrous oxide to produce postoperative nausea and vomiting (PONV) with varying and often conflicting results. Generally speaking, nitrous oxide is theoretically an emetic and is believed to be associated with PONV (Tramer, Moore, & McQuay, 1996). This has ...


Does The Use Of A Regional Nerve Block Decrease The Incidence Of Post Operative Nausea And Vomiting, Decrease Pain Scores, Or Decrease Discharge Time Compared To General Anesthesia Alone?, Donald Lane Whitney 2015 University of Southern Mississippi

Does The Use Of A Regional Nerve Block Decrease The Incidence Of Post Operative Nausea And Vomiting, Decrease Pain Scores, Or Decrease Discharge Time Compared To General Anesthesia Alone?, Donald Lane Whitney

Doctoral Nursing Capstone Projects

Problem Statement: The use of regional anesthesia in orthopedic surgeries has been shown to decrease the rate of postoperative nausea and vomiting (PONV), postoperative pain, and decrease postoperative discharge time. However, some healthcare facilities continue to provide anesthesia for these procedures without the use of regional anesthesia techniques.

Purpose: The purpose of this capstone project was to determine if the addition of a regional anesthetic technique would be beneficial to the patient and cost efficient to the healthcare facility.

Methods: A retrospective chart review was conducted and data collected on the population of interest. Inclusion criteria were patients undergoing orthopedic ...


Cerebral Oximetry Readings In The Sitting Position Versus Supine Position For Patients Undergoing General Anesthesia, Christopher Turner 2015 University of Southern Mississippi

Cerebral Oximetry Readings In The Sitting Position Versus Supine Position For Patients Undergoing General Anesthesia, Christopher Turner

Doctoral Nursing Capstone Projects

Problem: Inadequate cerebral blood flow is a significant risk for patients undergoing surgery in the sitting position. Placing the patient in a sitting position may cause a drop in pressure at the level of the brain when compounded with induction and maintenance of general anesthesia. These changes may cause a decrease in cerebral blood flow and oxygenation. Inadequate perfusion for a prolonged period of time could produce negative neurological consequences in the short and long term postoperative period.

Purpose: The purpose of this project is to determine if there is a significant drop in cerebral oximetry, from baseline, when patients ...


A Pilot Study Of Propofol As An Anti-Emetic In Laparoscopic, Gynecologic Surgery Patients, Flem-Flam Aaron Flemister 2015 University of Southern Mississippi

A Pilot Study Of Propofol As An Anti-Emetic In Laparoscopic, Gynecologic Surgery Patients, Flem-Flam Aaron Flemister

Doctoral Nursing Capstone Projects

The goal of this project was to use sub-hypnotic doses of propofol to decrease post operative nausea and vomiting (PONV) rates in the immediate post-operative period in females, ages 18-65, undergoing laparoscopic gynecologic surgery.

PONV is one of the largest complications of anesthesia affecting 20-30% of all surgical patients. Risk factors associated with PONV are female gender, laparoscopy, general anesthesia, opioids, volatile agents, and post-operative pain; all of which are frequently encountered. The incidence of PONV can prolong recovery time, delay discharge, increase patient cost, decrease patient satisfaction, and can cause significant medical complications. Propofol has previously demonstrated anti-emetic properties ...


Pilot Study Comparing Simulation-Based And Didactic Lecture-Based Critical Care Teaching For Final-Year Medical Students., Orsolya Solymos, Patrick O'Kelly, Criona M Walshe 2015 Royal College of Surgeons in Ireland

Pilot Study Comparing Simulation-Based And Didactic Lecture-Based Critical Care Teaching For Final-Year Medical Students., Orsolya Solymos, Patrick O'Kelly, Criona M Walshe

Anaesthesia and Critical Care Articles

BACKGROUND: Simulation-based medical education has rapidly evolved over the past two decades, despite this, there are few published reports of its use in critical care teaching. We hypothesised that simulation-based teaching of a critical care topic to final-year medical students is superior to lecture-based teaching.

METHODS: Thirty-nine final-year medical students were randomly assigned to either simulation-based or lecture-based teaching in the chosen critical care topic. The study was conducted over a 6-week period. Efficacy of each teaching method was compared through use of multiple choice questionnaires (MCQ) - baseline, post-teaching and 2 week follow-up. Student satisfaction was evaluated by means of ...


Exaggerated Nighttime Sleep And Defective Sleep Homeostasis In A Drosophila Knock-In Model Of Human Epilepsy, Emily Petruccelli, Patrick Lansdon, Toshihiro Kitamoto 2015 University of Iowa

Exaggerated Nighttime Sleep And Defective Sleep Homeostasis In A Drosophila Knock-In Model Of Human Epilepsy, Emily Petruccelli, Patrick Lansdon, Toshihiro Kitamoto

Department of Anesthesia Publications

Despite an established link between epilepsy and sleep behavior, it remains unclear how specific epileptogenic mutations affect sleep and subsequently influence seizure susceptibility. Recently, Sun et al. (2012) created a fly knock-in model of human generalized epilepsy with febrile seizures plus (GEFS+), a wide-spectrum disorder characterized by fever-associated seizing in childhood and lifelong affliction. GEFS+ flies carry a disease-causing mutation in their voltage-gated sodium channel (VGSC) gene and display semidominant heat-induced seizing, likely due to reduced GABAergic inhibitory activity at high temperature. Here, we show that at room temperature the GEFS+ mutation dominantly modifies sleep, with mutants exhibiting rapid sleep ...


Game Theory And The Surgeon, Alan P. Marco 2015 Wright State University

Game Theory And The Surgeon, Alan P. Marco

Anesthesiology Faculty Publications

How the controversial study of strategic decision-making plays out in our profession.


Neuroimmune And Neuropathic Responses Of Spinal Cord And Dorsal Root Ganglia In Middle Age, William Galbavy, Martin Kaczocha, Michelino Puopolo, Mario Rebecchi 2015 SUNY Stony Brook

Neuroimmune And Neuropathic Responses Of Spinal Cord And Dorsal Root Ganglia In Middle Age, William Galbavy, Martin Kaczocha, Michelino Puopolo, Mario Rebecchi

Faculty Publications

Prior studies of aging and neuropathic injury have focused on senescent animals compared to young adults, while changes in middle age, particularly in the dorsal root ganglia (DRG), have remained largely unexplored. 14 neuroimmune mRNA markers, previously associated with peripheral nerve injury, were measured in multiplex assays of lumbar spinal cord (LSC), and DRG from young and middle-aged (3, 17 month) naïve rats, or from rats subjected to chronic constriction injury (CCI) of the sciatic nerve (after 7 days), or from aged-matched sham controls. Results showed that CD2, CD3e, CD68, CD45, TNF-α, IL6, CCL2, ATF3 and TGFβ1 mRNA levels were ...


Coagulopathy, Factor Ix Deficiency, Thomas McLoughlin 2015 Lehigh Valley Health Network

Coagulopathy, Factor Ix Deficiency, Thomas Mcloughlin

Thomas M McLoughlin Jr., MD

McLoughlin, T.(2010). Coagulopathy, Factor IX Deficiency. Essence of Anesthesia Practice.(pp.88). Philadelphia, PA: ELSEVIER Saunders.


Von Willebrand's Disease, Thomas McLoughlin 2015 Lehigh Valley Health Network

Von Willebrand's Disease, Thomas Mcloughlin

Thomas M McLoughlin Jr., MD

No abstract provided.


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